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<1>
Accession Number
2026873935
Title
Statin for mood and inflammation among adult patients with major
depressive disorder: an updated meta-analysis.
Source
Frontiers in Psychiatry. 14 (no pagination), 2023. Article Number:
1203444. Date of Publication: 2023.
Author
Xiao X.; Deng H.; Li P.; Sun J.; Tian J.
Institution
(Xiao, Tian) Department of Psychiatric, Beijing First Hospital of
Integrated Chinese and Western Medicine, Beijing, China
(Deng) Department of Innovation and Transformation, Beijing HuiLongGuan
Hospital, Peking University HuiLongGuan Clinical Medical School, Beijing,
China
(Li) The Key Laboratory of Geriatrics, Beijing Institute of Geriatrics,
Institute of Geriatric Medicine, Chinese Academy of Medical Sciences,
Beijing Hospital/National Center of Gerontology of National Health
Commission, Beijing, China
(Sun) Department of Radiology, Beijing First Hospital of Integrated
Chinese and Western Medicine, Beijing, China
Publisher
Frontiers Media SA
Abstract
Introduction: Several small sample-sized clinical trials have demonstrated
a beneficial effect of statin on depressive mood among major depressive
disorder (MDD) patients. However, observational studies have showed the
increased risk of anxiety/depression with statin treatment. Therefore, we
aimed to evaluate the effects of statin on depressive mood and
inflammation status among MDD patients. Method(s): We performed an
updated meta-analysis RCTs identified in systematic searches of PubMed,
Cochrane library, Embase, ClinicalTrials.gov, CNKI, Wan fang, VIP, and
SinoMed database (up to August 2023). The primary endpoint was the
Hamilton depression rating scale (HDRS). The secondary endpoints were rate
of response to treatment, remission rate, levels of C-reactive protein
(CRP), cognition and blood lipid. We evaluated the certainty of the
evidence using the Grading of Recommendations Assessment, Development, and
Evaluation (GRADE) approach. Result(s): The search identified seven
RCTs involving 448 patients with a median follow-up of 10.4 weeks (range,
6-12 weeks). Compared with selective serotonin reuptake inhibitors (SSRIs)
alone, treatment with statin plus SSRIs was associated with a
significantly decreased HDRS [mean difference (MD) = -2.79; 95% confidence
interval (CI): -3.83 to -1.76] and C-reactive protein (MD = -0.42 mg/L;
95% CI: -0.53 to -0.12 mg/L), and decreased levels of lipid profiles (P <
0.05). Moreover, statin plus SSRIs was associated with a comparable rate
of treatment response [relative risk (RR) = 1.26; 95% CI: 0.98 to 1.62],
remission rate (RR = 1.33; 95% CI: 0.89 to 1.99). Meta-regression
indicated that the follow-up period was a source of heterogeneity
regarding the HDRS (r = 0.302, P = 0.041). The quality of evidence was
rated as moderate for HDRS and response rate according to the GRADE.
 Conclusion(s): Statin could safely and effectively improve the
symptoms of depression and inflammation status among MDD patients.
Systematic review registration: https://inplasy.com/inplasy-2022-3-0016/,
identifier INPLASY2022230016. Copyright © 2023 Xiao, Deng, Li,
Sun and Tian.

<2>
Accession Number
2028846499
Title
Assessing the Efficacy of Omega-3 Fatty Acids + Statins vs. Statins Only
on Cardiovascular Outcomes: A Systematic Review and Meta-Analysis of
40,991 Patients.
Source
Current Problems in Cardiology. 49(2) (no pagination), 2024. Article
Number: 102245. Date of Publication: February 2024.
Author
Irfan A.; Haider S.H.; Nasir A.; Larik M.O.; Naz T.
Institution
(Irfan, Haider, Nasir, Larik, Naz) Department of Internal Medicine, Dow
Medical College, Dow University of Health Sciences, Karachi, Pakistan
Publisher
Elsevier Inc.
Abstract
Background: Clinical guidelines recommend statin use in patients with a
vast array of cardiovascular disturbances. However, there is insufficient
evidence regarding the concomitant use of omega-3 fatty acids in addition
to statins. This meta-analysis aims to uncover the complete effects of
this combination therapy on cardiovascular outcomes, lipid biomarkers,
inflammatory markers, and plaque markers. Method(s): A detailed
literature search was conducted using PubMed, Cochrane, and MEDLINE
databases, and all the relevant studies found up to September 2023 were
included. The primary outcomes assessed in this meta-analysis was 1)
Composite of fatal and non-fatal myocardial infarction, 2) Composite of
fatal and non-fatal stroke, 3) Coronary revascularization, 4) Death due to
cardiovascular causes, 5) MACE (Major Adverse Cardiovascular Events), 6)
Unstable angina, 7) Hospitalization due to unstable angina, 8) and lipid
volume index. Secondary outcomes included lipid markers, hsCRP, EPA
levels, and EPA/AA ratio. Result(s): 14 RCTs were included, featuring
a total of 40,991 patients. Patients receiving the omega-3 + statin
regimen were associated with a statistically significant decrease in the
incidence of MI, MACE, unstable angina, hospitalization due to unstable
angina, Total cholesterol levels, triglycerides, hsCRP, and lipid volume
index in comparison to their counterparts receiving placebo + statin (P <
0.05). In contrast, our analysis found no statistically significant
difference in the incidence of fatal and non-fatal stroke, coronary
revascularization, and cardiovascular mortality. Conclusion(s): Our
research reinforces that all patients, regardless of their cardiovascular
health, may benefit from adding omega-3 fatty acids to their statin
therapy. Copyright © 2023 Elsevier Inc.

<3>
Accession Number
2028809583
Title
Effectiveness and safety of injectable PCSK9 inhibitors in dyslipidaemias'
treatment and cardiovascular disease prevention: An overview of 86
systematic reviews and a network metaanalysis.
Source
Clinica e Investigacion en Arteriosclerosis. (no pagination), 2023. Date
of Publication: 2023.
Author
Pamporis K.; Karakasis P.; Simantiris S.; Sagris M.; Bougioukas K.I.;
Fragakis N.; Tousoulis D.
Institution
(Pamporis, Simantiris, Sagris, Tousoulis) 1st Cardiology Clinic, National
and Kapodistrian University of Athens, School of Medicine, Hippokration
General Hospital, Athens, Greece
(Pamporis, Karakasis, Bougioukas) Department of Hygiene, Social-Preventive
Medicine & Medical Statistics, School of Medicine, Faculty of Health
Sciences, Aristotle University of Thessaloniki, University Campus,
Thessaloniki 54124, Greece
(Karakasis, Fragakis) Second Department of Cardiology, Hippokration
General Hospital, Aristotle University of Thessaloniki, Greece
Publisher
Sociedad Espanola de Arteriosclerosis
Abstract
Objective: Multiple systematic reviews (SR) have been performed on the
effects of proprotein convertase subtilisin/kexin type 9 inhibitors
(PCSK9i), often providing conflicting findings. This overview and network
meta-analysis (NMA) aimed to summarize SR findings on the efficacy and
safety of PCSK9i and provide an updated NMA. Material(s) and
Method(s): MEDLINE (Pubmed), Scopus, Cochrane, Epistemonikos and Google
Scholar were searched from inception to September 21, 2023 for SRs of
randomized controlled trials (RCTs) and from January 1, 2020 to September
21, 2023 for additional RCTs. Double-independent study selection, data
extraction and quality assessment were performed. Qualitative analysis was
performed for SRs and a frequentist random-effects model NMA was performed
for RCTs. Result(s): Totally, 86 SRs and 76 RCTs were included.
Alirocumab (77/86 [90%]) and evolocumab (73/86 [85%]) were mostly
analyzed. Associations from SRs (35/42 [83%]) and the updated NMA
indicated PCSK9i benefit on major adverse cardiovascular events (MACEs).
Reductions were also noted for cerebrovascular events (47/66 [71%]),
coronary revascularization (29/33 [88%]) and myocardial infarction (41/63
[65%]). Alirocumab was associated with reductions on all-cause mortality
(RR = 0.82, 95%CI [0.72,0.94]). Data on any CV event reduction were
conflicting (7/16 [44%]). Inclisiran appeared effective only on MACEs (RR
= 0.76, 95%CI [0.61,0.94]). No reductions in heart failure were observed
(0/16). No increases were identified between PCSK9i and any (0/35) or
serious adverse events (0/52). However, PCSK9i were associated with
injection-site reactions (20/28 [71%]). Conclusion(s): PCSK9i
appeared to be effective in CV outcomes and their clinical application was
generally safe. Copyright © 2023 Sociedad Espanola de
Arteriosclerosis

<4>
Accession Number
2028728999
Title
Effect of using hypotension prediction index versus conventional
goal-directed haemodynamic management to reduce intraoperative hypotension
in non-cardiac surgery: A randomised controlled trial.
Source
Journal of Clinical Anesthesia. 93 (no pagination), 2024. Article Number:
111348. Date of Publication: May 2024.
Author
Yoshikawa Y.; Maeda M.; Kunigo T.; Sato T.; Takahashi K.; Ohno S.;
Hirahata T.; Yamakage M.
Institution
(Yoshikawa, Maeda, Kunigo, Sato, Takahashi, Ohno, Hirahata, Yamakage)
Department of Anaesthesiology, Sapporo Medical University School of
Medicine, South1 West16 291, Chuoku, Sapporo 060-8543, Japan
Publisher
Elsevier Inc.
Abstract
Study objective: It remains unclear whether it is the hypotension
prediction index itself or goal-directed haemodynamic therapy that
mitigates intraoperative hypotension. Design(s): A single centre
randomised controlled trial. Setting(s): Sapporo Medical University
Hospital. Patient(s): A total of 64 adults patients undergoing major
non-cardiac surgery under general anaesthesia. Intervention(s):
Patients were randomly assigned to either group receiving conventional
goal-directed therapy (FloTrac group) or combination of the hypotension
prediction index and conventional goal-directed therapy (HPI group). To
investigate the independent utility of the index, the peak rates of
arterial pressure and dynamic arterial elastance were not included in the
treatment algorithm for the HPI group. Measurements: The primary outcome
was the time-weighted average of the areas under the threshold. Secondary
outcomes were area under the threshold, the number of hypotension events,
total duration of hypotension events, mean mean arterial pressure during
the hypotension period, number of hypotension events with mean arterial
pressure < 50 mmHg, amounts of fluids, blood products, blood loss, and
urine output, frequency and amount of vasoactive agents, concentration of
haemoglobin during the monitoring period, and 30-day mortality. Main
Result(s): The time-weighted average of the area below the threshold was
lower in the HPI group than in the control group; 0.19 mmHg (interquartile
range, 0.06-0.80 mmHg) vs. 0.66 mmHg (0.28-1.67 mmHg), with a median
difference of -0.41 mmHg (95% confidence interval, -0.69 to -0.10 mmHg), p
= 0.005. Norepinephrine was administered to 12 (40%) and 5 (17%) patients
in the HPI and FloTrac groups, respectively (p = 0.045). No significant
differences were observed in the volumes of fluid and blood products
between the study groups. Conclusion(s): The current randomised
controlled trial results suggest that using the hypotension prediction
index independently lowered the cumulative amount of intraoperative
hypotension during major non-cardiac surgery. Copyright © 2023
Elsevier Inc.

<5>
Accession Number
2026919950
Title
Noninvasive respiratory support preventing reintubation after pediatric
cardiac surgery-A systematic review.
Source
Paediatric Anaesthesia. (no pagination), 2023. Date of Publication: 2023.
Author
Kuitunen I.; Uimonen M.
Institution
(Kuitunen) University of Eastern Finland, Institute of Clinical Medicine
and Department of Pediatrics, Kuopio, Finland
(Kuitunen) Department of Pediatrics, Kuopio University Hospital, Kuopio,
Finland
(Uimonen) Department of Cardiothoracic Surgery, Tampere Heart Hospital,
Tampere, Finland
Publisher
John Wiley and Sons Inc
Abstract
Objective: To analyze the optimal postextubation respiratory support in
pediatric cardiac surgery patients. Design(s): Systematic review of
randomized controlled trials. Setting(s): Pediatric or neonatal
intensive care units. Participant(s): All aged children (<16 years)
having cardiac surgery and postoperative invasive ventilation.
 Intervention(s): Noninvasive respiratory support, including high flow
nasal cannula (HFNC), conventional oxygen therapy (COT), noninvasive
positive pressure ventilation (NIPPV), continuous positive pressure
(CPAP), and noninvasive high-frequency oscillatory ventilation (NHFOV).
Measurement and Main Results: Studies were not pooled for statistical
synthesis due to the limited number and quality of the included studies.
Risk ratios with 95% confidence intervals were calculated for individual
studies. A total of 167 studies were screened and six were included. The
risk of bias was low in one, high in one, and had some concerns in four of
the studies. Extubation failure (defined as reintubation) was the main
outcome of interest. Risk ratio for reintubation was 0.10 (CI 0.02-0.40)
and 1.07 (CI 0.16-7.26) in HFNC versus COT, 0.49 (CI 0.05-5.28) in HFNC
versus NIPPV, 0.40 (CI 0.08-1.94) in HFNOV versus CPAP, 0.75 (CI
0.26-2.18) in HFNOV versus NIPPV, and 1.37 (CI 0.33-5.73) in CPAP versus
NIPPV. Treatment durations did not differ between the groups.
 Conclusion(s): We did not find clear evidence of a difference in
reintubation rates and other clinical outcomes between different
noninvasive ventilation strategies. Evidence certainty was assessed to be
very low due to the risk of bias, the small number of included studies,
and high imprecision. Future quality studies are needed to determine the
optimal postextubation support in pediatric cardiac surgery
patients. Copyright © 2023 The Authors. Pediatric Anesthesia
published by John Wiley & Sons Ltd.

<6>
Accession Number
2026919536
Title
Top 100 cited articles in the thromboangiitis obliterans: a bibliometric
analysis and visualized study.
Source
European Journal of Medical Research. 28(1) (no pagination), 2023. Article
Number: 551. Date of Publication: December 2023.
Author
Liu Z.; Ning W.; Liang J.; Zhang T.; Yang Q.; Zhang J.; Xie M.
Institution
(Liu, Ning, Liang, Zhang, Yang, Zhang, Xie) Department of Gastrointestinal
Surgery, Affiliated Hospital of Zunyi Medical University, Guizhou, Zunyi,
China
Publisher
BioMed Central Ltd
Abstract
Objective: Thromboangiitis obliterans (TAO) is one of the most common
types of peripheral arterial disease (PAD). This study aimed to explore
the characteristics of the top 100 most cited articles in the TAO.
 Method(s): A bibliometric analysis based on the Web of Science (WOS)
database was performed. Literature was retrieved and ranked by the
citations. Listed below are the top 100 citations, including original
articles, reviews, full-length proceeding papers, and case reports that
were included for analysis. The type of literature, research areas, and
languages were recorded. The trends of citations including the total
citations, an analysis of publication and citation numbers were conducted
each year. We analyzed citations from highly cited countries, authors,
institutions, and journals. Research hotspots were gathered by a
visualized analysis of author keywords. Result(s): Most of the highly
cited literature was original articles. A rising trend was observed in the
number of citations per year. The peaks in the number of highly cited
articles appeared in the year 1998 and 2006. The majority of the articles
focused on the cardiovascular system and surgery. Journal of Vascular
Surgery published most of the highly cited articles. The USA and Japan
contributed nearly half the number of highly cited articles. Mayo Clinic
and Nagoya University were highly cited institutions. Shionoya S and Olin
JW were both the author with the largest number of citations and the most
highly cited author in the reference. Articles that were highly cited most
often addressed the following topics: "vasculitis", "autoimmune disease",
and "critical limb ischemia". Keywords that were mostly used in recent
years were "stem cell therapy", "progenitor therapy", and
"immunoadsorption". The detection of bursts of author keywords showed the
following: "permeability", "differentiation", and "critical limb ischemia"
are recent keywords that have burst. Conclusion(s): In this study,
the highly cited contributors in the field of TAO research were
identified. Most cited articles in the top 100 focused on the
cardiovascular system and surgery. Treatment and pathophysiology including
stem cell therapy, progenitor therapy, genetics, autoimmunity, and
inflammation are the hotspots of TAO. Copyright © 2023, The
Author(s).

