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<1>
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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.

<2>
Accession Number
2025299265
Title
Off-pump injectable versus on-pump conventional tissue valves for
pulmonary valve replacement: The injectable valve implantation randomised
trial (INVITE).
Source
BMJ Open. 13(6) (no pagination), 2023. Article Number: e065192. Date of
Publication: 01 Jun 2023.
Author
Heys R.; Walker-Smith T.; Evans R.; Caputo M.; Culliford L.; Reeves B.;
Rogers C.; Turner M.; Hamilton M.; Sheehan K.; Viola N.; Stoica S.; Wright
K.; Angelini G.; Parry A.
Institution
(Heys, Walker-Smith, Evans, Culliford, Reeves, Rogers) Bristol Trials
Centre, Bristol Medical School, University of Bristol, Bristol, United
Kingdom
(Caputo, Turner, Hamilton, Stoica, Wright, Angelini, Parry) Bristol Heart
Institute, University of Bristol, Bristol, United Kingdom
(Sheehan) Bristol Royal Hospital for Children, University Hospitals
Bristol, Weston Foundation NHS Trust, Bristol, United Kingdom
(Viola) Southampton General Hospital, University Hospital Southampton NHS
Foundation Trust, Southampton, United Kingdom
Publisher
BMJ Publishing Group
Abstract
Objectives To assess the effectiveness of injectable tissue pulmonary
valve compared with standard pulmonary valve in patients requiring
pulmonary valve replacement surgery. Design A multicentre, single-blind,
parallel two-group randomised controlled trial. Participants were blind to
their allocation. Follow-up continued for 6 months. Randomised allocations
were generated by a computer using block randomisation, stratified by
centre. Setting Two National Health Service secondary care centres in the
UK. Participants People aged 12-80 years requiring pulmonary valve
replacement. Interventions Participants were randomly allocated (1:1
ratio) to injectable pulmonary valve replacement (IPVR) without
cardiopulmonary bypass (CPB) or standard pulmonary valve replacement
(SPVR) with CPB. Primary and secondary outcome measures The primary
outcome was chest drainage volume over the first 24 hours after surgery.
Secondary outcomes included in-hospital clinical outcomes; valve and heart
function 6 months postsurgery and health-related quality of life 6 weeks
and 6 months postsurgery. Results Nineteen participants agreed to take
part. Eleven were allocated to IPVR and eight to SPVR. The trial was
stopped before the target sample size of 60 participants was reached due
to challenges in recruitment. The primary analysis includes all randomised
participants; there were no withdrawals. Chest drain volume 24 hours after
surgery was on average 277.6 mL lower with IPVR (IPVR mean 340.0 mL; SPVR
mean 633.8 mL; mean difference, -277.6; 95% CI, -484.0 to -71.2; p=0.005).
There were no statistically significant differences in time to readiness
for extubation (p=0.476), time to fitness for discharge (p=0.577) and time
to first discharge from the intensive care unit (p=0.209). Six
participants with IPVR required CPB. Safety profiles and quality of life
scores were similar. Conclusions IPVR reduced chest drain volume despite
>50% of participants requiring CPB. There was no evidence of any other
benefit of IPVR. Trial registration number ISRCTN23538073. 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.

<3>
Accession Number
2025297478
Title
Does Down syndrome influence the outcomes of congenital cardiac surgery? A
systematic review and meta-analysis.
Source
European Heart Journal - Quality of Care and Clinical Outcomes. 9(3) (pp
240-248), 2023. Date of Publication: 01 Apr 2023.
Author
Wang B.; Verrocchi J.; Liew D.; Zentner D.
Institution
(Wang, Zentner) Cardiology Department, Royal Melbourne Hospital, 300
Grattan St, Parkville, VIC 3050, Australia
(Verrocchi) Monash Medical Centre, Monash Health, Clayton, VIC 3168,
Australia
(Liew) Department of Epidemiology and Preventive Medicine, Monash
University, Melbourne, VIC 3004, Australia
(Zentner) Department of Medicine, University of Melbourne, Parkville, VIC
3010, Australia
Publisher
Oxford University Press
Abstract
Background: Congenital cardiac surgery for individuals with Down syndrome
(DS) has historically occurred at a reduced frequency. Little data are
available regarding long-term post-congenital cardiac surgical outcomes.
Limited sample sizes and clinical heterogeneity require a pooled analysis
approach. Aim(s): To compare long-term outcomes post-congenital heart
surgery between adults with and without DS. Method(s): Databases
(Medline, Embase, and PubMed) were searched utilizing terms related to DS
and congenital heart disease. Studies that enrolled adults (>18 years)
with operated congenital heart disease and compared long-term outcomes
with respect to DS presence were included. All study designs were
included, but those with limited/peri-operative follow-up, non-English
texts, case studies, and literature reviews were excluded. Blinded
screening, data extraction, and quality assessment were independently
conducted by two reviewers. QUIPS criteria were used for risk of bias
analysis. Both random- and fixed-effects models were used for
meta-analysis. Result(s): A total of 23 studies (n = 10 466) were
included. Risk of bias was frequently high due to unblinded retrospective
study designs and analyses limited in adjustment for other prognostic
factors. Meta-analysis demonstrated no effect of DS on long-term mortality
[hazard ratio (HR) 0.86, 95% confidence interval (95% CI) 0.6-1.23], to a
maximum described follow-up of 38 years. Lower cardiac reoperation risk
(HR 0.6, 95% CI 0.46-0.78) for individuals with DS was found on pooled
analysis. Meta-analysis was limited by between-study variation.
 Conclusion(s): DS does not affect post-congenital cardiac surgical
survival in adulthood. Reduced reoperation may reflect challenges in
assessing functional and symptomatic status and/or concerns regarding
perceived reoperation difficulties or likely benefits. Copyright
© 2023 Oxford University Press. All rights reserved.

<4>
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.

<5>
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.

<6>
Accession Number
2023775310
Title
Cardiovascular risk management in the peri-operative setting.
Source
Medical Journal of Australia. 219(1) (pp 30-39), 2023. Date of
Publication: 03 Jul 2023.
Author
Mahendran S.; Thiagalingam A.; Hillis G.; Halliwell R.; Pleass H.C.C.;
Chow C.K.
Institution
(Mahendran) Westmead Applied Research Centre, University of Sydney,
Sydney, NSW, Australia
(Thiagalingam, Halliwell, Chow) Westmead Hospital, Sydney, NSW, Australia
(Hillis) Royal Perth Hospital, Perth, WA, Australia
(Pleass) Institute of Academic Surgery, Royal Prince Alfred Hospital,
Sydney, NSW, Australia
(Chow) University of Sydney, Sydney, NSW, Australia
Publisher
John Wiley and Sons Inc
Abstract
Peri-operative cardiovascular events occur in up to 3% of patients
undergoing non-cardiac surgery. Accurate cardiovascular risk assessment is
important in the peri-operative setting, as it allows informed and shared
decisions regarding the appropriateness of proceeding with surgery, guides
surgical and anaesthetic approaches, and may influence the use of
preventive medications and post-operative cardiac monitoring. Quantitative
risk assessment may also inform a reconsideration of choosing a more
limited lower risk type of surgery, or conservative management.
Pre-operative cardiovascular risk assessment starts with clinical
assessment and should include an estimate of functional capacity.
Specialised cardiac investigations are rarely indicated specifically to
assess pre-operative cardiovascular risk. The decision regarding cardiac
investigations is influenced by the nature, extent and urgency of surgery.
The strategy of performing pre-operative revascularisation to improve
post-operative outcomes is not evidence-based and recent international
guidelines recommend against this. Copyright © 2023 The Authors.
Medical Journal of Australia published by John Wiley & Sons Australia, Ltd
on behalf of AMPCo Pty Ltd.

<7>
Accession Number
2023252078
Title
Does deep neuromuscular blockade provide improved perioperative outcomes
in adult patients? A systematic review and meta-analysis of randomized
controlled trials.
Source
PLoS ONE. 18(3 March) (no pagination), 2023. Article Number: e0282790.
Date of Publication: March 2023.
Author
Liu S.; He B.; Deng L.; Li Q.; Wang X.
Institution
(Liu, He, Deng, Li, Wang) Department of Anesthesiology, Clinical Medical
College, Affiliated Hospital of Chengdu University, Sichuan, Chengdu,
China
Publisher
Public Library of Science
Abstract
Deep neuromuscular blockade provides better surgical workspace conditions
in laparoscopic surgery, but it is still not clear whether it improves
perioperative outcomes, not to mention its role in other types of
surgeries. We performed this systematic review and meta-analysis of
randomized controlled trials to investigate whether deep neuromuscular
blockade versus other more superficial levels of neuromuscular blockade
provides improved perioperative outcomes in adult patients in all types of
surgeries. Medline, Embase, Cochrane Central Register of Controlled
Trials, and Google Scholar were searched from inception to June 25, 2022.
Forty studies (3271 participants) were included. Deep neuromuscular
blockade was associated with an increased rate of acceptable surgical
condition (relative risk [RR]: 1.19, 95% confidence interval [CI]: [1.11,
1.27]), increased surgical condition score (MD: 0.52, 95% CI: [0.37,
0.67]), decreased rate of intraoperative movement (RR: 0.19, 95% CI:
[0.10, 0.33]), fewer additional measures to improve the surgical condition
(RR: 0.63, 95% CI: [0.43, 0.94]), and decreased pain score at 24 h (MD:
-0.42, 95% CI: [-0.74, -0.10]). There was no significant difference in the
intraoperative blood loss (MD: -22.80, 95% CI: [-48.83, 3.24]), duration
of surgery (MD: -0.05, 95% CI: [-2.05, 1.95]), pain score at 48 h (MD:
-0.49, 95% CI: [-1.03, 0.05]), or length of stay (MD: -0.05, 95% CI:
[-0.19, 0.08]). These indicate that deep neuromuscular blockade improves
surgical conditions and prevents intraoperative movement, and there is no
sufficient evidence that deep neuromuscular blockade is associated with
intraoperative blood loss, duration of surgery, complications,
postoperative pain, and length of stay. More high-quality randomized
controlled trials are needed, and more attention should be given to
complications and the physiological mechanism behind deep neuromuscular
blockade and postoperative outcomes. Copyright: © 2023 Liu et al.
This is an open access article distributed under the terms of the Creative
Commons Attribution License, which permits unrestricted use, distribution,
and reproduction in any medium, provided the original author and source
are credited.

<8>
Accession Number
2023071656
Title
Effect of the Obesity Paradox on Mortality in Patients with Acute Coronary
Syndrome: A Comprehensive Meta-analysis of the Literature.
Source
Balkan Medical Journal. 40(2) (pp 93-103), 2023. Date of Publication:
2023.
Author
Saylik F.; Cinar T.; Hayiroglu M.I.
Institution
(Saylik) Clinic of Cardiology, University of Health Sciences Turkey, Van
Training and Research Hospital, Van, Turkey
(Cinar) Clinic of Cardiology, University of Health Sciences Turkey, Sultan
Abdulhamid Han Training and Research Hospital, Istanbul, Turkey
(Hayiroglu) Clinic of Cardiology, Dr. Siyami Ersek Thoracic and
Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey
Publisher
Galenos Publishing House
Abstract
Background: The protective effect of obesity in patients with acute
coronary syndrome undergoing percutaneous coronary intervention or bypass
surgery has been described as the obesity paradox in the literature.
 Aim(s): In this comprehensive meta-analysis, we aimed to investigate
the pooled effect of the obesity paradox on mortality in acute coronary
syndrome patients. Study Design: Systemic meta-analysis and
metaregression. Method(s): We searched PubMed, Google Scholar, and
the Cochrane Library for eligible studies that compared the mortality
rates between body mass index cut-off points in acute coronary syndrome
patients. This meta-analysis comprised 54 studies with 534,903 patients.
Random-and fixed-effect models were used to calculate pooled effects sizes
in the presence of moderately high and low heterogeneity between studies,
respectively. A metaregression analysis was used to detect possible causes
of heterogeneity. A dose-response meta-analysis was also conducted to
detect the association between mortality risk and body mass index.
 Result(s): Overweight patients had lower mortality risk for 30-day
(RR =0.69; 0.62-0.76, p < 0.01) and long-term (RR =0.73; 0.70-0.77, p <
0.01) mortality than normal-weight patients. The 30-day mortality risk was
higher in low-weight patients than in normal-weight patients (RR =1.74;
1.39-2.18, p < 0.01). Meta-regression could not explain the possible
causes of between-study heterogeneity. Patients with body mass index <21.5
kg/m2 and >40 kg/m2 had a higher risk of mortality,
which was lowest at approximately 30 kg/m2. Conclusion(s):
Low-weight and overweight acute coronary syndrome patients had higher
mortality risk than normal-weight patients. A U-shaped nonlinear
association was detected between body mass index and mortality
risk. Copyright © Author(s)-Available online at
http://balkanmedicaljournal.org/.

<9>
Accession Number
2022693747
Title
Immunogenicity of COVID-19 vaccines in solid organ transplant recipients:
a systematic review and meta-analysis.
Source
Clinical Microbiology and Infection. 29(4) (pp 441-456), 2023. Date of
Publication: April 2023.
Author
Chen X.; Luo D.; Mei B.; Du J.; Liu X.; Xie H.; Liu L.; Su S.; Mai G.
Institution
(Chen, Xie, Liu, Mai) Department of Hepatobiliary Surgery, People's
Hospital of Deyang City, Deyang, China
(Luo, Su) Department of Hepatobiliary Surgery, The Affiliated Hospital of
Southwest Medical University, Luzhou, China
(Chen) Department of General, Visceral and Vascular Surgery, Jena
University Hospital, Jena, Germany
(Luo) Department of Nephrology, University Hospital Essen, University of
Duisburg-Essen, Essen, Germany
(Mei) Sichuan Cancer Hospital, School of Medicine, University of
Electronic Science and Technology of China, Chengdu, China
(Du) Department of Clinical Medicine, Southwest Medical University,
Luzhou, China
(Liu) Department of Hepatobiliary Surgery, The 4th People's Hospital of
Zigong City, Zigong, China
Publisher
Elsevier B.V.
Abstract
Background: Solid organ transplant (SOT) recipients are at increased risks
of morbidity and mortality associated with COVID-19. Objective(s):
This study aimed to evaluate the immunogenicity of COVID-19 vaccines in
SOT recipients. Data sources: Electronic databases were searched for
eligible reports published from 1 December 2019 to 31 May 2022. Study
eligibility criteria: We included reports evaluating the humoral immune
response (HIR) or cellular immune response rate in SOT recipients after
the administration of COVID-19 vaccines. Participant(s): SOT
recipients who received COVID-19 vaccines. Assessment of risk of bias: We
used the Newcastle-Ottawa scale to assess bias in case-control and cohort
studies. For randomised-controlled trials, the Jadad Scale was used.
 Method(s): We used a random-effects model to calculate the pooled
rates of immune response with 95% CI. We used a risk ratio (RR) with 95%
CI for a comparison of immune responses between SOT and healthy controls.
 Result(s): A total of 91 reports involving 11 886 transplant
recipients (lung: 655; heart: 539; liver: 1946; and kidney: 8746) and 2125
healthy controls revealed pooled HIR rates after the 1st, 2nd, and 3rd
COVID-19 vaccine doses in SOT recipients were 9.5% (95% CI, 7-11.9%),
43.6% (95% CI, 39.3-47.8%) and 55.1% (95% CI, 44.7-65.6%), respectively.
For specific organs, the HIR rates were still low after 1st vaccine dose
(lung: 4.4%; kidney: 9.4%; heart: 13.2%; liver: 29.5%) and 2nd vaccine
dose (lung: 28.4%; kidney: 37.6%; heart: 50.3%; liver: 64.5%).
 Conclusion(s): A booster vaccination enhances the immunogenicity of
COVID-19 vaccines in SOT; however, a significant share of the recipients
still has not built a detectable HIR after receiving the 3rd dose. This
finding calls for alternative approaches, including the use of monoclonal
antibodies. In addition, lung transplant recipients need urgent booster
vaccination to improve the immune response. Copyright © 2022

<10>
Accession Number
2017928061
Title
Transcatheter aortic valve implantation in patients with severe
symptomatic aortic valve stenosis: systematic review of cost-effectiveness
analysis.
Source
European Journal of Health Economics. 24(3) (pp 359-376), 2023. Date of
Publication: April 2023.
Author
Chotnoppharatphatthara P.; Yoodee V.; Taesotikul S.; Yadee J.; Permsuwan
U.
Institution
(Chotnoppharatphatthara, Yoodee, Taesotikul, Yadee, Permsuwan) Department
of Pharmaceutical Care, Faculty of Pharmacy, Chiang Mai University, Chiang
Mai 50200, Thailand
(Yadee, Permsuwan) Center for Medical and Health Technology Assessment
(CM-HTA), Faculty of Pharmacy, Chiang Mai University, Chiang Mai 50200,
Thailand
(Yoodee, Taesotikul) Pharmaceutical Care Training Center (PCTC), Faculty
of Pharmacy, Chiang Mai University, Chiang Mai 50200, Thailand
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Background: Transcatheter aortic valve implantation (TAVI) is a less
invasive and costly treatment for patients with severe aortic stenosis
(AS). This study aimed to systematically review the published literature
focusing on economic evaluation of TAVI compared with other alternative
treatments in AS populations. Method(s): A systematic review was
conducted from inception until May 2021 using PubMed, Scopus, Web of
science and Embase databases. The qualities of included studies were
evaluated using Consolidated Health Economic Evaluation Reporting Standard
(CHEERS) criteria. Data of costs, outcomes, incremental cost-effectiveness
ratio (ICER) and willingness to pay were extracted. To compare results,
ICERs were converted to the 2020 United States dollar (USD) rate.
 Result(s): Of the 29 included cost-effectiveness studies, TAVI was
cost-effective in all studies in the low-risk group (3/3), 77% of studies
(7/9) in the intermediate-risk group, half of the studies (6/12) in the
high-risk group, and 83% of studies (10/12) in the inoperable group. When
adjusted to USD 2020, ICERs ranged from USD 2741 to 1027,674 USD per
quality-adjusted life-year gained. The overall quality of the studies
ranged from moderate to high. Conclusion(s): TAVI is potentially a
cost-effective alternative to surgical aortic valve replacement (SAVR) for
patients with operable AS with low, intermediate or high risk compared
with medical management (MM) for patients with inoperable AS. TAVI was
associated with a significant gain in quality-adjusted life-years in
almost all studies compared to either SAVR or MM. TAVI is a costly
procedure; therefore, justifying its cost-effectiveness depends on the
acceptable threshold in each country. Copyright © 2022, The
Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part
of Springer Nature.

<11>
Accession Number
2025376633
Title
A Systematic Review and Meta-Analysis of Prevalence, Characteristics, and
Impact of Mitral Annular Calcification on Outcomes After Transcatheter
Aortic Valve Implantation.
Source
American Journal of Cardiology. 201 (pp 123-130), 2023. Date of
Publication: 15 Aug 2023.
Author
Moin A.; Lak H.M.; Zafar M.; Tariq R.; Shaikh F.H.; Mussa M.; Bansal A.;
Shekhar S.; Harb S.; Unai S.; Kapadia S.R.
Institution
(Moin, Zafar, Tariq, Mussa) Department of Internal Medicine, Dow Medical
College, Civil Hospital, Karachi, Pakistan
(Lak) Section of Clinical Cardiology, Robert and Suzanne Tomsich
Department of Cardiovascular Medicine, Sydell and Arnold Miller Family
Heart Vascular & Thoracic Institute, Cleveland Clinic, Cleveland, Ohio,
United States
(Shaikh) Department of Cardiology, Dow Medical College, Civil Hospital,
Karachi, Pakistan
(Bansal, Shekhar, Harb, Kapadia) Aortic Valve Center, Robert and Suzanne
Tomsich Department of Cardiovascular Medicine, Sydell and Arnold Miller
Family Heart Vascular & Thoracic Institute, Cleveland Clinic, Cleveland,
Ohio, United States
(Unai) Department of Thoracic and Cardiovascular Surgery, Cleveland
Clinic, Cleveland, Ohio, United States
Publisher
Elsevier Inc.
Abstract
There is a paucity of data on the prognostic impact of mitral annular
calcification (MAC) in patients who underwent transcatheter aortic valve
implantation (TAVI) with conflicting results being reported by the studies
that are published. Therefore, we performed a meta-analysis to assess the
short-term and long-term outcomes of MAC in patients after TAVI. Of 25,407
studies identified after the initial database search, 4 observational
studies comprising 2,620 patients (2,030 patients in the nonsevere MAC arm
and 590 patients in the severe MAC arm) were included in the final
analysis. Compared with patients with nonsevere MAC, the severe MAC group
was associated with significantly higher incidences of overall bleeding
(0.75 [0.57 to 0.98], p = 0.03, I2 = 0%) at 30 days. However,
no significant difference was observed between the 2 groups for the rest
of the 30-day outcomes: all-cause mortality (0.79 [0.42 to 1.48], p =
0.46, I2 = 9%), myocardial infarction (1.62 [0.37 to 7.04], p =
0.52, I2 = 0%), cerebrovascular accident or stroke (1.22 [0.53
to 2.83], p = 0.64, I2 = 0%), acute kidney injury (1.48 [0.64
to 3.42], p = 0.35, I2 = 0%), and pacemaker implantation (0.70
[0.39 to 1.25], p = 0.23, I2 = 68%). Similarly, follow-up
outcomes also showed no significant difference between the 2 groups:
all-cause mortality (0.69 [0.46 to 1.03], p = 0.07, I2 = 44%),
cardiovascular mortality (0.52 [0.24 to 1.13], p = 0.10, I2 =
70%) and stroke (0.83 [0.41 to 1.69], p = 0.61, I2 = 22%). The
sensitivity analysis, however, demonstrated significant results for
all-cause mortality (0.57 [0.39 to 0.84], p = 0.005, I2 = 7%)
by removing the study by Okuno et al5 and cardiovascular
mortality (0.41 [0.21 to 0.82], p = 0.01, I2 = 66%) by removing
the study by Lak et al.7 In conclusion, our meta-analysis
corroborates the notion that isolated MAC is not an independent predictor
of long-term mortality after TAVI and determines severe MAC to be a
predictor of mortality at follow-up because of the higher incidence of
mitral valve dysfunction associated with it. Copyright © 2023

<12>
Accession Number
2024071345
Title
Infective endocarditis involving MitraClip© devices: a
systematic literature review.
Source
Infection. (no pagination), 2023. Date of Publication: 2023.
Author
Bertolino L.; Ramadan M.S.; Zampino R.; Durante-Mangoni E.
Institution
(Bertolino, Zampino) Department of Advanced Medical & Surgical Sciences,
University of Campania 'L. Vanvitelli', Naples, Italy
(Ramadan, Zampino, Durante-Mangoni) Unit of Infectious and Transplant
Medicine, AORN Ospedali dei Colli-Monaldi Hospital, Piazzale Ettore
Ruggieri, Naples 80131, Italy
(Ramadan, Durante-Mangoni) Department of Precision Medicine, University of
Campania 'L. Vanvitelli', Naples, Italy
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Purpose: Progress of interventional cardiology has boosted the use of
newer cardiac devices. These devices are perceived to be less prone to
infections compared to traditional surgical prostheses, but little data
are currently available. In this systematic review (SR), we summarize
current literature regarding the clinical characteristics, management, and
outcomes of patients with MitraClip-related infective endocarditis (IE).
 Method(s): We conducted a SR of PubMed, Google Scholar, Embase, and
Scopus between January 2003 and March 2022. MitraClip-related IE was
defined according to 2015 ESC criteria whereas MitraClip involvement as
vegetation on the device or on the mitral valve. Risk of bias was assessed
through standardized checklist and potential bias of underestimation
cannot be excluded. Data regarding clinical presentation,
echocardiography, management, and outcome were collected. Result(s):
Twenty-six cases of MitraClip-related IE were retrieved. The median age of
patients was 76 [61-83] years with a median EuroScore of 41%. Fever was
present in 65.8% of patients followed by signs and symptoms of heart
failure (42.3%). IE occurred early in 20 (76.9%) cases with a median time
between MitraClip implantation and IE symptom onset of 5 [2-16] months.
Staphylococcus aureus was the major causative microorganism (46%).
Surgical mitral valve replacement was needed in 50% of patients. A
conservative medical approach was considered in the remainder. The overall
in-hospital mortality rate was 50% (surgical group: 38.4%; medical group:
58.3%; p = 0.433). Conclusion(s): Our results suggest that
MitraClip-related IE affects elderly, comorbid patients, is mostly due to
Staphylococcus aureus, and has a poor prognosis irrespective of the
therapeutic approach. Clinicians must be aware of the features of this new
entity among cardiovascular infections. Copyright © 2023, The
Author(s).

