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<1>
Accession Number
2011652785
Title
Oxygen delivery-guided perfusion for the prevention of acute kidney
injury: A randomized controlled trial.
Source
Journal of Thoracic and Cardiovascular Surgery. 165(2) (pp 750-760.e5),
2023. Date of Publication: February 2023.
Author
Mukaida H.; Matsushita S.; Yamamoto T.; Minami Y.; Sato G.; Asai T.; Amano
A.
Institution
(Mukaida, Minami, Sato) Department of Clinical Engineering, Juntendo
University Hospital, Tokyo, Japan
(Mukaida, Matsushita, Yamamoto, Asai, Amano) Department of Cardiovascular
Surgery, Juntendo University, Faculty of Medicine, Tokyo, Japan
Publisher
Elsevier Inc.
Abstract
Objectives: The reduction of postoperative acute kidney injury in patients
undergoing cardiopulmonary bypass surgery using an oxygen delivery-guided
perfusion strategy (oxygen delivery strategy) for cardiopulmonary bypass
management compared with a fixed flow perfusion (conventional strategy)
remains controversial. The purpose of this study was to determine whether
a oxygen delivery strategy would reduce the incidence of postoperative
acute kidney injury in patients undergoing cardiopulmonary bypass surgery.
<br/>Method(s): We randomly enrolled 300 patients undergoing
cardiopulmonary bypass surgery. Patients were randomly assigned to a
oxygen delivery strategy (maintaining a oxygen delivery index value >300
mL/min/m² through pump flow adjustments during cardiopulmonary
bypass) or a conventional strategy (a target pump flow was determined on
the basis of the body surface area). The primary end point was the
development of acute kidney injury. Secondary end points were the red
blood cell transfusion rate and number of red blood cell units, intubation
time, postoperative length of stay in the intensive care unit and the
hospital, predischarge estimated glomerular filtration rate, and hospital
mortality. <br/>Result(s): Acute kidney injury occurred in 20 patients
(14.6%) receiving the oxygen delivery strategy and in 42 patients (30.4%)
receiving the conventional strategy (relative risk, 0.48; 95% confidence
interval, 0.30-0.77; P = .002). The secondary end points were not
significantly different between strategies. In a prespecified subgroup
analysis of patients who had nadir hematocrit less than 23% or body
surface area less than 1.40 m², the oxygen delivery strategy
seemed to be superior to the conventional strategy and the existence of
quantitative interactions was suggested. <br/>Conclusion(s): An oxygen
delivery strategy for cardiopulmonary bypass management was superior to a
conventional strategy with respect to preventing the development of acute
kidney injury.<br/>Copyright &#xa9; 2021 The American Association for
Thoracic Surgery

<2>
Accession Number
2024022255
Title
Association between Achieved Low-Density Lipoprotein Cholesterol Levels
and Long-Term Cardiovascular and Safety Outcomes: An Analysis of
FOURIER-OLE.
Source
Circulation. 147(16) (pp 1192-1203), 2023. Date of Publication: 18 Apr
2023.
Author
Gaba P.; O'Donoghue M.L.; Park J.-G.; Wiviott S.D.; Atar D.; Kuder J.F.;
Im K.; Murphy S.A.; De Ferrari G.M.; Gaciong Z.A.; Toth K.; Gouni-Berthold
I.; Lopez-Miranda J.; Schiele F.; Mach F.; Flores-Arredondo J.H.; Lopez
J.A.G.; Elliott-Davey M.; Wang B.; Monsalvo M.L.; Abbasi S.; Giugliano
R.P.; Sabatine M.S.
Institution
(Gaba, O'Donoghue, Park, Wiviott, Kuder, Im, Murphy, Giugliano, Sabatine)
Thrombolysis in Myocardial Infarction (TIMI) Study Group, Brigham and
Women's Hospital, Harvard Medical School, Boston, MA, United States
(Atar) Division of Medicine, University of Oslo, Norway
(De Ferrari) Department of Medical Sciences, University of Turin, Azienda
Ospedaliera Universitaria Citta della Salute e della Scienza, Turin, Italy
(Gaciong) Department of Internal Medicine, Hypertension and Vascular
Diseases, The Medical University of Warsaw, Poland
(Toth) 1st Department of Medicine, University of Pecs, Medical School,
Hungary
(Gouni-Berthold) University of Cologne, Center for Endocrinology,
Diabetes, and Preventative Medicine, University of Cologne, Faculty of
Medicine, University Hospital, Germany
(Lopez-Miranda) Lipids and Atherosclerosis Unit, Maimonides Biomedical
Research Institute of Cordoba, Reina Sofia University Hospital, University
of Cordoba, CIBEROBN, Spain
(Schiele) University Hospital Center Besancon, EA 3920, France
(Mach) Cardiology Department, Geneva University Hospital, Switzerland
(Flores-Arredondo, Lopez, Elliott-Davey, Wang, Monsalvo, Abbasi) Amgen
Inc, Thousand Oaks, CA, United States
Publisher
Lippincott Williams and Wilkins
Abstract
Background: Low-density lipoprotein cholesterol (LDL-C) is a
well-established risk factor for atherosclerotic cardiovascular disease.
However, the optimal achieved LDL-C level with regard to efficacy and
safety in the long term remains unknown. <br/>Method(s): In FOURIER
(Further Cardiovascular Outcomes Research With PCSK9 Inhibition in
Subjects With Elevated Risk), 27 564 patients with stable atherosclerotic
cardiovascular disease were randomized to evolocumab versus placebo, with
a median follow-up of 2.2 years. In the open-label extension
(FOURIER-OLE), 6635 of these patients were transitioned to open-label
evolocumab regardless of initial treatment allocation in the parent trial
and were followed for an additional median of 5 years. In this
prespecified analysis, we examined the relationship between achieved LDL-C
levels (an average of the first 2 LDL-C levels measured) in FOURIER-OLE
(available in 6559 patients) and the incidence of subsequent
cardiovascular and safety outcomes. We also performed sensitivity analyses
evaluating cardiovascular and safety outcomes in the entire FOURIER and
FOURIER-OLE patient population. Multivariable modeling was used to adjust
for baseline factors associated with achieved LDL-C levels.
<br/>Result(s): In FOURIER-OLE, 1604 (24%), 2627 (40%), 1031 (16%), 486
(7%), and 811 (12%) patients achieved LDL-C levels of <20, 20 to <40, 40
to <55, 55 to <70, and >=70 mg/dL, respectively. There was a monotonic
relationship between lower achieved LDL-C levels - down to very low levels
<20 mg/dL - and a lower risk of the primary efficacy end point (composite
of cardiovascular death, myocardial infarction, stroke, hospital admission
for unstable angina or coronary revascularization) and the key secondary
efficacy end point (composite of cardiovascular death, myocardial
infarction, or stroke) that persisted after multivariable adjustment
(adjusted Ptrend<0.0001 for each end points). No statistically significant
associations existed in the primary analyses between lower achieved LDL-C
levels and increased risk of the safety outcomes (serious adverse events,
new or recurrent cancer, cataract-related adverse events, hemorrhagic
stroke, new-onset diabetes, neurocognitive adverse events, muscle-related
events, or noncardiovascular death). Similar findings were noted in the
entire FOURIER and FOURIER-OLE cohort up to a maximum follow-up of 8.6
years. <br/>Conclusion(s): In patients with atherosclerotic cardiovascular
disease, long-term achievement of lower LDL-C levels, down to <20 mg/dL
(<0.5 mmol/L), was associated with a lower risk of cardiovascular outcomes
with no significant safety concerns. Registration: URL:
https://www.clinicaltrials.gov; Unique identifier:
NCT01764633.<br/>Copyright &#xa9; 2023 American Heart Association, Inc.

<3>
Accession Number
2023603781
Title
The teammate trial: Study design and rationale tacrolimus and everolimus
against tacrolimus and MMF in pediatric heart transplantation using the
major adverse transplant event (MATE) score.
Source
American Heart Journal. 260 (pp 100-112), 2023. Date of Publication: June
2023.
Author
Almond C.S.; Sleeper L.A.; Rossano J.W.; Bock M.J.; Pahl E.; Auerbach S.;
Lal A.; Hollander S.A.; Miyamoto S.D.; Castleberry C.; Lee J.; Barkoff
L.M.; Gonzales S.; Klein G.; Daly K.P.
Institution
(Almond, Hollander, Lee, Barkoff, Gonzales) Departments of Pediatrics
(Cardiology), Stanford University School of Medicine, Palo Alto, CA,
United States
(Sleeper, Klein, Daly) Department of Cardiology, Boston Children's
Hospital and the Department of Pediatrics, Harvard Medical School
(Rossano) Department of Cardiology, Children's Hospital of Philadelphia,
University of Pennsylvania School of Medicine
(Bock) Division of Pediatric Cardiology, Loma Linda University Children's
Hospital, Loma Linda University School of Medicine
(Pahl) Department of Pediatrics, Lurie Children's Hospital, Northwestern
School of Medicine
(Auerbach, Miyamoto) Children's Hospital Colorado Heart Institute,
University of Colorado, Anschutz Medical Campus
(Lal) Department of Pediatrics Primary Children's Hospital, University of
Utah School of Medicine
(Castleberry) Departments of Pediatrics, St. Louis Children's Hospital,
Washington University in Saint Louis
Publisher
Elsevier Inc.
Abstract
Background: Currently there are no immunosuppression regimens FDA-approved
to prevent rejection in pediatric heart transplantation (HT). In recent
years, everolimus (EVL) has emerged as a potential alternative to standard
tacrolimus (TAC) as the primary immunosuppressant to prevent rejection
that may also reduce the risk of cardiac allograft vasculopathy (CAV),
chronic kidney disease (CKD) and cytomegalovirus (CMV) infection. However,
the 2 regimens have never been compared head-to-head in a randomized
trial. The study design and rationale are reviewed in light of the
challenges inherent in rare disease research. <br/>Method(s): The TEAMMATE
trial (IND 127980) is the first multicenter randomized clinical trial
(RCT) in pediatric HT. The primary purpose is to evaluate the safety and
efficacy of EVL and low-dose TAC (LD-TAC) compared to standard-dose TAC
and mycophenolate mofetil (MMF). Children aged <21 years at HT were
randomized (1:1 ratio) at 6 months post-HT to either regimen, and followed
for 30 months. Children with recurrent rejection, multi-organ transplant
recipients, and those with an estimated glomerular filtration rate (eGFR)
<30 mL/min/1.73m² were excluded. The primary efficacy
hypothesis is that, compared to TAC/MMF, EVL/LD-TAC is more effective in
preventing 3 MATEs: acute cellular rejection (ACR), CKD and CAV. The
primary safety hypothesis is that EVL/LD-TAC does not have a higher
cumulative burden of 6 MATEs (antibody mediated rejection [AMR],
infection, and post-transplant lymphoproliferative disorder [PTLD] in
addition to the 3 above). The primary endpoint is the MATE score, a
composite, ordinal surrogate endpoint reflecting the frequency and
severity of MATEs that is validated against graft loss. The study had a
target sample size of 210 patients across 25 sites and is powered to
demonstrate superior efficacy of EVL/LD-TAC. Trial enrollment is complete
and participant follow-up will be completed in 2023. <br/>Conclusion(s):
The TEAMMATE trial is the first multicenter RCT in pediatric HT. It is
anticipated that the study will provide important information about the
safety and efficacy of everolimus vs tacrolimus-based regimens and will
provide valuable lessons into the design and conduct of future trials in
pediatric HT<br/>Copyright &#xa9; 2023 Elsevier Inc.

<4>
Accession Number
2023789483
Title
Treat-to-Target or High-Intensity Statin in Patients with Coronary Artery
Disease: A Randomized Clinical Trial.
Source
JAMA. 329(13) (pp 1078-1087), 2023. Date of Publication: 04 Apr 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
American Medical Association
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. <br/>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. <br/>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).
<br/>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. <br/>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. <br/>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). <br/>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.<br/>Copyright &#xa9; 2023 American Medical
Association. All rights reserved.

<5>
Accession Number
2021816629
Title
Comparison of Demographic, Clinical, Biochemical, and Imaging Findings in
Hypertrophic Cardiomyopathy Prognosis: A Network Meta-Analysis.
Source
JACC: Heart Failure. 11(1) (pp 30-41), 2023. Date of Publication: January
2023.
Author
Georgiopoulos G.; Figliozzi S.; Pateras K.; Nicoli F.; Bampatsias D.;
Beltrami M.; Finocchiaro G.; Chiribiri A.; Masci P.G.; Olivotto I.
Institution
(Georgiopoulos, Finocchiaro, Chiribiri, Masci) School of Biomedical
Engineering and Imaging Sciences, King's College London, United Kingdom
(Georgiopoulos, Bampatsias) Department of Clinical Therapeutics, National
and Kapodistrian University of Athens, Greece
(Figliozzi) Humanitas Research Hospital IRCCS, Rozzano, Milan, Italy
(Pateras) Department of Biostatistics, Julius Center for Health Sciences
and Primary Care, University Medical Center Utrecht, Utrecht, Netherlands
(Nicoli) Humanitas Gavazzeni, Bergamo, Italy
(Beltrami, Olivotto) Department of Experimental and Clinical Medicine,
University of Florence, Meyer Children's Hospital and Careggi University
Hospital, Florence, Italy
Publisher
Elsevier Inc.
Abstract
Background: Despite hypertrophic cardiomyopathy (HCM) being the most
common inherited heart disease and conferring increased risk for heart
failure (HF) and sudden cardiac death (SCD), risk assessment in HCM
patients is still largely unresolved. <br/>Objective(s): This study aims
to synthesize and compare the prognostic impact of demographic, clinical,
biochemical, and imaging findings in patients with HCM. <br/>Method(s):
The authors searched PubMed, Embase, and Cochrane Library for studies
published from 1955 to November 2020, and the endpoints were: 1) all-cause
death; 2) an arrhythmic endpoint including SCD, sustained ventricular
tachycardia, ventricular fibrillation, or aborted SCD; and 3) a composite
endpoint including (1) or (2) plus hospitalization for HF or cardiac
transplantation. The authors performed a pairwise meta-analysis obtaining
the pooled estimate separately for the association between baseline
variables and study endpoints. A random-effects network meta-analysis was
subsequently used to comparatively assess the prognostic value of outcome
associates. <br/>Result(s): A total of 112 studies with 58,732 HCM
patients were included. Among others, increased brain natriuretic
peptide/N-terminal pro-B-type natriuretic peptide, late gadolinium
enhancement (LGE), positive genotype, impaired global longitudinal strain,
and presence of apical aneurysm conferred increased risk for the composite
endpoint. At network meta-analysis, LGE showed the highest prognostic
value for all endpoints and was superior to all other associates except
New York Heart Association functional class >class II. A multiparametric
imaging-based model was superior in predicting the composite endpoint
compared to a prespecified model based on conventional risk factors.
<br/>Conclusion(s): This network meta-analysis supports the development of
multiparametric risk prediction algorithms, including advanced imaging
markers additively to conventional risk factors, for refined risk
stratification in HCM. (Long-term prognosis of hypertrophic cardiomyopathy
according to genetic, clinical, biochemical and imaging findings: a
systemic review and meta-analysis; CRD42020185219)<br/>Copyright &#xa9;
2023 American College of Cardiology Foundation

<6>
Accession Number
2022465312
Title
Efficacy of remote ischaemic preconditioning on outcomes following
non-cardiac non-vascular surgery: a systematic review and meta-analysis.
Source
Perioperative Medicine. 12(1) (no pagination), 2023. Article Number: 9.
Date of Publication: December 2023.
Author
Papadopoulou A.; Dickinson M.; Samuels T.L.; Heiss C.; Forni L.;
Creagh-Brown B.
Institution
(Papadopoulou) Department of Anesthesia, King's College Hospital, Denmark
Hill, London SE5 9RS, United Kingdom
(Dickinson) Department of Anesthesia, Royal Surrey County Hospital,
Guildford, United Kingdom
(Samuels) Department of Critical Care, Surrey and Sussex Healthcare NHS
Trust, Redhill, United Kingdom
(Heiss) Vascular Department, Surrey and Sussex Healthcare NHS Trust,
Redhill, United Kingdom
(Heiss) Department of Clinical and Experimental Medicine, University of
Surrey, Guildford, United Kingdom
(Forni, Creagh-Brown) Department of Critical Care, Royal Surrey County
Hospital, Guildford, United Kingdom
Publisher
BioMed Central Ltd
Abstract
Background: Remote ischaemic preconditioning (RIPC) has been investigated
as a simple intervention to potentially mitigate the ischaemic effect of
the surgical insult and reduce postoperative morbidity. This review
systematically evaluates the effect of RIPC on morbidity, including
duration of hospital stay and parameters reflective of cardiac, renal,
respiratory, and hepatic dysfunction following non-cardiac non-vascular
(NCNV) surgery. <br/>Method(s): The electronic databases PubMed, Embase,
and the Cochrane Central Register of Controlled Trials (CENTRAL) were
searched from their inception date to November 2021. Studies investigating
the effect of local preconditioning or postconditioning were excluded.
Methodological quality and risk of bias were determined according to the
Revised Cochrane risk-of-bias tool for randomised trials (RoB 2).
Calculation of the odds ratios and a random effects model was used for
dichotomous outcomes and mean differences or standardised mean differences
as appropriate were used for continuous outcomes. The primary outcomes of
interest were cardiac and renal morbidity, and the secondary outcomes
included other organ function parameters and hospital length of stay.
<br/>Result(s): A systematic review of the published literature identified
36 randomised controlled trials. There was no significant difference in
postoperative troponin or acute kidney injury. RIPC was associated with
lower postoperative serum creatinine (9 studies, 914 patients, mean
difference (MD) - 3.81 micromol/L, 95% confidence interval (CI) - 6.79 to
- 0.83, p = 0.01, I² = 5%) and lower renal stress biomarker
(neutrophil gelatinase-associated lipocalin (NGAL), 5 studies, 379
patients, standardized mean difference (SMD) - 0.66, 95% CI - 1.27 to -
0.06, p = 0.03, I² = 86%). RIPC was also associated with
improved oxygenation (higher
P<inf>a</inf>O<inf>2</inf>/F<inf>i</inf>O<inf>2</inf>, 5 studies, 420
patients, MD 51.51 mmHg, 95% CI 27.32 to 75.69, p < 0.01, I² =
89%), lower biomarker of oxidative stress (malondialdehyde (MDA), 3
studies, 100 patients, MD - 1.24 micromol/L, 95% CI - 2.4 to - 0.07, p =
0.04, I² = 91%)) and shorter length of hospital stay (15
studies, 2110 patients, MD - 0.99 days, 95% CI - 1.75 to - 0.23, p = 0.01,
I² = 88%). <br/>Conclusion(s): This meta-analysis did not show
an improvement in the primary outcomes of interest with the use of RIPC.
RIPC was associated with a small improvement in certain surrogate
parameters of organ function and small reduction in hospital length of
stay. Our results should be interpreted with caution due to the limited
number of studies addressing individual outcomes and the considerable
heterogeneity identified. Trial registration: PROSPERO
CRD42019129503.<br/>Copyright &#xa9; 2023, The Author(s).

<7>
Accession Number
2022850117
Title
Timing of invasive strategy in non-ST-elevation acute coronary syndrome: A
meta-Analysis of randomized controlled trials.
Source
European Heart Journal. 43(33) (pp 3148-3161), 2022. Date of Publication:
01 Sep 2022.
Author
Kite T.A.; Kurmani S.A.; Bountziouka V.; Cooper N.J.; Lock S.T.; Gale
C.P.; Flather M.; Curzen N.; Banning A.P.; McCann G.P.; Ladwiniec A.
Institution
(Kite, Kurmani, Bountziouka, Cooper, Lock, McCann, Ladwiniec) Department
of Cardiovascular Sciences and the NIHR Leicester Biomedical Research
Centre, Glenfield Hospital, University of Leicester and University
Hospitals of Leicester NHS Trust, Leicester, United Kingdom
(Gale) Leeds Institute of Cardiovascular and Metabolic Medicine,
University of Leeds, Leeds, United Kingdom
(Gale) Leeds Institute for Data Analytics, University of Leeds, Leeds,
United Kingdom
(Gale) Department of Cardiology, Leeds Teaching Hospitals NHS Trust,
Leeds, United Kingdom
(Flather) Norwich Medical School, University of East Anglia and Norfolk
and Norwich University Hospital, Norwich, United Kingdom
(Curzen) University Hospital Southampton NHS Foundation Trust and School
of Medicine, University of Southampton, Southampton, United Kingdom
(Banning) Department of Cardiology, Oxford Heart Centre, John Radcliffe
Hospital, Oxford, United Kingdom
Publisher
Oxford University Press
Abstract
Aims: The optimal timing of an invasive strategy (IS) in non-ST-elevation
acute coronary syndrome (NSTE-ACS) is controversial. Recent randomized
controlled trials (RCTs) and long-Term follow-up data have yet to be
included in a contemporary meta-Analysis. <br/>Methods and Results: A
systematic review of RCTs that compared an early IS vs. delayed IS for
NSTE-ACS was conducted by searching MEDLINE, Embase, and Cochrane Central
Register of Controlled Trials. A meta-Analysis was performed by pooling
relative risks (RRs) using a random-effects model. The primary outcome was
all-cause mortality. Secondary outcomes included myocardial infarction
(MI), recurrent ischaemia, admission for heart failure (HF), repeat
re-vascularization, major bleeding, stroke, and length of hospital stay.
This study was registered with PROSPERO (CRD42021246131). Seventeen RCTs
with outcome data from 10 209 patients were included. No significant
differences in risk for all-cause mortality [RR: 0.90, 95% confidence
interval (CI): 0.78-1.04], MI (RR: 0.86, 95% CI: 0.63-1.16), admission for
HF (RR: 0.66, 95% CI: 0.43-1.03), repeat re-vascularization (RR: 1.04, 95%
CI: 0.88-1.23), major bleeding (RR: 0.86, 95% CI: 0.68-1.09), or stroke
(RR: 0.95, 95% CI: 0.59-1.54) were observed. Recurrent ischaemia (RR:
0.57, 95% CI: 0.40-0.81) and length of stay (median difference:-22h, 95%
CI:-36.7 to-7.5h) were reduced with an early IS. <br/>Conclusion(s): In
all-comers with NSTE-ACS, an early IS does not reduce all-cause mortality,
MI, admission for HF, repeat re-vascularization, or increase major
bleeding or stroke when compared with a delayed IS. Risk of recurrent
ischaemia and length of stay are significantly reduced with an early
IS.<br/>Copyright &#xa9; 2022 The Author(s). Published by Oxford
University Press on behalf of the European Society of Cardiology.

<8>
Accession Number
2023832532
Title
Which antithrombotic strategy provides the best outcomes after mitral
valve repair in patients who remain in sinus rhythm?.
Source
Interactive Cardiovascular and Thoracic Surgery. 35(3) (no pagination),
2022. Article Number: ivac085. Date of Publication: 01 Sep 2022.
Author
Trevis J.; Akowuah E.
Institution
(Trevis, Akowuah) Academic Cardiovascular Unit, South Tees NHS Foundation
Trust, Middlesbrough TS4 3BW, United Kingdom
(Akowuah) Newcastle University, Framlington Place, Newcastle-upon-Tyne NE2
4HH, United Kingdom
Publisher
Oxford University Press
Abstract
A best evidence topic in cardiac surgery was written according to a
structured protocol. The question addressed was 'in the first 3-months
after mitral valve repair (MVRep) which antiplatelet and/or anticoagulant
strategy should be instigated in patients who remain in normal sinus
rhythm'. Altogether 77 papers were found using the reported search, of
which 8 represented the best evidence to answer the clinical question. The
authors, journal, date and country of publication, patient group studied,
study type, relevant outcomes and results of these papers are tabulated.
We conclude that there remains a lack of high-quality randomized studies,
controlling for postoperative cardiac rhythm, comparing vitamin K
antagonists (VKA) and antiplatelet therapy in the early postoperative
period following isolated MVRep. Current guidelines are based on limited
evidence or expert consensus alone. Based on the currently available
evidence, the authors conclude that antiplatelet therapy (e.g. aspirin) is
safe and appropriate to use in the 3-month postoperative period following
isolated MVRep, in those without preoperative, or postoperative atrial
fibrillation. Rates of thromboembolic events are comparable between these
patient groups (i.e. VKA versus aspirin), whilst VKA therapy is associated
with increased rates of major bleeding events and mortality.<br/>Copyright
&#xa9; 2022 The Author(s). Published by Oxford University Press on behalf
of the European Association for Cardio-Thoracic Surgery.

<9>
Accession Number
2023832248
Title
Does surgical fixation improve pain and quality of life in patients with
non-flail rib fractures? A best evidence topic review.
Source
Interactive Cardiovascular and Thoracic Surgery. 35(3) (no pagination),
2022. Article Number: ivac214. Date of Publication: 01 Sep 2022.
Author
Raza S.; Eckhaus J.
Institution
(Raza) Department of Cardiothoracic Surgery, The Prince Charles Hospital,
Chermside, QLD, Australia
(Eckhaus) Department of Cardiothoracic Surgery, St Vincent's Hospital
Melbourne, Melbourne, VIC, Australia
Publisher
Oxford University Press
Abstract
A best evidence topic in thoracic surgery was written according to a
structured protocol. The question addressed was 'does surgical
stabilization of rib fractures improve pain and quality of life in
patients with non-flail rib fractures?'. Altogether >300 papers were found
using the reported search, of which 6 represented the best evidence to
answer the clinical question. The authors, journal, date and country of
publication, patient group studied, study type, relevant outcomes and
results of these papers were tabulated. Whilst several non-randomized
cohort studies demonstrate superior pain and quality of life outcomes with
surgical fixation as compared to conservative management, this is not
replicated by the findings of a recent randomized trial which found worse
pain, but early return to work in those treated with surgical
stabilization of rib fractures. Given this, clinicians will need to
carefully consider the indications for treating painful non-flail rib
fractures as surgical fixation represents a reasonable treatment option in
only appropriately selected candidates.<br/>Copyright &#xa9; 2022 The
Author(s). Published by Oxford University Press on behalf of the European
Association for Cardio-Thoracic Surgery.

<10>
Accession Number
2024058518
Title
Selected 2022 Highlights in Congenital Cardiac Anesthesia.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2023.
Date of Publication: 2023.
Author
Stein M.L.; Bilal M.B.; Faraoni D.; Zabala L.; Matisoff A.; Mossad E.B.;
Mittnacht A.J.C.; Nasr V.G.
Institution
(Stein, Nasr) Department of Anesthesiology, Critical Care and Pain
Medicine, Boston Children's Hospital, Boston, MA, United States
(Bilal, Faraoni, Mossad) Department of Anesthesiology, Perioperative and
Pain Medicine, Baylor College of Medicine, Texas Children's Hospital,
Houston, TX, United States
(Zabala) Department of Anesthesia and Pain Medicine, UT Southwestern
School of Medicine, Children's Medical Center Dallas, Dallas, TX, United
States
(Matisoff) Department of Anesthesiology, Perioperative and Pain Medicine,
George Washington University, Children's National Hospital, Washington,
DC, United States
(Mittnacht) Department of Anesthesiology, New York Medical College,
Westchester Medical Center, Valhalla, NY, United States
Publisher
W.B. Saunders
Abstract
This article is a review of the highlights of pertinent literature of
interest to the congenital cardiac anesthesiologist, and was published in
2022. After a search of the United States National Library of Medicine
PubMed database, several topics emerged in which significant contributions
were made in 2022. The authors of this manuscript considered the following
topics noteworthy to be included in this review-intensive care unit
admission after congenital cardiac catheterization interventions,
antifibrinolytics in pediatric cardiac surgery, the current status of the
pediatric cardiac anesthesia workforce in the United States, and kidney
injury and renal protection during congenital heart surgery.<br/>Copyright
&#xa9; 2023 Elsevier Inc.

<11>
Accession Number
2023995768
Title
Del Nido Cardioplegia in Adult Cardiac Surgery: Meta-Analysis of
Randomized Clinical Trials.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2023.
Date of Publication: 2023.
Author
Fresilli S.; Labanca R.; Monaco F.; Belletti A.; D'Amico F.; Blasio A.;
Kotani Y.; Landoni G.
Institution
(Fresilli, Labanca, Monaco, Belletti, D'Amico, Blasio, Kotani, Landoni)
Department of Cardiothoracic and Vascular Surgery, IRCCS San Raffaele
Scientific Institute, Milan, Italy
(Kotani) Department of Intensive Care Medicine, Kameda Medical Center,
Kamogawa, Japan
Publisher
W.B. Saunders
Abstract
Objective: To compare the outcomes of patients receiving del Nido solution
versus any other type of cardioplegia. <br/>Design(s): A systematic review
and meta-analysis of randomized trials. <br/>Setting(s): Cardiac operating
rooms. <br/>Participant(s): Adult patients (>=18 years old) undergoing
cardiac surgery. <br/>Intervention(s): The EMBASE, MEDLINE, and CENTRAL
databases were searched systematically from their inception until August
2022 for randomized controlled trials comparing del Nido versus other
cardioplegias. <br/>Measurements and Main Results: Ten studies were
included, including 1,812 patients (871 in the del Nido group and 941 in
the control group), and published after 2017. There were significant
reductions in postoperative stroke and/or transient ischemic attack rate
in the del Nido group: 9/467 (1.9%) v 25/540 (4.6%); odds ratio (OR),
0.43; 95% CI, 0.20-0.92 (p = 0.007). Del Nido cardioplegia was also
associated with significantly shorter aortic cross-clamp time (mean
difference, -8.99 minutes; 95% CI, -17.24 to -0.73 [p < 0.001]),
significantly reduced need for defibrillation (89/582 [15%] v 252/655
[38%]; OR, 0.33; 95% CI, 0.15-0.72 [p < 0.001]), significantly lower risk
of postoperative acute kidney injury (21/235 [8.9%] v 34/301 [11%]; OR,
0.50; 95% CI, 0.26-0.97 [p = 0.04]), with no effect on mortality (14/607
[2.3%] v 12/681 [1.8%]; p = 0.5). <br/>Conclusion(s): According to the
authors' meta-analysis of recent randomized clinical trials, del Nido is a
safe cardioplegic solution, which might provide better organ protection in
adult cardiac surgery without differences in mortality when compared to
other cardioplegic solutions.<br/>Copyright &#xa9; 2023 Elsevier Inc.

<12>
[Use Link to view the full text]
Accession Number
2014553208
Title
Effect of 6% Hydroxyethyl Starch 130/0.4 on Inflammatory Response and
Pulmonary Function in Patients Having Cardiac Surgery: A Randomized
Clinical Trial.
Source
Anesthesia and Analgesia. 133(4) (pp 906-914), 2021. Date of Publication:
01 Oct 2021.
Author
Lee M.J.; Tannenbaum C.; Mao G.; Jia Y.; Leung S.; Yilmaz H.O.; Ince I.;
Soltesz E.; Duncan A.E.
Institution
(Lee) Anesthesiology Institute
(Tannenbaum) Department of Inflammation and Immunity, Lerner Research
Institute, United States
(Mao, Jia, Leung, Yilmaz, Ince, Duncan) Department of Outcomes Research,
Cleveland Clinic, Cleveland, OH, United States
(Soltesz) Department of Thoracic and Cardiovascular Surgery, Cleveland
Clinic, Cleveland, OH, United States
(Duncan) Department of Cardiothoracic Anesthesia, Cleveland Clinic,
Cleveland, OH, United States
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND: Cardiac surgery with cardiopulmonary bypass induces a profound
inflammatory response that, when severe, can lead to multiorgan system
dysfunction. Preliminary data suggest that administration of hydroxyethyl
starch (HES) solutions may mitigate an inflammatory response and improve
pulmonary function. Our goal was to examine the effect of 6% HES 130/0.4
versus 5% human albumin given for intravascular plasma volume replacement
on the perioperative inflammatory response and pulmonary function in
patients undergoing cardiac surgery. <br/>METHOD(S): This was a
subinvestigation of a blinded, parallel-group, randomized clinical trial
of patients undergoing elective aortic valve replacement surgery at the
Cleveland Clinic main campus, titled "Effect of 6% Hydroxyethyl Starch
130/0.4 on Kidney and Haemostatic Function in Cardiac Surgical Patients."
Of 141 patients who were randomized to receive either 6% HES 130/0.4 or 5%
human albumin for intraoperative plasma volume replacement, 135 patients
were included in the data analysis (HES n = 66, albumin n = 69). We
assessed the cardiopulmonary bypass-induced inflammatory response end
points by comparing the 2 groups' serum concentrations of tumor necrosis
factor-alpha (TNF-alpha), interleukin-6 (IL-6), and macrophage migration
inhibitory factor (MIF), measured at baseline and at 1 and 24 hours after
surgery. We also compared the 2 groups' postoperative pulmonary function
end points, including the ratio of partial pressure of arterial oxygen to
fraction of inspired oxygen (Pao<inf>2</inf>:Fio<inf>2</inf>ratio),
dynamic lung compliance, oxygenation index (OI), and ventilation index
(VI) at baseline, within 1 hour of arrival to the intensive care unit, and
before tracheal extubation. The differences in the postoperative levels of
inflammatory response and pulmonary function between the HES and albumin
groups were assessed individually in linear mixed models. <br/>RESULT(S):
Serum concentrations of the inflammatory markers (TNF-alpha, IL-6, MIF)
were not significantly different (P >=.05) between patients who received
6% HES 130/0.4 or 5% albumin, and there was no significant heterogeneity
of the estimated treatment effect over time (P >=.15). The results of
pulmonary function parameters (Pao<inf>2</inf>:Fio<inf>2</inf>ratio,
dynamic compliance, OI, VI) were not significantly different (P >=.05)
between groups, and there was no significant heterogeneity of the
estimated treatment effect over time (P >=.15). <br/>CONCLUSION(S): Our
investigation found no significant difference in the concentrations of
inflammatory markers and measures of pulmonary function between cardiac
surgical patients who received 6% HES 130/0.4 versus 5%
albumin.<br/>Copyright &#xa9; 2021 Lippincott Williams and Wilkins. All
rights reserved.

