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<1>
Accession Number
364317599
Title
The consumption of the carp meat and plasma lipids in secondary prevention
in the heart ischemic disease patients.
Source
Neuroendocrinology Letters. 32(SUPPL. 2) (pp 17-20), 2011. Date of
Publication: 2011.
Author
Adamkova V.; Kacer P.; Mraz J.; Suchanek P.; Pickova J.; Kralova Lesna I.;
Skibova J.; Kozak P.; Maratka V.
Institution
(Adamkova, Kacer, Suchanek, Kralova Lesna, Skibova) Department of
Preventive Cardiology, Institute for Clinical and Experimental Medicine,
Videnska 1958/19, 140 21 Prague 4-Krc, Czechia
(Mraz, Pickova, Kozak) University of South Bohemia, Faculty of Fisheries
and Protection of Waters, Ceske Budejovice, Czechia
(Maratka) Spa Podebrady, Czechia
Publisher
Maghira and Maas Publications
Abstract
OBJECTIVES: Omega-3 fatty acids (FA) have been shown to be protective
against cardiovascular diseases (CVD). The effect of the consumption of
carp meat on CVD risk factors has not yet been examined in detail. We
ascertained the influence of a diet enriched with carp meat with an
elevated content of omega-3FA (200 g twice weekly for 4 weeks) in a group
of subjects after cardiac revascularization surgery for ischemic heart
disease with a follow-up spa treatment. DESIGN: After cardiac
revascularization surgery, the probands consumed either a standard spa
diet (56 individuals, 41 males, 15 females, age 41-80 years) or a diet
enriched with two portions of carp meat (87 individuals, 64 males, 23
females, age 50-82 years). The differences in body mass index
(kg/m²), blood pressure, plasma lipids and C-reactive protein
(CRP) of the groups were analyzed. <br/>RESULT(S): In the group with a
higher consumption of carp meat, significantly greater improvements in
lipid parameters in comparison to the standard spa diet were detected
(total cholesterol p<0.001, triglycerides p<0.001, LDL-C p<0.001, CRP
p<0.001, HDL-C p<0.001). No differences between these groups in blood
pressure and body mass index were found. <br/>CONCLUSION(S): We conclude
that the diet enriched with carp meat significantly improved plasma lipid
parameters in patients after major cardiac revascularization surgery.
&#xa9; 2011 Neuroendocrinology Letters.

<2>
Accession Number
2024290405
Title
Precision antiplatelet therapy.
Source
Research and Practice in Thrombosis and Haemostasis. 7(3) (no pagination),
2023. Article Number: 100138. Date of Publication: March 2023.
Author
Rocca B.; Patrono C.
Institution
(Rocca, Patrono) Section of Pharmacology, Catholic University School of
Medicine and Fondazione Policlinico Universitario Agostino Gemelli and
Istituto di Ricerca e Cura a Carattere Scientifico, Rome, Italy
Publisher
Elsevier B.V.
Abstract
A State of the Art lecture titled "Personalizing Antiplatelet Therapy
Based on Platelet Turnover and Metabolic Phenotype" was presented by
Bianca Rocca at the International Society on Thrombosis and Haemostasis
(ISTH) Congress in 2022. Increased variability in drug response may be
associated with serious, mechanism-based and off-target side effects,
especially in the case of drugs that do not routinely undergo therapeutic
drug monitoring, such as antiplatelet drugs or direct oral anticoagulants.
Precision pharmacology can be defined as the identification of a drug
regimen that maximizes the benefit/risk balance at the level of an
individual patient. Key tools for identifying relevant sources of
variability and developing precision drug dosing are represented by
genetic, biochemical, and pharmacological biomarkers recognized as a valid
surrogate or strong predictor of major clinical complications.
Pharmacodynamic, pharmacokinetic, and/or disease-related biomarkers are
central to identifying the right population to be targeted, characterizing
the sources of variability in drug response, guiding precision treatments
that maximize benefits and minimize risks, and designing precision dosing
trials. Another valuable tool for guiding precision pharmacology is
represented by in silico pharmacokinetic/pharmacodynamic models and
simulations instructed by real-world data of validated biomarkers. This
review critically analyzes the tools for precision dosing and exemplifies
conditions in which precision dosing can considerably optimize the
efficacy and safety of antiplatelet drugs, namely aspirin and
P2Y<inf>12</inf> receptor blockers, used alone and in combination.
Finally, we summarize relevant new data on this topic presented during the
2022 ISTH Congress.<br/>Copyright &#xa9; 2023 The Authors

<3>
Accession Number
2024022777
Title
Mobile health vs. standard care after cardiac surgery: results of The Box
2.0 study.
Source
Europace. 25(1) (pp 49-58), 2023. Date of Publication: 01 Jan 2023.
Author
Biersteker T.E.; Boogers M.J.; Schalij M.J.; Penning De Vries B.B.L.;
Groenwold R.H.H.; Van Alem A.P.; De Weger A.; Van Hof N.; Treskes R.W.
Institution
(Biersteker, Boogers, Schalij, Van Hof, Treskes) Department of Cardiology,
Leiden University Medical Center, Albinusdreef 2, Leiden 2333 ZA,
Netherlands
(Penning De Vries, Groenwold) Department of Clinical Epidemiology and
Biomedical Data Sciences, Leiden University Medical Center, Leiden,
Netherlands
(Van Alem) Department of Cardiology, Haaglanden Medisch Centrum, The
Hague, Netherlands
(De Weger) Department of Cardiothoracic Surgery, Leiden University Medical
Center, Leiden, Netherlands
Publisher
Oxford University Press
Abstract
Aims: Postoperative atrial fibrillation (POAF) is a common complication of
cardiac surgery, yet difficult to detect in ambulatory patients. The
primary aim of this study is to investigate the effect of a mobile health
(mHealth) intervention on POAF detection after cardiac surgery.
<br/>Methods and Results: We performed an observational cohort study among
730 adult patients who underwent cardiac surgery at a tertiary care
hospital in The Netherlands. Of these patients, 365 patients received
standard care and were included as a historical control group, undergoing
surgery between December 2017 and September 2018, and 365 patients were
prospectively included from November 2018 and November 2020, undergoing an
mHealth intervention which consisted of blood pressure, temperature,
weight, and electrocardiogram (ECG) monitoring. One physical outpatient
follow-up moment was replaced by an electronic visit. All patients were
requested to fill out a satisfaction and quality of life questionnaire.
Mean age in the intervention group was 62 years, 275 (70.4%) patients were
males. A total of 4136 12-lead ECGs were registered. In the intervention
group, 61 (16.7%) patients were diagnosed with POAF vs. 25 (6.8%) patients
in the control group [adjusted risk ratio (RR) of POAF detection: 2.15;
95% confidence interval (CI): 1.55-3.97]. De novo atrial fibrillation was
found in 13 patients using mHealth (6.5%) vs. 4 control group patients
(1.8%; adjusted RR 3.94, 95% CI: 1.50-11.27). <br/>Conclusion(s):
Scheduled self-measurements with mHealth devices could increase the
probability of detecting POAF within 3 months after cardiac surgery. The
effect of an increase in POAF detection on clinical outcomes needs to be
addressed in future research.<br/>Copyright &#xa9; 2022 The Author(s).
Published by Oxford University Press on behalf of the European Society of
Cardiology.

<4>
Accession Number
2023045999
Title
The effect of the multiple arterial grafts compared with single arterial
graft for coronary artery bypass grafting on sternal wound complications:
A meta-analysis.
Source
International Wound Journal. (no pagination), 2023. Date of Publication:
2023.
Author
Yang X.; Fu J.; Zhang S.
Institution
(Yang, Zhang) Department of Cardiothoracic Surgery, the First College of
Clinical Medical Science, China Three Gorges University, Hubei, Yichang,
China
(Yang, Zhang) Department of Cardiothoracic Surgery, Yichang Central
People's Hospital, Hubei, Yichang, China
(Fu) Department of Oncology, the Second People's Hospital of China Three
Gorges University, Hubei, Yichang, China
(Fu) Department of Oncology, Yichang Second People's Hospital, Hubei,
Yichang, China
Publisher
John Wiley and Sons Inc
Abstract
A meta-analysis investigation was executed to measure the influence of
multiple arterial grafts (MAGs) compared with single arterial graft (SAG)
for coronary artery bypass grafting (CABG) on sternal wound complications
(SWCs). A comprehensive literature inspection till February 2023 was
applied and 1048 interrelated investigations were reviewed. The seven
chosen investigations enclosed 11 201 individuals with CABG in the chosen
investigations' starting point, 4870 of them were using MAGs, and 6331
were using SAG. Odds ratio (OR) in addition to 95% confidence intervals
(CIs) were utilised to compute the value of the effect of the MAGs
compared with SAG for CABG on SWCs by the dichotomous approaches and a
fixed or random model. MAGs had significantly higher SWC (OR, 1.38; 95%
CI, 1.10-1.73, P =.005) compared with those with SAG in CABG. MAGs had
significantly higher SWC compared with those with SAG in CABG. However,
care must be exercised when dealing with its values because of the low
number of selected investigations for the meta-analysis.<br/>Copyright
&#xa9; 2023 The Authors. International Wound Journal published by
Medicalhelplines.com Inc and John Wiley & Sons Ltd.

<5>
Accession Number
2023036056
Title
Same-day discharge for left atrial appendage occlusion procedure: A
systematic review and meta-analysis.
Source
Journal of Cardiovascular Electrophysiology. (no pagination), 2023. Date
of Publication: 2023.
Author
Khan J.A.; Parmar M.; Bhamare A.; Agarwal S.; Khosla J.; Liu B.; Abraham
R.; Khan T.; Clifton S.; Munir M.B.; DeSimone C.V.; Deshmukh A.; Po S.;
Stavrakis S.; Asad Z.U.A.
Institution
(Khan, Parmar, Bhamare, Agarwal, Khosla, Khan, Po, Stavrakis, Asad)
Department of Medicine, University of Oklahoma Health Sciences Center,
Oklahoma City, OK, United States
(Liu, Abraham) College of Medicine, University of Oklahoma Health Sciences
Center, Oklahoma City, OK, United States
(Clifton) Robert M Bird Health Sciences Library, University of Oklahoma
Health Sciences Center, Oklahoma City, OK, United States
(Munir) Section of Electrophysiology, Division of Cardiology, University
of California Davis, Davis, CA, United States
(DeSimone, Deshmukh) Department of Cardiovascular Medicine, Mayo Clinic,
Rochester, MN, United States
Publisher
John Wiley and Sons Inc
Abstract
Introduction: Most patients undergoing a left atrial appendage occlusion
(LAAO) procedure are admitted for overnight observation. A same-day
discharge strategy offers the opportunity to improve resource utilization
without compromising patient safety. We compared the patient safety
outcomes and post-discharge complications between same-day discharge
versus hospital admission (HA) (>1 day) in patients undergoing LAAO
procedure. <br/>Method(s): A systematic search of MEDLINE and Embase was
conducted. Outcomes of interest included peri-procedural complications,
re-admissions, discharge complications including major bleeding and
vascular complications, ischemic stroke, all-cause mortality, and
peri-device leak >5 mm. Mantel-Haenszel risk ratios (RRs) with 95% CIs
were calculated. <br/>Result(s): A total of seven observational studies
met the inclusion criteria. There was no statistically significant
difference between same-day discharge versus HA regarding readmission (RR:
0.61; 95% confidence interval [CI]: [0.29-1.31]; p =.21), ischemic stroke
after discharge (RR: 1.16; 95% CI: [0.49-2.73]), peri-device leak >5 mm
(RR: 1.27; 95% CI: [0.42-3.85], and all-cause mortality (RR: 0.60; 95% CI:
[0.36-1.02]). The same-day discharge study group had significantly lower
major bleeding or vascular complications (RR: 0.71; 95% CI: [0.54-0.94]).
<br/>Conclusion(s): This meta-analysis of seven observational studies
showed no significant difference in patient safety outcomes and
post-discharge complications between same-day discharge versus HA. These
findings provide a solid basis to perform a randomized control trial to
eliminate any potential confounders.<br/>Copyright &#xa9; 2023 Wiley
Periodicals LLC.

<6>
Accession Number
2022325747
Title
Coaptation Length as Predictor of Recurrent Mitral Regurgitation After
Surgical Repair for Degenerative Mitral Valve Disease: Meta-Analysis of
Reconstructed Time-to-Event Data.
Source
Structural Heart. 7(3) (no pagination), 2023. Article Number: 100152. Date
of Publication: May 2023.
Author
Sa M.P.; Jacquemyn X.; Van den Eynde J.; Erten O.; Caldonazo T.; Doenst
T.; Marin-Cuartas M.; Borger M.A.; Clavel M.-A.; Pibarot P.; Rodriguez R.;
Ramlawi B.; Goldman S.
Institution
(Sa, Rodriguez, Ramlawi, Goldman) Department of Cardiothoracic Surgery,
Lankenau Heart Institute, Lankenau Medical Center, Main Line Health,
Wynnewood, PA, United States
(Sa, Erten, Rodriguez, Ramlawi, Goldman) Department of Cardiothoracic
Surgery Research, Lankenau Institute for Medical Research, Wynnewood, PA,
United States
(Jacquemyn, Van den Eynde) Department of Cardiovascular Sciences, KU
Leuven, Leuven, Belgium
(Caldonazo, Doenst) Department of Cardiothoracic Surgery,
Friedrich-Schiller-University Jena, Jena, Germany
(Marin-Cuartas, Borger) University Department of Cardiac Surgery, Leipzig
Heart Center, Leipzig, Germany
(Clavel, Pibarot) University Institute of Cardiology and Pulmonology of
Quebec - Laval University, Quebec City, Quebec, Canada
Publisher
Cardiovascular Research Foundation

<7>
Accession Number
2014317460
Title
Survival effect of radial artery usage in addition to bilateral internal
thoracic arterial grafting: A meta-analysis.
Source
Journal of Thoracic and Cardiovascular Surgery. 165(6) (pp 2076-2085.e9),
2023. Date of Publication: June 2023.
Author
Formica F.; Maestri F.; D'Alessandro S.; Di Mauro M.; Singh G.; Gallingani
A.; Nicolini F.
Institution
(Formica, Maestri, Gallingani, Nicolini) Cardiac Surgery Unit, Department
of Medicine and Surgery, Parma General Hospital, University of Parma,
Parma, Italy
(D'Alessandro) Cardiac Surgery Unit, Vito Fazzi Hospital, Lecce, Italy
(Di Mauro) Invasive Cardiology and Heart Failure Unit, Medicine
Department, "Pierangeli" Hospital, Pescara, Italy
(Di Mauro) Cardio-Thoracic Surgery Unit, Heart and Vascular Centre,
Maastricht University, Maastricht, Netherlands
(Singh) Medical Centre (MUMC), Cardiovascular Research Institute
Maastricht (CARIM), Maastricht, Netherlands
(Singh) Division of Cardiac Surgery and Department of Critical Care
Medicine, Mazankowski Alberta Heart Institute, University of Alberta,
Edmonton, AB, Canada
Publisher
Elsevier Inc.
Abstract
Objective: Little evidence shows whether the radial artery (RA) as third
arterial graft provides superior outcomes compared with the use of the
bilateral internal thoracic artery (BITA) and saphenous vein (SV) graft in
patients undergoing coronary artery bypass grafting. A meta-analysis of
propensity score-matched observational studies that compared the long-term
outcomes of coronary artery bypass grafting with the use of BITA and the
RA (BITA + RA) versus BITA and SV (BITA + SV) was performed.
<br/>Method(s): Electronic databases from January 2000 to November 2020
were screened. Studies that reported long-term mortality were analyzed.
The primary outcome was long-term overall mortality. A secondary end point
was in-hospital/30-day mortality. Pooled hazard ratio with 95% confidence
interval (CI) were calculated for survival and time-to-event analysis
according to a random effect model. Differences were expressed as odds
ratio with 95% CI for in-hospital/30-day mortality. <br/>Result(s): Six
propensity score-matched studies that reported on 2500 matched patients
(BITA + RA: 1250; BITA + SV: 1250) were identified for comparison. The use
of BITA + RA was not statistically associated with early mortality (odds
ratio, 0.90; 95% CI, 0.36-2.28; P = .83). The mean follow-up time ranged
from 7.5 to 12 years. The pooled analysis of long-term survival revealed a
significant difference between the 2 groups favoring BITA + RA treatment
(hazard ratio, 0.71; 95% CI, 0.50-0.91; P = .031). The survival rate for
BITA + RA versus BITA + SV at 5, 10, and 15 years were: 96.2% versus
94.8%, 88.9% versus 87.4%, and 83% versus 77.9%, respectively (log rank
test, P = .02). <br/>Conclusion(s): In patients with coronary artery
bypass grafting, BITA + RA usage is not associated with higher rates of
operative risk and is associated with superior long-term overall
survival.<br/>Copyright &#xa9; 2021 The American Association for Thoracic
Surgery

<8>
Accession Number
641029760
Title
Implementation of the Kidney Disease Improving Global Outcomes guidelines
for the prevention of acute kidney injury after cardiac surgery: An
international cohort survey.
Source
European journal of anaesthesiology. 40(6) (pp 418-424), 2023. Date of
Publication: 01 Jun 2023.
Author
Massoth C.; Kullmar M.; Moncho A.P.; Suarez S.G.; Grigoryev E.; Ivkin A.;
von Dossow V.; Ott S.; Rau N.; Meersch M.; Zarbock A.
Institution
(Massoth) From the Department of Anaesthesiology, Intensive Care and Pain
Medicine, University Hospital Munster, Germany (CM, La Fe University and
Polytechnic Hospital Valencia (APM), Department of Anaesthesiology,
University Hospital Vall d Hebron Barcelona, Scientific Research Institute
for Complex Issues of Cardiovascular Diseases, Institute of
Anaesthesiology and Pain Therapy, Heart and Diabetes Center Bad
Oeynhausen, Ruhr- University (VvD), German Heart Center Berlin (SO,
Department of Cardiac Anaesthesiology and Intensive Care Medicine, Germany
(SO) and Department of Intensive Care Medicine, University Hospital Vall
d'Hebron Barcelona, Charite-Universitatsmedizin Berlin, Kemerovo, Spain
Publisher
NLM (Medline)
Abstract
BACKGROUND: Increasing evidence from randomised controlled trials supports
the implementation of a six-measure care bundle proposed by the Kidney
Disease Improving Global Outcomes (KDIGO) guidelines in patients at high
risk for acute kidney injury (AKI) to reduce its incidence after cardiac
surgery. <br/>OBJECTIVE(S): To assess compliance with the KDIGO bundle in
clinical practice. DESIGN: Prospective observational multinational study.
SETTING: Six international tertiary care centres, from February 2021 to
November 2021. PATIENTS: Five hundred and thirty-seven consecutive
patients undergoing cardiac surgery during a 1-month observational period.
INTERVENTIONS: All patients were assessed for the postoperative
implementation of the following measures: avoidance of nephrotoxic
medication and radiocontrast agents whenever possible, strict glycaemic
control, close monitoring of renal function, optimisation of haemodynamic
and volume status and functional monitoring of haemodynamic status. MAIN
OUTCOME MEASURES: The primary endpoint was the proportion of patients
receiving fully compliant care. Secondary outcomes were occurrence of AKI
and major adverse kidney event rate at day 30. <br/>RESULT(S): The full
care bundle was applied to 0.4% of patients. There was avoidance of
nephrotoxic drugs in 15.6%, radiocontrast agents in 95.3% and
hyperglycaemia in 39.6%. Close monitoring of urine output and serum
creatinine was achieved in 6.3%, 57.4% underwent optimisation of volume
and haemodynamic status, and 43.9% received functional haemodynamic
monitoring. 27.2% developed AKI within 72 h after surgery. The average
number of implemented measures was 2.6 +/- 1.0 and did not differ between
AKI or non-AKI patients ( P = 0.854). <br/>CONCLUSION(S): Adherence with
the KDIGO bundle was very low in cardiac surgery patients. Initiatives to
improve guideline compliance might provide a strategy to mitigate the
burden of AKI. TRIAL REGISTRATION: www.drks.de DRKS00024204.<br/>Copyright
&#xa9; 2023 European Society of Anaesthesiology and Intensive Care.
Unauthorized reproduction of this article is prohibited.

<9>
Accession Number
631707729
Title
Prognostic Value of Late Gadolinium Enhancement for the Prediction of
Cardiovascular Outcomes in Dilated Cardiomyopathy: An International,
Multi-Institutional Study of the MINICOR Group.
Source
Circulation: Cardiovascular Imaging. 13(4) (pp E010105), 2020. Date of
Publication: 01 Apr 2020.
Author
Alba A.C.; Gaztanaga J.; Foroutan F.; Thavendiranathan P.; Merlo M.;
Alonso-Rodriguez D.; Vallejo-Garcia V.; Vidal-Perez R.; Corros-Vicente C.;
Barreiro-Perez M.; Pazos-Lopez P.; Perez-David E.; Dykstra S.; Flewitt J.;
Perez-Rivera J.A.; Vazquez-Caamano M.; Katz S.D.; Sinagra G.; Kober L.;
Poole J.; Ross H.; Farkouh M.E.; White J.A.
Institution
(Alba, Foroutan, Thavendiranathan, Ross, Farkouh) Peter Munk Cardiac
Centre, Department of Medicine, Toronto General Hospital, University
Health Network, ON, Canada
(Gaztanaga) Division of Cardiology, Department of Medicine, Nyu Winthrop
Hospital, Mineola, NY, United States
(Merlo, Sinagra) Cardiovascular Department, Azienda Sanitaria
Universitaria Giuliano Isontina (ASUGI), Universita Degli Studi di
Trieste, Trieste, Italy
(Alonso-Rodriguez) Department of Cardiology, Complejo Asistencial
Universitario de Leon, Spain
(Vallejo-Garcia, Barreiro-Perez) Department of Cardiology, Hospital
Clinico Universitario de Salamanca, Spain
(Vidal-Perez) Department of Cardiology, Hospital Universitario Lucus
Augusti, Lugo, Spain
(Corros-Vicente) Department of Cardiology, Hospital Universitario Central
de Asturias, Oviedo, Spain
(Pazos-Lopez) Department of Cardiology, Complejo Hospitalario
Universitario de Vigo, Spain
(Perez-David) Department of Cardiology, Hospital General Universitario
Gregorio Maranon, Madrid, Spain
(Dykstra, Flewitt, White) Departments of Cardiac Sciences and Diagnostic
Imaging, Libin Cardiovascular Institute of Alberta, Calgary, Canada
(Perez-Rivera) Hospital Universitario de Burgos, Spain
(Vazquez-Caamano) Hospital Povisa, Vigo, Spain
(Katz) Nyu Langone Health, Leon H. Charney Division of Cardiology, NY,
United States
(Kober) Rigshospitalet, Copenhagen University Hospital, Denmark
(Poole) Division of Cardiology, Department of Medicine, University of
Washington, Seattle, WA, United States
Publisher
Lippincott Williams and Wilkins
Abstract
Background: Dilated cardiomyopathy is associated with increased risk of
major cardiovascular events. Late gadolinium enhancement (LGE) cardiac
magnetic resonance imaging is a unique tissue-based marker that, in
single-center studies, suggests strong prognostic value. We
retrospectively studied associations between LGE presence and adverse
cardiovascular events in patients with dilated cardiomyopathy in a
multicenter setting as part of an emerging global consortium (MINICOR
[Multi-Modal International Cardiovascular Outcomes Registry]).
<br/>Method(s): Consecutive patients with dilated cardiomyopathy referred
for cardiac magnetic resonance (2000-2017) at 12 institutions in 4
countries were studied. Using multivariable Cox proportional hazard and
semiparametric Fine and Gray models, we evaluated the association between
LGE and the composite primary end point of all-cause mortality, heart
transplantation, or left ventricular assist device implant and a secondary
arrhythmic end point of sudden cardiac death or appropriate implantable
cardioverter-defibrillator shock. <br/>Result(s): We studied 1672
patients, mean age 56+/-14 years (29% female), left ventricular ejection
fraction 33+/-11%, and 25% having New York Heart Association class III to
IV; 650 patients (39%) had LGE. During 2.3 years (interquartile range,
1.0-4.3) follow-up, 160 patients experienced the primary end point, and 88
experienced the arrhythmic end point. In multivariable analyses, LGE was
associated with 1.5-fold (hazard ratio, 1.45 [95% CI, 1.03-2.04]) risk of
the primary end point and 1.8-fold (hazard ratio, 1.82 [95% CI,
1.20-3.06]) risk of the arrhythmic end point. Primary end point risk was
increased in patients with multiple LGE patterns, although arrhythmic risk
was higher among patients receiving primary prevention implantable
cardioverter-defibrillator and widening QRS. <br/>Conclusion(s): In this
large multinational study of patients with dilated cardiomyopathy, the
presence of LGE showed strong prognostic value for identification of
high-risk patients. Randomized controlled trials evaluating LGE-based care
management strategies are warranted. <br/>Copyright &#xa9; 2020 American
Heart Association, Inc.

<10>
Accession Number
641198647
Title
Effects of qCON and qNOX-guided general anaesthesia management on patient
opioid use and prognosis: a study protocol.
Source
BMJ open. 13(5) (pp e069134), 2023. Date of Publication: 02 May 2023.
Author
Kang J.; Fang C.; Yuan Y.; Niu K.; Zheng Y.; Yu Y.; Wang G.; Li Y.
Institution
(Kang, Fang, Li, Yuan, Zheng, Yu) Department of Anesthesiology, Tianjin
Medical University General Hospital, Tianjin, China
(Kang, Fang, Li, Yuan, Zheng, Yu, Wang, Li) Tianjin Research Institute of
Anesthesiology, Tianjin, China
(Niu) Nutritional Epidemiology Institute and School of Public Health,
Tianjin Medical University, Tianjin, China
(Wang) Department of Anesthesiology, Tianjin Medical University General
Hospital, Tianjin, China
(Li) Department of Anesthesiology, Tianjin Medical University General
Hospital, Tianjin, China
Publisher
NLM (Medline)
Abstract
INTRODUCTION: The adverse effects of general anaesthetic drugs (especially
opioids) cannot be ignored. However, current nociceptive-monitoring
techniques still lack consistency in guiding the use of opioids. This
trial will study the demand for opioid use and patient prognosis in qCON
and qNOX-guided general anaesthesia management. METHODS AND ANALYSIS: This
prospective, randomised, controlled trial will randomly recruit 124
patients undergoing general anaesthesia for non-cardiac surgery in equal
numbers to either the qCON or BIS group. The qCON group will adjust
intraoperative propofol and remifentanil dosage according to qCON and qNOX
values, while the BIS group will adjust according to BIS values and
haemodynamic fluctuations. The differences between the two groups will be
observed in remifentanil dosing and prognosis. The primary outcome will be
intraoperative remifentanil use. Secondary outcomes will include propofol
consumption; the predictive ability of BIS, qCON and qNOX on conscious
responses, noxious stimulus and body movements; and changes in cognitive
function at 90 days postoperatively. ETHICS AND DISSEMINATION: This study
involves human participants and was approved by the Ethics Committee of
the Tianjin Medical University General Hospital (IRB2022-YX-075-01).
Participants gave informed consent to participate in the study before
taking part. The study results will be published in peer-reviewed journals
and presented at relevant academic conferences. TRIAL REGISTRATION NUMBER:
ChiCTR2200059877.<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.

<11>
Accession Number
641198210
Title
Effect of the machine learning-derived Hypotension Prediction Index (HPI)
combined with diagnostic guidance versus standard care on depth and
duration of intraoperative and postoperative hypotension in elective
cardiac surgery patients: HYPE-2 - study protocol of a randomised clinical
trial.
Source
BMJ open. 13(5) (pp e061832), 2023. Date of Publication: 02 May 2023.
Author
Rellum S.R.; Schuurmans J.; Schenk J.; van der Ster B.J.P.; van der Ven
W.H.; Geerts B.F.; Hollmann M.W.; Cherpanath T.G.V.; Lagrand W.K.;
Wynandts P.; Paulus F.; Driessen A.H.G.; Terwindt L.E.; Eberl S.; Hermanns
H.; Veelo D.P.; Vlaar A.P.J.
Institution
(Rellum, Schuurmans, Schenk, van der Ster, van der Ven, Hollmann,
Wynandts, Terwindt, Eberl, Hermanns, Veelo) Department of Anesthesiology,
Amsterdam, Netherlands
(Rellum, Schuurmans, Cherpanath, Lagrand, Wynandts, Paulus, Vlaar)
Department of Intensive Care, Amsterdam, Netherlands
(Schenk) Department of Epidemiology & Data Science, Amsterdam, Netherlands
(Geerts) Medical affairs, Amsterdam, Netherlands
(Hollmann) Laboratory of Experimental Intensive Care and Anesthesiology,
Amsterdam, Netherlands
(Driessen) Department of Cardiothoracic Surgery, Heart Centre, Amsterdam,
Netherlands
Publisher
NLM (Medline)
Abstract
INTRODUCTION: Hypotension is common during cardiac surgery and often
persists postoperatively in the intensive care unit (ICU). Still,
treatment is mainly reactive, causing a delay in its management. The
Hypotension Prediction Index (HPI) can predict hypotension with high
accuracy. Using the HPI combined with a guidance protocol resulted in a
significant reduction in the severity of hypotension in four non-cardiac
surgery trials. This randomised trial aims to evaluate the effectiveness
of the HPI in combination with a diagnostic guidance protocol on reducing
the occurrence and severity of hypotension during coronary artery bypass
grafting (CABG) surgery and subsequent ICU admission. METHODS AND
ANALYSIS: This is a single-centre, randomised clinical trial in adult
patients undergoing elective on-pump CABG surgery with a target mean
arterial pressure of 65mm Hg. One hundred and thirty patients will be
randomly allocated in a 1:1 ratio to either the intervention or control
group. In both groups, a HemoSphere patient monitor with embedded HPI
software will be connected to the arterial line. In the intervention
group, HPI values of 75 or above will initiate the diagnostic guidance
protocol, both intraoperatively and postoperatively in the ICU during
mechanical ventilation. In the control group, the HemoSphere patient
monitor will be covered and silenced. The primary outcome is the
time-weighted average of hypotension during the combined study phases.
ETHICS AND DISSEMINATION: The medical research ethics committee and the
institutional review board of the Amsterdam UMC, location AMC, the
Netherlands, approved the trial protocol (NL76236.018.21). No publication
restrictions apply, and the study results will be disseminated through a
peer-reviewed journal. TRIAL REGISTRATION NUMBER: The Netherlands Trial
Register (NL9449), ClinicalTrials.gov (NCT05821647).<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.

<12>
Accession Number
2023692592
Title
Successful Treatment with Letermovir in a Heart Transplant Recipient with
UL97 Mutation Ganciclovir-Resistant Cytomegalovirus Colitis and Viremia: A
Case Report and Review of Literature.
Source
International Heart Journal. 64(1) (pp 95-99), 2023. Date of Publication:
2023.
Author
Yanase T.; Hatano M.; Bujo C.; Tsuji M.; Ishida J.; Amiya E.; Okamoto K.;
Ando M.; Shimada S.; Kinoshita O.; Fukushi S.; Yamada S.; Ono M.; Komuro
I.
Institution
(Yanase, Hatano, Bujo, Tsuji, Ishida, Amiya, Komuro) Department of
Cardiovascular Medicine, Graduate School of Medicine, The University of
Tokyo, Hongo 7-3-1, Bunkyo-ku, Tokyo 113-8655, Japan
(Hatano) Advanced Medical Center for Heart Failure, The University of
Tokyo Hospital, Tokyo, Japan
(Amiya) Department of Therapeutic Strategy for Heart Failure, The
University of Tokyo, Tokyo, Japan
(Okamoto) Department of Infectious Diseases, Graduate School of Medicine,
The University of Tokyo, Tokyo, Japan
(Ando, Shimada, Kinoshita, Ono) Department of Cardiac Surgery, Graduate
School of Medicine, The University of Tokyo, Tokyo, Japan
(Fukushi, Yamada) Department of Virology 1, National Institute of
Infectious Diseases, Tokyo, Japan
Publisher
International Heart Journal Association
Abstract
Currently available anti-cytomegalovirus (CMV) agents are sometimes poorly
tolerated, owing to their side effects. Letermovir is a novel anti-CMV
drug that is only approved for CMV prophylaxis in hematopoietic stem cell
transplant recipients, with fewer side effects. We report the case of a
heart transplant recipient with UL97 mutation (L595F)
ganciclovir-resistant cytomegalovirus colitis who was successfully treated
with off-label use of letermovir. In treating CMV infection or disease
with letermovir, a transient rise or lag in the clearance of CMV-DNA
polymerase chain reaction levels has been observed. Our case suggests that
CMV-pp65 antigenemia can be an additional marker of treatment
efficacy.<br/>Copyright &#xa9; All rights reserved by the International
Heart Journal Association.