<13>
Accession Number
2023854240
Title
The Role of High-Fidelity Simulation in the Acquisition of Endovascular
Surgical Skills: A Systematic Review.
Source
Annals of Vascular Surgery. 93 (pp 405-427), 2023. Date of Publication:
July 2023.
Author
Gomaa A.-R.; Grafton-Clarke C.; Saratzis A.; Davies R.S.M.
Institution
(Gomaa) Human Anatomy Resource Centre (HARC), University of Liverpool,
Liverpool, United Kingdom
(Grafton-Clarke) University of East Anglia, Norwich, United Kingdom
(Saratzis, Davies) Leicester Vascular Institute, University Hospitals of
Leicester NHS Trust, Leicester, United Kingdom
(Saratzis) Department of Cardiovascular Sciences, University of Leicester,
Leicester, United Kingdom
Publisher
Elsevier Inc.
Abstract
Background: The widespread introduction of minimally invasive endovascular
techniques in cardiovascular surgery has necessitated a transition in the
psychomotor skillset of trainees and surgeons. Simulation has previously
been used in surgical training; however, there is limited high-quality
evidence regarding the role of simulation-based training on the
acquisition of endovascular skills. This systematic review aimed to
systematically appraise the currently available evidence regarding
endovascular high-fidelity simulation interventions, to describe the
overarching strategies used, the learning outcomes addressed, the choice
of assessment methodology, and the impact of education on learner
performance. Method(s): A comprehensive literature review was
performed in accordance with the Preferred Reporting Items for Systematic
Reviews and Meta-Analyses (PRISMA) statement using relevant keywords to
identify studies evaluating simulation in the acquisition of endovascular
surgical skills. References of review articles were screened for
additional studies. Result(s): A total of 1,081 studies were
identified (474 after removal of duplicates). There was marked
heterogeneity in methodologies and reporting of outcomes. Quantitative
analysis was deemed inappropriate due to the risk of serious confounding
and bias. Instead, a descriptive synthesis was performed, summarizing key
findings and quality components. Eighteen studies were included in the
synthesis (15 observational, 2 case-control and 1 randomized control
studies). Most studies measured procedure time, contrast usage, and
fluoroscopy time. Other metrics were recorded to a lesser extent.
Significant reductions were noted in both procedure and fluoroscopy times
with the introduction of simulation-based endovascular training.
 Conclusion(s): The evidence regarding the use of high-fidelity
simulation in endovascular training is very heterogeneous. The current
literature suggests simulation-based training leads to improvements in
performance, mostly in terms of procedure and fluoroscopy time.
High-quality randomized control trials are needed to establish the
clinical benefits of simulation training, sustainability of improvements,
transferability of skills and its cost-effectiveness. Copyright ©
2023 The Author(s)

<14>
Accession Number
2023448831
Title
Comparison of Effects of Liuzijue Exercise and Conventional Respiratory
Training on Patients after Cardiac Surgery: A Randomized Controlled Trial.
Source
Chinese Journal of Integrative Medicine. 29(7) (pp 579-589), 2023. Date of
Publication: July 2023.
Author
Zhang Q.-L.; Ge M.; Chen C.; Fan F.-D.; Jin Y.; Zhang N.; Wang L.
Institution
(Zhang, Wang) Department of Rehabilitation Medicine, Nanjing Drum Tower
Hospital, Clinical College of Nanjing University of Chinese Medicine,
Nanjing 210008, China
(Zhang, Jin, Wang) Department of Rehabilitation, College of Acupuncture
and Moxibustion and Massage Health Preservation and Rehabilitation,
Nanjing University of Chinese Medicine, Nanjing 210023, China
(Ge, Chen, Fan) Department of Cardio-Thoracic Surgery, Nanjing Drum Tower
Hospital, the Affiliated Hospital of Nanjing University Medical School,
Nanjing 210008, China
(Zhang) Department of Ultrasound, Nanjing Drum Tower Hospital, the
Affiliated Hospital of Nanjing University Medical School, Nanjing 210008,
China
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Objective: To evaluate the feasibility and safety of Liuzijue exercise
(LE) for the clinical effect in patients after cardiac surgery.
 Method(s): Totally 120 patients who underwent cardiac surgery and
were admitted to the Cardiothoracic Intensive Care Unit of Nanjing Drum
Tower Hospital between July and Oclober, 2022 were allocated to the LE
group, the conventional respiratory training (CRT) group, and the control
group by a random number table at a ratio of 1:1:1; 40 patients in each
group. All patients received routine treatment and cardiac rehabilitation.
LE group and CRT group respectively performed LE and CRT once a day for 30
min for 7 days. Control group did not receive specialized respiratory
training. The forced vital capacity, forced expiratory volume in 1 s, peak
inspiratory flow rate, peak expiratory flow rate, maximum inspiratory
pressure, maximum expiratory pressure, modified Barthel index (MBI), and
Hamilton Rating Scale for Anxiety (HAM-A) were evaluated before, after 3
and 7 days of intervention. In addition, the postoperative length of
hospital stay (LOS) and the adverse events that occurred during the
intervention period were compared. Result(s): A total of 107 patients
completed the study, 120 patients were included in the analysis. After 3
days of intervention, the pulmonary function, respiratory muscle strength,
MBI and HAM-A of all 3 groups improved compared with that before the
intervention (P<0.05 or P<0.01). Compared with the control group,
pulmonary function and respiratory muscle strength were significantly
improved in the CRT and LE groups (P<0.05 or P<0.01). MBI and HAM-A were
significantly improved in the LE group compared with the control and CRT
groups (P<0.05 or P<0.01). On the 7th day after intervention, the
difference was still statistically significant (P<0.01), and was
significantly different from that on the 3rd day (P<0.05 or P<0.01). In
addition, on the 7th day of intervention, the pulmonary function and
respiratory muscle strength in the LE group were significantly improved
compared with those in the CRT group (P<0.01). MBI and HAM-A were
significantly improved in the CRT group compared with the control group
(P<0.01). There were no significant differences in postoperative LOS among
the 3 groups (P>0.05). No training-related adverse events occurred during
the intervention period. Conclusion(s): LE is safe and feasible for
improving pulmonary function, respiratory muscle strength, the ability to
complete activities of daily living and for relieving anxiety of patients
after cardiac surgery (Registration No. ChiCTR2200062964). Copyright
© 2023, The Chinese Journal of Integrated Traditional and Western
Medicine Press and Springer-Verlag GmbH Germany, part of Springer Nature.

<15>
Accession Number
2025421300
Title
Meta-Analysis Assessing Efficacy and Safety of Vitamin K Antagonists
Versus Direct Oral Anticoagulants for Atrial Fibrillation After
Transcatheter Aortic Valve Implantation.
Source
American Journal of Cardiology. 201 (pp 260-267), 2023. Date of
Publication: 15 Aug 2023.
Author
Selvaraj V.; Khan M.S.; Mufarrih S.H.; Kazimuddin M.; Waheed M.A.;
Tripathi A.; Bavishi C.; Hyder O.N.; Aronow H.D.; Saad M.; Abbott J.D.
Institution
(Selvaraj) Department of Medicine, The Miriam Hospital, Warren Alpert
Medical School of Brown University, Providence, Rhode Island, United
States
(Khan, Kazimuddin, Waheed) Division of Cardiology, University of Kentucky
College of Medicine - Bowling Green Campus, Bowling Green, KY, United
States
(Mufarrih) Department of Internal Medicine, University of Kentucky College
of Medicine - Bowling Green Campus, Bowling Green, KY, United States
(Tripathi) Division of Cardiology, CHI St. Vincent Heart Clinic Arkansas,
Searcy, AR, United States
(Bavishi) Division of Cardiology, University of Missouri School of
Medicine, Columbia, Missouri, United States
(Hyder, Saad, Abbott) Division of Cardiology, Lifespan Cardiovascular
Institute, Warren Alpert Medical School of Brown University, Providence,
Rhode Island, United States
(Aronow) Heart & Vascular Services, Henry Ford Health, Detroit, MI, United
States
Publisher
Elsevier Inc.
Abstract
Patients who underwent transcatheter aortic valve implantation (TAVI) with
concomitant atrial fibrillation (AF) are at a higher risk for
thromboembolic and bleeding events. The optimal antithrombotic strategy
for patients with AF after TAVI remains unclear. We sought to determine
the comparative efficacy and safety of direct oral anticoagulants (DOAC)
versus oral vitamin K antagonists (VKAs) in these patients. Electronic
databases such as PubMed, Cochrane, and Embase databases were searched
till January 31, 2023, for relevant studies evaluating clinical outcomes
of VKA versus DOAC in patients with AF after TAVI. Outcomes assessed were
(1) all-cause mortality, (2) stroke, (3) major/life-threatening bleeding,
and (4) any bleeding. Hazard ratios (HRs) were pooled in meta-analysis
using random effect model. Nine studies (2 randomized and 7 observational)
were included in systematic review, and 8 studies with 25,769 patients
were eligible to be included in the meta-analysis. The mean age of the
patients was 82.1 years, and 48.3% were male. Pooled analysis using
random-effects model showed no statistically significant difference in
all-cause mortality (HR 0.91, 95% confidence interval [CI] 0.76 to 1.10, p
= 0.33), stroke (HR 0.96, 95% CI 0.80 to 1.16, p = 0.70), and
major/life-threatening bleeding (HR 1.05, 95% CI 0.82 to 1.35, p = 0.70)
in patients that received DOAC compared with oral VKA. Risk of any
bleeding was lower in the DOAC group compared with oral VKA (HR 0.83, 95%
CI 0.76 to 0.91, p = 0.0001). In patients with AF, DOACs appear to be a
safe alternative oral anticoagulation strategy to oral VKA after TAVI.
Further randomized studies are required to confirm the role of DOACs in
those patients. Copyright © 2023 Elsevier Inc.

<16>
Accession Number
2024574339
Title
Management of Anxiety in Coronary Artery Bypass Grafting Patients: The
Influence of Chair Aerobics and Nadisodhana Pranayama-A Pilot Randomized
Clinical Trial.
Source
Indian Journal of Pharmaceutical Education and Research. 57(2) (pp
s405-s410), 2023. Date of Publication: Apr-June 2023.
Author
Ashok A.; Ku D.K.; Mundayat G.
Institution
(Ashok, Ku) NITTE Institute of Physiotherapy, NITTE (Deemed to be
University), Deralakatte, Karnataka, Mangalore, India
(Mundayat) Department of Cardiothoracic and Vascular Surgery, K. S. Hegde
Medical Academy, NITTE (Deemed to be University), Deralakatte, Karnataka,
Mangalore, India
Publisher
Association of Pharmaceutical Teachers of India
Abstract
Background: Anxiety is a primary concern affecting the prognosis of CABG
patients. Relieving anxiety is thus a component of management in patients
with CABG. We use two feasible and cost-effective treatment techniques to
know the improvement in symptoms of anxiety. Objective(s): To
evaluate the efficacy of chair aerobics and pranayama on anxiety in
patients who underwent CABG. We hypothesized that there would be an
improvement in anxiety in CABG patients after receiving the interventions.
 Material(s) and Method(s): In a total of 21 screened, 16 met
eligibility requirements. These were randomized into two, group A and
group B. Group A is treated with progressive chair aerobics, and group B
with Nadi-sodhana pranayama. Both groups were given standardised cardiac
rehabilitation techniques. The duration was fifteen minutes of activity
along with phase 1 cardiac rehabilitation. The treatment session was given
once a day in the morning. The intervention starts from the post-operative
day 3 to post-operative day 7. The anxiety is measured by the tool
"hospital anxiety and depression scale". Heart rate is estimated to know
the somatic and physiologic components of anxiety. Took all the outcome
measures before the surgery and on post-operative day 7 by a blinded
outcome assessor. Result(s): The results showed that the improvement
in the p-value of HADS anxiety, depression, and heart rate of both groups
is less than 0.05. Copyright © Author (s) 2023.

<17>
Accession Number
2024103114
Title
Prophylactic noninvasive respiratory support in the immediate
postoperative period after cardiac surgery - a systematic review and
network meta-analysis.
Source
BMC Pulmonary Medicine. 23(1) (no pagination), 2023. Article Number: 233.
Date of Publication: December 2023.
Author
Zhou X.; Pan J.; Wang H.; Xu Z.; Zhao L.; Chen B.
Institution
(Zhou, Pan, Wang, Xu, Chen) Department of Intensive Care Medicine, Ningbo
No.2 Hospital, Zhejiang, Ningbo 315000, China
(Zhao) Department of Cardiovascular Surgery, Ningbo No.2 Hospital,
Zhejiang, Ningbo, Ningbo 315000, China
Publisher
BioMed Central Ltd
Abstract
Background: Noninvasive respiratory support has been increasingly applied
in the immediate postoperative period to prevent postoperative pulmonary
complications (PPCs). However, the optimal approach remains uncertain. We
sought to evaluate the comparative effectiveness of various noninvasive
respiratory strategies used in the immediate postoperative period after
cardiac surgery. Method(s): We conducted a frequentist random-effect
network meta-analysis (NMA) of randomized controlled trials (RCTs)
comparing the prophylactic use of noninvasive ventilation (NIV),
continuous positive airway pressure (CPAP), high flow nasal cannula
(HFNC), or postoperative usual care (PUC) in the immediate postoperative
period after cardiac surgery. Databases were systematically searched
through September 28, 2022. Study selection, data extraction, and quality
assessment were performed in duplicate. The primary outcome was the
incidence of PPCs. Result(s): Sixteen RCTs enrolling 3011 patients
were included. Compared with PUC, NIV significantly reduced the incidence
of PPCs [relative risk (RR) 0.67, 95% confidence interval (CI): 0.49 to
0.93; absolute risk reduction (ARR) 7.6%, 95% CI: 1.6-11.8%; low
certainty] and the incidence of atelectasis (RR 0.65, 95% CI: 0.45 to
0.93; ARR 19.3%, 95% CI: 3.9-30.4%; moderate certainty); however,
prophylactic NIV was not associated with a decreased reintubation rate (RR
0.82, 95% CI: 0.29 to 2.34; low certainty) or reduced short-term mortality
(RR 0.64, 95% CI: 0.16 to 2.52; very low certainty). As compared to PUC,
the preventive use of CPAP (RR 0.85, 95% CI: 0.60 to 1.20; very low
certainty) or HFNC (RR 0.74, 95% CI: 0.46 to 1.20; low certainty) had no
significant beneficial effect on the incidence of PPCs, despite exhibiting
a downward trend. Based on the surface under the cumulative ranking curve,
the highest-ranked treatment for reducing the incidence of PPCs was NIV
(83.0%), followed by HFNC (62.5%), CPAP (44.3%), and PUC (10.2%).
 Conclusion(s): Current evidence suggest that the prophylactic use of
NIV in the immediate postoperative period is probably the most effective
noninvasive respiratory approach to prevent PPCs in patients undergoing
cardiac surgery. Given the overall low certainty of the evidence, further
high-quality research is warranted to better understand the relative
benefits of each noninvasive ventilatory support. Clinical Trial
Registration: PROSPERO, https://www.crd.york.ac.uk/prospero/ , registry
number: CRD42022303904. Copyright © 2023, The Author(s).

<18>
Accession Number
2025474473
Title
Continuous Ultrafiltration Enhances Recovery After Adult Cardiac Surgery
With Cardiopulmonary Bypass: A Systematic Review and Meta-analysis.
Source
CJC Open. (no pagination), 2023. Date of Publication: 2023.
Author
Bierer J.; Horne D.; Stanzel R.; Henderson M.; Boulos L.; Hayden J.A.
Institution
(Bierer, Horne) Division of Cardiac Surgery, Department of Surgery,
Dalhousie University, Halifax, NS, Canada
(Stanzel, Henderson) Department of Clinical Perfusion, Nova Scotia Health
Authority, Halifax, NS, Canada
(Boulos) Maritime SPOR SUPPORT Unit, Halifax, NS, Canada
(Hayden) Department of Community Health & Epidemiology, Dalhousie
University, Halifax, NS, Canada
Publisher
Elsevier Inc.
Abstract
Background: Cardiac surgery with cardiopulmonary bypass is associated with
systemic inflammation. Ultrafiltration used throughout the cardiopulmonary
bypass time, continuously, is hypothesized to be an immunomodulatory
therapy. Method(s): A systematic review and meta-analysis of
randomized trials investigating continuous forms of ultrafiltration during
adult cardiac surgery (CRD42020219309) was conducted and is reported
following PRISMA guidelines. MEDLINE, Embase, CENTRAL, and Scopus were
searched on November 3, 2021. The primary endpoint was operative
mortality, and secondary outcomes included intensive care unit length of
stay (ICU LOS), ventilation time, acute kidney injury or renal failure,
and pneumonia. Each study was assessed for risk of bias using the Cochrane
Risk-of Bias-Tool for Randomized Trials (RoB2) instrument. Outcomes were
analyzed with inverse variance random-effects models and assessed for
GRADE quality of evidence. Result(s): Twelve randomized trials
consisting of 989 adult patients undergoing coronary, valvular, or
concomitant cardiac procedures were included. Compared to controls,
patients receiving continuous ultrafiltration had no statistical
difference in operative mortality; risk ratio of 0.32 (95% confidence
interval [CI]: 0.10-1.03; P = 0.06). Reductions occurred in ICU LOS, by
7.01 hours (95% CI: 1.86-12.15; P = 0.008); ventilation time, by 2.11
hours (95% CI: 0.71-3.51; P = 0.003); and incidence of pneumonia, with a
risk ratio of 0.33 (95% CI: 0.15-0.75; P = 0.008). There wasno difference
in renal injury. The GRADE quality of evidence for these outcomes ranged
from very low to low. Conclusion(s): Continuous forms of
ultrafiltration enhance recovery after adult cardiac surgery by reducing
ICU LOS, ventilation time, and incidence of pneumonia. A multicentre
randomized trial could confirm and generalize these
findings. Copyright © 2023 The Authors

<19>
Accession Number
2025424427
Title
Discrepancies in Financial Conflicts of Interest in Robotic Cardiothoracic
Surgery Studies.
Source
Annals of Thoracic Surgery. (no pagination), 2023. Date of Publication:
2023.
Author
Karamchandani M.M.; Tian T.; Hall R.; Nickel I.; Aalberg J.; Lassaletta
A.D.; Chatterjee A.; Walters D.M.
Institution
(Karamchandani, Tian, Hall, Nickel) Department of Surgery, Tufts Medical
Center, Boston, MA, United States
(Aalberg) Tufts University School of Medicine, Boston, MA, United States
(Lassaletta, Walters) Division of Thoracic Surgery, Department of Surgery,
Tufts Medical Center, Boston, MA, United States
(Chatterjee) Division of Plastic and Reconstructive Surgery, Department of
Surgery, Tufts Medical Center, Boston, MA, United States
Publisher
Elsevier Inc.
Abstract
Background: In academic surgery publications, self-reporting of conflicts
of interest (COI) has often proved to be inaccurate. Here, we review the
accuracy of COI disclosures for studies related to the use of robotic
technology in cardiothoracic surgery and evaluate factors associated with
increased discrepancies. Method(s): A literature search identified
robotic surgery-related studies with at least 1 American author published
between January 2015 and December 2020 from 3 major American
cardiothoracic surgery journals (The Journal of Thoracic and
Cardiovascular Surgery, The Annals of Thoracic Surgery, and Annals of
Cardiothoracic Surgery). Industry payments from Intuitive Surgical
(Intuitive) were collected with use of the Centers for Medicare and
Medicaid Open Payments database. COI discrepancies were identified by
comparing author declaration statements with payments found for the year
of publication and the year prior (24-month period). Result(s): A
total of 144 studies (764 authors) were identified. At least 1 author of
112 studies (78%) had received payments from Intuitive. At least 1 author
of 98 studies (68%) had received an undeclared payment from Intuitive.
Authors who accurately disclosed payments received significantly higher
median payments compared with authors who did not ($16,511 [interquartile
range, $6389-$159,035] vs $1762 [interquartile range, $338-$7500]; P
<.0001). Last authors were significantly more likely to have a COI
discrepancy compared with middle and first authors (P =.018; P =.0015).
 Conclusion(s): Most studies investigating the use of robotic
technology in cardiothoracic surgery did not accurately declare COI with
Intuitive. This study highlights the need for improved accuracy of
reporting industry sponsorship by publishing authors. Copyright ©
2023 The Society of Thoracic Surgeons

<20>
Accession Number
2025418860
Title
Total ischemic time and age as predictors of PCI failure in STEMIs: A
systematic review.
Source
American Journal of the Medical Sciences. (no pagination), 2023. Date of
Publication: 2023.
Author
Kennedy S.R.; Kim Y.; Martin S.; Rose S.J.
Institution
(Kennedy, Kim, Rose) Sacred Heart University, Fairfield, CT, United States
(Martin) Heart and Vascular Institute, Stamford Hospital, Stamford, CT,
United States
(Rose) Department of Research and Discovery, Stamford Health, Stamford,
CT, United States
Publisher
Elsevier B.V.
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 h 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

<21>
Accession Number
2025418653
Title
2022 ACC/AHA guideline for the diagnosis and management of aortic disease:
A report of the American Heart Association/American College of Cardiology
Joint Committee on Clinical Practice Guidelines.
Source
Journal of Thoracic and Cardiovascular Surgery. (no pagination), 2023.
Date of Publication: 2023.
Author
Isselbacher E.M.; Preventza O.; Hamilton Black J.; Augoustides J.G.; Beck
A.W.; Bolen M.A.; Braverman A.C.; Bray B.E.; Brown-Zimmerman M.M.; Chen
E.P.; Collins T.J.; DeAnda A.; Fanola C.L.; Girardi L.N.; Hicks C.W.; Hui
D.S.; Schuyler Jones W.; Kalahasti V.; Kim K.M.; Milewicz D.M.; Oderich
G.S.; Ogbechie L.; Promes S.B.; Ross E.G.; Schermerhorn M.L.; Singleton
Times S.; Tseng E.E.; Wang G.J.; Woo Y.J.; Faxon D.P.; Upchurch G.R.; Aday
A.W.; Azizzadeh A.; Boisen M.; Hawkins B.; Kramer C.M.; Luc J.G.Y.;
MacGillivray T.E.; Malaisrie S.C.; Osteen K.; Patel H.J.; Patel P.J.;
Popescu W.M.; Rodriguez E.; Sorber R.; Tsao P.S.; Santos Volgman A.;
Beckman J.A.; Otto C.M.; O'Gara P.T.; Armbruster A.; Birtcher K.K.; de las
Fuentes L.; Deswal A.; Dixon D.L.; Gorenek B.; Haynes N.; Hernandez A.F.;
Joglar J.A.; Jones W.S.; Mark D.; Mukherjee D.; Palaniappan L.; Piano
M.R.; Rab T.; Spatz E.S.; Tamis-Holland J.E.
Publisher
Elsevier Inc.
Abstract
Aim: The "2022 ACC/AHA Guideline for the Diagnosis and Management of
Aortic Disease" provides recommendations to guide clinicians in the
diagnosis, genetic evaluation and family screening, medical therapy,
endovascular and surgical treatment, and long-term surveillance of
patients with aortic disease across its multiple clinical presentation
subsets (ie, asymptomatic, stable symptomatic, and acute aortic
syndromes). Method(s): A comprehensive literature search was
conducted from January 2021 to April 2021, encompassing studies, reviews,
and other evidence conducted on human subjects that were published in
English from PubMed, EMBASE, the Cochrane Library, CINHL Complete, and
other selected databases relevant to this guideline. Additional relevant
studies, published through June 2022 during the guideline writing process,
were also considered by the writing committee, where appropriate.
Structure: Recommendations from previously published AHA/ACC guidelines on
thoracic aortic disease, peripheral artery disease, and bicuspid aortic
valve disease have been updated with new evidence to guide clinicians. In
addition, new recommendations addressing comprehensive care for patients
with aortic disease have been developed. There is added emphasis on the
role of shared decision making, especially in the management of patients
with aortic disease both before and during pregnancy. The is also an
increased emphasis on the importance of institutional interventional
volume and multidisciplinary aortic team expertise in the care of patients
with aortic disease. Copyright © 2022 American College of
Cardiology Foundation and the American Heart Association, Inc. Published
by Elsevier

<22>
Accession Number
2025404837
Title
Intracranial bleeding and associated outcomes in atrial fibrillation
patients undergoing percutaneous left atrial appendage occlusion: Insights
from National Inpatient Sample 2016-2020.
Source
Heart Rhythm O2. (no pagination), 2023. Date of Publication: 2023.
Author
Khan M.Z.; Shatla I.; Darden D.; Neely J.; Mir T.; Abideen Asad Z.U.;
Agarwal S.; Raina S.; Balla S.; Singh G.D.; Srivatsa U.; Munir M.B.
Institution
(Khan, Balla) Division of Cardiology, West Virginia University Heart and
Vascular Institute, Morgantown, WV, United States
(Shatla) Department of Internal Medicine, Kansas University Medical
Center, Kansas City, KS, United States
(Darden) Division of Cardiology, Kansas City Heart Rhythm Institute,
Overland Park, KS, United States
(Neely, Singh, Srivatsa, Munir) Division of Cardiovascular Medicine,
University of California Davis, Sacramento, CA, United States
(Mir) Department of Medicine, Wayne State University, Detroit, MI, United
States
(Abideen Asad, Agarwal) Department of Internal Medicine, University of
Oklahoma, Oklahoma City, OK, United States
(Raina) Division of Cardiovascular Medicine, Stanford University,
Stanford, CA, United States
Publisher
Elsevier B.V.
Abstract
Background: Percutaneous left atrial appendage occlusion (LAAO) has proved
to be a safer alternative for long-term anticoagulation; however, patients
with a history of intracranial bleeding were excluded from large
randomized clinical trials. Objective(s): The purpose of this study
was to determine outcomes in atrial fibrillation (AF) patients with a
history of intracranial bleeding undergoing percutaneous LAAO.
 Method(s): National Inpatient Sample and International Classification
of Diseases, Tenth Revision, codes were used to identify patients with AF
who underwent LAAO during the years 2016-2020. Patients were stratified
based on a history of intracranial bleeding vs not. The outcomes assessed
in our study included complications, in-hospital mortality, and resource
utilization. Result(s): A total of 89,300 LAAO device implantations
were studied. Approximately 565 implantations (0.6%) occurred in patients
with a history of intracranial bleed. History of intracranial bleeding was
associated with a higher prevalence of overall complications and
in-patient mortality in crude analysis. In the multivariate model adjusted
for potential confounders, intracranial bleeding was found to be
independently associated with in-patient mortality (adjusted odds ratio
[aOR] 4.27; 95% confidence interval [CI] 1.68-10.82); overall
complications (aOR 1.74; 95% CI 1.36-2.24); prolonged length of stay (aOR
2.38; 95% CI 1.95-2.92); and increased cost of hospitalization (aOR 1.28;
95% CI 1.08-1.52) after percutaneous LAAO device implantation.
 Conclusion(s): A history of intracranial bleeding was associated with
adverse outcomes after percutaneous LAAO. These data, if proven in a large
randomized study, can have important clinical consequences in terms of
patient selection for LAAO devices. Copyright © 2023 Heart Rhythm
Society

<23>
Accession Number
2024135454
Title
Intraoperative suggestions to prevent postoperative delirium in patients
undergoing transaortic valvular replacement: a randomized
placebo-controlled trial.
Source
Aging Clinical and Experimental Research. (no pagination), 2023. Date of
Publication: 2023.
Author
Kaufmann C.; Zech N.; Brandt F.; Hilker M.; Debl K.; Creutzenberg M.;
Zeman F.; Graf B.M.; Sinner B.
Institution
(Kaufmann, Zech, Brandt, Creutzenberg, Graf, Sinner) Department of
Anesthesiology, University Hospital Regensburg, Regensburg, Germany
(Hilker) Department of Cardiothoracic Surgery, University Hospital
Regensburg, Regensburg, Germany
(Debl) Department of Cardiology, University Hospital Regensburg,
Regensburg, Germany
(Zeman) Department of Medical Biostatistics, University Hospital
Regensburg, Regensburg, Germany
(Sinner) Department of Anesthesia and Intensive Care, Medical University
Innsbruck, Anichstrasse 35, Innsbruck 6020, Austria
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Background: Postoperative delirium (POD) is a serious complication
following anaesthesia and surgery and significantly influences
postoperative outcome especially in the elderly population. Intraoperative
music and positive suggestions influence postoperative outcomes by
attenuating analgesic demand and increasing patient satisfaction.
 Aim(s): Here, we examined the effect of intraoperative music and
positive suggestions on the development of POD in aged patients undergoing
transcatheter aortic valve replacement (TAVR) procedure under general
anaesthesia. Method(s): For this randomized placebo-controlled study,
eligible patients without cognitive deficit, indicated by a MMSE < 10
points, were anesthetized using remifentanil and sevoflurane. Anaesthetic
depth was guide with bispectral index. An audiotape with positive
suggestions was applied from a MP3 player via headphones. POD, pain and
PONV was assessed. CAM-ICU and Nu-DESC were done twice daily for the first
5 days. Result(s): Of 140 patients 118 patients could be analysed (57
male, 80.6 +/- 5.1 years). POD was diagnosed in 16 patients (12.7%). POD
was significantly more often observed in male (12, 21.1%) than in female
(4, 6.6%, p = 0.02) and in patients with a low MMSE (23.6 +/- 4.5 vs. 26.8
+/- 2.8, p = 0.001). Anaesthetic depth did not influence the incidence of
POD. Intraoperative music and suggestions did not affect the rate of POD,
pain, analgesic requirement or PONV. Discussion(s): In patients
undergoing TAVR male sex and low MMSE scoring are associated with an
increase in POD. Conclusion(s): Intraoperative music and positive
suggestions do not influence the incidence of POD in this patient group.
Study registration: DRKS: 00024444, start of registration: 4.02.202, final
registration: 17.09.2021 Copyright © 2023, The Author(s).

