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<1>
Accession Number
2025216433
Title
Cerebrovascular Events After Transcatheter Edge-to-Edge Repair and
Guideline-Directed Medical Therapy in the COAPT Trial.
Source
JACC: Cardiovascular Interventions. 16(12) (pp 1448-1459), 2023. Date of
Publication: 26 Jun 2023.
Author
Vincent F.; Redfors B.; Kotinkaduwa L.N.; Kar S.; Lim D.S.; Mishell J.M.;
Whisenant B.K.; Lindenfeld J.; Abraham W.T.; Mack M.J.; Stone G.W.
Institution
(Vincent, Redfors, Kotinkaduwa) Clinical Trials Center, Cardiovascular
Research Foundation, New York, NY, United States
(Vincent) Department of Cardiology, Regional Hospital ISSSTE Puebla,
Puebla, Mexico
(Redfors) Department of Cardiology, Sahlgrenska University Hospital,
Gothenburg, Sweden
(Redfors) Department of Molecular and Clinical Medicine, Sahlgrenska
Academy, Gothenburg University, Gothenburg, Sweden
(Kar) Los Robles Regional Medical Center, Thousand Oaks, CA, United States
(Kar) Bakersfield Heart Hospital, Bakersfield, CA, United States
(Lim) Division of Cardiology, University of Virginia, Charlottesville, VA,
United States
(Mishell) Kaiser Permanente San Francisco Hospital, San Francisco, CA,
United States
(Whisenant) Intermountain Medical Center, Murray, UT, United States
(Lindenfeld) Advanced Heart Failure and Cardiac Transplantation Section,
Vanderbilt Heart and Vascular Institute, Nashville, TN, United States
(Abraham) Department of Medicine, The Ohio State University, Columbus, OH,
United States
(Abraham) Department of Physiology and Cell Biology, The Ohio State
University, Columbus, OH, United States
(Abraham) Division of Cardiovascular Medicine, The Ohio State University,
Columbus, OH, United States
(Abraham) Davis Heart and Lung Research Institute, The Ohio State
University, Columbus, OH, United States
(Mack) Baylor Scott & White Heart Hospital Plano, Plano, TX, United States
(Stone) Zena and Michael A. Wiener Cardiovascular Institute, Icahn School
of Medicine at Mount Sinai, New York, NY, United States
Publisher
Elsevier Inc.
Abstract
Background: Little is known regarding the risk of cerebrovascular events
(CVE) in patients with heart failure and severe secondary mitral
regurgitation treated with transcatheter edge-to-edge repair (TEER).
 Objective(s): The study sought to examine the incidence, predictors,
timing, and prognostic impact of CVE (stroke or transient ischemic attack)
in the COAPT (Cardiovascular Outcomes Assessment of the Mitraclip
Percutaneous Therapy for Heart Failure Patients with Functional Mitral
Regurgitation) trial. Method(s): A total of 614 patients with heart
failure and severe secondary mitral regurgitation were randomized to TEER
plus guideline-directed medical therapy (GDMT) vs GDMT alone.
 Result(s): At 4-year follow-up, 50 CVEs occurred in 48 (7.8%) of the
614 total patients enrolled in the COAPT trial; Kaplan-Meier event rates
were 12.3% in the TEER group and 10.2 in the GDMT alone group (P = 0.91).
Within 30 days of randomization, CVE occurred in 2 (0.7%) patients
randomized to TEER and 0% randomized to GDMT (P = 0.15). Baseline renal
dysfunction and diabetes were independently associated with increased risk
of CVE, while baseline anticoagulation was associated with a reduction of
CVE. A significant interaction was present between treatment group and
anticoagulation such that TEER compared with GDMT alone was associated
with a reduced risk of CVE among patients with anticoagulation (adjusted
HR: 0.24; 95% CI: 0.08-0.73) compared with an increased risk of CVE in
patients without anticoagulation (adjusted HR: 2.27; 95% CI: 1.08-4.81;
P<inf>interaction</inf> = 0.001). CVE was an independent predictor of
death within 30 days after the event (HR: 14.37; 95% CI: 7.61, 27.14; P <
0.0001). Conclusion(s): In the COAPT trial, the 4-year rate of CVE
was similar after TEER or GDMT alone. CVE was strongly associated with
mortality. Whether anticoagulation is effective at reducing CVE risk after
TEER warrants further study. (Cardiovascular Outcomes Assessment of the
MitraClip Percutaneous Therapy for Heart Failure Patients With Functional
Mitral Regurgitation [The COAPT Trial] and COAPT CAS [COAPT);
NCT01626079) Copyright © 2023 American College of Cardiology
Foundation

<2>
Accession Number
2025146741
Title
Minithoracotomy vs Conventional Sternotomy for Mitral Valve Repair: A
Randomized Clinical Trial.
Source
JAMA. 329(22) (pp 1957-1966), 2023. Date of Publication: 13 Jun 2023.
Author
Akowuah E.F.; Maier R.H.; Hancock H.C.; Kharatikoopaei E.; Vale L.;
Fernandez-Garcia C.; Ogundimu E.; Wagnild J.; Mathias A.; Walmsley Z.;
Howe N.; Kasim A.; Graham R.; Murphy G.J.; Zacharias J.
Institution
(Akowuah, Graham) Department of Cardiac Surgery, The James Cook University
Hospital, South Tees Hospitals NHS Foundation Trust, Middlesbrough, United
Kingdom
(Maier) Academic Cardiovascular Unit, The James Cook University Hospital,
South Tees Hosptials NHS Foundation Trust, Middlesbrough, United Kingdom
(Hancock, Mathias, Walmsley, Howe) Newcastle Clinical Trials Unit,
Newcastle University, Newcastle Upon Tyne, United Kingdom
(Kharatikoopaei, Wagnild, Kasim) Department of Anthropology, Durham
University, Durham, United Kingdom
(Vale, Fernandez-Garcia) Population Health Sciences Institute, Newcastle
University, Newcastle Upon Tyne, United Kingdom
(Ogundimu) Department of Mathematical Sciences, Durham University, Durham,
United Kingdom
(Kasim) GSK, United Kingdom
(Murphy) Department of Cardiovascular Sciences, NIHR Leicester Biomedical
Research Unit in Cardiovascular Medicine, University of Leicester,
Leicester, United Kingdom
(Zacharias) The Lancashire Cardiac Center, Blackpool Teaching Hospitals
NHS Foundation Trust, Blackpool, United Kingdom
Publisher
American Medical Association
Abstract
Importance: The safety and effectiveness of mitral valve repair via
thoracoscopically-guided minithoracotomy (minithoracotomy) compared with
median sternotomy (sternotomy) in patients with degenerative mitral valve
regurgitation is uncertain. Objective(s): To compare the safety and
effectiveness of minithoracotomy vs sternotomy mitral valve repair in a
randomized trial. Design, Setting, and Participant(s): A pragmatic,
multicenter, superiority, randomized clinical trial in 10 tertiary care
institutions in the UK. Participants were adults with degenerative mitral
regurgitation undergoing mitral valve repair surgery.
 Intervention(s): Participants were randomized 1:1 with concealed
allocation to receive either minithoracotomy or sternotomy mitral valve
repair performed by an expert surgeon. Main Outcomes and Measures:
The primary outcome was physical functioning and associated return to
usual activities measured by change from baseline in the 36-Item Short
Form Health Survey (SF-36) version 2 physical functioning scale 12 weeks
after the index surgery, assessed by an independent researcher masked to
the intervention. Secondary outcomes included recurrent mitral
regurgitation grade, physical activity, and quality of life. The
prespecified safety outcomes included death, repeat mitral valve surgery,
or heart failure hospitalization up to 1 year. Result(s): Between
November 2016 and January 2021, 330 participants were randomized (mean
age, 67 years, 100 female [30%]); 166 were allocated to minithoracotomy
and 164 allocated to sternotomy, of whom 309 underwent surgery and 294
reported the primary outcome. At 12 weeks, the mean between-group
difference in the change in the SF-36 physical function T score was 0.68
(95% CI, -1.89 to 3.26). Valve repair rates (= 96%) were similar in both
groups. Echocardiography demonstrated mitral regurgitation severity as
none or mild for 92% of participants at 1 year with no difference between
groups. The composite safety outcome occurred in 5.4% (9 of 166) of
patients undergoing minithoracotomy and 6.1% (10 of 163) undergoing
sternotomy at 1 year. Conclusions and relevance: Minithoracotomy is not
superior to sternotomy in recovery of physical function at 12 weeks.
Minithoracotomy achieves high rates and quality of valve repair and has
similar safety outcomes at 1 year to sternotomy. The results provide
evidence to inform shared decision-making and treatment guidelines. Trial
Registration: isrctn.org Identifier: ISRCTN13930454. Copyright ©
2023 American Medical Association. All rights reserved.

<3>
Accession Number
2025131370
Title
Efficacy of Multiple Exercise Therapy after Coronary Artery Bypass Graft:
A Systematic Review of Randomized Control Trials.
Source
Reviews in Cardiovascular Medicine. 24(5) (no pagination), 2023. Article
Number: 141. Date of Publication: May 2023.
Author
Moneruzzaman Md.; Sun W.-Z.; Changwe G.J.; Wang Y.-H.
Institution
(Moneruzzaman, Sun, Wang) Rehabilitation Center, Qilu Hospital of Shandong
University, Shandong, Jinan 250012, China
(Changwe) Department of Cardiac Surgery, Qilu Hospital of Shandong
University, Shandong, Jinan 250012, China
(Changwe) Department of Cardiovascular and Thoracic Surgery, National
Heart Hospital, Lusaka 10101, Zambia
Publisher
IMR Press Limited
Abstract
Background: Coronary artery bypass graft (CABG) is intended to restore
myocardial perfusion and alleviate morbidity among patients suffering from
coronary artery disease. Due to procedural complexity, and anesthetic
medications, post-operative complications are more prevalent, requiring
the integration of rehabilitation strategies. This review aimed to
determine the effect of single and multiple exercise therapy on
rehabilitation after CABG surgery. Method(s): We conducted a
systematic search of databases (EBSCOhost, Scopus, PubMed, and Web of
Science) from 01 January 2000 to 15 September 2022. The protocol of this
systematic review is registered to PROSPERO. Result(s): We found nine
randomized control trials composed of 599 CABG patients. In-patient
cardiac rehabilitation (CR), a combination of inspiratory muscle training,
mobilization, active upper and lower limb exercise, and aerobic exercise
as multiple exercise therapy, found significant improvement in 6-minute
walking distance (6MWD) than single exercise therapy (breathing exercise)
at discharge and follow-up (moderate quality evidence). Contrary, multiple
exercises group compared to single exercise groups did not improve the
peak volume of oxygen (VO2) at discharge. Still, significant improvement
was found at follow-up (moderate quality of evidence). On the other hand,
the out-patient CR made up of high-intensity inspiratory muscle training,
upper and lower limbs resistance training, and aerobic exercise as
multiple exercise therapy significantly improved 6MWD and peak VO2 at
discharge (High-quality evidence). Conclusion(s): Our review revealed
that multiple exercise therapy significantly improves functional and
exercise capacity in in-patient and out-patient cardiac rehabilitation
settings than single exercise therapy, but more than double exercise
therapy protocol may be inefficient for improvement of quality of life.
Inspiratory muscle training and resistance training in exercise therapy
protocols significantly supplant the outcome, which requires further
investigation. Copyright © 2023 The Author(s).

<4>
Accession Number
2024389051
Title
Mindfulness-based emotional regulation for patients with implantable
cardioverter-defibrillators: A randomized pilot study of efficacy,
applicability, and safety.
Source
Cardiology Journal. 30(3) (pp 401-410), 2023. Date of Publication: 13 Jun
2023.
Author
Ruiz S.M.; Vega B.R.; Perez C.B.; Peinado R.P.
Institution
(Ruiz) Faculty of Medicine, Universidad Autonoma de Madrid, Spain
(Vega, Perez) Liaison and Psychotherapy Unit, Department of Psychiatry,
Hospital Universitario La Paz, Universidad Autonoma de Madrid, Spain
(Peinado) Arrhythmia Unit, Cardiology Department, Hospital Universitario
La Paz, Universidad Autonoma de Madrid, Spain
Publisher
Via Medica
Abstract
Background: The efficacy of mindfulness-based interventions to reduce
anxiety or improve quality of life (QoL) in patients with cardiac
pathologies is well established. However, there is scarce information on
the efficacy, applicability, and safety of these interventions in adult
patients with an implantable cardioverter-defibrillator (ICD). In this
study, we examined their efficacy on QoL, psychological and biomedical
variables, as well as the applicability and safety of a mindfulness-based
intervention in patients with an ICD. Method(s): Ninety-six patients
with an ICD were randomized into two intervention groups and a control
group. The interventions involved training in mindfulness-based emotional
regulation, either face-to--face or using the "REM Volver a casa" mobile
phone application (app). Result(s): The sample presented medium-high
QoL baseline scores (mean: 68), low anxiety (6.84) and depression (3.89),
average mindfulness disposition (128), and cardiological parameters
similar to other ICD populations. After the intervention, no significant
differences were found in the variables studied between the intervention
and control groups. Retention was average (59%), and there were no adverse
effects due to the intervention. Conclusion(s): After training in
mindfulness-based emotional regulation (face-to-face or via app), no
significant differences were found in the QoL or psychological or
biomedical variables in patients with an ICD. The intervention proved to
be safe, with 59% retention. Copyright © 2023 Via Medica.

<5>
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. 113 (pp 75-82), 2023. Date of
Publication: July 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. 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. 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. Conclusion(s): The effects
of intensive SBP lowering on cardiovascular outcomes were consistent among
participants with normoglycemia, prediabetes, and diabetes. Copyright
© 2023 European Federation of Internal Medicine

<6>
Accession Number
2021017279
Title
Clinical Significance of Plasma D-Dimer and Fibrinogen in Outcomes after
Stroke: A Systematic Review and Meta-Analysis.
Source
Cerebrovascular Diseases. 52(3) (pp 318-343), 2023. Date of Publication:
01 May 2023.
Author
Bao Q.; Zhang J.; Wu X.; Zhao K.; Guo Y.; Yang M.; Du X.
Institution
(Bao, Wu, Zhao, Guo) Graduate School, Qinghai University, Xining, China
(Zhang) Department of Science and Education, Qinghai Provincial People's
Hospital, Xining, China
(Yang) Department of Neurosurgery, Qinghai Provincial People's Hospital,
Xining, China
(Du) Department of Nursing, Qinghai Institute of Health Sciences, Xining,
China
Publisher
S. Karger AG
Abstract
Background: There is increasing evidence on the prognostic significance of
D-dimer and fibrinolysis in stroke. However, the systematic analysis of
their relationship with adverse outcomes after stroke is lacking. Herein,
we comprehensively assessed the correlation of D-dimer and fibrinolysis
with stroke outcomes through meta-analysis. Method(s): Studies for
systematic literature review were retrieved from PubMed, EMBASE, and
Cochrane Library databases. The association of D-dimer and fibrinolysis
with outcomes of stroke patients was expressed as an odds ratio (OR) with
95% confidence intervals (95% CI). Result(s): Totally, 52 studies
comprising 21,473 stroke patients were included. The results showed that
the high D-dimer level was significantly associated with peripheral venous
thrombosis after stroke (OR 1.03, 95% CI 1.01-1.05), poor outcome (MRS >2)
after stroke (OR 1.731, 95% CI 1.464-2.048), death after stroke (OR 2.367,
95% CI 1.737-3.224), stroke recurrence (OR 1.229, 95% CI 1.113-1.358), and
early neurologic deterioration (NIHSS >4) (OR 1.791, 95% CI 1.117-2.870).
Moreover, high fibrinogen level was significantly associated with poor
outcome (MRS >2) after stroke (OR 1.650, 95% CI 1.314-2.071), death after
stroke (OR 1.310, 95% CI 1.128-1.520), stroke recurrence (OR 1.228, 95% CI
1.166-1.422), early neurologic deterioration (NIHSS >4) (OR 2.381, 95% CI
1.156-4.904), and coronary events after stroke (OR 1.427, 95% CI
1.232-1.653). Conclusion(s): Fibrinogen and D-dimer may be associated
with adverse outcomes in patients with stroke, suggesting that they may
serve as possible biomarkers for post-stroke adverse
outcomes. Copyright © 2023 Hormone Research in Paediatrics. All
rights reserved.

<7>
Accession Number
2019977299
Title
Comparison of outcomes between novel oral anticoagulants and warfarin
monotherapy in patients with left atrial appendage closure: A systematic
review and meta-analysis.
Source
Frontiers in Cardiovascular Medicine. 9 (no pagination), 2022. Article
Number: 1023941. Date of Publication: 24 Oct 2022.
Author
Sun B.; Chen R.R.; Gao C.; Tao L.
Institution
(Sun, Gao, Tao) Department of Cardiology, Xijing Hospital, Air Force
Medical University, Xi'an, China
(Chen) Department of Cardiology, Tangdu Hospital, Air Force Medical
University, Xi'an, China
Publisher
Frontiers Media S.A.
Abstract
Background: Pivotal trials of percutaneous left atrial appendage closure
(LAAC) used dedicated post-procedure antithrombotic protocols. However,
there is no consensus on the selection of new oral anticoagulants (NOAC)
and warfarin monotherapy after LAAC. This study aims to compare NOAC with
warfarin monotherapy for efficacy and safety in patients undergoing LAAC.
 Method(s): A database search was conducted using PubMed, EMBASE,
Cochrane Library, and Clinicaltrials.gov for trials that compared NOAC
with warfarin monotherapy after LAAC. The effective outcomes included any
major adverse events (all-cause death, stroke, major bleeding) and their
individual components. Safety outcomes included all-cause death, major
bleeding, total bleeding, DRT, and PDL >5 mm. Result(s): We included
10 non-randomized clinical trials with 10,337 patients, of whom 4,960
patients received NOAC, while 5,377 patients received warfarin. There were
no statistically significant differences in any major adverse events
(LogOR: -0.11, 95% CI: -0.27, 0.04, P = 0.16), stroke (LogOR: 0.00, 95%
CI: -0.42, 0.42, P = 1.00), all-cause death (LogOR: -0.23, 95% CI: -0.48,
0.02, P = 0.07), major bleeding (LogOR: -0.22, 95% CI: -0.45, 0.01, P =
0.06). NOAC was associated with a significant reduction in total bleeding
(LogOR: -1.01, 95% CI: -1.47, -0.55, P < 0.0001) compared to warfarin. No
statistically significant differences were found in DRT (LogOR: -0.19, 95%
CI: -0.15, 0.52, P = 0.27) and PDL >5 mm (LogOR: 0.19, 95% CI: -0.33,
0.72, P = 0.47). Meta-regression and subgroup analysis showed that total
bleeding (LogOR: -1.56, 95% CI: -2.15, -0.97, P < 0.001) was significantly
lower in the NOAC group in the subgroup of <75 y. Conclusion(s):
After LAAC, NOAC monotherapy was associated with a lower risk of bleeding
compared to warfarin monotherapy for 45 days. There was no significant
difference between NOAC and warfarin in terms of other results. Systematic
review registration: www.york.ac.uk/inst/crd, identifier:
CRD42022361244. Copyright © 2022 Sun, Chen, Gao and Tao.

<8>
Accession Number
2019169738
Title
Hemodynamic Performance of Sutureless vs. Conventional Bioprostheses for
Aortic Valve Replacement: The 1-Year Core-Lab Results of the Randomized
PERSIST-AVR Trial.
Source
Frontiers in Cardiovascular Medicine. 9 (no pagination), 2022. Article
Number: 844876. Date of Publication: 18 Feb 2022.
Author
Fischlein T.; Caporali E.; Asch F.M.; Vogt F.; Pollari F.; Folliguet T.;
Kappert U.; Meuris B.; Shrestha M.L.; Roselli E.E.; Bonaros N.; Fabre O.;
Corbi P.; Troise G.; Andreas M.; Pinaud F.; Pfeiffer S.; Kueri S.; Tan E.;
Voisine P.; Girdauskas E.; Rega F.; Garcia-Puente J.; De Kerchove L.;
Lorusso R.
Institution
(Fischlein, Vogt, Pollari, Pfeiffer) Cardiac Surgery, Klinikum Nurnberg,
Paracelsus Medical University, Nuremberg, Germany
(Caporali) Department of Cardiology, Istituto Cardiocentro Ticino, Lugano,
Switzerland
(Caporali) Department of Cardiac Surgery, Istituto Cardiocentro Ticino,
Lugano, Switzerland
(Caporali, Lorusso) Department of Cardio-Thoracic Surgery, Heart and
Vascular Centre, Maastricht University Medical Centre (MUMC+), Maastricht,
Netherlands
(Asch) MedStar Health Research Institute, Washington Hospital Center,
Washington, DC, United States
(Folliguet) Cardiac Surgery Unit, Hopital Henri Mondor, Universite Paris
12, Creteil, France
(Kappert) Herzzentrum Dresden GmbH Universitatsklinik, Dresden, Germany
(Meuris, Rega) Cardiac Surgery Unit, UZ Gasthuisberg Leuven, Leuven,
Belgium
(Shrestha) Cardiothoracic and Vascular Surgery, Hannover Medical School,
Hannover, Germany
(Roselli) Heart, Vascular and Thoracic Institute, Cleveland Clinic,
Cleveland, OH, United States
(Bonaros) Department of Cardiac Surgery, Medical University of Innsbruck,
Innsbruck, Austria
(Fabre) Lens Hospital and Bois Bernard Private Hospital, Lens, France
(Corbi) Poitiers University Hospital, Poitiers, France
(Troise) Fondazione Poliambulanza Istituto Ospedaliero, Brescia, Italy
(Andreas) Department of Cardiac Surgery, Medical University of Vienna,
Vienna, Austria
(Pinaud) Department of Cardiac Surgery, University Hospital Angers,
Angers, France
(Kueri) University Heart Center Freiburg, Bad Krozingen, Germany
(Tan) Catharina Ziekenhuis, Eindhoven, Netherlands
(Voisine) Division of Cardiac Surgery, Quebec Heart and Lung Institute,
Quebec, QC, Canada
(Girdauskas) University Heart Center Hamburg, Universitatsklinikum Hamburg
Eppendorf (UKE), Hamburg, Germany
(Garcia-Puente) University General Hospital Virgen de la Arrixaca, Murcia,
Spain
(De Kerchove) Cliniques Universitaires Saint-Luc (UCL), Bruxelles, Belgium
(Lorusso) Cardiac Surgery, Cardiovascular Research Institute Maastricht
(CARIM), Maastricht, Netherlands
Publisher
Frontiers Media S.A.
Abstract
Objective: Sutureless aortic valves are an effective option for aortic
valve replacement (AVR) showing non-inferiority to standard stented aortic
valves for major cardiovascular and cerebral events at 1-year. We report
the 1-year hemodynamic performance of the sutureless prostheses compared
with standard aortic valves, assessed by a dedicated echocardiographic
core lab. Method(s): Perceval Sutureless Implant vs. Standard Aortic
Valve Replacement (PERSIST-AVR) is a prospective, randomized, adaptive,
open-label trial. Patients undergoing AVR, as an isolated or combined
procedure, were randomized to receive a sutureless [sutureless aortic
valve replacement (Su-AVR)] (n = 407) or a stented sutured [surgical AVR
(SAVR)] (n = 412) bioprostheses. Site-reported echocardiographic
examinations were collected at 1 year. In addition, a subgroup of the
trial population (Su-AVR n = 71, SAVR = 82) had a complete
echocardiographic examination independently assessed by a Core Lab
(MedStar Health Research Institute, Washington D.C., USA) for the
evaluation of the hemodynamic performance. Result(s): The
site-reported hemodynamic data of stented valves and sutureless valves are
stable and comparable during follow-up, showing stable reduction of mean
and peak pressure gradients through one-year follow-up (mean: 12.1 +/- 6.2
vs. 11.5 +/- 4.6 mmHg; peak: 21.3 +/- 11.4 vs. 22.0 +/- 8.9 mmHg). These
results at 1-year are confirmed in the subgroup by the core-lab assessed
echocardiogram with an average mean and peak gradient of 12.8 +/- 5.7 and
21.5 +/- 9.1 mmHg for Su-AVR, and 13.4 +/- 7.7 and 23.0 +/- 13.0 mmHg for
SAVR. The valve effective orifice area was 1.3 +/- 0.4 and 1.4 +/- 0.4
cm2 at 1-year for Su-AVR and SAVR. These improvements are
observed across all valve sizes. At 1-year evaluation, 91.3% (n = 42) of
patients in Su-AVR and 82.3% in SAVR (n = 51) groups were free from
paravalvular leak (PVL). The rate of mild PVL was 4.3% (n = 2) in Su-AVR
and 12.9% (n = 8) in the SAVR group. A similar trend is observed for
central leak occurrence in both core-lab assessed echo groups.
 Conclusion(s): At 1-year of follow-up of a PERSIST-AVR patient
sub-group, the study showed comparable hemodynamic performance in the
sutureless and the stented-valve groups, confirmed by independent echo
core lab. Perceval sutureless prosthesis provides optimal sealing at the
annulus with equivalent PVL and central regurgitation extent rates
compared to sutured valves. Sutureless valves are therefore a reliable and
essential technology within the modern therapeutic possibilities to treat
aortic valve disease. Copyright © 2022 Fischlein, Caporali, Asch,
Vogt, Pollari, Folliguet, Kappert, Meuris, Shrestha, Roselli, Bonaros,
Fabre, Corbi, Troise, Andreas, Pinaud, Pfeiffer, Kueri, Tan, Voisine,
Girdauskas, Rega, Garcia-Puente, De Kerchove, Lorusso and on behalf of the
PERSIST-AVR Investigators.

<9>
Accession Number
2024565489
Title
A Multimodal Cardioprotection Strategy During Cardiac Surgery: The
ProCCard Study.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 37(8) (pp 1368-1376),
2023. Date of Publication: August 2023.
Author
Chiari P.; Desebbe O.; Durand M.; Fischer M.-O.; Lena-Quintard D.; Palao
J.-C.; Samson G.; Varillon Y.; Vaz B.; Joseph P.; Ferraris A.;
Jacquet-Lagreze M.; Pozzi M.; Maucort-Boulch D.; Ovize M.; Bidaux G.;
Mewton N.; Fellahi J.-L.
Institution
(Chiari, Joseph, Ferraris, Jacquet-Lagreze, Fellahi) Service
d'Anesthesie-Reanimation, Hopital Louis Pradel, Hospices Civils de Lyon,
Lyon, France
(Chiari, Jacquet-Lagreze, Ovize, Bidaux, Mewton, Fellahi) Inserm U1060,
Laboratoire CarMeN, IHU OPeRa, Lyon, France
(Desebbe) Service d'Anesthesie-Reanimation, Clinique de la Sauvegarde,
Ramsay Generale de Sante, Lyon, France
(Durand) Pole d'Anesthesie-Reanimation, Hopital Albert Michallon, Centre
Hospitalier Universitaire de Grenoble-Alpes, Grenoble, France
(Fischer) Service d'Anesthesie-Reanimation, Centre Hospitalier
Universitaire de Caen, Universite de Normandie, UNICAEN, Caen, France
(Lena-Quintard) Service d'Anesthesie-Reanimation, Institut Arnault Tzanck,
Saint Laurent du Var, France
(Palao) Service d'Anesthesie-Reanimation, Hopital Nord, Centre Hospitalier
Universitaire de Saint Etienne, Saint Etienne, France
(Samson, Varillon, Vaz, Ovize, Mewton) Centre d'Investigation Clinique de
Lyon (CIC 1407 Inserm), Hospices Civils de Lyon, Lyon, France
(Pozzi) Service de Chirurgie Cardiaque, Hopital Louis Pradel, Hospices
Civils de Lyon, Lyon, France
(Maucort-Boulch) Service de Biostatistique-Bioinformatique, Pole Sante
Publique, Hospices Civils de Lyon, Laboratoire de Biometrie et Biologie
Evolutive, Equipe Biostatistique-Sante, Lyon, France; Universite de Lyon,
Lyon, France; Universite Lyon 1, Villeurbanne, France; CNRS, UMR5558,
Villeurbanne, France
(Mewton) Service d'Insuffisance Cardiaque, Hopital Louis Pradel, Hospices
Civils de Lyon, Lyon, France
Publisher
W.B. Saunders
Abstract
Objective: The ProCCard study tested whether combining several
cardioprotective interventions would reduce the myocardial and other
biological and clinical damage in patients undergoing cardiac surgery.
 Design(s): Prospective, randomized, controlled trial.
 Setting(s): Multicenter tertiary care hospitals. Participant(s):
210 patients scheduled to undergo aortic valve surgery.
 Intervention(s): A control group (standard of care) was compared to a
treated group combining five perioperative cardioprotective techniques:
anesthesia with sevoflurane, remote ischemic preconditioning, close
intraoperative blood glucose control, moderate respiratory acidosis (pH
7.30) just before aortic unclamping (concept of the "pH paradox"), and
gentle reperfusion just after aortic unclamping. Measurements and
Main Results: The primary outcome was the postoperative 72-h area under
the curve (AUC) for high-sensitivity cardiac troponin I (hsTnI). Secondary
endpoints were biological markers and clinical events occurring during the
30 postoperative days and the prespecified subgroup analyses. The linear
relationship between the 72-h AUC for hsTnI and aortic clamping time,
significant in both groups (p < 0.0001), was not modified by the treatment
(p = 0.57). The rate of adverse events at 30 days was identical. A
non-significant reduction of the 72-h AUC for hsTnI (-24%, p = 0.15) was
observed when sevoflurane was administered during cardiopulmonary bypass
(46% of patients in the treated group). The incidence of postoperative
renal failure was not reduced (p = 0.104). Conclusion(s): This
multimodal cardioprotection has not demonstrated any biological or
clinical benefit during cardiac surgery. The cardio- and reno-protective
effects of sevoflurane and remote ischemic preconditioning therefore
remain to be demonstrated in this context. Copyright © 2023
Elsevier Inc.

<10>
Accession Number
2024500125
Title
Effect of Dexmedetomidine on Postoperative Renal Function in Patients
Undergoing Cardiac Valve Surgery Under Cardiopulmonary Bypass: A
Randomized Clinical Trial.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 37(8) (pp 1424-1432),
2023. Date of Publication: August 2023.
Author
Qiu Y.-Q.; Zhuang L.-P.; Wu P.-Y.; Zhong L.-Y.; Zhong X.-H.; Chen B.; Liu
Z.-K.; Luo H.-R.; Yang L.-P.
Institution
(Qiu) Department of Anesthesiology, the First Affiliated Hospital of
Fujian Medical University, Fuzhou, China
(Qiu) Anesthesiology Research Institute, the First Affiliated Hospital,
Fujian Medical University, Fuzhou, China
(Qiu) Department of Anesthesiology, National Regional Medical Center,
Binhai Campus of the First Affiliated Hospital, Fujian Medical University,
Fuzhou, China
(Zhuang) Fujian Key Laboratory of Molecular Neurology and Institute of
Neuroscience, Fujian Medical University, Fuzhou, China
(Wu) The Graduate School of Fujian Medical University, Fujian Medical
University, Fuzhou, China
(Zhong) Department of Clinical Medicine, Xiamen Medical College, Xiamen,
China
(Zhong) Key Laboratory of Sports Function Evaluation of General
Administration of Sports of the People's Republic of China, School of PE
and Sport Science, Fujian Normal University, Fuzhou, China
(Chen) Department of Colorectal Surgery, the First Affiliated Hospital of
Fujian Medical University, Fujian, China
(Liu) Sports Teaching and Research Department, Fujian Medical University,
Fuzhou, China
(Luo) Department of Anesthesiology, Fujian Medical University Union
Hospital, Fuzhou, China
(Yang) Department of Cardiovascular Surgery, Fujian Medical University
Union Hospital, Fuzhou, China
Publisher
W.B. Saunders
Abstract
Objective: The effect of dexmedetomidine on postoperative renal function
was investigated in patients undergoing cardiac valve surgery under
cardiopulmonary bypass (CPB). Design(s): A randomized controlled
trial. Setting(s): University teaching, grade A tertiary hospital.
 Participant(s): A total of 70 patients scheduled to undergo cardiac
valve replacement or valvuloplasty under CPB were eligible and randomly
divided into groups D (n = 35) and C (n = 35) between January 2020 and
March 2021. Intervention(s): Patients in group D were administered
0.6 mug/kg/h of dexmedetomidine intravenously from 10 minutes before
anesthesia induction to 6 hours after surgery; normal saline was used
instead of dexmedetomidine in group C. Measurements and Main Results:
The primary outcome was the incidence of acute kidney injury (AKI). Acute
kidney injury was defined according to the Kidney Disease Improving Global
Outcomes (2012). It was 22.86% and 48.57% in groups D and C, respectively
(p = 0.025). The secondary outcomes were intraoperative hemodynamics and
various indices in serum. Ten minutes before CPB (T<inf>1</inf>), 10
minutes after CPB (T<inf>2</inf>), and 30 minutes after CPB
(T<inf>3</inf>), mean arterial pressure in group D was lower than that in
group C, with statistical significance (74.94 +/- 8.52 v 81.89 +/- 13.66
mmHg, p=0.013; 62.83 +/- 11.27 v 71.86 +/- 7.89 mmHg, p < 0.001; 72.26 +/-
8.75 v 78.57 +/- 8.83 mmHg, p = 0.004). At T<inf>1</inf>, the heart rate
in group D was significantly lower than in group C (80.89 +/- 14.04 v
95.54 +/- 12.53 bpm, p=0.022). The tumor necrosis factor alpha,
interleukin-6, C-reactive protein, and cystatin C levels in group D were
lower than those in group C after the surgery (T<inf>4</inf>) and 24 hours
after surgery (T<inf>5</inf>), with statistical significance. The duration
of mechanical ventilation, intensive-care-unit stay time, and hospital
stay time in group D were significantly shorter than in group C. The
incidences of tachycardia, hypertension, nausea, and vomiting in group D
were similar to those in group C. Conclusion(s): Dexmedetomidine may
be considered as a way to reduce the incidence and severity of
postoperative AKI in patients undergoing cardiac valve surgery under
cardiopulmonary bypass. Copyright © 2023 Elsevier Inc.

<11>
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. 37(8) (pp 1358-1367),
2023. Date of Publication: August 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, United States
(Awad, Awad) Faculty of Medicine, Ain Shams University, Cairo, Egypt
(George) University of Toledo College of Medicine and Life Sciences,
Toledo, OH, United States
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.
 Design(s): A random effects pairwise meta-analysis via the
Mantel-Haenszel method. Setting(s): Not applicable, as this is a
meta-analysis. Participant(s): No individual patient data were used.
 Intervention(s): Not applicable, as this is a meta-analysis.
 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). 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. Copyright © 2023 Elsevier Inc.

<12>
Accession Number
2020044664
Title
Heart transplantation in end-stage heart failure secondary to cardiac
sarcoidosis: an updated systematic review.
Source
Heart Failure Reviews. 28(4) (pp 961-966), 2023. Date of Publication: July
2023.
Author
Buttar C.; Lakhdar S.; Pavankumar T.; Guzman-Perez L.; Mahmood K.; Collura
G.
Institution
(Buttar) Department of Cardiology, Tulane Hospital, New Orleans, LA,
United States
(Lakhdar, Pavankumar) Department of Cardiology, Ochsner Medical Center,
New Orleans, LA, United States
(Guzman-Perez) Department of Medicine, Icahn School of Medicine at Mount
Sinai/NYC H+H/Queens, Queens, NY, United States
(Mahmood) Department of Heart Failure and Transplant, Icahn School of
Medicine at Mount Sinai, New York, NY, United States
(Collura) Division of Cardiology, Icahn School of Medicine at Mount Sinai,
NYC H+H/Queens, Queens, NY, United States
Publisher
Springer
Abstract
The prevalence of cardiac sarcoidosis is increasing with improved cardiac
imaging and may lead to severe heart failure, cardiomyopathy, and
arrhythmias that warrant heart transplant consideration. This study aimed
to evaluate the outcomes of heart transplantation in sarcoidosis. We
systematically searched PubMed/MEDLINE, EMBASE and Cochrane Library
following the Preferred Reporting Items for Systematic Reviews and
Meta-analysis (PRISMA) guidelines. We identified 15 articles that examined
patients with cardiac sarcoidosis. The study aimed to evaluate the
outcomes of heart transplantation in cardiac sarcoidosis. We
systematically searched EMBASE, PubMed/MEDLINE, and Cochrane Library
following the Preferred Reporting Items for Systematic Reviews and
Meta-analyses (PRISMA) guidelines. We identified 15 studies that examined
1075 patients with cardiac sarcoidosis who underwent heart
transplantation. A total of five studies reported individual patient data.
Forty-two patients have been pooled for further analysis. There were 22
male patients, 14 female patients, and 7 patients whose gender was not
reported. Among these patients, 10 patients had concomitant pulmonary
sarcoidosis at the time of diagnosis. The mean survival was reported for
all 42 patients. The mean survival in months was 71.4 months, with a range
of 2 days to 288 months. Three patients died of graft failure, 2 patients
from septic shock, 2 patients from pneumonia, 1 patient from cervical
cancer, and 1 patient from sudden cardiac death. One patient developed a
malignant arrythmia in the setting of CMV myocarditis post-heart
transplant. Sarcoidosis recurrence after heart transplant was reported in
3 of 30 patients.Patients with cardiac sarcoidosis have shown to have
favorable outcomes after heart transplant. Despite these outcomes, some
centers still hesitate to pursue heart transplant for CS patients.
Carefully selected patients with advanced-stage heart failure due to
cardiac sarcoidosis have encouraging outcomes after transplantation.
Further studies will be needed to evaluate the outcomes of heart
transplantation in sarcoidosis. Copyright © 2022, The Author(s),
under exclusive licence to Springer Science+Business Media, LLC, part of
Springer Nature.

<13>
Accession Number
2024009672
Title
A bibliometric analysis of myocardial ischemia/reperfusion injury from
2000 to 2023.
Source
Frontiers in Cardiovascular Medicine. 10 (no pagination), 2023. Article
Number: 1180792. Date of Publication: 2023.
Author
Wang Y.; Guo L.; Zhang Z.; Fu S.; Huang P.; Wang A.; Liu M.; Ma X.
Institution
(Wang, Guo, Zhang, Fu, Huang, Wang, Liu, Ma) Xiyuan Hospital, China
Academy of Chinese Medical Sciences, Beijing, China
(Wang, Zhang, Fu) Graduate School, Beijing University of Chinese Medicine,
Beijing, China
(Guo, Liu, Ma) National Clinical Research Center for Chinese Medicine
Cardiology, Beijing, China
Publisher
Frontiers Media S.A.
Abstract
Background: Myocardial ischemia/reperfusion injury (MIRI) refers to the
more severe damage that occurs in the previously ischemic myocardium after
a short-term interruption of myocardial blood supply followed by
restoration of blood flow within a certain period of time. MIRI has become
a major challenge affecting the therapeutic efficacy of cardiovascular
surgery. Method(s): A scientific literature search on MIRI-related
papers published from 2000 to 2023 in the Web of Science Core Collection
database was conducted. VOSviewer was used for bibliometric analysis to
understand the scientific development and research hotspots in this field.
 Result(s): A total of 5,595 papers from 81 countries/regions, 3,840
research institutions, and 26,202 authors were included. China published
the most papers, but the United States had the most significant influence.
Harvard University was the leading research institution, and influential
authors included Lefer David J., Hausenloy Derek J., Yellon Derek M., and
others. All keywords can be divided into four different directions: risk
factors, poor prognosis, mechanisms and cardioprotection.
 Conclusion(s): Research on MIRI is flourishing. It is necessary to
conduct an in-depth investigation of the interaction between different
mechanisms and multi-target therapy will be the focus and hotspot of MIRI
research in the future. Copyright 2023 Wang, Guo, Zhang, Fu, Huang,
Wang, Liu and Ma.