<7>
Accession Number
642903220
Title
Several key issues must be noted in determining postoperative analgesic
efficacy of intercostal nerve block for thoracoscopic surgery.
Source
Journal of cardiothoracic surgery. 18(1) (pp 350), 2023. Date of
Publication: 01 Dec 2023.
Author
Li X.-T.; Yang W.-H.; Xue F.-S.
Institution
(Li, Yang, Xue) Department of Anesthesiology, Beijing Friendship Hospital,
Capital Medical University, No. 95 Yong-An Road, Xi-Cheng District,
Beijing 100050, China
Abstract
The letter to the editor was written in response to "The effect of
ultrasound-guided intercostal nerve block on postoperative analgesia in
thoracoscopic surgery: a randomized, double-blinded, clinical trial",
which was recently published by Li et al. (J Cardiothorac Surg 18(1):128,
2023). In this article, Li et al. showed that addition of a preoperative
intercostal nerve block to the multimodal analgesic strategy significantly
reduced the pain scores within 48 h after surgery. However, we noted
several issues in this study that were not well addressed. They were no
use of a standard opioid-sparing multimodal analgesic strategy recommended
in the current Enhanced Recovery After Surgery protocols for thoracic
surgery, the lack of clear description for reasonable selection of rescue
analgesics, the interpretion of between-group differences in the
postoperative pain scores based on only statistical differences rather
than clinically meaningful differences, inclusion of patients who were not
blinded to study intervention, not reporting cumulative opioid consumption
and complications of intercostal nerve block. We believe that
clarification of these issues is not only useful for improving design
quality of randomized clinical trials which assess postoperative analgesic
efficacy of nerve blocks, but also is helpful for the readers who want to
use an opioid-sparing multimodal protocol including a nerve block in
patients undergoing thoracoscopic surgery. Copyright © 2023. The
Author(s).

<8>
Accession Number
2026810842
Title
Quality of Life After Percutaneous Coronary Intervention Versus Coronary
Artery Bypass Grafting.
Source
Journal of the American Heart Association. 12(22) (no pagination), 2023.
Article Number: e030069. Date of Publication: 21 Nov 2023.
Author
Dimagli A.; Spadaccio C.; Myers A.; Demetres M.; Rademaker-Havinga T.;
Stone G.W.; Spertus J.A.; Redfors B.; Fremes S.; Gaudino M.; Creber R.M.
Institution
(Dimagli) Bristol Heart Institute, University of Bristol, Bristol, United
Kingdom
(Dimagli, Demetres, Gaudino) Department of Cardiothoracic Surgery, Weill
Cornell Medical College, New York, United States
(Spadaccio) Mayo Clinic Department of Cardiovascular Surgery, Rochester,
MN, United States
(Myers) Columbia University Irving Medical Center, New York, NY, United
States
(Rademaker-Havinga) Cardialysis, Rotterdam, Netherlands
(Stone) Zena and Michael A. Wiener Cardiovascular Institute, Icahn School
of Medicine at Mount Sinai, New York, NY, United States
(Spertus) Saint Luke's Mid America Heart Institute, University of
Missouri, Kansas City, MO, United States
(Redfors) Sahlgrenska University Hospital, Gothenburg, Sweden
(Fremes) Sunnybrook Health Sciences Center, University of Toronto,
Toronto, Canada
(Creber) Columbia University School of Nursing, Columbia University Irving
Medical Center, New York, NY, United States
Publisher
American Heart Association Inc.
Abstract
BACKGROUND: Differences in quality of life (QoL) after coronary artery
bypass grafting (CABG) compared with percutaneous coronary intervention
(PCI) are not well characterized. We aimed to compare the short-and
long-term effects of CABG versus PCI on QoL. METHODS AND RESULTS: We
performed a systematic review and meta-analysis of randomized controlled
trials comparing CABG versus PCI using the Seattle Angina Questionnaire
(SAQ)-Angina Frequency, SAQ-QoL, SAQ-Physical Limitations, EuroQoL-5D, and
Short-Form Questionnaire. We calculated mean changes within each group
from baseline to 1, 6, 12, and 36 to 60 months (latest follow-up) and the
weighted mean differences between groups using inverse-variance methods. A
total of 10 760 patients were enrolled in 5 trials. From baseline to 12
months and 36 to 60 months, the mean change in SAQ-Angina Frequency was
>22 points (95% CI, 21.0-25.6) after both PCI and CABG. The mean
difference in SAQ-Angina Frequency was similar between procedures at 1
month and at 36 to 60 months but favored CABG at 12 months (1.97 [95% CI,
0.68-3.26]). SAQ-QoL favored PCI at 1 month (-2.92 [95% CI, -4.66 to
-1.18]) and CABG at 6 (2.50 [95% CI, 1.02-3.97]), 12 (3.30 [95% CI,
1.78-4.82]), and 36 to 60 months (3.17 [95% CI, 0.54 5.80). SAQ-Physical
Limitations (-12.61 [95% CI, -16.16 to -9.06]) and EuroQoL-5D (-0.07 [95%
CI, -0.08 to -0.07) favored PCI at 1 month. Short-Form
Questionnaire-Physical Component favored CABG at 12 months (1.18 [95% CI,
0.46-1.90]). CONCLUSION(S): Both PCI and CABG improved long-term
disease-specific and generic QoL. Copyright © 2023 The Authors.

<9>
Accession Number
2028689693
Title
Coronary calcification in patients presenting with acute coronary
syndromes: insights from the MATRIX trial.
Source
European Heart Journal: Acute Cardiovascular Care. 12(11) (pp 782-791),
2023. Date of Publication: 01 Nov 2023.
Author
Sanz-Sanchez J.; Garcia-Garcia H.M.; Branca M.; Frigoli E.; Leonardi S.;
Gagnor A.; Calabro P.; Garducci S.; Rubartelli P.; Briguori C.; Ando G.;
Repetto A.; Limbruno U.; Garbo R.; Sganzerla P.; Russo F.; Lupi A.;
Cortese B.; Ausiello A.; Ierna S.; Esposito G.; Santarelli A.; Sardella
G.; Varbella F.; Tresoldi S.; de Cesare N.; Rigattieri S.; Zingarelli A.;
Tosi P.; van 't Hof A.; Boccuzzi G.; Omerovic E.; Sabate M.; Heg D.;
Vranckx P.; Valgimigli M.
Institution
(Sanz-Sanchez) Cardiology Department, Hospital Universitari i Politecnic
La Fe, Valencia, Spain
(Sanz-Sanchez) Centro de Investigacion Biomedica en Red (CIBERCV), Madrid,
Spain
(Garcia-Garcia) Interventional Cardiology, MedStar Washington Hospital
Center, 10 Irving St NW, Washington, DC 2001, United States
(Branca, Frigoli, Heg) CTU Bern, University of Bern, Bern, Switzerland
(Leonardi, Repetto) Coronary Care Unit, Department of Molecular Medicine,
University of Pavia, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
(Gagnor) Department of Invasive Cardiology, Maria Vittoria Hospital,
Turin, Italy
(Calabro) Division of Cardiology, 'Sant'Anna e San Sebastiano' Hospital,
Caserta, Italy
(Calabro) Department of Translational Medicine, University of Campania
'Luigi Vanvitelli', Caserta, Italy
(Garducci) Cardiology Department, A.O. Ospedale Civile di Vimercate,
Vimercate, Italy
(Rubartelli) Department of Cardiology, ASL3 Ospedale Villa Scassi, Genoa,
Italy
(Briguori) Cardiology Department, Clinica Mediterranea, Naples, Italy
(Ando) Azienda Ospedaliera Universitaria Policlinico 'Gaetano Martino',
University of Messina, Messina, Italy
(Limbruno) UO Cardiologia, ASL 9 Grosseto, Grosseto, Italy
(Garbo, Boccuzzi) Maria Pia Hsopital, GVM Care & Research, Turin, Italy
(Sganzerla) Cardiology Department, AO Ospedale Treviglio-Caravaggio,
Treviglio, Italy
(Russo) Interventional Cardiology Unit, IRCCS San Raffaele Scientific
Institute, Milan, Italy
(Lupi) Division of Cardiology, ASL VCO, Verbania, Italy
(Cortese) Cardiology Department, Ospedale FatebeneFratelli, Milano, Italy
(Ausiello) Cardiology Department, Casa di Cura Villa Verde, Taranto, Italy
(Ierna) Cardiology Department, Ospedale Sirai, Carbonia, Italy
(Esposito) Division of Cardiology, Department of Advanced Biomedical
Sciences, Federico II University of Naples, Naples, Italy
(Santarelli) Cardiovascular Department, Infermi Hospital, Rimini, Italy
(Sardella) Policlinico Umberto I, 'Sapienza' University of Rome, Rome,
Italy
(Varbella) Cardiology Unit, Ospedali Riuniti di Rivoli, ASL Torino 3,
Turin, Italy
(Tresoldi) Cardiology Department, Azienda Ospedaliera Ospedale di Desio,
Desio, Italy
(de Cesare) Cardiology Department, Policlinico San Marco, Zingonia, Italy
(Rigattieri) Interventional Cardiology Unit, Sandro Pertini Hospital Rome,
Rome, Italy
(Zingarelli) Cardiology Department, IRCCS Azienda Ospedaliera
Universitaria San Martino, San Martino, Italy
(Tosi) Cardiology Department, Mater Salutis Hospital, Legnago, Italy
(van 't Hof) Cardiovascular Research Institute Maastricht (CARIM),
Maastricht University, Maastricht, Netherlands
(Omerovic) Cardiology Department, Ahlgrenska University Hospital,
Goteborg, Sweden
(Sabate) Hospital Clinic, University of Barcelona, Thorax Institute,
Department of Cardiology, Barcelona, Spain
(Vranckx) Department of Cardiology and Critical Care Medicine, Hartcentrum
Hasselt, Jessa Ziekenhuis, Hasselt, Belgium
(Valgimigli) Division of Cardiology, Cardiocentro Ticino Institute, Ente
Ospedaliero Cantonale, Via Tesserete 48, Lugano 6900, Switzerland
Publisher
Oxford University Press
Abstract
Aims The role of coronary calcification on clinical outcomes among
different revascularization strategies in patients presenting with acute
coronary syndromes (ACSs) has been rarely investigated. The aim of this
investigation is to evaluate the role of coronary calcification, detected
by coronary angiography, in the whole spectrum of patients presenting with
acute ACS. Methods and results The present study was a post hoc analysis
of the MATRIX programme. The primary endpoint was major adverse
cardiovascular events (MACE), defined as the composite of all-cause
mortality, myocardial infarction (MI), or stroke up to 365 days. Among the
8404 patients randomized in the MATRIX trial, data about coronary
calcification were available in 7446 (88.6%) and therefore were included
in this post hoc analysis. Overall, 875 patients (11.7%) presented with
severe coronary calcification, while 6571 patients (88.3%) did not present
severe coronary calcification on coronary angiography. Fewer patients with
severe coronary calcification underwent percutaneous coronary intervention
whereas coronary artery bypass grafting or medical therapy-only was more
frequent compared with patients without severe calcification. At 1-year
follow-up, MACE occurred in 237 (27.1%) patients with severe calcified
coronary lesions and 985 (15%) patients without severe coronary calcified
lesions [hazard ratio (HR) 1.91; 95% confidence interval (CI) 1.66-2.20, P
< 0.001]. All-cause mortality was 8.6% in patients presenting with and
3.7% in those without severe coronary calcification (HR 2.38, 1.84-3.09, P
< 0.001). Patients with severe coronary calcification incurred higher rate
of MI (20.1% vs. 11.5%, HR 1.81; 95% CI 1.53-2.1, P < 0.001) and similar
rate of stroke (0.8% vs. 0.6%, HR 1.35; 95% CI 0.61-3.02, P = 0.46).
Conclusion Patients with ACS and severe coronary calcification, as
compared to those without, are associated with worse clinical outcomes
irrespective of the management strategy. Copyright © The
Author(s) 2023. Published by Oxford University Press on behalf of the
European Society of Cardiology. All rights reserved.

<10>
Accession Number
2026934703
Title
Minimally Invasive Surgical Versus Transcatheter Aortic Valve Replacement:
A Retrospective Observational Single-Center Study in Japan.
Source
Innovations: Technology and Techniques in Cardiothoracic and Vascular
Surgery. (no pagination), 2023. Date of Publication: 2023.
Author
Yamamoto H.; Nakayama T.; Ishii N.; Nakamura Y.
Institution
(Yamamoto) Department of Cardiovascular Medicine, Narita-Tomisato
Tokushukai Hospital, Japan
(Nakayama, Nakamura) Department of Cardiovascular Surgery, Chiba-Nishi
General Hospital, Matsudo, Japan
(Ishii) Department of Gastroenterology, Tokyo Shinagawa Hospital, Japan
Publisher
SAGE Publications Ltd
Abstract
Objective: This study aimed to compare the outcomes of minimally invasive
aortic valve replacement (MICS-AVR) versus transfemoral transcatheter
aortic valve replacement (TF-TAVR) in Asian patients. Method(s): We
conducted a retrospective, observational, single-center study in Japan,
including cases of MICS-AVR (n = 202) and TF-TAVR (n = 248) between 2014
and 2021. In a total of 450 cases, propensity score matching was performed
at a ratio of 1:1, resulting in 96 pairs. Furthermore, we performed
competing-risk regression and mediation analyses to determine the
treatment effect on outcomes of interests, considering death as a
competing risk, and to evaluate the mediation effect of paravalvular leak
(PVL) severity. Result(s): There were similar incidences of all-cause
death, cardiac death, stroke and cerebral hemorrhage, and aortic valve
reintervention between the 2 groups. However, the TF-TAVR cohort had a
longer hospital length of stay and higher rates of significant PVL
compared with the MICS-AVR cohort. Multivariable-adjusted Cox regression
analyses revealed that heart failure hospitalization (hazard ratio [HR] =
0.129, 95% confidence interval [CI]: 0.038 to 0.445, p = 0.001) and
permanent pacemaker implantation (HR = 0.050, 95% CI: 0.006 to 0.409, p =
0.005) favored MICS-AVR. Competing-risk regression analyses confirmed
similar findings. All outcomes were unrelated to PVL severity.
 Conclusion(s): To our knowledge, this is the first comparative study
of clinical outcomes in Asian patients undergoing MICS-AVR versus TF-TAVR,
revealing that MICS-AVR could be a feasible and efficient alternative to
TF-TAVR. Future larger-scale randomized controlled trials are needed to
validate the present results. Copyright © The Author(s) 2023.

