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<1>
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Accession Number
2026978893
Title
The effect of bedtime versus morning dosing of antihypertensive drugs on
the cardiovascular outcomes: A systematic review and meta-analysis of
randomized controlled trials.
Source
Journal of Hypertension. 41(10) (pp 1595-1605), 2023. Date of Publication:
01 Oct 2023.
Author
Abuelazm M.; Saleh O.; Albarakat M.M.; Katamesh B.; Abdalshafy H.; Mahmoud
A.; Abdelazeem B.
Institution
(Abuelazm, Katamesh) Faculty of Medicine, Tanta University, Tanta, Egypt
(Saleh) Faculty of Medicine, The Hashemite University, Zarqa, Jordan
(Albarakat) Faculty of Medicine, Jordan University of Science and
Technology, Irbid, Jordan
(Abdalshafy) Faculty of Medicine, Cairo University, Cairo, Egypt
(Mahmoud) Faculty of Medicine, Minia University, Minia, Egypt
(Abdelazeem) Department of Internal Medicine, McLaren Healthcare, Flint,
Michigan State University, East Lansing, MI, United States
(Abdelazeem) Department of Internal Medicine, Michigan State University,
East Lansing, MI, United States
Publisher
Lippincott Williams and Wilkins
Abstract
Background and objective:Antihypertensive drugs are one of the most
effective strategies to prevent disability and mortality; however, there
have been contradictory findings about the best dosing time for
antihypertensive drugs. Therefore, we aim to evaluate the effect of
bedtime versus morning dosing of antihypertensive drugs on cardiovascular
outcomes. <br/>Method(s):We synthesized randomized controlled studies
(RCTs) from the Web of Science, SCOPUS, EMBASE, PubMed, and CENTRAL until
13 October 2022. The risk ratio (RR) for dichotomous outcomes with the
corresponding 95% confidence interval (CI) was used. The study protocol
was registered in PROSPERO with ID: CRD42022368612. <br/>Result(s):Five
RCTs with 59 200 participants were included. Bedtime dosing was
significantly associated with less incidence of myocardial infarction (MI)
[RR: 0.80 with 95% CI (0.70-0.91), P = 0.0007] compared with morning
dosing; however, there was no statistically significant difference between
bedtime and morning dosing, regarding all-cause mortality [RR: 0.77 with
95% CI (0.51-1.16), P = 0.21], cardiovascular mortality [RR: 0.65 with 95%
CI (0.35-1.21), P = 0.17], major adverse cardiac events (MACE) [RR: 0.79
with 95% CI (0.56-1.10), P = 0.16], heart failure [RR: 0.68 with 95% CI
(0.42-1.09), P = 0.11], cerebrovascular accidents [RR: 0.80 with 95% CI
(0.53-1.22), P = 0.30], coronary revascularization [RR: 0.79 with 95% CI
(0.50-1.24), P = 0.30}, and angina [RR: 0.91 with 95% CI (0.55-1.50), P =
0.70]. <br/>Conclusion(s):Evidence about the comparative efficacy of
bedtime versus morning dosing of antihypertensives is still uncertain.
However, bedtime dosing significantly reduced MI, which warrants more
robust RCTs to validate.<br/>&#xa9; Copyright 2023 Wolters Kluwer Health,
Inc. All rights reserved.

<2>
Accession Number
2026212129
Title
Clinical Outcomes of Transcatheter Aortic Valve Replacement With and
Without Percutaneous Coronary Intervention-An Updated Meta-Analysis and
Systematic Review.
Source
Current Problems in Cardiology. 48(11) (no pagination), 2023. Article
Number: 101980. Date of Publication: November 2023.
Author
Yassen M.; Moustafa A.; Venkataramany B.; Schodowski E.; Royfman R.;
Eltahawy E.
Institution
(Yassen) Department of Internal Medicine, University of Toledo Medical
Center, Toledo, OH, United States
(Moustafa, Eltahawy) Department of Internal Medicine, Division of
Cardiovascular Medicine, University of Toledo Medical Center, Toledo, OH,
United States
(Venkataramany, Schodowski, Royfman) University of Toledo, College of
Medicine and Life Sciences, Toledo, OH, United States
Publisher
Elsevier Inc.
Abstract
Transcatheter aortic valve replacement (TAVR) is indicated for high-risk
patients with severe degenerative aortic stenosis (AS). Given the shared
risk factors and coexistence of obstructive coronary artery disease (CAD)
and AS, there is inconsistent clinical data regarding potential survival
benefits of paired percutaneous coronary intervention (PCI) with TAVR
procedures. We performed a literature search using PubMed, Embase, and
Cochrane Library from inception through June 2023 assessing the impact of
concomitant PCI in patients with obstructive CAD undergoing TAVR. The
primary outcomes were 30-day all-cause mortality, 30-day cardiovascular
mortality, and 6 months-1 year all-cause mortality. Secondary outcomes
included 30-day myocardial infarction, stroke, major bleeding
complications, and acute kidney injury (AKI). A total of 11 studies
involving 2804 patients were included in the final analysis. Compared to
patients undergoing TAVR alone, the TAVR+PCI group showed no significant
difference in 30-day all-cause mortality (RR 0.90, CI 0.66, 1.22, P =
0.49), 30-day cardiovascular mortality (RR 0.71 CI 0.44, 1.14, P = 0.16),
or 6 months-1 year all-cause mortality (RR 0.94, CI 0.75, 1.18, P = 0.57).
Regarding secondary outcomes, 30-day myocardial infarction was higher in
the TAVR+PCI group (RR 3.09, CI 1.26, 7.57, P = 0.01), with no significant
differences noted in rates of 30-day stroke (RR 1.14, CI 0.56, 2.33, P =
0.72), major bleeding/vascular complications (RR 1.11, CI 0.79, 1.56, P =
0.55), and AKI (RR 1.07, CI 0.75, 1.54, P = 0.71). Concomitant PCI does
not confer any mortality benefit in patients with obstructive CAD and
high-grade AS undergoing TAVR. Further trials are needed to confirm our
findings.<br/>Copyright &#xa9; 2023 Elsevier Inc.

<3>
Accession Number
2025680391
Title
Impact of bariatric surgery on carotid intima-media thickness,
flow-mediated dilation, and nitrite-mediated dilation: a systematic review
and meta-analysis.
Source
Surgery for Obesity and Related Diseases. 19(10) (pp 1188-1199), 2023.
Date of Publication: October 2023.
Author
Esparham A.; Roohi S.; Ahmadyar S.; Dalili A.; Nelson P.R.; Khorgami Z.
Institution
(Esparham, Roohi, Ahmadyar) Student Research Committee, College of
Medicine, Mashhad University of Medical Sciences, Mashhad, Iran, Islamic
Republic of
(Dalili) Department of General Surgery, School of Medicine, Surgical
Oncology Research Center, Imam, Reza Hospital, Mashhad University of
Medical Sciences, Mashhad, Iran, Islamic Republic of
(Nelson) Division of Vascular Surgery, Department of Surgery, University
of Oklahoma, Tulsa, OK, United States
(Khorgami) Department of Surgery, University of Oklahoma College of
Community Medicine, Tulsa, OK, United States
(Khorgami) Harold Hamm Diabetes Center, University of Oklahoma Health
Sciences Center, Oklahoma City, OK, United States
Publisher
Elsevier Inc.
Abstract
Obesity is considered one of the independent risk factors for
atherosclerosis and is strongly correlated with cardiovascular morbidity
and mortality. Previous studies showed carotid intima-media thickness
(CIMT), flow-mediated dilation (FMD), and nitrite-mediated dilatation
(NMD) are reliable non-invasive markers of arterial damage and
dysfunction. The aim of this study was to evaluate the effect of bariatric
surgery on CIMT, FMD, and NMD markers in patients with obesity. A
systematic search was performed in the PubMed, Embase, Scopus, and Web of
Science databases until May 2022. All the English-published studies on the
effect of bariatric surgery on CIMT, FMD, and NMD were included. A
quantitative meta-analysis was performed, as well as subgroup analyses for
the type of procedure and duration of follow-up. Meta-analysis of 41
studies with 1639 patients showed CIMT was significantly reduced by.11 mm
after bariatric surgery (95% CI, -.14 to -.08; P <.001; mean follow-up =
10.8 mo). The pooled analysis of 23 studies with 1106 patients showed an
increase of FMD by 4.57% after bariatric surgery (95% CI, 2.69-6.44; P
<.001; mean follow-up = 11.5 mo). The results of a pooled analysis of 12
studies with 346 patients showed a significant increase of NMD by 2.46%
after bariatric surgery (95% CI,.99-3.94; P <.001; mean follow-up = 11.4
mo). The random effect meta-regression demonstrated that baseline CIMT and
FMD significantly affect the changes in CIMT and FMD. This meta-analysis
showed bariatric surgery can improve CIMT, FMD, and NMD markers in
patients with obesity. These improvements show the known effect of
metabolic surgery in decreasing cardiovascular risk.<br/>Copyright &#xa9;
2023 American Society for Metabolic and Bariatric Surgery

<4>
Accession Number
642266427
Title
Colchicine for the secondary prevention of cardiovascular events.
Source
Cochrane Database of Systematic Reviews. 2023(8) (no pagination), 2023.
Article Number: CD014808. Date of Publication: 29 Aug 2023.
Author
Ebrahimi F.; Hirt J.; Schonenberger C.; Ewald H.; Briel M.; Janiaud P.;
Hemkens L.G.
Institution
(Ebrahimi) University Center for Gastrointestinal and Liver Diseases,
University Hospital Basel, Basel, Switzerland
(Ebrahimi) Department of Medical Epidemiology and Biostatistics,
Karolinska Institutet, Stockholm, Sweden
(Hirt, Janiaud, Hemkens) Department of Clinical Research, University
Hospital Basel, University of Basel, Basel, Switzerland
(Hirt, Janiaud, Hemkens) Pragmatic Evidence Lab, Research Center for
Clinical Neuroimmunology and Neuroscience Basel (RC2NB), University
Hospital Basel and University of Basel, Basel, Switzerland
(Hirt) Institute of Nursing Science, Department of Health, Eastern
Switzerland University of Applied Sciences, St Gallen, Switzerland
(Hirt) International Graduate Academy, Institute of Health and Nursing
Science, Medical Faculty, Martin Luther University Halle-Wittenberg, Halle
(Saale), Germany
(Schonenberger, Briel) CLEAR Methods Center, Division of Clinical
Epidemiology, Department of Clinical Research, University Hospital Basel,
Basel, Switzerland
(Schonenberger, Briel) University of Basel, Basel, Switzerland
(Ewald) University Medical Library, University of Basel, Basel,
Switzerland
(Hemkens) Meta-Research Innovation Center at Stanford (METRICS), Stanford
University, Stanford, CA, United States
(Hemkens) Meta-Research Innovation Center Berlin (METRIC-B), Berlin
Institute of Health, Berlin, Germany
Publisher
John Wiley and Sons Ltd
Abstract
Objectives: This is a protocol for a Cochrane Review (intervention). The
objectives are as follows:. To evaluate the benefits and harms of low-dose
colchicine in the prevention of cardiovascular events in adults with a
history of stable CVD or following myocardial infarction or
stroke.<br/>Copyright &#xa9; 2023 The Cochrane Collaboration. Published by
John Wiley & Sons, Ltd.

<5>
Accession Number
2026573510
Title
On-table Extubation After Minimally Invasive Cardiac Surgery: A
Retrospective Observational Pilot Study.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 37(11) (pp 2244-2251),
2023. Date of Publication: November 2023.
Author
Jaquet O.; Gos L.; Amabili P.; Donneau A.-F.; Mendes M.A.; Bonhomme V.;
Tchana-Sato V.; Hans G.A.
Institution
(Jaquet, Gos, Amabili, Mendes, Bonhomme, Hans) Department of Anesthesia
and Intensive Care Medicine, Liege University Hospital, Liege, Belgium
(Donneau) Department of Public Health, University of Liege, Liege, Belgium
(Bonhomme) Anesthesia and Perioperative Neuroscience Laboratory,
GIGA-Consciousness Thematic Unit, GIGA-Research, Liege University, Liege,
Belgium
(Tchana-Sato) Department of Cardiovascular Surgery, Liege University
Hospital, Liege, Belgium
Publisher
W.B. Saunders
Abstract
Objective: To assess the safety of "on-table" extubation after
minimally-invasive heart valve surgery. <br/>Design(s): A single-center
retrospective observational study. <br/>Setting(s): At a tertiary referral
academic hospital. <br/>Participant(s): Patients who underwent nonemergent
isolated heart valve surgery through a minithoracotomy approach between
January 2016 and August 2021. <br/>Intervention(s): All patients were
treated by 1 of the 6 cardiac anesthesiologists of the hospital. Only some
of them practiced "on-table" extubation, and the outcome of patients
extubated "on-table" was compared to those extubated in the intensive care
unit (ICU). Measurement and Main Results: The primary outcome was the
occurrence of any postoperative respiratory complication during the entire
hospital stay. Secondary outcomes included the use of inotropes and
vasopressors, de novo atrial fibrillation, and lengths of stay in the ICU
and the hospital. A total of 294 patients met inclusion criteria, of whom
186 (63%) were extubated "on-table." Cardiopulmonary bypass duration was
significantly longer, and moderate intraoperative hypothermia was
significantly more frequent in patients extubated in the ICU. After
adjustment for these confounders and for the European System for Cardiac
Operative Risk Evaluation (EuroSCORE) II using a multivariate logistic
model, no association was found between the extubation strategy and
postoperative pulmonary complications (adjusted odds ratio = 0.84; 95% CI
= 0.40-1.77; p = 0.64). "On-table" extubation was associated with a lower
risk of postoperative pneumonia and fewer vasopressors requirements.
<br/>Conclusion(s): "On-table" extubation was not associated with an
increased incidence of respiratory complications. A randomized controlled
trial is warranted to confirm these results and determine whether
"on-table" extubation offers additional benefits.<br/>Copyright &#xa9;
2023 Elsevier Inc.

<6>
Accession Number
2025579846
Title
Psoas muscle quantified muscle status and long-term mortality after
cardiovascular interventions.
Source
Annals of Medicine. 55(2) (no pagination), 2023. Article Number: 2259798.
Date of Publication: 2023.
Author
Jarvinen O.; Tynkkynen J.T.; Virtanen M.; Maaranen P.; Lindstrom I.;
Vakhitov D.; Laurikka J.; Oksala N.K.; Hernesniemi J.A.
Institution
(Jarvinen, Lindstrom, Vakhitov, Laurikka, Oksala, Hernesniemi) Faculty of
Medicine and Health Technology, Tampere University, Tampere, Finland
(Jarvinen, Laurikka, Oksala, Hernesniemi) Finnish Cardiovascular Research
Centre Tampere, Tampere, Finland
(Tynkkynen, Vakhitov, Oksala) Centre for Vascular Surgery and
Interventional Radiology, Tampere University Hospital, Tampere, Finland
(Virtanen, Maaranen, Laurikka, Hernesniemi) Heart Hospital, Tampere
University Hospital, Tampere, Finland
Publisher
Taylor and Francis Ltd.
Abstract
Background Psoas muscle area (PMA) and density (PMD) measured using
computed tomography are potential surrogates for evaluating
sarcopenia-related mortality risk among patients undergoing cardiovascular
interventions. However, the optimal measurement method remains unclear.
Methods A retrospective registry study of three observational cohorts
comprising 2248 patients undergoing cardiovascular interventions (n = 828
for abdominal aortic aneurysms, n = 983 transcatheter aortic valve
implantations, and 437 patients undergoing open surgery for thoracic
aortic and aortic valve pathology) was conducted. Age-independent
associations between mortality and PMA, PMD, PMA indexed to height or body
surface area, and the combination of PMA and PMD (lean PMA) were
meta-analyzed (using individual participant data) across cohorts after sex
stratification with median follow-up times ranging from three to five
years for each cohort. <br/>Result(s): In the meta-analysis, psoas muscle
measurements were significantly associated with mortality among men (p <
0.05), with high heterogeneity in the associations across all cohorts.
There was very little difference in the association between PMA and PMD
and mortality (HR 0.83, 95% CI 0.69-0.99, p = 0.002; HR 0.85, 95% CI
0.77-0.94, p = 0.041 for one SD increase in PMA and PMD in the random
effects model). Combining PMA and PMD into one composite variable by
multiplying their values together showed the most robust association in
terms of the magnitude of the effect size in men (HR, 0.77; 95% CI
0.73-0.87, p < 0.001). Indexing PMA to body size did not result in any
significant differences in this association. Among women, psoas muscle
measurements were not associated with long-term mortality in this
meta-analysis. <br/>Conclusion(s): Different psoas muscle measurements
were significantly and very similarly associated with mortality among men
but not among women. No single measurement stands out, although combining
PMA and PMD seems to be a slightly stronger estimate in terms of effect
size and should be considered in further studies.<br/>Copyright &#xa9;
2023 The Author(s). Published by Informa UK Limited, trading as Taylor &
Francis Group.

<7>
Accession Number
2027243395
Title
causalCmprsk: An R package for nonparametric and Cox-based estimation of
average treatment effects in competing risks data.
Source
Computer Methods and Programs in Biomedicine. 242 (no pagination), 2023.
Article Number: 107819. Date of Publication: December 2023.
Author
Vakulenko-Lagun B.; Magdamo C.; Charpignon M.-L.; Zheng B.; Albers M.W.;
Das S.
Institution
(Vakulenko-Lagun) Department of Statistics, University of Haifa, Haifa,
Israel
(Magdamo, Albers) Laboratory of Systems Pharmacology, Harvard Medical
School, Boston, MA, United States
(Charpignon) Institute for Data, Systems, and Society, Massachusetts
Institute of Technology, Cambridge, MA, United States
(Zheng) Department of Non-communicable Disease Epidemiology, London School
of Hygiene & Tropical Medicine, London, United Kingdom
(Albers, Das) Department of Neurology, Massachusetts General Hospital,
Harvard Medical School, Boston, MA, United States
Publisher
Elsevier Ireland Ltd
Abstract
Background and Objective: Competing risks data arise in both observational
and experimental clinical studies with time-to-event outcomes, when each
patient might follow one of the multiple mutually exclusive competing
paths. Ignoring competing risks in the analysis can result in biased
conclusions. In addition, possible confounding bias of the
treatment-outcome relationship has to be addressed, when estimating
treatment effects from observational data. In order to provide tools for
estimation of average treatment effects on time-to-event outcomes in the
presence of competing risks, we developed the R package causalCmprsk. We
illustrate the package functionality in the estimation of effects of a
right heart catheterization procedure on discharge and in-hospital death
from observational data. <br/>Method(s): The causalCmprsk package
implements an inverse probability weighting estimation approach, aiming to
emulate baseline randomization and alleviate possible treatment selection
bias. The package allows for different types of weights, representing
different target populations. causalCmprsk builds on existing methods from
survival analysis and adapts them to the causal analysis in non-parametric
and semi-parametric frameworks. <br/>Result(s): The causalCmprsk package
has two main functions: fit.cox assumes a semiparametric structural Cox
proportional hazards model for the counterfactual cause-specific hazards,
while fit.nonpar does not impose any structural assumptions. In both
frameworks, causalCmprsk implements estimators of (i) absolute risks for
each treatment arm, e.g., cumulative hazards or cumulative incidence
functions, and (ii) relative treatment effects, e.g., hazard ratios, or
restricted mean time differences. The latter treatment effect measure
translates the treatment effect from probability into more intuitive time
domain and allows the user to quantify, for example, by how many days or
months the treatment accelerates the recovery or postpones illness or
death. <br/>Conclusion(s): The causalCmprsk package provides a convenient
and useful tool for causal analysis of competing risks data. It allows the
user to distinguish between different causes of the end of follow-up and
provides several time-varying measures of treatment effects. The package
is accompanied by a vignette that contains more details, examples and
code, making the package accessible even for non-expert
users.<br/>Copyright &#xa9; 2023 Elsevier B.V.

<8>
Accession Number
2027186601
Title
Effectiveness of aortic valve replacement in Heyde syndrome: a
meta-analysis.
Source
European Heart Journal. 44(33) (pp 3168-3177), 2023. Date of Publication:
01 Sep 2023.
Author
Goltstein L.C.M.J.; Rooijakkers M.J.P.; Hoeks M.; Li W.W.L.; Van Wely
M.H.; Rodwell L.; Van Royen N.; Drenth J.P.H.; Van Geenen E.-J.M.
Institution
(Goltstein, Drenth, Van Geenen) Department of Gastroenterology and
Hepatology, Radboud University Medical Center, Geert Grooteplein Zuid 10,
P.O. Box 9101, Nijmegen 6500 HB, Netherlands
(Rooijakkers, Van Wely, Van Royen) Department of Cardiology, Radboud
University Medical Center, Geert Grooteplein Zuid 10, P.O. Box 9101,
Nijmegen 6500 HB, Netherlands
(Hoeks) Department of Haematology, Radboud University Medical Center,
Geert Grooteplein Zuid 10, P.O. Box 9101, Nijmegen 6500 HB, Netherlands
(Li) Department of Cardiothoracic Surgery, Radboud University Medical
Center, Geert Grooteplein Zuid 10, P.O. Box 9101, Nijmegen 6500 HB,
Netherlands
(Rodwell) Department of Health Evidence, Radboud Institute for Health
Sciences, Radboud University Medical Center, Section Biostatistics, Geert
Grooteplein Zuid 10, P.O. Box 9101, Nijmegen 6500 HB, Netherlands
Publisher
Oxford University Press
Abstract
Aims: Heyde syndrome is the co-occurrence of aortic stenosis, acquired von
Willebrand syndrome, and gastrointestinal bleeding. Aortic valve
replacement has been demonstrated to resolve all three associated
disorders. A systematic review and meta-analysis were performed to obtain
best estimates of the effect of aortic valve replacement on acquired von
Willebrand syndrome and gastrointestinal bleeding. <br/>Methods and
Results: A literature search was performed to identify articles on Heyde
syndrome and aortic valve replacement up to 25 October 2022. Primary
outcomes were the proportion of patients with recovery of acquired von
Willebrand syndrome within 24 h (T1), 24-72 h (T2), 3-21 days (T3), and 4
weeks to 2 years (T4) after aortic valve replacement and the proportion of
patients with cessation of gastrointestinal bleeding. Pooled proportions
and risk ratios were calculated using random-effects models. Thirty-three
studies (32 observational studies and one randomized controlled trial) on
acquired von Willebrand syndrome (n = 1054), and 11 observational studies
on gastrointestinal bleeding (n = 300) were identified. One study reported
on both associated disorders (n = 6). The pooled proportion of Heyde
patients with acquired von Willebrand syndrome recovery was 86% (95% CI,
79%-91%) at T1, 90% (74%-96%) at T2, 92% (84%-96%) at T3, and 87%
(67%-96%) at T4. The pooled proportion of Heyde patients with
gastrointestinal bleeding cessation was 73% (62%-81%). Residual aortic
valve disease was associated with lower recovery rates of acquired von
Willebrand syndrome (RR 0.20; 0.05-0.72; P = 0.014) and gastrointestinal
bleeding (RR 0.57; 0.40-0.81; P = 0.002). <br/>Conclusion(s): Aortic valve
replacement is associated with rapid recovery of the bleeding diathesis in
Heyde syndrome and gastrointestinal bleeding cessation. Residual valve
disease compromises clinical benefits.<br/>Copyright &#xa9; 2023 The
Author(s). Published by Oxford University Press on behalf of the European
Society of Cardiology.

<9>
Accession Number
2025959084
Title
Optimisation and Effect Analysis of the Blood Collection Method in
Pre-Deposit Autotransfusion Patients Undergoing Thoracotomy Surgery.
Source
Journal of Multidisciplinary Healthcare. 16 (pp 2793-2798), 2023. Date of
Publication: 2023.
Author
Jia L.; Wang Y.; Zhang W.; Lin Y.; Chen F.; Wan Y.; Fu X.
Institution
(Jia, Lin, Chen, Wan) Department of Cardiothoracic Surgery, Taizhou
Hospital of Zhejiang Province Affiliated to Wenzhou Medical University,
Zhejiang, Taizhou 317000, China
(Wang) Department of Geriatrics, Taizhou Central Hospital (Taizhou
University Hospital) of Zhejiang, Zhejiang, Taizhou 318000, China
(Zhang) Department of ICU, Taizhou Hospital of Zhejiang Province
Affiliated to Wenzhou Medical University, Zhejiang, Taizhou 317000, China
(Fu) Department of Radiology, Taizhou Hospital of Zhejiang Province
Affiliated to Wenzhou Medical University, Zhejiang, Taizhou 317000, China
(Fu) Department of Radiology, Enze Hospital, Taizhou Enze Medical Center
(Group), Zhejiang, Taizhou 318000, China
Publisher
Dove Medical Press Ltd
Abstract
Background and Purpose: To explore the feasibility of the modified blood
collection method in pre-deposit autotransfusion in patients undergoing
thoracotomy surgery. <br/>Method(s): This double-blinded randomised
controlled trial enrolled 92 patients from the cardiothoracic surgery
department from February 2019 to October 2020. <br/>Result(s): Compared
with the conventional blood collection method, the modified blood
collection method avoided blood overflow from the oblique plane of the
needle (chi² = 61.986, P < 0.01) and reduced the diameter of
the bruising area after 24 hours (chi² = 24.611, P < 0.01).
Furthermore, due to optimising the blood collection method, diastolic
blood pressure reduced slightly before and after blood collection (t =
2.036, P < 0.05), and patients in the test group had less pain (based on
the numerical rating score) (t = 5.556, P < 0.01). Meanwhile, the time
required to collect 400 mL of blood was shortened (t = 17.744, p < 0.01).
<br/>Conclusion(s): An improved blood collection method can enhance the
blood donation experience, avoid blood spillage, lessen pain and reduce
adverse reactions. This may be of great significance in ensuring blood
quality and the safety of subsequent transfusions. Clinical Trials
Registration: ClinicalTrials.gov Identifier: NCT05539846.<br/>Copyright
&#xa9; 2023 Jia et al. This work is published and licensed by Dove Medical
Press Limited.

<10>
Accession Number
2027199865
Title
EuroSCORE Versus EuroSCORE II in Evaluation of the Risk of Cardiac
Surgery: Review Article.
Source
Journal of Cardiovascular Disease Research. 12(7) (pp 463-471), 2021. Date
of Publication: 2021.
Author
Elnahal N.M.H.; Mahdy A.M.S.; Elnewihy M.A.; Mohammed M.I.
Institution
(Elnahal, Elnewihy, Mohammed) Zagazig University, Egypt
(Mahdy) National heart institute, Egypt
Publisher
EManuscript Technologies
Abstract
Background: The EuroSCORE-II has been recently developed in an attempt to
address the shortcomings of the original EuroSCORE models for contemporary
cardiac surgery. The validations of the EuroSCORE-II have so far been
positive. There is striking similarity between the two models however
there are a number of key differences between the two in the EuroSCORE-II
renal impairment has been split into categories rather than dichotomized,
neurological dysfunction has been replaced with poor mobility and the
level of dyspnea and diabetes are now included. Post-infarct septal
rupture is no longer included and both the operation type and urgency have
been reclassified. <br/>Objective(s): Aim of review article to highlight
EuroSCORE versus EuroSCORE II in evaluation of the risk of cardiac
surgery. <br/>Method(s): The databases were searched for articles
published in English in 3 data bases [PubMed - Google scholar- science
direct] and Boolean operators (AND, OR, NOT) had been used such as
[Cardiac Surgery AND EuroSCORE OR EuroSCORE II] and in peer-reviewed
articles between 1994 and 2021. <br/>Conclusion(s): EuroSCORE II had
better predictive discrimination for operative mortality than EuroSCORE I,
which greatly overestimated this risk. EuroSCORE II fared well compared
with the risk of cardiac surgery. The inclusive nature of EuroSCORE II for
numerous procedures provides more flexibility than the risk of cardiac
surgery for complex procedures.<br/>Copyright &#xa9; 2021 EManuscript
Technologies. All rights reserved.

<11>
Accession Number
2027165332
Title
Reticulated Platelets Predict Cardiovascular Death and Adverse Events in
Coronary Artery Disease: A Systematic Review and Meta-analysis.
Source
Thrombosis and Haemostasis. (no pagination), 2023. Date of Publication:
2023.
Author
Bongiovanni D.; Novelli L.; Condello F.; Kirmes K.; Han J.; Wein B.;
Elvinger S.; Viggiani G.; Von Scheidt M.; Laugwitz K.-L.; Raake P.W.J.;
Kastrati A.; Chiarito M.; Bernlochner I.
Institution
(Bongiovanni, Wein, Elvinger, Raake) Department of Internal Medicine I,
Cardiology, University Hospital Augsburg, University of Augsburg, Germany
(Bongiovanni, Novelli, Condello, Chiarito) Department of Cardiovascular
Medicine, Humanitas Clinical and Research Center IRCCS, Humanitas
University, Rozzano, Milan, Italy
(Bongiovanni, Kirmes, Han, Viggiani, Laugwitz, Bernlochner) Department of
Internal Medicine I, School of Medicine, University Hospital Rechts der
Isar, Technical University of Munich, Munich, Germany
(Von Scheidt, Kastrati) Department of Cardiology, Deutsches Herzzentrum
Munchen, Technical University of Munich, Munich, Germany
(Laugwitz, Kastrati, Bernlochner) German Center for Cardiovascular
Research (DZHK), Partner Site Munich Heart Alliance, Germany
Publisher
Georg Thieme Verlag
Abstract
Background The pro-thrombotic immature or reticulated platelets (RPs) are
known to be elevated in high-risk patients and in different pathological
settings. It has been shown that RPs correlate with an insufficient
antiplatelet response to antiplatelet agents. RPs are emerging novel
predictors of adverse cardiovascular events in cardiovascular disease.
This study, using the totality of existing evidence, evaluated the
prognostic role of RPs in patients with coronary artery disease. Methods
We performed a systematic review and meta-analysis including trials of
acute and chronic coronary syndrome reporting clinical outcomes according
to RPs levels in the peripheral blood. We compared patients with elevated
RPs (RPs^high) to patients without elevated RPs
(RPs^low). Odds ratios (ORs) and 95% CIs were used as metric of
choice for treatment effects with random-effects models. The primary
endpoint was major adverse cardiovascular and cerebrovascular events
(MACCE). Secondary endpoints were cardiovascular death, myocardial
infarction, ischemic stroke, urgent coronary revascularization and
bleedings. Results A total of 7 studies, including 2213 patients, were
included. The risk for MACCE was significantly higher in
RPs^highcompared to RPs^lowpatients (OR 2.67 [1.87;
3.81], I²= 43.8%). RPs^highwere associated with
cardiovascular death (OR 2.09 [1.36; 3.22], I²= 40.4%). No
associations for RPs^highwere detected with the other singular
components of MACCE: myocardial infarction (OR 1.73 [0.89; 3.38]
I²= 60.5%) and stroke (OR 1.72 [0.59; 4.96] I²=
21%). The risk of bleeding did not differ between groups(OR 0.58 [0.15;
2.22] I²= 86.1%). Conclusion Elevated RPs are significantly
associated with increased risk of cardiovascular events and cardiovascular
death.<br/>Copyright &#xa9; 2023 Georg Thieme Verlag. All rights reserved.

<12>
Accession Number
2025620507
Title
The percutaneous management of pulmonary metastases.
Source
Journal of Medical Imaging and Radiation Oncology. (no pagination), 2023.
Date of Publication: 2023.
Author
de Baere T.; Bonnet B.; Tselikas L.; Deschamps F.
Institution
(de Baere, Bonnet, Tselikas, Deschamps) Department of Interventional
Radiology, Gustave Roussy, Villejuif, France
(de Baere, Tselikas) University of Paris-Saclay, UFR Medecine Le
Kremlin-Bicetre, Le Kremlin-Bicetre, France
(de Baere, Tselikas) Centre d'Investigation Clinique BIOTHERIS, INSERM
CIC1428, Villejuif, France
Publisher
John Wiley and Sons Inc
Abstract
Local treatment of lung metastases has been in the front scene since late
90s when an international registry of thoracic surgery reported a median
overall survival of 35 months in resected patients versus 15 months in
non-resected patients. Today, other local therapies are available for
patients with oligometastatic lung disease, including image guided thermal
ablation, such as ablation, microwave ablation, and cryoablation.
Image-guided ablation is increasingly offered, and now recommended in
guidelines as option to surgery. Today, the size of the target tumour
remains the main driver of success and selection of patients with limited
tumour size allowing for local tumour control in the range of 90% in most
recent and larger series targeting lung metastases up to 3.5 cm. Overall
survival exceeding five-years in large series of thermal ablation for lung
metastases from colorectal origin are align with outcome of same patients
treated with surgical resection. Moreover, thermal ablation in such
population allows for one-year chemotherapy holidays in all comers and
over 18 months in lung only metastatic patients, allowing for improved
patient quality of life and preserving further lines of systemic treatment
when needed. Tolerance of thermal ablation is excellent and better than
surgery with no lost in respiratory function, allowing for repeated
treatment when needed. In the future, it is likely that practice of lung
surgery for small oligometastatic lung disease will decrease, and that
minimally invasive techniques will replace surgery in such indications.
Randomized study will be difficult to obtain as demonstrated by
discontinuation of many studies testing the hypothesis of surgery versus
observation, or surgery versus SBRT.<br/>Copyright &#xa9; 2023 Royal
Australian and New Zealand College of Radiologists.