<13>
[Use Link to view the full text]
Accession Number
634795606
Title
Assessing Left Ventricular Early Diastolic Velocities With Tissue Doppler
and Speckle Tracking by Transesophageal and Transthoracic
Echocardiography.
Source
Anesthesia and Analgesia. 132(5) (pp 1400-1409), 2021. Date of
Publication: 01 May 2021.
Author
Mauermann E.; Bouchez S.; Bove T.; Vandenheuvel M.; Wouters P.
Institution
(Mauermann, Bouchez, Vandenheuvel, Wouters) Department of Anesthesiology
and Perioperative Medicine, Ghent University Hospital, Ghent, Belgium
(Mauermann) Department for Anesthesia, Surgical Intensive Care,
Prehospital Emergency Medicine and Pain Therapy, Basel University
Hospital, Basel, Switzerland
(Bove) Department of Cardiac Surgery, Ghent University Hospital, Ghent,
Belgium
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND: Assessing diastolic dysfunction is essential and should be
part of every routine echocardiography examination. However, clinicians
routinely observe lower mitral annular velocities by transesophageal
echocardiography (TEE) under anesthesia than described by awake
transthoracic echocardiography (TTE). It would be important to know
whether this difference persists under constant loading conditions. We
hypothesized that mean early diastolic mitral annular velocity, measured
by tissue Doppler imaging (TDI, E<inf>TDI</inf> ') would be different in
the midesophageal 4-chamber (ME 4Ch) than in the apical 4-chamber (AP 4Ch)
view under unchanged or constant loading conditions. Secondarily we
examined (1) E<inf>TDI</inf> ' in an alternative transesophageal view with
presumed superior Doppler beam alignment, the deep transgastric view
(DTG), compared to those in the AP 4Ch, and (2) early diastolic speckle
tracking-based strain rate (E<inf>SR</inf> '), in the ME 4Ch and in the AP
4Ch. <br/>METHOD(S): Twenty-five consecutive adult patients undergoing
on-pump cardiac surgery from February 2017 to July 2017 were included.
Both TTE and TEE measurements were obtained under anesthesia in a
randomized order in the AP 4Ch, ME 4Ch, and DTG views. Within-patient
average values were compared by paired t tests with a Bonferroni
adjustment. Box plots, correlation, and agreement by Bland-Altman were
examined for all 3 comparisons. A second echocardiographer independently
acquired and analyzed images; images were reanalyzed after 4 weeks. Image
quality and reproducibility were also reported. <br/>RESULT(S): Averaged
E<inf>TDI</inf> ' measurements were lower in the ME 4Ch than in the AP 4Ch
(6.6 +/- 1.7 cm/s vs 7.0 +/- 1.5 cm, P = .028; within-patient difference
mean +/- standard deviation: 0.6 +/- 1.2 cm/s). An alternative TEE view
for E<inf>TDI</inf> ', the DTG, also exhibited lower mean values (6.0 +/-
1.6 cm/s, P = .006; within-patient difference mean +/- standard deviation:
1.1 +/- 1.8 cm/s). E<inf>SR</inf> ' strain rate showed a low degree of
bias, but greater variability (ME 4Ch: 0.87 +/- 0.32%/s vs AP 4Ch: 0.73
+/- 0.18%/s, P = .078; within-patient difference mean +/- standard
deviation: -0.1 +/- 0.2%/s). <br/>CONCLUSION(S): This study confirms that
TEE modestly underestimates E<inf>TDI</inf> ' but not to a clinically
relevant extent. While E<inf>TDI</inf> ' in the DTG is not a promising
alternative, the future role for speckle tracking-based early diastolic
strain rate is unknown.<br/>Copyright &#xa9; 2021 International Anesthesia
Research Society.

<14>
[Use Link to view the full text]
Accession Number
631588088
Title
Prevention of Early Postoperative Decline: A Randomized, Controlled
Feasibility Trial of Perioperative Cognitive Training.
Source
Anesthesia and Analgesia. 130(3) (pp 586-595), 2020. Date of Publication:
01 Mar 2020.
Author
O'Gara B.P.; Mueller A.; Gasangwa D.V.I.; Patxot M.; Shaefi S.; Khabbaz
K.; Banner-Goodspeed V.; Pascal-Leone A.; Marcantonio E.R.; Subramaniam B.
Institution
(O'Gara, Mueller, Gasangwa, Patxot, Shaefi, Banner-Goodspeed, Subramaniam)
Department of Anesthesia, Beth Israel Deaconess Medical Center, 1
Deaconess Rd, Rosenberg 470, Boston, MA 02215, United States
(Khabbaz) Department of Surgery, Division of Cardiac Surgery, United
States
(Pascal-Leone) Department of Neurology, Division of Cognitive Neurology,
Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA,
United States
(Pascal-Leone) Neurorehabilitation Institut Guttman, Universitat Autonoma
Barcelona, Bellaterra, Spain
(Marcantonio) Department of Medicine, Division of General Medicine and
Primary Care, Beth Israel Deaconess Medical Center, Harvard Medical
School, Boston, MA, United States
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND: Postoperative delirium and postoperative cognitive dysfunction
(POCD) are common after cardiac surgery and contribute to an increased
risk of postoperative complications, longer length of stay, and increased
hospital mortality. Cognitive training (CT) may be able to durably improve
cognitive reserve in areas deficient in delirium and POCD and, therefore,
may potentially reduce the risk of these conditions. We sought to
determine the feasibility and potential efficacy of a perioperative CT
program to reduce the incidence of postoperative delirium and POCD in
older cardiac surgery patients. <br/>METHOD(S): Randomized controlled
trial at a single tertiary care center. Participants included 45 older
adults age 60-90 undergoing cardiac surgery at least 10 days from
enrollment. Participants were randomly assigned in a 1:1 fashion to either
perioperative CT via a mobile device or a usual care control. The primary
outcome of feasibility was evaluated by enrollment patterns and adherence
to protocol. Secondary outcomes of postoperative delirium and POCD were
assessed using the Confusion Assessment Method and the Montreal Cognitive
Assessment, respectively. Patient satisfaction was assessed via a
postoperative survey. <br/>RESULT(S): Sixty-five percent of eligible
patients were enrolled. Median (interquartile range [IQR]) adherence (as a
percentage of prescribed minutes played) was 39% (20%-68%), 6% (0%-37%),
and 19% (0%-56%) for the preoperative, immediate postoperative, and
postdischarge periods, respectively. Median (IQR) training times were 245
(136-536), 18 (0-40), and 122 (0-281) minutes for each period,
respectively. The incidence of postoperative delirium (CT group 5/20 [25%]
versus control 3/20 [15%]; P =.69) and POCD (CT group 53% versus control
37%; P =.33) was not significantly different between groups for either
outcome in this limited sample. CT participants reported a high level of
agreement (on a scale of 0-100) with statements that the program was easy
to use (median [IQR], 87 [75-97]) and enjoyable (85 [79-91]). CT
participants agreed significantly more than controls that their memory
(median [IQR], 75 [54-82] vs 51 [49-54]; P =.01) and thinking ability
(median [IQR], 78 [64-83] vs 50 [41-68]; P =.01) improved as a result of
their participation in the study. <br/>CONCLUSION(S): A CT program
designed for use in the preoperative period is an attractive target for
future investigations of cognitive prehabilitation in older cardiac
surgery patients. Changes in the functionality of the program and
enrichment techniques may improve adherence in future trials. Further
investigation is necessary to determine the potential efficacy of
cognitive prehabilitation to reduce the risk of postoperative delirium and
POCD.<br/>Copyright &#xa9; 2020 Lippincott Williams and Wilkins. All
rights reserved.

<15>
[Use Link to view the full text]
Accession Number
631587890
Title
Fibrinogen Concentrate as an Alternative to Cryoprecipitate in a
Postcardiopulmonary Transfusion Algorithm in Infants Undergoing Cardiac
Surgery: A Prospective Randomized Controlled Trial.
Source
Anesthesia and Analgesia. 130(3) (pp 740-751), 2020. Date of Publication:
01 Mar 2020.
Author
Downey L.A.; Andrews J.; Hedlin H.; Kamra K.; McKenzie E.D.; Hanley F.L.;
Williams G.D.; Guzzetta N.A.
Institution
(Downey, Guzzetta) Department of Anesthesiology, Children's Healthcare of
Atlanta, 1405 Clifton Rd NE, Atlanta, GA 30322., United States
(Andrews) Departments of Pathology, Microbiology and Immunology, United
States
(Andrews) Pediatrics Vanderbilt University Medical Center, Nashville, TN,
United States
(Hedlin) Department of Quantitative Sciences Unit, Stanford University
School of Medicine, Palo Alto, CA, United States
(Kamra, Williams) Department of Anesthesiology, Stanford University School
of Medicine, Lucile Packard Children's Hospital, Palo Alto, CA, United
States
(McKenzie) Division of Congenital Heart Surgery, Department of Surgery,
Baylor College of Medicine, Texas Children's Hospital, Houston, TX, United
States
(Hanley) Departments of Cardiovascular Surgery, United States
(Hanley) Pediatric Cardiac Surgery, Stanford University School of
Medicine, Lucile Packard Children's Hospital, Palo Alto, CA, United States
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND: Infants undergoing cardiac surgery are at risk for bleeding
and massive transfusion due to an immature coagulation system, complex
surgeries, and cardiopulmonary bypass (CPB) effects. Hemodilution from CPB
promotes an acquired hypofibrinogenemia that results in impaired fibrin
formation, inadequate clot formation, and increased bleeding. In North
America, the current standard of care to supplement fibrinogen is
cryoprecipitate. An alternative option is the off-label use of fibrinogen
concentrate (FC; RiaSTAP; CSL Behring, Marburg, Germany), a purified
fibrinogen. Because perioperative allogenic transfusions are associated
with increased morbidity and mortality, we sought to determine whether FC
would be an acceptable alternative to cryoprecipitate in a post-CPB
transfusion algorithm in infants undergoing open-heart surgery.
<br/>METHOD(S): We randomized 60 infants (<12 months) undergoing
nonemergent cardiac surgery with CPB at 2 tertiary care children's
hospitals to receive either cryoprecipitate or FC in a post-CPB
transfusion algorithm. Infants underwent a stratified randomization based
on institution and surgical complexity. The primary outcome was the
difference in number of intraoperative allogenic blood product
transfusions. Secondary outcomes included 24-hour chest tube output (CTO),
mechanical ventilation time, adverse events (AEs), intensive care unit
(ICU) length of stay (LOS), hospital LOS, postoperative thrombosis, and
death within 30 days of surgery. The primary analysis followed the
intent-To-Treat (ITT) principle and was performed using linear regression
adjusted for institution and complexity of surgery. A per-protocol (PP)
analysis was also performed. <br/>RESULT(S): Between June 2016 and January
2018, we enrolled 60 patients with complete data available for 25 patients
who received cryoprecipitate and 29 patients who received FC. Patients in
the cryoprecipitate group (median age: 4 months [2-6 months]) received 5.5
(4.0-7.0) allogeneic blood units in the ITT analysis and 6.0 units
(5.0-7.0 units) in the PP analysis. Patients in the FC group (median age:
4 months [2-5]) received 4 units (3.0-5.0 units) in the ITT analysis and
4.0 units (3.0-5.0 units) in the PP analysis. In the adjusted ITT
analysis, the FC group received 1.79 units (95% confidence interval [CI],
0.64-2.93; P =.003) less than the cryoprecipitate group. In the adjusted
PP analysis, the FC group received 2.67 units (95% CI, 1.75-3.59; P <.001)
less than the cryoprecipitate group. There were no significant differences
in secondary outcomes or AEs. <br/>CONCLUSION(S): Our findings suggest
that FC may be considered as an alternative to cryoprecipitate for the
treatment of hypofibrinogenemia in infants with bleeding after CPB.
Although we found no significant differences between secondary outcomes or
AEs, further studies are needed to assess safety.<br/>Copyright &#xa9;
2020 Lippincott Williams and Wilkins. All rights reserved.

<16>
Accession Number
2015115464
Title
Management of saccular superior cerebellar artery aneurysms: The Buffalo
experience case series and systematic review.
Source
Interventional Neuroradiology. 29(2) (pp 148-156), 2023. Date of
Publication: April 2023.
Author
Lim J.; Nyabuto E.; Aguirre A.O.; Waqas M.; Vakharia K.; Cappuzzo J.M.;
Siddiqui A.H.
Institution
(Lim, Nyabuto, Waqas, Vakharia, Cappuzzo, Siddiqui) Department of
Neurosurgery, Jacobs School of Medicine and Biomedical Sciences,
University at Buffalo, Buffalo, NY, United States
(Lim, Nyabuto, Waqas, Vakharia, Cappuzzo, Siddiqui) Gates Vascular
Institute, Buffalo General Medical Center/Kaleida Health, Buffalo, NY,
United States
(Aguirre) Jacobs School of Medicine and Biomedical Sciences, University at
Buffalo, Buffalo, NY, United States
(Siddiqui) Department of Radiology, Jacobs School of Medicine and
Biomedical Sciences, University at Buffalo, Buffalo, NY, United States
(Siddiqui) Canon Stroke and Vascular Research Center, University at
Buffalo, Buffalo, NY, United States
(Siddiqui) Jacobs Institute, Buffalo, NY, United States
Publisher
SAGE Publications Inc.
Abstract
Background: Results of the management of superior cerebellar artery (SCA)
aneurysms are typically reported in combination with those for all
posterior circulation aneurysms. We report our experience with the
management of SCA aneurysms and a systematic review of the endovascular
management of these rare aneurysms. <br/>Method(s): Patients with saccular
SCA aneurysms that were not associated with arteriovenous malformations
and who presented to our institute between 2000 and 2017 were identified.
Patient demographics, aneurysm characteristics, interventions, and
follow-up data were collected, compared, and analyzed. For the review,
data including number of aneurysm treated, outcomes, follow-up, and
occlusion rates were collected. <br/>Result(s): Mean age of the 31
identified patients was 57.4 +/- 12.3 years; 19.4% were men. Mean aneurysm
size was 5.1 +/- 2.9 mm. Seven of 21 patients with unruptured aneurysms
were managed conservatively. Ten patients (32.3%) presented with ruptured
aneurysms (mean aneurysm size, 6.2 +/- 3.2 mm). Treatment was successfully
completed in 22 patients: 13-primary coiling, 7-stent-assisted coiling,
and 2-microsurgical clipping. Complete angiographic aneurysm occlusion
after primary treatments was achieved in 19 (86.4%) patients. The total
complication rate among treated patients was 4.2% (1 of 24 treated
aneurysms). No minor complications occurred. However, in 2 patients, coil
embolization was attempted but aborted due to coil protrusion into the
parent artery. Clinical and angiographic follow-up data were available for
26 observed or treated patients. Mean follow-up duration was 5.3 +/- 4.5
years. Six articles met our review inclusion criteria and demonstrated
similar mean treated aneurysm sizes ranging from 4.6-7.7 mm, and follow-up
from these articles ranged from 15.3-50 months. <br/>Conclusion(s):
Endovascularly treated patients with ruptured and unruptured SCA
aneurysms, of which most were <7 mm, had good clinical outcomes with
minimal complications.<br/>Copyright &#xa9; The Author(s) 2022.

<17>
Accession Number
2020854926
Title
CD19 CAR-T therapy in solid organ transplant recipients: case report and
systematic review.
Source
Bone Marrow Transplantation. 58(4) (pp 353-359), 2023. Date of
Publication: April 2023.
Author
Portuguese A.J.; Gauthier J.; Tykodi S.S.; Hall E.T.; Hirayama A.V.; Yeung
C.C.S.; Blosser C.D.
Institution
(Portuguese, Gauthier, Tykodi, Hall, Hirayama, Yeung, Blosser) University
of Washington, Seattle, WA, United States
(Portuguese, Gauthier, Tykodi, Hall, Hirayama, Yeung) Fred Hutchinson
Cancer Center, Seattle, WA, United States
(Blosser) Seattle Children's Hospital, Seattle, WA, United States
Publisher
Springer Nature
Abstract
Post-transplant lymphoproliferative disorder (PTLD) is a leading cause of
cancer death in solid organ transplant recipients (SOTRs). Relapsed or
refractory (R/R) PTLD portends a high risk of death and effective
management is not well established. CD19-targeted CAR-T cell therapy has
been utilized, but the risks and benefits are unknown. We report the first
case of diffuse large B-cell lymphoma (DLBCL) PTLD treated with
lisocabtagene maraleucel and present a systematic literature review of
SOTRs with PTLD treated with CD19 CAR-T therapy. Our patient achieved a
complete response (CR) with limited toxicity but experienced a
CD19⁺ relapse 8 months after infusion despite CAR-T
persistence. Literature review revealed 14 DLBCL and 2 Burkitt lymphoma
PTLD cases treated with CD19 CAR-T cells. Kidney (n = 12), liver (n = 2),
heart (n = 2), and pancreas after kidney (n = 1) transplant recipients
were analyzed. The objective response rate (ORR) was 82.4% (14/17), with
58.5% (10/17) CRs and a 6.5-month median duration of response. Among
kidney transplant recipients, the ORR was 91.7% (11/12). Allograft
rejection occurred in 23.5% (4/17). No graft failure occurred. Our
analysis suggests that CD19 CAR-T therapy offers short-term effectiveness
and manageable toxicity in SOTRs with R/R PTLD. Further investigation
through larger datasets and prospective study is needed.<br/>Copyright
&#xa9; 2022, The Author(s), under exclusive licence to Springer Nature
Limited.

<18>
Accession Number
2023422170
Title
Comparison Between Central Venous Catheter Placement and Ultrasound Guide
and Anatomical Landmarks in Pediatric Patients Undergoing Cardiac
Surgeries.
Source
Iranian Heart Journal. 24(2) (pp 55-61), 2023. Date of Publication: April
2023.
Author
Sadeghi A.; Ziyaeifard M.; Azarfarin R.; Rastravan R.; Totonchi Z.;
Heydarpour E.
Institution
(Sadeghi, Rastravan, Totonchi, Heydarpour) Department of Cardiac
Anesthesia, Rajaie Cardiovascular Medical and Research Center, Iran
University of Medical Sciences, Tehran, Iran, Islamic Republic of
(Ziyaeifard, Azarfarin) Cardio-Oncology Research Center, Rajaie
Cardiovascular Medical and Research Center, Iran University of Medical
Sciences, Tehran, Iran, Islamic Republic of
Publisher
Iranian Heart Association
Abstract
Background: Controversies exist surrounding the advantages and
disadvantages of anatomical landmarks (ALs) and ultrasound (US) guidance
as 2 methods of central venous catheter (CVC) placement among pediatric
patients. The present study compared the success rate and complications of
CVC placement in the internal jugular vein between US guidance and
traditional AL methods among pediatric patients. <br/>Method(s): The
present open-labeled randomized clinical trial was performed on 120
pediatric patients aged 3 months to 6 years undergoing cardiac surgeries.
The patients were randomly allocated to the US-guided and AL groups. After
the induction of anesthesia and intubation, the CVC was placed according
to the placement method of each trial group. The success rate of
first-attempt CVC placements was the primary outcome, while placement
time, vein punctures, and arrhythmias constituted the secondary outcomes.
<br/>Result(s): The trial assessed 120 patients (63, 52.5% female). The
mean CVC placement time was 204.1+/-111.7 seconds. The success rate of
first-attempt CVC placements was the same in both groups (47/60; 78.33%).
The AL group experienced significantly more side effects than the
US-guided group (23 arrhythmias [38.33%] and 5 arterial punctures [8.33%]
vs 2 arrhythmias [3.33%] and 3 arterial punctures [5%]; P<0.001).
<br/>Conclusion(s): The complication rate of CVC placement in the
US-guided group was lower than that in the AL group; thus, the former
method can be considered safer in pediatric patients.<br/>Copyright &#xa9;
2023, Iranian Heart Association. All rights reserved.

<19>
Accession Number
2023422163
Title
Effects of Epinephrine, Norepinephrine, and Phenylephrine on Cerebral
Oxygen Saturation in Patients Undergoing Cardiopulmonary Bypass: A
Randomized Clinical Trial.
Source
Iranian Heart Journal. 24(2) (pp 6-13), 2023. Date of Publication: April
2023.
Author
Ziyaeifard M.; Rostami R.; Azarfarin R.; Yaghoubi-Golverdi A.; Fattahi M.;
Jamalian J.
Institution
(Ziyaeifard, Azarfarin) Cardio-Oncology Research Center, Rajaie
Cardiovascular Medical and Research Center, Iran University of Medical
Sciences, Tehran, Iran, Islamic Republic of
(Rostami, Yaghoubi-Golverdi, Fattahi, Jamalian) Rajaie Cardiovascular
Medical and Research Center, Iran University of Medical Sciences, Tehran,
Iran, Islamic Republic of
Publisher
Iranian Heart Association
Abstract
Background: Epinephrine, norepinephrine, and phenylephrine may have
different effects on cerebral O<inf>2</inf> saturation when used to treat
intraoperative hypotension. The present study aimed to evaluate these
effects on cerebral O<inf>2</inf> saturation in patients undergoing
cardiopulmonary bypass (CPB) during heart surgeries. <br/>Method(s): The
current randomized clinical trial enrolled 114 adult patients, 90 of whom
were eligible for randomization into 3 groups (each=30) receiving
epinephrine, norepinephrine, and phenylephrine if they experienced
hypotension (mean arterial pressure [MAP]<60 mm Hg) during surgery.
Cerebral oximetry as the primary outcome, hemodynamic parameters,
consisting of heart rate, MAP, and arterial blood gas (ABG), and lactate
levels were recorded prior to surgery and 120, 150, and 180 seconds after
vasopressor administration during CPB. <br/>Result(s): The 3 study groups
were similar regarding demographic variables. Hemodynamic parameters,
including ABG, and lactate levels showed no statistically significant
differences between the groups (P>0.05). Additionally, cerebral
O<inf>2</inf> saturation at baseline and 120, 150, and 180 seconds after
vasopressor administration was not statistically different between the 3
groups (P>0.05). <br/>Conclusion(s): The administration of epinephrine,
norepinephrine, or phenylephrine in adult patients undergoing cardiac
surgery with CPB support yielded no statistically significant differences
in clinical and hemodynamic parameters .<br/>Copyright &#xa9; 2023,
Iranian Heart Association. All rights reserved.

<20>
Accession Number
2021337171
Title
Response to "Levosimendan's ability on veno-arterial extracorporeal
membrane oxygenation weaning: Evidence says yes!".
Source
International Journal of Artificial Organs. 46(4) (pp 191-192), 2023. Date
of Publication: April 2023.
Author
Hau M.; Fong K.-M.; Au S.-Y.
Institution
(Hau, Fong, Au) Intensive Care Unit, Queen Elizabeth Hospital, Hong Kong
Publisher
SAGE Publications Ltd

<21>
Accession Number
2023310516
Title
Surgical prehabilitation in older and frail individuals: a scoping review.
Source
International Anesthesiology Clinics. 61(2) (pp 34-46), 2023. Date of
Publication: 2023.
Author
Sadlonova M.; Katz N.B.; Jurayj J.S.; Flores L.; Celano C.M.; Von Arnim
C.A.F.; Silver J.K.
Institution
(Sadlonova, Celano) Department of Psychiatry, Massachusetts General
Hospital, Boston, MA, United States
(Sadlonova, Celano) Department of Psychiatry, Harvard Medical School,
Boston, MA, United States
(Sadlonova) Department of Physical Medicine and Rehabilitation, Spaulding
Rehabilitation Hospital, Charlestown, MA, United States
(Sadlonova) Department of Physical Medicine and Rehabilitation, Harvard
Medical School, Boston, MA, United States
(Sadlonova) Department of Physical Medicine and Rehabilitation,
Massachusetts General Hospital, Boston, MA, United States
(Katz) University of Rochester, School of Medicine and Dentistry,
Rochester, NY, United States
(Katz, Silver) University of Nebraska Medical Center, Omaha, NE, United
States
(Jurayj) Department of Psychosomatic Medicine and Psychotherapy,
University of Gottingen Medical Center, Gottingen, Germany
(Flores) Department of Cardiovascular and Thoracic Surgery, University of
Gottingen Medical Center, Gottingen, Germany
(Von Arnim) DZHK (German Center for Cardiovascular Research), Partner site
Gottingen, Germany
(Silver) Department of Geriatrics, University of Gottingen Medical Center,
Gottingen, Germany
Publisher
Lippincott Williams and Wilkins

<22>
Accession Number
2022557460
Title
Heart-brain axis: Association of congenital heart abnormality and brain
diseases.
Source
Frontiers in Cardiovascular Medicine. 10 (no pagination), 2023. Article
Number: 1071820. Date of Publication: 2023.
Author
Sha L.; Li Y.; Zhang Y.; Tang Y.; Li B.; Chen Y.; Chen L.
Institution
(Sha, Tang, Li, Chen) Department of Neurology, Joint Research Institution
of Altitude Health, West China Hospital, Sichuan University, Chengdu,
China
(Li, Chen) Department of Cardiology, West China Hospital, Sichuan
University, Chengdu, China
(Zhang) Fujian Provincial Key Laboratory of Neurodegenerative Disease and
Aging Research, Institute of Neuroscience, School of Medicine, Xiamen
University, Xiamen, China
Publisher
Frontiers Media S.A.
Abstract
Brain diseases are a major burden on human health worldwide, and little is
known about how most brain diseases develop. It is believed that
cardiovascular diseases can affect the function of the brain, and many
brain diseases are associated with heart dysfunction, which is called the
heart-brain axis. Congenital heart abnormalities with anomalous
hemodynamics are common treatable cardiovascular diseases. With the
development of cardiovascular surgeries and interventions, the long-term
survival of patients with congenital heart abnormalities continues to
improve. However, physicians have reported that patients with congenital
heart abnormalities have an increased risk of brain diseases in adulthood.
To understand the complex association between congenital heart
abnormalities and brain diseases, the paper reviews relevant clinical
literature. Studies have shown that congenital heart abnormalities are
associated with most brain diseases, including stroke, migraine, dementia,
infection of the central nervous system, epilepsy, white matter lesions,
and affective disorders. However, whether surgeries or other interventions
could benefit patients with congenital heart abnormalities and brain
diseases remains unclear because of limited evidence.<br/>Copyright 2023
Sha, Li, Zhang, Tang, Li, Chen and Chen.

<23>
Accession Number
2023698203
Title
Acute Type A Aortic Dissection and Coarctation: Single-Stage Repair Using
a Clamshell Incision and a Systematic Literature Review.
Source
Heart Surgery Forum. 25(6) (pp E822-E828), 2022. Date of Publication:
2022.
Author
Iosifescu A.G.; Timisescu A.T.; Prodan B.; Popescu A.; Iliescu V.A.
Institution
(Iosifescu, Iliescu) Carol Davila University of Medicine and Pharmacy,
Bucharest, Romania
(Iosifescu, Timisescu, Iliescu) Department of Cardiac Surgery, C.C.
Iliescu Emergency Institute for Cardiovascular Diseases, Bucharest,
Romania
(Prodan) Department of Anesthesia and Intensive Care, C.C. Iliescu
Emergency Institute for Cardiovascular Diseases, Bucharest, Romania
(Popescu) Department of Cardiac Surgery, Emergency Clinical Hospital for
Children, Maria Sklodowska Curie, Poland
Publisher
Forum Multimedia Publishing LLC
Abstract
Background: Aortic coarctation (CoAo) may be discovered only when
complicated by acute type A aortic dissection (ATAAD). We present a case
with a one-stage repair of this pathologic association and review the
relevant literature focusing on the surgical choices. Case report: A
43-year-old man presented with acute thoracic pain. Computed tomography
and echocardiography demonstrated CoAo, ATAAD type II, an ascending aorta
aneurysm, and moderate regurgitation of a bicuspid aortic valve. Emergency
surgery was performed. A clamshell incision, cardiopulmonary bypass with
dual arterial cannulation (axillo-femoral), CoAo repair (by
resection-interposition), and supracoronary aorta replacement were
performed. Four years later, the patient was healthy and asymptomatic.
Review: Thirty surgical cases of ATAAD with CoAo repair after the
dissection onset were included. Iatrogenic dissections and formerly
repaired CoAo without surgical indication were excluded. <br/>Result(s):
The mean patient age was 27.8 +/- 12 years; there was a male predominance
(76.7%). The patients frequently presented with ascending aorta aneurysm
(86.2%), bicuspid aortic valve (69%), and type II dissection (79.3%);
dissection never extended below the CoAo. The one-stage treatment (15
patients; 55.5%) included 12 surgical repairs of CoAo (mostly by
ascending-to-descending aorta extra-anatomic bypass; 58.3%) and three
balloon angioplasties. In patients with uncorrected CoAo at the onset of
cardiopulmonary bypass, double arterial perfusion was used in 55.5%.
<br/>Conclusion(s): One-stage repair (hybrid or surgical), double arterial
perfusion, and extra-anatomic ascending-to-descending aorta bypass are the
most common options for treating ATAAD-CoAo. The clamshell incision
provides excellent access for an extended arch procedure and facilitates
anatomic isthmus repair.<br/>Copyright &#xa9; 2022 Forum Multimedia
Publishing, LLC.

<24>
Accession Number
2019975078
Title
Hybrid coronary revascularization (HCR) versus coronary artery bypass
grafting (CABG) in multivessel coronary artery disease (MVCAD): A
meta-analysis of 14 studies comprising 4226 patients.
Source
Catheterization and Cardiovascular Interventions. 100(7) (pp 1182-1194),
2022. Date of Publication: 01 Dec 2022.
Author
Nagraj S.; Tzoumas A.; Kakargias F.; Giannopoulos S.; Ntoumaziou A.;
Kokkinidis D.G.; Alvarez Villela M.; Latib A.
Institution
(Nagraj) Jacobi Medical Center/Albert Einstein College of Medicine, The
Bronx, NY, United States
(Tzoumas) University of Cincinnati Medical Center, Cincinnati, OH, United
States
(Kakargias) Department of Medicine, Aristotle University of Thessaloniki,
Thessaloniki, Greece
(Giannopoulos) Division of Cardiology, Rocky Mountain Regional VA Medical
Center, Aurora, CO, United States
(Ntoumaziou) General Hospital of Filiates, Filiates, Greece
(Kokkinidis) Section of Cardiovascular Medicine, Yale University School of
Medicine, Yale New Haven Hospital, New Haven, CT, United States
(Alvarez Villela) Division of Cardiology, Jacobi Medical Center/Albert
Einstein College of Medicine, The Bronx, NY, United States
(Latib) Department of Cardiology, Montefiore Medical Center/Albert
Einstein College of Medicine, New York City, NY, United States
Publisher
John Wiley and Sons Inc
Abstract
Objectives: To compare the outcomes of hybrid coronary revascularization
(HCR) with traditional coronary artery bypass grafting (CABG) in
multivessel coronary artery disease (MVCAD). <br/>Background(s): HCR has
emerged as an alternative to CABG in patients with MVCAD. Through
minimally invasive surgical techniques, HCR carries the potential for
faster recovery postoperatively, fewer complications, and lower
utilization of resources. <br/>Method(s): Systematic search of electronic
databases was conducted up to December 2021 and studies comparing HCR with
CABG in the treatment of MVCAD were included in this meta-analysis.
Primary outcomes of interest were incidence of 5-year mortality and major
adverse cardiac and cerebral event (MACCE). <br/>Result(s): Fourteen
studies (12 observational studies and 2 randomized controlled trials)
comprising 4226 patients were included. The rates of 5-year mortality
(odds ratios [OR]: 1.55; 95% confidence interval [CI]: 0.92-2.62;
I² = 83.0%) and long-term MACCE (OR: 0.97; 95% CI: 0.47-2.01;
I² = 74.7%) were comparable between HCR and CABG groups. HCR
was associated with a significantly lower likelihood of perioperative
blood transfusion (OR: 0.36; 95% CI: 0.25-0.51; I² = 55.9%),
shorter mean hospital stay (weighted mean difference: -2.04; 95% CI: -2.60
to -1.47; I² = 54%), and risk of postoperative acute kidney
injury (OR: 0.45; 95% CI: 0.23-0.88; p = 0.02). CABG demonstrated a lower
likelihood of requiring long-term repeat revascularization (OR: 1.51; 95%
CI: 1.03-2.20; I² = 18%) over a follow-up duration of 29.14 +/-
21.75 months. <br/>Conclusion(s): This meta-analysis suggests that HCR is
feasible and safe for the treatment of MVCAD. However, benefits of HCR
should be carefully weighed against the increased long-term risk of
repeat-revascularization when selecting patients, and further studies
evaluating differences in long-term mortality between HCR and CABG are
required.<br/>Copyright &#xa9; 2022 Wiley Periodicals LLC.

<25>
Accession Number
638140459
Title
Risk for post-operative delirium related to comorbidities in older adult
cardiac patients: An integrative review.
Source
Journal of clinical nursing. 32(9-10) (pp 2128-2139), 2023. Date of
Publication: 01 May 2023.
Author
Ramos M.D.; Vergara F.H.; Shackleford J.; Briggs C.; Gomez C.; Mofazali
M.; Preston J.
Institution
(Ramos, Shackleford, Briggs, Gomez, Mofazali, Preston) WellStar School of
Nursing, Kennesaw State University, Kennesaw, GA, United States
(Vergara) HCA Florida Fawcett Hospital, Port Charlotte, FL, United States
Publisher
NLM (Medline)
Abstract
BACKGROUND: Delirium is defined as a sudden onset of confusion due to
disruption in normal brain functioning. Although it is highly prevalent in
post-operative patients, most significantly the older adult population,
limited information exists explaining why its onset occurs. PURPOSE: This
integrative review aimed to synthesise specific comorbidities that can
contribute to the development of post-operative delirium in older adult
cardiac surgical patients. <br/>METHOD(S): PRISMA statement was used to
report the identification, selection, appraisal and synthesis of articles
and the PRISMA diagram reports the selection process. The Johns Hopkins
Evidence-Based Practice Tools were used as guide in literature review,
critical analysis, levelling of evidence and quality rating. PubMed,
ProQuest, CINAHL plus, EMBASE, MEDLINE, Ovid Nursing Collection and
Cochrane databases were searched from 2015 to 2020. <br/>RESULT(S): The
initial search yielded 1529 articles. Following the removal of duplicates
and screening, 14 articles were included for this review. The following
comorbidities were identified in the studies: Diabetes mellitus, atrial
fibrillation, depression, impaired olfaction, pre-existing cerebrovascular
disease, pre-existing cardiovascular disease, insomnia and frailty.
<br/>CONCLUSION(S): There was a strong indication of the development of
post-operative delirium among older adult cardiac surgical patients with
comorbidities. RELEVANCE TO CLINICAL PRACTICE: Awareness of the impact of
comorbidities in developing post-operative delirium may help healthcare
providers to plan and implement proper care management among older adult
cardiac surgical patients with comorbidities.<br/>Copyright &#xa9; 2022
John Wiley & Sons Ltd.