<14>
Accession Number
2023979124
Title
Intensive cycles of neoadjuvant camrelizumab combined with chemotherapy in
locally advanced esophageal squamous cell carcinoma: a single-arm, phase
II trial.
Source
Journal of Translational Medicine. 21(1) (no pagination), 2023. Article
Number: 411. Date of Publication: December 2023.
Author
Yang G.; Su X.; Huang Y.; Luo G.; Wang Z.; Cai P.; Zheng Y.; Bei T.; Huang
M.; Bai Y.; He H.; Xiang J.; Cai M.; Zhong J.; Guo Q.; Zhang X.
Institution
(Yang, Su, Huang, Zhong, Guo, Zhang) Department of Thoracic Oncology, Sun
Yat-Sen University Cancer Center, Guangzhou, China
(Yang, Su, Huang, Zhong, Guo, Zhang) Guangdong Esophageal Cancer
Institute, Guangzhou, China
(Yang, Su, Huang, Luo, Wang, Cai, He, Xiang, Cai, Zhong, Guo, Zhang) State
Key Laboratory of Oncology in South China, Collaborative Innovation Center
of Cancer Medicine, Guangzhou, China
(Luo) Department of Endoscopy, Sun Yat-Sen University Cancer Center,
Guangzhou, China
(Wang) Department of Medical Oncology, Sun Yat-Sen University Cancer
Center, Guangzhou, China
(Cai, He) Department of Medical Imaging and Interventional Radiology, Sun
Yat-Sen University Cancer Center, Guangzhou, China
(Zheng, Bei, Huang, Bai) Medical Affairs, 3D Medicines, Inc, Shanghai,
China
(Xiang, Cai) Department of Pathology, Sun Yat-Sen University Cancer
Center, Guangzhou, China
Publisher
BioMed Central Ltd
Abstract
Background: Two cycles of neoadjuvant PD-1 blockade plus chemotherapy
induced favorable pathological response and tolerant toxicity in patients
with locally advanced esophageal squamous cell carcinoma (ESCC). However,
approximately 25% of patients relapsed within 1 year after surgery,
indicating that a short course of treatment may not be sufficient.
Therefore, exploring the effects of intensive treatment is needed for
optimal clinical outcomes. Method(s): Locally advanced ESCC patients
were administered three cycles of camrelizumab plus nab-paclitaxel and
capecitabine, followed by thoracoscopic esophagectomy. The primary
endpoint was pathologic response. Secondary endpoints included safety,
feasibility, radiologic response, survival outcomes, and
immunologic/genomic correlates of efficacy. Result(s): Forty-seven
patients were enrolled in the study. Forty-two patients received surgery,
and R0 resection was achieved in all cases. The complete and major
pathological response rates were 33.3% and 64.3%, respectively, and the
objective response rate was 80.0%. Three cycles of treatment significantly
improved T down-staging compared to two cycles (P = 0.03). The most common
treatment-related adverse events were grades 1-2, and no surgical delay
was reported. With a median follow-up of 24.3 months, the 1-year
disease-free survival and overall survival rates were both 97.6%, and the
2-year disease-free survival and overall survival rates were 92.3% and
97.6%, respectively. Three patients experienced disease recurrence or
metastasis ranging from 12.5 to 25.8 months after surgery, and one patient
died 6 months after surgery due to cardiovascular disease. Neither
programmed death-ligand 1 expression nor tumor mutational burden was
associated with pathological response. An increased infiltration of
CD56dim natural killer cells in the pretreatment tumor was
correlated with better pathological response in the primary tumor.
 Conclusion(s): It seems probable that intensive cycles of neoadjuvant
camrelizumab plus nab-paclitaxel and capecitabine increased tumor
regression and improved survival outcomes. Randomized controlled trials
with larger sample sizes and longer follow-up periods are needed to
validate these findings. Trial registration Chinese Clinical Trial
Registry, ChiCTR2000029807, Registered February 14, 2020,
https://www.chictr.org.cn/showproj.aspx?proj=49459 . Copyright ©
2023, The Author(s).

<15>
Accession Number
2025293858
Title
Outcomes of SAPIEN 3 Transcatheter Aortic Valve Replacement Compared With
Surgical Valve Replacement in Intermediate-Risk Patients.
Source
Journal of the American College of Cardiology. 82(2) (pp 109-123), 2023.
Date of Publication: 11 Jul 2023.
Author
Madhavan M.V.; Kodali S.K.; Thourani V.H.; Makkar R.; Mack M.J.; Kapadia
S.; Webb J.G.; Cohen D.J.; Herrmann H.C.; Williams M.; Greason K.; Pibarot
P.; Hahn R.T.; Jaber W.; Xu K.; Alu M.; Smith C.R.; Leon M.B.
Institution
(Madhavan, Kodali, Hahn, Alu, Smith, Leon) Columbia University Irving
Medical Center and NewYork-Presbyterian Hospital, New York, NY, United
States
(Madhavan, Cohen, Hahn, Alu, Leon) Cardiovascular Research Foundation, New
York, NY, United States
(Thourani) Piedmont Heart Institute, Atlanta, GA, United States
(Makkar) Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles,
CA, United States
(Mack) Baylor Scott & White Health, Plano, TX, United States
(Kapadia, Jaber) Cleveland Clinic, Cleveland, OH, United States
(Webb) St Paul's Hospital, Vancouver, BC, Canada
(Cohen) St Francis Hospital, Roslyn, NY, United States
(Herrmann) Hospital of the University of Pennsylvania, Philadelphia, PA,
United States
(Williams) New York University Langone Medical Center, New York, NY,
United States
(Greason) Mayo Clinic, Rochester, MN, United States
(Pibarot) Quebec Heart and Lung Institute, Laval University, Quebec City,
QC, Canada
(Xu) Edwards Lifesciences, Irvine, CA, United States
Publisher
Elsevier Inc.
Abstract
Background: Previous studies demonstrated transcatheter aortic valve
replacement (TAVR) with an earlier generation balloon-expandable valve to
be noninferior to surgical aortic valve replacement (SAVR) for death and
disabling stroke in intermediate-risk patients with symptomatic, severe
aortic stenosis at 5 years. However, limited long-term data are available
with the more contemporary SAPIEN 3 (S3) bioprosthesis. Objective(s):
The aim of this study was to compare 5-year risk-adjusted outcomes in
intermediate-risk patients undergoing S3 TAVR vs SAVR. Method(s):
Propensity score matching was performed to account for baseline
differences in intermediate-risk patients undergoing S3 TAVR in the
PARTNER 2 (Placement of Aortic Transcatheter Valves) S3 single-arm study
and SAVR in the PARTNER 2A randomized clinical trial. The primary
composite endpoint consisted of 5-year all-cause death and disabling
stroke. Result(s): A total of 783 matched pairs of intermediate-risk
patients with severe aortic stenosis were studied. There were no
differences in the primary endpoint between S3 TAVR and SAVR at 5 years
(40.2% vs 42.7%; HR: 0.87; 95% CI: 0.74-1.03; P = 0.10). The incidence of
mild or greater paravalvular regurgitation was more common after S3 TAVR.
There were no differences in structural valve deterioration-related stage
2 and 3 hemodynamic valve deterioration or bioprosthetic valve failure.
 Conclusion(s): In this propensity-matched analysis of
intermediate-risk patients, 5-year rates of death and disabling stroke
were similar between S3 TAVR and SAVR. Rates of structural valve
deterioration-related hemodynamic valve deterioration were similar, but
paravalvular regurgitation was more common after S3 TAVR. Longer-term
follow-up is needed to further evaluate differences in late adverse
clinical events and bioprosthetic valve durability. (PII S3i [PARTNER II
Trial: Placement of Aortic Transcatheter Valves II - S3 Intermediate],
NCT03222128; PII A (PARTNER II Trial: Placement of Aortic Transcatheter
Valves II - XT Intermediate and High Risk], NCT01314313) Copyright
© 2023

<16>
Accession Number
2025143269
Title
Effectiveness and quality of life in lung cancer, pre-, post- and
perioperative rehabilitation - A review.
Source
Physiology International. (no pagination), 2023. Date of Publication:
2023.
Author
Abidi Y.; Fekete M.; Farkas A.; Horvath A.; Varga J.T.
Institution
(Abidi, Varga) Department of Pulmonology, Semmelweis University, Budapest
H-1083, Hungary
(Fekete) Department of Public Health, Faculty of Medicine, Semmelweis
University, Budapest, Hungary
(Farkas) Centre for Energy Research, Budapest H-1121, Hungary
(Horvath) Chiesi Hungary Kft., Budapest H-1138, Hungary
(Varga) Department of Pulmonary Rehabilitation, National Koranyi Institute
of Pulmonology, Budapest H-1122, Hungary
Publisher
Akademiai Kiado ZRt.
Abstract
Functional conditions like lung function and exercise capacity are
important limiting factors of chest surgery in lung cancer with
co-morbidities (chronic obstructive pulmonary disease (COPD) and other
chronic respiratory diseases). Pulmonary rehabilitation has a favourable
effect on the cardiovascular system, metabolism, respiratory and
peripheral muscles and lung mechanics. Our aim was to assess the role of
pre-, post- and peri-operative pulmonary rehabilitation in lung cancer in
this review. We sought to size up the importance of pulmonary
rehabilitation in patients undergoing surgery with or without
(neo)adjuvant treatment, radiotherapy, chemotherapy, chemoradiotherapy,
major physiological impairments and complications. Searches were performed
in PubMed and ClinicalTrials.gov databases using the terms "exercise",
"rehabilitation", "small cell lung cancer", "non-small cell lung cancer",
"exercise capacity", "chest surgery"and "quality of life"from inception to
February 7th, 2022. Pulmonary rehabilitation has been recognized as an
effective intervention to reduce lung cancer related symptoms and improve
the pulmonary function, lung mechanics, chest kinematics, respiratory- and
peripheral muscle function, physical activity and quality of life (QoL) of
the patients. In conclusion, this review shows positive, highly
encouraging and effective results of pulmonary rehabilitation in terms of
the patients' lung function, functional mobility and quality of life. The
tools for complex pulmonary rehabilitation have evolved considerably over
the past two decades, thus this research has been conducted on a variety
of studies about this subject and serves as a synthesis of the systematic
and meta-analytic reviews. Copyright © 2023 The Author(s).

<17>
Accession Number
2024009250
Title
Glutamate infusion associated with reduced rises of p-Copeptin after
coronary surgery: Substudy of GLUTAMICS II.
Source
Acta Anaesthesiologica Scandinavica. (no pagination), 2023. Date of
Publication: 2023.
Author
Svedjeholm R.; Ferrari G.; Vanky F.; Friberg O.; Holm J.
Institution
(Svedjeholm, Vanky, Holm) Department of Thoracic and Vascular Surgery,
Department of Health, Medicine and Caring Sciences, Unit of Cardiovascular
Medicine, Linkoping University, Linkoping, Sweden
(Ferrari, Friberg) Department of Cardiothoracic and Vascular Surgery,
Faculty of Medicine and Health, Health Care Research Centre, Orebro
University, Orebro, Sweden
Publisher
John Wiley and Sons Inc
Abstract
Background: Glutamate plays a key role for post-ischaemic recovery of
myocardial metabolism. According to post hoc analyses of the two GLUTAMICS
trials, patients without diabetes benefit from glutamate with less
myocardial dysfunction after coronary artery bypass surgery (CABG).
Copeptin reflects activation of the Arginine Vasopressin system and is a
reliable marker of heart failure but available studies in cardiac surgery
are limited. We investigated whether glutamate infusion is associated with
reduced postoperative rises of plasma Copeptin (p-Copeptin) after CABG.
 Method(s): A prespecified randomised double-blind substudy of
GLUTAMICS II. Patients had left ventricular ejection fraction <=0.30 or
EuroSCORE II >=3.0 and underwent CABG +/- valve procedure. Intravenous
infusion of 0.125 M L-glutamic acid or saline at 1.65 mL/kg/h was
commenced 10-20 min before the release of the aortic cross-clamp and then
continued for another 150 min P-Copeptin was measured preoperatively and
postoperatively on day one (POD1) and day three. The primary endpoint was
an increase in p-Copeptin from the preoperative level to POD1.
Postoperative stroke <=24 h and mortality <=30 days were safety outcomes.
 Result(s): We included 181 patients of whom 48% had diabetes. The
incidence of postoperative mortality <=30 days (0% vs. 2.1%; p =.50) and
stroke <=24 h (0% vs. 3.2%; p =.25) did not differ between the glutamate
group and controls. P-Copeptin increased postoperatively with the highest
values recorded on POD1 without significant inter-group differences. Among
patients without diabetes, p-Copeptin did not differ preoperatively but
postoperative rise from preoperative level to POD1 was significantly
reduced in the glutamate group (73 +/- 66 vs. 115 +/- 102 pmol/L; p =.02).
P-Copeptin was significantly lower in the Glutamate group on POD1 (p =.02)
and POD 3 (p =.02). Conclusion(s): Glutamate did not reduce rises of
p-Copeptin significantly after moderate to high-risk CABG. However,
glutamate was associated with reduced rises of p-Copeptin among patients
without diabetes. These results agree with previous observations
suggesting that glutamate mitigates myocardial dysfunction after CABG in
patients without diabetes. Given the exploratory nature of these findings,
they need to be confirmed in future studies. Copyright © 2023 The
Authors. Acta Anaesthesiologica Scandinavica published by John Wiley &
Sons Ltd on behalf of Acta Anaesthesiologica Scandinavica Foundation.

<18>
Accession Number
2024817389
Title
A systematic review of biological changes in surgeons' acute stress levels
during surgery.
Source
Surgery in Practice and Science. 13 (no pagination), 2023. Article Number:
100174. Date of Publication: June 2023.
Author
Budden A.; Song S.; Henry A.; Wakefield C.E.; Abbott J.
Institution
(Budden, Song, Abbott) Gynaecological Research and Clinical Evaluation
(GRACE) Group, Royal Hospital for Women, Sydney, Australia
(Budden, Song, Henry, Wakefield, Abbott) School of Clinical Medicine,
UNSW, Sydney, Australia
(Henry) Department of Women's and Children's Health, St George Hospital,
Sydney, Australia
(Wakefield) Kids Cancer Centre, Sydney Children's Hospital, Sydney,
Australia
Publisher
Elsevier Ltd
Abstract
Background: While a degree of stress facilitates learning and task
performance, excessive stress in surgeons may lead to poor patient
outcomes, with maladaptive stress as a risk factor for surgeon burnout or
self-harm through mechanisms including substance abuse, and suicide. We
aim to systematically review publications investigating how measures of
surgeons' acute biological stress change during surgery. Method(s):
Medline, Embase, Cochrane library, and The United States, Australian, and
European clinical trials registries were searched using the terms stress;
surgeon; cortisol; skin conductance; and heart rate. Studies had to report
at least one measure of biological stress related to surgery or simulated
surgical exercise and have been published between January 1996 to June
2022. Result(s): Twenty-eight studies with a total of 433
participants met inclusion criteria with cortisol, heart rate, heart rate
variability, and electrodermal activity being reported. Salivary cortisol
was measured in four studies with conflicting directional changes
reported. Mean heart rate increased in nine studies (by 6-22
beats/minute), however the impact of the physical work of surgery was not
reported. Heart rate variability, as measured by low-frequency to
high-frequency ratio, was significantly increased in three of six studies.
One study measured electrodermal activity reporting significant increase
in skin conductance in a simulation setting. Conclusion(s): While
some biological measures appear able to detect changes in acute stress in
surgeons (particularly heart rate), appropriate measures of stress during
non-stressful and stressful surgery are yet to be fully identified.
Importantly, there are no current pathways for identifying surgeons at
risk of burnout or self-harm and this is a critical unmet research
need. Copyright © 2023

<19>
Accession Number
2019171040
Title
Prognostic Outcome of New-Onset Left Bundle Branch Block After
Transcatheter Aortic Valve Replacement in Patients With Aortic Stenosis: A
Systematic Review and Meta-Analysis.
Source
Frontiers in Cardiovascular Medicine. 9 (no pagination), 2022. Article
Number: 842929. Date of Publication: 08 Apr 2022.
Author
Wang J.; Liu S.; Han X.; Chen Y.; Chen H.; Wan Z.; Song B.
Institution
(Wang, Han, Chen, Chen) The First Clinical Medical College of Lanzhou
University, Lanzhou University, Lanzhou, China
(Liu, Wan, Song) Department of Cardiovascular Surgery, First Hospital of
Lanzhou University, Lanzhou, China
Publisher
Frontiers Media S.A.
Abstract
Background: Left bundle branch block (LBBB) is a common complication of
the transcatheter aortic valve replacement (TAVR), and its impact on
prognosis is controversial. Method(s): A comprehensive electronic
search was conducted in databases (PubMed, Embase, Cochrane Library, and
The Web of Science), from the date of database establishment till March
2021, to screen for studies on new-onset LBBB after TAVR. We next
performed a meta-analysis to evaluate the effect of new-onset LBBB after
TAVR on patient prognosis, based on the Preferred Reporting Items for
Systematic Reviews and Meta-Analyses (PRISMA) statement. Result(s): A
total of 17 studies, including 9205 patients, were eligible for our
analysis. Patients with new-onset LBBB had elevated all-cause mortality
risk verses patients without new-onset LBBB, during all follow ups. The
relevant data are as follows: 30-day (RR:1.71; 95%CI:1.27-2.29; P <
0.001), 1-year (RR:1.31; 95%CI:1.12-1.52; P < 0.001), and 2-year (RR:1.31;
95%CI:1.09-1.56; P = 0.003) follow ups. Likewise, new-onset LBBB patients
also experienced increased cardiovascular mortality, compared to
non-new-onset LBBB patients, but only in the 1-year follow up (RR:1.49;
95%CI:1.23-1.82; P < 0.001). Hospitalization for heart failure was
dramatically elevated in patients with new-onset LBBB verses non-new-onset
LBBB, in all follow ups. The relevant data are as follows: 30-day
(RR:1.56; 95%CI:1.13-2.12; P = 0.007), 1-year (RR:1.35; 95%CI:1.08-1.68; P
= 0.007), and 2-year (RR:1.49; 95%CI:1.21-1.84; P < 0.001). Similarly,
new-onset LBBB patients had higher PPI risk than non-new-onset LBBB
patients, in all follow ups. The relevant data are as follows: 30-day
(RR:3.05; 95%CI:1.49-6.22; P = 0.002), 1-year (RR:2.15; 95%CI:1.52-3.03; P
< 0.001), and 2-year (RR:2.52; 95%CI:1.68-3.78; P < 0.001).
 Conclusion(s): Patients with new-onset LBBB have worse prognosis
after TAVR than those without new-onset LBBB. Recognition of the adverse
effects of post-TAVR new-onset LBBB can lead to the development of new
strategies that enhance clinical outcomes. Systematic Trial Registration:
https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=197224,
identifier: 19722. Copyright © 2022 Wang, Liu, Han, Chen, Chen,
Wan and Song.

<20>
Accession Number
2025326975
Title
Metabolic Sequelae of Everolimus Treatment After Cardiac Transplant: A
Hypothesis-Generating Study.
Source
Heart Lung and Circulation. (no pagination), 2023. Date of Publication:
2023.
Author
Raven L.M.; Muir C.A.; Pouliopoulos J.; Hayward C.S.; Macdonald P.S.;
Greenfield J.R.; Jabbour A.
Institution
(Raven, Muir, Greenfield) Department of Diabetes and Endocrinology, St
Vincent's Hospital, Sydney, NSW, Australia
(Raven, Greenfield) Clinical Diabetes, Appetite and Metabolism Laboratory,
Garvan Institute of Medical Research, Sydney, NSW, Australia
(Raven, Muir, Pouliopoulos, Hayward, Macdonald, Greenfield, Jabbour)
School of Clinical Medicine, St Vincent's Campus, Faculty of Medicine and
Health, University of New South Wales, Sydney, NSW, Australia
(Pouliopoulos, Hayward, Macdonald, Jabbour) Victor Chang Cardiac Research
Institute, Sydney, NSW, Australia
(Pouliopoulos, Hayward, Macdonald, Jabbour) Department of Heart and Lung
Transplantation, St Vincent's Hospital, Sydney, NSW, Australia
Publisher
Elsevier Ltd
Abstract
Background: Although modern immunosuppressants improve survival
post-transplant, they are associated with long-term metabolic
complications, such as post-transplant diabetes mellitus (PTDM).
Calcineurin inhibitor-sparing regimens using everolimus attenuate some
complications such as left ventricular hypertrophy. However, the metabolic
effects of everolimus following transplant are less clear. Method(s):
Post-hoc analysis to compare PTDM and other metabolic outcomes in
participants of a randomised open-label clinical trial of low-dose
everolimus and tacrolimus versus standard-dose tacrolimus in heart
transplant recipients (RADTAC1 study). Result(s): There
were 39 participants in the trial; mean follow-up was 6.4+/-1.5 years.
There was a high rate of pre-existing diabetes (26%) and newly diagnosed
PTDM (36%) during follow-up. Half the patients who developed PTDM in the
everolimus-tacrolimus group (n=4/8) ceased diabetes medications during
follow-up, which was not observed in patients on standard tacrolimus
(n=0/6). In the first 12 months there was a higher use of non-insulin
treatment for diabetes in the everolimus-tacrolimus group compared to the
standard tacrolimus group. Conclusion(s): This study suggests that
treatment with everolimus may be associated with improved glycaemic
control of PTDM relative to treatment with standard doses of calcineurin
inhibitor. These findings should be further studied in prospective
randomised trials. Copyright © 2023 Australian and New Zealand
Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society
of Australia and New Zealand (CSANZ)

<21>
Accession Number
2025326884
Title
Bariatric surgery and left ventricular assist device in patients with
heart failure: A systematic review and meta-analysis.
Source
American Journal of Surgery. (no pagination), 2023. Date of Publication:
2023.
Author
Sharma I.; Nakanishi H.; Hage K.; Marrero K.; Diwan T.S.; daSilva-deAbreu
A.; Davis Jr S.S.; Clapp B.; Ghanem O.M.
Institution
(Sharma, Hage, Ghanem) Department of Surgery, Mayo Clinic, Rochester, MN,
United States
(Nakanishi) St George's University of London, London SW17 0RE, United
Kingdom
(Marrero) Carle Foundation Hospital General Surgery Residency, Champaign,
IL, United States
(Diwan) Division of Transplantation, Department of Surgery, Mayo Clinic,
Rochester, MN, United States
(daSilva-deAbreu) Department of Cardiovascular Medicine, Mayo Clinic,
Rochester, MN, United States
(Davis Jr) Department of Surgery, Emory University School of Medicine,
Atlanta, GA, United States
(Clapp) Department of Surgery, Texas Tech HSC Paul Foster School of
Medicine, El Paso, TX, United States
Publisher
Elsevier Inc.
Abstract
Background: The role of metabolic and bariatric surgery (MBS), in synergy
with left ventricular assist device (LVAD) implantation, in the scope of
end-stage heart failure management for patients with severe obesity is not
well elucidated. Method(s): We conducted a meta-analysis using
Cochrane, Embase, PubMed, and Scopus databases to include articles from
their inception to November 2022. Result(s): A total of 271 patients
who underwent MBS during or after the LVAD implantation were included from
eleven separate studies. After surgery, 67.4% of patients were listed on
the heart transplant waitlist with 32.5% undergoing a successful
transplant. We reported a mean listing time of 13.8 months. Finally, the
pooled postoperative complication rate, 30-day readmission rate, and
one-year mortality rate were 47.6%, 23.6% and 10.2% respectively.
 Conclusion(s): MBS and LVAD is a safe and effective approach to
bridge patients with severe obesity and end-stage heart failure for
definitive heart transplantation. Copyright © 2023 Elsevier Inc.

<22>
Accession Number
2025288974
Title
Practice Changing Updates in Perioperative Medicine Literature 2022. A
Systematic Review.
Source
American Journal of Medicine. (no pagination), 2023. Date of Publication:
2023.
Author
Khambaty M.; Devalapalli A.P.; Silbert R.E.; Kashiwagi D.T.; Regan D.W.;
Sundsted K.K.; Mauck K.F.
Institution
(Khambaty, Devalapalli, Kashiwagi, Regan, Sundsted) Division of Hospital
Internal Medicine, Department of Medicine, Mayo Clinic, Rochester, MN,
United States
(Silbert, Mauck) Division of General Internal Medicine, Department of
Medicine, Mayo Clinic and Mayo Clinic College of Medicine, Rochester, MN,
United States
(Kashiwagi) Department of Internal Medicine, Sheikh Shakhbout Medical City
in partnership with Mayo Clinic, Abu Dhabi, United Arab Emirates
Publisher
Elsevier Inc.
Abstract
Perioperative medicine is a rapidly growing multidisciplinary field with
significant advances published each year. In this review, we highlight
important perioperative publications in 2022. A multi-database literature
search from January to December of 2022 was undertaken. Original research
articles, systematic reviews, meta-analyses, and guidelines were included.
Abstracts, case reports, letters, protocols, pediatric and obstetric
articles, and cardiac surgery literature were excluded. Two authors
reviewed each reference using the Distiller SR systematic review software
(Evidence Partners Inc., Ottawa, Ont, Canada). A modified Delphi technique
was used to identify 8 practice-changing articles. We identified another
10 articles for tabular summaries. We highlight why these articles have
the potential to change clinical perioperative practice and areas where
more information is needed. Copyright © 2023 Elsevier Inc.

<23>
Accession Number
2025276236
Title
Prognostic Value of Coronary Computed Tomography Angiography in Coronary
Artery Bypass Graft Patients Systematic Review and Meta-Analysis.
Source
American Journal of Cardiology. 201 (pp 107-115), 2023. Date of
Publication: 15 Aug 2023.
Author
Hakimjavadi R.; DiRienzo L.; Rattanawong P.; Ayoub C.; Visintini S.M.;
Small G.R.; Chow B.
Institution
(Hakimjavadi, DiRienzo, Visintini, Small, Chow) Division of Cardiology,
University of Ottawa Heart Institute, Canada
(Rattanawong, Ayoub) Department of Cardiovascular Medicine, Mayo Clinic,
Scottsdale, Arizona, United States
(Chow) Department of Radiology, University of Ottawa, Canada
Publisher
Elsevier Inc.
Abstract
We sought to assess the prognostic value of coronary computed tomographic
angiography (CCTA) in patients with coronary artery bypass graft (CABG) by
meta-analysis. MEDLINE, Embase, Cochrane Central Register of Controlled
Trials, and Scopus were searched for relevant original articles published
up to July 2021. CCTA prognostic studies enrolling patients with CABG were
screened and included if outcomes included all-cause mortality or major
adverse cardiac events. Maximally adjusted hazard ratios (HRs) were
extracted for CCTA-derived prognostic factors. HRs were log-transformed
and pooled across studies using the DerSimonian-Laird random-effects model
and statistical heterogeneity was assessed using the I2
statistic. Of 1,576 screened articles, 4 retrospective studies fulfilled
all inclusion criteria. Collectively, a total of 1,809 patients with CABG
underwent CCTA (mean [SD] age 67.0 [8.5] years across 3 studies, 81.5%
male across 4 studies). Coronary artery disease severity and
revascularization were categorized using 2 models: unprotected coronary
territories and coronary artery protection score. The pooled HRs from the
random-effects models using the most highly adjusted study estimate were
3.64 (95% confidence interval 2.48 to 5.34, I2 = 57.8%, p
<0.001; 4 studies) and 4.85 (95% confidence interval 3.17 to 7.43,
I2 = 39.9%, p <0.001; 2 studies) for unprotected coronary
territories and coronary artery protection score, respectively. In
conclusion, in a limited number of studies, CCTA is an independent
predictor of adverse events in patients with CABG. Larger studies using
uniform models and endpoints are needed. Copyright © 2023
Elsevier Inc.

<24>
Accession Number
2023961575
Title
Left-Sided Double-Lumen Tube vs EZ-Blocker for One-Lung Ventilation in
Thoracic Surgery: A Systematic Review and Meta-Analysis.
Source
Seminars in Cardiothoracic and Vascular Anesthesia. (no pagination),
2023. Date of Publication: 2023.
Author
Kumar N.; Mitchell J.; Siemens A.; Deiparine S.; Saddawi-Konefka D.;
Hussain N.; Iyer M.H.; Essandoh M.; Sawyer T.R.; Hao D.
Institution
(Kumar, Siemens, Saddawi-Konefka, Hao) Harvard Medical School, Department
of Anesthesiology, Pain Medicine, and Critical Care Medicine,
Massachusetts General Hospital, Boston, MA, United States
(Mitchell, Deiparine) The Ohio State University College of Medicine,
Columbus, OH, United States
(Hussain, Iyer, Essandoh) Department of Anesthesiology, The Ohio State
University Wexner Medical Center, Columbus, OH, United States
(Sawyer) Central Michigan University College of Medicine, Mt. Pleasant,
MI, United States
Publisher
SAGE Publications Inc.
Abstract
Background. The EZ-Blocker is the newest generation of bronchial blocker
and offers a potential alternative to left-sided double lumen tubes for
lung isolation and one-lung ventilation during thoracic surgery. Methods.
Databases were searched for randomized controlled trials comparing
left-sided double lumen tube to the EZ-Blocker for one-lung ventilation
during thoracic surgery. The time for placement, incidence of
intraoperative displacement, and surgeons' rating of lung collapse quality
were designated as coprimary outcomes. The safety profiles of the two
devices, including the incidence of airway trauma and post-extubation
discomfort were also examined. Results. Six randomized controlled trials
(495 patients) were analyzed. Compared to the EZ-Blocker, the left-sided
double lumen tube was faster to place by a weighted mean difference of
[95% CI] of -61.24 seconds [-102.48, -20.00] (P =.004) and was much less
likely to become displaced during lung isolation with an odds ratio [95%
CI] of.56 [.34,.91] (P =.02). The left-sided double lumen tube and the
EZ-Blocker provided similar surgeon-rated quality of lung isolation.
Although the left-sided double lumen tube caused a greater degree of
post-extubation sore throat, there was a similar incidence of carinal
trauma and post-extubation hoarseness compared to the EZ-Blocker.
Conclusion. Our analysis suggests that the left-sided double lumen tube
can be placed more quickly and is less prone to intraoperative
displacement compared to the EZ-Blocker; the quality of lung collapse is
similar. Thus, evidence appears to support the continued utilization of
the left-sided double lumen tube for routine thoracic surgery requiring
one-lung ventilation. Copyright © The Author(s) 2023.

<25>
Accession Number
2023961323
Title
Platelet-rich plasma influence on the sternal wounds healing: A
meta-analysis.
Source
International Wound Journal. (no pagination), 2023. Date of Publication:
2023.
Author
Zhu S.; Gao J.; Yu W.; Xiong J.
Institution
(Zhu) Department of Thoracic Surgery, The First Affiliated Hospital of
Gannan Medical University, Ganzhou, China
(Zhu) Ganzhou Key Lab of Brain Injury & Brain Protection, Ganzhou, China
(Gao, Yu) The First Clinical Medical College, Gannan Medical University,
Ganzhou, China
(Xiong) Department of Cardiovascular Surgery, The First Affiliated
Hospital of Gannan Medical University, Ganzhou, China
Publisher
John Wiley and Sons Inc
Abstract
A meta-analysis research was executed to appraise the effect of
platelet-rich plasma (PRP) on sternal wound healing (SWH). Inclusive
literature research till April 2023 was done and 1098 interconnected
researches were revised. The 11 picked researches, enclosed 8961 cardiac
surgery (CS) persons were in the utilised researchers' starting point,
3663 of them were utilising PRP, and 5298 were control. Odds ratio (OR)
and 95% confidence intervals (CIs) were utilised to appraise the effect of
PRP on the SWH by the dichotomous approach and a fixed or random model.
PRP had significantly lower sternal wound infection (SWI) (OR, 0.11; 95%
CI, 0.03-0.34, p < 0.001), deep SWI (OR, 0.29; 95% CI, 0.16-0.51, p <
0.001), and superficial SWI (OR, 0.20; 95% CI, 0.13-0.33, p < 0.001),
compared to control in CS persons. PRP had significantly lower SWI, deep
SWI, and superficial SWI, compared to control in CS persons. However,
caution must be taken when interacting with its values since there was a
low sample size of some of the nominated research found for the
comparisons in the meta-analysis. Copyright © 2023 The Authors.
International Wound Journal published by Medicalhelplines.com Inc and John
Wiley & Sons Ltd.

<26>
Accession Number
2023945785
Title
Impact of Right Ventricular Surface Area-to-Volume Ratio on Ventricular
Remodeling After Pulmonary Valve Replacement.
Source
Pediatric Cardiology. (no pagination), 2023. Date of Publication: 2023.
Author
Thatte N.; Sleeper L.A.; Lu M.; Tang D.; Geva T.
Institution
(Thatte, Sleeper, Lu, Geva) Department of Cardiology, Boston Children's
Hospital, 300 Longwood Ave, Boston, MA 02115, United States
(Thatte, Sleeper, Geva) Department of Pediatrics, Harvard Medical School,
Boston, MA, United States
(Tang) Mathematical Sciences Department, Worcester Polytechnic Institute,
Worcester, MA, United States
Publisher
Springer
Abstract
Optimal reverse remodeling of the right ventricle (RV), a sentinel goal of
pulmonary valve replacement (PVR) in patients with repaired tetralogy of
Fallot, is not fully predicted by volume-based pre-PVR parameters. Our
objectives were to characterize novel geometric RV parameters in patients
receiving PVR and in controls, and to identify associations between these
parameters and chamber remodeling post-PVR. Secondary analysis was
performed on cardiac magnetic resonance (CMR) data from 60 patients
enrolled in a randomized trial of PVR with and without surgical RV
remodeling. 20 healthy age-matched subjects served as controls. The
primary outcome was optimal post-PVR RV remodeling (end-diastolic volume
index (EDVi) <= 114 ml/m2 and ejection fraction (EF) >= 48%)
vs. suboptimal remodeling (EDVi >= 120 ml/m2 and EF <= 45%). RV
geometry was markedly different at baseline in PVR patients compared with
controls, with lower systolic surface area-to-volume ratio (SAVR) (1.16
+/- 0.26 vs.1.44 +/- 0.21 cm2/mL, p < 0.001) and lower systolic
circumferential curvature (0.87 +/- 0.27 vs. 1.07 +/- 0.30 cm-
1, p = 0.007) but similar longitudinal curvature. In the PVR cohort,
higher systolic SAVR was associated with higher RVEF both pre- and
post-PVR (p < 0.001). Among PVR patients, 15 had optimal and 19 had
suboptimal remodeling post-PVR. Multivariable modeling showed that among
the geometric parameters, higher systolic SAVR (OR 1.68 per 0.1
cm2/mL increase; p = 0.049) and shorter systolic RV long-axis
length (OR 0.92 per 0.1 cm increase; p = 0.035) were independently
associated with optimal remodeling. Compared with controls, PVR patients
have lower SAVR and lower circumferential but not longitudinal curvature.
Higher pre-PVR systolic SAVR is associated with optimal remodeling
post-PVR. Copyright © 2023, The Author(s), under exclusive
licence to Springer Science+Business Media, LLC, part of Springer Nature.

<27>
Accession Number
2023639721
Title
Direct assessment of microcirculation in shock: a randomized-controlled
multicenter study.
Source
Intensive Care Medicine. 49(6) (pp 645-655), 2023. Date of Publication:
June 2023.
Author
Bruno R.R.; Wollborn J.; Fengler K.; Flick M.; Wunder C.; Allgauer S.;
Thiele H.; Schemmelmann M.; Hornemann J.; Moecke H.M.E.; Demirtas F.;
Palici L.; Franz M.; Saugel B.; Kattan E.; De Backer D.; Bakker J.;
Hernandez G.; Kelm M.; Jung C.
Institution
(Bruno, Schemmelmann, Hornemann, Moecke, Demirtas, Palici, Kelm, Jung)
Medical Faculty, Department of Cardiology, Pulmonology and Vascular
Medicine, Heinrich-Heine-University Duesseldorf, Moorenstrase 5,
Duesseldorf 40225, Germany
(Wollborn) Department of Anesthesiology, Perioperative and Pain Medicine,
Brigham and Women's Hospital, Harvard Medical School, Boston, United
States
(Fengler, Thiele) Department of Cardiology, Heart Center Leipzig at
University of Leipzig, Leipzig, Germany
(Flick, Saugel) Department of Anesthesiology, Center of Anesthesiology and
Intensive Care Medicine, University Medical Center Hamburg-Eppendorf,
Hamburg, Germany
(Wunder) Department of Anesthesiology and Intensive Care Medicine,
Robert-Bosch-Krankenhaus, Stuttgart, Germany
(Allgauer) Department of Cardiology, Robert-Bosch-Krankenhaus, Stuttgart,
Germany
(Kattan, Hernandez) Departamento de Medicina Intensiva, Facultad de
Medicina, Pontificia Universidad Catolica de Chile, Santiago, Chile
(De Backer) Department of Intensive Care, CHIREC Hospitals, Universite
Libre de Bruxelles, Brussels, Belgium
(Bakker) NYU Langone Health and Columbia University Irving Medical Center,
New York, United States
(Franz, Bakker) Erasmus MC University Medical Center, Rotterdam,
Netherlands
(Kelm) CARID (Cardiovascular Research Institute Dusseldorf), Dusseldorf,
Germany
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Purpose: Shock is a life-threatening condition characterized by
substantial alterations in the microcirculation. This study tests the
hypothesis that considering sublingual microcirculatory perfusion
variables in the therapeutic management reduces 30-day mortality in
patients admitted to the intensive care unit (ICU) with shock.
 Method(s): This randomized, prospective clinical multicenter
trial-recruited patients with an arterial lactate value above two mmol/L,
requiring vasopressors despite adequate fluid resuscitation, regardless of
the cause of shock. All patients received sequential sublingual
measurements using a sidestream-dark field (SDF) video microscope at
admission to the intensive care unit (+/- 4 h) and 24 (+/- 4) hours later
that was performed blindly to the treatment team. Patients were randomized
to usual routine or to integrating sublingual microcirculatory perfusion
variables in the therapy plan. The primary endpoint was 30-day mortality,
secondary endpoints were length of stay on the ICU and the hospital, and
6-months mortality. Result(s): Overall, we included 141 patients with
cardiogenic (n = 77), post cardiac surgery (n = 27), or septic shock (n =
22). 69 patients were randomized to the intervention and 72 to routine
care. No serious adverse events (SAEs) occurred. In the interventional
group, significantly more patients received an adjustment (increase or
decrease) in vasoactive drugs or fluids (66.7% vs. 41.8%, p = 0.009)
within the next hour. Microcirculatory values 24 h after admission and
30-day mortality did not differ [crude: 32 (47.1%) patients versus 25
(34.7%), relative risk (RR) 1.39 (0.91-1.97); Cox-regression: hazard ratio
(HR) 1.54 (95% confidence interval (CI) 0.90-2.66, p = 0.118)].
 Conclusion(s): Integrating sublingual microcirculatory perfusion
variables in the therapy plan resulted in treatment changes that do not
improve survival at all. Graphical Abstract: [Figure not available: see
fulltext.]. Copyright © 2023, The Author(s).