<13>
Accession Number
2026619680
Title
Benzodiazepine-Free Cardiac Anesthesia for Reduction of Postoperative
Delirium (B-Free): A Protocol for a Multi-centre Randomized Cluster
Crossover Trial.
Source
CJC Open. 5(9) (pp 691-699), 2023. Date of Publication: September 2023.
Author
Spence J.; Belley-Cote E.; Jacobsohn E.; Lee S.F.; D'Aragon F.; Avidan M.;
Mazer C.D.; Rousseau-Saine N.; Rajamohan R.; Pryor K.; Klein R.; Tan
E.C.-H.; Cameron M.; Di Sante E.; DeBorba E.; Mustard M.; Couture E.;
Zamper R.; Law M.; Djaiani G.; Saha T.; Choi S.; Hedlin P.; Pikaluk R.;
Lam W.Y.; Deschamps A.; Whitlock R.; Dulong B.; Devereaux P.J.; Beaver C.;
Kloppenburg S.; Oczkowski S.; McIntyre W.F.; McFarling M.; Lamy A.;
Vincent J.; Connolly S.
Institution
(Spence) Departments of Anesthesia and Critical Care and Health Research
Methods, Evaluation, and Impact, McMaster University; and Perioperative
Research Division, Population Health Research Institute, Hamilton, ON,
Canada
(Belley-Cote, Devereaux) Departments of Medicine (Cardiology and Critical
Care) and Health Research Methods, Evaluation, and Impact, McMaster
University and Perioperative Research Division, Population Health Research
Institute, Hamilton, ON, Canada
(Jacobsohn) Departments of Anesthesia and Perioperative Medicine and
Medicine (Critical Care), University of Manitoba, Winnipeg, MB, Canada
(Lee) Department of Health Research Methods, Evaluation, and Impact,
McMaster University and Population Health Research Institute, Hamilton,
ON, Canada
(D'Aragon) Departement d'anesthesiologie, Universite de Sherbrooke,
Sherbrooke, QC, Canada
(Avidan) Department of Anesthesia, Washington University at St. Louis, St.
Louis, MO, United States
(Mazer) Department of Anesthesia and Li Ka Shing Knowledge Institute, St.
Michael's Hospital and Department of Anesthesiology and Pain Medicine,
University of Toronto, Toronto, ON, Canada
(Rousseau-Saine, Deschamps) Departement d'anesthesiologie, Universite de
Montreal, Montreal, QC, Canada
(Rajamohan, Klein, Law) Department of Anesthesia, University of British
Columbia, Vancouver, BC, Canada
(Pryor) Department of Anesthesiology, Weill Cornell Medical College, New
York, NY, United States
(Tan, Dulong) Department of Anesthesia, Dalhousie University, Halifax, NS,
Canada
(Cameron) Department of Anesthesia, McGill University, Montreal, QC,
Canada
(Di Sante, DeBorba, Vincent) Population Health Research Institute,
McMaster University, Hamilton, ON, Canada
(Mustard) St. Michael's Hospital, Toronto, ON, Canada
(Couture) Departement d'anesthesiologie, Universite Laval, Quebec City,
QC, Canada
(Zamper) Department of Anesthesia, University of Western Ontario, London,
ON, Canada
(Djaiani, Choi) Department of Anesthesiology and Pain Medicine, University
of Toronto, Toronto, ON, Canada
(Saha) Department of Anesthesia, Queen's University, Kingston, ON, Canada
(Hedlin, Pikaluk) Department of Anesthesia, University of Saskatchewan,
Saskatoon, SK, Canada
(Lam) Department of Anesthesia, University of Alberta, Edmonton, AB,
Canada
(Whitlock) Departments of Surgery (Cardiac Surgery) and Health Research
Methods, Evaluation, and Impact, McMaster University and Perioperative
Research Division, Population Health Research Institute, Hamilton, ON,
Canada
(Beaver) Sheridan College, Brampton, ON, Canada
(Kloppenburg) Population Health Research Institute, Hamilton, ON, Canada
(Oczkowski) Department of Medicine (Critical Care), McMaster University,
Hamilton, ON, Canada
(McIntyre) Department of Medicine (Cardiology), McMaster University and
Perioperative Research Division, Population Health Research Institute,
Hamilton, ON, Canada
(McFarling) Department of Anesthesia, McMaster University, Hamilton, ON,
Canada
(Lamy) Departments of Surgery (Cardiac Surgery) and Health Research
Methods, Evaluation, and Impact, McMaster University, Perioperative
Research Division, Population Health Research Institute, Hamilton, ON,
Canada
(Connolly) Department of Medicine (Cardiology), McMaster University and
Population Health Research Institute, Hamilton, ON, Canada
Publisher
Elsevier Inc.
Abstract
Delirium is common after cardiac surgery and is associated with adverse
outcomes. Administration of benzodiazepines before and after cardiac
surgery is associated with delirium; guidelines recommend minimizing their
use. Benzodiazepine administration during cardiac surgery remains common
because of its recognized benefits. The Benzodiazepine-Free Cardiac
Anesthesia for Reduction of Postoperative Delirium (B-Free) trial is a
randomized cluster crossover trial evaluating whether an institutional
policy of restricting intraoperative benzodiazepine administration (ie, >=
90% of patients do not receive benzodiazepines during cardiac surgery), as
compared with a policy of liberal intraoperative benzodiazepine
administration (ie, >= 90% of patients receive >= 0.03 mg/kg midazolam
equivalent), reduces delirium. Hospitals performing >= 250 cardiac
surgeries a year are included if their cardiac anesthesia group agrees to
apply both benzodiazepine policies per their randomization, and patients
are assessed for postoperative delirium every 12 hours in routine clinical
care. Hospitals apply the restricted or liberal benzodiazepine policy
during 12 to 18 crossover periods of 4 weeks each. Randomization for all
periods takes place in advance of site startup; sites are notified of
their allocated policy during the last week of each crossover period.
Policies are applied to all patients undergoing cardiac surgery during the
trial period. The primary outcome is the incidence of delirium at up to 72
hours after surgery. The B-Free trial will enroll >= 18,000 patients
undergoing cardiac surgery at 20 hospitals across North America. Delirium
is common after cardiac surgery, and benzodiazepines are associated with
the occurrence of delirium. The B-Free trial will determine whether an
institutional policy restricting the administration of benzodiazepines
during cardiac surgery reduces the incidence of delirium after cardiac
surgery. Clinicaltrials.gov registration number: NCT03928236 (First
registered April 26, 2019).<br/>Copyright &#xa9; 2023 The Authors

<14>
Accession Number
2026182347
Title
Cardiovascular Safety of Testosterone-Replacement Therapy.
Source
New England Journal of Medicine. 389(2) (pp 107-117), 2023. Date of
Publication: 2023.
Author
Lincoff A.M.; Bhasin S.; Flevaris P.; Mitchell L.M.; Basaria S.; Boden
W.E.; Cunningham G.R.; Granger C.B.; Khera M.; Thompson I.M.; Wang Q.;
Wolski K.; Davey D.; Kalahasti V.; Khan N.; Miller M.G.; Snabes M.C.; Chan
A.; Dubcenco E.; Li X.; Yi T.; Huang B.; Pencina K.M.; Travison T.G.;
Nissen S.E.
Institution
(Lincoff, Mitchell, Wang, Wolski, Davey, Kalahasti, Nissen) He Cleveland
Clinic Coordinating Center for Clinical Research, Department of
Cardiovascular Medicine, Cleveland Clinic, Boston, United States
(Bhasin, Basaria, Pencina) The Research Program in Men's Health: Aging and
Metabolism, Brigham and Women's Hospital, Harvard Medical School, Boston,
MA, United States
(Boden) Veterans Affairs Boston Healthcare System and Massachusetts
Veterans Epidemiology, Research, and Information Center, Boston
University, School of Medicine, Boston, MA, United States
(Travison) Marcus Institute for Aging Research, Beth Israel Deaconess
Medical Center, Harvard Medical School, Boston, MA, United States
(Flevaris, Khan, Miller, Snabes, Chan, Dubcenco, Li, Yi, Huang) AbbVie,
North Chicago, IL, United States
(Cunningham, Khera) Baylor College of Medicine, Houston, TX, United States
(Thompson) CHRISTUS Santa Rosa Health System, The University of Texas
Health Science Center, San Antonio, TX, United States
(Granger) Duke Clinical Research Institute, Durham, NC, United States
Publisher
Massachussetts Medical Society
Abstract
Background: The cardiovascular safety of testosterone-replacement therapy
in middle-aged and older men with hypogonadism has not been determined.
<br/>Method(s): In a multicenter, randomized, double-blind,
placebo-controlled, noninferiority trial, we enrolled 5246 men 45 to 80
years of age who had preexisting or a high risk of cardiovascular disease
and who reported symptoms of hypogonadism and had two fasting testosterone
levels of less than 300 ng per deciliter. Patients were randomly assigned
to receive daily transdermal 1.62% testosterone gel (dose adjusted to
maintain testosterone levels between 350 and 750 ng per deciliter) or
placebo gel. The primary cardiovascular safety end point was the first
occurrence of any component of a composite of death from cardiovascular
causes, nonfatal myocardial infarction, or nonfatal stroke, assessed in a
time-to-event analysis. A secondary cardiovascular end point was the first
occurrence of any component of the composite of death from cardiovascular
causes, nonfatal myocardial infarction, nonfatal stroke, or coronary
revascularization, assessed in a time-to-event analysis. Noninferiority
required an upper limit of less than 1.5 for the 95% confidence interval
of the hazard ratio among patients receiving at least one dose of
testosterone or placebo. <br/>Result(s): The mean (+/-SD) duration of
treatment was 21.7+/-14.1 months, and the mean follow-up was 33.0+/-12.1
months. A primary cardiovascular end-point event occurred in 182 patients
(7.0%) in the testosterone group and in 190 patients (7.3%) in the placebo
group (hazard ratio, 0.96; 95% confidence interval, 0.78 to 1.17; P<0.001
for noninferiority). Similar findings were observed in sensitivity
analyses in which data on events were censored at various times after
discontinuation of testosterone or placebo. The incidence of secondary
end-point events or of each of the events of the composite primary
cardiovascular end point appeared to be similar in the two groups. A
higher incidence of atrial fibrillation, of acute kidney injury, and of
pulmonary embolism was observed in the testosterone group.
<br/>Conclusion(s): In men with hypogonadism and preexisting or a high
risk of cardiovascular disease, testosterone-replacement therapy was
noninferior to placebo with respect to the incidence of major adverse
cardiac events.<br/>Copyright &#xa9; 2023 Massachusetts Medical Society.

<15>
Accession Number
2025536168
Title
Comprehensive evaluation of time-varied outcomes for invasive and
conservative strategies in patients with NSTE-ACS: a meta-analysis of
randomized controlled trials.
Source
Frontiers in Cardiovascular Medicine. 10 (no pagination), 2023. Article
Number: 1197451. Date of Publication: 2023.
Author
Zhao Y.-J.; Sun Y.; Wang F.; Cai Y.-Y.; Alolga R.N.; Qi L.-W.; Xiao P.
Institution
(Zhao, Alolga) State Key Laboratory of Natural Medicines, School of
Traditional Chinese Pharmacy, China Pharmaceutical University, Nanjing,
China
(Zhao, Cai, Alolga, Qi) The Clinical Metabolomics Center, China
Pharmaceutical University, Nanjing, China
(Sun) Department of Pharmacy, Children's Hospital, Zhejiang University
School of Medicine, National Clinical Research Center for Child Health,
Hangzhou, China
(Wang) School of International Pharmaceutical Business, China
Pharmaceutical University, Nanjing, China
(Qi) College of Traditional Chinese Medicine and Food Engineering, Shanxi
University of Chinese Medicine, Taiyuan, China
(Xiao) Department of Cardiology, The Fourth Affiliated Hospital of Nanjing
Medical University, Nanjing, China
Publisher
Frontiers Media SA
Abstract
Background: Results from randomized controlled trials (RCTs) and
meta-analyses comparing invasive and conservative strategies in patients
with non-ST-elevation acute coronary syndrome (NSTE-ACS) are highly
debatable. We systematically evaluate the efficacy of invasive and
conservative strategies in NSTE-ACS based on time-varied outcomes.
<br/>Method(s): The RCTs for the invasive versus conservative strategies
were identified by searching PubMed, Cochrane Central Register of
Controlled Trials, Embase, and ClinicalTrials.gov. Trial data for studies
with a minimum follow-up time of 30 days were included. We categorized the
follow-up time into six varied periods, namely, <=6 months, 1 year, 2
years, 3 years, 5 years, and >=10 years. The time-varied outcomes were
major adverse cardiovascular event (MACE), death, myocardial infarction
(MI), rehospitalization, cardiovascular death, bleeding, in-hospital
death, and in-hospital bleeding. Risk ratios (RRs) and 95% confidence
intervals (Cis) were calculated. The random effects model was used.
<br/>Result(s): This meta-analysis included 30 articles of 17 RCTs
involving 12,331 participants. We found that the invasive strategy did not
provide appreciable benefits for NSTE-ACS in terms of MACE, death, and
cardiovascular death at all time points compared with the conservative
strategy. Although the risk of MI was reduced within 6 months (RR 0.80,
95% CI 0.68-0.94) for the invasive strategy, no significant differences
were observed in other periods. The invasive strategy reduced the
rehospitalization rate within 6 months (RR 0.69, 95% CI 0.52-0.90), 1 year
(RR 0.73, 95% CI 0.63-0.86), and 2 years (RR 0.77, 95% CI 0.60-1.00). Of
note, an increased risk of bleeding (RR 1.80, 95% CI 1.28-2.54) and
in-hospital bleeding (RR 2.17, 95% CI 1.52-3.10) was observed for the
invasive strategy within 6 months. In subgroups stratified by high-risk
features, the invasive strategy decreased MACE for patients aged >=65
years within 6 months (RR 0.68, 95% CI 0.58-0.78) and 1 year (RR 0.75, 95%
CI 0.62-0.91) and showed benefits for men within 6 months (RR 0.71, 95% CI
0.55-0.92). In other subgroups stratified according to diabetes,
ST-segment deviation, and troponin levels, no significant differences were
observed between the two strategies. <br/>Conclusion(s): An invasive
strategy is superior to a conservative strategy in reducing early events
for MI and rehospitalizations, but the invasive strategy did not improve
the prognosis in long-term outcomes for patients with NSTE-ACS. Systematic
Review Registration:
https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021289579,
identifier PROSPERO 2021 CRD42021289579.<br/>Copyright 2023 Zhao, Sun,
Wang, Cai, Alolga, Qi and Xiao.

<16>
Accession Number
2024464921
Title
Intramyocardial Stem Cell Transplantation during Coronary Artery Bypass
Surgery Safely Improves Cardiac Function: Meta-Analysis of 20 Randomized
Clinical Trials.
Source
Journal of Clinical Medicine. 12(13) (no pagination), 2023. Article
Number: 4430. Date of Publication: July 2023.
Author
Soetisna T.W.; Thamrin A.M.H.; Permadijana D.; Ramadhani A.N.E.; Sugisman;
Santoso A.; Mansyur M.
Institution
(Soetisna, Thamrin, Permadijana, Ramadhani, Sugisman) Adult Cardiac
Surgery Division, Department of Thoracic and Cardiovascular Surgery,
Harapan Kita National Cardiovascular Center Hospital, Jakarta 11420,
Indonesia
(Soetisna, Sugisman) Department of Thoracic and Cardiovascular Surgery,
Faculty of Medicine, University of Indonesia, Jakarta 10430, Indonesia
(Thamrin) Faculty of Medicine, Syarif Hidayatullah State Islamic
University, Haji Hospital, Jakarta 13560, Indonesia
(Santoso) Department of Cardiology and Vascular Medicine, Harapan Kita
National Cardiovascular Center Hospital, Jakarta 11420, Indonesia
(Santoso) Department of Cardiology and Vascular Medicine, Faculty of
Medicine, University of Indonesia, Jakarta 10430, Indonesia
(Mansyur) Department of Community Medicine, Faculty of Medicine,
University of Indonesia, Jakarta 10430, Indonesia
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
IMSC transplantation during CABG is considered one of the most promising
methods to effectively deliver stem cells and has been widely studied in
many trials. But the results of outcomes and safety of this modality still
vary widely. We conducted this meta-analysis of randomized controlled
trials (RCTs) to evaluate not only the outcome but also the safety of this
promising method. A meta-analysis was performed according to Preferred
Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA)
guidelines. A comprehensive literature search was undertaken using the
PubMed, Scopus, and Cochrane databases. Articles were thoroughly evaluated
and analyzed. Twenty publications about IMSC during CABG were included.
Primary outcomes were measured using LVEF, LVESV, LVESVI, LVESD, LVEDV,
LVEDVI, LVEDD, WMSI, and 6-MWT. Safety measures were depicted by total
deaths, MACE, CRD, CVA, myocardial infarction, ventricular arrhythmia, and
cardiac-related readmission. IMSC transplantation during CABG
significantly improved LVEF (MD = 3.89%; 95% CI = 1.31% to 6.46%; p =
0.003) and WMSI (MD = 0.28; 95% CI = 0.01-0.56; p = 0.04). Most of the
other outcomes showed favorable results for the IMSC group but were not
statistically significant. The safety analysis also showed no significant
risk difference for IMSC transplantation compared to CABG alone. IMSC
during CABG can safely improve cardiac function and tend to improve
cardiac volumes and dimensions. The analysis and application of
influencing factors that increase patients' responses to IMSC
transplantation are important to achieve long-term
improvement.<br/>Copyright &#xa9; 2023 by the authors.

<17>
Accession Number
2026325983
Title
Efficacy of Incisional Ropivacaine Infiltration by Presternal
Multi-Orifice Catheter for Post-sternotomy Pain Relief in Pediatric
Patients Undergoing Cardiac Surgery: A Prospective, Randomized, Controlled
Study.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 37(11) (pp 2282-2288),
2023. Date of Publication: November 2023.
Author
Das D.; Chauhan S.; Gayatri S.; Chaudhury M.; Makhija N.; Bisoi A.K.
Institution
(Das, Chauhan, Chaudhury, Makhija) Department of Cardiac Anesthesia and
Critical Care, Cardiothoracic Centre, AIIMS, New Delhi, India
(Gayatri, Bisoi) Department of Cardiothoracic and Vascular Surgery,
Cardiothoracic Centre, AIIMS, New Delhi, India
Publisher
W.B. Saunders
Abstract
Objective: To evaluate the efficacy of incisional ropivacaine infiltration
by presternal multi-orifice catheter to manage poststernotomy pain in
pediatric cardiac surgery. <br/>Design(s): A prospective, randomized, and
double-blind comparative study. <br/>Setting(s): At a single-institution
tertiary referral cardiac center. <br/>Participant(s): The study comprised
200 children undergoing cardiac surgeries through a midline sternotomy.
<br/>Intervention(s): Children were allocated randomly to 1 of 3 groups.
Group A (n = 65) and group B (n = 64) received 0.375% ropivacaine infusion
and intermittent bolus, respectively, by presternal multi-orifice
catheter, whereas Group C (n = 64) did not receive any local anesthetic
(LA) drug. Postoperatively, intravenous paracetamol was used for
multimodal analgesia, and fentanyl was given as rescue analgesia,
respectively. <br/>Measurements and Main Results: Pain was assessed by a
Modified Objective Pain Score (MOPS) for 48 hours postextubation. Group B
had significantly lower early MOPS at the first hour, but in the later
period, the mean MOPS was lower in group A. The requirement of the first
rescue analgesia was 3 +/- 1.51, 6.1 +/- 2.26, and 2.6 +/- 0.87 hours for
groups A (n = 60), B (n = 60), and C (n = 60), respectively. The 48-hour
fentanyl consumption was significantly lower (p < 0.001) in group A (0.5
+/- 0.68 microg/kg) and group B (0.7 +/- 0.86 microg/kg) than the control
group (3.4 +/- 0.68 microg/kg). The length of intensive care unit stay was
lower (p < 0.001) in groups A and B than in group C; however, the length
of hospital stay was comparable (p = 0.07). <br/>Conclusion(s): LA bolus
and infusion through presternal multi-orifice catheter provided effective
analgesia postoperatively. However, the bolus was more efficacious in the
early phase but equivalent in later periods. Therefore, bolus and LA
infusion can be used for steady poststernotomy pain relief in children
undergoing cardiac surgeries.<br/>Copyright &#xa9; 2023 Elsevier Inc.

<18>
Accession Number
2026211591
Title
Efficacy of Perioperative Infusion of N(2)-L-alanyl-L-glutamine in
Glycemic Control for Patients With Uncontrolled Diabetes Mellitus
Presented for Urgent Coronary Artery Bypass Surgery: A Randomized
Controlled Trial.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 37(11) (pp 2289-2298),
2023. Date of Publication: November 2023.
Author
Ahmad A.H.M.; Kamal Eldin F.; Rashed M.M.
Institution
(Ahmad, Kamal Eldin, Rashed) Faculty of Medicine, Ain Shams University,
Cairo, Egypt
Publisher
W.B. Saunders
Abstract
Objectives: To evaluate the efficacy of preoperative glutamine infusion in
reducing insulin requirements in patients with uncontrolled type 2
diabetes, defined as glycated hemoglobin (HbA1c) >7%, undergoing urgent
coronary artery bypass graft (CABG) surgery. <br/>Design(s): A randomized
controlled trial. <br/>Setting(s): At Ain Shams University Hospital,
Cardiothoracic Academy. <br/>Participant(s): Ninety-three patients (of
both sexes) with uncontrolled diabetes presenting for urgent CABG were
categorized into 2 groups. <br/>Intervention(s): The dipeptiven group (n =
46) was given an infusion of dipeptiven 1.5 mL/kg body weight dissolved in
normal saline (200 mL) over 3 hours before surgery. The control group (n =
47) received a normal saline infusion (200 mL). <br/>Measurements and Main
Results: The dipeptiven group demonstrated statistically significant lower
intraoperative (173.74 +/- 19.97 mg/dL v 198.22 +/-14.64 mg/dL) and
postoperative (162.36 +/-13.11 mg/dL v 176.13 +/-14.86 mg/dL) mean blood
glucose levels. In addition, dipeptiven infusion was found to reduce mean
total insulin requirements intraoperatively by 3.64 +/- 0.56 units/h and
postoperatively by 37.109 +/- 4.30 units/24 h in comparison to placebo
(50.98 +/- 16.55 units/24 h and 5.10 +/- 2.28 units/h, respectively).
<br/>Conclusion(s): A preoperative infusion of dipeptiven can contribute
to ameliorating stress hyperglycemia in uncontrolled diabetic patients
undergoing urgent CABG.<br/>Copyright &#xa9; 2023 Elsevier Inc.

<19>
Accession Number
2025620465
Title
Does heparin rebound lead to postoperative blood loss in patients
undergoing cardiac surgery with cardiopulmonary bypass?.
Source
Perfusion (United Kingdom). (no pagination), 2023. Date of Publication:
2023.
Author
Rijpkema M.; Vlot E.A.; Stehouwer M.C.; Bruins P.
Institution
(Rijpkema, Vlot, Bruins) Department of Anaesthesiology, Intensive Care and
Pain Management, St Antonius Hospital, Nieuwegein, Netherlands
(Stehouwer) Department of extracorporeal circulation, St Antonius
Hospital, Nieuwegein, Netherlands
Publisher
SAGE Publications Ltd
Abstract
Background: Heparin rebound is a common observed phenomenon after cardiac
surgery with CPB and is associated with increased postoperative blood
loss. However, the administration of extra protamine may lead to increased
blood loss as well. Therefore, we want to investigate the relation between
heparin rebound and postoperative blood loss and the necessity to provide
extra protamine to reverse heparin rebound. <br/>Method(s): We searched
PubMed, Cochrane, EMBASE, Google Scholar and Web of Science to review the
question: "Does heparin rebound lead to postoperative blood loss in
patients undergoing cardiac surgery with cardiopulmonary bypass."
Combination of search words were framed within four major categories:
heparin rebound, blood loss, cardiac surgery and cardiopulmonary bypass.
All studies that met our question were included. Quality assessment was
performed using the Cochrane risk of bias (RoB2) tool for randomized
controlled trials and the risk of bias in non-randomized studies of
intervention (ROBINS-I) for non-randomised trials. <br/>Result(s): 4
randomized and 17 non-randomized studies were included. The mean incidence
of heparin rebound was 40%. The postoperative heparin levels, due to
heparin rebound, were often below or equal to 0.2 IU/mL. We could not
demonstrate an association between heparin rebound and postoperative blood
loss or transfusion requirements. However the quality of evidence was poor
due to a broad variety of definitions of heparin rebound, measured by
various coagulation tests and studies with small sample sizes.
<br/>Conclusion(s): The influence of heparin rebound on postoperative
bleeding seems to be negligible, but might get significant in conjunction
with incomplete heparin reversal or other coagulopathies. For that reason,
it might be useful to get a picture of the entire coagulation spectrum
after cardiac surgery, as can be done by the use of a viscoelastic test in
conjunction with an aggregometry test.<br/>Copyright &#xa9; The Author(s)
2023.

<20>
Accession Number
2025534083
Title
Vitamin C may reduce troponin and CKMB levels after PCI and CABG: a
meta-analysis.
Source
BMC Cardiovascular Disorders. 23(1) (no pagination), 2023. Article Number:
475. Date of Publication: December 2023.
Author
Rozemeijer S.; Hemila H.; van Baaren M.; de Man A.M.E.
Institution
(Rozemeijer, van Baaren, de Man) Department of Intensive Care Medicine,
Research VUmc Intensive Care (REVIVE), Amsterdam Cardiovascular Science
(ACS), Amsterdam Infection and Immunity Institute (AI&II), Amsterdam
Medical Data Science (AMDS), Amsterdam UMC, Location VUmc, Vrije
Universiteit Amsterdam, De Boelelaan 1117, Amsterdam 1081 HV, Netherlands
(Rozemeijer) Department of Anesthesiology, Amsterdam UMC, Location VUmc,
Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam 1081 HV,
Netherlands
(Hemila) Department of Public Health, University of Helsinki, Helsinki,
Finland
Publisher
BioMed Central Ltd
Abstract
Background: Ischemia/reperfusion injury contributes to periprocedural
myocardial injury (PMI) in patients undergoing percutaneous coronary
intervention (PCI) or coronary artery bypass grafting (CABG). PMI can be
estimated by the elevation of troponin (Tn) and creatine kinase-MB (CKMB)
plasma levels, and it is associated with increased risk of cardiovascular
events and mortality. Vitamin C might have a beneficial effect on PMI by
improving endothelial function, improving myocardial perfusion, and by
reducing oxidative stress generated during/after reperfusion. In several
small animal models of cardiac stress, vitamin C reduced the increase in
Tn and CKMB levels. The aim of this meta-analysis was to investigate
whether vitamin C administration may have an effect on Tn and CKMB levels
in patients undergoing PCI or CABG. <br/>Method(s): We searched PubMed,
Cochrane, Embase and Scopus databases for controlled clinical trials
reporting on Tn and CKMB levels in adult patients who underwent PCI or
CABG and received vitamin C. As secondary outcomes we collected data on
biomarkers of oxidative stress in the included trials. In our
meta-analysis, we used the relative scale and estimated the effect as the
ratio of means. <br/>Result(s): We found seven controlled trials which
included 872 patients. All included trials administered vitamin C
intravenously, with a range from 1 to 16 g/day, and all initiated vitamin
administration prior to the procedure. Vitamin C decreased peak Tn plasma
levels in four trials on average by 43% (95% CI: 13 to 63%, p = 0.01) and
peak CKMB plasma levels in five trials by 14% (95% CI: 8 to 21%, p <
0.001). Vitamin C also significantly decreased the biomarkers of oxidative
stress. <br/>Conclusion(s): Vitamin C may decrease cardiac enzyme levels
in patients undergoing elective PCI or CABG. This may be explained
partially by its antioxidant effects. Our findings encourage further
research on vitamin C administration during cardiac procedures and in
other clinical contexts that increase the level of cardiac enzymes. Future
studies should search for an optimal dosing regimen, taking baseline and
follow-up plasma vitamin C levels into account.<br/>Copyright &#xa9; 2023,
BioMed Central Ltd., part of Springer Nature.

<21>
Accession Number
641124175
Title
Perioperative Arrhythmias.
Source
Deutsches Arzteblatt international. 120(33-34) (pp 564-574), 2023. Date of
Publication: 21 Aug 2023.
Author
Pecha S.; Kirchhof P.; Reissmann B.
Institution
(Pecha) University Heart & Vascular Center Hamburg, Department of
Cardiology; Institute of Cardiovascular Sciences, University of
Birmingham, UK
Publisher
NLM (Medline)
Abstract
BACKGROUND: Perioperative arrhythmias are common depending on the type of
the operation and can increase morbidity and mortality. <br/>METHOD(S):
This review is based on pertinent publications retrieved by a selective
search in PubMed, as well as the relevant European guidelines.
<br/>RESULT(S): Arrhythmias are seen in more than 90% of cardiac
operations; they are usually transient and often asymptomatic. The risk
factors for arrhythmia include ion channel diseases, old age, structural
heart disease, cardiac surgery, noncardiac surgery with major fluid
shifts, and pulmonary resection. The full spectrum of supraventricular and
ventricular arrhythmias can arise perioperatively. Correct ECG
interpretation, consideration of the arrhythmia in the overall clinical
context, and an understanding of its causes, pathophysiology, and options
for effective treatment are critically important. According to a
meta-analysis, betablockers lower the risk of perioperative atrial
fibrillation (OR = 0.56; 95% confidence interval: [0.35; 0.91]). If
anticoagulant treatment is not interrupted for surgery, there is less
bleeding with direct oral anticoagulants than with vitamin K antagonists
(relative risk: 0.62 [0.47; 0.82]). Moreover, clinical follow-up is
important, especially for patients with new-onset atrial fibrillation or
heart failure. <br/>CONCLUSION(S): The identification of high-risk
patients and the provision of individualized perioperative monitoring are
essential aspects of patient safety. Outpatient cardiological follow-up
can improve outcomes.

<22>
Accession Number
642328509
Title
The Academic Impact of Congenital Heart Surgeons' Society (CHSS) Studies.
Source
World journal for pediatric & congenital heart surgery. 14(5) (pp
602-619), 2023. Date of Publication: 01 Sep 2023.
Author
Jacobs J.P.; DeCampli W.M.; Karamlou T.; Najm H.K.; Marino B.S.;
Blackstone E.H.; McCrindle B.W.; Jegatheeswaran A.; St Louis J.D.; Austin
E.H.; Caldarone C.A.; Mavroudis C.; Overman D.M.; Dearani J.A.; Jacobs
M.L.; Tchervenkov C.I.; Svensson L.G.; Barron D.; Kirklin J.K.; Williams
W.G.
Institution
(Jacobs) Congenital Heart Center, Division of Cardiovascular Surgery,
Departments of Surgery and Pediatrics, University of Florida, Gainesville,
FL, United States
(DeCampli) Division of Pediatric Cardiac Surgery, Arnold Palmer Hospital
for Children, Orlando, FL, United States
(Karamlou, Najm, Marino, Blackstone, Svensson) Pediatric and Adult
Congenital Heart Center, Cleveland Clinic, Cleveland, OH, United States
(McCrindle) Division of Pediatric Cardiology, Hospital for Sick Children,
Toronto, ON, Canada
(Jegatheeswaran) Cardiac Unit, Great Ormond Street Hospital for Children,
London, United Kingdom
(St Louis) Department of Cardiac Surgery, Inova Fairfax Hospital and Inova
L.J Murphy Children's Hospital, Fairfax, VA, United States
(St Louis) Departments of Surgery and Pediatrics, Children's Hospital of
Georgia, Augusta University, Augusta, GA, United States
(Austin) Department of Cardiovascular and Thoracic Surgery, University of
Louisville, Louisville, KY, United States
(Austin) Norton Children's Hospital, Louisville, KY, United States
(Caldarone) Pediatric Cardiac Surgery, Texas Children's Hospital, Houston,
TX, United States
(Mavroudis) Pediatric Cardiothoracic Surgery, Peyton Manning Children's
Hospital, Indianapolis, IN, United States
(Mavroudis) Johns Hopkins University School of Medicine, Baltimore, MD,
United States
(Overman, Dearani) Division of Cardiovascular Surgery, Mayo
Clinic-Children's Minnesota Cardiovascular Collaborative, Minneapolis, MN,
United States
(Jacobs) Department of Surgery, Johns Hopkins University School of
Medicine, Baltimore, MD, United States
(Tchervenkov) Division of Cardiovascular Surgery, Montreal Children's
Hospital, McGill University Health Centre, Montreal, Quebec, Canada
(Barron, Williams) Division of Cardiovascular Surgery, Hospital for Sick
Children, Toronto, ON, Canada
(Kirklin) Kirklin Institute for Research in Surgical Outcomes, Birmingham,
AL, United States
Publisher
NLM (Medline)
Abstract
PURPOSE: We reviewed all 64 articles ever published by The Congenital
Heart Surgeons' Society (CHSS) Data Center to estimate the academic impact
of these peer-reviewed articles. MATERIALS AND METHODS: The Congenital
Heart Surgeons' Society has performed research based on 12 Diagnostic
Inception Cohorts. The first cohort (Transposition) began enrolling
patients on January 1, 1985. We queried PubMed to determine the number of
publications that referenced each of the 64 journal articles generated by
the datasets of the 12 Diagnostic Inception Cohorts that comprise the CHSS
Database. Descriptive summaries of the data were tabulated using mean with
standard deviation and median with range. <br/>RESULT(S): Sixty-four
peer-reviewed papers have been published based on the CHSS Database.
Fifty-nine peer-reviewed articles have been published based on the 12
Diagnostic Inception Cohorts, and five additional articles have been
published based on Data Science. Excluding the recently established
Diagnostic Inception Cohort for patients with Ebstein malformation of
tricuspid valve, the number of papers published per cohort ranged from 1
for coarctation to 11 for transposition of the great arteries. The 11
articles generated from the CHSS Transposition Cohort were referenced by a
total of 111 articles (median number of references per journal article=9
[range=0-22, mean=10.1]). Overall, individual articles were cited by an
average of 11 (mean), and a maximum of 41 PubMed-listed publications.
Overall, these 64 peer-reviewed articles based on the CHSS Database were
cited 692 times in PubMed-listed publications. The first CHSS
peer-reviewed article was published in 1987, and during the 35 years from
1987 to 2022, inclusive, the annual number of CHSS publications has ranged
from 0 to 7, with a mean of 1.8 publications per year (median=1, mode=1).
<br/>CONCLUSION(S): Congenital Heart Surgeons' Society studies are widely
referenced in the pediatric cardiac surgical literature, with over 10
citations per published article. These cohorts provide unique information
unavailable in other sources of data. A tool to access this analysis is
available at:
[https://data-center.chss.org/multimedia/files/2022/CAI.pdf].