<26>
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. 8(5) (pp 980-988), 2023. Date of
Publication: May 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. <br/>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. <br/>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. <br/>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.<br/>Copyright &#xa9; 2023 International Society of Nephrology

<27>
Accession Number
2017201609
Title
Cerebral Embolic Protection during Transcatheter Aortic Valve
Implantation: Updated Systematic Review and Meta-Analysis.
Source
Current Problems in Cardiology. 48(6) (no pagination), 2023. Article
Number: 101127. Date of Publication: June 2023.
Author
Zahid S.; Ullah W.; Zia Khan M.; Faisal Uddin M.; Rai D.; Abbas S.; Usman
Khan M.; Hussein A.; Salama A.; Bandyopadhyay D.; Baibhav B.; Rao M.; Alam
M.; Alraies M.C.; Balla S.; Alkhouli M.; Depta J.P.
Institution
(Zahid, Faisal Uddin, Rai, Hussein, Salama, Baibhav, Rao, Depta)
Sands-Constellation Heart Institute, Rochester General Hospital,
Rochester, NY, United States
(Ullah, Usman Khan) Department of Cardiovascular Medicine, Thomas
Jefferson University Hospitals, Philadelphia, PA, United States
(Zia Khan, Balla) Division of Cardiovascular Medicine, West Virginia
University Heart & Vascular Institute, Morgantown, WV, United States
(Abbas) Department of Medicine, Dow Medical College, Karachi, Pakistan
(Bandyopadhyay) Division of Cardiovascular Medicine, Westchester Medical
Center at New York Medical College, Valhalla, New York, NY, United States
(Alam) Division of Cardiology, Baylor College of Medicine, Houston, TX,
United States
(Alraies) Division of Cardiology, Detroit Medical Center, Detroit, MI,
United States
(Alkhouli) Division of Interventional Cardiology, Mayo Clinic, Rochester,
MN, United States
Publisher
Elsevier Inc.
Abstract
In patient undergoing transcatheter aortic valve implantation (TAVI),
stroke remains a potentially devastating complication associated with
significant morbidity, and mortality. To reduce the risk of stroke,
cerebral protection devices (CPD) were developed to prevent debris from
embolizing to the brain during TAVI. We performed a systematic review and
meta-analysis to determine the safety and efficacy of CPD in TAVI. The
MEDLINE (PubMed, Ovid) and Cochrane databases were queried with various
combinations of medical subject headings to identify relevant articles.
Statistical analysis was performed using a random-effects model to
calculate unadjusted odds ratio (OR), including subgroup analyses based on
follow-up duration, study design, and type of CPD. Using a pooled
analysis, CPD was associated with a significant reduction in major adverse
cardiovascular events MACE (OR 0.75, 95% CI 0.70-0.81, P < 0.01),
mortality (OR 0.65, 95% CI 0.58-0.74, P < 0.01) and stroke (OR 0.84, 95%
CI 0.76-0.93, P < 0.01) in patients undergoing TAVI. Similarly, on MRI
volume per lesion were lower for patients with CPD use. No significant
difference was observed in acute kidney injury (OR 0.75, 95% CI 0.42-1.37,
P = 0.68), bleeding (OR 0.92, 95% CI 0.71-1.20, P = 0.55) or vascular
complications (OR 0.90, 95% CI 0.62-1.31, P = 0.6) for patients undergoing
TAVI with CPD. In conclusion, CPD device use in TAVI is associated with a
reduction of MACE, mortality, and stroke compared with patients undergoing
TAVI without CPD. However, the significant reduction in mortality is
driven mainly by observational studies.<br/>Copyright &#xa9; 2022 Elsevier
Inc.

<28>
Accession Number
2022706885
Title
Iron metabolism-related indicators as predictors of the incidence of acute
kidney injury after cardiac surgery: a meta-analysis.
Source
Renal Failure. 45(1) (no pagination), 2023. Article Number: 2201362. Date
of Publication: 2023.
Author
Zhao L.; Yang X.; Zhang S.; Zhou X.
Institution
(Zhao) The Fifth Clinical Medical College of Shanxi Medical University,
Shanxi, Taiyuan, China
(Yang) Department of Microbiology and Immunology, School of Basic
Medicine, Shanxi Medical University, Shanxi, Taiyuan, China
(Zhang) Fourth People's Hospital of Taiyuan, Shanxi, Taiyuan, China
(Zhou) Department of Nephrology, Shanxi Provincial People's Hospital, The
Fifth Clinical Medical College of Shanxi Medical University, Shanxi,
Taiyuan, China
Publisher
Taylor and Francis Ltd.
Abstract
Background: Some studies have found that ferroptosis plays an important
role in the incidence of acute kidney injury (AKI) after cardiac surgery.
However, whether iron metabolism-related indicators can be used as
predictors of the incidence of AKI after cardiac surgery remains unclear.
<br/>Objective(s): We aimed to systematically evaluate whether iron
metabolism-related indicators can be used as predictors of the incidence
of AKI after cardiac surgery via meta-analysis. <br/>Search Method(s): The
PubMed, Embase, Web of Science, and Cochrane Library databases were
searched from January 1971 to February 2023 to identify prospective
observational and retrospective observational studies examining iron
metabolism-related indicators and the incidence of AKI after cardiac
surgery among adults. Data Extraction and Synthesis: The following data
were extracted by two independent authors (ZLM and YXY): date of
publication, first author, country, age, sex, number of included patients,
iron metabolism-related indicators, outcomes of patients, patient types,
study types, sample, and specimen sampling time. The level of agreement
between authors was determined using Cohen's kappa value. The
Newcastle-Ottawa Scale (NOS) was used to evaluate the quality of studies.
Statistical heterogeneity across the studies was measured by the
I² statistic. The standardized mean difference (SMD) and 95%
confidence interval (CI) were used as effect size measures. Meta-analysis
was performed using Stata 15. <br/>Result(s): After applying the inclusion
and exclusion criteria, 9 articles on iron metabolism-related indicators
and the incidence of AKI after cardiac surgery were included in this
study. Meta-analysis revealed that after cardiac surgery, baseline serum
ferritin (mug/L) (I² = 43%, fixed effects model, SMD = -0.3,
95% CI:-0.54 to -0.07, p = 0.010), preoperative and 6-hour postoperative
fractional excretion (FE) of hepcidin (%) (I² = 0.0%, fixed
effects model, SMD = -0.41, 95% CI: -0.79 to -0.02, p = 0.038;
I² = 27.0%, fixed effects model, SMD = -0.49, 95% CI: -0.88 to
-0.11, p = 0.012), 24-hour postoperative urinary hepcidin (mug/L)
(I² = 0.0%, fixed effects model, SMD = -0.60, 95% CI: -0.82 to
-0.37, p < 0.001) and urine hepcidin/urine creatinine ratio (mug/mmoL)
(I² = 0.0%, fixed effects model, SMD = -0.65, 95% CI: -0.86 to
-0.43, p < 0.001) were significantly lower in patients who developed to
AKI than in those who did not. <br/>Conclusion(s): After cardiac surgery,
patients with lower baseline serum ferritin levels (mug/L), lower
preoperative and 6-hour postoperative FE of hepcidin (%), lower 24-hour
postoperative hepcidin/urine creatinine ratios (mug/mmol) and lower
24-hour postoperative urinary hepcidin levels (mug/L) are more likely to
develop AKI. Therefore, these parameters have the potential to be
predictors for AKI after cardiac surgery in the future. In addition, there
is a need for relevant clinical research of larger scale and with multiple
centers to further test these parameters and prove our conclusion. Trial
Registration: PROSPERO identifier: CRD42022369380.<br/>Copyright &#xa9;
2023 The Author(s). Published by Informa UK Limited, trading as Taylor &
Francis Group.

<29>
Accession Number
2022632120
Title
High-flow nasal oxygen vs. standard oxygen therapy for patients undergoing
transcatheter aortic valve replacement with conscious sedation: a
randomised controlled trial.
Source
Perioperative Medicine. 12(1) (no pagination), 2023. Article Number: 11.
Date of Publication: December 2023.
Author
Scheuermann S.; Tan A.; Govender P.; Mckie M.; Pack J.; Martinez G.;
Falter F.; George S.; A. Klein A.
Institution
(Scheuermann, Tan, Govender, Pack, Martinez, Falter, George, A. Klein)
Department of Anaesthesia and Intensive Care, Royal Papworth Hospital,
Cambridge, United Kingdom
(Mckie) MRC Biostatistics Unit, University of Cambridge, Cambridge, United
Kingdom
Publisher
BioMed Central Ltd
Abstract
Background: Minimally invasive surgery is becoming more common and
transfemoral transcatheter aortic valve replacement is offered to older
patients with multiple comorbidities. Sternotomy is not required but
patients must lie flat and still for up to 2-3 h. This procedure is
increasingly being performed under conscious sedation with supplementary
oxygen, but hypoxia and agitation are commonly observed. <br/>Method(s):
In this randomised controlled trial, we hypothesised that high-flow nasal
oxygen would provide superior oxygenation as compared with our standard
practice, 2 l min^-1 oxygen by dry nasal specs. This was
administered using the Optiflow THRIVE Nasal High Flow delivery system
(Fisher and Paykel, Auckland, New Zealand) at a flow rate of 50 l
min^-1 and FiO<inf>2</inf> 0.3. The primary endpoint was the
change in arterial partial pressure of oxygen (pO<inf>2</inf>) during the
procedure. Secondary outcomes included the incidence of oxygen
desaturation, airway interventions, the number of times the patient
reached for the oxygen delivery device, incidence of cerebral
desaturation, peri-operative oxygen therapy duration, hospital length of
stay and patient satisfaction scores. <br/>Result(s): A total of 72
patients were recruited. There was no difference in change in
pO<inf>2</inf> from baseline using high-flow compared with standard oxygen
therapy: median [IQR] increase from 12.10 (10.05-15.22 [7.2-29.8]) to
13.69 (10.85-18.38 [8.5-32.3]) kPa vs. decrease from 15.45 (12.17-19.33
[9.2-22.8]) to 14.20 (11.80-19.40 [9.7-35.1]) kPa, respectively. The
percentage change in pO2 after 30 min was also not significantly different
between the two groups (p = 0.171). There was a lower incidence of oxygen
desaturation in the high-flow group (p = 0.027). Patients in the high-flow
group assigned a significantly higher comfort score to their treatment (p
<= 0.001). <br/>Conclusion(s): This study has demonstrated that high flow,
compared with standard oxygen therapy, does not improve arterial
oxygenation over the course of the procedure. There are suggestions that
it may improve the secondary outcomes studied. Trial registration:
International Standard Randomised Controlled Trial Number (ISRCTN)
13,804,861. Registered on 15 April 2019.
https://doi.org/10.1186/ISRCTN13804861<br/>Copyright &#xa9; 2023, The
Author(s).

<30>
Accession Number
2022631906
Title
Propofol and survival: an updated meta-analysis of randomized clinical
trials.
Source
Critical Care. 27(1) (no pagination), 2023. Article Number: 139. Date of
Publication: December 2023.
Author
Kotani Y.; Pruna A.; Turi S.; Borghi G.; Lee T.C.; Zangrillo A.; Landoni
G.; Pasin L.
Institution
(Kotani, Pruna, Turi, Borghi, Zangrillo, Landoni) Department of Anesthesia
and Intensive Care, San Raffaele Hospital, IRCCS San Raffaele Scientific
Institute, Via Olgettina, Milan 60-20132, Italy
(Kotani, Zangrillo, Landoni) School of Medicine, Vita-Salute San Raffaele
University, Milan, Italy
(Kotani) Department of Intensive Care Medicine, Kameda Medical Center,
Kamogawa, Japan
(Lee) Division of Infectious Diseases, Department of Medicine, McGill
University, Montreal, QC, Canada
(Pasin) Anesthesia and Intensive Care Unit, Padua University Hospital,
Padua, Italy
Publisher
BioMed Central Ltd
Abstract
Background: Propofol is one of the most widely used hypnotic agents in the
world. Nonetheless, propofol might have detrimental effects on clinically
relevant outcomes, possibly due to inhibition of other interventions'
organ protective properties. We performed a systematic review and
meta-analysis of randomized controlled trials to evaluate if propofol
reduced survival compared to any other hypnotic agent in any clinical
setting. <br/>Method(s): We searched eligible studies in PubMed, Google
Scholar, and the Cochrane Register of Clinical Trials. The following
inclusion criteria were used: random treatment allocation and comparison
between propofol and any comparator in any clinical setting. The primary
outcome was mortality at the longest follow-up available. We conducted a
fixed-effects meta-analysis for the risk ratio (RR). Using this RR and 95%
confidence interval, we estimated the probability of any harm (RR > 1)
through Bayesian statistics. We registered this systematic review and
meta-analysis in PROSPERO International Prospective Register of Systematic
Reviews (CRD42022323143). <br/>Result(s): We identified 252 randomized
trials comprising 30,757 patients. Mortality was higher in the propofol
group than in the comparator group (760/14,754 [5.2%] vs. 682/16,003
[4.3%]; RR = 1.10; 95% confidence interval, 1.01-1.20; p = 0.03;
I² = 0%; number needed to harm = 235), corresponding to a 98.4%
probability of any increase in mortality. A statistically significant
mortality increase in the propofol group was confirmed in subgroups of
cardiac surgery, adult patients, volatile agent as comparator, large
studies, and studies with low mortality in the comparator arm.
<br/>Conclusion(s): Propofol may reduce survival in perioperative and
critically ill patients. This needs careful assessment of the risk versus
benefit of propofol compared to other agents while planning for large,
pragmatic multicentric randomized controlled trials to provide a
definitive answer. Graphical Abstract: [Figure not available: see
fulltext.]<br/>Copyright &#xa9; 2023, The Author(s).

<31>
Accession Number
2024078542
Title
Transcatheter vs Surgical Aortic Valve Replacement Outcomes Among Solid
Organ Transplant Patients: A Systematic Review and Meta-Analysis.
Source
Current Problems in Cardiology. 48(8) (no pagination), 2023. Article
Number: 101685. Date of Publication: August 2023.
Author
Jaiswal V.; Ang S.P.; Ishak A.; Joshi A.; Chia J.E.; Kalra K.; Attia A.M.;
Sharma P.; Biswas M.; Grubb K.J.
Institution
(Jaiswal, Joshi) Department of Cardiovascular Research, Larkin Community
Hospital, South Miami, FL, United States
(Ang) Department of Internal Medicine, Rutgers Health/Community Medical
Center, NJ, United States
(Ishak) Department of Research and Academic affairs, Larkin Community
Hospital, South Miami, FL, United States
(Chia) Department of Medicine, International Medical University, Malaysia
(Kalra) Department of Cardiology, Medstar Washington Hospital Center, WD
(Attia) Department of Medicine, Cairo University, Egypt
(Sharma) Department of Cardiology, King George's Medical University, Uttar
Pradesh, Lucknow, India
(Biswas) General Cardiology & Advanced Heart Failure, Wellspan Cardiology,
Lancaster, Pennsylvania, USA & University of Maryland Medical Center,
Baltimore, MD, United States
(Grubb) Division of Cardiothoracic Surgery, Department of Surgery, Emory
University School of Medicine, Atlanta, GA, United States
Publisher
Elsevier Inc.
Abstract
The safety and clinical outcomes of transcatheter aortic valve replacement
(TAVR) compared to surgical aortic valve replacement (SAVR) among patients
with solid organ transplants is not well understood. This study aimed to
evaluate the clinical outcomes of TAVR and SAVR among patients with a
history of solid organ transplantation. We performed a systematic
literature search of databases for relevant articles from inception until
May 1st, 2022. Unadjusted odds ratios (OR) were pooled using a
random-effect model, and a P-value of <0.05 was considered statistically
significant. A total of 3240 studies were identified of which 3 studies
with a total of 2960 patients were included in the final analysis. For
solid organ transplants patients, the odds of in-hospital mortality (OR
0.37, 95% CI 0.20-0.71, P < 0.001), 30-day mortality (OR 0.51, 95% CI
0.35-0.74, P < 0.001), acute kidney injury (OR 0.45, 95% CI 0.35-0.59, P <
0.001), and bleeding (OR 0.35, 95% CI 0.27-0.46, P < 0.001) were
significantly lower in patients undergoing TAVR compared to SAVR. In
contrast, the odds of pacemaker implantation (OR 2.60, 95% CI 0.36-18.90,
P = 0.34), postprocedural stroke (OR 0.36, 95% CI 0.13-1.03, P = 0.06)
were similar between both groups of patients. Length of hospital stay was
significantly lower in TAVR compared to SAVR patients (SMD -0.82, 95% CI
-0.95 to -0.70, P < 0.001). In solid organ transplant patients, TAVR
appeared to be a safe procedure with fewer postprocedure complications,
shorter length of hospital stay, and lower in hospital mortality compared
with SAVR.<br/>Copyright &#xa9; 2023 Elsevier Inc.

<32>
Accession Number
2024054974
Title
Comparative Efficacy of Adjuvant Nonopioid Analgesia in Adult Cardiac
Surgical Patients: A Network Meta-Analysis.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2023.
Date of Publication: 2023.
Author
Heybati K.; Zhou F.; Lynn M.J.; Deng J.; Ali S.; Hou W.; Heybati S.;
Tzanis K.; Krever M.; Mughal R.; Ramakrishna H.
Institution
(Heybati) Mayo Clinic Alix School of Medicine, Mayo Clinic - Rochester,
Rochester, MN, United States
(Zhou, Lynn, Deng, Ali, Hou, Mughal) Faculty of Health Sciences, McMaster
University, Hamilton, ON, Canada
(Lynn) Faculty of Medicine, University of British Columbia, Vancouver, BC,
Canada
(Deng) Temerty Faculty of Medicine, University of Toronto, Toronto, ON,
Canada
(Ali) Michael G. DeGroote School of Medicine, McMaster University,
Hamilton, ON, Canada
(Hou, Mughal) Schulich School of Medicine & Dentistry, University of
Western Ontario, London, ON, Canada
(Heybati) Faculty of Science, Queen's University, Kingston, ON, Canada
(Tzanis) Faculty of Science, University of Toronto, Toronto, ON, Canada
(Krever) Faculty of Science, Wilfrid Laurier University, Waterloo, ON,
Canada
(Ramakrishna) Department of Anesthesiology and Perioperative Medicine,
Mayo Clinic, Rochester, MN, United States
Publisher
W.B. Saunders
Abstract
Objectives: To compare the relative efficacy of adjuvant nonopioid
analgesic regimens in adult cardiac surgical patients. <br/>Design(s):
This frequentist, random-effects network meta-analysis (NMA) was
prospectively registered on PROSPERO (CRD42021282913) and conducted
according to the Preferred Reporting Items for Systematic Review and
Meta-Analyses for Network Meta-Analyses (PRISMA-NMA). The risk of bias
(RoB) and confidence of evidence were assessed by RoB 2 and Confidence in
Network Meta-Analysis, respectively. Relevant databases were searched from
inception to October 9, 2021. <br/>Setting(s): A total of 124 (N = 26,257)
randomized controlled trials were included, of which 110 were analyzed.
<br/>Participant(s): Trials enrolling adults (>=18 years of age)
undergoing cardiac surgery that compared nonopioid analgesics against
other nonopioid analgesics, placebo, or no additional treatment, as
adjuvants to standard analgesic management, and reported at least 1 of the
outcomes of interest. Measurement and Main Results: Outcomes of interest
included resting postoperative pain scores at 24 hours. Compared with
standard care and/or placebo, pain scores were reduced significantly by 10
different regimens, including acetaminophen (N = 176; mean difference [MD]
-0.66 points, 95% CI -1.16 to -0.15 points; high confidence), magnesium (N
= 323; -0.05 points, 95% CI -0.07 to -0.02 points; high confidence),
gabapentin (N = 96; MD -0.40 points, 95% CI -0.71 to -0.09; moderate
confidence), and clonidine (N = 64; MD v0.38 points, 95% CI -0.73 to v0.04
points; moderate confidence). Indomethacin, diclofenac, magnesium, and
gabapentin significantly reduced 24-hour opioid consumption. Four regimens
significantly decreased the intensive care unit length of stay.
Hydrocortisone, dexmedetomidine, and clonidine significantly decreased the
duration of mechanical ventilation. Magnesium decreased, while
methylprednisolone significantly increased, the risk of myocardial
infarction. <br/>Conclusion(s): Given the increasing emphasis on enhanced
recovery after surgery(ERAS) protocols and the eventual goal of limiting
opiate prescriptions postoperatively, the authors' data suggested far
greater use of nonopioid adjuncts to minimize pain and enhance recovery
following cardiac surgery.<br/>Copyright &#xa9; 2023 Elsevier Inc.

<33>
Accession Number
2022651685
Title
Computed tomography-derived membranous septum length as predictor of
conduction abnormalities and permanent pacemaker implantation after TAVI:
A meta-analysis of observational studies.
Source
Catheterization and Cardiovascular Interventions. (no pagination), 2023.
Date of Publication: 2023.
Author
Michel Pompeu S.a.; Van den Eynde J.; Jacquemyn X.; Erten O.; Rodriguez
R.; Goldman S.; Coady P.M.; Gnall E.; Gray W.A.; Jarrett H.; Abramson
S.V.; Clavel M.-A.; Pibarot P.; Ramlawi B.
Institution
(Michel Pompeu, Rodriguez, Goldman, Ramlawi) Department of Cardiothoracic
Surgery, Lankenau Medical Center, Lankenau Heart Institute, Main Line
Health, Wynnewood, PA, United States
(Michel Pompeu, Erten, 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
(Coady, Gnall, Gray) Department of Interventional Cardiology, Lankenau
Medical Center, Lankenau Heart Institute, Main Line Health, Wynnewood, PA,
United States
(Jarrett, Abramson) Department of Cardiovascular Imaging, Lankenau Medical
Center, Lankenau Heart Institute, Main Line Health, Wynnewood, PA, United
States
(Clavel, Pibarot) Centre de Recherche de l'Institut Universitaire de
Cardiologie et de Pneumologie de Quebec, Quebec City, QC, Canada
(Clavel, Pibarot) Department of Medicine, Faculty of Medicine, Universite
Laval, Quebec City, QC, Canada
Publisher
John Wiley and Sons Inc
Abstract
Background: Permanent pacemaker implantation (PPI) after transcatheter
aortic valve implantation (TAVI) is associated with higher risk of
mortality and rehospitalization for heart failure. Efforts to prevent
conduction abnormalities (CA) requiring PPI after TAVI should be made. The
membranous septum (MS) length and its interaction with implantation depth
(ID-DELTAMSID) could provide useful information about the risk of CA/PPI
following TAVI. <br/>Objective(s): To identify MS length and DELTAMSID as
predictors of CA/PPI following TAVI. <br/>Method(s): Study-level
meta-analysis of studies published by September 30, 2022. <br/>Result(s):
Eighteen studies met our eligibility including 5740 patients. Shorter MS
length was associated with a significantly higher risk of CA/PPI (per 1 mm
decrease: odds ratio [OR] 1.60, 95% confidence interval [CI] 1.28-1.99, p
< 0.001). Similarly, lower DELTAMSID was associated with a significantly
higher risk of CA/PPI (per 1 mm decrease: OR 1.75, 95% CI 1.32-2.31, p <
0.001). Meta-regression analyses revealed a statistically significant
modulation of the effect of shorter MS length and lower DELTAMSID on the
outcome (CA/PPI) by balloon postdilatation (positive regression
coefficients with p < 0.001); with increasing use of balloon
postdilatation, the effect of shorter MS length and lower DELTAMSID on the
outcome increased. MS length and DELTAMSID demonstrated excellent
discriminative abilities, with diagnostic ORs equaling 9.49 (95% CI
4.73-19.06), and 7.19 (95% CI 3.31-15.60), respectively.
<br/>Conclusion(s): Considering that short MS length and low DELTAMSID are
associated with higher risk of CA and PPI, we should include measurement
of MS length in the pre-TAVI planning with MDCT and try to establish
optimal ID values before the procedure to avoid CA/PPI.<br/>Copyright
&#xa9; 2023 Wiley Periodicals LLC.

<34>
Accession Number
2021964765
Title
Effect of transverse thoracic muscle plane block on postoperative
cognitive dysfunction after open cardiac surgery: A randomized clinical
trial.
Source
Journal of Cellular and Molecular Medicine. 27(7) (pp 976-981), 2023. Date
of Publication: April 2023.
Author
Chen S.; Zhang H.; Zhang Y.
Institution
(Chen, Zhang) Department of Anesthesiology, First Affiliated Hospital of
Nanchang University, Nanchang, China
(Zhang) Department of Anesthesiology, Nanchang Hongdu Hospital of TCM,
Nanchang, China
Publisher
John Wiley and Sons Inc
Abstract
The transversus thoracis muscle plane (TTMP) block provides effective
analgesia in cardiac surgery patients. The aim of this study was to assess
whether bilateral TTMP blocks can reduce the incidence of postoperative
cognitive dysfunction (POCD) in patients undergoing cardiac valve
replacement. A group of 103 patients were randomly divided into the TTM
group (n = 52) and the PLA (placebo) group (n = 51). The primary endpoint
was the incidence of POCD at 1 week after surgery. Secondary outcome
measures included a reduction of intraoperative mean arterial pressure
(MAP) >20% from baseline, intraoperative and postoperative sufentanil
consumption, length of stay in the ICU, incidence of postoperative nausea
and vomiting (PONV), time to first faeces, postoperative pain at 24 h
after surgery, time to extubation and the length of hospital stay.
Interleukin (IL)-6, TNF-alpha, S-100beta, insulin, glucose and insulin
resistance were measured at before induction of anaesthesia, 1, 3and 7
days after surgery. The MoCA scores were significantly lower and the
incidence of POCD decreased significantly in TTM group compared with PLA
group at 7 days after surgery. Perioperative sufentanil consumption, the
incidence of PONV and intraoperative MAP reduction >20% from baseline,
length of stay in the ICU, postoperative pain at 24 h after surgery, time
to extubation and the length of hospital stay were significantly decreased
in the TTM group. Postoperatively, IL-6, TNF-alpha, S-100beta, HOMA-IR,
insulin, glucose levels increased and the TTM group had a lower degree
than the PLA group at 1, 3 and 7 days after surgery. In summary, bilateral
TTMP blocks could improve postoperative cognitive function in patients
undergoing cardiac valve replacement.<br/>Copyright &#xa9; 2023 The
Authors. Journal of Cellular and Molecular Medicine published by
Foundation for Cellular and Molecular Medicine and John Wiley & Sons Ltd.

<35>
Accession Number
2021953466
Title
Reducing cardiovascular risk with immunomodulators: A randomised active
comparator trial among patients with rheumatoid arthritis.
Source
Annals of the Rheumatic Diseases. 82(3) (pp 324-330), 2023. Date of
Publication: March 2023.
Author
Solomon D.H.; Giles J.T.; Liao K.P.; Ridker P.M.; Rist P.M.; Glynn R.J.;
Broderick R.; Lu F.; Murray M.T.; Vanni K.; Santacroce L.M.; Abohashem S.;
Robson P.M.; Fayad Z.; Mani V.; Tawakol A.; Bathon J.
Institution
(Solomon, Liao, Ridker, Rist, Glynn, Lu, Murray, Vanni, Santacroce)
Brigham and Women's Hospital, Boston, MA, United States
(Giles, Broderick, Bathon) Columbia University Medical Center, New York,
NY, United States
(Abohashem, Tawakol) Massachusetts General Hospital, Boston, MA, United
States
(Robson, Fayad, Mani) Mount Sinai Medical Center, New York, NY, United
States
Publisher
BMJ Publishing Group
Abstract
Objective Recent large-scale randomised trials demonstrate that
immunomodulators reduce cardiovascular (CV) events among the general
population. However, it is uncertain whether these effects apply to
rheumatoid arthritis (RA) and if certain treatment strategies in RA reduce
CV risk to a greater extent. Methods Patients with active RA despite use
of methotrexate were randomly assigned to addition of a tumour necrosis
factor (TNF) inhibitor (TNFi) or addition of sulfasalazine and
hydroxychloroquine (triple therapy) for 24 weeks. Baseline and follow-up
18 F-fluorodeoxyglucose-positron emission tomography/CT scans were
assessed for change in arterial inflammation, an index of CV risk,
measured as an arterial target-to-background ratio (TBR) in the carotid
arteries and aorta. Results 115 patients completed the protocol. The two
treatment groups were well balanced with a median age of 58 years, 71%
women, 57% seropositive and a baseline disease activity score in 28 joints
of 4.8 (IQR 4.0, 5.6). Baseline TBR was similar across the two groups.
Significant TBR reductions were observed in both groups - DELTATNFi: -0.24
(SD=0.51), DELTAtriple therapy: -0.19 (SD=0.51) - without difference
between groups (difference in DELTAs: -0.02, 95% CI -0.19 to 0.15,
p=0.79). While disease activity was significantly reduced across both
treatment groups, there was no association with change in TBR (beta=0.04,
95% CI -0.03 to 0.10). Conclusion We found that addition of either a TNFi
or triple therapy resulted in clinically important improvements in
vascular inflammation. However, the addition of a TNFi did not reduce
arterial inflammation more than triple therapy. Trial registration number
NCT02374021.<br/>Copyright &#xa9; 2023 Authors. All rights reserved.

<36>
Accession Number
2016834677
Title
Postoperative Quality of Life After Full-sternotomy and Ministernotomy
Aortic Valve Replacement.
Source
Annals of Thoracic Surgery. 115(5) (pp 1189-1196), 2023. Date of
Publication: May 2023.
Author
Perrotti A.; Francica A.; Monaco F.; Quintana E.; Sponga S.; El-Dean Z.;
Salizzoni S.; Loizzo T.; Salsano A.; Di Cesare A.; Benassi F.; Castella
M.; Rinaldi M.; Chocron S.; Vendramin I.; Faggian G.; Santini F.; Nicolini
F.; Milano A.D.; Ruggieri V.G.; Onorati F.
Institution
(Perrotti, Monaco, Chocron) Department of Thoracic and Cardiovascular
Surgery, University of Franche-Comte, Besancon, France
(Francica, Faggian, Onorati) Division of Cardiac Surgery, University of
Verona Medical School, Verona, Italy
(Quintana, Castella) Division of Cardiac Surgery, Hospital Clinic,
University of Barcelona Medical School, Barcelona, Spain
(Sponga, Vendramin) Division of Cardiac Surgery, Udine University
Hospital, Udine, Italy
(El-Dean) Department of Cardiac Surgery, Glenfield Hospital, University
Hospitals of Leicester, Leicester, United Kingdom
(Salizzoni, Rinaldi) Department of Cardiac Surgery, Citta della Salute e
della Scienza, University of Turin Medical School, Turin, Italy
(Loizzo, Milano) Cardiac Surgery Unit, Department of Emergency and Organ
Transplants, Bari, Italy
(Salsano, Santini) Division of Cardiac Surgery, IRCCS San Martino
Polyclinic Hospital, University of Genova, Genova, Italy
(Di Cesare, Ruggieri) Cardiovascular and Thoracic Surgery Unit, Robert
Debre University Hospital, Reims, France
(Di Cesare, Ruggieri) University of Reims Champagne-Ardennes, Reims,
France
(Benassi, Nicolini) Department of Medicine and Surgery, University of
Parma, Parma, Italy
Publisher
Elsevier Inc.
Abstract
Background: Few longitudinal data exist comparing quality of life (QoL)
after full sternotomy (fs) aortic valve replacement (AVR) (fsAVR) with
ministernotomy AVR (msAVR). <br/>Method(s): A total of 1844 consecutive
patients undergoing AVR who were prospectively enrolled in a European
multicenter registry were dichotomized according to surgical access.
Nonparsimonious propensity score matching selected 187 pairs of patients
who underwent fsAVR or msAVR with comparable baseline characteristics.
Hospital outcome was compared in the 2 groups. QoL was assessed with the
Short Form-36, further detailed in its Physical Component Summary (PCS)
score and the Mental Component Summary (MCS) score. QoL was investigated
at hospital admission, at discharge, and at 1 month, 6 months, and 1 year
thereafter. <br/>Result(s): There were 1654 patients undergoing fsAVR and
190 undergoing msAVR in the entire population. The fsAVR group showed a
worse preoperative risk profile, a longer intensive care unit length of
stay (59.7 hours vs 38.8 hours; p =.002), and a higher rate of
life-threatening or disabling bleeding (4.1% vs 0%; P =.011); the msAVR
group had a higher rate of early reintervention for failed index
intervention (2.1% vs 0.5%; P =.001). QoL investigations showed better PCS
and MCS at 1 month after fsAVR, but no temporal trend differences (PCS
group-time P =.202; MCS group-time P =.141). Propensity-matched pairs
showed comparable baseline characteristics and hospital outcomes (P = not
significant for all end points) and comparable improvements of PCS and MCS
over time, but no between-group differences over time (PCS group time P
=.834; MCS group time P =.737). <br/>Conclusion(s): Patients with similar
baseline profiles report comparable hospital outcomes and comparable
improvements of physical and mental health, up to 1 year after surgery,
with both fsAVR and msAVR. As for QoL, ministernotomy does not seem to
offer any advantage compared with the traditional approach.<br/>Copyright
&#xa9; 2023 The Society of Thoracic Surgeons

<37>
Accession Number
2023698216
Title
Effects of Percutaneous Coronary Intervention and Coronary Artery Bypass
Grafting on Clinical Outcomes in Patients with Reduced Ejection Fraction
Heart Failure and Coronary Heart Disease: A Meta-Analysis.
Source
Heart Surgery Forum. 26(1) (pp E62-E73), 2023. Date of Publication: 2023.
Author
Yu Z.-X.; Yan J.; Wang M.-Y.; Chen R.; Luo J.-Y.; Li X.-M.; Xie X.; Ma
Y.-T.
Institution
(Yu, Yan, Wang, Chen, Luo, Li, Xie, Ma) Department of Cardiology, Heart
Center, The First Affiliated Hospital of Xinjiang Medical University,
Urumqi, China
Publisher
Forum Multimedia Publishing LLC
Abstract
Objective: To clarify the effects of percutaneous coronary intervention
(PCI) and coronary artery bypass grafting (CABG) on the clinical outcomes
of patients with coronary heart disease (CHD) complicated with reduced
ejection fraction heart failure (HFrEF) through meta-analysis.
<br/>Method(s): Three major literature databases - PubMed, Web of Science,
and Cochrane - were searched by search terms and the literature retrieval
time was publications dating from January 2007 to December 2021. To search
for observational studies and randomized controlled trials (RCT) comparing
the efficacy of PCI and CABG in patients with CHD and HFrEF, the abstract
or full text of the literature was read and the final included literature
was determined, according to inclusion and exclusion criteria. The quality
of the included literature was evaluated using the Ottawa scale and data
extraction was further completed. Data analysis was made using RevMan5.4
and R4.1 software; relevant forest plots and funnel plots were made,
according to the extracted data. Egger's test was used to evaluate whether
the data had publication bias. Outcomes were the major adverse
cardiovascular events (MACE). <br/>Result(s): A total of 10 studies were
included and 11, 032 subjects were included, made up of 5, 521 cases of
PCI and 5, 511 cases of CABG. The results showed no significant difference
between the two groups in cardiac mortality (CM) (RR=1.13, 95% CI
0.98-1.30, P = 0.10) and in overall all-cause mortality (ACM) (RR=1.12,
95% CI 0.92-1.37, P = 0.25). In the subgroup analysis of ACM, in the
subgroups with left ventricular ejection fraction (LVEF) less than 35% and
exceeding 35% and less than 50% (RR=1.12, 95% CI 0.92-1.37, P = 0.25)
between the two groups, there was no statistical difference. However,
among other MACE, compared with the PCI group, the CABG group had a lower
risk of MACE (RR=1.58, 95%CI 1.49-1.70, P < 0.00001), myocardial
infarction (MI) (RR=1.99, 95% CI 1.02-3.88, P = 0.04), heart failure (HF)
(RR=1.29, 95% CI 1.17-1.43, P < 0.00001) and revascularization (RR=2.74,
95% CI 1.93-3.90, P < 0.00001). Finally in the CABG group, the risk of
stroke or transient ischemic attack (TIA) was higher (RR=0.71, 95% CI
0.58-0.86, P = 0.0006) than the PCI group. <br/>Conclusion(s): The
mortality rates of PCI and CABG were similar in patients with CHD
complicated with HFrEF. Compared with PCI, CABG had a lower incidence of
MACE, MI, HF, and revascularization, and a higher incidence of stroke or
TIA.<br/>Copyright &#xa9; 2022 Forum Multimedia Publishing, LLC.