<28>
Accession Number
2023602561
Title
Lost in Translation: The Impact of Language Barriers on the Outcomes of
Patients Receiving Coronary Artery Revascularization.
Source
Cardiovascular Revascularization Medicine. 52 (pp 94-98), 2023. Date of
Publication: July 2023.
Author
Gupta A.K.; Kleinig O.; Tan S.; Nagarathinam B.; Kovoor J.G.; Bacchi S.;
Zaka A.; He C.; Stroebel A.; Beltrame J.F.; Vallely M.P.; Bennetts J.S.;
Maddern G.J.
Institution
(Gupta, Kleinig, Tan, Kovoor, Bacchi, Beltrame, Maddern) University of
Adelaide, Adelaide, Australia
(Gupta, Zaka, He, Stroebel) Gold Coast University Hospital, Southport,
Australia
(Nagarathinam, Bacchi, Bennetts) Flinders University, Adelaide, Australia
(Kovoor, Bacchi, Beltrame) Royal Adelaide Hospital, Adelaide, Australia
(Vallely) Mount Sinai Heart, New York City, United States
(Bennetts) Flinders Medical Centre, Adelaide, Australia
Publisher
Elsevier Inc.
Abstract
Introduction: Clear and effective communication is vital in discussions
regarding coronary revascularization. Language barriers may limit
communication in healthcare settings. Previous studies on the influence of
language barriers on the outcomes of patients receiving coronary
revascularization have produced conflicting results. The aim of this
systematic review was to evaluate and synthesise the existing evidence
regarding the effects of language barrier on the outcomes of patients
receiving coronary revascularization. Method(s): A systematic review
was conducted, including a search of the PubMed, EMBASE, Cochrane, and
Google Scholar databases on 01/10/2022. The review was conducted in
accordance with PRISMA guidelines. This review was also prospectively
registered on PROSPERO. Result(s): Searches identified 3983 articles
of which a total 12 studies were included in the review. Most studies
describe that language barriers result in delayed presentation, but not
delays in treatment following hospital arrival with respect to coronary
revascularization. The findings with respect to the likelihood of
receiving revascularization have varied significantly; however, some
studies have indicated that those with language barriers may be less
likely to receive revascularization. There have been some conflicting
results with respect to the association between language barrier and
mortality. However, most studies suggest that there is no association with
increased mortality. In studies that evaluated length of stay variable
results have been reported based on geographical location. Namely
Australian studies have suggested no association between language barrier
and length of stay, but Canadian studies support an association. Language
barriers may also be associated with readmissions following discharge, and
major adverse cardiovascular and cerebrovascular events (MACCE).
 Conclusion(s): This study demonstrates that patients with language
barriers may have poorer outcomes from coronary revascularization. Future
interventional studies will be required to consider the sociocultural
context of patients with language barriers, and may be targeted at
timepoints including prior to, during, or after hospitalisation for
coronary revascularization. Further examination of the adverse health
outcomes of those with language barriers in fields outside of coronary
revascularization are required in view of the stark inequities identified
in this field. Copyright © 2023

<29>
Accession Number
639840456
Title
Protective Efficacy on Adult Ischemic Myocardium under Bypass: Del Nido
vs. St. Thomas Blood Cardioplegia.
Source
Annals of thoracic and cardiovascular surgery : official journal of the
Association of Thoracic and Cardiovascular Surgeons of Asia. 29(3) (pp
125-132), 2023. Date of Publication: 20 Jun 2023.
Author
Zhang X.; Du Y.; Wang A.
Institution
(Zhang, Wang) Department of Cardiac and Macrovascular Surgery, Suzhou
Hospital of Anhui Medical University, Suzhou, China
(Zhang, Du) Department of Cardiac Surgery, People's Hospital of Jilin
Province, Changchun, China
Publisher
NLM (Medline)
Abstract
PURPOSE: To compare the myocardial protective efficacy of del Nido
cardioplegia (DNC) with St. Thomas blood cardioplegia (SBC) in adult
cardiac surgery. METHOD(S): From January to December 2021, all the
patients who underwent elective cardiac operation were randomly divided
into two cohorts based on the type of cardioplegia: DNC group and SBC
group. Three categories of variables were compared: patient demographics,
clinical variables, and laboratory variables. RESULT(S): A total of
133 patients were enrolled in this study: DNC group, n = 65; and SBC
group, n = 68. Except that the volume of cardioplegia administration were
obvious less in the DNC group (P <0.01), no significant difference was
found in the other postoperative clinical variables (P >0.05). No
statistical significance was proved (P >0.05) in postoperative troponin I,
creatine kinase, and B-type natriuretic peptide. The malondialdehyde
concentration was higher in the SBC group, whether it is at 4 hours (P
<0.05) or 24 hours (P >0.05) after operation. At the same two points in
time, the change in superoxide dismutase activity was more significant in
the SBC group (P <0.05). CONCLUSION(S): The DNC cardioplegia was safe
and effective on adult myocardium protection. The potential antioxidant
stress effect in DNC may provide a direction for further improvement on
the formula of cardioplegic solution.

<30>
Accession Number
639801053
Title
Conventional Prostheses versus Sutureless Perceval for Aortic Valve
Replacement: A Meta-Analysis.
Source
Annals of thoracic and cardiovascular surgery : official journal of the
Association of Thoracic and Cardiovascular Surgeons of Asia. 29(3) (pp
107-124), 2023. Date of Publication: 20 Jun 2023.
Author
Colarossi G.; Migliorini F.; Becker M.; Arias J.P.; Autschbach R.; Moza
A.; Aljalloud A.
Institution
(Colarossi, Arias, Autschbach, Moza, Aljalloud) Department of Thoracic and
Cardiovascular Surgery, RWTH University Hospital Aachen, Aachen, Germany
(Colarossi, Becker, Aljalloud) Department of Cardiology, Germany
(Migliorini) Department of Orthopaedic, Trauma, Reconstructive Surgery,
RWTH University Hospital Aachen, Aachen, Germany
Publisher
NLM (Medline)
Abstract
PURPOSE: Perceval sutureless valves have gained popularity. Whether this
implant performs superior to the traditional sutured prosthesis remains
unclear. This meta- analysis compared the Perceval implants versus the
sutured conventional valves for aortic valve replacement (AVR).
 METHOD(S): This meta-analysis was conducted according to the
Preferred Reporting Items for Systematic Reviews and Meta-Analyses
guidelines. The following databases were accessed: PubMed, Google Scholar,
Web of Science, Scopus, and EMBASE. All clinical investigations comparing
Perceval versus the conventional prostheses for AVR were considered.
 RESULT(S): The Perceval group demonstrated higher rate of pacemaker
implantation (P <0.00001). Aortic cross-clamp (ACC) time (P <0.00001) and
cardiopulmonary bypass (CPB) time (P <0.00001) were shorter in the
Perceval group. Similarity was found in mean and peak pressure gradient (P
= 0.8 and P = 0.2, respectively), mean aortic valve area (P = 0.3), length
of intensive care unit (P = 0.4) and hospital stay (P = 0.2), rate of
revision (P = 0.11), hemorrhages (P = 0.05), paravalvular leak (P = 0.3),
cerebrovascular complication (P = 0.7), and early mortality (P = 0.06).
 CONCLUSION(S): Given the shorter ACC time and CPB time, Perceval AVR
can be an alternative in high-risk patients. The higher rate of pacemaker
implantation following Perceval may limit its routine implantation.

<31>
Accession Number
2025335293
Title
Calcification of Synthetic Vascular Grafts: A Systematic Review.
Source
EJVES Vascular Forum. 60 (pp 1-7), 2023. Date of Publication: January
2023.
Author
Lejay A.; Bratu B.; Kuntz S.; Neumann N.; Heim F.; Chakfe N.
Institution
(Lejay, Bratu, Kuntz, Chakfe) Department of Vascular Surgery and Kidney
Transplantation, University Hospital of Strasbourg, France
(Lejay, Kuntz, Neumann, Heim, Chakfe) Gepromed, Medical Device Hub for
Patient Safety, Strasbourg, France
(Heim) Laboratoire de Physique et Mecanique Textiles (LPMT), ENSISA,
Mulhouse, France
Publisher
Elsevier Ltd
Abstract
Objective: Calcification of vascular grafts, including polyethylene
terephthalate (PET) and expanded polytetrafluoroethylene (ePTFE) grafts
may contribute to graft failure, but is under reported. The aim of this
study was to review the literature to assess whether vascular graft
calcification is deleterious to vascular graft outcomes. Data sources: The
Medline and Embase databases were searched. Review methods: A systematic
literature search according to PRISMA Guidelines was performed using a
combined search strategy of MeSH terms. The MeSH terms used were
"calcification, physiologic", "calcinosis", "vascular grafting", "blood
vessel prosthesis", "polyethylene terephthalates", and
"polytetrafluoroethylene". Result(s): The systematic search
identified 17 cases of PET graft calcification and 73 cases of ePTFE graft
calcification over a 35 year period. All cases of PET graft calcification
were reported in grafts explanted for graft failure. The majority of cases
of ePTFE graft calcification were unexpectedly noted in grafts used during
cardiovascular procedures and subsequently removed. Conclusion(s):
Calcification of synthetic vascular grafts is under reported but can
compromise the long term performance of the grafts. More data, including
specific analysis of radiological findings as well as explant analysis are
needed to obtain a more sensitive and specific analysis of the prevalence
and incidence of vascular graft calcification and the impact of
calcification on synthetic graft outcomes. Copyright © 2023 The
Authors

<32>
[Use Link to view the full text]
Accession Number
2025334285
Title
Prevalence and Characteristics of Persistent Postoperative Pain After
Thoracic Surgery: A Systematic Review and Meta-Analysis.
Source
Anesthesia and Analgesia. 137(1) (pp 48-57), 2023. Date of Publication: 01
Jul 2023.
Author
Wang L.; Yang M.; Meng W.
Institution
(Wang, Meng) Department of Nursing, Xinyang Vocational and Technical
College, Henan, Xinyang, China
(Yang) Department of Coronary Intensive Care Unit, Xinyang Vocational and
Technical College Affiliated Hospital, Henan, Xinyang, China
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND: A systematic review and meta-analysis was conducted to
investigate the prevalence and characteristics of persistent (>=3 months)
postoperative pain (PPP) after thoracic surgery. METHOD(S): For this
purpose, Medline, Embase, and CINAHL databases were searched for the
prevalence and characteristics of PPP after thoracic surgery from their
inception to May 1, 2022. Random-effect meta-analysis was used to estimate
pooled prevalence and characteristics. RESULT(S): We included 90
studies with 19,001 patients. At a median follow-up of 12 months, the
pooled overall prevalence of PPP after thoracic surgery was 38.1% (95%
confidence interval [CI], 34.1-42.3). Among patients with PPP, 40.6% (95%
CI, 34.4-47.2) and 10.1% (95% CI, 6.8-14.8) experienced moderate-to-severe
(rating scale >=4/10) and severe (rating scale >=7/10) PPP, respectively.
Overall, 56.5% (95% CI, 44.3-67.9) of patients with PPP required opioid
analgesic use, and 33.0% (95% CI, 22.5-44.3) showed a neuropathic
component. CONCLUSION(S): One in 3 thoracic surgery patients
developed PPP. There is a need for adequate pain treatment and follow-up
in patients undergoing thoracic surgery. Copyright © 2023
Lippincott Williams and Wilkins. All rights reserved.

<33>
[Use Link to view the full text]
Accession Number
2025334284
Title
Practice Advisory for Preoperative and Intraoperative Pain Management of
Cardiac Surgical Patients: Part 2.
Source
Anesthesia and Analgesia. 137(1) (pp 26-47), 2023. Date of Publication: 01
Jul 2023.
Author
Makkad B.; Heinke T.L.; Sheriffdeen R.; Khatib D.; Brodt J.L.; Meng M.-L.;
Grant M.C.; Kachulis B.; Popescu W.M.; Wu C.L.; Bollen B.A.
Institution
(Makkad) Department of Anesthesiology, University of Cincinnati Medical
Center, Cincinnati, OH, United States
(Heinke) Department of Anesthesia and Perioperative Medicine, Medical
University of South Carolina, Charleston, SC, United States
(Sheriffdeen) Department of Anesthesiology, Medstar Washington Hospital
Center, Washington, DC, United States
(Khatib) Department of Anesthesiology, Weil Cornell Medical College, New
York, NY, United States
(Brodt) Department of Anesthesiology, Perioperative and Pain Medicine,
Stanford University, Stanford, CA, United States
(Meng) Department of Anesthesiology, Duke University Medical Center,
Durham, NC, United States
(Grant) Department of Anesthesiology and Critical Care Medicine, Johns
Hopkins University School of Medicine, Baltimore, MD, United States
(Kachulis) Department of Anesthesiology, Columbia University, New York,
NY, United States
(Popescu) Department of Anesthesiology, Yale School of Medicine, New
Haven, CT, United States
(Popescu) Va Connecticut Healthcare System, West Haven, CT, United States
(Wu) Department of Anesthesiology, Hospital of Special Surgery, Weill
Cornell Medical College, New York, NY, United States
(Bollen) Missoula Anesthesiology, Missoula, MT, United States
(Bollen) The International Heart Institute of Montana, Missoula, MT,
United States
Publisher
Lippincott Williams and Wilkins
Abstract
Pain after cardiac surgery is of moderate to severe intensity, which
increases postoperative distress and health care costs, and affects
functional recovery. Opioids have been central agents in treating pain
after cardiac surgery for decades. The use of multimodal analgesic
strategies can promote effective postoperative pain control and help
mitigate opioid exposure. This Practice Advisory is part of a series
developed by the Society of Cardiovascular Anesthesiologists (SCA)
Quality, Safety, and Leadership (QSL) Committee's Opioid Working Group. It
is a systematic review of existing literature for various interventions
related to the preoperative and intraoperative pain management of cardiac
surgical patients. This Practice Advisory provides recommendations for
providers caring for patients undergoing cardiac surgery. This entails
developing customized pain management strategies for patients, including
preoperative patient evaluation, pain management, and opioid use-focused
education as well as perioperative use of multimodal analgesics and
regional techniques for various cardiac surgical procedures. The
literature related to this field is emerging, and future studies will
provide additional guidance on ways to improve clinically meaningful
patient outcomes. Copyright © 2023 Lippincott Williams and
Wilkins. All rights reserved.

<34>
[Use Link to view the full text]
Accession Number
2025334283
Title
Practice Advisory for Preoperative and Intraoperative Pain Management of
Thoracic Surgical Patients: Part 1.
Source
Anesthesia and Analgesia. 137(1) (pp 2-25), 2023. Date of Publication: 01
Jul 2023.
Author
Makkad B.; Heinke T.L.; Sheriffdeen R.; Khatib D.; Brodt J.L.; Meng M.-L.;
Grant M.C.; Kachulis B.; Popescu W.M.; Wu C.L.; Bollen B.A.
Institution
(Makkad) Department of Anesthesiology, University of Cincinnati Medical
Center, Cincinnati, OH, United States
(Heinke) Department of Anesthesia and Perioperative Medicine, Medical
University of South Carolina, Charleston, SC, United States
(Sheriffdeen) Department of Anesthesiology, Medstar Washington Hospital
Center, Washington, DC, United States
(Khatib) Department of Anesthesiology, Weil Cornell Medical College, New
York, NY, United States
(Brodt) Department of Anesthesiology, Perioperative and Pain Medicine,
Stanford University, Stanford, CA, United States
(Meng) Department of Anesthesiology, Duke University Medical Center,
Durham, NC, United States
(Grant) Department of Anesthesiology and Critical Care Medicine, Johns
Hopkins University School of Medicine, Baltimore, MD, United States
(Kachulis) Department of Anesthesiology, Columbia University, New York,
NY, United States
(Popescu) Department of Anesthesiology, Yale School of Medicine, New
Haven, CT, United States
(Wu) Department of Anesthesiology, Hospital of Special Surgery, Weill
Cornell Medical College, New York, NY, United States
(Bollen) Missoula Anesthesiology and the International Heart Institute of
Montana, Missoula, MT, United States
Publisher
Lippincott Williams and Wilkins
Abstract
Pain after thoracic surgery is of moderate-to-severe intensity and can
cause increased postoperative distress and affect functional recovery.
Opioids have been central agents in treating pain after thoracic surgery
for decades. The use of multimodal analgesic strategies can promote
effective postoperative pain control and help mitigate opioid exposure,
thus preventing the risk of developing persistent postoperative pain. This
practice advisory is part of a series developed by the Society of
Cardiovascular Anesthesiologists (SCA) Quality, Safety, and Leadership
(QSL) Committee's Opioid Working Group. It is a systematic review of
existing literature for various interventions related to the preoperative
and intraoperative pain management of thoracic surgical patients and
provides recommendations for providers caring for patients undergoing
thoracic surgery. This entails developing customized pain management
strategies for patients, which include preoperative patient evaluation,
pain management, and opioid use-focused education as well as perioperative
use of multimodal analgesics and regional techniques for various thoracic
surgical procedures. The literature related to this field is emerging and
will hopefully provide more information on ways to improve clinically
relevant patient outcomes and promote recovery in the
future. Copyright © 2023 Lippincott Williams and Wilkins. All
rights reserved.

<35>
Accession Number
641657684
Title
Effects of remote ischaemic preconditioning on myocardial injury after
major abdominal surgery in patients at high risk for cardiovascular
adverse events in China (RIPC-MAS): protocol for a randomised,
sham-controlled, observer-blinded trial.
Source
BMJ open. 13(6) (pp e073038), 2023. Date of Publication: 23 Jun 2023.
Author
Wang F.; Liang C.-J.; Shi J.-K.; Huang Q.-S.; Nassirou B.M.; Wang X.; Jin
S.-Q.; Zhao Y.
Institution
(Wang, Liang, Shi, Huang, Nassirou) Department of Anaesthesia, Sixth
Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China
(Wang, Liang, Shi, Huang, Nassirou, Jin, Zhao) Biomedical Innovation
Center, Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou,
Guangdong, China
(Wang) Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou,
Guangdong, China
(Jin) Department of Anaesthesia, Sixth Affiliated Hospital, Sun Yat-sen
University, Guangzhou, Guangdong, China
(Zhao) Department of Anaesthesia, Sixth Affiliated Hospital, Sun Yat-sen
University, Guangzhou, Guangdong, China
Publisher
NLM (Medline)
Abstract
INTRODUCTION: Myocardial injury after non-cardiac surgery (MINS) caused by
an ischaemic mechanism is common and is associated with adverse short-term
and long-term prognoses. However, MINS is a recent concept, and few
studies have prospectively used it as a primary outcome. Remote ischaemic
preconditioning (RIPC) is a non-invasive procedure that induces innate
cardioprotection and may reduce MINS. METHODS AND ANALYSIS: This is a
multicentre, randomised, sham-controlled, observer-blinded trial. Patients
with a high clinical risk of cardiovascular events who are scheduled to
undergo major abdominal surgery will be enrolled. A total of 766
participants will be randomised (1:1 ratio) to receive RIPC or control
treatment before anaesthesia. RIPC will comprise four cycles of cuff
inflation for 5 min to 200 mm Hg and deflation for 5 min. In the controls,
an identical-looking cuff will be placed around the arm but will not be
actually inflated. The primary outcome will be MINS, defined as at least
one postoperative cardiac troponin (cTn) concentration above the 99th
percentile upper reference limit of the cTn assay as a result of a
presumed ischaemic mechanism. This trial will test the concentration of
high-sensitivity cardiac troponin T (hs-cTnT). The secondary outcomes will
be hs-cTnT levels reaching/above the prognostically important thresholds,
peak hs-cTnT and total hs-cTnT release during the initial 3 days after
surgery, length of hospital stay after surgery, length of stay in the
intensive care unit, myocardial infarction, major adverse cardiovascular
events, cardiac-related death, all-cause death within 30 days, 6 months, 1
year and 2 years after surgery, and postoperative complications and
adverse events within 30 days after surgery. ETHICS AND DISSEMINATION:
This study protocol (version 5.0 on 7 April 2023) was approved by the
Ethics Committee of Sixth Affiliated Hospital of Sun Yat-sen University.
The findings will be published in peer-reviewed journals. TRIAL
REGISTRATION NUMBER: NCT05733208. Copyright © 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.

<36>
Accession Number
2024441526
Title
A Systematic Review and Statistical Analysis of Factors Influencing the
Cost-Effectiveness of Transcatheter Aortic Valve Implantation for
Symptomatic Severe Aortic Stenosis.
Source
ClinicoEconomics and Outcomes Research. 15 (pp 459-475), 2023. Date of
Publication: 2023.
Author
Heathcote L.; Candolfi P.; Srivastava T.; Sarmah A.; Kearns B.; Sutton A.
Institution
(Heathcote, Srivastava, Kearns, Sutton) School for Health and Related
Research, University of Sheffield, Sheffield, United Kingdom
(Candolfi, Sarmah) Edwards Lifesciences SA, Nyon, Switzerland
Publisher
Dove Medical Press Ltd
Abstract
Objective: Transcatheter aortic valve implantation (TAVI) is a disruptive
technology recommended for patients with symptomatic severe aortic
stenosis (sSAS). Despite being available for over 15 years in Europe, with
an extensive volume of clinical and economic evaluations across all
surgical risk groups, there is little evidence on the identification of
the key drivers of TAVI's cost-effectiveness. This study sought to
identify these factors and quantify their role. Method(s): A
systematic literature review was conducted to identify published economic
evaluations of TAVI. This was supplemented by health technology assessment
reports. The primary outcome was the likelihood of TAVI being found
cost-effective. Secondary outcomes of TAVI being dominant, and the
incremental health benefits of TAVI were also explored. Result(s):
Forty-two studies, reporting 65 unique analyses, were identified. TAVI was
found to be cost-effective and dominant in 74% and 20% of analyses,
respectively. The latest generation balloon-expandable TAVI device (SAPIEN
3) was more likely to be found cost-effective, as was TAVI use in low-risk
populations and when performed via transfemoral access route. There was
heterogeneity in the approach taken to economic modelling, which may also
influence estimates of cost-effectiveness. Analyses that found TAVI to be
dominant always compared it to surgery and usually considered the latest
generation balloon-expandable TAVI device. Largest health benefits were
observed for the inoperable risk group. Conclusion(s): For patients
with sSAS, TAVI is typically a cost-effective treatment option. There are
important differences by device generation, risk group and access route.
It is crucial to consider these differences when appraising the health
economic evidence-base for TAVI. Copyright © 2023 Heathcote et
al.

<37>
Accession Number
2025302627
Title
Influences of etomidate combined with propofol on cognitive function,
inflammation and immunity in patients undergoing gastric cancer surgery.
Source
Cellular and Molecular Biology. 69(4) (pp 81-85), 2023. Date of
Publication: 2023.
Author
Tian X.
Institution
(Tian) Department of Anesthesia, Affiliated Geriatric Hospital, Wuhan
University of Science and Technology, Hubei Province, Wuhan 430205, China
Publisher
Cellular and Molecular Biology Association
Abstract
This study examined how etomidate combined with propofol affected
cognitive function, inflammation, and immunity in patients undergoing
gastric cancer surgery. 182 gastric cancer patients treated in our
hospital were enrolled and randomly divided into two groups, namely group
A (anesthetized using etomidate) and group B (anesthetized using etomidate
combined with propofol). Then the cognitive function, inflammation and
immunity indicators were determined in the two groups. Compared with group
A, group B exhibited shorter operation duration and hospital stay and
smaller bleeding volume (p<0.01). At 3 d after the operation, group B had
a higher Ramsay score, but a lower visual analogue scale (VAS) score than
group A (p<0.05). Moreover, the mini-mental state examination (MMSE) score
was lower in group A than that in group B (p<0.01). At the end of the
operation, the heart rate (HR), mean arterial pressure (MAP) and
saturation of pulse oxygen (SpO2) were decreased to a great extent in both
groups compared with those before anesthesia (p<0.05). Compared with those
before anesthesia, the levels of immunoglobulin (Ig)M, IgG and IgA were
lower in group A at the end of the operation and 1 and 3 d after the
operation (p<0.05), but they were substantially higher in group B than
those in group A (p<0.05). At the end of the operation and 1 and 3 d after
the operation, the levels of the T-cell subset indicators decreases in
group A were greater than those in group B (p<0.05). Etomidate combined
with propofol has few influences on the immune and cognitive functions of
gastric cancer patients and can effectively lower the expression levels of
inflammatory factors in these patients. Copyright © 2023 Cellular
and Molecular Biology Association. All rights reserved.

<38>
Accession Number
2025293853
Title
Impact of Malnutrition in Patients With Heart Failure and Secondary Mitral
Regurgitation: The COAPT Trial.
Source
Journal of the American College of Cardiology. 82(2) (pp 128-138), 2023.
Date of Publication: 11 Jul 2023.
Author
Scotti A.; Coisne A.; Granada J.F.; Driggin E.; Madhavan M.V.; Zhou Z.;
Redfors B.; Kar S.; Lim D.S.; Cohen D.J.; Lindenfeld J.; Abraham W.T.;
Mack M.J.; Asch F.M.; Stone G.W.
Institution
(Scotti, Coisne, Granada, Madhavan, Zhou, Redfors, Cohen) Cardiovascular
Research Foundation, New York, NY, United States
(Scotti, Coisne) Montefiore-Einstein Center for Heart and Vascular Care,
Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY,
United States
(Coisne) University of Lille, Inserm, CHU Lille, Institut Pasteur de
Lille, Lille, France
(Driggin, Madhavan, Redfors) Division of Cardiology, New York-Presbyterian
Hospital/Columbia University Irving Medical Center, New York, NY, United
States
(Redfors) Department of Cardiology, Sahlgerenska University Hospital,
Gothenburg, Sweden
(Kar) Los Robles Regional, Thousand Oaks, CA, United States
(Kar) Bakersfield Heart Hospital, Bakersfield, CA, United States
(Lim) Division of Cardiology, Department of Medicine, University of
Virginia Health System, Charlottesville, VA, United States
(Cohen) Saint Francis Hospital, Roslyn, NY, United States
(Lindenfeld) Advanced Heart Failure and Cardiac Transplantation Section,
Vanderbilt Heart and Vascular Institute, Nashville, TN, United States
(Abraham) Division of Cardiovascular Medicine, The Ohio State University,
Columbus, OH, United States
(Mack) Baylor Scott & White Health, Plano, TX, United States
(Asch) MedStar Health Research Institute, Georgetown University,
Washington, DC, United States
(Stone) The Zena and Michael A. Wiener Cardiovascular Institute, Icahn
School of Medicine at Mount Sinai, New York, NY, United States
Publisher
Elsevier Inc.
Abstract
Background: Although malnutrition is associated with poor prognosis in
several diseases, its prognostic impact in patients with heart failure
(HF) and secondary mitral regurgitation (SMR) is not understood.
 Objective(s): The purpose of this study was to assess the prevalence
and impact of malnutrition in HF patients with severe SMR randomized to
transcatheter edge-to-edge repair (TEER) with the MitraClip plus
guideline-directed medical therapy (GDMT) vs GDMT alone in the COAPT
trial. Method(s): Baseline malnutrition risk was calculated using the
validated geriatric nutritional risk index (GNRI) score. Patients were
categorized as having "malnutrition" (GNRI <=98) vs "no malnutrition"
(GNRI >98). Outcomes were assessed through 4 years. The primary endpoint
of interest was all-cause mortality. Result(s): Among 552 patients,
median baseline GNRI was 109 (IQR: 101-116); 94 (17.0%) had malnutrition.
All-cause mortality at 4 years was greater in patients with vs those
without malnutrition (68.3% vs 52.8%; P = 0.001). Using multivariable
analysis, both baseline malnutrition (adjusted-HR [adj-HR]: 1.37; 95% CI:
1.03-1.82; P = 0.03) and randomization to TEER plus GDMT compared with
GDMT alone (adj-HR: 0.65; 95% CI: 0.51-0.82; P = 0.0003) were independent
predictors of 4-year mortality. In contrast, GNRI was unrelated to the
4-year rate of heart failure hospitalization (HFH), although TEER
treatment reduced HFH (adj-HR: 0.46; 95% CI: 0.36-0.56). The reductions in
death (adj-P<inf>interaction</inf> = 0.46) and HFH
(adj-P<inf>interaction</inf> = 0.67) with TEER were consistent in patients
with and without malnutrition. Conclusion(s): Malnutrition was
present in 1 of 6 patients with HF and severe SMR enrolled in COAPT and
was independently associated with increased 4-year mortality (but not
HFH). TEER reduced mortality and HFH in patients with and without
malnutrition. (Cardiovascular Outcomes Assessment of the MitraClip
Percutaneous Therapy for Heart Failure Patients With Functional Mitral
Regurgitation [The COAPT Trial] and COAPT CAS [COAPT];
NCT01626079) Copyright © 2023 American College of Cardiology
Foundation

<39>
Accession Number
2025326659
Title
Systematic review and meta-analysis of the treatment strategies for
coronary artery bypass graft patients with concomitant carotid artery
atherosclerotic disease.
Source
Journal of Vascular Surgery. (no pagination), 2023. Date of Publication:
2023.
Author
Tsukagoshi J.; Yokoyama Y.; Fujisaki T.; Takagi H.; Shirasu T.; Kuno T.
Institution
(Tsukagoshi) Department of Surgery, University of Texas Medical Branch,
Galveston, TX, United States
(Yokoyama) Department of Surgery, St. Luke's University Health Network,
Bethlehem, PA, United States
(Fujisaki) Department of Medicine, Icahn School of Medicine at Mount
Sinai, Mount Sinai Morningside and West, New York, NY, United States
(Fujisaki) Department of Cardiovascular Medicine, Graduate School of
Medical Sciences, Kumamoto University, Kumamoto, Japan
(Takagi) Department of Cardiovascular Surgery, Shizuoka Medical Center,
Shizuoka, Japan
(Shirasu) Division of Vascular Surgery, Department of Surgery, The
University of Tokyo, Tokyo, Japan
(Kuno) Department of Cardiology, Montefiore Medical Center, Albert
Einstein College of Medicine, Bronx, NY, United States
Publisher
Elsevier Inc.
Abstract
Objective: Stroke is one of the devastating complications after coronary
artery bypass graft (CABG). Underlying carotid artery atherosclerotic
disease is reported to be an independent risk factor. The optimal
treatment strategy for these patients remains under debate.
 Method(s): We aimed to perform a network meta-analysis to evaluate
the safety and efficacy of additional carotid interventions for patients
with concomitant carotid artery atherosclerotic disease who require CABG
by comparing perioperative adverse event rates. All articles through
February 2022 were searched using MEDLINE and EMBASE to identify studies
that investigated outcomes of CABG only as well as additional staged vs
combined carotid interventions by both carotid endarterectomy (CEA) and
carotid artery stenting (CAS). Result(s): Two randomized controlled
trials and 23 observational studies were included, yielding a total of
32,473 patients who underwent combined CEA and CABG (n = 20,204), CEA and
staged CABG (n = 6882), CABG and staged CEA (n = 340), CAS and CABG
regardless of timing and sequences (n = 1224), and CABG only (n = 3823).
No strategy showed a significant advantage over CABG only in all
perioperative outcomes. CEA and staged CABG was associated with the lowest
perioperative stroke/transient ischemic attack (TIA) rate, significantly
lower compared with CAS and CABG (odds ratio [OR], 0.52; 95% confidence
interval [CI], 0.36-0.76) as well as CABG and staged CEA (OR, 0.41; 95%
CI, 0.23-0.74), but was also associated with the highest perioperative
mortality (OR, 2.50; 95% CI, 1.67-3.85, vs CAS and CABG) and myocardial
infarction rate (OR, 3.70 [95% CI, 1.16-12.5] and OR, 2.50 [95% CI,
1.35-4.55] vs CAS and CABG, vs combined CEA and CABG, respectively).
 Conclusion(s): CEA and staged CABG are associated with low
perioperative stroke/transient ischemic attack rates with a tradeoff of
higher mortality and myocardial infarction rate. No strategy showed a
significant advantage over the CABG-only strategy in all perioperative
outcomes, outlining the importance of a tailored approach and determining
proper indications for carotid intervention in these
patients. Copyright © 2023 Society for Vascular Surgery

<40>
Accession Number
2025248170
Title
Efficacy and Safety of Moderate-Intensity Continuous Training on the
Improvement of Cardiopulmonary Function in Patients After Transcatheter
Aortic Valve Replacement (ENERGY): A Randomized Controlled Trial.
Source
Journal of the American Medical Directors Association. (no pagination),
2023. Date of Publication: 2023.
Author
Hu Q.; Li Y.-S.; Ren Q.; Liang Y.-C.; Zhang J.; Wang Y.-X.; Wang C.-L.;
Hong T.-L.; Wang S.-Y.; Zhang Y.; Zhang Q.-Y.; Han Y.-L.
Institution
(Hu, Li, Ren, Liang, Zhang, Wang, Wang, Hong, Wang, Zhang, Zhang, Han)
Department of Cardiology, General Hospital of Northern Theater Command,
Shenyang, China
(Hu) Department of Cardiology, Air Force Hospital of Western Theater
Command, Chengdu, China
Publisher
Elsevier Inc.
Abstract
Objectives: To investigate the effect of moderate-intensity continuous
training (MICT) on the improvement of cardiopulmonary function for
patients undergoing transcatheter aortic valve replacement (TAVR).
 Design(s): Randomized controlled study. Setting and Participants:
Between August 20, 2021, and February 28, 2022, a total of 66 patients
after TAVR were screened for inclusion and randomly divided into the MICT
and control groups at a ratio of 1:1. MICT was scheduled 3 times per week
for 3 months in the intervention group. Patients in the control group
received one-time advice on physical activity according to the current
guideline. Method(s): The primary endpoint was the 3-month change in
peak oxygen consumption (peak VO<inf>2</inf>) assessed by cardiopulmonary
exercise testing. The secondary endpoints included the 3-month change in
6-minute walk test (6MWT), the 12-Item Short Form Health Survey (SF-12),
New York Heart Association (NYHA) class, echocardiographic parameters, and
laboratory parameters. Result(s): After 3 months, the change in peak
VO<inf>2</inf> was higher in the MICT group than that in the control group
(1.63 mL/kg/min, 95% CI 0.58-2.67, P = .003). Change in 6MWT (21.55 m, 95%
CI 0.38-42.71, P = .046) was higher in the MICT group compared with the
control group. A significant change in favor of MICT was also observed for
low-density lipoprotein cholesterol (-0.62 mmol/L, 95% CI -1.00 to -0.23,
P = .002). However, there were no significant changes in other
echocardiographic indices, laboratory parameters, and SF-12 between the 2
groups (all P > .05). Conclusions and Implications: MICT had a positive
effect on the cardiopulmonary function and physical capacity of patients
after TAVR. Copyright © 2023 AMDA - The Society for Post-Acute
and Long-Term Care Medicine

<41>
Accession Number
2025206316
Title
Efficacy of intraoperative thoracoscopic intercostal nerve blocks in
nonintubated and intubated video-assisted thoracic surgery: A randomized
study.
Source
Journal of the Formosan Medical Association. (no pagination), 2023. Date
of Publication: 2023.
Author
Chan K.-C.; Wu L.-L.; Han S.-C.; Chen J.-S.; Cheng Y.-J.
Institution
(Chan) Department of Anesthesiology, National Taiwan University Hospital,
Taipei, Taiwan (Republic of China)
(Wu, Han, Cheng) Department of Anesthesiology, National Taiwan University
Cancer Center, National Taiwan University College of Medicine, Taipei,
Taiwan (Republic of China)
(Chen) Department of Surgery, National Taiwan University Cancer Center,
National Taiwan University College of Medicine, Taipei, Taiwan (Republic
of China)
Publisher
Elsevier B.V.
Abstract
Background: The efficacy of thoracoscopic intercostal nerve blocks (TINBs)
for noxious stimulation from video-assisted thoracic surgery (VATS)
remains unclear. The efficacy of TINBs may also be different between
nonintubated VATS (NIVATS) and intubated VATS (IVATS). We aim to compare
the efficacy of TINBs on analgesia and sedation for NIVATS and IVATs
intraoperatively. Method(s): Sixty patients randomized to the NIVATS
or IVATS group (30 each) received target-controlled propofol and
remifentanil infusions, with bispectral index (BIS) maintained at 40-60,
and multilevel (T3-T8) TINBs before surgical manipulations. Intraoperative
monitoring data, including pulse oximetry, mean arterial pressure (MAP),
heart rate, BIS, density spectral arrays (DSAs), and propofol and
remifentanil effect-site concentration (Ce) at different time points. A
two way ANOVA with post hoc analysis was applied to analyze the
differences and interactions of groups and time points. Result(s): In
both groups, DSA monitoring revealed burst suppression and alpha dropout
immediately after the TINBs. The Ce of the propofol infusion had to be
reduced within 5 min post-TINBs in both NIVATS (p < 0.001) and IVATS (p =
0.252) groups. The Ce of remifentanil infusion was significantly reduced
after TINBs in both groups (p < 0.001), and was significantly lower in
NIVATS (p < 0.001) without group interactions. Conclusion(s): The
surgeon-performed intraoperative multilevel TINBs allow reduced anesthetic
and analgesic requirement for VATS. With lower requirement of remifentanil
infusion, NIVATS presents a significantly higher risk of hypotension after
TINBs. DSA is beneficial for providing real-time data that facilitate the
preemptive management, especially for NIVATS. Copyright © 2023

<42>
Accession Number
2025144498
Title
Effect of vitamin D on postoperative atrial fibrillation in patients who
underwent coronary artery bypass grafting: A systematic review and
meta-analysis.
Source
Journal of Cardiology. (no pagination), 2023. Date of Publication: 2023.
Author
Hameed I.; Malik S.; Nusrat K.; Siddiqui O.M.; Khan M.O.; Mahmood S.;
Memon A.; Usman M.S.; Siddiqi T.J.
Institution
(Hameed, Malik, Nusrat, Siddiqui, Khan, Mahmood, Memon) Dow University of
Health Sciences, Karachi, Pakistan
(Usman, Siddiqi) University of Mississippi Medical Center, Jackson, MS,
United States
Publisher
Japanese College of Cardiology (Nippon-Sinzobyo-Gakkai)
Abstract
Background: Vitamin D insufficiency/deficiency has been identified as a
risk factor for postoperative atrial fibrillation (POAF) after coronary
artery bypass grafting (CABG). This is associated with significantly
increased morbidity and mortality leading to not only prolonged hospital
and intensive care unit (ICU) stay, but increased risk of stroke, heart
failure, dementia, and long-term atrial fibrillation. This analysis aims
to evaluate the efficacy of vitamin D supplementation in preventing POAF
in patients undergoing CABG. Method(s): We searched PubMed, Cochrane
Central Register of Controlled Trials and SCOPUS from inception to June
2022 for randomized controlled trials (RCTs). The outcome of interest was
the incidence of POAF. Secondarily, we analyzed the length of ICU stay,
length of hospital stay, cardiac arrest, cardiac tamponade, and blood
transfusion. Results were pooled using a random-effect model. Three RCTs
consisting of 448 patients were included. Result(s): Our results
suggest that vitamin D significantly reduced the incidence of POAF (RR:
0.60; 95 % CI: 0.40, 0.90; p = 0.01; I2 = 8 %). It was also
observed that vitamin D significantly reduced the duration of ICU stay
(WMD: -1.639; 95 % CI: -1.857, -1.420; p < 0.00001). Furthermore, the
length of hospital stay (WMD: -0.85; 95 % CI: -2.14, 0.43; p = 0.19;
I2 = 87 %) was also reduced, however, the result was not
significant. Conclusion(s): Our pooled analysis suggests that vitamin
D prevents POAF. Future large-scale randomized trials are needed to
confirm our results. Copyright © 2023 Elsevier Ltd

<43>
Accession Number
641658464
Title
Virtual reality-assisted distraction during transcatheter aortic valve
implantation under local anaesthesia: A randomised study.
Source
International journal of cardiology. (pp 131130), 2023. Date of
Publication: 22 Jun 2023.
Author
Lind A.; Esfahan M.A.; Totzeck M.; Al-Rashid F.; Haddad A.; Dubler S.;
Brenner T.; Skarabis A.; Mohamed E.G.; Rassaf T.; Janosi R.A.
Institution
(Lind, Esfahan, Totzeck, Al-Rashid, Rassaf, Janosi) Department of
Cardiology and Vascular Medicine, West-German Heart and Vascular Center
Essen, University Hospital Essen, University Duisburg-Essen, Essen,
Germany
(Haddad, Dubler, Brenner, Skarabis) Department of Anaesthesiology and
Intensive Care Medicine, University Hospital Essen, University
Duisburg-Essen, Essen, Germany
(Mohamed) Department of Heart Surgery, West-German Heart and Vascular
Center Essen, University Hospital Essen, University Duisburg-Essen, Essen,
Germany
Publisher
NLM (Medline)
Abstract
BACKGROUND: A minimal approach, using local anaesthesia alone, has been
advocated to promote faster transcatheter aortic valve replacement (TAVR)
procedures in intermediate-risk patients. Pre- and periprocedural anxiety
and pain remain a concern. Virtual reality (VR) is a form of
non-pharmacological distraction that can potentially modulate pain and
anxiety. This randomised study explored whether VR reduces pain and
anxiety during TAVR without sedation and compared the effects of VR with
those of standard care. METHODS AND RESULTS: Between June 2022 and March
2023, 207 patients underwent transfemoral TAVR (TF-TAVR). Of these, 117
(56.5%) patients were willing to participate in the study and met the
educational background and mental status criteria for assessment.
Fifty-nine patients underwent TF-TAVR with VR glasses (VR group).
Fifty-eight patients underwent standard TF-TAVR without VR (control group;
CG). Post-interventional anxiety scores (STAI-S) (31.5+/-13.4 vs.
38.5+/-19.2, p=0.02) and the perceived duration of the procedure
(60.1+/-32.3 vs. 73.0+/-32.4, p=0.04) were lower in the VR than in the CG.
Procedure time, pain, and anxiety scores (visual analogue scale) were
similar between the groups. The complication rate was low and not
associated with VR. Post-interventional delirium occurred in nine
patients, and was similar between the groups (VR: 4 [6.8%] vs. CG: 5
[8.6%], p=0.71). No periprocedural strokes were observed.
 CONCLUSION(S): VR for TAVR is feasible and safe and expands the
non-drug spectrum of therapy for anxiety and pain in patients undergoing
TAVR with a minimalistic approach. Copyright © 2023. Published by
Elsevier B.V.