<13>
Accession Number
2023666103
Title
A Systematic Review of Benefits and Risks of Fetal Surgery for Congenital
Cardiac Defects Such as Pulmonary Valve Stenosis and Critical Aortic
Stenosis.
Source
Brazilian Journal of Cardiovascular Surgery. 38(3) (pp 398-404), 2023.
Date of Publication: 2023.
Author
Diniz A.M.B.; Manso P.H.; Santos M.V.; Rodrigues A.J.; Sbragia L.
Institution
(Diniz, Sbragia) Division of Pediatric Surgery, Department of Surgery and
Anatomy, Faculdade de Medicina de Ribeirao Preto, Universidade de Sao
Paulo, Sao Paulo, Ribeirao Preto, Brazil
(Manso) Division of Pediatric Cardiology, Department of Pediatrics,
Faculdade de Medicina de Ribeirao Preto, Universidade de Sao Paulo, Sao
Paulo, Ribeirao Preto, Brazil
(Santos) Division of Pediatric Neurosurgery, Department of Surgery and
Anatomy, Faculdade de Medicina de Ribeirao Preto, Universidade de Sao
Paulo, Sao Paulo, Ribeirao Preto, Brazil
(Rodrigues) Division of Cardiothoracic Surgery, Faculdade de Medicina de
Ribeirao Preto, Universidade de Sao Paulo, Sao Paulo, Ribeirao Preto,
Brazil
Publisher
Sociedade Brasileira de Cirurgia Cardiovascular
Abstract
Introduction: Congenital heart diseases (CHDs) constitute the most
prevalent congenital pathology, and they are a consequence of structural
and functional abnormalities during fetal development. The etiology of CHD
involves the interaction of genetic and environmental factors. Fetal
cardiac surgery aims at preventing natural pathways of CHD in utero,
mitigating progression to more complex abnormalities. The goal of this
review was to demonstrate the benefits and risks of fetal interventions in
the two most prevalent CHDs, pulmonary stenosis and pulmonary atresia with
an intact ventricular septum, but also critical aortic stenosis and
hypoplastic left heart syndrome. <br/>Method(s): Original and relevant
articles were selected by meta-aggregation to perform a qualitative
analysis of fetal cardiac interventions for pulmonary stenosis and
critical aortic stenosis. The Joanna Briggs Institute's Qualitative
Assessment and Review Instrument (or JBI-QARI) was used for data quality
appraisal. <br/>Result(s): Of 61 potential articles, 13 were selected, and
nine were finally included. <br/>Discussion(s): The present review
demonstrated that fetal cardiac surgery increases right ventricular growth
and hemodynamic flow in pulmonary stenosis, whereas in critical aortic
stenosis it enables growth of the left ventricle and increases left
ventricular pressure. However, it has a high complication rate, along with
considerable morbidity and mortality. <br/>Conclusion(s): The benefits of
fetal cardiac surgery for pulmonary stenosis and critical aortic stenosis
are well-described in the literature; however, there is a significant risk
of complications which can be reduced by the surgeon's technical expertise
and well-structured hospital facilities.<br/>Copyright &#xa9; 2023,
Sociedade Brasileira de Cirurgia Cardiovascular. All rights reserved.

<14>
Accession Number
2024160518
Title
Comparison of meta-analytical estimates of outcomes after Alfieri or
neochordal repair in isolated anterior mitral prolapse.
Source
European Journal of Cardio-thoracic Surgery. 63(2) (no pagination), 2023.
Article Number: ezac587. Date of Publication: 01 Feb 2023.
Author
Khairallah S.; Rahouma M.; Dabsha A.; Demetres M.; Gaudino M.Fl.; Mick
S.L.
Institution
(Khairallah, Rahouma, Dabsha, Gaudino, Mick) Cardiothoracic Surgery
Department, Weill Cornell Medicine New York-Presbyterian Hospital (WCM),
New York, NY, United States
(Demetres) Scholarly Communications Librarian, Weill Cornell Medicine
(WCM), Samuel J. Wood Library & C.V. Starr Biomedical Information Center,
New York, NY, United States
Publisher
European Association for Cardio-Thoracic Surgery
Abstract
OBJECTIVES: Repair of the isolated degenerative anterior mitral leaflet
has been considered more challenging and associated with compromised
durability compared with isolated posterior leaflet in major series.
Implantation of neochordae or Alfieri edge-to-edge is the most employed
repair technique for isolated anterior repair currently, but little data
exist comparing their relative durability. We sought to investigate this
issue with this meta-analysis. <br/>METHOD(S): A literature search was
performed (Ovid MEDLINE, Ovid Embase and The Cochrane Library). The
primary outcome was the incidence rate (IR) of reoperation, the secondary
outcomes were recurrent moderately severe/severe mitral regurgitation
(MR), in-hospital/ 30-day reoperation and mortality and follow-up
mortality. A random-effect model was used. Leave-one-out, subgroup
analysis (Alfieri versus neochordae) and meta-regression were done.
<br/>RESULT(S): Seventeen studies (including 1358 patients) were included.
At a weighted mean follow-up of 5.56 +/- 3.31 years, the IR for
reoperation was 14.45 event per 1000 person-year and significantly lower
in Alfieri than neochordae repair (9.40 vs 18.61, P = 0.04) on subgroup
analysis. The IR of follow-up moderately severe/severe MR was 19.89 event
per 1000 person-year and significantly lower in Alfieri than neochordae
repair (10.68 and 28.63, P = 0.01). In a sensitivity analysis comparing
homogenous studies, a significant difference in the recurrence of
regurgitation in favour of the Alfieri approach remained. There were no
differences in operative outcomes or survival. There were significant
associations between increased incidence of late reoperation and New York
Heart Association class III/IV and associated coronary artery bypass graft
procedure for whole cohort. <br/>CONCLUSION(S): Alfieri repair may be
associated with a lower incidence of recurrent MR compared with
neochordae-based repair in the setting of isolated degenerative anterior
mitral pathology. This is the first such meta-analysis and further inquiry
into this area is needed.<br/>Copyright &#xa9; The Author(s) 2023.
Published by Oxford University Press on behalf of the European Association
for Cardio-Thoracic Surgery. All rights reserved.

<15>
Accession Number
2023061741
Title
Rivaroxaban versus nadroparin for thromboprophylaxis following thoracic
surgery for lung cancer: A randomized, noninferiority trial.
Source
American Journal of Hematology. (no pagination), 2023. Date of
Publication: 2023.
Author
Zhao M.; Bao Y.; Jiang C.; Chen L.; Xu L.; Liu X.; Yang Y.; Jiang G.; Li
J.; She Y.; Chen Q.; Shen L.; Chen C.
Institution
(Zhao, Bao, Jiang, Chen, Liu, Li, Yang, Jiang, She, Chen, Shen, Chen)
Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji
University School of Medicine, Shanghai, China
(Xu) Department of Ultrasound, Shanghai Pulmonary Hospital, Tongji
University School of Medicine, Shanghai, China
(Li) Clinical Research Center, Ruijin Hospital, Shanghai Jiaotong
University School of Medicine, Shanghai, China
(Shen) Department of Infectious Diseases, Shanghai Key Laboratory of
Infectious Diseases and Biosafety Emergency Response, National Medical
Center for Infectious Diseases, Huashan Hospital, Fudan University,
Shanghai, China
Publisher
John Wiley and Sons Inc
Abstract
The benefit of rivaroxaban in thromboprophylaxis after oncologic lung
surgery remains unknown. To evaluate the efficacy and safety of
rivaroxaban, patients who underwent thoracic surgery for lung cancer were
enrolled, and randomly assigned to rivaroxaban or nadroparin groups in a
1:1 ratio; anticoagulants were initiated 12-24 h after surgery and
continued until discharge. Four hundred participants were required
according to a noninferiority margin of 2%, assuming venous
thromboembolism (VTE) occurrence rates of 6.0% and 12.6% for patients in
the rivaroxaban and nadroparin groups, respectively. The primary efficacy
outcome was any VTE during the treatment and 30-day follow-up periods. The
safety outcome was any on-treatment bleeding event. Finally, 403 patients
were randomized (intention-to-treat [ITT] population), with 381 included
in per-protocol (PP) population. The primary efficacy outcomes occurred in
12.5% (25/200) of the rivaroxaban group and 17.7% (36/203) of the
nadroparin group (absolute risk reduction, -5.2%; 95% confidence interval
[CI], [-12.2-1.7]), indicating the noninferiority of rivaroxaban in ITT
population. Sensitivity analysis was performed in the PP population and
yielded similar results, confirming the noninferiority of rivaroxaban. In
the safety analysis population, the incidence of any on-treatment bleeding
events did not differ significantly between the groups (12.2% for
rivaroxaban vs. 7.0% for nadroparin; relative risk [RR], 1.9; 95% CI,
[0.9-3.7]; p =.08), including major bleeding (9.7% vs. 6.5%; RR, 1.6 [95%
CI, 0.9-3.7]; p =.24), and nonmajor bleeding (2.6% vs. 0.5%; RR, 5.2 [95%
CI, 0.6-45.2]; p =.13). Rivaroxaban for thromboprophylaxis after oncologic
lung surgery was shown to be noninferior to nadroparin.<br/>Copyright
&#xa9; 2023 Wiley Periodicals LLC.

<16>
Accession Number
2023106246
Title
Erector spinae plane block for postoperative analgesia in
robotically-assisted coronary artery bypass surgery: Results of a
randomized placebo-controlled trial.
Source
Journal of Clinical Anesthesia. 87 (no pagination), 2023. Article Number:
111088. Date of Publication: August 2023.
Author
Hoogma D.F.; Van den Eynde R.; Oosterlinck W.; Al Tmimi L.; Verbrugghe P.;
Tournoy J.; Fieuws S.; Coppens S.; Rex S.
Institution
(Hoogma, Van den Eynde, Al Tmimi, Coppens, Rex) Department of
Anesthesiology, University Hospitals of Leuven, Leuven, Belgium
(Hoogma, Oosterlinck, Al Tmimi, Verbrugghe, Coppens, Rex) Department of
Cardiovascular Sciences, Biomedical Sciences Group, University of Leuven,
Leuven, Belgium
(Oosterlinck, Verbrugghe) Department of Cardiac Surgery, University
Hospitals of Leuven, Leuven, Belgium
(Tournoy) Department of Public Health and Primary Care, Geriatric
Medicine, University Hospitals Leuven, Leuven, Belgium
(Fieuws) Leuven Biostatistics and Statistical Bioinformatics Centre
(L-BioStat), Biomedical Sciences Group, University of Leuven, Leuven,
Belgium
Publisher
Elsevier Inc.
Abstract
Study objective: To investigate if an erector spinae plane (ESP) block
decreases postoperative opioid consumption, pain and postoperative nausea
and vomiting in patients undergoing robotically-assisted minimally
invasive direct coronary artery bypass surgery (RAMIDCAB). <br/>Design(s):
A single-center, double-blind, prospective, randomized, placebo-controlled
trial. <br/>Setting(s): Postoperative period; operating room,
post-anesthesia care unit (PACU) and hospital ward in a university
hospital. <br/>Patient(s): Sixty-four patients undergoing RAMIDCAB surgery
via left-sided mini-thoracotomy and enrolled in the institutional enhanced
recovery after cardiac surgery program. <br/>Intervention(s): At the end
of surgery, patients received an ESP catheter at vertebra T5 under
ultrasound guidance and were randomized to the administration of either
ropivacaine 0.5% (loading dose of 30 ml and three additional doses of 20
ml each, interspersed with a 6 h interval) or normal saline 0.9% (with an
identical administration scheme). In addition, patients received
multimodal analgesia including acetaminophen, dexamethasone and
patient-controlled analgesia with morphine. Following the final ESP bolus
and before catheter removal, the position of the catheter was re-evaluated
by ultrasound. Patients, investigators and medical personnel were blinded
for the group allocation during the entire trial. Measurements: Primary
outcome was cumulative morphine consumption during the first 24 h after
extubation. Secondary outcomes included location and severity of pain,
presence/extent of sensory block, duration of postoperative ventilation
and hospital length of stay. Safety outcomes comprised the incidence of
adverse events. <br/>Main Result(s): Median (IQR) 24-h morphine
consumption was not different between the intervention- and
control-groups, 67 mg (35-84) versus 71 mg (52-90) (p = 0.25),
respectively. Likewise, no differences were detected in secondary and
safety endpoints. <br/>Conclusion(s): Following RAMIDCAB surgery, adding
an ESP block to a standard multimodal analgesia regimen did not reduce
opioid consumption and pain scores.<br/>Copyright &#xa9; 2023 Elsevier
Inc.

<17>
Accession Number
2018847596
Title
Effect of cocoa flavanol supplementation for the prevention of
cardiovascular disease events: The COcoa Supplement and Multivitamin
Outcomes Study (COSMOS) randomized clinical trial.
Source
American Journal of Clinical Nutrition. 115(6) (pp 1490-1500), 2022. Date
of Publication: 01 Jun 2022.
Author
Johnson L.G.; Moorthy M.V.; Carrick W.R.; Manson J.E.; Sesso H.D.; Rist
P.M.; Bassuk S.S.; Leboff M.S.; Okereke O.I.; Cook N.R.; Christen W.;
Friedenberg G.; Copeland T.; Hanna J.; Clar A.; D'Agostino D.;
Vinayagamoorthy M.; Gibson H.; Kim E.; Van Denburgh M.; Kotler G.; Li C.;
Bubes V.; Sarkissian A.; Smith D.; Pereira E.C.; Okeke M.; Roche E.; Ridge
C.; Phillips A.; Salvo B.; Wilson A.; Hall L.; Baez J.; Sim Y.-H.; Cardoso
H.; Senor G.; Rudnicki C.; Huynh H.; Nguyen V.; Terrell N.; Holman B.A.;
Walter J.; Johnson L.F.; Casarella A.; O'Connell J.; Lagerstrom S.R.;
Djousse L.; Chandler P.D.; Hazra A.; Tobias D.K.; Farukhi Z.M.; Wang L.;
Zhang X.; Breen K.; Menjin Jr G.V.; Rodriguez R.; Curry S.; Arsenault L.;
Solano O.; Weinberg A.; Coates J.; Kilroe M.; Zernicke L.; Hasson K.;
Matthew K.; Mora S.; Pfeffer C.; Duszlak J.; Bates D.; Guzman V.; Falcon
J.; Romero A.; Kupets H.; Cortez F.; Lesuer J.C.; Hrbek A.; Bowes E.;
Quinn P.; Mele M.; Anderson G.L.; Johnson L.; Tinker L.F.; Aragaki A.K.;
Herndon M.; Mann S.L.; Pettinger M.; Hunt R.P.; Carrick B.; Szyperski K.;
Proulx-Burns L.; Burrows E.; Limacher M.; Hsia J.; Asaithambi G.; Khan M.;
Nagaraja N.; Ocava L.C.; Wold J.; Silver B.; Connelly S.; Van Lom G.;
Garvida C.; Hightower K.; Spaulding P.; Lin W.; Schoenberg J.; Olee P.;
Cohen L.S.; Colton T.; Henderson I.C.; Hulley S.; Lichtenstein A.H.;
Passamani E.R.; Silliman R.A.; Wenger N.; Ludlam S.E.; Schroeter H.; Fare
M.; Ottawani J.; Kwik-Uribe C.; Arnaiz C.; Costanza A.; Greene J.;
Hennessey P.; Vadlamani S.; Karmsetty M.; Martini P.; Van Klinken J.-W.;
Shah A.; Stern L.
Institution
(Sesso, Manson, Rist, Friedenberg, Copeland, Clar, Mora, Moorthy,
Sarkissian) Division of Preventive Medicine, Brigham and Women's Hospital,
Harvard Medical School, Boston, MA, United States
(Sesso, Manson, Rist) Department of Epidemiology, Harvard T.H. Chan School
of Public Health, Boston, MA, United States
(Aragaki, Johnson, Carrick, Anderson) Division of Public Health Sciences,
Fred Hutchinson Cancer Research Center, Seattle, WA, United States
(Mora) Division of Cardiovascular Medicine, Brigham and Women's Hospital,
Harvard Medical School, Boston, MA, United States
(Arnaiz, Costanza, Greene, Hennessey) Contract Pharmacal Corp, United
States
(Vadlamani, Karmsetty, Martini, Van Klinken, Shah, Stern) Pfizer Consumer
Healthcare, United States
(Manson, Sesso, Rist, Lagerstrom, Bassuk, Wang, Hazra, Gibson, Leboff,
Mora, Okereke, Tobias, Cook, Chandler, Christen, Christen, Friedenberg,
Copeland, Hanna, Clar, D'Agostino, Vinayagamoorthy, Gibson, Kim, Van
Denburgh, Kotler, Li, Bubes, Sarkissian, Smith, Pereira, Okeke, Roche,
Bates, Ridge, Phillips, Salvo, Wilson, Hall, Baez, Sim, Cardoso, Senor,
Rudnicki, Huynh, Nguyen, Terrell, Holman, Walter, Johnson, Casarella,
O'Connell, Lagerstrom, Djousse, Chandler, Hazra, Tobias, Farukhi, Wang,
Zhang, Breen, Menjin Jr, Rodriguez, Curry, Mora, Arsenault, Solano,
Weinberg, Coates, Kilroe, Zernicke, Hasson, Matthew, Mora, Pfeffer,
Duszlak, Bates, Guzman, Falcon, Romero, Kupets, Cortez, Lesuer, Hrbek,
Bowes, Quinn, Mele) Brigham and Women's Hospital, United States
(Anderson, Johnson, Tinker, Aragaki, Herndon, Mann, Pettinger, Hunt,
Carrick, Szyperski, Proulx-Burns, Burrows, Limacher, Hsia, Asaithambi,
Khan, Nagaraja, Ocava, Wold, Silver, Connelly, Van Lom, Garvida,
Hightower, Spaulding, Lin, Schoenberg, Olee) Fred Hutchinson Cancer
Research Center, Women's Health Initiative, United States
Publisher
Elsevier B.V.
Abstract
Background: Cocoa extract is a source of flavanols that favorably
influence vascular risk factors in small and short-term trials, yet
effects on clinical cardiovascular events are untested. <br/>Objective(s):
We examined whether cocoa extract supplementation decreases total
cardiovascular disease (CVD) among older adults. <br/>Method(s): We
conducted a randomized, double-blind, placebo-controlled, 2-by-2 factorial
trial of cocoa extract supplementation and multivitamins for prevention of
CVD and cancer among 21,442 US adults (12,666 women aged >=65 y and 8776
men aged >=60 y), free of major CVD and recently diagnosed cancer. The
intervention phase was June 2015 through December 2020. This article
reports on the cocoa extract intervention. Participants were randomly
assigned to a cocoa extract supplement [500 mg flavanols/d, including 80
mg (-)-epicatechin] or placebo. The primary outcome was a composite of
confirmed incident total cardiovascular events, including myocardial
infarction (MI), stroke, coronary revascularization, cardiovascular death,
carotid artery disease, peripheral artery surgery, and unstable angina.
<br/>Result(s): During a median follow-up of 3.6 y, 410 participants
taking cocoa extract and 456 taking placebo had confirmed total
cardiovascular events (HR: 0.90; 95% CI: 0.78, 1.02; P = 0.11). For
secondary endpoints, HRs were 0.73 (95% CI: 0.54, 0.98) for CVD death,
0.87 (95% CI: 0.66, 1.16) for MI, 0.91 (95% CI: 0.70, 1.17) for stroke,
0.95 (95% CI: 0.77, 1.17) for coronary revascularization, neutral for
other individual cardiovascular endpoints, and 0.89 (95% CI: 0.77, 1.03)
for all-cause mortality. Per-protocol analyses censoring follow-up at
nonadherence supported a lower risk of total cardiovascular events (HR:
0.85; 95% CI: 0.72, 0.99). There were no safety concerns.
<br/>Conclusion(s): Cocoa extract supplementation did not significantly
reduce total cardiovascular events among older adults but reduced CVD
death by 27%. Potential reductions in total cardiovascular events were
supported in per-protocol analyses. Additional research is warranted to
clarify whether cocoa extract may reduce clinical cardiovascular
events.<br/>Copyright &#xa9; 2022 The Author(s) 2022.

<18>
Accession Number
2024175414
Title
Fast vs. ultraslow thrombolytic infusion regimens in patients with
obstructive mechanical prosthetic valve thrombosis: a pilot randomized
clinical trial.
Source
European Heart Journal - Cardiovascular Pharmacotherapy. 8(7) (pp
668-676), 2022. Date of Publication: 01 Nov 2022.
Author
Sadeghipour P.; Saedi S.; Saneei L.; Rafiee F.; Yoosefi S.; Parsaee M.;
Siami R.; Saberi M.; Pouraliakbar H.; Ghadrdoost B.; Bakhshandeh H.;
Peighambari M.M.; Farrashi M.; Mohebbi B.; Naderi N.; Amin A.; Maleki M.;
Khajali Z.; De Caterina R.
Institution
(Sadeghipour, Mohebbi, Maleki) Cardiovascular Intervention Research
Center, Rajaie Cardiovascular, Medical and Research Center, Iran
University of Medical Sciences, Tehran, Iran, Islamic Republic of
(Sadeghipour, Ghadrdoost, Bakhshandeh) Clinical Trial Center, Rajaie
Cardiovascular, Medical and Research Center, Iran University of Medical
Sciences, Tehran, Iran, Islamic Republic of
(Saedi, Saneei, Rafiee, Yoosefi, Siami, Saberi, Pouraliakbar, Ghadrdoost,
Bakhshandeh, Peighambari, Naderi, Amin, Khajali) Rajaie Cardiovascular,
Medical and Research Center, Iran University of Medical Sciences, Vali-Asr
Ave, Niyayesh Blvd, Tehran 1996911101, Iran, Islamic Republic of
(Parsaee, Farrashi) Echocardiography Research Center, Rajaie
Cardiovascular, Medical and Research Center, Iran University of Medical
Sciences, Tehran, Iran, Islamic Republic of
(De Caterina) University Cardiology Division, Pisa University Hospital,
University of Pisa, Via Paradisa 2, Pisa 56124, Italy
(De Caterina) Fondazione Villa Serena per la Ricerca, Citta Sant'Angelo,
Pescara, Italy
Publisher
Oxford University Press
Abstract
Aims Thrombolysis is an alternative to surgery for mechanical prosthetic
valve thrombosis (MPVT). Randomized clinical trials have yet to test the
safety and efficacy of a proposed ultraslow thrombolytic infusion regimen.
Methods and This single-centre, open-label, pilot randomized clinical
trial randomized adult patients with acute obstructive MPVT to results an
ultraslow thrombolytic regimen [25 mg of recombinant tissue-type
plasminogen activator (rtPA) infused in 25 h] and a fast thrombolytic
regimen (50 mg of rtPA infused in 6 h). If thrombolysis failed, a repeated
dose of 25 mg of rtPA for 6 h was administered in both groups up to a
cumulative dose of 150 mg or the occurrence of a complication. The primary
outcome was a complete MPVT resolution (>75% fall in the obstructive
gradient by transthoracic echocardiography, <10degree limitation in
opening and closing valve motion angles by fluoroscopy, and symptom
improvement). The key safety outcome was a Bleeding Academic Research
Consortium type III or V major bleeding. Overall, 120 patients, including
63 (52.5%) women, at a mean age of 36.3 +/- 15.3 years, were randomized.
Complete thrombolysis success was achieved in 51 patients (85.0%) in the
ultraslow-regimen group and 47 patients (78.3%) in the fast-regimen group
[odds ratio 1.58; 95% confidence interval (CI) 0.25-1.63; P = 0.34]. One
case of transient ischaemic attack and three cases of intracranial
haemorrhage (absolute risk difference -6.6%; 95%CI -12% -0.3%; P = 0.07)
were observed only in the fast-regimen group. Conclusion The ultraslow
thrombolytic regimen conferred a high thrombosis resolution rate without
major complications. Such findings should be replicated in more adequately
powered trials.<br/>Copyright &#xa9; The Author(s) 2021. Published by
Oxford University Press on behalf of the European Society of Cardiology.
All rights reserved.

<19>
[Use Link to view the full text]
Accession Number
2024014152
Title
Bempedoic Acid and Cardiovascular Outcomes in Statin-Intolerant Patients.
Source
New England Journal of Medicine. 388(15) (pp 1353-1364), 2023. Date of
Publication: 2023.
Author
Nissen S.E.; Lincoff A.M.; Brennan D.; Ray K.K.; Mason D.; Kastelein
J.J.P.; Thompson P.D.; Libby P.; Cho L.; Plutzky J.; Bays H.E.; Moriarty
P.M.; Menon V.; Grobbee D.E.; Louie M.J.; Chen C.-F.; Li N.; Bloedon L.;
Robinson P.; Horner M.; Sasiela W.J.; McCluskey J.; Davey D.;
Fajardo-Campos P.; Petrovic P.; Fedacko J.; Zmuda W.; Lukyanov Y.;
Nicholls S.J.
Institution
(Nissen, Lincoff, Brennan, Cho, Menon, McCluskey, Davey) Cleveland Clinic,
Cleveland, United States
(Ray, Mason) Imperial College London, London, United Kingdom
(Kastelein) University of Amsterdam Academic Medical Center, Amsterdam,
Netherlands
(Grobbee) University Medical Center Utrecht, Utrecht, Netherlands
(Thompson) Hartford Hospital, Hartford, CT, United States
(Libby, Plutzky) Brigham and Women s Hospital, Harvard Medical School,
Boston, United States
(Bays) Louisville Metabolic and Atherosclerosis Research Center,
Louisville, KY, United States
(Moriarty) University of Kansas Medical Center, Kansas City, United States
(Louie, Chen, Li, Bloedon, Robinson, Horner, Sasiela) Esperion
Therapeutics, Ann Arbor, MI, United States
(Fajardo-Campos) Centro de Investigacion Cardiovascular y Metabolica,
Tijuana, Mexico
(Petrovic) General Hospital Sveti Luka, Smederevo, Serbia
(Fedacko) Center of Clinical and Preclinical Research Medipark, Pavol
Jozef Safarik University, Kosice, Slovakia
(Zmuda) Medicome, Oswiecim, Poland
(Lukyanov) Pavlov First St. Petersburg State Medical University, St.
Petersburg, Russian Federation
(Nicholls) Victorian Heart Institute, Monash University, Melbourne, VIC,
Australia
Publisher
Massachussetts Medical Society
Abstract
Background Bempedoic acid, an ATP citrate lyase inhibitor, reduces
low-density lipoprotein (LDL) cholesterol levels and is associated with a
low incidence of muscle-related adverse events; its effects on
cardiovascular outcomes remain uncertain. Methods We conducted a
double-blind, randomized, placebo-controlled trial involving patients who
were unable or unwilling to take statins owing to unacceptable adverse
effects ("statin-intolerant"patients) and had, or were at high risk for,
cardiovascular disease. The patients were assigned to receive oral
bempedoic acid, 180 mg daily, or placebo. The primary end point was a
four-component composite of major adverse cardiovascular events, defined
as death from cardiovascular causes, nonfatal myocardial infarction,
nonfatal stroke, or coronary revascularization. Results A total of 13,970
patients underwent randomization; 6992 were assigned to the bempedoic acid
group and 6978 to the placebo group. The median duration of follow-up was
40.6 months. The mean LDL cholesterol level at baseline was 139.0 mg per
deciliter in both groups, and after 6 months, the reduction in the level
was greater with bempedoic acid than with placebo by 29.2 mg per
deciliter; the observed difference in the percent reductions was 21.1
percentage points in favor of bempedoic acid. The incidence of a primary
end-point event was significantly lower with bempedoic acid than with
placebo (819 patients [11.7%] vs. 927 [13.3%]; hazard ratio, 0.87; 95%
confidence interval [CI], 0.79 to 0.96; P=0.004), as were the incidences
of a composite of death from cardiovascular causes, nonfatal stroke, or
nonfatal myocardial infarction (575 [8.2%] vs. 663 [9.5%]; hazard ratio,
0.85; 95% CI, 0.76 to 0.96; P=0.006); fatal or nonfatal myocardial
infarction (261 [3.7%] vs. 334 [4.8%]; hazard ratio, 0.77; 95% CI, 0.66 to
0.91; P=0.002); and coronary revascularization (435 [6.2%] vs. 529 [7.6%];
hazard ratio, 0.81; 95% CI, 0.72 to 0.92; P=0.001). Bempedoic acid had no
significant effects on fatal or nonfatal stroke, death from cardiovascular
causes, and death from any cause. The incidences of gout and
cholelithiasis were higher with bempedoic acid than with placebo (3.1% vs.
2.1% and 2.2% vs. 1.2%, respectively), as were the incidences of small
increases in serum creatinine, uric acid, and hepatic-enzyme levels.
Conclusions Among statin-intolerant patients, treatment with bempedoic
acid was associated with a lower risk of major adverse cardiovascular
events (death from cardiovascular causes, nonfatal myocardial infarction,
nonfatal stroke, or coronary revascularization). (Funded by Esperion
Therapeutics; CLEAR Outcomes ClinicalTrials.gov number,
NCT02993406.)<br/>Copyright &#xa9; 2023 Massachusetts Medical Society.

<20>
Accession Number
2022850222
Title
Pharmacogenetics-guided dalcetrapib therapy after an acute coronary
syndrome: The dal-GenE trial.
Source
European Heart Journal. 43(39) (pp 3947-3956), 2022. Date of Publication:
14 Oct 2022.
Author
Tardif J.C.; Pfeffer M.A.; Kouz S.; Koenig W.; Maggioni A.P.; McMurray
J.J.V.; Mooser V.; Waters D.D.; Gregoire J.C.; L'Allier P.L.; Wouter
Jukema J.; White H.D.; Heinonen T.; Black D.M.; Laghrissi-Thode F.;
Levesque S.; Guertin M.C.; Dube M.P.
Institution
(Tardif, Gregoire, L'Allier, Dube) Department of Medicine, Montreal Heart
Institute, Universite de Montreal, 5000 Belanger Street, Montreal, PQ
H1T1C8, Canada
(Tardif, Dube) Beaulieu-Saucier Pharmacogenomics Centre, Universite de
Montreal, Montreal, Canada
(Tardif, Levesque, Guertin) The Montreal Health Innovations Coordinating
Center (MHICC), Montreal, Canada
(Pfeffer) Department of Medicine, The Brigham and Women's Hospital,
Harvard Medical School, Boston, MA, United States
(Kouz) Department of Medicine, Centre Hospitalier Regional de Lanaudiere,
Joliette, Canada
(Koenig) Deutsches Herzzentrum Munchen, Technische Universitat Munchen,
Munich, Germany
(Koenig) German Centre for Cardiovascular Research (DZHK), Partner Site
Munich Heart Alliance, Munich, Germany
(Koenig) Institute of Epidemiology and Medical Biometry, University of
Ulm, Ulm, Germany
(Maggioni) ANMCO Research Center, Florence, Italy
(McMurray) Department of Medicine, British Heart Foundation Cardiovascular
Research Centre, University of Glasgow, Glasgow, United Kingdom
(Mooser) Department of Medicine, McGill University, Montreal, Canada
(Waters) Division of Cardiology, San Francisco General Hospital, Leiden,
Netherlands
(Wouter Jukema) Department of Cardiology, Leiden University Medical
Center, Leiden, Netherlands
(Wouter Jukema) Netherlands Heart Institute, Utrecht, Netherlands
(Wouter Jukema) Department of Medicine, Durrer Center for Cardiovascular
Research, Amsterdam, Netherlands
(White) Green Lane Cardiovascular Unit, Auckland City Hospital, University
of Auckland, New Zealand
(Heinonen, Black, Laghrissi-Thode) DalCor Pharmaceuticals, Montreal,
Canada
(Heinonen, Black, Laghrissi-Thode) DalCor Pharmaceuticals, Sarasota, FL,
United States
Publisher
Oxford University Press
Abstract
Aims: In a retrospective analysis of dal-Outcomes, the effect of
dalcetrapib on cardiovascular events was influenced by an adenylate
cyclase type 9 (ADCY9) gene polymorphism. The dal-GenE study was conducted
to test this pharmacogenetic hypothesis. <br/>Methods and Results:
dal-GenE was a double-blind trial in patients with an acute coronary
syndrome within 1-3 months and the AA genotype at variant rs1967309 in the
ADCY9 gene. A total of 6147 patients were randomly assigned to receive
dalcetrapib 600mg or placebo daily. The primary endpoint was the time from
randomization to first occurrence of cardiovascular death, resuscitated
cardiac arrest, non-fatal myocardial infarction, or non-fatal stroke.
After a median follow-up of 39.9 months, the primary endpoint occurred in
292 (9.5%) of 3071 patients in the dalcetrapib group and 327 (10.6%) of
3076 patients in the placebo group [hazard ratio 0.88; 95% confidence
interval (CI) 0.75-1.03; P = 0.12]. The hazard ratios for the components
of the primary endpoint were 0.79 (95% CI 0.65-0.96) for myocardial
infarction, 0.92 (95% CI 0.64-1.33) for stroke, 1.21 (95% CI 0.91-1.60)
for death from cardiovascular causes, and 2.33 (95% CI 0.60-9.02) for
resuscitated cardiac arrest. In a pre-specified on-Treatment sensitivity
analysis, the primary endpoint event rate was 7.8% (236/3015) in the
dalcetrapib group and 9.3% (282/3031) in the placebo group (hazard ratio
0.83; 95% CI 0.70-0.98). <br/>Conclusion(s): Dalcetrapib did not
significantly reduce the risk of occurrence of the primary endpoint of
ischaemic cardiovascular events at end of study. A new trial would be
needed to test the pharmacogenetic hypothesis that dalcetrapib improves
the prognosis of patients with the AA genotype. Clinical Trial
Registration: Trial registration dal-GenE ClinicalTrials.gov Identifier:
NCT02525939<br/>Copyright &#xa9; 2022 The Author(s). Published by Oxford
University Press on behalf of European Society of Cardiology.

<21>
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.