<11>
Accession Number
642905502
Title
Functionally unicuspid aortic valve in an adult: case report and
literature review.
Source
Current problems in cardiology. (pp 102223), 2023. Date of Publication:
30 Nov 2023.
Author
Abraham A.; Charles K.; Pozo D.; Bishev D.; Pondicherry-Harish R.
Institution
(Abraham, Charles, Pozo, Bishev) University of Central Florida College of
Medicine, Internal Medicine Residency Program, Graduate Medical Education
/ HCA Florida North Florida Hospital6500 W Newberry Rd, Gainesville, FL
32605, Puerto Rico
(Pondicherry-Harish) University of Central Florida College of Medicine,
Graduate Medical Education / HCA Florida North Florida Hospital, Internal
Medicine Residency Program, 6500 W Newberry Rd, Gainesville, Florida,
32605; The Cardiac and Vascular Institute, 1151 NW 64th Terrace,
Gainesville, Florida, 32605
Abstract
Aortic stenosis is one of the most prevalent cardiac valvular diseases
throughout the world and has a significant impact on quality of life.
While there are several etiologies, we will be discussing the case of a
male in his mid-thirties of southeast Asian descent with a bicuspid aortic
valve which was found to be functionally unicuspid and complicated by
aortic dilation. Following a comprehensive review of literature, it
appears this subset of aortic stenosis is not commonly encountered. In
addition to presenting this fascinating case, we will review the
epidemiology, classification and management of aortic stenosis.
Furthermore, we will examine the latest evidence-based literature on
bicuspid aortic valve and unicuspid aortic valve and discuss interventions
and diagnostic tools that may improve clinical prognosis. Copyright
© 2023. Published by Elsevier Inc.

<12>
Accession Number
642904757
Title
Retraction Speed and Chronic Post-Sternotomy Pain: A Randomized Controlled
Trial.
Source
The Journal of thoracic and cardiovascular surgery. (no pagination),
2023. Date of Publication: 30 Nov 2023.
Author
Phelan R.; Petsikas D.; Shelley J.; Hopman W.M.; DuMerton D.; Parry M.;
Payne D.; Allard R.; Cummings M.; Parlow J.L.; Tanzola R.; Wang L.T.;
Stewart C.; Saha T.K.
Institution
(Phelan, Shelley, DuMerton, Allard, Cummings, Parlow, Tanzola, Wang, Saha)
Department of Anesthesiology and Perioperative Medicine, Queen's
University, Kingston, ON, Canada
(Petsikas, Payne) Division of Cardiac Surgery, Department of Surgery,
Queen's University, Kingston, ON, Canada
(Hopman) Kingston General Health Research Institute (KGHRI), Kingston
Health Sciences Centre, Kingston, ON, Canada; Department of Public Health
Sciences, Queen's University, Kingston, ON, Canada
(Parry) Lawrence S Bloomberg Faculty of Nursing, University of Toronto,
Toronto, ON, Canada
(Stewart) Queen's University School of Medicine, Queen's University,
Kingston, ON, Canada
Abstract
OBJECTIVES: Approximately 30% of patients develop chronic post-sternotomy
pain (CPSP) following cardiac surgery with sternal retraction. Risk
factors have been described but no causal determinants identified.
Investigators hypothesized that opening the sternum slowly would impart
less force (and thereby less nerve/tissue damage) and translate to a
reduced incidence of CPSP. The main objectives were to determine if slower
sternal retraction would reduce the incidence of CPSP and improve
health-related quality of life (HRQoL). METHOD(S): Patients
undergoing coronary artery bypass graft surgery were recruited to this
randomized controlled trial. Patients were randomized to Slow or Standard
retraction (i.e., sternum opened over 15 minutes vs. 30 seconds
respectively). While the anesthesiologist and surgeon were aware of the
randomization, the patients, assessors and postoperative nursing staff
remained blinded. Sternotomy pain and analgesics were measured in
hospital. At 3, 6 and 12 months postoperatively, all patients completed
the Medical Outcomes Survey Short Form (SF-36) and reported on CPSP and
complications requiring rehospitalization. Thirty-day rehospitalizations
and mortality were recorded. RESULT(S): In total, 326 patients
consented to participate and 313 were randomized: Slow (n=159) vs.
Standard retraction (n=154). No clinically relevant differences were
detected in acute pain, analgesic consumption or the incidence of CPSP or
HRQoL. Although the slow group had significantly more hospitalizations at
3 & 12 months postoperatively, the reasons were unrelated to retraction
speed. No differences were observed in 30-day rehospitalizations or
mortality. CONCLUSION(S): All outcomes were consistent with previous
reports, but no clinically significant differences were observed with
retraction speed. Copyright © 2023. Published by Elsevier Inc.

<13>
Accession Number
2028619955
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. Part C. 49(1) (no pagination), 2024.
Article Number: 102090. Date of Publication: January 2024.
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, MA, United States
(Joury) Division of Cardiology, McGill University Health Centre, McGill
University, Montreal, QC, Canada
(Joury) King Salman Heart Center, King Fahad Medical City, Riyadh, Saudi
Arabia
(Tutor, Desai, Eiswirth, Krim, Wever-Pinzon, Lavie, Ventura) John Ochsner
Heart and Vascular Institute, Ochsner Clinic Foundation, New Orleans, LA,
United States
(Desai, Eiswirth, Krim, Wever-Pinzon, Lavie, Ventura) The University of
Queensland Ochsner Clinical School, Faculty of Medicine, The University of
Queensland, New Orleans, LA, United States
Publisher
Elsevier Inc.
Abstract
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. 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 5
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 8-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 1 year. 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. Copyright © 2023
Elsevier Inc.

<14>
Accession Number
2028558027
Title
Efficacy and Complication Profiles of Left Ventricular Assist Devices in
Adult Heart Failure Management: A Systematic Review and Meta-Analysis.
Source
Current Problems in Cardiology. Part C. 49(1) (no pagination), 2024.
Article Number: 102118. Date of Publication: January 2024.
Author
Llerena-Velastegui J.; Santafe-Abril G.; Villacis-Lopez C.; Hurtado-Alzate
C.; Placencia-Silva M.; Santander-Aldean M.; Trujillo-Delgado M.;
Freire-Ona X.; Santander-Fuentes C.; Velasquez-Campos J.
Institution
(Llerena-Velastegui, Santander-Aldean) Pontifical Catholic University of
Ecuador, Medical School, Quito, Ecuador
(Santafe-Abril) Juan N. Corpas University Foundation, Medical School,
Bogota, Colombia
(Villacis-Lopez) Central University of Ecuador, Medical School, Quito,
Ecuador
(Hurtado-Alzate) La Sabana University, Medical School, Bogota, Colombia
(Placencia-Silva, Velasquez-Campos) Equinoctial Technological University,
Medical School, Quito, Ecuador
(Trujillo-Delgado) Catholic University of Santiago de Guayaquil, Medical
School, Guayaquil, Ecuador
(Freire-Ona) Regional Autonomous University of Los Andes, Medical School,
Ambato, Ecuador
(Santander-Fuentes) San Francisco University of Quito, Medical School,
Quito, Ecuador
Publisher
Elsevier Inc.
Abstract
Left ventricular assist devices (LVADs) have marked a milestone in the
evolution of treatment for patients with end-stage heart failure. Their
popularity and use are steadily rising. This systematic review and
meta-analysis aimed to evaluate the effectiveness of LVADs in improving
the survival rate of patients with end-stage heart failure and to identify
the complications or adverse events associated with LVAD use. Articles for
this systematic review and meta-analysis were sourced from PubMed, Google
Scholar, and the Cochrane Library databases. Only studies that met the
predefined PICOS eligibility criteria were analyzed. LVADs significantly
improved the 6, 12, 18, and 24-month survival rates in patients with
end-stage heart failure compared to no LVAD or other therapies: OR 1.87
(95%CI [1.27-2.76]), OR 2.29 (95%CI [1.61-3.26]), OR 2.07 (95%CI
[0.61-6.61]), and OR 1.73 (95%CI [0.88-3.41]) for 6, 12, 18, and 24
months, respectively. The incidence of adverse events was significantly
higher in the LVAD group than in the non-LVAD treatments: bleeding OR
12.53 (95%CI [2.60-60.41]), infections OR 4.15 (95%CI [1.19-14.45]),
stroke OR 2.58 (95%CI [1.38-4.82]), and arrhythmia OR 2.81 (95%CI
[1.64-4.80]). Overall, complications were higher in the LVAD group
compared to those without LVAD treatment. Hospital readmissions due to
adverse events were significantly more frequent in the LVAD group, OR 2.98
(95%CI [1.38-6.43]). Despite the elevated risk of adverse events
associated with LVADs, these devices have demonstrated a notable
enhancement in the survival outcomes for patients with end-stage heart
failure. Copyright © 2023 Elsevier Inc.

<15>
Accession Number
2028549045
Title
Outcomes of coronary revascularization vs. optimal medical therapy alone
for ischemic left ventricular dysfunction: A meta-analysis of randomized
controlled trials.
Source
Kardiologia Polska. 81(9) (pp 909-912), 2023. Date of Publication: 2023.
Author
Bujak K.; Hudzik B.; Pyka L.; Skrzypek M.; Brugaletta S.; Sabate M.;
Tajstra M.; Legutko J.; Wojakowski W.; Gasior M.
Institution
(Bujak, Hudzik, Pyka, Tajstra, Gasior) 3rd Department of Cardiology,
Faculty of Medical Sciences in Zabrze, Medical University of Silesia,
Katowice, Poland
(Bujak, Brugaletta, Sabate) Hospital Clinic, Cardiovascular Clinic
Institute, Institut d'Investigacions Biomediques August Pi i Sunyer
(IDIBAPS), University of Barcelona, Barcelona, Spain
(Skrzypek) Department of Biostatistics, Faculty of Health Sciences in
Bytom, Medical University of Silesia, Katowice, Poland
(Legutko) Clinical Department of Interventional Cardiology, John Paul II
Hospital, Krakow, Poland
(Legutko) Department of Interventional Cardiology, Institute of
Cardiology, Jagiellonian University Medical College, Krakow, Poland
(Wojakowski) Department of Cardiology and Structural Heart Diseases,
Medical University of Silesia, Katowice, Poland
Publisher
Via Medica

<16>
[Use Link to view the full text]
Accession Number
2028541883
Title
Feasibility of selective coronary angiography and percutaneous coronary
intervention following self-expanding transcatheter aortic valve
replacement: a systematic review and meta-analysis.
Source
Coronary Artery Disease. 33(8) (pp 678-681), 2022. Date of Publication: 01
Dec 2022.
Author
Gin J.H.; Castles A.; Koshy A.N.; Yudi M.B.
Institution
(Gin, Castles, Koshy, Yudi) Department of Cardiology, Austin Health,
Melbourne, VIC, Australia
(Castles, Koshy, Yudi) Department of Medicine, The University of
Melbourne, Melbourne, VIC, Australia
Publisher
Lippincott Williams and Wilkins

<17>
Accession Number
2028539987
Title
The Canadian Study of Arterial Inflammation in Patients with Diabetes and
Recent Vascular Events, Evaluation of Colchicine Effectiveness (CADENCE):
protocol for a randomised, double-blind, placebo-controlled trial.
Source
BMJ Open. 13(11) (no pagination), 2023. Article Number: e074463. Date of
Publication: 10 Nov 2023.
Author
Boczar K.E.; Shin S.; Dekemp R.A.; Dowlatshahi D.; Tavoosi A.; Wiefels C.;
Liu P.; Lochnan H.; MacPherson P.A.; Chong A.Y.; Torres C.; Leung E.;
Tawakol A.; Ahmadi A.; Garrard L.; Lefebvre C.; Kelly C.; MacPhee P.;
Tilokee E.; Raggi P.; Wells G.A.; Beanlands R.
Institution
(Boczar, Shin, Dekemp, Tavoosi, Wiefels, Chong, Leung, Ahmadi, Garrard,
Lefebvre, Kelly, MacPhee, Tilokee, Beanlands) University of Ottawa Heart
Institute, Ottawa, ON, Canada
(Boczar) Department of Medicine, University of Pennsylvania Perelman
School of Medicine, Philadelphia, PA, United States
(Dowlatshahi) Department of Neurology, The Ottawa Hospital, Ottawa, ON,
Canada
(Liu) University of Ottawa, Ottawa, ON, Canada
(Lochnan, Beanlands) Department of Medicine, University of Ottawa, Ottawa,
ON, Canada
(MacPherson) Department of Medicine, Division of Infectious Diseases,
Ottawa Hospital General Campus, Ottawa, ON, Canada
(Torres) Department of Radiology, University of Ottawa, Ottawa, ON, Canada
(Tawakol) Harvard Medical School, Boston, MA, United States
(Raggi) Department of Medicine, University of Alberta, Edmonton, AB,
Canada
(Wells) School of Epidemiology and Public Health, University of Ottawa,
Ottawa, ON, Canada
(Wells) Cardiovascular Research Methods Centre, University of Ottawa Heart
Institute, Ottawa, ON, Canada
Publisher
BMJ Publishing Group
Abstract
Background Inflammation is a key mediator in the development and
progression of the atherosclerotic disease process as well as its
resultant complications, like myocardial infarction (MI), stroke and
cardiovascular (CV) death, and is emerging as a novel treatment target.
Trials involving anti-inflammatory medications have demonstrated outcome
benefit in patients with known CV disease. In this regard, colchicine
appears to hold great promise. However, there are potential drawbacks to
colchicine use, as some studies have identified an increased risk of
infection, and a non-significant trend for increased all-cause mortality.
Thus, a more thorough understanding of the underlying mechanism of action
of colchicine is needed to enable a better patient selection for this
novel CV therapy. Objective The primary objective of the Canadian Study of
Arterial Inflammation in Patients with Diabetes and Recent Vascular
Events, Evaluation of Colchicine Effectiveness (CADENCE) trial is to
assess the effect of colchicine on vascular inflammation in the carotid
arteries and ascending aorta measured with 18 F-fluorodeoxyglucose (FDG)
positron emission tomography (PET)/CT in patients with type 2 diabetes
mellitus (T2DM) or pre-diabetes who have experienced a recent vascular
event (acute coronary syndrome (ACS)/MI, transient ischaemic attack (TIA)
or stroke). Secondary objectives include determining colchicine's effect
on inflammatory biomarkers (high-sensitivity C reactive protein (hs-CRP)
and interleukin-6 (IL-6)). Additionally, we will assess if baseline
inflammation imaging or biomarkers are associated with a treatment
response to colchicine determined by imaging. Exploratory objectives will
look at: (1) the difference in the inflammatory response to colchicine in
patients with coronary events compared with patients with cerebral events;
(2) the difference in the inflammatory response to colchicine in different
vascular beds; (3) the relationship of FDG-PET imaging markers with serum
biomarkers and (4) assessment of quality-of-life changes. Methods and
design CADENCE is a multicentre, prospective, randomised, double-blinded,
placebo-controlled study to determine the effect of colchicine on arterial
inflammation as assessed with imaging and circulatory biomarkers,
specifically carotid arteries and aortic FDG uptake as well as hs-CRP and
IL-6 among others. Patients with T2DM or pre-diabetes who have recently
experienced a CV event (within 30-120 days after an ACS (ie, ST-elevation
MI (STEMI) or non-STEMI)) or TIA/stroke with documented large vessel
atherosclerotic disease will be randomised to treatment with either
colchicine 0.6 mg oral daily or placebo. Participants will undergo
baseline clinical evaluation including EQ5D assessment, blood work for
inflammatory markers and FDG PET/CT scan of the ascending aorta and left
and right carotid arteries. Patients will undergo treatment for 6 months
and have repeat clinical evaluation including EQ5D assessment, blood work
for inflammatory markers and FDG PET/CT scan at the conclusion of the
study. The primary outcome will be the change in the maximum target to
background ratio (TBR max) in the ascending aorta (or carotid arteries)
from baseline to follow-up on FDG PET/CT imaging. Discussion Colchicine is
an exciting potential new therapy for CV risk reduction. However, its use
is associated with side effects and greater understanding of its
underlying mechanism of action is needed. Importantly, the current study
will determine whether its anti-inflammatory action is an indirect
systemic effect, or a more local plaque action that decreases
inflammation. The results will also help identify patients who will
benefit most from such therapy. Trial registration number
NCT04181996. Copyright © Author(s) (or their employer(s)) 2023.
Re-use permitted under CC BY-NC. No commercial re-use. See rights and
permissions. Published by BMJ.