<24>
Accession Number
641723489
Title
Prognostic Value of Pretreatment Serum Carcinoembryonic Antigen Level in
1130 Patients With Non-small Cell Lung Cancer: A Propensity Score Matching
Cohort Study and Cumulative Mate-analysis.
Source
American journal of clinical oncology. (no pagination), 2023. Date of
Publication: 27 Jun 2023.
Author
Li F.; Lv Q.; Zhao S.; Guo T.; Wang G.; Gu C.
Institution
(Li, Zhao, Guo, Gu) Department of Thoracic Surgery, First Affiliated
Hospital of Dalian Medical University, Dalian, Liaoning, China
(Li, Zhao, Guo, Gu) Lung Cancer Diagnosis and Treatment Center, Dalian,
Liaoning, China
(Lv) Department of Oncology, First Affiliated Hospital of Dalian Medical
University, Dalian, Liaoning, China
(Lv, Wang) Graduate school, Dalian Medical University, Dalian, Liaoning,
China
Publisher
NLM (Medline)
Abstract
OBJECTIVES: Carcinoembryonic antigen (CEA) is the most frequently used
tumor marker for non-small cell lung cancer (NSCLC). The current study
aimed to provide the highest-level evidence of the prognostic value of
pretreatment serum CEA level for NSCLC through the appropriate statistical
methodology and large-sample cohorts. METHOD(S): The current
retrospective cohort study with 1130 patients with NSCLC treated by
thoracic surgery with pretreatment serum CEA concentrations above/below 5
ng/mL. Propensity score matching, Kaplan-Miere survival analysis, and Cox
proportional hazard regression models were used to study the intergroup
variance. The overall/disease-free hazard ratios (HRs) of the current
study were combined with the previously published studies using cumulative
meta-analysis to provide the highest-level evidence. RESULT(S):
Intergroup confounding variables were well controlled by propensity score
matching, and the survival differences were statistically significant. The
Cox univariate analysis showed that the overall and disease-free HRs of
the high CEA towards patients with low CEA were 1.595 (95% CI:
1.329-1.863, P = 0.004) and 1.498 (95% CI: 1.271-1.881, P = 0.004). The
HRs of multivariate analysis were adjusted to 1.586 (95% CI: 1.398-1.812,
P = 0.016) and 1.413 (95% CI: 1.22-1.734, P = 0.022) respectively. The
cumulative meta-analysis showed that the cumulative overall HR was in
accord with previous studies, and the cumulative disease-free HR turn to
be statistically significant. CONCLUSION(S): Pretreatment serum CEA
level was an independent influence factor of overall/disease-free survival
of patients with NSCLC, and even for patients with the same pTNM stages or
pathologic stages, it is used for prognosis. Copyright © 2023
Wolters Kluwer Health, Inc. All rights reserved.

<25>
Accession Number
641722021
Title
Neutrophil Gelatinase-Associated Lipocalin Cutoff Value Selection and
Acute Kidney Injury Classification System Determine Phenotype Allocation
and Associated Outcomes.
Source
Annals of laboratory medicine. 43(6) (pp 539-553), 2023. Date of
Publication: 01 Nov 2023.
Author
Albert A.; Radtke S.; Blume L.; Bellomo R.; Haase M.; Stieger P.; Hinkel
U.P.; Braun-Dullaeus R.C.; Albert C.
Institution
(Albert) Department of Nephrology and Endocrinology, Ernst von Bergmann
Hospital, Potsdam, Germany
(Radtke, Blume, Stieger, Braun-Dullaeus, Albert) University Clinic for
Cardiology and Angiology, Otto-von-Guericke University Magdeburg, Germany
(Bellomo) Department of Intensive Care, Austin Hospital, Melbourne,
Australia
(Bellomo) Centre for Integrated Critical Care, University of Melbourne,
Melbourne, Australia
(Haase) Medical Faculty, Otto-von-Guericke University Magdeburg, Germany
(Haase) PotsdamGermany
(Haase) Department of Nephrology and Hypertension, Hannover Medical
School, Hannover, Germany
(Hinkel, Albert) Department of Nephrology, Central Clinic Bad Berka, Bad
Berka, Germany
Publisher
NLM (Medline)
Abstract
Background: We explored the extent to which neutrophil
gelatinase-associated lipocalin (NGAL) cutoff value selection and the
acute kidney injury (AKI) classification system determine clinical
AKI-phenotype allocation and associated outcomes. Method(s): Cutoff
values from ROC curves of data from two independent prospective cardiac
surgery study cohorts (Magdeburg and Berlin, Germany) were used to predict
Kidney Disease: Improving Global Outcome (KDIGO)- or Risk, Injury,
Failure, Loss of kidney function, End-stage (RIFLE)-defined AKI.
Statistical methodologies (maximum Youden index, lowest distance to [0, 1]
in ROC space, sensitivityspecificity) and cutoff values from two NGAL
meta-analyses were evaluated. Associated risks of adverse outcomes (acute
dialysis initiation and in-hospital mortality) were compared.
 Result(s): NGAL cutoff concentrations calculated from ROC curves to
predict AKI varied according to the statistical methodology and AKI
classification system (10.6-159.1 and 16.85-149.3 ng/mL in the Magdeburg
and Berlin cohorts, respectively). Proportions of attributed subclinical
AKI ranged 2%-33.0% and 10.1%-33.1% in the Magdeburg and Berlin cohorts,
respectively. The difference in calculated risk for adverse outcomes
(fraction of odds ratios for AKI-phenotype group differences) varied
considerably when changing the cutoff concentration within the RIFLE or
KDIGO classification (up to 18.33- and 16.11-times risk difference,
respectively) and was even greater when comparing cutoff methodologies
between RIFLE and KDIGO classifications (up to 25.7-times risk
difference). Conclusion(s): NGAL positivity adds prognostic
information regardless of RIFLE or KDIGO classification or cutoff
selection methodology. The risk of adverse events depends on the
methodology of cutoff selection and AKI classification system.

<26>
Accession Number
641715648
Title
Multicentre, randomised, double-blind, parallel controlled trial to
investigate timing of platelet inhibition after coronary artery bypass
grafting: TOP-CABG trial study.
Source
BMJ open. 13(6) (pp e070823), 2023. Date of Publication: 29 Jun 2023.
Author
Yuan X.; Chu Q.; Chen K.; Wang Y.; Zhang L.; Zheng Y.; Hu S.
Institution
(Yuan, Chu, Chen, Hu) State Key Laboratory of Cardiovascular Disease,
Fuwai Hospital, National Centre for Cardiovascular Diseases, Chinese
Academy of Medical Sciences and Peking Union Medical College, Beijing,
China
(Yuan, Chu, Chen, Hu) Department of Cardiac Surgery, Fuwai Hospital,
Chinese Academy of Medical Science and Peking Union Medical College,
Beijing, China
(Wang, Zhang) National Clinical Research Centre of Cardiovascular
Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital,
National Centre for Cardiovascular Diseases, Chinese Academy of Medical
Sciences and Peking Union Medical College, Beijing, China
(Zheng) Department of Pharmacy, Fuwai Hospital, Chinese Academy of Medical
Science and Peking Union Medical College, Beijing, China
Publisher
NLM (Medline)
Abstract
INTRODUCTION: Dual antiplatelet therapy (DAPT), referred to as the
combination of aspirin and P2Y12 receptor antagonist (clopidogrel or
ticagrelor), potentially improves patency of saphenous vein grafts (SVG)
after coronary artery bypass grafting (CABG), while it is further proposed
that DAPT potentially increases bleeding risk. Compared with DAPT,
de-escalated DAPT (De-DAPT) is an effective antiplatelet strategy for
acute coronary syndrome treatment, which significantly reduces the risk of
bleeding without increasing the incidence of major adverse cardiovascular
events. However, insufficient evidence is available to determine the
timing of DAPT after CABG. METHODS AND ANALYSIS: ETHICS AND DISSEMINATION:
The Ethics Committee in Fuwai hospital approved this study (2022-1774).
Fifteen centres agreed to participate the TOP-CABG trial, and the study
has been approved in these 15 centres by whose ethics committee. The
results of the trial will be submitted for publication in a peer-reviewed
journal. TRIAL REGISTRATION NUMBER: NCT05380063. 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.

<27>
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

<28>
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

<29>
Accession Number
2021979404
Title
Gut microbiota-associated metabolites and risk of ischemic stroke in
REGARDS.
Source
Journal of Cerebral Blood Flow and Metabolism. 43(7) (pp 1089-1098), 2023.
Date of Publication: July 2023.
Author
Ament Z.; Patki A.; Bhave V.M.; Chaudhary N.S.; Garcia Guarniz A.-L.;
Kijpaisalratana N.; Judd S.E.; Cushman M.; Long D.L.; Irvin M.R.; Kimberly
W.T.
Institution
(Ament, Kimberly) Center for Genomic Medicine, Massachusetts General
Hospital, Harvard Medical School, Boston, MA, United States
(Ament, Garcia Guarniz, Kijpaisalratana, Kimberly) Department of
Neurology, Massachusetts General Hospital, Boston, MA, United States
(Patki, Chaudhary, Irvin) Department of Epidemiology, School of Public
Health, University of Alabama at Birmingham, Birmingham, AL, United States
(Bhave) Harvard Medical School, Boston, MA, United States
(Chaudhary) Department of Epidemiology, Human Genetics, and Environmental
Sciences, School of Public Health, Human Genetics Center, University of
Texas Health Science Center at Houston, Houston, TX, United States
(Kijpaisalratana) Division of Neurology, Department of Medicine and
Division of Academic Affairs, Faculty of Medicine, Chulalongkorn
University, Bangkok, Thailand
(Judd, Long) Department of Biostatistics, School of Public Health,
University of Alabama at Birmingham, Birmingham, AL, United States
(Cushman) Department of Medicine, Larner College of Medicine at the
University of Vermont, Burlington, VT, United States
Publisher
SAGE Publications Ltd
Abstract
Several metabolite markers are independently associated with incident
ischemic stroke. However, prior studies have not accounted for
intercorrelated metabolite networks. We used exploratory factor analysis
(EFA) to determine if metabolite factors were associated with incident
ischemic stroke. Metabolites (n = 162) were measured in a case-control
cohort nested in the REasons for Geographic and Racial Differences in
Stroke (REGARDS) study, which included 1,075 ischemic stroke cases and 968
random cohort participants. Cox models were adjusted for age, gender,
race, and age-race interaction (base model) and further adjusted for the
Framingham stroke risk factors (fully adjusted model). EFA identified
fifteen metabolite factors, each representing a well-defined metabolic
pathway. Of these, factor 3, a gut microbiome metabolism factor, was
associated with an increased risk of stroke in the base (hazard ratio per
one-unit standard deviation, HR = 1.23; 95%CI = 1.15-1.31; P = 1.98 x
10-10) and fully adjusted models (HR = 1.13; 95%CI = 1.06-1.21;
P = 4.49 x 10-4). The highest tertile had a 45% increased risk
relative to the lowest (HR = 1.45; 95%CI = 1.25-1.70; P = 2.24 x
10-6). Factor 3 was also associated with the Southern diet
pattern, a dietary pattern previously linked to increased stroke risk in
REGARDS (beta = 0.11; 95%CI = 0.03-0.18; P = 8.75 x 10-3).
These findings highlight the role of diet and gut microbial metabolism in
relation to incident ischemic stroke. Copyright © The Author(s)
2023.

<30>
Accession Number
2018968676
Title
Statins and Mortality of Patients After Transcatheter Aortic Valve
Implantation: A Systematic Review and Meta-analysis.
Source
Angiology. 74(7) (pp 611-623), 2023. Date of Publication: August 2023.
Author
Yarahmadi P.; Kabiri A.; Forouzannia S.M.; Yousefifard M.
Institution
(Yarahmadi, Forouzannia) School of Medicine, Tehran University of Medical
Sciences, Tehran, Iran, Islamic Republic of
(Kabiri) School of Medicine, Iran University of Medical Sciences, Tehran,
Iran, Islamic Republic of
(Yousefifard) Physiology Research Center, Iran University of Medical
Sciences, Tehran, Iran, Islamic Republic of
Publisher
SAGE Publications Inc.
Abstract
While TAVI is widely used, optimal medical therapy to reduce the mortality
rate after transcatheter aortic valve implantation (TAVI) is still
unclear. We performed a systematic review and meta-analysis to evaluate
the impact of statins on mortality following TAVI. Present systematic
review of the literature was performed using Medline, Embase, Scopus, and
Web of Science; all studies reported all-cause mortality in patients who
underwent TAVI and received or did not receive statin therapy. Data were
analyzed using random-effects models. Seventeen articles (21 380 patients)
were included in the meta-analysis. Statin therapy was associated with a
reduction of all-cause mortality (Hazard ratio [HR] =.78, 95% Confidence
interval [CI].68-.89, P <.001). Moderate between-study heterogeneity was
observed (I2 = 45.2). High-intensity statin therapy was more
effective than low or moderate intensity statin therapy in reduction of
all-cause mortality (Risk ratio [RR] =.62, 95% CI 0.45-.85, P =.003,
I2 =.0). Statin therapy could reduce the mid-term all-cause
mortality rate following TAVI. However, all included studies were
observational and, therefore, randomized controlled trials are still
needed to assess the effect of statin therapy on mortality after
TAVI. Copyright © The Author(s) 2022.

<31>
Accession Number
2024791293
Title
Phase angle of bioimpedance as a marker of inflammation in cardiovascular
diseases: A systematic review.
Source
Nutrition. 112 (no pagination), 2023. Article Number: 112064. Date of
Publication: August 2023.
Author
Ceolin J.; de Borba E.L.; Mundstock E.; de Oliveira J.R.; Mattiello R.;
Bodanese L.C.
Institution
(Ceolin, de Borba, Mundstock, de Oliveira, Bodanese) Pontificia
Universidade Catolica do Rio Grande do Sul, PUCRS, Rio Grande do Sul,
Porto Alegre, Brazil
(Mattiello) Universidade Federal do Rio Grande do Sul, UFRGS, Rio Grande
do Sul, Porto Alegre, Brazil
Publisher
Elsevier Inc.
Abstract
Objective: The aim of this systematic review was to investigate whether
phase angle (PhA) of bioelectrical impedance is associated with
inflammatory markers in cardiovascular diseases (CVDs). Method(s): A
search was performed in the following databases: MEDLINE, EMBASE, Cochrane
Central Register of Controlled Trials (CENTRAL), Latin American Caribbean
Health Sciences Literature (LILACS), Cumulative Index to Nursing and
Allied Health Literature (CINAHL), Web of Science and Scopus; and in the
gray literature up to January 2022. Studies with individuals with CVDs
were included, to evaluate the association between PhA and the
inflammatory markers interleukin (IL)-6, IL-10, IL-18, IL-1beta, IL-33,
tumor necrosis factor (TNF)-alpha, C-reactive protein (CRP), toll-like
receptor (TLR) 2, TLR 4, nuclear factor kappaB, pathogen-associated
molecular pattern molecules, lipopolysaccharides,
interferon-gamma-inducing factor, and JAK STAT. Result(s): We
identified 755 articles and, after an eligibility analysis, 5 studies were
included. The inflammatory markers investigated in the studies were CRP,
TNF-alpha, and IL-33. In patients with CVDs, PhA was negatively associated
with CRP and TNF-alpha in 80% and 100% of the studies, respectively.
 Conclusion(s): The present results suggested that PhA is inversely
associated with inflammatory markers in individuals with CVDs, and its
clinical use is encouraged for better therapeutic planning. Copyright
© 2023 Elsevier Inc.

<32>
Accession Number
2024307319
Title
Effects of Dexmedetomidine Combined with Sufentanil on Hemodynamics,
Myocardial Injury and Pulmonary Function in Patients Undergoing Heart
Valve Replacement under Cardiopulmonary Bypass.
Source
Latin American Journal of Pharmacy. 42(1) (pp 13-18), 2023. Date of
Publication: 2023.
Author
Yang C.; Liang X.; Zheng Q.; Xing Z.
Institution
(Yang, Liang, Zheng, Xing) Western Hospital of Affiliated Hospital of
Yangzhou University, Yangzhou 225009, China
Publisher
Colegio de Farmaceuticos de la Provincia de Buenos Aires
Abstract
SUMMARY. This work explored the effects of dexmedetomidine combined with
sufentanil on hemodynamics, myocardial injury and pulmonary function in
patients undergoing heart valve replacement (HVR) under cardiopulmonary
bypass (CPB). A total of 92 patients with elective HVR under CPB were
randomly divided into control group (n = 46) and observation group (n =
46). The observation group was treated with dexmedetomidine combined with
sufentanil before anesthesia induction and during and after surgery, while
the control group was only treated with sufentanil. Results showed that,
the postoperative propofol dosage in observation group was significantly
lower than those in control group (p < 0.05). At the time point after
intubation, cutting skin, splitting sternum, before CPB and 10 min after
CPB shutdown, the heart rate and mean arterial pressure in observation
group WERE significantly lower than those in control group (p < 0.05). At
the time point 12 h after CPB shutdown, compared with control group, in
observation group the serum cardiac troponin I and creatine kinase
isoenzyme levels were significantly decreased (p < 0.05), the arterial
partial pressure of oxygen and oxygenation index were significantly
increased (p < 0.05), and the arterial partial pressure of carbondioxide
was significantly decreased (p < 0.05). In conclusion, for patients
undergoing HVR under CPB, dexmedetomidine combined with sufentanil has a
definite analgesic effect, and it is conducive to maintaining the
hemodynamic stability, reducing the myocardial injury, and improving the
pulmonary function. Copyright © 2023, Colegio de Farmaceuticos de
la Provincia de Buenos Aires. All rights reserved.

<33>
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.

<34>
Accession Number
2023816661
Title
Esketamine opioid-free intravenous anesthesia versus opioid intravenous
anesthesia in spontaneous ventilation video-assisted thoracic surgery: a
randomized controlled trial.
Source
Frontiers in Oncology. 13 (no pagination), 2023. Article Number: 1145953.
Date of Publication: 2023.
Author
Fan Q.; Luo J.; Zhou Q.; Zhang Y.; Zhang X.; Li J.; Jiang L.; Lan L.
Institution
(Fan, Luo, Zhang, Zhang, Li, Lan) Department of Anesthesia, The First
Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
(Zhou) Department of Medical Imaging, Guangdong Second Provincial General
Hospital, Guangzhou, China
(Jiang) National Clinical Research Center for Respiratory Disease,
Departments of Thoracic Surgery, The First Affiliated Hospital of
Guangzhou Medical University, Guangzhou, China
Publisher
Frontiers Media S.A.
Abstract
Background: Opioid-free anesthesia (OFA) provides adequate analgesia and
can reduce postoperative opioid consumption, but its efficacy in
spontaneous ventilation video-assisted thoracic surgery (SV-VATS) has not
been demonstrated. We aimed to investigate the hypothesis that OFA could
provide the same perioperative pain control as opioid anesthesia (OA),
maintain safe and stable respiration and hemodynamics during surgery, and
improve postoperative recovery. Method(s): Sixty eligible patients
(OFA group: n=30; OA group: n=30) treated between September 15, 2022, and
December 15, 2022, at The First Hospital of Guangzhou Medical University
were included. They were randomized to receive standard balanced OFA with
esketamine or OA with remifentanil combined with sufentanil. The primary
outcome was the pain numeric rating score (NRS) at postoperative 24 h, and
the secondary outcomes were intraoperative respiratory and hemodynamic
data, opioid consumption, vasoactive drug dosage, and recovery in the
post-anesthesia care unit and ward. Result(s): There was no
significant difference in the postoperative pain scores and recovery
quality between the two groups. The OFA group had a significantly lower
dose of phenylephrine (P=0.001) and a lower incidence of hypotension
(P=0.004) during surgery. The OFA group resumed spontaneous respiration
faster (P<0.001) and had a higher quality of lung collapse (P=0.02).
However, the total doses of propofol and dexmetomidine were higher (P=0.03
and P=0.02), and the time to consciousness was longer (P=0.039) in the OFA
group. Conclusion(s): OFA provides the same level of postoperative
pain control as OA, but it is more advantageous in maintaining circulatory
and respiratory stability and improving the quality of pulmonary collapse
in SV-VATS. Copyright © 2023 Fan, Luo, Zhou, Zhang, Zhang, Li,
Jiang and Lan.

<35>
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).

<36>
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.

<37>
Accession Number
2024544734
Title
Current State of Platelet-rich Plasma in the Treatment of Rheumatic
Disease: A Retrospective Review of the Literature.
Source
Current Rheumatology Reviews. 19(4) (pp 400-407), 2023. Date of
Publication: 2023.
Author
Jacobs A.; Elghawy O.; Baruqui D.L.; Elghawy A.A.
Institution
(Jacobs, Baruqui) Mount Sinai Medical Center, Miami Beach, FL, United
States
(Elghawy) University of Virginia School of Medicine, Charlottesville, VA,
United States
(Elghawy) Department of Rheumatologic and Immunologic Disease, Cleveland
Clinic, Cleveland, OH, United States
Publisher
Bentham Science Publishers
Abstract
Introduction: Rheumatic diseases are a spectrum of autoimmune or
inflammatory diseases that cause damage to the musculoskeletal system as
well as vital organs, such as the heart, lungs, kidneys, and central
nervous system. Method(s): The study of rheumatic disease has made
great progress in the understanding and management of these conditions in
the last few decades using disease-modifying antirheumatic drugs and
synthesized biological immunomodulating therapies. However, one potential
treatment that has not been well investigated in rheumatic disease is
platelet-rich plasma (PRP). PRP is proposed to facilitate the healing of
injured tendons and ligaments through a variety of mechanisms, including
mitogenesis, angiogenesis and macrophage activation via cytokine release,
although its exact mechanism is unclear. Result(s): There has been a
great deal of work in determining the exact preparation method and
composition of PRP for regenerative purposes in orthopedic surgery, sports
medicine, dentistry, cardiac surgery, pediatric surgery, gynecology,
urology, plastic surgery, ophthalmology, and dermatology. Despite this,
there is a paucity of research on the impact of PRP on rheumatic disease.
 Conclusion(s): This study aims to summarize and evaluate the current
research concerning the use of PRP in rheumatic disease. Copyright
© 2023 Bentham Science Publishers.

<38>
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.

<39>
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.