<22>
Accession Number
2021649111
Title
Non-pharmacological prevention of postoperative delirium by occupational
therapy teams: A randomized clinical trial.
Source
Frontiers in Medicine. 10 (no pagination), 2023. Article Number: 1099594.
Date of Publication: 02 Feb 2023.
Author
Alvarez E.A.; Rojas V.A.; Caipo L.I.; Galaz M.M.; Ponce D.P.; Gutierrez
R.G.; Salech F.; Tobar E.; Reyes F.I.; Vergara R.C.; Egana J.I.; Briceno
C.A.; Penna A.
Institution
(Alvarez) Terapia Ocupacional, Universidad Central de Chile, Santiago,
Chile
(Alvarez, Briceno) Departamento de Terapia Ocupacional y Ciencia de la
Ocupacion, Universidad de Chile, Santiago, Chile
(Rojas, Tobar) Critical Care Unit, Department of Medicine, Hospital
Clinico de la Universidad de Chile, Santiago, Chile
(Rojas, Caipo, Galaz, Ponce, Gutierrez, Salech, Egana, Penna) Centro de
Investigacion Clinica Avanzada (CICA), Hospital Clinico y Facultad de
Medicina de la Universidad de Chile, Santiago, Chile
(Gutierrez, Egana, Penna) Departamento de Anestesiologia y Medicina
Perioperatoria, Hospital Clinico de la Universidad de Chile, Santiago,
Chile
(Salech) Seccion de Geriatria, Departamento de Medicina, Hospital Clinico
de la Universidad de Chile, Santiago, Chile
(Reyes) Servicio de Anestesiologia, Hospital Santiago Oriente Doctor Luis
Tisne Brousse, Santiago, Chile
(Vergara) Nucleo de Bienestar y Desarrollo Humano (NUBIDEH), Centro de
Investigacion en Educacion (CIE-UMCE), Universidad Metropolitana de
Ciencias de la Educacion, Santiago, Chile
(Vergara) Facultad de Artes y Educacion Fisica, Departamento de
Kinesiologia, Universidad Metropolitana de Ciencias de la Educacion,
Santiago, Chile
(Vergara) Centro Nacional de Inteligencia Artificial (CENIA), Santiago,
Chile
Publisher
Frontiers Media S.A.
Abstract
Background: Patients who develop postoperative delirium (POD) have several
clinical complications, such as increased morbidity, increased hospital
stays, higher hospital costs, cognitive and functional impairment, and
higher mortality. POD is a clinical condition preventable by standard
non-pharmacological measures An intensive Occupational Therapy (OT)
intervention has been shown to be highly effective in preventing delirium
in critically ill medical patients, but it is unknown the effect in
surgical patients. Thus, we designed a prospective clinical study with the
aim to determine whether patients undergoing intervention by the OT team
have a lower incidence of POD compared to the group treated only with
standard measures. <br/>Method(s): A multicenter, single-blind, randomized
clinical trial was conducted between October 2018 and April 2021, in
Santiago of Chile, at a university hospital and at a public hospital.
Patients older than 75 years undergoing elective major surgery were
eligible for the trial inclusion. Patients with cognitive impairment,
severe communication disorder and cultural language limitation, delirium
at admission or before surgery, and enrolled in another study were
excluded. The intervention consisted of OT therapy twice a day plus
standard internationally recommended non-pharmacological prevention
intervention during 5 days after surgery. Our primary outcome was
development of delirium and postoperative subsyndromal delirium.
<br/>Result(s): In total 160 patients were studied. In the interventional
group, treated with an intensive prevention by OT, nine patients (12.9%)
developed delirium after surgery and in the control group four patients
(5.5%) [p = 0.125, RR 2.34 CI 95 (0.75-7.27)]. Whereas subsyndromal POD
was present in 38 patients in the control group (52.1%) and in 34 (48.6%)
in the intervention group [p = 0.4, RR 0.93 CI95 (0.67-1.29)]. A post hoc
analysis determined that the patient's comorbidity and cognitive status
prior to hospitalization were the main risk factors to develop delirium
after surgery. <br/>Discussion(s): Patients undergoing intervention by the
OT team did not have a lower incidence of POD compared to the group
treated only with standard non-pharmacological measures in adults older
than 75 years who went for major surgery. Clinical trial registration:
www.ClinicalTrials.gov, identifier NCT03704090.<br/>Copyright &#xa9; 2023
Alvarez, Rojas, Caipo, Galaz, Ponce, Gutierrez, Salech, Tobar, Reyes,
Vergara, Egana, Briceno and Penna.

<23>
Accession Number
2017780277
Title
Patient-Level Analysis of Watchman Left Atrial Appendage Occlusion in
Practice Versus Clinical Trials.
Source
JACC: Cardiovascular Interventions. 15(9) (pp 950-961), 2022. Date of
Publication: 09 May 2022.
Author
Friedman D.J.; Du C.; Wang Y.; Agarwal V.; Varosy P.D.; Masoudi F.A.;
Holmes D.R.; Reddy V.Y.; Price M.J.; Curtis J.P.; Freeman J.V.
Institution
(Friedman, Wang, Curtis, Freeman) Section of Cardiovascular Medicine,
Department of Internal Medicine, Yale University School of Medicine, New
Haven, CT, United States
(Friedman) Division of Cardiology, Duke University School of Medicine,
Durham, NC, United States
(Du, Wang, Agarwal, Curtis, Freeman) Center for Outcomes Research and
Evaluation, Yale New Haven Health, New Haven, CT, United States
(Varosy, Masoudi) Division of Cardiology, University of Colorado School of
Medicine, Denver, CO, United States
(Varosy) Cardiology Section, VA Eastern Colorado Health Care System,
Aurora, CO, United States
(Holmes) Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN,
United States
(Reddy) Division of Cardiology, Icahn School of Medicine at Mount Sinai,
New York, NY, United States
(Price) Division of Cardiovascular Diseases, Scripps Clinic, La Jolla, CA,
United States
Publisher
Elsevier Inc.
Abstract
Objectives: The aim of this study was to compare outcomes among patients
from the PROTECT-AF (WATCHMAN Left Atrial Appendage System for Embolic
PROTECTion in Patients With Atrial Fibrillation) and PREVAIL (Evaluation
of the WATCHMAN Left Atrial Appendage [LAA] Closure Device in Patients
With Atrial Fibrillation Versus Long Term Warfarin Therapy) left atrial
appendage occlusion (LAAO) trials with matched patients from the National
Cardiovascular Data Registry LAAO Registry using patient-level data.
<br/>Background(s): Patients undergoing LAAO in clinical practice
generally have more comorbidities than trial participants. <br/>Method(s):
Propensity-matched analyses, with up to 3 registry patients matched to
each trial patient, were performed using Cox proportional hazards and
Fine-Gray models. <br/>Result(s): A total of 1,904 registry patients were
matched to 667 trial LAAO patients; 1,010 registry patients were matched
to 348 warfarin patients. Compared with registry patients, trial LAAO
patients experienced more pericardial effusion requiring intervention
(3.8% vs 0.6%, P < 0.001), periprocedural ischemic stroke (0.9% vs 0.2%, P
= 0.005), and failed device implantation (7.5% vs 3.6%, P < 0.001). The
425-day risk of ischemic stroke in trial LAAO patients was higher than in
registry patients (2.70% vs 1.21%; HR: 1.951; P = 0.03); warfarin patients
had comparable rates of ischemic stroke compared with registry patients
(1.15% vs 1.29%; HR: 0.728; P = 0.57). Hemorrhagic stroke risk was similar
among trial LAAO and registry patients (P = 0.88). Hemorrhagic stroke risk
was greater among warfarin patients versus registry patients (1.44% vs
0.20%; HR: 5.871, P = 0.03). Mortality was lower in trial LAAO patients
than in registry patients (2.92% vs 6.23%; HR: 0.477; P = 0.004), a
difference attributable to noncardiovascular deaths. Mortality was similar
(P = 0.44) among trial warfarin (4.48%) and registry (5.86%) patients.
<br/>Conclusion(s): In clinical practice, patients who meet trial criteria
and undergo LAAO experience a lower risk of ischemic stroke, a similar
risk of hemorrhagic stroke, and a higher risk of death after implant
versus LAAO trial patients. (WATCHMAN Left Atrial Appendage System for
Embolic PROTECTion in Patients With Atrial Fibrillation [PROTECT-AF],
NCT00129545; Evaluation of the WATCHMAN Left Atrial Appendage [LAA]
Closure Device in Patients With Atrial Fibrillation Versus Long Term
Warfarin Therapy [PREVAIL], NCT01182441)<br/>Copyright &#xa9; 2022
American College of Cardiology Foundation

<24>
Accession Number
2021119137
Title
Reduction of permanent pacemaker implantation by using the cusp overlap
technique in transcatheter aortic valve replacement: a meta-analysis.
Source
Clinical Research in Cardiology. 112(5) (pp 633-644), 2023. Date of
Publication: May 2023.
Author
Rawish E.; Macherey S.; Jurczyk D.; Patz T.; Jose J.; Stiermaier T.; Eitel
I.; Frerker C.; Schmidt T.
Institution
(Rawish, Jurczyk, Patz, Stiermaier, Eitel, Frerker, Schmidt) University
Hospital Schleswig-Holstein, Medical Clinic II, University Heart Center
Lubeck, Lubeck, Germany
(Rawish, Stiermaier, Eitel, Frerker, Schmidt) DZHK (German Centre for
Cardiovascular Research), Partner Site Hamburg/Kiel/Lubeck, Lubeck,
Germany
(Macherey) University of Cologne, Faculty of Medicine and University
Hospital Cologne, Clinic III for Internal Medicine, Cologne, Germany
(Jose) Cardiac Valve and Structural Heart Disease Clinic, Christian
Medical College Hospital, Vellore, India
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Background: The need for permanent pacemaker (PPM) implantation is a
common complication after transcatheter aortic valve replacement (TAVR).
Deep implantation position is a risk factor for PPM implantation. Thus, in
the field of self-expandable (SE) transcatheter heart valves (THV) cusp
overlap projection (COP) technique was implemented to reduce parallax,
allowing a more precise guidance of implantation depth. <br/>Aim(s): This
meta-analysis aims to report the outcome of patients undergoing TAVR with
SE THV using COP versus conventional implantation technique (CIT).
<br/>Method(s): Systematical search in MEDLINE and EMBASE yielded five
observational controlled studies comparing both implantation techniques
for the SE Evolut prosthesis (Medtronic Intern. Ltd., CA, USA) and
fulfilling the inclusion criteria for meta-analysis. <br/>Result(s):
Totally, 1227 patients were included, comprising 641 who underwent COP and
586 CIT TAVR. Incidence of post-procedural need for PPM implantation was
significantly lower in COP group (9.8% vs 20.6%; OR = 0.43; p < 0.00001).
This was accompanied by significantly higher implantation position in COP
group (mean difference distance from distal end of the intraventricular
portion of the THV to the non-coronary cusp (NCC): - 1.03 mm; p =
0.00001). Incidence of new-onset left bundle branch block did not differ.
Regarding procedural and 30-day mortality, technical success,
post-procedural aortic regurgitation, and rates of multiple device
implantation, no difference between COP and CIT was found.
<br/>Conclusion(s): COP is an effective and safe implantation technique to
reduce the need for a permanent pacemaker implantation during TAVR with SE
Evolut prosthesis. Graphical abstract: [Figure not available: see
fulltext.].<br/>Copyright &#xa9; 2023, The Author(s).

<25>
Accession Number
631606061
Title
Stent-Only Versus Adjunctive Balloon Angioplasty Approach for Saphenous
Vein Graft Percutaneous Coronary Intervention: Insights from DIVA Trial.
Source
Circulation: Cardiovascular Interventions. 13(2) (pp E008494), 2020. Date
of Publication: 01 Feb 2020.
Author
Latif F.; Uyeda L.; Edson R.; Bhatt D.L.; Goldman S.; Holmes D.R.; Rao
S.V.; Shunk K.; Aggarwal K.; Uretsky B.; Bolad I.; Ziada K.; McFalls E.;
Irimpen A.; Truong H.T.; Kinlay S.; Papademetriou V.; Velagaleti R.S.;
Rangan B.V.; Mavromatis K.; Shih M.-C.; Banerjee S.; Brilakis E.S.
Institution
(Latif) VA Medical Center, Oklahoma City, United States
(Latif) University of Oklahoma, Oklahoma City, United States
(Latif, Uyeda, Edson, Kinlay, Shih) VA Cooperative Studies Program
Coordinating Center, Mountain View, CA, United States
(Bhatt, Velagaleti) VA Boston Healthcare System, MA, United States
(Bhatt) Brigham and Women's Hospital, Heart & Vascular Center, Boston, MA,
United States
(Bhatt) Harvard Medical School, Boston, MA, United States
(Goldman) University of Arizona, Sarver Heart Center, Tucson, United
States
(Holmes) Mayo Clinic, Rochester, MN, United States
(Rao) Durham VA Medical Center, NC, United States
(Shunk) San Francisco VA Medical Center, CA, United States
(Aggarwal) Harry S Truman VA Hospital, Columbia, MO, United States
(Aggarwal) University of Missouri Healthcare, Columbia, United States
(Uretsky) Central Arkansas Veterans Health System, Little Rock, United
States
(Uretsky) University of Arkansas for Medical Sciences, Little Rock, United
States
(Bolad) Indiana University, School of Medicine, Indianapolis, United
States
(Bolad) Roudebush VA Medical Center, Indianapolis, IN, United States
(Ziada) University of Kentucky, Lexington, United States
(McFalls) VA Medical Center, Minneapolis, MN, United States
(McFalls) University of Minnesota, Minneapolis, United States
(Irimpen) Southeast Louisiana Veterans Health Care System, New Orleans,
United States
(Irimpen) Tulane University, Heart and Vascular Institute, New Orleans,
LA, United States
(Truong) VA Loma Linda Medical Center, CA, United States
(Papademetriou) VA Medical Center, Washington, DC, United States
(Papademetriou) Georgetown University, Washington, DC, United States
(Rangan, Brilakis) Minneapolis Heart Institute Foundation, MN, United
States
(Mavromatis) Atlanta VA Healthcare System, GA, United States
(Mavromatis) Emory University, Atlanta, GA, United States
(Banerjee) Dallas VA Medical Center, TX, United States
(Banerjee) University of Texas, Southwestern Medical Center, Dallas,
United States
(Brilakis) Minneapolis Heart Institute, MN, United States
(Brilakis) Abbott Northwestern Hospital, Minneapolis, MN, United States
Publisher
Lippincott Williams and Wilkins
Abstract
Background: Direct stenting without pre-dilation or post-dilation has been
advocated for saphenous vein graft percutaneous coronary intervention to
decrease the incidence of distal embolization, periprocedural myocardial
infarction, and target lesion revascularization. <br/>Method(s): We
performed a post hoc analysis of patients enrolled in the DIVA
(Drug-Eluting Stents Versus Bare Metal Stents in Saphenous Vein Graft
Angioplasty; NCT 01121224) prospective, double-blind, randomized
controlled trial. Patients were stratified into stent-only and
balloon-stent groups. Primary end point was 12-month incidence of target
vessel failure (defined as the composite of cardiac death, target vessel
myocardial infarction, or target vessel revascularization). Secondary end
points included all-cause death, stent thrombosis, myocardial infarction,
and target lesion revascularization during follow-up. <br/>Result(s): Of
the 575 patients included in this substudy, 185 (32%) patients underwent
stent-only percutaneous coronary intervention. Patients in the stent-only
versus balloon-stent group had similar baseline characteristics and
similar incidence of target vessel failure at 12-months (15% versus 19%;
hazard ratio, 1.34 [95% CI, 0.86-2.08]; P=0.19). During long-term
follow-up (median of 2.7 years), the incidence of definite stent
thrombosis (1% versus 5%; hazard ratio, 9.20 [95% CI, 1.23-68.92];
P=0.0085), the composite of definite or probable stent thrombosis (5%
versus 11%; hazard ratio, 2.52 [95% CI, 1.23-5.18]; P=0.009), and target
vessel myocardial infarction (8% versus 14%; hazard ratio, 1.92 [95% CI,
1.08-3.40]; P=0.023) was lower in the stent-only group. Multivariable
analysis showed that a higher number of years since coronary artery bypass
grafting and >1 target saphenous vein graft lesions were associated with
increased target vessel failure during entire follow-up, while
preintervention Thrombolysis in Myocardial Infarction-3 flow was
protective. <br/>Conclusion(s): In patients undergoing percutaneous
coronary intervention of de novo saphenous vein graft lesions, there was
no difference in target vessel failure at 12 months and long-term
follow-up in the stent-only versus the balloon-stent group; however, the
incidence of stent thrombosis was lower in the stent-only group, as was
target vessel myocardial infarction. Registration: URL:
https://www.clinicaltrials.gov. Unique identifier: NCT
01121224.<br/>Copyright &#xa9; 2020 Lippincott Williams and Wilkins. All
rights reserved.

<26>
[Use Link to view the full text]
Accession Number
2024319691
Title
Transcatheter mitral valve repair and replacement: The next frontier of
transcatheter valve intervention.
Source
Current Opinion in Cardiology. 36(2) (pp 163-171), 2021. Date of
Publication: 01 Mar 2021.
Author
Kang J.J.H.; Bozso S.J.; El-Andari R.; Adams C.; Nagendran J.
Institution
(Kang, El-Andari) Faculty of Medicine and Dentistry, Canada
(Bozso, Nagendran) Division of Cardiac Surgery, University of Alberta,
Edmonton, Canada
(Adams) Section of Cardiac Surgery, Department of Cardiac Sciences, Libin
Cardiovascular Institute of Alberta, University of Calgary, Calgary, AB,
Canada
Publisher
Lippincott Williams and Wilkins
Abstract
Purpose of reviewWe summarize the recent developments in transcatheter
mitral valve repair (TMVr) and replacement (TMVR), discuss determinants of
MitraClip outcomes in various mitral regurgitation causes, and highlight
newly emerging devices and randomized trials.Recent findingsThe discordant
results published in the two recent randomized trials for MitraClip, the
COAPT and the MITRA-FR trial have led to the emergence of a new conceptual
framework such as the proportionate versus disproportionate mitral
regurgitation and hemodynamics assessment tools like the real-time
continuous left atrial pressure monitoring. Learning curve and
volume-outcome analyses and studies examining the MitraClip usage in
patients with degenerative mitral regurgitation are recent developments
that have influenced MitraClip regulation and coverage. Several trials for
TMVr devices that take an alternative approach to the edge-to-edge repair
are underway and advancements in the TMVR technologies are continuing to
progress to fill the unmet needs of treating high surgical risk patients
whose complex valve anatomy make TMVr unfeasible.SummaryEvidence supports
careful analysis of the valve area and left ventricular function in
addition to the left atrial hemodynamics will improve the MitraClip
outcome. Operator experience plays a greater effect when achieving
excellent results with 1+ or less residual mitral regurgitation whereas
surgical MVr volume did not influence TMVr outcome. Interventions on the
complex primary mitral regurgitation remain under the surgical domain, but
MITRA high risk (HR) and REPAIR mitral regurgitation trials are underway
to evaluate the role of MitraClip in high to intermediate surgical risk
patients with primary mitral regurgitation. Despite the slow developments
in TMVR, the results of the early trials of its devices are
promising.<br/>Copyright &#xa9; 2021 Lippincott Williams and Wilkins. All
rights reserved.

<27>
[Use Link to view the full text]
Accession Number
2024319672
Title
Hypertension in cardiac transplant recipients: Tackling a new face of an
old foe.
Source
Current Opinion in Cardiology. 35(4) (pp 368-375), 2020. Date of
Publication: 01 Jul 2020.
Author
Campbell P.T.; Krim S.R.
Institution
(Campbell) Division of Cardiology, Baptist Health Medical Center, Little
Rock, AR, United States
(Krim) Division of Cardiology, John Ochsner Heart and Vascular Institute,
United States
(Krim) Section of Cardiomyopathy and Heart Transplantation, John Ochsner
Heart and Vascular Institute, Ochsner Clinic Foundation, United States
(Krim) The University of Queensland, School of Medicine, Ochsner Clinical
School, New Orleans, LA, United States
Publisher
Lippincott Williams and Wilkins
Abstract
Purpose of reviewSystemic hypertension (HTN) is a common complication
arising in the heart transplant recipient. This article aims to review the
most current literature and update readers on the epidemiology,
pathophysiology and management of HTN in heart transplant patients.Recent
findingsIn contrast to the general nontransplant hypertensive patient
population, traditional risk factors, including family history of HTN,
obesity and diabetes, play a minor role in the genesis of posttransplant
HTN. Dysregulation in sodium and water balance, vascular stiffness,
endothelial dysfunction, abnormal cardiorenal neural reflexes resulting
from immunosuppression and cardiac denervation seem to be the predominant
factors leading to postheart transplant HTN. Calcineurin inhibitors
induced nephrotoxicity and steroid use further contributes to
posttransplant HTN.SummaryOwing to the paucity of data, particularly
randomized controlled trials to guide the evaluation and management of HTN
in the cardiac transplant patients, much of the available data come from
the renal transplant population. The choice of antihypertensive should be
based on timing related to transplantation and patient's comorbidities.
Although calcium channel blockers and loop diuretics are the preferred
agents in the early postheart transplant period,
angiotensin-converting-enzyme inhibitors and angiotensin receptor blockers
may be beneficial in the late postheart transplant period especially in
the setting of diabetes and in the presence of proteinuria.<br/>Copyright
&#xa9; 2020 Lippincott Williams and Wilkins. All rights reserved.

<28>
[Use Link to view the full text]
Accession Number
2024251515
Title
A Novel Patient-Specific Model for Predicting Severe Oliguria; Development
and Comparison With Kidney Disease: Improving Global Outcomes Acute Kidney
Injury Classification.
Source
Critical Care Medicine. 48(1) (pp E18-E25), 2020. Date of Publication: 01
Jan 2020.
Author
Howitt S.H.; Oakley J.; Caiado C.; Goldstein M.; Malagon I.; Mccollum C.;
Grant S.W.
Institution
(Howitt, Oakley, Malagon, Mccollum, Grant) Division of Cardiovascular
Sciences, University of Manchester, ERC, Manchester University Hospitals
Foundation Trust, Manchester, United Kingdom
(Howitt, Malagon) Department of Cardiothoracic Anaesthesia and Critical
Care, Wythenshawe Hospital, Manchester University Hospitals Foundation
Trust, Manchester, United Kingdom
(Oakley, Caiado, Goldstein) Department of Mathematical Sciences, Durham
University, Durham, United Kingdom
Publisher
Lippincott Williams and Wilkins
Abstract
Objectives: The Kidney Disease: Improving Global Outcomes urine output
criteria for acute kidney injury lack specificity for identifying patients
at risk of adverse renal outcomes. The objective was to develop a model
that analyses hourly urine output values in real time to identify those at
risk of developing severe oliguria. <br/>Design(s): This was a
retrospective cohort study utilizing prospectively collected data.
<br/>Setting(s): A cardiac ICU in the United Kingdom. <br/>Patient(s):
Patients undergoing cardiac surgery between January 2013 and November
2017. <br/>Intervention(s): None. Measurement and Main Results: Patients
were randomly assigned to development (n = 981) and validation (n = 2,389)
datasets. A patient-specific, dynamic Bayesian model was developed to
predict future urine output on an hourly basis. Model discrimination and
calibration for predicting severe oliguria (< 0.3 mL/kg/hr for 6 hr)
occurring within the next 12 hours were tested in the validation dataset
at multiple time points. Patients with a high risk of severe oliguria (p >
0.8) were identified and their outcomes were compared with those for
low-risk patients and for patients who met the Kidney Disease: Improving
Global Outcomes urine output criterion for acute kidney injury. Model
discrimination was excellent at all time points (area under the curve >
0.9 for all). Calibration of the model's predictions was also excellent.
After adjustment using multivariable logistic regression, patients in the
high-risk group were more likely to require renal replacement therapy
(odds ratio, 10.4; 95% CI, 5.9-18.1), suffer prolonged hospital stay (odds
ratio, 4.4; 95% CI, 3.0-6.4), and die in hospital (odds ratio, 6.4; 95%
CI, 2.8-14.0) (p < 0.001 for all). Outcomes for those identified as high
risk by the model were significantly worse than for patients who met the
Kidney Disease: Improving Global Outcomes urine output criterion.
<br/>Conclusion(s): This novel, patient-specific model identifies patients
at increased risk of severe oliguria. Classification according to model
predictions outperformed the Kidney Disease: Improving Global Outcomes
urine output criterion. As the new model identifies patients at risk
before severe oliguria develops it could potentially facilitate
intervention to improve patient outcomes.<br/>Copyright &#xa9; 2020
Lippincott Williams and Wilkins. All rights reserved.

<29>
Accession Number
641193380
Title
Incidence of postoperative delirium in older adults undergoing surgical
procedures: A systematic literature review and meta-analysis.
Source
Worldviews on evidence-based nursing. (no pagination), 2023. Date of
Publication: 02 May 2023.
Author
Igwe E.O.; Nealon J.; O'Shaughnessy P.; Bowden A.; Chang H.-C.R.; Ho
M.-H.; Montayre J.; Montgomery A.; Rolls K.; Chou K.-R.; Chen K.-H.;
Traynor V.; Smerdely P.
Institution
(Igwe, Bowden, Chang, Montgomery, Rolls, Traynor) School of Nursing,
Faculty of Science, Medicine and Health, University of Wollongong,
Wollongong, NSW, Australia
(Igwe, Nealon, Bowden, Chang, Montgomery, Traynor) Illawarra Health and
Medical Research Institute (IHMRI), Wollongong, NSW, Australia
(Nealon) School of Medicine, Faculty of Science, Medicine and Health,
University of Wollongong, Wollongong, NSW, Australia
(O'Shaughnessy) School of Mathematics and Applied Statistics, Faculty of
Engineering and Information Sciences, University of Wollongong,
Wollongong, NSW, Australia
(Bowden) Illawarra Shoalhaven Local Health District, Wollongong, NSW,
Australia
(Chang) School of Nursing and Midwifery, Western Sydney University,
Penrith, NSW, Australia
(Ho) School of Nursing, LKS Faculty of Medicine, University of Hong Kong,
Pok Fu Lam, Hong Kong
(Montayre) School of Nursing, Hong Kong Polytechnic University, Hong Kong
SAR, Hung Hom
(Chou) School of Nursing, College of Nursing, Taipei Medical University,
Taipei, Taiwan (Republic of China)
(Chou, Chen) Center for Nursing and Healthcare Research in Clinical
Practice Application, Wan Fang Hospital, Taipei Medical University,
Taipei, Taiwan (Republic of China)
(Chou) Department of Nursing, Taipei Medical University-Shuang Ho
Hospital, Taiwan (Republic of China)
(Chou) Psychiatric Research Center, Taipei Medical University Hospital,
Taipei, Taiwan (Republic of China)
(Chen) Post-Baccalaureate Program in Nursing, College of Nursing, Taipei
Medical University, Taipei, Taiwan (Republic of China)
(Chen) Cochrane Taiwan, Taipei Medical University, Taipei, Taiwan
(Republic of China)
(Chen) Evidence-based Knowledge Translation Center, Wan Fang Hospital,
Taipei Medical University, Taipei, Taiwan (Republic of China)
(Smerdely) School of Population Health, UNSW Medicine, Sydney, NSW,
Australia
(Smerdely) St George Hospital, Kogarah, NSW, Australia
Publisher
NLM (Medline)
Abstract
BACKGROUND: With the increase in life expectancy around the globe, the
incidence of postoperative delirium (POD) among older people (>=65years)
is growing. Previous studies showed a wide variation in the incidence of
POD, from 4% to 53%, with a lack of specific evidence about the incidence
of POD by specific surgery type among older people. The aim of this
systematic review and meta-analysis was to determine the incidence of POD
by surgery type within populations 65years and over. <br/>METHOD(S):
Databases including PubMed, Cochrane library, Embase, and CINAHL were
searched until October 2020. Due to the relatively higher number of
meta-analyses undertaken in this area of research, a streamlined
systematic meta-analysis was proposed. <br/>RESULT(S): A total of 28
meta-analyses (comprising 284 individual studies) were reviewed. Data from
relevant individual studies (n=90) were extracted and included in the
current study. Studies were grouped into eight surgery types and the
incidence of POD for orthopedic, vascular, spinal, cardiac, colorectal,
abdominal, urologic, and mixed surgeries was 20%, 14%, 13%, 32%, 14%, 30%,
10%, and 26%, respectively. POD detection instruments were different
across the studies, with Confusion Assessment Method (CAM & CAM-ICU) being
the most frequently adopted. LINKING EVIDENCE TO ACTION: This study showed
that POD incidence in older people undergoing surgery varied widely across
surgery type. The more complex surgeries like cardiac and abdominal
surgeries were associated with a higher risk of POD. This highlights the
need to include the level of surgery complexity as a risk factor in
preoperative assessments.<br/>Copyright &#xa9; 2023 The Authors.
Worldviews on Evidence-based Nursing published by Wiley Periodicals LLC on
behalf of Sigma Theta Tau International.

<30>
Accession Number
2024161176
Title
Erector Spinae Plane Block With Liposomal Bupivacaine: Analgesic Adjunct
in Adult Pectus Surgery.
Source
Journal of Surgical Research. 289 (pp 171-181), 2023. Date of Publication:
September 2023.
Author
Malan S.H.; Jaroszewski D.E.; Craner R.C.; Weis R.A.; Murray A.W.;
Meinhardt J.R.; Girardo M.E.; Abdelrazek A.S.; Borah B.J.; Dholakia R.;
Smith B.B.
Institution
(Malan) Adult Cardiothoracic Anesthesiology Fellow, Baylor Scott & White
Medical Center, Texas A&M Health Science Center College of Medicine,
Temple, Texas, United States
(Jaroszewski) Professor of Surgery, Department of Cardiovascular Surgery,
Mayo Clinic, Phoenix, Arizona, United States
(Craner, Weis, Murray, Smith) Assistant Professor of Anesthesiology,
Department of Anesthesiology and Perioperative Medicine, Mayo Clinic,
Phoenix, Arizona, United States
(Meinhardt) Mayo Clinic Alix School of Medicine, Phoenix, Arizona, United
States
(Girardo) Department of Research Biostatistics, Mayo Clinic, Phoenix,
Arizona, United States
(Abdelrazek) Research Fellow, Cardiovascular Surgery Research, Mayo
Clinic, Rochester, Minnesota, United States
(Borah, Dholakia) Mayo Clinic College of Medicine & Science Robert D. &
Patricia E. Kern Center for the Science of Healthcare Delivery, Mayo
Clinic, Rochester, Minnesota, United States
Publisher
Academic Press Inc.
Abstract
Introduction: Pain management may be challenging in patients undergoing
pectus excavatum (PE) bar removal surgery. To enhance recovery, opioid
sparing strategies with regional anesthesia including ultrasound-guided
erector spinae plane block (ESPB) have been implemented. The purpose of
this study was to evaluate the safety and efficacy of bilateral ESPB with
a liposomal bupivacaine/traditional bupivacaine mixture as part of an
enhanced patient recovery pathway. <br/>Material(s) and Method(s): A
retrospective review of adult patients who underwent PE bar removal from
January 2019 to December 2020 was performed. Perioperative data were
reviewed and recorded. Patients who received ESPB were compared to
historical controls (non-ESPB patients). <br/>Result(s): A total of 202
patients were included (non-ESPB: 124 patients; ESPB: 78 patients). No
adverse events were attributed to ESPB. Non-ESPB patients received more
intraoperative opioids (milligram morphine equivalents; 41.8 +/- 17.0 mg
versus 36.7 +/- 17.1, P = 0.05) and were more likely to present to the
emergency department within 7 d postoperatively (4.8% versus 0%, P = 0.05)
when compared to ESPB patients. No significant difference in total
perioperative milligram morphine equivalents, severe pain in
postanesthesia care unit (PACU), time from PACU arrival to analgesic
administration, PACU length of stay, or postprocedure admission rates
between groups were observed. <br/>Conclusion(s): In patients undergoing
PE bar removal surgery, bilateral ESPB with liposomal bupivacaine was
performed without complications. ESPB with liposomal bupivacaine may be
considered as an analgesic adjunct to enhance recovery in patients
undergoing cardiothoracic procedures but further prospective randomized
clinical trials comparing liposomal bupivacaine to traditional local
anesthetics with and without indwelling nerve catheters are
necessary.<br/>Copyright &#xa9; 2023 Elsevier Inc.