<38>
Accession Number
2023793537
Title
A Systematic Review on PETTICOAT and STABILISE Techniques for the
Management of Complicated Acute Type B Aortic Dissection.
Source
Reviews in Cardiovascular Medicine. 24(2) (no pagination), 2023. Article
Number: A30. Date of Publication: February 2023.
Author
Nana P.; Kouvelos G.; Behrendt C.-A.; Giannoukas A.; Kolbel T.; Spanos K.
Institution
(Nana, Kouvelos, Giannoukas, Spanos) Vascular Surgery Department, Larissa
University Hospital, Faculty of Medicine, University of Thessaly, Larissa
41110, Greece
(Behrendt, Kolbel, Spanos) German Aortic Center, Department of Vascular
Medicine, University Heart and Vascular Center UKE Hamburg, Hamburg 20251,
Germany
Publisher
IMR Press Limited
Abstract
Background: Extended downstream endovascular management has been applied
in acute complicated type B aortic dissection (acTBAD), distally to
standard thoracic endovascular aortic repair (TEVAR), using bare metal
stents, with or without lamina disruption, using balloon inflation. The
aim of this systematic review was to assess technical success, 30-day
mortality, and mortality during followup in patients with acTBAD managed
with the Provisional Extension To Induce Complete Attachment (PETTICOAT)
or stent-assisted balloon-induced intimal disruption and relamination
(STABILISE) technique. <br/>Method(s): The Preferred Reporting Items for
Systematic Reviews and Meta-analyses (PRISMA) 2020 statement was followed.
A search of the English literature, via Ovid, using MEDLINE, EMBASE, and
CENTRAL databases, until 30th August 2022, was executed. Randomized
controlled trials and observational studies (published between 2000-2022),
with >=5 patients, reporting on technical success, 30-day mortality and
mortality during the available follow-up among patients that underwent
PETTICOAT or STABILISE technique for acTBAD were eligible. The
Newcastle-Ottawa Scale was applied to assess the risk of bias. Primary
outcomes were technical success and 30-day mortality, and secondary
outcome was mortality during the available follow-up. <br/>Result(s):
Thirteen studies were considered eligible, twelve in the quantitative
analysis. In total, 418 patients with acTBAD managed with the PETTICOAT
(83%) or STABILISE (17%) technique were included. Technical success ranged
between 97-100%, 99% for the PETTICOAT and 100% for the STABILISE
sub-cohort. Thirty-day mortality was estimated at 3.7% (12/321), 1.4% for
the STABILISE and 4.4% for the PETTICOAT technique. All studies reported
the mean available follow-up which was estimated at 20 months (range 3-168
months), 22 months (mean value) for the PETTICOAT and 17 months (mean
value) for the STABILISE technique. Twenty-three patients died during
follow-up, with an estimated mortality rate at 5.7% for the total cohort.
The mortality during follow-up was 0% for the STABILISE and 7.0% for the
PETTICOAT approach. <br/>Conclusion(s): Both, the PETTICOAT and STABILISE
techniques presented less than 4% perioperative mortality in patients with
acTBAD with high technical success rate. The mid-term mortality rate was
at 6%. However, the heterogeneity in the available studies' highlights the
need for further prospective studies, including larger volume and longer
follow-up.<br/>Copyright &#xa9; 2023 The Author(s).

<39>
Accession Number
2023145140
Title
Optimal Anticoagulation on TAVI Patients Based on Thrombotic and Bleeding
Risk and the Challenge Beyond: A Systematic Review and Meta-Analysis.
Source
Current Problems in Cardiology. 48(6) (no pagination), 2023. Article
Number: 101632. Date of Publication: June 2023.
Author
Tsoumas I.; Oz A.; Lampropoulos K.
Institution
(Tsoumas, Oz, Lampropoulos) European University Cyprus, Nicosia, Cyprus
Publisher
Elsevier Inc.
Abstract
Transcatheter Aortic Valve Replacement (TAVR) has been established as the
treatment of choice for symptomatic aortic stenosis, while it is expanding
in all risk-related group categories of patients, gaining gradually ground
over the surgical approach. However, complications and adverse events are
yet to be effectively limited and diminished with thrombotic and
hemorrhagic events being rooted as a crucial topic of discussion.
Favorable anticoagulation pharmacotherapy options are constantly being
revised and tested, whilst guidelines are being modified to meet current
clinical evidence. This review aims to systematically assess already
existing guidelines on anticoagulation in post-TAVI patients and examine
novel regimens for the specific use, like apixaban, rivaroxaban, and other
anticoagulants, essentially constructing a holistic point of view on
future progress on this matter. The added complexity brought by
coagulation-affecting comorbidities such as atrial fibrillation, coronary
artery disease, and more contributes to the direct association of the
topic to the quality of healthcare as a public service. The literature was
systematically searched to examine the effectiveness and safety of various
anticoagulation treatments and cross-evaluate them based on the according
category of patients that were assigned to. Clinical trials, observational
studies and systematic reviews were included and, eventually, conclusive
remarks and future considerations were developed and presented. In the
category of patients without prior indication to anticoagulation, SAPT was
proven safer and still effective, when antiplatelet therapies were
compared, while a comparison of antiplatelet versus anticoagulation
strategies noted the first one, with limited data, as the optimal one.
Lastly, direct oral anticoagulants were shown to be safe substitutes for
vitamin K antagonists for patients with prior indication to
anticoagulation<br/>Copyright &#xa9; 2023 Elsevier Inc.

<40>
Accession Number
2022789671
Title
Exploring trust development in families of children towards surgical and
emergency care providers: A scoping review of the literature.
Source
Journal of Pediatric Surgery. 58(5) (pp 871-878), 2023. Date of
Publication: May 2023.
Author
Serhan O.; Moise A.; Guadagno E.; Issa A.M.; Poenaru D.
Institution
(Serhan) Faculty of Medicine and Health Sciences, University of
Sherbrooke, Sherbrooke, QC, Canada
(Moise, Poenaru) Faculty of Medicine and Health Sciences, McGill
University, Montreal, QC, Canada
(Guadagno, Poenaru) Harvey E. Beardmore Division of Pediatric Surgery, The
Montreal Children's Hospital, Montreal, QC, Canada
(Issa) Dept of Family Medicine, Faculty of Medicine and Health Sciences,
McGill University, Montreal, QC, Canada
Publisher
W.B. Saunders
Abstract
Background: Trust is central to the therapeutic relationship between
patients and their providers, yet little is known about how it is
developed in the unique context of children facing surgical emergencies.
We sought to identify factors fostering trust development, gaps, and areas
for improvement. <br/>Method(s): We searched eight databases from
inception to June 2021 to identify studies focusing on trust in pediatric
surgical and urgent care settings. PRISMA-ScR protocols were followed, and
screening carried out by two independent reviewers. Data collection
included study characteristics, outcomes, and results. <br/>Result(s): Out
of 5578 articles screened, 12 fulfilled the inclusion criteria. Four major
trust constructs were identified: competence, communication,
dependability, and caring. Despite various instruments used, all studies
reported a high level of parental trust. Nearly all studies (11/12) noted
trust depending on parents' sociodemographic background, with ethnicity
(3/12) and level of education and language barriers (2/12) limiting
parents' confidence in physicians. High trust levels significantly
correlated with effective communication and perceived quality of care.
Most effective interventions enhancing trust included communication and
caring trust constructs (10/12) rather than competence and dependability
(5/12). Parents' individual experiences, development of compassionate
interactions, and practice of family-centered care appeared important in
developing trust. <br/>Conclusion(s): Improving communication and
providing compassionate care, as well as encouraging a patient-centered
approach, appear to be most effective in promoting trust in pediatric
surgical and urgent settings. Our findings can guide future educational
interventions towards strengthening parental trust and promoting child-
and family-centered care in pediatric surgical settings. <br/>Level of
Evidence: 1.<br/>Copyright &#xa9; 2023 Elsevier Inc.

<41>
Accession Number
2022429395
Title
Impact of low-density lipoprotein cholesterol and lipoprotein(a) on
mid-term clinical outcomes following coronary artery bypass grafting: A
secondary analysis of the DACAB trial.
Source
Frontiers in Cardiovascular Medicine. 10 (no pagination), 2023. Article
Number: 1103681. Date of Publication: 2023.
Author
Yu Q.; Xue Q.; Liu H.; Hu J.; Wang R.; Song Y.; Zhou Y.; Zhang W.; Zhu Y.;
Zhao Q.
Institution
(Yu, Zhou, Zhu, Zhao) Department of Cardiovascular Surgery, Ruijin
Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai,
China
(Xue) Department of Cardiovascular Surgery, The First Affiliated Hospital
of Naval Medical University, Shanghai Changhai Hospital, Shanghai, China
(Liu) Department of Cardiothoracic Surgery, Xinhua Hospital, Shanghai Jiao
Tong University School of Medicine, Shanghai, China
(Hu) Department of Cardiac Surgery, Heart Center of Henan Provincial
People's Hospital, Central China Fuwai Hospital of Zhengzhou University,
Zhengzhou, China
(Wang) Department of Cardiovascular Surgery, Nanjing First Hospital,
Nanjing Medical University, Nanjing, China
(Song) Department of Cardiovascular Surgery, Jiangsu Province Hospital,
Nanjing, China
(Zhang) Department of Biostatistics, School of Public Health, Fudan
University, Shanghai, China
Publisher
Frontiers Media S.A.
Abstract
Purpose: The objective was to evaluate the influence of low-density
lipoprotein cholesterol (LDL-C) and lipoprotein(a) [Lp(a)] on clinical
outcomes in patients undergoing coronary artery bypass grafting (CABG).
<br/>Method(s): This is a secondary analysis of a 5-year follow-up of the
DACAB trial (NCT02201771), in which 500 patients who underwent primary
isolated CABG were randomized to three-antiplatelet therapy for 1 year
after surgery. Of them, 459 patients were recruited in this secondary
analysis. Baseline LDL-C and Lp(a) levels were collected, and repeated
measurement of LDL-C levels during the follow-up were recorded. Cut-off
values for LDL-C were set at 1.8 and 2.6 mmol/L; thus, the patients were
stratified into LDL-C <1.8, 1.8-<2.6, and >=2.6 mmol/L subgroups. Cut-off
value for Lp(a) was 30 mg/dL; thus, the patients were divided into Lp(a)
<30 and >=30 mg/dL subgroups. The primary outcome was 4-point major
adverse cardiovascular events (MACE-4), a composite of all-cause death,
myocardial infarction, stroke, and repeated revascularization. Median
follow-up time was 5.2 (interquartile range, 4.2-6.1) years.
<br/>Result(s): During the follow-up, 129 (28.1%) patients achieved the
attainment of LDL-C <1.8 mmol/L, 186 (40.5%) achieved LDL-C 1.8-<2.6
mmol/L, and 144 (31.4%) remained LDL-C >=2.6 mmol/L. Compared with the
postoperative LDL-C <1.8 mmol/L group, the risk of MACE-4 was
significantly higher in the LDL-C 1.8-<2.6 mmol/L group [adjusted hazard
ratio (aHR) = 1.92, 95% CI, 1.12-3.29; P = 0.019] and LDL-C >=2.6 mmol/L
group (aHR = 3.90, 95% CI, 2.29-6.64; P < 0.001). Baseline Lp(a) >=30
mg/dL was identified in 131 (28.5%) patients and was associated with an
increased risk of MACE-4 (aHR = 1.52, 95% CI, 1.06-2.18; P = 0.022).
<br/>Conclusion(s): For CABG patients, exposure to increased levels of
postoperative LDL-C or baseline Lp(a) was associated with worse mid-term
clinical outcomes. Our findings suggested the necessity of achieving LDL-C
target and potential benefit of adding Lp(a) targeted lipid-lowering
therapy in CABG population.<br/>Copyright 2023 Yu, Xue, Liu, Hu, Wang,
Song, Zhou, Zhang, Zhu and Zhao.

<42>
Accession Number
2022215405
Title
Renoprotective effect of febuxostat on contrast-induced acute kidney
injury in chronic kidney disease patients stage 3: randomized controlled
trial.
Source
BMC Nephrology. 24(1) (no pagination), 2023. Article Number: 65. Date of
Publication: December 2023.
Author
Sarhan I.I.; Abdellatif Y.A.; Saad R.E.; Teama N.M.
Institution
(Sarhan, Teama) Department of Internal Medicine and Nephrology, Faculty of
Medicine, Ain Shams University, Ramses Street 38, Abbasia, Cairo 11566,
Egypt
(Abdellatif) Department of Cardiology, Faculty of Medicine, Ain Shams
University, Cairo, Egypt
(Saad) Department of Nephrology, Elsahel teaching hospital, Cairo, Egypt
Publisher
BioMed Central Ltd
Abstract
Introduction: Contrast-induced acute kidney injury (CI-AKI) is known to be
a complication of using intravascular contrast injection. Unfortunately,
it is associated with adverse outcomes such as prolonged length of
hospitalization and increased burden of health care costs. So, we aimed to
determine the efficacy of febuxostat in the prevention of contrast-induced
acute kidney injury among patients with chronic kidney disease Stage 3
performing percutaneous coronary intervention (PCI). <br/>Method(s): In a
randomized controlled trial we enrolled 120 CKD stage 3 Patients with
acute coronary syndrome referred to the cardiology department Ain-Shams
University hospital for performing PCI and stenting. Patients were
randomly assigned to two arms: Group I (study group): Included 60 patients
who received Febuxostat added to the traditional treatment (IV hydration
and N-acetylcysteine). The patients received Feburic 80 mg within 6-18 h
before and within 6-18 h after the coronary intervention (a time gap of 24
h between two doses). Group II (control group): included 60 patients who
received only traditional treatment. <br/>Result(s): The incidence of AKI
was higher in the control group with a statistically significant
difference. We found that Independent Significant risk factors that led to
AKI were febuxostate avoidance, DM, high urea level, high creatinine
level, CKD stage 3B, high Mehran score and high AKI risk.
<br/>Conclusion(s): We demonstrated that febuxostat has a Reno protective
effect and it can help to reduce the incidence CI-AKI in CKD patients
stage 3 performing PCI.<br/>Copyright &#xa9; 2023, The Author(s).

<43>
Accession Number
2023782504
Title
Cardiorenal syndrome in the pediatric population: A systematic review.
Source
Annals of Pediatric Cardiology. 15(5) (pp 493-510), 2022. Date of
Publication: September 2022.
Author
Pradhan S.; Adnani H.; Safadi R.; Yerigeri K.; Nayak S.; Raina R.; Sinha
R.
Institution
(Pradhan) Division of Pediatric Nephrology, Sardar Vallabhbhai Patel Post
Graduate Institute of Pediatrics and Scb Medical College, Odisha, Cuttack,
India
(Adnani) Anne Arundel Medical Center, Luminis Health System, Annapolis,
MD, United States
(Safadi, Raina) Akron Nephrology Associates/Cleveland Clinic Akron General
Medical Center, Akron, OH, United States
(Yerigeri, Raina) Department of Nephrology, Children s Hospital, Akron,
OH, United States
(Nayak) Department of Pediatrics, Sardar Vallabhbhai Patel Post Graduate
Institute of Pediatrics and Scb Medical College, Odisha, Cuttack, India
(Sinha) Division of Pediatric Nephrology, Institute of Child Health, West
Bengal, Kolkata, India
(Sinha) Department of Pediatrics, Apollo Gleneagles Hospital, West Bengal,
Kolkata, India
Publisher
Wolters Kluwer Medknow Publications
Abstract
The concept of cardiorenal syndrome (CRS) is derived from the crosstalk
between the heart and kidneys in pathological conditions. Despite the
rising importance of CRS, there is a paucity of information on the
understanding of its pathophysiology and management, increasing both
morbidity and mortality for patients. This review summarizes the existing
conceptual pathophysiology of different types of CRS and delves into the
associated therapeutic modalities with a focus on pediatric cases.
Prospective or retrospective observational studies, comparative studies,
case reports, case-control, and cross-sectional studies that include
pediatric patients with CRS were included in this review. Literature was
searched using PubMed, EMBASE, and Google Scholar with keywords including
'cardio-renal syndrome, type,' 'reno-cardio syndrome,' 'children,' 'acute
kidney injury,' and 'acute decompensated heart failure' from January 2000
to January 2021. A total of 14 pediatric studies were ultimately included
and analyzed, comprising a combined population of 3608 children of which
32% had CRS. Of the 14 studies, 57% were based on type 1 CRS, 14% on types
2 and 3 CRS, and 7% were on types 4 and 5 CRS. The majority of included
studies were prospective cohort, although a wide spectrum was observed in
terms of patient age, comorbidities, etiologies, and treatment strategies.
Commonly observed comorbidities in CRS type 1 were hematologic, oncologic,
cardiology-related side effects, muscular dystrophy, and
pneumonia/bronchiolitis. CRS, particularly type 1, is prevalent in
children and has a significant risk of mortality. The current treatment
regimen primarily involves diuretics, extracorporeal fluid removal, and
treatment of underlying etiologies and comorbidities.<br/>Copyright &#xa9;
2022 Wolters Kluwer Medknow Publications. All rights reserved.

<44>
Accession Number
2023966288
Title
Safety and performance parameters of the Myval transcatheter aortic valve
bioprosthesis: The SAPPHIRE prospective registry.
Source
Cardiovascular Revascularization Medicine. (no pagination), 2023. Date of
Publication: 2023.
Author
Testa L.; Criscione E.; Popolo Rubbio A.; Squillace M.; Ielasi A.; Tespili
M.; Brambilla N.; Bedogni F.
Institution
(Testa, Criscione, Popolo Rubbio, Squillace, Tespili, Brambilla, Bedogni)
Dept of Cardiology, IRCCS Pol. S. Donato, San Donato Milanese, Milan,
Italy
(Ielasi) Cardiology Division, IRCCS Ospedale Galeazzi Sant'Ambrogio,
Milan, Italy
Publisher
Elsevier Inc.
Abstract
Background: TAVR is an established treatment for patients with severe
symptomatic aortic stenosis. Different THV platforms are nowadays
available, each of them with its inherent limitations and others are under
development aiming at overcoming such limitations. We thus sought to
investigate the performance and 1-year clinical outcome of a new
generation, balloon expandable, THV: the MyvalTM (Meril Life Sciences Pvt.
Ltd., Vapi, Gujarat, India). <br/>Method(s): This registry included the
first 100 consecutive patients (mean age 80.7 +/- 7.7; STS 4.3 +/- 3.3 %),
who underwent transcatheter aortic valve implantation for severe stenosis
of the native aortic valve from May 2020 to December 2020, in two Italian
Centers. Clinical and procedural outcomes were defined according to VARC-3
criteria. <br/>Result(s): Transfemoral Myval THV was successfully
implanted in all patients, with no intra-hospital mortality (technical
success 100 %): vascular access complications were all "minor" (16 %), and
managed by compression/balloon inflation; no cases of annular rupture or
coronary obstruction occurred; 5 % of patients required an in-hospital
pacemaker implantation (PM). Device success was 99 %. Overall and
cardiovascular mortality were 6 % (CI 5 %-7 %) and 4 % (CI 2 %-5 %) at 1-
year, while 12 % (CI 9 %-14 %) and 7 % (6-9 %) at 2 years. A total of 9 %
of the patients required a PM within 12 months, and no further PM
implantation occurred afterwards. No cerebrovascular events, renal failure
and myocardial infarction occurred between discharge and 2-year follow-up.
No events of structural valve deterioration but a sustained improvement of
echocardiographic parameters were observed. <br/>Conclusion(s): The Myval
THV has a promising safety/efficacy profile at 2 year follow up. This
performance should be further evaluated in the context of randomized
trials to better elucidate its potential.<br/>Copyright &#xa9; 2023

<45>
Accession Number
2022382823
Title
Remote ischemic preconditioning and clinical outcomes after pediatric
cardiac surgery: a systematic review and meta-analysis.
Source
BMC Anesthesiology. 23(1) (no pagination), 2023. Article Number: 105. Date
of Publication: December 2023.
Author
Li J.; Wang X.; Liu W.; Wen S.; Li X.
Institution
(Li, Liu, Li) Departments of Anesthesiology, DongGuan SongShan Lake
Tungwah Hospital, DongGuan, China
(Wang, Wen) Departments of Anesthesiology, The First Affiliated Hospital,
Sun Yat-Sen University, Guangzhou, China
Publisher
BioMed Central Ltd
Abstract
Background: The benefit of remote ischemia preconditioning (RIPreC) in
pediatric cardiac surgery is unclear. The objective of this systematic
review and meta-analysis was to examine the effectiveness of RIPreC in
reducing the duration of mechanical ventilation and intensive care unit
(ICU) length of stay after pediatric cardiac surgery. <br/>Method(s): We
searched PubMed, EMBASE and the Cochrane Library from inception to
December 31, 2022. Randomized controlled trials comparing RIPreC versus
control in children undergoing cardiac surgery were included. The risk of
bias of included studies was assessed using the Risk of Bias 2 (RoB 2)
tool. The outcomes of interest were postoperative duration of mechanical
ventilation and ICU length of stay. We conducted random-effects
meta-analysis to calculate weighted mean difference (WMD) with 95%
confidence interval (CI) for the outcomes of interest. We performed
sensitivity analysis to examine the influence of intraoperative propofol
use. <br/>Result(s): Thirteen trials enrolling 1,352 children were
included. Meta-analyses of all trials showed that RIPreC did not reduce
postoperative duration of mechanical ventilation (WMD -5.35 h, 95% CI
-12.12-1.42) but reduced postoperative ICU length of stay (WMD -11.48 h,
95% CI -20.96- -2.01). When only trials using propofol-free anesthesia
were included, both mechanical ventilation duration (WMD -2.16 h, 95% CI
-3.87- -0.45) and ICU length of stay (WMD -7.41 h, 95% CI -14.77- -0.05)
were reduced by RIPreC. The overall quality of evidence was moderate to
low. <br/>Conclusion(s): The effects of RIPreC on clinical outcomes after
pediatric cardiac surgery were inconsistent, but both postoperative
mechanical ventilation duration and ICU length of stay were reduced in the
subgroup of children not exposed to propofol. These results suggested a
possible interaction effect of propofol. More studies with adequate sample
size and without intraoperative propofol use are needed to define the role
of RIPreC in pediatric cardiac surgery.<br/>Copyright &#xa9; 2023, The
Author(s).

<46>
Accession Number
2024058573
Title
A norepinephrine weaning strategy using dynamic arterial elastance is
associated with reduction of acute kidney injury in patients with
vasoplegia after cardiac surgery: A post-hoc analysis of the randomized
SNEAD study.
Source
Journal of Clinical Anesthesia. 88 (no pagination), 2023. Article Number:
111124. Date of Publication: September 2023.
Author
Guinot P.-G.; Huette P.; Bouhemad B.; Abou-Arab O.; Nguyen M.
Institution
(Guinot, Bouhemad, Nguyen) Department of Anaesthesiology and Critical Care
Medicine, Dijon University Medical Centre, Dijon 21000, France
(Guinot, Bouhemad, Nguyen) University of Burgundy and Franche-Comte, LNC
UMR1231, Dijon F-21000, France
(Huette, Abou-Arab) Department of Anaesthesiology and Critical Care
Medicine, Amiens University Medical Centre, Amiens 80000, France
Publisher
Elsevier Inc.
Abstract
Study objective: To evaluate the impact of a dynamic arterial elastance
guided norepinephrine weaning strategy on the occurrence of acute kidney
injury (AKI) in patients with vasoplegia after cardiac surgery.
<br/>Design(s): A post-hoc analysis of a monocentric randomized controlled
trial. <br/>Setting(s): A tertiary care hospital in France.
<br/>Participant(s): Vasoplegic cardiac surgical patients treated with
norepinephrine. <br/>Intervention(s): Patients were randomized to an
algorithm-based norepinephrine weaning intervention (dynamic arterial
elastance) group or a control group. Measurements: The primary endpoint
was the number of patients with AKI defined according to Kidney Disease
Improving Global Outcomes (KDIGO) criteria. The secondary endpoint were
major adverse cardiac post-operative events (new onset of atrial
fibrillation or flutter, low cardiac output syndrome, and in-hospital
death). End points were evaluated during the first seven post-operative
days. <br/>Result(s): 118 patients were analyzed. In the overall study
population, the mean age was 70 (62-76) years, 65% were male and the
median EuroSCORE was 7 (5-10). Overall, 46 (39%) patients developed AKI
(30 KDIGO 1, 8 KDIGO 2, 8 KDIGO 3), and 6 patients required renal
replacement therapy. The incidence of AKI was significantly lower in the
intervention group than in the control group (16 patients (27%) vs 30
patients (51%), p = 0.12). Higher dose and longer duration of
norepinephrine were associated with AKI severity. <br/>Conclusion(s):
Decreasing norepinephrine exposure by using a dynamic arterial elastance
guided norepinephrine weaning strategy was associated with a reduced
incidence of acute kidney injury in patients with vasoplegia after cardiac
surgery. Further prospective multicentric studies are needed to confirm
these results.<br/>Copyright &#xa9; 2023 The Author(s)

<47>
Accession Number
2023994225
Title
Preprocedural muscle strength and physical performance and the association
with functional decline or mortality in frail older patients after
transcatheter aortic valve implementation: a systematic review and
meta-analysis.
Source
Age and Ageing. 51(9) (no pagination), 2022. Article Number: afac211. Date
of Publication: 01 Sep 2022.
Author
Van Erck D.; Dolman C.D.; Limpens J.; Scholte Op Reimer W.J.M.; Henriques
J.P.; Delewi R.; Schoufour J.D.
Institution
(Van Erck, Scholte Op Reimer, Henriques, Delewi) Department of Cardiology,
Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
(Dolman) Department of Cardiothoracic Surgery, Amsterdam UMC, University
of Amsterdam, Amsterdam, Netherlands
(Limpens) Medical Library, Amsterdam UMC, University of Amsterdam,
Amsterdam, Netherlands
(Scholte Op Reimer) Research Group Chronic Diseases, HU University of
Applied Sciences, Utrecht, Netherlands
(Schoufour) Faculty of Health, Center of Expertise Urban Vitality,
Amsterdam University of Applied Science, Amsterdam, Netherlands
(Schoufour) Faculty of Sports and Nutrition, Center of Expertise Urban
Vitality, Amsterdam University of Applied Science, Amsterdam, Netherlands
Publisher
Oxford University Press
Abstract
Background: A significant number of older patients planned for
transcatheter aortic valve implantation (TAVI) experience a decline in
physical functioning and death, despite a successful procedure.
<br/>Objective(s): To systematically review the literature on the
association of preprocedural muscle strength and physical performance with
functional decline or long-term mortality after TAVI. <br/>Method(s): We
followed the PRISMA guidelines and pre-registered this review at PROSPERO
(CRD42020208032). A systematic search was conducted in MEDLINE and EMBASE
from inception to 10 December 2021. Studies reporting on the association
of preprocedural muscle strength or physical performance with functional
decline or long-term (>6 months) mortality after the TAVI procedure were
included. For outcomes reported by three or more studies, a meta-analysis
was performed. <br/>Result(s): In total, two studies reporting on
functional decline and 29 studies reporting on mortality were included.
The association with functional decline was inconclusive. For mortality,
meta-analysis showed that low handgrip strength (hazard ratio (HR) 1.80
[95% confidence interval (CI): 1.22-2.63]), lower distance on the 6-minute
walk test (HR 1.15 [95% CI: 1.09-1.21] per 50 m decrease), low performance
on the timed up and go test (>20 s) (HR 2.77 [95% CI: 1.79-4.30]) and slow
gait speed (<0.83 m/s) (HR 2.24 [95% CI: 1.32-3.81]) were associated with
higher long-term mortality. <br/>Conclusion(s): Low muscle strength and
physical performance are associated with higher mortality after TAVI,
while the association with functional decline stays inconclusive. Future
research should focus on interventions to increase muscle strength and
physical performance in older cardiac patients. <br/>Copyright &#xa9; 2022
The Author(s). Published by Oxford University Press on behalf of the
British Geriatrics Society. All rights reserved.

<48>
Accession Number
2022740767
Title
Factors related to loss of appetite in postoperative cardiac surgery
patients: A systematic review.
Source
F1000Research. 10 (no pagination), 2021. Article Number: 350. Date of
Publication: 2021.
Author
Prasankok C.; Banharak S.
Institution
(Prasankok) Nursing Department, Queen Sirikit Heart Center of the
Northeast, Khon Kaen University, Khon Kaen 40002, Thailand
(Banharak) Gerontological Nursing Department, Faculty of Nursing, Khon
Kaen University, Khon Kaen 40002, Thailand
Publisher
F1000 Research Ltd
Abstract
Background: Postoperative cardiac surgery patients often experience
appetite loss. Although nutritional status is known to be associated with
time of recovery, functional status, and length of stay, less is known
about factors related to patient's loss of appetite after cardiac surgery.
This review aimed to identify and understand factors related to loss of
appetite in postoperative cardiac surgery patients, systematic review with
narrative summary design was applied. Data sources including CINAHL,
SCOPUS, PubMed, ProQuest, ScienceDirect, ThaiLIS, ThaiJo, and E-Thesis
were searched without restriction on publication year through August 2020.
<br/>Method(s): We conducted the review following the Joanna Briggs
Institute methodology, using the Preferred Reporting Items for Systematic
Reviews and Meta-analyses (PRISMA) checklist to categorize methodological
quality and the PRISMA flow diagram to record the studies' factors.
<br/>Result(s): Six studies reported one or more of 16 factors related to
loss of appetite: older age, sex (female), illiteracy, history of chronic
disease, not knowing someone in health field, pain score >= 7, pain
medications containing codeine, constipation, depression, heart-lung
machine >= 120 minutes, preoperative serum creatinine levels >= 179
micromol/L, emergency surgery, perfusion pressure <= 40 mmHg, low cardiac
output syndrome, mechanical ventilation >= 96 hours, and a New York Heart
Association class III and IV. <br/>Conclusion(s): The small number of
publications restrict our conclusions. Future research should focus on
multiple factors related to appetite loss in postoperative cardiac surgery
patients. Additional research will provide a foundation for evidence-based
interventions to reduce appetite loss and improve patient nutritional
status after cardiac surgery. Nurses and other health professionals should
assess postoperative cardiac surgery patients for the presence of the 16
significant factors. To promote patients' nutritional status, there should
be evidence-based practice guidelines on the management of postoperative
symptoms such as pain management, treatment of constipation, and reduction
of emotional stress and depression.<br/>Copyright: &#xa9; 2021 Prasankok C
and Banharak S.

<49>
Accession Number
2022740742
Title
Does the speed of sternal retraction during coronary artery bypass graft
surgery affect postoperative pain outcomes? A randomized controlled trial
protocol.
Source
F1000Research. 10 (no pagination), 2021. Article Number: 248. Date of
Publication: 2021.
Author
Petsikas D.; Stewart C.; Phelan R.; Allard R.; Cummings M.; DuMerton D.;
Parlow J.; Payne D.; Tanzola R.; Wang L.; Saha T.
Institution
(Petsikas, Payne) Department of Surgery, Queen's University, Kingston, ON
K7L 2V7, Canada
(Stewart) School of Medicine, Queen's University, Kingston, ON K7L 2V7,
Canada
(Phelan, Allard, Cummings, DuMerton, Parlow, Tanzola, Wang, Saha)
Anesthesiology and Perioperative Medicine, Queen's University, Kingston,
ON K7L 2V7, Canada
Publisher
F1000 Research Ltd
Abstract
Background: Chronic pain is a serious health issue impacting both the
quality of life and productivity of patients. Chronic post-sternotomy pain
(CPSP) is characterized by numbness, severe tenderness on palpation,
allodynia, as well as constant pain across the anterior chest wall that
can persist for months to years after sternotomy. All patients experience
early post-operative pain following coronary artery bypass graft (CABG);
unfortunately, approximately 30-40% of CABG patients subsequently develop
CPSP.  Methods: The current study is a prospective,
double-blinded, randomized controlled trial. A sample size of 316 randomly
assigned patients (n=158 per group) will provide an 80% power at a 2-sided
alpha of 0.05 to detect a 40% decrease in CPSP incidence at 6 months.
Eligible patients scheduled for elective, primary coronary artery bypass
graft surgery will be randomly assigned to the CONTROL group, in which
sternal retraction is conducted over 30 seconds (as per standard
practice); or the SLOW group, in which sternal retraction is achieved over
15 minutes. Surgical and perioperative anesthesia protocols between the
two groups are otherwise the same. Our primary outcome is the incidence of
CPSP at 6 months. Secondary outcomes are: CPSP incidence at 3 and 12
months, daily sternal incision pain intensity (numeric rating scale (NRS))
at rest and while coughing, and daily analgesic consumption while in
hospital and at 7 days postoperatively; pain quality, quality of life, and
pain interference with daily function at 3, 6, and 12 months
post-operatively. <br/>Discussion(s): Our randomized controlled trial will
determine whether retracting the sternum more slowly for exposure of the
heart during CABG surgery will decrease the incidence and/or severity of
CPSP.<br/>Copyright: &#xa9; 2021 Petsikas D et al.