<18>
Accession Number
2028318345
Title
Effect of intravenous levosimendan or milrinone on left atrial pressure in
patients undergoing off-pump coronary artery bypass grafting - A
prospective double-blind, randomized controlled trial.
Source
Annals of Cardiac Anaesthesia. 26(4) (pp 411-417), 2023. Date of
Publication: October 2023.
Author
Mondal A.; Ghosh K.; Kar S.K.; Dammalapati P.K.; Dasgupta C.S.
Institution
(Mondal, Ghosh, Kar, Dammalapati, Dasgupta) Department of Cardio Thoracic
Vascular Anaesthesiology, Institute of Post Graduate Medical Education and
Research (IPGME&R), West Bengal, Kolkata, India
Publisher
Wolters Kluwer Medknow Publications
Abstract
Background: Maintaining a low left atrial pressure (LAP) in off-pump
coronary artery bypass grafting (OPCAB) is desirable. This study was done
to compare the effects of intravenous levosimendan or milrinone on LAP at
different stages of OPCAB. Material(s) and Method(s): After
institutional ethics committee clearance, this two-arm double-blind
randomized control trial was done in 44 adult patients with triple vessel
coronary artery disease undergoing OPCAB at cardiac OT of IPGME&R,
Kolkata. The patients were randomly allocated into two groups receiving
intraoperative either levosimendan or milrinone. Pulmonary capillary wedge
pressure (PCWP) was compared as the primary outcome parameter, whereas
other echocardiographic and hemodynamic parameters were also assessed
during six stages of OPCAB, that is, after sternotomy, proximal(s), left
anterior descending artery (LAD), obtuse marginal (OM), posterior
descending artery (PDA) grafting, and before sternal closure. Numerical
parameters were compared using Student's unpaired two-tailed t-test.
 Result(s): PCWP was found to be significantly lower (P < 0.05) in the
levosimendan group during proximal (P = 0.047), LAD (P = 0.018), OM (P <
0.0001), PDA grafting (P = 0.028), and before sternal closure (P = 0.015).
Other parameters indicate LAP, that is, from mitral early diastolic inflow
velocity to mitral annular early diastolic velocity ratio (E/e'), which
indicated significantly lower LAP in levosimendan group during LAD, OM,
and PDA grafting and before sternal closure. Conclusion(s):
Levosimendan may be used as a primary inotrope in terms of better
reduction in left atrial pressure during different stages of OPCAB,
translating to a decrease in left ventricular end-diastolic pressure,
therefore maintaining optimum coronary perfusion pressure, which is the
primary goal of the surgery. Copyright © 2023 Wolters Kluwer
Medknow Publications. All rights reserved.

<19>
Accession Number
2026845115
Title
The effects of volatile anesthetics and propofol in patients undergoing
off-pump coronary artery bypass grafting: a systematic review and
meta-analysis.
Source
Frontiers in Cardiovascular Medicine. 10 (no pagination), 2023. Article
Number: 1271557. Date of Publication: 2023.
Author
Zhang C.; He C.; Chen Z.; Chen X.; Qin J.; Xu Y.; Ma J.
Institution
(Zhang) School of Medicine, Hangzhou Normal University, Hangzhou, China
(He, Chen, Chen, Qin, Xu, Ma) Department of Anesthesiology, Affiliated
Hospital of Hangzhou Normal University, Hangzhou, China
Publisher
Frontiers Media SA
Abstract
Background: Studies investigating the cardioprotective effect of volatile
anesthetics on cardiac troponins in off-pump coronary artery bypass
grafting (OPCAB) surgery remain controversial. This current study was
conducted to systematically evaluate the impact of volatile anesthetics
and propofol on patients undergoing OPCAB surgery. Method(s): A
computerized search of electronic databases was conducted up to July 21,
2023, to identify relevant studies using appropriate search terms. The
primary outcomes of interest were the levels of myocardial injury
biomarkers (e.g., cTnI, cTnT), while secondary outcomes included
extubation time, length of ICU stay, 30-day mortality, transfusion and
thrombosis, and postoperative recovery, which were compared between two
anesthesia techniques. Result(s): A search of databases produced 14
relevant studies with a combined total of 703 patients. Among them, 355
were allocated to the volatile anesthetics group and 348 to the propofol
group. Our study reveals a statistically significant reduction in
myocardial injury biomarkers among patients who received volatile
anesthetics compared to those who received propofol (P <.001). Subgroup
analysis showed that patients using sevoflurane had lower postoperative
cardiac troponins levels compared to propofol (P =.01). However,
desflurane and isoflurane currently have no significant advantage over
propofol (all P > 0.05). There was no significant difference in
postoperative mechanical ventilation time, length of ICU stay, and
mortality between the two groups (all P > 0.05). Conclusion(s): This
study suggested that volatile anesthetics, specifically sevoflurane, in
adult OPCAB surgery provide a better cardioprotective effect than
propofol. Systematic Review Registration: PROSPERO
(CRD42023444277). Copyright 2023 Zhang, He, Chen, Chen, Qin, Xu and
Ma.

<20>
Accession Number
2026759261
Title
Computed Tomography Scanning for Sternal Wound Infections: A Systematic
Review.
Source
Ulster Medical Journal. 92(3) (pp 139-147), 2023. Date of Publication: Sep
2023.
Author
Shirke M.M.; Dominic C.; Debnath P.; Sunny J.; Haq M.; Nawaz H.; Harky A.
Institution
(Shirke) School of Medicine, Queen's University Belfast, School of
Medicine, Belfast, United Kingdom
(Dominic, Nawaz) Barts and the London School of Medicine, QMUL, United
Kingdom
(Debnath) School of Medicine, University of Nottingham, Nottingham, United
Kingdom
(Sunny) Department of Medicine, University of Central Lancashire, Preston,
United Kingdom
(Haq) Faculty of Medicine, St. George's University of London, London,
United Kingdom
(Harky) Department of Cardiothoracic Surgery, Liverpool Heart and Chest,
Liverpool, United Kingdom
(Harky) Department of Integrative Biology, Faculty of Life Science,
University of Liverpool, Liverpool, United Kingdom
(Harky) Liverpool Centre for Cardiovascular Science, University of
Liverpool and Liverpool Heart and Chest Hospital, Liverpool, United
Kingdom
Publisher
Ulster Medical Society
Abstract
Background Sternal wound infection (SWI) has always been a significant
risk in patients who undergo sternotomies as part of their cardiac
surgical procedures. Computed tomography (CT) imaging is often used to
diagnose and assess sternal wound infections. Its purpose includes
identifying and locating infection and any sternal dehiscence. Methods A
systematic literature review across PubMed, Embase, and Ovid was performed
according to PRISMA guidelines to identify relevant articles that
discussed the utility of CT scanning for SWI, common features identified,
patient outcomes and sensitivity/specificity (Figure 1). Results 25 papers
were included. 100% (n=25) of the papers were published in peer-reviewed
journals. CT scans in SWIs can be seen as a beneficial aid in diagnosing
as well as determining the components of infection. Commonalities were
identified such as fluid collection in the mediastinum, free gas, pleural
effusions, and sternal dehiscence which point towards the presence of
sternal wound infection. Conclusion CT scanning is a novel and emerging
methodology for imaging in SWI and post-sternotomy complications, hence
increased research is required to expand the literature on this area as
well as the creation of guidelines and cut-offs or signs for radiology
professionals to identify and determine the extent of
infection. Copyright © 2023, Ulster Medical Society. All rights
reserved.

<21>
Accession Number
2026523543
Title
The effect of resistance training on PCSK9 levels in patients undergoing
cardiac rehabilitation after coronary artery bypass grafting: a randomized
study.
Source
BMC Cardiovascular Disorders. 23(1) (no pagination), 2023. Article Number:
549. Date of Publication: December 2023.
Author
Dwiputra B.; Santoso A.; Purwowiyoto B.S.; Radi B.; Ambari A.M.
Institution
(Dwiputra, Santoso, Purwowiyoto, Radi, Ambari) Department of Cardiology
and Vascular Medicine, Faculty of Medicine, Universitas Indonesia/ Harapan
Kita National Cardiovascular Center, Jl Letjen S Parman Kav 87, Palmerah,
Jakarta Barat 11420, Indonesia
Publisher
BioMed Central Ltd
Abstract
Background: Resistance training is commonly recommended as part of
secondary prevention for post-coronary artery bypass graft (CABG) patients
in conjunction with aerobic exercise. Despite its potential benefits,
there is currently a lack of studies investigating the impact of
resistance training on proprotein convertase subtilisin kexin 9 (PCSK9).
 Aim(s): To evaluate the effect of intensive resistance training on
proprotein convertase subtilisin kexin 9 (PCSK9) levels among post-CABG
patients undergoing cardiac rehabilitation (CR). Method(s): In this
prospective, open-label, randomized trial, 87 post-coronary artery bypass
graft (CABG) patients were randomly assigned into two groups: moderate to
high intensity resistance training and aerobic training (n = 44) or
aerobic training alone (n = 43) for a total of 12 sessions. Changes in
PCSK9 levels was determined as a primary endpoint, while secondary
endpoints included changes in the six-minute walk test (6-MWT) results,
aerobic capacity, WHO-5 well-being index, fasting blood glucose, and lipid
profile. Both groups underwent intention-to-treat analysis.
 Result(s): Following completion of cardiac rehabilitation program,
the intervention group demonstrated a significant decrease in mean PCSK9
levels when compared to the control group (beta = -55 ng/ml, 95% CI -6.7
to -103.3, p = 0.026), as well as significant improvements in the 6-MWT
result (beta = 28.2 m, 95% CI 2.4-53.9, p = 0.033), aerobic capacity (beta
= 0.9 Mets, 95% CI 0.1-1.7, p = 0.021), and WHO-5 well-being index (beta =
8.1, 95% CI 2.0-14.4, p = 0.011) in patients who received resistance and
aerobic training. No statistically significant changes were observed in
fasting blood glucose, cholesterol, LDL-C, HDL-C, and triglyceride levels.
 Conclusion(s): Resistance training in CR significantly reduced PCSK-9
levels and increases patient's functional capacity and quality of life.
(NCT02674659 04/02/2016). Copyright © 2023, The Author(s).

<22>
Accession Number
2024958253
Title
Effect of thoracoscopic and thoracotomy on postoperative wound
complications in patients with lung cancer: A meta-analysis.
Source
International Wound Journal. 20(10) (pp 4217-4226), 2023. Date of
Publication: December 2023.
Author
Qiu B.; Han J.; Zhao J.
Institution
(Qiu, Zhao) Department of Thoracic Surgery, Affiliated Hospital of Weifang
Medical University, Weifang, China
(Han) Department of Interventional Oncology, Affiliated Hospital of
Weifang Medical University, Weifang, China
Publisher
John Wiley and Sons Inc
Abstract
Because of the difficult surgical procedures, patients with lung cancer
who have received thoracic surgery tend to have postoperative
complications. It may lead to postoperative complications like wound
infection, wound haematoma and pneumothorax. A lot of research has
assessed the effect of various surgery methods on postoperative
complications in pulmonary cancer. The purpose of this meta-analysis is to
establish if thoracoscopic is superior to that of thoracotomy in the rate
of post-operative complications. From the beginning to the end of June
2023, we performed an exhaustive search on four main databases for key
words. The Hazard of Bias in Non-Randomized Interventional Studies
(ROBINS-I) was evaluated in the literature. In the end, 13 trials that
fulfilled the eligibility criteria underwent further statistical analyses.
The results showed that thoracoscopic intervention decreased the risk of
post operative wound infection (dominant ratio [OR], 3.00; 95% confidence
margin [CI], 1.98, 4.55; p < 0.00001) and air-leakage after operation (OR,
1.30; 95% CI, 1.04, 1.63; p = 0.02). There was no statistically
significant difference between the two groups in terms of the rate of
haemorrhage after operation (OR, 0.10; 95% CI, 0.73, 1.66; p = 0.63). Our
findings indicate that thoracoscopic is less likely to cause post
operative infection and gas leakage than thoracotomy, and it does not
decrease the risk of postoperative haemorrhage. As some of the chosen
trials are too small to conduct meta-analyses, care must be taken when
handling the data. In the future, a large number of randomized, controlled
trials will be required to provide additional evidence for this
research. Copyright © 2023 The Authors. International Wound
Journal published by Medicalhelplines.com Inc and John Wiley & Sons Ltd.

<23>
Accession Number
2028748967
Title
Recombinant Activated Factor VII (rFVIIa) for Bleeding After Thoracic
Aortic Surgery: A Scoping Review of Current Literature.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2023.
Date of Publication: 2023.
Author
Navarro R.; Bojic S.; Fatima R.; El-Tahan M.; El-Diasty M.
Institution
(Navarro) Faculty of Medicine, Queen's University, Kingston, ON, Canada
(Bojic) Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
(Fatima) Department of Surgery, Queen's University, Kingston, ON, Canada
(El-Tahan) Anesthesiology Department, College of Medicine, Imam
Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
(El-Diasty) Cardiac Surgery Department, Harrington Heart Institute,
University Hospitals, Cleveland, OH, United States
Publisher
W.B. Saunders
Abstract
Background: Bleeding after surgery on the thoracic aorta is a frequent
complication, and can be associated with a significant increase in
morbidity and mortality. Recombinant activated factor VII (rFVIIa) was
developed initially for treating patients with hemophilia; however, it has
been used increasingly "off-label" to achieve hemostasis after thoracic
aortic procedures. Objective(s): This scoping review aimed to present
the available literature on the role of rFVIIa in the management of
refractory postoperative bleeding after thoracic aortic surgery.
Methods/Results: An electronic database search was conducted using
Medline, Embase, Cochrane Library, and Google Scholar in June 2023. The
authors included studies that reported the use of rFVIIa in patients
undergoing surgical repair of ascending or descending aortic aneurysm or
dissection. Single-case reports were excluded. Ten publications with a
pooled number of 649 patients (319 patients received rFVIIa and 330 in the
control groups) were identified: 3 case series, 6 retrospective studies,
and 1 nonrandomized clinical trial. All studies reported the potential
role of rFVIIa in correcting coagulopathy and reducing postoperative blood
loss in this group of patients. Overall, there was not enough evidence to
suggest that rFVIIa was associated with higher rates of thromboembolic
complications or mortality. Conclusion(s): Limited evidence suggests
that rFVIIa may be useful in managing postoperative refractory bleeding in
patients undergoing thoracic aortic surgery. However, the impact of rFVIIa
on thromboembolic complications and mortality rates remains
unclear. Copyright © 2023 Elsevier Inc.