<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
2024066286
Title
Maribavir for Refractory Cytomegalovirus Infections With or Without
Resistance Post-Transplant: Results From a Phase 3 Randomized Clinical
Trial.
Source
Clinical Infectious Diseases. 75(4) (pp 690-701), 2022. Date of
Publication: 15 Aug 2022.
Author
Avery R.K.; Alain S.; Alexander B.D.; Blumberg E.A.; Chemaly R.F.;
Cordonnier C.; Duarte R.F.; Florescu D.F.; Kamar N.; Kumar D.; Maertens
J.; Marty F.M.; Papanicolaou G.A.; Silveira F.P.; Witzke O.; Wu J.;
Sundberg A.K.; Fournier M.
Institution
(Avery) Division of Infectious Diseases, Johns Hopkins University,
Baltimore, MD, United States
(Alain) Department of Virology and National Reference Center for
Herpesviruses, Limoges University Hospital, UMR Inserm 1092, University of
Limoges, Limoges, France
(Alexander) Division of Infectious Diseases and International Health, Duke
University, Durham, NC, United States
(Blumberg) Department of Medicine, Perelman School of Medicine, University
of Pennsylvania, Philadelphia, PA, United States
(Chemaly) Department of Infectious Diseases,Infection Control, and
Employee Health, University of Texas MD Anderson Cancer Center, Houston,
TX, United States
(Cordonnier) Haematology Department, Henri Mondor Hospital and University
Paris-Est-Crteil, Crteil, France
(Duarte) Department of Haematology, Hospital Universitario Puerta de
Hierro Majadahonda, Madrid, Spain
(Florescu) Infectious Diseases Division, University of Nebraska Medical
Center, Omaha, NE, United States
(Kamar) Department of Nephrology and Organ Transplantation, Toulouse
Rangueil University Hospital, INFINITY-Inserm U1291-CNRS U5051, University
Paul Sabatier, Toulouse, France
(Kumar) Transplant Centre, University Health Network, Toronto, ON, Canada
(Maertens) Haematology Department, University Hospitals Leuven, KU Leuven,
Leuven, Belgium
(Marty) Department of Infectious Disease, Brigham and Women's Hospital and
Dana-Farber Cancer Institute, Boston, MA, United States
(Papanicolaou) Infectious Disease Service, Department of Medicine,
Memorial Sloan Kettering Cancer Center, New York, NY, United States
(Papanicolaou) Department of Medicine, Weill Cornell Medicine, New York,
NY, United States
(Silveira) Department of Medicine, Division of Infectious Diseases,
University of Pittsburgh and University of Pittsburgh Medical Center,
Pittsburgh, PA, United States
(Witzke) Department of Infectious Diseases, West German Centre of
Infectious Diseases, University Medicine Essen, University Duisburg-Essen,
Essen, Germany
(Wu) Biostatistics, Takeda Development Center Americas, Inc, Lexington,
MA, United States
(Sundberg, Fournier) Clinical Sciences, Takeda Development Center
Americas, Inc, Lexington, MA, United States
Publisher
Oxford University Press
Abstract
Background: Therapies for refractory cytomegalovirus infections (with or
without resistance [R/R]) in transplant recipients are limited by
toxicities. Maribavir has multimodal anti-cytomegalovirus activity through
the inhibition of UL97 protein kinase. <br/>Method(s): In this phase 3,
open-label study, hematopoietic-cell and solid-organ transplant recipients
with R/R cytomegalovirus were randomized 2:1 to maribavir 400 mg twice
daily or investigator-assigned therapy (IAT; valganciclovir/ganciclovir,
foscarnet, or cidofovir) for 8 weeks, with 12 weeks of follow-up. The
primary endpoint was confirmed cytomegalovirus clearance at end of week 8.
The key secondary endpoint was achievement of cytomegalovirus clearance
and symptom control at end of week 8, maintained through week 16.
<br/>Result(s): 352 patients were randomized (235 maribavir; 117 IAT).
Significantly more patients in the maribavir versus IAT group achieved the
primary endpoint (55.7% vs 23.9%; adjusted difference [95% confidence
interval (CI)]: 32.8% [22.80-42.74]; P < .001) and key secondary endpoint
(18.7% vs 10.3%; adjusted difference [95% CI]: 9.5% [2.02-16.88]; P =
.01). Rates of treatment-emergent adverse events (TEAEs) were similar
between groups (maribavir, 97.4%; IAT, 91.4%). Maribavir was associated
with less acute kidney injury versus foscarnet (8.5% vs 21.3%) and
neutropenia versus valganciclovir/ganciclovir (9.4% vs 33.9%). Fewer
patients discontinued treatment due to TEAEs with maribavir (13.2%) than
IAT (31.9%). One patient per group had fatal treatment-related TEAEs.
<br/>Conclusion(s): Maribavir was superior to IAT for cytomegalovirus
viremia clearance and viremia clearance plus symptom control maintained
post-therapy in transplant recipients with R/R cytomegalovirus. Maribavir
had fewer treatment discontinuations due to TEAEs than IAT. Clinical
Trials Registration. NCT02931539 (SOLSTICE).<br/>Copyright &#xa9; 2021 The
Author(s). Published by Oxford University Press for the Infectious
Diseases Society of America.

<33>
Accession Number
2022929443
Title
Cardiotoxicity, Cardioprotection, and Prognosis in Survivors of Anticancer
Treatment Undergoing Cardiac Surgery: Unmet Needs.
Source
Cancers. 15(8) (no pagination), 2023. Article Number: 2224. Date of
Publication: April 2023.
Author
Palmieri V.; Vietri M.T.; Montalto A.; Montisci A.; Donatelli F.; Coscioni
E.; Napoli C.
Institution
(Palmieri, Montalto) Unit of Cardiac Surgery, Cardiovascular Department,
Azienda Ospedaliera di Rilevanza Nazionale "San Sebastiano e Sant'Anna",
Caserta 81100, Italy
(Vietri) Department of Precision Medicine, School of Medicine, "Luigi
Vanvitelli" University of Campania, Naples 80100, Italy
(Montisci) Division of Cardiothoracic Intensive Care, Cardiothoracic
Department, ASST Spedali Civili, Brescia 25123, Italy
(Donatelli) Department of Cardiac Surgery, Istituto Clinico Sant'Ambrogio,
Milan 20161, Italy
(Donatelli) Cardiac Surgery, University of Milan, Milan 20122, Italy
(Coscioni) Division of Cardiac Surgery, AOU San Giovanni di Dio e Ruggi
D'Aragona, Salerno 84131, Italy
(Napoli) Department of Advanced Medical and Surgical Sciences (DAMSS),
"Luigi Vanvitelli" University of Campania School of Medicine, Naples
80100, Italy
Publisher
MDPI
Abstract
Background: Anticancer treatments are improving the prognosis of patients
fighting cancer. However, anticancer treatments may also increase the
cardiovascular (CV) risk by increasing metabolic disorders.
Atherosclerosis and atherothrombosis related to anticancer treatments may
lead to ischemic heart disease (IHD), while direct cardiac toxicity may
induce non-ischemic heart disease. Moreover, valvular heart disease (VHD),
aortic syndromes (AoS), and advanced heart failure (HF) associated with CV
risk factors and preclinical CV disease as well as with chronic
inflammation and endothelial dysfunction may also occur in survivors of
anti-carcer treatments. <br/>Method(s): Public electronic libraries have
been searched systematically looking at cardiotoxicity, cardioprotection,
CV risk and disease, and prognosis after cardiac surgery in survivors of
anticancer treatments. <br/>Result(s): CV risk factors and disease may not
be infrequent among survivors of anticancer treatments. As cardiotoxicity
of established anticancer treatments has been investigated and is
frequently irreversible, cardiotoxicity associated with novel treatments
appears to be more frequently reversible, but also potentially synergic.
Small reports suggest that drugs preventing HF in the general population
may be effective also among survivors of anticancer treatments, so that CV
risk factors and disease, and chronic inflammation, may lead to indication
to cardiac surgery in survivors of anticancer treatments. There is a lack
of substantial data on whether current risk scores are efficient to
predict prognosis after cardiac surgery in survivors of anticancer
treatments, and to guide tailored decision-making. IHD is the most common
condition requiring cardiac surgery among survivors of anticancer
treatments. Primary VHD is mostly related to a history of radiation
therapy. No specific reports exist on AoS in survivors of anticancer
treatments. <br/>Conclusion(s): It is unclear whether interventions to
dominate cancer- and anticancer treatment-related metabolic syndromes,
chronic inflammation, and endothelial dysfunction, leading to IHD, nonIHD,
VHD, HF, and AoS, are as effective in survivors of anticancer treatments
as in the general population. When CV diseases require cardiac surgery,
survivors of anticancer treatments may be a population at specifically
elevated risk, rather than affected by a specific risk
factor.<br/>Copyright &#xa9; 2023 by the authors.

<34>
Accession Number
2022921703
Title
Early and Mid-Term Outcomes of Transcatheter Aortic Valve Implantation
versus Surgical Aortic Valve Replacement: Updated Systematic Review and
Meta-Analysis.
Source
Journal of Cardiovascular Development and Disease. 10(4) (no pagination),
2023. Article Number: 157. Date of Publication: April 2023.
Author
Lerman T.T.; Levi A.; Talmor-Barkan Y.; Kornowski R.
Institution
(Lerman) Department of Internal Medicine F-Recanati, Beilinson Hospital,
Rabin Medical Center, Petah Tikva 4941492, Israel
(Lerman, Levi, Talmor-Barkan, Kornowski) Department of Cardiology, Rabin
Medical Center, Petah Tikva 4941492, Israel
(Lerman, Levi, Talmor-Barkan, Kornowski) The Faculty of Medicine, Tel Aviv
University, Tel Aviv 6997801, Israel
Publisher
MDPI
Abstract
(1) Background: The use of transcatheter aortic valve implantation (TAVI)
for the treatment of severe symptomatic aortic stenosis is expanding
significantly. We aimed to perform a meta-analysis comparing the safety
and efficacy of TAVI versus surgical aortic valve replacement (SAVR)
during the early and mid-term follow-up period. (2) Methods: We conducted
a meta-analysis of randomized controlled trials (RCTs) comparing 1- to
2-year outcomes between TAVI and SAVR. The study protocol was
preregistered in PROSPERO and the results were reported according to
PRISMA guidelines. (3) Results: The pooled analysis included data from
eight RCTs totaling 8780 patients. TAVI was associated with a lower risk
of all-cause mortality or disabling stroke (OR 0.87, 95%CI 0.77-0.99),
significant bleeding (OR 0.38, 95%CI 0.25-0.59), acute kidney injury (AKI;
OR 0.53, 95%CI 0.40-0.69) and atrial fibrillation (OR 0.28, 95%CI
0.19-0.43). SAVR was associated with a lower risk of major vascular
complication (MVC; OR 1.99, 95%CI 1.29-3.07) as well as permanent
pacemaker implantation (PPI; OR 2.28, 95%CI 1.45-3.57). (3)
<br/>Conclusion(s): TAVI compared with SAVR during early and mid-term
follow-up was associated with a lower risk of all-cause mortality or
disabling stroke, significant bleeding, AKI and atrial fibrillation;
however, it was associated with a higher risk of MVC and
PPI.<br/>Copyright &#xa9; 2023 by the authors.

<35>
Accession Number
2020578395
Title
Quality of life and psychosocial outcomes of adults who were pediatric
solid organ transplant recipients: A systematic review.
Source
Pediatric Transplantation. 27(3) (no pagination), 2023. Article Number:
e14448. Date of Publication: May 2023.
Author
Laliberte Durish C.; Lin J.; Pol S.J.; Damer A.; Anthony S.J.; Wray J.;
Gold A.
Institution
(Laliberte Durish, Gold) The Department of Psychology, The Hospital for
Sick Children, Toronto, ON, Canada
(Lin, Pol, Damer, Anthony) Child Health Evaluative Sciences (CHES), The
Hospital for Sick Children, Toronto, ON, Canada
(Anthony) Factor-Inwentash Faculty of Social Work, University of Toronto,
Toronto, ON, Canada
(Wray) Heart and Lung Directorate, Great Ormond Street Hospital for
Children NHS Foundation Trust, London, United Kingdom
(Gold) Transplant and Regenerative Medicine Centre, The Hospital for Sick
Children, Toronto, ON, Canada
Publisher
John Wiley and Sons Inc
Abstract
Background: The number of pediatric SOT recipients surviving into
adulthood is increasing. Thus, understanding their psychosocial and QoL
outcomes is important. We conducted a systematic review to collate
existing literature examining QoL outcomes (physical functioning,
psychological functioning, social functioning), as well as risk and
protective factors associated with QoL, among adults who underwent SOT
during childhood. <br/>Method(s): A systematic search of five databases,
from inception to January 6, 2021, was conducted to identify articles that
reported on QoL outcomes for adults (>=18-year of age) who received a SOT
during childhood (<19-year of age). <br/>Result(s): Twenty-five articles
met inclusion criteria. Studies examined QoL across a range of SOT
populations (liver, kidney, heart). QoL and psychosocial outcomes were
variable; however, the majority of studies indicated QoL in this
population to be similar to the general population, or at least similar to
other chronic illness groups, with the exception of physical and social
functioning. Factors related to a more optimal medical course, younger age
at transplant and follow-up, and positive psychosocial functioning, were
found to be predictive of better QoL outcomes. <br/>Conclusion(s): While
several studies indicated QoL to be similar to the general population, the
literature is limited in both quantity and quality. No study employed
prospective, longitudinal methodologies to systematically evaluate QoL
over time and few studies utilized normative-based measures of QoL.
Furthermore, several SOT groups were under-represented in the literature
(e.g., lung, intestine, multi-visceral). Nonetheless, findings have
implications for intervention and clinical decision-making.<br/>Copyright
&#xa9; 2022 Wiley Periodicals LLC.

<36>
Accession Number
641176237
Title
Malnutrition Predicts Adverse Outcomes After Transcatheter Aortic Valve
Replacement: A Systematic Review and Meta-Analysis.
Source
Anatolian journal of cardiology. 27(5) (pp 240-248), 2023. Date of
Publication: 01 May 2023.
Author
Dong M.; Cheng J.; Gong L.; Xiao Y.; Shao S.; Song J.
Institution
(Dong, Song) Department of Nursing, Second Affiliated Hospital of Zhejiang
University School of Medicine, Hangzhou City, China
(Cheng) Cardiac Intervention Center, Second Affiliated Hospital of
Zhejiang University School of Medicine, Hangzhou City, China
(Gong) Department of Cardiology, Yuechi County People's Hospital, Sichuan
Province, China
(Xiao) School of Nursing, School of Medicine, Huzhou University, China
(Shao) School of Medicine, Huzhou University, China
Publisher
NLM (Medline)
Abstract
BACKGROUND: Several studies have shown that malnutrition helps to predict
the occurrence of adverse outcomes after transcatheter aortic valve
replacement. However, there is still controversy and uncertainty regarding
the prevalence and consequences of malnutrition. We performed a systematic
review and meta-analysis to assess the relationship between malnutrition
and poor postoperative outcomes in transcatheter aortic valve replacement.
<br/>METHOD(S): Observational studies were searched in PubMed, EMBASE,
Cochrane Library, Web of Science, and MEDLINE regarding the relationship
between malnutrition and adverse outcomes after transcatheter aortic valve
replacement, with the primary end-point being all-cause mortality and
secondary outcomes such as cardiovascular complications and readmission
rates. This meta-analysis was registered in PROSPERO (number
CRD42022310139). <br/>RESULT(S): A total of 10 studies involving 5936
subjects were included in the systematic review and meta-analysis. The
results showed that malnourished patients had an increased risk of
all-cause mortality after transcatheter aortic valve replacement compared
with non-malnourished patients (hazard ratios [HR] = 1.32, 95% CI [1.13,
1.53], P <.01). Subgroup analysis showed that in Asia, postoperative
all-cause mortality was significantly higher in malnourished transcatheter
aortic valve replacement patients than in non-malnourished transcatheter
aortic valve replacement patients (P <.01), and in addition, sample size
and follow-up time may have contributed to the large heterogeneity.
<br/>CONCLUSION(S): Malnutrition increases the risk of all-cause mortality
in such patients and may predict the occurrence of adverse postoperative
outcomes.

<37>
Accession Number
2022944367
Title
Association of Troponin T measurements with long-term outcomes in patients
with coronary artery disease participating in a secondary prevention
trial.
Source
BMC Cardiovascular Disorders. 23(1) (no pagination), 2023. Article Number:
210. Date of Publication: December 2023.
Author
Kaldal A.; Tonstad S.; Jortveit J.
Institution
(Kaldal) Department of Research, Sorlandet Hospital, Box 416 Lundsiden,
Arendal 4604, Norway
(Tonstad) Department of Endocrinology, Obesity and Preventive Medicine,
Section of Preventive Cardiology, Oslo University Hospital, Oslo, Norway
(Jortveit) Department of Cardiology, Sorlandet Hospital, Arendal, Norway
Publisher
BioMed Central Ltd
Abstract
Background and aims: Identification of high-risk patients in secondary
cardiovascular prevention may be challenging, although risk stratification
tools are available. Cardiac troponins might have predictive value in
identification of high-risk patients. The aim of this study was to
investigate the association between cardiac Troponin T (cTnT) levels
following a coronary event and long-term outcomes. <br/>Method(s): This
study was carried out as a subanalysis from a randomized controlled trial
conducted at Sorlandet Hospital, Norway, where patients hospitalized with
myocardial infarction (MI) or scheduled percutaneous coronary intervention
(PCI)/coronary artery bypass grafting (CABG) were included between 2007
and 2017. Participants were followed-up for up to 10 years after the index
event through out-patient consultations. cTnT was assessed at each
consultation as well as information regarding new cardiovascular events or
death. <br/>Result(s): A total of 1278 patients (18-80 years) with
complete measurements of cTnT were included. cTnT was elevated (>= 14
ng/L) one year after the primary event in 241 (19%) of participants.
Median follow-up was 5.7 [SD 2.7] years. Cox regression analyses showed
reduced survival (adjusted HR 0.37, 95% CI 0.19-0.72; p = 0.003) and
composite endpoint-free survival (adjusted HR 0.73, 95% CI 0.55-0.98; p =
0.04) in participants with elevated cTnT versus participants with low cTnT
after adjustment for risk factors at inclusion and randomization
assignment. <br/>Conclusion(s): Assessment of cTnT after coronary heart
events may help identify patients at high risk of poor outcomes and might
contribute to more focused secondary preventive treatment. Trial
registration: The study is registered in ClinicalTrials.gov
(NCT00679237).<br/>Copyright &#xa9; 2023, The Author(s).

<38>
Accession Number
2024291530
Title
Multimodality therapy for lung cancer invading the chest wall: A study of
the French EPITHOR database.
Source
Lung Cancer. 181 (no pagination), 2023. Article Number: 107224. Date of
Publication: July 2023.
Author
Tricard J.; Filaire M.; Verge R.; Pages P.-B.; Brichon P.-Y.; Loundou A.;
Boyer L.; Thomas P.A.
Institution
(Tricard, Filaire, Verge, Pages, Brichon, Thomas) EPITHOR Group, French
Society of Thoracic and Cardiovascular Surgery, 56 Bd Vincent Auriol,
Paris 75013, France
(Tricard) Department of Cardio-Thoracic Surgery, University Hospital of
Limoges, 16 Rue Bernard Descottes, Limoges 87042, France
(Filaire) Department of Thoracic and Endocrinological Surgery, Center Jean
Perrin, 58 Rue Montalembert, Clermont-Ferrand 63011, France
(Verge) Department of Thoracic Surgery, University Hospital of Toulouse,
24 Chem. de Pouvourville, Toulouse 31400, France
(Pages) Department of Thoracic and Cardiovascular Surgery, University
Hospital of Dijon, 14 Rue Paul Gaffarel, Dijon 21000, France
(Brichon) Department of Thoracic Surgery, University Hospital of Grenoble,
Av. des Maquis du Gresivaudan, La Tronche 38700, France
(Loundou, Boyer) Department of Medical Information, Assistance Publique -
Hopitaux Marseille & Centre d'Etudes et de Recherches sur les Services de
Sante et qualite de vie, CEReSS/EA 3279, 27 Bd Jean Moulin, Marseille
13385, France
(Thomas) Department of Thoracic Surgery, North Hospital, Assistance
Publique - Hopitaux Marseille, & Predictive Oncology Laboratory, CRCM,
Inserm UMR 1068, CNRS, UMR 7258, Aix-Marseille University UM105, Chem. des
Bourrely, Marseille 13015, France
Publisher
Elsevier Ireland Ltd
Abstract
Objectives: According to a nation-based study, we intend to report the
data of the patients operated on for lung cancer invading the chest wall,
taking into consideration the completion of induction chemotherapy
(Ind_CT), induction radiochemotherapy (Ind_RCT) or no induction therapy
(0_Ind). <br/>Material(s) and Method(s): All patients with a primary lung
cancer invading the chest wall who underwent radical resection from 2004
to 2019 were included. Superior sulcus tumors were excluded.
<br/>Result(s): Overall, 688 patients were included: 522 operated without
induction therapy, 101 with Ind_CT and 65 with Ind_RCT. Postoperative
90-day mortality was 10.7% in the 0_Ind group, 5.0% in the Ind_CT group,
7.7% in the Ind_RCT group (p = 0.17). Incomplete resection rate was 14.0%
in the 0_Ind group, 6.9% in the Ind_CT group, 6.2% in the Ind_RCT group (p
= 0.04). In the 0_Ind group, 70% of the patients received adjuvant
therapies. Overall survival (OS) analysis disclosed the best long-term
outcomes in the Ind_RCT group (5-year OS probability: 56.5% versus 40.0%
and 40.5% for 0_Ind and Ind_CT groups, respectively; p = 0.035). At
multivariable analysis, Ind_RCT (HR = 0.571; p = 0.008), age > 60 years
old (HR = 1,373; p = 0.005), male sex (HR = 1.710; p < 0.001),
pneumonectomy (HR = 1.368; p = 0.025), pN2 status (HR = 1.981; p < 0.001),
>=3 resected ribs (HR = 1.329; p = 0.019), incomplete resection (HR =
2.284; p < 0.001) and lack of adjuvant therapy (HR = 1.959; p < 0.001)
were associated with OS. Ind_CT was not associated with survival (HR =
0.848; p = 0.257). <br/>Conclusion(s): Induction chemoradiation therapy
seems to improve survival. Therefore, the present results should be
confirmed by a prospective randomized trial testing the benefit of
induction radiochemotherapy for NSCLC invading the chest
wall.<br/>Copyright &#xa9; 2023 Elsevier B.V.

<39>
Accession Number
2024160461
Title
Long-term outcomes of mini-sternotomy versus conventional sternotomy for
aortic valve replacement: a randomized controlled trial.
Source
European Journal of Cardio-thoracic Surgery. 63(1) (no pagination), 2023.
Article Number: ezac540. Date of Publication: 01 Jan 2023.
Author
Telyuk P.; Hancock H.; Maier R.; Batty J.A.; Goodwin A.; Owens W.A.;
Ogundimu E.; Akowuah E.
Institution
(Telyuk, Batty) Department of Cardiology, The James Cook University
Hospital, Middlesbrough, United Kingdom
(Hancock, Maier) Newcastle Clinical Trials Unit, Newcastle upon Tyne,
United Kingdom
(Goodwin, Owens, Akowuah) Department of Cardiovascular Surgery, The James
Cook University Hospital, Middlesbrough, United Kingdom
(Ogundimu) Department of Mathematical Sciences, Durham University, Durham,
United Kingdom
Publisher
European Association for Cardio-Thoracic Surgery
Abstract
OBJECTIVES: Aortic valve replacement (AVR) for severe symptomatic aortic
stenosis is one of the most common cardiac surgical procedures with
excellent long-term outcomes. Multiple previous studies have compared
short-term outcomes of AVR with mini-sternotomy versus AVR with
conventional sternotomy. We have previously reported the results of the
randomized MAVRIC trial, which aimed to evaluate early postoperative
morbidity among patients undergoing mini-sternotomy and conventional
sternotomy AVR. We now report the long-term all-cause mortality,
reoperation, MACE outcomes and echocardiographic data from this trial.
<br/>METHOD(S): The prospective, randomized, single-centre, single-blind
MAVRIC (manubrium-limited mini-sternotomy versus conventional sternotomy
for aortic valve replacement) trial compared manubrium-limited
mini-sternotomy and conventional median sternotomy for the treatment of
patients with severe aortic stenosis. The previously reported primary
outcome was the proportion of patients receiving red cell transfusion
postoperatively and within 7 days of the index procedure. Currently
reported exploratory analyses of a combined long-term all-cause mortality
and reoperation were compared between groups via the log-rank test.
Sensitivity analyses reviewed individual components of the combined end
point. The primary analysis and long-term exploratory analyses were based
on an intention-to-treat principle. <br/>RESULT(S): Between March 2014 and
June 2016, 270 patients were enrolled and randomized in a 1:1 fashion to
undergo mini-sternotomy AVR (n = 135) or conventional median sternotomy
AVR (n = 135). At the median follow-up of 6.1 years, the composite outcome
of all-cause mortality and reoperation occurred in 18.5% (25/135) of
patients in the conventional sternotomy group and in 17% (23/135) of
patients in the mini-sternotomy group. The incidence of chronic kidney
disease, cerebrovascular accident and myocardial infarction was not
significantly different between 2 groups. Follow-up echocardiographic data
suggested no difference in peak and mean gradients or incidence of aortic
regurgitation between 2 approaches. <br/>CONCLUSION(S): This exploratory
long-term analysis demonstrated that, in patients with severe aortic
stenosis undergoing isolated AVR, there was no significant difference
between manubrium-limited mini-sternotomy and conventional sternotomy with
respect to all-cause mortality, rate of reoperation, MACE events and
echocardiographic data at the median of 6.1-year follow-up.<br/>Copyright
&#xa9; The Author(s) 2022. Published by Oxford University Press on behalf
of the European Association for Cardio-Thoracic Surgery. All rights
reserved.

<40>
Accession Number
2024160454
Title
Early anticoagulation after aortic valve replacement with porcine
bioprosthesis randomized control trial (ANTIPRO).
Source
European Journal of Cardio-thoracic Surgery. 63(1) (no pagination), 2023.
Article Number: ezac507. Date of Publication: 01 Jan 2023.
Author
Fernandez A.; Loza G.; Parma G.; Florio L.; Estigarribia J.; Soca G.;
Robaina R.; Duran A.; Brusich D.; Dayan V.
Institution
(Fernandez, Estigarribia, Soca, Robaina, Dayan) Instituto Nacional de
Cirugia Cardiaca, Montevideo, Uruguay
(Loza, Parma, Florio, Duran, Brusich, Dayan) Centro Cardiovascular
Universitario, Universidad de la Republica del Uruguay, Montevideo,
Uruguay
Publisher
European Association for Cardio-Thoracic Surgery
Abstract
OBJECTIVES: Most evidence for anticoagulation (AC) in aortic bioprosthesis
is centred on embolic events, bleeding and reintervention risk. The effect
of AC on haemodynamics has not been previously assessed. Our hypothesis
was that patients with early AC after aortic valve replacement (AVR) with
porcine bioprosthesis have better haemodynamics at 1 year of follow-up.
<br/>METHOD(S): Prospective, randomized, open-label trial conducted at 2
cardiac surgery centres. All patients undergoing AVR with porcine
bioprosthesis were consecutively recruited. The anticoagulated group
received warfarin + aspirin and the non-anticoagulated (control) only
aspirin. The primary outcome was mean gradient after 1 year of AVR and
change in New York Heart Association class. Secondary outcomes were major
and minor bleeding, embolic events and prosthetic leak. <br/>RESULT(S): Of
140 participants in the study, 71 were assigned to the anticoagulated
group and 69 to the control group. The mean age of the overall population
was 72.4 (SD: 7.1) years. Global EuroSCORE was 7.65 (SD: 5.73). At 1 year,
the mean gradient was similar between both groups [18.6 (SD: 1.1 mmHg) and
18.1 (SD: 1.0 mmHg) in the control and anticoagulated groups,
respectively, P = 0.701]. No differences in functional class at 3 months
or 1 year were found among groups. No differences were found among groups
in the secondary outcomes. <br/>CONCLUSION(S): The addition of 3 months of
oral AC to anti-aggregation treatment was not detected to affect
bioprosthetic haemodynamics nor functional class at 1 year after AVR.
Likewise, AC does not lead to the higher incidence of
complications.<br/>Copyright &#xa9; The Author(s) 2022. Published by
Oxford University Press on behalf of the European Association for
Cardio-Thoracic Surgery. All rights reserved.

<41>
Accession Number
2024160453
Title
Joint 2022 European Society of Thoracic Surgeons and the American
Association for Thoracic Surgery guidelines for the prevention of
cancer-associated venous thromboembolism in thoracic surgery.
Source
European Journal of Cardio-thoracic Surgery. 63(1) (no pagination), 2023.
Article Number: ezac488. Date of Publication: 01 Jan 2023.
Author
Shargall Y.; Wiercioch W.; Brunelli A.; Murthy S.; Hofstetter W.; Lin J.;
Li H.; Linkins L.-A.; Crowther M.; Davis R.; Rocco G.; Morgano G.P.;
Schunemann F.; Muti-Schunemann G.; Douketis J.; Schunemann H.J.; Litle
V.R.
Institution
(Shargall) Department of Surgery, McMaster University, Hamilton, ON,
Canada
(Wiercioch, Morgano, Muti-Schunemann, Schunemann) Department of Health
Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON,
Canada
(Brunelli) Department of Thoracic Surgery, St. James's University
Hospital, Leeds, United Kingdom
(Murthy) Department of Thoracic and Cardiovascular Surgery, Cleveland
Clinic, Cleveland, OH, United States
(Hofstetter) Department of Thoracic and Cardiovascular Surgery, The
University of Texas MD Anderson Cancer Center, Houston, TX, United States
(Lin) Section of Thoracic Surgery, University of Michigan, Ann Arbor, MI,
United States
(Li) Department of Thoracic Surgery, Capital Medical University, Beijing,
China
(Linkins, Crowther, Douketis, Schunemann) Department of Medicine, McMaster
University, Hamilton, ON, Canada
(Davis) BurlingtonONCanada
(Rocco) Memorial Sloan Kettering Cancer Center, New York, NY, United
States
(Schunemann) Medizinische Fakultat, Albert-Ludwigs-Universitat Freiburg,
Freiburg, Germany
(Litle) Department of Surgery, Boston University School of Medicine,
Boston, MA, United States
Publisher
European Association for Cardio-Thoracic Surgery
Abstract
Background: Venous thromboembolism (VTE), which includes deep vein
thrombosis and pulmonary embolism, is a potentially fatal but preventable
postoperative complication. Thoracic oncology patients undergoing surgical
resection, often after multimodality induction therapy, represent among
the highest risk groups for postoperative VTE. Currently there are no VTE
prophylaxis guidelines specific to these thoracic surgery patients.
Evidenced-based recommendations will help clinicians manage and mitigate
risk of VTE in the postoperative period and inform best practice.
<br/>Objective(s): These joint evidence-based guidelines from The American
Association for Thoracic Surgery and the European Society of Thoracic
Surgeons aim to inform clinicians and patients in decisions about
prophylaxis to prevent VTE in patients undergoing surgical resection for
lung or esophageal cancer. <br/>Method(s): The American Association for
Thoracic Surgery and the European Society of Thoracic Surgeons formed a
multidisciplinary guideline panel that included broad membership to
minimize potential bias when formulating recommendations. The McMaster
University GRADE Centre supported the guideline development process,
including updating or performing systematic evidence reviews. The panel
prioritized clinical questions and outcomes according to their importance
for clinicians and patients. The Grading of Recommendations Assessment,
Development and Evaluation (GRADE) approach was used, including GRADE
Evidence-to-Decision frameworks, which were subject to public comment.
<br/>Result(s): The panel agreed on 24 recommendations focused on
pharmacological and mechanical methods for prophylaxis in patients
undergoing lobectomy and segmentectomy, pneumonectomy, and esophagectomy,
as well as extended resections for lung cancer. <br/>Conclusion(s): The
certainty of the supporting evidence for the majority of recommendations
was judged as low or very low, largely due to a lack of direct evidence
for thoracic surgery. The panel made conditional recommendations for use
of parenteral anticoagulation for VTE prevention, in combination with
mechanical methods, over no prophylaxis for cancer patients undergoing
anatomic lung resection or esophagectomy. Other key recommendations
include: conditional recommendations for using parenteral anticoagulants
over direct oral anticoagulants, with use of direct oral anticoagulants
suggested only in the context of clinical trials; conditional
recommendation for using extended prophylaxis for 28 to 35 days over
in-hospital prophylaxis only for patients at moderate or high risk of
thrombosis; and conditional recommendations for VTE screening in patients
undergoing pneumonectomy and esophagectomy. Future research priorities
include the role of preoperative thromboprophylaxis and the role of risk
stratification to guide use of extended prophylaxis.<br/>Copyright &#xa9;
2022 The American Association for Thoracic Surgery, European Association
for Cardio-Thoracic Surgery Published by Elsevier Inc and Oxford
University Press. All rights reserved.

<42>
Accession Number
2024156249
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) (no pagination), 2023. Article Number: 070096. 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, Gregory, Avidan) 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
Publisher
BMJ Publishing Group
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.

<43>
Accession Number
2024153766
Title
The effect of head and facial massage on sleep condition after coronary
artery bypass graft surgery.
Source
Traditional Medicine Research. 8(4) (no pagination), 2023. Article Number:
24. Date of Publication: 01 Apr 2023.
Author
Ozudi M.R.; Bagheri-Nesami M.; Setareh J.; Moosazadeh M.; Habibi V.;
Saatchi K.
Institution
(Ozudi) Student Research Committee, Mazandaran University of Medical
Sciences, Sari 4816715793, Iran, Islamic Republic of
(Bagheri-Nesami) Traditional and Complementary Medicine Research Center,
Addiction Institute, Mazandaran University of Medical Sciences, Sari
4816715793, Iran, Islamic Republic of
(Bagheri-Nesami) World Federation of Acupuncture-Moxibustion Societies
(WFAS), Beijing 100000, China
(Setareh) Psychiatry and Behavioral Sciences Research Center, Addiction
Institute, Mazandaran University of Medical Sciences, Sari 4816715793,
Iran, Islamic Republic of
(Moosazadeh) Gastrointestinal Cancer Research Center, Non-communicable
Diseases Institute, Mazandaran University of Medical Sciences, Sari
4816715793, Iran, Islamic Republic of
(Habibi) Department of Cardiac Surgery, Fatemeh Zahra Hospital, Mazandaran
University of Medical Sciences, Sari 4816715793, Iran, Islamic Republic of
(Saatchi) Board of Directors of Acupuncture Society of Iran, Tehran
1414734117, Iran, Islamic Republic of
Publisher
TMR Publishing Group
Abstract
Background: Sleep disorders after heart surgery lead to increased heart
rate, myocardial oxygen demand, and cause dysrhythmia that worsens heart
ischemia. The purpose of this study was to determine the effect of head
and facial massage on sleep conditions following coronary artery bypass
graft surgery. <br/>Material(s) and Method(s): A randomized controlled
trial was performed on 72 patients. They were randomly divided into
interventional (n = 36) and control groups (n = 36). On the third to fifth
day after the operation, head and the facial massage were done for 15 min
in the intervention group. The patients in the control group received only
routine care. Richard Campbell's Sleep Questionnaire was completed for
four consecutive days for each group. Data were analyzed in SPSS V26.
<br/>Result(s): Mean scores for sleep conditions before the intervention
no statistically significant difference seen between the two groups (P >
0.05). After the intervention, there was a statistically significant
difference between mean scores for sleep conditions of the interventional
and control groups (P < 0.001). Also with general estimated equation test
compared mean scores for sleep conditions between two groups. That
revealed sleep condition total score in the intervention group was more
than the control group and the trend of changes over time was
statistically significant (P < 0.001). <br/>Conclusion(s): Head and facial
massage is an effective nursing intervention in improving the sleep
condition of patients after coronary artery bypass graft. Due to the fact
that head and face massage is an easy method and brings patient
satisfaction, it is recommended to use this method as a suitable
supplement for drug therapy and postoperative interventions in these
patients.<br/>Copyright &#xa9; 2023 By Author(s). Published by TMR
Publishing Group Limited.