<23>
Accession Number
642332782
Title
Effects of permissive hypercapnia on intraoperative cerebral oxygenation
and early postoperative cognitive function in older patients with
non-acute fragile brain function undergoing laparoscopic colorectal
surgery: protocol study.
Source
BMC geriatrics. 23(1) (pp 581), 2023. Date of Publication: 21 Sep 2023.
Author
Li Z.; Zhu Y.; Qin S.; Gao X.; Kang Y.; Li S.; Chai J.
Institution
(Li, Gao, Li) Department of Anesthesiology, Shengjing Hospital of China
Medical University, Shenyang, China
(Zhu) Department of Anesthesiology, Affiliated Hospital of Qingdao
University, Qingdao, China
(Qin) Department of Anesthesiology, Liaoning Cancer Hospital & Institute,
Shenyang, China
(Kang) Department of Anesthesiology, First Hospital of China Medical
University, Shenyang, China
(Chai) Department of Anesthesiology, Shengjing Hospital of China Medical
University, Shenyang, China
Publisher
NLM (Medline)
Abstract
BACKGROUND: Perioperative brain protection in older patients has been the
focus of research recently; meanwhile, exploring the relationship between
regional cerebral oxygen saturation (rSO2) and brain function in the
perioperative period has been an emerging and challenging area-the
difficulties related to the real-time monitoring of rSO2 and the choice of
feasible interventions. As an advanced instrument for intraoperative rSO2
monitoring, the clinical application of near-infrared spectrum (NIRS)
cerebral oxygen monitoring has gradually increased in popularity and is
being recognized for its beneficial clinical outcomes in patients
undergoing cardiac and noncardiac surgery. In addition, although
sufficient evidence to support this hypothesis is still lacking, the
effect of permissive hypercapnia (PHC) on rSO2 has expanded from basic
research to clinical exploration. Therefore, monitoring intraoperative
rSO2 in older patients with NIRS technology and exploring possible
interventions that may change rSO2 and even improve postoperative
cognitive performance is significant and clinically valuable.
<br/>METHOD(S): This study is a single-center randomized controlled trial
(RCT). 76 older patients are enrolled as subjects. Patients who meet the
screening criteria will be randomly assigned 1:1 to the control and
intervention groups. PHC-based mechanical ventilation will be regarded as
an intervention. The primary outcome is the absolute change in the percent
change in rSO2 from baseline to the completion of surgery in the
intervention and control groups. Secondary outcomes mainly include
observations of intraoperative cerebral oxygenation and metabolism,
markers of brain injury, and assessments of patients' cognitive function
using scale through postoperative follow-up. DISCUSSION: The findings of
this RCT will reveal the effect of PHC on intraoperative rSO2 in older
patients with nonacute fragile brain function (NFBF) and the approximate
trends over time, and differences in postoperative cognitive function
outcomes. We anticipate that the trial results will inform clinical policy
decision-makers in clinical practice, enhance the management of
intraoperative cerebral oxygen monitoring in older patients with comorbid
NFBF, and provide guidance for clinical brain protection and improved
postoperative cognitive function outcomes. TRIAL REGISTRATION: ChiCTR,
ChiCTR2200062093, Registered 9/15/2022.<br/>Copyright &#xa9; 2023. BioMed
Central Ltd., part of Springer Nature.

<24>
Accession Number
2027124525
Title
Percutaneous Mitral Valve Repair for Secondary Mitral Regurgitation: A
Systematic Review and Meta-Analysis.
Source
American Journal of Cardiology. 207 (pp 159-169), 2023. Date of
Publication: 15 Nov 2023.
Author
Kaddoura R.; Bhattarai S.; Abushanab D.; Al-Hijji M.
Institution
(Kaddoura) Pharmacy Department, Heart Hospital, Hamad Medical Corporation,
Doha, Qatar
(Bhattarai) Department of hematology and oncology, Bhaktapur Cancer
Hospital, Bhaktapur, Dudhpati, Nepal
(Abushanab) Drug Information Center, Hamad Medical Corporation, Qatar,
Doha, Qatar
(Al-Hijji) Interventional Cardiology Department, Heart Hospital, Hamad
Medical Corporation, Qatar, Doha, Qatar
Publisher
Elsevier Inc.
Abstract
This systematic review and meta-analysis aimed to investigate whether
percutaneous mitral valve repair (PMVr) using MitraClip was more effective
than surgery or medical therapy for long-term morbidity and mortality. We
searched MEDLINE, EMBASE, and CENTRAL (Cochrane Library) databases to
identify relevant studies that recruited adult patients with functional or
secondary mitral valve regurgitation who underwent PMVr with MitraClip
implantation using appropriate search terms and Boolean operators. The
odds ratios (ORs) were pooled using the random-effects model. A total of
14 studies recruiting 2,593 patients were included. Within 12 months of
follow-up, patients who underwent PMVr did not maintain mitral valve
regurgitation grade 2+ (OR 0.22, 95% confidence interval [CI] 0.12 to
0.41, p <0.0001, I² = 0.0%, p = 0.52) or symptom-free heart
failure (OR 0.47, 95% CI 0.29 to 0.77, p = 0.0028, I² = 0.0%, p
= 0.66) compared with their surgical counterparts. Patients were more
likely to be rehospitalized for heart failure (OR 2.79, 95% CI 1.54 to
5.05, p = 0.0007, I² = 0.0%, p = 0.51). However, there was no
difference between the groups in terms of all-cause or cardiovascular
mortality. Whereas, in comparison with medical therapy, PMVr significantly
reduced all-cause mortality at 12 and >=24 months of follow-up (OR 0.41,
95% CI 0.24, 0.69, p = 0.0009, I² = 32%, p = 0.23 and OR 0.55,
95% CI 0.40, 0.75, p = 0.0002, I² = 0.0%, p = 0.45,
respectively). In conclusion, there was no difference in all-cause death
at 12 or 24 months of follow-up between PMVr and the surgical approach,
but the durability of valvular repair was inferior to PMVr. In comparison
with medical therapy, there was a significant reduction in mortality with
PMVr.<br/>Copyright &#xa9; 2023 The Author(s)

<25>
Accession Number
2027114486
Title
Predictors of All-Cause Mortality After Successful Transcatheter Aortic
Valve Implantation in Patients With Atrial Fibrillation.
Source
American Journal of Cardiology. 207 (pp 150-158), 2023. Date of
Publication: 15 Nov 2023.
Author
Yamamoto M.; Hayashida K.; Hengstenberg C.; Watanabe Y.; Van Mieghem N.M.;
Jin J.; Saito S.; Valgimigli M.; Nicolas J.; Mehran R.; Moreno R.; Kimura
T.; Chen C.; Unverdorben M.; Dangas G.D.
Institution
(Yamamoto) Department of Cardiology, Toyohashi Heart Center, Aichi, Japan
(Hayashida) Department of Cardiology, Keio University School of Medicine,
Tokyo, Japan
(Hengstenberg) Division of Cardiology, Department of Internal Medicine II,
Vienna General Hospital, Medical University, Vienna, Austria
(Watanabe) Division of Cardiology, Teikyo University Hospital, Tokyo,
Japan
(Van Mieghem) Department of Cardiology, Erasmus University Medical Center,
Thoraxcenter, Rotterdam, Netherlands
(Jin, Chen, Unverdorben) Global Specialty Medical Affairs, Daiichi Sankyo,
Inc., Basking Ridge, NJ, United States
(Saito) Division of Cardiology & Catheterization Laboratories, Shonan
Kamakura General Hospital, Kamakura, Japan
(Valgimigli) Division of Cardiocentro Ticino Institute, Ente Ospedaliero
Cantonale, Universita della Svizzera Italiana (USI), Lugano, Switzerland
(Valgimigli) Department of Cardiology, University of Bern, Bern,
Switzerland
(Nicolas) Icahn School of Medicine, New York, NY, United States
(Mehran, Dangas) Zena and Michael A. Wiener Cardiovascular Institute,
Mount Sinai Hospital, New York, New York, United States
(Moreno) Department of Cardiology, University Hospital La Paz, Madrid,
Spain
(Kimura) Primary Medical Science Department, Daiichi Sankyo Co., Ltd.,
Tokyo, Japan
Publisher
Elsevier Inc.
Abstract
Prevalent and incident atrial fibrillation are common in patients who
undergo transcatheter aortic valve implantation and are associated with
impaired postprocedural outcomes, including mortality. We determined
predictors of long-term mortality in patients with atrial fibrillation
after successful transcatheter aortic valve implantation. The EdoxabaN
Versus standard of care and theIr effectS on clinical outcomes in pAtients
havinG undergonE Transcatheter Aortic Valve Implantation-Atrial
Fibrillation (ENVISAGE-TAVI AF) trial (NCT02943785) was a multicenter,
prospective, randomized controlled trial in patients with prevalent or
incident atrial fibrillation after successful transcatheter aortic valve
implantation who received edoxaban or vitamin K antagonists. A Cox
proportional hazard model was performed to identify predictors of
all-cause mortality using a stepwise approach for multiple regression
analysis. In addition, we assessed the performance of different risk
scores and prediction models using ENVISAGE-TAVI AF data. Of 1,426
patients in ENVISAGE-TAVI AF, 178 (12.5%) died during the follow-up period
(median 548 days). Our stepwise approach identified greater risk of
mortality with older age, impaired renal function, nonparoxysmal atrial
fibrillation, excessive alcohol use, New York Heart Association heart
failure class III/IV, peripheral artery disease, and history of major
bleeding or predisposition to bleeding. The present model (concordance
statistic [c-statistic] 0.67) was a better discriminator than were other
frequently used risk scores, such as the Society of Thoracic Surgeons
score (c-statistic 0.56); Congestive heart failure, Hypertension, Age
>=75, Diabetes, Stroke, Vascular disease, Age 65 to 74 years, and Sex
category (CHA<inf>2</inf>DS<inf>2</inf>-VASc) score (c-statistic 0.54); or
Hypertension, Abnormal renal/liver function, Stroke, Bleeding history or
predisposition, Labile international normalized ratio, Elderly, and
Drugs/alcohol concomitantly (HAS-BLED) score (c-statistic 0.58). In
ENVISAGE-TAVI AF, several modifiable and nonmodifiable clinical
characteristics were significantly associated with greater long-term
all-cause mortality. Improved risk stratification to estimate the
probability of mortality after successful transcatheter aortic valve
implantation in patients with atrial fibrillation may improve long-term
patient prognosis.<br/>Copyright &#xa9; 2023 The Author(s)

<26>
Accession Number
2027201146
Title
Atrial Fibrillation and Bioprosthetic Valves: An Evidence-Based Approach
to Anticoagulation Therapy With Direct Oral Anticoagulants and Vitamin K
Antagonists: A Systematic Review, Meta-Analysis, and Network
Meta-Analysis.
Source
American Journal of Cardiology. (no pagination), 2023. Date of
Publication: 2023.
Author
Orban M.
Institution
(Orban) Nemocnicna a.s., Cardiology Clinic, Slovakia, Malacky, Slovakia
Publisher
Elsevier Inc.

<27>
Accession Number
2025535784
Title
Etiologies, Mechanisms, Management, and Outcomes of Electrical Storm.
Source
Journal of Intensive Care Medicine. (no pagination), 2023. Date of
Publication: 2023.
Author
Trohman R.G.
Institution
(Trohman) Section of Electrophysiology, Division of Cardiology, Department
of Internal Medicine, Rush University Medical Center, Chicago, IL, United
States
Publisher
SAGE Publications Inc.
Abstract
Electrical storm (ES) is characterized by three or more discrete sustained
ventricular tachyarrhythmia episodes occurring within a limited time frame
(generally <= 24 h) or an incessant ventricular tachyarrhythmia lasting >
12 h. In patients with an implantable cardioverterdefibrillator (ICD), ES
is defined as three or more appropriate device therapies, separated from
each other by at least 5 min, which occur within a 24-h period. ES may
constitute a medical emergency, depending on the number arrhythmic
episodes, their duration, the type, and the cycle length of the
ventricular arrhythmias, as well as the underlying ventricular function.
This narrative review was facilitated by a search of MEDLINE to identify
peer-reviewed clinical trials, randomized controlled trials,
meta-analyses, and other clinically relevant studies. The search was
limited to English-language reports published between 1999 and 2023. ES
was searched using the terms mechanisms, genetics, channelopathies,
management, pharmacological therapy, sedation, neuraxial modulation,
cardiac sympathetic denervation, ICDs, and structural heart disease.
Google and Google scholar as well as bibliographies of identified articles
were reviewed for additional references. This manuscript examines the
current strategies available to treat ES and compares pharmacological and
invasive treatment strategies to diminish ES recurrence, morbidity, and
mortality.<br/>Copyright &#xa9; The Author(s) 2023.

<28>
Accession Number
642327106
Title
Outcomes of Patients with Left Ventricular Assist Devices Requiring
Intermittent Hemodialysis: Single Center Cohort, Systematic Review, and
Individual-Participant Data Meta-Analysis.
Source
Current problems in cardiology. (pp 102090), 2023. Date of Publication:
19 Sep 2023.
Author
daSilva-deAbreu A.; Faaborg-Andersen C.; Joury A.; Tutor A.; Desai S.;
Eiswirth C.; Krim S.R.; Wever-Pinzon J.; Lavie C.J.; Ventura H.O.
Institution
(daSilva-deAbreu) Department of Cardiovascular Medicine, Mayo Clinic,
Rochester, MN, United States
(Faaborg-Andersen) Department of Internal Medicine, Massachusetts General
Hospital/Harvard Medical School, Boston, United States
(Joury) Division of Cardiology, McGill University Health Centre, McGill
University, Montreal, QC, Canada; King Salman Heart Center, King Fahad
Medical City, Riyadh, Saudi Arabia
(Tutor) John Ochsner Heart and Vascular Institute, Ochsner Clinic
Foundation, New Orleans, LA, United States
(Desai, Eiswirth, Krim, Wever-Pinzon, Lavie, Ventura) John Ochsner Heart
and Vascular Institute, Ochsner Clinic Foundation, New Orleans, LA, USA;
The University of Queensland Ochsner Clinical School, Faculty of Medicine,
The University of Queensland, New Orleans, LA, USA
Publisher
NLM (Medline)
Abstract
INTRODUCTION: Patients with left ventricular assist devices (LVADs) who
require intermittent hemodialysis (iHD) are considered to have a poor
prognosis despite a paucity of supportive evidence, mostly from small
single-center cohorts and extrapolations from studies of patients who
received continuous renal replacement therapy but no iHD. METHODS/RESULTS:
We conducted a systematic review and individual-participant-data
meta-analysis of the literature including our single-center cohort to
examine the outcomes of patients initiated on iHD following LVAD
implantation. Sixty-four patients from five cohorts met selection criteria
(age 57.5 [46-64.5] years, 87% HeartMate II, mostly bridge to
transplantation). Follow-up after iHD initiation was 87.5 (38.5-269.5)
days, although it was considerably longer in our center than in other
cohorts (601.5 [93-1559] days vs. 65 [26-180] days, p=0.0007). The
estimated median survival was 308 [76-912.5] days and varied significantly
among cohorts, ranging from 60 [57-65] to 838 [103-1872] days (p=0.0096).
Twelve (18.8%) patients achieved either heart transplantation (HT) or
remission during follow-up. Patients who received HT had an eight-fold
longer estimated median survival (1972 [799-1972] days vs. 244 [64-838]
days, p=0.0112). Being from a more recent cohort was associated with
better 1-year survival. Renal recovery occurred in eight patients (13.1%)
at 30 days and its cumulative incidence increased to 73% (27/37 patients
with available data) at one year. <br/>CONCLUSION(S): Most patients
initiated on iHD after LVAD experienced renal recovery within the first
year after implantation. Improved survival was observed for patients who
received HT and in those from more recent cohorts. Some patients were able
to survive on LVAD and iHD support for several years.<br/>Copyright &#xa9;
2023. Published by Elsevier Inc.

<29>
Accession Number
2027036375
Title
Frequency and clinical significance of atrial cavities in situ thrombosis:
A large-scale study and literature review.
Source
Journal of Cardiovascular Echography. 33(2) (pp 61-68), 2023. Date of
Publication: April 2023.
Author
Cresti A.; Baratta P.; Aloia E.; De Sensi F.; Solari M.; Limbruno U.
Institution
(Cresti, Baratta, Aloia, De Sensi, Limbruno) Department of Cardiological,
Misericordia Hospital, Grosseto, Italy
(Solari) Department of Cardiological, S. Giuseppe Hospital, Empoli, Italy
Publisher
Wolters Kluwer Medknow Publications
Abstract
Background: Atrial tachyarrhythmias are the main cause of atrial
thrombosis, and are usually in the left appendage. The prevalence and
causes of endocavitarian thrombosis have not been investigated in recent
large-scale studies. Aim of our work was to describe the epidemiology, the
clinical characteristics and predisposing factors of 'extra-appendicular'
atrial thrombosis and to report a systematic review of recent literature.
<br/>Methods and Results: 5,862 consecutive adult patients referred to a
transesophageal echocardiographic exam, were enrolled. A total of 175
subjects with Atrial Thrombosis were found with a prevalence of 2.98%;
among those 22 was found in left (0.38%) and 2 in the right (0.03%)
atrium. Among the 22 patients with left atrial thrombosis, 8 were
associated with prosthetic valves, 4 with mitral stenosis and the
remaining with hypercoagulative conditions (cancer, septic shock,
eosinophilic pneumonia, cardiogenic shock and warfarin under-dosage in
permanent atrial fibrillation and decompensated heart failure). Cancer was
associated in one of the two patients with a right atrial clot. The review
of the literature from 2000 to December 2019 revealed conflicting results
of 48 case reports of atrial cavity thrombosis; pooling this data proved
the rarity of extra-appendage thrombosis and confirmed its association
with a valvular heart disease or a systemic hypercoagulable state.
<br/>Conclusion(s): Atrial 'extra-appendage' thrombosis is a rare
condition usually associated to 'valvular' atrial fibrillation (such as
prosthetic valves and mitral stenosis). A minority, but significant, cases
are secondary to a thrombophilic conditions. In absence of valvular heart
disease an underlying condition should be sought.<br/>Copyright &#xa9;
2023 Wolters Kluwer Medknow Publications. All rights reserved.

<30>
Accession Number
2026881405
Title
A Systematic Review of the Clinical Appropriateness of Blood Transfusion
in India.
Source
Journal of Cardiovascular Disease Research. 14(5) (pp 878-887), 2023. Date
of Publication: 2023.
Author
Cheema R.K.; Tripathi P.P.; Badhan A.; Jindal P.
Institution
(Cheema) Department of Transfusion Medicine, Maharishi Markandeshwar
College of Medical Sciences & Research (MMCMSR), Sadopur, Haryana, Ambala,
India
(Tripathi) Department of Transfusion Medicine and Hematology, National
Institute of Mental Health and Neurosciences (NIMHANS), Karnataka,
Bangalore, India
(Badhan) Department of Transfusion Medicine, Maharishi Markandeshwar
Institute of Medical Sciences & Research (MMIMSR), Mullana, Haryana,
Ambala, India
(Jindal) Department of Biochemistry, Maharishi Markandeshwar College of
Medical Sciences & Research, Sadopur, Haryana, Ambala, India
Publisher
EManuscript Technologies
Abstract
Background: Human blood is a scarce and precious resource with no
substitute. Blood and its components hold significant value as a crucial
and valuable health resource. Blood transfusion is a vital therapeutic
method that can be lifesaving in specific situations and is an
irreplaceable means of clinical treatment. <br/>Aim(s): In light of the
lack of a comprehensive systematic analysis on the rational utilization of
blood in India, this systematic analysis was undertaken to address this
significant issue of evaluation of clinical appropriateness of blood
transfusion in India. <br/>Method(s): The database search was carried out
using PubMed, Medline, Embase, Scopus and Cochrane Library for the studies
existing from the initial records till December 2022, that reported the
incidence of inappropriateness of blood transfusion in India. After going
through the databases, 1464 relevant articles were identified as per the
search strategy. Among those 1308 duplicate records were taken away. Among
the remaining one 166 records, 138 records were excluded majorly going
through their titles and abstracts. Next matching our inclusion criteria
and going through the full texts, 13 studies were excluded. Lastly, after
excluding the reviews we included relevant 15 studies that reported
clinical appropriateness of blood and blood products transfusion in India.
All the included studies were published between years 2009-2022.
<br/>Result(s): The rates of inappropriate use varied between 3.3% to 53%,
depending on the specific type of blood component utilized. The highest
rates of inappropriateness were found in cases involving Fresh frozen
plasma (FFP), followed by Packed Red Blood Cells (PRBC).
<br/>Conclusion(s): India faces challenges in ensuring the clinical
appropriateness of blood transfusion, particularly regarding the use of
plasma and red blood cells (RBCs). Inadequate dosing, lack of awareness
regarding guidelines for blood component transfusion, and concerns about
patient safety are the major contributing factors. Moving forward, it is
crucial to implement comprehensive measures to enhance the clinical
appropriateness of blood transfusions.<br/>Copyright &#xa9; 2023
EManuscript Technologies. All rights reserved.

<31>
Accession Number
2025966555
Title
Renin-angiotensin-aldosterone system dynamics after targeted blood
pressure control using angiotensin II or norepinephrine in cardiac
surgery: mechanistic randomised controlled trial.
Source
British Journal of Anaesthesia. 131(4) (pp 664-672), 2023. Date of
Publication: October 2023.
Author
Coulson T.G.; Miles L.F.; Zarbock A.; Burrell L.M.; Patel S.K.; von Groote
T.; Pilcher D.; Weinberg L.; Landoni G.; Bellomo R.
Institution
(Coulson) Department of Anaesthesiology and Perioperative Medicine, Alfred
Health and Monash University, Melbourne, VIC, Australia
(Coulson, Miles, Weinberg, Bellomo) Department of Critical Care,
University of Melbourne, Melbourne, VIC, Australia
(Miles, Weinberg) Department of Anaesthesia and Pain Medicine, Austin
Health, Melbourne, VIC, Australia
(Zarbock, von Groote) Department of Anaesthesiology, Intensive Care and
Pain Medicine, University Hospital Munster, Munster, Germany
(Burrell, Patel) Department of Medicine, Austin Health, University of
Melbourne, Heidelberg, VIC, Australia
(Burrell) Department of Cardiology, Austin Health, Heidelberg, VIC,
Australia
(Burrell) The Institute for Breathing and Sleep, Heidelberg, VIC,
Australia
(Pilcher) Department of Intensive Care, Alfred Hospital, Melbourne, VIC,
Australia
(Pilcher, Bellomo) Australian and New Zealand Intensive Care Research
Centre, Monash University, Melbourne, VIC, Australia
(Landoni) Department of Anaesthesia, IRCCS San Raffaele Scientific
Institute, Milan, Italy
(Landoni) Vita-Salute San Raffaele University, Milan, Italy
(Bellomo) Department of Intensive Care, Royal Melbourne Hospital,
Melbourne, VIC, Australia
(Bellomo) Department of Intensive Care, Austin Hospital, Melbourne, VIC,
Australia
(Bellomo) Data Analytics Research and Evaluation Centre, Austin Hospital,
Melbourne, VIC, Australia
Publisher
Elsevier Ltd
Abstract
Background: The role of the renin-angiotensin-aldosterone axis in
vasoplegia after cardiac surgery remains unclear. We tested the hypothesis
that, compared with norepinephrine, infusion of angiotensin II titrated to
achieve similar mean arterial pressure (MAP) would suppress plasma renin
concentration (PRC) while maintaining aldosterone levels. <br/>Method(s):
In a double-blind, randomised controlled trial, subjects received either
an infusion of angiotensin II or norepinephrine to maintain MAP 70-80 mm
Hg from induction of anaesthesia. We compared PRC, aldosterone, dipeptidyl
peptidase-3, and angiotensin-converting enzyme 2 activity between
treatment groups, before surgery, on ICU admission, and 24 h after
surgery. <br/>Result(s): In 60 patients (11.7% female; mean age 68 yr [11
yr]), norepinephrine increased median PRC at ICU admission (median
difference [MD] 46 [inter-quartile range, IQR, 3-88] muU ml^-1;
P<0.001) but angiotensin II did not (MD -3 [IQR -62 to 35] muU
ml^-1; P=0.36). Aldosterone levels increased with both. The
aldosterone:PRC ratio did not change with norepinephrine (MD -0.01 [IQR
-0.14 to 0.03] muU ml^-1 per ng dl^-1, P=0.76) but
increased with angiotensin II (MD 0.05 [IQR 0.004-0.26] muU
ml^-1 per ng dl^-1, P<0.001). The upper quartile of
PRC before surgery was associated with higher vasopressor requirements
when norepinephrine was used to maintain MAP, but not angiotensin II.
Dipeptidyl peptidase-3 levels and angiotensin-converting enzyme 2
activities were similar at all time points. <br/>Conclusion(s):
Angiotensin II suppressed renin release while maintaining aldosterone
levels compared with norepinephrine. Higher plasma renin concentration
before surgery was associated with greater vasopressor requirement for
norepinephrine, but not angiotensin II. Clinical trial registration:
Australian and New Zealand Clinical Trials Registry-ACTRN12621000195853
23/02/2021.<br/>Copyright &#xa9; 2023 British Journal of Anaesthesia

<32>
Accession Number
2025534511
Title
Restrictive versus conventional ward fluid therapy in non-cardiac surgery
patients and the effect on postoperative complications: a meta-analysis.
Source
Perioperative Medicine. 12(1) (no pagination), 2023. Article Number: 52.
Date of Publication: December 2023.
Author
Bosboom J.J.; Wijnberge M.; Geerts B.F.; Kerstens M.; Mythen M.G.; Vlaar
A.P.J.; Hollmann M.W.; Veelo D.P.
Institution
(Bosboom, Wijnberge, Kerstens, Hollmann, Veelo) Department of
Anesthesiology, Amsterdam UMC, Amsterdam University, Amsterdam,
Netherlands
(Bosboom, Wijnberge, Vlaar) Department of Intensive Care Medicine,
Amsterdam UMC, Amsterdam University, Amsterdam, Netherlands
(Bosboom) Department of Anesthesiology, Intensive Care, and Pain Medicine,
Amphia Hospital, Breda, Netherlands
(Geerts) Healthplus.Ai-R&D B.V., Amsterdam, Netherlands
(Mythen) Departments of Anesthesia and Critical Care, University College
London Hospitals, National Institute of Health Research Biomedical
Research Centre, London, United Kingdom
Publisher
BioMed Central Ltd
Abstract
Background: Diligent fluid management is an instrumental part of Enhanced
Recovery After Surgery. However, the effect of a ward regimen to limit
intravenous fluid administration on outcome remains unclear. We performed
a meta-analysis investigating the effect of a restrictive versus a
conventional fluid regimen on complications in patients after non-cardiac
surgery in the postoperative period on the clinical ward. Study design: We
performed a systematic search in MEDLINE, Embase, Cochrane Library, and
CINAHL databases, from the start of indexing until June 2022, with
constraints for English language and adult human study participants. Data
were combined using classic methods of meta-analyses and were expressed as
weighted pooled risk ratio (RR) or odds ratio (OR) with 95% confidence
interval (CI). Quality assessment and risk of bias analyses was performed
according to PRISMA guidelines. <br/>Result(s): Seven records, three
randomized controlled trials, and four non-randomized studies were
included with a total of 883 patients. A restrictive fluid regimen was
associated with a reduction in overall complication rate in the RCTs (RR
0.46, 95% CI 0.23 to 0.95; P <.03; I ² = 35%). This reduction
in overall complication rate was not consistent in the non-randomized
studies (RR 0.74, 95% CI 0.53 to 1.03; P 0.07; I ² = 45%). No
significant association was found for mortality using a restrictive fluid
regimen (RCTs OR 0.51, 95% CI 0.05 to 4.90; P = 0.56; I ² = 0%,
non-randomized studies OR 0.30, 95% CI 0.06 to 1.46; P = 0.14; I
² = 0%). A restrictive fluid regimen is significantly
associated with a reduction in postoperative length of stay in the
non-randomized studies (MD - 1.81 days, 95% CI - 3.27 to - 0.35; P = 0.01;
I ² = 0%) but not in the RCTs (MD 0.60 days, 95% CI - 0.75 to
1.95; P = 0.38). Risk of bias was moderate to high. Methodological quality
was very low to moderate. <br/>Conclusion(s): This meta-analysis suggests
restrictive fluid therapy on the ward may be associated with an effect on
postoperative complication rate. However, the quality of evidence was
moderate to low, the sample size was small, and the data came from both
RCTs and non-randomized studies.<br/>Copyright &#xa9; 2023, BioMed Central
Ltd., part of Springer Nature.

<33>
Accession Number
2025514188
Title
Impact of premature coronary artery disease on adverse event risk
following first percutaneous coronary intervention.
Source
Frontiers in Cardiovascular Medicine. 10 (no pagination), 2023. Article
Number: 1160201. Date of Publication: 2023.
Author
Pinxterhuis T.H.; Ploumen E.H.; Zocca P.; Doggen C.J.M.; Schotborgh C.E.;
Anthonio R.L.; Roguin A.; Danse P.W.; Benit E.; Aminian A.; Hartmann M.;
Linssen G.C.M.; von Birgelen C.
Institution
(Pinxterhuis, Ploumen, Zocca, Hartmann, von Birgelen) Department of
Cardiology, Thoraxcentrum Twente, Medisch Spectrum Twente, Enschede,
Netherlands
(Pinxterhuis, Ploumen, Doggen, von Birgelen) Department of Health
Technology and Services Research, Faculty BMS, Technical Medical Centre,
University of Twente, Enschede, Netherlands
(Schotborgh) Department of Cardiology, Haga Hospital, The Hague,
Netherlands
(Anthonio) Department of Cardiology, Treant Zorggroep, Scheper Hospital,
Emmen, Netherlands
(Roguin) Department of Cardiology, Hillel Yaffe Medical Center, Hadera and
B. Rappaport-Faculty of Medicine, Israel, Institute of Technology, Haifa,
Israel
(Danse) Department of Cardiology, Rijnstate Hospital, Arnhem, Netherlands
(Benit) Department of Cardiology, Jessa Hospital, Hasselt, Belgium
(Aminian) Department of Cardiology, Centre Hospitalier Universitaire de
Charleroi, Charleroi, Belgium
(Linssen) Department of Cardiology, Ziekenhuisgroep Twente, Hengelo,
Almelo, Netherlands
Publisher
Frontiers Media SA
Abstract
Objectives: We assessed differences in risk profile and 3-year outcome
between patients undergoing percutaneous coronary intervention (PCI) for
premature and non-premature coronary artery disease (CAD).
<br/>Background(s): The prevalence of CAD increases with age, yet some
individuals develop obstructive CAD at younger age. <br/>Method(s): Among
participants in four randomized all-comers PCI trials, without previous
coronary revascularization or myocardial infarction (MI), we compared
patients with premature (men <50 years; women <55 years) and non-premature
CAD. Various clinical endpoints were assessed, including multivariate
analyses. <br/>Result(s): Of 6,171 patients, 887 (14.4%) suffered from
premature CAD. These patients had fewer risk factors than patients with
non-premature CAD, but were more often smokers (60.7% vs. 26.4%) and
overweight (76.2% vs. 69.8%). In addition, premature CAD patients
presented more often with ST-segment elevation MI and underwent less often
treatment of multiple vessels, and calcified or bifurcated lesions.
Furthermore, premature CAD patients had a lower all-cause mortality risk
(adj.HR: 0.23, 95%-CI: 0.10-0.52; p < 0.001), but target vessel
revascularization (adj.HR: 1.63, 95%-CI: 1.18-2.26; p = 0.003) and
definite stent thrombosis risks (adj.HR: 2.24, 95%-CI: 1.06-4.72; p =
0.034) were higher. MACE rates showed no statistically significant
difference (6.6% vs. 9.4%; adj.HR: 0.86, 95%-CI: 0.65-1.16; p = 0.33)
<br/>Conclusion(s): About one out of seven PCI patients was treated for
premature CAD. These patients had less complex risk profiles than patients
with non-premature CAD; yet, their risk of repeated revascularization and
stent thrombosis was higher. As lifetime event risk of patients with
premature CAD is known to be particularly high, further efforts should be
made to improve modifiable risk factors such as smoking and overweight.
TWENTE trials: (TWENTE I, clinicaltrials.gov: NCT01066650), DUTCH PEERS
(TWENTE II, NCT01331707), BIO-RESORT (TWENTE III, NCT01674803), and BIONYX
(TWENTE IV, NCT02508714).
(Figure presented.) Impact of premature coronary artery disease on adverse
event risk following percutaneous coronary intervention with
new-generation drug-eluting stents. Kaplan-Meier cumulative event curves
for major adverse cardiac events and all-cause mortality of patients with
premature (orange) and non-premature (purple) coronary artery disease. CI,
confidence interval; HR, hazard ratio.<br/>Copyright 2023 Pinxterhuis,
Ploumen, Zocca, Doggen, Schotborgh, Anthonio, Roguin, Danse, Benit,
Aminian, Hartmann, Linssen and von Birgelen.

<34>
Accession Number
2025441500
Title
Cardiac hydatid disease; a systematic review.
Source
BMC Infectious Diseases. 23(1) (no pagination), 2023. Article Number: 600.
Date of Publication: December 2023.
Author
Banisefid E.; Baghernezhad K.; Beheshti R.; Hamzehzadeh S.; Nemati S.;
Samadifar Z.; Owaysee Osquee H.; Javanshir E.; Naseri A.
Institution
(Banisefid, Baghernezhad, Beheshti, Hamzehzadeh, Naseri) Student Research
Committee, Tabriz University of Medical Sciences, Tabriz, Iran, Islamic
Republic of
(Nemati, Samadifar, Javanshir) Cardiovascular Research Center, Tabriz
University of Medical Sciences, Golgasht Street, Tabriz, East Azerbaijan
5166/15731, Iran, Islamic Republic of
(Owaysee Osquee) Department of Infectious Disease, Tabriz University of
Medical Sciences, Tabriz, Iran, Islamic Republic of
(Naseri) Research Center for Evidence-Based Medicine, Iranian EBM Center:
A Joanna Briggs Institute Center of Excellence, Tabriz University of
Medical Sciences, Tabriz, Iran, Islamic Republic of
Publisher
BioMed Central Ltd
Abstract
Background and objectives: Human cystic echinococcosis (CE), is a common
health problem in low- and middle-income countries. Cardiac involvement is
a relatively rare manifestation of Echinococcus infection. This study aims
to summarize the evidence regarding the features of cardiac CE.
<br/>Method(s): Case series of the patients with cardiac CE, were included
in this study. Non-English papers, case reports, reviews, letters, ,
commentaries, and conference abstracts were not included. A systematic
search was conducted in PubMed and EMBASE databases and the risk of bias
in the included studies was assessed using the Joanna Briggs Institute
(JBI) Critical Appraisal Checklist. <br/>Result(s): Out of 3985 results of
the searches, finally 37 studies were included in this systematic review.
Based on available evidence, cardiac involvement is an uncommon but
serious presentation of CE which presents with some non-specific signs and
symptoms. Dyspnea, chest pain, and palpitation are the most common
symptoms of the disease and normal sinus rhythm is the most common
Electrocardiogram (ECG) feature. The disease is not associated with high
mortality in case of timely diagnosis and appropriate management.
<br/>Discussion(s): Consecutive and complete inclusion of participants,
statistical analysis, and appropriate reporting of the demographics were
the sources of bias in the included studies. The exclusion of non-English
papers was a limitation during the review process. <br/>Funding(s): The
research protocol was approved and supported by the Student Research
Committee, Tabriz University of Medical Sciences (grant number: 69380).
Registration: This study was registered in the International prospective
register of systematic reviews (PROSPERO ID:
CRD42022381204).<br/>Copyright &#xa9; 2023, BioMed Central Ltd., part of
Springer Nature.