<24>
Accession Number
2028717681
Title
Effectiveness and safety of short-term anticoagulant regimens after left
atrial appendage occlusion: A systematic review and meta-analysis.
Source
Thrombosis Research. 233 (pp 88-98), 2024. Date of Publication: January
2024.
Author
Zhou Q.; Liu X.; Yang X.; Huang X.-H.; Wu Y.-Z.; Tao Y.-Y.; Wei M.
Institution
(Zhou, Huang, Wu, Tao, Wei) Department of Clinical Pharmacy, Jinling
Hospital, Affiliated Hospital of Medical School, Nanjing University,
Nanjing, China
(Liu) Department of Pharmacy and Traditional Chinese Pharmacy, Jiangsu
College of Nursing, Huaian, China
(Yang) Department of Pharmacy, Nanjing Drum Tower Hospital, Affiliated
Hospital of Medical School, Nanjing University, Nanjing, China
Publisher
Elsevier Ltd
Abstract
Introduction: Left atrial appendage occlusion (LAAO) provides an
alternative for poor candidates of long-term oral anticoagulant (OAC)
therapy; however, anticoagulant therapy after surgical procedures has
limited use due to associated uncertainties. We aimed to evaluate the
effectiveness and safety of the short-term use of direct oral
anticoagulant (DOAC) and warfarin after LAAO. Method(s): Electronic
databases such as PubMed, Embase, Medline, and Cochrane Library databases
were searched up to November 11, 2022. Our study compared DOAC therapy and
warfarin in patients after LAAO. A meta-analysis was conducted with the
Review Manager software (version 5.4). Result(s): The meta-analysis
included 13 cohort studies with a total of 32,607 patients. Our findings
indicated that the incidence of stroke/TIA/SE, peri-device leaks>5 mm,
device-related thrombosis, and all-cause mortality were not significantly
different between the two groups after LAAO (P > 0.05). The DOAC group had
a significantly lower incidence of major bleeding (OR = 0.83, 95 % CI:
0.74-0.94, P = 0.003), any bleeding (OR = 0.34, 95 % CI: 0.23-0.51, P <
0.001), stroke/TIA/SE and major bleeding (OR = 0.57, 95 % CI: 0.34-0.95, P
= 0.03), and any major adverse event (OR = 0.89, 95 % CI:0.82-0.97, P =
0.010) than the warfarin group. The subgroup analysis revealed that the
rate of stroke/TIA/SE was similar in the two groups in terms of the
different regions, follow-up time, study type, anticoagulant strategy, and
bleeding risk. The incidence of major bleeding in the DOAC group was
significantly lower than that in the warfarin group in North America, as
well as at follow-up period <=6 months, retrospective cohort, HAS-BLED
average score >= 3. In addition, the risk of major bleeding was higher
with the combination of OAC and single antiplatelet therapy (SAPT) than
with OAC alone. Finally, in the North American region, retrospective
cohort, and HAS-BLED average score >= 3, the incidence of any serious
adverse event in the DOAC group was still significantly lower than that in
the warfarin group. Conclusion(s): Compared to warfarin, DOAC reduced
the risk of major bleeding and any serious adverse event in patients after
LAAO. This advantage was particularly notable in North America and
high-risk populations for bleeding. In addition, the incidence of
device-related thrombosis, peri-device leaks, stroke/TIA/SE and all-cause
mortality were similar in both groups. The risk of major bleeding was
lower in patients taking OAC alone compared with those taking OAC plus
SAPT, without increasing the risk of thrombosis. Copyright © 2023
Elsevier Ltd

<25>
Accession Number
2028135612
Title
Gender disparities in patients with acute aortic dissection: A scoping
review.
Source
Seminars in Vascular Surgery. (no pagination), 2023. Date of Publication:
2023.
Author
Filiberto A.C.; Ramadan O.I.; Wang G.J.; Cooper M.A.
Institution
(Filiberto, Cooper) Department of Surgery, Division of Vascular Surgery,
University of Florida, Gainesville, FL 32610, United States
(Ramadan, Wang) Department of Surgery, University of Pennsylvania Perelman
School of Medicine, Philadelphia, PA, United States
(Ramadan, Wang) Leonard Davis Institute of Health Economics, University of
Pennsylvania, Philadelphia, PA, United States
Publisher
W.B. Saunders
Abstract
Disparities in outcomes for patients with cardiovascular disease and those
undergoing cardiac or vascular operations are well-established. These
disparities often span several dimensions and persist despite advancements
in medical and surgical care; gender is among the most pervasive.
Specifically, female gender has been implicated as a predictor of poor
outcomes in both patients with acute type A aortic dissections (ATAADs)
and type B aortic dissections (TBADs). For instance, one study, using the
International Registry of Acute Aortic Dissection database, found that
women with acute aortic dissection-including ATAAD and TBAD that were
either medically or surgically managed-had 40% higher odds of in-hospital
mortality than men. Notably, both types of acute aortic dissections affect
men more commonly than women and can be life-threatening without prompt,
appropriate treatment. The underlying mechanisms for these disparities are
unclear but are thought to be multifactorial. The association of gender
with patterns of disease and outcomes in patients with ATAAD or TBAD
remains unclear, with conflicting reports from different studies. Thus, we
sought to review the literature regarding gender disparities in patients
with ATAAD and TBAD. Copyright © 2023 Elsevier Inc.

<26>
Accession Number
2026898569
Title
Meta-analysis of clinical adverse events after CABG vs. PCI in patients
with chronic kidney disease and coronary artery disease.
Source
BMC Cardiovascular Disorders. 23(1) (no pagination), 2023. Article Number:
590. Date of Publication: December 2023.
Author
Luo C.; wang Q.; Nong S.; Chen Y.; Li L.; Gui C.
Institution
(Luo, wang, Nong, Chen, Li, Gui) Department of Cardiology, The First
Affiliated Hospital of Guangxi Medical University, Guangxi Zhuang
Autonomous Region, Nanning 530021, China
(Luo) Department of Cardiology, The Fourth Affiliated Hospital of Guangxi
Medical University, Liuzhou, China
(Gui) Guangxi Key Laboratory Base of Precision Medicine in
Cardiocerebrovascular Diseases Control and Prevention, Guangxi Clinical
Research Center for Cardiocerebrovascular Diseases, Guangxi Zhuang
Autonomous Region, Nanning 530021, China
Publisher
BioMed Central Ltd
Abstract
Aim: To investigate the efficacy and postoperative clinical adverse events
of coronary artery bypass grafting (CABG) or percutaneous coronary
intervention (PCI) for chronic kidney disease (CKD) study participants
combined with coronary artery disease (CAD). Method(s): All
randomized controlled trials (RCTs) that focus on the therapeutic effect
evaluation of CABG and PCI and their effect on postoperative clinical
adverse events as well as main adverse cardiovascular and cerebrovascular
events (MACCEs) in CKD study participants with CAD were screened from the
following databases, including CNKI, CBM, Wan Fang, VIP, Embase, PubMed,
as well as Cochrane library clinical controlled trials. The study was
conducted under the PRISMA 2020 criteria. Data were extracted, and quality
control was evaluated from the modified Jadad rating scale. Meta-analysis
was then undertaken through STATA 16.0 software. Result(s): A total
of 5 RCTs were obtained, including 1198 patients. Study participants were
subdivided into two groups, including the PCI group (n = 604) and the CABG
group (n = 594). Meta-analysis of clinical adverse events results showed
that the long-term survival results of CAD patients with CKD who underwent
PCI were worsened compared to CABG, such as long-term MACCEs (RR = 1.59,
95%CI: 1.04-2.43) and the long-term repeated revascularization (RR = 2.48,
95%CI: 1.76-3.49). Also, cardiac death (RR = 1.68, 95%CI:1.04-2.71), as
well as cerebrovascular accident (RR = 1.74, 95%CI:1.04-2.90) in CABG
group was significantly lower than that in PCI group. Conclusion(s):
This meta-analysis showed that CABG provided a better therapeutic effect
than PCI in CKD patients with CAD when considering long-term prognosis.
However, more prospective RCTs are needed to define the proper
revascularization strategy for CAD patients with CKD. Copyright ©
2023, The Author(s).

<27>
Accession Number
2026876511
Title
Myocardial protection with phosphocreatine in high-risk cardiac surgery
patients: a randomized trial.
Source
BMC Anesthesiology. 23(1) (no pagination), 2023. Article Number: 389. Date
of Publication: December 2023.
Author
Lomivorotov V.; Merekin D.; Fominskiy E.; Ponomarev D.;
Bogachev-Prokophiev A.; Zalesov A.; Cherniavsky A.; Shilova A.; Guvakov
D.; Lomivorotova L.; Lembo R.; Landoni G.
Institution
(Lomivorotov, Guvakov) Department of Anesthesiology and Perioperative
Medicine, Penn State College of Medicine, Penn State Milton S. Hershey
Medical Center, Hershey, PA, United States
(Lomivorotov, Merekin, Ponomarev, Shilova, Lomivorotova) Department of
Anesthesiology and Intensive Care, E. Meshalkin National Medical Research
Center, Novosibirsk, Russian Federation
(Fominskiy, Lembo, Landoni) Department of Anesthesia and Intensive Care,
IRCCS San Raffaele Scientific Institute, Via Olgettina 60, Milan 20132,
Italy
(Bogachev-Prokophiev, Zalesov) Department of Heart Valve Surgery, E.
Meshalkin National Medical Research Center, Novosibirsk, Russian
Federation
(Cherniavsky) Department of Aortic and Coronary Artery Surgery, E.
Meshalkin National Medical Research Center, Novosibirsk, Russian
Federation
(Landoni) Vita-Salute San Raffaele University, Milan, Italy
Publisher
BioMed Central Ltd
Abstract
Background: This study was conducted to test the hypothesis that
phosphocreatine (PCr), administered intravenously and as cardioplegia
adjuvant in patients undergoing cardiac surgery with prolonged aortic
cross clamping and cardiopulmonary bypass (CPB) time, would decrease
troponin I concentration after surgery. Method(s): In this
randomized, double-blind, placebo-controlled pilot study we included 120
patients undergoing double/triple valve repair/replacement under
cardiopulmonary bypass in the cardiac surgery department of a tertiary
hospital. The treatment group received: intravenous administration of 2 g
of PCr after anesthesia induction; 2.5 g of PCr in every 1 L of
cardioplegic solution (concentration = 10 mmol/L); intravenous
administration of 2 g of PCr immediately after heart recovery following
aorta declamping; 4 g of PCr at intensive care unit admission. The control
group received an equivolume dose of normosaline. Result(s): The
primary endpoint was peak concentration of troponin I after surgery.
Secondary endpoints included peak concentration of serum creatinine, need
for, and dosage of inotropic support, number of defibrillations after
aortic declamping, incidence of arrhythmias, duration of Intensive Care
Unit (ICU) stay, length of hospitalization. There was no difference in
peak troponin I concentration after surgery (PCr, 10,508 pg/ml [IQR
6,838-19,034]; placebo, 11,328 pg/ml [IQR 7.660-22.894]; p = 0.24). There
were also no differences in median peak serum creatinine (PCr, 100
micromol/L [IQR 85.0-117.0]; placebo, 99.5 micromol/L [IQR 90.0-117.0]; p
= 0.87), the number of patients on vasopressor/inotropic agents (PCr, 49
[88%]; placebo, 57 [91%]; p = 0.60), the inotropic score on postoperative
day 1 (PCr, 4.0 (0-7); placebo, 4.0 (0-10); p = 0.47), mean SOFA score on
postoperative day 1 (PCr, 5.25 +/- 2.33; placebo, 5,45 +/- 2,65; p =
0.83), need for defibrillation after declamping of aorta (PCr, 22 [39%];
placebo, 25 [40%]; p = 0.9), duration of ICU stay and length of
hospitalization as well as 30-day mortality (PCr, 0 (0%); placebo,1
(4.3%); p = 0.4). Conclusion(s): PCr administration to patients
undergoing double/triple valve surgery under cardiopulmonary bypass is
safe but is not associated with a decrease in troponin I concentration.
Phosphocreatine had no beneficial effect on clinical outcomes after
surgery. Trial registration: The study is registered at ClinicalTrials.gov
with the Identifier: NCT02757443. First posted (published):
02/05/2016. Copyright © 2023, The Author(s).

<28>
Accession Number
642277737
Title
Effects of yoga on anxiety, pain, inflammatory and stress biomarkers in
patients undergoing cardiac surgery: A systematic review and
meta-analysis.
Source
Complementary therapies in clinical practice. 53 (pp 101798), 2023. Date
of Publication: 01 Nov 2023.
Author
Chandrababu R.; Ramesh J.; Jagadeesh N.S.; Guo P.; Reddy G.G.; Hayter M.
Institution
(Chandrababu) Department of Medical Surgical Nursing, Sri Ramachandra
Faculty of Nursing, Sri Ramachandra Institute of Higher Education and
Research, Porur, Chennai, 600116, India
(Ramesh) Sri Ramachandra Faculty of Nursing, Sri Ramachandra Institute of
Higher Education and Research, Porur, Chennai, 600116, India
(Jagadeesh) Sri Ramachandra Faculty of Nursing, Sri Ramachandra Institute
of Higher Education and Research, Porur, Chennai, 600116, India.
Electronic address: sjnalini@sriramachandra.edu.in
(Guo) School of Nursing and Midwifery, Institute of Clinical Sciences,
College of Medical and Dental Sciences, University of Birmingham,
Birmingham, United Kingdom
(Reddy) Centre for Integrative Medicine and Research, Manipal Academy of
Higher Education, Manipal, Karnataka 576104, India
(Hayter) Department of Nursing, Manchester Metropolitan University, All
Saints Building, Manchester M15 6BH, United Kingdom
Abstract
BACKGROUND: The most common surgical method of managing coronary artery
disease is coronary artery bypass grafting (CABG). Stress, anxiety, and
pain are commonly identified postoperative symptoms and are closely
correlated to patient recovery. OBJECTIVE(S): The purpose of this
review was to investigate the effects of yoga interventions on anxiety,
pain, inflammatory and stress biomarkers in CABG surgery patients.
 METHOD(S): and analysis: The databases PUBMED, The Cochrane CENTRAL,
EMBASE, CINAHL, Scopus, and Web of Science were comprehensively searched
from the inception to December 2022. The quantitative research studies
that evaluated the effects of yoga on anxiety, pain, inflammatory and
stress biomarkers in CABG patients were included. This systematic review
and meta-analysis followed the Cochrane guidelines and is reported using
the PRISMA checklist. The RevMan 5.4 software was used for the
meta-analysis. RESULT(S): Seventeen studies met the inclusion
criteria, representing 1227 patients with a mean age of 58 years. All
studies have reported that yoga interventions significantly reduced
anxiety, pain, inflammatory and stress biomarkers in the experimental
group compared to the control group. According to the GRADE criteria,
moderate quality of evidence was found on effects of yoga intervention in
CABG surgery patients. CONCLUSION(S): Yoga has been shown to benefit
patients undergoing CABG surgery. It can be used as an adjunctive
intervention. However, more rigorous randomized controlled trials are
required to generate high-quality evidence for yoga interventions.
REGISTRATION: PROSPERO CRD42020175833. Copyright © 2023 Elsevier
Ltd. All rights reserved.