<44>
Accession Number
641658421
Title
3-Year Outcome in Patients With Combined Precapillary and Postcapillary
Pulmonary Hypertension: Results From PADN-5 Trial.
Source
JACC. Heart failure. (no pagination), 2023. Date of Publication: 12 Jun
2023.
Author
Zhang H.; Kan J.; Zhang J.; Xie D.; Li X.; Zhou W.; Dong J.; Gu H.; Han
Y.; Chen S.-L.
Institution
(Zhang, Kan, Zhang, Zhou) Division of Cardiology, Nanjing First Hospital,
Nanjing Medical University, Nanjing, China
(Xie, Li) Division of Cardiology, Nanjing Cardiovascular Hospital,
Nanjing, China
(Dong, Gu) Division of Pulmonology, Anzhen Hospital, Capital Medical
University, Beijing, China
(Han) Division of Cardiology, Shenyang Northern Hospital, Shenyang, China
(Chen) Division of Cardiology, Nanjing First Hospital, Nanjing Medical
University, Nanjing, China
Publisher
NLM (Medline)
Abstract
BACKGROUND: Long-term benefits of pulmonary artery denervation (PADN) for
patients with combined precapillary and postcapillary pulmonary
hypertension (CpcPH) secondary to left heart failure are unknown.
 OBJECTIVE(S): The authors sought to report the 3-year clinical
results of PADN for patients with CpcPH. METHOD(S): A total of 98
patients with CpcPH, defined as having mean pulmonary arterial pressure of
>=25 mm Hg, pulmonary capillary wedge pressure of >15 mm Hg, and pulmonary
vascular resistance of >3.0 WU, were randomly assigned to receive the sham
+ sildenafil or PADN. The primary endpoint was the occurrence of clinical
worsening defined as cardiopulmonary death, rehospitalization or
heart/lung transplantation at 3-year follow-up. Changes in the 6-minute
walk distance and N-terminal pro-B-type natriuretic peptide served as
secondary points. RESULT(S): At the 3-year follow-up, clinical
worsening was reported in 49 (50.0%) patients, with 31 (62.0%) in the sham
+ sildenafil group and 18 (37.5%) in the PADN group (HR: 2.13 [95% CI:
1.19-3.81]; P = 0.011), largely driven by a higher rate of
rehospitalization in the sham + sildenafil group (56.2% vs 35.4%; HR: 1.96
[95% CI: 1.07-3.58]; P = 0.029) by Cox proportional hazards regression. At
the end of the study, cardiopulmonary-related deaths occurred in 16
(32.0%) patients in the sham and 9 (18.8%) (P = 0.167) patients in the
PADN group. PADN also resulted in a more profound increase in the 6-minute
walk distance and reduction in N-terminal pro-B-type natriuretic peptide.
 CONCLUSION(S): PADN is associated with significant improvements in
exercise capacity, cardiac function, and clinical outcomes. Further study
without approved drugs for pulmonary arterial hypertension is required to
confirm the benefits of PADN for patients with CpcPH. (Pulmonary Arterial
Denervation in Patients With Pulmonary Hypertension Associated With the
Left Heart Failure [PADN-5]; NCT02220335). Copyright © 2023
American College of Cardiology Foundation. Published by Elsevier Inc. All
rights reserved.

<45>
Accession Number
641657710
Title
Bempedoic Acid for Primary Prevention of Cardiovascular Events in
Statin-Intolerant Patients.
Source
JAMA. (no pagination), 2023. Date of Publication: 24 Jun 2023.
Author
Nissen S.E.; Menon V.; Nicholls S.J.; Brennan D.; Laffin L.; Ridker P.;
Ray K.K.; Mason D.; Kastelein J.J.P.; Cho L.; Libby P.; Li N.; Foody J.;
Louie M.J.; Lincoff A.M.
Institution
(Nissen, Menon, Brennan, Laffin, Mason, Cho, Lincoff) Cleveland Clinic,
Cleveland, OH, United States
(Nicholls) Victorian Heart Institute, Monash University, Melbourne,
Australia
(Ridker, Libby) Brigham and Women's Hospital, Harvard Medical School,
Boston, MA, United States
(Ray) Imperial College London, London, United Kingdom
(Kastelein) University of Amsterdam Academic Medical Center, Amsterdam,
Netherlands
(Li, Foody, Louie) Esperion Therapeutics Inc, Ann Arbor, MI, United States
Publisher
NLM (Medline)
Abstract
Importance: The effects of bempedoic acid on cardiovascular outcomes in
statin-intolerant patients without a prior cardiovascular event (primary
prevention) have not been fully described. Objective(s): To determine
the effects of bempedoic acid on cardiovascular outcomes in primary
prevention patients. Design, Setting, and Participant(s): This
masked, randomized clinical trial enrolled 13970 statin-intolerant
patients (enrollment December 2016 to August 2019 at 1250 centers in 32
countries), including 4206 primary prevention patients.
 Intervention(s): Participants were randomized to oral bempedoic acid,
180 mg daily (n=2100), or matching placebo (n=2106). Main Outcome
Measure(s): The primary efficacy measure was the time from randomization
to the first occurrence of any component of a composite of cardiovascular
death, nonfatal myocardial infarction (MI), nonfatal stroke, or coronary
revascularization. Result(s): Mean participant age was 68 years, 59%
were female, and 66% had diabetes. From a mean baseline of 142.5 mg/dL,
compared with placebo, bempedoic acid reduced low-density lipoprotein
cholesterol levels by 30.2 mg/dL (21.3%) and high-sensitivity C-reactive
protein levels by 0.56 mg/L (21.5%), from a median baseline of 2.4 mg/L.
Follow-up for a median of 39.9 months was associated with a significant
risk reduction for the primary end point (111 events [5.3%] vs 161 events
[7.6%]; adjusted hazard ratio [HR], 0.70 [95% CI, 0.55-0.89]; P=.002) and
key secondary end points, including the composite of cardiovascular death,
MI, or stroke (83 events [4.0%] vs 134 events [6.4%]; HR, 0.64 [95% CI,
0.48-0.84]; P<.001); MI (29 events [1.4%] vs 47 events [2.2%]; HR, 0.61
[95% CI, 0.39-0.98]); cardiovascular death (37 events [1.8%] vs 65 events
[3.1%]; HR, 0.61 [95% CI, 0.41-0.92]); and all-cause mortality (75 events
[3.6%] vs 109 events [5.2%]; HR, 0.73 [95% CI, 0.54-0.98]). There was no
significant effect on stroke or coronary revascularization. Adverse
effects with bempedoic acid included a higher incidence of gout (2.6% vs
2.0%), cholelithiasis (2.5% vs 1.1%), and increases in serum creatinine,
uric acid, and hepatic enzyme levels. Conclusion(s): In a subgroup of
high-risk primary prevention patients, bempedoic acid treatment was
associated with reduced major cardiovascular events. Trial Registration:
ClinicalTrials.gov Identifier: NCT02993406.

<46>
Accession Number
641657625
Title
Meta-Analysis of the Prognostic Significance of Carotid Artery Stenosis in
Patients Who Underwent Transcatheter Aortic Valve Implantation.
Source
The American journal of cardiology. (no pagination), 2023. Date of
Publication: 16 May 2023.
Author
Vella A.; Roux O.; Antiochos P.; Monney P.; Maurizi N.; Skalidis I.;
Fournier S.; Eeckhout E.; Roguelov C.; Oestreicher S.; Kirsch M.; Muller
O.; Lu H.
Institution
(Vella) Service of Cardiology, Geneva University Hospital and University
of Geneva, Geneva, Switzerland
(Roux) HerzHirslanden Group, Herzzentrum im Park AG, Zurich, Switzerland
(Antiochos, Monney, Maurizi, Skalidis, Fournier, Eeckhout, Roguelov,
Muller, Lu) Service of Cardiology, Lausanne University Hospital and
University of Lausanne, Lausanne, Switzerland
(Oestreicher) Service of Internal Medicine, Lausanne University Hospital
and University of Lausanne, Lausanne, Switzerland
(Kirsch) Service of Cardiovascular Surgery, Lausanne University Hospital
and University of Lausanne, Lausanne, Switzerland
Publisher
NLM (Medline)
Abstract
Stroke is a known complication of both transcatheter aortic valve
implantation (TAVI) and carotid artery stenosis (CAS). Whether CAS is a
predictor of worse prognosis after TAVI is unclear. We performed a
meta-analysis to assess the impact of CAS on the incidence of
neurovascular complications and mortality after TAVI. We searched
PubMed/MEDLINE and EMBASE databases from inception to January 2023. CAS
was defined by >=50% stenosis of at 1 carotid artery. Studies comparing
CAS versus non-CAS TAVI populations were included. Patients' baseline
characteristics and 30-day clinical outcomes were extracted. End points
included the 30-day incidence of neurovascular complications (stroke or
transient ischemic attack) and 30-day all-cause mortality. We identified
six studies, totaling 6,763 patients in the CAS group and 23,861 patients
in the non-CAS group. Patients with CAS had a higher prevalence of
hypertension, diabetes mellitus, dyslipidemia, previous myocardial
infarction, coronary artery bypass graft, peripheral artery disease,
previous neurovascular disease, and chronic kidney disease. There was no
significant difference in the rates of 30-day neurovascular complications
between CAS and non-CAS groups (relative risk 1.23, 95% confidence
interval 0.63 to 2.40, p = 0.54). CAS was associated with a higher risk of
30-day all-cause mortality (relative risk 1.28, 95% confidence interval
1.12 to 1.47, p <0.001), not found in a sensitivity analysis. In
conclusion, patients with CAS presented with a significantly higher
co-morbidity burden. CAS was not associated with an increased risk of
30-day neurovascular complications. 30-day mortality was higher in the CAS
group but that may be a surrogate of the heavy co-morbidity burden of
patients with CAS. Copyright © 2023 The Author(s). Published by
Elsevier Inc. All rights reserved.

<47>
Accession Number
641652869
Title
Impact of On-pump and Off-pump Coronary Artery Bypass Grafting on 10-Year
Mortality versus Percutaneous Coronary Intervention.
Source
European journal of cardio-thoracic surgery : official journal of the
European Association for Cardio-thoracic Surgery. (no pagination), 2023.
Date of Publication: 22 Jun 2023.
Author
Kageyama S.; Serruys P.W.; Ninomiya K.; O'Leary N.; Masuda S.; Kotoku N.;
Colombo A.; van Geuns R.-J.; Milojevic M.; Mack M.J.; Soo A.; Garg S.;
Onuma Y.; Davierwala P.M.
Institution
(Kageyama, Serruys, Ninomiya, O'Leary, Masuda, Kotoku, Onuma) Department
of Cardiology, National University of Ireland, Galway (NUIG), Galway,
Ireland
(Serruys) National Heart and Lung Institute, Imperial College London,
London, United Kingdom
(Colombo) Department of Biomedical Sciences, Humanitas University, Italy
-Humanitas Clinical and Research Centre IRCCS, Italy
(van Geuns) Department of Cardiology, Radboud University Medical Centre,
Nijmegen, Netherlands
(Milojevic) Department of Cardiothoracic Surgery, Erasmus University
Medical Centre, Rotterdam, Netherlands
(Milojevic) Department of Cardiac Surgery and Cardiovascular Research,
Dedinje Cardiovascular Institute, Belgrade, Serbia
(Mack) Department of Cardiothoracic Surgery, Baylor University Medical
Center, Dallas, TX, United States
(Soo) Department of Cardiothoracic Surgery, University Hospital Galway,
Ireland
(Garg) Department of Cardiology, Royal Blackburn Hospital, Blackburn,
United Kingdom
(Davierwala) Department of Surgery, University of Toronto, Canada Division
of Cardiovascular Surgery, Peter Munk Cardiac Centre, Toronto General
Hospital, Toronto, United States
(Davierwala) University Health Network, Toronto, ON, Canada
Publisher
NLM (Medline)
Abstract
OBJECTIVES: The very long-term mortality of off-pump and on-pump coronary
artery bypass grafting (CABG) versus percutaneous coronary intervention
(PCI) in a randomized complex coronary artery disease (CAD) population is
unknown. This study aims to investigate the impact of on-pump and off-pump
CABG versus PCI on 10-year all-cause mortality. METHOD(S): The SYNTAX
trial randomized 1800 patients with three-vessel and/or left main CAD to
PCI or CABG and assessed their survival at 10years. In this sub-study, the
hazard of mortality over 10years was compared according to the technique
of revascularization: on-pump CABG (n=725), off-pump CABG (n=128), and PCI
(n=903). RESULT(S): There was substantial inter-site variation in the
use of off-pump CABG despite baseline characteristics being largely
homogeneous amongst the three groups. The crude rate of mortality was
significantly lower following on-pump CABG versus PCI (25.6% vs 28.4%,
Hazard Ratio [HR] 0.79, 95% Confidence Interval [CI] 0.65-0.96), whilst it
was comparable between off-pump CABG and PCI (28.5% vs 28.4%, HR 0.98, 95%
CI 0.69-1.40). After adjusting for the nine variables included in the
SYNTAX score II 2020, 10-year mortality remained significantly lower with
on-pump CABG than PCI (HR 0.75 against PCI, p=0.009). CONCLUSION(S):
In the SYNTAXES trial, 10-year mortality adjusted for major confounders
was significantly lower following on-pump CABG compared to PCI. There was
no evidence for unadjusted difference between off-pump CABG and PCI,
although the unadjusted estimated HR had a wide CI. Site heterogeneity in
the technique used in bypass surgery has had measurable effects on
treatment performance. CLINICAL REGISTRATION NUMBER:
NCT03417050. Copyright © The Author(s) 2023. Published by Oxford
University Press on behalf of the European Association for Cardio-Thoracic
Surgery. All rights reserved.

<48>
Accession Number
2025286467
Title
High efficacy and low early mortality in high-volume center tricuspid
valve surgery.
Source
Thoracic and Cardiovascular Surgeon. (no pagination), 2022. Date of
Publication: 2022.
Author
Gotte J.; Zittermann A.; Schramm R.; Bleiziffer S.; Deutsch M.-A.; Renner
A.; Gummert J.F.
Institution
(Gotte, Renner) Herz- und Diabeteszentrum Nordrhein-Westfalen, Bad
Oeynhausen, Germany
(Zittermann) Department of Cardio-Thoracic Surgery, Herz- und
Diabeteszentrum Nordrhein-Westfalen, Bad Oeynhausen, Germany
(Schramm, Deutsch, Gummert) Clinic for Thoracic and Cardiovascular
Surgery, Herz- und Diabeteszentrum Nordrhein-Westfalen, Bad Oeynhausen,
Germany
(Bleiziffer) Clinic for Cardiovascular Surgery, Herz- und Diabeteszentrum
Nordrhein-Westfalen, Bad Oeynhausen, Germany
Publisher
Georg Thieme Verlag
Abstract
Background: Isolated tricuspid valve surgery has been associated with
early mortality rates of up to 10%. With rapidly emerging interventional
catheter-based options, the question arises of whether current technical
and perioperative protocols in cardiac surgery might translate into lower
than previously expected mortality rates, especially when looking at data
from high-volume centers. Method(s): We performed a retrospective
single-center analysis in 369 patients undergoing isolated tricuspid valve
repair (n=256) or replacement (n=113) between 2009 and 2021. Surgical
approaches included full sternotomy, as well as right-sided
mini-thoracotomy. According to a recently introduced clinical risk score
(CRS), patients were divided into scoring groups and observed (O) versus
expected (E) early mortality were compared. Pre- and postoperative
tricuspid valve function was also analyzed. Result(s): Overall,
30-day mortality was 4.1%, ranging from 0% (scoring group 0-1 points) to
8.7% (scoring group >=10 points), which was substantially lower than the
expected early mortality (2% in the lowest to 34% in the highest scoring
group). Preoperative tricuspid regurgitation was severe in 71.3% (n=263),
moderate to severe in 14.9% (n=55), and mild or less in 6.5% (n=24). The
corresponding postoperative values were 0% (n=0), 1.4% (n=5), and 81.6%
(n=301). Conclusion(s): Our high-volume center data indicate
substantially lower than predicted 30-day mortality in different cardiac
surgical risk scoring groups. The majority of patients had zero to minimal
residual tricuspid valve insufficiency postoperatively. Randomized
controlled trials are needed to compare tricuspid valve functional results
and long-term outcomes of surgical versus interventional procedures in
patients undergoing isolated tricuspid valve procedures. Copyright
© 2022 Georg Thieme Verlag. All rights reserved.

<49>
Accession Number
2025077315
Title
Assessment of Atherothrombotic Risk in Patients With Type 2 Diabetes
Mellitus.
Source
Journal of the American College of Cardiology. 81(25) (pp 2391-2402),
2023. Date of Publication: 27 Jun 2023.
Author
Berg D.D.; Moura F.A.; Bellavia A.; Scirica B.M.; Wiviott S.D.; Bhatt
D.L.; Raz I.; Bohula E.A.; Giugliano R.P.; Park J.-G.; Feinberg M.W.;
Braunwald E.; Morrow D.A.; Sabatine M.S.
Institution
(Berg, Moura, Bellavia, Scirica, Wiviott, Bohula, Giugliano, Park,
Braunwald, Morrow, Sabatine) TIMI Study Group, Division of Cardiovascular
Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston,
MA, United States
(Bhatt) Mount Sinai Heart, Icahn School of Medicine at Mount Sinai Health
System, New York, NY, United States
(Raz) Faculty of Medicine, Hadassah Hebrew University Hospital, Jerusalem,
Israel
(Feinberg) Division of Cardiovascular Medicine, Brigham and Women's
Hospital, Harvard Medical School, Boston, MA, United States
Publisher
Elsevier Inc.
Abstract
Background: Risk of atherothrombotic events is not uniform in patients
with type 2 diabetes mellitus (T2DM). Tailored risk assessment may help
guide selection of pharmacotherapies for cardiovascular primary and
secondary prevention. Objective(s): The purpose of this study was to
develop a risk model for atherothrombosis in patients with T2DM.
 Method(s): We developed and validated a risk model for myocardial
infarction (MI) or ischemic stroke (IS) in a pooled cohort of 42,181
patients with T2DM from 4 TIMI (Thrombolysis In Myocardial Infarction)
clinical trial cohorts. Candidate variables were assessed with
multivariable Cox regression, and independent variables (P < 0.05) were
retained in the final model. Discrimination and calibration were assessed.
Treatment interactions with dapagliflozin (sodium-glucose cotransporter-2
inhibitor) and evolocumab (proprotein convertase subtilisin/kexin type 9
inhibitor) were explored in the DECLARE-TIMI 58 (Dapagliflozin Effect on
CardiovascuLAR Events-Thrombolysis In Myocardial Infarction 58) and
FOURIER (Further Cardiovascular Outcomes Research with PCSK9 Inhibition in
Subjects with Elevated Risk) trials, respectively. Result(s): Sixteen
variables were independent predictors of MI or IS. The model identified a
>8-fold gradient of MI or IS rates between the top vs bottom risk
quintiles in the validation cohort (3-year Kaplan-Meier rate: 14.9% vs
1.4%; P < 0.0001). C-indexes were 0.704 and 0.706 in the derivation and
validation cohorts, respectively. The model was well-calibrated in both
primary and secondary prevention. Absolute reduction in the rates of MI or
IS tended to be greater in patients with higher baseline predicted risk
for both dapagliflozin (absolute risk reduction: 2.1% vs 0.2%) and
evolocumab (absolute risk reduction: 3.2% vs 1.0%). Conclusion(s): We
developed and validated a risk score for atherothrombotic events,
leveraging 16 routinely assessed clinical variables in patients with T2DM.
The score has the potential to improve risk assessment and inform clinical
decision-making. Copyright © 2023 The Authors

<50>
Accession Number
2025219308
Title
The effect of melatonin on cognitive functions following coronary artery
bypass grafting: A triple-blind randomized-controlled trial.
Source
Journal of Research in Medical Sciences. 28(1) (pp 14), 2023. Date of
Publication: 01 Jan 2023.
Author
Jouybar R.; Zohoori K.; Khademi S.; Akhlagh S.H.; Mani A.; Akhlagh S.A.R.;
Asadpour E.
Institution
(Jouybar, Zohoori, Khademi, Akhlagh, Akhlagh, Asadpour) Anesthesiology and
Critical Care Research Center, Shiraz University of Medical Sciences,
Shiraz, Iran, Islamic Republic of
(Mani) Research Center for Psychiatry and Behavior Sciences, Shiraz
University of Medical Sciences, Shiraz, Iran, Islamic Republic of
Publisher
Wolters Kluwer Medknow Publications
Abstract
Background: Cognitive dysfunction presents one of the chief causes of
postoperative morbidity. Melatonin as a neurohormone can improve
neurocognitive functioning and sleep disorders. We evaluated the effect of
melatonin on the postoperative cognitive function of patients undergoing
coronary artery bypass grafting (CABG). Material(s) and Method(s): A
triple-blind randomized-controlled trial was conducted on 66 CABG
candidates in Namazee Hospital (Shiraz, Iran). Patients were assigned
equally into two groups receiving melatonin 10 mg or a placebo daily for 4
weeks before surgery and 2 days after surgery in the intensive care unit.
The Mini-Mental State Examination (MMSE), Tower of London (ToL), and
Wechsler Adults Intelligence Scale-Revised (WAIS-R) cognitive function
tests were performed in both groups 4 weeks before surgery (time point 1),
2 days after surgery (time point 2), and 6 weeks after initial
administration of melatonin (time point 3). Result(s): The mean
change score (time point 3-time point 1) differed significantly between
the two groups in the MMSE (P <= 0.001), ToL total score (P = 0.001), and
WAIS-R general IQ (P <= 0.001), picture completion (P <= 0.001),
vocabulary (P = 0.024), and digit span (P = 0.01). On the other hand, no
significant differences were detected in the WAIS-R block design, ToL
total time delay, ToL total lab, and ToL total result scores.
 Conclusion(s): The MMSE and WAIS-R tests revealed that melatonin
might have prophylactic effects against postoperative cognitive
disturbance in patients undergoing elective CABG. Copyright ©
2023 Journal of Research in Medical Sciences.

<51>
Accession Number
2025216551
Title
Minimum Core Data Elements for Transcatheter Mitral Therapies: Scientific
Statement by PASSION CV, HVC, and TVTR.
Source
JACC: Cardiovascular Interventions. 16(12) (pp 1437-1447), 2023. Date of
Publication: 26 Jun 2023.
Author
Vemulapalli S.; Simonato M.; Ben Yehuda O.; Wu C.; Feldman T.; Popma J.J.;
Sundareswaren K.; Krohn C.; Hardy K.M.; Guibone K.; Christensen B.; Alu
M.C.; Ng V.G.; Chau K.H.; Chen S.; Shahim B.; Vincent F.; MacMahon J.;
James S.; Mack M.; Leon M.B.; Thourani V.H.; Carroll J.; Krucoff M.W.
Institution
(Vemulapalli, Krucoff) Duke University Health/Duke Clinical Research
Institute, Durham, NC, United States
(Simonato) Yale School of Medicine, New Haven, CT, United States
(Ben Yehuda) University of California San Diego, San Diego, CA, United
States
(Ben Yehuda, Alu, Vincent) Cardiovascular Research Foundation, New York,
NY, United States
(Wu) U.S. Food and Drug Administration, Silver Spring, MD, United States
(Feldman) Edwards Lifesciences, Irvine, CA, United States
(Popma) Medtronic, Inc, Minneapolis, MN, United States
(Sundareswaren) Abbott Vascular, Santa Rosa, CA, United States
(Krohn) Society of Thoracic Surgeons, Chicago, IL, United States
(Hardy) Common Spirit Health, Chicago, IL, United States
(Guibone) Beth Israel Deaconness Medical Center, Boston, MA, United States
(Christensen) American College of Cardiology, Washington, DC, United
States
(Ng, Chau, Leon) Columbia University Irving Medical Center, New York, NY,
United States
(Chen) Cornell Weill Medical Center/New York-Presbyterian, New York, NY,
United States
(Shahim) Karolinska University Hospital, Stockholm, Sweden
(MacMahon) Mitre Medical Corporation, Morgan Hill, CA, United States
(James) Department of Medical Sciences and Uppsala Clinical Research
Center, Uppsala, Sweden
(Mack) Baylor Scott and White, Plano, TX, United States
(Thourani) Piedmont Heart and Vascular Institute, Atlanta, GA, United
States
(Carroll) University of Colorado School of Medicine, Denver, CO, United
States
Publisher
Elsevier Inc.
Abstract
Mitral regurgitation is the most common valvular disease and is estimated
to affect over 5 million Americans. Real-world data collection contributes
to safety and effectiveness evidence for the U.S. Food and Drug
Administration, quality evaluation for the Centers for Medicare and
Medicaid Services and hospitals, and clinical best practice research. We
aimed to establish a minimum core data set in mitral interventions to
promote efficient, reusable real-world data collection for all of these
purposes. Two expert task forces separately evaluated and reconciled a
list of candidate elements derived from: 1) 2 ongoing transcatheter mitral
trials; and 2) a systemic literature review of high-impact mitral trials
and U.S multicenter, multidevice registries. From 703 unique data elements
considered, unanimous consensus agreement was achieved on 127 "core" data
elements, with the most common reasons for exclusion from the minimum core
data set being burden or difficulty in accurate assessment (41.2%),
duplicative information (25.0%), and low likelihood of affecting outcomes
(19.6%). After a systematic review and extensive discussions, a
multilateral group of academicians, industry representatives, and
regulators established and implemented into the national Society of
Thoracic Surgery/American College of Cardiology Transcatheter Valve
Therapies Registry 127 interoperable, reusable core data elements to
support more efficient, consistent, and informative transcatheter mitral
device evidence for regulatory submissions, safety surveillance, best
practice development, and hospital quality assessments. Copyright
© 2023 American College of Cardiology Foundation

<52>
Accession Number
2023777698
Title
Risk of lower limb amputation in diabetic patients using SGLT2 inhibitors
versus DPP4 inhibitors or GLP-1 agonists: a meta-analysis of 2 million
patients.
Source
Therapeutic Advances in Drug Safety. 14 (no pagination), 2023. Date of
Publication: January-December 2023.
Author
Lu Y.; Guo C.
Institution
(Lu) Department of Endocrinology, YuYao People's Hospital, Zhejiang
Province, Ningbo, China
(Guo) Department of Endocrinology, YuYao People's Hospital, 800 Chengdong
Road, Yuyao, Zhejiang, Ningbo 315400, China
Publisher
SAGE Publications Ltd
Abstract
Background: The objective of this review was to assess the risk of lower
limb amputation (LLA) in type 2 diabetic patients based on the use of
sodium-glucose cotransporter 2 inhibitors (SGLT2i) versus dipeptidyl
peptidase 4 inhibitors (DPP4i) or glucagon-like peptide-1 receptor
agonists (GLP1a). Method(s): PubMed, CENTRAL, Scopus, Web of Science,
and Embase were referenced for articles published up to 5 February 2023.
All types of studies comparing the drugs for LLA risk and reporting hazard
ratios (HR) were included. Result(s): Thirteen studies with 2,095,033
patients were included. Meta-analysis of eight studies comparing SGLT2i
with Dipeptidyl peptidase inhibitors (DPPi) showed that there was no
difference in the risk of LLA between the two drug groups (HR: 0.98 95%
CI: 0.73, 1.31 I2 = 89%). The outcomes were unchanged on
sensitivity analysis. Another pooled analysis of six studies found no
significant difference in the risk of LLA between SGLT2i and GLP1a users
(HR: 1.26; 95% CI: 0.99, 1.60; I2 = 69%). The exclusion of a
single study showed an increased risk of LLA with SGLT2i (HR: 1.35; 95%
CI: 1.14, 1.60; I2 = 14%). Conclusion(s): The current
updated meta-analysis found no significant difference in the risk of LLA
between SGLT2i and DPP4i users. A tendency of increased risk of LLA was
noted with SGLT2i as compared to GLP1a. Further studies shall increase the
robustness of current findings. Copyright © The Author(s), 2023.

<53>
Accession Number
2022632636
Title
Experiences of sexual well-being interventions in males affected by
genitourinary cancers and their partners: an integrative systematic
review.
Source
Supportive Care in Cancer. 31(5) (no pagination), 2023. Article Number:
265. Date of Publication: May 2023.
Author
Schubach K.; Niyonsenga T.; Turner M.; Paterson C.
Institution
(Schubach, Niyonsenga, Turner, Paterson) Faculty of Health, University of
Canberra, Bruce ACT, Australia
(Schubach, Niyonsenga, Turner, Paterson) Rehabilitation, Activity, Cancer,
Exercise and Survivorship (PACES) Research Group, University of Canberra,
Bruce ACT, Australia
(Paterson) Robert Gordon University, Aberdeen, Scotland, United Kingdom
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Purpose: Sexual well-being has been identified as an unmet supportive care
need among many individuals with genitourinary (GU) cancers. Little is
known about the experiences of using sexual well-being interventions among
men and their partners. Method(s): This review was reported using the
Preferred Reporting Items for Systematic Reviews and Meta-Analyses
(PRISMA) and followed a systematic review protocol. Data extraction and
methodological quality appraisal were performed, and a narrative synthesis
was conducted. Result(s): A total of 21 publications (reporting on 18
studies) were included: six randomised control trials, seven
cross-sectional studies, three qualitative studies, and five mixed methods
studies. Sexual well-being interventions comprised medical/pharmacological
and psychological support, including counselling and group discussion
facilitation. The interventions were delivered using various modes:
face-to-face, web-based/online, or telephone. Several themes emerged and
included broadly: (1) communication with patient/partner and healthcare
professionals, (2) educational and informational needs, and (3) timing
and/or delivery of the interventions. Conclusion(s): Sexual
well-being concerns for men and their partners were evident from diagnosis
and into survivorship. Participants benefited from interventions but many
articulated difficulties with initiating the topic due to embarrassment
and limited access to interventions in cancer services. Noteworthy, all
studies were only representative of men diagnosed with prostate cancer,
underscoring a significant gap in other GU cancer patient groups where
sexual dysfunction is a prominent consequence of treatment. Implications
for cancer survivors: This systematic review provides valuable new
insights to inform future models of sexual well-being recovery
interventions for patients and partners with prostate cancer, but further
research is urgently needed in other GU cancer populations. Copyright
© 2023, The Author(s).

<54>
Accession Number
2022389808
Title
Design and rationale of the efficacy of spinal cord stimulation in
patients with refractory angina pectoris (SCRAP) trial.
Source
Clinical Cardiology. 46(6) (pp 689-697), 2023. Date of Publication: June
2023.
Author
Vervaat F.E.; van der Gaag A.; Smetsers C.; Barneveld P.C.; van't Veer M.;
Teeuwen K.; van Suijlekom H.; Dekker L.; Wijnbergen I.F.
Institution
(Vervaat, van't Veer, Teeuwen, Dekker, Wijnbergen) Department of
Cardiology, Catharina Hospital, Eindhoven, Netherlands
(van der Gaag, Smetsers, van Suijlekom) Department of Anesthesiology,
Catharina Hospital, Eindhoven, Netherlands
(Barneveld) Department of Nuclear Medicine, Jeroen Bosch Hospital,
's-Hertogenbosch, Netherlands
Publisher
John Wiley and Sons Inc
Abstract
Background: The use of spinal cord stimulation (SCS) in patients with
refractory angina pectoris (RAP) is still under debate. Studies up to date
have shown a positive effect with an improvement in quality of life.
However, no double blinded randomized controlled trials have been
performed. Hypothesis & Methods: The objective of this trial is to
investigate if high density SCS leads to a significant reduction in the
amount of myocardial ischemia in patients with RAP. Eligible patients must
meet the criteria for RAP, have proven ischemia and a positive
transcutaneous electrical nerve stimulator treadmill test. Patients who
meet the inclusion criteria will receive an implanted spinal cord
stimulator. Patients receive 6 months of high density SCS and 6 months of
no stimulation using a cross-over design. The order of the treatment
options is determined using randomization. The primary endpoint is the
effect of SCS measured by the change in percentage of myocardial ischemia
using myocardial perfusion positron emission tomography scan. Key
secondary endpoints are patient related outcome measures, major cardiac
adverse events and safety endpoints. The follow-up period is 1 year for
the primary and key secondary endpoints. Result(s): The SCRAP trial
began enrollment on December 21, 2021 and is set to complete the primary
assessments in June 2025. To date, January 2, 2023, 18 patients have been
enrolled in the study and 3 patients have completed the 1-year follow-up.
 Conclusion(s): The SCRAP trial is an investigator-initiated,
single-center, double-blind, placebo-controlled, and cross-over randomized
controlled trial investigating the efficacy of SCS in patients with RAP.
(ClinicalTrials. gov Identifier: NCT04915157). Copyright © 2023
The Authors. Clinical Cardiology published by Wiley Periodicals, LLC.

<55>
Accession Number
2021978279
Title
Lower or higher oxygenation targets for acute Hypoxaemic respiratory
failure: Protocol for an individual patient data meta-analysis.
Source
Acta Anaesthesiologica Scandinavica. 67(6) (pp 811-819), 2023. Date of
Publication: July 2023.
Author
Nielsen F.M.; Klitgaard T.L.; Bruun N.H.; Moller M.H.; Schjorring O.L.;
Rasmussen B.S.
Institution
(Nielsen, Klitgaard, Schjorring, Rasmussen) Department of Anaesthesia and
Intensive Care, Aalborg University Hospital, Aalborg, Denmark
(Nielsen, Schjorring, Rasmussen) Department of Clinical Medicine, Aalborg
University, Aalborg, Denmark
(Nielsen, Klitgaard, Moller, Schjorring, Rasmussen) Collaboration for
Research in Intensive Care (CRIC), Copenhagen, Denmark
(Bruun) Unit of Clinical Biostatistics, Aalborg University Hospital,
Aalborg, Denmark
(Moller) Department of Intensive Care, Copenhagen University Hospital -
Rigshospitalet, Copenhagen, Denmark
Publisher
John Wiley and Sons Inc
Abstract
Background: Supplemental oxygen therapy is central to the treatment of
acute hypoxaemic respiratory failure, a condition which remains a major
driver for morbidity and mortality in intensive care. Despite several
large randomised clinical trials comparing a higher versus a lower
oxygenation target for these patients, significant differences in study
design impede analysis of aggregate data and final clinical
recommendations. Method(s): This paper presents the protocol for
conducting an individual patient data meta-analysis where full individual
patient data according to the intention-to-treat principle will be pooled
from the HOT-ICU and HOT-COVID trials in a one-step procedure. The two
trials are near-identical in design. We plan to use a hierarchical general
linear mixed model that accounts for data clustering at a trial and site
level. The primary outcome will be 90-day all-cause mortality while the
secondary outcome will be days alive without life-support at 90 days.
Further, we outline 14 clinically relevant predefined subgroups which we
will analyse for heterogeneity in the intervention effects and
interactions, and we present a plan for assessing the credibility of the
subgroup analyses. Conclusion(s): The presented individual patient
data meta-analysis will synthesise individual level patient data from two
of the largest randomised clinical trials on targeted oxygen therapy in
intensive care. The results will provide a re-analysis of the intervention
effects on the pooled intention-to-treat populations and facilitate
subgroup analyses with an increased power to detect clinically important
effect modifications. Copyright © 2023 The Authors. Acta
Anaesthesiologica Scandinavica published by John Wiley & Sons Ltd on
behalf of Acta Anaesthesiologica Scandinavica Foundation.

<56>
Accession Number
2018770702
Title
A Review of Adrenomedullin in Pediatric Patients: A Useful Biomarker.
Source
Children. 9(8) (no pagination), 2022. Article Number: 1181. Date of
Publication: August 2022.
Author
Sole-Ribalta A.; Bobillo-Perez S.; Jordan-Garcia I.
Institution
(Sole-Ribalta, Bobillo-Perez, Jordan-Garcia) Pediatric Intensive Care Unit
Service, Hospital Sant Joan de Deu, 08950 Esplugues de Llobregat,
Barcelona, Spain
Publisher
MDPI
Abstract
Adrenomedullin has several properties. It acts as a potent vasodilator,
has natriuretic effects, and reduces endothelial permeability. It also
plays a role in initiating the early hyperdynamic phase of sepsis. Since
its discovery, many articles have been published studying the uses and
benefits of this biomarker. The aim of this review is to determine the
usefulness of adrenomedullin in pediatric patients. Relevant studies
covering adrenomedullin in pediatrics (<18 years) and published up until
August 2021 were identified through a search of MEDLINE, PubMed, Embase,
Web of Science, Scopus, and Cochrane. Seventy studies were included in the
present review, most of them with a low level of evidence (IV to VI).
Research on adrenomedullin has primarily been related to infection and the
cardiovascular field. The performance of adrenomedullin to quantify
infection in children seems satisfactory, especially in sepsis. In
congenital heart disease, this biomarker seems to be a useful indicator
before, during, and after cardiopulmonary bypass. Adrenomedullin seems to
be useful in the pediatric population for a large variety of pathologies,
especially regarding infection and cardiovascular conditions. However, it
should be used in combination with other biomarkers and clinical or
analytical variables, rather than as a single tool. Copyright ©
2022 by the authors.