<50>
Accession Number
2024058204
Title
Diuresis-matched versus standard hydration in patients undergoing
percutaneous cardiovascular procedures: meta-analysis of randomized
clinical trials.
Source
Revista Espanola de Cardiologia. (no pagination), 2023. Date of
Publication: 2023.
Author
Occhipinti G.; Laudani C.; Spagnolo M.; Greco A.; Capodanno D.
Institution
(Occhipinti, Laudani, Spagnolo, Greco, Capodanno) Division of Cardiology,
Azienda Ospedaliero-Universitaria Policlinico G. Rodolico-San Marco,
University of Catania, Catania, Italy
Publisher
Ediciones Doyma, S.L.
Abstract
Introduction and objectives: Contrast-associated acute kidney injury
(CA-AKI) is a potential complication of procedures requiring
administration of iodinated contrast medium. RenalGuard, which provides
real-time matching of intravenous hydration with furosemide-induced
diuresis, is an alternative to standard periprocedural hydration
strategies. The evidence on RenalGuard in patients undergoing percutaneous
cardiovascular procedures is sparse. We used a Bayesian framework to
perform a meta-analysis of RenalGuard as a CA-AKI preventive strategy.
<br/>Method(s): We searched Medline, Cochrane Library and Web of Science
for randomized trials of RenalGuard vs standard periprocedural hydration
strategies. The primary outcome was CA-AKI. Secondary outcomes were
all-cause death, cardiogenic shock, acute pulmonary edema, and renal
failure requiring renal replacement therapy. A Bayesian random-effect risk
ratio (RR) with corresponding 95% credibility interval (95%CrI) was
calculated for each outcome. PROSPERO database number CRD42022378489.
<br/>Result(s): Six studies were included. RenalGuard was associated with
a significant relative reduction in CA-AKI (median RR, 0.54; 95%CrI,
0.31-0.86) and acute pulmonary edema (median RR, 0.35; 95%CrI, 0.12-0.87).
No significant differences were observed for the other secondary endpoints
[all-cause death (RR, 0.49; 95%CrI, 0.13-1.08), cardiogenic shock (RR,
0.06; 95%CrI, 0.00-1.91), and renal replacement therapy (RR, 0.52; 95%CrI,
0.18-1.18)]. The Bayesian analysis also showed that RenalGuard had a high
probability of ranking first for all the secondary outcomes. These results
were consistent in multiple sensitivity analyses. <br/>Conclusion(s): In
patients undergoing percutaneous cardiovascular procedures, RenalGuard was
associated with a reduced risk of CA-AKI and acute pulmonary edema
compared with standard periprocedural hydration strategies.<br/>Copyright
&#xa9; 2023

<51>
Accession Number
641076052
Title
The First Dedicated Comprehensive Heart Failure Program in the US: the
Division of Circulatory Physiology at Columbia Presbyterian (1992-2004).
Source
Journal of cardiac failure. (no pagination), 2023. Date of Publication:
17 Apr 2023.
Author
Packer M.
Institution
(Packer) Baylor Heart and Vascular Institute, Baylor University Medical
Center, Dallas, Texas and Imperial College, London, UK
Publisher
NLM (Medline)
Abstract
The first dedicated multidisciplinary heart failure program in the US was
founded as the Division of Circulatory Physiology at the Columbia
University College of Physicians & Surgeons in 1992. The Division was
administratively and financially independent of the Division of Cardiology
and grew to 24 faculty members at its peak. Its administrative innovations
included (1) a comprehensive full-integrated service line, with two
differentiated clinical teams, one devoted to drug therapy and the other
to heart transplantation and ventricular assist devices; (2) a nurse
specialist/physician assistant-led clinical service; and (3) a financial
structure independent of (and not supported by) other cardiovascular
medical or surgical services. The Division had three overarching missions:
(1) to promote a unique career development path for each faculty member to
be linked to recognition in a specific area of heart failure expertise;
(2) to change the trajectory and enhance the richness of intellectual
discourse in the discipline of heart failure, so as to foster an
understanding of fundamental mechanisms and to develop new therapeutics;
and (3) to provide optimal medical care to patients and to promote the
ability of other physicians to provide optimal care. The major research
achievements of the Division included: (1) the development of
beta-blockers for heart failure, from initial hemodynamic assessments to
proof-of-concept studies to large-scale international trials; (2) the
development and definitive assessment of flosequinan, amlodipine and
endothelin antagonists; (3) initial clinical trials and concerns with
nesiritide; (4) large-scale trials evaluating dosing of angiotensin
converting-enzyme inhibitors and the efficacy and safety of neprilysin
inhibition; (5) identification of key mechanisms in heart failure,
including neurohormonal activation, microcirculatory endothelial
dysfunction, deficiencies in peripheral vasodilator pathways, noncardiac
factors in driving dyspnea, and the first identification of subphenotypes
of heart failure and a preserved ejection fraction; (6) the development of
a volumetric approach to the assessment of myocardial shortening; (7)
conceptualization and early studies of cardiac contractility modulation as
a treatment for heart failure; (8) novel approaches to the identification
of cardiac allograft rejection and new therapeutics to prevent allograft
vasculopathy; and (9) demonstration of the effect of left ventricular
assist devices to induce reverse remodeling, and the first randomized
trial showing a survival benefit with ventricular assist devices. Above
all, the Division served as an exceptional incubator for a generation of
leaders in the field of heart failure.<br/>Copyright &#xa9; 2023.
Published by Elsevier Inc.

<52>
Accession Number
2022705825
Title
Comparison of intracardiac echocardiography with transesophageal
echocardiography for left atrial appendage occlusion: an updated
systematic review and meta-analysis.
Source
Journal of Interventional Cardiac Electrophysiology. (no pagination),
2023. Date of Publication: 2023.
Author
Krishan S.; Hashim L.; Javed L.; Gomez-Perez J.; Muhammad R.; Gondal J.;
Sacco J.; Clifton S.; Khattab M.; Munir M.B.; DeSimone C.V.; Deshmukh A.;
Stavrakis S.; Asad Z.U.A.
Institution
(Krishan, Hashim, Javed, Gomez-Perez, Gondal, Sacco, Khattab, Stavrakis,
Asad) Department of Medicine, University of Oklahoma Health Sciences
Center, 800 Stanton L. Young Blvd, AAT 5400, Oklahoma City, OK 73104,
United States
(Muhammad) Oklahoma State University College of Osteopathic Medicine,
Tulsa, OK, United States
(Clifton) Robert M. Bird Health Sciences Library, University of Oklahoma
Health Sciences Center, Oklahoma City, OK, United States
(Munir) Department of Cardiovascular Medicine, Section of
Electrophysiology, University of California Davis, Davis, CA, United
States
(DeSimone, Deshmukh) Department of Cardiovascular Medicine, Mayo Clinic,
Rochester, MN, United States
Publisher
Springer

<53>
Accession Number
2022677233
Title
The role of urinary Dickkopf-3 in the prediction of acute kidney injury: a
systematic review meta-analysis.
Source
International Urology and Nephrology. (no pagination), 2023. Date of
Publication: 2023.
Author
Xing H.; Jiang Z.; Wu Y.; Ou S.; Qin J.; Xue L.; Wu W.
Institution
(Xing, Jiang, Wu, Ou, Qin, Wu) Department of Nephrology, Affiliated
Hospital of Southwest Medical University, Luzhou, China
(Xue) Department of Urology, Affiliated Hospital of Southwest Medical
University, No. 25 Taiping Street, Jiangyang District, Sichuan, Luzhou
646000, China
(Xing, Jiang, Wu, Ou, Qin, Xue, Wu) Sichuan Clinical Research Center for
Nephropathy, Luzhou, China
(Xing, Jiang, Wu, Ou, Qin, Wu) Metabolic Vascular Disease Key Laboratory,
Luzhou, China
Publisher
Springer Science and Business Media B.V.
Abstract
Background: To systematically evaluate the diagnostic efficacy of urinary
Dickkopf-Related Protein 3 (DKK-3) in acute kidney injury and to explore
the clinical application value of urinary DKK-3. <br/>Method(s): English
databases (PubMed, Embase, Cochrane, and WOS) and Chinese databases (VIP,
WanFang data, and China National Knowledge Internet) were screened for
relevant papers published before March 12, 2023. After literature
screening and data extraction, quality assessment was performed according
to the QUADAS-2 scoring system. Then, the combined diagnostic and
predictive parameters were calculated using a bivariate mixed effect
meta-analysis model. Deek's funnel plot asymmetry test assessed
publication bias, and Fagan's nomogram plot was used to verify its
clinical utility. <br/>Result(s): A total of 5 studies involving 2787
patients were included in this meta-analysis, of which 4 focused on
contrast-induced acute kidney injury (CI-AKI) and 1 focused on AKI
associated with cardiac surgery. The analysis showed that urine Dickkopf-3
has high diagnostic accuracy for AKI, with a sensitivity of 0.55 (95% CI
[0.41, 0.68]), specificity of 0.80 (95% CI [0.70, 0.87]), positive
likelihood ratio (PLR) of 2.7 [1.8, 4.1], negative likelihood ratio (NLR)
of 0.56 [0.42, 0.75], diagnostic odds ratio (DOR) of 5 [3, 9], and AUC of
0.74 [0.70-0.77]. We did not perform subgroup analyses for predictive
value due to the small number of included studies. <br/>Conclusion(s):
Urinary DKK3 may have limited predictive ability for acute kidney injury,
especially for AKI associated with cardiac surgery. Therefore, urinary
DKK3 may serve as a potential predictor for AKI. However, clinical studies
with larger samples are still needed for validation.<br/>Copyright &#xa9;
2023, The Author(s), under exclusive licence to Springer Nature B.V.

<54>
Accession Number
641077766
Title
Practice Advisory for Preoperative and Intraoperative Pain Management of
Thoracic Surgical Patients: Part 1.
Source
Anesthesia and analgesia. (no pagination), 2023. Date of Publication: 20
Apr 2023.
Author
Makkad B.; Heinke T.L.; Sheriffdeen R.; Khatib D.; Brodt J.L.; Meng M.-L.;
Grant M.C.; Kachulis B.; Popescu W.M.; Wu C.L.; Bollen B.A.
Institution
(Makkad) From the Department of Anesthesiology, University of Cincinnati
Medical Center, Cincinnati, OH, United States
(Heinke) Department of Anesthesia and Perioperative Medicine, Medical
University of South Carolina, Charleston, SC, United States
(Sheriffdeen) Department of Anesthesiology, Medstar Washington Hospital
Center, WA, United States
(Khatib) Department of Anesthesiology, Weil Cornell Medical College, NY,
United States
(Brodt) Department of Anesthesiology, Perioperative and Pain Medicine,
Stanford University, Stanford, CA, United States
(Meng) Department of Anesthesiology, Duke University Medical Center,
Durham, NC, United States
(Grant) Department of Anesthesiology and Critical Care Medicine, Johns
Hopkins University School of Medicine, Baltimore, MD, Liberia
(Kachulis) Department of Anesthesiology, Columbia University, NY, United
States
(Popescu) Department of Anesthesiology, Yale School of Medicine, New
Haven, CT, United States
(Wu) Department of Anesthesiology, Hospital of Special Surgery, Weill
Cornell Medical College, NY, United States
(Bollen) Missoula Anesthesiology and The International Heart Institute of
Montana, Missoula, MT, Bulgaria
Publisher
NLM (Medline)
Abstract
Pain after thoracic surgery is of moderate-to-severe intensity and can
cause increased postoperative distress and affect functional recovery.
Opioids have been central agents in treating pain after thoracic surgery
for decades. The use of multimodal analgesic strategies can promote
effective postoperative pain control and help mitigate opioid exposure,
thus preventing the risk of developing persistent postoperative pain. This
practice advisory is part of a series developed by the Society of
Cardiovascular Anesthesiologists (SCA) Quality, Safety, and Leadership
(QSL) Committee's Opioid Working Group. It is a systematic review of
existing literature for various interventions related to the preoperative
and intraoperative pain management of thoracic surgical patients and
provides recommendations for providers caring for patients undergoing
thoracic surgery. This entails developing customized pain management
strategies for patients, which includes preoperative patient evaluation,
pain management, and opioid use-focused education as well as perioperative
use of multimodal analgesics and regional techniques for various thoracic
surgical procedures. The literature related to this field is emerging and
will hopefully provide more information on ways to improve clinically
relevant patient outcomes and promote recovery in the
future.<br/>Copyright &#xa9; 2023 International Anesthesia Research
Society.

<55>
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.
<br/>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.
<br/>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). <br/>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.<br/>Copyright &#xa9; 2023, The Author(s), under exclusive
licence to Springer-Verlag GmbH Germany, part of Springer Nature.

<56>
Accession Number
2021281738
Title
Neuromarkers which can predict neurodevelopmental impairment among
children with congenital heart defects after cardiac surgery: A systematic
literature review.
Source
Developmental Neurorehabilitation. 26(3) (pp 206-215), 2023. Date of
Publication: 2023.
Author
Chiperi L.E.; Tecar C.; Toganel R.
Institution
(Chiperi) Department of Pediatric Cardiology, Emergency Institute for
Cardiovascular Diseases and Heart Transplant, Targu Mures, Romania
(Chiperi) Doctoral School of I.O.S.U.D, George Emil Palade University of
Medicine, Pharmacy, Sciences and Technology, Targu Mures, Romania
(Tecar) Department of Neurosciences, Iuliu Hatieganu University of
Medicine and Pharmacy, Cluj-Napoca, Romania
(Toganel) Department of Pediatrics, George Emil Palade University of
Medicine, Pharmacy, Sciences and Technology, Targu Mures, Romania
Publisher
Taylor and Francis Ltd.
Abstract
The aim of this systematic literature review was to assess the data
regarding neuromarkers used to evaluate the impact of cardiovascular
surgery on neurodevelopmental pattern of children with congenital heart
defects. A systematic search was performed on PubMed and Google Scholar
databases. Out of 713 publications screened, 10 studies (471 patients) met
the inclusion criteria. The included studies were coded on several
variables: number and heterogeneity of patients (age, congenital heart
defects), exclusion of patients with conditions that predispose to
neurological impairment, neuroimaging workup pre- and post-surgery,
neurodevelopmental assessment, interventions (part of a different study),
and follow-up period. Results were reported according to PRISMA
guidelines. Findings include: neuron-specific enolase and brain-derived
neurotrophic factor are not reliable neuromarkers, for protein S100B
different results were reported, for activin A there is lack of evidence,
and glial fibrillary acidic protein could represent a reliable neuromarker
for acute brain-injury. Directions for future research are
discussed.<br/>Copyright &#xa9; 2023 Taylor & Francis Group, LLC.

<57>
Accession Number
2022390999
Title
Guided vs. conventional anti-platelet therapy for patients with acute
coronary syndrome: A meta-analysis of randomized controlled trials.
Source
Frontiers in Cardiovascular Medicine. 10 (no pagination), 2023. Article
Number: 1079332. Date of Publication: 2023.
Author
Zhong P.-Y.; Deng J.-P.; Zhao J.-H.; Peng L.; Liu T.; Wang H.-Y.
Institution
(Zhong, Deng, Zhao, Liu, Wang) Department of Cardiology, Nanchong Central
Hospital, The Second Clinical Medical College of North Sichuan Medical
College, Nanchong, China
(Peng) Department of Urology, The Second Hospital of Lanzhou University
Medical School, Lanzhou, China
(Peng) South China Hospital, Health Science Center, Shenzhen University,
Shenzhen, China
Publisher
Frontiers Media S.A.
Abstract
Background: Whether guided antiplatelet therapy in patients with acute
coronary syndrome (ACS) is effective in improving net clinical benefits
compared with conventional antiplatelet therapy remains controversial.
Therefore, we assessed the safety and efficacy of guided antiplatelet
therapy in patients with ACS and undergoing percutaneous coronary
intervention. <br/>Method(s): We searched PubMed, EMBASE, and Cochrane
Library databases to select the relevant randomized controlled trials
comparing the guided and conventional antiplatelet therapy in patients
with ACS. The primary and safety outcomes are major adverse cardiovascular
events (MACE) and major bleeding, respectively. The efficacy outcomes
included myocardial infarction, stent thrombosis, all-cause death, and
cardiovascular death. We selected the relative risk (RR) and 95%
confidence intervals (CIs) as effect size and calculated it using the
Review Manager software. In addition, we evaluated the final results by
trial sequential analysis (registered by PROSPERO, CRD 42020210912).
<br/>Result(s): We selected seven randomized controlled trials and
included 8,451 patients in this meta-analysis. Guided antiplatelet therapy
can significantly reduce the risk of MACE (RR 0.64, 95% CI 0.54-0.76, P <
0.00001), myocardial infarction (RR 0.62, 95% CI 0.49-0.79, P = 0.0001),
all-cause death (RR 0.61, 95% CI 0.44-0.85, P = 0.003), and cardiovascular
death (RR 0.66, 0.49-0.90, P = 0.009). In addition, there is no
significant difference between the two groups in stent thrombosis (RR
0.67, 95% CI 0.44-1.03, P = 0.07) and major bleeding (RR 0.86, 95% CI
0.65-1.13, P = 0.27). The subgroup analysis showed that the guided group
based on genotype tests could bring benefits in MACE and myocardial
infarction. <br/>Conclusion(s): The guided antiplatelet therapy is not
only associated with a comparable risk of bleeding but also with a lower
risk of MACE, myocardial infarction, all-cause death, cardiovascular
death, and stent thrombosis than the conventional strategy in patients
with ACS.<br/>Copyright 2023 Zhong, Deng, Zhao, Peng, Liu and Wang.

<58>
[Use Link to view the full text]
Accession Number
2022379969
Title
Empagliflozin and Left Ventricular Remodeling in People Without Diabetes:
Primary Results of the EMPA-HEART 2 CardioLink-7 Randomized Clinical
Trial.
Source
Circulation. 147(4) (pp 284-295), 2023. Date of Publication: 24 Jan 2023.
Author
Connelly K.A.; Mazer C.D.; Puar P.; Teoh H.; Wang C.-H.; Mason T.;
Akhavein F.; Chang C.-W.; Liu M.-H.; Yang N.-I.; Chen W.-S.; Juan Y.-H.;
Opingari E.; Salyani Y.; Barbour W.; Pasricha A.; Ahmed S.; Kosmopoulos
A.; Verma R.; Moroney M.; Bakbak E.; Krishnaraj A.; Bhatt D.L.; Butler J.;
Kosiborod M.N.; Lam C.S.P.; Hess D.A.; Rizzi Coelho-Filho O.;
Lafreniere-Roula M.; Thorpe K.E.; Quan A.; Leiter L.A.; Yan A.T.; Verma S.
Institution
(Connelly, Akhavein, Yan) Division of Cardiology, St. Michael's Hospital
of Unity Health, Toronto, ON, Canada
(Mazer) Department of Anesthesia, St. Michael's Hospital of Unity Health,
Toronto, ON, Canada
(Puar, Teoh, Mason, Opingari, Salyani, Barbour, Pasricha, Ahmed,
Kosmopoulos, Verma, Moroney, Bakbak, Krishnaraj, Quan, Verma) Division of
Cardiac Surgery, St. Michael's Hospital of Unity Health, Toronto, ON,
Canada
(Teoh, Leiter) Division of Endocrinology and Metabolism, St. Michael's
Hospital of Unity Health, Toronto, ON, Canada
(Hess) Division of Vascular Surgery, St. Michael's Hospital of Unity
Health, Toronto, ON, Canada
(Lafreniere-Roula, Thorpe) Applied Health Research Centre, St. Michael's
Hospital of Unity Health, Toronto, ON, Canada
(Connelly, Leiter, Yan) Department of Medicine, University of Toronto, ON,
Canada
(Connelly, Mazer) Department of Physiology, University of Toronto, ON,
Canada
(Mazer) Department of Anesthesiology and Pain Medicine, University of
Toronto, ON, Canada
(Opingari, Kosmopoulos) Temerty Faculty of Medicine, University of
Toronto, ON, Canada
(Bakbak, Krishnaraj, Hess, Verma) Department of Pharmacology and
Toxicology, University of Toronto, ON, Canada
(Thorpe) Dana Lana School of Public Health, University of Toronto, ON,
Canada
(Leiter) Department of Nutritional Sciences, University of Toronto, ON,
Canada
(Verma) Department of Surgery, University of Toronto, ON, Canada
(Puar, Ahmed) Faculty of Medicine, University of British Columbia,
Vancouver, Canada
(Wang, Chang, Liu, Yang, Chen) Heart Failure Research Center, Division of
Cardiology, Department of Internal Medicine, Keelung Chang Gung Memorial
Hospital, Taiwan (Republic of China)
(Chang) Department of Diagnostic Radiology, Keelung Chang Gung Memorial
Hospital, Taiwan (Republic of China)
(Chen) Intensive Care Unit, Division of Cardiology, Department of Internal
Medicine, Keelung Chang Gung Memorial Hospital, Taiwan (Republic of China)
(Wang, Chang, Yang, Juan) School of Medicine, Chang Gung University,
Taoyuan, Taiwan (Republic of China)
(Juan) Institute for Radiological Research, Chang Gung University,
Taoyuan, Taiwan (Republic of China)
(Liu) Department of Nursing, Ching Kuo Institute of Management and Health,
Keelung, Taiwan (Republic of China)
(Juan) Department of Medical Imaging and Intervention, Linkou Chang Gung
Memorial Hospital, Taoyuan, Taiwan (Republic of China)
(Salyani, Verma, Moroney) School of Medicine, Royal College of Surgeons in
Ireland, Dublin, Ireland
(Barbour, Hess) Department of Physiology and Pharmacology, Western
University, London, ON, Canada
(Pasricha) Department of Health & Exercise Science, Wake Forest
University, Winston-Salem, NC, United States
(Bhatt) Division of Cardiovascular Medicine, Brigham and Women's Hospital
Heart & Vascular Center, Harvard Medical School, Boston, MA, United States
(Butler) Baylor Scott and White Research Institute, Dallas, TX, United
States
(Butler) Department of Medicine, University of Mississippi, Jackson,
United States
(Kosiborod) Saint Luke's Mid America Heart Institute, University of
Missouri-Kansas City, United States
(Lam) National Heart Centre Singapore, Singapore
(Lam) Division of Cardiology, Duke-National University of Singapore,
Singapore
(Hess) Molecular Medicine Research Laboratories, Robarts Research
Institute, London, ON, Canada
(Rizzi Coelho-Filho) Faculdade de Ciencias Medicas, Universidade Estadual
de Campinas, Sao Paulo, Brazil
(Lam) Division of Cardiology, Department of Medicine, State University of
Campinas (UNICAMP), Sao Paulo, Brazil
Publisher
Lippincott Williams and Wilkins
Abstract
Background: Sodium-glucose cotransporter 2 inhibitors have been
demonstrated to promote reverse cardiac remodeling in people with diabetes
or heart failure. Although it has been theorized that sodium-glucose
cotransporter 2 inhibitors might afford similar benefits in people without
diabetes or prevalent heart failure, this has not been evaluated. We
sought to determine whether sodium-glucose cotransporter 2 inhibition with
empagliflozin leads to a decrease in left ventricular (LV) mass in people
without type 2 diabetes or significant heart failure. <br/>Method(s):
Between April 2021 and January 2022, 169 individuals, 40 to 80 years of
age, without diabetes but with risk factors for adverse cardiac remodeling
were randomly assigned to empagliflozin (10 mg/d; n=85) or placebo (n=84)
for 6 months. The primary outcome was the 6-month change in LV mass
indexed (LVMi) to baseline body surface area as measured by cardiac
magnetic resonance imaging. Other measures included 6-month changes in LV
end-diastolic and LV end-systolic volumes indexed to baseline body surface
area and LV ejection fraction. <br/>Result(s): Among the 169 participants
(141 men [83%]; mean age, 59.3+/-10.5 years), baseline LVMi was
63.2+/-17.9 g/m2 and 63.8+/-14.0 g/m2 for the empagliflozin- and
placebo-assigned groups, respectively. The difference (95% CI) in LVMi at
6 months in the empagliflozin group versus placebo group adjusted for
baseline LVMi was -0.30 g/m2 (-2.1 to 1.5 g/m2; P=0.74). Median baseline
(interquartile range) NT-proBNP (N-terminal-pro B-type natriuretic
peptide) was 51 pg/mL (20-105 pg/mL) and 55 pg/mL (21-132 pg/mL) for the
empagliflozin- and placebo-assigned groups, respectively. The 6-month
treatment effect of empagliflozin versus placebo (95% CI) on blood
pressure and NT-proBNP (adjusted for baseline values) were -1.3 mm Hg
(-5.2 to 2.6 mm Hg; P=0.52), 0.69 mm Hg (-1.9 to 3.3 mm Hg; P=0.60), and
-6.1 pg/mL (-37.0 to 24.8 pg/mL; P=0.70) for systolic blood pressure,
diastolic blood pressure, and NT-proBNP, respectively. No clinically
meaningful between-group differences in LV volumes (diastolic and systolic
indexed to baseline body surface area) or ejection fraction were observed.
No difference in adverse events was noted between the groups.
<br/>Conclusion(s): Among people with neither diabetes nor significant
heart failure but with risk factors for adverse cardiac remodeling,
sodium-glucose cotransporter 2 inhibition with empagliflozin did not
result in a meaningful reduction in LVMi after 6 months. Registration:
URL: https://www.clinicaltrials.gov; Unique identifier:
NCT04461041.<br/>Copyright &#xa9; 2022 American Heart Association, Inc.

<59>
Accession Number
2022332749
Title
Effect of Remote Ischaemic Preconditioning on Perioperative Endothelial
Dysfunction in Non-Cardiac Surgery: A Randomised Clinical Trial.
Source
Cells. 12(6) (no pagination), 2023. Article Number: 911. Date of
Publication: March 2023.
Author
Wahlstrom K.L.; Hansen H.F.; Kvist M.; Burcharth J.; Lykkesfeldt J.;
Gogenur I.; Ekeloef S.
Institution
(Wahlstrom, Hansen, Kvist, Burcharth, Gogenur, Ekeloef) Center for
Surgical Science, Department of Surgery, Zealand University Hospital,
Lykkebaekvej 1, Koge 4600, Denmark
(Lykkesfeldt) Section of Experimental Animal Models, Department of
Veterinary and Animal Sciences, Faculty of Health and Medical Sciences,
University of Copenhagen, Ridebanevej 9, Frederiksberg C 1871, Denmark
(Gogenur) Department of Clinical Medicine, University of Copenhagen,
Blegdamsvej 3B, Copenhagen N 2200, Denmark
Publisher
MDPI
Abstract
Endothelial dysfunction result from inflammation and excessive production
of reactive oxygen species as part of the surgical stress response. Remote
ischemic preconditioning (RIPC) potentially exerts anti-oxidative and
anti-inflammatory properties, which might stabilise the endothelial
function after non-cardiac surgery. This was a single centre randomised
clinical trial including 60 patients undergoing sub-acute laparoscopic
cholecystectomy due to acute cholecystitis. Patients were randomised to
RIPC or control. The RIPC procedure consisted of four cycles of five
minutes of ischaemia and reperfusion of one upper extremity. Endothelial
function was assessed as the reactive hyperaemia index (RHI) and
circulating biomarkers of nitric oxide (NO) bioavailability (L-arginine,
asymmetric dimethylarginine (ADMA), L-arginine/ADMA ratio, tetra- and
dihydrobiopterin (BH<inf>4</inf> and BH<inf>2</inf>), and total plasma
biopterin) preoperative, 2-4 h after surgery and 24 h after surgery. RHI
did not differ between the groups (p = 0.07). Neither did levels of
circulating biomarkers of NO bioavailability change in response to RIPC.
L-arginine and L-arginine/ADMA ratio was suppressed preoperatively and
increased 24 h after surgery (p < 0.001). The
BH<inf>4</inf>/BH<inf>2</inf>-ratio had a high preoperative level,
decreased 2-4 h after surgery and remained low 24 h after surgery (p =
0.01). RIPC did not influence endothelial function or markers of NO
bioavailability until 24 h after sub-acute laparoscopic cholecystectomy.
In response to surgery, markers of NO bioavailability increased, and
oxidative stress decreased. These findings support that a minimally
invasive removal of the inflamed gallbladder countereffects reduced
markers of NO bioavailability and increased oxidative stress caused by
acute cholecystitis.<br/>Copyright &#xa9; 2023 by the authors.

<60>
Accession Number
2023946163
Title
Clinical Outcomes of PASCAL Compared With the MitraClip for Symptomatic
Mitral Regurgitation: A Meta-Analysis.
Source
JACC: Cardiovascular Interventions. 16(8) (pp 1005-1007), 2023. Date of
Publication: 24 Apr 2023.
Author
Bansal A.; Faisaluddin M.; Agarwal S.; Badwan O.; Harb S.C.; Krishnaswamy
A.; Gillinov M.; Kapadia S.R.
Publisher
Elsevier Inc.

<61>
Accession Number
2023881067
Title
Clinical Outcomes of Individualized Antiplatelet Therapy Based on Platelet
Function Test in Patients after Percutaneous Coronary Intervention: A
Systematic Review and Meta-analysis.
Source
Journal of Cardiovascular Pharmacology. 81(4) (pp 270-279), 2023. Date of
Publication: 29 Apr 2023.
Author
Peng W.; Zhang Y.; Lin B.; Lin Y.
Institution
(Peng, Zhang, Lin, Lin) Department of Pharmacy, Beijing Anzhen Hospital,
Capital Medical University, Beijing, China
(Zhang, Lin) School of Pharmaceutical Sciences, Capital Medical
University, Beijing, China
Publisher
Lippincott Williams and Wilkins
Abstract
Platelet function test (PFT) is universally used to assess platelet
reactivity to antiplatelet drugs in patients after percutaneous coronary
intervention (PCI). However, it remains controversial whether
individualized antiplatelet therapy guided by PFT can improve the
prognosis in patients after PCI. This meta-analysis was conducted to
explore the efficacy and safety of individualized antiplatelet therapy
guided by PFT in patients after PCI. Studies that compared PFT-guided
antiplatelet therapy with standard antiplatelet therapy were researched.
The risks of major adverse cardiovascular and cerebrovascular events
(MACCE) and major bleeding events were assessed. Pooled odds ratios (ORs)
with 95% CIs were obtained. Finally, a total of 16,835 patients from 22
studies met the criteria and were included in the meta-analysis. Compared
with standard antiplatelet therapy, individualized antiplatelet therapy
guided by PFT significantly decreased the risk of MACCE (OR: 0.58, 95% CI:
0.43-0.77) in patients after PCI. There was no significant difference in
major bleeding events (OR: 0.85, 95% CI: 0.70-1.05, P = 0.13). This study
identified that PFT-guided individualized antiplatelet therapy could
reduce the incidence of MACCE without increasing the risk of hemorrhage in
patients after PCI.<br/>Copyright &#xa9; 2023 Lippincott Williams and
Wilkins. All rights reserved.

<62>
Accession Number
2023850070
Title
Transseptal vs Transapical Transcatheter Mitral Valve-in-Valve and
Valve-in-Ring Implantation: A Systematic Review and Meta-Analysis.
Source
Current Problems in Cardiology. 48(7) (no pagination), 2023. Article
Number: 101684. Date of Publication: July 2023.
Author
Al-Tawil M.; Butt S.; Reap S.; Duric B.; Harahwa T.; Chandiramani A.;
Zeinah M.; Harky A.
Institution
(Al-Tawil) Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
(Butt) Department of Thoracic Surgery, Nottingham City Hospital,
Nottingham, United Kingdom
(Reap) Department of Vascular Surgery, Manchester Royal Infirmary,
Manchester, United Kingdom
(Duric) King's College London, GKT School of Medical Education, London,
United Kingdom
(Harahwa) Department of Obstetrics and Gynecology, University Hospital
Lewisham, London, United Kingdom
(Chandiramani) Department of General Surgery, Aberdeen Royal Infirmary,
Scotland, United Kingdom
(Zeinah) Faculty of Medicine, Ain Sham University, Cairo, Egypt
(Zeinah, Harky) Department of Cardiothoracic Surgery, Liverpool Heart and
Chest Hospital, Liverpool, United Kingdom
Publisher
Elsevier Inc.
Abstract
Transcatheter mitral valve replacement has become a useful alternative for
patients with failed mitral prosthesis or annuloplasty rings who are
deemed high risk for redo surgery. We aimed to compare the clinical
outcomes following transseptal (TS) and transapical (TA) approaches in
transcatheter mitral valve-in-valve and valve-in-ring implantation
(TMViV/R). Electronic databases PubMed, MEDLINE, and Embase were searched
through November 2022. Both clinical trials and observational studies
comparing patients undergoing TS and TA TMViV/R were eligible for
inclusion. Primary outcomes were 30-day and 1-year mortality.
Postoperative stroke, left ventricle outlet tract (LVOT) obstruction,
mitral valve pressure gradient (MVPG), bleeding, and length of hospital
stay were also evaluated. Seven observational studies were included
comparing patients undergoing TS (n = 1875) and TA (n = 1120) TMViV/R. The
TS group had significantly lower 30-day mortality (OR: 0.66; 95%
confidence interval [CI] [0.47, 0.94]; P = 0.02, I2 = 0%) and lower
one-year mortality risk group (HR: 0.79; 95% CI [0.63, 0.99]; P = 0.04, I2
= 0%) compared to the TA group. The TS group had consistent shorter
in-hospital stay (MD = -3.79; 95% CI [-5.23, -2.34] days; P < 0.0001, I2 =
75%). Postoperative stroke, bleeding and LVOT obstruction tended to be
lower in the TS but the results did not reach statistical significance.
Postoperative MVPG was similar between both groups. The TS approach has
lower early mortality, lower 1-year death hazard, shorter in-hospital
stay, and a trend toward lower complication rates when compared to TA
TMViV/R. Further controlled trials may support the evidence and provide
long-term outcomes.<br/>Copyright &#xa9; 2023 Elsevier Inc.