<29>
Accession Number
642148616
Title
Down the rabbit hole: reviewing the evidence for primary prevention of
cardiovascular disease in people with obesity.
Source
European journal of preventive cardiology. 30(17) (pp 1895-1905), 2023.
Date of Publication: 30 Nov 2023.
Author
Stumpf M.A.M.; Cercato C.; de Melo M.E.; Santos R.D.; Mancini M.C.
Institution
(Stumpf, Cercato, de Melo, Mancini) Obesity Unit, Division of
Endocrinology and Metabolism, University of Sao Paulo Medical School
Hospital, Street Dr. Ovidio Pires de Campos, Sao Paulo 05403-010, Brazil
(Santos) Lipid Clinic Heart Institute (InCor), University of Sao Paulo
Medical School Hospital, Sao Paulo, Brazil
(Santos) Academic Research Organization, Hospital Israelita Albert
Einstein, Sao Paulo, Brazil
Abstract
Obesity is a prevalent chronic disorder and a well-known risk factor for
cardiovascular disease. However, the evidence of treating obesity for
primary prevention of major cardiovascular events is still scarce and
controversial. In this review, we provided a comprehensive description of
the current evidence in treating obesity regarding cardiovascular
protection. Bariatric surgery appears to be the most robust method to
reduce events in people without established cardiovascular disease. High
compliance to lifestyle interventions can further reduce cardiovascular
risk. Concerning pharmacological therapies, a post hoc analysis from
SUSTAIN-6 and a meta-analysis from STEP trials suggest that semaglutide, a
GLP-1 receptor agonist, could reduce cardiovascular events in people
without established cardiovascular disease. The first study addressed
specifically a high-risk population with diabetes and, the second, low- or
intermediary-risk individuals without diabetes. Tirzepatide, a novel dual
GIP/GLP-1 agonist, although not yet tested in specific cardiovascular
outcomes trials, could be an alternative since it induces loss in weight
similar to the achieved by bariatric surgery. Therefore, extrapolated data
in distinct baseline cardiovascular risk populations suggest that these
two drugs could be used in primary prevention with the aim of preventing
cardiovascular events, but the grade of this evidence is still low.
Specifically designed studies are needed to address this specific
topic. Copyright © The Author(s) 2023. Published by Oxford
University Press on behalf of the European Society of Cardiology. All
rights reserved. For permissions, please e-mail:
journals.permissions@oup.com.

<30>
Accession Number
640139973
Title
Effectiveness of iodine-impregnated incise drapes for preventing surgical
site infection in patients with clean or clean contaminated wounds: A
systematic literature review and cost-consequence analysis.
Source
Journal of perioperative practice. 33(12) (pp 368-379), 2023. Date of
Publication: 01 Dec 2023.
Author
Sworn K.; Poku E.; Thokala P.; Sutton A.; Foster S.; Siddall I.; Reuter H.
Institution
(Sworn, Poku, Thokala, Sutton) School of Health and Related Research
(ScHARR), University of Sheffield, Sheffield, United Kingdom
(Foster, Siddall) 3M UK PLC, Loughborough, United Kingdom
(Reuter) Medical Solutions Division, 3M Deutschland GmbH, Neuss, Germany
Abstract
BACKGROUND: Surgical site infection is a serious complication associated
with significant morbidity, mortality and health care expenditure. AIMS:
To determine the clinical effectiveness and economic impact of using
iodine-impregnated incise drapes for preventing surgical site infection.
 METHOD(S): MEDLINE, Embase, Cochrane Library and CINAHL databases
were systematically searched. Critical appraisal and synthesis of clinical
evidence informed a decision analytical cost-consequence model. FINDINGS:
Nine studies were included in the systematic literature review. Evidence
from cardiac surgery patients was considered appropriate to inform the
cost analysis. The economic model evaluation estimated cost savings of 549
per patient with the iodophor-impregnated drape in the deterministic
analysis and a mean cost saving per patient of 554,172 per 1000 in the
probabilistic analysis. CONCLUSION(S): Using iodine-impregnated
drapes in cardiac surgery patients may effectively reduce infections and
provide cost-savings, but further research is required.

<31>
Accession Number
642886147
Title
The efficacy and safety of automatic modes during respiratory support
after cardiac surgery.
Source
Intensive Care Medicine Experimental. Conference: European Society of
Intensive Care Medicine Annual Congress, ESICM 2023. Milan Italy.
11(Supplement 1) (no pagination), 2023. Date of Publication: 2023.
Author
Komnov R.; Eremenko A.; Titov P.; Gerasimenko S.; Urbanov A.; Vasileva O.;
Fominykh M.; Koshek E.; Goncharova A.; Balakin E.
Institution
(Komnov, Eremenko, Titov, Gerasimenko, Urbanov, Vasileva, Fominykh,
Koshek, Goncharova) Cardiac Intensive Care Unit, Petrovsky National
Research Center of Surgery, Moscow, Russian Federation
(Balakin) Department of Heart Valve Surgery, Petrovsky National Research
Center of Surgery, Moscow, Russian Federation
Publisher
Springer
Abstract
Introduction: In recent years, there is an active automation of processes
in medicine and robotic (Intellectual) ventilation modes are being
actively introduced into the daily practice of intensive care units. These
modes allow for automated respiratory support, minimizing clinician's
involvement. Currently, the most automated mode is INTELLiVENT- ASV
(Adaptive Support Ventilation). Objective(s): To compare the
effect(s) and safety of full closed loop ventilation and oxygenation
Intellivent-ASV mode with closed loop ASV mode and conventional
ventilation modes during respiratory support after uncomplicated cardiac
surgery. Method(s): In this randomized controlled trial 40 adult
patients were ventilated with Intellivent-ASV, 40 with ASV mode and 40
with conventional ventilation modes. Hamilton G5 ventilators were used and
8 physicians were involved into the study. Care of groups were
standardized, except modes of postoperative ventilation. We compared: (1)
the physician's workload, through accounting number of manual ventilator
settings and time they spent near the ventilator in every group; (2)
evaluation of ventilation safety by considering driving pressure (DELTAP),
mechanical power, PEEP, tidal volume (Vt) and FiO2 level; (3) duration of
tracheal intubation in the ICU. Result(s): In Intellivent-ASV group
the number of manual ventilator settings and physician's time spent near
the ventilator before tracheal extubation were significantly lower: 0
(0-0) vs 2 (2-3) (ASV) and 4 (3-5) (control group), and 35 (27-45) sec vs
99 +/- 35 s (ASV) vs 164 +/- 69 s (control group) respectively (median
(25%-75% quartile), p < 0.0001 in all cases). Duration of respiratory
support in the ICU were significantly shorter in the Intellivent-ASV
group: 226 +/- 31 vs 259 +/- 66 (ASV) and 271 +/- 78 min (control) (mean
+/- SD, p = 0.0042) and time on spontaneous ventilation (without any
mandatory breaths) were significantly longer in Intellivent-ASV group: 90
(75-103) vs 80 (60-110) (ASV) vs 60 (60-105) (control) min (p = 0.0462).
Intellivent-ASV provided a significantly more protective ventilation
through reduction in the driving pressure, tidal volume, FiO2 and PEEP
levels, but without differences between paO2/ FiO2 ratio and mechanical
power. DELTAP and Vt on mechanical ventilation were significantly lower in
Intellivent group: DELTAP was 6 (6-7) cmH2O vs 6 (6-7) (ASV) and 7 (7-9)
(control) cmH2O (p < 0.0001 in all cases); Vt was 6 (6-7) vs 7 (6-7.7)
(ASV) and 7 (7-8) (control) ml/kg/PBW (p < 0.0001 in all cases). PEEP and
FiO2 level on mechanical ventilation were also significantly lower in
Intellivent group: PEEP was 5 (5-7) cmH2O vs 8 (7-10) (ASV) and 7 (6.5-9)
(control) cmH2O and FiO2 level was 26 (24-30) vs 34 (30-35) (ASV) and 34
(30-38) (control) %, respectively (p < 0.0001 in all cases). There were no
significant differences between the groups in paO2/ FiO2 ratio during all
the phases of respiratory support and after extubation of trachea, and
also there were no differences in mechanical power level, frequency of
undesirable events (patient-ventilator asynchrony, patient's anxiety)
during respiratory support and duration of ICU stay. Conclusion(s):
Application of intellectual technologies after uncomplicated cardiac
surgery gives the opportunity for interactive personalization of
respiratory support and provides more protective mechanical ventilation
and reduces the physician's workload without compromising the quality of
respiratory support and safety of patients.

<32>
Accession Number
642886015
Title
Effect of different noninvasive respiratory support methods on gas
exchange parameters in the postoperative cardiac surgery patients.
Source
Intensive Care Medicine Experimental. Conference: European Society of
Intensive Care Medicine Annual Congress, ESICM 2023. Milan Italy.
11(Supplement 1) (no pagination), 2023. Date of Publication: 2023.
Author
Fomina D.; Eremenko A.; Komnov R.; Sorokina L.; Urbanov A.
Institution
(Fomina, Eremenko, Komnov, Sorokina, Urbanov) Cardiac Intensive Care Unit,
Petrovsky National Research Center of Surgery, Moscow, Russian Federation
Publisher
Springer
Abstract
Introduction: Methods of noninvasive respiratory support are used to
improve gas exchange, reduce the work of respiration and straightening of
the collapsed alveoli due to formation of hypoventilation and
microatelectasis. The most commonly used methods: non-invasive mask
positive pressure ventilation (NIMPPV), high-flow nasal oxygen therapy
(HFNO) and non-invasive positive pressure ventilation with helmet
(NIHPPV). Objective(s): Comparison of the effectiveness of
respiratory support methods depending on their effect on gas exchange in
patients with moderate respiratory failure in the early period after
cardiac surgery. Method(s): In randomized prospective study
(ClinicalTrials.gov-NCT 04787666) 42 cardiac surgery patients with 200 <
P/F < 300 were divided into 3 groups depending on the methods of
respiratory support used (NIMPPV; HFNO and NIPPVH). The main point of the
study was to assess the dynamics of the gas exchange before, during and
after their application. To carry out ventilation with a helmet, a higher
level of pressure support then in mask ventilation was required due to the
presence of an additional ventilated space inside it. Result(s): All
three methods demonstrated statistically significant improvement in gas
exchange ( SpO2, PaO2, HbO2, Qsp/Qt), which persisted after the end of
their application (Table 1). In this pilot study we did not receive
significant differences between the methods investigated on their effect
on blood gases and SpO2. Conclusion(s): Noninvasive respiratory
support significantly improves oxygenating lung function in the early
postoperative period of cardiac surgery patients. NIHPPV and NIMPPV are
more effective compared to HFNO. In case of helmet interface, a higher
level of support was required and the most significant clinical effect was
achieved.

<33>
Accession Number
642885890
Title
Comparison of two oxygenation SpO2 targets with two different oximeters -
impact on oxygen flow rates and on oxygenation parameters.
Source
Intensive Care Medicine Experimental. Conference: European Society of
Intensive Care Medicine Annual Congress, ESICM 2023. Milan Italy.
11(Supplement 1) (no pagination), 2023. Date of Publication: 2023.
Author
Lellouche F.; Bouchard P.A.
Institution
(Lellouche, Bouchard) Centre De Recherche, Institut Universitaire de
Cardiologie et de Pneumologie de Quebec-Universite Laval, Quebec, Canada
Publisher
Springer
Abstract
Introduction: SpO2 target influences oxygen utilization1. It was recently
shown that oximeter brand influenced the SpO2 measurements2.
 Objective(s): To evaluate the impact of the combination of SpO2
target and oximeter brand on oxygen utilization, oxygen weaning, occult
hypoxemia and occult hyperoxemia. Method(s): We currently conduct a
randomized cross-over study in 20 stable ICU patients requiring oxygen
therapy delivered through nasal canula after cardiac surgery. Patients
without adequate SpO2 signal are excluded. Four randomized periods of 10
min are conducted in all patients with different SpO2 targets (90 and 94%)
and different oximeters (Nonin and Philips). For each period we collect
the oxygen flow and oxygen blood gases at the end of the period. We
compared the oxygen flow, the rate of occult hypoxemia (SaO2 < 90% with
SpO2 >= 90%) and occult hyperoxemia (SaO2 > 96% with SpO2 <= 96%), oxygen
partial weaning (< 0.5L/min) or complete weaning and the rate of high O2
flow requirements (> 5L/min). Result(s): We present preliminary data
based on first 18 patients (mean age 69 +/- 9 years, 15 were men, all had
light skin pigmentation, none had shock). At baseline, SpO2 was 93.2 +/-
1.9% and oxygen flow was 2.0 +/- 1.5 L/min. Main results for the oxygen
flow and oxygenation parameters in the different study periods are
displayed in the figure. Differences in mean oxygen flow during Nonin 90
(1.7 +/- 2.0 L/min) and Philips 94 (2.1 +/- 2.1 L/min) are not
statistically different (P = 0.11). However, all other comparisons of the
oxygen flow are statistically different. The rate of complete weaning was
50% in the Philips 90 period and 0% in other periods. Oxygenation
parameters (SaO2, PaO2) were similar during Nonin 90 (94 +/- 1%, 72 +/- 5
mmHg) and Philips 94% (94 +/- 1%, 72 +/- 8 mmHg). Conversely, there were
statistically different oxygenation levels with Nonin 94 (97 +/- 1%, 91
+/- 6 mmHg) and Philips 90 (91 +/- 1%, 64 +/- 5 mmHg). Conclusion(s):
In patients requiring conventional oxygen therapy, the SpO2 target, the
oximeter brand and even more the combination of both had major impact on
oxygen utilization, oxygen weaning and both occult hypoxemia and
hyperoxemia. Patients managed with Nonin 90 and Philips 94 had similar
oxygen flow and similar arterial oxygenation parameters. These data
underline the necessity to use corrected SpO2 targets rather than
universal SpO2 targets to manage oxygen therapy. (Figure Presented).

<34>
Accession Number
642885717
Title
ESICM LIVES 2023.
Source
Intensive Care Medicine Experimental. Conference: European Society of
Intensive Care Medicine Annual Congress, ESICM 2023. Milan Italy.
11(Supplement 1) (no pagination), 2023. Date of Publication: 2023.
Author
Anonymous
Publisher
Springer
Abstract
The proceedings contain 924 papers. The topics discussed include:
antibiotic target failure in neurocritically ill patients: a dolphin trial
post hoc analysis; machine learning approach for detecting hydrostatic
pulmonary oedema in the emergency department through hemoglobin changes;
long term brain structural correlates of cognitive outcome in survivors of
Covid 19 related ARDS (C ARDS); Enhancing early rehabilitation across two
adult critical care units; Virtual Reality pre operative immersive
experience to improve patients ICU experience and reduce post operative
delirium incidence; Predictive value of the EEG after cardiac arrest:
validation of the ERC ESICM recommendations; red blood cell transfusion in
the intensive care unit: the InPUT study, a worldwide prospective cohort
study on transfusion practices; impact of subject ventilator dyssynchrony
on diaphragm function and structure; and effect of regional nerve block on
postoperative delirium or cognitive dysfunction after cardiothoracic
surgery: a systematic review and meta analysis.