<44>
Accession Number
2024160652
Title
Multicentric randomized evaluation of a tricuspid valve percutaneous
repair system (clip for the tricuspid valve) in the treatment of severe
secondary tricuspid regurgitation Tri.Fr Design paper.
Source
European Heart Journal Cardiovascular Imaging. 23(12) (pp 1617-1627),
2022. Date of Publication: 01 Dec 2022.
Author
Donal E.; Leurent G.; Ganivet A.; Lurz P.; Coisne A.; De Groote P.;
Lafitte S.; Leroux L.; Karam N.; Biere L.; Rouleau F.; Sportouch C.;
Dreyfus J.; Nejjari M.; Josselin J.-M.; Anselmi A.; Galli E.; Bajeux E.;
Guerin P.; Obadia J.-F.; Trochu J.-N.; Oger E.
Institution
(Donal, Leurent, Anselmi, Galli) Univ Rennes, CHU Rennes, Inserm,
LTSI-UMR, Rennes 1099, France
(Ganivet) Direction for Research and Innovation, CHU Rennes, Rennes,
France
(Lurz) Heart Center, University of Leipzig, Leipzig, Germany
(Coisne, De Groote) CHU Lille, Department of Clinical Physiology and
Echocardiography, Univ Lille, U1011 -EGID, Lille, France
(Lafitte, Leroux) CHU Bordeaux, University of Bordeaux, Bordeaux, France
(Karam) University of Paris, Medico-Surgical Heart Valve Unit, European
Hospital Georges-Pompidou, INSERM, Paris U970, France
(Biere, Rouleau) Institute MitoVasc, Angers University, CHU Angers, CNRS
UMR6015, INSERM U, Angers 1083, France
(Sportouch) Clinique du Millenaire, Montpellier, France
(Dreyfus, Nejjari) Centre Cardiologique du Nord, Saint Denis, France
(Josselin, Bajeux) INSERM1085, IRSET, University Rennes, CHU Rennes,
Rennes, France
(Guerin, Trochu) Institut du Thorax, CHU Nantes, University Nantes,
Nantes, France
(Obadia) Department of Cardiac Surgery, Cardiologic CHU Lyon, University
Lyon, Lyon, France
(Oger) EA Reperes, CHU Rennes, University Rennes, Rennes, France
Publisher
Oxford University Press
Abstract
Aims Tricuspid regurgitation (TR) is associated with significant morbidity
and mortality. Its independent prognostic role has been repeatedly
demonstrated. However, this valvular heart condition is largely
undertreated because of the increased risk of surgical repair. Recently,
transcatheter techniques for the treatment of TR have emerged, but their
implications for the clinical endpoints are still unknown.Methods and The
Tri.fr trial will be a multicentre, controlled, randomized (1:1 ratio),
superior, open-label, and parallel-group results study conducted in 300
patients with severe secondary TR that is considered non-surgical by heart
teams. Inclusion will be possible only after core laboratory review of
transthoracic and transoesophageal echocardiography and after validation
by the clinical eligibility committee. A description of the mechanisms of
the TR will be conducted by the core laboratory. Atrial or ventricular
impacts on the severity of the secondary TR will be taken into account for
the randomization. The patients will be followed for 12-month, and the
primary outcome will be the Packer composite clinical endpoint [combining
New York Heart Association class, patient global assessment (PGA), and
major cardiovascular events]. It will test the hypothesis that a tricuspid
valve percutaneous repair strategy using a clip dedicated to the tricuspid
valve is superior to best guideline-directed medical therapy in
symptomatic patients with severe secondary TR.Conclusion Tri.fr will be
the first randomized, academic, multicentre study testing the value of
percutaneous correction in patients with severe secondary
TR.<br/>Copyright &#xa9; The Author(s) 2021.

<45>
[Use Link to view the full text]
Accession Number
2024319718
Title
Temporary mechanical circulatory support devices: Updates from recent
studies.
Source
Current Opinion in Cardiology. 36(4) (pp 375-383), 2021. Date of
Publication: 01 Jul 2021.
Author
Marbach J.A.; Chweich H.; Miyashita S.; Kapur N.K.
Institution
(Marbach, Chweich) Division of Pulmonary, Critical Care and Sleep
Medicine, Tufts Medical Center, Tufts University, School of Medicine,
Boston, MA, United States
(Marbach, Miyashita, Kapur) Department of Medicine, Tufts Medical Center,
Tufts University, School of Medicine, Boston, MA, United States
(Miyashita, Kapur) The Cardiovascular Center, Tufts Medical Center, Tufts
University, School of Medicine, Boston, MA, United States
Publisher
Lippincott Williams and Wilkins
Abstract
Purpose of reviewOver the past several years, the role of short-term
mechanical circulatory support (MCS) devices has become the dominant focus
in efforts to improve outcomes in patients with cardiogenic shock (CS).
Alongside these efforts, temporary MCS devices have been increasingly used
to support patients prior to cardiac surgery, during high-risk
percutaneous coronary intervention, awaiting cardiac transplantation, and
in the setting of refractory cardiac arrest. The present review aims to
provide an update on the recent literature evaluating the evolving role of
temporary MCS devices, and to provide insights into the current challenges
and future directions of MCS research.Recent findingsRecent observational
data have demonstrated potential roles for intra-aortic balloon pump
preoperatively in high-risk patients awaiting coronary artery bypass
grafting, and advanced heart failure patients awaiting transplantation.
Impella continues to demonstrate promising results as part of an early MCS
strategy in CS, as a temporary bridge to transplantation, and as a
mechanism for left ventricular unloading in patients on venoarterial
extracorporeal membrane oxygenation (ECMO). Finally, the first randomized
trial of ECMO facilitated resuscitation in the United States demonstrated
improved survival in patients with refractory out of hospital cardiac
arrest.SummaryThough randomized data remains limited, observational data
continue to support the role of temporary MCS devices in a variety of
clinical settings.<br/>Copyright &#xa9; 2021 Lippincott Williams and
Wilkins. All rights reserved.

<46>
Accession Number
2024317233
Title
Hybrid Ablation Versus Repeated Catheter Ablation in Persistent Atrial
Fibrillation: A Randomized Controlled Trial.
Source
JACC: Clinical Electrophysiology. (no pagination), 2023. Date of
Publication: 2023.
Author
van der Heijden C.A.J.; Weberndorfer V.; Vroomen M.; Luermans J.G.;
Chaldoupi S.-M.; Bidar E.; Vernooy K.; Maessen J.G.; Pison L.; van Kuijk
S.M.J.; La Meir M.; Crijns H.J.G.M.; Maesen B.
Institution
(van der Heijden, Bidar, Maessen, La Meir, Maesen) Department of
Cardiothoracic Surgery, Maastricht University Medical Center, Maastricht,
Netherlands
(Weberndorfer, Vroomen, Luermans, Chaldoupi, Vernooy, Crijns) Department
of Cardiology, Maastricht University Medical Center, Maastricht,
Netherlands
(Weberndorfer, Luermans, Chaldoupi, Bidar, Vernooy, Maessen, Crijns,
Maesen) Cardiovascular Research Institute Maastricht, Maastricht,
Netherlands
(Vroomen) Department of Cardiac Surgery, Robert Bosch Hospital, Stuttgart,
Germany
(Pison) Department of Cardiology, Hospital Oost Limburg, Genk, Belgium
(van Kuijk) Department of Clinical Epidemiology and Medical Technology
Assessment, Maastricht University Medical Centre, Maastricht, Netherlands
(La Meir) Department of Cardiac Surgery, UZ Brussel, Brussels, Belgium
Publisher
Elsevier Inc.
Abstract
Background: Although catheter ablation (CA) is successful for the
treatment of paroxysmal atrial fibrillation (AF), results are less
satisfactory in persistent AF. Hybrid ablation (HA) results in better
outcomes in patients with persistent atrial fibrillation (persAF), as it
combines a thoracoscopic epicardial and transvenous endocardial approach
in a single procedure. <br/>Objective(s): The purpose of this study was to
compare the effectiveness and safety of HA with CA in a prospective,
superiority, unblinded, randomized controlled trial. <br/>Method(s):
Forty-one ablation-naive patients with (long-standing)-persAF were
randomized to HA (n = 19) or CA (n = 22) and received pulmonary vein
isolation, posterior left atrial wall isolation and, if needed, a
cavotricuspid isthmus ablation. The primary efficacy endpoint was freedom
from any atrial tachyarrhythmia >5 minutes off antiarrhythmic drugs after
12 months. The primary and secondary safety endpoints included major and
minor complications and the total number of serious adverse events.
<br/>Result(s): After 12 months, the freedom of atrial tachyarrhythmias
off antiarrhythmic drugs was higher in the HA group compared with the CA
group (89% vs 41%, P = 0.002). There was 1 pericarditis requiring
pericardiocentesis and 1 femoral arteriovenous-fistula in the HA group. In
the CA arm, 1 bleeding from the femoral artery occurred. There were no
deaths, strokes, need for pacemaker implantation, or conversions to
sternotomy, and the number of (serious) adverse events was comparable
between groups (21% vs 14%, P = 0.685). <br/>Conclusion(s): Hybrid AF
ablation is an efficacious and safe procedure and results in better
outcomes than catheter ablation for the treatment of patients with
persistent AF. (Hybrid Versus Catheter Ablation in Persistent AF
[HARTCAP-AF]; NCT02441738)<br/>Copyright &#xa9; 2023 The Authors

<47>
Accession Number
2024278697
Title
Hydroxocobalamin for Vasodilatory Hypotension in Shock: A Systematic
Review With Meta-Analysis for Comparison to Methylene Blue.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2023.
Date of Publication: 2023.
Author
Brokmeier H.M.; Seelhammer T.G.; Nei S.D.; Gerberi D.J.; Mara K.C.;
Wittwer E.D.; Wieruszewski P.M.
Institution
(Brokmeier, Nei, Wieruszewski) Department of Pharmacy, Mayo Clinic,
Rochester, MN, United States
(Seelhammer, Wittwer, Wieruszewski) Department of Anesthesiology, Mayo
Clinic, Rochester, MN, United States
(Gerberi) Mayo Medical Libraries, Mayo Clinic, Rochester, MN, United
States
(Mara) Department of Quantitative Health Sciences, Division of Clinical
Trials and Biostatistics, Mayo Clinic, Rochester, MN, United States
Publisher
W.B. Saunders
Abstract
Hydroxocobalamin inhibits nitric oxide-mediated vasodilation, and has been
used in settings of refractory shock. However, its effectiveness and role
in treating hypotension remain unclear. The authors systematically
searched Ovid Medline, Embase, EBM Reviews, Scopus, and Web of Science
Core Collection for clinical studies reporting on adult persons who
received hydroxocobalamin for vasodilatory shock. A meta-analysis was
performed with random-effects models comparing the hemodynamic effects of
hydroxocobalamin to methylene blue. The Risk of Bias in Nonrandomized
Studies of Interventions tool was used to assess the risk of bias. A total
of 24 studies were identified and comprised mainly of case reports (n =
12), case series (n = 9), and 3 cohort studies. Hydroxocobalamin was
applied mainly for cardiac surgery vasoplegia, but also was reported in
the settings of liver transplantation, septic shock, drug-induced
hypotension, and noncardiac postoperative vasoplegia. In the pooled
analysis, hydroxocobalamin was associated with a higher mean arterial
pressure (MAP) at 1 hour than methylene blue (mean difference 7.80, 95% CI
2.63-12.98). There were no significant differences in change in MAP (mean
difference -4.57, 95% CI -16.05 to 6.91) or vasopressor dosage (mean
difference -0.03, 95% CI -0.12 to 0.06) at 1 hour compared to baseline
between hydroxocobalamin and methylene blue. Mortality was also similar
(odds ratio 0.92, 95% CI 0.42-2.03). The evidence supporting the use of
hydroxocobalamin for shock is limited to anecdotal reports and a few
cohort studies. Hydroxocobalamin appears to positively affect hemodynamics
in shock, albeit similar to methylene blue.<br/>Copyright &#xa9; 2023
Elsevier Inc.

<48>
Accession Number
2022867044
Title
Analysis of perioperative corticosteroid therapy in children undergoing
cardiac surgery: A systematic review and meta-analysis.
Source
Clinical Cardiology. (no pagination), 2023. Date of Publication: 2023.
Author
Chen D.; Du Y.
Institution
(Chen) Gastrointestinal Surgery, Chunzhou County Hospital of Huai'an City,
Huai'an, China
(Du) Pediatric Surgery, Huai'an Maternal and Child Health Care Hospital,
China
Publisher
John Wiley and Sons Inc
Abstract
The advantages and disadvantages of using corticosteroids in children
undergoing cardiac surgery is still contentious. To examine how
perioperative corticosteroids affect postoperative mortality and clinical
outcomes in pediatric cardiac surgery with cardiopulmonary bypass (CPB).
We used MEDLINE, EMBASE, and the Cochrane Database to conduct a
comprehensive search up through January 2023. Children aged 0-18
undergoing cardiac surgery were included in the meta-analysis of
randomized controlled studies comparing perioperative corticosteroids with
other therapeutic therapies, placebo, or no treatment. All-cause hospital
mortality was the primary endpoint of the study. Hospitalization duration
was a secondary result. The Cochrane Risk of Bias Assessment Tool was used
to evaluate the research quality. Ten trials and 7798 pediatric
participants were included in our analysis. Children taking
corticosteroids had no significant difference in all-cause in-hospital
mortality using a random-effect model with relative risk (RR) = 0.38, 95%
confidence interval (CI) = 0.16-0.91, I² = 79%, p =.03 for
methylprednisolone and RR = 0.29, 95% CI = 0.09-0.97, I² = 80%,
p =.04. For the secondary outcome, there was a significant difference
between the corticosteroid and placebo groups, with pooled standard mean
difference (SMD) = -0.86, 95% CI = -1.57 to -0.15, I² = 85%, p
=.02 for methylprednisolone and SMD = -0.97, 95% CI -1.90 to -0.04,
I² = 83%, p =.04 for dexamethasone. Perioperative
corticosteroids may not improve mortality, but they reduce hospital stay
compared to placebo. Further evidence from randomized controlled studies
with larger samples is required for approaching at a valid
conclusion.<br/>Copyright &#xa9; 2023 The Authors. Clinical Cardiology
published by Wiley Periodicals, LLC.

<49>
Accession Number
641183729
Title
Surgical vs Transcatheter Aortic Valve Replacement in Bicuspid Aortic
Valve Stenosis: A Systematic Review and Meta-analysis.
Source
Trends in cardiovascular medicine. (no pagination), 2023. Date of
Publication: 28 Apr 2023.
Author
Kang J.J.; Fialka N.M.; El-Andari R.; Watkins A.; Hong Y.; Mathew A.;
Bozso S.J.; Nagendran J.
Institution
(Kang, El-Andari, Hong, Bozso, Nagendran) Division of Cardiac Surgery,
Department of Surgery, University of Alberta, Edmonton, AB, Canada
(Fialka, Watkins) Faculty of Medicine and Dentistry, University of
Alberta, Edmonton, AB, Canada
(Mathew) Division of Cardiology, Department of Medicine, University of
Alberta, Edmonton, AB, Canada
Publisher
NLM (Medline)
Abstract
This systematic review and meta-analysis aim to provide a comprehensive
analysis of the literature directly comparing the outcomes of surgical
aortic valve replacement (SAVR) and TAVR in patients with BAV stenosis.
Medline, PubMed, and Scopus were systematically searched for articles
published between 2000-2023, 1,862 studies were screened, and 6
retrospective studies met the inclusion criteria. We included 6,550
patients in the final analyses: 3,292 and 3,258 in the SAVR and TAVR
groups, respectively. Both groups have similar rates of in-hospital
mortality (odds ratio (OR) 1.11; 95% CI 0.59-2.10; p=0.75) and stroke (OR
1.25; 95% CI 0.85-1.86; p=0.26. Patients who underwent SAVR experienced
lower rates of permanent pacemaker implantation (OR 0.54; 95% CI
0.35-0.83; p=0.005) and paravalvular leak (OR 0.47; 95% CI 0.26-0.86;
p=0.02). On the other hand, patients who underwent TAVR displayed lower
rates of acute kidney injury (OR 1.81; 95% CI 1.15-2.84; p=0.010), major
bleeding (OR 3.76; 95% CI 2.18-6.49; p<0.00001), and pulmonary
complications (OR 7.68; 95% CI 1.21-48.84; p=0.03). Despite the early
mortality data suggesting that TAVR may be a reasonable strategy for
patients with bicuspid AS with low to intermediate surgical risk, the
increased risk of PPI and PVL is concerning. A prospective, randomized,
controlled trial reporting long-term outcomes with pre-defined subgroup
analyses based on BAV morphology is paramount. In the interim, caution
should be exercised in the widespread adoption of TAVR in lower
surgical-risk patients.<br/>Copyright &#xa9; 2023. Published by Elsevier
Inc.

<50>
[Use Link to view the full text]
Accession Number
2024209806
Title
Effectiveness of the Family Heart Talk Communication Tool in Improving
Family Member Screening for Dilated Cardiomyopathy: Results of a
Randomized Trial.
Source
Circulation. 147(17) (pp 1281-1290), 2023. Date of Publication: 25 Apr
2023.
Author
Kinnamon D.D.; Jordan E.; Haas G.J.; Hofmeyer M.; Kransdorf E.; Ewald
G.A.; Morris A.A.; Owens A.; Lowes B.; Stoller D.; Tang W.H.W.; Garg S.;
Trachtenberg B.H.; Shah P.; Pamboukian S.V.; Sweitzer N.K.; Wheeler M.T.;
Wilcox J.E.; Katz S.; Pan S.; Jimenez J.; Aaronson K.D.; Fishbein D.P.;
Smart F.; Wang J.; Gottlieb S.S.; Judge D.P.; Moore C.K.; Mead J.O.;
Huggins G.S.; Ni H.; Burke W.; Hershberger R.E.
Institution
(Kinnamon, Jordan, Mead, Ni, Hershberger) Department of Internal Medicine,
Division of Human Genetics, The Ohio State University, Columbus, United
States
(Haas) The Davis Heart and Lung Research Institute, The Ohio State
University, Columbus, United States
(Kinnamon, Hershberger) Department of Internal Medicine, Division of
Cardiovascular Medicine, The Ohio State University, Columbus, United
States
(Hofmeyer) Medstar Research Institute, Washington Hospital Center, DC,
United States
(Kransdorf) Smidt Heart Institute, Cedars-Sinai Medical Center, Los
Angeles, CA, United States
(Ewald) Washington University, St. Louis, MO, United States
(Morris) Emory University, School of Medicine, Atlanta, GA, United States
(Owens) Center for Inherited Cardiovascular Disease, Division of
Cardiology, Perelman School of Medicine, University of Pennsylvania,
Philadelphia, United States
(Lowes, Stoller) University of Nebraska, Medical Center, Omaha, United
States
(Tang) Department of Cardiovascular Medicine, Heart, Vascular and Thoracic
Institute, Cleveland Clinic, OH, United States
(Garg) University of Texas, Southwestern Medical Center, Dallas, United
States
(Trachtenberg) Houston Methodist DeBakey Heart and Vascular Center, J.C.
Walter Jr. Transplant Center, TX, United States
(Shah) Inova Heart and Vascular Institute, Falls Church, VA, United States
(Pamboukian) University of Alabama, Birmingham, United States
(Sweitzer) University of Washington, Seattle, United States
(Wheeler) Division of Cardiology, Washington University, St. Louis, MO,
United States
(Wilcox) Northwestern University, Feinberg School of Medicine, Chicago,
IL, United States
(Katz) New York University, Langone Medical Center, NY, United States
(Pan) Department of Cardiology, Westchester Medical Center, New York
Medical College, Valhalla, NY, United States
(Jimenez) Miami Cardiac & Vascular Institute, Baptist Health South, FL,
United States
(Aaronson) University of Michigan, Medical Center, Ann Arbor, United
States
(Fishbein) University of Washington, Seattle, United States
(Smart) Louisiana State University, Health Sciences Center, New Orleans,
United States
(Wang) University of California, Los Angeles Medical Center, United States
(Gottlieb) University of Maryland, School of Medicine, Baltimore, United
States
(Judge) Medical University of South Carolina, Charleston, United States
(Moore) University of Mississippi, Medical Center, Jackson, United States
(Huggins) Cardiology Division, Tufts Medical Center, Tufts University,
School of Medicine, Boston, MA, United States
(Burke) Department of Bioethics and Humanities, University of Washington,
Seattle, United States
(Sweitzer) Sarver Heart Center, University of Arizona, Tucson, United
States
(Wheeler) Division of Cardiovascular Medicine, Stanford University, School
of Medicine, CA, United States
Publisher
Lippincott Williams and Wilkins
Abstract
Background: Managing disease risk among first-degree relatives of probands
diagnosed with a heritable disease is central to precision medicine. A
critical component is often clinical screening, which is particularly
important for conditions like dilated cardiomyopathy (DCM) that remain
asymptomatic until severe disease develops. Nonetheless, probands are
frequently ill-equipped to disseminate genetic risk information that
motivates at-risk relatives to complete recommended clinical screening. An
easily implemented remedy for this key issue has been elusive.
<br/>Method(s): The DCM Precision Medicine Study developed Family Heart
Talk, a booklet designed to help probands with DCM communicate genetic
risk and the need for cardiovascular screening to their relatives. The
effectiveness of the Family Heart Talk booklet in increasing
cardiovascular clinical screening uptake among first-degree relatives was
assessed in a multicenter, open-label, cluster-randomized, controlled
trial. The primary outcome measured in eligible first-degree relatives was
completion of screening initiated within 12 months after proband
enrollment. Because probands randomized to the intervention received the
booklet at the enrollment visit, eligible first-degree relatives were
limited to those who were alive the day after proband enrollment and not
enrolled on the same day as the proband. <br/>Result(s): Between June 2016
and March 2020, 1241 probands were randomized (1:1) to receive Family
Heart Talk (n=621) or not (n=620) within strata defined by site and
self-identified race/ethnicity (non-Hispanic Black, non-Hispanic White, or
Hispanic). Final analyses included 550 families (n=2230 eligible
first-degree relatives) in the Family Heart Talk arm and 561 (n=2416) in
the control arm. A higher percentage of eligible first-degree relatives
completed screening in the Family Heart Talk arm (19.5% versus 16.0%), and
the odds of screening completion among these first-degree relatives were
higher in the Family Heart Talk arm after adjustment for proband
randomization stratum, sex, and age quartile (odds ratio, 1.30 [1-sided
95% CI, 1.08-]). A prespecified subgroup analysis did not find evidence of
heterogeneity in the adjusted intervention odds ratio across
race/ethnicity strata (P=0.90). <br/>Conclusion(s): Family Heart Talk, a
booklet that can be provided to patients with DCM by clinicians with
minimal additional time investment, was effective in increasing
cardiovascular clinical screening among first-degree relatives of these
patients. Registration: URL: https://www.clinicaltrials.gov; Unique
identifier: NCT03037632.<br/>Copyright &#xa9; 2023 Lippincott Williams and
Wilkins. All rights reserved.

<51>
Accession Number
2024124060
Title
Hamartoma of mature cardiac myocytes: systematic review.
Source
Cardiovascular Pathology. 65 (no pagination), 2023. Article Number:
107538. Date of Publication: 01 Jul 2023.
Author
Techasatian W.; Gozun M.; Morihara C.; Pham A.; Benavente K.; Nagamine T.;
Nishimura Y.
Institution
(Techasatian, Gozun, Morihara, Pham, Benavente, Nagamine, Nishimura)
Department of Medicine, John A. Burns School of Medicine, University of
Hawai'i, Honolulu, HI, United States
Publisher
Elsevier Inc.
Abstract
Background: While primary cardiac tumors are rare, it has been
increasingly recognized due to improvement in screening measures. However,
the hamartoma of mature cardiac myocytes has been underrecognized compared
to other cardiac tumors, such as cardiac myxomas and papillary
fibroelastomas, and is still potentially associated with critical
consequences such as sudden death. This systematic review aims to
summarize the evidence regarding the hamartoma of mature cardiac myocytes
and characterize the presentations and symptoms for clinicians.
<br/>Method(s): Following the PRISMA statement, we searched MEDLINE and
EMBASE for all peer-reviewed articles using keywords including "hamartoma
of mature cardiac myocytes" from their inception to January 2, 2023.
<br/>Result(s): We included 25 articles, including 34 cases, in this
systematic review. Patients with hamartoma of mature cardiac myocytes
commonly presented with nonspecific symptoms such as dyspnea (35.3%),
although a few presented with sudden death and syncope. The left ventricle
was the common site of origin (41.2%), followed by the right atrium and
ventricle. Surgery was commonly pursued for diagnosis and treatment, while
a few required cardiac transplants (8.8%), and 29.4% were diagnosed with
autopsy or expired. <br/>Conclusion(s): Hamartoma of mature cardiac
myocytes is a potentially underrecognized primary cardiac tumor associated
with treatable yet potentially critical consequences. Given the challenges
of differentiating it from malignancy such as angiosarcoma, multimodal
imaging needs to be utilized to pursue a diagnosis. Future studies are
warranted to develop a noninvasive diagnosis mode for cardiac
tumor.<br/>Copyright &#xa9; 2023 Elsevier Inc.

<52>
Accession Number
2024109757
Title
Effect of preoperative inspiratory muscle training on postoperative
outcomes in patients undergoing cardiac surgery: A systematic review and
meta-analysis.
Source
World Journal of Clinical Cases. 11(13) (pp 2981-2991), 2023. Date of
Publication: 06 May 2023.
Author
Wang J.; Wang Y.-Q.; Shi J.; Yu P.-M.; Guo Y.-Q.
Institution
(Wang, Wang, Shi, Guo) Department of Cardiovascular Surgery, Sichuan
University West China Hospital, Sichuan Province, Chengdu 610041, China
(Yu) Rehabilitation Medicine Center, West China Hospital, Sichuan
University, Sichuan Province, Chengdu 610041, China
Publisher
Baishideng Publishing Group Inc
Abstract
BACKGROUND Cardiovascular disease is the most prevalent disease worldwide
and places a great burden on the health and economic welfare of patients.
Cardiac surgery is an important way to treat cardiovascular disease, but
it can prolong mechanical ventilation time, intensive care unit (ICU)
stay, and postoperative hospitalization for patients. Previous studies
have demonstrated that preoperative inspiratory muscle training could
decrease the incidence of postoperative pulmonary complications. AIM To
explore the effect of preoperative inspiratory muscle training on
mechanical ventilation time, length of ICU stay, and duration of
postoperative hospitalization after cardiac surgery. METHODS A literature
search of PubMed, Web of Science, Cochrane Library, EMBASE, China National
Knowledge Infrastructure, WanFang, and the China Science and Technology
journal VIP database was performed on April 13, 2022. The data was
independently extracted by two authors. The inclusion criteria were: (1)
Randomized controlled trial; (2) Accessible as a full paper; (3) Patients
who received cardiac surgery; (4) Preoperative inspiratory muscle training
was implemented in these patients; (5) The study reported at least one of
the following: Mechanical ventilation time, length of ICU stay, and/or
duration of postoperative hospitalization; and (6) In English language.
RESULTS We analyzed six randomized controlled trials with a total of 925
participants. The pooled mean difference of mechanical ventilation time
was -0.45 h [95% confidence interval (CI): -1.59-0.69], which was not
statistically significant between the intervention group and the control
group. The pooled mean difference of length of ICU stay was 0.44 h (95%CI:
-0.58-1.45). The pooled mean difference of postoperative hospitalization
was -1.77 d in the intervention group vs the control group [95%CI:
-2.41-(-1.12)]. CONCLUSION Preoperative inspiratory muscle training may
decrease the duration of postoperative hospitalization for patients
undergoing cardiac surgery. More high-quality studies are needed to
confirm our conclusion<br/>Copyright &#xa9; The Author(s) 2023. Published
by Baishideng Publishing Group Inc. All rights reserved.

<53>
Accession Number
2024106605
Title
Palliative oral care in terminal cancer patients: Integrated review.
Source
World Journal of Clinical Cases. 11(13) (pp 2966-2980), 2023. Date of
Publication: 06 May 2023.
Author
Silva A.R.P.; Bodanezi A.V.; Chrun E.S.; Lisboa M.L.; de Camargo A.R.;
Munhoz E.A.
Institution
(Silva, Bodanezi, de Camargo) Department of Dentistry, Federal University
of Santa Catarina, Florianopolis 88040-379, Brazil
(Chrun) Department of Pathology, Federal University of Santa Catarina,
Florianopolis 88040900, Brazil
(Lisboa) Professor Polydoro Sao Thiago Ernani Hospital, Federal University
of Santa Catarina, Florianopolis 88040900, Brazil
(Munhoz) Department of Dentistry, Health Science Centre, Federal
University of Santa Catarina, Florianopolis 88040-379, Brazil
Publisher
Baishideng Publishing Group Inc
Abstract
BACKGROUND Palliative care (PC) aims to improve quality of life in
patients and its families against life threatening diseases, through
suffering's prevention and relief. It is the duty of the dental surgeon to
possess the knowledge needed to treat a patient with little life span, in
order to establish an adequate treatment plan for each situation. AIM To
synthesize the published evidence on oral conditions, impact, management
and challenges in managing oral conditions among palliative patients.
METHODS Articles were selected from PubMed and Scopus electronic
platforms, using a research strategy with diverse descriptors related to
"palliative care", "cancer" and "oral health". The article's selection was
done in two phases. The first one was performed by the main researcher
through the reading of the abstracts. In the second phase two researchers
selected eligible articles after reading in full those previous selected.
Data was tabulated and analyzed, obtaining information about what is found
in literature related to this subject and what is necessary to be
approached in future researches about PC. RESULTS As results, the total of
15 articles were eligible, being one a qualitative analysis, 13 (92.8%)
clinical trials and one observational study. Of the 15 articles, 8 (53.4%)
involved questionnaires, while the rest involved: one systematic review
about oral care in a hospital environment, 2 oral exams and oral sample
collection, one investigation of terminal patient's (TP) oral assessment
records, 2 collection of oral samples and their respective analysis and
one treatment of the observed oral complications. CONCLUSION It can be
concluded that the oral manifestations in oncologic patients in terminal
stage are, oral candidiasis, dry mouth, dysphagia, dysgeusia, oral
mucositis and orofacial pain. Determining a protocol for the care of these
and other complications of cancer - or cancer therapy - based on
scientific evidence with the latest cutting-edge research results is of
fundamental importance for the multidisciplinary team that works in the
care of patients in PC. To prevent complications and its needed to initial
the dentist as early as possible as a multidisciplinary member. It has
been suggested palliative care protocol based on the up to date literature
available for some frequent oral complications in TP with cancer. Other
complications in terminal patients and their treatments still need to have
further studying<br/>Copyright &#xa9; The Author(s) 2023. Published by
Baishideng Publishing Group Inc. All rights reserved

<54>
Accession Number
2023287895
Title
Effects of Dexmedetomidine on Brain and Inflammatory Outcomes In Pediatric
Cardiac Surgery: A Systematic Review and Meta-Analysis of Randomized
Controlled Trials.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 37(6) (pp 1013-1020),
2023. Date of Publication: June 2023.
Author
Hashiya M.; Okubo Y.; Kato T.
Institution
(Hashiya) Department of Anesthesiology, National Center for Child Health
and Development, Tokyo, Japan
(Okubo, Kato) Department of Social Medicine, National Center for Child
Health and Development, Tokyo, Japan
Publisher
W.B. Saunders
Abstract
Objective: Dexmedetomidine use decreases adverse neurocognitive outcomes
in adults undergoing cardiovascular surgery, but its effect has been
unclear in children with congenital heart disease. <br/>Method(s): The
authors conducted a systematic review using the PubMed, Embase, and
Cochrane Library databases for randomized controlled trials (RCTs) that
compared intravenous dexmedetomidine with normal saline during pediatric
cardiac surgery under anesthesia. Published randomized controlled trials
that evaluated children aged <18 years who underwent congenital heart
surgery were included. Nonrandomized trials, observational studies, case
series and case reports, editorials, reviews, and conference papers were
excluded. The quality of the included studies was assessed using the
Cochrane revised tool for assessing risk-of-bias in randomized trials.
Meta-analysis was performed to estimate the effects of intravenous
dexmedetomidine on brain markers (neuron-specific enolase [NSE], S-100beta
protein) and inflammatory markers (interleukin-6, tumor necrosis factor
[TNF]-alpha, nuclear factor kappa-B [NF-kappaB]) during and after cardiac
surgery, using random-effect models for standardized mean difference
(SMD). <br/>Result(s): Seven RCTs involving 579 children were eligible for
the following meta-analyses. Most children underwent cardiac surgery for
atrial or ventricular septum defects. Pooled analyses (5 treatment groups
in 3 RCTs with 260 children) showed that dexmedetomidine use was
associated with reduced serum levels of NSE (pooled SMD, -0.54; 95% CI,
-0.96 to -0.12) and S-100beta (pooled SMD, -0.85; 95% CI, -1.67 to -0.04)
within 24 hours after the surgery. Also, dexmedetomidine use was
associated with reduced levels of interleukin-6 (pooled SMD, -1.55; 95%
CI, -2.82 to -0.27; 4 treatment groups in 2 RCTs with 190 children). In
contrast, the authors observed similar levels of TNF-alpha (pooled SMD,
-0.07; 95% CI, -0.33 to 0.19; 4 treatment groups in 2 RCTs with 190
children) and NF-kappaB (pooled SMD, -0.27; 95% CI, -0.62 to 0.09; 2
treatment groups in 1 RCT with 90 children) between the dexmedetomidine
and control groups. <br/>Conclusion(s): The authors' findings support the
effect of dexmedetomidine on reductions in brain markers among children
who undergo cardiac surgery. Further studies would be needed to elucidate
its clinically meaningful effects using cognitive functions in the long
term, and its effects among children who undergo more complex cardiac
surgeries.<br/>Copyright &#xa9; 2023 Elsevier Inc.