<40>
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

<41>
Accession Number
2023353753
Title
Current status of transcatheter mitral valve replacement: systematic
review and meta-analysis.
Source
Frontiers in Cardiovascular Medicine. 10 (no pagination), 2023. Article
Number: 1130212. Date of Publication: 2023.
Author
Alperi A.; Avanzas P.; Leon V.; Silva I.; Hernandez-Vaquero D.; Almendarez
M.; Alvarez R.; Fernandez F.; Moris C.; Pascual I.
Institution
(Alperi, Avanzas, Leon, Silva, Hernandez-Vaquero, Almendarez, Alvarez,
Fernandez, Moris, Pascual) Department of Cardiology, Heart Area, Hospital
Universitario Central de Asturias, Oviedo, Spain
(Alperi, Avanzas, Hernandez-Vaquero, Almendarez, Moris, Pascual) Health
Research Institute of Asturias (Instituto de Investigacion Sanitaria del
Principado de Asturias), Oviedo, Spain
(Avanzas, Hernandez-Vaquero, Moris, Pascual) Department of Medicine,
Faculty of Medicine, University of Oviedo, Oviedo, Spain
Publisher
Frontiers Media S.A.
Abstract
Introduction: Mitral Regurgitation (MR) has a strong impact on quality of
life and on mid-term survival. Transcatheter mitral valve replacement
(TMVR) is rapidly expanding and a growing number of studies have been
published recently. Method(s): A systematic review of studies
reporting on clinical data for patients with symptomatic severe MR
undergoing TMVR was performed. Early- and mid-term outcomes (clinical and
echocardiographic) were evaluated. Overall weighted means and rates were
calculated. Risk ratios or mean differences were calculated for pre- and
post-procedural comparisons. Result(s): A total of 12 studies and 347
patients who underwent TMVR with devices clinically available or under
clinical evaluation were included. Thirty-day mortality, stroke and major
bleeding rates were 8.4%, 2.6%, and 15.6%, respectively. Pooled
random-effects demonstrated a significant reduction of >= grade 3+ MR (RR:
0.05; 95% CI: 0.02-0.11; p < 0.001) and in the rates of patients in NYHA
class 3-4 after the intervention (RR: 0.27; 95% CI: 0.22-0.34; p < 0.001).
Additionally, the pooled fixed-effect mean difference for quality of life
based on the KCCQ score yielded an improvement in 12.9 points (95%
CI:7.4-18.4, p < 0.001), and exercise capacity improved by a pooled
fixed-effect mean difference of 56.8 meters in the 6-minute walk test (95%
CI 32.2-81.3, p < 0.001). Conclusion(s): Among 12 studies and 347
patients comprising the updated evidence with current TMVR systems there
was a statistically significant reduction in >= grade 3+ MR and in the
number of patients exhibiting poor functional class (NYHA 3 or 4) after
the intervention. Overall rate of major bleeding was the main shortcoming
of this technique. Copyright 2023 Alperi, Avanzas, Leon, Silva,
Hernandez-Vaquero, Almendarez, Alvarez, Fernandez, Moris and Pascual.

<42>
Accession Number
2023301967
Title
Effect of High-Dose Selenium on Postoperative Organ Dysfunction and
Mortality in Cardiac Surgery Patients: The SUSTAIN CSX Randomized Clinical
Trial.
Source
JAMA Surgery. 158(3) (pp 235-244), 2023. Date of Publication: 08 Mar 2023.
Author
Stoppe C.; McDonald B.; Meybohm P.; Christopher K.B.; Fremes S.; Whitlock
R.; Mohammadi S.; Kalavrouziotis D.; Elke G.; Rossaint R.; Helmer P.;
Zacharowski K.; Gunther U.; Parotto M.; Niemann B.; Boning A.; Mazer C.D.;
Jones P.M.; Ferner M.; Lamarche Y.; Lamontagne F.; Liakopoulos O.J.;
Cameron M.; Muller M.; Zarbock A.; Wittmann M.; Goetzenich A.; Kilger E.;
Schomburg L.; Day A.G.; Heyland D.K.
Institution
(Stoppe, McDonald) University of Ottawa Heart Institute, Ottawa, ON,
Canada
(Meybohm, Helmer) Department of Anaesthesiology Intensive Care, Emergency,
and Pain Medicine, University Hospital Wuerzburg, Wuerzburg, Germany
(Christopher) Division of Renal Medicine, Brigham and Women's Hospital,
Boston, MA, United States
(Fremes) Sunnybrook Research Institute, Toronto, ON, Canada
(Whitlock) Hamilton Health Sciences, Hamilton, ON, Canada
(Mohammadi, Kalavrouziotis) Quebec Heart and Lung Institute, Laval
University, Quebec City, QC, Canada
(Elke) University Hospital Schleswig-Holstein, Kiel, Germany
(Rossaint, Goetzenich) University Hospital Aachen, Aachen, Germany
(Zacharowski) University Hospital Frankfurt, Frankfurt, Germany
(Gunther) Oldenburg Clinic, University of Oldenburg, Oldenburg, Germany
(Parotto) Department of Anesthesiology and Pain Medicine, Toronto General
Hospital, Toronto, ON, Canada
(Parotto) Division of Critical Care Medicine, Department of Anesthesia,
Interdepartmental University of Toronto, Toronto, ON, Canada
(Niemann, Boning) University Hospital of Giessen, Giessen, Germany
(Mazer) Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto,
ON, Canada
(Mazer) Department of Anesthesiology and Pain Medicine, Department of
Physiology, University of Toronto, Toronto, ON, Canada
(Jones) London Health Sciences Centre, London, ON, Canada
(Ferner) University Medical Center, Johannes Gutenberg-University Mainz,
Mainz, Germany
(Lamarche) Hopital du Sacre-Coeur de Montreal, Montreal, QC, Canada
(Lamarche) Montreal Heart Institute, Montreal, QC, Canada
(Lamontagne) Hopital Fleurimont (CHUS), Sherbrooke, QC, Canada
(Liakopoulos) Department of Cardiothoracic Surgery, Heart Center,
University Hospital of Cologne, Cologne, Germany
(Cameron) Jewish General Hospital, Montreal, QC, Canada
(Muller) University Heart Center Freiburg Bad Krozingen, Bad Krozingen,
Germany
(Zarbock) University Hospital Munster, Munster, Germany
(Wittmann) University Hospital Bonn, Bonn, Germany
(Goetzenich) Abiomed Europe GmbH, Aachen, Germany
(Kilger) Ludwig Maximilian University of Munich, Munich, Germany
(Schomburg) Institute for Experimental Endocrinology,
Charite-Universitatsmedizin Berlin, Berlin, Germany
(Day, Heyland) Clinical Evaluation Research Unit, Queen's University,
Kingston, ON, Canada
(Heyland) Department of Critical Care Medicine, Queen's University,
Kingston, ON, Canada
(Stoppe) Department of Anaesthesiology, Intensive Care, Emergency, and
Pain Medicine, University Hospital Wuerzburg, Oberduerrbacher Str. 6,
Wuerzburg 97080, Germany
Publisher
American Medical Association
Abstract
Importance: Selenium contributes to antioxidative, anti-inflammatory, and
immunomodulatory pathways, which may improve outcomes in patients at high
risk of organ dysfunctions after cardiac surgery. Objective(s): To
assess the ability of high-dose intravenous sodium selenite treatment to
reduce postoperative organ dysfunction and mortality in cardiac surgery
patients. Design, Setting, and Participant(s): This multicenter,
randomized, double-blind, placebo-controlled trial took place at 23 sites
in Germany and Canada from January 2015 to January 2021. Adult cardiac
surgery patients with a European System for Cardiac Operative Risk
Evaluation II score-predicted mortality of 5% or more or planned combined
surgical procedures were randomized. Intervention(s): Patients were
randomly assigned (1:1) by a web-based system to receive either
perioperative intravenous high-dose selenium supplementation of 2000 mug/L
of sodium selenite prior to cardiopulmonary bypass, 2000 mug/L immediately
postoperatively, and 1000 mug/L each day in intensive care for a maximum
of 10 days or placebo. Main Outcomes and Measures: The primary end
point was a composite of the numbers of days alive and free from organ
dysfunction during the first 30 days following cardiac surgery.
 Result(s): A total of 1416 adult cardiac surgery patients were
analyzed (mean [SD] age, 68.2 [10.4] years; 1043 [74.8%] male). The median
(IQR) predicted 30-day mortality by European System for Cardiac Operative
Risk Evaluation II score was 8.7% (5.6%-14.9%), and most patients had
combined coronary revascularization and valvular procedures. Selenium did
not increase the number of persistent organ dysfunction-free and alive
days over the first 30 postoperative days (median [IQR], 29 [28-30] vs 29
[28-30]; P =.45). The 30-day mortality rates were 4.2% in the selenium and
5.0% in the placebo group (odds ratio, 0.82; 95% CI, 0.50-1.36; P =.44).
Safety outcomes did not differ between the groups. Conclusions and
Relevance: In high-risk cardiac surgery patients, perioperative
administration of high-dose intravenous sodium selenite did not reduce
morbidity or mortality. The present data do not support the routine
perioperative use of selenium for patients undergoing cardiac surgery.
Trial Registration: ClinicalTrials.gov Identifier:
NCT02002247. Copyright © 2023 American Medical Association. All
rights reserved.

<43>
Accession Number
2023301965
Title
Cost-effectiveness of Fibrinogen Concentrate vs Cryoprecipitate for
Treating Acquired Hypofibrinogenemia in Bleeding Adult Cardiac Surgical
Patients.
Source
JAMA Surgery. 158(3) (pp 245-253), 2023. Date of Publication: 08 Mar 2023.
Author
Abrahamyan L.; Tomlinson G.; Callum J.; Carcone S.; Grewal D.; Bartoszko
J.; Krahn M.; Karkouti K.
Institution
(Abrahamyan, Tomlinson, Carcone, Krahn, Karkouti) Toronto General Hospital
Research Institute, University Health Network, 10th Floor Eaton North,
Room 237, 200 Elizabeth St, Toronto, ON M5G 2C4, Canada
(Abrahamyan, Carcone, Krahn) Toronto Health Economics and Technology
Assessment (THETA) Collaborative, University Health Network, Toronto, ON,
Canada
(Abrahamyan, Tomlinson, Bartoszko, Krahn, Karkouti) Institute of Health
Policy Management and Evaluation, University of Toronto, Toronto, ON,
Canada
(Tomlinson) Biostatistics Research Unit, University Health Network,
Toronto, ON, Canada
(Callum) Department of Pathology and Molecular Medicine, Kingston Health
Sciences Centre, Queen's University, Kingston, ON, Canada
(Grewal, Bartoszko, Karkouti) Department of Anesthesia and Pain
Management, Sinai Health System, Women's College Hospital, University
Health Network, Toronto, ON, Canada
(Bartoszko, Karkouti) Department of Anesthesiology and Pain Medicine,
University of Toronto, Toronto, ON, Canada
(Bartoszko, Karkouti) Peter Munk Cardiac Centre, University Health
Network, Toronto, ON, Canada
Publisher
American Medical Association
Abstract
Importance: Excessive bleeding requiring fibrinogen replacement is a
serious complication of cardiac surgery. However, the relative
cost-effectiveness of the 2 available therapies - fibrinogen concentrate
and cryoprecipitate - is unknown. Objective(s): To determine
cost-effectiveness of fibrinogen concentrate vs cryoprecipitate for
managing active bleeding in adult patients who underwent cardiac surgery.
 Design, Setting, and Participant(s): A within-trial economic
evaluation of the Fibrinogen Replenishment in Surgery (FIBERS) randomized
clinical trial (February 2017 to November 2018) that took place at 4
hospitals based in Ontario, Canada, hospitals examined all in-hospital
resource utilization costs and allogeneic blood product (ABP) transfusion
costs incurred within 28 days of surgery. Participants included a subset
of 495 adult patients from the FIBERS trial who underwent cardiac surgery
and developed active bleeding and acquired hypofibrinogenemia requiring
fibrinogen replacement. Intervention(s): Fibrinogen concentrate (4 g
per dose) or cryoprecipitate (10 units per dose) randomized (1:1) up to 24
hours postcardiopulmonary bypass. Main Outcomes and Measures:
Effectiveness outcomes included number of ABPs administered within 24
hours and 7 days of cardiopulmonary bypass. ABP transfusion (7-day) and
in-hospital resource utilization (28-day) costs were evaluated and a
multivariable net benefit regression model built for the full sample and
predefined subgroups. Result(s): Patient level costs for 495 patients
were evaluated (mean [SD] age 59.2 [15.4] years and 69.3% male.)
Consistent with FIBERS, ABP transfusions and adverse events were similar
in both treatment groups. Median (IQR) total 7-day ABP cost was CAD $2280
(US dollars [USD] $1697) (CAD $930 [USD $692]-CAD $4970 [USD $3701]) in
the fibrinogen concentrate group and CAD $2770 (USD $1690) (IQR, CAD $1140
[USD $849]-CAD $5000 [USD $3723]) in the cryoprecipitate group. Median
(interquartile range) total 28-day cost was CAD $38180 (USD $28431) $(IQR,
CAD $26350 [USD $19622]-CAD $65080 [USD $48463]) in the fibrinogen
concentrate group and CAD $38790 (USD $28886) (IQR, CAD $26180 [USD
$19495]-CAD $70380 [USD $52409]) in the cryoprecipitate group. After
exclusion of patients who were critically ill before surgery (11%) due to
substantial variability in costs, the incremental net benefit of
fibrinogen concentrate vs cryoprecipitate was positive (probability of
being cost-effective 86% and 97% at $0 and CAD $2000 (USD $1489)
willingness-to-pay, respectively). Net benefit was highly uncertain for
nonelective and patients with critical illness. Conclusions and
Relevance: Fibrinogen concentrate is cost-effective when compared with
cryoprecipitate in most bleeding adult patients who underwent cardiac
surgery with acquired hypofibrinogenemia requiring fibrinogen replacement.
The generalizability of these findings outside the Canadian health system
needs to be verified. Copyright © 2023 American Medical
Association. All rights reserved.

<44>
Accession Number
2023258187
Title
A Systematic Review of Periprocedural Risk Prediction Scores in Chronic
Total Occlusion Percutaneous Coronary Intervention.
Source
American Journal of Cardiology. 193 (pp 118-125), 2023. Date of
Publication: 15 Apr 2023.
Author
Simsek B.; Rempakos A.; Kostantinis S.; Karacsonyi J.; Rangan B.V.;
Mastrodemos O.C.; Patel U.A.; Allana S.; Azzalini L.; Kearney K.E.; Hirai
T.; Sandoval Y.; Burke M.N.; Brilakis E.S.
Institution
(Simsek, Rempakos, Kostantinis, Karacsonyi, Rangan, Mastrodemos, Allana,
Sandoval, Burke, Brilakis) Center for Coronary Artery Disease, Minneapolis
Heart Institute and Minneapolis Heart Institute Foundation, Minneapolis,
MN, United States
(Patel) School of Medicine, Pramukhswami Medical College, Gujarat,
Karamsad, India
(Azzalini, Kearney) Division of Cardiology, Department of Medicine,
University of Washington, Seattle, WA, United States
(Hirai) Division of Cardiovascular Medicine, University of Missouri,
Columbia, Missouri, United States
Publisher
Elsevier Inc.
Abstract
Chronic total occlusion (CTO) percutaneous coronary intervention (PCI) is
associated with high incidence of complications. We queried PubMed and the
Cochrane Library (last search: October 26, 2022) for CTO PCI-specific
periprocedural complication risk scores. We identified 8 CTO PCI-specific
risk scores: (1) Angiographic coronary artery perforation (OPEN-CLEAN
[Outcomes, Patient Health Status, and Efficiency iN (OPEN) Chronic Total
Occlusion (CTO) Hybrid Procedures - CABG, Length (occlusion), EF <50%,
Age, CalcificatioN] perforation, c-statistic 0.75): previous coronary
artery bypass graft surgery, occlusion length 20 to 60 mm or >=60 mm, left
ventricular ejection fraction (LVEF) <50%, age 50 to 70 years or >=70
years, heavy calcification. (2) Major adverse cardiovascular events (MACE)
(PROGRESS-CTO complication, c-statistic 0.76): age >65 years, lesion
length >=23 mm, retrograde strategy, and (3) MACE (PROGRESS-CTO MACE,
c-statistic 0.74): age >=65 years, female gender, moderate/severe
calcification, blunt/no stump, anterograde dissection and re-entry (ADR)
or retrograde strategy. (4) All-cause mortality (PROGRESS-CTO mortality,
c-statistic 0.80): age >=65, moderate/severe calcification, LVEF <=45%,
ADR or retrograde strategy. (5) Perforation requiring pericardiocentesis
(PROGRESS-CTO pericardiocentesis, c-statistic 0.78): age >=65 years,
moderate/severe calcification, female gender, ADR or retrograde strategy.
(6) Acute myocardial infarction (PROGRESS-CTO acute myocardial infarction,
c-statistic 0.72): previous coronary artery bypass graft surgery, atrial
fibrillation, blunt/no stump. (7) Perforation requiring any treatment
(PROGRESS-CTO perforation, c-statistic 0.74): age >=65 years,
moderate/severe calcification, blunt/no stump, ADR, or retrograde
strategy. (8) Contrast-induced acute kidney injury (c-statistic 0.84): age
>=75, LVEF <40%, serum creatinine >1.5 mg/100 ml, serum albumin <=30,
30<albumin<=40 or >40 g/L. There are 8 CTO PCI periprocedural risk scores
that may facilitate risk assessment and procedural planning in patients
who underwent CTO PCI. Copyright © 2023 Elsevier Inc.

<45>
Accession Number
2013264659
Title
Comparison of SYNTAX score strata effects of percutaneous and surgical
revascularization trials: A meta-analysis.
Source
Journal of Thoracic and Cardiovascular Surgery. 165(4) (pp 1405-1413.e13),
2023. Date of Publication: April 2023.
Author
Gaudino M.; Hameed I.; Di Franco A.; Naik A.; Demetres M.; Biondi-Zoccai
G.; Bangalore S.
Institution
(Gaudino, Hameed, Di Franco, Naik) Department of Cardiothoracic Surgery,
Weill Cornell Medicine, New York, NY, United States
(Hameed) Section of Cardiac Surgery, Yale University School of Medicine,
New Haven, Conn, United States
(Demetres) Samuel J. Wood Library and C.V. Starr Biomedical Information
Center, Weill Cornell Medicine, New York, NY, United States
(Biondi-Zoccai) Department of Medico-Surgical Sciences and
Biotechnologies, Sapienza University of Rome, Rome, Italy
(Biondi-Zoccai) Mediterranea Cardiocentro, Napoli, Italy
(Bangalore) New York University Grossman School of Medicine, New York, New
York, NY, United States
Publisher
Elsevier Inc.
Abstract
Objectives: The evidence supporting the use of the Synergy Between
Percutaneous Coronary Intervention With TAXUS and Cardiac Surgery (SYNTAX)
score for risk stratification is controversial. We performed a systematic
review and meta-analysis of all the randomized controlled trials comparing
percutaneous coronary intervention versus coronary artery bypass grafting
that reported their outcomes stratified by SYNTAX score, focusing on
between-strata comparisons. Method(s): A systematic review of
MEDLINE, EMBASE, Cochrane Library databases was performed. Incidence rate
ratios were pooled with a random effect model. Between-group statistical
heterogeneity according to accepted SYNTAX score tertiles was computed in
the main analysis. Ratios of incidence rate ratios were computed to
appraise between-strata effect, as sensitivity analysis. Primary and
secondary outcomes were major adverse cardiac and cerebrovascular events
and all-cause mortality, respectively. Separate sub-analyses were
performed for left main and multivessel disease. Result(s): From 425
citations, 6 trials were eventually included (8269 patients [4134
percutaneous coronary interventions, 4135 coronary artery bypass
graftings]; mean follow-up: 6.2 years [range: 3.8-10]). Overall,
percutaneous coronary intervention was associated with a significant
increase in major adverse cardiac and cerebrovascular events (incidence
rate ratio, 1.39, 95% confidence interval, 1.27-1.51) and nonsignificant
increase in all-cause mortality (incidence rate ratio, 1.17, 95%
confidence interval, 0.98-1.40). There was no significant statistical
heterogeneity of treatment effect by SYNTAX score for major adverse
cardiac and cerebrovascular events or mortality (P = .40 and P = .34,
respectively). Results were consistent also for patients with left main
and multivessel disease (major adverse cardiac and cerebrovascular events:
P = .85 in left main, P = .78 in multivessel disease 0.78; mortality: P =
.12 in left main; P = .34 in multivessel disease). Results of analysis
based on ratios of incidence rate ratios were consistent with the main
analysis. Conclusion(s): No significant association was found between
SYNTAX score and the comparative effectiveness of percutaneous coronary
intervention and coronary artery bypass grafting. These findings have
implications for clinical practice, future guidelines, and the design of
percutaneous coronary intervention versus coronary artery bypass grafting
trials. Copyright © 2021 The American Association for Thoracic
Surgery

<46>
Accession Number
2024043072
Title
Dapagliflozin for inpatient hyperglycemia in cardiac surgery patients with
type 2 diabetes: randomised controlled trial (Dapa-Hospital trial).
Source
Acta Diabetologica. (no pagination), 2023. Date of Publication: 2023.
Author
Kuchay M.S.; Khatana P.; Mishra M.; Surendran P.; Kaur P.; Wasir J.S.;
Gill H.K.; Singh A.; Jain R.; Kohli C.; Bakshi G.; Radhika V.; Saheer S.;
Singh M.K.; Mishra S.K.
Institution
(Kuchay, Khatana, Mishra, Kaur, Wasir, Gill, Singh, Jain, Kohli, Bakshi,
Radhika, Saheer, Mishra) Division of Endocrinology and Diabetes,
Medanta-The Medicity Hospital, Haryana, Gurugram 122001, India
(Surendran) ICMR - National Institute of Epidemiology, Tamil Nadu,
Ayapakkam, Ambattur, Chennai 600077, India
(Singh) Department of Clinical Research and Studies, Medanta-The Medicity
Hospital, Haryana, Gurugram 122001, India
Publisher
Springer-Verlag Italia s.r.l.
Abstract
Aims: To examine the efficacy and safety of dapagliflozin in the treatment
of hyperglycemia in cardiac surgery patients with type 2 diabetes (T2D).
 Method(s): Cardiac surgery patients with T2D (n = 250) were randomly
assigned (1:1) to receive dapagliflozin plus basal-bolus insulin (DAPA
group) or basal-bolus insulin alone (INSULIN group) in the early
postoperative period. The primary outcome was mean difference in daily
blood glucose (BG) concentrations between groups. The major safety
outcomes were the occurrence of severe ketonemia/diabetic ketoacidosis
(DKA) and hypoglycemia. All analyses were performed according to the
intention-to-treat principle. Result(s): The median age of the
patients was 61 years (range, 55-61), and 219 (87.6%) were men. Overall,
the randomization blood glucose was 165 mg/dL (SD, 37) and glycated
hemoglobin was 7.7% (SD, 1.4). There were no differences in mean daily BG
concentrations (149 vs. 150 mg/dL), mean percentage of readings within
target BG of 70-180 mg/dL (82.7% vs. 82.5%), total daily insulin dose
(mean, 39 vs. 40 units/day), number of daily insulin injections (median,
3.9 vs. 4), length of hospital stay (median, 10 vs. 10 days), or hospital
complications (21.6% vs. 24.8%) between the DAPA and INSULIN groups. The
mean plasma ketone levels were significantly higher in the DAPA group than
in the INSULIN group at day 3 (0.71 vs. 0.30 mmol/L) and day 5 (0.42 vs.
0.19 mmol/L) of randomization. Six patients in the DAPA group developed
severe ketonemia, but no patient developed DKA. There were no differences
in the proportion of patients with BG < 70 mg/dL (9.6% vs. 7.2%) between
the two groups. Conclusion(s): Dapagliflozin complementary to
basal-bolus insulin does not improve glycemia further over and above the
basal-bolus insulin alone in hospitalized cardiac surgery patients.
Dapagliflozin significantly increases plasma ketones levels. Safety of
dapagliflozin in hospitalized patients needs further investigation. Trial
registration ClinicalTrials.gov NCT05457933. Copyright © 2023,
Springer-Verlag Italia S.r.l., part of Springer Nature.

<47>
Accession Number
2024041293
Title
The perioperative use of inhaled prostacyclins in cardiac surgery: a
systematic review and meta-analysis.
Source
Canadian Journal of Anesthesia. (no pagination), 2023. Date of
Publication: 2023.
Author
Marcus B.; Marynen F.; Fieuws S.; Van Beersel D.; Rega F.; Rex S.
Institution
(Marcus, Marynen, Van Beersel, Rex) Department of Anesthesiology,
Universitair Ziekenhuis Leuven, Leuven, Belgium
(Fieuws, Van Beersel, Rega, Rex) Department of Cardiovascular Sciences,
Group Biomedical Sciences, Katholieke Universiteit Leuven, Leuven, Belgium
(Fieuws) Leuvens Biostatistiek en Statistische Bioinformatica Centrum,
Katholieke Universiteit Leuven, Leuven, Belgium
(Rega) Department of Cardiac Surgery, Universitair Ziekenhuis Leuven,
Leuven, Belgium
Publisher
Springer
Abstract
Purpose: Perioperative pulmonary hypertension (PH) is an independent risk
factor for morbidity and mortality in cardiac surgery. While inhaled
prostacyclins (iPGI<inf>2</inf>s) are an established treatment of chronic
PH, data on the efficacy of iPGI<inf>2</inf>s in perioperative PH are
scarce. Method(s): We searched PubMed, Embase, the Web of Science,
CENTRAL, and the grey literature from inception until April 2021. We
included randomized controlled trials investigating the use of
iPGI<inf>2</inf>s in adult and pediatric patients undergoing cardiac
surgery with an increased risk of perioperative right ventricle failure.
We assessed the efficacy and safety of iPGI<inf>2</inf>s compared with
placebo and other inhaled or intravenous vasodilators with random-effect
meta-analyses. The primary outcome was mean pulmonary artery pressure
(MPAP). Secondary outcomes included other hemodynamic parameters and
mortality. Result(s): Thirteen studies were included, comprising 734
patients. Inhaled prostacyclins significantly decreased MPAP compared with
placebo (standardized effect size, 0.46; 95% confidence interval [CI],
0.11 to 0.87; P = 0.01) and to intravenous vasodilators (1.26; 95% CI,
0.03 to 2.49; P = 0.045). Inhaled prostacyclins significantly improved the
cardiac index compared with intravenous vasodilators (1.53; 95% CI, 0.50
to 2.57; P = 0.004). In contrast, mean arterial pressure was significantly
lower in patients treated with iPGI<inf>2</inf>s vs placebo (-0.39; 95%
CI, -0.62 to 0.16; P = 0.001), but higher than in patients treated with
intravenous vasodilators (0.81; 95% CI, 0.29 to 1.33; P = 0.002). With
respect to hemodynamics, iPGI<inf>2</inf>s had similar effects as other
inhaled vasodilators. Mortality was not affected by iPGI<inf>2</inf>s.
 Conclusion(s): The results of this systematic review and
meta-analysis show that iPGI<inf>2</inf>s improved pulmonary hemodynamics
with similar efficacy as other inhaled vasodilators, but caused a
significant small decrease in arterial pressure when compared with
placebo, indicating spill-over into the systemic circulation. These
effects did not affect clinical outcomes. Study registration date:
PROSPERO (CRD42021237991); registered 26 May 2021. Copyright ©
2023, Canadian Anesthesiologists' Society.