<35>
Accession Number
2018953611
Title
Infant's difficult temperament characteristics predict poor quality of
life in parents of infants with complex CHDs post-cardiac surgery.
Source
Cardiology in the Young. 33(8) (pp 1316-1321), 2023. Date of Publication:
22 Aug 2023.
Author
Golfenshtein N.; Lisanti A.J.; Medoff-Cooper B.
Institution
(Golfenshtein) University of Haifa, Department of Nursing, 199 Abba Hushi
Ave., Haifa 3498838, Israel
(Golfenshtein, Lisanti, Medoff-Cooper) University of Pennsylvania, School
of Nursing, Claire M. Fagin Hall, 418 Curie Blvd, Philadelphia, PA 19104,
United States
(Lisanti) Children's Hospital of Philadelphia, 3401 Civic Center Blvd,
Philadelphia, PA 19104, United States
Publisher
Cambridge University Press
Abstract
Background & Aims: Parents of infants with complex CHDs often describe
their infants as especially fussy, irritable, and difficult to sooth,
which together with the illness caretaking demands add to their stress.
Little is known about how the behavioural style or temperament in the
early months after discharge relates to parental quality of life. This
study aimed to explore the associations between early infant temperament
characteristics and parental quality of life in parents of infants with
complex CHD. <br/>Method(s): This descriptive, cross-sectional study,
utilised data collected in a previously described multisite randomised
clinical trial in the United States. Multivariable linear regression
models were used to examine the associations of interest. <br/>Finding(s):
Results demonstrated negative significant associations between most infant
temperament subscales and parental quality of life. Higher scores on the
Activity (beta = -3.03, p = 0.021), Approach (beta = -1.05, p = 0.021),
Adaptability (beta = -3.47, p = 0.004), Intensity (beta = -2.78, p =
0.008), Mood (beta = -4.65, p < 0.001), and Distractibility (beta = -3.36,
p = 0.007 were all significantly associated with lower parental quality of
life scores, adjusting for parental dyadic adjustment, insurance type,
number of medications, and number of unscheduled cardiologist visits.
<br/>Conclusion(s): Parental perceptions of infant's difficult behavioural
style or temperament characteristics appear to be associated with poorer
quality of life in parents of infants with complex CHD post-cardiac
surgery. Findings can be used in the screening process of families at
potential risk of increased stress and poor illness adaptation and in the
design of interventions to target parental mental health in this
vulnerable patient population.<br/>Copyright &#xa9; The Author(s), 2022.
Published by Cambridge University Press.

<36>
Accession Number
2027096182
Title
One-Lung Ventilation and Postoperative Pulmonary Complications After Major
Lung Resection Surgery. A Multicenter Randomized Controlled Trial.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2023.
Date of Publication: 2023.
Author
Piccioni F.; Langiano N.; Bignami E.; Guarnieri M.; Proto P.; D'Andrea R.;
Mazzoli C.A.; Riccardi I.; Bacuzzi A.; Guzzetti L.; Rossi I.; Scolletta
S.; Comi D.; Benigni A.; Pierconti F.; Coccia C.; Biscari M.; Murzilli A.;
Umari M.; Peratoner C.; Serra E.; Baldinelli F.; Accardo R.; Diana F.;
Fasciolo A.; Amodio R.; Ball L.; Greco M.; Pelosi P.; Della Rocca G.
Institution
(Piccioni) Department of Anesthesia and Intensive Care, IRCCS Humanitas
Research Hospital, Rozzano, Milan, Italy
(Langiano, Riccardi) SOC Anesthesia and Intensive Care Medicine Clinic -
Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy
(Bignami) Anesthesiology, Critical Care and Pain Medicine Division,
Department of Medicine and Surgery, University of Parma, Parma, Italy
(Guarnieri) Department of Medicine and Surgery, University of Milan
Bicocca, Milan, Italy
(Proto) Department of Critical and Supportive Therapy, Fondazione IRCCS
Istituto Nazionale Tumori, Milan, Italy
(D'Andrea) Department of Anesthesia, Intensive Care Medicine and
Emergency, IRRCS Policlinico di Sant' Orsola, Bologna Academic Hospital,
Bologna, Italy
(Mazzoli) Department of Anesthesia, Intensive Care Medicine and
Prehospital Emergency, Maggiore Hospital Carlo Alberto Pizzardi, Bologna,
Italy
(Bacuzzi, Guzzetti) ASST Settelaghi Ospedale di Circolo e Fondazione
Macchi, Varese, Italy
(Rossi, Scolletta) Cardio-thoracic and vascular Department, UOC
Cardio-thoracic and vascular Anesthesia and ICM, Azienda
ospedaliero-universitaria Senese, Siena, Italy
(Comi, Benigni) Anesthesia and Intensive Care Unit, ASST Papa Giovanni
XXIII, Bergamo, Italy
(Pierconti, Coccia) IRCCS-IFO National Institute of Oncology - Regina
Elena, DPT of Oncologic Clinic and Research, UOC Anesthesia and ICM, Rome,
Italy
(Biscari, Murzilli) Arcispedale Santa Maria Nuova, IRCCS AUSL di Reggio
Emilia, Italy
(Umari, Peratoner) SOC Anesthesia and Intensive Care Medicine - Azienda
Sanitaria Universitaria Giuliana, Cattinara Hospital, Trieste, Italy
(Serra) Anesthesia and Intensive Care Medicine Institute - Azienda
Ospedaliera-Universita of Padua, Padua, Italy
(Baldinelli) Azienda Sanitaria dell'Alto Adige, Bozen, Italy
(Accardo) Division of Anesthesia, Department of Anesthesia, Endoscopy and
Cardiology, Istituto Nazionale Tumori Fondazione G. Pascale - IRCCS,
Naples, Italy
(Diana) Anesthesia and Intensive Care Unit, Azienda Ospedaliera Brotzu -
Ospedale Oncologico Businco, Cagliari, Italy
(Fasciolo) IRRCS Policlinico San Martino Hospital, Genoa, Italy
(Amodio) Department of Anesthesia, Intensive Care and Pain Medicine, IRCCS
Centro di Riferimento Oncologico della Basilicata/OECI Clinical Cancer
Center - Rionero in Vulture, Potenza, Italy
(Ball, Pelosi) Department of Surgical Sciences and Integrated Diagnostics,
IRCCS AOU San Martino-IST, University of Genoa, Genoa, Italy
(Greco) Department of Biomedical Sciences, Humanitas University, Milan,
Italy
(Greco) Department of Anaesthesiology and Intensive Care, IRCCS Humanitas
Research Hospital, Milan, Italy
(Della Rocca) Department of Medical Area, University of Udine, Udine,
Italy
Publisher
W.B. Saunders
Abstract
Objectives: The effect of one-lung ventilation (OLV) strategy based on low
tidal volume (TV), application of positive end-expiratory pressure (PEEP),
and alveolar recruitment maneuvers (ARM) to reduce postoperative acute
respiratory distress syndrome (ARDS) and pulmonary complications (PPCs)
compared with higher TV without PEEP and ARM strategy in adult patients
undergoing lobectomy or pneumonectomy has not been well established.
<br/>Design(s): Multicenter, randomized, single-blind, controlled trial.
<br/>Setting(s): Sixteen Italian hospitals. <br/>Participant(s): A total
of 880 patients undergoing elective major lung resection.
<br/>Intervention(s): Patients were randomized to receive lower tidal
volume (LTV group: 4 mL/kg predicted body weight, PEEP of 5
cmH<inf>2</inf>O, and ARMs) or higher tidal volume (HTL group: 6 mL/kg
predicted body weight, no PEEP, and no ARMs). After OLV, until extubation,
both groups were ventilated using a tidal volume of 8 mL/kg and a PEEP
value of 5 cmH<inf>2</inf>O. The primary outcome was the incidence of
in-hospital ARDS. Secondary outcomes were the in-hospital rate of PPCs,
major cardiovascular events, unplanned intensive care unit (ICU)
admission, in-hospital mortality, ICU length of stay, and in-hospital
length of stay. <br/>Measurements and Main Results: ARDS occurred in 3 of
438 patients (0.7%, 95% CI 0.1-2.0) and in 1 of 442 patients (0.2%, 95% CI
0-1.4) in the LTV and HTV group, respectively (Risk ratio: 3.03 95% CI
0.32-29, p = 0.372). Pulmonary complications occurred in 125 of 438
patients (28.5%, 95% CI 24.5-32.9) and in 136 of 442 patients (30.8%, 95%
CI 26.6-35.2) in the LTV and HTV group, respectively (risk ratio: 0.93,
95% CI 0.76-1.14, p = 0.507). The incidence of major complications,
in-hospital mortality, and unplanned ICU admission, ICU and in-hospital
length of stay were comparable in both groups. <br/>Conclusion(s): In
conclusion, among adult patients undergoing elective lung resection, an
OLV with lower tidal volume, PEEP 5 cmH<inf>2</inf>O, and ARMs and a
higher tidal volume strategy resulted in low ARDS incidence and comparable
postoperative complications, in-hospital length of stay, and
mortality.<br/>Copyright &#xa9; 2023 Elsevier Inc.

<37>
Accession Number
2026366812
Title
Clinical Practice Guideline of Spanish Society of Pneumology and Thoracic
Surgery (SEPAR) on Pharmacological Treatment of Tobacco Dependence 2023.
Source
Archivos de Bronconeumologia. 59(10) (pp 651-661), 2023. Date of
Publication: October 2023.
Author
Rabade-Castedo C.; de Granda-Orive J.I.; Riesco-Miranda J.A.; De
Higes-Martinez E.; Ramos-Pinedo A.; Cabrera-Cesar E.; Signes-Costa Minana
J.; Garcia Rueda M.; Pastor-Espla E.; Jimenez-Ruiz C.A.
Institution
(Rabade-Castedo) Servicio de Neumologia, Complejo Hospitalario
Universitario de Santiago de Compostela, Santiago de Compostela, La
Coruna, Spain
(de Granda-Orive) Servicio de Neumologia, Hospital Universitario 12 de
octubre Madrid, Spain
(de Granda-Orive) Universidad Complutense, Madrid, Spain
(Riesco-Miranda) Servicio de Neumologia, Hospital Universitario de
Caceres, Caceres, Spain
(Riesco-Miranda) Centro de Investigacion en Red de enfermedades
respiratorias (CIBERES), Madrid, Spain
(Riesco-Miranda) Instituto Universitario de Investigacion Biosanitaria de
Extremadura (INUBE), Spain
(De Higes-Martinez, Ramos-Pinedo) Unidad de Neumologia, Hospital
Universitario Fundacion Alcorcon, Spain
(De Higes-Martinez, Ramos-Pinedo) Universidad Rey Juan Carlos, Madrid,
Spain
(Cabrera-Cesar) Servicio de Neumologia, Hospital Universitario Virgen de
la Victoria, Malaga, Spain
(Signes-Costa Minana) Servicio de Neumologia, Hospital Clinico
Universitario de Valencia, Spain
(Signes-Costa Minana) Instituto de Investigacion Sanitaria de Valencia
(INCLIVA), Valencia, Spain
(Garcia Rueda) Servicio de Neumologia, Hospital Carlos Haya de Malaga,
Malaga, Spain
(Pastor-Espla) Servicio de Neumologia, Hospital Universitario San Juan de
Alicante, Alicante, Spain
(Jimenez-Ruiz) Unidad Especializada en Tabaquismo de la Comunidad de
Madrid, Hospital Clinico San Carlos, Madrid, Spain
Publisher
Sociedad Espanola de Neumologia y Cirugia Toracica (SEPAR)
Abstract
Introduction: There are multiple systematic reviews and meta-analyses on
the efficacy and safety of pharmacological treatments against nicotine
dependence. However, there are few guidelines to answer frequent questions
asked by a clinician treating a smoker. Therefore, the aim of this paper
is to facilitate the treatment of tobacco addiction. <br/>Material(s) and
Method(s): 12 PICO questions are formulated from a GLOBAL PICO question:
"Efficacy and safety of pharmacological treatment of tobacco dependence".
A systematic review was carried out to answer each of the questions and
recommendations were made. The GRADE (Grading of Recommendations,
Assessment, Development and Evaluation) system was used to grade the
certainty of the estimated effects and the strength of the
recommendations. <br/>Result(s): Varenicline, nicotine replacement therapy
(NRT), bupropion and cytisine are more effective than placebo. Varenicline
and combined nicotine therapy are superior to the other therapies. In
smokers with high dependence, a combination of drugs is recommended, being
more effective those associations containing varenicline. Other
optimization strategies with lower efficacy consist of increasing the
doses, the duration, or retreat with varenicline. In specific populations
varenicline or NRT is recommended. In hospitalized, the treatment of
choice is NRT. In pregnancy it is indicated to prioritize behavioral
treatment. The financing of smoking cessation treatments increases the
number of smokers who quit smoking. There is no scientific evidence of the
efficacy of pharmacological treatment of smoking cessation in adolescents.
<br/>Conclusion(s): The answers to the 12 questions allow us to extract
recommendations and algorithms for the pharmacological treatment of
tobacco dependence.<br/>Copyright &#xa9; 2023 The Author(s)

<38>
Accession Number
2025513944
Title
Standardized Treatment and Diagnostic Approach to Reduce Disease burden in
the early postoperative phase in children with congenital heart
defects-STANDARD study: a pilot randomized controlled trial.
Source
European Journal of Pediatrics. (no pagination), 2023. Date of
Publication: 2023.
Author
Vogt A.; Meyer S.; Schafers H.-J.; Weise J.J.; Wagenpfeil S.; Abdul-Khaliq
H.; Poryo M.
Institution
(Vogt) Medical School, University of Saarland, Homburg/Saar, Germany
(Meyer) Franz-Lust Klinik fur Kinder- und Jugendmedizin, Stadtisches
Klinikum Karlsruhe, Karlsruhe, Germany
(Schafers) Department of Thoracic and Cardiovascular Surgery, Saarland
University Medical Center, Homburg/Saar, Germany
(Weise, Wagenpfeil) Institute for Medical Biometry, Epidemiology and
Medical Informatics, Saarland University Medical Center, Homburg/Saar,
Germany
(Abdul-Khaliq, Poryo) Department of Pediatric Cardiology, Saarland
University Medical Center, Kirrberger Strase, Building 9, Homburg/Saar
D-66421, Germany
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
To explore the effect of a daily goal checklist on pediatric cardiac
intensive care unit (PCICU) length of stay (LOS) after congenital heart
surgery. This study is a prospective randomized single-center study. Group
characteristics were as follows: STANDARD group: n = 30, 36.7% female,
median age 0.9 years; control group: n = 33, 36.4% female, median age 1.1
years. Invasive ventilation time, STAT categories, mean
vasoactive-inotropic score (VIS)<inf>24h</inf>, maximal (max.)
VIS<inf>24h</inf>, mean VIS<inf>24-48h</inf>, max. VIS<inf>24-48h</inf>,
VIS category, number of sedatives, analgesics, diuretics, number of
deployed diagnostic modalities, morbidities, and mortality did not differ
between both groups. Median PCICU LOS was 96.0 h (STANDARD group) versus
101.5 h (control group) (p = 0.63). In the overall cohort, univariate
regression analysis identified age at surgery (b = -0.02), STAT category
(b = 18.3), severity of CHD (b = 40.6), mean VIS<inf>24h</inf> (b = 3.5),
max. VIS<inf>24h</inf> (b = 2.2), mean VIS<inf>24-48h</inf> (b = 6.5), and
VIS category (b = 13.8) as significant parameters for prolonged PCICU LOS.
In multivariate regression analysis, age at surgery (b = -0.2), severity
of CHD (b = 44.0), and mean VIS<inf>24h</inf> (b = 6.7) were of
significance. Within the STANDARD sub-group, univariate regression
analysis determined STAT category (b = 32.3), severity of CHD (b = 70.0),
mean VIS<inf>24h</inf> (b = 5.0), mean VIS<inf>24-48h</inf> (b = 5.9),
number of defined goals (b = 2.6), number of achieved goals (b = 3.3),
number of not achieved goals (b = 10.8), and number of unevaluated goals
(b = 7.0) as significant parameters for prolonged PCICU LOS. Multivariate
regression analysis identified the number of defined goals (b = 2.5) and
the number of unevaluated goals (b = -3.0) to be significant parameters.
<br/>Conclusion(s): The structured realization and recording of daily
goals is of advantage in patients following pediatric cardiac surgery by
reducing PCICU LOS. What is known: * Communication errors are the most
frequent reasons for adverse events in intensive care unit patients. *
Improved communication can be achieved by discussion and documentation of
the patients' goals during daily rounds. What is new: * In the overall
cohort age at surgery, severity of congenital heart defect and mean
vasoactive inotropic score within the first 24 hours had significant
impact on pediatric cardiac intensive care unit (PCICU) length of stay
(LOS). * In the intervention group, the number of defined goals and the
number of unevaluated goals were significant parameters for prolonged
PCICU LOS.<br/>Copyright &#xa9; 2023, The Author(s).

<39>
Accession Number
2025458843
Title
Effect of intravenous vs. inhaled penehyclidine on respiratory mechanics
in patients during one-lung ventilation for thoracoscopic surgery: a
prospective, double-blind, randomised controlled trial.
Source
BMC Pulmonary Medicine. 23(1) (no pagination), 2023. Article Number: 353.
Date of Publication: December 2023.
Author
An M.-Z.; Xu C.-Y.; Hou Y.-R.; Li Z.-P.; Gao T.-S.; Zhou Q.-H.
Institution
(An, Xu, Hou) Anesthesia Medicine, Jiaxing University Master Degree
Cultivation Base, Zhejiang Chinese Medical University, Zhejiang Province,
Hangzhou, China
(An, Gao) Department of anaesthesiology, Jiaxing Chinese Medical Hospital,
No. 1501, Zhongshan East Road, Zhejiang Province, Jiaxing, China
(Xu, Hou, Li, Zhou) Department of anaesthesiology and pain medicine,
affiliated hospital of Jiaxing University, No.1882, South Central Road,
Zhejiang Province, Jiaxing, China
Publisher
BioMed Central Ltd
Abstract
Background: Minimising postoperative pulmonary complications (PPCs) after
thoracic surgery is of utmost importance. A major factor contributing to
PPCs is the driving pressure, which is determined by the ratio of tidal
volume to lung compliance. Inhalation and intravenous administration of
penehyclidine can improve lung compliance during intraoperative mechanical
ventilation. Therefore, our study aimed to compare the efficacy of inhaled
vs. intravenous penehyclidine during one-lung ventilation (OLV) in
mitigating driving pressure and mechanical power among patients undergoing
thoracic surgery. <br/>Method(s): A double-blind, prospective, randomised
study involving 176 patients scheduled for elective thoracic surgery was
conducted. These patients were randomly divided into two groups, namely
the penehyclidine inhalation group and the intravenous group before their
surgery. Driving pressure was assessed at T<inf>1</inf> (5 min after OLV),
T<inf>2</inf> (15 min after OLV), T<inf>3</inf> (30 min after OLV), and
T<inf>4</inf> (45 min after OLV) in both groups. The primary outcome of
this study was the composite measure of driving pressure during OLV. The
area under the curve (AUC) of driving pressure from T<inf>1</inf> to
T<inf>4</inf> was computed. Additionally, the secondary outcomes included
mechanical power, lung compliance and the incidence of PPCs.
<br/>Result(s): All 167 participants, 83 from the intravenous group and 84
from the inhalation group, completed the trial. The AUC of driving
pressure for the intravenous group was 39.50 +/- 9.42, while the
inhalation group showed a value of 41.50 +/- 8.03 (P = 0.138). The
incidence of PPCs within 7 days after surgery was 27.7% in the intravenous
group and 23.8% in the inhalation group (P = 0.564). No significant
differences were observed in any of the other secondary outcomes between
the two groups (all P > 0.05). <br/>Conclusion(s): Our study found that
among patients undergoing thoracoscopic surgery, no significant
differences were observed in the driving pressure and mechanical power
during OLV between those who received an intravenous injection of
penehyclidine and those who inhaled it. Moreover, no significant
difference was observed in the incidence of PPCs between the two
groups.<br/>Copyright &#xa9; 2023, BioMed Central Ltd., part of Springer
Nature.

<40>
Accession Number
2025069933
Title
HEART Score Recalibration Using Higher Sensitivity Troponin T.
Source
Annals of Emergency Medicine. 82(4) (pp 449-462), 2023. Date of
Publication: October 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. <br/>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.
<br/>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).
<br/>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.<br/>Copyright &#xa9; 2023 American College of Emergency
Physicians

<41>
Accession Number
642311218
Title
Comparison of early mobilization protocols on postoperative cognitive
dysfunction, pain, and length of hospital stay in patients undergoing
coronary artery bypass graft surgery: A randomized controlled trial.
Source
Applied nursing research : ANR. 73 (pp 151731), 2023. Date of Publication:
01 Oct 2023.
Author
Allahbakhshian A.; Khalili A.F.; Gholizadeh L.; Esmealy L.
Institution
(Allahbakhshian) Department of Medical-Surgical, Faculty of Nursing and
Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran, Islamic
Republic of
(Khalili) Department of Physical Medicine Research Center, Faculty of
Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz,
Iran, Islamic Republic of
(Gholizadeh) Faculty of Health, University of Technology Sydney, Sydney,
Australia
(Esmealy) Faculty of Nursing and Midwifery, Tabriz University of Medical
Sciences, Tabriz, Iran, Islamic Republic of
Publisher
NLM (Medline)
Abstract
Although coronary artery bypass graft (CABG) surgery improves the life
expectancy of patients with coronary artery disease, it is associated with
various short and long-term complications. Early mobilization has been
shown to reduce the risk of these complications. This study aimed to
compare the effectiveness of different early mobilization protocols on
postoperative cognitive dysfunction (POCD), pain intensity, and length of
hospital stay (LOS) in patients undergoing CABG. This three-arm parallel
randomized controlled trial included 120 patients undergoing CABG surgery
who were randomly assigned to Intervention A, which received a four-phase
early mobilization protocol; Intervention B, which received a three-phase
early mobilization protocol; and the Control group, which received routine
care. Postoperative cognitive dysfunction and pain were assessed using
Mini Mental State Examination (MMSE) and visual analog scale (VAS),
respectively. Groups were comparable in demographic and clinical
characteristics and postoperative cognitive dysfunction at baseline. After
the intervention, Group B had statistically significantly (p < 0.001) less
cognitive dysfunction (25.8 +/- 1.7) compared to Group A (24.1 +/- 2.2)
and the Control Group (23.4 +/- 2.7). Likewise, hospital stay was
statistically (p < 0.01) shorter for Group B (7.7 +/- 1.5) than the
Control group (8.9 +/- 1.9). However, the experience of pain was
statistically significantly lower over time in Group A than in the other
groups (p < 0.001). This study concludes that an early mobilization
protocol based on deep breathing exercises and chest physiotherapy may
better improve postoperative cognitive dysfunction and length of hospital
stay than an early mobilization protocol based on passive and active range
of motion activities or routine care.<br/>Copyright &#xa9; 2023. Published
by Elsevier Inc.

<42>
Accession Number
642082206
Title
Fractional Flow Reserve-Guided PCI or Coronary Bypass Surgery for 3-Vessel
Coronary Artery Disease: 3-Year Follow-Up of the FAME 3 Trial.
Source
Circulation. 148(12) (pp 950-958), 2023. Date of Publication: 19 Sep 2023.
Author
Zimmermann F.M.; Ding V.Y.; Pijls N.H.J.; Piroth Z.; van Straten A.H.M.;
Szekely L.; Davidavicius G.; Kalinauskas G.; Mansour S.; Kharbanda R.;
Ostlund-Papadogeorgos N.; Aminian A.; Oldroyd K.G.; Al-Attar N.; Jagic N.;
Dambrink J.-H.E.; Kala P.; Angeras O.; MacCarthy P.; Wendler O.; Casselman
F.; Witt N.; Mavromatis K.; Miner S.E.S.; Sarma J.; Engstrom T.;
Christiansen E.H.; Tonino P.A.L.; Reardon M.J.; Otsuki H.; Kobayashi Y.;
Hlatky M.A.; Mahaffey K.W.; Desai M.; Woo Y.J.; Yeung A.C.; De Bruyne B.;
Fearon W.F.
Institution
(Zimmermann, Pijls, van Straten, Tonino) Catharina Hospital, Eindhoven,
Netherlands
(Ding, Desai) Quantitative Sciences Unit (V.Y.D., Stanford University, CA,
United States
(Piroth, Szekely) Gottsegen National Cardiovascular Center, Hungary (Z.P.,
Hungary
(Davidavicius, Kalinauskas) Clinic of Cardiac and Vascular Diseases,
Institute of Clinical Medicine, Vilnius University, Lithuania
(Davidavicius, Kalinauskas) Vilnius University Hospital Santaros Klinikos,
Lithuania
(Mansour) Centre Hospitalier de l'Universite de Montreal, Canada
(Kharbanda) Oxford University Hospital NHS Trust
(Ostlund-Papadogeorgos) Danderyd University Hospital and Karolinska
Institutet, Solna, Sweden
(Aminian) Centre Hospitalier Universitaire de Charleroi, Belgium
(Oldroyd, Al-Attar) Golden Jubilee National Hospital, Glasgow, United
Kingdom
(Jagic) Clinical Hospital Centre Zemun, University of Belgrade, Serbia
(Dambrink) Isala Hospital, Zwolle, Netherlands
(Kala) Medical Faculty of Masaryk University and University Hospital Brno,
Czech Republic (P.K.), Czechia
(Angeras) Sahlgrenska University Hospital, Sweden
(MacCarthy, Wendler) Kings College Hospital, London, United Kingdom
(Casselman, De Bruyne) Cardiovascular Center Aalst, Belgium
(Witt) Sodersjukhuset Hospital, Stockholm, Sweden
(Witt) Karolinska Institutet, Solna, Sweden
(Mavromatis) Atlanta VA Healthcare System, Decatur, United States
(Mavromatis) Emory University School of Medicine, Atlanta, United States
(Miner) Southlake Regional Health Centre, Newmarket, United Kingdom
(Sarma) Wythenshawe Hospital, Manchester, Jamaica
(Engstrom) Rigshospitalet, Copenhagen, Denmark
(Christiansen) Aarhus University Hospital, Denmark
(Reardon) Houston Methodist Hospital
(Otsuki, Yeung, Fearon) Division of Cardiovascular Medicine and Stanford
Cardiovascular Institute (H.O., Stanford University, A.C.Y, CA, United
States
(Kobayashi) New York Presbyterian Brooklyn Methodist and Weill Cornell
Medical College (Y.K.)
(Hlatky) Departments of Health Policy and Medicine (M.A.H.), Stanford
University, CA, United States
(Mahaffey) Stanford Center for Clinical Research, Department of Medicine,
Stanford University School of Medicine
(Woo) Department of Cardiothoracic Surgery (Y.J.W.), Stanford University,
CA, United States
(De Bruyne) Lausanne University Centre Hospital, Switzerland
(Fearon) VA Palo Alto Health Care System
Publisher
NLM (Medline)
Abstract
BACKGROUND: Previous studies comparing percutaneous coronary intervention
(PCI) with coronary artery bypass grafting (CABG) in patients with
multivessel coronary disease not involving the left main have shown
significantly lower rates of death, myocardial infarction (MI), or stroke
after CABG. These studies did not routinely use current-generation
drug-eluting stents or fractional flow reserve (FFR) to guide PCI.
<br/>METHOD(S): FAME 3 (Fractional Flow Reserve versus Angiography for
Multivessel Evaluation) is an investigator-initiated, multicenter,
international, randomized trial involving patients with 3-vessel coronary
artery disease (not involving the left main coronary artery) in 48 centers
worldwide. Patients were randomly assigned to receive FFR-guided PCI using
zotarolimus drug-eluting stents or CABG. The prespecified key secondary
end point of the trial reported here is the 3-year incidence of the
composite of death, MI, or stroke. <br/>RESULT(S): A total of 1500
patients were randomized to FFR-guided PCI or CABG. Follow-up was achieved
in >96% of patients in both groups. There was no difference in the
incidence of the composite of death, MI, or stroke after FFR-guided PCI
compared with CABG (12.0% versus 9.2%; hazard ratio [HR], 1.3 [95% CI,
0.98-1.83]; P=0.07). The rates of death (4.1% versus 3.9%; HR, 1.0 [95%
CI, 0.6-1.7]; P=0.88) and stroke (1.6% versus 2.0%; HR, 0.8 [95% CI,
0.4-1.7]; P=0.56) were not different. MI occurred more frequently after
PCI (7.0% versus 4.2%; HR, 1.7 [95% CI, 1.1-2.7]; P=0.02).
<br/>CONCLUSION(S): At 3-year follow-up, there was no difference in the
incidence of the composite of death, MI, or stroke after FFR-guided PCI
with current-generation drug-eluting stents compared with CABG. There was
a higher incidence of MI after PCI compared with CABG, with no difference
in death or stroke. These results provide contemporary data to allow
improved shared decision-making between physicians and patients with
3-vessel coronary artery disease. REGISTRATION: URL: https://www.
CLINICALTRIALS: gov; Unique identifier: NCT02100722.

<43>
Accession Number
641147386
Title
Prophylactic Administration with Methylene Blue Improves Hemodynamic
Stabilization During Obstructive Jaundice-Related Diseases' Operation: a
Blinded Randomized Controlled Trial.
Source
Journal of gastrointestinal surgery : official journal of the Society for
Surgery of the Alimentary Tract. 27(9) (pp 1837-1845), 2023. Date of
Publication: 01 Sep 2023.
Author
Huang J.; Gao X.; Wang M.; Yang Z.; Xiang L.; Li Y.; Yi B.; Gu J.; Wen J.;
Lu K.; Zhao H.; Ma D.; Chen L.; Ning J.
Institution
(Huang, Gao, Wang, Yang, Li, Yi, Gu, Wen, Lu, Ning) Department of
Anesthesiology, Southwest Hospital, Third Military Medical University, 30
Gaotanyan Road, Chongqing 400038, China
(Xiang, Zhao) Department of Nephrology, Southwest Hospital, Third Military
Medical University, 30 Gaotanyan Road, Chongqing 400038, China
(Ma) Division of Anaesthetics, Pain Medicine and Intensive Care,
Department of Surgery and Cancer, Faculty of Medicine, Imperial College
London, Chelsea and Westminster Hospital, 369 Fulham Road, London SW109NH,
United Kingdom
(Chen) Breast Disease Center, Southwest Hospital, Third Military Medical
University, Chongqing 400038, China
Publisher
NLM (Medline)
Abstract
OBJECTIVES: Patients with obstruction jaundice are at a high risk of
hypotension and need high volume of fluids and a high dose of
catecholamine to maintain organ perfusion during operation procedure. All
these likely contribute to high perioperative morbidity and mortality. The
aim of the study is to evaluate the effects of methylene blue on the
hemodynamics in patients undergoing surgeries associated with obstructive
jaundice. DESIGN: A prospective, randomized, and controlled clinical
study. SETTING: The enrolled patients randomly received 2 mg/kg of
methylene blue in saline or saline (50 ml) before anesthesia induction.
The primary outcome was the frequency and dose of noradrenaline
administration to maintain mean arterial blood pressure over 65 mmHg
or>80% of baseline, and systemic vascular resistance (SVR) over 800
dyne/s/cm5 during operation. The secondary outcomes were liver and kidney
functions, and ICU stay. PATIENTS: Seventy patients were enrolled in the
study and randomly assigned to receive either methylene blue or control
(n=35/group). <br/>RESULT(S): Fewer patients received noradrenaline in the
methylene blue group when compared with the control group (13/35 vs 23/35,
P=0.017), and the noradrenaline dose administrated during operation was
reduced in the methylene blue group when compared with the control group
(0.32+/-0.57 mg vs 1.787+/-3.51 mg, P=0.018). The blood level of
creatinine, glutamic oxalacetic transaminase, and glutamic-pyruvic
transaminase after the operation was reduced in the methylene blue group
when compared with the control group. <br/>CONCLUSION(S): Prophylactic
administration of methylene blue before operation associated with
obstructive jaundice improves hemodynamic stability and short-term
prognosis. QUESTION: Methylene blue use prevented refractory hypotension
during cardiac surgery, sepsis, or anaphylactic shock. It is still unknown
that methylene blue on the vascular hypo-tone associated with obstructive
jaundice. FINDINGS: Prophylactic administration with methylene blue
improved peri-operative hemodynamic stability, and hepatic and kidney
function on the patients with obstructive jaundice. MEANINGS: Methylene
blue is a promising and recommended drug for the patients undergoing the
surgeries of relief obstructive jaundice during peri-operation
management.<br/>Copyright &#xa9; 2023. The Author(s).

<44>
Accession Number
2027131625
Title
Evaluating YouTube as a Source of Education for Patients Undergoing
Surgery: A Systematic Review.
Source
Annals of Surgery. 278(4) (pp E712-E718), 2023. Date of Publication: 01
Oct 2023.
Author
Javidan A.; Nelms M.W.; Li A.; Lee Y.; Zhou F.; Kayssi A.; Naji F.
Institution
(Javidan, Nelms, Kayssi) Division of Vascular Surgery, Department of
Surgery, University of Toronto, Toronto, ON, Canada
(Li) The Ottawa Hospital Research Institute, Faculty of Medicine,
University of Ottawa, Ottawa, ON, Canada
(Lee, Zhou, Naji) Division of Vascular Surgery, Department of Surgery,
McMaster University, Hamilton, ON, Canada
Publisher
Wolters Kluwer Health
Abstract
Objective: The objective of this systematic review is to characterize the
peer-reviewed literature investigating YouTube as a source of patient
education for patients undergoing surgery. Summary Background Data:
YouTube is the largest online video sharing platform and has become a
substantial source of health information that patients are likely to
access before surgery, yet there has been no systematic assessment of
peer-reviewed studies. A comprehensive literature search was conducted
using EMBASE, MEDLINE, and Ovid HealthStar from inception through to
December of 2021. <br/>Method(s): All primary studies evaluating YouTube
as a source of patient education relating to surgical procedures (general,
cardiac, urology, otolaryngology, plastic, vascular) were included. Study
screening and data extraction occurred in duplicate with two reviewers.
Characteristics extracted included video length, view count, upload
source, overall video educational quality, and quality of individual
studies. <br/>Result(s): Among 6,453 citations, 56 studies were identified
that examined 6,797 videos with 547 hours of content and 1.39 billion
views. There were 49 studies that evaluated the educational quality of the
videos. A total of 43 quality assessment tools were used, with each study
using a mean of 1.90 assessment tools. Per the global rating for
assessments, 34/49 studies (69%) concluded that the overall quality of
educational content was poor. <br/>Conclusion(s): While the impact of
non-peer-reviewed YouTube videos on patient knowledge for surgery is
unclear, the large amount of online content suggests that they are in
demand. The overall educational content of these videos is poor, however,
and there is substantial heterogeneity in the quality assessment tools
used in their evaluation. A peer-reviewed and standardized approach to
online education with video content is needed to better support patients.
<br/>Copyright &#xa9; 2023 Wolters Kluwer Health, Inc. All rights
reserved.