<55>
Accession Number
2022988943
Title
Family risk communication preferences in pediatric surgery: A scoping
review.
Source
Journal of Pediatric Surgery. 58(5) (pp 891-901), 2023. Date of
Publication: May 2023.
Author
Selvarajan A.; Arulanandam B.; Guadagno E.; Poenaru D.
Institution
(Selvarajan, Arulanandam, Poenaru) McGill University Faculty of Medicine
and Health Sciences, Montreal, QC, Canada
(Guadagno, Poenaru) Harvey E. Beardmore Division of Pediatric Surgery, The
Montreal Children's Hospital, McGill University Health Centre, Montreal,
QC, Canada
Publisher
W.B. Saunders
Abstract
Background: Effective patient-surgeon communication is vital in pediatric
surgical practice. However, family (including child) preferences for the
format and content of risk communication information are largely unknown.
In order to optimize the shared-decision making process, this scoping
review explored the family-preferred methods for risk communication in
pediatric surgery. <br/>Method(s): A search was conducted in 7 databases
from inception until June 2020 to identify family risk communication
preferences in pediatric surgical patients, with language restricted to
English and French. Two independent reviewers completed the screening in
Rayyan software following PRISMA protocol. Included publications were
reviewed for data extraction, analyzed, and assessed for risk of bias
using standardized instruments. <br/>Result(s): A total of 6370
publications were retrieved, out of which 70 were included. Studies were
predominantly from ENT (30.0%), general surgery (15.7%), and urology
(11.4%). Family-preferred risk communication methods were classified as
visual, verbal, technology-based, written, decision aids or other.
Technological (32.4%) and written tools (29.7%) were most commonly chosen
by families as their preferred risk communication methods. Written tools
were frequently used in general surgery and urology, while
technology-based tools were widely used in ENT. Most studies were
cross-sectional and had a significant risk of bias. <br/>Conclusion(s):
Eliciting families' preferences for risk communication methods is critical
for the implementation of shared decision-making. Different risk
communication media appear to be preferred within specific surgical
domains. To further improve shared-decision making in pediatric surgery,
the development and usage of robust, validated risk communication tools
are necessary. <br/>Level of Evidence: Level IV (Scoping
Review).<br/>Copyright &#xa9; 2023 The Author(s)

<56>
Accession Number
2022612176
Title
Impact of maintenance dose of eptifibatide in patients with ST-segment
elevation myocardial infarction who underwent primary percutaneous
coronary intervention.
Source
Egyptian Heart Journal. 75(1) (no pagination), 2023. Article Number: 28.
Date of Publication: December 2023.
Author
Jalalian R.; Bagheri B.; Yazdani Charati J.; Khalaghi S.; Iranian M.;
Mohammadi M.
Institution
(Jalalian, Bagheri, Khalaghi) Department of Cardiology, Faculty of
Medicine, Cardiovascular Research Center, Mazandaran University of Medical
Sciences, Sari, Iran, Islamic Republic of
(Yazdani Charati) Department of Biostatistics, Faculty of Health,
Mazandaran University of Medical Sciences, Sari, Iran, Islamic Republic of
(Iranian, Mohammadi) Rajaie Cardiovascular Medical and Research Center,
School of Medicine, Iran University of Medical Sciences, Tehran, Iran,
Islamic Republic of
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Background: ST-segment elevation myocardial infarction (STEMI) is usually
caused by a rupture in the atherosclerotic plaque, followed by platelet
aggregation which ultimately leads to acute coronary artery occlusion. So
far, few studies have investigated the effect of maintenance dose of
Eptifibatide (glycoprotein IIb/IIIa inhibitor) in STEMI patients who
underwent primary percutaneous coronary intervention (PPCI). Therefore, in
this study, we investigated the effect of maintenance dose of Eptifibatide
in patients with STEMI who underwent PPCI. 264 patients who had acute
chest pain suggestive of STEMI were entered in the study. All patients
received the same dose of bolus dose of Eptifibatide in the cardiac
catheterization laboratory. Then the patients were randomly divided into
two groups, one group (n = 147) received a maintenance dose of intravenous
Eptifibatide (infusion of 2 mug/kg/min) and the other group (n = 117) did
not receive this treatment. Standard medical treatment of STEMI after PPCI
was performed based on guidelines and the same in both groups. All
patients were evaluated 1, 2, and 3 months after the start of treatment in
terms of predicted outcomes. <br/>Result(s): The occurrence of 3-month
major adverse cardiovascular events (MACE) between the case and control
groups did not have a statistically significant difference (28.6% versus
35.0%; P value: 0.286). Also, investigations showed that the rate of
re-infarction (P value: 0.024) and target lesion revascularization (P
value: 0.003) was significantly lower in the group that received
Eptifibatide infusion. <br/>Conclusion(s): Eptifibatide maintenance dose
infusion in patients who undergo PPCI in the context of STEMI, does not
significantly reduce MACE, although it does significantly reduce
re-infarction and target lesion revascularization. It also does not
increase the risk of bleeding and cerebrovascular events.<br/>Copyright
&#xa9; 2023, The Author(s).

<57>
Accession Number
2021685597
Title
Chest Tube Management: Past, Present, and Future Directions for Developing
Evidence-Based Best Practices.
Source
Innovations: Technology and Techniques in Cardiothoracic and Vascular
Surgery. 18(1) (pp 41-48), 2023. Date of Publication: January/February
2023.
Author
Lobdell K.W.; Engelman D.T.
Institution
(Lobdell) Sanger Heart & Vascular Institute, Atrium Health, Charlotte, NC,
United States
(Engelman) Heart & Vascular Program, Baystate Health, University of
Massachusetts Medical School - Baystate, Springfield, MA, United States
Publisher
SAGE Publications Ltd
Abstract
In the field of modern cardiothoracic surgery, chest drainage has become
ubiquitous and yet characterized by a wide variation in practice.
Meanwhile, the evolution of chest drain technology has created gaps in
knowledge that represent opportunities for new research to support the
development of best practices in chest drain management. The chest drain
is an indispensable tool in the recovery of the cardiac surgery patient.
However, decisions about chest drain management-including those about
type, material, number, maintenance of patency, and the timing of
removal-are largely driven by tradition due to a scarcity of quality
evidence. This narrative review surveys the available evidence regarding
chest-drain management practices with the objective of highlighting
scientific gaps, unmet needs, and opportunities for further
research.<br/>Copyright &#xa9; The Author(s) 2023.

<58>
Accession Number
2021030768
Title
Coronary Revascularization in Patients With Diabetes: A Meta-Analysis of
Randomized Controlled Trials and Propensity-Matched Studies.
Source
Innovations: Technology and Techniques in Cardiothoracic and Vascular
Surgery. 18(1) (pp 29-40), 2023. Date of Publication: January/February
2023.
Author
Ahmed A.; Varghese K.S.; Fusco P.J.; Mathew D.M.; Mathew S.M.; Ahmed S.;
Rogando D.O.; Salazar S.A.; Pandey R.; Awad A.K.; Levy K.H.; Hernandez M.;
Calixte R.
Institution
(Ahmed, Varghese, Fusco, Mathew, Mathew, Ahmed, Rogando, Salazar, Pandey,
Awad, Levy, Hernandez) City University of New York School of Medicine, New
York, NY, United States
(Calixte) Epidemiology and Biostatistics, SUNY Downstate Health Sciences
University, Brooklyn, NY, United States
Publisher
SAGE Publications Ltd
Abstract
Objective: Patients with diabetes have poorer outcomes with coronary
artery disease (CAD) and pose a unique clinical population for
revascularization. We performed a pairwise meta-analysis of randomized
trials (RCTs) and propensity-matched observational studies (PMS) to
compare the clinical outcomes of coronary artery bypass grafting (CABG)
and percutaneous coronary intervention (PCI) in patients with diabetes.
<br/>Method(s): A comprehensive literature search was performed to
identify RCT and PMS studies comparing CABG with PCI in patients with
diabetes with concurrent CAD. Studies were pooled using the random-effects
model to perform a pairwise meta-analysis. Primary outcomes included
long-term all-cause mortality, cardiac mortality, myocardial infarction
(MI), major adverse cardiac and cerebrovascular events (MACCE), and repeat
revascularization. Meta-regression was used to explore the effects of
baseline risk factors on primary outcomes with moderate to high
heterogeneity. <br/>Result(s): A total of 18 RCTs and 9 PMS with 28,846
patients were included. PCI was associated with increased long-term
all-cause mortality (risk ratio [RR] = 1.34, P < 0.001), cardiac mortality
(RR = 1.52, P < 0.001), MI (RR = 1.51, P = 0.009), MACCE (RR = 1.65, P <
0.001), and repeat revascularization (RR = 2.48, P < 0.001) compared with
CABG. There was no difference in long-term stroke between the 2 groups (RR
= 0.95, P = 0.82). At meta-regression, a greater proportion of female
patients in studies was associated with a decreased protective benefit for
CABG for long-term all-cause mortality but an increased protective benefit
for long-term MI and repeat revascularization. <br/>Conclusion(s):
Revascularization of patients with diabetes using CABG is associated with
significantly reduced long-term mortality, MI, MACCE, and repeat
revascularizations. Future studies exploring the influence of gender on
revascularization outcomes are necessary to elucidate the ideal treatment
modality in patients with diabetes.<br/>Copyright &#xa9; The Author(s)
2023.

<59>
Accession Number
2012196783
Title
Difference in spontaneous myocardial infarction and mortality in
percutaneous versus surgical revascularization trials: A systematic review
and meta-analysis.
Source
Journal of Thoracic and Cardiovascular Surgery. 165(2) (pp 662-669.e14),
2023. Date of Publication: February 2023.
Author
Gaudino M.; Di Franco A.; Spadaccio C.; Rahouma M.; Robinson N.B.;
Demetres M.; Fremes S.; Doenst T.
Institution
(Gaudino, Di Franco, Rahouma, Robinson) Department of Cardiothoracic
Surgery, Weill Cornell Medicine, New York, NY, United States
(Spadaccio) Department of Cardiothoracic Surgery, Golden Jubilee National
Hospital, Glasgow, United Kingdom
(Demetres) Samuel J. Wood Library & C. V. Starr Biomedical Information
Center, Weill Cornell Medicine, New York, NY, United States
(Fremes) Division of Cardiac Surgery, Department of Surgery, Schulich
Heart Centre, Sunnybrook Health Sciences Centre, University of Toronto,
Toronto, ON, Canada
(Doenst) Department of Cardiothoracic Surgery, University Hospital Jena,
Friedrich Schiller University of Jena, Jena, Germany
Publisher
Elsevier Inc.
Abstract
Objectives: It has been hypothesized that the survival benefit of coronary
artery bypass (CABG) compared with percutaneous interventions (PCI) may be
associated with the reduction in spontaneous myocardial infarction (SMI)
achieved by surgery. This, however, has not been formally investigated.
The present meta-analysis aims to evaluate the association between the
difference in SMI and in survival in PCI versus CABG randomized controlled
trials (RCTs). <br/>Method(s): A systematic search was performed to
identify all RCTs comparing PCI with CABG for the treatment of coronary
artery disease and reporting SMI outcomes. Generic inverse variance method
was used to pool outcomes as natural logarithms of the incident rate
ratios across studies. Subgroup analysis and interaction test were used to
compare the difference of the primary outcome among trials that did and
did not report a significant reduction in SMI- in the patients treated by
CABG. Primary outcome was all-cause mortality; secondary outcome was SMI.
<br/>Result(s): Twenty RCTs were included in the meta-analysis. A
statistically significant difference in SMI in favor of CABG was found in
7 of the included trials (35%). Overall, PCI was associated with
significantly greater all-cause mortality (incident rate ratio, 1.13; 95%
confidence interval, 1.01-1.28). At subgroup analysis, a significant
difference in survival in favor of CABG was seen only in trials that
reported a significant reduction in SMI in the surgical arm (P for
interaction 0.02). <br/>Conclusion(s): In the published PCI versus CABG
trials, the reduction in all-cause mortality in the surgical arm is
associated with the protective effect of CABG against SMI.<br/>Copyright
&#xa9; 2021 The American Association for Thoracic Surgery

<60>
Accession Number
2024200753
Title
General Anesthesia Versus Local Anesthesia in Patients Undergoing
Transcatheter Aortic Valve Replacement: An Updated Meta-Analysis and
Systematic Review.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2023.
Date of Publication: 2023.
Author
Ahmed A.; Mathew D.M.; Mathew S.M.; Varghese K.S.; Khaja S.; Vega E.;
Pandey R.; Thomas J.J.; Mathew C.S.; Ahmed S.; George J.; Awad A.K.; Fusco
P.J.
Institution
(Ahmed, Mathew, Mathew, Varghese, Khaja, Vega, Pandey, Thomas, Mathew,
Ahmed, Fusco) City University of New York School of Medicine, New York, NY
(Awad, Awad) Faculty of Medicine, Ain Shams University, Cairo, Egypt
(George) University of Toledo College of Medicine and Life Sciences,
Toledo, OH
Publisher
W.B. Saunders
Abstract
Objectives: For patients with aortic stenosis, transcatheter aortic valve
replacement (TAVR) offers a less invasive treatment modality than
conventional surgical valve replacement. Although the surgery is performed
traditionally under general anesthesia (GA), recent studies have described
success with TAVR using local anesthesia (LA) and/or conscious sedation.
The study authors performed a pairwise meta-analysis to compare the
clinical outcomes of TAVR based on operative anesthesia management.
<br/>Design(s): A random effects pairwise meta-analysis via the
Mantel-Haenszel method. <br/>Setting(s): Not applicable, as this is a
meta-analysis. <br/>Participant(s): No individual patient data were used.
<br/>Intervention(s): Not applicable, as this is a meta-analysis.
<br/>Measurements and Main Results: The authors comprehensively searched
the PubMed, Embase, and Cochrane databases to identify studies comparing
TAVR performed using LA or GA. Outcomes were pooled as risk ratios (RR) or
standard mean differences (SMD) and their 95% CIs. The authors' pooled
analysis included 14,388 patients from 40 studies (7,754 LA; 6,634 GA).
Compared to GA TAVR, LA TAVR was associated with significantly lower rates
of 30-day mortality (RR 0.69; p < 0.01) and stroke (RR 0.78; p = 0.02).
Additionally, LA TAVR patients had lower rates of 30-day major and/or
life-threatening bleeding (RR 0.64; p = 0.01), 30-day major vascular
complications (RR 0.76; p = 0.02), and long-term mortality (RR 0.75; p =
0.009). No significant difference was seen between the 2 groups for a
30-day paravalvular leak (RR 0.88, p = 0.12). <br/>Conclusion(s):
Transcatheter aortic valve replacement performed using LA is associated
with lower rates of adverse clinical outcomes, including 30-day mortality
and stroke. No difference was seen between the 2 groups for a 30-day
paravalvular leak. These results support the use of minimally invasive
forms of TAVR without GA.<br/>Copyright &#xa9; 2023 Elsevier Inc.

<61>
Accession Number
2023101193
Title
A Randomized Trial of an Exclusive Human Milk Diet in Neonates with Single
Ventricle Physiology.
Source
Journal of Pediatrics. 256 (pp 105-112.e4), 2023. Date of Publication: May
2023.
Author
Blanco C.L.; Hair A.; Justice L.B.; Roddy D.; Bonagurio K.; Williams P.K.;
Machado D.; Marino B.S.; Chi A.; Takao C.; Gordon E.E.; Ashrafi A.; Cacho
N.; Pruetz J.D.; Costello J.M.; Cooper D.S.
Institution
(Blanco, Bonagurio) Division of Neonatology, Department of Pediatrics,
University of Texas Health Science Center and University Health, San
Antonio, TX, United States
(Hair) Division of Neonatology, Department of Pediatrics, Texas Children's
Hospital, Baylor College of Medicine, Houston, TX, United States
(Justice) Department of Cardiology, The Heart Institute, Cincinnati
Children's Hospital Medical Center, Cincinnati, OH, United States
(Roddy) Division of Pediatric Critical Care, Department of Pediatrics,
Texas Children's Hospital, Baylor College of Medicine, Houston, TX, United
States
(Williams) Division of Neonatal Perinatal Medicine, Department of
Pediatrics, Oklahoma Children's Hospital, University of Oklahoma Health
Sciences Center, Oklahoma City, OK, United States
(Machado) Pediatric Cardiac ICU, Congenital Heart Center, Shands Hospital
University of Florida, Gainesville, FL, United States
(Marino, Costello) Department of Pediatrics, Ann & Robert H. Lurie
Children's Hospital of Chicago, Chicago, IL, United States
(Marino) Department of Pediatric Cardiology, Cleveland Clinic Children's,
Cleveland, OH, United States
(Chi) Division of Neonatology, Cook Children's Medical Center, Fort Worth,
TX, United States
(Takao, Pruetz) Division of Cardiology, Department of Pediatrics,
Children's Hospital of Los Angeles, University of Southern California, Los
Angeles, CA, United States
(Gordon) Division of Critical Care, Department of Pediatrics, University
of Texas Southwestern., Dallas, TX, United States
(Ashrafi) Department of Pediatrics, Children's Hospital of Orange County,
Orange, CA, United States
(Cacho) Division of Neonatology, Congenital Heart Center, Department of
Pediatrics, Shands Hospital University of Florida, Gainesville, FL, United
States
(Costello) Pediatric Cardiology, Department of Pediatrics, Shawn Jenkins
Children's Hospital, Medical University of South Carolina, Charleston, SC,
United States
(Cooper) The Heart Institute, Cincinnati Children's Hospital Medical
Center, Department of Pediatrics, University of Cincinnati College of
Medicine, Cincinnati, OH, United States
Publisher
Elsevier Inc.
Abstract
Objective: To determine whether weight gain velocity (g/kg/day) 30 days
after the initiation of feeds after cardiac surgery and other clinical
outcomes improve in infants with single ventricle physiology fed an
exclusive human milk diet compared with a mixed human and bovine diet.
Study design: In this multicenter, randomized, single blinded, controlled
trial, term neonates 7 days of age or younger with single ventricle
physiology and anticipated cardiac surgical palliation within 30 days of
birth were enrolled at 10 US centers. Both groups received human milk if
fed preoperatively. During the 30 days after feeds were started
postoperatively, infants in the intervention group received human milk
fortified once enteral intake reached 60 mL/kg/day with a human milk-based
fortifier designed for term neonates. The control group received standard
fortification with formula once enteral intake reached 100 mL/kg/day.
Perioperative feeding and parenteral nutrition study algorithms were
followed. <br/>Result(s): We enrolled 107 neonates (exclusive human milk =
55, control = 52). Baseline demographics and characteristics were similar
between the groups. The median weight gain velocity at study completion
was higher in exclusive human milk vs control group (12 g/day [IQR, 5-18
g/day] vs 8 g/day [IQR, 0.4-14 g/day], respectively; P = .03). Other
growth measures were similar between groups. Necrotizing enterocolitis of
all Bell stages was higher in the control group (15.4 % vs 3.6%,
respectively; P = .04). The incidence of other major morbidities, surgical
complications, length of hospital stay, and hospital mortality were
similar between the groups. <br/>Conclusion(s): Neonates with single
ventricle physiology have improved short-term growth and decreased risk of
NEC when receiving an exclusive human milk diet after stage 1 surgical
palliation. Trial Registration: This trial is registered with
ClinicalTrials.gov (www.clinicaltrials.gov, Trial ID:
NCT02860702).<br/>Copyright &#xa9; 2022 Elsevier Inc.

<62>
Accession Number
2021978337
Title
Association between serum albumin and outcomes in heart failure and
secondary mitral regurgitation: the COAPT trial.
Source
European Journal of Heart Failure. 25(4) (pp 553-561), 2023. Date of
Publication: April 2023.
Author
Feng K.Y.; Ambrosy A.P.; Zhou Z.; Li D.; Kong J.; Zaroff J.G.; Mishell
J.M.; Ku I.A.; Scotti A.; Coisne A.; Redfors B.; Mack M.J.; Abraham W.T.;
Lindenfeld J.; Stone G.W.
Institution
(Feng, Ambrosy, Kong, Zaroff, Mishell, Ku) Department of Cardiology,
Kaiser Permanente San Francisco Medical Center, San Francisco, CA, United
States
(Ambrosy) Division of Research, Kaiser Permanente Northern California,
Oakland, CA, United States
(Zhou, Li, Scotti, Coisne, Redfors) Clinical Trials Center, Cardiovascular
Research Foundation, New York, NY, United States
(Redfors) Department of Cardiology, Sahlgrenska University Hospital,
Gothenburg, Sweden
(Redfors) NewYork-Presbyterian Hospital/Columbia University Medical
Center, New York, NY, United States
(Mack) Department of Cardiothoracic Surgery, Baylor Scott & White Health,
Plano, TX, United States
(Abraham) Division of Cardiovascular Medicine, Ohio State University
Medical Center, Columbus, OH, United States
(Lindenfeld) Advanced Heart Failure and Cardiac Transplantation Section,
Vanderbilt Heart and Vascular Institute, Nashville, TN, United States
(Stone) The Zena and Michael A. Wiener Cardiovascular Institute, Icahn
School of Medicine at Mount Sinai, New York, NY, United States
Publisher
John Wiley and Sons Ltd
Abstract
Aims: Low serum albumin levels are associated with poor prognosis in
numerous chronic disease states but the relationship between albumin and
outcomes in patients with heart failure (HF) and secondary mitral
regurgitation (SMR) has not been described. <br/>Methods and Results: The
randomized COAPT trial evaluated the safety and effectiveness of
transcatheter edge-to-edge repair (TEER) with the MitraClip^TM
plus guideline-directed medical therapy (GDMT) versus GDMT alone in
patients with symptomatic HF and moderate-to-severe or severe SMR.
Baseline serum albumin levels were measured at enrolment. Among 614
patients enrolled in COAPT, 559 (91.0%) had available baseline serum
albumin levels (median 4.0 g/dl, interquartile range 3.7-4.2 g/dl).
Patients with albumin <4.0 g/dl compared with >=4.0 g/dl were older and
more likely to have ischaemic cardiomyopathy and a hospitalization within
the year prior to enrolment. After multivariable adjustment, patients with
albumin <4.0 g/dl had higher 4-year rates of all-cause death (63.7% vs.
47.6%; adjusted hazard ratio 1.34, 95% confidence interval 1.02-1.74; p =
0.032), but there were no significant differences in HF hospitalizations
(HFH) or all-cause hospitalizations according to baseline serum albumin
level. The relative effectiveness of TEER plus GDMT versus GDMT alone was
consistent in patients with low and high albumin levels
(p<inf>interaction</inf> = 0.19 and 0.35 for death and HFH, respectively).
<br/>Conclusion(s): Low baseline serum albumin levels were independently
associated with reduced 4-year survival in patients with HF and severe SMR
enrolled in the COAPT trial, but not with HFH. Patients treated with TEER
derived similarly robust reductions in both death and HFH regardless of
baseline albumin level.<br/>Copyright &#xa9; 2023 European Society of
Cardiology.

<63>
Accession Number
2017662314
Title
Corticosteroids in patients undergoing cardiac surgery: A meta-analysis of
12,559 patients.
Source
Perfusion (United Kingdom). 38(4) (pp 853-859), 2023. Date of Publication:
May 2023.
Author
Chen L.; Xiang F.; Hu Y.
Institution
(Chen, Xiang, Hu) Department of Pharmacy, The Second Affiliated Hospital
of Wenzhou Medical University, Wenzhou, China
Publisher
SAGE Publications Ltd
Abstract
Objective: Corticosteroids can attenuate the inflammatory response to
cardiopulmonary bypass, but their benefits on clinical outcomes are
unclear. We conducted a meta-analysis to evaluate whether corticosteroid
therapy affects outcomes in patients undergoing cardiac surgery.
<br/>Method(s): We searched PubMed, Embase, EBSCO and Cochrane databases
from 1 January 2010 to 14 March 2022 for randomized controlled trials
(RCTs) that assessed corticosteroid versus non- corticosteroid therapy in
patients undergoing cardiac surgery. The primary outcome was in-hospital
mortality. Secondary outcomes were renal failure, infection, delirium,
intensive care unit (ICU) and hospital stay. <br/>Result(s): Four RCTs
including 12,559 patients (6265 randomized to corticosteroid therapy and
6294 to non-corticosteroid therapy) were included. One-hundred and 92 of
6265 patients (3.1%) randomized to the corticosteroid group versus 221 of
6294 patients (3.5%) randomized to the non-corticosteroid group
experienced death during hospitalization. Compared the control group,
corticosteroid therapy did not significantly reduce in-hospital mortality,
with an RR of 0.87 (0.72-1.06), p =.16. There was no difference in the
incidence of infection (RR 0.78 (0.56-1.10), p =.16), delirium during
hospitalization (RR 1.01 (0.90-1.14), p =.85), or the length of hospital
stay (MD -0.13 (-0.32 to 0.05), p =.17). However, corticosteroid therapy
significantly reduced the risk of renal failure (RR 0.82 (0.67-0.99), p
=.04), and the length of ICU stay (MD -0.41 (-0.65 to -0.17), p <.01).
<br/>Conclusion(s): Corticosteroids did not significantly reduce the rates
of in-hospital mortality, infection, or delirium, but reduce the incidence
of renal failure and the length of ICU stay.<br/>Copyright &#xa9; The
Author(s) 2022.

<64>
Accession Number
2016587284
Title
Respect versus resect approaches for mitral valve repair: A study-level
meta-analysis.
Source
Trends in Cardiovascular Medicine. 33(4) (pp 225-239), 2023. Date of
Publication: May 2023.
Author
Sa M.P.; Cavalcanti L.R.P.; Van den Eynde J.; Amabile A.; Escorel Neto
A.C.; Perazzo A.M.; Weymann A.; Ruhparwar A.; Sicouri S.; Bisleri G.;
Torregrossa G.; Geirsson A.; Ramlawi B.
Institution
(Sa, Torregrossa) Department of Cardiac Surgery, Lankenau Heart Institute
/ Main Line Health, Philadelphia, PA, United States
(Sa, Sicouri, Torregrossa) Division of Cardiac Surgery Research, Lankenau
Institute for Medical Research / Main Line Health, Philadelphia, PA,
United States
(Cavalcanti, Escorel Neto, Perazzo, Ramlawi) Division of Cardiovascular
Surgery of Pronto Socorro Cardiologico de Pernambuco - PROCAPE, Recife,
Brazil
(Cavalcanti, Escorel Neto, Perazzo, Ramlawi) University of Pernambuco -
UPE., Recife, Brazil
(Van den Eynde) Department of Cardiovascular Diseases, Unit of Cardiac
Surgery, University Hospitals Leuven, Leuven, Belgium
(Amabile, Geirsson) Division of Cardiac Surgery, Department of Surgery,
Yale School of Medicine, New Haven, CT, United States
(Weymann, Ruhparwar) Department of Thoracic and Cardiovascular Surgery,
West German Heart and Vascular Center Essen, University Hospital of Essen,
University Duisburg-Essen, Essen, Germany
(Bisleri) Division of Cardiac Surgery, University of Toronto, Toronto, ON,
Canada
Publisher
Elsevier Inc.
Abstract
Mitral valve repair (MVr) restores leaflets coaptation while preserving
the patient's own valve. The two main techniques are: (a) chordal
replacement ("respect approach"), whereby artificial neochordae are used
to resuspend prolapsed segments of the affected leaflet - and (b) leaflet
resection ("resect approach"), whereby diseased leaflet segment is
resected, and the remaining segments are sutured together. Both techniques
of MVr are associated with better long-term results, fewer valve-related
complications and lower mortality when compared with mitral valve
replacement (MVR). They also restore quality of life and improve survival
to rates equivalent to those of the general population. We performed a
meta-analysis to pool data of clinical studies that compared outcomes of
MVr stratified by the surgical technique. Seventeen studies accounting for
6,046 patients fulfilled our eligibility criteria. The "respect approach"
outperformed the "resect approach" with lower permanent pacemaker
implantation rates and lower mean gradients. Despite any possible
advantages of one technique over the other, which approach is best for
each patient must be decided on a case-by-case basis and more long-term
follow-up data are warranted.<br/>Copyright &#xa9; 2022

<65>
Accession Number
2015599783
Title
Ticagrelor for patients undergoing coronary artery bypass grafting: A
meta-analysis of randomized controlled trials.
Source
Perfusion (United Kingdom). 38(4) (pp 698-705), 2023. Date of Publication:
May 2023.
Author
Xiang F.; Lin Y.; Chen B.
Institution
(Xiang, Lin, Chen) Department of Pharmacy, The Second Affiliated Hospital,
Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
Publisher
SAGE Publications Ltd
Abstract
Objective: Ticagrelor may be an alternative to aspirin as it provides
robust and consistent platelet inhibition. However, the effect of
ticagrelor treatment in patients undergoing coronary artery bypass
grafting (CABG) has not been well confirmed. We conducted a meta-analysis
to appraise whether ticagrelor therapy affects outcomes in CABG patients.
<br/>Method(s): We searched PubMed, Embase, EBSCO, and Cochrane databases
from its inception up to 4 December 2020 for randomized controlled trials
that assessed ticagrelor versus non-ticagrelor in patients undergoing
CABG. The primary outcome was the incidence of saphenous vein graft (SVG)
occlusion at 1 year after CABG. Secondary outcomes were SVG occlusion at 7
days, major adverse cardiovascular events (MACE), and bleeding requiring
reoperation. <br/>Result(s): Seven trials including 4305 patients (2153
randomized to ticagrelor therapy and 2152 to non-ticagrelor therapy) were
included. One-hundred and thirty of 1140 patients (11.4%) randomized to
the ticagrelor group versus 175 of 1220 patients (14.3%) randomized to the
non-ticagrelor group experienced SVG occlusion at 1 year after CABG.
Compared to the control group, ticagrelor therapy yielded a significantly
lower risk of SVG occlusion [RR 0.79 (0.64-0.97), p = 0.03]. In the
subgroup analysis, ticagrelor plus aspirin compared with aspirin alone did
not decrease the risk of SVG occlusion after 1 year [RR 0.65 (0.40-1.07),
p = 0.09]. There was no difference in the incidence of SVG occlusion at 7
days [RR 0.67 (0.42-1.06), p = 0.09], MACE up to 1 year [RR 0.99
(0.81-1.21), p = 0.90], or bleeding requiring reoperation [RR 1.16
(0.80-1.70), p = 0.44]. <br/>Conclusion(s): Compared with non-ticagrelor
therapy, ticagrelor decreased the risk of saphenous vein graft occlusion
after 1 year in patients undergoing elective CABG with saphenous vein
grafting.<br/>Copyright &#xa9; The Author(s) 2022.

<66>
Accession Number
2015583769
Title
Non-heparin-induced thrombocytopenia in patients after open-heart surgery.
Source
Perfusion (United Kingdom). 38(4) (pp 781-790), 2023. Date of Publication:
May 2023.
Author
Keles E.; Bilen C.; Aygun H.; Gencpinar T.; Catalyurek H.
Institution
(Keles, Aygun) Bakircay University Cigli Training and Research Hospital,
Izmir, Turkey
(Bilen) Health Sciences University Dr Behcet Uz Training and Research
Hospital, Izmir, Turkey
(Gencpinar, Catalyurek) Dokuz Eylul University Hospital, Izmir, Turkey
Publisher
SAGE Publications Ltd
Abstract
Background: Thrombocytopenia (platelet count below 150 x
10³/muL) is a common finding after open-heart surgery and can
lead to various complications, including patient death. This study aimed
to determine the extent of non-heparin-induced thrombocytopenia in
open-heart surgery and to highlight the associated factors.
<br/>Material(s) and Method(s): In this cohort study, 842 patients who
underwent valve and/or coronary bypass surgery over a 5-year period were
retrospectively analyzed. After open-heart surgery, patients whose
platelet count was less than 150 x 10³/muL on a complete blood
count 12 and 24 h after surgery were classified as thrombocytopenic. Three
hundred twenty patients without thrombocytopenia and 21 patients with a
high probability of heparin-induced thrombocytopenia were excluded from
the study. Logistic regression analysis was used to assess the association
of independent variables in moderate-severe thrombocytopenia: Age groups,
sex, underlying disease, symptoms, type of surgery, pump time, pulsatile
or non-pulsatile duration, degree of hypothermia, hemodilution, oxygenator
type, use of an intra-aortic balloon, and erythrocyte transfusion counts
were included in the analysis. <br/>Result(s): A total of 501 patients
were diagnosed as having non-heparin-induced thrombocytopenia, and 64.3%
were male. Three hundred seventy-seven (75.2%) patients had mild
thrombocytopenia and 124 (24.7%) had moderate-severe thrombocytopenia. The
postoperative platelet count was significantly lower than the preoperative
platelet count (213 x 10³ vs.117 x 10³/muL; p <
0.001). Moderate-severe thrombocytopenia was associated with age >=80
years odds (OR = 9.026, 95% CI: [1.757-46.363]; p = 0.008), isolated valve
surgery (OR = 3.090, 95% CI: [1.867-5.114]; p < 0.001), and valve surgery
with coronary bypass (OR = 4.938, 95% CI: [1.638-14.889]; p = 0.005)
compared to isolated coronary bypass, type of oxygenator (Nipro vital
compared with Affinity OR = 11.097, 95% CI: [1.923-64.023]; p = 0.007),
erythrocyte transfusion count (OR = 1.219, 95%CI: [1.046-1.420]; p =
0.011). <br/>Conclusion(s): Age 80 years or older, surgical procedures
including heart-valve surgery, and the number of red blood cell
transfusions are associated with the risk of moderate-to-severe
thrombocytopenia. This study provides a guide in terms of risk factors
that may lead to moderate-to-severe thrombocytopenia after open-heart
surgery. However, future multicentre prospective randomized studies may
provide more detailed information on this subject.<br/>Copyright &#xa9;
The Author(s) 2022.