<48>
Accession Number
2017428106
Title
Large animal model of vein grafts intimal hyperplasia: A systematic
review.
Source
Perfusion (United Kingdom). 38(5) (pp 894-930), 2023. Date of Publication:
July 2023.
Author
Fashina O.; Abbasciano R.G.; McQueen L.W.; Ladak S.; George S.J.; Suleiman
S.; Punjabi P.P.; Angelini G.D.; Zakkar M.
Institution
(Fashina, Abbasciano, McQueen, Ladak, Zakkar) Department of Cardiovascular
Sciences, University of Leicester, Glenfield Hospital, Leicester, United
Kingdom
(George, Suleiman, Angelini) Bristol Heart Institute and Translational
Biomedical Research Centre, Bristol Medical School, University of Bristol,
Bristol Royal Infirmary, Bristol, United Kingdom
(Punjabi) Department of Cardiovascular Sciences, Imperial College,
Hammersmith Hospital, London, United Kingdom
Publisher
SAGE Publications Ltd
Abstract
Coronary artery bypass grafting remains the treatment of choice for a
large cohort of patients with significant coronary disease. Despite the
increased use of arterial grafts, the long saphenous vein remains the most
commonly used conduit. Long-term graft patency continues to be the
Achilles heel of saphenous vein grafts. This is due to the development of
intimal hyperplasia, a chronic inflammatory disease that results in the
narrowing and occlusion of a significant number of vein grafts. Research
models for intimal hyperplasia are essential for a better understanding of
pathophysiological processes of this condition. Large animal models
resemble human anatomical structures and have been used as a surrogate to
study disease development and prevention over the years. In this paper, we
systematically review all published studies that utilized large animal
models of vein graft disease with a focus on the type of model and any
therapeutic intervention, specifically the use of external
stents/mesh. Copyright © The Author(s) 2022.

<49>
Accession Number
2016913342
Title
Unilateral versus bilateral anterograde cerebral perfusion in acute type A
aortic dissection repair: A systematic review and meta-analysis.
Source
Perfusion (United Kingdom). 38(5) (pp 931-938), 2023. Date of Publication:
July 2023.
Author
Tasoudis P.T.; Varvoglis D.N.; Vitkos E.; Ikonomidis J.S.; Athanasiou T.
Institution
(Tasoudis, Varvoglis) Department of Cardiothoracic Surgery, Faculty of
Medicine, School of Health Sciences, University of Thessaly, Athens,
Greece
(Vitkos) Surgery Working Group, Society of Junior Doctors, Athens, Greece
(Ikonomidis) Department of Surgery, School of Medicine, University of
North Carolina at Chapel Hill Chapel HillUniversity, NC, United States
(Athanasiou) Department of Surgery and Cancer, Imperial College London, St
Mary's Hospital, London, United Kingdom
(Athanasiou) Department of Cardiothoracic Surgery, University Hospital of
Larissa, Greece
Publisher
SAGE Publications Ltd
Abstract
Objectives: The aim of the study is to compare the safety and efficacy of
unilateral anterograde cerebral perfusion (UACP) and bilateral anterograde
cerebral perfusion (BACP) for acute type A aortic dissection (ATAAD).
 Method(s): A systematic review of the MEDLINE (PubMed), Scopus, and
Cochrane Library databases (last search: August 7th, 2021) was performed
according to the PRISMA statement. Studies directly comparing UACP versus
BACP for ATAAD were included. Random-effects meta-analyses were performed.
 Result(s): Eight retrospective cohort studies were identified,
incorporating 2416 patients (UACP: 843, BACP: 1573). No statistically
significant difference was observed regarding in-hospital mortality (odds
ratio [OR]:1.05 [95% Confidence Interval (95% CI):0.70-1.57]), permanent
neurological deficit (PND) (OR: 0.94 [95% CI: 0.52-1.70]), transient
neurological deficit (TND) (OR: 1.37 [95% CI: 0.98-1.92]), renal failure
(OR: 0.96 [95% CI: 0.70-1.32]), and re-exploration for bleeding (OR: 0.77
[95% CI: 0.48-1.22]). Meta-regression analysis revealed that PND and TND
were not influenced by differences in rates of total arch repair, Bentall
procedure, and concomitant CABG in UACP and BACP groups. Cardiopulmonary
bypass time (Standard Mean Difference [SMD]: -0.11 [95% CI: -0.22, 0.44]),
Cross clamp time (SMD: -0.04 [95% CI: -0.38, 0.29]), and hypothermic
circulatory arrest time (SMD: -0.12 [95% CI: -0.55, 0.30]) were comparable
between UACP and BACP. Intensive care unit stay was shorter in BACP arm
(SMD:0.16 [95% CI: 0.01, 0.31]); however, length of hospital stay was
shorter in UACP arm (SMD: -0.25 [95% CI: -0.45, -0.06]).
 Conclusion(s): UACP and BACP had similar results in terms of
in-hospital mortality, PND, TND, renal failure, and re-exploration for
bleeding rate in patients with ATAAD. ICU stay was shorter in the BACP arm
while LOS was shorter in the UACP arm. Copyright © The Author(s)
2022.

<50>
Accession Number
2016578122
Title
Pulsatile versus non-pulsatile perfusion in coronary artery bypass
operation: The comparison of laboratory and clinical outcomes.
Source
Perfusion (United Kingdom). 38(5) (pp 1053-1061), 2023. Date of
Publication: July 2023.
Author
Shahandashti F.J.; Asadian S.; Habibi N.; Gorjipour F.; Jalali A.;
Toloueitabar Y.
Institution
(Shahandashti, Asadian, Habibi, Gorjipour, Jalali, Toloueitabar) Iranian
Scientific Society Of Extracorporeal Technology, Rajaie Cardiovascular
Medical and Research Center, Iran University of Medical Sciences, Tehran,
Iran, Islamic Republic of
Publisher
SAGE Publications Ltd
Abstract
Introduction: The superiority of pulsatile or non-pulsatile perfusion in
cardiopulmonary bypass (CPB) regarding morbidity and mortality is still
debated. Therefore, we aimed to investigate the effect of different pulse
rates in pulsatile perfusion in patients undergoing coronary artery bypass
graft (CABG) and compared it with non-pulsatile perfusion.
 Material(s) and Method(s): In this randomized clinical trial, 90
patients who were all candidates for CABG under CPB were enrolled.
Patients in groups A and B received pulsatile perfusion with 30 and 70
pulses per minute, and group C received non-pulsatile perfusion. The
biochemical and clinical parameters in the ICU were evaluated in the study
groups. Result(s): There was no statistically significant difference
between patients' clinical outcomes and kidney and liver function markers
(all Ps> 0.05). Mean serum lactate level increased but did not show a
statistically significant difference between the study groups (p = 0.8).
The mean urine volume at 12 and 24 h after surgery was higher in group A,
but there was no statistically significant difference between the three
groups during the study period (p = 0.3). No significant difference was
found in the length of the ICU stay between the study groups (p = 0.2).
 Conclusion(s): Our studied parameters demonstrated no significant
difference between pulsatile and non-pulsatile and between 30 and 70 pulse
rate pulsatile perfusion methods. Our findings support that pulsatile
perfusion with different pulse rates has no advantages over non-pulsatile
perfusion in selected CABG cases. Copyright © The Author(s) 2022.

<51>
Accession Number
641697826
Title
Invasive acupuncture for gastroparesis after thoracic or abdominal
surgery: a systematic review and meta-analysis.
Source
BMJ open. 13(6) (pp e068559), 2023. Date of Publication: 26 Jun 2023.
Author
Fan Z.; Qiu Y.; Qi X.; Xu J.; Wan Y.; Hao Y.; Niu W.; Huang J.
Institution
(Fan, Qi, Xu, Wan, Huang) Department of minimally invasive acupuncture
Oncology, Third Affiliated Hospital, Beijing University of Chinese
Medicine, Beijing, China
(Qiu) Department of Integrated Traditional Chinese and Western Medicine,
First Affiliated Hospital of Chongqing Medical University, Chongqing,
China
(Hao) China-Japan Friendship Hospital, Oncology Department of Integrated
Traditional Chinese and Western Medicine, Beijing, China
(Niu) Center for Evidence-Based Medicine, Capital Institute of Pediatrics,
Beijing, China
Publisher
NLM (Medline)
Abstract
OBJECTIVES: This meta-analysis aimed to systematically evaluate the
efficacy of acupuncture in treating postsurgical gastroparesis syndrome
(PGS) after thoracic or abdominal surgery. DESIGN: Systematic review and
meta-analysis. DATA SOURCES: Twelve databases (PubMed, Embase, Cochrane
Library Cochrane Central Register of Controlled Trials (CENTRAL), Medline
(Ovid) (from 1946), Web of Science, EBSCO, Scopus, Open Grey, China
National Knowledge Infrastructure (CNKI), Wanfang Database, Chinese
Scientific Journals Database (VIP) and China Biology Medicine disc (CBM))
and three registration websites (WHO International Clinical Trials
Registry Platform (ICTRP), ClinicalTrials.gov, and Chinese Clinical Trial
Registry (ChiCTR)) were searched from the inception to September 2022, and
citations of the included literature were screened. ELIGIBILITY CRITERIA:
All randomised controlled trials addressing invasive acupuncture for PGS.
DATA EXTRACTION AND SYNTHESIS: Key information on the included studies was
extracted by two reviewers independently. Risk ratio (RR) with 95%CI was
used for categorical data, and mean difference with 95%CI for continuous
data. The quality of evidence was assessed using Grading of
Recommendations Assessment, Development and Evaluation. Outcomes were
conducted with trial sequential analysis (TSA). RESULT(S): Fifteen
studies with 759 patients met the inclusion criteria. Subgroup analyses
revealed that compared with the drug group, the drug and acupuncture group
had a greater positive effect on the total effective rate (TER) (nine
trials, n=427; RR=1.20; 95%CI 1.08 to 1.32; P-heterogeneity=0.20, I2=28%,
p=0.0004) and the recovery rate (RCR) (six trials, n=294; RR=1.61; 95%CI
1.30 to 1.98; P-heterogeneity=0.29, I2=19%, p<0.0001) of PGS after
abdominal surgery. However, acupuncture showed no significant advantages
in terms of the TER after thoracic surgery (one trial, p=0.13) or
thoracic/abdominal surgery-related PGS (two trials, n=115; RR=1.18; 95%CI
0.89 to 1.57; P-heterogeneity=0.08, I2=67%, p=0.24) and the RCR after
thoracic/abdominal surgery (two trials, n=115; RR=1.40; 95%CI 0.97 to
2.01; P-heterogeneity=0.96, I2=0%, p=0.07). The quality of evidence for
TER and RCR was moderate certainty. Only one study reported an
acupuncture-related adverse event, in the form of mild local subcutaneous
haemorrhage and pain that recovered spontaneously. TSA indicated that
outcomes reached a necessary effect size except for clinical symptom
score. CONCLUSION(S): Based on subgroup analysis, compared with the
drug treatment, acupuncture combined drug has significant advantages in
the treatment of PGS associated with abdominal surgery, but not with
thoracic surgery. PROSPERO REGISTRATION NUMBER:
CRD42022299189. Copyright © Author(s) (or their employer(s))
2023. Re-use permitted under CC BY. Published by BMJ.

<52>
Accession Number
641709341
Title
Predictors of Major Adverse Cardiovascular Events in Patients With
Moderate Aortic Stenosis: Implications for Aortic Valve Replacement.
Source
Circulation. Cardiovascular imaging. (pp e015475), 2023. Date of
Publication: 29 Jun 2023.
Author
Howard T.; Majmundar M.; Sarin S.; Kumar A.; Ajay A.; Krishnaswamy A.;
Reed G.W.; Harb S.C.; Harmon E.; Dykun I.; Ghandakly E.; Kapadia S.R.;
Kalra A.; Puri R.
Institution
(Howard, Kumar, Ajay, Krishnaswamy, Reed, Harb, Harmon, Ghandakly,
Kapadia, Puri) Department of Cardiovascular Medicine, Cleveland Clinic,
A.A., S.C.H., E.G., S.R.K., Cleveland, A.K, United States
(Majmundar) Department of Cardiovascular Medicine, University of Kansas
Medical Center
(Sarin) Case Western Reserve University, School of Medicine, Cleveland,
United States
(Dykun) Department of Cardiology and Vascular Medicine, West German Heart
and Vascular Center, University of Duisburg-Essen, Germany (I.D.), Germany
(Kalra) Franciscan Health, Lafayette, United States
Publisher
NLM (Medline)
Abstract
BACKGROUND: Although the prognosis and management of severe aortic
stenosis has been extensively studied, the risk stratification and
outcomes of patients with moderate aortic stenosis remain elusive.
 METHOD(S): This study included 674 patients from the Cleveland Clinic
Health System with moderate aortic stenosis (aortic valve area, 1-1.5 cm2;
mean gradient, 20-40 mmHg; and peak velocity <4 m/s) and an NT-proBNP
(N-terminal pro-B-type natriuretic peptide) level within 3 months of index
diagnosis. The primary outcome of major adverse cardiovascular events
(defined as the composite outcome of progression to severe aortic stenosis
requiring aortic valve replacement, heart failure hospitalization, or
death) was extracted from the electronic medical record. RESULT(S):
The mean age was 75.3+/-12 years, and 57% were men. During a median
follow-up of 316 days, the composite end point occurred in 305 patients.
There were 132 (19.6%) deaths, 144 (21.4%) heart failure hospitalizations,
and 114 (16.9%) patients underwent aortic valve replacement. Elevated
NT-proBNP (1.41 [95% CI, 1.01-1.95]; P=0.048), diabetes (1.46 [95% CI,
1.08-1.96]; P=0.01), elevated averaged mitral valve E/e' ratio (hazard
ratio, 1.57 [95% CI, 1.18-2.10]; P<0.01), and presence atrial fibrillation
at the time of index echocardiogram (hazard ratio, 1.83 [95% CI,
1.15-2.91]; P=0.01) were each independently associated with an increased
hazard for the composite outcome and when taken collectively, each of
these factors incrementally increased risk. CONCLUSION(S): These
results further elucidate the relatively poor short-medium term outcomes
and risk stratification of patients with moderate aortic stenosis,
supporting randomized trials assessing the efficacy of transcatheter
aortic valve replacement in this population.

<53>
Accession Number
641704929
Title
More Than 50 Percent Reduction in LDL Cholesterol in Patients With Target
LDL <70 mg/dL After a Stroke.
Source
Stroke. (no pagination), 2023. Date of Publication: 28 Jun 2023.
Author
Amarenco P.; Lavallee P.C.; Kim J.S.; Labreuche J.; Charles H.; Giroud M.;
Lee B.-C.; Mahagne M.-H.; Meseguer E.; Nighoghossian N.; Steg P.G.; Vicaut
E.; Bruckert E.
Institution
(Amarenco, Lavallee, Charles, Meseguer) APHP, Department of Neurology and
Stroke Center, Bichat Hospital, INSERM LVTS-U1148, DHU FIRE, University of
Paris, P.C.L., H.C., France
(Amarenco) Population Health Research Institute, MacMaster University,
Hamilton, Ontario, Canada (P.A.)
(Kim) Kangneung Asan Hospital, South Korea (J.S.K.)
(Labreuche) Department of Biostatistics, CHU Lille
(Giroud) Department of Neurology, University Hospital of Dijon, Dijon
Stroke Registry, University of Burgundy, UBFC, EA 7460, Spain
(Lee) Department of Neurology, Hallym University Sacred Heart Hospital,
Anyang, China
(Mahagne) Stroke Unit, Pasteur Hospital, Nice, France
(Nighoghossian) Hospices Civils de Lyon, Department of Neurology and
Stroke Center, Lyon University, France
(Steg) Universite de Paris, INSERM LVTS-U1148, Paris F-75018, United
States
(Steg) AP-HP, Hopital Bichat, F-765018 Paris
(Vicaut) APHP, Department of Biostatistics, Universite Paris-Diderot,
Fernand Widal Hospital, Sorbonne-Paris Cite
(Bruckert) APHP, Department of Endocrinology, Pitie-Salpetriere Hospital,
Sorbonne University, Paris, United States
Publisher
NLM (Medline)
Abstract
BACKGROUND: Whether a strategy to target an LDL (low-density lipoprotein)
cholesterol <70 mg/dL is more effective when LDL is reduced >50% from
baseline rather than <50% from baseline has not been investigated.
 METHOD(S): The Treat Stroke to Target trial was conducted in France
and South Korea in 61 sites between March 2010 and December 2018. Patients
with ischemic stroke in the previous 3 months or transient ischemic attack
within the previous 15 days and evidence of cerebrovascular or coronary
artery atherosclerosis were randomly assigned to a target LDL cholesterol
of <70 mg/dL or 100+/-10 mg/dL, using statin and/or ezetimibe as needed.
We used the results of repeated LDL measurements (median, 5 [2-6] per
patient) during 3.9 years (interquartile range, 2.1-6.8) of follow-up. The
primary outcome was the composite of ischemic stroke, myocardial
infarction, new symptoms requiring urgent coronary or carotid
revascularization, and vascular death. Cox regression model including
lipid-lowering therapy as a time-varying variable, after adjustment for
randomization strategy, age, sex, index event (stroke or transient
ischemic attack), and time since the index event. RESULT(S): Among
2860 patients enrolled, patients in the lower target group who had >50%
LDL cholesterol reduction from baseline during the trial had a higher
baseline LDL cholesterol and a lower LDL cholesterol achieved as compared
to patients who had <50% LDL cholesterol reduction (155+/-32 and 62 mg/dL
versus 121+/-34 and 74 mg/dL, respectively, P<0.001 for both). In the <70
mg/dL target group, patients with >50% LDL reduction had a significant
reduction in the primary outcome as compared to the higher target group
(hazard ratio, 0.61 [95% CI, 0.43-0.88]; P=0.007) and patients with <50%
LDL reduction from baseline had little reduction (hazard ratio, 0.96 [95%
CI, 0.73-1.26]; P=0.75). CONCLUSION(S): In this post hoc analysis of
the TST trial, targeting an LDL cholesterol of <70 mg/dL reduced the risk
of primary outcome compared with 100+/-10 mg/dL provided LDL cholesterol
reduction from baseline was superior to 50%, thereby suggesting that the
magnitude of LDL cholesterol reduction was as important to consider as the
target level to achieve. REGISTRATION: URL: https://www. CLINICALTRIALS:
gov; Unique identifier: NCT01252875; https://clinicaltrialsregister.eu;
Unique identifier: EUDRACT2009-A01280-57.

<54>
Accession Number
641704540
Title
Rhomboid intercostal block or thoracic paravertebral block for
postoperative recovery quality after video-assisted thoracic surgery: A
prospective, non-inferiority, randomised controlled trial.
Source
European journal of anaesthesiology. (no pagination), 2023. Date of
Publication: 29 Jun 2023.
Author
Wang X.; Jia X.; Li Z.; Zhou Q.
Institution
(Wang) From the Department of Anaesthesiology and Pain Medicine,
Affiliated Hospital of Jiaxing University, China (XW, Zhejiang Province,
Jiaxing, China
Publisher
NLM (Medline)
Abstract
BACKGROUND: The analgesic characteristics of rhomboid intercostal block
(RIB) remain unclear. Before it can be fully recommended, we compared the
recovery quality and analgesic effects of RIB and thoracic paravertebral
block (TPVB) for video-assisted thoracoscopic surgery (VATS).
 OBJECTIVE(S): The current study aimed to investigate whether there is
a difference in postoperative recovery quality between TPVB and RIB.
DESIGN: A prospective, non-inferiority, randomised controlled trial.
SETTING: Affiliated Hospital of Jiaxing University in China from March
2021 to August 2022. PATIENTS: Eighty patients aged 18 to 80 years, with
ASA physical status I to III, and scheduled for elective VATS were
enrolled in the trial. INTERVENTION: Ultrasound-guided TPVB or RIB was
performed with 20 ml 0.375% ropivacaine. MAIN OUTCOME MEASURES: The
primary outcome of the study was the mean difference of quality of
recovery-40 scores 24 h postoperatively. The non-inferiority margin was
defined as 6.3. Numeric rating scores (NRS) for pain at 0.5, 1, 3, 6, 12,
24 and 48 h postoperatively in all patients were also recorded.
 RESULT(S): A total of 75 participants completed the study. The mean
difference of quality of recovery-40 scores 24 h postoperatively was -1.6
(95% CI, -4.5 to 1.3), demonstrating the non-inferiority of RIB to TPVB.
There was no significant difference between the two groups in the area
under the curve for pain NRS over time, at rest and on movement, at 6, 12,
24 and 48 h postoperatively (all P > 0.05), except for the area under the
curve pain NRS over time on movement at 48 h postoperatively (P = 0.046).
There were no statistical differences between the two groups in the
postoperative sufentanil use at 0 to 24 h or 24 to 48 h (all P > 0.05).
 CONCLUSION(S): Our study suggests that RIB was non-inferior to TPVB
for the quality of recovery, with almost the same postoperative analgesic
effect as TPVB after VATS. CLINICAL TRIAL REGISTRATION: chictr.org.cn:
ChiCTR2100043841. Copyright © 2023 European Society of
Anaesthesiology and Intensive Care. Unauthorized reproduction of this
article is prohibited.

<55>
Accession Number
641697922
Title
Influenza vaccination and cardiovascular events in patients with ischaemic
heart disease and heart failure: A meta-analysis.
Source
European journal of heart failure. (no pagination), 2023. Date of
Publication: 27 Jun 2023.
Author
Modin D.; Lassen M.C.H.; Claggett B.; Johansen N.D.; Keshtkar-Jahromi M.;
Skaarup K.G.; Nealon J.; Udell J.A.; Vardeny O.; Solomon S.D.; Gislason
G.; Biering-Sorensen T.
Institution
(Modin, Lassen, Johansen, Skaarup, Gislason, Biering-Sorensen) Department
of Cardiology, Copenhagen University Hospital - Herlev & Gentofte,
Copenhagen, Denmark
(Claggett, Solomon) Department of Medicine, Cardiovascular Medicine
Division, Brigham and Women's Hospital, Harvard Medical School, Boston,
MA, United States
(Keshtkar-Jahromi) Division of Infectious Diseases, Department of
Medicine, Johns Hopkins University School of Medicine, Baltimore, MD,
Liberia
(Nealon) School of Public Health, Li Ka Shing Faculty of Medicine,
University of Hong Kong, Hong Kong Special Administrative Region, China
(Udell) Cardiovascular Division, Department of Medicine, Women's College
Hospital, Toronto, Canada
(Vardeny) Department of Medicine, University of Minnesota, Minneapolis VA
Health Care System, Minneapolis, MN, United States
(Gislason) Institute of Clinical Medicine, Faculty of Health Sciences,
University of Copenhagen, Denmark
(Biering-Sorensen) Department of Biomedical Sciences, Faculty of Health
and Medical Sciences, University of Copenhagen, Denmark
Publisher
NLM (Medline)
Abstract
BACKGROUND: Randomized controlled trials (RCTs) enrolling patients with
high cardiovascular risk have found that influenza vaccination may reduce
the incidence of cardiovascular events. We performed an updated
meta-analysis assessing the effect of influenza vaccination on the
incidence of cardiovascular events in patients with ischemic heart disease
or heart failure. METHOD(S): We searched PubMed, EMBASE and other
sources to identify RCTs examining the effect of influenza vaccination on
the incidence of cardiovascular events assessed as efficacy outcomes in
patients with ischemic heart disease or heart failure. Eligible studies
followed patients for at least one influenza season, defined as a minimum
duration of six months. The primary endpoint was a composite of
cardiovascular death, acute coronary syndrome, stent thrombosis or
coronary revascularization, stroke or heart failure hospitalization. The
secondary endpoints were cardiovascular death and all-cause death. Two
investigators independently identified and extracted data from studies.
Results were compared using hazard ratios (HRs) in both random effects and
fixed effects models. RESULT(S): We included five peer-reviewed and
one non peer-reviewed RCTs for a total of 9340 patients. Five trials
included patients with ischemic heart disease (N=4211) and one trial
included patients with heart failure (N=5129). Influenza vaccination was
associated with a reduced incidence of the primary composite endpoint
(Random effects hazard ratio (rHR) 0.74, 95% CI 0.63-0.88, p<0.001,
I2=52%), cardiovascular death (rHR 0.63, 95% CI 0.42-0.95, p=0.028, I2
=58%) and all-cause death (rHR 0.72, 95% CI 0.54-0.95, p=0.0227, I2=52%).
Results were similar when non peer-reviewed data were excluded.
 CONCLUSION(S): In this meta-analysis of available RCTs in patients at
high cardiovascular risk, influenza vaccination was associated with a
reduced incidence of cardiovascular events, cardiovascular death and
all-cause death as compared to placebo or no treatment. Copyright This
article is protected by copyright. All rights reserved.