<35>
Accession Number
642885404
Title
Effect of regional nerve block on postoperative delirium or cognitive
dysfunction after cardiothoracic surgery: a systematic review and
meta-analysis.
Source
Intensive Care Medicine Experimental. Conference: European Society of
Intensive Care Medicine Annual Congress, ESICM 2023. Milan Italy.
11(Supplement 1) (no pagination), 2023. Date of Publication: 2023.
Author
Shin H.J.; Na H.S.; Lee S.; Koo C.H.
Institution
(Shin, Na, Lee, Koo) Department of Anesthesiology and Pain Medicine, Seoul
National University Bundang Hospital, Seongnam, South Korea
Publisher
Springer
Abstract
Introduction. Regional nerve blocks reduce the incidence of postoperative
delirium (POD) and postoperative cognitive dysfunction (POCD) in adult
patients undergoing cardiothoracic surgery. However, conflicting results
have been reported in several randomized controlled trials (RCTs).
Objectives. This systematic review and meta-analysis was conducted to
identify the benefits of regional nerve blocks, focusing on the effects of
nerve blocks on postoperative cognitive function in patients after
cardiothoracic surgery. Methods. Electronic databases, including PubMed,
EMBASE, CINAHL, Scopus, and Web of Science, were searched to identify
studies that evaluated the effects of regional nerve blocks on POD and
POCD. The primary outcome was the incidence of POD or POCD during the
postoperative recovery period. The secondary outcome was postoperative
pain scores at 24 and 48 h after surgery. We estimated the log odds ratio
(LOR) and standardized mean difference using the Hedges' g method with 95%
confidence intervals (CIs) to determine the effect size using a
random-effect model. The LOR was converted to an OR when describing the
effect size of categorical data. Results. A total of 1010 adult patients
from seven randomized controlled trials were included in the final
analysis. The incidence of POD and POCD was 14.1% and 16.7%, respectively,
in the regional nerve block group, and 27.3% and 35.2%, respectively, in
the control group. The pooled effect size revealed that regional nerve
blocks significantly reduced the incidence of POD (OR, 0.44; 95% CI 0.30
to 0.64; P < 0.001; I2 = 0.00%) and POCD (OR 0.43, 95% CI 0.24 to 0.76; P
< 0.001; I2 = 0.00%) in adult patients undergoing cardiothoracic surgery.
Additionally, adults in the regional nerve block group reported
significantly lower pain scores than those in the control group at 24 h
(SMD, - 2.60; 95% CI - 3.90 to - 1.30, P < 0.001; I2 = 97.68%) and 48 h
(SMD - 1.80, 95%CI - 3.18 to - 0.41, P = 0.01; I2 = 98.14%)
postoperatively. Conclusions. Regional nerve blocks can reduce the
incidence of POD and improve POCD in adult patients after cardiothoracic
surgery.

<36>
Accession Number
642885400
Title
HYPE-2-efficacy of the hypotension prediction index with diagnostic
guidance on hypotension during elective cardiac surgery and postoperative
intensive care unit admission-a randomised clinical trial.
Source
Intensive Care Medicine Experimental. Conference: European Society of
Intensive Care Medicine Annual Congress, ESICM 2023. Milan Italy.
11(Supplement 1) (no pagination), 2023. Date of Publication: 2023.
Author
Schuurmans J.; Rellum S.R.; Schenk J.; Van Der Ster B.J.P.; Van Der Ven
W.H.; Geerts B.F.; Hollmann M.W.; Cherpanath T.G.V.; Lagrand W.K.;
Wynandts P.; Paulus F.; Driessen A.H.G.; Terwindt L.E.; Eberl S.; Hermanns
H.; Veelo D.P.; Vlaar A.P.J.
Institution
(Schuurmans, Rellum, Cherpanath, Lagrand, Paulus, Vlaar) Adult Intensive
Care, Amsterdam UMC location University of Amsterdam, Amsterdam,
Netherlands
(Schenk, Van Der Ster, Van Der Ven, Hollmann, Wynandts, Terwindt, Eberl,
Hermanns, Veelo) Anesthesiology, Amsterdam UMC Location University of
Amsterdam, Amsterdam, Netherlands
(Geerts) AI,Healthplus.ai, Amsterdam, Netherlands
(Driessen) Cardiothoracic Surgery, Amsterdam UMC Location University of
Amsterdam, Amsterdam, Netherlands
Publisher
Springer
Abstract
Introduction: Maintaining adequate perfusion is a pivotal aspect of
intraoperative and critical care. Mean arterial blood pressure (MAP) is
often used as a surrogate for perfusion pressure [1, 2]. The Hypotension
Prediction Index (HPI) is a machine learning-derived algorithm that
enables clinicians to initiate hemodynamic interventions prior to the
onset of hypotension [3]. The use of HPI in combination with a diagnostic
guidance protocol led to a significant reduction in the severity of
hypotension in five out of six non-cardiac surgery trials [4-9], but its
efficacy during cardiac surgery and intensive care unit (ICU) stay is to
be determined. Objective(s): Our primary objective was to test in a
randomised trial the efficacy of HPI with a diagnostic guidance protocol
on top of standard of care on reducing the severity of hypotension during
elective onpump coronary artery bypass grafting (CABG) procedures and
postoperative ICU stay. The secondary objectives were to assess
differences in the severity of hypertension and the total dosage of
administered fluids and medication. Method(s): Single-centre,
single-blinded randomised clinical trial conducted at the Amsterdam
University Medical Centres, the Netherlands. Adult patients scheduled for
an elective on-pump CABG procedure with or without additional single heart
valve surgery were eligible if a MAP of >= 65 mmHg was the set target
during the off-pump phases of the procedure and the subsequent ICU
admission. After providing informed consent, the participants were
randomised in a 1:1 allocation ratio to the HPI-guided or standard care
arm. An Acumen IQ sensor connected to a HemoSphere monitor was attached to
the arterial catheter in all patients (Edwards Lifesciences, Irvine, CA,
USA). However, clinicians were only provided with HPI and the additional
diagnostic guidance protocol in the HPI-guided arm. In the standard care
group, HPI was measured, but the HemoSphere was covered, and alerts were
silenced. Once HPI was >= 75 for at least one minute, treatment within two
minutes was suggested to the clinician (Figure 1). In the operating room,
treatment type and dosage were left to the anaesthesiologist's discretion.
A nurse-driven hypotension treatment protocol was created for use in the
ICU to minimise treatment delay. Result(s): Between May 2021 and
March 2023, 142 out of 450 eligible patients were enrolled, with 130
included in the final analysis (Figure 2). The patients' baseline
characteristics were well-balanced in the two groups. The overall
time-weighted average of hypotension was significantly lower in the
HPI-guided arm, with a median of differences of 0.40 mmHg (95% CI
0.26-0.65 mmHg; P <= 0.0001) (Figure 3). An overview of the secondary
endpoint results is available in Table 1. Conclusion(s): The use of
HPI in combination with a diagnostic guidance protocol and nurse-driven
treatment protocol on top of standard of care significantly decreased the
severity of hypotension in elective CABG patients without increasing the
severity of hypertension compared to standard care alone.

<37>
Accession Number
642885305
Title
Brain computer tomography perfusion in patients with suspected ischemic
cerebral conditions after cardiac surgery.
Source
Intensive Care Medicine Experimental. Conference: European Society of
Intensive Care Medicine Annual Congress, ESICM 2023. Milan Italy.
11(Supplement 1) (no pagination), 2023. Date of Publication: 2023.
Author
Liu H.; Luo M.H.; Luo J.C.; Zhang Y.J.; Hao G.W.; Hou J.Y.; Su Y.; Ma
G.G.; Wang C.S.; Tu G.W.; Luo Z.
Institution
(Liu, Luo, Luo, Zhang, Hao, Hou, Su, Ma, Tu, Luo) Cardiac Intensive Care
Center, Zhongshan Hospital, Fudan University, Shanghai, China
(Wang) Department of Cardiac Surgery, Zhongshan Hospital, Fudan
University, Shanghai, China
Publisher
Springer
Abstract
Introduction. Non-contrast CT (NCCT) imaging of the head is widely
accepted in evaluating acute stroke. However, its sensitivity in
identifying the ischemic regions is low. Current guidelines only recommend
using NCCT to exclude hemorrhage [1]. To assess the extent of brain
ischemia, CT perfusion (CTP) helps to evaluate the hemodynamic status of
brain with quantified perfusion values. Several randomized controlled
trials have also used CTP results to guide thrombodectomy [2].
Unfortunately, the advantages of CTP imaging in the assessment of
patients, who have undergone cardiac surgery, are largely unknown.
Objectives. To investigate the association between CTP results and
neurological outcomes, and to compare NCCT and CTP in terms of their
correlation with clinical outcomes in patients with suspected ischemic
cerebral conditions after cardiac surgery. Methods. Data of patients
undergoing cardiac surgery presenting with postoperative neurological
symptoms were prospectively collected from June 2020 to July 2022. NCCT
was used to exclude those with cerebral hemorrhage. Patients with
suspected ischemic cerebral conditions examined by both NCCT and CTP were
included. ASPECT score was calculated. Volume of CBF < 30%, volume of Tmax
> 6.0 s and mismatch volume were determined based on CTP images to reflect
ischemic core and penumbra. The primary outcome was the Modified Rankin
Scale (mRS) on discharge from hospital. Secondary outcomes included
in-hospital mortality, length of hospital and intensive care unit stay,
and tracheotomy. The area under the receiver operating characteristic
(AUROC) curve was used to evaluate the predictive power. Results. 9134
patients were screened. Among them, 132 presented with postoperative
neurological symptoms. 45 patients were included for the analysis. There
was no statistically significant difference in mRs on discharge between
patients with a positive initial NCCT result and those with a negative
result (4.00 vs 3.00, P = 0.062). There was also no significant difference
in all the secondary outcomes stratified by NCCT results. Patients with
unfavorable neurological outcomes (mRs > 3) had significantly lower ASPECT
score (P = 0.034), higher volume of ischemic core (P < 0.001) and penumbra
(P < 0.002) (Table). The ASPECT score, volume of ischaemic core and
penumbra correlated with the mRS on discharge. The AUROC of the ASPECT
score, volume of ischemic core and penumbra in predicting unfavorable
neurological outcomes were 0.679 (0.523-0.810), 0.792 (0.644-0.898) and
0.696 (0.541-0.824) respectively (Fig. 2). Conclusions. NCCT result was
not associated with the neurological outcome in patients with suspected
ischemic cerebral conditions after cardiac surgery. Patients with
unfavorable neurological outcomes presented significantly worse markers on
CTP. Volume of ischemic core on CTP may be better to predict the
neurological outcomes in patients with suspected ischemic cerebral
conditions after cardiac surgery.

<38>
Accession Number
642884841
Title
Risk factors for readmission after isolated coronary bypass graft surgery:
context matters.
Source
European Journal of Cardiovascular Nursing. Conference: Association of
Cardiovascular Nursing and Allied Professions, ACNAP 2023. Edinburgh
United Kingdom. 22(Supplement 1) (pp i92), 2023. Date of Publication:
August 2023.
Author
Wynne R.; Mctier L.; Matthews S.; Nolte J.; Ferguson C.
Institution
(Wynne, Mctier, Matthews, Nolte, Ferguson) 1Royal Melbourne Hospital,
Cardiothoracic Surgery, Melbourne, Australia Deakin University, Melbourne,
Australia University of Wollongong, Wollongong, Australia
Publisher
Oxford University Press
Abstract
Background: Risk prediction scores are primarily based on preoperative
factors and most applicable to their country of origin. Factors that
contribute to these scores are commonly used to predict risk of
readmission that is also highly variable. A recent systematic review of
risk factors for unplanned readmission after first time isolated coronary
artery bypass grafting (CABG)1 included cohort studies from the USA alone.
 Purpose(s): To contrast risk factors for unplanned readmission in an
Australian cohort with those identified in the systematic review.
 Method(s): A single centre, retrospective cohort analysis of adult
patients from a major metropolitan tertiary teaching hospital having first
time isolated CABG (N = 6155) between August 2002 and 2022. Unplanned
inpatient readmission within 30-days of surgery was the primary outcome
measure. Direct entry logistic regression modelling was used to identify
risk factors for readmission in this cohort. Result(s): The rate of
readmission was 10.6% (n = 655). Female sex (OR 1.0, 95%CI 1-1.01),
preoperative dialysis (OR 3.3, 95%CI 2.19-5.12), preoperative atrial
fibrillation (OR 1.4, 95%CI 1.06-1.87), diabetes (OR 1.22, 95%CI
1.03-1.45), and peripheral vascular disease (OR 1.3, 95%CI 1.05-1.67) were
the only significant predictors retained in the full model (c2(27, N =
6155) = 111.28, p <0.001) that correctly classified 89.3% of cases but
only explained 3.6% (Nagelkerke R squared) of variation in readmission
rate. The Hosmer-Lemeshow goodness of fit test indicated good support for
the model despite this (p 0.841). Conclusion(s): Risk factors predicting
readmission in this patient cohort were not consistent with those
identified in the review of studies from the USA. Risk prediction is
context specific. Research investigating factors associated with risk
needs to capture variables that impact on context.

<39>
Accession Number
642884833
Title
A pilot RCT of an mHealth self-help intervention on readmission rate
reduction after adult cardiac surgery: preliminary findings.
Source
European Journal of Cardiovascular Nursing. Conference: Association of
Cardiovascular Nursing and Allied Professions, ACNAP 2023. Edinburgh
United Kingdom. 22(Supplement 1) (pp i91), 2023. Date of Publication:
August 2023.
Author
Nolte J.; Wynne R.; Matthews S.; Angel J.; Moore A.; Campbell T.; Ferguson
C.
Institution
(Nolte, Wynne, Matthews, Angel, Moore, Campbell, Ferguson) 1Royal
Melbourne Hospital, Cardiothoracic Surgery, Melbourne, Australia
University of Wollongong, Wollongong, Australia
Publisher
Oxford University Press
Abstract
Background: Readmission is multifaceted, potentially avoidable and costly.
Patients' ability to enact self-care behaviors after cardiac surgery are
under-investigated. Purpose(s): To evaluate the feasibility of a RCT
investigating an mHealth intervention for self-help, and readmission rate
reduction. Method(s): Elective adult (>18 years) elective cardiac
surgery (via median sternotomy) patients were eligible for inclusion.
Patients had to be discharged home, able to understand spoken English, and
own and use a smartphone, tablet or computer. The intervention comprised a
narrative online library (Healthily GoShare platform) with videos
describing patient and carer experiences focused on preoperative
preparation, acute postoperative care (sent within 1 week of discharge)
and ongoing recovery Sent 30 days after surgery). Patients were randomised
preoperatively 1:1 to the intervention, accessible via a text or email
link, or the control group receiving usual care that comprised
postoperative education and a brochure. Follow-up phone interviews took
place 30, 60 and 90 days after surgery. Result(s): From August 2021
to December 2022, 341 (65%) patients were scheduled for elective surgery,
229 (67.2%) were transferred elsewhere secondary to COVID-19 bed closures,
22 (6.5%) were undergoing reoperation, 13 (3.8%) did not adequately
understand spoken English and 7 (2.1%) did not own a smartphone or tablet.
Of the 70 (20.5%) eligible patients, 61 (87.1%) agreed to participate and
2 (2.8%) did not proceed. Follow-up (FUP) is complete for 43 (72.9%)
patients. Accessed preoperative 14 (63.6%), postoperative 16 (72.7%) and
recovery bundles 12 (54.5%) were reported as helpful or very helpful by
95% (n = 21) of participants. A single patient from the intervention group
was lost to FUP at 30 days and 5 control group patients at 60 days. 30-day
readmission was more frequent in the control (3/21, 14.3%) than
intervention group (0/22; p = 0.06). Conclusion(s): Findings to date
indicate COVID-19 bed closures have impacted on elective surgical
scheduling thus recruitment. The intervention was feasible and acceptable.
To be 95% confident the readmission rate is within 10%, assuming a 15%
readmission rate, a minimum of 50 patients are required. Follow-up is
ongoing.