<57>
Accession Number
2017918513
Title
Clopidogrel Vs Aspirin Monotherapy Following Dual Antiplatelet Therapy
After Percutaneous Coronary Intervention: A Systematic Review and
Meta-analysis.
Source
Current Problems in Cardiology. 48(8) (no pagination), 2023. Article
Number: 101174. Date of Publication: August 2023.
Author
Tan B.E.-X.; Wong P.Y.; Baibhav B.; Thakkar S.; Azhar A.Z.; Rao M.; Cheung
J.W.
Institution
(Tan, Thakkar, Azhar) Department of Internal Medicine, Rochester General
Hospital, Rochester, NY, United States
(Wong) Department of Internal Medicine, Sungai Buloh Hospital, Selangor,
Malaysia
(Baibhav, Rao) Sands-Constellation Heart Institute, Rochester Regional
Health, Rochester, NY, United States
(Cheung) Division of Cardiology, Department of Medicine, Weill Cornell
Medicine, New York, NY, United States
Publisher
Elsevier Inc.
Abstract
Current guidelines recommend 6-12 months of dual antiplatelet therapy
(DAPT) after percutaneous coronary intervention (PCI) followed by aspirin
monotherapy indefinitely. We aimed to assess the efficacy and safety of
clopidogrel vs aspirin in the post-PCI population after completing DAPT.
We systematically searched 5 electronic databases to identify studies
comparing clopidogrel with aspirin following completion of DAPT after PCI.
We pooled outcomes for major adverse cardiac events (MACE), cardiac death,
all-cause death, major bleeding, myocardial infarction (MI), and stroke.
We included 5 studies with 13,850 patients, of whom 5601 (40.4%) received
clopidogrel. Mean follow-up was 12-36 months. All patients received
drug-eluting stents. Duration of DAPT before antiplatelet monotherapy was
1-18 months. Clopidogrel was associated with reductions in MACE (Risk
ratio [RR] 0.77, 95% confidence interval [CI] 0.65-0.91), any stroke (RR
0.51; 95% confidence interval [CI] 0.35-0.76), ischemic stroke (RR 0.55;
95% CI 0.32-0.94), and hemorrhagic stroke (RR 0.24; 95% CI 0.09-0.68) when
compared with aspirin. Cardiac death (RR 0.87; 95% CI 0.53-1.41),
all-cause death (RR 1.06; 95% CI 0.81-1.39), major bleeding (RR 0.74; 95%
CI 0.43-1.29), MI (RR 1.01; 95% CI 0.64-1.60), repeat revascularization
(RR 0.88; 95% CI 0.71-1.09), target vessel revascularization (RR 0.76; 95%
CI 0.52-1.13), and stent thrombosis (RR 0.96; 95% CI 0.35-2.59) were not
significantly different among groups. Compared with aspirin, clopidogrel
was associated with reductions in MACE and stroke (ischemic and
hemorrhagic) following DAPT completion after PCI. There were no
significant differences in mortality, major bleeding, MI, and repeat
revascularization between groups. Copyright © 2022 Elsevier Inc.

<58>
Accession Number
2023928974
Title
Extrapleural infusion of levobupivacaine versus
levobupivacaine-sufentanil-adrenaline after video-assisted thoracoscopic
surgery (VATS): A randomised controlled trial.
Source
Acta Anaesthesiologica Scandinavica. (no pagination), 2023. Date of
Publication: 2023.
Author
Larsson M.; Sartipy U.; Franco-Cereceda A.; Spigset O.; Loevenich M.;
Owall A.; Jakobsson J.
Institution
(Larsson, Sartipy, Franco-Cereceda, Owall) Department of Molecular
Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
(Larsson, Owall) Function Perioperative Medicine and Intensive Care,
Section for Cardiothoracic Anaesthesia and Intensive Care, Karolinska
University Hospital, Stockholm, Sweden
(Sartipy, Franco-Cereceda) Department of Cardiothoracic Surgery,
Karolinska University Hospital, Stockholm, Sweden
(Spigset, Loevenich) Department of Clinical Pharmacology, St. Olav
University Hospital, Trondheim, Norway
(Spigset) Department of Clinical and Molecular Medicine, Norwegian
University of Science and Technology, Trondheim, Norway
(Jakobsson) Institution for Clinical Sciences, Karolinska Institutet at
Danderyd Hospital, Stockholm, Sweden
(Jakobsson) Department of Anaesthesia and Intensive Care, Danderyd
Hospital, Stockholm, Sweden
Publisher
John Wiley and Sons Inc
Abstract
Background: Peripheral blocks are increasingly used for analgesia after
video-assisted thoracic surgery (VATS). We hypothesised that addition of
sufentanil and adrenaline to levobupivacaine would improve the analgesic
effect of a continuous extrapleural block. Method(s): We randomised
60 patients undergoing VATS to a 5-mL h-1 extrapleural infusion
of levobupivacaine at 2.7 mg mL-1 (LB group) or levobupivacaine
at 1.25 mg mL-1, sufentanil at 0.5 mug mL-1, and
adrenaline at 2 mug mL-1 (LBSA group). The primary outcome was
the cumulative morphine dose administered as patient-controlled analgesia
(PCA-morphine) at 48 and 72 h. The secondary outcomes were pain according
to numerical rating scale (NRS) at rest and after two deep breaths twice
daily, peak expiratory flow (PEF) daily, quality of recovery (QoR)-15
score at 1 day and 3 weeks postoperatively, serum levobupivacaine
concentrations at 1 h after the start and at the end of the intervention,
and adverse events. Result(s): At 48 h, the median cumulative
PCA-morphine dose for the LB group was 6 mg (IQR, 2-10 mg) and for the
LBSA group 7 mg (IQR, 3-13.5 mg; p =.378). At 72 h, morphine doses were 10
mg (IQR, 3-22 mg) and 12.5 mg (IQR, 4-21 mg; p =.738), respectively.
Median NRS score at rest and after two deep breaths was 3 or lower at all
time points for both treatment groups. PEF did not differ between groups.
Three weeks postoperatively, only the LB group returned to baseline QoR-15
score. The LB group had higher, but well below toxic, levobupivacaine
concentrations at 48 and 72 h. The incidence of nausea, dizziness,
pruritus and headache was equally low overall. Conclusion(s): For a
continuous extrapleural block, and compared to plain levobupivacaine at
13.5 mg h-1, levobupivacaine at 6.25 mg h-1 with
addition of sufentanil and adrenaline did not decrease postoperative
morphine consumption. The levobupivacaine serum concentrations after 48
and 72 h of infusion were well below toxic levels, therefore our findings
support the use of the maximally recommended dose of levobupivacaine for a
2- to 3-day continuous extrapleural block. Copyright © 2023 The
Authors. Acta Anaesthesiologica Scandinavica published by John Wiley &
Sons Ltd on behalf of Acta Anaesthesiologica Scandinavica Foundation.

<59>
Accession Number
2025267980
Title
Systematic review and meta-analysis of the efficacy of olprinone and MEFV
gene in treating heart failure.
Source
Cellular and Molecular Biology. 69(3) (pp 82-91), 2023. Date of
Publication: 2023.
Author
Fu Y.; Wang X.; Pan Y.; Zhang H.
Institution
(Fu, Wang, Pan, Zhang) Department of Emergency Intensive Medicine,
Tangshan Central Hospital, Hebei Province, Tangshan 063008, China
Publisher
Cellular and Molecular Biology Association
Abstract
Cardiovascular failure is the main cause of death in industrialized
societies. The results of recent studies have shown that some mutations in
the MEFV gene are common in heart failure patients. For this reason, the
study of mutations and genetic factors has been of great help in the
treatment of this disease, but despite this, due to the heterogeneity of
clinical symptoms, multiple pathophysiological processes, and
environmental genetic factors, the complete understanding of the genetic
causes of this disease is very complicated. As the new generation of
phosphodiesterase (PDE) III inhibitor, olprinone, the inhibition of human
heart PDE III by olprinone is highly selective. It is suitable for the
treatment of acute heart failure (HF) and acute cardiac insufficiency
after cardiac surgery. In this study Olprinone, milrinone, PDE inhibitors,
cardiac failure, and HF were selected as the search terms to retrieve
articles published between January 1999 and March 2022. RevMan5.3 and
Stata were employed to analyze and evaluate the risk bias of the included
articles. Besides, the Q test and heterogeneity were utilized to evaluate
the heterogeneity between articles. The results of this research showed No
heterogeneity was found between each research group. The sensitivity (Sen)
and specificity (Spe) of the two methods were compared. Olprinone showed
more significant therapeutic effects than other PDE inhibitors. Besides,
the therapeutic effect on the patients with HF in the two groups was
obvious. The incidence of postoperative adverse reactions among the
patients without relieving HF was low. The influences on urine flow of the
two group's demonstrated heterogeneity, and its effect revealed no
statistical meaning. The meta-analysis confirmed that the Spe and Sen of
olprinone treatment were higher than those of other PDE inhibitors. In
terms of hemodynamics, there was little difference between various
treatment methods. Copyright: © 2023 by the C.M.B. Association.
All rights reserved.

<60>
Accession Number
2025259161
Title
Aspirin vs Clopidogrel for Long-term Maintenance after Coronary Stenting
in Patients with Diabetes: A Post Hoc Analysis of the HOST-EXAM Trial.
Source
JAMA Cardiology. 8(6) (pp 535-544), 2023. Date of Publication: 14 Jun
2023.
Author
Rhee T.-M.; Bae J.-W.; Park K.W.; Rha S.-W.; Kang J.; Lee H.; Yang H.-M.;
Kwak S.-H.; Chae I.-H.; Shin W.-Y.; Kim D.-K.; Oh J.H.; Jeong M.H.; Kim
Y.H.; Lee N.H.; Hur S.-H.; Yoon J.; Han J.-K.; Shin E.-S.; Koo B.-K.; Kim
H.-S.
Institution
(Rhee, Park, Kang, Yang, Kwak, Han, Koo, Kim) Seoul National University
Hospital and Seoul National University, College of Medicine, Seoul, South
Korea
(Bae) Chungbuk National University, College of Medicine, Cheongju, South
Korea
(Rha) Korea University Guro Hospital, Seoul, South Korea
(Lee) Seoul National University Healthcare System Gangnam Center, Seoul
National University, College of Medicine, Seoul, South Korea
(Chae) Seoul National University Bundang Hospital, Seongnam, South Korea
(Shin) Soonchunhyang University Cheonan Hospital, Cheonan, South Korea
(Kim) Busan Paik Hospital, Inje University, Busan, South Korea
(Oh) Samsung Changwon Hospital, Sungkyunkwan University, Changwon, South
Korea
(Jeong) Chonnam National University Hospital, Gwangju, South Korea
(Kim) Kangwon National University, School of Medicine, Chuncheon, South
Korea
(Lee) Kangnam Sacred Heart Hospital, Hallym University, Seoul, South Korea
(Hur) Keimyung University Dongsan Hospital, Daegu, South Korea
(Yoon) Yonsei University Wonju Severance Christian Hospital, Wonju, South
Korea
(Shin) Ulsan University Hospital, Ulsan, South Korea
Publisher
American Medical Association
Abstract
Importance: Selecting the optimal antiplatelet agent in patients who have
received percutaneous coronary intervention is especially important in
those with diabetes due to the heightened risk of ischemic events in this
population. Studies on the efficacy and safety of clopidogrel vs aspirin
for long-term maintenance after percutaneous coronary intervention in
patients with diabetes are lacking. Objective(s): To investigate
cardiovascular outcomes with clopidogrel vs aspirin in patients with and
without diabetes. Design, Setting, and Participant(s): This was a
post hoc analysis of the HOST-EXAM randomized clinical trial, an
investigator-initiated, prospective, randomized, open-label, multicenter
trial performed at 37 centers in Korea. Patients who received dual
antiplatelet therapy without clinical events for 6 to 18 months after
percutaneous coronary intervention with drug-eluting stents were enrolled
from March 2014 to May 2018 with follow-up at 6, 12, 18, and 24 months.
All 5438 patients in the original trial were included in this analysis,
which was conducted from June to October 2021. Interventions and
Exposures: Enrolled patients were randomized 1:1 to clopidogrel or aspirin
monotherapy. Subgroup analyses were performed by the presence of diabetes.
 Main Outcomes and Measures: The main outcome was primary composite
end point of all-cause death, nonfatal myocardial infarction, stroke,
readmission due to acute coronary syndrome, and major bleeding (Bleeding
Academic Research Consortium type 3 or 5) at 24-month follow-up.
 Result(s): Of 5438 patients (mean [SD] age, 63.5 [10.7] years; 1384
[25.5%] female), 1860 (34.2%) had diabetes (925 in the clopidogrel arm and
935 in the aspirin arm), and 5338 (98.2%) completed follow-up. The rate of
the primary composite end point was significantly lower in the clopidogrel
group compared to the aspirin group in patients with diabetes (6.3% vs
9.2%; hazard ratio [HR], 0.69; 95% CI, 0.49-0.96; P =.03; absolute risk
difference [ARD], 2.7%; number needed to treat [NNT], 37) and without
diabetes (5.3% vs 7.0%; HR, 0.76; 95% CI, 0.58-1.00; P =.046; ARD, 1.6%,
NNT, 63; P for interaction =.65). The presence of diabetes was not
associated with a difference in benefit observed with clopidogrel
monotherapy over aspirin for the thrombotic composite end point (HR, 0.68;
95% CI, 0.45-1.04 for patients with diabetes vs HR, 0.68; 95% CI,
0.49-0.93 for those without; P for interaction =.99) and any bleeding with
Bleeding Academic Research Consortium 2, 3, or 5 (HR, 0.65; 95% CI,
0.39-1.09 for patients with diabetes vs HR, 0.74; 95% CI, 0.48-1.13 for
those without; P for interaction =.71). Conclusion and Relevance: In this
study, clopidogrel monotherapy was associated with a lower rate of the
primary composite end point compared to aspirin monotherapy as long-term
maintenance therapy after dual antiplatelet therapy for coronary stenting
in both patients with and without diabetes. Clopidogrel might thus be
considered rather than aspirin in patients who have undergone coronary
stenting and successfully completed dual antiplatelet therapy, regardless
of diabetes status. Trial Registration: ClinicalTrials.gov Identifier:
NCT02044250. Copyright © 2023 American Medical Association. All
rights reserved.

<61>
Accession Number
641634237
Title
Safety and Efficacy of Colchicine for the Prevention of Post-Operative
Atrial Fibrillation in Patients Undergoing Cardiac Surgery: A
Meta-Analysis of Randomized Controlled Trials.
Source
Europace : European pacing, arrhythmias, and cardiac electrophysiology :
journal of the working groups on cardiac pacing, arrhythmias, and cardiac
cellular electrophysiology of the European Society of Cardiology. (no
pagination), 2023. Date of Publication: 21 Jun 2023.
Author
Agarwal S.; Beard C.; Khosla J.; Clifton S.; Anwaar M.F.; Ghani A.; Farhat
K.; Pyrpyris N.; Momani J.; Munir M.B.; DeSimone C.V.; Deshmukh A.;
Stavrakis S.; Jackman W.S.; Po S.; Asad Z.U.A.
Institution
(Agarwal, Beard, Khosla, Anwaar, Ghani, Farhat, Stavrakis, Jackman, Po,
Asad) Department 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
(Pyrpyris) First Department of Cardiology, School of Medicine, National
and Kapodistrian University of Athens, Hippokration Hospital, Athens,
Greece
(Momani) Alfaisal University, Riyadh, Saudi Arabia
(Munir) Division of Cardiovascular Medicine, University of California
Davis, Sacramento, CA, United States
(DeSimone, Deshmukh) Department of Cardiovascular Medicine, Mayo Clinic,
Rochester, MN, United States
Publisher
NLM (Medline)
Abstract
BACKGROUND AND AIMS: Colchicine is an anti-inflammatory drug that may
prevent postoperative atrial fibrillation (POAF). The effect of this drug
has been inconsistently shown in previous clinical trials. We aimed to
compare the efficacy and safety of colchicine versus placebo to prevent
POAF in patients undergoing cardiac surgery. METHOD(S): A systematic
search of EMBASE, MEDLINE, SCOPUS, ClinicalTrials.gov, and the Cochrane
Library for randomized controlled trials (RCTs) was conducted from
inception till April 2023. The primary outcome was the incidence of POAF
after any cardiac surgery. The secondary outcome was the rate of drug
discontinuation due to adverse events and adverse gastrointestinal events.
Risk ratios (RR) were reported using the Mantel Haenszel method.
 RESULT(S): A total of 8 RCTs comprising 1,885 patients were included.
There was a statistically significant lower risk of developing POAF with
colchicine vs. placebo (RR: 0.70; 95% CI: 0.59-0.82; p<0.01, I2=0%), and
this effect persisted across different subgroups. There was a
significantly higher risk of adverse gastrointestinal events (RR: 2.20;
95% CI: 1.38-3.51; p<0.01, I2=55%) with no difference in the risk of drug
discontinuation in patients receiving colchicine vs. placebo (RR: 1.33;
95% CI: 0.93-1.89; p=0.11, I2=0%). CONCLUSION(S): This meta-analysis
of 8 RCTs shows that colchicine is effective at preventing POAF, with a
significantly higher risk of adverse gastrointestinal events but no
difference in the rate of drug discontinuation. Future studies are
required to define the optimal duration and dose of colchicine for the
prevention of POAF. Copyright © The Author(s) 2023. Published by
Oxford University Press on behalf of the European Society of Cardiology.

<62>
Accession Number
2024703342
Title
The efficacy and safety of intravenous administration of tranexamic acid
in patients undergoing cardiac surgery: Evidence from a single
cardiovascular center.
Source
Medicine (United States). 102(20) (pp E33819), 2023. Date of Publication:
19 May 2023.
Author
Lin P.-S.; Yao Y.-T.; Tian L.-J.; Jiang J.-J.; Zhang Y.; He L.-X.; Yu
Y.-P.; Ma J.
Institution
(Lin, Yao, Tian, Yu) Department of Anesthesiology, Fuwai Hospital,
National Center for Cardiovascular Diseases, Peking Union Medical College,
Chinese Academy of Medical Sciences, Beijing, China
(Lin) Department of Cardiovascular Surgery, Fujian Medical University
Affiliated First Quanzhou Hospital, Fujian, China
(Jiang) Key Laboratory of Clinical Research for Cardiovascular
Medications, Fuwai Hospital, National Center for Cardiovascular Diseases,
Peking Union Medical College, Chinese Academy of Medical Sciences,
Beijing, China
(Zhang) Department of Laboratory Medicine, National Center for
Cardiovascular Diseases, Peking Union Medical College, Chinese Academy of
Medical Sciences, Beijing, China
(He) Department of Anesthesiology, Fuwai Yunnan Cardiovascular Hospital,
Kunming, China
(Ma) Department of Pharmacy, Fuwai Hospital, National Center for
Cardiovascular Diseases, Peking Union Medical College, Chinese Academy of
Medical Sciences, Beijing, China
Publisher
Lippincott Williams and Wilkins
Abstract
Background: The current study was performed to systemically review the
efficacy and safety of tranexamic acid (TXA) in patients undergoing
cardiac surgery at a single large-volume cardiovascular center.
 Method(s): A computerized search of electronic databases was
performed to identify all relevant studies using search terms till
December 31st, 2021. The primary outcomes were postoperative
blood loss and the composite incidence of mortality and morbidities during
hospitalization. Secondary outcomes included postoperative massive
bleeding and transfusion, postoperative recovery profiles, coagulation
functions, inflammatory variables, and biomarkers of vital organ injury.
 Result(s): Database search yielded 23 qualified studies including
27,729 patients in total. Among them, 14,136 were allocated into TXA group
and 13,593 into Control group. The current study indicated that
intravenous TXA significantly reduced total volume of postoperative
bleeding in both adult and pediatric patients, and that medium- and
high-dose TXA were more effective than low-dose TXA in adult patients (P
<.05). The current study also demonstrated that intravenous TXA, as
compared to Control, remarkably reduced postoperative transfusion
incidences and volume of red blood cell and fresh frozen plasma, and
reduced postoperative transfusion incidence of platelet concentrates (PC)
(P <.05) without obvious dose-effects (P >.05), but TXA did not reduce PC
transfusion volume postoperatively in adult patients (P >.05). For
pediatrics, TXA did not significantly reduce postoperative transfusion
incidence and volume of allogenic red blood cell, fresh frozen plasma and
PC (P >.05). Additionally, the current study demonstrated that intravenous
TXA did not influence the composite incidence of postoperative mortality
and morbidities in either adults or pediatrics during hospitalization (P
>.05), and that there was no obvious dose-effect of TXA in adult patients
(P >.05). Conclusion(s): This current study suggested that
intravenous TXA significantly reduced total volume of postoperative
bleeding in both adult and pediatric patients undergoing cardiac surgery
at the single cardiovascular center without increasing the composite
incidence of mortality and morbidities. Copyright © 2023
Lippincott Williams and Wilkins. All rights reserved.

<63>
Accession Number
2005603837
Title
Efficacy and safety of riociguat in combination therapy for patients with
pulmonary arterial hypertension (PATENT studies).
Source
Pulmonary Circulation. 10(3) (no pagination), 2020. Date of Publication:
July 2020.
Author
Ghofrani H.-A.; Grunig E.; Jansa P.; Langleben D.; Rosenkranz S.; Preston
I.R.; Rahaghi F.; Sood N.; Busse D.; Meier C.; Humbert M.
Institution
(Ghofrani) University of Giessen and Marburg Lung Center, Member of German
Center for Lung Research, Giessen, Germany
(Ghofrani) Department of Medicine, Imperial College London, London, United
Kingdom
(Grunig) Center for Pulmonary Hypertension, Thoraxklinic, University
Hospital Heidelberg, Member of the German Center for Lung Research (DZL,
Heidelberg, Germany
(Jansa) First Faculty of Medicine and General Teaching Hospital, Charles
University, Prague, Czechia
(Langleben) Center for Pulmonary Vascular Disease and Lady Davis
Institute, Jewish General Hospital, McGill University, Montreal, QC,
Canada
(Rosenkranz) Klinik III fur Innere Medizin, Herzzentrum der Universitat zu
Koln, Koln, Germany
(Preston) Critical Care and Sleep Division, Tufts Medical Center, Tufts
University School of Medicine, Boston, MA, United States
(Rahaghi) Department of Pulmonary and Critical Care Medicine, Cleveland
Clinic Florida, Weston, FL, United States
(Sood) The Lung Center, The Ohio State University, Columbus, OH, United
States
(Busse) Chrestos Concept GmbH Co. KG, Essen, Germany
(Meier) Bayer AG, Berlin, Germany
(Humbert) Assistance Publique-Hopitaux de Paris, Service de Pneumologie,
Hopital Bicetre, Universite Paris-Sud, Laboratoire d'Excellence en
Recherche sur le Medicament et Innovation Therapeutique, Institut National
de la Sante et de la Recherche Medicale Unite 999, Le Kremlin-Bicetre,
France
Publisher
SAGE Publications Ltd
Abstract
Many patients with pulmonary arterial hypertension do not achieve
treatment goals with monotherapy, and therefore combination therapy is
becoming the standard of care. The soluble guanylate cyclase stimulator
riociguat is licensed for the treatment of pulmonary arterial
hypertension; here we present findings from patients who were receiving
combined riociguat plus endothelin receptor antagonists or non-intravenous
prostanoids in the randomized, placebo-controlled PATENT-1 study and its
open-label extension (PATENT-2). Moreover, we include new data from
patients receiving early sequential combination therapy (three to six
months of endothelin receptor antagonist treatment) or long-term
background endothelin receptor antagonist therapy (>6 months). Patients
were randomized to riociguat 2.5 mg-maximum (N = 131 pretreated patients)
and placebo (N = 60 pretreated patients). Riociguat improved 6-min walking
distance (PATENT-1 primary endpoint), functional capacity, and
hemodynamics after 12 weeks in pretreated patients. The placebo-corrected
changes in 6-min walking distance were +24 m in endothelin receptor
antagonist-pretreated patients and +106 m in the small group of
prostanoid-pretreated patients. In the early sequential combination and
long-term background endothelin receptor antagonist groups, the
placebo-corrected changes in 6-min walking distance were +65 m (95% CI: 17
to 113 m) and +13 m (95% CI: -8 to 33 m), respectively. In conclusion,
these data suggest that early sequential combination of an endothelin
receptor antagonist plus riociguat is a feasible treatment option. Both
early sequential therapy and long-term background endothelin receptor
antagonist plus riociguat were well tolerated in the PATENT
studies. Copyright © The Author(s) 2020.

<64>
Accession Number
2025168680
Title
Matching Ablation Endpoints to Long-Term Outcome: The Prospective
Multicenter Italian Ventricular Tachycardia Ablation Registry.
Source
JACC: Clinical Electrophysiology. 9(6) (pp 836-847), 2023. Date of
Publication: June 2023.
Author
Radinovic A.; Peretto G.; Sgarito G.; Cauti F.M.; Castro A.; Narducci
M.L.; Mantovan R.; Scaglione M.; Solimene F.; Scopinaro A.; Tondo C.;
Filippini G.; Bianco E.; Bonso A.; Calzolari V.; Ferraris F.; Zardini M.;
Piacenti M.; D'Angelo G.; Bosica F.; Della Bella P.
Institution
(Radinovic, Peretto, D'Angelo, Bosica, Della Bella) Department of Cardiac
Electrophysiology and Arrhythmology, IRCCS San Raffaele Hospital, Milan,
Italy
(Sgarito) ARNAS Ospedale Civico, Palermo, Italy
(Cauti) Fatebenefratelli San Giovanni Calibita, Rome, Italy
(Castro) Cardiology unit Pertini Hospital- Azienda USL Roma B, Rome, Italy
(Narducci) Fondazione Policlinico Universitario Agostino Gemelli, IRCCS,
Rome, Italy
(Mantovan) Presidio Ospedaliero di Conegliano, Conegliano, Italy
(Scaglione) Cardinal Massaia Hospital of Asti, Asti, Italy
(Solimene) Casa di Cura Montevergine, Mercogliano, Italy
(Scopinaro) Alessandria Hospital - SS. Antonio, Biagio, Cesare Arrigo,
Alessandria, Italy
(Tondo) Heart Rhythm Center, Centro Cardiologico Monzino, IRCCS
Dipartimento di Scienze Biomediche, Chirurgiche e Odontoiatriche
Universita degli Studi di Miano, Milan, Italy
(Filippini) Ospedale di Circolo di Busto Arsizio, Busto Arsizio, Italy
(Bianco) Cattinara Hospital, Trieste, Italy
(Bonso) ULSS2 FELTRE- Ospedale, Feltre, Italy
(Calzolari) Electrophysiology, Division of Cardiology,
Neuro-Cardio-Vascular Department, Hospital of Treviso, ULSS 2 "Marca
Trevigiana," Treviso, Italy
(Ferraris) A.O.U. Citta della Salute e della Scienza di Torino, Turin,
Italy
(Zardini) Cardiac Electrophysiology Section, Zenda
Ospedaliero-Universitaria di Parma, Parma, Italy
(Piacenti) CNR - Area della Ricerca di Pisa Fondazione Toscana G.
Monasterio, Pisa, Italy
Publisher
Elsevier Inc.
Abstract
Background: Multicenter ventricular tachycardia (VT) ablation studies have
shown poorer outcomes compared with single-center experiences. This
difference could be related to heterogeneous mapping and ablation
strategies. Objective(s): This study evaluated a homogenous
simplified catheter ablation strategy for different substrates and
compared the results with those of a single referral center.
 Method(s): This was a multicenter prospective VT ablation registry of
patients with the following 4 causes of VT: previous myocardial
infarction; previous myocarditis; arrhythmogenic right ventricular
dysplasia; or idiopathic dilated cardiomyopathy. The procedural protocol
included precise mapping and ablation steps with the combined endpoint of
late potential (LP) abolition and noninducibility of VT. The long-term
primary efficacy endpoint was freedom from VT. Result(s): A total of
309 patients were enrolled. LPs were present in 70% of patients and were
abolished in 83%. At the end of the procedure 74% of LPs were
noninducible. The primary combined endpoint of LP abolition and
noninducibility was achieved in 64% of patients with LPs at baseline.
Freedom from VT at 12 months was observed in 67% of patients. In the
overall study group, VT inducibility was the only predictor of freedom
from VT (P = 0.013). In patients with LPs, the VT recurrence rate was
lower both for patients with complete LP abolition (P = 0.040) and for
patients meeting the composite endpoint (P = 0.035). Conclusion(s): A
standardized VT mapping and ablation technique reproduced the procedural
outcomes of a single referral center in a multicenter prospective study.
LP abolition and noninducibility were effective in reducing VT recurrences
in patients with 4 causes of cardiomyopathy. (Ventricular Tachycardia
Ablation Registry; NCT03649022) Copyright © 2023 American College
of Cardiology Foundation

<65>
Accession Number
2025131361
Title
The Place of Transaxillary Access in Transcatheter Aortic Valve
Implantation (TAVI) Compared to Alternative Routes-A Systematic Review
Article.
Source
Reviews in Cardiovascular Medicine. 24(5) (no pagination), 2023. Article
Number: 150. Date of Publication: May 2023.
Author
Herremans A.; Stevesyns D.T.; El Jattari H.; Rosseel M.; Rosseel L.
Institution
(Herremans, Stevesyns, El Jattari, Rosseel, Rosseel) Department of
Cardiology, Algemeen Stedelijk Ziekenhuis, Oost-Vlaanderen, Aalst 9300,
Belgium
(Herremans, Stevesyns) Faculty of Medicine and Health Sciences, University
Gent, Oost-Vlaanderen, Gent 9000, Belgium
Publisher
IMR Press Limited
Abstract
Background: Transfemoral transcatheter aortic valve implantation (TAVI)
has proven non-inferior or superior against surgical aortic valve
replacement (SAVR) for patients at high, intermediate or low surgical
risk. However, transfemoral access is not always feasible in patients with
severely atherosclerotic or tortuous iliofemoral arteries. For these
cases, alternative access techniques have been developed, such as
transcarotid, transcaval, direct aortic or transaxillary access. In recent
years, growing preference towards the transaxillary access has emerged. To
provide a summary of data available on transaxillary TAVI and compare this
approach to other alternative access techniques. Method(s): A
literature search was performed in PubMed by two independent reviewers.
Studies reporting the outcome of at least 10 patients who underwent
transaxillary TAVI, either in case series or in comparative studies, were
included in this review. Articles not reporting outcomes according to the
Valve Academic Research Consortium (VARC) 1-3 definitions were excluded.
 Result(s): In total 193 records were found of which 18 were withheld
for inclusion in this review. This review reports on the combined data of
the 1519 patients who underwent transaxillary TAVI. Procedural success was
achieved in 1203 (92.2%) of 1305 cases. Life-threatening, major, and minor
bleeding occurred respectively in 4.5% (n = 50 in 1112 cases), 12.9% (n =
143 in 1112 cases) and 8.8% (n = 86 in 978 cases). Major and minor
vascular complications were reported in respectively 6.6% (n = 83 in 1256
cases) and 10.0% (n = 105 in 1048 cases) of patients. 30-day mortality was
5.2% (n = 76 out of 1457 cases). At one year follow-up, the mortality rate
was 1% (n = 184 out of 1082 cases). Similar 30-day and 1-year mortality is
observed in studies that compare with transaxillary, transfemoral or other
alternative access techniques (p > 0.05). Conclusion(s): A wide
application of transaxillary access as an alternative approach for TAVI
has emerged. This technique has an excellent procedural success rate up to
92.0%, with low procedural complication rates. Clinical outcome of
transaxillary TAVI is comparable to the other alternative TAVI approaches.
However, these conclusions are solely based on observational
data. Copyright © 2023 The Author(s).

<66>
Accession Number
2024701909
Title
Current indications for spinal anesthesia-a narrative review.
Source
Best Practice and Research: Clinical Anaesthesiology. 37(2) (pp 89-99),
2023. Date of Publication: June 2023.
Author
Balavenkatasubramanian; Senthilkumar; Kumar V.
Institution
(Balavenkatasubramanian, Senthilkumar, Kumar) Department of
Anaesthesiology, Ganga Medical Centre and Hospitals Pvt Ltd, 313,
Mettupalayam Road, Coimbatore 641043, India
Publisher
Bailliere Tindall Ltd
Abstract
Spinal anesthesia is a commonly performed regional anesthesia technique by
most anesthesiologists worldwide. This technique is learned early during
training and is relatively easy to master. Despite being an old technique,
spinal anesthesia has evolved and developed in various aspects. This
review attempts to highlight the current indications of this technique.
Understanding the finer aspects and knowledge gaps will help postgraduates
and practicing anesthesiologists in designing patient-specific techniques
and interventions. Copyright © 2023 Elsevier Ltd

<67>
Accession Number
2024263114
Title
P2Y12 Inhibitors for Non-ST-Segment Elevation Acute Coronary Syndrome: A
Systematic Review and Network Meta-Analysis.
Source
Texas Heart Institute Journal. 50(3) (no pagination), 2023. Article
Number: e227916. Date of Publication: 01 May 2023.
Author
Fujisaki T.; Kuno T.; Briasoulis A.; Misumida N.; Takagi H.; Latib A.
Institution
(Fujisaki) Department of Medicine, Icahn School of Medicine at Mount
Sinai, Mount Sinai Morningside, and Mount Sinai West, New York, NY, United
States
(Fujisaki) Department of Cardiovascular Medicine, Graduate School of
Medical Sciences, Kumamoto University, Kumamoto, Japan
(Fujisaki) Department of Cardiovascular Medicine, National Cerebral and
Cardiovascular Center, Osaka, Japan
(Kuno) Department of Medicine, Icahn School of Medicine at Mount Sinai,
Mount Sinai Beth Israel, New York, NY, United States
(Kuno, Latib) Division of Cardiology, Montefiore Medical Center, Albert
Einstein College of Medicine, Bronx, New York, United States
(Briasoulis) Division of Cardiovascular Diseases, Section of Heart Failure
and Transplant, University of Iowa Hospitals and Clinics, Iowa City, IA,
United States
(Misumida) Division of Cardiovascular Medicine, Gill Heart and Vascular
Institute, University of Kentucky, Lexington, KY, United States
(Takagi) Department of Cardiovascular Surgery, Shizuoka Medical Center,
Shizuoka, Japan
Publisher
Texas Heart Institute
Abstract
Background: For patients with non-ST-segment elevation acute coronary
syndrome (NSTE-ACS), prasugrel was recommended over ticagrelor in a recent
randomized controlled trial, although more data are needed on the
rationale. Here, the effects of P2Y12 inhibitors on ischemic and bleeding
events in patients with NSTE-ACS were investigated. Method(s):
Clinical trials that enrolled patients with NSTE-ACS were included,
relevant data were extracted, and a network meta-analysis was performed.
 Result(s): This study included 37,268 patients with NSTE-ACS from 11
studies. There was no significant dif-ference between prasugrel and
ticagrelor for any end point, although prasugrel had a higher likelihood
of event reduction than ticagrelor for all end points except
cardiovascular death. Compared with clopidogrel, prasugrel was associated
with decreased risks of major adverse cardiovascular events (MACE) (hazard
ratio [HR], 0.84; 95% CI, 0.71-0.99) and myocardial infarction (HR, 0.82;
95% CI, 0.68-0.99) but not an increased risk of major bleeding (HR, 1.30;
95% CI, 0.97-1.74). Similarly, compared with clopidogrel, ticagrelor was
associated with a reduced risk of cardiovascular death (HR, 0.79; 95% CI,
0.66-0.94) and an increased risk of major bleeding (HR, 1.33; 95% CI,
1.00-1.77; P =.049). For the primary efficacy end point (MACE), prasugrel
showed the highest likelihood of event reduction (P =.97) and was superior
to ticagrelor (P =.29) and clopi-dogrel (P =.24). Conclusion(s):
Prasugrel and ticagrelor had comparable risks for every end point,
although prasugrel had the highest probability of being the best treatment
for reducing the primary efficacy end point. This study high-lights the
need for further studies to investigate optimal P2Y12 inhibitor selection
in patients with NSTE-ACS. Copyright © 2023 by The Texas Heart
Institute, Houston.

<68>
Accession Number
2023815522
Title
The ReInforcement of adherence via self-monitoring app orchestrating
biosignals and medication of RivaroXaban in patients with atrial
fibrillation and co-morbidities: a study protocol for a randomized
controlled trial (RIVOX-AF).
Source
Frontiers in Cardiovascular Medicine. 10 (no pagination), 2023. Article
Number: 1130216. Date of Publication: 2023.
Author
Yoon M.; Park J.J.; Hur T.; Hua C.-H.; Shim C.Y.; Yoo B.-S.; Cho H.-J.;
Kim H.M.; Kim J.-H.; Lee S.; Choi D.-J.
Institution
(Yoon, Park, Hur, Choi) Division of Cardiology, Department of Internal
Medicine, Seoul National University Bundang Hospital, Seoul National
University College of Medicine, Seongnam, South Korea
(Hua, Lee) Department of Computer Science and Engineering, Kyung Hee
University, Yongin, South Korea
(Shim) Division of Cardiology, Department of Internal Medicine, Severance
Hospital, Yonsei University College of Medicine, Seoul, South Korea
(Yoo) Department of Internal Medicine, Yonsei University Wonju College of
Medicine, Wonju, South Korea
(Cho) Department of Internal Medicine, Seoul National University Hospital,
Seoul National University College of Medicine, Seoul, South Korea
(Lee) Division of Cardiology, Department of Internal Medicine,
Cardiovascular Center, Keimyung University Dongsan Hospital, Daegu, South
Korea
(Kim) Division of Cardiology, Department of Internal Medicine, Chung-Ang
University Hospital, Seoul, South Korea
(Kim) Cardiovascular Center, Dongguk University Ilsan Hospital, Goyang,
South Korea
Publisher
Frontiers Media S.A.
Abstract
Background: Because of the short half-life of non-vitamin K antagonist
oral anticoagulants (NOACs), consistent drug adherence is crucial to
maintain the effect of anticoagulants for stroke prevention in atrial
fibrillation (AF). Considering the low adherence to NOACs in practice, we
developed a mobile health platform that provides an alert for drug intake,
visual confirmation of drug administration, and a list of medication
intake history. This study aims to evaluate whether this smartphone
app-based intervention will increase drug adherence compared with usual
care in patients with AF requiring NOACs in a large population.
 Method(s): This prospective, randomized, open-label, multicenter
trial (RIVOX-AF study) will include a total of 1,042 patients (521
patients in the intervention group and 521 patients in the control group)
from 13 tertiary hospitals in South Korea. Patients with AF aged >=19
years with one or more comorbidities, including heart failure, myocardial
infarction, stable angina, hypertension, or diabetes mellitus, will be
included in this study. Participants will be randomly assigned to either
the intervention group (MEDI-app) or the conventional treatment group in a
1:1 ratio using a web-based randomization service. The intervention group
will use a smartphone app that includes an alarm for drug intake, visual
confirmation of drug administration through a camera check, and
presentation of a list of medication intake history. The primary endpoint
is adherence to rivaroxaban by pill count measurements at 12 and 24 weeks.
The key secondary endpoints are clinical composite endpoints, including
systemic embolic events, stroke, major bleeding requiring transfusion or
hospitalization, or death during the 24 weeks of follow-up.
 Discussion(s): This randomized controlled trial will investigate the
feasibility and efficacy of smartphone apps and mobile health platforms in
improving adherence to NOACs. Trial registration: The study design has
been registered in ClinicalTrial.gov (NCT05557123). Copyright 2023
Yoon, Park, Hur, Hao, Shim, Yoo, Cho, Lee, Kim, Kim, Lee and Choi.