<45>
Accession Number
2025580386
Title
Effects of negative pressure wound therapy on surgical site wound
infections after cardiac surgery: A meta-analysis.
Source
International Wound Journal. (no pagination), 2023. Date of Publication:
2023.
Author
Tao Y.; Zhang Y.; Liu Y.; Tang S.
Institution
(Tao) Department of Cardiovascular Medicine, The First Affiliated Hospital
of Guizhou University of Traditional Chinese Medicine, Guiyang, China
(Zhang) Interventional Surgery of Radiology, The First Affiliated Hospital
of Guizhou University of Traditional Chinese Medicine, Guiyang, China
(Liu) Department of Scientific Research Division, The First Affiliated
Hospital of Guizhou University of Traditional Chinese Medicine, Guiyang,
China
(Tang) Department of Anaesthesia, The First Affiliated Hospital of Guizhou
University of Traditional Chinese Medicine, Guiyang, China
Publisher
John Wiley and Sons Inc
Abstract
We conducted a comprehensive analysis to evaluate the benefits of negative
pressure wound therapy (NPWT) versus traditional dressings in preventing
surgical site infections in patients undergoing cardiac surgery. We
thoroughly examined several databases, including PubMed, EMBASE, Cochrane
Library, China National Knowledge Infrastructure (CNKI), VIP, Chinese
Biomedical Literature Database (CBM) and Wanfang, from inception until
July 2023. Two independent researchers were responsible for the literature
screening, data extraction and quality assessment; analyses were performed
using RevMan 5.4 software. Thirteen studies comprising 8495 patients were
deemed relevant. A total of 2685 patients were treated with NPWT, whereas
5810 received conventional dressings. The findings revealed that NPWT was
more effective in reducing surgical site infections after cardiac surgery
than conventional dressings (4.88% vs. 5.87%, odds ratio [OR]: 0.50, 95%
confidence intervals [CIs]: 0.40-0.63, p < 0.001). Additionally, NPWT was
more effective in reducing deep wound infections (1.48% vs. 4.15%, OR:
0.36, 95% CI: 0.23-0.56, p < 0.001) and resulted in shorter hospital stays
(SMD: -0.33, 95% CIs: -0.54 to -0.13, p = 0.001). However, the rate of
superficial wound infections was not significantly affected by the method
of wound care (3.72% vs. 5.51%, OR: 0.63, 95% CI: 0.32-1.23, p = 0.180).
In conclusion, NPWT was shown to be advantageous in preventing
postoperative infections and reducing hospital stay durations in patients
undergoing cardiac surgery. Nonetheless, given the limitations in the
number and quality of the included studies, further research is
recommended to validate these findings.<br/>Copyright &#xa9; 2023 The
Authors. International Wound Journal published by Medicalhelplines.com Inc
and John Wiley & Sons Ltd.

<46>
Accession Number
642321753
Title
Oral Anticoagulation Use and Left Atrial Appendage Occlusion in LAAOS III.
Source
Circulation. (no pagination), 2023. Date of Publication: 21 Sep 2023.
Author
Connolly S.J.; Healey J.S.; Belley-Cote E.P.; Balasubramanian K.;
Paparella D.; Brady K.; Reents W.; Danner B.C.; Devereaux P.J.; Sharma M.;
Ramasundarahettige C.; Yusuf S.; Whitlock R.P.
Institution
(Connolly, Healey, Belley-Cote, Balasubramanian, Brady, Devereaux, Sharma,
Ramasundarahettige, Yusuf, Whitlock) Population Health Research Institute,
Hamilton Health Sciences, McMaster University, Ontario, Canada (S.J.C.,
J.S.H., E.P.B.-C., K. Balasubramanian, K. Brady, P.J.D., M.S., C.R., S.Y.,
R.P.W.)
(Paparella) University of Foggia, Italy
(Paparella) Santa Maria Hospital, GVM Care & Research, Bari, Somalia
(Reents) Germany (W.R.), Rhon-Klinikum Campus Bad Neustadt
(Danner) Universitatsmedizin Gottingen, Germany (B.C.D.), Germany
Publisher
NLM (Medline)
Abstract
BACKGROUND: LAAOS III (Left Atrial Appendage Occlusion Study III) showed
that left atrial appendage (LAA) occlusion reduces the risk of ischemic
stroke or systemic embolism in patients with atrial fibrillation
undergoing cardiac surgery. This article examines the effect of LAA
occlusion on stroke reduction according to variation in the use of oral
anticoagulants (OACs). <br/>METHOD(S): Information regarding OAC use was
collected at every follow-up visit. Adjusted proportional hazards
modeling, including using landmarks of hospital discharge, 1 and 2 years
after randomization, evaluated the effect of LAA occlusion on the risk of
ischemic stroke or systemic embolism, according to OAC use. Adjusted
proportional hazard modeling, with OAC use as a time-dependent covariate,
was also performed to assess the effect of LAA occlusion, according to OAC
use throughout the study. <br/>RESULT(S): At hospital discharge, 3027
patients (63.5%) were receiving a vitamin K antagonist, and 879 (18.5%)
were receiving a non-vitamin K antagonist oral anticoagulant (direct OAC),
with no difference in OAC use between treatment arms. There were 2887
(60.5%) patients who received OACs at all follow-up visits, 1401 (29.4%)
who received OAC at some visits, and 472 (9.9%) who never received OACs.
The effect of LAA occlusion on the risk of ischemic stroke or systemic
embolism was consistent after discharge across all 3 groups: hazard ratios
of 0.70 (95% CI, 0.51-0.96), 0.63 (95% CI, 0.43-0.94), and 0.76 (95% CI,
0.32-1.79), respectively. An adjusted proportional hazards model with OAC
use as a time-dependent covariate showed that the reduction in stroke or
systemic embolism with LAA occlusion was similar whether patients were
receiving OACs or not. <br/>CONCLUSION(S): The benefit of LAA occlusion
was consistent whether patients were receiving OACs or not. LAA occlusion
provides thromboembolism reduction in patients independent of OAC use.

<47>
Accession Number
642316363
Title
Treatment of hypoplastic left heart syndrome: a systematic review and
meta-analysis of randomised controlled trials.
Source
Cardiology in the young. (pp 1-8), 2023. Date of Publication: 19 Sep
2023.
Author
Kim A.Y.; Woo W.; Saxena A.; Tanidir I.C.; Yao A.; Kurniawati Y.; Thakur
V.; Shin Y.R.; Shin J.I.; Jung J.W.; Barron D.J.
Institution
(Kim, Jung) Division of Pediatric Cardiology, Department of Pediatrics,
Severance Cardiovascular Hospital, Yonsei University College of Medicine,
Seoul, South Korea
(Kim, Jung) Department of Pediatrics, Yonsei University College of
Medicine, Seoul, South Korea
(Woo) Department of Thoracic and Cardiovascular Surgery, Gangnam Severance
Hospital, Yonsei University College of Medicine, Seoul, South Korea
(Saxena) Department of Cardiology, All India Institute of Medical
Sciences, New Delhi, India
(Tanidir) Department of Pediatric Cardiology, Basaksehir Cam and Sakura
City Hospital, Istanbul, Turkey
(Yao) Department of Health Service Promotion, University of Tokyo, Japan
(Kurniawati) Department of Pediatric Cardiology, National Cardiovascular
Center Harapan Kita, Jakarta, Indonesia
(Thakur, Shin) Department of Pediatrics, Labatt Family Heart Center,
Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
(Shin) Department of Cardiovascular Surgery, Yonsei University College of
Medicine, Seoul, South Korea
(Shin) Severance Underwood Meta-research Center, Institute of Convergence
Science, Yonsei University, Seoul, South Korea
(Barron) Division of Cardiovascular Surgery, Department of Surgery,
Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
Publisher
NLM (Medline)
Abstract
BACKGROUND: This meta-analysis aimed to consolidate existing data from
randomised controlled trials on hypoplastic left heart syndrome.
<br/>METHOD(S): Hypoplastic left heart syndrome specific randomised
controlled trials published between January 2005 and September 2021 in
MEDLINE, EMBASE, and Cochrane databases were included. Regardless of
clinical outcomes, we included all randomised controlled trials about
hypoplastic left heart syndrome and categorised them according to their
results. Two reviewers independently assessed for eligibility, relevance,
and data extraction. The primary outcome was mortality after Norwood
surgery. Study quality and heterogeneity were assessed. A random-effects
model was used for analysis. <br/>RESULT(S): Of the 33 included randomised
controlled trials, 21 compared right ventricle-to-pulmonary artery shunt
and modified Blalock-Taussig-Thomas shunt during the Norwood procedure,
and 12 regarded medication, surgical strategy, cardiopulmonary bypass
tactics, and ICU management. Survival rates up to 1 year were superior in
the right ventricle-to-pulmonary artery shunt group; this difference began
to disappear at 3 years and remained unchanged until 6 years. The right
ventricle-to-pulmonary artery shunt group had a significantly higher
reintervention rate from the interstage to the 6-year follow-up period.
Right ventricular function was better in the modified
Blalock-Taussig-Thomas shunt group 1-3 years after the Norwood procedure,
but its superiority diminished in the 6-year follow-up. Randomised
controlled trials regarding medical treatment, surgical strategy during
cardiopulmonary bypass, and ICU management yielded insignificant results.
<br/>CONCLUSION(S): Although right ventricle-to-pulmonary artery shunt
appeared to be superior in the early period, the two shunts applied during
the Norwood procedure demonstrated comparable long-term prognosis despite
high reintervention rates in right ventricle-to-pulmonary artery shunt due
to pulmonary artery stenosis. For medical/perioperative management of
hypoplastic left heart syndrome, further randomised controlled trials are
needed to deliver specific evidence-based recommendations.

<48>
Accession Number
2025391713
Title
Innovations in Diabetes Device Training: A Scoping Review.
Source
Endocrine Practice. 29(10) (pp 803-810), 2023. Date of Publication:
October 2023.
Author
Tindall L.N.; Xavier N.A.
Institution
(Tindall, Xavier) Department of Connected Care, Eli Lilly and Company,
Indianapolis, IN, United States
Publisher
Elsevier B.V.
Abstract
Objective: The coronavirus disease 2019 pandemic highlighted a
pre-existing need for alternatives to traditional in-person diabetes
device trainings. Barriers to care, which include the heavy burden of
training, pose a threat to optimal adoption and utilization of these
devices. We searched the literature for alternative methods of training,
evaluated user satisfaction, and compared short-term clinical outcomes
with guideline-based glucometric targets and historical training results.
<br/>Method(s): A scoping review of Embase articles from 2019 to 2021 was
conducted following Preferred Reporting Items for Systematic Reviews and
Meta-Analyses extension for Scoping Reviews guidelines using key words
relevant to diabetes technologies. Original full-text articles
investigating training of new users on devices were included. Titles and
abstracts were screened for eligibility by 2 independent reviewers, and
results were summarized. <br/>Result(s): Of 25 articles retrieved from the
database, 11 met the criteria. Alternative training strategies included
video conferencing, phone calls, mobile applications, and hybrids with
traditional trainings. Overall, there was a high degree of user
satisfaction with virtual visits, with a preference for hybrid approaches
(6 articles). Although glucometrics varied between articles, short-term
glucometrics were satisfactory overall (8 articles), including improved
glycated hemoglobin measurements and time in range. Two articles compared
time in range over various time points after traditional and remote
training. One found equivalency, and the other identified a 5% improvement
with remote training. <br/>Conclusion(s): Alternative training approaches
are a viable option to reduce the barriers to care and to alleviate
training burden. Intentional implementation of alternatives should be
considered a solution to address current barriers.<br/>Copyright &#xa9;
2023 AACE

<49>
Accession Number
2027058196
Title
Efficacy and Safety of Ticagrelor versus Aspirin and Clopidogrel for
Stroke Prevention in Patients with Vascular Disease: A Systematic Review
and Meta-Analysis.
Source
European Neurology. 86(4) (pp 229-241), 2023. Date of Publication: 01 Sep
2023.
Author
Ma X.; Li D.; Liu S.; Chen Y.; Zhong P.
Institution
(Ma, Li, Liu, Chen, Zhong) Suzhou Hospital of Anhui Medical University,
Yongqiao District, Suzhou, China
Publisher
S. Karger AG
Abstract
Introduction: Currently, it is still controversial to treat stroke with
ticagrelor alone. The purpose of our study was to systematically review
and analyze the efficacy and safety of ticagrelor on cerebrovascular
outcomes in patients with vascular risk factors. <br/>Method(s): The
PubMed, Cochrane Library, and Embase databases were systematically
searched using the keywords stroke, ticagrelor, clopidogrel, and aspirin
to identify randomized controlled trials (RCTs). Primary outcomes included
reported stroke, ischemic stroke, and complex events; the secondary
outcome was hemorrhagic stroke. The safety outcomes included major
bleeding events, major or minor bleeding, and intracranial bleeding. The
pooled odds ratio (OR), hazard ratios (HRs), and 95% confidence interval
(CI) were calculated. We used I² statistics to assess
statistical heterogeneity. <br/>Result(s): This meta-analysis included 15
RCTs involving 63,865 patients. Compared to the control group, ticagrelor
reduced the risk of stroke (OR: 0.90; 95% CI: 0.81-0.99, p = 0.03;
I² = 3%), ischemic stroke (OR: 0.81; 95% CI: 0.74-0.90, p <
0.0001; I² = 0%). Ticagrelor was not associated with an
increased risk of all-cause mortality (OR: 0.94; 95% CI: 0.84-1.06, p =
0.31; I² = 62%), major bleeding (OR: 1.06; 95% CI: 0.97-1.15, p
= 0.20; I² = 17%), hemorrhagic strokes (OR: 1.22, 95% CI:
0.76-1.96, p = 0.41; I² = 0%), and intracranial hemorrhage (OR:
1.06; 95% CI: 0.78-1.43, p = 0.71; I² = 12%). There was an
increased risk of major or minor bleeding with ticagrelor compared to the
control group (OR: 1.40; 95% CI: 1.19-1.66, p < 0.0001; I² =
56%). Additional analyses demonstrated that ticagrelor reduced the risk of
incident recurrent stroke (HR: 0.83; 95% CI: 0.75-0.93, p = 0.0009;
I² = 0%), recurrent ischemic stroke (HR: 0.79; 95% CI:
0.71-0.89, p < 0.0001; I² = 0%) among patients with a history
of acute ischemic stroke (AIS) or transient ischemic attack (TIA). There
were no significant differences in safety outcomes. <br/>Conclusion(s):
Ticagrelor is slightly better than clopidogrel and aspirin in preventing
stroke, especially ischemic stroke, with significant safety risks. For
patients with a history of AIS/TIA, the use of ticagrelor was superior to
the use of clopidogrel or aspirin in reducing the risk of subsequent
stroke. We believe that ticagrelor is a potential alternative to aspirin
or clopidogrel in some cases, especially for patients with CYP2C19
deficiency.<br/>Copyright &#xa9; 2023 S. Karger AG, Basel.

<50>
Accession Number
2027022138
Title
The choice of perioperative inotropic support impacts the outcome of small
infants undergoing complex cardiac surgery: an observational study.
Source
Minerva Anestesiologica. 89(9) (pp 753-761), 2023. Date of Publication:
September 2023.
Author
Willems A.; Havaux R.; Schmartz D.; Fils J.-F.; de Pooter F.; van der
Linden P.
Institution
(Willems) Pediatric Intensive Care Unit, Department of Pediatrics, Queen
Fabiola University Children's Hospital, Brussels, Belgium
(Havaux, Schmartz, de Pooter, van der Linden) Department of
Anesthesiology, University Hospital Brugmann, Queen Fabiola University
Children's Hospital, Brussels, Belgium
(Fils) Ars Statistica, Nivelles, Belgium
Publisher
Edizioni Minerva Medica
Abstract
BACKGROUND: Vaso-inotropic agents are frequently used to prevent and/or
treat low cardiac output syndrome in infants undergoing surgery for
congenital heart disease. Due to the lack of comparative studies, their
use is largely dependent on physician- and center preferences. The aim was
to assess the impact of two different inotropic regimens,
milrinone-epinephrine versus dobutamine on postoperative morbi-mortality
in young children undergoing complex cardiac surgery. <br/>METHOD(S): All
consecutive children younger than one year of age admitted for complex
cardiac surgery (Risk Adjustment in Congenital Heart Surgery-1 [RACHS-1]
score >=3) with cardiopulmonary bypass (CPB) from January 2008 to December
2018 were included. Children received either milrinone in association with
low dose epinephrine (milrinone-epinephrine group) or dobutamine
(dobutamine group) groups were matched and compared using a propensity
score. Our primary outcome was a composite measure including either
hospital death and/or the presence of at least two of the following
events: respiratory failure, prolonged inotropic support, or renal
failure. <br/>RESULT(S): Two hundred and fifty patients were included in
the analysis. Children in the milrinone-epinephrine group (N.=184)
suffered more frequently from a cyanotic heart disease and had longer
surgery, CPB, and aortic cross clamp times than those in the dobutamine
group (N.=66). After matching, children in the milrinone-epinephrine group
had a higher incidence of severe postoperative morbidity or mortality
compared to those in the dobutamine group (27.4 versus 13.9%; P=0.016).
Respiratory failure (28% vs. 12%), prolonged inotropic support (71% vs.
35%) and in-hospital death (3 vs. 0%) were more frequent in the
milrinone-epinephrine group. <br/>CONCLUSION(S): In young infants
undergoing complex cardiac surgery, milrinone combined with epinephrine is
associated with a higher incidence of postoperative morbidity or mortality
compared to dobutamine for perioperative inotropic support. Further
prospective randomized studies are required to confirm this
finding.<br/>Copyright &#xa9; 2023 EDIZIONI MINERVA MEDICA.

<51>
Accession Number
2027022102
Title
Effect of intraoperative low vs. conventional tidal volume on the
incidence of postoperative acute kidney injury after noncardiac surgery: a
two-center randomized clinical trial.
Source
Minerva Anestesiologica. 89(9) (pp 762-772), 2023. Date of Publication:
September 2023.
Author
Jia X.-Y.; Wang X.-R.; Jiang Y.-Y.; An M.-Z.; Pei D.-Q.; Li Z.-P.; Zhou
Q.-H.
Institution
(Jia, Wang, An) Department of Anesthesia Medicine, Zhejiang Chinese
Medical University, Hangzhou, China
(Jia, Wang, Jiang, An, Li, Zhou) Department of Anesthesiology and Pain
Medicine, Affiliated Hospital of Jiaxing University, Jiaxing, China
(Jiang) Department of Anesthesia Medicine, Bengbu Medical College, Bengbu,
China
(Pei) Department of Anesthesiology, Second Affiliated Hospital of Jiaxing
University, Jiaxing, China
Publisher
Edizioni Minerva Medica
Abstract
BACKGROUND: In adults undergoing noncardiac surgery, the correlation
between intraoperative tidal volume and postoperative acute kidney injury
(AKI) is unclear. This study aimed to investigate the effects of low tidal
volume ventilation on the incidence of postoperative AKI compared with
conventional tidal volume in adults undergoing noncardiac surgery.
<br/>METHOD(S): This was a two-center prospective randomized controlled
trial on adult patients who underwent noncardiac surgery and had a
mechanical ventilation of >60 min. Patients were randomized to receive
either a tidal volume of 6 mlL/ kg pre-predicted body weight (PBW, low
tidal volume) or a tidal volume of 10 mlL/kg pre-predicted body weight
(conventional tidal volume). The primary outcome was the incidence of AKI
after non-cardiac surgery. Appropriate statistical methods were used for
this study. RESUlLTS: Among the 1982 randomized patients, 943 with low
tidal volume and 958 with conventional tidal volume were evaluable for the
primary outcome. Postoperative AKI occurred in 12 patients (1.3%) in the
low tidal volume group and 11 patients (1.1%) in the conventional tidal
volume group, with an odds ratio of 0.889 (95%CI, 0.391-2.03) and a
relative risk of 0.999 ([95%CI, 0.989-1.01]; P=0.804). Postoperative serum
creatinine levels increased in 284 (30.0%) patients with low tidal volume
compared to 316 (32.0%) patients with conventional tidal volume (P=0.251).
No difference in postoperative serum creatinine levels was found between
the two groups (57.5 [49.0-68.2] mumol/lL vs. 58.8[50.4-69.5] mumol/lL,
P=0.056). CONClLUSIONS: Among adults undergoing noncardiac surgery, low
tidal volume mechanical ventilation did not significantly reduce the
incidence of postoperative AKI compared with conventional tidal
volume.<br/>Copyright &#xa9; 2023 EDIZIONI MINERVA MEDICA.

<52>
Accession Number
2026979787
Title
Study protocol for IMPRoVE: a multicentre prospective observational cohort
study of the incidence, impact and mechanisms of perioperative right
ventricular dysfunction in non-cardiac surgery.
Source
BMJ Open. 13(9) (no pagination), 2023. Article Number: e074687. Date of
Publication: 06 Sep 2023.
Author
Keast T.; McErlane J.; Kearns R.; McKinlay S.; Raju I.; Watson M.;
Robertson K.E.; Berry C.; Greenlaw N.; Ackland G.; McCall P.; Shelley B.
Institution
(Keast, McErlane, Kearns, McCall, Shelley) Anaesthesia, Critical Care and
Peri-operative Medicine Research Group, University of Glasgow, Glasgow,
United Kingdom
(Keast, McErlane, McCall, Shelley) Department of Anaesthesia, Golden
National Jubilee Hospital, Clydebank, United Kingdom
(Kearns, McKinlay) Department of Anaesthesia, Glasgow Royal Infirmary,
Glasgow, United Kingdom
(Raju, Watson) Department of Anaesthesia and Critical Care, Queen
Elizabeth University Hospital, Glasgow, United Kingdom
(Robertson) Golden Jubilee National Hospital West of Scotland Regional
Heart and Lung Centre, Clydebank, United Kingdom
(Berry) Institute of Cardiovascular and Medical Sciences, University of
Glasgow, Glasgow, United Kingdom
(Greenlaw) Robertson Centre for Biostatistics, University of Glasgow,
Glasgow, United Kingdom
(Ackland) Department of Anaesthesia and Perioperative Medicine, Barts
Health Nhs Trust, Royal London Hospital, London, United Kingdom
Publisher
BMJ Publishing Group
Abstract
Introduction Perioperative myocardial injury evidenced by elevated cardiac
biomarkers (both natriuretic peptides and troponin) is common after major
non-cardiac surgery. However, it is unclear if the rise in cardiac
biomarkers represents global or more localised cardiac injury. We have
previously shown isolated right ventricular (RV) dysfunction in patients
following lung resection surgery, with no change in left ventricular (LV)
function. Given that perioperative RV dysfunction (RVD) can manifest
insidiously, we hypothesise there may be a substantial burden of covert
yet clinically important perioperative RVD in other major non-cardiac
surgical groups. The Incidence, impact and Mechanisms of Perioperative
Right VEntricular dysfunction (IMPRoVE) study has been designed to address
this knowledge gap. Methods and analysis A multicentre prospective
observational cohort study across four centres in the West of Scotland and
London. One hundred and seventy-five patients will be recruited from five
surgical specialties: thoracic, upper gastrointestinal, vascular,
colorectal and orthopaedic surgery (35 patients from each group). All
patients will undergo preoperative and postoperative (day 2-4)
echocardiography, with contemporaneous cardiac biomarker testing. Ten
patients from each surgical specialty (50 patients in total) will undergo
T1-cardiovascular magnetic resonance (CMR) imaging preoperatively and
postoperatively. The coprimary outcomes are the incidence of perioperative
RVD (diagnosed by RV speckle tracking echocardiography) and the effect
that RVD has on days alive and at home at 30 days postoperatively.
Secondary outcomes include LV dysfunction and clinical outcomes informed
by Standardised Endpoints in Perioperative Medicine consensus definitions.
T1 CMR will be used to investigate for imaging correlates of myocardial
inflammation as a possible mechanism driving perioperative RVD. Ethics and
dissemination Approval was gained from Oxford C Research Ethics Committee
(REC reference 22/SC/0442). Findings will be disseminated by various
methods including social media, international presentations and
publication in peer-reviewed journals. Trial registration number
NCT05827315.<br/>Copyright &#xa9; 2023 Authors. All rights reserved.

<53>
Accession Number
2026872652
Title
Efficacy and safety of the traditional herbal medication Chai-Ling-Tang
(in China), Siryung-tang (in Republic of Korea) or Sairei-To (in Japan).
Source
Journal of Ethnopharmacology. Part 1. 319 (no pagination), 2024. Article
Number: 117127. Date of Publication: 30 Jan 2024.
Author
Bailly C.
Institution
(Bailly) OncoWitan, Consulting Scientific Office, Wasquehal, Lille 59290,
France
(Bailly) University of Lille, Faculty of Pharmacy, Institut de Chimie
Pharmaceutique Albert Lespagnol (ICPAL), 3 rue du Professeur Laguesse,
Lille 59000, France
(Bailly) University of Lille, CNRS, Inserm, CHU Lille, UMR9020 - UMR1277 -
Canther - Cancer Heterogeneity, Plasticity and Resistance to Therapies,
Lille 59000, France
Publisher
Elsevier Ireland Ltd
Abstract
Ethnopharmacological relevance: The herbal medicine designated
Chai-Ling-Tang in China, Siryung-tang in South Korea, and Sairei-To (or
Tsumura Saireito extract granules, TJ-114) in Japan is a complex
polyherbal formulations with 12 plant components. It is used historically
to treat Shaoyang syndrome, recorded in an ancient Chinese medical text
"Treatise on Cold Damage Disorder" (Shanghan Lun). Chai-Ling-Tang formula
combines two traditional Chinese herbal medicine prescriptions:
Xiao-Chai-Hu-Tang and Wu-Ling-San (known as Sho-Saiko-To and Goreisan in
Japan, and So Shi Ho Tang and Oreonsang in Korea, respectively). These
traditional Chinese/Korean medicines and Kampo medicine have been used for
more than 2000 years in East Asia, notably as regulators of body fluid
homeostasis. Aim of the study: This study aims to evaluate clinical uses,
pharmacological effects and unwanted effects of Sairei-To through a
narrative literature survey. The main active phytoconstituents and their
mechanism of actions are also collated based on the literature.
<br/>Method(s): Several databases including SciFinder and PubMed were
searched in sourcing information using keywords corresponding to the
medicinal treatment names and the corresponding plants and phytochemicals.
Relevant textbooks, reviews, and digital documents (mostly in English)
were consulted to collate all available scientific literature and to
provide a complete science-based survey of the topic. <br/>Result(s):
Sairei-To derives from ten plants and two fungi. The three major
components are Bupleuri radix (Saiko), Pinelliae rhizoma (Hange), and
Alismatis rhizoma (Takusha). The rest includes the species Scutellariae
radix, Zizyphi fructus, Ginseng radix, Glycyrrhizae radix, Zingiberis
rhizoma, Cinnamomi cortex, Atractylodis lanceae rhizoma, Poria sclerotium,
and Polyporus sclerotium. The therapeutic uses of Sairei-To are very
diversified, ranging from the treatment of autoimmune diseases, intestinal
inflammatory disorders, edema, intestinal and kidney diseases, cancers,
inflammatory skin pathologies, and other conditions such as reproductive
failure. Sairei-To is considered as a safe and efficient medication, with
potential rare unwanted side effects, notably lung injuries (pneumonitis
essentially). Marked anti-inflammatory and immune-modulatory effects of
Sairei-To have been reported, generally associated to the action of
saponins (saikosaponins, glycyrrhizin), terpenoids (alisols) and
flavonoids (baicalin, oroxylin A). <br/>Conclusion(s): Sairei-To is
commonly used to treat inflammatory diseases and appears efficient to
decrease the side effects of corticosteroids. Its immune-regulatory action
is well recognized and exploited to treat certain skin lesions and
chemotherapy-related toxic effects. The activity of the Sairei-To product
relies on the synergistic action of its individual ingredients. Further
studies are warranted to quantify the synergy of action inherent to this
interesting botanical medication.<br/>Copyright &#xa9; 2023 Elsevier B.V.

<54>
Accession Number
2026862287
Title
Comparison between a dedicated stent positioning system and conventional
stenting of aorto-ostial lesions: a prospective, multi-center, randomized
controlled study.
Source
Cardiovascular Diagnosis and Therapy. 13(4) (pp 650-659), 2023. Date of
Publication: 2023.
Author
Zhen L.; Wang X.; Li W.; Shi S.; Zhao X.; Ai H.; Que B.; Wang M.; Wang C.;
Li Q.; Li Z.; Li T.; Wang L.; Jiang X.; Liu Q.; Nie S.
Institution
(Zhen, Wang, Shi, Zhao, Ai, Que, Wang, Wang, Li) Center for Coronary
Artery Disease, Division of Cardiology, Beijing Anzhen Hospital, Capital
Medical University, Beijing, China
(Li) Medical Research & Biometrics Center, National Center for
Cardiovascular Diseases, Cardiovascular Institute and Fu Wai Hospital,
Chinese Academy of Medical Sciences, Beijing, China
(Li) The People's Hospital of Liaoning Province, Shenyang, China
(Li) The Six Medical Center of PLA General Hospital, Beijing, China
(Wang) Beijing Chaoyang Hospital, Capital Medical University, Beijing,
China
(Jiang) Renmin Hospital of Wuhan University, Wuhan, China
(Liu) Beijing Advanced Medical Technologies, Ltd. Inc., Beijing, China
(Nie) Center for Coronary Artery Disease, Division of Cardiology, Beijing
Anzhen Hospital, Capital Medical University, 2 Anzhen Road, Chaoyang
District, Beijing 100029, China
Publisher
AME Publishing Company
Abstract
Background: The accurate placement of stents for treatment of coronary
aorto-ostial lesions (AOLs) is technically challenging. The purpose of
this study was to evaluate the efficacy and safety of a stent positioning
system with a dedicated nitinol device and compare them with those of the
conventional approach for stenting of coronary AOLs. <br/>Method(s): In
this prospective, multi-center, open-label, randomized study, conducted
from November 2015 to April 2019, patients with coronary AOLs that
underwent percutaneous coronary intervention (PCI) were randomly allocated
(allocation ratio 1:1) using block randomization method to either a stent
positioning system group or a conventional technique group. The primary
endpoint was the range of stent slippage when positioning. The following
secondary endpoints were applied: (I) the extent of swing of the guiding
catheters during stent positioning; (II) the rate of accurate stent
placement; (III) the procedure time; and (IV) the incidence of major
adverse cardiovascular events (MACEs) including cardiac death, myocardial
infarction, target lesion revascularization, and stent thrombosis.
<br/>Result(s): During the study period, 139 patients with aorto-ostial
coronary artery stenosis were included at 5 centers. A total of 69
patients were allocated to the stent positioning system group and 70
patients to the conventional technique group. Angiographic and clinical
success were achieved in 100% of the patients included in both groups. The
range of stent slippage was significantly shorter in the stent positioning
system group than it was in the conventional technique group [0.64 (0.22;
1.35) vs. 1.11 (0.48; 1.72) mm, P=0.01]. The rate of accurate placement of
stents was higher in the stent positioning system group than it was in the
conventional technique group (74.6% vs. 57.1%, P=0.03). The extent of
guiding catheter swing during the stent positioning [0.24 (0.19; 0.53) vs.
0.23 (0.19; 0.53) mm; P=0.95] and the MACEs rates (1.4% vs. 2.9%, P>0.99)
were similar between the 2 groups. The procedural time of the stent
positioning system was longer than that of the conventional approach [1.00
(0.50; 1.50) vs. 0.80 (0.50; 1.50) min, P=0.09]. <br/>Conclusion(s): The
dedicated stent positioning system was is safer and provides more accurate
placement of stents for coronary AOLs than the conventional approach, and
the associated prolongation of procedure time is
insignificant.<br/>Copyright &#xa9; Cardiovascular Diagnosis and Therapy.
All rights reserved.