<63>
Accession Number
2023849890
Title
Meta-analysis of the efficacy and safety of tirofiban in patients with
acute ischaemic stroke undergoing mechanical thrombectomy.
Source
Clinical Neurology and Neurosurgery. 228 (no pagination), 2023. Article
Number: 107702. Date of Publication: May 2023.
Author
Liu C.; Yang X.; Liu M.; Wang J.; Li G.
Institution
(Liu, Li) Department of Neurology, The Frist Affiliated Hospital of
Chongqing Medical University, Chongqing 400016, China
(Yang) Department of Neurology, Hechuan District People's Hospital,
Chongqing 401500, China
(Liu) Department of Neurology, Zhongshan Hospital Affiliated to Fudan
University, Shanghai 200032, China
(Wang) Department of Neurology, Chongqing University Central Hospital
400050, China
Publisher
Elsevier B.V.
Abstract
Introduction: Mechanical thrombectomy is now widely used in acute
ischaemic stroke, but its adjunctive antiplatelet aggregation regimen is
controversial. This study aimed to investigate the safety and efficacy of
tirofiban in patients with acute ischaemic stroke (AIS) who underwent
mechanical thrombectomy. <br/>Method(s): We systematically searched
Pubmed, Embase, Cochrane Library, and Web of science. Randomized
controlled studies and cohort studies comparing the tirofiban group and
non-tirofiban group (control group) in patients with AIS who underwent
mechanical thrombectomy. The primary safety outcomes were symptomatic
intracranial hemorrhage (sICH), 3-month mortality, and re-occlusion rate.
The primary efficacy outcomes were good functional outcome (mRS 0-2),
excellent functional outcome (mRS 0-1), and successful recanalization
(mTICI>=2b). <br/>Result(s): We included 22 studies with a total of 6062
patients. For safety outcomes, the tirofiban group had a non-significantly
higher rate of sICH (OR = 0.90, 95 % CI = 0.73-1.10, P = 0.29) and a
significantly lower rate of re-occlusion (OR = 0.40, 95 % CI = 0.19-0.82,
P = 0.01) and 3-month mortality (OR = 0.71, 95 % CI = 0.61-0.82, P <
0.00001) compared to the control group. In terms of efficacy outcomes,
significant improvement in good functional outcomes (mRS 0-2) (OR = 1.24,
95 % CI = 1.11-1.39, P = 0.0002) and recanalization rate (OR = 1.38, 95%
CI = 1.17-1.62, P = 0.0001) compared to tirofiban, but not significant
improvement in excellent functional outcomes(OR = 1.14, 95 % CI =
0.93-1.39, P = 0.21). In addition, compared with cardiogenic stroke, the
large atherosclerotic stroke had a higher rate of good functional outcome
(OR = 1.58, 95 % CI = 1.18-2.11, P = 0.002) and a lower rate of 3-month
mortality (OR = 0.58, 95 % CI = 0.39-0.85, P = 0.005). Subgroup analysis
by route of administration showed a significant improvement in good
functional outcome in the intravenous group (OR = 1.27, 95 % CI =
1.08-1.50, P = 0.004), while no significant difference was found between
the arterial and arteriovenous groups. <br/>Conclusion(s): Treatment with
tirofiban in patients with AIS with mechanical thrombectomy is effective
in improving functional prognosis, arterial recanalization rates, and
reducing 3-month mortality and re-occlusion rates, particularly in
patients with large atherosclerotic stroke, without increasing the rate of
symptomatic intracranial hemorrhage. Intravenous administration of
tirofiban significantly improves the clinical prognosis compared to
arterial administration. Tirofiban is effective and safe in patients with
AIS.<br/>Copyright &#xa9; 2023 Elsevier B.V.

<64>
Accession Number
2023793555
Title
Transcatheter Aortic Valve Implantation Outcomes and Challenges in Asia: A
Systematic Review and Meta-Analysis.
Source
Reviews in Cardiovascular Medicine. 24(3) (no pagination), 2023. Article
Number: A48. Date of Publication: March 2023.
Author
Rivera F.B.; De Luna D.V.; Ansay M.F.M.; Nguyen R.T.; Flores G.P.;
Magalong J.V.; Cha S.W.; Aparece J.P.; Gonzales J.S.T.; Salva W.F.C.;
Mangubat G.F.E.; Mahilum M.L.P.; Inohara T.; Vijayaraghavan K.; Collado
F.M.S.; Latib A.
Institution
(Rivera) Department of Medicine, Lincoln Medical Center, New York, NY
10451, United States
(De Luna) Department of Internal Medicine, Danbury Hospital, Danbury, CT
06810, United States
(Ansay) Ateneo de Manila School of Medicine and Public Health, Pasig 1604,
Philippines
(Nguyen) Department of Medicine, Houston Methodist, Houston, TX 77030,
United States
(Flores) King George Hospital, Ilford IG3 8YB, United Kingdom
(Magalong) Department of Medicine, San Beda University College of
Medicine, Manila 1005, Philippines
(Cha, Aparece, Gonzales, Salva) Cebu Institute of Medicine, Cebu 6000,
Philippines
(Mangubat, Mahilum) Southern Philippines Medical Center, Davao 8000,
Philippines
(Inohara) Department of Cardiology, Keio University School of Medicine,
Tokyo 160-8582, Japan
(Vijayaraghavan) University of Arizona, Tucson, AZ 85721, United States
(Collado) Department of Cardiology, Rush University Medical Center,
Chicago, IL 60612, United States
(Latib) Section of Interventional Cardiology-Structural Heart, Montefiore
Medical Center, Albert Einstein College of Medicine, New York, NY 10461,
United States
Publisher
IMR Press Limited
Abstract
Background: Aortic stenosis (AS) is the world's most prevalent heart valve
disease. Transcatheter aortic valve replacement (TAVR) or Implantation
(TAVI) is widely available yet adopting this procedure in Asia has been
slow due to high device cost, the need for specific training programs, and
the lack of specialized heart teams and dedicated infrastructures. The
limited number of randomized controlled trials describing TAVI outcomes
among the Asian population hampered the approval for medical
reimbursements as well as acceptance among surgeons and operators in some
Asian countries. <br/>Method(s): A comprehensive medical literature search
on TAVI and/or TAVR performed in Asian countries published between January
2015 and June 2022 was done through MEDLINE and manual searches of
bibliographies. The full text of eligible articles was obtained and
evaluated for final analysis. The event rates for key efficacy and safety
outcomes were calculated using the data from the registries and randomized
controlled trials. <br/>Result(s): A total of 15,297 patients were
included from 20 eligible studies. The mean patient age was 82.88 +/- 9.94
years, with over half being females (62.01%). All but one study reported
Society of Thoracic Surgeons (STS) scores averaging an intermediate risk
score of 6.28 +/- 1.06%. The mean logistic European Systems for Cardiac
Operations Risk Evaluation (EuroSCORE) was 14.85. The mean baseline
transaortic gradient and mean aortic valve area were 50.93 +/- 3.70 mmHg
and 0.64 +/- 0.07 cm2, respectively. The mean procedural success rate was
95.28 +/- 1.51%. The weighted mean 30-day and 1-year all-cause mortality
rate was 1.66 +/- 1.21% and 8.79 +/- 2.3%, respectively. The mean average
for stroke was 1.98 +/- 1.49%. The acute kidney injury (AKI) rate was 6.88
+/- 5.71%. The overall major vascular complication rate was 2.58 +/-
2.54%; the overall major bleeding rate was 3.88 +/- 3.74%. Paravalvular
aortic regurgitation rate was 15.07 +/- 9.58%. The overall rate of
pacemaker insertion was 7.76 +/- 4.6%. <br/>Conclusion(s): Compared to
Americans and Europeans, Asian patients who underwent TAVI had lower
all-cause mortality, bleeding, and vascular complications, however, had a
higher rate of postprocedural aortic regurgitation. More studies with
greater sample sizes are needed among Asian patients for a more robust
comparison.<br/>Copyright &#xa9; 2023 The Author(s).

<65>
Accession Number
2023793545
Title
Procedural Characteristics and Clinical Outcomes Associated with Chronic
Total Occlusion Percutaneous Coronary Intervention in Patients with a
History of Prior Coronary Artery Bypass Graft: A Meta-Analysis.
Source
Reviews in Cardiovascular Medicine. 24(3) (no pagination), 2023. Article
Number: A38. Date of Publication: March 2023.
Author
He S.; Li Y.; Cheng Z.; Shi Y.; Liu J.
Institution
(He, Li, Cheng, Shi, Liu) Center for Coronary Artery Disease (CCAD),
Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of
Heart, Lung and Blood Vessel Diseases, Beijing 100029, China
Publisher
IMR Press Limited
Abstract
Background: Owing to advances in procedural techniques and the training of
interventional staff in catheterization labs, recent work has demonstrated
the safety of percutaneous coronary intervention (PCI) as a treatment for
patients suffering from chronic total occlusion (CTO). However, there has
been little research focused on systematic comparisons of PCI outcomes in
CTO patients that did or did not exhibit a history of previous coronary
artery bypass grafting (CABG). <br/>Method(s): Electronic databases were
systematically searched for all studies comparing CTO-PCI outcomes for
patients with and without a history of CABG, with event rates subsequently
being compared via random-effects models with forest plots and odds ratios
with 95% confidence intervals (CI), owing to the assumption of
between-studies heterogeneity. <br/>Result(s): In total, 8 observational
studies enrolling 13,509 CTO patients were identified, including 3389 and
10,120 patients with and without a history of prior CABG, respectively.
Patients were enrolled in these studies from 1999-2018. Pooled analyses
indicated that CABG history was not linked to a lower proportion of radial
access 24 (95% CI 0.52-1.03, p = 0.08), and a prior CABG history was
linked to a greater contrast volume (95% CI 0.12-0.44, p<0.001), higher
radiation dose (95% CI 0.27-0.40, p< 0.001), longer fluoroscopy time (95%
CI 0.42-0.61, p < 0.001), longer procedural time (95% CI 0.38-0.64, p <
0.001), a higher number of implanted stents (95% CI 0.41-0.60, p < 0.001),
longer total stent length (95% CI 0.21-0.60, p < 0.001), higher technical
failure rates (95% CI 1.46-1.85, p < 0.001), and higher rates of
procedural failure (95% CI 1.42-1.79, p < 0.001). The in-hospital
mortality (95% CI 1.50-4.03, p < 0.001) and periprocedural mortality (95%
CI 1.63-3.73, p < 0.001) of patients with a history of CABG were also
higher. While stroke incidence was comparable in both groups (95% CI
0.80-4.47, p = 0.15), periprocedural major adverse cardiovascular and
cerebrovascular events (MACCE) rates were significantly higher among
patients exhibiting a history of CABG (95% CI 1.66-2.94, p < 0.001).
<br/>Conclusion(s): These results suggest that CTO-PCI procedures may be
more challenging and associated with lower rates of success in CABG
patients relative to procedures performed in patients without any history
of CABG. Moreover, in-hospital outcomes including MACCE and mortality were
worse for patients that had undergone prior CABG.<br/>Copyright &#xa9;
2023 The Author(s).

<66>
Accession Number
2023793527
Title
Long-Term Efficacy and Safety of Left Atrial Appendage Occlusion (LAAO) vs
Direct Oral Anticoagulation (DOAC) in Patients with Atrial Fibrillation: A
Systematic Review and Meta-Analysis.
Source
Reviews in Cardiovascular Medicine. 24(2) (no pagination), 2023. Article
Number: A20. Date of Publication: February 2023.
Author
Razzack A.A.; Lak H.M.; Erasani G.; Rahman S.; Hussain N.; Ali B.F.; Eapi
S.; Yasmin F.; Najeeb H.; Mustafa A.; Chawla S.; Munir M.B.; Barakat A.F.;
Saliba W.; Wazni O.; Hussein A.A.
Institution
(Razzack, Erasani) Department of Internal Medicine, Dr. N.T.R University
of Health Sciences, Vijayawada 520008, India
(Lak, Chawla) Department of Internal Medicine, Cleveland Clinic
Foundation, Cleveland OH 44195, United States
(Rahman) Department of Internal Medicine, Jalalabad Ragib Rabeya Medical
College and Hospital, Sylhet 3030, Bangladesh
(Hussain) Department of Medicine, Saba University School of Medicine,
JQG3+87 The Bottom JQG3+87, Netherlands
(Ali) Department of Medicine, Akhtar Saeed Medical and Dental College,
Lahore 54000, Pakistan
(Eapi) Department of Medicine, Hackensack University Medical Center,
Hackensack, NJ NJ 07601, United States
(Yasmin, Najeeb) Department of Internal Medicine, Dow University of Health
Sciences, Karachi 74200, Pakistan
(Mustafa) Department of Internal Medicine, Staten Island University
Hospital, Staten Island, United States
(Munir) Section of Electrophysiology, Department of Cardiovascular
Medicine, University of. California San Diego, San Diego CA 92111, United
States
(Barakat) Section of Electrophysiology, UPMC Heart and Vascular Institute,
University of Pittsburgh, Pittsburgh PA 15260, United States
(Saliba, Wazni, Hussein) Section of Cardiac Pacing and Electrophysiology,
Robert and Suzanne Tomsich Department of Cardiovascular Medicine, Sydell
and Arnold Miller Family Heart, Vascular and Thoracic Institute, Cleveland
Clinic, Cleveland OH 44195, United States
Publisher
IMR Press Limited
Abstract
Background: Prevention of stroke by anticoagulation is essential in
patients with Atrial fibrillation (AF); with direct oral anticoagulants
(DOACs) being preferred over warfarin in most patients. The Long-term
efficacy and safety of DOACs vs. Left Atrial Appendage Occlusion (LAAO)
remain unknown. <br/>Method(s): Electronic databases (PubMed, Embase,
Scopus) were searched from inception to February 10th, 2021. The primary
endpoint was cardiovascular mortality. Secondary outcomes included
incidence of ischemic stroke/transient ischemic attack (TIA) and
systemicembolism. The safety endpoint was clinically relevant bleeding (a
composite of major or minor clinically relevant bleeding). <br/>Result(s):
A total of three studies with 3039 participants (LAAO = 1465; DOACs =
1574) were included. Mean age was 74.2 and 75.3 years in the LAAO and DOAC
group respectively. Average follow-up period was 2 years. There was no
difference in terms of cardiac mortality (RR 0.90, 95% CI 0.40-2.03; p =
0.81), ischemic stroke/TIA (RR 1.15, 95% CI 0.80-1.65; p = 0.46; I2 = 0)
and clinically significant bleeding (RR 0.77, 95% CI 0.50-1.17; p = 0.22;
I2 = 69) between the groups. <br/>Conclusion(s): Among patients with AF,
LAAO was comparable to DOACs with similar efficacy and safety
profiles.<br/>Copyright &#xa9; 2022 The Author(s).

<67>
Accession Number
2023789488
Title
Diagnosis and Treatment of Acute Myocarditis: A Review.
Source
JAMA. 329(13) (pp 1098-1113), 2023. Date of Publication: 04 Apr 2023.
Author
Ammirati E.; Moslehi J.J.
Institution
(Ammirati) De Gasperis Cardio Center, Transplant Center, Niguarda
Hospital, Milano, Italy
(Ammirati) Department of Health Sciences, University of Milano-Bicocca,
Monza, Italy
(Moslehi) Section of Cardio-oncology and Immunology, Cardiovascular
Research Institute, University of California San Francisco School of
Medicine, San Francisco, United States
Publisher
American Medical Association
Abstract
Importance: Acute myocarditis, defined as a sudden inflammatory injury to
the myocardium, affects approximately 4 to 14 people per 100000 each year
globally and is associated with a mortality rate of approximately 1% to
7%. Observations: The most common causes of myocarditis are viruses, such
as influenza and coronavirus; systemic autoimmune disorders, such as
systemic lupus erythematosus; drugs, such as immune checkpoint inhibitors;
and vaccines, including smallpox and mRNA COVID-19 vaccines. Approximately
82% to 95% of adult patients with acute myocarditis present with chest
pain, while 19% to 49% present with dyspnea, and 5% to 7% with syncope.
The diagnosis of myocarditis can be suggested by presenting symptoms,
elevated biomarkers such as troponins, electrocardiographic changes of ST
segments, and echocardiographic wall motion abnormalities or wall
thickening. Cardiac magnetic resonance imaging or endomyocardial biopsy
are required for definitive diagnosis. Treatment depends on acuity,
severity, clinical presentation, and etiology. Approximately 75% of
patients admitted with myocarditis have an uncomplicated course, with a
mortality rate of approximately 0%. In contrast, acute myocarditis that is
complicated by acute heart failure or ventricular arrhythmias is
associated with a 12% rate of either in-hospital mortality or need for
heart transplant. Approximately 2% to 9% of patients have hemodynamic
instability, characterized by inability to maintain adequate end-organ
perfusion, and require inotropic agents, or mechanical circulatory
devices, such as extracorporeal life support, to facilitate functional
recovery. These patients have an approximately 28% rate of mortality or
heart transplant at 60 days. Immunosuppression (eg, corticosteroids) is
appropriate for patients who have myocarditis characterized by
eosinophilic or giant cell myocardial infiltrations or due to systemic
autoimmune disorders. However, the specific immune cells that should be
targeted to improve outcomes in patients with myocarditis remain unclear.
<br/>Conclusions and Relevance: Acute myocarditis affects approximately 4
to 14 per 100000 people per year. First-line therapy depends on acuity,
severity, clinical presentation, and etiology and includes supportive
care. While corticosteroids are often used for specific forms of
myocarditis (eg, eosinophilic or giant cell infiltrations), this practice
is based on anecdotal evidence, and randomized clinical trials of optimal
therapeutic interventions for acute myocarditis are needed..<br/>Copyright
&#xa9; 2023 American Medical Association. All rights reserved.

<68>
Accession Number
2023678950
Title
Incidence, risk factors, and clinical outcomes of HBV reactivation in
non-liver solid organ transplant recipients with resolved HBV infection: A
systematic review and meta-analysis.
Source
PLoS Medicine. 20(3 March) (no pagination), 2023. Article Number:
e1004196. Date of Publication: March 2023.
Author
Yin S.; Zhang F.; Wu J.; Lin T.; Wang X.
Institution
(Yin, Zhang, Wu, Lin, Wang) Department of Urology, Institute of Urology,
West China Hospital, Sichuan University, Sichuan Province, Chengdu City,
China
(Yin, Zhang, Wu, Lin, Wang) Organ Transplantation Center, West China
Hospital, Sichuan University, Sichuan Province, Chengdu City, China
Publisher
Public Library of Science
Abstract
Background Current guidelines do not recommend routine antiviral
prophylaxis to prevent hepatitis B virus (HBV) reactivation in non-liver
solid organ transplant (SOT) recipients with resolved HBV infection, even
in anti-hepatitis B surface antigen (anti-HBs)-negative recipients and
those receiving intense immunosuppression. This systematic review and
meta-analysis aimed to determine the incidence, risk factors, and clinical
outcomes of HBV reactivation in non-liver SOT recipients. Methods and
findings Three databases (PubMed, Embase, and Cochrane Library) were
systematically searched up to December 31, 2022. Clinical studies
reporting HBV reactivation in non-liver SOT recipients were included. Case
reports, case series, and cohort studies with a sample size of less than
10 patients were excluded. Random-effects analysis was used for all
meta-analyses. We included 2,913 non-liver SOT recipients with resolved
HBV infection from 16 retrospective cohort studies in the analysis. The
overall HBV reactivation rate was 2.5% (76/2,913; 95% confidence interval
[95% CI 1.6%, 3.6%]; I² = 55.0%). Higher rates of reactivation
were observed in recipients with negative anti-HBs (34/421; 7.8%; 95% CI
[5.2%, 10.9%]; I² = 36.0%) by pooling 6 studies, experiencing
acute rejection (13/266; 5.8%; 95% CI [2.3%, 14.5%]; I² =
63.2%) by pooling 3 studies, receiving ABO blood type-incompatible
transplantation (8/111; 7.0%; 95% CI [2.9%, 12.7%]; I² = 0%) by
pooling 3 studies, receiving rituximab (10/133; 7.3%; 95% CI [3.4%,
12.6%]; I² = 0%) by pooling 3 studies, and receiving
anti-thymocyte immunoglobulin (ATG, 25/504; 4.9%; 95% CI [2.5%, 8.1%];
I² = 49.0%) by pooling 4 studies. Among recipients with
post-transplant HBV reactivation, 11.0% (7/52; 95% CI [4.0%, 20.8%];
I² = 0.3%) developed HBV-related hepatic failure, and 11.0%
(7/52; 95% CI [4.0%, 20.8%]; I² = 0.3%) had HBV-related death.
Negative anti-HBs (crude odds ratio [OR] 5.05; 95% CI [2.83, 9.00]; p <
0.001; I² = 0%), ABO blood type-incompatible transplantation
(crude OR 2.62; 95% CI [1.05, 6.04]; p = 0.040; I² = 0%),
history of acute rejection (crude OR 2.37; 95% CI [1.13, 4.97]; p = 0.022;
I² = 0%), ATG use (crude OR 3.19; 95% CI [1.48,
edforthoseusedinthetext 6.87]; p = 0.003;
I:Pleaseverifythatallentriesarecorrect ² = 0%), and rituximab
use:(crude OR 3.16; 95% CI [1.24, 8.06]; p = 0.016; I² = 0%)
increased the risk of reactivation. Adjusted analyses reported similar
results. Limitations include moderate heterogeneity in the meta-analyses
and that most studies were conducted in kidney transplant recipients.
Conclusions Non-liver SOT recipients with resolved HBV infection have a
high risk of HBV-related hepatic failure and HBV-related death if HBV
reactivation occurs. Potential risk factors for HBV reactivation include
rituximab use, anti-thymocyte immunoglobulin use, anti-HBs negative
status, acute rejection history, and ABO blood type-incompatible
transplantation. Further research on monitoring and routine antiviral
prophylaxis of non-liver SOT recipients at higher risk of HBV reactivation
is required.<br/>Copyright &#xa9; 2023 Yin 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.

<69>
Accession Number
2023675143
Title
The influence of elevated heart rate assessed by automated office blood
pressure measurement on the risk of cardiovascular events.
Source
Polish Archives of Internal Medicine. 133(3) (no pagination), 2023.
Article Number: 16398. Date of Publication: 29 Mar 2023.
Author
Sobieraj P.; Sinski M.P.; Lewandowski J.
Institution
(Sobieraj, Sinski, Lewandowski) Department of Internal Medicine,
Hypertension and Vascular Diseases, Medical University of Warsaw, Warsaw,
Poland
Publisher
Medycyna Praktyczna Cholerzyn
Abstract
INTROduCTION The predictive value of heart rate (HR) assessed using an
automated office blood pres- sure measurement (AOBPM) remains unknown.
ObjECTIvEs This study aimed to determine the impact of AOBPM HR on the
risk of cardiovascular events in hypertensive patients with and without
prior cardiovascular disease (CVD). PATIENTs ANd mEThOds Data of 9361
participants of the Systolic Blood Pressure Intervention Trial (median
follow-up, 3.26 years) were used to perform a post hoc analysis based on
baseline AOBPM HR levels (<50, 50-60, 60-70, 70-80, and >80 bpm). Clinical
composite end point (CE) was defined as myocardial infarction (MI), acute
coronary syndrome other than MI, heart failure exacerbation, stroke, or
cardiovascular death. Cardiovascular-related and all-cause mortalities
were also evaluated. REsuLTs A total of 1877 participants with and 7484
individuals without CVD were included. Those with higher baseline HR were
less frequently men and more often smokers, had higher body mass index and
estimated glomerular filtration rate, lower baseline systolic blood
pressure, and higher diastolic blood pressure. No differences were
observed in the CE frequency, its components, and all-cause death between
the baseline HR groups. Elevated HR (>70 bpm) was associated with a higher
risk of CE, MI, and cardiovascular death in a multivariable Cox model.
Moreover, the model determining the MI risk showed a J-shaped relationship
with HR and a significant interaction term (P = 0.049) between HR and CVD
history. CONCLusIONs High AOBPM HR is associated with a higher risk of
cardiovascular events and mortality, whereas low HR may result in higher
MI risk in patients with previous CVD.<br/>Copyright by the Author(s),
2023.

<70>
Accession Number
2023832242
Title
The use of objective assessments in the evaluation of technical skills in
cardiothoracic surgery: a systematic review.
Source
Interactive Cardiovascular and Thoracic Surgery. 35(3) (no pagination),
2022. Article Number: ivac194. Date of Publication: 01 Sep 2022.
Author
Hussein N.; Van Den Eynde J.; Callahan C.; Guariento A.;
Gollmann-Tepekoylu C.; Elbatarny M.; Loubani M.
Institution
(Hussein, Loubani) Hull-York-Medical-School, University of York, York,
United Kingdom
(Hussein, Loubani) Department of Cardiothoracic Surgery, Castle Hill
Hospital, Cottingham, United Kingdom
(Van Den Eynde) Department of Cardiovascular Sciences, Ku Leuven, Leuven,
Belgium
(Callahan) Department of Surgery, Washington University School of
Medicine, St. Louis, MO, United States
(Guariento) Pediatric and Congenital Cardiac Surgery Unit, Department of
Cardiac, Thoracic, Vascular Sciences and Public Health, University of
Padua, Padua, Italy
(Gollmann-Tepekoylu) Department of Cardiac Surgery, Medical University of
Innsbruck, Innsbruck, Austria
(Elbatarny) Department of Cardiac Surgery, University of Toronto, Toronto,
ON, Canada
Publisher
Oxford University Press
Abstract
OBJECTIVES: With reductions in training time and intraoperative exposure,
there is a need for objective assessments to measure trainee progression.
This systematic review focuses on the evaluation of trainee technical
skill performance using objective assessments in cardiothoracic surgery
and its incorporation into training curricula. <br/>METHOD(S): Databases
(EBSCOHOST, Scopus and Web of Science) and reference lists of relevant
articles for studies that incorporated objective assessment of technical
skills of trainees/residents in cardiothoracic surgery were included. Data
extraction included task performed; assessment setting and tool used;
number/level of assessors; study outcome and whether the assessments were
incorporated into training curricula. The methodological rigour of the
studies was scored using the Medical Education Research Study Quality
Instrument (MERSQI). <br/>RESULT(S): Fifty-four studies were included for
quantitative synthesis. Six were randomized-controlled trials. Cardiac
surgery was the most common speciality utilizing objective assessment
methods with coronary anastomosis the most frequently tested task.
Likert-based assessment tools were most commonly used (61%). Eighty-five
per cent of studies were simulation-based with the rest being
intraoperative. Expert surgeons were primarily used for objective
assessments (78%) with 46% using blinding. Thirty (56%) studies explored
objective changes in technical performance with 97% demonstrating
improvement. The other studies were primarily validating assessment tools.
Thirty-nine per cent of studies had established these assessment tools
into training curricula. The mean +/- standard deviation MERSQI score for
all studies was 13.6 +/- 1.5 demonstrating high validity.
<br/>CONCLUSION(S): Despite validated technical skill assessment tools
being available and demonstrating trainee improvement, their regular
adoption into training curricula is lacking. There is a need to
incorporate these assessments to increase the efficiency and transparency
of training programmes for cardiothoracic surgeons.<br/>Copyright &#xa9;
2022 The Author(s). Published by Oxford University Press on behalf of the
European Association for Cardio-Thoracic Surgery.

<71>
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.<br/>Copyright &#xa9; 2022 The Authors

<72>
Accession Number
2022341075
Title
Basic pathophysiology and options of treatment for surgical management of
functional tricuspid regurgitation: a systematic review.
Source
Journal of Thoracic Disease. 14(11) (pp 4521-4544), 2022. Date of
Publication: November 2022.
Author
Giuseppe G.; Dell'Angela L.; Fiore A.; Singh S.S.A.; Couetil J.-P.;
Folliguet T.; Sinagra G.; Mazzaro E.; Nappi F.
Institution
(Giuseppe, Sinagra, Mazzaro) Cardio-Thoracic & Vascular Department,
Trieste University Hospital, Trieste, Italy
(Dell'Angela) Division of Cardiology, Gorizia & Monfalcone Hospital,
Gorizia, Italy
(Fiore, Folliguet) Department of Cardiac Surgery, Hopitaux Universitaires
Henri Mondor, Assistance Publique-Hopitaux de Paris, Creteil, France
(Singh) Department of Cardiothoracic Surgery, Aberdeen Royal Infirmary,
Aberdeen, United Kingdom
(Couetil, Nappi) Department of Cardiac Surgery, Centre Cardiologique du
Nord, Saint-Denis, France
Publisher
AME Publishing Company
Abstract
Background: Functional tricuspid regurgitation (TR) appears frequently in
the presence of left-sided heart valve diseases, combined with symptoms of
heart failure, worsens if left untreated, and is associated with poor
patient survival. Correct indications for surgery and the choice of
suitable technique, which should be based on pathophysiology of disease
are of utmost importance to ensure longevity and durability of repair;
particularly given the risky nature of reoperations due to
residual/recurrent TR. <br/>Method(s): A systematic review was performed
using Embase, Ovid Medline, Cochrane, Web of Science, and Google to deepen
knowledge of major and controversial aspects of the subject.
<br/>Result(s): A total of 1,579 studies were reviewed, and 32 of these
were enclosed in the final review: 13 studies were primarily focused on
pathophysiology and preoperative assessment of functional TR; 19 studies
on surgical treatment of functional TR. A total of 15,509 patients were
included. <br/>Conclusion(s): Indications for treatment of TR are based on
the severity of regurgitation (grading), as well as on the presence of
signs and symtoms of right-sided heart failure and on the extent of
tricuspid annular dilation, leaflet tethering, and pulmonary hypertension
(staging of disease). Despite improved knowledge of the underlying
pathophysiology of TR, issues regarding indications for treatment and
options of repair remain present. There is no consensus within the
scientific community, for the preferred method to quantify the severity of
TR; the recently introduced 5-grade TR classification based on objective
quantitative parameters has not yet become common practice. The assessment
of TR during stress exercise is rarely performed, though it takes into
account the changes in severity of regurgitation that occur under
different physiological conditions. Magnetic resonance imaging, which is
the gold standard for the right heart evaluation is occasionally carried
out before surgery. The threshold beyond which the tricuspid annular
dilation should be repaired is unclear and recent studies put forward the
idea that it may be lower than current recommendations. Tricuspid valve
annuloplasty is the most adopted surgical option today. However, the ideal
annuloplasty device remains elusive. In addition, as severe leaflet
tethering cannot be addressed by annuloplasty alone, the addition of new
techniques further increasing leaflet coaptation might optimize long-term
valve continence. Further investigations are needed to address all these
issues, alongside the potential of percutaneous options.<br/>Copyright
&#xa9; Journal of Thoracic Disease. All rights reserved.

<73>
Accession Number
2020113619
Title
Coronary Intervention Guided by Quantitative Flow Ratio vs Angiography in
Patients With or Without Diabetes.
Source
Journal of the American College of Cardiology. 80(13) (pp 1254-1264),
2022. Date of Publication: 27 Sep 2022.
Author
Jin Z.; Xu B.; Yang X.; Jia R.; Meng S.; Hu H.; Deng Y.; Cao X.; Ruan Y.;
Han J.; Liu J.; Qu X.; Zhou Y.; Wang J.; Fu G.; Yu B.; Wang Y.; Guan C.;
Song L.; Tu S.; Qiao S.; Stone G.W.
Institution
(Jin, Yang, Jia, Meng, Hu, Cao, Ruan, Han) Cardiology and Cardiac
Macrovascular Surgical Center, Beijing Tiantan Hospital, Capital Medical
University, Beijing, China
(Xu, Deng, Guan, Song, Qiao) Department of Cardiology, Fuwai Hospital,
National Clinical Research Center for Cardiovascular Diseases, National
Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences
and Peking Union Medical College, Beijing, China
(Xu) National Clinical Research Center for Cardiovascular Diseases, Fuwai
Hospital Chinese Academy of Medical Sciences, Shenzhen, Shenzhen, China
(Liu) Department of Cardiology, Peking University People's Hospital,
Beijing, China
(Qu) Department of Cardiology, Huadong Hospital Affiliated to Fudan
University, Shanghai, China
(Zhou) Department of Cardiology, Beijing Anzhen Hospital, Capital Medical
University, Beijing, China
(Wang) Department of Cardiology, Second Affiliated Hospital, Zhejiang
University School of Medicine, Hangzhou, China
(Fu) Department of Cardiology, Sir Run Shaw Hospital, Zhejiang University
School of Medicine, Hangzhou, China
(Yu) Department of Cardiology, the Second Affiliated Hospital of Harbin
Medical University, Harbin, China
(Wang) Medical Research and Biometrics Center, National Center for
Cardiovascular Diseases, Beijing, China
(Tu) Biomedical Instrument Institute, School of Biomedical Engineering,
Shanghai Jiao Tong University, Shanghai, China
(Stone) Zena and Michael A. Wiener Cardiovascular Institute, Icahn School
of Medicine at Mount Sinai, New York, NY, United States
Publisher
Elsevier Inc.
Abstract
Background: The clinical utility of the quantitative flow ratio (QFR), a
novel angiography-based index for the functional assessment of coronary
stenoses, has recently been demonstrated in patients undergoing
percutaneous coronary intervention (PCI). <br/>Objective(s): This study
aimed to ascertain whether the beneficial outcomes of QFR guidance for
lesion selection during PCI is affected by diabetes status.
<br/>Method(s): This substudy from the FAVOR III China trial, in which
diabetes was one of the prespecified factors for stratified randomization,
compared clinical outcomes of QFR-guided vs angiography-guided PCI lesion
selection according to the presence of diabetes. The primary endpoint was
the 1-year risk of major adverse cardiac events (MACE) (a composite of
all-cause death, myocardial infarction, or ischemia-driven
revascularization). <br/>Result(s): Among 3,825 patients enrolled, 1,295
(33.9%) had diabetes, 347 (26.8%) of whom were treated with insulin.
Baseline characteristics were well balanced between treatment arms in both
diabetic and nondiabetic patients. Compared with standard
angiography-based lesion selection, the QFR-guided strategy consistently
reduced the risk of 1-year MACE in both diabetic patients (6.2% vs 9.6%;
HR: 0.64; 95% CI: 0.43-0.95) and nondiabetic patients (5.6% vs 8.3%; HR:
0.66; 95% CI: 0.49-0.89) (P<inf>interaction</inf> = 0.88). Among patients
in whom PCI was deferred after QFR, the risk of 1-year MACE was similar in
patients with and without diabetes (4.5% vs 6.2%; P = 0.51).
<br/>Conclusion(s): A QFR-guided lesion selection strategy improves PCI
outcomes compared with standard angiography guidance in patients both with
and without diabetes. (The Comparison of Quantitative Flow Ratio Guided
and Angiography Guided Percutaneous Intervention in Patients with Coronary
Artery Disease [FAVOR III China Study]; NCT03656848).<br/>Copyright &#xa9;
2022 American College of Cardiology Foundation

<74>
Accession Number
2020574475
Title
Effect of remimazolam tosilate versus etomidate on hemodynamics in
patients undergoing valve replacement surgery: study protocol for a
randomized controlled trial.
Source
Trials. 23(1) (no pagination), 2022. Article Number: 992. Date of
Publication: December 2022.
Author
Hu B.; Zhou H.; Zou X.; Tan L.; Song T.; Zellmer L.; Li X.
Institution
(Hu, Zou, Tan, Song, Li) Department of Anesthesiology, The Affiliated
Hospital of Guizhou Medical University, 28 Guiyi Rd, Guizhou Province,
Guiyang 550004, China
(Zhou) Department of Cardiology, The Affiliated Hospital of Guizhou
Medical University, 28 Guiyi Rd, Guizhou Province, Guiyang 550004, China
(Zou) College of Anesthesiology, Guizhou Medical University, 9 Beijing Rd,
Guizhou Province, Guiyang 550004, China
(Zellmer) Department of Medicine, Hennepin County Medical Center, 730
South 8th St, Minneapolis, MN 55415, United States
Publisher
BioMed Central Ltd
Abstract
Background: Patients with a history of cardiac disease are prone to
develop cardiovascular adverse events such as hypotension, hypertension,
and tachycardia during anesthesia induction. Therefore, hemodynamic
stability is one of the most important concerns for induction of
anesthesia in patients undergoing cardiac surgery. Remimazolam tosilate is
a new, ultra-short-acting benzodiazepine agent, with the advantages of
rapid onset, rapid offset, and minimal cardiorespiratory depression. We
aim to compare the effect of remimazolam tosilate and etomidate on
hemodynamics during anesthesia induction in patients undergoing valve
replacement surgery. Methods/design: The trial is a prospective,
randomized, double-blinded, controlled, single-center trial to compare the
effect of remimazolam tosilate and etomidate on hemodynamics in patients
undergoing valve replacement surgery. One hundred seventeen patients
undergoing selective valve replacement surgery between January 1, 2022,
and December 31, 2023, will be enrolled and randomly allocated into one of
three groups: low-dose remimazolam group (Group LR), high-dose remimazolam
group (Group HR), or etomidate group (Group E). The primary outcome is
hemodynamic fluctuations during anesthesia induction (the difference
between mean arterial pressure [MAP] to baseline, MAP; and the difference
between maximum or minimum heart rate [HR] and baseline, HR). Secondary
outcomes include the incidence of adverse cardiovascular events
(hypotension, severe bradycardia, hypertension, tachycardia, and
arrhythmia), the cumulative doses of vasoactive drugs used per patient,
incidence and degree of injection pain and myoclonus, blood glucose
values, and vital signs at different time points. <br/>Discussion(s): This
research will determine the effectiveness and safety of remimazolam
tosilate induction on hemodynamics in patients undergoing valve
replacement surgery. Trial registration: www.chictr.org.cn identifier
ChiCTR2100052535. Registered on 17th Dec 2021,
http://www.chictr.org.cn/).<br/>Copyright &#xa9; 2022, The Author(s).