<56>
Accession Number
2025446870
Title
Iatrogenic lung hernia, a rare complication of thoracoscopic spinal
fusion: A case report and review of literature.
Source
Radiology Case Reports. 18(9) (pp 3240-3242), 2023. Date of Publication:
September 2023.
Author
de Villa A.R.; Obeidat O.; Oyetoran A.; Okonoboh P.
Institution
(de Villa, Obeidat, Oyetoran, Okonoboh) UCF College of Medicine HCA
Healthcare GME Consortium, 6500 W Newberry Rd, Gainesville, FL 32605,
United States
(de Villa, Obeidat, Oyetoran, Okonoboh) HCA Florida North Florida
Hospital, Internal Medicine Residency Program, 6500 W Newberry Rd,
Gainesville, FL 32605, United States
(Okonoboh) HCA Florida North Florida Hospital, Critical Care Medicine,
Gainesville, FL, United States
Publisher
Elsevier Inc.
Abstract
A lung hernia is a rare and potentially severe complication that may occur
due to thoracic surgery amongst other etiologies. This case report
describes the clinical presentation, imaging findings, and management of a
patient who developed an iatrogenic lung hernia after undergoing thoracic
fusion surgery at the level of T6-T7. The patient presented with
persistent chest pain, shortness of breath, and a nonproductive cough.
Initial imaging studies revealed the presence of an abnormality within the
pleural space, later confirmed through computed tomography of the chest.
This case highlights the importance of considering iatrogenic lung hernia
as a potential complication of thoracic fusion surgery and the need for
close monitoring and prompt intervention in cases when it
occurs. Copyright © 2023

<57>
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.

<58>
Accession Number
2024439014
Title
REDEFINE: A Prospective Randomized Evaluation of the ControlRad System to
Reduce Radiation Exposure During Cardiac Implantable Device Procedures.
Source
JACC: Clinical Electrophysiology. 9(5) (pp 713-714), 2023. Date of
Publication: May 2023.
Author
Mehta N.K.; France J.; Shah K.; Kutinsky I.; Williamson B.; Goel A.; Dixon
S.; Haines D.E.
Publisher
Elsevier Inc.

<59>
Accession Number
2023904256
Title
Comparison of the effects of remimazolam and dexmedetomidine on early
postoperative cognitive function in elderly patients with gastric cancer.
Source
Frontiers in Aging Neuroscience. 15 (no pagination), 2023. Article Number:
1123089. Date of Publication: 2023.
Author
Liao Y.Q.; Min J.; Wu Z.X.; Hu Z.
Institution
(Liao, Min, Wu, Hu) Department of Anesthesiology, Medical Center of
Anesthesiology and Pain, The First Affiliated Hospital of Nanchang
University, Jiangxi, Nanchang, China
Publisher
Frontiers Media S.A.
Abstract
Purpose: To compare the effects of remimazolam and dexmedetomidine on
early postoperative cognitive dysfunction (POCD) in aged gastric cancer
patients. Method(s): From June to December 2022, 104 elderly patients
(aged 65-80 years) received laparoscopic radical resection of gastric
cancer at the First Affiliated Hospital of Nanchang University. Using the
random number table approach, the patients were separated into three
groups: remimazolam (Group R), dexmedetomidine (Group D), and saline
(Group C). The primary outcome was the incidence of POCD, and secondary
outcomes included TNF-alpha and S-100beta protein concentrations,
hemodynamics, VAS scores, anesthesia recovery indicators, and the
occurrence of adverse events within 48 h postoperatively. Result(s):
At 3 and 7 days after surgery, there were no statistically significant
differences in the incidence of POCD, the MMSE and MoCA scores between
groups R and D (p > 0.05). However, compared to the saline group, both
groups had higher MMSE and MoCA scores and decreased incidences of POCD.
These differences were statistically significant (p < 0.05). Between group
R and group D, there were no statistically significant changes (p > 0.05)
in the levels of TNF-alpha and S-100beta protein at the three time points
(at the end of the surgery, 1 day later, and 3 days later). Even though
neither group's concentration of the two factors was as high as that of
the saline group, the differences were statistically significant (p <
0.05). At all three time points-following induction (T<inf>2</inf>), 30
min into the operation (T<inf>3</inf>), and at the conclusion of the
surgery (T<inf>4</inf>)-the heart rate and blood pressure in group R were
greater than those in groups D and C. Statistics showed that the
differences were significant (p < 0.05). The incidence of intraoperative
hypotension was highest in group D and lowest in group R (p < 0.05). The
dose of propofol and remifentanil, group C > group R > group D. Extubation
and PACU residence times did not differ statistically significantly (p >
0.05) between the three groups. There was no significant difference in VAS
scores between groups R and D after 24 h postoperatively (p > 0.05),
although both had lower scores than group C, and the difference was
statistically significant (p < 0.05). The VAS scores between the three
groups at 72 h (T<inf>6</inf>) and 7 days (T<inf>7</inf>) were not
statistically significant (p > 0.05). Adverse reactions such as
respiratory depression, hypotension, bradycardia, agitation, drowsiness,
and nausea and vomiting had the lowest incidence in group R and the
highest incidence in group C (p < 0.05). Conclusion(s): Remimazolam
is similarly beneficial as dexmedetomidine in lowering the incidence of
early POCD in aged patients after radical gastric cancer resection,
probably due to reduced inflammatory response. Copyright © 2023
Liao, Min, Wu and Hu.

<60>
Accession Number
2023533024
Title
Physiological and pathophysiological mechanisms of the molecular and
cellular biology of angiogenesis and inflammation in moyamoya angiopathy
and related vascular diseases.
Source
Frontiers in Neurology. 14 (no pagination), 2023. Article Number: 661611.
Date of Publication: 2023.
Author
Dorschel K.B.; Wanebo J.E.
Institution
(Dorschel) Medical Faculty, Heidelberg University Medical School,
Ruprecht-Karls-Universitat Heidelberg, Heidelberg, Germany
(Wanebo) Department of Neurosurgery, Barrow Neurological Institute, St.
Joseph's Hospital and Medical Center, Phoenix, AZ, United States
(Wanebo) Department of Neuroscience, HonorHealth Research Institute,
Scottsdale, AZ, United States
Publisher
Frontiers Media S.A.
Abstract
Rationale: The etiology and pathophysiological mechanisms of moyamoya
angiopathy (MMA) remain largely unknown. MMA is a progressive, occlusive
cerebrovascular disorder characterized by recurrent ischemic and
hemorrhagic strokes; with compensatory formation of an abnormal network of
perforating blood vessels that creates a collateral circulation; and by
aberrant angiogenesis at the base of the brain. Imbalance of angiogenic
and vasculogenic mechanisms has been proposed as a potential cause of MMA.
Moyamoya vessels suggest that aberrant angiogenic, arteriogenic, and
vasculogenic processes may be involved in the pathophysiology of MMA.
Circulating endothelial progenitor cells have been hypothesized to
contribute to vascular remodeling in MMA. MMA is associated with increased
expression of angiogenic factors and proinflammatory molecules. Systemic
inflammation may be related to MMA pathogenesis. Objective(s): This
literature review describes the molecular mechanisms associated with
cerebrovascular dysfunction, aberrant angiogenesis, and inflammation in
MMA and related cerebrovascular diseases along with treatment strategies
and future research perspectives. Methods and Results: References
were identified through a systematic computerized search of the medical
literature from January 1, 1983, through July 29, 2022, using the PubMed,
EMBASE, BIOSIS Previews, CNKI, ISI web of science, and Medline databases
and various combinations of the keywords "moyamoya," "angiogenesis,"
"anastomotic network," "molecular mechanism," "physiology,"
"pathophysiology," "pathogenesis," "biomarker," "genetics," "signaling
pathway," "blood-brain barrier," "endothelial progenitor cells,"
"endothelial function," "inflammation," "intracranial hemorrhage," and
"stroke." Relevant articles and supplemental basic science articles almost
exclusively published in English were included. Review of the reference
lists of relevant publications for additional sources resulted in 350
publications which met the study inclusion criteria. Detection of growth
factors, chemokines, and cytokines in MMA patients suggests the hypothesis
of aberrant angiogenesis being involved in MMA pathogenesis. It remains to
be ascertained whether these findings are consequences of MMA or are
etiological factors of MMA. Conclusion(s): MMA is a heterogeneous
disorder, comprising various genotypes and phenotypes, with a complex
pathophysiology. Additional research may advance our understanding of the
pathophysiology involved in aberrant angiogenesis, arterial stenosis, and
the formation of moyamoya collaterals and anastomotic networks. Future
research will benefit from researching molecular pathophysiologic
mechanisms and the correlation of clinical and basic research
results. Copyright © 2023 Dorschel and Wanebo.

<61>
Accession Number
2023127789
Title
An investigation on the respiratory mechanics of mechanically ventilated
patients during spontaneous breathing trials with enhanced low-level
pressure support ventilation.
Source
Clinical Respiratory Journal. 17(6) (pp 527-535), 2023. Date of
Publication: June 2023.
Author
Zhang B.; Zhang Z.; Qin H.; Jiang Z.; Deng Q.; Sun Q.; Wang Y.; Zhou J.;
Lin Z.; He W.; Hua D.; Xu Y.
Institution
(Zhang, Jiang, Deng, Sun, Wang, Zhou, Lin, He, Xu) Department of Critical
Care Medicine, The First Affiliated Hospital of Guangzhou Medical
University, Guangzhou, China
(Zhang) Guangzhou Respiratory Health Research Institute, The First
Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
(Qin) Department of Pulmonary and Critical Care Medicine, The Second
People's Hospital of Fengkai, Zhaoqing, China
(Hua) Department of General Medicine, Bunbury Regional Hospital, Bunbury,
WA, Australia
Publisher
John Wiley and Sons Inc
Abstract
Introduction: Low-level pressure support ventilation (PSV) is most
commonly adopted in spontaneous breathing trials (SBTs), and some have
proposed setting the positive end-expiratory pressure (PEEP) to 0
cmH<inf>2</inf>O in order to shorten the observation time of SBTs. This
study aims to investigate the effects of two PSV protocols on the
patients' respiratory mechanics. Material(s) and Method(s): A
prospective randomized self-controlled crossover design was adopted in
this study, which involved enrolling 30 difficult-to-wean patients who
were admitted to the intensive care unit of the First Affiliated Hospital
of Guangzhou Medical University between July 2019 and September 2021.
Patients were subjected to the S group (pressure support: 8
cmH<inf>2</inf>O, PEEP: 5 cmH<inf>2</inf>O) and S1 group (PS: 8
cmH<inf>2</inf>O, PEEP: 0 cmH<inf>2</inf>O) for 30 min in a random order,
and respiratory mechanics indices were dynamically monitored via a
four-lumen multi-functional catheter with an integrated gastric tube.
Among the 30 enrolled patients, 27 were successfully weaned.
 Result(s): The S group showed higher airway pressure (Paw),
intragastric pressure (Pga) and airway pressure-time product (PTP) than
the S1 group. The S group also showed a shorter inspiratory trigger delay,
(93.80 +/- 47.85) versus (137.33 +/- 85.66) ms (P = 0.004); and fewer
abnormal triggers, (0.97 +/- 2.65) versus (2.67 +/- 4.48) (P = 0.042)
compared with the S1 group. Stratification based on the causes of
mechanical ventilation revealed that under the S1 protocol, patients with
chronic obstructive pulmonary disease (COPD) had a longer inspiratory
trigger delay compared to both post-thoracic surgery (PTS) patients and
patients with acute respiratory distress syndrome. Despite providing
greater respiratory support, S group led to significant reductions in
inspiratory trigger delay and less abnormal triggers compared to S1 group,
especially among patients with chronic obstructive pulmonary disease.
 Conclusion(s): These findings suggest that the zero PEEP group was
more likely to induce a higher number of patient-ventilator asynchronies
in difficult-to-wean patients. Copyright © 2023 The Authors. The
Clinical Respiratory Journal published by John Wiley & Sons Ltd.

<62>
Accession Number
2022921696
Title
Impella Versus VA-ECMO for Patients with Cardiogenic Shock: Comprehensive
Systematic Literature Review and Meta-Analyses.
Source
Journal of Cardiovascular Development and Disease. 10(4) (no pagination),
2023. Article Number: 158. Date of Publication: April 2023.
Author
Ardito V.; Sarucanian L.; Rognoni C.; Pieri M.; Scandroglio A.M.;
Tarricone R.
Institution
(Ardito, Sarucanian, Rognoni, Tarricone) Centre for Research on Health and
Social Care Management (CERGAS), SDA Bocconi School of Management, Milan
20136, Italy
(Pieri, Scandroglio) Department of Anesthesia and Intensive Care, IRCCS
San Raffaele Scientific Institute, Milan 20132, Italy
(Tarricone) Department of Social and Political Science, Bocconi
University, Milan 20136, Italy
Publisher
MDPI
Abstract
Impella and VA-ECMO are two possible therapeutic courses for the treatment
of patients with cardiogenic shock (CS). The study aims to perform a
systematic literature review and meta-analyses of a comprehensive set of
clinical and socio-economic outcomes observed when using Impella or
VA-ECMO with patients under CS. A systematic literature review was
performed in Medline, and Web of Science databases on 21 February 2022.
Nonoverlapping studies with adult patients supported for CS with Impella
or VA-ECMO were searched. Study designs including RCTs, observational
studies, and economic evaluations were considered. Data on patient
characteristics, type of support, and outcomes were extracted.
Additionally, meta-analyses were performed on the most relevant and
recurring outcomes, and results shown using forest plots. A total of 102
studies were included, 57% on Impella, 43% on VA-ECMO. The most common
outcomes investigated were mortality/survival, duration of support, and
bleeding. Ischemic stroke was lower in patients treated with Impella
compared to the VA-ECMO population, with statistically significant
difference. Socio-economic outcomes including quality of life or resource
use were not reported in any study. The study highlighted areas where
further data collection is needed to clarify the value of complex, new
technologies in the treatment of CS that will enable comparative
assessments focusing both on the health impact on patient outcomes and on
the financial burden for government budgets. Future studies need to fill
the gap to comply with recent regulatory updates at the European and
national levels. Copyright © 2023 by the authors.

<63>
Accession Number
2022867044
Title
Analysis of perioperative corticosteroid therapy in children undergoing
cardiac surgery: A systematic review and meta-analysis.
Source
Clinical Cardiology. 46(6) (pp 607-614), 2023. Date of Publication: June
2023.
Author
Chen D.; Du Y.
Institution
(Chen) Gastrointestinal Surgery, Chunzhou County Hospital of Huai'an City,
Huai'an, China
(Du) Pediatric Surgery, Huai'an Maternal and Child Health Care Hospital,
China
Publisher
John Wiley and Sons Inc
Abstract
The advantages and disadvantages of using corticosteroids in children
undergoing cardiac surgery is still contentious. To examine how
perioperative corticosteroids affect postoperative mortality and clinical
outcomes in pediatric cardiac surgery with cardiopulmonary bypass (CPB).
We used MEDLINE, EMBASE, and the Cochrane Database to conduct a
comprehensive search up through January 2023. Children aged 0-18
undergoing cardiac surgery were included in the meta-analysis of
randomized controlled studies comparing perioperative corticosteroids with
other therapeutic therapies, placebo, or no treatment. All-cause hospital
mortality was the primary endpoint of the study. Hospitalization duration
was a secondary result. The Cochrane Risk of Bias Assessment Tool was used
to evaluate the research quality. Ten trials and 7798 pediatric
participants were included in our analysis. Children taking
corticosteroids had no significant difference in all-cause in-hospital
mortality using a random-effect model with relative risk (RR) = 0.38, 95%
confidence interval (CI) = 0.16-0.91, I2 = 79%, p =.03 for
methylprednisolone and RR = 0.29, 95% CI = 0.09-0.97, I2 = 80%,
p =.04. For the secondary outcome, there was a significant difference
between the corticosteroid and placebo groups, with pooled standard mean
difference (SMD) = -0.86, 95% CI = -1.57 to -0.15, I2 = 85%, p
=.02 for methylprednisolone and SMD = -0.97, 95% CI -1.90 to -0.04,
I2 = 83%, p =.04 for dexamethasone. Perioperative
corticosteroids may not improve mortality, but they reduce hospital stay
compared to placebo. Further evidence from randomized controlled studies
with larger samples is required for approaching at a valid
conclusion. Copyright © 2023 The Authors. Clinical Cardiology
published by Wiley Periodicals, LLC.

<64>
Accession Number
2021622191
Title
Pharmacological prevention of postoperative delirium in patients
undergoing cardiac surgery: a bayesian network meta-analysis.
Source
Journal of Anesthesia. 37(2) (pp 294-310), 2023. Date of Publication:
April 2023.
Author
Meco M.; Giustiniano E.; Cecconi M.; Albano G.
Institution
(Meco) Department of Anesthesia and Intensive Care, San Carlo Clinic, Via
Dell'Ospedale, 2, Paderno Dugnano, Milan 20030, Italy
(Giustiniano, Cecconi) Department of Anesthesia and Intensive Care,
IRCCS-Humanitas Research Hospital, Via Manzoni 56, Rozzano, Milan 20089,
Italy
(Albano) Department of Anesthesia and Intensive Care, Humanitas Gavazzeni
Hospital, Via Gavazzeni, 27, Bergamo 24125, Italy
Publisher
Springer
Abstract
The incidence of postoperative delirium in patients undergoing cardiac
surgery is very high and increases morbidity and mortality. The
possibility of pharmacological means to reduce its incidence is very
attractive. At present, there is still no clear demonstration that any
drug can prevent postoperative delirium in these patients. The aim of this
Bayesian network meta-analysis (NMA) was to evaluate whether there is
evidence that a drug is effective in reducing the incidence of POD in
cardiac surgical patients. Our NMA showed that preoperative ketamine at
subanesthetic doses can significantly reduce the incidence of POD.
Risperidone also decreases the incidence of POD, but not
significantly. Copyright © 2023, The Author(s) under exclusive
licence to Japanese Society of Anesthesiologists.

<65>
Accession Number
2020664012
Title
Mechanical Heart Valves, Pregnancy, and Bleeding: A Systematic Review and
Meta-Analysis.
Source
Seminars in Thrombosis and Hemostasis. 49(5) (pp 542-552), 2023. Date of
Publication: 12 Jun 2023.
Author
Jakobsen C.; Larsen J.B.; Fuglsang J.; Hvas A.-M.
Institution
(Jakobsen, Larsen) Thrombosis and Hemostasis Research Unit, Department of
Clinical Biochemistry, Aarhus University Hospital, Aarhus C, Denmark
(Larsen, Fuglsang) Department of Clinical Medicine, Aarhus University,
Aarhus C, Denmark
(Fuglsang) Department of Obstetrics and Gynecology, Aarhus University
Hospital, Aarhus C, Denmark
(Hvas) Faculty of Health, Aarhus University, Aarhus C, Denmark
Publisher
Thieme Medical Publishers, Inc.
Abstract
Anticoagulant therapy is essential in pregnant women with mechanical heart
valves to prevent valve thrombosis. The risk of bleeding complications in
these patients has not gained much attention. This systematic review and
meta-analysis investigate the prevalence of bleeding peri-partum and
post-partum in women with mechanical heart valves and also investigate
whether bleeding risk differed across anticoagulant regimens or according
to delivery mode. The present study was conducted according to The
Preferred Reporting Items for Systematic reviews and Meta-Analyses
(PRISMA) statement. Studies reporting bleeding prevalence in pregnant
women with mechanical heart valves receiving anticoagulant therapy were
identified through PubMed and Embase on December 08, 2021. Data on
bleeding complications, delivery mode, and anticoagulation therapy were
extracted. A total of 37 studies were included, reporting 423 bleeding
complications in 2,508 pregnancies. A meta-analysis calculated a pooled
prevalence of 0.13 (95% confidence interval [CI]: 0.09-0.18) bleeding
episodes per pregnancy across anticoagulant regimens. The combination of
unfractionated heparin (UFH) and vitamin K antagonist (VKA) and single VKA
therapy showed the lowest risk of bleeding (8 and 12%). Unexpectedly, the
highest risk of bleeding was found in women receiving a combination of
low-molecular-weight-heparin (LMWH) and VKA (33%) or mono-therapy with
LMWH (22%). However, this could be dose related. No difference in bleeding
was found between caesarean section versus vaginal delivery (p = 0.08). In
conclusion, bleeding episodes are common during pregnancy in women with
mechanical heart valves receiving anticoagulant therapy. A combination of
UFH and VKA or VKA monotherapy showed the lowest risk of
bleeding. Copyright © 2022. Thieme. All rights reserved.

<66>
Accession Number
641685874
Title
Presentation and outcomes in patients with acute myocardial injury and
type 2 myocardial infarction with prior coronary artery disease.
Source
Scottish Medical Journal. Conference: 31st Annual General Meeting of the
Scottish Cardiac Society. Virtual. 68(2) (pp NP3-NP4), 2023. Date of
Publication: May 2023.
Author
Taggart C.; Gard A.; Bularga A.; Wereski R.; Lindahl B.; Eggers A.R.C.K.;
Mills N.L.
Institution
(Taggart, Gard, Bularga, Wereski, Lindahl, Eggers, Mills) Chancellors
Building, Edinburgh, United Kingdom
Publisher
SAGE Publications Ltd
Abstract
Purpose: To determine if there are similarities between patients with type
2 myocardial infarction or acute myocardial injury who have underlying
coronary artery disease. Background(s): Acute myocardial injury and
type 2 myocardial infarction typically occur in the setting of a
concurrent illness and do not result from atherosclerotic plaque rupture
and thrombosis. Separating acute myocardial injury and type 2 myocardial
infarction is challenging in practice as this relies on the assessment of
ischaemia. Indeed, some have challenged whether this distinction is
important, as to date no study has demonstrated differences in clinical
outcomes between these groups, both of which have a high rate of all-cause
death, and significant future cardiovascular risk at five years.
 Method(s): We conducted a secondary analysis of a multicentre
randomised controlled trial of 48,282 consecutive patients with suspected
acute coronary syndrome. Patients with an adjudicated diagnosis of acute
myocardial injury and type 2 myocardial infarction were stratified
according to previous coronary artery disease defined as prior coronary
revascularisation, myocardial infarction, or angina. Cardiovascular death
or myocardial infarction adjusted for the competing risk of
non-cardiovascular death and all-cause death at one year was compared.
 Result(s): There were 9115 patients with cardiac troponin
concentrations above the 99th centile in whom a diagnosis of acute
myocardial injury and type 2 myocardial infarction was made in 1676 (18%)
and 1121 (12%) patients, respectively. In the total population of 2797
patients with type 2 myocardial infarction or acute myocardial injury,
those with coronary disease were older than those without coronary disease
(mean [standard deviation] age 78 [11] vs. 73 [16] years) and were more
likely to be female than male (55% vs. 45%). Coronary disease was
previously identified in 40% (454/1121) and 30% (509/1167) of those with
type 2 myocardial infarction and acute myocardial injury. Cardiovascular
death or myocardial infarction at one year occurred more frequently in
those patients known to have coronary artery disease than those without
for type 2 myocardial infarction (20% [91/454] vs. 10% [69/667]; log-rank
p < 0.001) and acute myocardial injury (23% [115/509]) vs. 14%
[158/11.67]; log-rank p < 0.001) respectively (Figure 1). Similarly,
all-cause death at one year was higher in patients with coronary disease
in both type 2 myocardial infarction (40% [115/ 509] vs. 30% [135/454];
log-rank p < 0.001) and acute myocardial injury (31% [357/1167] vs. 18%
[123/667]; log-rank p < 0.001), respectively (Figure 2).
 Conclusion(s): Coronary artery disease is recognised in around
one-third of patients with acute myocardial injury and type 2 myocardial
infarction and is associated with a higher rate of cardiovascular events
or death. The risk doubled in those with coronary artery disease and was
similar whether the index diagnosis was myocardial injury or infarction.
(Figure Presented).

<67>
Accession Number
641675558
Title
Association of mortality by statin intensity in chronic liver disease
patients with atherosclerotic cardiovascular disease: A nationwide cohort
study.
Source
Pharmacoepidemiology and Drug Safety. Conference: 38th International
Conference on Pharmacoepidemiology: Advancing Pharmacoepidemiology and
Real-World Evidence for the Global Community. Copenhagen Denmark.
31(Supplement 2) (pp 142), 2022. Date of Publication: September 2022.
Author
Bea S.; Oh I.-S.; Kim J.H.; Sinn D.H.; Chang Y.; Ryu S.; Shin J.-Y.
Institution
(Bea, Oh, Kim, Shin) School of Pharmacy, Sungkyunkwan University, Seoul,
South Korea
(Sinn) Department of Medicine, Samsung Medical Center, Sungkyunkwan
University, Seoul, South Korea
(Chang, Ryu) Department of Clinical Research Design and Evaluation,
Samsung Advanced Institute for Health Sciences and Technology,
Sungkyunkwan University, Seoul, South Korea
Publisher
John Wiley and Sons Ltd
Abstract
Background: AHA/ACC 2018 Cholesterol guideline recommends statin in
patients with chronic and/or stable liver disease for secondary prevention
of atherosclerotic cardiovascular disease (ASCVD), yet remains equivocal
on the adequate intensity of statin for patients with chronic liver
disease (CLD). Objective(s): To assess the association between statin
intensity and mortality among CLD patients with ASCVD Methods: We
conducted a retrospective cohort study of the South Korea National Health
Insurance System database to identify CLD patients with a diagnosis record
of liver cirrhosis and/or viral hepatitis between 1 January 2011 and 31
December 2020. The study cohort included those with ASCVD identified using
a procedural code for coronary revascularization. We used a 30-day period
following ASCVD diagnosis to determine statin intensity. Follow-up began
on the day after exposure assessment period, and patients were followed up
until death or end of study (31 Dec 2020), using intention-to-treat
approach. Rate differences (RDs) and adjusted hazard ratios (HRs) with 95%
confidence intervals (CIs) of all-cause mortality, cardiovascular (CV)
related mortality, liver-related mortality and recurrent ASCVD events were
estimated using inverse probability of treatment weighting, comparing
high-intensity statin users to low/moderateintensity statin users.
 Result(s): Of 10 442 study population, 5515 (52.81%) received
highintensity statin, and 4927 (47.19%) received low/moderate-intensity
statin. During average follow-up of 2.35 person-years, high-intensity
statin was associated with lower risk for all-cause mortality (HR, 0.83
[95% CI 0.75 to 0.92]), CV-related mortality (HR, 0.85 [95% CI 0.71 to
1.01]), and liver-related mortality (HR, 0.72 [95% CI 0.54 to 0.97])
compared with low/moderate statin. Although both hospitalizations for
recurrent MI and stroke were shown to be increased among high-intensity
statin users, the effect estimate was homogenous in the absolute scale
(MI: HR 1.12 [1.04 to 1.19], RD 7.57 [-0.69 to 15.84] per 1000
personyears; Stroke: HR 1.11 [0.97 to 1.27]; RD -1.70 [-5.19 to 1.78]).
 Conclusion(s): Our findings not only endorse the 2018 AHA/ACC
guidelines for statin use but also highlight the improved mortality
benefit associated with high-intensity statin in CLD patients with ASCVD.
Further studies, including from randomized clinical trials, are needed to
confirm required to provide the decisive evidence for statin use and
secondary prevention of ASCVD in patients with underlying liver disease
conditions.