<69>
Accession Number
2023534149
Title
Thoracic epidural analgesia prolongs postoperative QT interval on
electrocardiogram in major non-cardiac surgery: a randomized comparison
and a prospective cohort analysis.
Source
Frontiers in Pharmacology. 14 (no pagination), 2023. Article Number:
936242. Date of Publication: 2023.
Author
Hori K.; Tsujikawa S.; Egami M.; Waki S.; Watanabe R.; Hino H.; Matsuura
T.; Mori T.
Institution
(Hori, Tsujikawa, Watanabe, Hino, Matsuura, Mori) Department of
Anesthesiology, Osaka Metropolitan University Graduate School of Medicine,
Osaka, Japan
(Egami) Central Laboratory, Osaka Metropolitan University Graduate School
of Medicine, Osaka, Japan
(Waki) Department of Anesthesiology, Osaka Rosai Hospital, Osaka, Japan
Publisher
Frontiers Media S.A.
Abstract
Introduction: Prolongation of QT interval on electrocardiogram can be
associated with perioperative lethal arrhythmia. Epidural analgesia is a
commonly used modality to relieve surgical pain by blocking sensory
nerves, which also blocks the autonomic nervous system and can affect QT
interval. Since patient monitoring becomes much less frequent after
surgery than intraoperative period, we investigated the effects of
epidural analgesia on postoperative QT interval with a randomized clinical
trial and a prospective cohort study. Method(s): In a randomized
study, we assigned 60 patients undergoing thoracic epidural analgesia to
an epidural analgesia or no-epidural analgesia group, in which 3 ml/h of
0.25% epidural levobupivacaine (7.5 mg/h) was administered only in the
epidural analgesia group during surgery. The primary outcome was the
postoperative heart rate-corrected QT interval. In a prospective cohort
study, patients were assigned to receive 5 ml/h epidural levobupivacaine
(12.5 mg/h). The plasma concentration of levobupivacaine was measured
using liquid chromatography-mass spectrometry. Result(s): The median
postoperative corrected QT interval interval with 3 ml/h epidural
levobupivacaine was significantly longer than that without epidural
analgesia. Using multiple regression analysis for the factors known to
affect postoperative corrected QT interval interval, epidural analgesia
was found to be an independent variable for prolongation, and the mean
difference of the corrected QT interval interval with or without epidural
analgesia was 23 ms after adjustment. The median plasma concentration of
levobupivacaine at the end of surgery was 164 ng/ml with 3 ml/h epidural
levobupivacaine, and the correlation coefficient to the postoperative
corrected QT interval interval was 0.14, showing a not significant
correlation. A prospective cohort study showed that 5 ml/h epidural
levobupivacaine significantly prolonged postoperative corrected QT
interval interval compared to preoperative baseline. The median plasma
concentration of levobupivacaine was 166 ng/ml with 5 ml/h, the
correlation coefficient of which showed no significant correlation.
 Conclusion(s): Thoracic epidural analgesia could enhance
postoperative corrected QT interval prolongation after general anesthesia.
The mechanism is possibly caused by blocking neighboring or part of the
cardiac sympathetic nerves, rather than by systemic effects of epidurally
administered levobupivacaine. Clinical trial number: UMIN000013347 for the
randomized study and UMIN000041518 for the prospective cohort study, which
were registered at University hospital Medical Information Network
Center. Copyright © 2023 Hori, Tsujikawa, Egami, Waki, Watanabe,
Hino, Matsuura and Mori.

<70>
Accession Number
2023027757
Title
Association of late gadolinium enhancement in cardiac magnetic resonance
with mortality, ventricular arrhythmias, and heart failure in patients
with nonischemic cardiomyopathy: A systematic review and meta-analysis.
Source
Heart Rhythm O2. 4(4) (pp 241-250), 2023. Date of Publication: April 2023.
Author
Al-Sadawi M.; Aslam F.; Tao M.; Fan R.; Singh A.; Rashba E.
Institution
(Al-Sadawi, Aslam, Tao, Fan, Singh, Rashba) Stony Brook Heart Institute,
Stony Brook Medicine, Stony Brook, NY, United States
Publisher
Elsevier B.V.
Abstract
Background: Late gadolinium enhancement (LGE) on cardiac magnetic
resonance is a predictor of adverse events in patients with nonischemic
cardiomyopathy (NICM). Objective(s): This meta-analysis evaluated the
correlation between LGE and mortality, ventricular arrhythmias (VAs) and
sudden cardiac death (SCD), and heart failure (HF) outcomes.
 Method(s): A literature search was conducted for studies reporting
the association between LGE in NICM and the study endpoints. The primary
endpoint was mortality. Secondary endpoints included VA and SCD, HF
hospitalization, improvement in left ventricular ejection fraction (LVEF)
to >35%, and heart transplantation referral. The search was not restricted
to time or publication status. The minimum follow-up duration was 1 year.
 Result(s): A total of 46 studies and 10,548 NICM patients (4610 with
LGE, 5938 without LGE) were included; mean follow-up was 3 years (range
13-71 months). LGE was associated with increased mortality (odds ratio
[OR] 2.9; 95% confidence interval [CI] 2.3-3.8; P < .01) and VA and SCD
(OR 4.6; 95% CI 3.5-6.0; P < .01). LGE was associated with an increased
risk of HF hospitalization (OR 3.4; 95% CI 2.3-5.0; P < .01), referral for
transplantation (OR 5.1; 95% CI 2.5-10.4; P < .01), and decreased
incidence of LVEF improvement to >35% (OR 0.2; 95% CI 0.03-0.85; P = .03).
 Conclusion(s): LGE in NICM patients is associated with increased
mortality, VA and SCD, and HF hospitalization and heart transplantation
referral during long-term follow up. Given these competing risks of
mortality and HF progression, prospective randomized controlled trials are
required to determine if LGE is useful for guiding prophylactic
implantable cardioverter-defibrillator placement in NICM
patients. Copyright © 2023 Heart Rhythm Society

<71>
Accession Number
2022466131
Title
Anticoagulation therapy and clinical outcomes following transcatheter
mitral valve repair for patients with mitral regurgitation: A
meta-analysis.
Source
Clinical Cardiology. 46(6) (pp 598-606), 2023. Date of Publication: June
2023.
Author
Zhang J.; Yang Y.; Jia L.; Su J.; Xiao A.; Lin X.
Institution
(Zhang, Yang, Jia, Su, Xiao, Lin) Cardiology Department, The First
Affiliated Hospital of Anhui Medical University, Anhui, Hefei, China
(Zhang, Yang, Jia, Su, Xiao) Graduate School, Anhui Medical University,
Anhui, China
Publisher
John Wiley and Sons Inc
Abstract
Transcatheter mitral valve repair (TMVR) using MitraClip (MC) is now an
established technique in the interventional treatment of mitral
regurgitation. Common complications after MC procedure are bleeding and
ischemic events. However, 2017 ESC/EACTS and 2020 ACC/AHA did not give a
clear antithrombotic protocol, the policy has been based on clinical
experience. Here, we performed a meta-analysis comparing outcomes with and
without the addition of anticoagulants after TMVR. We searched the
Cochrane Library, EMBASE, PubMed, and Web of Science from inception to
October 6, 2022 to identify studies with or without the use of
anticoagulants after TMVR. From each study, we extracted the number of
people with bleeding, stroke, combined endpoints, and all-cause death.
Five observational cohort studies were included, enrolling a total of 1892
patients undergoing TMVR who were assigned to either the anticoagulation
group (n = 1209) or the no-anticoagulation group (n = 683). Pooled
analysis showed a significantly lower stroke rate in the anticoagulated
group (at least 4 weeks duration) compared with the non-anticoagulated
group (RR [95% CI] = 0.14 [0.0-0.77], p = 0.02), and similar rates of
bleeding, combined endpoints, and all-cause death in both groups (RR [95%
CI] = 0.76 [0.48-1.22], p = 0.26), (RR [95% CI] = 0.52 [0.10-2.63], p =
0.43), and (RR [95% CI] = 0.89 [0.58-1.35], p = 0.58). We observed a
reduced risk of stroke without elevated risk of bleeding, combined
endpoints, or all-cause death in patients using anticoagulants (at least 4
weeks duration) after TMVR compared to no anticoagulants. Copyright
© 2023 The Authors. Clinical Cardiology published by Wiley
Periodicals, LLC.

<72>
Accession Number
2022289965
Title
Electrophysiology practice in low- and middle-income countries: An updated
review on access to care and health delivery.
Source
Heart Rhythm O2. 4(1) (pp 69-77), 2023. Date of Publication: January 2023.
Author
Khurshid R.; Awais M.; Malik J.
Institution
(Khurshid) Department of Medicine, Rawalpindi Medical University,
Rawalpindi, Pakistan
(Awais, Malik) Department of Electrophysiology, Armed Forces Institute of
Cardiology, Rawalpindi, Pakistan
(Malik) Cardiovascular Analytics Group, Hong Kong, Hong Kong
Publisher
Elsevier B.V.
Abstract
Concurrent with the epidemiological transition to cardiovascular diseases
in low- and middle-income countries (LMICs), the burden of arrhythmias is
increasing significantly. However, registries of electrophysiological
disorders and their management in LMICs are limited. The advancement of
telemedicine technology can play a distinctive role in providing accurate
diagnoses in resource-limited settings. The estimated pacemaker
implantation requirements (1 million per year) demand an alternate source
of pacemakers, including reused permanent pacemakers and implantable
cardioverter-defibrillators. In addition, the majority of supraventricular
tachycardias and atrial fibrillation can be managed with radiofrequency
ablation, which not only is cost-effective but is curative for most
patients. Copyright © 2022 Heart Rhythm Society

<73>
Accession Number
2021363976
Title
Invasive electrophysiological testing to predict and guide permanent
pacemaker implantation after transcatheter aortic valve implantation: A
meta-analysis.
Source
Heart Rhythm O2. 4(1) (pp 24-33), 2023. Date of Publication: January 2023.
Author
Siontis K.C.; Kara Balla A.; Cha Y.-M.; Pilgrim T.; Sweda R.; Roten L.;
Reichlin T.; Friedman P.A.; Windecker S.; Siontis G.C.M.
Institution
(Siontis, Kara Balla, Cha, Friedman) Department of Cardiovascular
Medicine, Mayo Clinic, Rochester, Minnesota, United States
(Pilgrim, Sweda, Roten, Reichlin, Windecker, Siontis) Department of
Cardiology, Bern University Hospital, University of Bern, Bern,
Switzerland
Publisher
Elsevier B.V.
Abstract
Background: Atrioventricular conduction abnormalities after transcatheter
aortic valve implantation (TAVI) are common. The value of
electrophysiological study (EPS) for risk stratification of high-grade
atrioventricular block (HG-AVB) and guidance of permanent pacemaker (PPM)
implantation is poorly defined. Objective(s): The purpose of this
study was to identify EPS parameters associated with HG-AVB and determine
the value of EPS-guided PPM implantation after TAVI. Method(s): We
performed a systematic review and meta-analysis of studies investigating
the value of EPS parameters for risk stratification of TAVI-related HG-AVB
and for guidance of PPM implantation among patients with equivocal PPM
indications after TAVI. Result(s): Eighteen studies (1230 patients)
were eligible. In 7 studies, EPS was performed only after TAVI, whereas in
11 studies EPS was performed both before and after TAVI. Overall PPM
implantation rate for HG-AVB was 16%. AV conduction intervals prolonged
after TAVI, with the AH and HV intervals showing the largest magnitude of
changes. Pre-TAVI HV >70 ms and the absolute value of the post-TAVI HV
interval were associated with subsequent HG-AVB and PPM implantation with
odds ratios of 2.53 (95% confidence interval [CI] 1.11-5.81; P = .04) and
1.10 (95% CI 1.03-1.17; P = .02; per 1-ms increase), respectively. In 10
studies, PPM was also implanted due to abnormal EPS findings in patients
with equivocal PPM indications post-TAVI (typically new left bundle branch
block or transient HG-AVB). Among them, the rate of long-term PPM
dependency was 57%. Conclusion(s): Selective EPS testing may assist
in the risk stratification of post-TAVI HG-AVB and in the guidance of PPM
implantation, especially in patients with equivocal PPM indications
post-TAVI. Copyright © 2022 Heart Rhythm Society

<74>
Accession Number
2020732008
Title
Feeding Neonates and Infants Prior to Surgery for Congenital Heart
Defects: Systematic Review and Meta-Analysis.
Source
Children. 9(12) (no pagination), 2022. Article Number: 1856. Date of
Publication: December 2022.
Author
Bell D.; Suna J.; Marathe S.P.; Perumal G.; Betts K.S.; Venugopal P.;
Alphonso N.
Institution
(Bell) The Prince Charles Hospital, Brisbane, QLD 4032, Australia
(Suna, Marathe, Venugopal, Alphonso) Queensland Paediatric Cardiac Service
(QPCS), Queensland Children's Hospital, Brisbane, QLD 4101, Australia
(Suna, Marathe, Venugopal, Alphonso) School of Clinical Medicine,
Children's Health Queensland Clinical Unit, University of Queensland,
Brisbane, QLD 4072, Australia
(Suna, Marathe, Betts, Venugopal, Alphonso) Children's Health Research
Centre, University of Queensland, Brisbane, QLD 4101, Australia
(Perumal) UCSF Benioff Children's Hospital, San Francisco, CA 94158,
United States
Publisher
MDPI
Abstract
Background: Necrotising enterocolitis (NEC) is a significant cause of
mortality and morbidity in neonates requiring cardiac surgery. Feeding
practices vary significantly across institutions and remain controversial.
We conducted a systematic review of the literature and a meta-analysis to
identify associations between feeding practices and necrotising
enterocolitis. Method(s): This study was carried out in accordance
with the PRISMA guidelines. A literature search was performed in November
2022 using the Cochrane Central Register, Embase, and Pubmed. Two
investigators then independently retrieved eligible manuscripts considered
suitable for inclusion. Data extracted included gestational age, birth
weight, sex, nature of congenital heart lesion, type of operation
performed, time on ventilator, ICU stay, hospital stay, post-operative
feeding strategy, and complications. The methodological quality was
assessed using the Downs and Black score for all randomised control trials
and observational studies. Result(s): The initial search yielded 92
studies. After removing duplicates, there were 85 abstracts remaining.
After excluding ineligible studies, 8 studies were included for the
meta-analysis. There was no significant risk of NEC associated with
pre-operative feeding [OR = 1.22 (95% CI 0.77,1.92)] or umbilical artery
catheter placement [OR = 0.91 (95% CI 0.44, 1.89)] and neither outcome
exhibited heterogeneity [I2 = 8% and 0%, respectively]. There
was a significant association between HLHS and NEC [OR = 2.56 (95% CI
1.56, 4.19)] as well as prematurity and NEC [OR 3.34 (95% CI 1.94, 5.75)]
and neither outcome exhibited heterogeneity [I2 = 0% and 0%,
respectively]. Conclusion(s): There was no association between NEC
and pre-operative feeding status in neonates awaiting cardiac surgery.
Pre-operative feeding status was not associated with prolonged hospital
stay or need for tube assisted feeding at discharge. HLHS and prematurity
were associated with increased incidence of NEC. Copyright © 2022
by the authors.

<75>
Accession Number
2017846998
Title
Transcatheter Versus Surgical Aortic Valve Replacement in Hypertrophic
Cardiomyopathy Patients with Aortic Stenosis.
Source
Current Problems in Cardiology. 48(8) (no pagination), 2023. Article
Number: 101180. Date of Publication: August 2023.
Author
Mhanna M.; Minhas A.M.K.; Ariss R.W.; Ahuja K.R.; Mostafa A.; Nazir S.;
Sheikh M.
Institution
(Mhanna) Department of Internal Medicine, The University of Toledo,
Toledo, OH, United States
(Minhas) Division of Medicine, Forrest General Hospital, Hattiesburg, MS,
United States
(Ariss, Mostafa, Nazir) Department of Cardiovascular Medicine, University
of Toledo, Toledo, OH, United States
(Ahuja) Division of Cardiology, Reading Hospital-Tower Health System, West
Reading, PA, United States
(Sheikh) Division of Cardiovascular Medicine, ProMedica Toledo Hospital,
Toledo, OH, United States
Publisher
Elsevier Inc.
Abstract
Surgical aortic valve replacement (SAVR) and transcatheter aortic valve
replacement (TAVR) are well established treatment options for severe
aortic stenosis (AS). However, patients with hypertrophic cardiomyopathy
(HCM) were excluded from pivotal randomized controlled trials of TAVR vs
SAVR. We queried the 2016 to 2019 National Inpatient Sample to identify
adult hospitalizations with HCM who underwent SAVR or TAVR for severe AS.
The primary outcome was in-hospital mortality. Secondary outcomes included
cardiac arrest, new permanent pacemaker (PPM), cardiac tamponade, bleeding
requiring transfusion, stroke/transient ischemic attack, acute kidney
injury (AKI), and resource utilization (length of stay [LOS], hospital
costs, and discharge to facility). Of 1245 HCM hospitalizations with
severe AS, 595(47.8%) underwent TAVR and 650 (52.2%) underwent SAVR.
In-hospital mortality rate was lower in the TAVR group. Cardiac arrest,
cardiogenic shock, pressor use, new PPM, and cardiac tamponade were not
significantly different between the 2 groups. When compared to SAVR, TAVR
was associated with lower rates of bleeding requiring transfusion,
vascular complications, AKI, and invasive mechanical ventilation.
Furthermore, TAVR was associated with a shorter hospital stay, fewer
facility discharges, but comparable hospital costs. Our findings indicate
that TAVR is associated with lower risk of in-hospital mortality, certain
peri-procedural complications, shorter hospital stay, and fewer facility
discharges in HCM patients with isolated AS compared to SAVR. Further
studies are needed to assess the mid- and long-term outcomes of TAVR vs
SAVR in HCM patients with AS. Copyright © 2022 Elsevier Inc.

<76>
Accession Number
2017001383
Title
Structural valve degeneration of bioprosthetic aortic valves: A network
meta-analysis.
Source
Journal of Thoracic and Cardiovascular Surgery. 166(1) (pp 52-59), 2023.
Date of Publication: July 2023.
Author
Squiers J.J.; Robinson N.B.; Audisio K.; Ryan W.H.; Mack M.J.; Rahouma M.;
Cancelli G.; Kirov H.; Doenst T.; Gaudino M.; DiMaio J.M.
Institution
(Squiers, Ryan, Mack, Rahouma, DiMaio) Department of Cardiothoracic
Surgery, Baylor Scott & White The Heart Hospital, Plano, Tex, United
States
(Robinson, Audisio, Cancelli, Gaudino) Department of Cardiothoracic
Surgery, Weill Cornell Medicine, New York, NY, United States
(Kirov, Doenst) Department of Cardiothoracic Surgery, University of Jena,
Jena, Germany
Publisher
Elsevier Inc.
Abstract
Objective: To compare the rate of structural valve degeneration (SVD)
following surgical aortic valve replacement associated with the Trifecta
(TF) valve (St Jude Medical) versus other bioprosthetic valves.
 Method(s): A systematic literature search was conducted for studies
comparing durability of the TF prosthesis to other valve types, including
Perimount (Edwards Lifesciences), Carpentier-Edwards Perimount Magna Ease
(ME) (Edwards Lifesciences), and Mitroflow (LivaNova USA) after surgical
aortic valve replacement. Random effect pairwise and network meta-analyses
were performed to compare the incident rate ratio of the composite primary
outcome of SVD or reintervention due to SVD. Result(s): Ten studies
with 31,029 patients were included, of whom 6832 received TF, 19,023
received Perimount, 3514 received ME, and 713 received Mitroflow. When
compared with TF, ME was associated with lower rates of SVD or
reintervention for SVD (incident rate ratio, 0.13; 95% CI, 0.02-0.92; P =
.04). Similarly, at network meta-analysis, when compared with TF, only ME
was associated with significantly lower rates of SVD or reintervention for
SVD (incident rate ratio, 0.13; 95% CI, 0.02-0.97). ME (incident rate
ratio, 0.18; 95% CI, 0.07-0.47) and PM (incident rate ratio, 0.34; 95% CI,
0.12-0.98) were associated with significantly lower rate of all-cause
reintervention when compared with TF. No differences in the other
secondary outcomes were found. Conclusion(s): The TF valve is
associated with significantly higher rates of SVD or reintervention for
SVD than the ME valve, but not the Mitroflow valve. The TF valve was also
associated with higher rates of all-cause reintervention than ME and
Perimount valves. The underlying mechanism(s) of these findings warrant
further investigation. Copyright © 2022 The American Association
for Thoracic Surgery

<77>
Accession Number
2015587444
Title
All that glitters is not sarcoidosis: Importance of systematic review of
18F-FDG-PET data and integration of clinical information.
Source
Journal of Nuclear Cardiology. 30(3) (pp 1250-1252), 2023. Date of
Publication: June 2023.
Author
Mshelbwala F.S.; Ananthasubramaniam K.
Institution
(Mshelbwala, Ananthasubramaniam) Heart and Vascular Institute, Henry Ford
West Bloomfield Hospital, 6777 W Maple, West Bloomfield, MI 48322, United
States
Publisher
Springer

<78>
Accession Number
2025212754
Title
Transcatheter vacuum aspiration of valvular and lead related infective
endocarditis.
Source
Cardiovascular Revascularization Medicine. (no pagination), 2023. Date of
Publication: 2023.
Author
Gill G.S.; Chakrala T.; Kanmanthareddy A.; Alla V.M.
Institution
(Gill, Kanmanthareddy, Alla) Division of Cardiovascular Disease, Creighton
University School of Medicine, Omaha, NE, United States
(Chakrala) Department on Medicine, University of Florida, Gainesville, FL,
United States
Publisher
Elsevier Inc.
Abstract
Background: Transcatheter aspiration is utilized for removal of thrombi
and vegetations in inoperable patients and high-risk surgical candidates
where medical therapy alone is unlikely to achieve desired outcome. A
number of case reports and series have been published since the
introduction of AngioVac system (AngioDynamics Inc., Latham, NY) in 2012
where this technology was used in the treatment of endocarditis. However,
there is a lack of consolidated data reporting on patient selection,
safety and outcomes. Method(s): PubMed and Google Scholar databases
were queried for publications reporting cases where transcatheter
aspiration was used for endocarditis vegetation debulking or removal. Data
on patient characteristics, outcomes and complications from select reports
were extracted and systematically reviewed. Result(s): Data from 11
publications with 232 patients were included in the final analyses. Of
these, 124 had lead vegetation aspiration, 105 had valvular vegetation
aspiration, and 3 had both lead as well as valvular vegetation aspiration.
Among the 105 valvular endocarditis cases, 102 (97 %) patients had right
sided vegetation removal. Patients with valvular endocarditis were younger
(mean age 35 years) vs. patients with lead vegetations (mean age 66
years). Among the valvular endocarditis cases, there was a 50-85 %
reduction in vegetation size, 14 % had worsening valvular regurgitation, 8
% had persistent bacteremia and 37 % required blood transfusion. Surgical
valve repair or replacement was subsequently performed in 3 % and
in-hospital mortality was 11 %. Among patients with lead infection,
procedural success rate was reported at 86 %, 2 % had vascular
complications and in-hospital mortality was 6 %. Persistent bacteremia,
renal failure requiring hemodialysis, and clinically significant pulmonary
embolism occurred in about 1 % each. Conclusion(s): Transcatheter
aspiration of vegetations in infective endocarditis has acceptable success
rates in vegetation debulking as well as rates of morbidity or mortality.
Large prospective multi-center studies are warranted to determine
predictors of complications, thus helping identify suitable
patients. Copyright © 2023 Elsevier Inc.

<79>
Accession Number
2023923304
Title
The influence of cardiopulmonary bypass on pediatric pharmacokinetics.
Source
Expert Opinion on Drug Metabolism and Toxicology. (no pagination), 2023.
Date of Publication: 2023.
Author
van Saet A.; Tibboel D.
Institution
(van Saet) Department of Anesthesiology, Erasmus Medical Center,
Rotterdam, Netherlands
(Tibboel) Department of Intensive Care and Pediatric Surgery, Erasmus
Medical Center, Rotterdam, Netherlands
Publisher
Taylor and Francis Ltd.
Abstract
Introduction: Every year thousands of children undergo surgery for
congenital heart disease. Cardiac surgery requires the use of
cardiopulmonary bypass, which can have unexpected consequences for
pharmacokinetic parameters. Areas covered: We describe the
pathophysiological properties of cardiopulmonary bypass that may influence
pharmacokinetic parameters, with a focus on literature published in the
last 10 years. We performed a PubMed database search with the keywords
'Cardiopulmonary bypass' AND 'Pediatric' AND 'Pharmacokinetics'. We
searched related articles on PubMed and checked the references of articles
for relevant studies. Expert opinion: Interest in the influence of
cardiopulmonary bypass on pharmacokinetics has increased over the last 10
years, especially due to the use of population pharmacokinetic modeling.
Unfortunately, study design usually limits the amount of information that
can be obtained with sufficient power and the best way to model
cardiopulmonary bypass is yet unknown. More information is needed on the
pathophysiology of pediatric heart disease and cardiopulmonary bypass.
Once adequately validated, PK models should be integrated in the patient
electronic database integrating covariates and biomarkers influencing PK,
making it possible to predict real-time drug concentrations and guide
further clinical management for the individual patient at the
bedside. Copyright © 2023 Informa UK Limited, trading as Taylor &
Francis Group.

<80>
Accession Number
2023904612
Title
The effects of ergonomic sleep mask use on sleep quality and comfort in
intensive care patients.
Source
Journal of Sleep Research. (no pagination), 2023. Date of Publication:
2023.
Author
Altintas S.; Celik S.; Karahan E.
Institution
(Altintas, Celik, Karahan) Department of Nursing, Bartin University
Faculty of Health Sciences, Bartin, Turkey
Publisher
John Wiley and Sons Inc
Abstract
This study was conducted to determine the effects of the use of ergonomic
sleep mask on sleep quality and comfort in intensive care patients. This
randomised controlled experimental study was completed with 128 surgical
intensive care patients (control = 64, experimental = 64). During the
second night of their stay in the unit, ergonomic sleep masks were given
to the patients in the experimental group, and earplugs and eye masks were
given to the patients in the control group. A Patient information form,
Visual analogue scale for discomfort, and the Richard-Campbell sleep
questionnaire were used to collect data. While 51.6% of the patients were
female, the mean age of the patients was 63.87 +/- 14.94 years. The
highest rates of patients had undergone cardiovascular surgery (28.9%) and
general anaesthesia (57.8%). It was determined that the sleep quality of
the patients in the experimental group was statistically and clinically
significantly higher after the intervention (50.86 +/- 21.46 vs 37.64 +/-
14.97, t = -5.355, Cohen's d = 0.450, p < 0.001). Likewise, the patients
who used ergonomic sleep masks had a statistically significantly lower
mean VAS for Discomfort score, and their comfort level was higher (p <
0.001), but the difference was not clinically significant (Cohen's d =
0.208). The results of this study showed that the use of ergonomic sleep
masks in surgical intensive care patients had a more positive effect on
both the sleep quality and comfort levels of patients compared with
earplugs and eye masks. The use of an ergonomic sleep mask is recommended
in the early period to facilitate sleep and rest in surgical intensive
care patients. Copyright © 2023 European Sleep Research Society.

<81>
Accession Number
641600944
Title
Hemostatic efficacy of a flowable collagen-thrombin matrix during coronary
artery bypass grafting: a double-blind randomized controlled trial.
Source
Journal of cardiothoracic surgery. 18(1) (pp 193), 2023. Date of
Publication: 15 Jun 2023.
Author
Kim H.-H.; Lee K.J.; Kang D.R.; Lee J.H.; Youn Y.-N.
Institution
(Kim, Lee, Youn) Division of Cardiovascular Surgery, Severance
Cardiovascular Hospital, Yonsei University College of Medicine, Yonsei
University Health System, 250 Seongsanno ,Seodaemun-gu, Seoul 03722, South
Korea
(Kim) Department of Cardiothoracic Surgery, Ilsan Hospital, National
Health Insurance Service, Goyang-si 10444, South Korea
(Kang, Lee) Department of Biostatistics, Wonju College of Medicine, Yonsei
University, South Korea
Publisher
NLM (Medline)
Abstract
BACKGROUND: Flowable hemostatic agents have the advantage of being able to
be applied to irregular wound surfaces and difficult to reach areas. We
sought to compare the effectiveness and safety of the flowable hemostatic
sealants Collastat (collagen hemostatic matrix, [CHM]) and Floseal
(gelatin hemostatic matrix, [GHM]) during off-pump coronary artery bypass
(OPCAB). METHOD(S): In this prospective, double-blind, randomized
controlled trial, 160 patients undergoing elective OPCAB surgery were
enrolled between March 2018 and February 2020. After primary suture of the
aortocoronary anastomosis, an area of hemorrhage was identified, and
patients received either CHM or GHM (n=80, each). Study endpoints were the
following: proportion of successful intraoperative hemostasis and time
required for hemostasis overall postoperative bleeding, proportion of
transfusion of blood products, and surgical revision for bleeding.
 RESULT(S): Of the total patients, 23% were female, and the mean age
was 63 years (range 42-81 years). Successful hemostasis proportion within
5 min was achieved for 78 patients (97.5%) in the GHM group, compared to
80 patients (100%) in the CHM group (non-inferiority p=0.006). Two
patients receiving GHM required surgical revision to achieve hemostasis.
There were no differences in the mean time required to obtain hemostasis
[GHM vs. CHM, mean 1.49 (SD 0.94) vs. 1.35 (0.60) min, p=0.272], as
confirmed by time-to-event analysis (p=0.605). The two groups had similar
amounts of mediastinal drainage for 24 h postoperatively [538.5 (229.1)
vs. 494.7 (190.0) ml, p=0.298]. The CHM group required less packed red
blood cells, fresh frozen plasma, and platelets for transfusion than the
GHM group (0.5 vs. 0.7 units per patient, p=0.047; 17.5% vs. 25.0%,
p=0.034; 7.5% vs. 15.0%, p=0.032; respectively). CONCLUSION(S): CHM
was associated with a lower need for FFP and platelet transfusions. Thus,
CHM is a safe and effective alternative to GHM. TRIAL REGISTRATION:
ClinicalTrials.gov, NCT04310150. Copyright © 2023. The Author(s).

<82>
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. 20(3) (pp 220-237), 2023. Date of
Publication: 01 Jun 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. 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. 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. Copyright © 2023 The Authors.
Worldviews on Evidence-based Nursing published by Wiley Periodicals LLC on
behalf of Sigma Theta Tau International.

<83>
Accession Number
2025215891
Title
Effects of Different Anesthetic Techniques on Neutrophil Lymphocyte Ratio
and Monocyte Lymphocyte Ratio in Patients Undergoing Major Non-Cardiac
Surgery: A Prospective, Single-Blind, Randomized Study.
Source
Bali Journal of Anesthesiology. 7(2) (pp 76-81), 2023. Date of
Publication: 2023.
Author
Boruah P.; Gupta B.; Kumar A.; Bhadoria A.S.; Chandra H.; Kumari R.
Institution
(Boruah, Gupta, Kumar, Kumari) Department of Anestheisology, All India
Institute of Medical Sciences, Rishikesh, India
(Bhadoria) Department of Community and Family Medicine, All India
Institute of Medical Sciences, Rishikesh, India
(Chandra) Department of Biochemistry, All India Institute of Medical
Sciences, Uttarakhand, Rishikesh, India
Publisher
Wolters Kluwer Medknow Publications
Abstract
Background: Various surgical and anesthetic techniques can produce stress.
This study aimed to see the changes in neutrophil-to-lymphocyte ratio
(NLR) and monocyte-to-lymphocyte ratio (MLR) in patients undergoing major
surgery at different time points. Material(s) and Method(s): A
prospective randomized controlled single blinded study was conducted
involving 300 patients, scheduled for elective non-cardiac surgeries,
randomly grouped into Group 1 (general anesthesia [GA]), Group 2 (total
intravenous anesthesia [TIVA]), and Group 3 (combined spinal and epidural
[CSE]). Blood samples were collected for NLR and MLR (preoperatively,
end-of-surgery, 6 and 24 h after surgery). Result(s): There was an
increase in NLR in all three groups and increase in mean NLR was highest
in group GA at the end of the surgery, 6 and 24 h after surgery. The mean
comparison of NLR at 6 and 24 h after surgery was also found to be
significant when comparison was made between groups 1 and 2 (P = 0.001),
and between groups 1 and 3 (P < 0.001); however, the difference was found
to be insignificant when comparison was made between groups 2 and 3.
 Conclusion(s): The mean comparison of NLR at 24 h after surgery was
found to be significant when comparison was made between GA and TIVA, GA
and CSE; however, the difference was insignificant between-TIVA and CSE
groups. Highest rise in the mean NLR 24 h after surgery was found in
patients who underwent surgeries under GA than TIVA followed by neuraxial
blockade. Copyright © 2023 Bali Journal of Anesthesiology.

<84>
Accession Number
2023919832
Title
Impact of 1-week preoperative auto-CPAP treatment on postoperative
outcomes in patients undergoing heart valve replacement surgery: a
prospective randomized controlled trial.
Source
Frontiers in Neurology. 14 (no pagination), 2023. Article Number: 1152168.
Date of Publication: 2023.
Author
Su M.; Lin W.; Xu Q.; Ni B.; Zhang X.; Zhang S.; Ding N.
Institution
(Su, Zhang, Ding) Department of Respiratory and Critical Care Medicine,
The First Affiliated Hospital of Nanjing Medical University, Nanjing,
China
(Lin) Department of Geriatrics, The First Affiliated Hospital of Nanjing
Medical University, Nanjing, China
(Xu) Department of Oncology, The First Affiliated Hospital of Nanjing
Medical University, Nanjing, China
(Ni, Zhang) Department of Cardiovascular Surgery, The First Affiliated
Hospital of Nanjing Medical University, Nanjing, China
Publisher
Frontiers Media S.A.
Abstract
Background: Whether preoperative continuous positive airway pressure
(CPAP) treatment improves postoperative outcomes in patients undergoing
cardiac valve replacement (CVR) remains unknown. Hypothesis: This study
was to evaluate the effects of 1-week perioperative auto-continuous
positive airway pressure (CPAP) treatment on postoperative heart and
pulmonary outcomes in patients with obstructive sleep apnea (OSA) and
valvular heart disease. Method(s): Thirty-two patients with OSA and
valvular heart disease were randomly assigned to 1-week CPAP (n = 15)
group and non-CPAP treatments (n = 17) group. After the treatment, all
patients underwent CVR surgery. The length of ICU and hospital stays,
postoperative cardiac and respiratory complications were assessed and
compared between the 2 groups. Result(s): The results showed there
was no significant difference in the baseline characteristics between the
CPAP and non-CPAP treatment groups. The length of postoperative ICU and
hospital stays, as well as the duration of mechanical ventilation were
significantly reduced in the CPAP treatment group compared to the non-CPAP
treatment group; however, there were no significant differences in cardiac
complications (postoperative arrhythmias, pacemaker use, first dose of
dopamine in the ICU, and first dose of dobutamine in the ICU), and
respiratory complications (reintubation and pneumonia).
 Conclusion(s): We concluded that in patients underwent CVR,
preoperative use of auto-CPAP for OSA significantly decreased the duration
of mechanical ventilation, and postoperative stays in the ICU and
hospital. Clinical Trial Registration: https://ClinicalTrials.gov,
identifier NCT03398733. Copyright © 2023 Su, Lin, Xu, Ni, Zhang,
Zhang and Ding.

<85>
Accession Number
2024180356
Title
Hemodynamic Response of Dexmedetomidine as an Adjuvant to Fentanyl in
Patients Undergoing Valvular Heart Surgery: A Comparative Study.
Source
International Journal of Pharmaceutical and Clinical Research. 15(5) (pp
1114-1123), 2023. Date of Publication: 2023.
Author
Mourya M.K.; Rajbala; Gill A.; Jajoriya R.L.; Verma I.
Institution
(Mourya, Rajbala, Gill, Jajoriya, Verma) Department of Anesthesia, SMS
Medical College & Hospital, Jaipur, India
Publisher
Dr Yashwant Research Labs Pvt Ltd
Abstract
Background: Rheumatic fever (RF) and rheumatic heart disease (RHD) pose
significant health risks in developing countries and sporadically in
developed economies. Echocardiographic studies highlight the burden of
RHD, necessitating updated diagnostic guidelines. RHD, a non-suppurative
manifestation of Group A streptococcal pharyngitis, remains a major cause
of morbidity and mortality in developing nations, including India with an
estimated 2.0 to 2.5 million affected individuals. Method(s): This
study included adult patients undergoing cardiac surgeries for valve
replacement. They were randomized into two groups: one receiving
dexmedetomidine infusion and the other saline infusion. Preoperative
assessments and baseline data collection were performed. General
anesthesia was induced, and intraoperative hemodynamic monitoring was
conducted. After surgery, renal function parameters were monitored in the
ICU. Result(s): The study evaluated the hemodynamic response of
dexmedetomidine as an adjuvant to fentanyl in patients undergoing valvular
heart surgery. Dexmedetomidine demonstrated significant effects on heart
rate, blood pressure, and plasma catecholamine concentrations during
emergence from general anesthesia. The combination of dexmedetomidine and
fentanyl resulted in better hemodynamic stability compared to fentanyl
alone. Conclusion(s): In valvular heart surgery, adding
dexmedetomidine to fentanyl improved hemodynamic stability.
Dexmedetomidine positively affected heart rate, blood pressure, and plasma
catecholamine levels, showing promise for perioperative management.
Further research is needed to validate these findings and investigate
long-term benefits and safety of dexmedetomidine in this
setting. Copyright © 2023, Dr Yashwant Research Labs Pvt Ltd. All
rights reserved.

<86>
Accession Number
2023778534
Title
Systematic Review and Meta-Analysis of Transradial Access for Carotid
Artery Stenting.
Source
Angiology. (no pagination), 2023. Date of Publication: 2023.
Author
Du M.; Hu Y.; Zhu D.; Cao W.; Li P.; Qi D.; Wu C.; He J.; Ye S.; Li S.;
Fang Y.
Institution
(Du, Hu, Zhu, Cao, Li, Qi, Wu, He, Ye, Li, Fang) Department of
Neurovascular Disease, Shanghai Fourth People's Hospital, School of
Medicine, Tongji University, Shanghai, China
Publisher
SAGE Publications Inc.
Abstract
There is an increasing number of studies on the transradial approach (TRA)
for carotid artery stenting. We aimed to summarize the published data on
TRA vs the transfemoral approach (TFA). We searched Science Direct,
Embase, PubMed, and Web of Science databases for the relevant literature.
Primary outcomes included surgical success and cardiovascular and
cerebrovascular complication rates; secondary outcomes included the rates
of vascular access-related and other complications. We also compared the
crossover rate, success rate, and complications between TRA and TFA
carotid stenting. This is the first such meta-analysis regarding TRA and
TFA. Twenty studies on TRA carotid stenting were included (n = 1300).
Among 19 studies, the success rate of TRA carotid stenting was.951 (95%
confidence interval [CI]:.926-.975); death rate was.022 (.011-.032);
stroke rate was.005 (.001-.008); radial artery occlusion rate was.008
(.003-.013); and forearm hematoma rate was.003 (-.000 to.006). Among 4
studies comparing TRA and TFA, the success rate was lower (odds ratio:.02;
95% CI:.00-.23) and crossover rate was higher (odds ratio: 40.16; 95% CI:
4.41-365.73) with TRA. Thus, transradial neuro-interventional surgery has
a lower success rate than TFA. Copyright © The Author(s) 2023.