<55>
Accession Number
2026612914
Title
Investigation of the Effects of Acupuncture on Post-Operative Chest Pain
after Open Heart Surgery.
Source
JAMS Journal of Acupuncture and Meridian Studies. 16(4) (pp 133-138),
2023. Date of Publication: 2023.
Author
Roshanzamir S.; Haririan Y.; Ghaderpanah R.; Jahromi L.S.M.; Dabbaghmanesh
A.
Institution
(Roshanzamir, Haririan, Jahromi) Department of Physical Medicine and
Rehabilitation, Shiraz Medical School, Shiraz University of Medical
Sciences, Shiraz, Iran, Islamic Republic of
(Ghaderpanah) Students Research Committee, School of Medicine, Shiraz
University of Medical Sciences, Shiraz, Iran, Islamic Republic of
(Dabbaghmanesh) Department of Internal Medicine, Shiraz University of
Medical Sciences, Shiraz, Iran, Islamic Republic of
Publisher
Medical Association of pharmacopuncture Institute
Abstract
Background: Coronary artery bypass grafting (CABG) accounts for more than
half of all adult cardiac surgeries worldwide. Post-operative chest pain
is a common CABG complication and can cause significant discomfort.
<br/>Objective(s): Because taking large amounts of analgesics can have
many side effects, we evaluated whether acupuncture effectively reduces
pain and the use of analgesics by CABG patients. <br/>Method(s): In this
clinical trial, 30 patients who had recently undergone CABG were randomly
allocated to two groups. For both groups, exercise therapy and routine
analgesics were recommended. The intervention group underwent bilateral
acupuncture in distinct acupoints, including the HT3, HT4, HT5, HT6, HT7,
PC3, PC5, PC6, and PC7 for 10 daily sessions constantly. Visual analog
scale (VAS) and analgesic use were evaluated in both groups at baseline
and after completing the 10-day treatment. <br/>Result(s): Our analysis
revealed significant decreases in the mean VAS scores in both the
intervention and the control group, and that the reduction was more
significant in the acupuncture group (p < 0.001). Moreover, analgesic use
was significantly lower in the acupuncture group when compared with the
control group (p < 0.001). <br/>Conclusion(s): Our findings highlight
acupuncture as an alternative method of controlling CABG-associated
post-operative chest pain and reducing the use of analgesics, which might
have many side effects.<br/>Copyright &#xa9; Medical Association of
Pharmacopuncture Institute (MAPI)

<56>
Accession Number
2026533399
Title
Comparison of radial, dorsalis pedis, and posterior tibial arteries for
ultrasound-guided arterial catheterisation with dynamic needle tip
positioning in paediatric patients: a randomised controlled trial.
Source
British Journal of Anaesthesia. 131(4) (pp 739-744), 2023. Date of
Publication: October 2023.
Author
Takeshita J.; Nakayama Y.; Tachibana K.; Nakajima Y.; Hamaba H.; Shime N.
Institution
(Takeshita, Tachibana, Hamaba) Department of Anesthesiology, Osaka
Prefectural Hospital Organization, Osaka Women's and Children's Hospital,
Murodo-cho, Izumi, Osaka, Japan
(Nakayama) Department of Molecular, Cellular and Biomedical Sciences CUNY
School of Medicine, City College of New York, Convent Avenue, New York,
NY, United States
(Nakajima) Department of Anesthesiology and Intensive Care, Kinki
University Faculty of Medicine, Ohnohigashi, Sayama, Osaka, Japan
(Nakajima) Outcomes Research Consortium, Euclid Avenue, Cleveland, OH,
United States
(Shime) Department of Emergency and Critical Care Medicine, Graduate
School of Biomedical & Health Sciences, Hiroshima University, Kagamiyama,
Higashihiroshima, Hiroshima, Japan
Publisher
Elsevier Ltd
Abstract
Background: Arterial catheterisation in children can be challenging and
time-consuming. We aimed to compare the success rates of ultrasound-guided
arterial catheterisation utilising the short-axis out-of-plane approach
with dynamic needle tip positioning in the radial, dorsalis pedis, and
posterior tibial arteries in paediatric patients. We also examined the
factors influencing the catheterisation success using dynamic needle tip
positioning. <br/>Method(s): Paediatric patients (aged <3 yr) undergoing
cardiac surgery were randomly assigned to three groups based on puncture
sites: radial artery (Group R), dorsalis pedis artery (Group D), and
posterior tibial artery (Group P). The first-attempt and overall success
rates of arterial catheterisation were compared, followed by multiple
logistic regression analysis (dependent variable: first-attempt success;
independent variables: body weight, diameter and depth of the artery,
targeted artery, and trisomy 21). <br/>Result(s): The study included 270
subjects (n=90 per group). There was no significant difference in the
first-attempt (Group R: 82%, Group D: 76%, and Group P: 81%) and overall
success rates (Group R: 94%, Group D: 93%, and Group P: 91%) among the
three groups. The diameter of the artery (per 0.1 mm) (odds ratio: 1.32,
95% confidence interval: 1.09-1.60) and trisomy 21 (odds ratio: 0.43, 95%
confidence interval: 0.20-0.92) were independent predictors of
first-attempt success or failure. <br/>Conclusion(s): The first-attempt
and overall success rates of arterial catheterisation of the dorsalis
pedis and posterior tibial arteries were not inferior to those in the
radial artery when using dynamic needle tip positioning. These two lower
extremity peripheral arteries present viable alternative catheterisation
sites in paediatric patients. Clinical trial registration:
UMIN000042847.<br/>Copyright &#xa9; 2023 British Journal of Anaesthesia

<57>
Accession Number
2025896546
Title
Transcatheter Valve Replacement in Patients with Aortic Valve Stenosis: An
Overview of Systematic Reviews and Meta-Analysis with Different
Populations.
Source
Arquivos Brasileiros de Cardiologia. 120(7) (no pagination), 2023. Article
Number: e20220701. Date of Publication: 2023.
Author
Diegoli H.; Alves M.R.D.; Okumura L.M.; Kroll C.; Silveira D.; Furlan
L.H.P.
Institution
(Diegoli) Academia VBHC Educacao e Consultoria Ltda, SP, Sao Paulo, Brazil
(Alves, Silveira) Edwards Lifesciences Corporation, SP, Sao Paulo, Brazil
(Okumura) Universidade de York, York, United Kingdom
(Kroll) Universidade da Regiao de Joinville, SC, Joinville, Brazil
(Furlan) Unimed do Parana, PR, Curitiba, Brazil
Publisher
Sociedade Brasileira de Cardiologia
Abstract
Background: Randomized controlled trials (RCTs) and observational studies
have compared the efficacy and safety of transcatheter aortic valve
replacement (TAVR) and surgical aortic valve replacement (SAVR) in
patients with severe aortic stenosis. <br/>Objective(s): Compare TAVR and
SAVR in patients with different surgical risks, population
characteristics, and different transcatheter prosthetic valves.
<br/>Method(s): An overview of systematic reviews (SRs) was conducted
following a structured protocol. Results were grouped by surgical risk,
population characteristics, and different valves. RCTs in the SRs were
reanalyzed through meta-analyses, and the results were summarized using
the GRADE method. The adopted level of statistical significance was 5%.
<br/>Result(s): Compared to SAVR, patients with high surgical risk using
TAVR had a lower risk of (odds ratio, 95% confidence interval, absolute
risk difference) atrial fibrillation (AF) (0.5, 0.29-0.86, -106/1000) and
life-threatening bleeding (0.29, 0.2-0.42, -215/1000). Patients with
intermediate surgical risk had a lower risk of AF (0.27, 0.23-0.33,
-255/1000), lifethreatening bleeding (0.15, 0.12-0.19, -330/1000), and
acute renal failure (ARF) (0.4, 0.26-0.62, -21/1000). Patients with low
surgical risk had a lower risk of death (0.58, 0.34-0.97, -16/1000),
stroke (0.51, 0.28-0.94, -15/1000), AF (0.16, 0.12- 0.2, -295/1000),
life-threatening bleeding (0.17, 0.05-0.55, -76/1000), and ARF (0.27,
0.13-0.55, -21/1000), and had a higher risk of permanent pacemaker
implantation (PPI) (4.22, 1.27-14.02, 141/1000). Newer generation devices
had a lower risk of AF than older generations, and patients using
balloon-expandable devices did not experience higher risks of PPI.
<br/>Conclusion(s): This paper provides evidence that patients at low,
intermediate, and high surgical risks have better outcomes when treated
with TAVR compared with SAVR.<br/>Copyright &#xa9; 2023, Sociedade
Brasileira de Cardiologia. All rights reserved.

<58>
Accession Number
2025769835
Title
Comparative Effectiveness of Coronary CT Angiography and Standard of Care
for Evaluating Acute Chest Pain: A Living Systematic Review and
Meta-Analysis.
Source
Radiology: Cardiothoracic Imaging. 5(4) (no pagination), 2023. Article
Number: e230022. Date of Publication: August 2023.
Author
Barbosa M.F.; Canan A.; Xi Y.; Litt H.; Diercks D.B.; Abbara S.; Kay F.U.
Institution
(Barbosa, Canan, Abbara, Kay) Department of Radiology, Cardiothoracic
Division, UT Southwestern Medical Center at Dallas, 5323 Harry Hines Blvd,
Dallas, TX 75390, United States
(Xi) Department of Radiology, UT Southwestern Medical Center at Dallas,
5323 Harry Hines Blvd, Dallas, TX 75390, United States
(Diercks) Department of Emergency Medicine, UT Southwestern Medical Center
at Dallas, 5323 Harry Hines Blvd, Dallas, TX 75390, United States
(Litt) Department of Radiology, University of Pennsylvania, Philadelphia,
PA, United States
Publisher
Radiological Society of North America Inc.
Abstract
Purpose: To perform a living systematic review and meta-analysis of
randomized controlled trials comparing the effectiveness of coronary CT
angiography (CCTA) and standard of care (SOC) in the evaluation of acute
chest pain (ACP). <br/>Material(s) and Method(s): Multiple electronic
databases were systematically searched, with the most recent search
conducted on October 31, 2022. Studies were stratified into two groups
according to the pretest probability for acute coronary syndrome (group 1
with predomi-nantly low-to-intermediate risk vs group 2 with high risk). A
meta-regression analysis was also conducted using participant risk, type
of SOC used, and the use or nonuse of high-sensitivity troponins as
independent variables. <br/>Result(s): The final analysis included 22
randomized controlled trials (9379 total participants; 4956 assigned to
CCTA arms and 4423 to SOC arms). There was a 14% reduction in the length
of stay and a 17% reduction in immediate costs for the CCTA arm compared
with the SOC arm. In group 1, the length of stay was 17% shorter and costs
were 21% lower using CCTA. There was no evidence of differences in
referrals to invasive coronary angiography, myocardial infarction,
mortality, rate of hospitalization, further stress testing, or
readmissions between CCTA and SOC arms. There were more revascularizations
(relative risk, 1.45) and medication changes (rela-tive risk, 1.33) in
participants with low-to-intermediate acute coronary syndrome risk and
increased radiation exposure in high-risk participants (mean difference,
7.24 mSv) in the CCTA arm compared with the SOC arm. The meta-regression
analysis found signifi-cant differences between CCTA and SOC arms for rate
of hospitalization, further stress testing, and medication changes
depending on the type of SOC (P <.05). <br/>Conclusion(s): The results
support the use of CCTA as a safe, rapid, and less expensive in the short
term strategy to exclude acute coronary syndrome in low-to
intermediate-risk patients presenting with acute chest pain.<br/>Copyright
&#xa9; 2023, Radiological Society of North America Inc.. All rights
reserved.

<59>
Accession Number
2025520829
Title
Comparison of Edge of Lamina Block with Thoracic Paravertebral Block and
Retrolaminar Block for Analgesic Efficacy in Adult Patients Undergoing
Video-Assisted Thoracic Surgery: A Prospective Randomized Study.
Source
Journal of Pain Research. 16 (pp 2375-2382), 2023. Date of Publication:
2023.
Author
Gao X.; Chen M.; Liu P.; Zhou S.; Kong S.; Zhang J.; Cao J.
Institution
(Gao, Chen, Liu, Zhou, Kong, Zhang, Cao) Department of Anesthesiology,
Shanghai Sixth People's Hospital, No. 600, Yishan Road, Shanghai 200233,
China
Publisher
Dove Medical Press Ltd
Abstract
Background: A novel ultrasound-guided paravertebral block, the edge
laminar block (ELB) was reported recently. However, it was unclear how
effective ELB was in comparison with traditional blocking methods. We
conducted a trial to compare the analgesic efficacy of ELB with the
thoracic paravertebral block (TPVB) and the retrolaminar block (RLB) in
patients undergoing video-assisted thoracic surgery (VATS).
<br/>Method(s): We identified 90 patients who were scheduled for VATS and
randomly assigned them to three groups: ELB group (Group E), TPVB group
(Group T), and RLB group (Group R). Each group underwent ELB, TPVB, and
RLB, respectively, under ultrasound guidance before general anesthesia
induction. All patients received post-operative routine analgesia
protocol. Our primary outcome was the extent of dermatomal sensory loss on
the midclavicular, midaxillary, and scapular lines, measured using a
pinprick 15 minutes after the nerve block. Secondary outcomes included the
intraoperative dose of sufentanil, the numerical rating scale (NRS) scores
assessed in the post-anesthesia care unit (PACU) and at 6, 12, and 24
hours post-operatively, and pethidine administrated as analgesic rescue
dose. <br/>Result(s): The percentages of nerve block range reaching the
midclavicular line, midaxillary line, and scapular line in Group E were
96.7%, 93.3%, 93.3%, and 60% in Group T and 30%, 56.7%, and 96.7% in Group
R, respectively. Group E had wider dermatomal sensory loss on the
midclavicular line and midaxillary line compared to Group R (P < 0.001)
and had a wider range compared to Group T on the scapular line (P <
0.001). There was no significant difference in the intraoperative use of
sufentanil in the three groups. Post-operative NRS scores at each time
point were significantly lower in Group E than those in the other two
groups (P < 0.01). <br/>Conclusion(s): ELB had a wider nerve block range
and applied better post-operative analgesia in comparison with TPVB and
RLB.<br/>Copyright &#xa9; 2023 Gao et al.

<60>
Accession Number
2025441674
Title
Glycaemic control using mobile-based intervention in patients with
diabetes undergoing coronary artery bypass-study protocol for a randomized
controlled trial.
Source
Trials. 24(1) (no pagination), 2023. Article Number: 585. Date of
Publication: December 2023.
Author
Song Y.; Nan Y.; Feng W.
Institution
(Song, Nan, Feng) Department of Cardiovascular Surgery, National Clinical
Research Center of Cardiovascular Diseases, National Center for
Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical
Sciences and Peking Union Medical College, Beijing, China
Publisher
BioMed Central Ltd
Abstract
Background: Applying technology through the use of the Internet and mobile
phones can help provide education and trained peer support for patients
with diabetes after coronary artery bypass (CABG). We are conducting a
randomized controlled trial to evaluate the efficacy and feasibility of
mobile-based coaching intervention in improving risk-factor control and
secondary prevention in patients with diabetes after CABG. <br/>Method(s):
The glycaemic control using miniprogram-based intervention in patients
with diabetes undergoing coronary artery bypass to promote self-management
(GUIDE ME) study is a multi-centre, randomized controlled trial of mobile
intervention versus standard treatment with 6 months follow-up conducted
in 2 hospitals in China. The interventions are education and a reminder
system based on the WeChat mini-program. Participants in the intervention
groups receive 180 videos (including lines) about secondary prevention
education for 6 months as well as the standard treatment. Behavioural
change techniques, such as prompting barrier identification, motivational
skills, and goal setting, are employed. A total sample size of 820
patients would be adequate for the GUIDE ME study. The primary outcome is
the change of glycaemic haemoglobin (HbA<inf>1c</inf>) at 6 months.
Secondary outcomes include a change in the proportions of patients
achieving HbA<inf>1c</inf>, fasting blood glucose, systolic blood
pressure, low-density lipoprotein cholesterol (LDL-C) and medication
adherence. <br/>Discussion(s): This trial is the first to investigate the
efficacy of mobile phone WeChat-based video coaching and medication
reminder mini-program system to improve self-management in patients with
diabetes and coronary heart disease (CHD) after CABG and has the potential
to be applied in resource-limited settings across diverse populations. If
successful, such mobile intervention could be used and scaled up to
improve care for this high-risk group of patients. Trial registration:
ClinicalTrials, NCT04192409 . Registered on December 10,
2019.<br/>Copyright &#xa9; 2023, BioMed Central Ltd., part of Springer
Nature.

<61>
Accession Number
2024857397
Title
Comparative effects of minimally invasive approaches vs. conventional for
obese patients undergoing aortic valve replacement: a systematic review
and network meta-analysis.
Source
BMC Cardiovascular Disorders. 23(1) (no pagination), 2023. Article Number:
392. Date of Publication: December 2023.
Author
Abdelaal S.A.; Abdelrahim N.A.; Mamdouh M.; Ahmed N.; Ahmed T.R.; Hefnawy
M.T.; Alaqori L.K.; Abozaid M.
Institution
(Abdelaal) Kharkiv National Medical University, Kharkiv, Ukraine
(Abdelrahim) Faculty of Medicine, Tanta University, Tanta, Egypt
(Mamdouh) Faculty of Medicine, Beni-Suef University, Beni-Suef, Egypt
(Ahmed, Ahmed, Hefnawy) Faculty of Medicine, Zagazig University, Zagazig,
Egypt
(Alaqori) Faculty of Medicine, University of Aden, Aden, Yemen
(Abozaid) Mayo Clinic, Rochester, MN, United States
Publisher
BioMed Central Ltd
Abstract
Background: Minimally invasive approaches like mini-thoracotomy and
mini-sternotomy for Aortic Valve Replacement (AVR) showed impressive
outcomes. However, their advantages for obese patients are questionable.
We aimed in this network meta-analysis to compare three surgical
approaches: Full sternotomy (FS), Mini-sternotomy (MS), and
Mini-thoracotomy (MT) for obese patients undergoing AVR. <br/>Method(s):
We followed the PRISMA extension for this network meta-analysis.
PubMed/Medline, Scopus, Web of Science, and Cochrane searched through
March 2023 for relevant articles. The analysis was performed using R
version 4.2.3. <br/>Result(s): Out of 344, 8 articles met the criteria
with 1392 patients. The main outcomes assessed were perioperative
mortality, re-exploration, atrial fibrillation, renal failure, ICU stay,
hospital stay, cross-clamp time, and bypass time. In favor of MS, the
length of ICU stay and hospital stay was significantly lower than for FS
[MD -0.84, 95%CI (-1.26; -0.43)], and [MD -2.56, 95%CI (-3.90; -1.22)],
respectively. Regarding peri-operative mortality, FS showed a
significantly higher risk compared to MS [RR 2.28, 95%CI (1.01;5.16)].
Also, patients who underwent minimally invasive approaches; MT and MS,
required less need of re-exploration compared to FS [RR 0.10, 95%CI
(0.02;0.45)], and [RR 0.33, 95%CI (0.14;0.79)], respectively. However,
Intraoperative timings; including aortic cross-clamp, and cardiopulmonary
bypass time, were significantly lower with FS than for MS [MD -9.16, 95%CI
(-1.88; -16.45)], [MD -9.61, 95%CI (-18.64; -0.59)], respectively.
<br/>Conclusion(s): Our network meta-analysis shows that minimally
invasive approaches offer some advantages for obese patients undergoing
AVR over full sternotomy. Suggesting that these approaches might be
considered more beneficial alternatives for obese patients undergoing
AVR.<br/>Copyright &#xa9; 2023, BioMed Central Ltd., part of Springer
Nature.

<62>
Accession Number
2024622463
Title
Transcatheter edge-to-edge repair for mitral regurgitation using PASCAL or
MitraClip.
Source
Catheterization and Cardiovascular Interventions. 102(3) (pp 521-527),
2023. Date of Publication: 01 Sep 2023.
Author
Elbadawi A.; Dang A.T.; Hamed M.; Ali A.; Saad M.; Jneid H.; Chhatriwalla
A.K.; Goel S.; Bhatt A.; Mani P.; Bavry A.; Kumbhani D.J.
Institution
(Elbadawi, Bhatt, Mani, Bavry, Kumbhani) Division of Cardiology,
University of Texas Southwestern Medical Center, Dallas, TX, United States
(Dang) Department of Internal Medicine, University of Texas Medical
Branch, Galveston, TX, United States
(Hamed) Department of Internal Medicine, Florida Atlantic University, Boca
Raton, FL, United States
(Ali) Division of Internal Medicine, Department of Cardiology, The
University of Texas MD Anderson Cancer Center, Houston, TX, United States
(Saad) Department of Medicine' Division of Cardiology, Alpert Medical
School of Brown University, Lifespan Cardiovascular Institute, Providence,
RI, United States
(Jneid) Division of Cardiology, University of Texas Medical Branch,
Galveston, TX, United States
(Chhatriwalla) Division of Cardiology, Saint Luke's Mid America Heart
Institute and University of Missouri-Kansas City, Kansas City, MO, United
States
(Goel) Division of Cardiology, Houston Methodist, Houston, TX, United
States
Publisher
John Wiley and Sons Inc
Abstract
Background: There is a paucity of data regarding the comparative efficacy
and safety of Mitral valve transcatheter edge-to-edge repair (MTEER) using
the PASCAL or MitraClip systems for patients with mitral regurgitation
(MR). <br/>Method(s): An electronic search was conducted for MEDLINE,
COCHRANE, and EMBASE, through February 2023, for studies comparing the
clinical outcomes of MTEER using PASCAL versus MitraClip systems among
patients with severe MR. The primary study outcome was residual MR <= 2 at
discharge. Data were pooled using a random-effects model. <br/>Result(s):
The final analysis included six studies with a total of 1581 patients,
with a weighted follow-up period of 3.5 months. Two studies only included
patients with degenerative MR, while the remaining studies included both
degenerative and functional MR. There was no significant difference in
procedure duration between MTEER with the PASCAL or MitraClip systems.
There was no difference in residual MR <= 2 at discharge (94.7% vs. 91.9%;
odds ratio [OR]: 1.44; 95% confidence interval [CI]: 0.92-2.27) or
residual MR <= 2 at the mid-term follow-up (94.6% vs. 91.0%, p = 0.05)
among the PASCAL versus MitraClip systems. There was no difference between
both groups in residual MR <= 1 at discharge (73.1% vs. 63.8%, p = 0.12),
while there was greater incidence of residual MR <= 1 at midterm follow-up
with the PASCAL system (71.3% vs. 56.2%, p < 0.001). There was no
difference between the PASCAL and MitraClip MTEER systems in technical
success (97.0% vs. 97.9%, p = 0.15), procedural success (89.1% vs. 87.1%,
p = 0.78), single leaflet detachment (1.8% vs. 1.4%, p = 0.55), or
all-cause mortality (3.6% vs. 4.6%, p = 0.71). <br/>Conclusion(s): In this
meta-analysis, we demonstrated comparable efficacy and safety between the
PASCAL and MitraClip MTEER systems at short- and mid-term assessments.
Randomized trials are warranted to evaluate the comparative long-term
outcomes between both MTEER systems.<br/>Copyright &#xa9; 2023 Wiley
Periodicals LLC.

<63>
Accession Number
2024595055
Title
Comparison of intravascular ultrasound, optical coherence tomography, and
conventional angiography-guided percutaneous coronary interventions: A
systematic review, network meta-analysis, and meta-regression.
Source
Catheterization and Cardiovascular Interventions. 102(3) (pp 440-450),
2023. Date of Publication: 01 Sep 2023.
Author
Park D.Y.; An S.; Jolly N.; Attanasio S.; Yadav N.; Gutierrez J.A.; Nanna
M.G.; Rao S.V.; Vij A.
Institution
(Park) Department of Medicine, Cook County Health, Chicago, IL, United
States
(An) Department of Biomedical Science, Seoul National University Graduate
School, Seoul, South Korea
(Jolly, Attanasio) Division of Cardiology, Rush University Medical Center,
Chicago, IL, United States
(Yadav, Vij) Division of Cardiology, Cook County Health, Chicago, IL,
United States
(Yadav, Vij) Division of Cardiology, Rush Medical College, Chicago, IL,
United States
(Gutierrez) Division of Cardiology, Duke Clinical Research Institute, Duke
University Health System, Durham, NC, United States
(Nanna) Division of Cardiovascular Medicine, Yale School of Medicine, New
Haven, CT, United States
(Rao) Division of Cardiology, NYU Langone Health System, New York, NY,
United States
Publisher
John Wiley and Sons Inc
Abstract
Background: Intracoronary imaging modalities, including intravascular
ultrasound (IVUS) and optical coherence tomography (OCT), provide valuable
supplemental data unavailable on coronary angiography (CA) and have shown
to improve clinical outcomes. We sought to compare the clinical efficacy
of IVUS, OCT, and conventional CA-guided percutaneous coronary
interventions (PCI). <br/>Method(s): Frequentist and Bayesian network
meta-analyses of randomized clinical trials were performed to compare
clinical outcomes of PCI performed with IVUS, OCT, or CA alone.
<br/>Result(s): A total of 28 trials comprising 12,895 patients were
included. IVUS when compared with CA alone was associated with a
significantly reduced risk of major adverse cardiovascular events (MACE)
(risk ratio: [RR] 0.74, 95% confidence interval: [CI] 0.63-0.88), cardiac
death (RR: 0.64, 95% CI: 0.43-0.94), target lesion revascularization (RR:
0.68, 95% CI: 0.57-0.80), and target vessel revascularization (RR: 0.64,
95% CI: 0.50-0.81). No differences in comparative clinical efficacy were
found between IVUS and OCT. Rank probability analysis bestowed the highest
probability to IVUS in ranking as the best imaging modality for all
studied outcomes except for all-cause mortality. <br/>Conclusion(s):
Compared with CA, the use of IVUS in PCI guidance provides significant
benefit in reducing MACE, cardiac death, and revascularization. OCT had
similar outcomes to IVUS, but more dedicated studies are needed to confirm
the superiority of OCT over CA.<br/>Copyright &#xa9; 2023 Wiley
Periodicals LLC.

<64>
Accession Number
2023225726
Title
The connotation between perioperative glycemic control approach and
sternal wound infection in individuals with diabetes mellitus experiencing
cardiac surgery: A meta-analysis.
Source
International Wound Journal. 20(8) (pp 3324-3330), 2023. Date of
Publication: October 2023.
Author
Tan G.; Li Y.; Zhou G.
Institution
(Tan) Department of Cardiovascular Medicine, Sichuan Academy of Medical
Sciences & Sichuan Provincial People's Hospital, Sichuan, China
(Li) Department of Endoscopy, Sichuan Academy of Medical Sciences &
Sichuan Provincial People's Hospital, Sichuan, China
(Zhou) Department of Endocrinology, Sichuan Academy of Medical Sciences &
Sichuan Provincial People's Hospital, Sichuan, China
Publisher
John Wiley and Sons Inc
Abstract
A meta-analysis investigation to measure the connotation between
perioperative glycemic control (GC) approach and sternal wound infection
(SWI) in individuals with diabetes mellitus (DM) experiencing cardiac
surgery (CS). A comprehensive literature inspection till February 2023 was
applied and 2654 interrelated investigations were reviewed. The 12 chosen
investigations enclosed 1564 individuals with DM and CS in the chosen
investigations' starting point, 790 of them were using strict GC, and 774
were using moderate GC. Odds ratio (OR) in addition to 95% confidence
intervals (CIs) were used to compute the value of the Connotation between
the perioperative GC approach and SWI in individuals with DM experiencing
CS by the dichotomous and continuous approaches and a fixed or random
model. Strict GC had significantly lower SWI (OR, 0.33; 95% CI,
-0.22-0.50, P <.001) compared with those with moderate GC in individuals
with DM and CS. Strict GC had significantly lower SWI compared with those
with moderate GC in individuals with DM and CS. However, caused of the
small sample sizes of several chosen investigations for this
meta-analysis, care must be exercised when dealing with its
values.<br/>Copyright &#xa9; 2023 The Authors. International Wound Journal
published by Medicalhelplines.com Inc and John Wiley & Sons Ltd.

<65>
Accession Number
2023208702
Title
Immediate flap increases patient safety for deep sternal wound infection:
A meta-analysis.
Source
International Wound Journal. 20(8) (pp 3271-3278), 2023. Date of
Publication: October 2023.
Author
Qiu X.; Sun X.; Huang G.
Institution
(Qiu, Sun) Affiliated Hospital of Weifang Medical University, School of
Clinical Medicine, Weifang Medical University, Weifang, China
(Qiu, Huang) Department of Burns and Plastic Surgery, Jinan Central
Hospital, Jinan, China
(Huang) Department of Burns and Plastic Surgery, Central Hospital
Affiliated to Shandong First Medical University, Jinan, China
Publisher
John Wiley and Sons Inc
Abstract
Deep sternal wound infection is a severe complication after cardiac
surgery. We performed a meta-analysis evaluating the impact of immediate
flap and NPWT on mortality and length of hospital stay. The meta-analysis
was registered (CRD42022351755). A systematic literature search was
conducted from inception to January, 2023, including PubMed, EMBASE,
Cochrane Library, ClinicalTrials.gov and EU Clinical Trials Register. The
main outcome were in-hospital mortality and late mortality. And additional
outcomes were length of stay and ICU stay time. A total of 438 patients
(Immediate flap: 229; NPWT: 209) from four studies were included in this
study. Immediate flap was associated with lower in-hospital mortality (OR
0.33, 95% CI 0.13-0.81, P =.02) and length of stay (SMD -13.24, 95% CI
-20.53 to -5.94, P =.0004). Moreover, pooled analysis demonstrated no
significant difference was found in two groups in terms of late mortality
(OR 0.64, 95% CI 0.35-1.16, P =.14) and ICU stay time (SMD -1.65, 95% CI
-4.13 to 0.83, P =.19). Immediate flap could reduce in-hospital mortality
and length of stay for patients with deep sternal wound infection. Flap
transplantation as soon as possible may be advised.<br/>Copyright &#xa9;
2023 The Authors. International Wound Journal published by
Medicalhelplines.com Inc and John Wiley & Sons Ltd.

<66>
Accession Number
2021254278
Title
Tofacitinib and risk of cardiovascular outcomes: results from the Safety
of TofAcitinib in Routine care patients with Rheumatoid Arthritis
(STAR-RA) study.
Source
Annals of the Rheumatic Diseases. 81(6) (pp 798-804), 2022. Date of
Publication: 2022.
Author
Khosrow-Khavar F.; Kim S.C.; Lee H.; Lee S.B.; Desai R.J.
Institution
(Khosrow-Khavar, Kim, Lee, Lee, Desai) Division of Pharmacoepidemiology
and Pharmacoeconomics, Brigham and Women's Hospital, Boston, MA, United
States
(Kim) Division of Rheumatology, Inflammation, and Immunity, Brigham and
Women's Hospital, Boston, MA, United States
Publisher
BMJ Publishing Group
Abstract
Objectives Recent results from 'ORAL Surveillance' trial have raised
concerns regarding the cardiovascular safety of tofacitinib in patients
with rheumatoid arthritis (RA). We further examined this safety concern in
the real-world setting. Methods We created two cohorts of patients with RA
initiating treatment with tofacitinib or tumour necrosis factor inhibitors
(TNFI) using deidentified data from Optum Clinformatics (2012-2020), IBM
MarketScan (2012-2018) and Medicare (parts A, B and D, 2012- 2017) claims
databases: (1) A 'real-world evidence (RWE) cohort' consisting of routine
care patients and (2) A 'randomised controlled trial (RCT)-duplicate
cohort' mimicking inclusion and exclusion criteria of the ORAL
surveillance trial to calibrate results against the trial findings. Cox
proportional hazards models with propensity score fine stratification
weighting were used to estimate HR and 95% CIs for composite outcome of
myocardial infarction and stroke and accounting for 76 potential
confounders. Database-specific effect estimates were pooled using fixed
effects models with inverse-variance weighting. Results In the RWE cohort,
102 263 patients were identified of whom 12 852 (12.6%) initiated
tofacitinib. The pooled weighted HR (95% CI) comparing tofacitinib with
TNFI was 1.01 (0.83 to 1.23) in RWE cohort and 1.24 (0.90 to 1.69) in
RCT-duplicate cohort which aligned closely with ORAL-surveillance results
(HR: 1.33, 95% CI 0.91 to 1.94). Conclusions We did not find evidence for
an increased risk of cardiovascular outcomes with tofacitinib in patients
with RA treated in the real-world setting; however, tofacitinib was
associated with an increased risk of cardiovascular outcomes, although
statistically non-significant, in patients with RA with cardiovascular
risk factors.<br/>Copyright &#xa9; Author(s) (or their employer(s)) 2022.

<67>
Accession Number
2015606043
Title
Comparison of haemodynamic response to tracheal intubation with two
different videolaryngoscopes: A randomized clinical trial.
Source
Brazilian Journal of Anesthesiology (English Edition). 73(5) (pp 548-555),
2023. Date of Publication: 01 Sep 2023.
Author
..ardak..z.. T.L.; Arslan Z.P.; Cesur S.; Aksu B.
Institution
(..ardak..z.., Arslan, Cesur) Kocaeli University of Medical Faculty,
Department of Anesthesiology and Reanimation, ..zmit, Turkey
(Aksu) Kocaeli University of Kand..ra Vocational School, ..zmit, Turkey
Publisher
Elsevier Editora Ltda
Abstract
Background: Endotracheal intubation (ETI), which is the gold standard in
coronary artery bypass grafting (CABG), may cause myocardial ischaemia by
disturbing the balance between haemodynamic changes and oxygen supply and
consumption of the myocardium as a result of sympathetic stimulation. In
this study, we aimed to compare two different videolaryngoscopes (C-MAC
and Airtraq) in the hemodynamic response to ETI. <br/>Method(s): Fifty ASA
II...III CABG surgery patients were randomly assigned to C-MAC or Airtraq.
The hemodynamic data included arterial blood pressure [systolic (SAP),
diastolic (DAP) and mean (MAP)] and heart rate (HR) and were recorded at
six different points in time: before laryngoscopy-T1, during
laryngoscopy-T2, immediately after intubation-T3, and 3 (T4), 5 (T5) and
10 (T6) minutes after intubation. Intraoperative complications were
recorded. Patients were questioned about postoperative complications 2 and
24...hours following extubation. <br/>Result(s): The hemodynamic response
to ETI was significantly greater with C-MAC. The increase in HR started
with the laryngoscopy procedure, whereas increases in SAP, DAP, and MAP
started immediately after ETI (p...=...0.024; p...=...0.012;
p...=...0.030; p...=...0.009, respectively). In group analyses, T1...T2,
T2...T3 and T1...T3 comparisons did not show any significant differences
in HR with Airtraq. However, with C-MAC, HR after intubation increased
significantly compared to the pre-laryngoscopy values (T1...T3)
(p...=...0.004). The duration of laryngoscopy was significantly reduced
with C-MAC (p...<...0.001), but the duration of intubation and total
intubation were similar (p...=...0.36; p...=...0.79). <br/>Conclusion(s):
Compared to C-MAC, the hemodynamic response to ETI was less with Airtraq.
Thus, Airtraq may be preferred in CABG patients for ETI.<br/>Copyright
&#xa9; 2021 Sociedade Brasileira de Anestesiologia

<68>
Accession Number
2026676158
Title
Expert systematic review on the choice of conduits for coronary artery
bypass grafting: endorsed by the European Association for Cardio-Thoracic
Surgery (EACTS) and The Society of Thoracic Surgeons (STS).
Source
Journal of Thoracic and Cardiovascular Surgery. 166(4) (pp 1099-1114),
2023. Date of Publication: October 2023.
Author
Gaudino M.; Bakaeen F.G.; Sandner S.; Aldea G.S.; Arai H.; Chikwe J.;
Firestone S.; Fremes S.E.; Gomes W.J.; Bong-Kim K.; Kisson K.; Kurlansky
P.; Lawton J.; Navia D.; Puskas J.D.; Ruel M.; Sabik J.F.; Schwann T.A.;
Taggart D.P.; Tatoulis J.; Wyler von Ballmoos M.
Institution
(Gaudino) Department of Cardiothoracic Surgery, Weill Cornell Medicine,
New York-Presbyterian Hospital, New York, NY, United States
(Bakaeen) Department of Thoracic and Cardiovascular Surgery, Cleveland
Clinic, Cleveland, Ohio, United States
(Sandner) Department of Cardiac Surgery, Medical University of Vienna,
Vienna, Austria
(Aldea) Division of Cardiothoracic Surgery, University of Washington
School of Medicine, Wash, Seattle, United States
(Arai) Department of Cardiovascular Surgery, Graduate School of Medical
and Dental Science, Tokyo Medical and Dental University (TMDU), Tokyo,
Japan
(Chikwe) Department of Cardiac Surgery, Smidt Heart Institute,
Cedars-Sinai Medical Center, Los Angeles, Calif, United States
(Firestone, Kisson) The Society of Thoracic Surgeons, Chicago, Ill, United
States
(Fremes) Schulich Heart Centre, Sunnybrook Health Sciences Centre,
Institute of Health Policy Management and Evaluation, University of
Toronto, Toronto, ON, Canada
(Gomes) Cardiology and Cardiovascular Surgery Disciplines, Sao Paulo
Hospital, Universidade Federal de Sao Paulo (Unifesp), Escola Paulista de
Medicina, Sao Paulo, Brazil
(Bong-Kim) Cardiovascular Center, Myong-ji Hospital, Gyeong-gi-do, South
Korea
(Kurlansky) Division of Cardiac Surgery, Department of Surgery, Columbia
University, New York, NY, United States
(Lawton) Division of Cardiac Surgery, Department of Surgery, Johns Hopkins
University, Baltimore, Md, United States
(Navia) Department of Cardiac Surgery, ICBA Instituto Cardiovascular,
Buenos Aires, Argentina
(Puskas) Department of Cardiovascular Surgery, Mount Sinai Saint Luke's,
New York, NY, United States
(Ruel) Division of Cardiac Surgery, University of Ottawa Heart Institute,
Ottawa, ON, Canada
(Sabik) Department of Surgery, University Hospitals Cleveland Medical
Center, Cleveland, Ohio, United States
(Schwann) Division of Cardiac Surgery, Baystate Health, Springfield, Mass,
United States
(Taggart) Department of Cardiac Surgery, John Radcliffe Hospital,
University of Oxford, Oxford, United Kingdom
(Tatoulis) Department of Cardiothoracic Surgery, Royal Melbourne Hospital,
University of Melbourne, Melbourne, Australia
(Wyler von Ballmoos) Division of Cardiothoracic Surgery, Houston Methodist
DeBakey Heart & Vascular Center, Houston, Tex, United States
Publisher
Elsevier Inc.