<68>
Accession Number
641675159
Title
Flaxseed interaction with warfarin and clopidogrel and the potential risk
of bleeding.
Source
Pharmacoepidemiology and Drug Safety. Conference: 38th International
Conference on Pharmacoepidemiology: Advancing Pharmacoepidemiology and
Real-World Evidence for the Global Community. Copenhagen Denmark.
31(Supplement 2) (pp 600-601), 2022. Date of Publication: September 2022.
Author
Alghamdi W.; Alfadel N.; Alharbi F.F.
Institution
(Alghamdi, Alfadel, Alharbi) Saudi Food and Drug Authority, Saudi Arabia
Publisher
John Wiley and Sons Ltd
Abstract
Background: Flaxseed (Linum usitatissimum) is a herbal product, which
contains approximately 55% alpha-linolenic acid (ALA). It is commonly used
to improve digestive health or relieve constipation. Some studies suggest
that flaxseed can decrease platelet aggregation and increase bleeding
time. Objective(s): To assess the relatedness of the potential
drug-herbal interaction between flaxseed and warfarin/clopidogrel as a
part of drug -herbal interaction assessment project initiated by the Saudi
Food and Drug Authority. Method(s): We conducted a systematic search
in Embase, Cochrane, PubMed, and Google Scholar. Also, a search was
performed in the Adis Insight database, and the Natural Medicines
Database. The search included published work from inception to February
2022. Moreover, a search in the World Health Organization (WHO) database
(VigiBase) was conducted in February 2022 to retrieve all reported cases
worldwide of potential drug-herbal interaction between Flaxseed and
Anticoagulants/antiplatelets. The assessment of interaction was performed
by using the Drug Interaction Probability Scale (DIPs) tool.
 Result(s): We found two published cases with flaxseed interaction.
The cases were reported with warfarin and clopidogrel. The first case
report was for clopidogrel and flaxseed interaction. A positive
re-challenge was found between flaxseed oil and bruising intensity while
taking clopidogrel. The second case described a warfarin and flaxseed
interaction that increased international normalized ratio (INR) readings.
The probability of interaction using the DIPS scale is probable for both
cases. For the global cases retrieved from the WHO database, one case was
the same published case for clopidogrel interaction with flaxseed. While
the other global case was for a 49 years old male who was on warfarin for
heart valve replacement. Concomitant products include flaxseed, ascorbic
acid, and multivitamins. The interaction resulted in INR fluctuations.
 Conclusion(s): The available evidence shows a possible
pharmacodynamics interaction between flaxseed and warfarin/clopidogrel.
Further assessment by well-designed pharmacoepidemiological studies is
needed.

<69>
Accession Number
2025407427
Title
TAVR in Bicuspid Aortic Stenosis: Current Evidence and Proposal for a
Randomized Controlled Trial Design.
Source
JACC: Cardiovascular Interventions. 16(13) (pp 1682-1687), 2023. Date of
Publication: 10 Jul 2023.
Author
Nuyens P.; De Backer O.; Sathananthan J.; Hojsgaard Jorgensen T.; Treede
H.; Leipsic J.A.; Bax J.J.; Webb J.G.; Mehran R.; Chen M.; Reardon M.;
Leon M.B.; Sondergaard L.
Institution
(Nuyens, De Backer, Hojsgaard Jorgensen, Sondergaard) The Heart Centre,
Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
(Sathananthan, Leipsic, Webb) St. Paul's Hospital, Vancouver, BC, Canada
(Sathananthan, Webb) Centre for Cardiovascular and Heart Valve Innovation,
Vancouver, BC, Canada
(Treede) Department of Cardiac and Vascular Surgery, Mainz University
Hospital, Mainz, Germany
(Bax) Leiden University Medical Center, Leiden, Netherlands
(Mehran) Mount Sinai, New York, NY, United States
(Chen) Department of Cardiology, West China Hospital, Sichuan University,
Chengdu, China
(Reardon) DeBakey Heart & Vascular Center, Houston Methodist Hospital,
Houston, TX, United States
(Leon) Columbia Interventional Cardiovascular Care, Columbia University
Medical Center, New York, NY, United States
(Leon) Cardiovascular Research Foundation, New York, NY, United States
Publisher
Elsevier Inc.

<70>
Accession Number
2025404759
Title
Virtual reality-assisted distraction during transcatheter aortic valve
implantation under local anaesthesia: A randomised study.
Source
International Journal of Cardiology. (no pagination), 2023. Article
Number: 131130. Date of Publication: 2023.
Author
Lind A.; Ahsan M.; Totzeck M.; Al-Rashid F.; Haddad A.; Dubler S.; Brenner
T.; Skarabis A.; El Gabry M.; Rassaf T.; Janosi R.A.
Institution
(Lind, Ahsan, 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
(El Gabry) Department of Heart Surgery, 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
Publisher
Elsevier Ireland Ltd
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 Elsevier B.V.

<71>
Accession Number
641691785
Title
Paediatric aortic valve replacement: a meta-analysis and microsimulation
study.
Source
European heart journal. (no pagination), 2023. Date of Publication: 27
Jun 2023.
Author
Notenboom M.L.; Schuermans A.; Etnel J.R.G.; Veen K.M.; van de Woestijne
P.C.; Rega F.R.; Helbing W.A.; Bogers A.J.J.C.; Takkenberg J.J.M.
Institution
(Notenboom, Etnel, Veen, van de Woestijne, Bogers, Takkenberg) Department
of Cardiothoracic Surgery, Erasmus University Medical Centre, Erasmus MC,
Rotterdam 3015 GD, Netherlands
(Schuermans, Rega) Department of Cardiac Surgery, University Hospitals
Leuven, UZ Leuven Gasthuisberg, Herestraat 49, Leuven, Flanders 3000,
Belgium
(Schuermans) Cardiovascular Research Center, Massachusetts General
Hospital, 149 13th Street, 4th floor, Boston, MA 02129, USA
(Schuermans) Program in Medical and Population Genetics and the
Cardiovascular Disease Initiative, Broad Institute of Harvard and MIT,
Merkin Building, 415 Main St., Cambridge MA 02142, United States
(Helbing) Department of Paediatrics, Division of Paediatric Cardiology,
Erasmus MC-Sophia Children's Hospital, Wytemaweg 80, Rotterdam 3015 CN,
Netherlands
Publisher
NLM (Medline)
Abstract
AIMS: To support decision-making in children undergoing aortic valve
replacement (AVR), by providing a comprehensive overview of published
outcomes after paediatric AVR, and microsimulation-based age-specific
estimates of outcome with different valve substitutes. METHODS AND
RESULTS: A systematic review of published literature reporting clinical
outcome after paediatric AVR (mean age <18 years) published between
1/1/1990 and 11/08/2021 was conducted. Publications reporting outcome
after paediatric Ross procedure, mechanical AVR (mAVR), homograft AVR
(hAVR), and/or bioprosthetic AVR were considered for inclusion. Early
risks (<30d), late event rates (>30d) and time-to-event data were pooled
and entered into a microsimulation model. Sixty-eight studies, of which
one prospective and 67 retrospective cohort studies, were included,
encompassing a total of 5259 patients (37 435 patient-years; median
follow-up: 5.9 years; range 1-21 years). Pooled mean age for the Ross
procedure, mAVR, and hAVR was 9.2 +/- 5.6, 13.0 +/- 3.4, and 8.4 +/- 5.4
years, respectively. Pooled early mortality for the Ross procedure, mAVR,
and hAVR was 3.7% (95% CI, 3.0%-4.7%), 7.0% (5.1%-9.6%), and 10.6%
(6.6%-17.0%), respectively, and late mortality rate was 0.5%/year
(0.4%-0.7%/year), 1.0%/year (0.6%-1.5%/year), and 1.4%/year
(0.8%-2.5%/year), respectively. Microsimulation-based mean life-expectancy
in the first 20 years was 18.9 years (18.6-19.1 years) after Ross
(relative life-expectancy: 94.8%) and 17.0 years (16.5-17.6 years) after
mAVR (relative life-expectancy: 86.3%). Microsimulation-based 20-year risk
of aortic valve reintervention was 42.0% (95% CI: 39.6%-44.6%) after Ross
and 17.8% (95% CI: 17.0%-19.4%) after mAVR. CONCLUSION(S): Results of
paediatric AVR are currently suboptimal with substantial mortality
especially in the very young with considerable reintervention hazards for
all valve substitutes, but the Ross procedure provides a survival benefit
over mAVR. Pros and cons of substitutes should be carefully weighed during
paediatric valve selection. Copyright © The Author(s) 2023.
Published by Oxford University Press on behalf of the European Society of
Cardiology.

<72>
Accession Number
641690995
Title
Safety and feasibility of ultrasound-guided serratus anterior plane block
and intercostal nerve block for management of post-sternotomy pain in
pediatric cardiac patients: a prospective, randomized trial.
Source
Anaesthesia, critical care & pain medicine. (pp 101268), 2023. Date of
Publication: 24 Jun 2023.
Author
He Y.; Xu M.; Li Z.; Deng L.; Kang Y.; Zuo Y.
Institution
(He) Department of Anesthesiology, West China Hospital, Sichuan University
& The Research Units of West China (2018RU012), Chinese Academy of Medical
Sciences, China
(Xu) Department of Anesthesiology, West China Hospital, Sichuan University
& The Research Units of West China (2018RU012), Chinese Academy of Medical
Sciences, China
(Li) Department of Critical Care Medicine, Cheng Du Shang Jin Nan Fu
Hospital, West China Hospital of Sichuan University, Chengdu, Sichuan,
China
(Deng) Department of Critical Care Medicine, West China Hospital/West
China School of Medicine, Sichuan University, Chengdu, Sichuan, China
(Kang) Department of Anesthesiology and Translational Neuroscience Center,
Laboratory of Anesthesia and Critical Care Medicine, West China Hospital,
Sichuan University, Chengdu, China
(Zuo) Department of Anesthesiology, West China Hospital, Sichuan
University & The Research Units of West China (2018RU012), Chinese Academy
of Medical Sciences, China
Publisher
NLM (Medline)
Abstract
BACKGROUND: Postoperative analgesia in the cardiothoracic ICU has
traditionally relied on intravenous opioids. Thoracic nerve blocks are
attractive alternatives for analgesia that reduce the requirement for
opioids, but their safety and feasibility remain unclear. METHOD(S):
Sixty children were allocated randomly to three groups: Group C received
intravenous opioids alone, while Group SAPB (deep serratus anterior plane
block) and Group ICNB (intercostal nerve block) received opioids combined
with ultrasound-guided regional nerve blocks (0.2% ropivacaine 2.5mg.kg-1)
after patients were transferred to the ICU. The primary outcome was opioid
requirement in the first 24h after surgery. Other outcomes included the
postoperative FLACC scale value, tracheal extubation time, and plasma
ropivacaine concentrations after the block. RESULT(S): Cumulative
opioids administered postoperatively within 24hours in the SAPB (168.6
[76.9]mug.kg-1) and ICNB groups (170.0 [86.8]mug.kg-1) were significantly
lower by nearly 53% than those in Group C (359.3 [125.3]mug.kg-1,
p=0.000). The tracheal extubation time was shorter in the regional block
groups than that in the control group, but the difference was not
statistically significant (p=0.177). The FLACC scale values at 0, 1, 3, 6,
12, and 24h post-extubation were similar in the three groups. The mean
peak plasma ropivacaine concentrations in the SAP and ICNB groups were 2.1
[0.8] and 1.8 [0.7]mg.L-1, respectively, 10minutes post-block and then
slowly decreased. No noticeable complications associated with regional
anesthesia were observed. CONCLUSION(S): Ultrasound-guided SAPB and
ICNB provided safe and satisfactory early postoperative analgesia while
reducing opioid consumption following sternotomy in pediatric patients.
CLINICAL TRIAL REGISTRATION: Chinese Clinical Trial Registry
ChiChiCTR2100046754. Copyright © 2023 Elsevier Ltd. All rights
reserved.

<73>
Accession Number
2025101540
Title
An Updated Meta-Analysis on the Clinical Outcomes of Percutaneous Left
Atrial Appendage Closure Versus Direct Oral Anticoagulation in Patients
With Atrial Fibrillation.
Source
American Journal of Cardiology. 200 (pp 135-143), 2023. Date of
Publication: 01 Aug 2023.
Author
Jiang H.; Koh T.H.; Vengkat V.; Fei G.; Ding Z.P.; Ewe S.H.; Jappar I.;
Lim S.T.; Yap J.
Institution
(Jiang, Vengkat) Lee Kong Chian School of Medicine, Nanyang Technological
University, Singapore
(Jiang, Koh, Fei, Ding, Ewe, Jappar, Lim, Yap) Department of Cardiology,
National Heart Center Singapore, Singapore
(Koh, Ding, Ewe, Jappar, Lim, Yap) Duke-NUS Medical School, Singapore
Publisher
Elsevier Inc.
Abstract
The availability of direct oral anticoagulants (DOACs) with known lower
bleeding risk compared with warfarin have raised questions about the role
of left atrial appendage closure (LAAC). We aimed to perform a
meta-analysis to compare the clinical outcomes for LAAC versus DOACs. All
studies directly comparing LAAC with DOACs up to January 2023 were
included. The outcomes studied included the combined major adverse
cardiovascular (CV) events outcomes, ischemic stroke and thromboembolic
events, major bleeding, CV mortality, and all-cause mortality. Hazard
ratios (HRs) and their 95% confidence interval were extracted or estimated
from the data and pooled together with a random-effects model. A total of
7 studies (1 randomized controlled trial, 6 propensity-matched
observational studies) were finally included, with a pooled population of
4,383 patients who underwent LAAC and 4,554 patients on DOACs. There were
no significant differences between patients who underwent LAAC and
patients on DOACs in terms of baseline age (75.0 vs 74.7, p = 0.27),
CHA<inf>2</inf>DS<inf>2</inf>-VASc score (5.1 vs 5.1, p = 0.33), or
HAS-BLED score (3.3 vs 3.3, p = 0.36). After a mean weighted follow-up of
22.0 months, LAAC was associated with significantly lower rates of
combined major adverse CV event outcomes (HR 0.73 [0.56 to 0.95], p =
0.02), all-cause mortality (HR 0.68 [0.54 to 0.86], p = 0.02), and CV
mortality (HR 0.55 [0.41 to 0.72], p<0.01). There were no significant
differences in the rates of ischemic stroke or systemic embolism (HR 1.12
[0.92 to 1.35], p = 0.25), major bleeding (HR 0.94 [0.67 to 1.32], p =
0.71), or hemorrhagic stroke (HR 1.07 [0.74 to 1.54], p = 0.74) between
LAAC and DOAC. In conclusion, percutaneous LAAC was found to be as
efficacious as DOACs for stroke prevention, with lower all-cause and CV
mortality. The rates of major bleeding and hemorrhagic stroke were
similar. LAAC has a potential role to play in stroke prevention in
patients with atrial fibrillation in the era of DOACs, but further
randomized data are needed. Copyright © 2023 Elsevier Inc.

<74>
Accession Number
2022365812
Title
Atrial natriuretic peptide in the prevention of acute renal dysfunction
after heart transplantation-a randomized placebo-controlled double-blind
trial.
Source
Acta Anaesthesiologica Scandinavica. 67(6) (pp 738-745), 2023. Date of
Publication: July 2023.
Author
Tholen M.; Kolsrud O.; Dellgren G.; Karason K.; Lannemyr L.; Ricksten
S.-E.
Institution
(Tholen, Lannemyr, Ricksten) Department of Anesthesiology and Intensive
Care Medicine, Institute of Clinical Sciences, University of Gothenburg,
Gothenburg, Sweden
(Kolsrud, Dellgren) Department of Cardiothoracic Surgery, Institute of
Medicine, University of Gothenburg, Gothenburg, Sweden
(Dellgren, Karason) Deparment of Transplantation Surgery, Institute of
Transplantation, University of Gothenburg, Gothenburg, Sweden
(Karason) Department of Cardiology, Institute of Medicine, University of
Gothenburg, Gothenburg, Sweden
Publisher
John Wiley and Sons Inc
Abstract
Background: Acute kidney injury (AKI) and renal dysfunction after heart
transplantation are common and serious complications. Atrial natriuretic
peptide (ANP) has been shown to increase glomerular filtration rate (GFR)
and exert renoprotective effects when used for the prevention/treatment of
AKI in cardiac surgery. We tested the hypothesis that intraoperative and
postoperative administration of ANP could prevent a postoperative decrease
in renal function early after heart transplantation. Method(s):
Seventy patients were randomized to receive either ANP (50 ng/kg/min) (n =
33) or placebo (n = 37) starting after induction of anesthesia and
continued for 4 days after heart transplantation or until treatment with
dialysis was started. The primary end-point of the present study was
measured GFR (mGFR) at day 4, assessed by plasma clearance of a renal
filtration marker. Also, the incidence of postoperative AKI and dialysis
were assessed. Result(s): Median (IQR) mGFR at day 4 postoperatively
was 60.0 (57.0) and 50.1 (36.3) ml/min/1.72 m2 for the placebo
and ANP groups, respectively (p =.705). During ongoing ANP infusion, the
need for dialysis was 21.6% and 9.1% for the placebo and ANP groups,
respectively (p =.197). The incidences of AKI for the placebo and the ANP
groups were 76.5% and 63.6%, respectively (p =.616). The incidences of AKI
stage 1 were 32.4% and 21.2% for the placebo and ANP groups, respectively
(p =.420) and for AKI stage 2 or 3, 37.8% and 42.4%, respectively (p
=.808). Conclusion(s): The study failed to detect that ANP infusion
attenuates renal dysfunction or decreases the incidence of AKI after heart
transplantation. Copyright © 2023 The Authors. Acta
Anaesthesiologica Scandinavica published by John Wiley & Sons Ltd on
behalf of Acta Anaesthesiologica Scandinavica Foundation.

<75>
Accession Number
2022028839
Title
Conduction Disorders after Surgical Aortic Valve Replacement Using a Rapid
Deployment Aortic Valve Prosthesis: Medium-Term Follow-Up.
Source
Journal of Clinical Medicine. 12(5) (no pagination), 2023. Article Number:
2083. Date of Publication: March 2023.
Author
Mogilansky C.; Massoudy P.; Czesla M.; Balan R.
Institution
(Mogilansky, Massoudy, Czesla, Balan) Department of Cardiac Surgery,
Klinikum Passau, Passau 94032, Germany
Publisher
MDPI
Abstract
Background: We have previously reported that the incidence of
postoperative conduction disorders, especially left bundle branch block
(LBBB), after implantation of a rapid deployment IntuityTM Elite aortic
valve prosthesis (Edwards Lifesciences, Irvine, CA, USA), was
significantly increased compared with conventional aortic valve
replacement. We were now interested in how these disorders behaved at
intermediate follow-up. Method(s): All 87 patients who had undergone
surgical aortic valve replacement (SAVR) using the rapid deployment
IntuityTM Elite prosthesis and were shown to have conduction disorders at
the time of hospital discharge were followed up after surgery. These
patients' ECGs were recorded at least 1 year after surgery, and the
persistence of the new postoperative conduction disorders was assessed.
 Result(s): At hospital discharge, 48.1% of the patients had developed
new postoperative conduction disorders, with LBBB being the predominant
conduction disturbance (36.5%). At medium-term follow-up (526 days,
standard deviation (SD) = 169.6, standard error (SE) = 19.3 days,
respectively), 44% of the new LBBB and 50% of the new right bundle branch
block (RBBB) had disappeared. There was no new atrio-ventricular block III
(AVB III) that occurred. One new pacemaker (PM) was implanted during
follow-up because of AVB II Mobitz type II. Conclusion(s): At
medium-term follow-up after the implantation of a rapid deployment
IntuityTM Elite aortic valve prosthesis, the number of new postoperative
conduction disorders, especially LBBB, has considerably decreased but
remains high. The incidence of postoperative AV block III remained
stable. Copyright © 2023 by the authors.

<76>
Accession Number
2019146122
Title
Lipid Management in Korean People With Type 2 Diabetes Mellitus: Korean
Diabetes Association and Korean Society of Lipid and Atherosclerosis
Consensus Statement.
Source
Journal of Lipid and Atherosclerosis. 12(1) (pp 12-22), 2023. Date of
Publication: Jan 2023.
Author
Yang Y.S.; Kim H.-L.; Kim S.-H.; Moon M.K.
Institution
(Yang) Department of Medicine, Seoul National University College of
Medicine, Seoul, South Korea
(Kim, Kim, Moon) Department of Internal Medicine, Seoul Metropolitan
Government-Seoul National University Boramae Medical Center, Seoul, South
Korea
(Kim, Kim, Moon) Department of Internal Medicine, Seoul National
University College of Medicine, Seoul, South Korea
Publisher
Korean Society of Lipid and Atherosclerosis
Abstract
Dyslipidemia in patients with diabetes is an important treatment target as
a modifiable risk factor for cardiovascular disease (CVD). Although the
primary treatment goal for dyslipidemia is to control low-density
lipoprotein cholesterol (LDL-C), achieving this goal remains suboptimal
according to recent studies. It is important to set the target goal for
LDL-C control based on an accurate risk assessment for CVD. Here, we
summarize the latest evidence on lipid management in patients with
diabetes and present a consensus of the Korean Diabetes Association and
Korean Society of Lipid and Atherosclerosis on the treatment goals of
LDL-C according to the duration of diabetes, presence of CVD, target organ
damage, or major cardiovascular risk factors. In patients with type 2
diabetes mellitus (T2DM) and CVD, an LDL-C goal of <55 mg/dL and a
reduction in LDL-C level by 50% or more from the baseline is recommended.
For the primary prevention of CVD in patients with T2DM with a duration of
diabetes >=10 years, major cardiovascular risk factors, or target organ
damage, an LDL-C goal of <70 mg/dL is recommended. In patients with T2DM
with a duration of diabetes <10 years and no major cardiovascular risk
factors, an LDL-C goal of <100 mg/dL is recommended. Copyright ©
2023 The Korean Society of Lipid and Atherosclerosis.

<77>
Accession Number
641670887
Title
Stroke Risk with Warfarin vs. NOACs in Artificial Heart Valves: a
Meta-Analysis.
Source
Neurology. Conference: American Academy Of Neurology Annual Meeting, AAN
2023. Boston, MA United States. 100(17 Supplement 2) (no pagination),
2023. Date of Publication: April 2023.
Author
Srivastava Y.; Almader-Douglas D.; Deo S.; Sharma U.
Publisher
Lippincott Williams and Wilkins
Abstract
Objective: This systematic review and meta-analysis evaluates multiple
clinical outcomes between warfarin and NOACs in patients with artificial
heart valves. Background(s): Although novel oral anticoagulants
(NOAC) have been proven as effective alternatives to warfarin in patients
with atrial fibrillation, the effectiveness of NOACs in patients with
artificial (bioprosthetic and mechanical) heart valves is not known.
Design/Methods: PubMed, CINHAL, and Clinicaltrials.gov were searched
through May 2022 for studies comparing clinical outcomes of adults with
artificial heart valves that received warfarin vs. NOACs. Data was pooled
with Der Simonian and Laird's random effects model. Result(s): Eight
studies (n = 183167, 38% female) met the criteria for study inclusion.
Four were randomized control trials (RCTs) and four were retrospective
cohort studies. Mechanical and bioprosthetic valves were represented in
14.7% and 85.3% of patients respectively. There was no statistically
significant difference between NOACs and warfarin for all bleeding,
all-cause mortality, TIA, systemic embolism, and all-stroke outcomes.
Overall Warfarin led to 22% more major bleeding (OR = 1.22, 95% CI =
[1.05, 1.41], p = 0.01) and more ischemic stroke (OR = 1.72, 95% CI =
[1.1, 2.68], p = 0.02) compared to NOACs. Also amongst patients with
bioprosthetic heart valves, Warfarin led to 33% more major bleeding
compared to NOACs (OR = 1.33, 95% CI = [1.06, 1.66]). However, NOACs led
to 65% more major bleeding compared to warfarin among those with
mechanical heart valves (OR = 0.35, 95% CI = [0.18, 0.67]).
 Conclusion(s): Compared with warfarin, NOACs reduced the risk of
ischemic stroke and major bleeding in patients with artificial heart
valves. NOACs reduced the risk of ischemic stroke and major bleeding in
patients with bioprosthetic heart valves, but not in patients with
mechanical heart valves compared to Warfarin.