<67>
Accession Number
634773548
Title
Randomized Trial of Aspirin Versus Warfarin After Transcatheter Aortic
Valve Replacement in Low-Risk Patients.
Source
Circulation: Cardiovascular Interventions. 14(1) (pp E009983), 2021. Date
of Publication: 01 Jan 2021.
Author
Rogers T.; Shults C.; Torguson R.; Shea C.; Parikh P.; Bilfinger T.; Cocke
T.; Brizzio M.E.; Levitt R.; Hahn C.; Hanna N.; Comas G.; Mahoney P.;
Newton J.; Buchbinder M.; Moreno R.; Zhang C.; Craig P.; Asch F.M.;
Weissman G.; Garcia-Garcia H.M.; Ben-Dor I.; Satler L.F.; Waksman R.
Institution
(Rogers, Torguson, Shea, Zhang, Craig, Ben-Dor, Satler, Waksman) Section
of Interventional Cardiology, MedStar Washington Hospital Center, WA,
United States
(Shults) Department of Cardiac Surgery, MedStar Washington Hospital
Center, WA, United States
(Asch) MedStar Health Research Institute, MedStar Washington Hospital
Center, WA, United States
(Weissman, Garcia-Garcia) Department of Cardiology, MedStar Washington
Hospital Center, WA, United States
(Torguson) Cardiovascular Branch, Division of Intramural Research,
National Heart, Lung, and Blood Institute, National Institutes of Health,
Bethesda, MD, United States
(Parikh) Department of Cardiology, Stony Brook University Hospital, NY,
United States
(Bilfinger) Department of Cardiothoracic Surgery, Stony Brook University
Hospital, NY, United States
(Cocke) Department of Cardiology, The Valley Hospital, Ridgewood, NJ,
United States
(Brizzio) Department of Cardiothoracic Surgery, The Valley Hospital,
Ridgewood, NJ, United States
(Levitt) Henrico Cardiology Associates, Hca Virginia Health System, United
States
(Hahn) Cardiothoracic Surgical Associates - Richmond, Hca Virginia Health
System, United States
(Hanna) Department of Cardiology, St. John Health System, Tulsa, OK,
United States
(Comas) Department of Cardiothoracic Surgery, St. John Health System,
Tulsa, OK, United States
(Mahoney) Department of Cardiology, Sentara Norfolk General Hospital, VA,
United States
(Newton) Department of Cardiothoracic Surgery, Sentara Norfolk General
Hospital, VA, United States
(Buchbinder) Department of Cardiology, Foundation for Cardiovascular
Medicine, San Diego, CA, United States
(Moreno) Department of Cardiothoracic Surgery, Foundation for
Cardiovascular Medicine, San Diego, CA, United States
Publisher
Lippincott Williams and Wilkins
Abstract
Background: The optimal antithrombotic regimen after transcatheter aortic
valve replacement remains unclear. <br/>Method(s): In this randomized
open-label study, low-risk patients undergoing transfemoral transcatheter
aortic valve replacement at 7 centers in the United States were randomized
1:1 to low-dose aspirin or warfarin plus low-dose aspirin for 30 days.
Patients who could not be randomized were enrolled in a separate registry.
Computed tomography or transesophageal echocardiography was performed at
30 days. The primary effectiveness end point was a composite of the
following at 30 days: hypoattenuated leaflet thickening, at least
moderately reduced leaflet motion, hemodynamic dysfunction (mean aortic
valve gradient >=20 mm Hg, effective orifice area <=1.0 cm²,
dimensionless valve index <0.35, or moderate or severe aortic
regurgitation), stroke, or transient ischemic attack. <br/>Result(s):
Between July 2018 and October 2019, 94 patients were randomly assigned, 50
to aspirin and 44 to warfarin plus aspirin, and 30 were enrolled into the
registry. In the intention-to-treat analysis of the randomized cohort, the
composite primary effectiveness end point was met in 26.5% for aspirin
versus 7.0% for warfarin plus aspirin (P=0.014; odds ratio, 4.8 [95% CI,
1.3-18.3]). The rate of hypoattenuated leaflet thickening was 16.3% for
aspirin versus 4.7% for warfarin plus aspirin (P=0.07; odds ratio, 4.0
[95% CI, 0.8-20.0]). There was no excess bleeding at 30 days with
anticoagulation. In the as-treated analysis of pooled randomized and
registry cohorts, the rate of hypoattenuated leaflet thickening was 16.7%
for aspirin versus 3.1% for warfarin plus aspirin (P=0.011; odds ratio,
6.3 [95% CI, 1.3-30.6]). <br/>Conclusion(s): In low-risk transcatheter
aortic valve replacement patients, anticoagulation with warfarin may
prevent transcatheter heart valve dysfunction in the short term without
excess bleeding. Registration: URL: https://www.clinicaltrials.gov. Unique
identifier: NCT03557242.<br/>Copyright &#xa9; 2021 Lippincott Williams and
Wilkins. All rights reserved.

<68>
Accession Number
2022976569
Title
Association of Oral or Intravenous Vitamin C Supplementation with
Mortality: A Systematic Review and Meta-Analysis.
Source
Nutrients. 15(8) (no pagination), 2023. Article Number: 1848. Date of
Publication: April 2023.
Author
Xu C.; Yi T.; Tan S.; Xu H.; Hu Y.; Ma J.; Xu J.
Institution
(Xu, Hu, Ma, Xu) Department of Neurosurgery, West China Hospital, Sichuan
University, No. 37, Guoxue Alley, Wuhou District, Chengdu 610000, China
(Yi) Department of Neurology, The Second People's Hospital of Deyang City,
No. 340 Minjiang West Road, Deyang 618000, China
(Tan) Outpatient Department, West China Hospital, Sichuan University, No.
37, Guoxue Alley, Wuhou District, Chengdu 610000, China
(Xu) Department of Neurosurgery, The Second People's Hospital of Liangshan
Yi, Autonomous Prefecture, Liangshan 615000, China
Publisher
MDPI
Abstract
Mortality is the most clinically serious outcome, and its prevention
remains a constant struggle. This study was to assess whether intravenous
or oral vitamin C (Vit-C) therapy is related to reduced mortality in
adults. Data from Medline, Embase, and the Cochrane Central Register
databases were acquired from their inception to 26 October 2022. All
randomized controlled trials (RCTs) involving intravenous or oral Vit-C
against a placebo or no therapy for mortality were selected. The primary
outcome was all-cause mortality. Secondary outcomes were sepsis, COVID-19,
cardiac surgery, noncardiac surgery, cancer, and other mortalities.
Forty-four trials with 26540 participants were selected. Although a
substantial statistical difference was observed in all-cause mortality
between the control and the Vit-C-supplemented groups (p = 0.009, RR 0.87,
95% CI 0.78 to 0.97, I² = 36%), the result was not validated by
sequential trial analysis. In the subgroup analysis, mortality was
markedly reduced in Vit-C trials with the sepsis patients (p = 0.005, RR
0.74, 95% CI 0.59 to 0.91, I² = 47%), and this result was
confirmed by trial sequential analysis. In addition, a substantial
statistical difference was revealed in COVID-19 patient mortality between
the Vit-C monotherapy and the control groups (p = 0.03, RR 0.84, 95% CI
0.72 to 0.98, I² = 0%). However, the trial sequential analysis
suggested the need for more trials to confirm its efficacy. Overall, Vit-C
monotherapy does decrease the risk of death by sepsis by 26%. To confirm
Vit-C is associated with reduced COVID-19 mortality, additional clinical
random control trials are required.<br/>Copyright &#xa9; 2023 by the
authors.

<69>
[Use Link to view the full text]
Accession Number
2024169577
Title
Ultrasound- Versus Fluoroscopy-Guided Strategy for Transfemoral
Transcatheter Aortic Valve Replacement Access: A Systematic Review and
Meta-Analysis.
Source
Circulation: Cardiovascular Interventions. 14(10) (pp E010742), 2021. Date
of Publication: 01 Oct 2021.
Author
Kotronias R.A.; Bray J.J.H.; Rajasundaram S.; Vincent F.; Delhaye C.;
Scarsini R.; Marin F.; Terentes-Printzios D.; Halcox J.P.J.; Mamas M.A.;
Kharbanda R.; Van Belle E.; Banning A.P.
Institution
(Kotronias, Bray, Rajasundaram, Scarsini, Marin, Terentes-Printzios,
Kharbanda, Banning) Oxford Heart Centre, Oxford University Hospitals, Nhs
Trust, United Kingdom
(Kotronias) Department of Cardiovascular Medicine, University of Oxford,
United Kingdom
(Bray, Halcox) Institute of Life Sciences 2, Swansea Bay University Health
Board, Swansea University Medical School, United Kingdom
(Rajasundaram) University Hospital of Wales, Cardiff and Vale University
Health Board, United Kingdom
(Vincent, Delhaye, Van Belle) Centre Hospitalier Universitaire de
Lille-Cardiologie, France
(Delhaye) Department of Medicine, Division of Cardiology, University of
Verona, Italy
(Mamas) Keele Cardiovascular Research Group, Centre for Prognosis
Research, Keele University, United Kingdom
Publisher
Lippincott Williams and Wilkins
Abstract
Background: Access site vascular and bleeding complications remain
problematic for patients undergoing transcatheter aortic valve replacement
(TAVR). Ultrasound-guided transfemoral access approach has been suggested
as a technique to reduce access site complications, but there is wide
variation in adoption in TAVR. We performed a systematic review and
meta-analysis to compare access site vascular and bleeding complications
according to the Valve Academic Research Consortium-2 classification
following the use of either ultrasound- or conventional fluoroscopy-guided
transfemoral TAVR access. <br/>Method(s): Medline, Embase, Web of Science,
and The Cochrane Library were searched to November 2020 for studies
comparing ultrasound- and fluoroscopy-guided access for transfemoral TAVR.
A priori defined primary outcomes were extracted: (1) major, (2) minor,
and (3) major and minor (total) access site vascular complications and (4)
life-threatening/major, (5) minor, and (6) life-threatening, major, and
minor (total) access site bleeding complications. <br/>Result(s): Eight
observational studies (n=3875) were included, with a mean participant age
of 82.8 years, STS score 5.81, and peripheral vascular disease in 23.5%.
An ultrasound-guided approach was significantly associated with a reduced
risk of total (Mantel-Haenszel odds ratio [MH-OR], 0.50 [95% CI,
0.35-0.73]), major (MH-OR, 0.51 [95% CI, 0.35-0.74]), and minor (MH-OR,
0.59 [95% CI, 0.38-0.91]) access site vascular complications. Ultrasound
guidance was also significantly associated with total access site bleeding
complications (MH-OR, 0.59 [95% CI, 0.39-0.90]). The association remained
significant in sensitivity analyses of maximally adjusted minor and total
vascular access site complications (MH-OR, 0.51 [95% CI, 0.29-0.90];
MH-OR, 0.44 [95% CI, 0.20-0.99], respectively). <br/>Conclusion(s): In the
absence of randomized studies, our data suggests a potential benefit for
ultrasound guidance to obtain percutaneous femoral access in TAVR.
Registration: URL: https://www.crd.york.ac.uk/PROSPERO/; Unique
identifier: CRD42020218259.<br/>Copyright &#xa9; 2021 Lippincott Williams
and Wilkins. All rights reserved.

<70>
Accession Number
641176435
Title
Albumin Infusion and Blood Loss after Cardiac Surgery.
Source
The Annals of thoracic surgery. (no pagination), 2023. Date of
Publication: 27 Apr 2023.
Author
Talvasto A.; Ilmakunnas M.; Raivio P.; Vlasov H.; Hiippala S.; Suojaranta
R.; Wilkman E.; Petaja L.; Helve O.; Juvonen T.; Pesonen E.
Institution
(Talvasto, Ilmakunnas, Vlasov, Hiippala, Suojaranta, Wilkman, Petaja,
Pesonen) Department of Anesthesiology, Intensive Care and Pain Medicine,
University of Helsinki and Helsinki University Hospital, Helsinki, Finland
(Raivio, Juvonen) Department of Cardiac Surgery, Heart and Lung Center,
University of Helsinki and Helsinki University Hospital, Helsinki, Finland
(Helve) Children's Hospital, Pediatric Research Center, University of
Helsinki and Helsinki University Hospital, Helsinki, Finland; Infectious
Disease Control and Vaccinations Unit, Department of Health Security,
Finnish Institute for Health and Welfare, Helsinki, Finland
Publisher
NLM (Medline)
Abstract
BACKGROUND: In the recent ALBICS trial (ALBumin In Cardiac Surgery), 4%
albumin used for cardiopulmonary bypass priming and volume replacement
increased perioperative bleeding, compared to Ringer's acetate. In the
present exploratory study, albumin-related bleeding was further
characterized. <br/>METHOD(S): Ringer's acetate and 4% albumin were
compared in a randomized, double-blinded fashion in 1386 on-pump adult
cardiac surgical patients. The study endpoints for bleeding were the
Universal Definition of Perioperative Bleeding (UDPB) class and its
components. <br/>RESULT(S): The UDPB bleeding grades were higher in the
albumin than the Ringer group: "insignificant" (albumin vs. Ringer: 47.5%
vs. 62.9%), "mild" (12.7% vs. 8.9%), "moderate" (28.7% vs. 24.4%),
"severe" (10.2% vs. 3.2%), "massive" (0.9% vs. 0.6%), p<0.001. Patients in
the albumin group received red blood cells (45.2% vs. 31.5%, p<0.001, odds
ratio (OR) 1.80, 95% confidence interval (CI) 1.44-2.24), platelets (33.3%
vs.21.8%, p<0.001, OR 1.79, CI 1.41-2.28), and fibrinogen (5.6% vs. 2.6%,
p<0.05, OR 2.24: CI 1.27-3.95), and underwent resternotomy (5.3% vs. 1.9%,
p<0.001, OR 2.95, CI 1.55-5.60) more often than patients in the Ringer
group. The strongest predictors of bleeding were albumin group allocation
(OR 2.18, CI 1.74-2.74) and complex- (OR 2.61, CI 2.02-3.37) and urgent
surgery (OR 1.63, CI 1.26-2.13). In interaction analysis, the effect of
albumin on the risk of bleeding was stronger in patients on preoperative
acetylsalicylic acid. <br/>CONCLUSION(S): Perioperative administration of
albumin, compared to Ringer's acetate, resulted in increased blood loss
and higher UDBP class. The magnitude of this effect was similar to the
complexity and urgency of the surgery.<br/>Copyright &#xa9; 2023.
Published by Elsevier Inc.

<71>
Accession Number
2024277327
Title
Socioeconomic deprivation and prognostic outcomes in acute coronary
syndrome: A meta-analysis using multidimensional socioeconomic status
indices.
Source
International Journal of Cardiology. (no pagination), 2023. Date of
Publication: 2023.
Author
Anand V.V.; Zhe E.L.C.; Chin Y.H.; Goh R.S.J.; Lin C.; Kueh M.T.W.; Chong
B.; Kong G.; Tay P.W.L.; Dalakoti M.; Muthiah M.; Dimitriadis G.K.; Wang
J.-W.; Mehta A.; Foo R.; Tse G.; Figtree G.A.; Loh P.H.; Chan M.Y.; Mamas
M.A.; Chew N.W.S.
Institution
(Anand, Zhe, Chin) Lee Kong Chian School of Medicine, Nanyang
Technological University, Singapore
(Chin, Goh, Lin, Chong, Kong, Tay, Dalakoti, Muthiah, Wang, Foo, Loh,
Chan) Yong Loo Lin School of Medicine, National University Singapore,
Singapore
(Kueh) Royal College of Surgeons in Ireland and University College Dublin
Malaysia Campus, Malaysia
(Dalakoti, Foo, Loh, Chan, Chew) Department of Cardiology, National
University Heart Centre, National University Health System, Singapore
(Muthiah) Division of Gastroenterology and Hepatology, Department of
Medicine, National University Hospital, Singapore
(Muthiah) National University Centre for Organ Transplantation, National
University Health System, Singapore
(Dimitriadis) Faculty of Life Sciences and Medicine, School of Life Course
Sciences, King's College London, London, United Kingdom
(Dimitriadis) Department of Endocrinology ASO/EASO COM, King's College
Hospital NHS Foundation Trust, Denmark Hill, London, United Kingdom
(Wang) Department of Surgery, Cardiovascular Research Institute (CVRI),
National University of Singapore, Singapore
(Wang) Nanomedicine Translational Research Programme, Centre for
NanoMedicine, Yong Loo Lin School of Medicine, National University of
Singapore, Singapore
(Mehta) Division of Cardiology, Department of Internal Medicine, Virginia
Commonwealth University Pauley Heart Centre, Richmond, VA, United States
(Tse) Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular
Disease, Department of Cardiology, Tianjin Institute of Cardiology, Second
Hospital of Tianjin Medical University, Tianjin 300211, China
(Tse) Kent and Medway Medical School, Kent, Canterbury CT2 7NT, United
Kingdom
(Tse) School of Nursing and Health Studies, Hong Kong Metropolitan
University, Hong Kong
(Figtree) Northern Clinical School, Kolling Institute of Medical Research,
University of Sydney, Sydney, NSW, Australia
(Figtree) Department of Cardiology, Royal North Shore Hospital, Sydney,
NSW, Australia
(Mamas) Keele Cardiovascular Research Group, School of Medicine, Keele
University, Stoke-on-Trent, United Kingdom
(Mamas) Institute of Population Health, University of Manchester, United
Kingdom
Publisher
Elsevier Ireland Ltd
Abstract
Background: Low socioeconomic status (SES) is an important prognosticator
amongst patients with acute coronary syndrome (ACS). This paper analysed
the effects of SES on ACS outcomes. <br/>Method(s): Medline and Embase
were searched for articles reporting outcomes of ACS patients stratified
by SES using a multidimensional index, comprising at least 2 of the
following components: Income, Education and Employment. A comparative
meta-analysis was conducted using random-effects models to estimate the
risk ratio of all-cause mortality in low SES vs high SES populations,
stratified according to geographical region, study year, follow-up
duration and SES index. <br/>Result(s): A total of 29 studies comprising
of 301,340 individuals were included, of whom 43.7% were classified as low
SES. While patients of both SES groups had similar cardiovascular risk
profiles, ACS patients of low SES had significantly higher risk of
all-cause mortality (adjusted HR:1.19, 95%CI: 1.10-1.1.29, p < 0.001)
compared to patients of high SES, with higher 1-year mortality (RR:1.08,
95%CI:1.03-1.13, p = 0.0057) but not 30-day mortality (RR:1.07,
95%CI:0.98-1.16, p = 0.1003). Despite having similar rates of ST-elevation
myocardial infarction and non-ST-elevation ACS, individuals with low SES
had lower rates of coronary revascularisation (RR:0.95, 95%CI:0.91-0.99, p
= 0.0115) and had higher cerebrovascular accident risk (RR:1.25,
95%CI:1.01-1.55, p = 0.0469). Excess mortality risk was independent of
region (p = 0.2636), study year (p = 0.7271) and duration of follow-up (p
= 0.0604) but was dependent on the SES index used (p < 0.0001).
<br/>Conclusion(s): Low SES is associated with increased mortality
post-ACS, with suboptimal coronary revascularisation rates compared to
those of high SES. Concerted efforts are needed to address the global
ACS-related socioeconomic inequity. Registration and protocol: The current
study was registered with PROSPERO, ID: CRD42022347987.<br/>Copyright
&#xa9; 2023 Elsevier B.V.

<72>
Accession Number
2024264287
Title
The Influence of baseline glycemic status on the effects of intensive
blood pressure lowering: Results from the STEP randomized trial.
Source
European Journal of Internal Medicine. (no pagination), 2023. Date of
Publication: 2023.
Author
Yang R.; Wang Y.; Tong A.; Yu J.; Zhao D.; Cai J.
Institution
(Yang, Wang, Cai) Hypertension Center, Fuwai Hospital, State Key
Laboratory of Cardiovascular Disease, National Center for Cardiovascular
Diseases, Peking Union Medical College & Chinese Academy of Medical
Sciences, Beilishi Road 167, Xicheng District, Beijing 100037, China
(Tong) Department of Endocrinology, NHC key laboratory of Endocrinology,
Peking Union Medical College Hospital, Peking Union Medical College &
Chinese Academy of Medical Sciences, Beijing 100730, China
(Yu) Hypertension Center, Lanzhou University Second Hospital, No. 82
Cuiyingmen, Lanzhou 730030, China
(Zhao) Department of Cardiology, First Affiliated Hospital of Harbin
Medical University, No. 199 Dazhi Street, Harbin 150001, China
Publisher
Elsevier B.V.
Abstract
Background: Intensive systolic blood pressure (SBP) lowering showed
cardiovascular benefits in the Strategy of Blood Pressure Intervention in
the Elderly Hypertensive Patients (STEP) trial. We investigated whether
baseline glycemic status influences the effects of intensive SBP lowering
on cardiovascular outcomes. <br/>Method(s): In this post hoc analysis of
the STEP trial, participants were randomly assigned to receive intensive
(110 to <130 mmHg) or standard SBP treatment (130 to <150 mmHg) and
categorized by baseline glycemic status into three subgroups:
normoglycemia, prediabetes, and diabetes. The primary outcome was a
composite of stroke, acute coronary syndrome, acute decompensated heart
failure, coronary revascularization, atrial fibrillation, or death from
cardiovascular causes. A competing risk proportional hazards regression
model was used in the analysis. <br/>Result(s): Of the 8,318 participants,
3,275, 2,769, and 2,274 had normoglycemia, prediabetes, and diabetes,
respectively. Over a median follow-up of 3.33 years, intensive SBP
lowering significantly reduced the risk of the primary outcome (adjusted
hazard ratio 0.73, 95% confidence interval [CI] 0.59-0.91). The adjusted
hazard ratios for the primary outcome in the normoglycemia, prediabetes,
and diabetes subgroups were 0.72 (95% CI 0.49-1.04), 0.69 (95% CI
0.46-1.02), and 0.80 (95% CI 0.56-1.15), respectively. The intensive SBP
lowering strategy resulted in similar effects among participants in the
three subgroups (all interaction P >0.05). The sensitivity analyses showed
consistent results with the main analysis. <br/>Conclusion(s): The effects
of intensive SBP lowering on cardiovascular outcomes were consistent among
participants with normoglycemia, prediabetes, and diabetes.<br/>Copyright
&#xa9; 2023 European Federation of Internal Medicine

<73>
Accession Number
2024178266
Title
Preoperative risk assessment tools for morbidity after cardiac surgery: A
systematic review.
Source
European Journal of Cardiovascular Nursing. 21(7) (pp 655-664), 2022. Date
of Publication: 01 Sep 2022.
Author
Sanders J.; Makariou N.; Tocock A.; Magboo R.; Thomas A.; Aitken L.M.
Institution
(Sanders) St Bartholomew's Hospital, Barts Health NHS Trust, West
Smithfield, London EC1A 7DN, United Kingdom
(Sanders, Magboo, Thomas) William Harvey Research Institute, Queen Mary
University of London, Charterhouse Square, London, United Kingdom
(Makariou) Barts and the London Medical School, Queen Mary University of
London, Charterhouse Square, London, United Kingdom
(Tocock) Knowledge and Library Services, St Bartholomew's Hospital, Barts
Health NHS Trust, West Smithfield, London, United Kingdom
(Magboo, Thomas) Critical Care, St Bartholomew's Hospital, Barts Health
NHS Trust, West Smithfield, London, United Kingdom
(Aitken) School of Health Sciences, City, University of London,
Northampton Square, London, United Kingdom
Publisher
Oxford University Press
Abstract
Background: Postoperative morbidity places considerable burden on health
and resources. Thus, strategies to identify, predict, and reduce
postoperative morbidity are needed. <br/>Aim(s): To identify and explore
existing preoperative risk assessment tools for morbidity after cardiac
surgery. <br/>Method(s): Electronic databases (including MEDLINE, CINAHL,
and Embase) were searched to December 2020 for preoperative risk
assessment models for morbidity after adult cardiac surgery. Models
exploring one isolated postoperative morbidity and those in patients
having heart transplantation or congenital surgery were excluded. Data
extraction and quality assessments were undertaken by two authors.
<br/>Result(s): From 2251 identified papers, 22 models were found. The
majority (54.5%) were developed in the USA or Canada, defined morbidity
outcome within the in-hospital period (90.9%), and focused on major
morbidity. Considerable variation in morbidity definition was identified,
with morbidity incidence between 4.3% and 52%. The majority (45.5%)
defined morbidity and mortality separately but combined them to develop
one model, while seven studies (33.3%) constructed a morbidity-specific
model. Models contained between 5 and 50 variables. Commonly included
variables were age, emergency surgery, left ventricular dysfunction, and
reoperation/previous cardiac surgery, although definition differences
across studies were observed. All models demonstrated at least reasonable
discriminatory power [area under the receiver operating curve
(0.61-0.82)]. <br/>Conclusion(s): Despite the methodological heterogeneity
across models, all demonstrated at least reasonable discriminatory power
and could be implemented depending on local preferences. Future strategies
to identify, predict, and reduce morbidity after cardiac surgery should
consider the ageing population and those with minor and/or multiple
complex morbidities.<br/>Copyright &#xa9; 2022 The Author(s).

<74>
Accession Number
2024178265
Title
A systematic review, meta-Analysis, and meta-regression of patient
education for secondary prevention in patients with coronary heart
disease: Impact on psychological outcomes.
Source
European Journal of Cardiovascular Nursing. 21(7) (pp 643-654), 2022. Date
of Publication: 01 Sep 2022.
Author
Shi W.; Ghisi G.L.M.; Zhang L.; Hyun K.; Pakosh M.; Gallagher R.
Institution
(Shi, Zhang, Gallagher) Susan Wakil School of Nursing and Midwifery,
Faculty of Medicine and Health, The University of Sydney, Western Ave,
Camperdown, NSW 2050, Australia
(Shi, Zhang, Gallagher) Charles Perkins Centre, Faculty of Medicine and
Health, The University of Sydney, Sydney, Australia
(Ghisi) Cardiovascular Prevention and Rehabilitation Program, Toronto
Rehabilitation Institute, University Health Network, Toronto, ON, Canada
(Hyun) School of Health Sciences, Faculty of Medicine and Health,
University of Sydney, Sydney, Australia
(Pakosh) Library and Information Services, Toronto Rehabilitation
Institute, University Health Network, Toronto, ON, Canada
Publisher
Oxford University Press
Abstract
Background: Patient education is a cardiac rehabilitation core component
and is associated with improvements in self-management of patients with
coronary heart disease (CHD). However, the efficacy of such interventions
on psychosocial outcomes and relative impact of duration is less clear.
<br/>Objective(s): This study aimed to assess the efficacy of patient
education for secondary prevention related to behaviour change and risk
factor modification on psychological outcomes in CHD patients.
<br/>Design(s): A systematic review and meta-Analysis. Data sources:
PsycINFO, CINAHL, Embase, EmCare, MEDLINE, PubMed, and the Cochrane
Central Register of Controlled Trials were searched from inception to
February 2021. Eligibility criteria for study selection: Randomized
controlled trials (RCTs) evaluating patient education in CHD patients, or
following myocardial infarction, or revascularization compared with usual
care were identified. Outcomes included depression and anxiety at <6 and
6-12 months of follow-up. <br/>Result(s): A total of 39 RCTs and 8748
participants were included. Patient education significantly improved
participants' depressive symptoms at <6 (SMD-0.82) and 6-12 months
(SMD-0.38) of follow-up and anxiety level at <6 (SMD-0.90), and 6-12
months (SMD-0.32) of follow-up. Patient education also reduced the risk
for having clinical depression by 35% and anxiety by 60%. Longer patient
education of >=3 months, resulted in more improvement in depressive
symptoms at 6-12 months (coefficient-0.210) compared to shorter duration.
<br/>Conclusion(s): Patient education for secondary prevention reduces
anxiety and depressive symptoms in CHD patients. Regardless of intensity,
longer patient education improves depression more than short duration.
More information is needed on the relative impact of other intervention
components. Data registration: PROSPERO (CRD42020200504).<br/>Copyright
&#xa9; 2022 The Author(s).

<75>
Accession Number
2024178251
Title
Relationship between physical capacity and depression in heart failure
patients undergoing hybrid comprehensive telerehabilitation vs. usual
care: Subanalysis from the TELEREH-HF Randomized Clinical Trial.
Source
European Journal of Cardiovascular Nursing. 21(6) (pp 568-577), 2022. Date
of Publication: 01 Aug 2022.
Author
Piotrowicz E.; Mierzynska A.; Jaworska I.; Opolski G.; Banach M.; Zareba
W.; Kowalik I.; Pencina M.; Orzechowski P.; Szalewska D.; Pluta Sl.;
Glowczynska R.; Kalarus Z.; Irzmanski R.; Piotrowicz R.
Institution
(Piotrowicz, Orzechowski) Telecardiology Center, National Institute of
Cardiology, Alpejska 42, Warsaw 04-628, Poland
(Mierzynska, Kowalik, Piotrowicz) National Institute of Cardiology,
Alpejska 42 Street, Warsaw 04-628, Poland
(Jaworska) Department of Cardiac, Vascular and Endovascular Surgery and
Transplantology, Medical University of Silesia in Katowice, Silesian
Centre for Heart Diseases, M. Sklodowskiej-Curie 9 Street, Zabrze 41-800,
Poland
(Jaworska) Palliative Medicine Department, St. Camillus Hospital, Bytomska
22 Street, Tarnowskie Gory 42-606, Poland
(Opolski, Glowczynska) 1st Chair and Department of Cardiology, Medical
University of Warsaw, Zwirki i Wigury 61 Street, Warsaw 02-091, Poland
(Banach) Department of Hypertension, Medical University of Lodz, Al. T.
Kosciuszki 4 Street, Lodz 90-419, Poland
(Zareba) Department of Medicine, University of Rochester Medical Center,
Rochester, 601 Elmwood Ave, Rochester, NY 14642, United States
(Pencina) Department of Biostatistics and Bioinformatics, Duke University
School of Medicine, Durham, NC 27708, United States
(Szalewska) Chair and Clinic of Rehabilitation Medicine, Faculty of Health
Sciences, Medical University of Gdansk, M. Sklodowskiej-Curie 3a Street,
Gdansk 80-210, Poland
(Pluta) Silesian Center for Heart Diseases, M. Sklodowskiej-Curie 9
Street, Zabrze 41-800, Poland
(Kalarus) Division of Medical Sciences in Zabrze, Department of
Cardiology, Congenital Heart Disease and Electrotherapy, Medical
University of Silesia, Poniatowskiego 15 Street, Katowice 40-055, Poland
(Irzmanski) Department of Internal Medicine and Cardiac Rehabilitation,
Medical University of Lodz, Al. T. Kosciuszki Street, Lodz 90-419, Poland
(Piotrowicz) Department of Physiotherapy, College of Rehabilitation, M.
Kasprzaka 49 Street, Warsaw 01-234, Poland
Publisher
Oxford University Press
Abstract
Aims: The hybrid comprehensive telerehabilitation (HCTR) consisting of
telecare (with psychological telesupport), telerehabilitation, and remote
monitoring of cardiovascular implantable electronic devices might be an
option to improve both physical capacity and depressive symptoms. The aim
of the study was to investigate the influence of HCTR on depressive
symptoms and physical capacity in heart failure (HF) patients in
comparison with usual care (UC). <br/>Methods and Results: The present
analysis formed part of a multicentre, randomized trial that enrolled 850
HF patients (New York Heart Association I-III, left ventricular ejection
fraction ? 40%). Patients were randomized 1:1 to HCTR or UC. Patients
underwent an HCTR programme (1 week in hospital and 8 weeks at home;
exercise training 5 times weekly) or UC with observation. The Beck
Depression Inventory II (BDI-II) score (cut point for depression ? 14) was
used to assess depression and the physical capacity was measured by peak
oxygen consumption (peak VO2; mL/kg/min). Measurements were made before
and after 9-week intervention/observation (HCTR/UC group). Both groups
were comparable in terms of demographic and clinical characteristics. In
HCTR group, at entry, 23% of the sample obtained BDI-II scores ?14 vs.
27.5% in UC group. There were no significant differences between groups
regarding ?BDI-II score (P = 0.992) after 9-week HCTR/UC. There was a
significant improvement in physical capacity only in the HCTR group in
both patients with (P = 0.033) and without (P < 0.001) depression.
<br/>Conclusion(s): In HF patients, HCTR provided similar reduction of
depressive symptoms as UC. HCTR resulted in a significant improvement in
physical capacity in patients with and without depression.<br/>Copyright
&#xa9; 2022 Published on behalf of the European Society of Cardiology. All
rights reserved.