<69>
Accession Number
2025458330
Title
An analysis of quality of life and functional outcomes as reported in
randomized trials for red cell transfusions.
Source
Transfusion. (no pagination), 2023. Date of Publication: 2023.
Author
Pagano M.B.; Dennis J.A.; Idemudia O.M.; Stanworth S.J.; Carson J.L.
Institution
(Pagano) Department of Laboratory Medicine and Pathology, University of
Washington, Seattle, WA, United States
(Dennis) Cochrane Injuries Group, London School of Hygiene & Tropical
Medicine, London, United Kingdom
(Idemudia, Carson) Department of Medicine, Rutgers Robert Wood Johnson
Medical School, Piscataway, NJ, United States
(Stanworth) NHS Blood and Transplant, Oxford, United Kingdom
(Stanworth) Oxford University Hospitals NHS Foundation Trust, John
Radcliffe Hospital, Oxford, United Kingdom
(Stanworth) Radcliffe Department of Medicine, University of Oxford,
Oxford, United Kingdom
Publisher
John Wiley and Sons Inc
Abstract
Background: Meta-analyses of randomized controlled trials (RCTs)
evaluating thresholds for red blood cell (RBC) transfusion typically focus
on mortality; however, other outcomes are highly relevant. The aim of this
study is to summarize the effects of different transfusion thresholds on
the outcomes of quality of life (QoL) and function. <br/>Study Design: We
extracted data from RCTs identified in a recently published Cochrane
systematic review. Primary analysis was descriptive. <br/>Result(s): A
total of 23 RCTs with 13,743 adult participants were included. Fifteen
RCTs included patients in the postoperative period, of which 9 RCTs were
conducted in hip (n = 3024) and 6 (n = 8672) in cardiac surgeries; 5 RCTs
(n = 489) were in patients with hematological malignancies; 2 in the
setting of bleeding (gastrointestinal bleed [n = 936] and postpartum [n =
521]); and one RCT (n = 936) included critically ill patients. QoL and
function were reported using a variety of questionnaires and tools. The
timing of assessments varied between trials. No clear clinical differences
in QoL outcomes were identified in comparisons between restrictive and
liberal transfusion thresholds. <br/>Discussion(s): There is no evidence
that a liberal transfusion strategy improves QoL and functional outcomes.
However, the substantial limitations of many included studies indicate the
need for further well-designed and adequately powered
trials.<br/>Copyright &#xa9; 2023 AABB.

<70>
Accession Number
2025456457
Title
Effect of perioperative goal-directed fluid therapy on postoperative
complications after thoracic surgery with one-lung ventilation: a
systematic review and meta-analysis.
Source
World Journal of Surgical Oncology. 21(1) (no pagination), 2023. Article
Number: 297. Date of Publication: December 2023.
Author
Li X.; Zhang Q.; Zhu Y.; Yang Y.; Xu W.; Zhao Y.; Liu Y.; Xue W.; Fang Y.;
Huang J.
Institution
(Li, Zhang, Zhu, Yang, Xu, Zhao, Liu, Xue, Fang, Huang) Department of
Anesthesiology, The First Affiliated Hospital of Kunming Medical
University, KunMing, China
Publisher
BioMed Central Ltd
Abstract
Background: An understanding of the impact of goal-directed fluid therapy
(GDFT) on the outcomes of patients undergoing one-lung ventilation (OLV)
for thoracic surgery remains incomplete and controversial. This
meta-analysis aimed to assess the effect of GDFT compared to other fluid
therapy strategies on the incidence of postoperative complications in
patients with OLV. <br/>Method(s): The Embase, Cochrane Library, Web of
Science, and MEDLINE via PubMed databases were searched from their
inception to November 30, 2022. Forest plots were constructed to present
the results of the meta-analysis. The quality of the included studies was
evaluated using the Cochrane Collaboration tool and Risk Of Bias In
Non-Randomized Study of Interventions (ROBINS-I). The primary outcome was
the incidence of postoperative complications. Secondary outcomes were the
length of hospital stay, PaO<inf>2</inf>/FiO<inf>2</inf> ratio, total
fluid infusion, inflammatory factors (TNF-alpha, IL-6), and postoperative
bowel function recovery time. <br/>Result(s): A total of 1318 patients
from 11 studies were included in this review. The GDFT group had a lower
incidence of postoperative complications [odds ratio (OR), 0.47; 95%
confidence interval (95% CI), 0.29-0.75; P = 0.002; I ², 67%],
postoperative pulmonary complications (OR 0.48, 95% CI 0.27-0.83; P =
0.009), and postoperative anastomotic leakage (OR 0.51, 95% CI 0.27-0.97;
P = 0.04). The GDFT strategy reduces total fluid infusion.
<br/>Conclusion(s): GDFT is associated with lower postoperative
complications and better survival outcomes after thoracic surgery for
OLV.<br/>Copyright &#xa9; 2023, BioMed Central Ltd., part of Springer
Nature.

<71>
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. 366(3) (pp 227-235), 2023. Date
of Publication: September 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. <br/>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.
<br/>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. <br/>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.<br/>Copyright &#xa9; 2023
Southern Society for Clinical Investigation

<72>
Accession Number
2026593984
Title
Bempedoic Acid and Cardiovascular Outcomes in Statin Intolerant Patients
At High Cardiovascular Risk: CLEAR OUTCOME.
Source
Journal of Clinical Lipidology. Conference: National Lipid Association
2023 Scientific Sessions. Atlanta United States. 17(4 Supplement) (pp
e62), 2023. Date of Publication: 01 Jul 2023.
Author
Cho L.
Publisher
Elsevier Ltd
Abstract
Background/Synopsis: Statins have been proven to lower cardiovascular
events. However, some patients report adverse events from statins, most
commonly muscle-related symptoms, and cannot take statins. Alternative
therapies are needed to lower LDL-C in patients unable to meet guideline
treatment goals. Bempedoic acid is an ATP citrate lyase inhibitor that
targets cholesterol synthesis upstream of HMG-CoA reductase, the enzyme
targeted by statins. It has been approved as a treatment for LDL-C
lowering since 2020 based on studies that have shown LDL-C reduction of
15-25%. However, to date, there have been no CV outcomes trials with
bempedoic acid. Objective/Purpose: To determine the effects of Bempedoic
acid on cardiovascular events, we conducted the CLEAR Outcomes
(Cholesterol Lowering via Bempedoic Acid, an ACL-Inhibiting Regimen) trial
in a mixed population of primary and secondary prevention patients who
were unable or unwilling to take guideline-recommended doses of statins.
<br/>Method(s): The CLEAR OUTCOMES trial was a randomized,
placebo-controlled, double-blind trial that enrolled14,016 patients at
1,252 sites in 32countries. Eligible patients had a previous CV event or
features that placed them at high CV risk. Patients were required to
complain of statin intolerance due to an adverse effect that started or
increased during statin therapy and resolved or improved when therapy was
discontinued. Patients and providers were required to document in writing
that the patient was unable to tolerate two or more statins or
alternatively, a single statin if unwilling or advised not to take a
second statin. Trial started in December 2016 and finished enrolling in
August 2019. Patients were randomized 1:1 to oral Bempedoic acid, 180 mg
daily, or matching placebo. The primary endpoint was a composite of CV
death, nonfatal myocardial infarction (MI), nonfatal stroke, or coronary
revascularization with 1,620 events and >=2 years follow up required for
completion. The first key secondary end point was time to the first
occurrence of the composite of cardiovascular death, nonfatal stroke, or
nonfatal MI with 810 events required. <br/>Result(s): Pending. Full
results are under embargo and to be presented on 03/4/2023 at American
College of Cardiology meeting. <br/>Conclusion(s): Pending. Full results
are under embargo and to be presented on 03/4/2023 at American College of
Cardiology meeting. External Funding: Yes Funding Sources: ESPERION
Pharmaceutical.<br/>Copyright &#xa9; 2023

<73>
Accession Number
2026541585
Title
A four-year follow-up of the Abdominal Aortic Aneurysm Get Fit randomised
control trial.
Source
British Journal of Anaesthesia. Conference: RA-UK Annual Scientific
Meeting. Newcastle United Kingdom. 131(3) (pp e94), 2023. Date of
Publication: September 2023.
Author
Tay T.; Haque A.
Institution
(Tay, Haque) Manchester Vascular Centre, Manchester University NHS
Foundation Trust, Manchester, United Kingdom
(Tay) Lancaster University, Royal Lancaster Infirmary, Lancaster, United
Kingdom
(Haque) Cardiovascular Sciences, University of Manchester, Manchester,
United Kingdom
Publisher
Elsevier Ltd
Abstract
Ruptured abdominal aortic aneurysm (AAA) carries a mortality rate of up to
80%. Cochrane review on prehabilitation exercise before AAA repair
reported reduced cardiac and renal complications, however the evidence is
lacking in whether it reduces 30-day mortality and need for
reintervention.¹ A randomised, controlled trial of individuals
on AAA surveillance comparing those on community exercise programme (CEP)
or standard clinical care (AAA Get Fit) showed significant improvement in
cardiopulmonary exercise test and anaerobic threshold.²
However, long-term outcomes of this trial are unknown. This study aims to
investigate the long-term outcomes of individuals under AAA surveillance
who were part of the AAA Get Fit trial. A prospective study of
participants who were enrolled in the AAA Get Fit trial was conducted.
This trial (NCT02997618) randomly assigned participants to either: (i) a
24-week CEP with choice of gym or home exercises, or (ii) standard
clinical care including advice on weight loss and exercise. The primary
outcome of our study is 30-day morbidity after surgery, cardiovascular
event and mortality. We defined 30-day postoperative morbidity using
Clavien-Dindo classification >=3. Descriptive analysis and Kaplan-Meier
survival analysis were conducted using SPSS v.27. A total of 56
participants were included in this analysis; 28 were in the intervention
arm. Mean age at time of enrolment was 72.8 (standard deviation [sd] 5.7)
yr, and 86% were males. A total of 14 (25%) underwent surgery (50% open
repair). Median time from intervention to surgery was 34 (range 5-50)
months. Rate of 30-day postoperative morbidity and 1-yr mortality was
3.6%. Nine (16.1%) had a cardiovascular event, of whom 7 (78%) were in the
control group (P=0.14). Eight (14%) participants died and none were as a
result of ruptured AAA. As expected, mean aneurysm diameter increased
(3.70 cm vs 4.58 cm, P<0.01). Comparing those who were from the CEP and
control groups, there was no statistical significance in whether one
underwent surgery, type of surgery, cardiovascular event and death. Mean
overall survival of both groups was 47.1 (sd 6.7) and 45.4 (sd 11.3)
months, respectively (P=0.56). As compared with published literature, the
AAA Get Fit trial showed significant benefits in the cardiovascular
fitness of patients. In the long-term follow-up, there is no significant
difference in outcomes among individuals of the CEP and control groups.
References: 1. Fenton C, Tan AR, Abaraogu UO, McCaslin JE. Cochrane
Database Syst Rev 2021; 7: CD013662 2. Haque A, Wisely N, McCollum C. Eur
J Vasc Endovasc Surg 2022; 64: 309-19 <br/>Copyright &#xa9; 2023

<74>
Accession Number
2026427692
Title
PO-03-217 SUTURE CLOSURE AFTER VEIN ACCESS FOR CARDIAC PROCEDURES
(SAFE-VEIN) TRIAL: A RANDOMIZED, PROSPECTIVE STUDY OF THE SAFETY AND
EFFICACY OF PERCLOSE PROGLIDE CLOSURE DEVICE COMPARED WITH A CONVENTIONAL
CLOSURE STRATEGY IN LARGE BORE VENOUS ACCESS PROCEDURES.
Source
Heart Rhythm. Conference: Heart Rhythm 2023. New Orleans United States.
20(9) (pp e148-e149), 2023. Date of Publication: September 2023.
Author
Ali M.; Masood F.; Erickson L.; Kanani J.; Adefisoye J.; Walczak S.; Ajam
T.; Kieu A.; Premjee M.; Shereef H.; Jan M.F.; Allaqaband S.Q.; Bajwa T.;
Khitha J.; Zilinski J.; Jahangir A.; Djelmami-Hani M.; Sra J.; Niazi I.;
Mortada M.E.
Publisher
Elsevier B.V.
Abstract
Introduction: The Perclose ProGlide (PPG) Suture-Mediated Closure System
(Abbott, Abbott Park, IL) has been shown to be safe and can reduce time to
hemostasis (TTH) following procedures requiring arterial access. We
compared PPG with figure-8 suture in patients who underwent interventional
catheter procedures requiring large bore venous access (>=13 French).
<br/>Method(s): This was a physician-initiated, randomized, single-center,
prospective study (clinicaltrials.gov ID: NCT04632641) that did not
require external funding. Patients gave informed consent. After a single
stick venous access was obtained under ultrasound guidance, 107 eligible
patients were randomized 1:1 and 100 subjects received allocated treatment
to either PPG (n=47) or figure-8 suture (n=53) from April 2021 to December
2022 (Fig). No femoral arterial access was used. If venous access was
obtained in the opposite groin site, the same randomized method was used
for closure. Primary outcomes were TTH (time from sheath removal to first
observed venous hemostasis) and time to ambulation (TTA, time from sheath
removal to 20 feet ambulation). Secondary outcomes were time to discharge
(TTD), major or minor bleeding, access site hematoma, other vascular
complications, and mortality related to vascular complications. A
Shapiro-Wilks normality test was conducted, and groups were not normally
distributed; therefore, Wilcoxon rank-sum test was used to compare
outcomes between study arms. <br/>Result(s): Patient characteristics and
procedure details are listed in the Table. TTH (min) was significantly
lower in the PPG arm than figure-8 suture arm [median, (Q1, Q3)] [7 (2,
10) vs. 11 (10, 15), respectively, P<0.001]. TTA (min) was significantly
lower in the PPG arm than figure-8 suture arm [321.5 (246, 452) vs. 403
(352.5, 632.5), respectively, P=0.005]. TTD (min) was not significantly
different between the PPG and figure-8 suture arms [1256.5 (1081, 1544)
vs. 1338 (1171, 1435), respectively, P=0.649] (Fig). There were no
differences in minor bleeding or access site hematomas between arms
(Table). No major bleeding, vascular thrombosis, vascular dissection,
pseudoaneurysm, arteriovenous fistula or mortality related to vascular
complications were recorded. Application: PPG provided safe and quicker
hemostasis with earlier ambulation than figure-8 suture. This may allow
same-day discharge in patients undergoing interventional catheter
procedures with large venous access. Next Steps/Future: Analysis to
compare procedure and stay costs between the two arms is being conducted.
[Formula presented] [Formula presented]<br/>Copyright &#xa9; 2023

<75>
Accession Number
2025928230
Title
Long-Term Outcomes of Patients Undergoing Aortic Root Replacement With
Mechanical Versus Bioprosthetic Valves: Meta-Analysis of Reconstructed
Time-to-Event Data.
Source
Journal of the American Heart Association. 12(18) (no pagination), 2023.
Article Number: e030629. Date of Publication: 19 Sep 2023.
Author
Sa M.P.; Tasoudis P.; Jacquemyn X.; Eynde J.V.D.; Caranasos T.G.;
Ikonomidis J.S.; Chu D.; Serna-Gallegos D.; Sultan I.
Institution
(Sa, Chu, Serna-Gallegos, Sultan) Department of Cardiothoracic Surgery,
University of Pittsburgh, Pittsburgh, PA, United States
(Sa, Chu, Serna-Gallegos, Sultan) UPMC Heart and Vascular Institute,
University of Pittsburgh Medical Center, Pittsburgh, PA, United States
(Tasoudis, Caranasos, Ikonomidis) Division of Cardiothoracic Surgery,
Department of Surgery, University of North Carolina, Chapel Hill, NC,
United States
(Jacquemyn, Eynde) Department of Cardiovascular Sciences, KU Leuven,
Leuven, Belgium
Publisher
American Heart Association Inc.
Abstract
BACKGROUND: An aspect not so clear in the scenario of aortic surgery is
how patients fare after composite aortic valve graft replacement (CAVGR)
depending on the type of valve (bioprosthetic versus mechanical). We
performed a study to evaluate the long-term outcomes of both strategies
comparatively. METHODS AND RESULTS: Pooled meta-analysis of Kaplan-Meier-
derived time-to-event data from studies with follow-up for overall
survival (all-cause death), event-free survival (composite end point of
cardiac death, valve-related complications, stroke, bleeding, embolic
events, and/or endocarditis), and freedom from reintervention.
Twenty-three studies met our eligibility criteria, including 11 428
patients (3786 patients with mechanical valves and 7642 patients with
bioprosthetic valve). The overall population was mostly composed of men
(mean age, 45.5-75.6 years). In comparison with patients who underwent
CAVGR with bioprosthetic valves, patients undergoing CAVGR with mechanical
valves presented no statistically significant difference in the risk of
all-cause death in the first 30 days after the procedure (hazard ratio
[HR], 1.24 [95% CI, 0.95-1.60]; P=0.109), but they had a significantly
lower risk of all-cause mortality after the 30-day time point (HR, 0.89
[95% CI, 0.81- 0.99]; P=0.039) and lower risk of reintervention (HR, 0.33
[95% CI, 0.24- 0.45]; P<0.001). Despite its increased risk for the
composite end point in the first 6 years of follow-up (HR, 1.41 [95% CI,
1.09-1.82]; P=0.009), CAVGR with mechanical valves is associated with a
lower risk for the composite end point after the 6-year time point (HR,
0.46 [95% CI, 0.31- 0.67]; P<0.001). <br/>CONCLUSION(S): CAVGR with
mechanical valves is associated with better long-term outcomes in
comparison with CAVGR with bioprosthetic valves.<br/>Copyright &#xa9; 2023
The Authors. Published on behalf of the American Heart Association, Inc.,
by Wiley.

<76>
Accession Number
2027057217
Title
TPVB and general anesthesia affects postoperative functional recovery in
elderly patients with thoracoscopic pulmonary resections based on ERAS
pathway.
Source
Translational Neuroscience. 14(1) (no pagination), 2023. Article Number:
20220305. Date of Publication: 01 Jan 2023.
Author
An N.; Dong W.; Pang G.; Zhang Y.; Liu C.
Institution
(An, Dong, Pang, Liu) Department of Anesthesia 1, Inner Mongolia People's
Hospital, Inner Mongolia, Hohhot 010020, China
(Zhang) Department of Thyroid Oncology, Inner Mongolia People's Hospital,
Inner Mongolia, Hohhot 010020, China
Publisher
Walter de Gruyter GmbH
Abstract
Objective: Thoracic surgery is easy to cause various perioperative
complications, especially in elderly patients, due to their physical
weakness and physiological function degeneration. Postoperative cognitive
dysfunction is a common complication in elderly patients undergoing
thoracic surgery. This study focuses on exploring the effects of thoracic
paravertebral block (TPVB) combined with general anesthesia on
postoperative functional recovery in elderly patients undergoing
thoracoscopic radical resection for lung cancer based on enhanced recovery
after surgery (ERAS) pathway. <br/>Method(s): A total of 104 patients aged
60 years or older undergoing thoracoscopic radical resection of lung
cancer were randomized into the combination group (n = 52) and the control
group (n = 52). Patients in the control group were given general
anesthesia alone, while patients in the combination group were given TPVB
combined with general anesthesia. All patients applied the ERAS model for
the perioperative intervention. Hemodynamic indices (heart rate [HR] and
mean arterial pressure [MAP]) before anesthesia (T0), 5 min after
thoracoscopic trocar placement (T1), at extubation (T2), 30 min after
extubation (T3), and 6 h after the surgery (T4), postoperative analgesia,
preoperative and postoperative serum pain stress factors
(5-hydroxytryptamine [5-HT], prostaglandin E2 [PGE2], cortisol [Cor],
substance P [SP], and norepinephrine [NE]), tumor markers (CYFRA21-1, CEA,
and CA50), inflammatory factors (IL-6, TNF-alpha, and c-reactive protein
(CRP)), lung function indicators (forced vital capacity [FVC] and forced
expiratory volume in the first second [FEV1]), 6 min walking distance
(6MWD), clinical recovery indicators, hospitalization status, and
postoperative complications in patients between both groups were compared.
<br/>Result(s): Compared with the control group, patients in the
combination group had lower HR and MAP at T1-T4 time points, less
intraoperative doses of remifentanil and propofol, less patient-controlled
interscalene analgesia compression number 24 h after the surgery, lower
visual analogue scale scores 24 h after the surgery, shorter
hospitalization time, postoperative off-bed time, postoperative chest tube
removal time, postoperative first feeding time and gastrointestinal
function recovery time, reduced postoperative serum levels of 5-HT, PGE2,
Cor, SP, NE, CYFRA21-1, CEA, CA50, IL-6, TNF-alpha, and CRP, decreased
complications, and higher FVC, FEV1, and 6MWD. <br/>Conclusion(s): Based
on the ERAS pathway, TPVB combined with general anesthesia in
thoracoscopic surgery for lung cancer in elderly patients can effectively
reduce the patients' hemodynamic fluctuations, alleviate postoperative
pain, accelerate the recovery process, and reduce complications.
<br/>Copyright &#xa9; 2023 the author(s), published by De Gruyter.

<77>
Accession Number
2027162988
Title
An investigator-sponsored pragmatic randomized controlled trial of
AntiCoagulation vs AcetylSalicylic Acid after Transcatheter Aortic Valve
Implantation: Rationale and design of ACASA-TAVI.
Source
American Heart Journal. 265 (pp 225-232), 2023. Date of Publication:
November 2023.
Author
Dodgson C.S.; Beitnes J.O.; Klove S.F.; Herstad J.; Opdahl A.; Undseth R.;
Eek C.H.; Broch K.; Gullestad L.; Aaberge L.; Lunde K.; Bendz B.; Lie O.H.
Institution
(Dodgson, Beitnes, Klove, Eek, Broch, Gullestad, Aaberge, Lunde, Bendz,
Lie) Department of Cardiology, Oslo University Hospital Rikshospitalet,
Oslo, Norway
(Herstad) Department of Cardiology, Haukeland University Hospital, Bergen,
Norway
(Opdahl) Department of Cardiology, Oslo University Hospital Ulleval, Oslo,
Norway
(Undseth) The Intervention Centre, Oslo University Hospital, Oslo, Norway
(Dodgson, Broch, Gullestad, Bendz) Institute of Clinical Medicine, Faculty
of Medicine, University of Oslo, Oslo, Norway
(Broch, Gullestad) K. G. Jebsen Cardiac Research Centre, University of
Oslo, Oslo, Norway
Publisher
Elsevier Inc.
Abstract
Background: The optimal antithrombotic therapy after transcatheter aortic
valve implantation (TAVI) is unknown. Bioprosthetic valve dysfunction
(BVD) is associated with adverse outcomes and may be prevented by
anticoagulation therapy. A dedicated randomized trial comparing
monotherapy NOAC to single antiplatelet therapy has not been performed
previously. We hypothesize that therapy with any anti-factor Xa NOAC will
reduce BVD compared to antiplatelet therapy, without compromising safety.
<br/>Method(s): ACASA-TAVI is a multicenter, prospective, randomized,
open-label, blinded endpoint, all-comers trial comparing a monotherapy
anti-factor Xa NOAC strategy (intervention arm) with a single antiplatelet
therapy strategy (control arm) after successful TAVI. Three-hundred and
sixty patients without indication for oral anticoagulation will be
randomized in a 1:1 ratio to either apixaban 5 mg twice per day, edoxaban
60 mg daily, or rivaroxaban 20 mg daily for 12 months followed by
acetylsalicylic acid 75 mg daily indefinitely, or to acetylsalicylic acid
75 mg daily indefinitely. The 2 co-primary outcomes are (1) incidence of
Hypo-Attenuated Leaflet Thickening (HALT) on 4-dimensional cardiac CT at
12 months, and (2) a Safety Composite of VARC-3 bleeding events,
thromboembolic events (myocardial infarction and stroke), and death from
any cause, at 12 months. <br/>Result(s): The first 100 patients had a mean
age of 74 +/- 3.6 years, 33% were female, the average body-mass index was
27.9 +/- 4.4 kg/m², and 15% were smokers. A balloon-expanded
valve was used in 82% and a self-expandable valve in 18%.
<br/>Conclusion(s): The trial is planned, initiated, funded, and conducted
without industry involvement. Trial Registration: ClinicalTrials.gov
Identifier NCT05035277.<br/>Copyright &#xa9; 2023 The Author(s)

<78>
Accession Number
2027142959
Title
Glutamate Infusion Reduces Myocardial Dysfunction after Coronary Artery
Bypass Grafting According to NT-proBNP: Summary of 2 Randomized Controlled
Trials (GLUTAmate for Metabolic Intervention in Coronary Surgery
[GLUTAMICS I-II]).
Source
American Journal of Clinical Nutrition. (no pagination), 2023. Date of
Publication: 2023.
Author
Holm J.; Vanky F.; Svedjeholm R.
Institution
(Holm, Vanky, Svedjeholm) Department of Thoracic and Vascular Surgery,
Department of Health, Medicine and Caring Sciences, Unit of Cardiovascular
Medicine, Linkoping University, Sweden
Publisher
Elsevier B.V.
Abstract
Background: Glutamate is reported to enhance the recovery of oxidative
metabolism and contractile function of the heart after ischemia. The
effect appears to be blunted in diabetic hearts. Elevated plasma
N-terminal pro-brain natriuretic peptide (NT-proBNP) reflects myocardial
dysfunction. In the GLUTAmate for Metabolic Intervention in Coronary
Surgery (GLUTAMICS) II trial, the proportion of patients with diabetes had
nearly doubled to 47% compared with the cohort used for sample size
estimation, and a significant effect on the postoperative rise in
NT-proBNP was only observed in patients without diabetes.
<br/>Objective(s): We aimed to summarize the pooled NT-proBNP results from
both GLUTAMICS trials and address the impact of diabetes. <br/>Method(s):
Data from 2 prospective, randomized, double-blind multicenter trials with
similar inclusion criteria and endpoints were pooled. Patients underwent a
coronary artery bypass grafting (CABG) +/- valve procedure and had a
left-ventricular ejection fraction of <=0.30 or a European System for
Cardiac Operative Risk Evaluation II (EuroSCORE II) of >=3.0 with at least
1 cardiac risk factor. Intravenous infusion of 0.125 M L-glutamic acid or
saline at 1.65 mL/kg/h was started 10-20 min before reperfusion and
continued for 150 min. The primary endpoint was the difference between
preoperative and day 3 postoperative NT-proBNP levels. <br/>Result(s): A
total of 451 patients, 224 receiving glutamate and 227 controls, fulfilled
the inclusion criteria. Glutamate was associated with a reduced primary
endpoint (5344 +/- 5104 ng/L and 6662 +/- 5606 ng/L in glutamate and
control groups, respectively; P = 0.01). Postoperative mortality at <=30 d
was 0.9% and 3.5% (P = 0.11), whereas stroke at <=24 h was 0.4% and 2.6%
in glutamate and control groups, respectively (P = 0.12). No adverse
events related to glutamate were observed. A significant interaction
regarding the primary endpoint was only detected between glutamate and
insulin-treated diabetes groups (P = 0.04). Among patients without
insulin-treated diabetes, the primary endpoint was 5047 +/- 4705 ng/L and
7001 +/- 5830 ng/L in the glutamate and control groups, respectively (P =
0.001). <br/>Conclusion(s): Infusion of glutamate reduced the
postoperative rise in NT-proBNP after CABG in medium- to high-risk
patients. A significantly blunted effect was observed only in
insulin-treated patients with diabetes. Clinical trial details: This trial
was registered at www.clinicaltrials.gov as NCT02592824.<br/>Copyright
&#xa9; 2023 The Author(s)

<79>
Accession Number
642310299
Title
Induction Chemoimmunotherapy with Surgery versus Concurrent Chemoradiation
followed by Immunotherapy for Stage III-N2 Non-small Cell Lung Cancer.
Source
The Journal of thoracic and cardiovascular surgery. (no pagination),
2023. Date of Publication: 16 Sep 2023.
Author
Kumar A.; Srinivasan D.; Potter A.; Mathey-Andrews C.; Lanuti M.; Martin
L.W.; Jeffrey Yang C.-F.
Institution
(Kumar) Icahn School of Medicine at Mount Sinai, New York, NY, United
States
(Srinivasan, Potter, Mathey-Andrews, Lanuti) Department of Surgery,
Division of Thoracic Surgery, Massachusetts General Hospital, Boston, MA,
United States
(Martin) Department of Surgery, Division of Thoracic and Cardiovascular
Surgery, University of Virginia, Charlottesville, VA, United States
(Jeffrey Yang) Department of Surgery, Division of Thoracic Surgery,
Massachusetts General Hospital, Boston, MA, United States
Publisher
NLM (Medline)
Abstract
OBJECTIVE: Despite the growing relevance of immunotherapy for non-small
cell lung cancer (NSCLC), there is limited consensus on the optimal
treatment strategy for locally advanced NSCLC. This study evaluated the
overall survival of patients with stage III-N2 NSCLC undergoing induction
chemoimmunotherapy with surgery ("CT/IO+Surgery") and definitive
concurrent chemoradiation followed by immunotherapy ("cCRT+IO").
<br/>METHOD(S): Patients with cT1-3, N2, M0 NSCLC in the National Cancer
Database (2013-2019) were included and stratified by treatment regimen:
CT/IO+Surgery or cCRT+IO. Overall survival was evaluated using
Kaplan-Meier analysis, Cox proportional hazards modeling, and propensity
score matching on 10 prognostic variables. <br/>RESULT(S): Of the 3,382
patients satisfying study eligibility criteria, 3,289 (97.3%) received
cCRT+IO and 93 (2.8%) received CT/IO+Surgery. 3-year overall survival of
the entire cohort was 58.2% (95% CI: 56.2-60.1). Multivariable-adjusted
Cox proportional hazards modeling demonstrated better survival after
CT/IO+Surgery than cCRT+IO (HR: 0.52, 95% CI: 0.32-0.84, p=0.007). In a
3:1 variable ratio propensity score-matched analysis of 223 patients who
received cCRT+IO and 76 patients who received CT/IO+Surgery, 3-year
overall survival was 63.2% (95% CI: 55.9-70.2) after cCRT+IO and 77.2%
(95% CI: 64.6-85.7) after CT/IO+Surgery (p=0.029). <br/>CONCLUSION(S): In
this national analysis, multimodal treatment including immunotherapy was
associated with a 3-year overall survival rate of 58.2% for all patients
with stage III-N2 NSCLC, and 77.2% for patients who underwent
chemoimmunotherapy followed by surgery. These results should be considered
hypothesis generating and demonstrate the importance of developing a
randomized trial to evaluate the role of surgery versus chemoradiation for
locally advanced NSCLC in the modern immunotherapy era.<br/>Copyright
&#xa9; 2023. Published by Elsevier Inc.

<80>
Accession Number
2026936194
Title
A family intervention to prevent postoperative delirium in patients
undergoing cardiac valve surgery: A randomized controlled study.
Source
Heart and Lung. 63 (pp 1-8), 2024. Date of Publication: 01 Jan 2024.
Author
Lin L.; Peng Y.; Huang X.; Li S.; Chen L.; Lin Y.
Institution
(Lin) Department of Nursing, Fujian medical university, Fujian, Fuzhou,
China
(Lin, Peng, Huang, Li, Chen, Lin) Department of Cardiovascular Surgery,
Fujian Medical University Union Hospital, Fujian, Fuzhou, China
(Lin, Peng, Huang, Li, Chen, Lin) Heart Center of Fujian Medical
University, Fujian, Fuzhou, China
(Lin) Department of Nursing, Fujian Medical University Union Hospital,
Fujian, Fuzhou, China
Publisher
Elsevier Inc.
Abstract
Background: Multiple guidelines recommend that families be involved in the
care of ICU patients, which has been widely used in ICU delirium
management in recent years. Postoperative delirium (POD) occurs frequently
after cardiac surgery and is associated with poor outcomes; however, the
effects of family intervention on this group are rarely studied.
<br/>Objective(s): This study aimed to investigate the effects of family
intervention on the incidence of POD and the ICU prognoses of patients
undergoing cardiac valve surgery. <br/>Method(s): This was a two-group,
single-blind, randomized controlled trial involving 80 patients undergoing
cardiac valve surgery, with 40 patients in each group. The control group
received routine ICU visits, and the experimental group implemented a
family intervention that instructed family caregivers to participate in
delirium management during ICU visits. The occurrence of POD, ICU stay,
mechanical ventilation time of patients; as well as the anxiety,
depression, and satisfaction levels of family caregivers were compared
between the two groups. <br/>Result(s): The incidence of POD and ICU stay
of patients were significantly lower in the experimental group compared to
the control group (P < 0.05). The anxiety and depression incidence of
family caregivers in the experimental group was lower than those of the
control group (P < 0.05), and satisfaction scores were higher than those
of the control group (P < 0.05). <br/>Conclusion(s): Family intervention
has the potential to reduce the incidence of POD in patients undergoing
cardiac valve surgery, shorten ICU stays, reduce the incidence of anxiety
and depression in family caregivers, and improve their satisfaction. These
findings suggest that family intervention could be incorporated into
routine nursing practice.<br/>Copyright &#xa9; 2023

<81>
Accession Number
2026124414
Title
Mortality, Revascularization, and Cardioprotective Pharmacotherapy After
Acute Coronary Syndrome in Patients With Severe Mental Illness: A
Systematic Review and Meta-analysis.
Source
Schizophrenia Bulletin. 48(5) (pp 981-998), 2022. Date of Publication: 01
Sep 2022.
Author
Chan J.K.N.; Chu R.S.T.; Hung C.; Law J.W.Y.; Wong C.S.M.; Chang W.C.
Institution
(Chan, Chu, Hung, Law, Chang) Department of Psychiatry, LKS Faculty of
Medicine, The University of Hong Kong, Pokfulam, Hong Kong
(Wong) School of Public Health, LKS Faculty of Medicine, The University of
Hong Kong, Pokfulam, Hong Kong
(Chang) State Key Laboratory of Brain and Cognitive Sciences, The
University of Hong Kong, Pokfulam, Hong Kong
Publisher
Oxford University Press
Abstract
Background and Hypothesis: People with severe mental illness (SMI) may
experience excess mortality and inequitable treatment following acute
coronary syndrome (ACS). However, cardioprotective pharmacotherapy and SMI
diagnoses other than schizophrenia are rarely examined in previous
reviews. We hypothesized that SMI including bipolar disorder (BD) is
associated with increased post-ACS mortality, decreased revascularization,
and cardioprotective medication receipt relative to those without SMI.
<br/>Study Design: We performed a meta-analysis to quantitatively
synthesize estimates of post-ACS mortality, major adverse cardiac events
(MACEs), and receipt of invasive coronary procedures and cardioprotective
medications in patients with SMI, comprising schizophrenia, BD, and other
nonaffective psychoses, relative to non-SMI counterparts. Subgroup
analyses stratified by SMI subtypes (schizophrenia, BD), incident ACS
status, and post-ACS time frame for outcome evaluation were conducted.
Study Results: Twenty-two studies were included (n = 12 235 501, including
503 686 SMI patients). SMI was associated with increased overall (relative
risk [RR] = 1.40 [95% confidence interval = 1.21-1.62]), 1-year (1.68
[1.42-1.98]), and 30-day (1.26 [1.05-1.51]) post-ACS mortality, lower
receipt of revascularization (odds ratio = 0.57 [0.49-0.67]), and
cardioprotective medications (RR = 0.89 [0.85-0.94]), but comparable rates
of any/specific MACEs relative to non-SMI patients. Incident ACS status
conferred further increase in post-ACS mortality. Schizophrenia was
associated with heightened mortality irrespective of incident ACS status,
while BD was linked to significantly elevated mortality only in incident
ACS cohort. Both schizophrenia and BD patients had lower revascularization
rates. Post-ACS mortality risk remained significantly increased with mild
attenuation after adjusting for revascularization. <br/>Conclusion(s): SMI
is associated with increased post-ACS mortality and undertreatment.
Effective multipronged interventions are urgently needed to reduce these
physical health disparities.<br/>Copyright &#xa9; The Author(s) 2022.
Published by Oxford University Press on behalf of the Maryland Psychiatric
Research Center. All rights reserved.