<87>
Accession Number
2023775539
Title
Opioid-free anesthesia versus opioid-based anesthesia in patients
undergoing cardiovascular and thoracic surgery: a meta-analysis and
systematic review.
Source
Seminars in Cardiothoracic and Vascular Anesthesia. (no pagination),
2023. Date of Publication: 2023.
Author
Mathew D.M.; Fusco P.J.; Varghese K.S.; Awad A.K.; Vega E.; Mathew S.M.;
Polizzi M.; George J.; Mathew C.S.; Thomas J.J.; Calixte R.; Ahmed A.
Institution
(Fusco, Varghese, Vega, Mathew, Polizzi, Mathew, Thomas, Ahmed) CUNY
School of Medicine, New York, NY, United States
(Awad) Faculty of Medicine, Ain Shams University, Cairo, Egypt
(George) University of Toledo College of Medicine and Life Sciences,
Toledo, OH, United States
(Calixte) Epidemiology and Biostatistics, SUNY Downstate Health Sciences
University, Brooklyn, NY, United States
Publisher
SAGE Publications Inc.
Abstract
Background: Despite their extensive clinical use, opioids are
characterized by several side effects. These complications, coupled with
the ongoing opioid epidemic, have favored the rise of
opioid-free-anesthesia (OFA). Herein, we perform the first pairwise
meta-analysis of clinical outcomes for OFA vs opioid-based anesthesia
(OBA) in patients undergoing cardiovascular and thoracic surgery.
 Method(s): We comprehensively searched medical databases to identify
studies comparing OFA and OBA in patients undergoing cardiovascular or
thoracic surgery. Pairwise meta-analysis was performed using the
Mantel-Haenszel method. Outcomes were pooled as risk ratios (RR) or
standard mean differences (SMD) and their 95% confidence intervals (95%
CI). Result(s): Our pooled analysis included 919 patients (8
studies), of whom 488 underwent surgery with OBA and 431 with OFA. Among
cardiovascular surgery patients, compared to OBA, OFA was associated with
significantly reduced post-operative nausea and vomiting (RR, 0.57; P
=.042), inotrope need (RR.84, P =.045), and non-invasive ventilation
(RR,.54; P =.028). However, no differences were observed for 24hr pain
score (SMD, -.35; P =.510) or 48hr morphine equivalent consumption (SMD,
-1.09; P =.139). Among thoracic surgery patients, there was no difference
between OFA and OBA for any of the explored outcomes, including
post-operative nausea and vomiting (RR, 0.41; P =.025).
 Conclusion(s): Through the first pooled analysis of OBA vs OFA in a
cardiothoracic-exclusive cohort, we found no significant difference in any
of the pooled outcomes for thoracic surgery patients. Although limited to
2 cardiovascular surgery studies, OFA was associated with significantly
reduced postoperative nausea and vomiting, inotrope need, and non-invasive
ventilation in these patients. With growing use of OFA in invasive
operations, further studies are needed to assess their efficacy and safety
in cardiothoracic patients. Copyright © The Author(s) 2023.

<88>
Accession Number
2023746802
Title
Clinical outcomes of different revascularization approaches for patients
with multi-vessel coronary artery disease: A network meta-analysis.
Source
Perfusion (United Kingdom). (no pagination), 2023. Date of Publication:
2023.
Author
Hasan S.U.; Pervez A.; Naseeb M.W.; Rajput B.S.; Faheem A.; Hameed I.; Sa
M.P.; Zubair M.M.
Institution
(Hasan, Pervez) Aga Khan University Hospital, Karachi, Pakistan
(Naseeb, Rajput, Faheem) Dow University of Health Sciences, Karachi,
Pakistan
(Hameed) Department of Cardiothoracic Surgery, Yale School of Medicine,
New Haven, CT, United States
(Sa) Department of Cardiac Surgery, Lankenau Heart Institute, Wynnewood,
PA, United States
(Zubair) Department of Cardiac Surgery, Smidt Heart Institute,
Cedars-Sinai Medical Center, Los Angeles, CA, United States
Publisher
SAGE Publications Ltd
Abstract
Background: As surgical techniques continue to evolve, the optimal
approach for revascularizing multi-vessel coronary artery disease (CAD)
remains a matter of ongoing debate. Accordingly, our objective was to
compare and contrast various surgical techniques utilized in the
management of multi-vessel CAD. Method(s): A systematic literature
review was performed using PubMed, Embase, and Cochrane central register
of controlled trials from inception to May 2022. Random-effects network
meta-analysis was performed for the primary outcome; target vessel
revascularization (TVR), and secondary outcomes; mortality, major adverse
cardiac and cerebrovascular events, postoperative myocardial infarction,
new-onset atrial fibrillation, stroke, new-onset dialysis, in patients
undergoing percutaneous coronary intervention (PCI) with a stent, off-pump
coronary bypass graft, on-pump coronary artery bypass graft (ONCABG),
hybrid coronary revascularization, minimally-invasive coronary artery
bypass, or robot-assisted coronary artery bypass (RCAB) surgeries.
 Result(s): A total of 8841 patients were included from 23 studies.
The analysis showed that ONCABG had the highest freedom from TVR, with a
mean (SD) absolute risk of 0.027 (0.029); although ONCABG was found to be
superior to all other methods, it was only significantly better than
first-generation stent PCI. While RCAB did not demonstrate significant
superiority over other treatments, it showed a greater probability of
preventing postoperative complications. Notably, no significant
heterogeneity was calculated for any of the reported outcomes.
 Conclusion(s): ONCABG shows a better rank probability compared to all
other techniques for preventing TVR, while RCAB offers greater freedom
from most postoperative complications. However, given the absence of
randomized controlled trials, these results should be interpreted with
caution. Copyright © The Author(s) 2023.

<89>
Accession Number
2023701863
Title
Comparison of endovenous laser ablation and cyanoacrylate embolization in
the non-invasive treatment of superficial venous insufficiency in terms of
patient satisfaction.
Source
Phlebology. (no pagination), 2023. Date of Publication: 2023.
Author
ER Z.C.; Ikbali Afsar F.; Atilgan K.; Onuk B.E.
Institution
(ER) Cardiovascular Surgery, Bozok Universitesi Tip Fakultesi, Yozgat Mer,
Turkey
(Ikbali Afsar) Cardiovascular Surgery, 29 Mayis Devlet Hastanesi, Ankara,
Turkey
(Atilgan, Onuk) Cardiovascular Surgery, TOBB ETU Hospital, Ankara, Turkey
Publisher
SAGE Publications Ltd
Abstract
Objective: Ablation with n-butyl cyanoacrylate is a clinically newer
technique than endovenous laser ablation and other interventional
techniques in the treatment of chronic venous insufficiency (CVI). The aim
of this study was to compare the endovenous laser ablation (EVLA) and
n-butyl cyanoacrylate (NBCA) interventional techniques in terms of
benefit, effectiveness, and patient satisfaction. Material(s) and
Method(s): The study was conducted at Yozgat City Hospital and Bozok
University Research Hospital Cardiovascular Surgery clinics between
November 2016 and February 2021. A total of 260 symptomatic patients with
130 randomized cases in each intervention group were included. NBCA
patients constituted Group 1 and EVLA patients Group 2. The saphenous vein
was evaluated by color Doppler ultrasonography (CDUS) of the lower
extremity. Patients with saphenous veins over 5.5 mm in diameter and a
saphenous-femoral reflux time of 2 s or longer were included in the study.
The patients were asked about their satisfaction and symptoms in the first
postoperative week during an outpatient clinic follow-up with CDUS
investigation at the first and sixth months. Result(s): Although vena
saphenous magna (VSM) closure results were similar with the two methods,
satisfaction rates were found to be higher with the NBCA procedure.
 Conclusion(s): Comparison of the new methods used in the treatment of
CVI revealed similar VSM closure rates in the two methods, but the
satisfaction rate was higher with the NBCA technique in this
study. Copyright © The Author(s) 2023.

<90>
Accession Number
2023382125
Title
Percutaneous versus surgical approach to aortic valve replacement with
coronary revascularization: A systematic review andmeta-analysis.
Source
Perfusion (United Kingdom). (no pagination), 2023. Date of Publication:
2023.
Author
Guo Y.; Zhang W.; Wu H.
Institution
(Guo) Department of Graduate School, Changzhi Medical College, Shanxi,
Changzhi, China
(Zhang, Wu) Department of Cardiothoracic Surgery, Changzhi People's
Hospital, Shanxi, Changzhi, China
Publisher
SAGE Publications Ltd
Abstract
Objective: The optimal treatment of patients with severe aortic stenosis
(AS) and complex coronary artery disease (CAD) remains controversial. We
conducted a meta-analysis to investigate outcomes of transcatheter aortic
valve replacement (TAVR) with percutaneous coronary intervention (PCI)
versus surgical aortic valve replacement (SAVR) with coronary artery
bypass grafting (CABG). Method(s): We searched PubMed, Embase, and
Cochrane databases from its inception up to 17 December 2022 for studies
that assessed TAVR + PCI versus SAVR + CABG in patients with AS and CAD.
The primary outcome was perioperative mortality. Result(s): Six
observational studies including 135,003 patients assessing TAVI + PCI (n =
6988) versus SAVR + CABG (n = 128,015) were included. Compared to SAVR +
CABG, TAVR + PCI was not significantly associated with perioperative
mortality (RR, 0.76; 95% CI, 0.48-1.21; p = 0.25), vascular complications
(RR, 1.85; 95% CI, 0.72-4.71; p = 0.20), acute kidney injury (RR, 0.99;
95% CI, 0.73-1.33; p = 0.95), myocardial infraction (RR, 0.73; 95% CI,
0.30-1.77; p = 0.49), or stroke (RR, 0.87; 95% CI, 0.74-1.02; p = 0.09).
TAVR + PCI significantly reduced the incidence of major bleeding (RR,
0.29; 95% CI, 0.24-0.36; p < 0.01) and length of hospital stay (MD, -1.60;
95% CI, -2.45 to -0.76; p < 0.01), but increased the incidence of
pacemaker implantation (RR, 2.03; 95% CI, 1.88-2.19; p < 0.01). At
follow-up, TAVR + PCI was significantly associated with coronary
reintervention (RR, 3.17; 95% CI, 1.03-9.71; p = 0.04) and a reduced rate
of long-term survival (RR, 0.86; 95% CI, 0.79-0.94; p < 0.01)
 Conclusion(s): In patients with AS and CAD, TAVR + PCI did not
increase perioperative mortality, but increased the rates of coronary
reintervention and long-term mortality. Copyright © The Author(s)
2023.

<91>
Accession Number
641618867
Title
Early safety and feasibility of a first-in-class biomimetic transcatheter
aortic valve - DurAVR.
Source
EuroIntervention : journal of EuroPCR in collaboration with the Working
Group on Interventional Cardiology of the European Society of Cardiology.
(no pagination), 2023. Date of Publication: 19 May 2023.
Author
Kodali S.K.; Sorajja P.; Meduri C.U.; Feldt K.; Cavalcante J.L.; Garg P.;
Hamid N.; Poon K.K.; Settergren M.R.M.; Burns M.R.; Ruck A.; Sathananthan
J.; Zajarias A.; Shaburishvili T.; Zirakashvili T.; Zhividze M.;
Katchakhidze G.; Bapat V.N.
Institution
(Kodali) Columbia University Irving Medical Center, New York, NY, USA
(Sorajja, Cavalcante, Hamid, Burns, Bapat) Minneapolis Heart Institute,
Abbott Northwestern Hospital, Minneapolis, MN, United States
(Meduri, Feldt, Settergren, Ruck) Department of Cardiology, Karolinska
University Hospital, Stockholm, Sweden
(Feldt, Settergren, Ruck) Department of Medicine, Karolinska Institutet,
Solna, Stockholm, Sweden
(Garg) Norwich Medical School, University of East Anglia, Norwich, United
Kingdom
(Garg) Norfolk and Norwich University Hospitals NHS Foundation Trust,
Norwich, United Kingdom
(Poon) St. Andrew's War Memorial Hospital, Brisbane, Australia
(Sathananthan) St. Paul's Hospital, Vancouver, BC, Canada
(Zajarias) Washington University School of Medicine, St. Louis, MO, United
States
(Shaburishvili, Zirakashvili, Zhividze) Cardiovascular Clinic, Tbilisi
Heart and Vascular Clinic, Tbilisi, Georgia
(Katchakhidze) Aversi Clinic, Tbilisi, Georgia
Publisher
NLM (Medline)
Abstract
BACKGROUND: TAVI is a widely accepted treatment for patients with severe
aortic stenosis (AS). Despite the adoption of diverse therapies,
opportunities remain to develop technologies tailored to provide optimal
acute and potential long-term benefits, particularly around haemodynamics,
flow and durability. AIMS: We aimed to evaluate the safety and feasibility
of the DurAVR transcatheter heart valve (THV), a first-in-class biomimetic
valve, in the treatment of patients with symptomatic severe AS.
 METHOD(S): This was a first-in-human (FIH), prospective,
non-randomised, single-arm, single-centre study. Patients with severe,
symptomatic AS of any surgical risk and who were eligible for the DurAVR
THV prosthesis were recruited; they were assessed at baseline, 30 days, 6
months, and 1 year post-procedure for implant success, haemodynamic
performance, and safety. RESULT(S): Thirteen patients (73.9+/-6.4
years old, 77% female) were enrolled. The DurAVR THV was successfully
implanted in 100% of cases with no device-related complications. One
access site complication, one permanent pacemaker implantation, and one
case of moderate aortic regurgitation occurred. Otherwise, no deaths,
stroke, bleeding, reinterventions, or myocardial infarction were reported
during any of the follow-up visits. Despite a mean annulus size of
22.95+/-1.09 mm, favourable haemodynamic results were observed at 30 days
(effective orifice area [EOA] 2.00+/-0.17 cm2, and mean pressure gradient
[MPG] 9.02+/-2.68 mmHg) and were sustained at 1 year (EOA 1.96+/-0.11 cm2,
MPG 8.82+/-1.38 mmHg), resulting in zero patients with any degree of
prosthesis-patient mismatch. Additionally, new valve performance measures
derived from cardiovascular magnetic resonance displayed restoration of
laminar flow, consistent with a predisease state, in conjunction with a
mean coaptation length of 8.3+/-1.7 mm. CONCLUSION(S): Preliminary
results from the FIH study with DurAVR THV demonstrate a good safety
profile with promising haemodynamic performance sustained at 1 year and
restoration of near-normal flow dynamics. Further clinical investigation
is warranted to evaluate how DurAVR THV may play a role in addressing the
challenge of lifetime management in AS patients.

<92>
Accession Number
641617292
Title
Effect of Cryothermic and Radiofrequency Cox-Maze IV Ablation on Atrial
Size and Function Assessed by 2D and 3D Echocardiography, a Randomized
Trial. To Freeze or to Burn.
Source
Clinical physiology and functional imaging. (no pagination), 2023. Date
of Publication: 19 Jun 2023.
Author
Boano G.; Vanky F.; Aneq M.A.
Institution
(Boano, Vanky) Department of Thoracic and Vascular Surgery in
Ostergotland, Department of Health, Medicine and Caring Sciences,
Linkoping University, Linkoping, Sweden
(Aneq) Department of Clinical Physiology in Linkoping, Department of
Health, Medicine and caring Sciences Linkoping University, Linkoping,
Sweden
Publisher
NLM (Medline)
Abstract
BACKGROUND: Atrial linear scars in Cox-Maze IV procedures are achieved
using Cryothermy (Cryo) or radiofrequency (RF) techniques. The subsequent
post-operative left atrial (LA) reverse remodeling is unclear. We used 2-
and 3-dimensional echocardiography (2- 3DE) to compare the impact of Cryo
and RF procedures on LA size and function one year after Cox-maze IV
ablation concomitant with Mitral valve (MV) surgery. METHOD(S):
Seventy-two patients with MV disease and AF were randomized to Cryo (n =
35) or RF (n = 37) ablation. Another 33 patients were enrolled without
ablation (NoMaze). All patients underwent an echocardiogram the day before
and one year after surgery. The LA function was assessed on 2D strain by
speckle tracking and 3DE. RESULT(S): Forty-two ablated patients
recovered sinus rhythm (SR) one year after surgery. They had comparable
left and right systolic ventricular function, LA volume index (LAVI) and
2D reservoir strain before surgery. At follow-up, the 3DE extracted
reservoir and booster function were higher after RF (37 +/- 10% vs. 26 +/-
6%; p < 0.001) than Cryo ablation (18 +/- 9 vs. 7 +/- 4%; p < 0.001),
while passive conduit function was comparable between groups (24 +/- 11
vs. 20 +/- 8%; p = 0.17). The extent of LAVI reduction depended on the
duration of AF preoperatively. CONCLUSION(S): SR restoration after MV
surgery and maze results in LA size reduction irrespective of the energy
source used. Compared to RF, the extension of ablation area produced by
Cryo implies a structural LA remodeling affecting LA systolic function.
This article is protected by copyright. All rights reserved.

<93>
Accession Number
641617038
Title
Regional disparity in continuously measured time-domain cerebrovascular
reactivity indices: a scoping review of human literature.
Source
Physiological measurement. (no pagination), 2023. Date of Publication: 19
Jun 2023.
Author
Sainbhi A.S.; Marquez I.; Gomez A.; Stein K.Y.; Amenta F.; Vakitbilir N.;
Froese L.; Zeiler F.A.
Institution
(Sainbhi, Stein, Vakitbilir, Froese) Biomedical Engineering, University of
Manitoba Faculty of Engineering, 75 Chancellor's Circle, Winnipeg, MB R3T
5V6, Canada
(Marquez) Undergraduate Engineering, University of Manitoba Faculty of
Engineering, 75A Chancellors Circle, Winnipeg, MB R3T 5V6, Canada
(Gomez, Zeiler) Section of Neurosurgery, Department of Surgery, University
of Manitoba Max Rady College of Medicine, AE101-820 Sherbrook Street,
Winnipeg, MB R3A 1R9, Canada
(Amenta) Undergraduate Engineering, University of Manitoba Faculty of
Engineering, 75A Chancellor's Circle, Winnipeg, MB R3T 5V6, Canada
Publisher
NLM (Medline)
Abstract
Cerebral blood vessels maintaining relatively constant cerebral blood flow
(CBF) over wide range of systemic arterial blood pressure (ABP) is
referred to as cerebral autoregulation (CA). Impairments in CA expose the
brain to pressure-passive flow states leading to hypoperfusion and
hyperperfusion. Cerebrovascular reactivity (CVR) metrics refer to
surrogate metrics of pressure-based CA that evaluate the relationship
between slow vasogenic fluctuations in cerebral perfusion pressure/ABP and
surrogate for pulsatile CBF/cerebral blood volume. We performed a
systematically conducted scoping review of all available human literature
examining the association between continuous CVR between more than one
brain region/channel using the same CVR index. In all the included 22
articles, only handful of transcranial doppler (TCD) and near-infrared
spectroscopy (NIRS) based metrics were calculated for only two brain
regions/channels. These metrics found no difference between left and right
sides in healthy volunteer, cardiac surgery, and intracranial hemorrhage
patient studies. In contrast, significant differences were reported in
endarterectomy, and subarachnoid hemorrhage studies, while varying results
were found regarding regional disparity in stroke, traumatic brain injury,
and multiple population studies. Further research is required to evaluate
regional disparity using NIRS-based indices and to understand if
NIRS-based indices provide better regional disparity information than
TCD-based indices. Copyright Creative Commons Attribution license.

<94>
Accession Number
641616484
Title
Predicting 1-Year Mortality in Outpatients With Heart Failure With Reduced
Left Ventricular Ejection Fraction: Do Empiric Models Outperform Physician
Intuitive Estimates? A Multicenter Cohort Study.
Source
Circulation. Heart failure. (pp e010312), 2023. Date of Publication: 20
Jun 2023.
Author
Alba A.C.; Buchan T.A.; Saha S.; Fan S.; Demers C.; Poon S.; Mak S.;
Al-Hesayen A.; Toma M.; Zieroth S.; Anderson K.; Porepa L.; Chih S.;
Giannetti N.; Rac V.; Levy W.C.; Ross H.J.; Guyatt G.H.
Institution
(Alba, Buchan, Saha, Fan, Rac, Ross) Peter Munk Cardiac Centre, Ted Rogers
Center for Heart Research, University Health Network, Toronto, ON, Canada
(A.C.A., T.A.B., S.S., S.F., V.R., H.J.R.)
(Alba, Buchan, Demers, Guyatt) Department of Health Research Methods,
Evidence, and Impact, McMaster University, Hamilton, ON, Canada (A.C.A.,
T.A.B., C.D., G.H.G.)
(Poon) Sunnybrook Health Sciences Centre, Toronto, ON, Canada
(Mak) Mount Sinai Hospital, Toronto, ON, Canada
(Al-Hesayen) Saint Michael's Hospital, Toronto, ON, Canada
(Toma) Providence Health Care, Vancouver, BC, Canada
(Zieroth) St. Boniface General Hospital, Winnipeg, MB, Canada
(Anderson) QEII Halifax Infirmary, Nova Scotia Health Authority, Halifax,
NS, Canada
(Porepa) Southlake Regional Health Centre, Newmarket, ON, Canada
(Chih) Ottawa Heart Institute, ON, Canada
(Giannetti) McGill University, Montreal, France
(Rac) Institute of Health Policy, Management and Evaluation, Dalla Lana
School of Public Health, University of Toronto, ON, Canada
(Levy) University of Washington
Publisher
NLM (Medline)
Abstract
BACKGROUND: Many studies have demonstrated that physicians often err in
estimating patient prognosis. No studies have directly compared physician
to model predictive performance in heart failure (HF). We aimed to compare
the accuracy of physician versus model predictions of 1-year mortality.
 METHOD(S): This multicenter prospective cohort study on 11 HF clinics
in 5 provinces in Canada included consecutive consented outpatients with
HF with reduced left ventricular ejection fraction (<40%). By collecting
clinical data, we calculated predicted 1-year mortality using the Seattle
HF Model (SHFM), the Meta-Analysis Global Group in Chronic HF score, and
the HF Meta-Score. HF cardiologists and family doctors, blinded to model
predictions, estimated patient 1-year mortality. During 1-year follow-up,
we recorded the composite end point of mortality, urgent ventricular
assist device implant, or heart transplant. We compared physicians and
model discrimination (C statistic), calibration (observed versus predicted
event rate), and risk reclassification. RESULT(S): The study included
1643 patients with ambulatory HF with a mean age of 65 years, 24% female,
and mean left ventricular ejection fraction of 28%. Over 1-year follow-up,
9% had an event. The SHFM had the best discrimination (SHFM C statistic
0.76; HF Meta-Score 0.73; Meta-Analysis Global Group in Chronic Heart
Failure 0.70) and calibration. Physicians' discrimination differed little
(0.75 for HF cardiologists and 0.73 for family doctors) but both physician
groups substantially overestimated risk by >10% in both low- and high-risk
patients (poor calibration). In risk reclassification analysis, among
patients without events, the SHFM better classified 51% in comparison to
HF cardiologists and 43% in comparison to family doctors. In patients with
events, the SHFM erroneously assigned lower risk to 44% in comparison to
HF cardiologists and 34% in comparison to family doctors.
 CONCLUSION(S): Family doctors and HF cardiologists showed adequate
risk discrimination, with however substantial overestimation of absolute
risk. Predictive models showed higher accuracy. Incorporating models in
family and HF cardiology practices may improve patient care and resource
use in HF with reduced left ventricular ejection fraction. REGISTRATION:
URL: https://www. CLINICALTRIALS: gov; Unique identifier: NCT04009798.

<95>
Accession Number
641615230
Title
Total ischemic time and age as predictors of PCI failure in STEMIs: A
systematic review.
Source
The American journal of the medical sciences. (no pagination), 2023. Date
of Publication: 16 Jun 2023.
Author
Kennedy S.R.; Kim Y.; Martin S.; Rose S.J.
Institution
(Kennedy, Kim) Sacred Heart University, Fairfield, CT, United States
(Martin) Heart and Vascular Institute, Stamford Hospital, Stamford, CT,
United States
(Rose) Sacred Heart University, Fairfield, CT, USA; Department of Research
and Discovery, Stamford Health, Stamford, Connecticut, USA
Publisher
NLM (Medline)
Abstract
BACKGROUND: When feasible, primary percutaneous coronary intervention
(PCI) is the definitive intervention for ST-elevation myocardial
infarction (STEMI). However, cardiac tissue reperfusion is not always
achievable after opening the infarct-related artery. Studies have
investigated associating factors and scoring for the "no-reflow"
phenomenon. This paper aims to systematically establish the predictive
values of total ischemic time and patient age as factors of coronary
no-reflow in patients undergoing primary PCI. METHOD(S): A systematic
search was performed using EBSCOhost, including CINAHL Complete, Academic
Search Premier, MEDLINE with Full Text, Cochrane Central Register of
Controlled Trials, and Cochrane Database of Systematic Reviews. Search
results were compiled utilizing Zotero reference manager and exported to
Covidence.org for screening, selection, and data extraction by two
independent reviewers. The Newcastle-Ottawa Quality Assessment Scale for
Cohort Studies was used to evaluate the eight selected studies.
 RESULT(S): The initial search resulted in 367 articles, with eight
meeting the inclusion criteria with a total of 7060 participants. Our
systematic review demonstrated that for patients older than 60 years, the
odds of the no-reflow phenomenon increased 1.53- 2.53 times. Additionally,
patients with increased total ischemic time had 1.147- 4.655 times the
odds of no-reflow incidence. CONCLUSION(S): Patients older than 60
years with a total ischemic time >4-6 hours are at higher risk of PCI
failure due to the no-reflow phenomenon. Therefore, new guidelines and
more research to prevent and treat this physiologic occurrence are
essential to improve coronary reperfusion after primary PCI. Copyright
© 2023. Published by Elsevier Inc.

<96>
Accession Number
641615224
Title
Effect of Active Physiotherapy With Positive Airway Pressure on Pulmonary
Atelectasis After Cardiac Surgery: A Randomized Controlled Study.
Source
Journal of cardiothoracic and vascular anesthesia. (no pagination), 2023.
Date of Publication: 30 May 2023.
Author
Baneton S.; Dauvergne J.E.; Gouillet C.; Cartron E.; Volteau C.; Nicolet
J.; Corne F.; Rozec B.
Institution
(Baneton, Gouillet) Service de kinesitherapie, hopital Laennec, CHU
Nantes, Nantes, France
(Dauvergne, Rozec) Nantes Universite, CHU Nantes, CNRS, INSERM, l'institut
du thorax, Nantes, France; Nantes Universite, CHU Nantes, Service
d'Anesthesie Reanimation, hopital Laennec, INSERM CIC 0004 Immunologie et
Infectiologie, Nantes, France
(Cartron) ECEVE UMR-S 1123, Faculte de sante, Paris, France
(Volteau) CHU Nantes, Direction de la Recherche et de l'innovation,
Plateforme de methodologie et biostatistique, Nantes, France
(Nicolet) CHU Nantes, CNRS, INSERM, l'institut du thorax, Nantes, France
(Corne) Service de soins intensifs de pneumologie, hopital Laennec, CHU
Nantes, Nantes, France
Publisher
NLM (Medline)
Abstract
OBJECTIVES: The authors investigated the effect of active work with
positive airway pressure (PAP) in addition to chest physiotherapy (CP) on
pulmonary atelectasis (PA) in patients undergoing cardiac surgery with
cardiopulmonary bypass. DESIGN: A randomized controlled study. SETTING: At
a single-center tertiary hospital. PARTICIPANTS: Eighty adult patients
undergoing cardiac surgery (coronary artery bypass grafting, valve
surgery, or both), and presenting with PA after tracheal extubation on
postoperative days 1 or 2, were randomized from November 2014 to September
2016. INTERVENTION: Three days of CP, twice daily, associated with active
work with PAP effect (intervention group) versus CP alone (control group).
Pulmonary atelectasis was assessed by using the radiologic atelectasis
score (RAS) measured from daily chest x-rays. All radiographs were
reviewed blindly. MEASUREMENTS AND MAIN RESULTS: Among included patients,
79 (99%) completed the trial. The primary outcome was mean RAS on day 2
after inclusion. It was significantly lower in the intervention group
(mean difference and 95% CI: -1.1 [-1.6 to -0.6], p < 0.001). The
secondary outcomes were the sniff nasal inspiratory pressure measured
before and after CP and clinical variables. Sniff nasal inspiratory
pressure was significantly higher in the intervention group on day 2 (7.7
[3.0-12.5] cmH2O, p = 0.002). The respiratory rate was lower in the
intervention group (-3.2 [95% CI -4.8 to -1.6] breaths/min, p < 0.001) on
day 2. No differences were found between the 2 groups for percutaneous
oxygen saturation/oxygen requirement ratio, heart rate, pain, and dyspnea
scores. CONCLUSION(S): Active work with the PAP effect, combined with
CP, significantly decreased the RAS of patients undergoing cardiac surgery
after 2 days of CP, with no differences observed in clinically relevant
parameters. Copyright © 2023 Elsevier Inc. All rights reserved.

<97>
Accession Number
2024825640
Title
Comparison of the effects of remimazolam tosylate and propofol on
postoperative delirium among older adults undergoing major non-cardiac
surgery: Protocol for a randomised controlled trial.
Source
BMJ Open. 13(5) (no pagination), 2023. Article Number: e071912. Date of
Publication: 29 May 2023.
Author
Li H.-X.; Li B.-L.; Wang T.-H.; Xu X.; Wang F.; Zhang X.; Li H.-Y.; Mu B.;
Sun Y.-L.; Zheng H.; Yan T.
Institution
(Li, Li, Wang, Xu, Zhang, Li, Mu, Zheng, Yan) Department of
Anesthesiology, National Cancer Center, National Clinical Research Center
for Cancer, Cancer Hospital, Chinese Academy of Medical Sciences, Peking
Union Medical College, Beijing, China
(Wang) Office of Cancer Screening, National Cancer Center, National
Clinical Research Center for Cancer, Cancer Hospital, Chinese Academy of
Medical Sciences, Peking Union Medical College, Beijing, China
(Zhang) Department of Pathergasiology, Peking University Sixth Hospital,
Peking University Institute of Mental Health, NHC Key Laboratory of Mental
Health (Peking University), National Clinical Research Center for Mental
Disorders (Peking University Sixth Hospital), Beijing, China
(Sun) State Key Laboratory of Molecular Oncology, National Cancer Center,
National Clinical Research Center for Cancer, Cancer Hospital, Chinese
Academy of Medical Sciences, Peking Union Medical College, Beijing, China
Publisher
BMJ Publishing Group
Abstract
Introduction Postoperative delirium (POD) is a common cognitive
disturbance in elderly individuals that is characterised by acute and
fluctuating impairments in attention and awareness. Remimazolam tosylate
is a novel, ultrashort-acting benzodiazepine, and there is limited
evidence of its correlation with the incidence of early POD. The aim of
this study is to evaluate the incidence of POD after anaesthesia induction
and maintenance with remimazolam tosylate or propofol in elderly patients
undergoing major non-cardiac surgery. Methods and analysis This is a
single-centre, randomised controlled trial. 636 elderly patients
undergoing major non-cardiac surgery will be enrolled and randomised at a
1:1 ratio to receive total intravenous anaesthesia with either remimazolam
tosylate or propofol. The primary outcome is the incidence of POD within 5
days after surgery. Delirium will be assessed twice daily by the 3 min
Diagnostic Interview for the Confusion Assessment Method or the Confusion
Assessment Method for the intensive care unit (ICU) for ICU patients.
Secondary outcomes are the onset and duration of delirium, cognitive
function at discharge and within 1-year postoperatively, postoperative
analgesia within 5 days, chronic pain at 3 months, quality of recovery and
postoperative inflammatory biomarker levels. Ethics and dissemination The
study was approved by the institutional ethics committee of the National
Cancer Center/National Clinical Research Center for Cancer/Cancer
Hospital, Chinese Academy of Medical Sciences (approval No. 22/520-3722).
Written informed consent will be obtained from each patient before
enrolment. The results of this trial will be presented at scientific
conferences and in peer-reviewed scientific journals. Trial registration
number ChiCTR2300067368. Copyright © 2023 BMJ Publishing Group.
All rights reserved.

<98>
Accession Number
2024825572
Title
Carbon dioxide flooding to reduce postoperative neurological injury
following surgery for acute type A aortic dissection: A prospective,
randomised, blinded, controlled clinical trial, CARTA study protocol -
Objectives and design.
Source
BMJ Open. 13(5) (no pagination), 2023. Article Number: e063837. Date of
Publication: 25 May 2023.
Author
Ede J.; Teurneau-Hermansson K.; Moseby-Knappe M.; Ramgren B.; Bjursten H.;
Ederoth P.; Larsson M.; Mattsson-Carlgren N.; Sjogren J.; Wierup P.;
Nozohoor S.; Zindovic I.
Institution
(Ede, Teurneau-Hermansson, Bjursten, Larsson, Sjogren, Wierup, Nozohoor,
Zindovic) Department of Clinical Sciences Lund, Skane University Hospital
Lund, Lund University, Lund, Sweden
(Moseby-Knappe, Mattsson-Carlgren) Department of Neurology, Skane
University Hospital Lund, Lund University, Lund, Sweden
(Ramgren) Department of Diagnostic Radiology, Skane University Hospital
Lund, Lund University, Lund, Sweden
(Ederoth) Department of Anaesthesiology and Intensive Care, Skane
University Hospital Lund, Lund University, Lund, Sweden
(Mattsson-Carlgren) Clinical Memory Research Unit, Faculty of Medicine,
Lund University, Lund, Sweden
Publisher
BMJ Publishing Group
Abstract
Introduction Neurological complications after surgery for acute type A
aortic dissection (ATAAD) increase patient morbidity and mortality. Carbon
dioxide flooding is commonly used in open-heart surgery to reduce the risk
of air embolism and neurological impairment, but it has not been evaluated
in the setting of ATAAD surgery. This report describes the objectives and
design of the CARTA trial, investigating whether carbon dioxide flooding
reduces neurological injury following surgery for ATAAD. Methods and
analysis The CARTA trial is a single-centre, prospective, randomised,
blinded, controlled clinical trial of ATAAD surgery with carbon dioxide
flooding of the surgical field. Eighty consecutive patients undergoing
repair of ATAAD, and who do not have previous neurological injuries or
ongoing neurological symptoms, will be randomised (1:1) to either receive
carbon dioxide flooding of the surgical field or not. Routine repair will
be performed regardless of the intervention. The primary endpoints are
size and number of ischaemic lesions on brain MRI performed after surgery.
Secondary endpoints are clinical neurological deficit according to the
National Institutes of Health Stroke Scale, level of consciousness using
the Glasgow Coma Scale motor score, brain injury markers in blood after
surgery, neurological function according to the modified Rankin Scale and
postoperative recovery 3 months after surgery. Ethics and dissemination
Ethical approval has been granted by Swedish Ethical Review Agency for
this study. Results will be disseminated through peer-reviewed media.
Trial registration number NCT04962646. Copyright © 2023 BMJ
Publishing Group. All rights reserved.

<99>
Accession Number
2022708433
Title
Pragmatic evaluation of events and benefits of lipid lowering in older
adults (PREVENTABLE): Trial design and rationale.
Source
Journal of the American Geriatrics Society. 71(6) (pp 1701-1713), 2023.
Date of Publication: June 2023.
Author
Joseph J.; Pajewski N.M.; Dolor R.J.; Sellers M.A.; Perdue L.H.; Peeples
S.R.; Henrie A.M.; Woolard N.; Jones W.S.; Benziger C.P.; Orkaby A.R.;
Mixon A.S.; VanWormer J.J.; Shapiro M.D.; Kistler C.E.; Polonsky T.S.;
Chatterjee R.; Chamberlain A.M.; Forman D.E.; Knowlton K.U.; Gill T.M.;
Newby L.K.; Hammill B.G.; Cicek M.S.; Williams N.A.; Decker J.E.; Ou J.;
Choudhary G.; Gazmuri R.J.; Schmader K.E.; Roumie C.L.; Vaughan C.P.;
Effron M.B.; Cooper-DeHoff R.M.; Supiano M.A.; Shah R.C.; Whittle J.C.;
Hernandez A.F.; Ambrosius W.T.; Williamson J.D.; Alexander K.P.; Romashkan
S.; Fine L.; Weiner M.; Cooper-DeHoff R.; Jones S.; Callahan K.; Espinoza
S.; Rubinstein J.; Snyder H.; Carrillo M.; Rothman R.; Shenkman B.; Carton
T.; Nauman B.; McTique K.; Jefferson M.; Wing J.; Bloodworth S.; Owens A.;
Bordelon L.; Heimberg M.; Massey J.; Gonzalez M.; Brashears B.; Kaczkowski
K.; King M.; Hoisington K.; Lovato J.; Almonte J.; White J.; Gaziano M.;
Lovato L.; Poddar K.; Taylor Z.; Hunt D.; Hervey J.; Kelsey M.; Leverty
R.; Batch B.; Richmond A.; Hufstedler M.; Chang A.; Hetzel J.; Laffey M.;
Pahor M.; Houston D.; Kitzman D.; Rapp S.; Sachs B.; Lang S.; Nulph R.;
Rives E.; Zieman S.; Newman A.; Kapitanovsky K.; Reboussin D.; Cicek M.;
Halverson K.; Gaussoin S.; Dohner C.; Monds P.; Alred C.; Bowman J.; Bunke
J.; Deckard N.; Lowe T.; Thiel R.; VanDoren K.; Whiteside H.; Reuben D.;
Peduzzi P.; Solomon S.; Florez H.; Breitner J.; Greenland P.; Travison T.;
Waitman R.; Bancks M.; Burnet K.; Telzak A.; Vanterpool Y.E.; Oberembt S.;
Davies I.; Shade L.; Strout K.; Kitzman H.; Patel M.; Rao G.; Ufholz K.;
Rao S.; Cardoso E.; Allen J.; Kulshreshtha A.; Brown W.; Cripps S.; Ford
D.; Gauvey-Kern M.; Meilander A.; Kohnhorst D.; Rosas S.; Druckrey J.;
Loepfe T.; Kaseno J.; Berendt M.; Akatue R.; Houtschilt S.; Linder J.;
Brown T.; Bazzano L.; Williams S.; Brill S.; Jindra M.; Yurko E.; Tapan
M.; Kirkwood L.; Azhar G.; Pangle A.; Carlson M.; Lu J.; Wells B.; Gordon
H.; Ashley N.; Ernst M.; Grdinovac K.; Lower E.; Hart J.; Carrasquillo O.;
Linares V.; Hall M.; Boyer L.; Hahn-Cover K.; Grieshaber V.; Fisher A.;
Kirke S.; Ake J.; Klawson E.; Lee J.; Johnson K.; Musi N.; Brown K.; Rubin
C.; Thompson G.; Bah H.; Wharton J.; Wall M.; Zamora E.; Betancourt J.;
Binder E.; Young A.; Goyal P.; Park F.; Almonte A.; Carlsson C.; Zylstra
H.; Munoz A.; Tinker A.; Soe K.; Clarke J.-A.; Vu K.; Hy C.; Lee C.; Zeng
A.; Hallock A.; Reuben-Hallock K.; Malm B.; Spreyer K.; Yaksic E.; Lee P.;
Runge C.; Kundu S.; Chau K.; Rodriguez-Cintron W.; Fuentes-Medina S.;
White S.M.; Liu M.; Romero I.; Tavabi A.; Penny W.; St. John M.; Eleazer
P.; Thongsa S.; Krishnasamy S.; Ricks J.; Walsh J.; Espique L.; Fernandes
J.; Willis T.; Ricci A.; Peek B.; Michael J.; Lockhart M.; Hall D.; Withee
C.; Markland A.; Davis D.; Todela T.; Sullivan D.; Sawyer L.; Lorscheter
J.; Gupta A.; Castle T.; Reynolds J.; Kramer H.; Kirchner K.; Spencer
A.K.; Godschalk M.; Taylor C.; Atlas S.; Guerrero R.B.; Kansal M.; Tenorio
J.; Singh V.; Kiran S.; Albert M.; Knipping V.; Childress R.; Beaverson
B.; Tamariz L.; Denizard J.; Peruvemba S.; Venetucci J.; Shivaswamy V.;
Ramalingam R.
Institution
(Joseph) VA Providence Healthcare System, Providence, RI, United States
(Pajewski, Perdue, Woolard, Shapiro, Ambrosius, Williamson) Wake Forest
University School of Medicine, Winston-Salem, NC, United States
(Dolor, Sellers, Jones, Chatterjee, Newby, Hammill, Hernandez, Alexander)
Duke Clinical Research Institute, Duke University School of Medicine,
Durham, NC, United States
(Peeples) VA Boston Healthcare System, Boston, MA, United States
(Henrie) Cooperative Studies Program Clinical Research Pharmacy
Coordinating Center, Office of Research and Development, Department of
Veterans Affairs, Albuquerque, NM, United States
(Benziger) Essentia Health, Duluth, MN, United States
(Orkaby) New England Geriatric Research, Education, and Clinical Center
(GRECC), VA Boston Healthcare System, and Division of Aging, Brigham &
Women's Hospital, Harvard Medical School, Boston, MA, United States
(Mixon, Roumie) Vanderbilt University Medical Center and Geriatric
Research Education and Clinical Center (GRECC), VA Tennessee Valley
Healthcare System, Nashville, TN, United States
(VanWormer) Marshfield Clinical Research Institute, Marshfield, WI, United
States
(Kistler) Department of Family Medicine, School of Medicine, University of
North Carolina at Chapel Hill, NC, United States
(Polonsky) University of Chicago Medicine, Chicago, IL, United States
(Chamberlain, Cicek) Mayo Clinic, Rochester, MN, United States
(Forman) Department of Medicine, Sections of Geriatrics and Cardiology,
University of Pittsburgh, Pittsburgh GRECC, VA Pittsburgh Healthcare
System, Pittsburgh, PA, United States
(Knowlton) Intermountain Healthcare, Salt Lake City, UT, United States
(Gill) Yale School of Medicine, New Haven, CT, United States
(Williams) TN CEAL, Nashville, TN, United States
(Decker) Section of Primary Care Medicine, Medical College of Wisconsin,
Milwaukee, WI, United States
(Ou) Cardiology Division, John Cochran VA Medical Center and Cardiology
Division, Washington University School of Medicine, St. Louis, MO, United
States
(Rubinstein) Division of Cardiology, Cincinnati VAMC and Division of
Cardiovascular Diseases, Department of Internal Medicine, College of
Medicine, University of Cincinnati, Cincinnati, OH, United States
(Choudhary) Providence VA Medical Center, and Lifespan Cardiovascular
Institute, Alpert Medical School of Brown University, Providence, RI,
United States
(Gazmuri) Captain James A. Lovell Federal Health Care Center, Rosalind
Franklin University of Medicine and Science, Chicago, IL, United States
(Schmader) Duke University and GRECC, Durham VA Medical Center, Durham,
NC, United States
(Vaughan) Birmingham/Atlanta Geriatric Research Education and Clinical
Center (GRECC), Department of Veterans Affairs, and Division of Geriatrics
& Gerontology, Department of Medicine, Emory University, Atlanta, GA,
United States
(Effron) John Ochsner Heart and Vascular Institute, The University of
Queensland Ochsner Clinical School, New Orleans, LA, United States
(Cooper-DeHoff) University of Florida, College of Pharmacy and College of
Medicine, Gainesville, FL, United States
(Supiano) The University of Utah, Salt Lake, UT, United States
(Shah) Family & Preventive Medicine and the Rush Alzheimer's Disease
Center, Rush University, Chicago, IL, United States
(Whittle) Clement J Zablocki VA Medical Center, Milwaukee, WI, United
States
Publisher
John Wiley and Sons Inc
Abstract
Whether initiation of statins could increase survival free of dementia and
disability in adults aged >=75 years is unknown. PREVENTABLE, a
double-blind, placebo-controlled randomized pragmatic clinical trial, will
compare high-intensity statin therapy (atorvastatin 40 mg) with placebo in
20,000 community-dwelling adults aged >=75 years without cardiovascular
disease, disability, or dementia at baseline. Exclusion criteria include
statin use in the prior year or for >5 years and inability to take a
statin. Potential participants are identified using computable phenotypes
derived from the electronic health record and local referrals from the
community. Participants will undergo baseline cognitive testing, with
physical testing and a blinded lipid panel if feasible. Cognitive testing
and disability screening will be conducted annually. Multiple data sources
will be queried for cardiovascular events, dementia, and disability;
survival is site-reported and supplemented by a National Death Index
search. The primary outcome is survival free of new dementia or persisting
disability. Co-secondary outcomes are a composite of cardiovascular death,
hospitalization for unstable angina or myocardial infarction, heart
failure, stroke, or coronary revascularization; and a composite of mild
cognitive impairment or dementia. Ancillary studies will offer mechanistic
insights into the effects of statins on key outcomes. Biorepository
samples are obtained and stored for future study. These results will
inform the benefit of statins for increasing survival free of dementia and
disability among older adults. This is a pioneering pragmatic study
testing important questions with low participant burden to align with the
needs of the growing population of older adults. Copyright © 2023
The American Geriatrics Society. This article has been contributed to by
U.S. Government employees and their work is in the public domain in the
USA.