<76>
Accession Number
2024175247
Title
Achievement of ESC/EAS LDL-C treatment goals after an acute coronary
syndrome with statin and alirocumab.
Source
European Journal of Preventive Cardiology. 29(14) (pp 1842-1851), 2022.
Date of Publication: 01 Oct 2022.
Author
Landmesser U.; McGinniss J.; Steg Ph.G.; Bhatt D.L.; Bittner V.A.; Diaz
R.; Dilic M.; Goodman S.G.; Jukema J.W.; Loy M.; Pecin I.; Pordy R.;
Poulsen S.H.; Szarek M.; White H.D.; Schwartz G.G.
Institution
(Landmesser) Department of Cardiology, Charite Universitatsmedizin Berlin,
Berlin, Germany
(McGinniss) Regeneron Pharmaceuticals, Tarrytown, NY, United States
(Steg) Universite de Paris, Assistance Publique-Hopitaux de Paris, Hopital
Bichat, FACT (French Alliance for Cardiovascular Trials), INSERM U1148,
Paris, France
(Steg) National Heart and Lung Institute, Imperial College, Royal Brompton
Hospital, London, United Kingdom
(Bhatt) Department of Medicine, Brigham and Women's Hospital Heart and
Vascular Center, Harvard Medical School, 75 Francis Street, Boston, MA
02115, United States
(Bittner) University of Alabama at Birmingham, Birmingham, AL, United
States
(Diaz) Estudios Clinicos Latino America, Instituto Cardiovascular de
Rosario, Rosario, Argentina
(Dilic) University Clinical Center Sarajevo, Sarajevo, Bosnia and
Herzegovina
(Goodman) Canadian VIGOUR Centre, University of Alberta, Edmonton, AB,
Canada
(Goodman) St. Michael's Hospital, University of Toronto, Toronto, ON,
Canada
(Jukema) Leiden University Medical Center, Leiden, Netherlands
(Jukema) Netherlands Heart Institute, Utrecht, Netherlands
(Loy) Sanofi, NJ, United States
(Pecin) University of Zagreb, Zagreb School of Medicine, University
Hospital Center Zagreb, Zagreb, Croatia
(Pordy) Regeneron Pharmaceuticals, Tarrytown, NY, United States
(Poulsen) Aarhus Universitetshospital Skejby, Aarhus N, Denmark
(Szarek) State University of New York, Downstate School of Public Health,
Brooklyn, NY, United States
(Szarek) CPC Clinical Research, Division of Cardiology, University of
Colorado School of Medicine, Aurora, CO, United States
(White) Green Lane Cardiovascular Services Auckland City Hospital,
Auckland, New Zealand
(Schwartz) University of Colorado School of Medicine, Aurora, CO, United
States
Publisher
Oxford University Press
Abstract
Aims European guidelines set low-density lipoprotein cholesterol (LDL-C)
treatment goals,1.4 mmol/L after acute coronary syndrome (ACS), and,1.0
mmol/L for patients with recurrent cardiovascular events <=2 years. Many
ACS patients do not achieve these goals on statin alone. We examined
actual goal achievement with alirocumab and projected achievement with
ezetimibe, either added to optimized statin therapy. Methods The ODYSSEY
OUTCOMES trial (NCT01663402) compared alirocumab with placebo in 18 924
patients with recent and results ACS and hyperlipidaemia despite
high-intensity or maximum-tolerated statin therapy. This subanalysis
comprised 17 589 patients with LDL-C >=1.4 mmol/L at baseline who did not
receive ezetimibe treatment. High-intensity statin treatment was used in
88.8%. Median (interquartile range) baseline LDL-C was 2.3 (1.9-2.7)
mmol/L. With alirocumab, 94.6% of patients achieved LDL-C,1.4 mmol/L at
>=1 post-baseline measurement vs. 17.3% with placebo. Among 2236 patients
with a previous cardiovascular event within 2 years (before the qualifying
ACS), 85.2% vs. 3.5%, respectively, achieved LDL-C,1.0 mmol/L. Among
patients not treated with ezetimibe, we projected that its use would have
achieved LDL-C,1.4 and,1.0 mmol/L in 10.6 and 0%, respectively, at
baseline (assuming 18 + 3% reduction of LDL-C). Conclusion Among patients
with recent ACS and LDL-C >=1.4 mmol/L despite optimized statin therapy,
the addition of alirocumab allowed 94.6% to achieve the 2019 European
guideline LDL-C goal,1.4 mmol/L, and 85.2% of those with recurrent
cardiovascular events to achieve,1.0 mmol/L. In contrast, the addition of
ezetimibe to optimized statin therapy was projected to achieve LDL-C,1.4
mmol/L in only 10.6% of patients at baseline.<br/>Copyright &#xa9; The
Author(s) 2022. Published by Oxford University Press on behalf of the
European Society of Cardiology.

<77>
Accession Number
2023965974
Title
Aortic valve replacement reduces mortality in moderate aortic stenosis: A
systematic review and meta-Analysis.
Source
Journal of Geriatric Cardiology. 20(1) (pp 61-67), 2023. Date of
Publication: January 2023.
Author
Franke K.B.; Bhatia D.; Roberts-Thomson R,l.; Psaltis P.J.
Institution
(Franke, Bhatia, Psaltis) Adelaide Medical School, University of Adelaide,
Adelaide, Australia
(Franke, Psaltis) Vascular Research Centre, Lifelong Health Theme, South
Australian Health and Medical Research Institute, Adelaide, Australia
(Roberts-Thomson, Psaltis) Department of Cardiology, Royal Adelaide
Hospital, Adelaide, Australia
Publisher
Science Press
Abstract
BACKGROUND With the introduction of transcatheter aortic valve replacement
and an evolving understanding of the natural progression and history of
aortic stenosis, the potential for earlier intervention in appropriate
patients is promising; however, the benefit of aortic valve replacement in
moderate aortic stenosis remains unclear. METHODS Pubmed, Embase, and the
Cochrane Library databases were searched up until 30th of December 2021
using keywords including moderate aortic stenosis and aortic valve
replacement. Studies reporting all-cause mortality and outcomes in early
aortic valve replacement (AVR) compared to conservative management in
patients with moderate aortic stenosis were included. Hazard ratios were
generated using random-effects meta-Analysis to determine effect
estimates. RESULTS 3470 publications were screened with title and abstract
review, which left 169 articles for full-Text review. Of these studies, 7
met inclusion criteria and were included, totalling 4,827 patients. All
studies treated AVR as a time-dependent co-variable in cox-regression
multivariate analysis of all-cause mortality. Intervention with surgical
or transcatheter AVR was associated with a 45% decreased risk of all-cause
mortality (HR = 0.55 [0.42-0.68], I2 = 51.5%, P < 0.001). All studies were
representative of the overall cohort with appropriate sample sizes, with
no evidence of publication, detection, or information biases in any of the
studies. CONCLUSIONIn this systematic review and meta-Analysis, we report
a 45% reduction in all-cause mortality in patients with moderate aortic
stenosis who were treated with early aortic valve replacement compared to
a strategy of conservative management. Randomised control trials are
awaited to determine the utility of AVR in moderate aortic
stenosis.<br/>Copyright &#xa9; 2023 Science Press. All rights reserved.

<78>
Accession Number
2023291728
Title
Levosimendan or Milrinone for Ventricular Septal Defect Repair With
Pulmonary Arterial Hypertension.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 37(6) (pp 972-979),
2023. Date of Publication: June 2023.
Author
Nag P.; Chowdhury S.R.; Behera S.K.; Das M.; Narayan P.
Institution
(Nag, Chowdhury) Department of Cardiac Anesthesia, Rabindranath Tagore
International Institute of Cardiac Sciences, Narayana Health, Kolkata,
India
(Behera, Das, Narayan) Department of Cardiac Surgery, Rabindranath Tagore
International Institute of Cardiac Sciences, Narayana Health, Kolkata,
India
Publisher
W.B. Saunders
Abstract
Objective: Both milrinone and levosimendan have been used in patients
undergoing surgical closure of ventricular septal defects (VSD) with
pulmonary artery hypertension (PAH); however, the evidence base for their
use is limited. In the present study, the authors sought to compare the
role of levosimendan and milrinone in the prevention of low-cardiac-output
syndrome in the early postoperative period. <br/>Design(s): A prospective,
randomized, controlled trial. <br/>Setting(s): At a tertiary-care center.
<br/>Participant(s): Children between 1 month and 12 years presenting with
VSD and PAH between 2018 and 2020. <br/>Intervention(s): A total of 132
patients were randomized into the following 2 groups: Group L
(levosimendan group) and Group M (milrinone group). <br/>Measurements and
Main Results: In addition to conventional hemodynamic parameters, the
authors also included a myocardial performance index assessment to compare
the groups. The levosimendan group had significantly lower mean arterial
pressure while coming off cardiopulmonary bypass, after shifting to
intensive therapy unit, as well as at 3 and 6 hours postoperatively. The
duration of ventilation (29.6 +/- 13.9 hours v 23.2 +/- 13.3 hours; p =
0.012), as well as postoperative intensive care unit stay, were
significantly prolonged in the levosimendan group (5.48 +/- 1.2 v 4.7 +/-
1.3 days, p = 0.003). There were 2 (1.6%) in-hospital deaths in the entire
cohort, 1 in each arm. There was no difference in the myocardial
performance index of the left or right ventricle. <br/>Conclusion(s): In
patients undergoing surgical repair for VSD with PAH, levosimendan does
not confer any additional benefit compared to milrinone. Both milrinone
and levosimendan appear to be safe in this cohort.<br/>Copyright &#xa9;
2023 Elsevier Inc.

<79>
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.

<80>
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.

<81>
Accession Number
2014810044
Title
Characteristics and Quality of National Cardiac Registries: A Systematic
Review.
Source
Circulation: Cardiovascular Quality and Outcomes. 14(9) (pp E007963),
2021. Date of Publication: 01 Sep 2021.
Author
Dawson L.P.; Biswas S.; Lefkovits J.; Stub D.; Burchill L.; Evans S.M.;
Reid C.; Eccleston D.
Institution
(Dawson, Lefkovits, Burchill, Eccleston) Department of Cardiology, The
Royal Melbourne Hospital, Melbourne, VIC, Australia
(Dawson, Biswas, Lefkovits, Stub, Evans, Reid) Department of Epidemiology
and Preventive Medicine, Monash University, Melbourne, VIC, Australia
(Dawson, Stub) Department of Cardiology, The Alfred Hospital, Melbourne,
VIC, Australia
(Stub) The Baker Institute, Melbourne, VIC, Australia
(Burchill, Eccleston) Department of Medicine, Melbourne University, VIC,
Australia
(Reid) Curtin School of Population Health, Curtin University, Perth, WA,
Australia
Publisher
Lippincott Williams and Wilkins
Abstract
Background: National cardiac registries are increasingly used for
informing health policy, improving the quality and cost-effectiveness of
patient care, clinical research, and monitoring the safety of novel
treatments. However, the quality of registries is variable. We aimed to
assess the characteristics and quality of national cardiac registries
across all subspecialties of cardiac care. <br/>Method(s): Publications
relating to national cardiac registries across six cardiac subspecialty
domains were identified by searching MEDLINE and the Google advanced
search function with 26 438 citations and 4812 full-text articles
reviewed. <br/>Result(s): A total of 155 registries, representing 49
countries, were included in the study. Of these, 45 related to coronary
disease or percutaneous coronary intervention, 28 related to devices,
arrhythmia, and electrophysiology, 24 related to heart failure,
transplant, and mechanical support, 21 related to structural heart
disease, 21 related to congenital heart disease, and 16 related to cardiac
surgery. Enrollment was procedure-based in 60% and disease-based in 40%. A
total of 73.10 million patients were estimated to have been enrolled in
cardiac registries. Quality scoring was performed using a validated
registry grading system, with registries performing best in the use of
explicit variable definitions and worst in assessment of data reliability.
Higher quality scores were associated with government funding, mandated
enrollment, linkage to other registries, and outcome risk adjustment.
Quality scores and number of registries within a country were positively
correlated with each other and with measures of national economic output,
health expenditure, and urbanization. <br/>Conclusion(s): There has been
remarkable growth in the uptake of national cardiac registries across the
last few decades. However, the quality of processes used to ensure data
completeness and accuracy remain variable and few countries have
integrated registries covering multiple subspecialty domains. Clinicians,
funders, and health policymakers should be encouraged to focus on the
range, quality, and integration of these registries.<br/>Copyright &#xa9;
2021 Lippincott Williams and Wilkins. All rights reserved.

<82>
Accession Number
640377479
Title
Anterolateral territory coronary artery bypass grafting strategies: a
non-inferiority randomized clinical trial: the AMI-PONT trial.
Source
European journal of cardio-thoracic surgery : official journal of the
European Association for Cardio-thoracic Surgery. 63(4) (no pagination),
2023. Date of Publication: 03 Apr 2023.
Author
Stevens L.-M.; Chartrand-Lefebvre C.; Mansour S.; Beland V.; Soulez G.;
Forcillo J.; Basile F.; Prieto I.; Noiseux N.
Institution
(Stevens, Forcillo, Basile, Prieto, Noiseux) Division of Cardiac Surgery,
Department of Surgery, Centre Hospitalier de l'Universite de Montreal,
Montreal, QC, Canada
(Stevens, Chartrand-Lefebvre, Mansour, Beland, Soulez, Forcillo, Noiseux)
CHUM Research Centre (CRCHUM), Montreal, QC, Canada
(Chartrand-Lefebvre, Soulez) Department of Radiology, Centre Hospitalier
de l'Universite de Montreal, Montreal, QC, Canada
(Mansour) Division of Cardiology, Department of Medicine, Centre
Hospitalier de l'Universite de Montreal, Montreal, QC, Canada
Publisher
NLM (Medline)
Abstract
OBJECTIVES: The main objective was to assess whether a composite coronary
artery bypass grafting strategy including a saphenous vein graft bridge to
distribute left internal mammary artery outflow provides non-inferior
patency rates compared to conventional grafting surgery with separated
left internal mammary artery to left anterior descending coronary graft
and aorto-coronary saphenous vein grafts to other anterolateral targets.
<br/>METHOD(S): All patients underwent isolated grafting surgery with
cardiopulmonary bypass and received >=2 grafts/patients on the
anterolateral territory. The graft patency (i.e. non-occluded) was
assessed using multislice spiral computed tomography at 1 year.
<br/>RESULT(S): From 2012 to 2021, 208 patients were randomized to a
bridge (n=105) or conventional grafting strategy (n=103). Patient
characteristics were comparable between groups. The anterolateral graft
patency was non-inferior in the composite bridge compared to conventional
grafting strategy at 1 year [risk difference 0.7% (90% confidence interval
-4.8 to 6.2%)]. The graft patency to the left anterior descending coronary
was no different between groups (P=0.175). Intraoperatively, the bridge
group required shorter vein length for anterolateral targets (P < 0.001)
and exhibited greater Doppler flow in the mammary artery pedicle
(P=0.004). The composite outcome of death, myocardial infarction or target
vessel reintervention at 30days was no different (P=0.164).
<br/>CONCLUSION(S): Anterolateral graft patency of the composite bridge
grafting strategy is non-inferior to the conventional grafting strategy at
1 year. This novel grafting strategy is safe, efficient, associated with
several advantages including better mammary artery flow and shorter vein
requirement, and could be a valuable alternative to conventional grafting
strategies. Ten-year clinical follow-up is underway. TRIAL REGISTRATION:
ClinicalTrials.gov: NCT01585285.<br/>Copyright &#xa9; The Author(s) 2023.
Published by Oxford University Press on behalf of the European Association
for Cardio-Thoracic Surgery. All rights reserved.

<83>
Accession Number
2024178283
Title
Sex differences in mortality after first time, isolated coronary artery
bypass graft surgery: a systematic review and meta-analysis of randomized
controlled trials.
Source
European Journal of Cardiovascular Nursing. 21(8) (pp 759-771), 2022. Date
of Publication: 01 Nov 2022.
Author
Matthews S.; Buttery A.; O'neil A.; Sanders J.; Marasco S.; Fredericks S.;
Martorella G.; Keenan N.; Ghanes A.; Wynne R.
Institution
(Matthews, Buttery) National Heart Foundation of Australia, Melbourne,
VIC, Australia
(Matthews, O'neil) Melbourne School of Population & Global Health,
University of Melbourne, Parkville, VIC, Australia
(Matthews, Wynne) Royal Melbourne Hospital, Parkville, VIC, Australia
(O'neil) Food and Mood Centre, School of Medicine, Barwon Health, Deakin
University, iMPACT (the Institute for Mental and Physical Health and
Clinical Translation), Geelong, VIC, Australia
(Sanders) St Bartholomew's Hospital, Barts Health NHS Trust, London,
United Kingdom
(Sanders) William Harvey Research Institute, Charterhouse Square Barts,
London, United Kingdom
(Sanders) London School of Medicine and Dentistry Queen Mary University of
London, London EC1 M 6BQ, United Kingdom
(Marasco) Department of Surgery, The Alfred Hospital, Melbourne, VIC,
Australia
(Marasco) Department of Surgery, Monash University, Melbourne, VIC,
Australia
(Fredericks) Daphne Cockwell School of Nursing, Ryerson University, 350
Victoria St, Toronto m5B 2K3, Canada
(Martorella) Tallahassee Memorial Healthcare Center for Research and
Evidence-Based Practice, Florida State University, 98 Varsity Way,
Tallahassee, FL 32304, United States
(Keenan) St James Hospital, Dublin, Ireland
(Ghanes) Barwon Health, Geelong, VIC, Australia
(Wynne) School of Nursing and Midwifery, Deakin University , Gheringhap
Street, Geelong, VIC 3220, Australia
Publisher
Oxford University Press
Abstract
Aim: Reports of sex-specific differences in mortality after coronary
artery bypass graft surgery (CABGS) are contradictory. The review aim was
to determine whether CABGS is differentially efficacious than alternative
procedures by sex, on short- and longer-term mortality. <br/>Methods and
Results: EMBASE, CINAHL, Medline, and the Cochrane Library were searched.
Inclusion criteria: English language, randomized controlled trials from
2010, comparing isolated CABGS to alternative revascularization. Analyses
were included Mantel-Haenszel fixed-effects modelling, risk of bias
(Cochrane RoB2), and quality assessment (CONSORT). PROSPERO Registration
ID: CRD42020181673. The search yielded 4459 citations, and full-text
review of 29 articles revealed nine studies for inclusion with variable
time to follow-up. Risk of mortality for women was similar in pooled
analyses [risk ratio (RR) 0.94, 95% confidence interval (CI) 0.84-1.05, P
= 0.26] but higher in sensitivity analyses excluding 'high risk' patients
(RR 1.22, 95% CI 1.01-1.48, P = 0.04). At 30 days and 10 years, in
contrast to men, women had an 18% (RR 0.82, 95% CI 0.66-1.02, P = 0.08)
and 19% (RR 0.81, 95% CI 0.69-0.95, P = 0.01) mortality risk reduction. At
1-2 years women had a 7% (RR 1.07, 95% CI 0.69-1.64, P = 0.77), and at 2-5
years a 25% increase in risk of mortality compared with men (RR 1.25, 95%
CI 1.03-1.53, P = 0.03). Women were increasingly under-represented over
time comprising 41% (30 days) to 16.7% (10 years) of the pooled
population. <br/>Conclusion(s): Meta-analysis revealed inconsistent
sex-specific differences in mortality after CABGS. Trials with
sex-specific stratification are required to ensure appropriate
sex-differentiated treatments for revascularization. <br/>Copyright &#xa9;
2022 The Author(s). Published by Oxford University Press on behalf of
European Society of Cardiology. All rights reserved.

<84>
Accession Number
2022943799
Title
The Influence of Extracerebral Tissue on Continuous Wave Near-Infrared
Spectroscopy in Adults: A Systematic Review of In Vivo Studies.
Source
Journal of Clinical Medicine. 12(8) (no pagination), 2023. Article Number:
2776. Date of Publication: April 2023.
Author
Eleveld N.; Esquivel-Franco D.C.; Drost G.; Absalom A.R.; Zeebregts C.J.;
de Vries J.-P.P.M.; Elting J.W.J.; Maurits N.M.
Institution
(Eleveld, Esquivel-Franco, Drost, Elting, Maurits) Department of
Neurology, University Medical Centre Groningen, University of Groningen,
Postbus 30001, Groningen 9700 RB, Netherlands
(Drost) Department of Neurosurgery, University Medical Centre Groningen,
University of Groningen, Postbus 30001, Groningen 9700 RB, Netherlands
(Absalom) Department of Anaesthesiology, University Medical Centre
Groningen, University of Groningen, Postbus 30001, Groningen 9700 RB,
Netherlands
(Zeebregts, de Vries) Department of Surgery, Division of Vascular Surgery,
University Medical Centre Groningen, University of Groningen, Postbus
30001, Groningen 9700 RB, Netherlands
Publisher
MDPI
Abstract
Near-infrared spectroscopy (NIRS) is a non-invasive technique for
measuring regional tissue haemoglobin (Hb) concentrations and oxygen
saturation (rSO<inf>2</inf>). It may be used to monitor cerebral perfusion
and oxygenation in patients at risk of cerebral ischemia or hypoxia, for
example, during cardiothoracic or carotid surgery. However, extracerebral
tissue (mainly scalp and skull tissue) influences NIRS measurements, and
the extent of this influence is not clear. Thus, before more widespread
use of NIRS as an intraoperative monitoring modality is warranted, this
issue needs to be better understood. We therefore conducted a systematic
review of published in vivo studies of the influence of extracerebral
tissue on NIRS measurements in the adult population. Studies that used
reference techniques for the perfusion of the intra- and extracerebral
tissues or that selectively altered the intra- or extracerebral perfusion
were included. Thirty-four articles met the inclusion criteria and were of
sufficient quality. In 14 articles, Hb concentrations were compared
directly with measurements from reference techniques, using correlation
coefficients. When the intracerebral perfusion was altered, the
correlations between Hb concentrations and intracerebral reference
technique measurements ranged between <br/>r<br/> = 0.45-0.88. When the
extracerebral perfusion was altered, correlations between Hb
concentrations and extracerebral reference technique measurements ranged
between <br/>r<br/> = 0.22-0.93. In studies without selective perfusion
modification, correlations of Hb with intra- and extracerebral reference
technique measurements were generally lower (<br/>r<br/> < 0.52). Five
articles studied rSO<inf>2</inf>. There were varying correlations of
rSO<inf>2</inf> with both intra- and extracerebral reference technique
measurements (intracerebral: <br/>r<br/> = 0.18-0.77, extracerebral:
<br/>r<br/> = 0.13-0.81). Regarding study quality, details on the domains,
participant selection and flow and timing were often unclear. We conclude
that extracerebral tissue indeed influences NIRS measurements, although
the evidence (i.e., correlation) for this influence varies considerably
across the assessed studies. These results are strongly affected by the
study protocols and analysis techniques used. Studies employing multiple
protocols and reference techniques for both intra- and extracerebral
tissues are therefore needed. To quantitatively compare NIRS with intra-
and extracerebral reference techniques, we recommend applying a complete
regression analysis. The current uncertainty regarding the influence of
extracerebral tissue remains a hurdle in the clinical implementation of
NIRS for intraoperative monitoring. The protocol was pre-registered in
PROSPERO (CRD42020199053).<br/>Copyright &#xa9; 2023 by the authors.

<85>
Accession Number
2024226824
Title
Influence of Gender on Transcatheter Aortic Valve Implantation: A
Systematic Review and Meta-Analysis.
Source
Reviews in Cardiovascular Medicine. 24(4) (no pagination), 2023. Article
Number: 116. Date of Publication: April 2023.
Author
Lang Z.; Zhu Y.; Jiang G.; Ji P.; Zhang X.; Zhang Y.; Sun X.; Bai M.
Institution
(Lang, Zhang) The First Clinical Medical College of Lanzhou University,
Gansu, Lanzhou 730000, China
(Zhu, Jiang, Bai) The First Hospital of Lanzhou University, Heart Center,
Gansu Provincial Cardiovascular Disease Clinical Medical Research Center,
Gansu Provincial Key Laboratory of Cardiovascular Disease, Gansu, Lanzhou
730000, China
(Ji, Zhang, Sun) The Second Clinical Medical College of Lanzhou
University, Gansu, Lanzhou 730000, China
Publisher
IMR Press Limited
Abstract
Background: To assess whether there are differences in common
postoperative complications and survival between men and women after
transcatheter aortic valve implantation. <br/>Method(s): We searched the
Cochrane Library, PubMed, Embase, and the Web of Science from January 2000
to August 2022. Gender-related articles reporting complications and
mortality after transcatheter aortic valve implantation were identified.
The primary outcomes were the thirty-day mortality, one-year mortality and
perivalvular leakage. The secondary outcomes were conversion to open heart
surgery during operation, ejection fraction after operation,
reintervention and other common postoperative complications. Data were
pooled using the risk ratio or standardized mean difference with 95%
confidence interval. Subgroup analysis, meta-regression, sensitivity
analysis, egger's test and begg's test were performed. The original study
protocol was registered prospectively with PROSPERO (CRD42021245858).
<br/>Result(s): There were 24 studies, a total of 92,499 patients,
enrolled in our systematic review and meta-analysis, including 43,948 men
and 48,551 women. Comprehensive analysis showed significant differences in
gender in postoperative complications and survival after transcatheter
aortic valve implantation. Men had a significantly higher risk of
perivalvular leakage (risk ratio (RR) = 1.42; 95% CI: 1.15 to 1.75; p =
0.001; I² = 68%), but lower risk in bleeding (RR = 0.69; 95%
CI: 0.61 to 0.79; p < 0.00001; I² = 82%), vascular
complications (RR = 0.56; 95% CI: 0.52 to 0.61; p < 0.00001; I²
= 48%), and stroke (RR = 0.86; 95% CI: 0.80 to 0.93; p < 0.00001;
I² = 12%). The thirty-day mortality of men is slightly lower
than that of women (RR = 0.87; 95% CI: 0.81 to 0.93; p = 0.0001;
I² = 47%), the difference in one-year mortality was also
significant (RR = 1.20; 95% CI: 1.08 to 1.33; p = 0.0008; I² =
59%). Univariate meta-regression analyses showed that pulmonary
hypertension is the major source of heterogeneity in bleeding.
<br/>Conclusion(s): Men after transcatheter aortic valve implantation have
a lower risk of related postoperative complications, but a higher risk of
paravalvular leak and no advantage in medium-term survival.<br/>Copyright:
&#xa9; 2023 The Author(s). Published by IMR Press.

<86>
Accession Number
2024226820
Title
Intravenous Tranexamic Acid Reduces Post-Operative Bleeding and Blood
Transfusion in Patients Undergoing Aortic Surgery: A PRISMA-Compliant
Systematic Review and Meta-Analysis.
Source
Reviews in Cardiovascular Medicine. 24(4) (no pagination), 2023. Article
Number: 120. Date of Publication: April 2023.
Author
Zhang B.; He L.-X.; Yao Y.-T.
Institution
(Zhang) Department of Anesthesiology, Tianjin Union Medical Center,
Tianjin 300121, China
(He) Department of Anesthesiology, Fuwai Yunnan Cardiovascular Hospital,
Yunnan, Kunming 650000, China
(Yao) Department of Anesthesiology, Fuwai Hospital, National Center for
Cardiovascular Diseases, Peking Union Medical College, Chinese Academy of
Medical Sciences, Beijing 100037, China
Publisher
IMR Press Limited
Abstract
Background: Tranexamic acid (TXA), an antifibrinolytic agent, has been
demonstrated to reduce blood loss and transfusion requirements in both
cardiac and non-cardiac surgery. However, the evidence regarding the
efficacy of intravenous TXA in aortic surgery has been seldomly analyzed.
Therefore, the current study was performed to address this question.
<br/>Method(s): Searches of PubMed, EMBASE, OVID, Cochrane Library and
CNKI were conducted comprehensively for randomized controlled trials
(RCTs) comparing intravenous TXA versus no-TXA. Independently and in
duplicate, we reviewed titles, abstracts and full-text articles, extracted
data and evaluated bias risks. A random effect or fixed effect model was
utilized to pool data. <br/>Result(s): The database search yielded 4 RCTs
involving 273 patients. Meta-analysis revealed that, there was a
significant reduction in bleeding volume within the first 4 hours
post-operatively [(weighted mean difference (WMD) = -74.33; 95% confidence
interval (CI): -133.55 to -15.11; p = 0.01)], and the first 24 hours
post-operatively [(WMD = -228.91; 95% CI: -352.60 to -105.23; p =
0.0003)], post-operative red blood cell (RBC) transfusion volume [(WMD =
-420.00; 95% CI: -523.86 to -316.14; p < 0.00001)], fresh frozen plasma
(FFP) transfusion volume [(WMD = -360.35; 95% CI: -394.80 to -325.89; p <
0.00001)] and platelet concentrate (PC) transfusion volume [(WMD = -1.27;
95% CI: -1.47 to -1.07; p < 0.0001)] following intravenous TXA
administration. In addition, intravenous TXA administration significantly
decreased the incidence of postoperative complications (53/451 (8.2%) vs.
75/421 (13.9%); odds ratio (OR) = 0.47; 95% CI: 0.30 to 0.75; p = 0.001),
according to this present meta-analysis. <br/>Conclusion(s): The current
study preliminarily demonstrated that, TXA significantly reduced
postoperative bleeding, blood transfusion requirements and postoperative
complications among patients undergoing aortic surgery. More well-designed
studies are warrant to confirm the efficacy and safety of intravenous TXA
in patients undergoing aortic surgery.<br/>Copyright: &#xa9; 2023 The
Author(s). Published by IMR Press.

<87>
Accession Number
2024178133
Title
A rare variant of a ruptured sinus of valsalva aneurysm forming an
aorto-Atrial fistula: A case report and review of literature.
Source
European Heart Journal - Case Reports. 7(2) (no pagination), 2023. Article
Number: ytad018. Date of Publication: 01 Feb 2023.
Author
Dayco J.S.; Dsouza A.; Baciewicz F.; Cardozo S.
Institution
(Dayco, Cardozo) Department of Medicine, Division of Cardiology, Wayne
State University, 4201 St Antoine St, Suite 2E, Detroit, MI, United States
(Dsouza) Wayne State University School of Medicine, 4201 St Antoine St,
Suite 2E, Detroit, MI, United States
(Baciewicz) Department of Surgery, Division of Cardiothoracic Surgery,
Wayne State University, 4201 St Antoine St, Suite 2E, Detroit, MI, United
States
Publisher
Oxford University Press
Abstract
Background: Sinus of valsalva aneurysms (SOVAs) are infrequent findings
and generally diagnosed incidentally. A SOVA may be at risk for rupture,
which would lead to an aorto-cardiac shunt. These patients present
similarly to decompensated heart failure. Case Presentation: We present a
case of a 44-year-old female with a ruptured non-coronary SOVA diagnosed
by echocardiogram during evaluation for exertional dyspnoea. A
trans-oesophageal echocardiogram (TEE) revealed a 2.1cm non-coronary SOVA
with windsock communication to the right atrium. The patient refused
surgery, and two years later, presented with florid right heart failure
with preserved left ventricular function. The right ventricle was severely
dilated and hypokinetic with right atrial enlargement. After finally
agreeing to surgery, a pre-operative catheterization revealed
non-obstructive coronaries and a significant left to right shunt with
elevated pulmonary pressure. The patient had suboptimal response to
diuretic therapy and was sent for successful repair of the aneurysm with
the closure of the aorto-Atrial fistula via bovine pericardial patch and
resolution of the left to right shunt as demonstrated by intra-operative
TEE. Her right-sided heart failure symptoms subsequently resolved.
<br/>Discussion(s): SOVA is a rare finding but should still be considered
in the differential in young and middle-Aged patients with symptoms of
acute heart failure, hemodynamic compromise, and a new continuous heart
murmur. Early surgical repair is highly recommended to prevent acute and
long-Term complications. <br/>Copyright &#xa9; 2023 The Author(s).
Published by Oxford University Press on behalf of the European Society of
Cardiology.

<88>
Accession Number
641164733
Title
Vascular access for Transcatheter aortic valve replacement: A network
Meta-analysis.
Source
Journal of cardiology. (no pagination), 2023. Date of Publication: 26 Apr
2023.
Author
Yokoyama Y.; Sakata T.; Mikami T.; Misumida N.; Scotti A.; Takagi H.;
Sugiura T.; Kuno T.; Latib A.
Institution
(Yokoyama) Department of Surgery, St. Luke's University Health Network,
Bethlehem, PA, United States
(Sakata) Cardiovascular Research Institute, Icahn School of Medicine at
Mount Sinai, New York, NY, USA
(Mikami) Department of Neurology, Medford and Somerville, Tufts Medical
Center, MA, United States
(Misumida) Division of Cardiovascular Medicine, Gill Heart and Vascular
Institute, University of Kentucky, Lexington, United States
(Scotti, Kuno, Latib) Department of Cardiology, Montefiore Medical Center,
Albert Einstein College of Medicine, Bronx, NY, United States
(Takagi) Department of Cardiovascular Surgery, Shizuoka Medical Center,
Shizuoka, Japan
(Sugiura) Department of Cardiothoracic & Vascular Surgery, Montefiore
Medical Center, Albert Einstein College of Medicine, Bronx, NY, United
States
Publisher
NLM (Medline)
Abstract
BACKGROUND: The choice of an alternative access for transcatheter aortic
valve replacement (TAVR) remains controversial when transfemoral (TF)
access is not feasible. <br/>METHOD(S): We conducted a network
meta-analysis to compare the outcomes of TAVR via various peripheral
vascular accesses. MEDLINE and EMBASE were searched through July 2022 to
identify studies that investigated outcomes in patients who underwent TAVR
via TF, trans-subclavian (Tsc), transcarotid (TC), or transcaval (Tcav)
access. A network meta-analysis was conducted via random-effects model.
Outcomes of interest were major or life-threatening bleeding, stroke,
major vascular complication, and 30-day mortality. <br/>RESULT(S): No
randomized trial was identified. Our analysis included 33 observational
studies that enrolled a total of 43,455 patients who underwent TAVR via TF
(n=36,202), Tsc (n=3869), TC (n=3066), or Tcav (n=318) access. The risk of
major or life-threatening bleeding was higher via Tsc compared with TF
[odds ratio (OR); 95% confidence interval (CI) =1.51 (1.03-2.23),
p=0.034]. The risk of stroke was higher via Tsc compared with TF and Tcav
[OR (95% CI) =2.00 (1.14-3.52), p=0.018, OR (95% CI) =2.43 (1.03-5.74),
p=0.044, respectively]. The risk of major vascular complications was lower
via TC compared with Tsc, and Tcav and higher with Tcav compared with TF
and Tsc. 30-day mortality was higher via Tsc compared with TF. Tsc was
associated with higher risk of major or life-threatening bleeding compared
with TF, and higher risk of stroke compared to TF and Tcav. Tcav had the
highest risk of major vascular complications. <br/>CONCLUSION(S): In
patients who underwent TF, Tsc, TC, or Tcav TAVR, Tsc had a higher rate of
stroke compared to TF and Tcav, and major or life-threatening bleeding
compared to TF. The rate of major vascular complications in Tcav was the
highest among the four approaches.<br/>Copyright &#xa9; 2023. Published by
Elsevier Ltd.