<82>
Accession Number
2025759903
Title
Changes in Left Ventricular Global Longitudinal Strain in Patients With
Heart Failure and Secondary Mitral Regurgitation: The COAPT Trial.
Source
Journal of the American Heart Association. 12(17) (no pagination), 2023.
Article Number: e029956. Date of Publication: 2023.
Author
Pio S.M.; Medvedofsky D.; Stassen J.; Delgado V.; Namazi F.; Weissman
N.J.; Grayburn P.; Kar S.; Lim D.S.; Zhou Z.; Alu M.C.; Redfors B.;
Kapadia S.; Lindenfeld J.; Abraham W.T.; Mack M.J.; Asch F.M.; Stone G.W.;
Bax J.J.
Institution
(Pio, Stassen, Delgado, Namazi, Bax) Department of Cardiology, Leiden
University Medical Center, Leiden, Netherlands
(Medvedofsky, Weissman, Asch) MedStar Health Research Institute,
Washington, DC, United States
(Stassen) Department of Cardiology, Jessa Hospital, Hasselt, Belgium
(Delgado) Hospital University Germans Trias i Pujol, Badalona, Spain
(Grayburn, Mack) Baylor Scott & White Health, Plano, TX, United States
(Kar) Los Robles Regional Medical Center, Thousand Oaks, CA, United States
(Kar) Bakersfield Heart Hospital, Bakersfield, CA, United States
(Lim) University of Virginia, Charlottesville, VA, United States
(Zhou, Alu, Redfors) Cardiovascular Research Foundation, New York, NY,
United States
(Redfors) Department of Cardiology, Sahlgrenska University Hospital,
Gothenburg, Sweden
(Kapadia) Cleveland Clinic, Cleveland, OH, United States
(Lindenfeld) Vanderbilt University Medical Center, Nashville, TN, United
States
(Abraham) Ohio State University Medical Center, Columbus, OH, United
States
(Stone) The Zena and Michael A. Wiener Cardiovascular Institute, Icahn
School of Medicine at Mount Sinai, New York, NY, United States
(Bax) Turku Heart Center, University of Turku and Turku University
Hospital, Turku, Finland
Publisher
American Heart Association Inc.
Abstract
BACKGROUND: Left ventricular (LV) global longitudinal strain (GLS)
provides incremental prognostic information over LV ejection fraction in
patients with heart failure (HF) and secondary mitral regurgitation. We
examined the prognostic impact of LV GLS improvement in this population.
METHODS AND RESULTS: The COAPT (Cardiovascular Outcomes Assessment of the
MitraClip Percutaneous Therapy for Heart Failure Patients With Functional
Mitral Regurgitation) trial randomized symptomatic patients with HF with
severe (3+/4+) mitral regurgitation to transcatheter edge-to-edge repair
with the MitraClip device plus maximally tolerated guideline-directed
medical therapy (GDMT) versus GDMT alone. LV GLS was measured at baseline
and 6-month follow-up. The relationship between the improvement in LV GLS
from baseline to 6 months and the composite of all-cause death or HF
hospitalization between 6-and 24-month follow-up were assessed. Among 383
patients, 174 (45.4%) had improved LV GLS at 6-month follow-up (83/195
[42.6%] with transcatheter edge-to-edge repair+GDMT and 91/188 [48.4%]
with GDMT alone; P=0.25). Improvement in LV GLS was strongly associated
with reduced death or HF hospitalization between 6 and 24 months
(P<0.009), with similar risk reduction in both treatment arms
(P<inf>interaction</inf> =0.40). By multivariable analysis, LV GLS
improvement at 6 months was inde-pendently associated with a lower risk of
death or HF hospitalization (hazard ratio [HR], 0.55 [95% CI, 0.36-0.83];
P=0.009), death (HR, 0.48 [95% CI, 0.29-0.81]; P=0.006), and HF
hospitalization (HR, 0.50 [95% CI, 0.31-0.81]; P=0.005) between 6 and 24
months. <br/>CONCLUSION(S): Among patients with HF and severe mitral
regurgitation in the COAPT trial, improvement in LV GLS at 6-month
follow-up was associated with improved outcomes after both transcatheter
edge-to-edge repair and GDMT alone between 6 and 24 months. REGISTRATION:
URL: https://www.clinicaltrials.gov; Unique identifier:
NCT01626079.<br/>Copyright &#xa9; 2023 The Authors. Published on behalf of
the American Heart Association, Inc., by Wiley.

<83>
Accession Number
2025598370
Title
Preemptive Pharmacogenetic-Guided Metoprolol Management for Postoperative
Atrial Fibrillation in Cardiac Surgery: The Preemptive
Pharmacogenetic-Guided Metoprolol Management for Atrial Fibrillation in
Cardiac Surgery Pilot Trial.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 37(10) (pp 1974-1982),
2023. Date of Publication: October 2023.
Author
Staben R.; Vnencak-Jones C.L.; Shi Y.; Shotwell M.S.; Absi T.; Shah A.S.;
Wanderer J.P.; Beller M.; Kertai M.D.
Institution
(Staben, Shotwell, Wanderer, Kertai) Department of Anesthesiology,
Vanderbilt University Medical Center, Nashville, TN, United States
(Vnencak-Jones) Department of Pathology, Microbiology and Immunology,
Vanderbilt University Medical Center, Nashville, TN, United States
(Shi, Shotwell) Department of Biostatistics, Vanderbilt University Medical
Center, Nashville, TN, United States
(Absi, Shah) Department of Cardiac Surgery, Vanderbilt University Medical
Center, Nashville, TN, United States
(Wanderer) Department of Biomedical Informatics, Vanderbilt University
Medical Center, Nashville, TN, United States
(Beller) Center for Precision Medicine, Vanderbilt University Medical
Center, Nashville, TN, United States
Publisher
W.B. Saunders
Abstract
Objectives: To test the hypothesis that implementation of a cytochrome
P-450 2D6 (CYP2D6) genotype-guided perioperative metoprolol administration
will reduce the risk of postoperative atrial fibrillation (AF), the
authors conducted the Preemptive Pharmacogenetic-Guided Metoprolol
Management for Atrial Fibrillation in Cardiac Surgery pilot study.
<br/>Design(s): Clinical pilot trial. <br/>Setting(s): Single academic
center. <br/>Participant(s): Seventy-three cardiac surgery patients.
<br/>Measurements and Main Results: Patients were classified as normal,
intermediate, poor, or ultrarapid metabolizers after testing for their
CYP2D6 genotype. A clinical decision support tool in the electronic health
record advised providers on CYP2D6 genotype-guided metoprolol dosing.
Using historical data, the Bayesian method was used to compare the
incidence of postoperative AF in patients with altered metabolizer status
to the reference incidence. A logistic regression analysis was performed
to study the association between the metabolizer status and postoperative
AF while controlling for the Multicenter Study of Perioperative Ischemia
AF Risk Index. Of the 73 patients, 30% (n = 22) developed postoperative
AF; 89% (n = 65) were normal metabolizers; 11% (n = 8) were
poor/intermediate metabolizers; and there were no ultrarapid metabolizer
patients identified. The estimated rate of postoperative AF in patients
with altered metabolizer status was 30% (95% CI 8%-60%), compared with the
historical reference incidence (27%). In the risk-adjusted analysis, there
was insufficient evidence to conclude that modifying metoprolol dosing
based on poor/intermediate metabolizer status was associated significantly
with the odds of postoperative AF (odds ratio 0.82, 95% CI 0.15-4.55, p =
0.82). <br/>Conclusion(s): A CYP2D6 genotype-guided metoprolol management
was not associated with a reduction of postoperative AF after cardiac
surgery.<br/>Copyright &#xa9; 2023

<84>
Accession Number
2025404130
Title
Prevention of cardiac surgery-associated acute kidney injury: a systematic
review and meta-analysis of non-pharmacological interventions.
Source
Critical Care. 27(1) (no pagination), 2023. Article Number: 354. Date of
Publication: December 2023.
Author
Hariri G.; Collet L.; Duarte L.; Martin G.L.; Resche-Rigon M.; Lebreton
G.; Bougle A.; Dechartres A.
Institution
(Hariri, Collet, Martin, Dechartres) Departement de Sante Publique, UMR-S
1136, AP-HP, INSERM, Institut Pierre Louis d'Epidemiologie et de Sante
Publique, Hopital Pitie-Salpetriere, Sorbonne Universite, Paris, France
(Hariri, Duarte, Bougle) Departement d'anesthesie et reanimation, GRC 29,
DMU DREAM, Institut de Cardiologie, Assistance Publique-Hopitaux de Paris
(AP-HP), Hopital La Pitie-Salpetriere, Sorbonne Universite, Paris 75013,
France
(Resche-Rigon) ECSTRRA - CRESS UMR1153, INSERM and SBIM, AP-HP, Hopital
Saint-Louis, Universite de Paris, Paris, France
(Lebreton) AP-HP, Service de Chirurgie Cardiaque, Institut de Cardiologie,
Hopital La Pitie-Salpetriere, Sorbonne Universite, Paris 75013, France
Publisher
BioMed Central Ltd
Abstract
Background: Cardiac surgery-associated acute kidney injury (CSA-AKI) is
frequent. While two network meta-analyses assessed the impact of
pharmacological interventions to prevent CSA-AKI, none focused on
non-pharmacological interventions. We aim to assess the effectiveness of
non-pharmacological interventions to reduce the incidence of CSA-AKI.
<br/>Method(s): We searched PubMed, Embase, Central and clinical trial
registries from January 1, 2004 (first consensus definition of AKI) to
July 1, 2023. Additionally, we conducted manual screening of abstracts of
major anesthesia and intensive care conferences over the last 5 years and
reference lists of relevant studies. We selected all randomized controlled
trials (RCTs) assessing a non-pharmacological intervention to reduce the
incidence of CSA-AKI, without language restriction. We excluded RCTs of
heart transplantation or involving a pediatric population. The primary
outcome variable was CSA-AKI. Two reviewers independently identified
trials, extracted data and assessed risk of bias. Random-effects
meta-analyses were conducted to calculate risk ratios (RRs) with 95%
confidence intervals (CIs). We used the Grading of Recommendations
Assessment, Development, and Evaluation to assess the quality of evidence.
<br/>Result(s): We included 86 trials (25,855 patients) evaluating 10
non-pharmacological interventions to reduce the incidence of CSA-AKI. No
intervention had high-quality evidence to reduce CSA-AKI. Two
interventions were associated with a significant reduction in CSA-AKI
incidence, with moderate quality of evidence: goal-directed perfusion (RR,
0.55 [95% CI 0.40-0.76], I ² = 0%; P <inf>het</inf> = 0.44) and
remote ischemic preconditioning (RR, 0.86 [0.78-0.95]; I ² =
23%; P <inf>het</inf> = 0.07). Pulsatile flow during cardiopulmonary
bypass was associated with a significant reduction in CSA-AKI incidence
but with very low quality of evidence (RR = 0.69 [0.48; 0.99]; I
² = 53%; P <inf>het</inf> < 0.01). We found high quality of
evidence for lack of effect of restrictive transfusion strategy (RR, 1.02
[95% CI 0.92; 1.12; P <inf>het</inf> = 0.67; I ² = 3%) and
tight glycemic control (RR, 0.86 [95% CI 0.55; 1.35]; P <inf>het</inf> =
0.25; I ² = 26%). <br/>Conclusion(s): Two non-pharmacological
interventions are likely to reduce CSA-AKI incidence, with moderate
quality of evidence: goal-directed perfusion and remote ischemic
preconditioning.<br/>Copyright &#xa9; 2023, BioMed Central Ltd., part of
Springer Nature.

<85>
Accession Number
2023045999
Title
The effect of the multiple arterial grafts compared with single arterial
graft for coronary artery bypass grafting on sternal wound complications:
A meta-analysis.
Source
International Wound Journal. 20(8) (pp 3249-3254), 2023. Date of
Publication: October 2023.
Author
Yang X.; Fu J.; Zhang S.
Institution
(Yang, Zhang) Department of Cardiothoracic Surgery, the First College of
Clinical Medical Science, China Three Gorges University, Hubei, Yichang,
China
(Yang, Zhang) Department of Cardiothoracic Surgery, Yichang Central
People's Hospital, Hubei, Yichang, China
(Fu) Department of Oncology, the Second People's Hospital of China Three
Gorges University, Hubei, Yichang, China
(Fu) Department of Oncology, Yichang Second People's Hospital, Hubei,
Yichang, China
Publisher
John Wiley and Sons Inc
Abstract
A meta-analysis investigation was executed to measure the influence of
multiple arterial grafts (MAGs) compared with single arterial graft (SAG)
for coronary artery bypass grafting (CABG) on sternal wound complications
(SWCs). A comprehensive literature inspection till February 2023 was
applied and 1048 interrelated investigations were reviewed. The seven
chosen investigations enclosed 11 201 individuals with CABG in the chosen
investigations' starting point, 4870 of them were using MAGs, and 6331
were using SAG. Odds ratio (OR) in addition to 95% confidence intervals
(CIs) were utilised to compute the value of the effect of the MAGs
compared with SAG for CABG on SWCs by the dichotomous approaches and a
fixed or random model. MAGs had significantly higher SWC (OR, 1.38; 95%
CI, 1.10-1.73, P =.005) compared with those with SAG in CABG. MAGs had
significantly higher SWC compared with those with SAG in CABG. However,
care must be exercised when dealing with its values because of the low
number of selected investigations for the meta-analysis.<br/>Copyright
&#xa9; 2023 The Authors. International Wound Journal published by
Medicalhelplines.com Inc and John Wiley & Sons Ltd.

<86>
Accession Number
642044868
Title
Aortic valve repair in neonates, infants and children: a systematic
review, meta-analysis and microsimulation study.
Source
European journal of cardio-thoracic surgery : official journal of the
European Association for Cardio-thoracic Surgery. 64(3) (no pagination),
2023. Date of Publication: 07 Sep 2023.
Author
Notenboom M.L.; Rhellab R.; Etnel J.R.G.; van den Bogerd N.; Veen K.M.;
Taverne Y.J.H.J.; Helbing W.A.; van de Woestijne P.C.; Bogers A.J.J.C.;
Takkenberg J.J.M.
Institution
(Notenboom, Rhellab, Etnel, van den Bogerd, Veen, Taverne, van de
Woestijne, Bogers, Takkenberg) Department of Cardiothoracic Surgery,
Erasmus University Medical Centre, Rotterdam, Netherlands
(Helbing) Department of Paediatrics, Div. of Cardiology, Erasmus
University Medical Centre, Rotterdam, Netherlands
Publisher
NLM (Medline)
Abstract
OBJECTIVES: To support clinical decision-making in children with aortic
valve disease, by compiling the available evidence on outcome after
paediatric aortic valve repair (AVr). <br/>METHOD(S): A systematic review
of literature reporting clinical outcome after paediatric AVr (mean age at
surgery <18years) published between 1 January 1990 and 23 December 2021
was conducted. Early event risks, late event rates and time-to-event data
were pooled. A microsimulation model was employed to simulate the lives of
individual children, infants and neonates following AVr. <br/>RESULT(S):
Forty-one publications were included, encompassing 2 623 patients with 17
217 patient-years of follow-up (median follow-up: 7.3years; range:
1.0-14.4 years). Pooled mean age during repair for aortic stenosis in
children (<18 years), infants (<1 year) or neonates (<30 days) was
5.2+/-3.9years, 35+/-137days and 11+/-6days, respectively. Pooled early
mortality after stenosis repair in children, infants and neonates,
respectively, was 3.5% (95% confidence interval: 1.9-6.5%), 7.4%
(4.2-13.0%) and 10.7% (6.8-16.9%). Pooled late reintervention rate after
stenosis repair in children, infants and neonates, respectively, was
3.31%/year (1.66-6.63%/year), 6.84%/year (3.95-11.83%/year) and 6.32%/year
(3.04-13.15%/year); endocarditis 0.07%/year (0.03-0.21%/year), 0.23%/year
(0.07-0.71%/year) and 0.49%/year (0.18-1.29%/year); and valve thrombosis
0.05%/year (0.01-0.26%/year), 0.15%/year (0.04-0.53%/year) and 0.19%/year
(0.05-0.77%/year). Microsimulation-based mean life expectancy in the first
20years for children, infants and neonates with aortic stenosis,
respectively, was 18.4years (95% credible interval: 18.1-18.7 years;
relative survival compared to the matched general population: 92.2%),
16.8years (16.5-17.0 years; relative survival: 84.2%) and 15.9years
(14.8-17.0 years; relative survival: 80.1%). Microsimulation-based 20-year
risk of reintervention in children, infants and neonates, respectively,
was 75.2% (72.9-77.2%), 53.8% (51.9-55.7%) and 50.8% (47.0-57.6%).
<br/>CONCLUSION(S): Long-term outcomes after paediatric AVr for stenosis
are satisfactory and dependent on age at surgery. Despite a high hazard of
reintervention for valve dysfunction and slightly impaired survival
relative to the general population, AVr is associated with low
valve-related event occurrences and should be considered in children with
aortic valve disease.<br/>Copyright &#xa9; The Author(s) 2023. Published
by Oxford University Press on behalf of the European Association for
Cardio-Thoracic Surgery.

<87>
Accession Number
2026211905
Title
A Systematic Review of Short-Term Outcomes of Leadless Pacemaker
Implantation After Transvenous Lead Removal of Infected Cardiac
Implantable Electronic Device.
Source
American Journal of Cardiology. 203 (pp 444-450), 2023. Date of
Publication: 15 Sep 2023.
Author
Tan M.C.; Tan J.L.; Tay S.T.; Sorajja D.; Scott L.; Cha Y.-M.; Russo A.M.;
Hussein A.; Lee J.Z.
Institution
(Tan, Sorajja, Scott) Division of Cardiovascular Medicine, Mayo Clinic,
Phoenix, Arizona, United States
(Tan) Department of Internal Medicine, New York Medical College at Saint
Michael's Medical Center, Newark, New Jersey, United States
(Tan) Division of Cardiovascular Medicine, Hospital of the University of
Pennsylvania, Philadelphia, Pennsylvania, United States
(Tay) Department of Medicine, School of Medicine, Chang Gung University,
Taoyuan City, Taiwan (Republic of China)
(Cha) Division of Cardiovascular Medicine, Mayo Clinic, Rochester,
Minnesota, United States
(Russo) Division of Cardiovascular Medicine, Cooper University Health
Care/Cooper Medical School of Rowan University, Camden, New Jersey, United
States
(Hussein, Lee) Division of Cardiovascular Medicine, Cleveland Clinic,
Cleveland, Ohio, United States
Publisher
Elsevier Inc.
Abstract
The outcomes of leadless pacemaker (LP) implantation after transvenous
lead removal (TLR) of infected cardiac implantable electronic devices
(CIEDs) are not well-established. This study sought to describe the
outcomes of LP implantation after TLR of infected CIED. We conducted a
literature search using PubMed and Embase for a combination of terms
including LP implantation, transvenous lead extraction, TLR, transvenous
lead explant, infected CIED, infected pacemaker, and infected implantable
cardioverter defibrillator. The inclusion criterion was LP implantation
after TLR of infected CIED. The exclusion criterion was TLR for
noninfectious reasons. Study end points included procedural complications
and LP infection during follow-up. Of 132 publications reviewed, 13
studies with a total of 253 patients (74 +/- 14 years of age, 174 [69%]
males) were included. The most common indication of the initial device
implantations was a high-degree atrioventricular block (n = 100 of 253,
39.5%). Of the 253 patients included, 105 patients (41.5%) underwent
concomitant LP implantation during the TLR procedure, and 36 patients
(14.2%) had temporary transvenous pacing as a bridge from TLR to LP
implantation. Of the 148 patients with data on the type of CIED infection,
56.8% had systemic CIED infection and 43.2% had isolated pocket infection.
Staphylococcus aureus was the most common causative organism in 33% of the
reported patients. The LP was implanted an average of 5.4 +/- 10.7 days
after TLR of infected CIED. During the LP implantation, 1 patient (0.4%)
had unsuccessful implantation because of an intraprocedural complication
requiring sternotomy. After LP implantation, 2 patients (0.8%) developed
groin hematoma, 2 patients (0.8%) developed femoral arteriovenous fistula,
and 1 patient (0.4%) developed pericardial effusion requiring
pericardiocentesis. During a mean follow-up of 11.3 +/- 10.6 months, 3
patients (1.2%) developed pacemaker syndrome, 1 patient (0.4%) developed
acute on chronic heart failure exacerbation, and only 1 patient (0.4%)
developed LP-related infection requiring LP retrieval. This study suggests
that LP implant is feasible and safe after removal of infected CIED with
cumulative adverse events at 4% and a reinfection rate of 0.4%. Large
prospective studies are needed to better evaluate the best timing of LP
implantation after TLR of an infected CIED.<br/>Copyright &#xa9; 2023
Elsevier Inc.

<88>
Accession Number
2027146671
Title
Prognostic value of positron emission tomography derived myocardial flow
reserve: A systematic review and meta-analysis.
Source
Atherosclerosis. 382 (no pagination), 2023. Article Number: 117280. Date
of Publication: October 2023.
Author
Ahmed A.I.; Saad J.M.; Alahdab F.; Han Y.; Nayfeh M.; Alfawara M.S.;
Al-Rifai M.; Al-mallah M.
Institution
(Ahmed, Saad, Alahdab, Han, Nayfeh, Alfawara, Al-Rifai, Al-mallah) Houston
Methodist DeBakey Heart & Vascular Center, Houston, TX, United States
(Ahmed) Yale School of Medicine, New Haven, CT, United States
Publisher
Elsevier Ireland Ltd
Abstract
Background and aims: Positron Emission Tomography (PET)-derived myocardial
flow reserve (MFR) has been shown to have a role in the diagnosis and
prognosis of patients with coronary artery disease (CAD). We performed a
systematic review and meta-analysis to summarize the body of literature
and synthesize the evidence on the prognostic role of PET-derived MFR in
patients with known or suspected CAD. <br/>Method(s): A comprehensive
literature search of the Medline database from its inception to August
2023, in humans, in any language, was conducted for clinical studies
examining the prognostic value of PET imaging in patients of any age, sex,
and CAD status. Systematic screening and data extraction of the identified
studies were followed by quantitative meta-analysis of PET-MFR's role in
predicting adverse clinical events using random effect model. Studies were
appraised using the modified Newcastle-Ottawa tool. <br/>Result(s): A
total of 21 studies assessing the prognostic role of PET derived MFR in
46,815 patients with known and/or suspected CAD were included (mean (SD)
age 66 (4) years, 48% women). The mean follow-up duration was 36 months
(range 10-96). Cardiovascular risk factors were prevalent (73%
hypertension, 35% diabetes and 67% dyslipidemia). The definition of the
composite outcome varied between studies, with various combinations of
mortality, non-fatal myocardial infarction, hospitalization, and coronary
revascularization. Pooled impaired MFR was significantly associated with
an increased risk of adverse outcomes (RR = 2.94, 95% CI 2.42-3.56, p <
0.001). Results were similar in a subgroup of patients with suspected CAD.
<br/>Conclusion(s): The available body of evidence shows that impaired
PET-derived MFR measured using different tracers and PET systems is
strongly associated with an increased risk of adverse cardiovascular
events. Limitations of this review include observational nature of
studies, marked heterogeneity in patient populations, inconsistency in
thresholds to define abnormal MFR, and differing components for the
composite outcome.<br/>Copyright &#xa9; 2023 Elsevier B.V.

<89>
Accession Number
2027145770
Title
Intraoperative hypotension and postoperative outcomes: a meta-analysis of
randomised trials.
Source
British Journal of Anaesthesia. (no pagination), 2023. Date of
Publication: 2023.
Author
D'Amico F.; Fominskiy E.V.; Turi S.; Pruna A.; Fresilli S.; Triulzi M.;
Zangrillo A.; Landoni G.
Institution
(D'Amico, Fominskiy, Turi, Pruna, Fresilli, Triulzi, Zangrillo, Landoni)
Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific
Institute, Milan, Italy
(Zangrillo, Landoni) School of Medicine, Vita-Salute San Raffaele
University, Milan, Italy
Publisher
Elsevier Ltd
Abstract
Introduction: Intraoperative hypotension is associated with adverse
postoperative outcomes; however these findings are supported only by
observational studies. The aim of this meta-analysis of randomised trials
was to compare the postoperative effects permissive management with
targeted management of intraoperative blood pressure. <br/>Method(s): We
searched PubMed, Cochrane, and Embase up to June 2023 for studies
comparing permissive (mean arterial pressure <=60 mm Hg) with targeted
(mean arterial pressure >60 mm Hg) intraoperative blood pressure
management. Primary outcome was all-cause mortality at the longest
follow-up available. Secondary outcomes were atrial fibrillation,
myocardial infarction, acute kidney injury, delirium, stroke, number of
patients requiring transfusion, time on mechanical ventilation, and length
of hospital stay. <br/>Result(s): We included 10 randomised trials
including a total of 9359 patients. Mortality was similar between
permissive and targeted blood pressure management groups (89/4644 [1.9%]
vs 99/4643 [2.1%], odds ratio 0.88, 95% confidence interval [CI],
0.65-1.18, P=0.38, I²=0% with nine studies included). Atrial
fibrillation (102/3896 [2.6%] vs 130/3887 [3.3%] odds ratio 0.71, 95% CI
0.53-0.96, P=0.03, I²=0%), and length of hospital stay (mean
difference -0.20 days, 95% CI -0.26 to -0.13, P<0.001, I²=0%)
were reduced in the permissive management group. No significant
differences were found in subgroup analysis for cardiac and noncardiac
surgery. <br/>Conclusion(s): Pooled randomised evidence shows that a
target intraoperative mean arterial pressure <=60 mm Hg is not associated
with increased mortality; nevertheless it is surprisingly associated with
a reduced rate of atrial fibrillation and of length of hospital stay.
Systematic review protocol: PROSPERO CRD42023393725.<br/>Copyright &#xa9;
2023 British Journal of Anaesthesia

<90>
Accession Number
642303081
Title
Comparative efficacy on outcomes of C-CABG, OPCAB and ONBEAT in coronary
heart disease: A systematic review and network meta-analysis of randomized
controlled trials.
Source
International journal of surgery (London, England). (no pagination),
2023. Date of Publication: 18 Sep 2023.
Author
Zhu L.; Li D.; Zhang X.; Wan S.; Liu Y.; Zhang H.; Luo J.; Luo Y.; An P.;
Jiang W.
Institution
(Zhu, Zhang, Wan, Luo, Luo, An) Department of Nutrition and Health,
Beijing Advanced Innovation Center for Food, Nutrition and Human Health,
Key Laboratory of Precision Nutrition and Food, Quality, China
Agricultural University, Beijing 100193, China
(Li, Liu, Zhang, Jiang) Department of Cardiac Surgery, Beijing Anzhen
Hospital, Capital Medical University, Beijing 100029, China
(Li, Liu, Zhang, Jiang) Beijing Advanced Innovation Center for Big
Data-based Precision Medicine, Capital Medical University, Beijing 100069,
China
(Li, Liu, Zhang, Jiang) Beijing Lab for Cardiovascular Precision Medicine,
Beijing 100069, China
(Li, Liu, Zhang, Jiang) Key Laboratory of Medical Engineering for
Cardiovascular Disease, Beijing 100069, China
Publisher
NLM (Medline)
Abstract
IMPORTANCE: Coronary artery bypass grafting (CABG) remains the gold
standard for the treatment of multivessel and left main coronary heart
disease. However, the current evidence about the optimal surgical
revascularization strategy is inconsistent and is not sufficient to allow
for definite conclusions. Thus, this topic needs to be extensively
discussed. <br/>OBJECTIVE(S): The aim of this present study was to compare
the clinical outcomes of off-pump CABG (OPCAB), conventional on-pump CABG
(C-CABG) and on-pump beating heart (ONBEAT) CABG via an updated systematic
review and network meta-analysis of randomized controlled trials (RCTs).
DATA SOURCES: PubMed, Web of Science and the Cochrane Central Registry
were searched for relevant RCTs that were published in English before
December 1, 2021. STUDY SELECTION: Published trials that included patients
who received OPCAB, C-CABG and ONBEAT CABG were selected. DATA EXTRACTION
AND SYNTHESIS: Two authors independently screened the search results,
assessed the full texts to identify eligible studies and the risk of bias
of the included studies, and extracted data. All processes followed the
Preferred Reporting Items for Systematic Review and Meta-analysis of
Individual Participant Data. MAIN OUTCOMES AND MEASURES: The primary
outcome was postoperative mortality in patients who underwent C-CABG,
OPCAB or ONBEAT CABG. The secondary outcomes were postoperative myocardial
infarction, stroke, and renal impairment in the three groups. The time
point for analysis of outcomes was all time periods during the
postoperative follow-up. <br/>RESULT(S): A total of 39385 patients
(83,496.2 person-years) in 65 studies who fulfilled the prespecified
criteria were included. In the network meta-analysis, OPCAB was associated
with an increase of 12% in the risk of all-cause mortality when compared
with C-CABG (OR: 1.12; 95% CI: 1.04 to 1.21), a reduction of 49% in the
risk of myocardial infarction when compared with ONBEAT (OR: 0.51; 95% CI:
0.26 to 0.99), a reduction of 16% in the risk of stroke when compared with
C-CABG (OR: 0.84; 95% CI: 0.72 to 0.99) and a similar risk of renal
impairment when compared with C-CABG and ONBEAT. CONCLUSIONS AND
RELEVANCE: OPCAB was associated with higher all-cause mortality but lower
postoperative stroke compared with C-CABG. OPCAB was associated with lower
postoperative myocardial infarction than that of ONBEAT. Early mortality
was comparable among OPCAB, ONBEAT and C-CABG.<br/>Copyright &#xa9; 2023
The Author(s). Published by Wolters Kluwer Health, Inc.

<91>
Accession Number
642301329
Title
Efficiency of Optimal Fluoroscopic Projection Angle defined by Computed
Tomography Angiography for Left Atrial Appendage Closure.
Source
Hellenic journal of cardiology : HJC = Hellenike kardiologike epitheorese.
(no pagination), 2023. Date of Publication: 15 Sep 2023.
Author
Lu X.; Wang X.; Wang Q.; Song T.; Liu G.; Liu A.; Shi X.; Guo J.; Chen T.
Institution
(Lu) Senior Department of Cardiology, The Sixth Medical Center of PLA
General Hospital, 6 Fucheng Road, Haidian District, Beijing 100048, China;
Outpatient Department, The 44th Sanatorium of Retired Cadres in Haidian
District, No. 19 Dahuisi Road, Haidian District, Beijing 100081, China.
Electronic address: Essence_of_heart@hotmail.com
(Wang) Senior Department of Cardiology, Sixth Medical Center of PLA
General Hospital, 6 Fucheng Road, Beijing 100048, China
(Wang) Senior Department of Cardiology, Sixth Medical Center of PLA
General Hospital, 6 Fucheng Road, Beijing 100048, China
(Song, Shi, Guo, Chen) Senior Department of Cardiology, Sixth Medical
Center of PLA General Hospital, 6 Fucheng Road, Beijing 100048, China
(Liu) Senior Department of Cardiology, Sixth Medical Center of PLA General
Hospital, 6 Fucheng Road, Beijing 100048, China
(Liu) Senior Department of Cardiology, Sixth Medical Center of PLA General
Hospital, 6 Fucheng Road, Beijing 100048, China
Publisher
NLM (Medline)
Abstract
BACKGROUND: Left atrial appendage (LAA) closure (LAAC) procedures are
conventionally performed using empirical fluoroscopic viewing angles.
However, because the LAA is a highly variable anatomical structure, these
angles cannot depict the LAA in the optimal position. The present study
aimed to assess the efficiency of using a novel optimal fluoroscopic
projection angle (OPA) for LAAC and to validate its feasibility.
<br/>METHOD(S): The OPAs of the derivation cohort were acquired using
cardiac computed tomography angiography (CCTA) to assess its superiority
for depicting LAA depth versus traditional working angles (TAs) of RAO
30degree, CAU 20degree. The practicability of OPA-guided LAAC was
demonstrated by comparison between clinical data from the validation
cohort and those from a propensity-score matched (PSM) control group, as
well as randomized controlled studies investigating LAAC. <br/>RESULT(S):
Of 705 patients in the derivation cohort, the median OPA was RAO 46degree,
CAU 31degree. Compared with TA, the OPA depicted a longer mean (+/- SD)
LAA depth (5.1+/-4.4) mm and a larger orifice diameter (1.1+/-1.1 mm),
(P<0.0001 for both). All 38 OPA-guided LAACs were successful, with a
shorter mean procedure duration (42.9 +/- 12.3 min versus [vs.] 107.2 +/-
41.5 min; P<0.0001) and reduced device consumption (1.08 vs. 1.5 per
case), compared with the PSM control group. At the 3-month follow-up, the
incidence of peri-device leak was 52.6% (20/38) detected by CCTA, with a
mean leakage of 1.6+/-0.8 mm. <br/>CONCLUSION(S): By unfolding the LAA
depth and orifice diameter to a better view, OPA demonstrated the
potential to optimize LAAC procedural efficiency, although further
larger-scale studies are required to confirm this.<br/>Copyright &#xa9;
2023 Hellenic Society of Cardiology. Published by Elsevier B.V. All rights
reserved.