<75>
Accession Number
641053084
Title
Feasibility pilot trial for the Trajectories of Recovery after Intravenous
propofol versus inhaled VolatilE anesthesia (THRIVE) pragmatic randomised
controlled trial.
Source
BMJ open. 13(4) (pp e070096), 2023. Date of Publication: 17 Apr 2023.
Author
Tellor Pennington B.R.; Colquhoun D.A.; Neuman M.D.; Politi M.C.; Janda
A.M.; Spino C.; Thelen-Perry S.; Wu Z.; Kumar S.S.; Gregory S.H.; Avidan
M.S.; Kheterpal S.
Institution
(Tellor Pennington) Anesthesiology, Washington University School of
Medicine, St. Louis, MO, United States
(Colquhoun, Janda, Kumar, Kheterpal) Anesthesiology, University of
Michigan Health System, Ann Arbor, MI, United States
(Neuman) Anesthesiology & Critical Care, University of Pennsylvania,
Philadelphia, PA, United States
(Politi) Surgery, Washington University in St. Louis, St. Louis, MO,
United States
(Spino, Thelen-Perry, Wu) Biostatistics, University of Michigan, Ann
Arbor, MI, United States
(Gregory, Avidan) Anesthesiology, Washington University School of
Medicine, St. Louis, MO, United States
Publisher
NLM (Medline)
Abstract
INTRODUCTION: Millions of patients receive general anaesthesia for surgery
annually. Crucial gaps in evidence exist regarding which technique,
propofol total intravenous anaesthesia (TIVA) or inhaled volatile
anaesthesia (INVA), yields superior patient experience, safety and
outcomes. The aim of this pilot study is to assess the feasibility of
conducting a large comparative effectiveness trial assessing patient
experiences and outcomes after receiving propofol TIVA or INVA. METHODS
AND ANALYSIS: This protocol was cocreated by a diverse team, including
patient partners with personal experience of TIVA or INVA. The design is a
300-patient, two-centre, randomised, feasibility pilot trial. Patients 18
years of age or older, undergoing elective non-cardiac surgery requiring
general anaesthesia with a tracheal tube or laryngeal mask airway will be
eligible. Patients will be randomised 1:1 to propofol TIVA or INVA,
stratified by centre and procedural complexity. The feasibility endpoints
include: (1) proportion of patients approached who agree to participate;
(2) proportion of patients who receive their assigned randomised
treatment; (3) completeness of outcomes data collection and (4)
feasibility of data management procedures. Proportions and 95% CIs will be
calculated to assess whether prespecified thresholds are met for the
feasibility parameters. If the lower bounds of the 95% CI are above the
thresholds of 10% for the proportion of patients agreeing to participate
among those approached and 80% for compliance with treatment allocation
for each randomised treatment group, this will suggest that our planned
pragmatic 12 500-patient comparative effectiveness trial can likely be
conducted successfully. Other feasibility outcomes and adverse events will
be described. ETHICS AND DISSEMINATION: This study is approved by the
ethics board at Washington University (IRB# 202205053), serving as the
single Institutional Review Board for both participating sites.
Recruitment began in September 2022. Dissemination plans include
presentations at scientific conferences, scientific publications,
internet-based educational materials and mass media. TRIAL REGISTRATION
NUMBER: NCT05346588.<br/>Copyright &#xa9; Author(s) (or their employer(s))
2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights
and permissions. Published by BMJ.

<76>
Accession Number
2021930019
Title
CONVERSION FACTORS BETWEEN KERMA-AREA PRODUCT AND EFFECTIVE/ORGAN DOSE FOR
CARDIAC INTERVENTIONAL FLUOROSCOPY PROCEDURES.
Source
Physica Medica. Conference: 4th European Congress of Medical Physics.
Dublin Ireland. 104(Supplement 1) (pp S71), 2022. Date of Publication:
December 2022.
Author
Kuchcinska A.; D'Alessio A.; Segota D.; Sukupova L.; Brambilla M.
Institution
(Kuchcinska) Maria Sklodowska-Curie National Research Institute of
Oncology, Warsaw, Poland
(D'Alessio, Brambilla) Medical Physics Department, Azienda Ospedaliero-
Universitaria Maggiore della Carita, Novara, Italy
(Segota) Medical Physics Department, UH Rijeka, Rijeka, Croatia
(Sukupova) Institute of Clinical and Experimental medicine, Czechia
Publisher
Associazione Italiana di Fisica Medica
Abstract
Purpose: The aim of this study is to lead a critical appraisal of the
evidence concerning the conversion factors between kerma-area product
(PKA) and effective/organ dose (DCED_PKA, DCHT_PKA) for cardiac
interventional fluoroscopy procedures performed in adults and paediatric
patients and to propose reference conversion factors to help standardize
dose calculations. <br/>Method(s): A systematic review of the published
literature was lead with a time restriction (since January 2007) to
capture the evolving trends of utilization of fluoroscopy-guided
intervention technologies only in recent years. The suggested DCED_PKA and
DCHT_PKA were synthesized by calculating the weighted averages of the
values reported by the authors with weights corresponding to the study
sample size. <br/>Result(s): Eighteen studies for both adult (9) and
paediatric (9) patients matching the search terms fulfilled the inclusion
criteria. The suggested value for DCED_PKA in adult patients amounts to
0.24 mSvGy-1cm-2. The suggested values for DCHT_PKA ranged from a minimum
of 0.15 mSvGy-1cm-2 for the female breast to a maximum of 0.97 mSvGy-1cm-2
for the lungs. The suggested values for DCED_PKA in paediatric patients
ranged from 3.45 mSvGy-1cm-2 for the new-born to 0.49 mSvGy-1cm-2 in the
15-years age class. The suggested values for DCHT_PKA ranged from a
minimum of 0.33 mSvGy-1cm-2 for bone marrow in the 15-years age class to a
maximum of 11.49 mSvGy-1cm-2 for the heart in the new-born.
<br/>Discussion(s): The value of 0.24 mSvGy-1cm-2 for DCED_PKA in adult
patients is consistently higher than the most often quoted value of 0.18
mSv Gy-1 cm-2. The increase in DCED_PKA can be partially explained by the
changes in the tissue weighting factors between ICRP 103 and ICRP 60 and
by the different X-ray beam quality used in modern angiographic equipment
with respect to older machines equipped with image intensifiers. The
values obtained of DCED_PKA can be useful for standardizing dose
calculations, hence for comparison of the radiation detriment from
different imaging procedures. Having a reliable set of DCHT_PKA could
prove to be very useful in the framework of epidemiologic
studies.<br/>Copyright &#xa9; 2023 Southern Society for Clinical
Investigation.

<77>
Accession Number
2022558783
Title
Late Clinical Outcomes of Total Arterial Revascularization or Multiple
Arterial Grafting Compared to Conventional Single Arterial with Saphenous
Vein Grafting for Coronary Surgery.
Source
Journal of Clinical Medicine. 12(7) (no pagination), 2023. Article Number:
2516. Date of Publication: April 2023.
Author
Ren J.; Royse C.; Royse A.
Institution
(Ren, Royse, Royse) Department of Surgery, University of Melbourne,
Melbourne, VIC 3050, Australia
(Royse, Royse) Department of Cardiothoracic Surgery, Royal Melbourne
Hospital, Melbourne, VIC 3050, Australia
(Royse) Outcomes Research Consortium, Cleveland Clinic, Cleveland, OH
44195, United States
Publisher
MDPI
Abstract
Coronary surgery provides better long-term outcomes than percutaneous
coronary intervention. Conventional practice is to use a single arterial
conduit supplemented by saphenous vein grafts. The use of multiple
arterial revascularization (MAG), or exclusive arterial revascularization
(TAR), however, is reported as having improved late survival. Survival is
a surrogate for graft failure that may lead to premature death, and
improved survival reflects fewer graft failures in the non-conventional
strategy groups. The reasons for not using MAG or TAR may be due to
perceived technical difficulties, a lack of definitive large-scale
randomized evidence, a lack of confidence in arterial conduits, or
resources or time constraints. Most people consider radial artery (RA)
grafting to be new, with use representing approximately 2-5% worldwide,
despite select centers reporting routine use in most patients for decades
with improved results. In conclusion, the current body of evidence
supports more extensive use of total and multiple arterial
revascularization procedures in the absence of
contraindications.<br/>Copyright &#xa9; 2023 by the authors.

<78>
Accession Number
2023397967
Title
Postoperative Analgesic Effects of Serratus Anterior Plane Block for
Thoracic and Breast Surgery: A Meta-analysis of Randomized Controlled
Trials.
Source
Pain Physician. 26(2) (pp E51-E62), 2023. Date of Publication: March/April
2023.
Author
Meng J.; Zhao H.-Y.; Zhuo X.-J.; Shen Q.-H.
Institution
(Meng, Zhao, Zhuo) Department of Anesthesiology, Sir Run Run Shaw Hospital
Affiliated to Zhejiang University, China
(Shen) Department of Anesthesiology, The Affiliated Hospital of Jiaxing
Universit, China
Publisher
American Society of Interventional Pain Physicians
Abstract
Background: Postoperative pain is a concern after thoracic and breast
surgeries. Recent studies have demonstrated that ultrasound-guided
serratus anterior plane block (SAPB) could provide postoperative
analgesia. <br/>Objective(s): The objective of this systematic review and
meta-analysis was to examine the effects of SAPB on postoperative
analgesia in thoracic and breast surgery. <br/>Study Design: A systematic
review and meta-analysis of randomized control trials (RCTs).
<br/>Method(s): We systematically queried the PubMed, Embase, Web of
Science, and Cochrane Library online databases from their establishment
through Mar 31, 2022. Eligible RCTs were selected for the purpose of
conducting the meta-analysis. The risk of bias of the included trials was
assessed by Cochrane Review Manager. The level of certainty was examined
utilizing the GRADE (Grade of Recommendations Assessment, Development, and
Evaluation) scale to determine whether the evidence was of high quality or
not. <br/>Result(s): During the process of the meta-analysis, a total of
27 pieces of literature was included in the present research. SAPB
significantly reduced the intraoperative opioid consumption (mean
difference [MD] =-9.52 mg of morphine equivalent, 95% CI,-15.50 to-3.54; P
< 0.01, I² = 98%) and postoperative pain opioid consumption (MD
=-23.12 mg of morphine equivalent, 95% CI,-30.59 to-15.65; P < 0.01,
I² = 100%. Also, patients in the SAPB group had lower pain
scores during the first postoperative 24 hours. Furthermore, SAPB
attenuated the occurrence of postsurgical nausea and vomiting, as well as
chronic postsurgical pain. <br/>Limitation(s): Double-blinding was not
performed in some trials, also some assessors were not blinded; the
included sample sizes of eligible trials which reported the incidence of
chronic postsurgical pain were relatively small; the comparisons between
SAPB and other types of blocks were not performed in our meta-analysis.
<br/>Conclusion(s): Our findings suggest that SAPB not only relieves acute
pain after thoracic and breast surgery, but also reduces the incidence of
chronic postsurgical pain.<br/>Copyright &#xa9; 2023, American Society of
Interventional Pain Physicians. All rights reserved.

<79>
Accession Number
2023943105
Title
Study protocol of a phase 2, randomised, placebo-controlled, double-blind,
adaptive, parallel group clinical study to evaluate the efficacy and
safety of recombinant alpha-1-microglobulin in subjects at high risk for
acute kidney injury following open-chest cardiac surgery (AKITA trial).
Source
BMJ Open. 13(4) (no pagination), 2023. Article Number: e068363. Date of
Publication: 06 Apr 2023.
Author
Mazer C.D.; Siadati-Fini N.; Boehm J.; Wirth F.; Myjavec A.; Brown C.D.;
Koyner J.L.; Boening A.; Engelman D.T.; Larsson T.E.; Renfurm R.; De
Varennes B.; Noiseux N.; Thielmann M.; Lamy A.; Laflamme M.; Von Groote
T.; Ronco C.; Zarbock A.
Institution
(Mazer) Department of Anesthesia, St. Michael's Hospital, Toronto, ON,
Canada
(Mazer) Department of Anesthesiology and Pain Medicine, Physiology and
Pharmacology and Toxicology, University of Toronto, Toronto, ON, Canada
(Siadati-Fini) Anaesthesia Department, St. Michael's Hospital, Toronto,
ON, Canada
(Boehm, Wirth) Department of Cardiovascular Surgery, Technische
Universitat Munchen, Munchen, Germany
(Boehm, Wirth) Insure (Institute for Translational Cardiac Surgery),
Department of Cardiovascular Surgery, German Heart Centre Munich, Munchen,
Germany
(Myjavec) Department of Cardiac Surgery, University of Hradec Kralove,
Hradec Kralove, Czechia
(Brown) Department of Cardiac Surgery, New Brunswick Heart Centre, Saint
John, NB, Canada
(Koyner) Department of Medicine, Section of Nephrology, University of
Chicago, Pritzker School of Medicine, Chicago, IL, United States
(Boening) Department of Cardiovascular Surgery, Justus-Liebig-University,
Giessen, Germany
(Engelman) Heart and Vascular Program, Baystate Medical Center,
Springfield, MA, United States
(Larsson) Guard Therapeutics, Stockholm, Sweden
(Renfurm) Global Drug Development Unit Cardio-Renal-Metabolism, Novartis
Pharma AG, Basel, Switzerland
(De Varennes) Division of Cardiac Surgery, McGill University, Faculty of
Medicine, Montreal, QC, Canada
(Noiseux) Division of Cardiac Surgery, Universite de Montreal, Montreal,
QC, Canada
(Thielmann, Lamy) Department for Thoracic and Cardiovascular Surgery,
West-German Heart and Vascular Center Essen, University Duisburg-Essen,
Essen, Germany
(Lamy) Population Health Research Institute, Hamilton Health Sciences,
Hamilton, ON, Canada
(Laflamme) Institut Universitaire de Cardiologie et de Pneumologie de
Quebec, University of Quebec, Quebec, QC, Canada
(Von Groote, Zarbock) Department of Anesthesiology, Intensive Care
Medicine, University Hospital Munster, Munster, Germany
(Ronco) International Renal Research Institute of Vicenza, San Bortolo
Hospital of Vicenza, Vicenza, Italy
Publisher
BMJ Publishing Group
Abstract
Introduction Acute kidney injury (AKI) is a common complication after
cardiac surgery (CS) and is associated with adverse short-term and
long-term outcomes. Alpha-1-microglobulin (A1M) is a circulating
glycoprotein with antioxidant, heme binding and mitochondrial-protective
mechanisms. RMC-035 is a modified, more soluble, variant of A1M and has
been proposed as a novel targeted therapeutic protein to prevent
CS-associated AKI (CS-AKI). RMC-035 was considered safe and generally well
tolerated when evaluated in four clinical phase 1 studies. Methods and
analysis This is a phase 2, randomised, double-blind, adaptive design,
parallel group clinical study that evaluates RMC-035 compared with placebo
in approximately 268 cardiac surgical patients at high risk for CS-AKI.
RMC-035 is administered as an intravenous infusion. In total, five doses
will be given. Dosing is based on presurgery estimated glomerular
filtration rate (eGFR), and will be either 1.3 or 0.65 mg/kg. The primary
study objective is to evaluate whether RMC-035 reduces the incidence of
postoperative AKI, and key secondary objectives are to evaluate whether
RMC-035 improves postoperative renal function compared with placebo. A
blinded interim analysis with potential sample size reassessment is
planned once 134 randomised subjects have completed dosing. An independent
data monitoring committee will evaluate safety and efficacy data at
prespecified intervals throughout the trial. The study is a global
multicentre study at approximately 30 sites. Ethics and dissemination The
trial was approved by the joint ethics committee of the physician chamber
Westfalen-Lippe and the University of Munster (code '2021-778 f-A') and
subsequently approved by the responsible ethics committees/relevant
institutional review boards for the participating sites. The study is
conducted in accordance with Good Clinical Practice, the Declaration of
Helsinki and other applicable regulations. Results of this study will be
published in a peer-reviewed scientific journal. Trial registration number
NCT05126303. <br/>Copyright &#xa9; Authors 2023

<80>
Accession Number
2023943103
Title
Effect of the VivaSight double-lumen tube on the incidence of hypoxaemia
during one-lung ventilation in patients undergoing thoracoscopic surgery:
A study protocol for a prospective randomised controlled trial.
Source
BMJ Open. 13(4) (no pagination), 2023. Article Number: e068071. Date of
Publication: 05 Apr 2023.
Author
Long S.; Li Y.; Guo J.; Hu R.
Institution
(Long, Li, Guo, Hu) Department of Anaesthesiology, Sun Yat-sen University
First Affiliated Hospital, Guangdong, Guangzhou, China
Publisher
BMJ Publishing Group
Abstract
Introduction A double-lumen tube (DLT) is a traditional one-lung
ventilation tool that needs to be positioned under the guidance of a
fibreoptic bronchoscope or auscultation. The placement is complex, and
poor positioning often causes hypoxaemia. In recent years, VivaSight
double-lumen tubes (v-DLTs) have been widely used in thoracic surgery.
Because the tubes can be continuously observed during intubation and the
operation, malposition can be corrected at any time. However, the effect
of v-DLT on perioperative hypoxaemia has been rarely reported. The aim of
this study was to observe the incidence of hypoxaemia during one-lung
ventilation with v-DLT and to compare the perioperative complications
between v-DLT and conventional double-lumen tube (c-DLT). Methods and
analysis One hundred patients planning to undergo thoracoscopic surgery
will be randomised into the c-DLT group and the v-DLT group. During
one-lung ventilation, both groups of patients will receive low tidal
volume for volume control ventilation. When the blood oxygen saturation
falls below 95%, the DLT will be repositioned and the oxygen concentration
will be increased to improve the respiratory parameters (5 cm H 2 O
Positive end-expiratory pressure (PEEP) on the ventilation side and 5 cm H
2 O CPAP (continuous airway positive pressure) on the operation side), and
double lung ventilation measures will be taken in sequence to prevent a
further decline in blood oxygen saturation. The primary outcomes are the
incidence and duration of hypoxaemia and the number of intraoperative
hypoxaemia treatments, and the secondary outcomes will be postoperative
complications and total hospitalisation expenses. Ethics and dissemination
The study protocol was approved by the Clinical Research Ethics Committee
of The First Affiliated Hospital, Sun Yat-sen University (2020-418) and
registered at the Chinese Clinical Trial Registry
(http://www.chictr.org.cn). The results of the study will be analysed and
reported. Trial registration number ChiCTR2100046484. <br/>Copyright
&#xa9; Authors 2023

<81>
Accession Number
2022683755
Title
Amiodarone versus beta-blockers for the prevention of postoperative atrial
fibrillation after cardiac surgery: An updated systematic review and
meta-analysis of randomised controlled trials.
Source
F1000Research. 11 (no pagination), 2022. Article Number: 569. Date of
Publication: 2022.
Author
Ardaya R.; Pratita J.; Juliafina N.N.; Rahman F.H.F.; Leonardo K.
Institution
(Ardaya, Pratita) Division of Surgical and Interventional Sciences,
University College London Medical School, London WC1E 6BT, United Kingdom
(Pratita) Division of Cardiothoracic and Vascular Surgery, Department of
Surgery, Dr. Cipto Mangunkusumo Hospital, Jakarta 10430, Indonesia
(Juliafina, Rahman) Metropolitan Medical Centre Hospital, Jakarta 12940,
Indonesia
(Juliafina) Faculty of Medicine, University of Indonesia, Jakarta 10430,
Indonesia
(Rahman) Faculty of Medicine, Airlangga University, Surabaya 60132,
Indonesia
(Leonardo) Faculty of Medicine, Public Health and Nursing, Universitas
Gadjah Mada, Daerah Istimewa Yogyakarta 55281, Indonesia
(Leonardo) Eka Hospital, Bumi Serpong Damai 15321, Indonesia
Publisher
F1000 Research Ltd
Abstract
Background: Amiodarone and beta-blockers are widely used as prophylaxis
for postoperative atrial fibrillation (AF). The current recommendations
from society guidelines are inconclusive, leading to differing practices
among physicians. This meta-analysis aimed to compare the efficacy of both
agents in preventing postoperative AF after cardiac surgery.
<br/>Method(s): We explored online medical databases, such as CINAHL,
CENTRAL, MEDLINE, and EMBASE for randomised controlled trials (RCTs)
comparing amiodarone and beta-blocker for prevention of AF after cardiac
surgery. Outcomes analysed in this study were AF number of events and
duration, hospital stay, and mean ventricular rate. Heterogeneity was
assessed using the I2 test, and publication bias was analysed using
Egger's test. Results: In total, eight RCTs comprising 1370 patients met
the inclusion criteria. Pooled analysis showed that patients in both
groups had no significant difference in both AF episodes (RR 0.83, 95% CI
0.66 to 1.04, p=0.10) and AF duration (SMD 0.46, 95% CI -1.14 to 2.05,
p=0.57). Furthermore, secondary outcome analysis on mean ventricular rate
and mean hospital length of stay in both groups showed no significant
difference (MD -4.48, 95% CI -14.36 to 5.39, p=0.37 and MD 0.29, 95% CI
-0.06 to 0.63, p=0.11, respectively). <br/>Conclusion(s): Amiodarone and
beta-blockers are equally effective in preventing postoperative atrial
fibrillation after cardiac surgery, with no difference in AF episode and
duration, mean ventricular rate, and hospital length of
stay.<br/>Copyright: &#xa9; 2022 Ardaya R et al.

<82>
Accession Number
2022683695
Title
Effectiveness of pedometer-based exercise program in phase 1 and phase 2
cardiac rehabilitation: A Systematic Review.
Source
F1000Research. 11 (no pagination), 2022. Article Number: 451. Date of
Publication: 2022.
Author
Vasavi V.L.; Khandekar J.; Singh V.P.; Rajan Samuel S.; Cynthia D'souza M.
Institution
(Vasavi, Khandekar, Singh, Rajan Samuel, Cynthia D'souza) Department of
Physiotherapy, Kasturba Medical College, Mangalore, Manipal Academy of
Higher Education, Manipal, India
Publisher
F1000 Research Ltd
Abstract
Background: Physical Inactivity (PI) and sedentary behaviour are the most
important and modifiable risk factors to prevent cardiovascular diseases
(CVD). Cardiac rehabilitation (CR) is a multidisciplinary program for
patients who have undergone cardiac surgeries. Through CR, monitoring
physical activity (PA) is possible and may reduce the rate of
rehospitalization. The pedometer is a device that is useful to track the
step count of the person day to day. It helps in self-monitoring of PA.
The purpose of this review was to summarise the evidence about the effect
of pedometer-based exercise program in phase 1 and phase 2 CR.
<br/>Method(s): Databases such as MEDLINE, Cochrane, Scopus, Embase, and
Web of Science were searched. This search is limited to randomized
controlled trials (RCTs), human trials, a 10-year period, and English
language journals. Based on inclusion criteria of pedometer-based exercise
programs in phase 1 (inpatient phase) and phase 2 (outpatient phase) of CR
and exclusion criteria of studies using pedometer in maintenance phase CR.
The primary outcome of the study is step count, while secondary is PA (in
terms of time), heart rate, sedentary behaviour, and quality of life. This
study quality was assessed by the Downs and Black's checklist.
<br/>Result(s): The study includes 6 RCTs based on the inclusion and
exclusion criteria. Most studies show a considerable increase in step
count associated with increased patient PA. Few studies have explained a
significant increase of PA in the study group and maintained for longer
terms. More research is needed to determine the impact of cardiovascular
risk factors.<br/>Copyright: &#xa9; 2022 Vasavi VL et al.

<83>
Accession Number
2022683650
Title
CYP2C19 polymorphism and coronary in-stent restenosis: A systematic review
and meta-analysis.
Source
F1000Research. 11 (no pagination), 2022. Article Number: 346. Date of
Publication: 2022.
Author
Pintaningrum Y.; Vitriyaturrida; Dewi I.P.; Putra H.B.P.; Mappangara I.;
Amir M.; Yusuf I.; Bukhari A.
Institution
(Pintaningrum) Department of Cardiology and Vascular Medicine, Faculty of
Medicine, University of Mataram, West Nusa Tenggara, Mataram 83126,
Indonesia
(Vitriyaturrida) Department of Cardiology and Vascular Medicine, Slamet
Martodirdjo General Hospital, Madura, Pamekasan 69317, Indonesia
(Dewi) Department of Cardiology and Vascular Medicine, Faculty of
Medicine, Airlangga University, Dr Soetomo General Hospital, East Java,
Surabaya 60132, Indonesia
(Dewi) Department of Cardiology and Vascular Medicine, Faculty of
Medicine, Duta Wacana Christian University, Special Region of Yogyakarta,
Yogyakarta 55224, Indonesia
(Putra) Emergency Department, dr. Ramelan Navy Hospital, East Java,
Surabaya 60244, Indonesia
(Mappangara, Amir) Department of Cardiology and Vascular Medicine, Faculty
of Medicine, University of Hasanuddin, South Sulawesi, Makasar 90245,
Indonesia
(Yusuf) Department of Physiology, Faculty of Medicine, University of
Hasanuddin, South Sulawesi, Makassar 90245, Indonesia
(Bukhari) Department of Nutrition, Faculty of Medicine, University of
Hasanuddin, South Sulawesi, Makassar 90245, Indonesia
Publisher
F1000 Research Ltd
Abstract
Background: In-stent restenosis (ISR) remains a major drawback in coronary
stenting. The association between the CYP2C19 loss of function (LOF) gene
and the prevalence of ISR after coronary stenting remains controversial.
Previous studies have produced conflicting results and have been limited
by their small population sizes. We conducted this systematic review and
meta-analysis to determine the association between the presence of the
CYP2C19 LOF gene and the prevalence of ISR. <br/>Method(s): A systematic
online database search was performed until April 2021. The primary outcome
was ISR and assessed using OR with 95% CI. Publication bias was assessed
using the Newcastle Ottawa Scale. I ² was applied to examine
heterogeneities among the studies. <br/>Result(s): A total of 284 patients
(four non-randomized controlled trial studies) were included in this
study. Two hundred and six patients had wild-type genotypes, while 78
patients had the LOF genotype. Among the 78 patients with the LOF gene, 40
patients had an ISR. Meanwhile, of the 206 patients with a wild-type gene,
69 patients had an ISR. The LOF gene was associated with a higher risk of
ISR (OR 95% CI = 2.84 [1.54-5.24], p = 0.0008). A major limitation in our
study was the small number of previous studies and small sample sizes.
<br/>Conclusion(s): Patients with LOF genes, regardless of the allele
variation, treated with clopidogrel, had a higher risk of developing ISR
after coronary stenting.<br/>Copyright: &#xa9; 2022 Pintaningrum Y et al.

<84>
Accession Number
2022683648
Title
The effects of multimedia information on recruitment and retention in a
children's cardiac surgery trial: a randomised controlled SWAT (study
within a trial).
Source
F1000Research. 11 (no pagination), 2022. Article Number: 340. Date of
Publication: 2022.
Author
Knapp P.; Heys R.; Dabner L.; Sheehan K.; Smartt H.; Walker-Smith T.;
Rogers C.A.; Stoica S.; Roche J.; Moe-Byrne T.; Martin-Kerry J.M.;
Sheridan R.; Coleman E.; Higgins S.
Institution
(Knapp, Roche, Moe-Byrne, Martin-Kerry, Sheridan, Coleman) Department of
Health Sciences, University of York, York, United Kingdom
(Heys, Dabner, Smartt, Walker-Smith, Rogers) Bristol Trials Centre,
Bristol Medical School, University of Bristol, Bristol, United Kingdom
(Sheehan, Stoica) University Hospitals Bristol and Weston NHS Foundation
Trust, Bristol, United Kingdom
(Higgins) School of Education, Durham University, Durham, United Kingdom
Publisher
F1000 Research Ltd
Abstract
Background: Digital multimedia information (MMI) has potential for use in
trial recruitment but there is little formal evaluation. The objectives
were to evaluate digital MMI about a trial for its effects on recruitment,
retention, participation decisions, and patients' acceptability, compared
with printed information (PIS) alone and when combined with PIS.
<br/>Method(s): SWAT (study within a trial) using random parallel-group
individual allocation within the Thermic-3 trial evaluating warm versus
cold cardioplegia solution during cardiac surgery. Set in one UK hospital,
participants were 147 children (0-16 years) awaiting surgery for
congenital heart defects; 38% were female. Participants and their
parents/guardian received trial information via multimedia (including
text, animated videos and talking-head videos) for viewing at home (MMI
group; n=49), or PIS (PIS group; n=47), or both (PIS&MMI group; n=51).
Primary outcome was recruitment rate to the Thermic-3 trial comparing
PIS-alone and MMI-alone. Secondary outcomes were recruitment rate
comparing PIS-alone and combined PIS&MMI; Decision-Making Questionnaire; 3
'free-text' questions (deriving subjective evaluations); trial retention.
Results: MMI produced a 14.2% absolute increase in recruitment, which was
not statistically significant: 32 (65.3%) participants were recruited from
the MMI group; 24 (51.1%) from the PIS group (OR 1.80; 95% CI 0.79 to
4.10, p = 0.16); and 22 from the PIS&MMI group. There was no difference in
recruitment through combined PIS&MMI (43.1% vs 51.1%; OR 0.73; 95% CI 0.33
to 1.61; p= 0.43). Questionnaires were returned by 17 (12%) participants
and analysed descriptively. Trial retention (at 3 months) was high in all
groups (72/77; 93.5% overall) and there was no difference due to
information format received before participating. <br/>Conclusion(s): MMI
increased recruitment to the Thermic-3 trial but the difference was not
statistically significant, and the SWAT was small. Trial registration:
TRECA https://trialsearch.who.int/?TrialID=ISRCTN73136092 ISRCTN73136092
and NI Hub for Trials Methodology Research SWAT Repository (SWAT 97).
Thermic-3: https://trialsearch.who.int/Trial2.aspx?TrialID=ISRCTN13467772
ISRCTN13467772.<br/>Copyright: &#xa9; 2022 Knapp P et al.