<100>
Accession Number
2022202571
Title
Association of hydroxytyrosol enriched olive oil with vascular function in
chronic coronary disease.
Source
European Journal of Clinical Investigation. 53(7) (no pagination), 2023.
Article Number: e13983. Date of Publication: July 2023.
Author
Ikonomidis I.; Katogiannis K.; Chania C.; Iakovis N.; Tsoumani M.;
Christodoulou A.; Brinia E.; Pavlidis G.; Thymis J.; Tsilivarakis D.;
Kountouri A.; Korakas E.; Lambadiari V.; Triposkiadis F.; Skaltsounis L.;
Tseti I.; Iliodromitis E.K.; Andreadou I.
Institution
(Ikonomidis, Katogiannis, Pavlidis, Thymis, Tsilivarakis, Iliodromitis)
Laboratory of Echocardiography and Preventive Cardiology, Second
Cardiology Department, Attikon University Hospital, National and
Kapodistrian University of Athens, Medical School, Athens, Greece
(Chania, Tsoumani, Christodoulou, Brinia, Andreadou) Laboratory of
Pharmacology, Faculty of Pharmacy, National and Kapodistrian University of
Athens, Athens, Greece
(Iakovis, Triposkiadis) Department of Cardiology, University Hospital of
Larissa, Larissa, Greece
(Kountouri, Korakas, Lambadiari) Second Department of Internal Medicine,
Attikon University Hospital, National and Kapodistrian University of
Athens, Medical School, Athens, Greece
(Skaltsounis) Division of Pharmacognosy and Natural Products Chemistry,
School of Pharmacy, National and Kapodistrian University of Athens,
Athens, Greece
(Tseti) Intermed, Athens, Greece
Publisher
John Wiley and Sons Inc
Abstract
Background: Hydroxytyrosol reduces low-density lipoprotein oxidation,
contributing to prevention of atherosclerosis progression. Method(s):
In a prospective, crossover, double-blind, placebo-controlled trial, 30
chronic coronary artery syndrome (CCAS) patients were randomized to 4
capsules/day, containing 412.5 mg olive oil with 2.5 mg hydroxytyrosol
(OOHT) each one or placebo for 1 month and then were crossed over to the
alternate treatment (placebo or OOHT). We measured (a) perfused boundary
region (PBR) of the sublingual arterial microvessels (increased PBR
indicates reduced glycocalyx thickness), (b) flow-mediated dilation (FMD),
(c) Coronary Flow Reserve (CFR) and markers of LV diastolic function by
Doppler echocardiography, (d) pulse wave velocity (PWV), and (e) oxidative
stress, inflammatory biomarkers and blood lipids at baseline and after
treatment. Result(s): Treatment with OOHT improved PBR, FMD, CFR and
PWV compared to baseline (1.8 +/-.3 vs. 1.7 +/-.4 mum, p =.040, 3.7 +/-
2.1 vs. 6.5% +/- 2.3%, p <.001, 2.3 +/-.4 vs. 2.5 +/-.4, p =.030 and 11.1
+/- 1.8 vs. 11.8 +/- 2.3 m/s, p =.002) while there was no effect after
placebo (p = NS). No effect of OOHT treatment was observed on blood
pressure. There was a parallel improvement of E' of the mitral annulus and
deceleration time of the E wave of mitral inflow after OOHT (p <.05) but
not after placebo. Compared to baseline, treatment with OOHT reduced
malondialdehyde, a marker of lipid peroxidation, oxidized LDL,
triglycerides, PCSK9 and CRP blood levels (p <.05) in contrast to placebo.
 Conclusion(s): Hydroxytyrosol-enriched olive oil may have beneficial
effects on endothelial, arterial and LV diastolic function likely by
reducing oxidative and inflammatory burden in CCAS, though further studies
are needed to confirm this mechanism. Copyright © 2023 The
Authors. European Journal of Clinical Investigation published by John
Wiley & Sons Ltd on behalf of Stichting European Society for Clinical
Investigation Journal Foundation.

<101>
Accession Number
2021652407
Title
The efficacy and safety of direct oral anticoagulants versus vitamin K
antagonists in patients with left-sided bioprosthetic heart valves and
atrial fibrillation: a systematic review and meta-analysis.
Source
European Journal of Clinical Pharmacology. 79(4) (pp 461-471), 2023. Date
of Publication: April 2023.
Author
Li D.; Chang P.; Zhang H.; Bai F.; Wu Q.
Institution
(Li, Chang, Zhang, Bai, Wu) Department of Cardiovascular Medicine, Second
Hospital of Lanzhou University, Lanzhou, China
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Background: The efficacy and safety of direct oral anticoagulants (DOACs)
versus vitamin K antagonists (VKAs) for the treatment of patients with
left-sided bioprosthetic heart valves (BHV) and atrial fibrillation (AF)
remain controversial. This study aims to perform a meta-analysis to
evaluate the efficacy and safety of DOACs versus VKAs in this region.
 Method(s): We retrieved all relevant randomized controlled studies
and observational cohort studies, which critically assessed the efficacy
and safety of DOACs versus VKAs among patients with left-sided BHV and AF
in databases of PubMed, Cochrane, ISI Web of Sciences, and Embase. The
efficacy outcomes of this meta-analysis were stroke events and all-cause
death when the safety outcomes included major and any bleeding.
 Result(s): The analysis integrated 13 studies while enrolling 27,793
patients with AF and left-sided BHV. DOACs reduced the rate of stroke by
33% compared with VKAs (risk ratio [RR] 0.67; 95% CI 0.50-0.91), with no
increased incidence of all-cause death (RR 0.96; 95% CI 0.82-1.12). For
safety outcomes, major bleeding was reduced by 28% using DOACs rather than
VKAs (RR 0.72; 95% CI 0.52-0.99), while there was no difference in the
events of any bleeding (RR 0.84; 95% CI 0.68-1.03). In addition, in
patients younger than 75 years old, the stroke rate was reduced by 45% in
the population using DOACs (RR 0.55; 95% CI 0.37-0.84).
 Conclusion(s): Our meta-analysis demonstrated that in patients with
AF and BHV, compared with VKAs, using DOACs was associated with reduced
stroke and major bleeding events without an increase of all-cause
mortality and any bleeding. In the population younger than 75 years old,
DOAC might be more effective in preventing cardiogenic
stroke. Copyright © 2023, The Author(s), under exclusive licence
to Springer-Verlag GmbH Germany, part of Springer Nature.

<102>
Accession Number
2024665116
Title
Inspiratory muscle training on quality of life and functional capacity
after hospital discharge in patients submitted to coronary artery bypass
grafting: A controlled clinical trial.
Source
Journal of Bodywork and Movement Therapies. 35 (pp 202-207), 2023. Date of
Publication: July 2023.
Author
Cordeiro A.L.L.; Almeida de Brito J.; Rodrigues Pereira L.; Duarte Pascoal
H.; Correia dos Santos V.T.; Raimundo Guimaraes A.; Petto J.
Institution
(Cordeiro, Almeida de Brito, Rodrigues Pereira, Duarte Pascoal, Correia
dos Santos, Petto) Centro Universitario Nobre, Bahia, Feira de Santana,
Brazil
(Cordeiro) Escola Bahiana de Medicina e Saude Publica, Salvador, Bahia,
Brazil
(Raimundo Guimaraes) Instituto Nobre de Cardiologia, Bahia, Feira de
Santana, Brazil
(Petto) Universidade Salvador, Salvador, Bahia, Brazil
Publisher
Churchill Livingstone
Abstract
Introduction: There is a gap in knowledge about functional capacity and
quality of life in patients undergoing coronary artery bypass grafting
(CABG) after hospital discharge and the contribution of inspiratory muscle
training (IMT). Objective(s): To evaluate the influence of IMT on
functional capacity and quality of life after hospital discharge of
patients undergoing CABG. Methodology: Clinical trial. In the preoperative
period, patients assessed maximum inspiratory pressure (MIP), quality of
life using the SF-36 and functional capacity using the Six-Minute Walk
Test (6MWT). On the first postoperative day, they were randomized into:
control group (CG) receiving routine assistance from the hospital;
intervention group(IG) in addition to conventional physical therapy and
submitted to an IMT protocol based on the glycemic threshold. Being
reevaluated on the day of hospital discharge and post-discharge month.
 Result(s): 41 patients were included. In the preoperative period of
the MIP assessment of the CG, it was 104 +/- 14 cmH<inf>2</inf>O already
in GI it was 103 +/- 19cmH<inf>2</inf>O (p = 0.78) CG at discharge 80 +/-
13 cmH<inf>2</inf>O already in GI it was 92 +/- 15cmH<inf>2</inf>O(p <
0.01), revaluation CG 91 +/- 11 cmH<inf>2</inf>O versus 98 +/- 12
cmH<inf>2</inf>O (p < 0.01) of the IG. In the 6MWT the preoperative of the
GC group was 420 +/- 70 m already in GI it was 429 +/- 71 m (p = 0,89), CG
at discharge 326 +/- 79 m versus 373 +/- 55 m and revaluation of the CG
377 +/- 75 m and IG 410 +/- 57 m (p < 0.01). Functional capacity, general
health status, emotional aspects and limitations due to physical aspects
were significant when the three moments were compared. Conclusion(s):
IMT increases functional capacity, inspiratory muscle strength and quality
of life after discharge from patients undergoing CABG. Copyright
© 2023 Elsevier Ltd

<103>
Accession Number
2023891247
Title
Effect of Nicorandil, Diltiazem, or Isosorbide Mononitrate for Oral
Antispastic Therapy After Coronary Artery Bypass Grafting Using Radial
Artery Grafts-A Pilot Randomized Controlled Trial (ASRAB-Pilot): Rationale
and Study Protocol.
Source
Advances in Therapy. (no pagination), 2023. Date of Publication: 2023.
Author
Zhu Y.; Qing K.; Liu Y.; Yao H.; Zhang W.; Zhao Q.
Institution
(Zhu, Qing, Liu, Yao, Zhao) Department of Cardiovascular Surgery, Ruijin
Hospital Shanghai Jiao Tong University School of Medicine, No.197 Ruijin
Er Road, Shanghai, China
(Zhang) Department of Biostatistics, School of Public Health, Fudan
University, Shanghai, China
Publisher
Adis
Abstract
Introduction: The current evidence for chronic oral antispastic medication
use after coronary artery bypass grafting using radial artery grafts
(RA-CABG) is controversial. Calcium channel blockers, such as diltiazem,
are the most commonly used antispastic medications after RA-CABG; other
options include nitrates and nicorandil, but to date no sufficiently
powered randomized controlled trials have been conducted to compare their
efficacy. Method(s): This is a single-center, open-label, parallel
three-arm, pilot randomized controlled trial. Patients without
contraindications to any study medications and who successfully underwent
RA-CABG surgery will be consecutively screened. Eligible patients will be
randomized in a ratio of 1:1:1 (a total of 150 patients, 50 per arm) to
receive nicorandil 5 mg orally thrice daily, diltiazem 180 mg orally once
daily, or isosorbide mononitrate 50 mg orally once daily for 24 weeks. The
primary outcomes are RA graft failure at week 1 and week 24. The secondary
outcomes include major adverse cardiovascular event (MACE, a composite of
all-cause death, myocardial infarction, stroke, and unplanned
revascularization) and angina recurrence. The safety outcomes include
hypotension occurrence, withdrawal of renin angiotensin aldosterone system
inhibitors, serious adverse events, and other concerned adverse events
within 24 weeks. Conclusion(s): This pilot trial will compare the
preliminary effects of nicorandil, diltiazem, and isosorbide mononitrate
on angiographic and clinical outcomes in patients who have undergone
RA-CABG. Recruitment began in June 2020, and the estimated primary
completion date is early 2023. Results of this study will provide much
needed information for design of large confirmatory trials on the
effectiveness of oral antispastic medications after RA-CABG. Copyright
© 2023, The Author(s), under exclusive licence to Springer Healthcare
Ltd., part of Springer Nature.

<104>
Accession Number
2023890995
Title
Cerebral embolic protection during transcatheter aortic valve replacement:
a systematic review and meta-analysis of propensity score matched and
randomized controlled trials using the Sentinel cerebral embolic
protection device.
Source
BMC Cardiovascular Disorders. 23(1) (no pagination), 2023. Article Number:
306. Date of Publication: December 2023.
Author
Wolfrum M.; Handerer I.J.; Moccetti F.; Schmeisser A.; Braun-Dullaeus
R.C.; Toggweiler S.
Institution
(Wolfrum, Moccetti, Toggweiler) Heart Center Lucerne, Luzerner
Kantonsspital, Lucerne, Switzerland
(Wolfrum, Handerer, Schmeisser, Braun-Dullaeus) Department of Internal
Medicine, Division of Cardiology and Angiology, Magdeburg University,
Magdeburg, Germany
Publisher
BioMed Central Ltd
Abstract
Background: The Sentinel cerebral embolic protection device (CEP) aims to
reduce the risk of stroke during transcatheter aortic valve replacement
(TAVR). We performed a systematic review and meta-analysis of propensity
score matched (PSM) and randomized controlled trials (RCT) investigating
the effect of the Sentinel CEP to prevent strokes during TAVR.
 Method(s): Eligible trials were searched through PubMed, ISI Web of
science databases, Cochrane database, and proceedings of major congresses.
Primary outcome was stroke. Secondary outcomes included all-cause
mortality, major or life-threatening bleeding, major vascular
complications and acute kidney injury at discharge. Fixed and random
effect models were used to calculate the pooled risk ratio (RR) with 95%
confidence intervals (CI) and absolute risk difference (ARD).
 Result(s): A total of 4066 patients from 4 RCTs (3'506 patients) and
1 PSM study (560 patients) were included. Use of Sentinel CEP was
successful in 92% of patients and was associated with a significantly
lower risk of stroke (RR: 0.67, 95% CI: 0.48-0.95, p = 0.02. ARD: -1.3%,
95% CI: -2.3 - -0.2, p = 0.02, number needed to treat (NNT) = 77), and a
reduced risk of disabling stroke (RR: 0.33, 95% CI: 0.17-0.65. ARD: -0.9%,
95% CI: -1.5 - -0.3, p = 0.004, NNT = 111). Use of Sentinel CEP was
associated with a lower risk of major or life-threatening bleeding (RR:
0.37, 95% CI: 0.16-0.87, p = 0.02). Risk for nondisabling stroke (RR:
0.93, 95% CI: 0.62-1.40, p = 0.73), all-cause mortality (RR: 0.70, 95% CI:
0.35-1.40, p = 0.31), major vascular complications (RR: 0.74, 95% CI:
0.33-1.67, p = 0.47) and acute kidney injury (RR: 0.74, 95% CI: 0.37-1.50,
p = 0.40) were similar. Conclusion(s): The use of CEP during TAVR was
associated with lower risks of any stroke and disabling stroke with an NNT
of 77 and 111, respectively. Copyright © 2023, The Author(s).

<105>
Accession Number
2023293965
Title
Whipple's disease-associated infective endocarditis: a systematic review.
Source
Infectious Diseases. 55(7) (pp 447-457), 2023. Date of Publication: 2023.
Author
Ioannou P.; Kourtidis M.; Mytilinis D.-O.; Psyllaki A.; Baliou S.;
Kofteridis D.
Institution
(Ioannou, Kofteridis) School of Medicine, University of Crete, Heraklion,
Greece
(Ioannou, Kourtidis, Mytilinis, Psyllaki, Baliou, Kofteridis) Department
of Internal Medicine & Infectious Diseases, University Hospital of
Heraklion, Heraklion, Greece
Publisher
Taylor and Francis Ltd.
Abstract
Whipple's disease is an uncommon chronic systemic disease caused by
Tropheryma whippelii. The most characteristic findings of late Whipple's
disease include diarrhoea, abdominal pain, weight loss, and arthralgias,
however, other clinical findings can occur, including lymphadenopathy,
fever, neurologic manifestations, myocarditis and endocarditis. The aim of
the present study was to systematically review all cases of Whipple's
disease-associated infective endocarditis (IE) in the literature. A
systematic review of PubMed, Scopus, and Cochrane Library (all published
studies up to 28 May 2022) for studies providing data on epidemiology,
clinical characteristics as well as data on treatment and outcomes of
Whipple's disease-associated IE was performed. A total of 72 studies,
containing data for 127 patients, were included. A prosthetic valve was
present in 8% of patients. The aortic valve was the most commonly involved
intracardiac site followed by the mitral valve. Heart failure, embolic
phenomena, and fever were the most common clinical presentations, however,
fever occurred in less than 30% of patients. Sepsis was rarely noted. The
diagnosis was most commonly performed through pathology through positive
PCR or histology in cardiac valves in 88.2% of patients. Trimethoprim with
sulfamethoxazole were the most commonly used antimicrobials followed by
cephalosporins and tetracyclines. Surgery was performed in 84.3% of
patients. Mortality was 9.4%. A multivariate logistic regression analysis
model identified presentation with sepsis or development of a paravalvular
abscess to be independently associated with increased mortality, while
treatment with the combination of trimethoprim with sulfamethoxazole was
independently associated with reduced mortality. Copyright © 2023
Society for Scandinavian Journal of Infectious Diseases.

<106>
Accession Number
2025054772
Title
Modification of attentional biases towards emotional information:
behavioral and autonomic approaches.
Source
International Journal of Psychophysiology. Conference: Proceedings of the
21st World Congress of Psychophysiology (IOP 2023) of the International
Organization of Psychophysiology (IOP). Geneva Switzerland.
188(Supplement) (pp 119), 2023. Date of Publication: June 2023.
Author
Lagacy A.; Leroy M.; De Zorzi L.; Ranfaing S.; Sequeira H.
Institution
(Lagacy, Leroy, De Zorzi, Sequeira) SCALab, CNRS & University of Lille,
Lille, France
(Ranfaing) ETHICS, Lille Catholic University, FLSH, Lille, France
Publisher
Elsevier B.V.
Abstract
Introduction: Attentional biases to emotion are present in healthy
individuals and interact with autonomically-mediated physiological
changes. Such attentional biases and autonomic activities are also
involved in the onset and maintenance of affective disorders such as
anxiety and depression. In this context, attention bias modification
training (ABMT) aims to alter attentional deployment to symptom-relevant
emotionally salient stimuli. The present study aims to explore the effects
of an ABMT, carried out in a single session, at the behavioral and
physiological levels. Method(s): Healthy participants (n=132) were
allocated by means of a double-blind randomized controlled trial into a
trained group and a control group. Each participant started by answering
questionnaires measuring their anxiety and depression levels. The
procedure begins with a baseline period to record the physiological
parameters at rest. The paradigm consists of a dot-probe task, using
emotional facial expressions, during which participants had to
discriminate two letters. In the training group, the probe was always
projected behind a joyful facial expression, while the control group
received the same instruction but the letters appeared with equal
probability behind the joyful, angry, and neutral expressions. Finally,
the procedure ends with a recovery period. During the dot-probe task, the
speed and accuracy discriminating the letter were measured by the reaction
time and percentage of correct responses. Participants' heart rate
variability (HRV), electrodermal activity (EDA) measured as skin
conductance (SC), and respiratory rate were measured during the whole
procedure. The mean heart rate (HR), the standard deviation of HR, and the
root mean square of successive R-R intervals differences (RMSSD) were
computed and the frequency domain method differentiated high frequency
(HF-HRV) and low frequency HRV (LF-HRV). Autonomic changes were assessed
by subtracting each parameter's value for the recovery period from values
for the baseline period. Result(s): At the behavioral level,
significant speed and accuracy variations throughout the task were
observed in the training group. Physiological results showed significant
autonomic changes between trained and control participants on HRV
parameters. Conclusion(s): Such results bring new knowledge regarding
the physiological impact of attentional procedures. They also show that a
dot-probe task can be used to modify attentional biases; therefore, such a
paradigm could be used by clinicians who work with patients suffering from
diverse psychopathologies, including anxiety or depression. Copyright
© 2023

<107>
Accession Number
641604393
Title
Goal Setting among Older Adults Starting Mobile Health Cardiac
Rehabilitation.
Source
Journal of the American Geriatrics Society. Conference: American
Geriatrics Society Annual Meeting, AGS 2023. Long Beach, CA United States.
71(Supplement 1) (pp S137-S138), 2023. Date of Publication: April 2023.
Author
Shwayder E.; Jennings L.A.; Tellez K.; Sanchez M.; Adhikari S.;
Schoenthaler A.; Dodson J.
Institution
(Shwayder, Tellez, Sanchez, Adhikari, Schoenthaler, Dodson) New York
University Grossman, School of Medicine, New York, NY, United States
(Jennings) University of Oklahoma, College of Medicine, Oklahoma City, OK,
United States
Publisher
John Wiley and Sons Inc
Abstract
BACKGROUND: There is growing recognition that healthcare should align with
individuals' health priorities, however these priorities remain undefined,
especially among older adults. The RESILIENT trial, which is designed to
test the efficacy of mobile health cardiac rehabilitation (mHealth-CR) in
an older cohort, also measures participant-defined health outcome goals as
a prespecified secondary endpoint. Our current study aimed to characterize
the health priorities of older adults with ischemic heart disease (IHD)
using goal attainment scaling (GAS)-a technique for measuring
individualized goal achievement-in a sample of 100 RESILIENT participants.
 METHOD(S): The ongoing RESILIENT trial randomizes patients age >=65
years with IHD (defined as hospitalization for acute coronary syndrome
and/or coronary revascularization), to receive mHealth-CR or usual care.
At baseline, we use GAS to prompt participants to identify a primary goal
and create a 5-category goal-attainment scale ranging from -2 (much less
than expected) to +2 (much more than expected) to describe what would
constitute goal achievement over 3 months. Participants also discuss their
action plans and perceived obstacles. For the current study, we randomly
selected batches of 20 participants, and used deductive and inductive
qualitative approaches to develop a coding scheme for their goals,
barriers, and plans until thematic saturation was achieved.
 RESULT(S): Our sample of 100 older adults set diverse health outcome
goals. Most (55.2%) prioritized functional recovery and physical activity,
fewer (17.2%) identified symptom management, fewer still (13.8%) listed
health metrics, mostly comprised of weight loss goals (10.3%), and by far
the fewest (< 3%) related to clinical metrics such as reducing cholesterol
or preventing hospital readmission. Participants anticipated extrinsic
(e.g. weather, time) and intrinsic (e.g. non-cardiac pain, motivation,
health uncertainty) barriers. Action plans commonly detailed strategies
for exercise, motivation, accountability, and overcoming time constraints.
 CONCLUSION(S): Using GAS, we elicited specific and measurable
recovery goals among older adults with IHD. Priorities were predominantly
functional which is discrepant with the types of clinical metrics likely
to be emphasized by clinicians and health care systems.

<108>
Accession Number
641604352
Title
Effect of frailty status on clinical outcomes in participants with
congestive heart failure and coronary artery disease treated with medical
therapy plus surgical intervention vs medical therapy alone:a post hoc
analysis of the STICH trial.
Source
Journal of the American Geriatrics Society. Conference: American
Geriatrics Society Annual Meeting, AGS 2023. Long Beach, CA United States.
71(Supplement 1) (pp S4), 2023. Date of Publication: April 2023.
Author
Patel L.; Segar M.; Singh S.; Betts T.; Subramanian V.; Keshvani N.;
Pandey A.
Institution
(Patel, Singh, Betts, Subramanian, Keshvani, Pandey) University of Texas,
Southwestern Medical Center, Dallas, TX, United States
(Segar) Texas Heart Institute, Houston, TX, United States
Publisher
John Wiley and Sons Inc
Abstract
Background: Coronary artery bypass surgery (CABG) has been shown to reduce
mortality among patients with heart failure (HF) and multivessel coronary
artery disease (CAD). However, patients with HF and CAD also have a high
burden of frailty, a syndrome of diminished physiologic reserve, and
increased vulnerability to stressors such as surgery. Whether the
mortality benefits of CABG in patients with HF and CAD are consistent
among those with high frailty burden at baseline is not well-established.
 Method(s): Participants of the STICH trial, a randomized trial of
CABG with medical therapy versus medical therapy alone among participants
with CAD and HF with ejection fraction <35%, were included. Baseline
frailty was assessed through a deficit accumulation approach (Rockwood
Frailty Index [FI]). Participants were characterized as frail with an FI
above the median vs. not frail below the median. A multivariable Cox
proportional hazard model was constructed to evaluate the association
between frailty status and risk of mortality adjusting for following
covariates: age, sex, race, ejection fraction and 6-minute walk distance.
The multiplicative interaction term for frailty*treatment arm was included
in the adjusted model to evaluate whether frailty status modified the
treatment effect of CABG on all-cause mortality. Result(s): Of 1179
participants (12.3% female, 2.5% black), 588 were characterized as frail
(median FI = 0.33 (IQR 0.24-0.4)). A higher frailty burden at baseline was
associated with an increased risk of mortality on follow-up (HR 1.22,95%
CI 1.03-1.44, p=0.019). Baseline frailty burden did not modify the
treatment effect of the CABG, with a consistent reduction in all-cause
mortality noted among the frail (P-interaction = 0.17). Furthermore, the
relative reduction in mortality risk associated with CABG was nominally
greater among frail (HR 0.69, 95% CI 0.55 - 0.87, p = 0.002) versus not
frail (HR 0.88, 95% CI 0.70 - 1.11, p = 0.28) participants.
 Conclusion(s): In this post-hoc analysis of the STICH trial, CABG was
associated with consistent mortality benefits among non-frail as well as
frail patients.

<109>
Accession Number
641602172
Title
The Edmonton frail scale is a tool to evaluate the effectiveness of
cardiac rehabilitation in frail older patients after open cardiac surgery.
Source
European Journal of Preventive Cardiology. Conference: ESC Preventive
Cardiology 2023. Malaga Spain. 30(Supplement 1) (pp i110), 2023. Date of
Publication: June 2023.
Author
Kuznecova I.; Tamuleviciute-Prasciene E.; Beigiene A.; Stonkuviene V.;
Tribiciute I.; Kubilius R.
Institution
(Kuznecova, Tamuleviciute-Prasciene, Beigiene, Stonkuviene, Tribiciute,
Kubilius) Lithuanian University of Health Sciences, Department of
Cardiology, Kaunas, Lithuania; Lithuanian University of Health Sciences,
Department of Rehabilitation, Kaunas, Lithuania; Lithuanian University of
Health Sciences, Kaunas, Lithuania
Publisher
Oxford University Press
Abstract
Introduction: Together with the aging population, the part of older frail
patients after cardiac surgery is increasing in cardiac rehabilitation
(CR) settings. Frailty detection is crucial for choosing appropriate
training programs, but according to the literature, there is not enough
evidence on what tools should be used to detect frailty and evaluate its
dynamics during CR. Purpose(s): To evaluate the effectiveness of CR
for older frail patients after open heart surgery using the Edmonton frail
scale. Method(s): A prospective, randomized controlled clinical
trial. Inclusion criteria: all patients were admitted to CR after open
heart surgery, >= 65 years old, within 6-minute walking distance (6-MWD)
>=150 m, Edmonton frailt scale (EFS) score >= 4, patient's agreement to
participate in the study. Patients (N=100, 73,3+/-5,1 years, 17,1+/-7,4
days post-surgery, 62,0% male)) were randomly allocated for gender
assigned (1:1 ration) to intervention or control groups (IG n=50, CG
n=50). Both groups participated in exercise training during inpatient-CR.
After completing the 20-day rehabilitation program, the intervention group
(IG) participated in home-based exercise training that lasted 12 weeks.
The home-based exercise training program included four different types of
exercise: aerobic endurance training (5/week, 20-60 min) including
walking, stair climbing, and cycling of moderate to high intensity;
sensomotoric training (3/week, 15 min) including exercises on postural
control, dynamic balance, and coordination of moderate to high intensity;
resistance training (3/week, 20-25 min) including 4 - 8 exercises at
moderate intensity, involving main muscle groups of the legs; flexibility
training (3/week, 10-15 min) including isolated type flexibility exercises
at low to moderate intensity. Participants of IG were monitored by phone
calls every two weeks and the CG were assigned to usual care. Patients
were assessed before (T1) and after 20-days inpatient CR (T2) and 12 weeks
after completion of CR (T3). Patients' frailty was evaluated between
groups and over time by the Edmonton frail scale (frail >= 6, prefrail
4-5, robust 0-3). SPSS 22 was used for statistical analysis. The
Mann-Whitney U and chi-squared tests were applied to compute p-values for
the differences between the groups and periods. Result(s): There were
no significant differences in patient characteristics between the groups
except that in CG there were more women (p=0,013). As a result of
inpatient-CR and home-based exercise training program prevalence of
frailty decreased in both groups, but no statistical significance between
the groups was observed. (Table 1). Conclusion(s): EFS is a suitable
tool to detect frailty and evaluate its dynamic during short-term CR
(after 20 days) and medium-term (after 12 weeks) home-based CR programs.
The results are encouraging, but probably because of the small sample size
and short monitoring time, no significant differences were found between
the groups. (Figure Presented).

<110>
Accession Number
2024277601
Title
Evaluation of the Effect of New Multimodal Analgesia Regimen for Cardiac
Surgery: A Prospective, Randomized Controlled, Single-Center Clinical
Study.
Source
Drug Design, Development and Therapy. 17 (pp 1665-1677), 2023. Date of
Publication: 2023.
Author
Jin L.; Liang Y.; Yu Y.; Miao P.; Huang Y.; Xu L.; Wang H.; Wang C.; Huang
J.; Guo K.
Institution
(Jin, Yu, Miao, Huang, Xu, Wang, Guo) Department of Anesthesia, Zhongshan
Hospital, Fudan University, Shanghai, China
(Liang) Department of Anesthesiology, University of Texas Health Center at
Houston, Houston, TX, United States
(Wang) Department of Cardiac Surgery, Zhongshan Hospital, Fudan
University, Shanghai, China
(Huang) Department of Anesthesiology & Perioperative Medicine University
of Louisville, Louisville, KY, United States
Publisher
Dove Medical Press Ltd
Abstract
Objective: To investigate the feasibility of multimodal regimen by
paracetamol, gabapentin, ketamine, lidocaine, dexmedetomidine and
sufentanil among cardiac surgery patients, and compare the analgesia
efficacy with conventional sufentanil-based regimen. Design(s): A
single-center, prospective, randomized, controlled clinical trial.
 Setting(s): One participating center, the cardiovascular center of
the major integrated teaching hospital. Participant(s): A total of
115 patients were assessed for eligibility: 108 patients were randomized,
7 cases were excluded. Intervention(s): The control group (group T)
received conventional anesthesia management. Interventions in the
multimodal group (group M) were as follows in addition to the standard of
care: gabapentin and acetaminophen 1 hour before surgery; ketamine for
induction and to maintain anesthesia with lidocaine and dexmedetomide.
Ketamine, lidocaine, and dexmedetomidine were added to routine sedatives
postoperatively in group M. Measurements and Main Results: The
incidence of moderate-to-severe pain on coughing made no significant
difference (68.5% vs 64.8%, P=0.683). Group M had significantly less
sufentanil use (135.72microg vs 94.85microg, P=0.000) and lower rescue
analgesia rate (31.5% vs 57.4%, P=0.007). There was no significant
difference in the incidence of chronic pain, PONV, dizziness, inflammation
index, mechanical ventilation time, length of stay, and complications
between the two groups. Conclusion(s): Our multimodal regimen in
cardiac surgery is feasible, but was not superior to traditional
sufentanil-based regimen in the aspects of analgesia effects; however, it
did reduce perioperative opioid consumption along with rescue analgesia
rate. Moreover, it showed the same length of stay and the incidences of
postoperative complications. Copyright © 2023 Jin et al. This
work is published and licensed by Dove Medical Press Limited.

<111>
Accession Number
2025191891
Title
Development and validation of an international preoperative risk
assessment model for postoperative delirium.
Source
Age and Ageing. 52(6) (no pagination), 2023. Article Number: afad086. Date
of Publication: 01 Jun 2023.
Author
Dodsworth B.T.; Reeve K.; Falco L.; Hueting T.; Sadeghirad B.; Mbuagbaw
L.; Goettel N.; Schmutz Gelsomino N.
Institution
(Dodsworth, Schmutz Gelsomino) PIPRA AG, Zurich 8005, Switzerland
(Reeve) Institute of Data Analysis and Process Design, Zurich University
of Applied Sciences, Winterthur 8400, Switzerland
(Falco) Zuhlke Engineering AG, Zurcherstrasse 39J, Schlieren 8952,
Switzerland
(Hueting) Evidencio, Irenesingel 19, Haaksbergen 7481 GJ, Netherlands
(Sadeghirad, Mbuagbaw) Department of Health Research Methods, Evidence,
and Impact, McMaster University, Hamilton, ON L8S 4L8, Canada
(Sadeghirad, Mbuagbaw) Department of Anesthesia, McMaster University,
Hamilton, ON L8S 4L8, Canada
(Mbuagbaw) Department of Pediatrics, McMaster University, Hamilton, ON L8S
4L8, Canada
(Mbuagbaw) Biostatistics Unit, Father Sean o'Sullivan Research Centre, St
Joseph's Healthcare, Hamilton, ON L8S 4L8, Canada
(Mbuagbaw) Centre for Development of Best Practices in Health (CDBPH),
Yaounde Central Hospital, Yaounde 12117, Cameroon
(Mbuagbaw) Division of Epidemiology and Biostatistics, Department of
Global Health, Stellenbosch University, Cape Town 7600, South Africa
(Goettel) Department of Anesthesiology, University of Florida College of
Medicine, Gainesville, FL 32610, United States
(Goettel) Department of Clinical Research, University of Basel, Basel
4031, Switzerland
(Schmutz Gelsomino) Department of Anaesthesia, University Hospital Basel,
Spitalstrasse 21, Basel 4031, Switzerland
Publisher
Oxford University Press
Abstract
Background: Postoperative delirium (POD) is a frequent complication in
older adults, characterised by disturbances in attention, awareness and
cognition, and associated with prolonged hospitalisation, poor functional
recovery, cognitive decline, long-term dementia and increased mortality.
Early identification of patients at risk of POD can considerably aid
prevention. Method(s): We have developed a preoperative POD risk
prediction algorithm using data from eight studies identified during a
systematic review and providing individual-level data. Ten-fold
cross-validation was used for predictor selection and internal validation
of the final penalised logistic regression model. The external validation
used data from university hospitals in Switzerland and Germany.
 Result(s): Development included 2,250 surgical (excluding cardiac and
intracranial) patients 60 years of age or older, 444 of whom developed
POD. The final model included age, body mass index, American Society of
Anaesthesiologists (ASA) score, history of delirium, cognitive impairment,
medications, optional C-reactive protein (CRP), surgical risk and whether
the operation is a laparotomy/thoracotomy. At internal validation, the
algorithm had an AUC of 0.80 (95% CI: 0.77-0.82) with CRP and 0.79 (95%
CI: 0.77-0.82) without CRP. The external validation consisted of 359
patients, 87 of whom developed POD. The external validation yielded an AUC
of 0.74 (95% CI: 0.68-0.80). Conclusion(s): The algorithm is named
PIPRA (Pre-Interventional Preventive Risk Assessment), has European
conformity (ce) certification, is available at http://pipra.ch/ and is
accepted for clinical use. It can be used to optimise patient care and
prioritise interventions for vulnerable patients and presents an effective
way to implement POD prevention strategies in clinical
practice. Copyright © 2023 The Author(s). Published by Oxford
University Press on behalf of the British Geriatrics Society. All rights
reserved.

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