<78>
Accession Number
2025395994
Title
Effects of Elective Coronary Revascularization vs Medical Therapy Alone on
Noncardiac Mortality: A Meta-Analysis.
Source
JACC: Cardiovascular Interventions. (pp 1144-1156), 2023. Date of
Publication: 2023.
Author
Navarese E.P.; Lansky A.J.; Farkouh M.E.; Grzelakowska K.; Bonaca M.P.;
Gorog D.A.; Raggi P.; Kelm M.; Yeo B.; Uminska J.; Curzen N.; Kubica J.;
Wijns W.; Kereiakes D.J.
Institution
(Navarese, Grzelakowska, Yeo, Uminska, Kubica) Interventional Cardiology
and Cardiovascular Medicine Research, Department of Cardiology and
Internal Medicine, Nicolaus Copernicus University, Bydgoszcz, Poland
(Navarese, Raggi) Faculty of Medicine, University of Alberta, Edmonton,
AB, Canada
(Navarese, Grzelakowska, Yeo, Uminska, Kubica) SIRIO MEDICINE Research
Network, Bydgoszcz, Poland
(Lansky) Yale School of Medicine, New Haven, CT, United States
(Farkouh) Peter Munk Cardiac Centre, University of Toronto, Toronto, ON,
Canada
(Farkouh) Cedars Sinai Health System, Los Angeles, Canada
(Bonaca) CPC Clinical Research, University of Colorado School of Medicine,
Aurora, CO, United States
(Gorog) Faculty of Medicine, National Heart and Lung Institute, Imperial
College London, London, United Kingdom
(Gorog) Cardiology Department, East and North Hertfordshire NHS Trust,
Stevenage, United Kingdom
(Kelm) Heinrich Heine University Medical Center Dusseldorf, Dusseldorf,
Germany
(Kelm) Division of Cardiology, Pulmonology, and Vascular Medicine,
Cardiovascular Research Institute Dusseldorf, Dusseldorf, Germany
(Curzen) University Hospital Southampton NHS Foundation Trust,
Southampton, United Kingdom
(Curzen) University of Southampton, Southampton, United Kingdom
(Wijns) Lambe Institute for Translational Medicine and CURAM, National
University of Ireland Galway and Saolta University Healthcare Group,
Galway, Ireland
(Kereiakes) Christ Hospital and Lindner Research Center, Cincinnati, OH,
United States
Publisher
Elsevier Inc.
Abstract
Background: Uncertainty exists whether coronary revascularization plus
medical therapy (MT) is associated with an increase in noncardiac
mortality in chronic coronary syndrome (CCS) when compared with MT alone,
particularly following recent data from the ISCHEMIA-EXTEND (International
Study of Comparative Health Effectiveness with Medical and Invasive
Approaches) trial. Objective(s): This study conducted a large-scale
meta-analysis of trials comparing elective coronary revascularization plus
MT vs MT alone in patients with CCS to determine whether revascularization
has a differential impact on noncardiac mortality at the longest
follow-up. Method(s): We searched for randomized trials comparing
revascularization plus MT vs MT alone in patients with CCS. Treatment
effects were measured by rate ratios (RRs) with 95% CIs, using
random-effects models. Noncardiac mortality was the prespecified endpoint.
The study is registered with PROSPERO (CRD42022380664). Result(s):
Eighteen trials were included involving 16,908 patients randomized to
either revascularization plus MT (n = 8,665) or to MT alone (n = 8,243).
No significant differences were detected in noncardiac mortality between
the assigned treatment groups (RR: 1.09; 95% CI: 0.94-1.26; P = 0.26),
with absent heterogeneity (I2 = 0%). Results were consistent
without the ISCHEMIA trial (RR: 1.00; 95% CI: 0.84-1.18; P = 0.97). By
meta-regression, follow-up duration did not affect noncardiac death rates
with revascularization plus MT vs MT alone (P = 0.52). Trial sequential
analysis confirmed the reliability of meta-analysis, with the cumulative
Z-curve of trial evidence within the nonsignificance area and reaching
futility boundaries. Bayesian meta-analysis findings were consistent with
the standard approach (RR: 1.08; 95% credible interval: 0.90-1.31).
 Conclusion(s): In patients with CCS, noncardiac mortality in late
follow-up was similar for revascularization plus MT compared with MT
alone. Copyright © 2023 American College of Cardiology Foundation

<79>
Accession Number
2025324608
Title
Delirium in older patients given propofol or sevoflurane anaesthesia for
major cancer surgery: a multicentre randomised trial.
Source
British Journal of Anaesthesia. (no pagination), 2023. Date of
Publication: 2023.
Author
Cao S.-J.; Zhang Y.; Zhang Y.-X.; Zhao W.; Pan L.-H.; Sun X.-D.; Jia Z.;
Ouyang W.; Ye Q.-S.; Zhang F.-X.; Guo Y.-Q.; Ai Y.-Q.; Zhao B.-J.; Yu
J.-B.; Liu Z.-H.; Yin N.; Li X.-Y.; Ma J.-H.; Li H.-J.; Wang M.-R.;
Sessler D.I.; Ma D.; Wang D.-X.
Institution
(Cao, Zhang, Zhang, Ma, Wang) Department of Anesthesiology, Peking
University First Hospital, Beijing, China
(Zhang) Clinical Research Institute, Shenzhen Peking University-The Hong
Kong University of Science and Technology Medical Center, Guangdong,
Shenzhen, China
(Zhao) Department of Anesthesiology, The Fourth Hospital of Hebei Medical
University, Hebei, Shijiazhuang, China
(Pan) Department of Anesthesiology, Guangxi Medical University Cancer
Hospital, Guangxi Zhuang Autonomous Region, Nanning, China
(Sun) Department of Anesthesiology, Tangdu Hospital, Air Force Medical
University (Fourth Military Medical University), Shaanxi, Xi'an, China
(Jia) Department of Anesthesiology, Affiliated Hospital of Qinghai
University, Qinghai, Xining, China
(Ouyang) Department of Anesthesiology, The Third Xiangya Hospital, Central
South University, Hunan, Changsha, China
(Ye) Department of Anesthesiology, People's Hospital of Ningxia Hui
Autonomous Region, Ningxia Hui Autonomous Region, Yinchuan, China
(Zhang) Department of Anesthesiology, Guizhou Provincial People's
Hospital, Guizhou, Guiyang, China
(Guo) Department of Anesthesiology, Shanxi Provincial People's Hospital,
Shanxi, Taiyuan, China
(Ai) Department of Anesthesiology, Pain and Perioperative Medicine, The
First Affiliated Hospital of Zhengzhou University, Henan, Zhengzhou, China
(Zhao) Department of Anesthesiology, Beijing Shijitan Hospital, Capital
Medical University, Beijing, China
(Yu) Department of Anesthesiology and Critical Care Medicine, Tianjin
Nankai Hospital, Tianjin Medical University, Tianjin, China
(Liu) Department of Anesthesiology, Shenzhen Second People's Hospital, The
First Affiliated Hospital of Shenzhen University, Health Science Center,
Guangdong, Shenzhen, China
(Yin) Department of Anesthesiology, Zhongda Hospital, Medical School of
Southeast University, Jiangsu, Nanjing, China
(Yin) Department of Anesthesiology, Sir Run Run Hospital, Nanjing Medical
University, Jiangsu, Nanjing, China
(Li) Department of Biostatistics, Peking University First Hospital,
Beijing, China
(Li, Wang) Peking University Clinical Research Institute, Peking
University Health Science Center, Beijing, China
(Sessler) Department of Outcomes Research, Cleveland Clinic, Cleveland,
OH, United States
(Sessler, Wang) Outcomes Research Consortium, Cleveland, OH, United States
(Ma) Division of Anesthetics, Pain Medicine and Intensive Care, Department
of Surgery and Cancer, Faculty of Medicine, Imperial College London,
Chelsea and Westminster Hospital, London, United Kingdom
(Ma) The Children's Hospital, Zhejiang University School of Medicine,
National Clinical Research Center for Child Health, Hangzhou, China
Publisher
Elsevier Ltd
Abstract
Background: Delirium is a common and disturbing postoperative complication
that might be ameliorated by propofol-based anaesthesia. We therefore
tested the primary hypothesis that there is less delirium after
propofol-based than after sevoflurane-based anaesthesia within 7 days of
major cancer surgery. Method(s): This multicentre randomised trial
was conducted in 14 tertiary care hospitals in China. Patients aged 65-90
yr undergoing major cancer surgery were randomised to either
propofol-based anaesthesia or to sevoflurane-based anaesthesia. The
primary endpoint was the incidence of delirium within 7 postoperative
days. Result(s): A total of 1228 subjects were enrolled and
randomised, with 1195 subjects included in the modified intention-to-treat
analysis (mean age 71 yr; 422 [35%] women); one subject died before
delirium assessment. Delirium occurred in 8.4% (50/597) of subjects given
propofol-based anaesthesia vs 12.4% (74/597) of subjects given
sevoflurane-based anaesthesia (relative risk 0.68 [95% confidence interval
{CI}: 0.48-0.95]; P=0.023; adjusted relative risk 0.59 [95% CI:
0.39-0.90]; P=0.014). Delirium reduction mainly occurred on the first day
after surgery, with a prevalence of 5.4% (32/597) with propofol
anaesthesia vs 10.7% (64/597) with sevoflurane anaesthesia (relative risk
0.50 [95% CI: 0.33-0.75]; P=0.001). Secondary endpoints, including ICU
admission, postoperative duration of hospitalisation, major complications
within 30 days, cognitive function at 30 days and 3 yr, and safety
outcomes, did not differ significantly between groups. Conclusion(s):
Delirium was a third less common after propofol than sevoflurane
anaesthesia in older patients having major cancer surgery. Clinicians
might therefore reasonably select propofol-based anaesthesia in patients
at high risk of postoperative delirium. Clinical trial registration:
Chinese Clinical Trial Registry (ChiCTR-IPR-15006209) and
ClinicalTrials.gov (NCT02662257). Copyright © 2023 The Authors

<80>
Accession Number
2025205257
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: 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, Nicolet, Rozec) Nantes Universite, CHU Nantes, CNRS, INSERM,
l'institut du thorax, Nantes, France
(Dauvergne, Rozec) 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, Universite Paris Cite,
Paris, France
(Volteau) Nantes Universite, CHU Nantes, Direction de la Recherche et de
l'innovation, Plateforme de methodologie et biostatistique, Nantes, France
(Corne) Service de soins intensifs de pneumologie, hopital Laennec, CHU
Nantes, Nantes, France
Publisher
W.B. Saunders
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(s): A randomized controlled study.
 Setting(s): At a single-center tertiary hospital.
 Participant(s): 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(s):
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]
cmH<inf>2</inf>O, 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.

<81>
Accession Number
2025069933
Title
HEART Score Recalibration Using Higher Sensitivity Troponin T.
Source
Annals of Emergency Medicine. (no pagination), 2023. Date of Publication:
2023.
Author
Khand A.U.; Backus B.; Campbell M.; Frost F.; Mullen L.; Fisher M.;
Theodoropoulos K.C.; Obeidat M.; Batouskaya K.; Carlton E.W.; Van Meerten
K.; Neoh K.; Dakshi A.; Mumma B.E.
Institution
(Khand, Campbell, Fisher, Obeidat, Batouskaya, Neoh, Dakshi) Liverpool
University Hospital, Liverpool, United Kingdom
(Khand, Mullen, Fisher, Theodoropoulos) Liverpool Heart and Chest
Hospital, Liverpool, United Kingdom
(Khand, Frost) Liverpool Centre for Cardiovascular Diseases, University of
Liverpool, Liverpool, United Kingdom
(Backus) Erasmus Medical Center, Rotterdam, Netherlands
(Carlton) North Bristol NHS Trust, Bristol, United Kingdom
(Van Meerten) Albert Schweitzer Hospital, Dordrecht, Netherlands
(Mumma) Department of Emergency Medicine, University of California, Davis
School of Medicine, Sacramento, CA, United States
Publisher
Elsevier Inc.
Abstract
Study objective: We examined the diagnostic performance of a recalibrated
History, Electrocardiogram, Age, Risk factors, Troponin (HEART), and
Thrombolysis in Myocardial Infarction (TIMI) score in patients with
suspected acute cardiac syndrome (ACS). Recalibration of troponin
thresholds was performed, including shifting from the 99th percentile to
the limit of detection (LOD) or to the limit of quantification (LOQ) We
compared the discharge potential and safety of the recalibrated composite
scores using a single presentation high-sensitivity cardiac troponin
(hs-cTn) T to the conventional scores and with a LOD/LOQ troponin strategy
alone. Method(s): We undertook a 2-center prospective cohort study in
the United Kingdom (UK) (2018) (Clinicaltrials.gov NCT03619733) to
specifically assess recalibrated risk scores (shifting the troponin subset
scoring from 99th percentile to LOD [UK]) and combined the results of this
with secondary analyses of 2 prospective cohort studies in the UK (2011)
and the United States (2018, using LOQ rather than LOD). The primary
outcome was major adverse cardiovascular events (MACE), defined as
adjudicated type 1 myocardial infarction (MI), urgent coronary
revascularization, and all-cause death, at 30 days. We evaluated the
original scores using hs-cTn below the 99th percentile and recalibrated
scores using hs-cTn <LOD/LOQ and compared these composite scores with a
single hs-cTnT less than LOD/LOQ combined with a nonischemic ECG. For each
discharge strategy, an assessment of clinical effectiveness was also made,
defined as the proportion of patients eligible for discharge from the
emergency department without the need for further inpatient testing.
 Result(s): We studied 3,752 patients (3,003 in the UK and 749 in the
United States). Median age was 58 years, and 48% were female. At 30 days,
330/3,752 (8.8%) experienced MACE. The sensitivities of the original HEART
less or equal to 3 and recalibrated HEART less or equal to 3 scores for
rule-out were 96.1% (95% confidence interval [CI], 93.4 to 97.9) and 98.6%
(95% CI, 96.5 to 99.5) respectively; the original TIMI less or equal to 1
and recalibrated TIMI less or equal to 1 scores' sensitivities were 79.7%
(95% CI, 74.9 to 83.9) and 96.1% (95% CI, 93.4 to 97.9) respectively; and
nonischemic ECG with hs-cTn T below the 99th percentile and hs-cTn T less
than LOD/LOQ was 79.7% (95%CI, 0.749 to 0.839) and 99.1% (95% CI, 0.974 to
0.998), respectively. Recalibrated HEART less or equal to 3 was projected
to discharge 14% more patients than hs-cTn T less than LOD/LOQ. The
improved sensitivity of rule-out for recalibrated HEART less than or equal
to 3 came at the cost of reduced specificity (50.8% versus 53.8% for
recalibrated HEART and conventional HEART respectively).
 Conclusion(s): This study indicates that recalibrated HEART score of
less or equal to 3 is a feasible and safe early discharge strategy using a
single presentation hs-cTnT. This finding should be further tested using
competitor hs-cTn assays in independent prospective cohorts before
implementation. Copyright © 2023 American College of Emergency
Physicians

<82>
Accession Number
2024912093
Title
Serratus anterior and pectoralis plane blocks for robotically assisted
mitral valve repair: a randomised clinical trial. Comment on Br J Anaesth
2023; 130: 786-794.
Source
British Journal of Anaesthesia. (no pagination), 2023. Date of
Publication: 2023.
Author
Coppens S.; Hoogma D.; Rex S.; Wolmarans M.; Merjavy P.
Institution
(Coppens, Hoogma, Rex) University Hospitals of Leuven, Department of
Anesthesiology, Leuven, Belgium
(Coppens, Hoogma, Rex) University of Leuven, Biomedical Sciences Group,
Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium
(Merjavy) Department of Anaesthesia, Craigavon Area University Teaching
Hospital, Northern Ireland, Craigavon, United Kingdom
(Wolmarans, Merjavy) Norwich Medical School, University of East Anglia,
Norwich, United Kingdom
(Wolmarans) Department of Anaesthesia, Norfolk & Norwich University
Hospital, Norwich, United Kingdom
Publisher
Elsevier Ltd

<83>
Accession Number
2024911917
Title
Transcatheter aortic valve implantation versus surgical aortic valve
replacement in chronic kidney disease: Meta-analysis of reconstructed
time-to-event data.
Source
Trends in Cardiovascular Medicine. (no pagination), 2023. Date of
Publication: 2023.
Author
Jacquemyn X.; Van den Eynde J.; Iwens Q.; Billiau J.; Jabagi H.;
Serna-Gallegos D.; Chu D.; Sultan I.; Sa M.P.
Institution
(Jacquemyn, Van den Eynde) Department of Cardiovascular Sciences, KU
Leuven, Leuven, Belgium
(Jacquemyn, Van den Eynde, Iwens, Billiau) Faculty of Medicine, KU Leuven,
Leuven, Belgium
(Jabagi) Department of Cardiothoracic Surgery, Valley Heart and Vascular
Institute, Ridgewood, NJ, United States
(Serna-Gallegos, Chu, Sultan, Sa) Department of Cardiothoracic Surgery,
University of Pittsburgh, Pittsburgh, PA, United States
(Serna-Gallegos, Chu, Sultan, Sa) Heart and Vascular Institute, University
of Pittsburgh Medical Center, Pittsburgh, PA, United States
Publisher
Elsevier Inc.
Abstract
Background: Patients with advanced chronic kidney disease (CKD) are a
challenging and understudied population. Specifically, the late outcomes
following surgical aortic valve replacement (SAVR) or transcatheter aortic
valve implantation (TAVI) in patients with CKD remains uncertain.
 Objective(s): To compare overall mortality risk in patients with
moderate-to-severe CKD following TAVI versus SAVR. Method(s):
Study-level meta-analysis of reconstructed time-to-event data from
Kaplan-Meier curves of studies published by August 2022. Result(s):
Nine studies met our inclusion criteria. Patients who underwent TAVI had a
higher 5-year mortality compared with patients undergoing SAVR in the
overall population (HR 1.56, 95% CI 1.44-1.69, P < 0.001) and in
populations with similar risk scores (HR 1.15, 95% CI 1.01-1.31, P =
0.035). The landmark analysis revealed a lower risk of 30-day mortality
with TAVI (HR 0.62, 95% CI 0.41-0.94, P = 0.023), followed by similar risk
until 7.5 months (HR 1, 95% CI 0.78-1.27, P = 0.978). In contrast, the
landmark analysis beyond 7.5 months yielded a reversal of the HR in favor
of SAVR (TAVI with HR 1.27, 95% CI 1.08-1.49 P = 0.003).
 Conclusion(s): In patients with CKD, TAVI provides an initial
survival benefit over SAVR. However, in the long run, a significant
survival benefit of SAVR over TAVI was observed. Our findings highlight
the need for randomized controlled trials to investigate outcomes in this
special population. Copyright © 2023 Elsevier Inc.

<84>
Accession Number
2024833246
Title
Current Status of Simulation in Thoracic Surgical Training.
Source
Annals of Thoracic Surgery. (no pagination), 2023. Date of Publication:
2023.
Author
Whittaker G.; Ghita I.-A.; Taylor M.; Salmasi M.Y.; Granato F.; Athanasiou
T.
Institution
(Whittaker, Salmasi, Athanasiou) Department of Surgery and Cancer,
Imperial College London, London, United Kingdom
(Whittaker, Taylor, Granato) Department of Cardiothoracic Surgery,
Manchester University NHS Foundation Trust, Manchester, United Kingdom
(Ghita) Faculty of Medicine, University of Medicine and Pharmacy of
Craiova, Craiova, Romania
Publisher
Elsevier Inc.
Abstract
Background: Simulation is playing an increasingly important role in
surgical training but is not yet a mandatory part of most surgical
curricula. A simulator must undergo rigorous validation to verify it as a
reliable tool. The aim of this study was to review the literature to
identify simulators that are currently available to augment thoracic
surgical training and to analyze any evidence supporting or validating
them. Method(s): A literature search of the MEDLINE (1946 to November
2022) and Embase (1947 to November 2022) databases was performed to
identify simulators for basic skills and procedures in thoracic surgery. A
selection of keywords were used to perform the literature search. After
identification of appropriate articles, data were extracted and analyzed.
 Result(s): Thirty-three simulators were found in 31 articles.
Simulators for basic skills (n = 13) and thoracic lobectomy (n = 13) were
most commonly described, followed by miscellaneous (n = 7). Most models
were of a hybrid modality (n = 18). Evidence of validity was established
in 48.5% (n = 16) of simulators. In total, 15.2% (n = 5) of simulators had
3 or more elements of validity demonstrated, and only 3.0% (n = 1)
accomplished full validation. Conclusion(s): Numerous simulators of
varying modality and fidelity exist for a variety of thoracic surgical
skills and procedures, although validation evidence is frequently
inadequate. Simulation models may be able to provide training in basic
surgical and procedural skills; however, further assessment of validity
needs to be undertaken before consideration of their integration into
training programs. Copyright © 2023 The Society of Thoracic
Surgeons

<85>
Accession Number
2024026023
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: 2023.
Author
Boano G.; Vanky F.; Astrom Aneq M.
Institution
(Boano, Vanky) Department of Thoracic and Vascular Surgery in
Ostergotland, and Department of Health, Medicine and Caring Sciences,
Linkoping University, Linkoping, Sweden
(Astrom Aneq) Department of Clinical Physiology in Linkoping, Department
of Health, Medicine and Caring Sciences Linkoping University, Linkoping,
Sweden
Publisher
John Wiley and Sons Inc
Abstract
Background: Atrial linear scars in Cox-Maze IV procedures are achieved
using Cryothermy (Cryo) or radiofrequency (RF) techniques. The subsequent
postoperative left atrial (LA) reverse remodelling 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 1 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 enroled without
ablation (NoMaze). All patients underwent an echocardiogram the day before
and 1 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) 1 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 remodelling affecting LA systolic
function. Copyright © 2023 The Authors. Clinical Physiology and
Functional Imaging published by John Wiley & Sons Ltd on behalf of
Scandinavian Society of Clinical Physiology and Nuclear Medicine.

<86>
Accession Number
641668844
Title
Implementation and Importance of Cardiac Rehabilitation for Cardiac
Patients in Saudi Arabia: A Systematic Review.
Source
Current vascular pharmacology. (no pagination), 2023. Date of
Publication: 23 Jun 2023.
Author
Hadi Ahmed R.; Bugis B.A.
Institution
(Hadi Ahmed) Department of Public Health, College of Health Sciences,
Saudi Electronic University, Riyadh, Saudi Arabia
(Hadi Ahmed) King Fahad Medical City, Second Health Cluster, Riyadh, Saudi
Arabia
(Bugis) Department of Public Health, College of Health Sciences, Saudi
Electronic University, Dammam, Saudi Arabia
Publisher
NLM (Medline)
Abstract
OBJECTIVE: Cardiac rehabilitation (CR) has progressed over the years from
a basic monitoring procedure for a safe return to physical activity to a
multidisciplinary strategy that emphasizes patient education, specifically
for designed exercise training, risk factor management, and the general
health of cardiac patients. METHOD(S): Preferred Reporting Items for
Systematic Reviews and Meta-Analyses (PRISMA) reporting was used for this
systematic review. The studies included were retrieved via an electronic
search of Google Scholar and PubMed using the following terms: cardiac
rehabilitation (CR), cardiac diseases, coronary artery bypass graft, heart
failure, cardiac rehabilitation guidelines, rehabilitation, recovery of
function, cardiac rehabilitation importance, cardiac rehabilitation
outcomes, physical therapy modalities, secondary prevention, physical
medicine, and cardiac rehabilitation phases. RESULT(S): Publications
(n=24) that included worldwide standards demonstrating the implementation
of CR programs in a variety of scenarios were reviewed. These publications
are based on well-defined guidelines that represent best practices from
several cardiology societies, which use varying valid programs by
comparing those guidelines with CR/secondary prevention programs.
 CONCLUSION(S): Several indications have been used in the development
of the CR program, with the goal of regaining autonomy and increasing
physical, psychological, and social activities. With the Saudi Vision 2030
initiatives for health national transformation programs, there are targets
set to ensure the reduction and prevention of noncommunicable diseases and
to reduce cardiovascular disease risks by initiating an accredited CR
program and guidelines for Saudi Arabia. Copyright© Bentham
Science Publishers; For any queries, please email at
epub@benthamscience.net.

<87>
Accession Number
641668026
Title
Prediction of adverse outcomes in nonischemic dilated cardiomyopathy: A
CMR-based nomogram.
Source
International journal of cardiology. (pp 131136), 2023. Date of
Publication: 23 Jun 2023.
Author
Xiang X.; Zhao K.; Chen X.; Song Y.; Yang K.; Yu S.; Yang S.; Wang J.;
Dong Z.; Lu M.; Ma L.; Zhao S.
Institution
(Xiang, Chen, Song, Yang, Yu, Yang, Wang, Dong, Lu, Zhao) MR Center, Fuwai
Hospital, National Center for Cardiovascular Diseases, Chinese Academy of
Medical Sciences and Peking Union Medical College, Beijing 100037, China
(Zhao) Paul C. Lauterbur Research Center for Biomedical Imaging, Shenzhen
Institutes of Advanced Technology, Chinese Academy of Sciences, SZ
University Town, Shenzhen 518055, China
(Ma) First Affiliated Hospital of USTC, Division of Life Sciences and
Medicine, University of Science and Technology of China, Hefei, Anhui
230036, China
Publisher
NLM (Medline)
Abstract
OBJECTIVES: To develop and validate a novel nomogram score to predict
outcomes in patients with nonischemic dilated cardiomyopathy (NIDCM) over
a long follow-up period. METHOD(S): A total of 335 consecutive NIDCM
patients who underwent cardiac magnetic resonance (CMR) imaging were
retrospectively enrolled. Comprehensive clinical evaluation and imaging
investigation were obtained, including measurements of late gadolinium
enhancement (LGE) and feature tracking (FT) images. All patients were
followed up for a composite endpoint of major adverse cardiac events
(MACE) including all-cause mortality and heart transplantation. These
patients were randomly divided into development and validation cohorts
(7:3). RESULT(S): MACE occurred in 87 (37.2%) out of 234 patients in
the development cohort, and in 31 (30.7%) out of 101 patients in the
validation cohort. Five variables including NYHA class III-IV, NT-proBNP,
beta-blocker medication, LGE presence, and LV global longitudinal strain
(GLS) were found to be significantly associated with MACE and were used
for constructing the nomogram. The nomogram achieved good discrimination
with C-indexes in development and validation cohorts respectively. The
calibration curve for 1-, 3-, and 5-year survival probability also showed
high coherence between the predicted and actual probability of MACE.
Decision curve analysis identified the model was significantly better net
benefit in predicting MACE. CONCLUSION(S): A novel nomogram score of
a predictive model that incorporates clinical factors and imaging features
was constructed, which could be conveniently used to facilitate risk
evaluation in patients with NIDCM. Copyright © 2023. Published by
Elsevier B.V.

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