<85>
Accession Number
2023832552
Title
Effects of crystalloid and colloid priming strategies for cardiopulmonary
bypass on colloid oncotic pressure and haemostasis: A meta-analysis.
Source
Interactive Cardiovascular and Thoracic Surgery. 35(3) (no pagination),
2022. Article Number: ivac127. Date of Publication: 01 Sep 2022.
Author
Beukers A.M.; De Ruijter J.A.C.; Loer S.A.; Vonk A.; Bulte C.S.E.
Institution
(Beukers, De Ruijter, Loer, Bulte) Amsterdam UMC Location, Vrije
Universiteit Amsterdam, Department of Anaesthesiology, Amsterdam,
Netherlands
(Vonk) Amsterdam UMC Location, University of Amsterdam, Department of
Cardiothoracic Surgery, Amsterdam, Netherlands
Publisher
Oxford University Press
Abstract
OBJECTIVES: Colloid oncotic pressure (COP) is an important factor in
cardiac surgery, owing to its role in haemodilution. The effect of
cardiopulmonary bypass prime fluids on the COP is unknown. In this study,
the effect of crystalloid and colloid prime fluids, with or without
retrograde autologous priming (RAP), on the COP during elective cardiac
surgery was evaluated. <br/>METHOD(S): Randomized controlled trials and
prospective clinical trials comparing crystalloid and colloid priming
fluids or with RAP were selected. The primary outcome was the COP;
secondary outcomes were fluid balance, fluid requirements, weight gain,
blood loss, platelet count and transfusion requirements. <br/>RESULT(S):
From 1582 records, 29 eligible studies were identified. COPs were
comparable between gelofusine and hydroxyethyl starch (HES) during bypass
[mean difference (MD): 0.69; 95% confidence interval (CI): -2.05, 3.43; P
= 0.621], after bypass (MD: -0.11; 95% CI: -2.54, 2.32; P = 0.930) and
postoperative (MD: -0.61; 95% CI: -1.60, 0.38; P = 0.228). Fluid balance
was lower with HES than with crystalloids. RAP reduced transfusion
requirements compared with crystalloids. Blood loss was comparable between
groups. <br/>CONCLUSION(S): COPs did not differ between crystalloids and
colloids. As a result of increased transcapillary fluid movement, fluid
balance was lower with HES than with crystalloids. Haematocrit and
transfusion requirements were comparable between groups. However, the
latter was lower when RAP was applied to crystalloid priming compared with
crystalloids alone. Finally, no differences in blood loss were observed
between the groups. <br/>Copyright &#xa9; 2022 The Author(s). Published by
Oxford University Press on behalf of the European Association for
Cardio-Thoracic Surgery.

<86>
Accession Number
2023832545
Title
In patients undergoing oesophagectomy does postoperative home enteral
nutrition have any impact on nutritional status?.
Source
Interactive Cardiovascular and Thoracic Surgery. 35(3) (no pagination),
2022. Article Number: ivac120. Date of Publication: 01 Sep 2022.
Author
Li X.; Hu J.; Zhou J.; Fang P.; Yuan Y.
Institution
(Li, Zhou, Fang, Yuan) Department of Thoracic Surgery, West China
Hospital, Sichuan University, Chengdu, China
(Hu) Anesthesia Operation Center, West China Hospital, West China School
of Nursing, Sichuan University, Chengdu, China
Publisher
Oxford University Press
Abstract
A best evidence topic in thoracic surgery was written according to a
structured protocol. The question addressed was 'In patients undergoing
oesophagectomy does postoperative home enteral nutrition have any impact
on nutritional status?' Altogether, 50 articles were found using the
reported search, of which 5 studies represented the best evidence to
answer the clinical question. This consisted of 1 systematic review
including a meta-analysis of 9 randomized controlled trials (RCTs), 3 RCTs
and 1 cohort study. Main outcomes included loss of body weight and body
mass index (BMI), change of serum albumin, haemoglobin, total protein and
prealbumin, rates of nutritional risk patients and score value of
patient-generated subjective global assessment. The meta-analysis
concluded that there were significant differences in the loss of body
weight and BMI between 2 groups, with higher values observed in the HEN
group than that in the control group. One RCT showed that patients
receiving HEN had a significantly lower weight loss compared with the
control group. However, in another RCT, there was no significant
difference between 2 groups in the loss of weight and body BMI. The
available evidence shows that patients receiving home enteral nutrition
yielded a significantly better BMI and lower decrease in body weight than
those without after surgical resection of oesophageal cancer. We conclude
that HEN could serve as an effective intervention for patients undergoing
oesophagectomy. Moreover, the optimal time for patients receiving HEN
could be 4-8 weeks after discharge. Feeding via jejunostomy and
nasointestinal tube are feasible and safety approaches for HEN.
<br/>Copyright &#xa9; 2022 The Author(s). Published by Oxford University
Press on behalf of the European Association for Cardio-Thoracic Surgery.

<87>
Accession Number
2024055465
Title
DOAC versus VKA in patients with atrial fibrillation and bioprosthetic
valves: a systematic review and meta-analysis.
Source
Revista Espanola de Cardiologia. (no pagination), 2023. Date of
Publication: 2023.
Author
Guardia Martinez P.; Aviles Toscano A.L.; Martinez Mayoral M.A.; Molto
Miralles J.
Institution
(Guardia Martinez) Servicio de Cardiologia, Hospital Costa del Sol,
Marbella, Malaga, Spain
(Aviles Toscano) Servicio de Cardiologia, Hospital de la Serrania de
Ronda, Ronda, Malaga, Spain
(Martinez Mayoral, Molto Miralles) Departamento de Estadistica,
Matematicas e Informatica, Universidad Miguel Hernandez, Elche, Alicante,
Spain
Publisher
Ediciones Doyma, S.L.
Abstract
Introduction and objectives: Direct oral anticoagulant (DOAC) therapy has
been shown to be safe and effective in patients with atrial fibrillation
(AF). However, outcomes in AF patients with bioprosthetic valves are
unclear, as this population has been underrepresented in clinical trials.
The aim of this study was to assess the safety and efficacy of DOACs in
this population based on the existing published literature.
<br/>Method(s): A systematic search and review were conducted to identify
randomized clinical trials and comparative observational studies published
from 2017 to January 2022 that compared DOACs and vitamin K antagonists
(VKAs) in AF patients with bioprosthetic valves. Hazard ratios (HR) were
collected to compare the 2 treatments in terms of cardiovascular and
all-cause mortality, stroke/systemic embolism, and major bleeding. A
meta-analysis combining the results was performed. <br/>Result(s): We
included 12 studies (30 283 patients). DOACs and VKAs were compared based
on HRs at the 95% confidence interval. DOAC therapy was associated with a
significant 9% reduction in all-cause mortality (HR, 0.91; 95%CI,
0.85-0.97; P = .0068; I² = 8%), with no significant differences
in the risk of stroke/systemic embolism (HR, 0.87; 95%CI, 0.67-1.14; P =
.29; I² = 45%) or major bleeding (HR, 0.82; 95%CI, 0.67-1.00; P
= .054; I² = 48.7%). <br/>Conclusion(s): DOAC therapy in AF
patients with bioprosthetic valves may be associated with a significant
reduction in all-cause mortality, with no reduction in the efficacy of
stroke/systemic embolism prevention or increase in major bleeding
risk.<br/>Copyright &#xa9; 2023

<88>
Accession Number
2024055398
Title
Coronary surgery provides better survival than drug-eluting stent: A
pooled meta-analysis of Kaplan- Meier-derived individual patient data.
Source
Journal of Thoracic and Cardiovascular Surgery. (no pagination), 2023.
Date of Publication: 2023.
Author
Urso S.; Sadaba R.; Gonzalez-Martin J.M.; Dayan V.; Nogales E.; Tena M.A.;
Abad C.; Portela F.
Institution
(Urso, Tena, Abad, Portela) Cardiac Surgery Department, Hospital
Universitario Dr Negrin, Las Palmas de Gran Canaria, Spain
(Sadaba) Cardiac Surgery Department, Hospital Universitario de Navarra,
Pamplona, Spain
(Gonzalez-Martin) Research Unit, Hospital Universitario Dr Negrin, Las
Palmas de Gran Canaria, Spain
(Dayan) Cardiac Surgery Department, Centro Cardiovascular Universitario,
Universidad de la Republica, Montevideo, Uruguay
(Nogales) Cardiology Department, Complejo Hospitalario Universitario
Insular-Materno Infantil, Las Palmas de Gran Canaria, Spain
Publisher
Elsevier Inc.
Abstract
Objectives: We explored the current evidence on coronary disease treatment
comparing the survival of 2 therapeutic strategies: coronary artery bypass
grafting (CABG) and percutaneous coronary intervention (PCI) with
drug-eluting stent (DES). <br/>Method(s): PubMed, Embase, and Google
Scholar were searched for randomized clinical trials comparing CABG versus
PCI with DES. The end point was overall mortality. Two statistical
approaches were used: the generic inverse variance method, which was used
to pool the incident rate ratios, and the pooled meta-analysis of
Kaplan-Meier-derived individual patient data. <br/>Result(s): Eight
randomized clinical trials comparing 4975 patients undergoing CABG and
4992 patients undergoing PCI were included in our meta-analysis. Generic
inverse variance method showed a statistically significant survival
benefit of the CABG group (incident rate ratio, 1.21; 95% confidence
interval, 1.09-1.35; P < .01). The Kaplan-Meier estimates of survival at
1, 5, and 10 years of the CABG group were 97.1%, 90.3%, and 80.3%,
respectively. The Kaplan-Meier estimates of survival at 1, 5, and 10 years
of the PCI group were 97.0%, 87.7%, and 76.4%, respectively. The log-rank
analysis confirmed a statistically significant benefit in term of overall
mortality of the CABG group (hazard ratio, 1.24; 95% confidence interval,
1.11-1.38; P = .0001). <br/>Conclusion(s): The present meta-analysis
suggests that CABG provides a consistent survival benefit over PCI with
DES.<br/>Copyright &#xa9; 2023 The American Association for Thoracic
Surgery

<89>
Accession Number
2022643587
Title
Advances in Clinical Cardiology 2022: A Summary of Key Clinical Trials.
Source
Advances in Therapy. (no pagination), 2023. Date of Publication: 2023.
Author
Savage P.; Cox B.; Shahmohammadi M.; Foster J.; Menown I.
Institution
(Savage, Cox, Shahmohammadi, Foster, Menown) Craigavon Cardiac Centre,
Southern Health and Social Care Trust, Northern Ireland, Craigavon, United
Kingdom
Publisher
Adis
Abstract
Introduction: Over the course of 2022, numerous key clinical trials with
valuable contributions to clinical cardiology were published or presented
at major international conferences. This review seeks to summarise these
trials and to reflect on their clinical context. <br/>Method(s): The
authors reviewed clinical trials presented at major cardiology conferences
during 2022, including the American College of Cardiology (ACC), European
Association for Percutaneous Cardiovascular Interventions (EuroPCR),
European Society of Cardiology (ESC), Transcatheter Cardiovascular
Therapeutics (TCT), American Heart Association (AHA), European Heart
Rhythm Association (EHRA), Society for Cardiovascular Angiography and
Interventions (SCAI), TVT-The Heart Summit (TVT) and Cardiovascular
Research Technologies (CRT). Trials with a broad relevance to the
cardiology community and those with potential to change current practice
were included. <br/>Result(s): A total of 93 key cardiology clinical
trials were identified for inclusion. Interventional cardiology data
included trials evaluating the use of new generation novel stent
technology and new intravascular physiology strategies such as
quantitative flow ratio (QFR) to guide revascularisation in stable and
unstable coronary artery disease. New trials in acute coronary syndromes
and intervention focused on long-term outcomes of optimal medical therapy
(OMT), revascularisation in ischaemic dysfunction and left main (LM)
intervention. Structural intervention trials included latest data on
optimal timing and anticoagulation strategies in transcatheter aortic
valve replacement (TAVR), in addition to expanding evidence in mitral and
tricuspid valve interventions. Heart failure data included trials with
sodium-glucose cotransporter 2 (SGLT2) inhibitors, iron replacement and
novel drugs such as omecamtiv. Prevention trials included new data on
proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors and
polypill strategies. In electrophysiology, new data regarding optimal
timing of ablative therapy for atrial fibrillation (AF) in addition to
novel screening strategies were evaluated. <br/>Conclusion(s): This
article presents a summary of key clinical cardiology trials published and
presented during the past year and should be of interest to both
practising clinicians and researchers.<br/>Copyright &#xa9; 2023, Crown.

<90>
Accession Number
2020866500
Title
An algorithmic approach to balloon undilatable coronary lesions.
Source
Catheterization and Cardiovascular Interventions. 101(2) (pp 355-362),
2023. Date of Publication: 01 Feb 2023.
Author
Rempakos A.; Kostantinis S.; Simsek B.; Karacsonyi J.; Allana S.; Egred
M.; Jneid H.; Mashayekhi K.; Di Mario C.; Krestyaninov O.; Khelimski D.;
Milkas A.; Sandoval Y.; Burke M.N.; Brilakis E.S.
Institution
(Rempakos, Kostantinis, Simsek, Karacsonyi, Allana, Sandoval, Burke,
Brilakis) Center for Coronary Artery Disease, Minneapolis Heart Institute
and Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital,
Minneapolis, MN, United States
(Egred) Department of Cardiology, Freeman Hospital, Newcastle upon Tyne,
United Kingdom
(Jneid) Division of Cardiology, Department of Medicine, Baylor College of
Medicine, Houston, TX, United States
(Mashayekhi) Division of Cardiology, MediClin Herzzentrum Lahr, Lahr,
Germany
(Di Mario) Division of Structural Interventional Cardiology, Department of
Clinical & Experimental Medicine, Careggi University Hospital, Florence,
Italy
(Krestyaninov, Khelimski) Department of Invasive Cardiology, Meshalkin
Novosibirsk Research Institute, Novosibirsk, Russian Federation
(Milkas) Division of Cardiology, Athens Naval and Veterans Hospital,
Athens, Greece
Publisher
John Wiley and Sons Inc
Abstract
Balloon undilatable lesions are lesions that have been successfully
crossed by both a guidewire and a balloon but cannot be expanded despite
multiple high-pressure balloon inflations. Balloon undilatable lesions can
be de novo or in-stent. We describe a systematic, algorithmic approach to
treat both de novo and in-stent balloon undilatable lesions using various
techniques, such as high-pressure balloon inflation, plaque modification
balloons, intravascular lithotripsy, very high-pressure balloon inflation,
coronary atherectomy, laser coronary angioplasty, and extraplaque lesion
crossing. Knowledge of the various techniques can increase the efficiency,
success and safety of the procedure.<br/>Copyright &#xa9; 2022 Wiley
Periodicals LLC.

<91>
Accession Number
2022850373
Title
Effects of omecamtiv mecarbil in heart failure with reduced ejection
fraction according to blood pressure: the GALACTIC-HF trial.
Source
European Heart Journal. 43(48) (pp 5006-5016), 2022. Date of Publication:
21 Dec 2022.
Author
Metra M.; Pagnesi M.; Claggett B.L.; Diaz R.; Michael Felker G.; McMurray
J.J.V.; Solomon S.D.; Bonderman D.; Fang J.C.; Fonseca C.; Goncalvesova
E.; Howlett J.G.; Li J.; O'Meara E.; Miao Z.M.; Abbasi S.A.; Heitner S.B.;
Kupfer S.; Malik F.I.; Teerlink J.R.
Institution
(Metra, Pagnesi) Cardiology, ASST Spedali Civili, Department of Medical
and Surgical Specialties, Radiological Sciences and Public Health,
University of Brescia, Brescia, Italy
(Claggett, Solomon, Miao) Division of Cardiovascular Medicine, Brigham and
Women's Hospital, Harvard Medical School, Boston, MA, United States
(Diaz) Estudios Clinicos Latino America (ECLA), Rosario, Argentina
(Michael Felker) Division of Cardiology, Duke University School of
Medicine, Duke Clinical Research Institute, Durham, NC, United States
(McMurray) British Heart Foundation Cardiovascular Research Centre,
University of Glasgow, Glasgow, United Kingdom
(Bonderman) Medical University of Vienna, Vienna, Austria
(Fang) University of Utah, Salt Lake City, UT, United States
(Fonseca) Hospital S. Francisco Xavier, Centro Hospitalar Lisboa
Ocidental, NOVA Medical School, Faculdade de Ciencias Medicas,
Universidade Nova de Lisboa, Lisbon, Portugal
(Goncalvesova) Faculty of Medicine, Comenius University, Bratislava,
Slovakia
(Howlett) Division of Cardiology, Libin Cardiovascular Institute of
Alberta, University of Calgary, Calgary, AB, Canada
(Li) National Clinical Research Center for Cardiovascular Diseases,
National Health Commission Key Laboratory of Clinical Research for
Cardiovascular Medications, Fuwai Hospital, Chinese Academy of Medical
Sciences, Peking Union Medical College, Beijing, China
(O'Meara) Montreal Heart Institute, Universite de Montreal, Montreal, QC,
Canada
(Abbasi) Amgen, Inc., Thousand Oaks, CA, United States
(Heitner, Kupfer, Malik) Cytokinetics, Inc., South San Francisco, CA,
United States
(Teerlink) Section of Cardiology, San Francisco Veterans Affairs Medical
Center, School of Medicine, University of California San Francisco, San
Francisco, CA, United States
Publisher
Oxford University Press
Abstract
Aim Patients with heart failure with reduced ejection fraction and low
systolic blood pressure (SBP) have high mortality, hospitalizations, and
poorly tolerate evidence-based medical treatment. Omecamtiv mecarbil may
be particularly helpful in such patients. This study examined its efficacy
and tolerability in patients with SBP <=100 mmHg enrolled in the Global
Approach to Lowering Adverse Cardiac outcomes Through Improving
Contractility in Heart Failure (GALACTIC-HF). Methods The GALACTIC-HF
enrolled patients with baseline SBP >=85 mmHg with a primary outcome of
time to cardiovascular and results death or first heart failure event. In
this analysis, patients were divided according to their baseline SBP
(<=100 vs. .100 mmHg). Among the 8232 analysed patients, 1473 (17.9%) had
baseline SBP <=100 mmHg and 6759 (82.1%) had SBP .100 mmHg. The primary
outcome occurred in 715 (48.5%) and 2415 (35.7%) patients with SBP <=100
and .100 mmHg, respectively. Patients with lower SBP were at higher risk
of adverse outcomes. Omecamtiv mecarbil, compared with placebo, appeared
to be more effective in reducing the primary composite endpoint in
patients with SBP <=100 mmHg [hazard ratio (HR), 0.81; 95% confidence
interval (CI), 0.70-0.94] compared with those with SBP .100 mmHg (HR,
0.95; 95% CI, 0.88-1.03; P-value for interaction = 0.051). In both groups,
omecamtiv mecarbil did not change SBP values over time and did not
increase the risk of adverse events, when compared with placebo.
Conclusion In GALACTIC-HF, risk reduction of heart failure outcomes with
omecamtiv mecarbil compared with placebo was large and significant in
patients with low SBP. Omecamtiv mecarbil did not affect SBP and was well
tolerated independent of SBP values.<br/>Copyright &#xa9; The Author(s)
2022. Published by Oxford University Press on behalf of European Society
of Cardiology.

<92>
Accession Number
640131443
Title
Early growth trajectory is associated with psychological stress in parents
of infants with congenital heart disease, but moderated by quality of
partner relationship.
Source
Journal of pediatric nursing. 69 (pp 93-100), 2023. Date of Publication:
01 Mar 2023.
Author
Lisanti A.J.; Golfenshtein N.; Min J.; Medoff-Cooper B.
Institution
(Lisanti, Medoff-Cooper) Department of Family and Community Health, School
of Nursing, University of Pennsylvania, United States of America; Research
Institute, Children's Hospital of Philadelphia, United States of America
(Golfenshtein) Department of Family and Community Health, School of
Nursing, University of Pennsylvania, United States of America; University
of Haifa, Department of Nursing, Israel
(Min) Department of Biomedical and Health Informatics, Research Institute,
Children's Hospital of Philadelphia, United States
Publisher
NLM (Medline)
Abstract
PURPOSE: To explore the relationships between growth trajectory, parenting
stress and parent post-traumatic stress (PTS), in infants with congenital
heart disease, and the moderating role of parents' dyadic adjustment on
those associations. DESIGN AND METHODS: A secondary analysis of data from
the REACH Telehalth home monitoring multi-site randomized clinical trial.
Parents completed the Parenting Stress Index (PSI), Post-traumatic
diagnostic scale, and the Dyadic Adjustment Scale. Multivariate logistic
regression models were used to examine the associations of interest.
<br/>RESULT(S): During 4-month follow-up after hospital discharge, parents
of infants with 'Never recovered' and 'Partially recovered' growth
trajectories had 2-5 times higher odds of experiencing higher stress on
the Parent Domain (OR = 4.8, CI = 1.3-18.0; OR = 2.5, CI = 1.0-5.9,
respectively) than those with stably grown infants. Parents of "Never
recovered" infants had 4 times higher odds of PTS symptoms (OR = 3.9; CI =
1.6-9.9). Parental dyadic adjustment moderated the relationships. Parents
of 'Partially recovered' infants and having low dyadic adjustment had 3-5
times higher odds of high stress on all PSI domains, while parents with
high dyadic adjustment did not have increased stress due to poor infant
growth. Parents of "Never recovered" infants had four times higher odds of
PTS symptom, even with high dyadic adjustment. <br/>CONCLUSION(S): Infant
growth trajectory over the first four months is associated with parenting
stress and PTS. Quality of partner relationship moderates some of these
associations. PRACTICE IMPLICATIONS: Infant growth should serve as a
screening aid for identifying parents at psychological risk. Interventions
targeting the quality of partner relationship may support parental coping
and mitigate stress. CLINICAL TRIAL REGISTRATION:
NCT01941667.<br/>Copyright &#xa9; 2022 Elsevier Inc. All rights reserved.

<93>
Accession Number
2023399032
Title
The Impact of Statins on Postdischarge Atrial Fibrillation After Cardiac
Surgery: Secondary Analysis from a Randomized Trial.
Source
CJC Open. 5(4) (pp 285-291), 2023. Date of Publication: April 2023.
Author
Hibino M.; Verma S.; Pandey A.K.; Bisleri G.; Yanagawa B.; Verma R.; Puar
P.; Quan A.; Teoh H.; Yau T.M.; Verma A.; Ha A.C.T.; Mazer C.D.
Institution
(Hibino) Division of Cardiothoracic Surgery, Emory University, School of
Medicine, Atlanta, GA, United States
(Verma, Bisleri, Yanagawa, Puar, Quan, Teoh) Division of Cardiac Surgery,
St. Michael's Hospital of Unity Health Toronto, Toronto, ON, Canada
(Verma, Bisleri, Yanagawa, Yau) Division of Cardiovascular Surgery,
Department of Surgery, University of Toronto, Toronto, ON, Canada
(Verma, Yanagawa) Department of Pharmacology and Toxicology, University of
Toronto, Toronto, ON, Canada
(Pandey) Michael G. DeGroote School of Medicine, McMaster University,
Hamilton, ON, Canada
(Verma) School of Medicine, Royal College of Surgeons in Ireland, Dublin,
Ireland
(Teoh) Division of Endocrinology and Metabolism, St. Michael's Hospital of
Unity Health Toronto, Toronto, ON, Canada
(Yau) Division of Cardiovascular Surgery, Toronto General Hospital
Research Institute, Toronto, ON, Canada
(Yau, Ha) Peter Munk Cardiac Centre, Toronto General Hospital, University
Health Network, Toronto, ON, Canada
(Verma) Division of Cardiology, McGill University, Montreal, QC, Canada
(Ha) Department of Medicine, University of Toronto, Toronto, ON, Canada
(Mazer) Department of Anesthesia, St. Michael's Hospital of Unity Health
Toronto, Toronto, ON, Canada
(Mazer) Department of Anesthesiology and Pain Medicine, University of
Toronto, Toronto, ON, Canada
(Mazer) Department of Physiology, University of Toronto, Toronto, ON,
Canada
Publisher
Elsevier Inc.
Abstract
Background: Whether statins reliably reduce the risk of postoperative
atrial fibrillation (POAF) in patients undergoing cardiac surgery remains
controversial. We sought to determine the impact of statin use on
new-onset postdischarge POAF in the Post-Surgical Enhanced Monitoring for
Cardiac Arrhythmias and Atrial Fibrillation (SEARCH-AF) CardioLink-1
randomized controlled trial. <br/>Method(s): We randomized 336 patients
with risk factors for stroke (CHA<inf>2</inf>DS<inf>2</inf>-VASc score >=
2) and no history of preoperative atrial fibrillation (AF) to 30-day
continuous cardiac rhythm monitoring after discharge from cardiac surgery
with a wearable, patched-based device or to usual care. The primary
endpoint was the occurrence of cumulative AF and/or atrial flutter lasting
for >= 6 minutes detected by continuous monitoring, or AF and/or atrial
flutter documented by a 12-lead electrocardiogram within 30 days of
randomization. <br/>Result(s): The 260 patients (77.4%) discharged on
statins were more likely to be male (P = 0.018) and to have lower
CHA<inf>2</inf>DS<inf>2</inf>-VASc scores (P = 0.011). Patients treated
with statins at discharge had a 2-fold lower rate of POAF than those who
were not treated with statins in the entire cohort (18.4% vs 8.1%,
log-rank P = 0.0076). On multivariable Cox regression including the
CHA<inf>2</inf>DS<inf>2</inf>-VASc score adjustment, statin use was
associated with a lower risk of POAF (hazard ratio 0.43, 95% confidence
interval: 0.25-0.98, P = 0.043). Use of statins at a higher intensity was
associated with lower risk of POAF, suggestive of a dose-response effect
(log-rank P<inf>trend</inf> = 0.0082). <br/>Conclusion(s): The use of
statins was associated with a reduction in postdischarge POAF risk among
patients undergoing cardiac surgery. The routine use of high-intensity
statin to prevent subacute POAF after discharge deserves further
study.<br/>Copyright &#xa9; 2022 The Authors

<94>
Accession Number
2023144100
Title
Pectus Excavatum in Cardiac Surgery Patients.
Source
Annals of Thoracic Surgery. 115(5) (pp 1312-1321), 2023. Date of
Publication: May 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. <br/>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. <br/>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.
<br/>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.<br/>Copyright &#xa9; 2023 The
Society of Thoracic Surgeons

<95>
Accession Number
2021904072
Title
A Randomized Trial of Clopidogrel vs Ticagrelor After Off-Pump Coronary
Bypass.
Source
Annals of Thoracic Surgery. 115(5) (pp 1127-1134), 2023. Date of
Publication: May 2023.
Author
Kim H.-H.; Yoo K.-J.; Youn Y.-N.
Institution
(Kim, Yoo, Youn) Division of Cardiovascular Surgery, Severance
Cardiovascular Hospital, Yonsei University College of Medicine, Yonsei
University Health System, Seoul, South Korea
Publisher
Elsevier Inc.
Abstract
Background: This study aimed to compare the outcomes of aspirin in
combination with either ticagrelor or clopidogrel after off-pump coronary
artery bypass (OPCAB) in patients with clopidogrel resistance.
<br/>Method(s): Between November 2014 and November 2020, 1739 patients
underwent OPCAB. Aspirin and clopidogrel treatment was initiated the day
after surgery. On postoperative days 7 to 9, clopidogrel resistance was
evaluated using a point-of-care assay. A total of 278 (18.9%) patients had
clopidogrel resistance ( platelet reaction unit >208) and were enrolled in
the study. The study investigators excluded patients with coresistance to
aspirin (n = 74) and divided the remaining patients (mean age, 67.4 +/-
8.5 years) into 2 groups (an aspirin and ticagrelor group [AT group; n =
102] and an aspirin and clopidogrel group [AC group; n = 102]), randomly
assigned using a 1:1 ratio block table. The primary end point was graft
patency and major adverse cardiovascular events (MACEs; defined as the
composite of cardiovascular mortality, myocardial infarction, and repeat
revascularization at 1 year after OPCAB), and the coprimary end point was
the graft patency rate. The data were analyzed using the intent-to-treat
method. <br/>Result(s): The graft occlusion rates in the AT and AC groups
were 3.9% and 5.9%, respectively (P = .52). Neither death from
cardiovascular causes (1.0% vs 2.9%; P = .32) nor myocardial infarction
showed significant differences (1.0% vs 3.9%; P = .18). No significant
difference in the rates of major bleeding were found between the 2 groups
(P = .75). However, the AT group was associated with a lower rate of MACEs
after OPCAB (hazard ratio, 0.77; 95% CI, 0.684-0.891; P = .01).
<br/>Conclusion(s): These results suggest that ticagrelor may be
associated with reducing MACEs in patients with clopidogrel resistance
after OPCAB.<br/>Copyright &#xa9; 2023 The Society of Thoracic Surgeons

<96>
Accession Number
2021160038
Title
A systematic review and meta-analysis of general versus regional
anesthesia for lower extremity amputation.
Source
Journal of Vascular Surgery. 77(5) (pp 1542-1552.e9), 2023. Date of
Publication: May 2023.
Author
Mufarrih S.H.; Qureshi N.Q.; Yunus R.A.; Katsiampoura A.; Quraishi I.;
Sharkey A.; Mahmood F.; Matyal R.
Institution
(Mufarrih, Qureshi, Yunus, Katsiampoura, Quraishi, Sharkey, Mahmood,
Matyal) Department of Anesthesia, Critical Care and Pain Medicine, Beth
Israel Deaconess Medical Center, Harvard Medical School, Boston, MA,
United States
Publisher
Elsevier Inc.
Abstract
Objective: Postoperative morbidity in patients undergoing lower extremity
amputation (LEA) has remained high. Studies investigating the influence of
the anesthetic modality on the postoperative outcomes have yielded
conflicting results. The aim of our study was to assess the effects of
regional anesthesia vs general anesthesia on postoperative complications
for patients undergoing LEA. <br/>Method(s): We systematically searched
PubMed, Embase, MEDLINE, Web of Science, and Google Scholar from 1990 to
2022 for studies investigating the effect of the anesthetic modality on
the postoperative outcomes after LEA. Regional anesthesia (RA) included
neuraxial anesthesia and peripheral nerve blocks. The outcomes included
30-day mortality, respiratory failure (unplanned postoperative intubation,
failure to wean, mechanical ventilation >24 hours), surgical site
infection, cardiac complications, urinary tract infection, renal failure,
sepsis, venous thrombosis, pneumonia, and myocardial infarction.
<br/>Result(s): Of the 25 studies identified, we included 10 retrospective
observational studies with 81,736 patients, of whom 69,754 (85.3%) had
received general anesthesia (GA) and 11,980 (14.7%) had received RA. In
the GA group, 50,468 patients were men (63.8%), and in the RA group, 7813
patients were men (62.3%). The results of the meta-analyses revealed that
GA was associated with a higher rate of respiratory failure (odds ratio,
1.38; 95% confidence interval, 1.06-1.80; P = .02) and sepsis (odds ratio,
1.21; 95% confidence interval, 1.11-1.33; P < .0001) compared with RA. No
differences were found in postoperative 30-day mortality, surgical site
infection, cardiac complications, urinary tract infection, renal failure,
venous thrombosis, pneumonia, and myocardial infarction between the GA and
RA groups. <br/>Conclusion(s): The results of our meta-analysis have shown
that GA could be associated with a higher rate of respiratory failure and
sepsis compared with RA for LEA.<br/>Copyright &#xa9; 2023

<97>
Accession Number
2022632739
Title
Recurrent Atherosclerotic Cardiovascular Disease Events Potentially
Prevented with Guideline-Recommended Cholesterol-Lowering Therapy
following Myocardial Infarction.
Source
Cardiovascular Drugs and Therapy. (no pagination), 2023. Date of
Publication: 2023.
Author
Sakhuja S.; Bittner V.A.; Brown T.M.; Farkouh M.E.; Levitan E.B.; Safford
M.M.; Woodward M.; Chen L.; Sun R.; Dhalwani N.; Jones J.; Kalich B.;
Exter J.; Muntner P.; Rosenson R.S.; Colantonio L.D.
Institution
(Sakhuja, Levitan, Chen, Muntner, Colantonio) Department of Epidemiology,
University of Alabama at Birmingham, Birmingham, AL, United States
(Bittner, Brown) Department of Medicine, Division of Cardiovascular
Disease, University of Alabama at Birmingham, Birmingham, AL, United
States
(Farkouh) Peter Munk Cardiac Centre, University of Toronto and Heart and
Stroke Richard Lewar Centre of Excellence, Toronto, ON, Canada
(Safford) Department of Medicine, Weill Cornell Medicine, New York, NY,
United States
(Woodward) The George Institute for Global Health, University of New South
Wales, Sydney, Australia
(Woodward) The George Institute for Global Health, School of Public
Health, Imperial College, London, United Kingdom
(Sun) Department of Healthcare Policy and Organization and Policy,
University of Alabama at Birmingham, Birmingham, AL, United States
(Dhalwani, Jones) Center for Observational Research, Amgen Inc., Thousand
Oaks, CA, United States
(Kalich, Exter) Amgen Inc., Thousand Oaks, CA, United States
(Rosenson) Icahn School of Medicine at Mount Sinai, Mount Sinai Heart, New
York, NY, United States
Publisher
Springer
Abstract
Purpose: Manyadults with atherosclerotic cardiovascular disease (ASCVD)
who are recommended to take a statin, ezetimibe and/or a proprotein
convertase subtilisin/kexin type 9 inhibitor (PCSK9i) by the 2018 American
Heart Association/American College of Cardiology cholesterol guideline do
not receive these medications. We estimated the percentage of recurrent
ASCVD events potentially prevented with guideline-recommended
cholesterol-lowering therapy following a myocardial infarction (MI)
hospitalization. <br/>Method(s): We conducted simulations using data from
US adults with government health insurance through Medicare or commercial
health insurance in the MarketScan database. We used data from patients
with an MI hospitalization in 2018-2019 to estimate the percentage
receiving guideline-recommended therapy. We used data from patients with
an MI hospitalization in 2013-2016 to estimate the 3-year cumulative
incidence of recurrent ASCVD events (i.e., MI, coronary revascularization
or ischemic stroke). The low-density lipoprotein cholesterol (LDL-C)
reduction with guideline-recommended therapy was derived from trials of
statins, ezetimibe and PCSK9i, and the associated ASCVD risk reduction was
estimated from a meta-analysis by the Cholesterol-Lowering Treatment
Trialists Collaboration. <br/>Result(s): Among 279,395 patients with an MI
hospitalization in 2018-2019 (mean age 75 years, mean LDL-C 92 mg/dL),
27.3% were receiving guideline-recommended cholesterol-lowering therapy.
With current cholesterol-lowering therapy use, 25.3% (95%CI: 25.2%-25.4%)
of patients had an ASCVD event over 3 years. If all patients were to
receive guideline-recommended therapy, 19.8% (95%CI: 19.5%-19.9%) were
estimated to have an ASCVD event over 3 years, representing a 21.6%
(95%CI: 20.5%-23.6%) relative risk reduction. <br/>Conclusion(s):
Implementation of guideline-recommended cholesterol-lowering therapy could
prevent a substantial percentage of recurrent ASCVD events.<br/>Copyright
&#xa9; 2023, The Author(s), under exclusive licence to Springer
Science+Business Media, LLC, part of Springer Nature.