<40>
Accession Number
642884822
Title
The effects of music in cardiac surgery patients: early results.
Source
European Journal of Cardiovascular Nursing. Conference: Association of
Cardiovascular Nursing and Allied Professions, ACNAP 2023. Edinburgh
United Kingdom. 22(Supplement 1) (pp i90), 2023. Date of Publication:
August 2023.
Author
Carroll D.L.; Donahue V.; Velez C.L.
Institution
(Carroll, Donahue, Velez) Massachusetts General Hospital, Boston, MA,
United States
Publisher
Oxford University Press
Abstract
Background/Significance: Research into the health benefits of music has
expanded, driven by a desire to see how it can be better applied in
healthcare. There has been an interest in the chemical and biological
biomarkers of music. Most studies have focused on physical, and
psychological findings. There have been few systematic studies that
consider the parallel psychological, physical, and biological effects of
music in cardiac surgical patients. Purpose(s): The purpose of this
study is to measure psychological, physiological, and biological responses
to a music intervention compared to standard of care in cardiac surgical
patients. The primary outcome is serum cortisol levels pre and post a
30-minute music intervention compared to the standard of care group. The
secondary outcomes are state anxiety, pain, blood pressure, heart rate,
respirations, and serum Immunoglobulin A (IgA). Method(s): This is a
randomized, placebo-controlled, pre/post clinical trial to compared
responses to the study intervention of music versus standard of care.
Psychological responses were measured for anxiety by the Spielberger State
Anxiety Scale, and pain by a visual analogy scale, physical responses were
measured by blood pressure, heart rate, and respirations, and the biologic
markers were measured by serum cortisol and IgA. Result(s):
Sixty-three patients were approached, 14 were excluded and 25 declined
participation. Most patients who declined stated that they did not feel
well enough to participate or did not want more blood samples taken. There
were 20 subjects, 15 males and 5 females, mean age of 58.8 years, who did
participate. The groups were similar on demographics and pre intervention
outcome measures. There was no difference between standard of care and
treatment group in the primary outcome, serum cortisol levels (17.8+7.4 vs
15.6+7.6) and no differences in the secondary outcomes post the
intervention period. Conclusion(s): This is the early results of a
study on use of music as a nursing intervention in cardiac surgery
patients. Subject enrollment will continue to provide evidence of the
benefits for patients after cardiac surgery.

<41>
Accession Number
642891151
Title
Efficacy of neuromuscular electrical stimulation for thoracic and
abdominal surgery: A systematic review and meta-analysis.
Source
PloS one. 18(11) (pp e0294965), 2023. Date of Publication: 2023.
Author
Nakashima Y.; Iwaki D.; Kataoka Y.; Ariie T.; Taito S.; Nishikawa Y.; Mio
N.; Mikami Y.
Institution
(Nakashima, Iwaki, Taito, Mio) Division of Rehabilitation, Department of
Clinical Practice and Support, Hiroshima University Hospital, Hiroshima,
Japan
(Nakashima, Kataoka, Ariie, Taito) Scientific Research WorkS Peer Support
Group (SRWS-PSG), Osaka, Japan
(Iwaki) Department of Neuromechanics, Graduate School of Biomedical and
Health Sciences, Hiroshima University, Hiroshima, Japan
(Kataoka) Department of Internal Medicine, Kyoto Min-iren Asukai Hospital,
Kyoto, Japan
(Kataoka) Section of Clinical Epidemiology, Department of Community
Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
(Kataoka) Department of Healthcare Epidemiology, Kyoto University Graduate
School of Medicine / Public Health, Kyoto, Japan
(Ariie) Department of Physical Therapy, School of Health Sciences at
Fukuoka, International University of Health and Welfare, Fukuoka, Japan
(Nishikawa) Faculty of Frontier Engineering, Institute of Science &
Engineering, Kanazawa University, Kanazawa, Japan
(Mikami) Department of Rehabilitation Medicine, Hiroshima University
Hospital, Hiroshima, Japan
Abstract
This systematic review and meta-analysis examined the efficacy of
neuromuscular electrical stimulation (NMES) on lower limb muscle strength
and health-related quality of life (HR-QOL) after thoracic and abdominal
surgery. We searched the Cochrane Central Register of Controlled Trials,
MEDLINE via PubMed, Excerpta Medica Database via Elsevier, Physiotherapy
Evidence Database, Cumulative Index to Nursing and Allied Health
Literature, World Health Organization International Clinical Trials
Registry Platform via their dedicated search portal, and
ClinicalTrials.gov on November 2021 and updated in April 2023 to identify
randomized controlled trials that examined the effects of NMES after
thoracic and abdominal surgery. The primary outcomes were lower limb
muscle strength, HR-QOL, and adverse events. We used the Cochrane Risk of
Bias Tool and the Grading of Recommendations, Assessment, Development, and
Evaluation approach to assess the certainty of evidence. A total of 18
randomized control trials involving 915 participants, including 10 on
cardiovascular surgery, two on pulmonary surgery, five on digestive system
surgery, and one on other surgery, were included. NMES slightly increased
lower limb muscle strength and adverse events in cardiovascular surgery.
Adverse events (hypotension, pain, and muscle discomfort) occurred in
seven patients. HR-QOL was measured in two studies on cardiovascular
surgery, but these were not pooled due to concept heterogeneity. Overall,
NMES slightly increases lower limb muscle strength after cardiovascular
surgery without serious adverse events. However, higher-quality randomized
control trials in thoracic and abdominal surgeries are
needed. Copyright: © 2023 Nakashima et al. This is an open access
article distributed under the terms of the Creative Commons Attribution
License, which permits unrestricted use, distribution, and reproduction in
any medium, provided the original author and source are credited.

<42>
Accession Number
642887273
Title
Systematic review of first-in-human and early phase clinical trials for
surgically implantable biological mitral valve substitutes.
Source
Journal of cardiothoracic surgery. 18(1) (pp 348), 2023. Date of
Publication: 30 Nov 2023.
Author
Sazzad F.; Tan Y.K.; Chan L.X.B.; Moideen I.S.B.M.; Gohary A.E.; Stevens
J.C.; Ramanathan K.R.; Kofidis T.
Institution
(Sazzad) Department of Surgery, Yong Loo Lin School of Medicine, Centre
for Translational Medicine, National University of Singapore, 14 Medical
Drive 117599, Singapore
(Tan, Chan, Moideen, Gohary, Stevens, Ramanathan, Kofidis) Department of
Surgery, Yong Loo Lin School of Medicine, Centre for Translational
Medicine, National University of Singapore, 14 Medical Drive 117599,
Singapore
(Ramanathan, Kofidis) Department of Cardiac, Thoracic and Vascular
Surgery, National University Heart Centre, National University Hospital,
Singapore
Abstract
BACKGROUND: The aim of this review was the creation of uniform protocols
to carry out and disclose First-In-Human and preliminary clinical trials
of biological mitral valve replacement. The need for consistent
methodology in these early trials was highlighted by the observation of
significant variability in the methods and protocols used across different
research. METHOD(S): An extensive search through six major databases
was carried out to retrieve First-In-Human (FIH) clinical studies
evaluating surgically implanted bio-prostheses in the mitral position.
 RESULT(S): Following the PRISMA guideline, a systematic search
identified 2082 published articles until March 2023. After removing
duplicates (189), 1862 citations were screened, resulting in 22 eligible
studies with 3332 patients for analysis. The mitral valve prostheses in
these studies ranged from 21 to 37 mm, with the 29 mm size being most
prevalent. Patient numbers varied, with the FIH subgroup including 31
patients and the older subgroup including 163 patients. Average study
durations differed: the older subgroup lasted 4.57 years, the FIH subgroup
2.85 years, and the early phase studies spanned 8.05 years on average.
 CONCLUSION(S): FIH clinical report is essential to assess the
significance of clinical data required for a "de novo" surgical implant.
In addition, understanding the performance of the device, and recognizing
the difficulties associated with the innovation constitute important
lessons. These insights could be beneficial for the development of
bioprosthetic heart valves and formulating a protocol for an FIH clinical
trial. Copyright © 2023. The Author(s).

<43>
Accession Number
2028793628
Title
Neurocognition in adults with congenital heart disease post-cardiac
surgery: A systematic review.
Source
Heart and Lung. 64 (pp 62-73), 2024. Date of Publication: 01 Mar 2024.
Author
Cabrera-Mino C.; DeVon H.A.; Aboulhosn J.; Brecht M.-L.; Choi K.R.; Pike
N.A.
Institution
(Cabrera-Mino) University of California Los Angeles, United States
(DeVon) Professor and Associate Dean for Research, University of
California Los Angeles, United States
(Aboulhosn, Pike) Professor University of California Los Angeles, United
States
(Brecht) Adjunct Professor University of California Los Angeles, United
States
(Choi) Assistant Professor University of California Los Angeles, United
States
Publisher
Elsevier Inc.
Abstract
Background: Congenital heart disease (CHD) is the most common birth defect
worldwide. Neurocognitive deficits and psychiatric disorders, which can
impact daily life, have been reported in over 50% of adolescents and young
adults with moderate to complex CHD. Objective(s): Conduct a
systematic review of sex, clinical, psychological and social determinants
of health (SDoH) factors affecting neurocognition in adults with CHD
post-cardiac surgery. Method(s): PubMed, Cumulated Index to Nursing
and Allied Health Literature, and Embase were searched for relevant
studies over the past 5 years. Thirteen articles met inclusion criteria
of: 1) CHD post-cardiac surgery, 2) age >= 18 years, and 3) used a
validated measure of neurocognition. Result(s): A total of 507
articles were identified. After screening, 30 articles underwent full text
review yielding 13 eligible articles. Twelve articles reported deficits in
multiple domains including executive function, intellectual functioning,
visuospatial ability, and verbal fluency in more complex CHD. Only three
studies examined cognition based on sex, with female and lower parental
SES associated with worse cognitive outcomes. Most studies were from
Europe, predominantly sampled Caucasian participants, had heterogeneous
samples of CHD complexity, and lacked standardized cognitive measures
which limited generalizability of findings. Conclusion(s): Adults
with CHD present with a wide variety of cognitive deficits, with some
associations with sex, clinical history, and SDoH factors. It remains
unclear to what degree these factors affect cognition in adults with
moderate to complex CHD. Future longitudinal studies should focus on
age-related effects on cognition and potential health care disparities in
diverse CHD samples. Copyright © 2023

<44>
Accession Number
2028071817
Title
Efficacy of erector spinae plane block for minimally invasive mitral valve
surgery: Results of a double-blind, prospective randomized
placebo-controlled trial: Response to Xue et al.
Source
Journal of Clinical Anesthesia. 92 (no pagination), 2024. Article Number:
111311. Date of Publication: February 2024.
Author
Hoogma D.F.; Coppens S.; Rex S.
Institution
(Hoogma, Coppens, Rex) Department of Anesthesiology, University Hospitals
of Leuven, Leuven, Belgium
(Hoogma, Coppens, Rex) Department of Cardiovascular Sciences, Biomedical
Sciences Group, University of Leuven, Leuven, Belgium
Publisher
Elsevier Inc.

<45>
Accession Number
2026904283
Title
Prevention of new-onset atrial fibrillation in elderly patients undergoing
anatomic pulmonary resection by infusion of magnesium sulfate: protocol
for a randomized controlled trial.
Source
Frontiers in Cardiovascular Medicine. 10 (no pagination), 2023. Article
Number: 1171713. Date of Publication: 2023.
Author
Jin S.; An L.; Chen L.; Liu H.; Chen H.; Lv X.
Institution
(Jin, An, Chen, Liu, Lv) Department of Anesthesiology, Shanghai Pulmonary
Hospital, School of Medicine, Tongji University, Shanghai, China
(An) Department of Anesthesiology, Kashgar Regional Second People's
Hospital, Xinjiang, China
(Chen) Department of Anesthesiology, Tongren Hospital, Shanghai Jiao Tong
University School of Medicine, Shanghai, China
Publisher
Frontiers Media SA
Abstract
Atrial fibrillation (AF) is the most commonly sustained arrhythmia after
pulmonary resection, which has been shown to predict higher hospital
morbidity and mortality. The lack of strong evidence-based medical
evidence makes doctors have very few options for medications to prevent
new-onset AF following thoracic surgery. Magnesium can prevent
perioperative AF in patients undergoing cardiac surgery. However, this has
not yet been fully studied in patients undergoing non-cardiac thoracic
surgery, which is the aim of this study. This is a single-center,
prospective, double-blind, randomized controlled trial. In total, 838
eligible patients were randomly assigned to one of two study groups,
namely, the control group or the magnesium group. The patients in the
magnesium group preoperatively received 80 mg magnesium sulfate/kg ideal
weight in 100 ml normal saline 30 min. The control group received the same
volumes of normal saline simultaneously. The primary outcome is the
incidence of new-onset AF intra-operative and on the first, second, and
third postoperative days. The secondary outcomes are bradycardia,
hypertension, hypotension, and flushing. The occurrence of stroke or any
other type of arrhythmia is also recorded. Postoperative respiratory
suppression and gastrointestinal discomfort, intensive care unit stays and
total duration of hospital stays, in-hospital mortality, and 3-month
all-cause mortality are also recorded as important outcomes. This study
aims to prospectively evaluate the prophylactic effects of magnesium
sulfate against AF compared with a placebo control group during and
following anatomic pulmonary resection. The results may provide reliable
evidence for the prophylactic value of magnesium against AF in patients
with lung cancer. The trial was approved by the Clinical Research Ethics
Committee of Shanghai Pulmonary Hospital and has been registered at
Chinese Clinical Trial Registry: www.chictr.org.cn, identifier:
ChiCTR2300068046. Copyright 2023 Jin, An, Chen, Liu, Chen and Lv.

<46>
Accession Number
2028762843
Title
Comparison of video assisted thoracoscopic surgery and thoracotomy for
treatment of pleural infection stage II and III: a literature review.
Source
Journal of Thoracic Disease. 15(11) (pp 6323-6332), 2023. Date of
Publication: 2023.
Author
Steen K.; Sorensen J.; Christensen M.; Petersen R.H.; Naidu B.; Bendixen
M.; Rahman N.M.; Laursen C.B.; Christensen T.D.
Institution
(Steen, Sorensen, Bendixen, Christensen) Department of Cardiothoracic and
Vascular Surgery, Aarhus University Hospital, Aarhus, Denmark
(Christensen, Petersen) Department of Cardiothoracic Surgery, Copenhagen
University Hospital, Rigshospitalet, Copenhagen, Denmark
(Petersen) Institute for Clinical Medicine, Faculty of Health Sciences,
University of Copenhagen, Copenhagen, Denmark
(Naidu) Department of Thoracic Surgery, Queen Elizabeth Hospital
Birmingham, Birmingham, United Kingdom
(Naidu) Institute of Inflammation and Ageing, University of Birmingham,
Birmingham, United Kingdom
(Rahman) NIHR Oxford Biomedical Research Centre, University of Oxford,
Oxford, United Kingdom
(Laursen) Department of Respiratory Medicine, Odense University Hospital,
Odense, Denmark
(Laursen) Odense Respiratory Research Unit (ODIN), Department of Clinical
Research, University of Southern Denmark, Odense, Denmark
(Christensen) Department of Clinical Medicine, Aarhus University Hospital,
Aarhus, Denmark
Publisher
AME Publishing Company
Abstract
Background and Objective: Pleural infection is associated with significant
mortality and morbidity worldwide, with a steadily increasing incidence.
We sought to investigate whether video-assisted thoracic surgery (VATS) or
thoracotomy provides the best outcomes in the treatment of stage II and
III pleural infection as indications remain controversial. Method(s):
Systematic review of relevant articles from the PubMed database. Key
Content and Findings: Nine non-randomized retrospective studies published
between 1996 and 2020 with a total of 2,121 patients were included.
Results varied between studies, but overall shorter operative and recovery
times and greater patient satisfaction were demonstrated using VATS
compared with thoracotomy. Conclusion(s): Although VATS and
thoracotomy are viable treatment options for stage II and III pleural
infection, VATS has potential advantages in terms of decreased operation
time, fewer days with tube drainage, shorter postoperative hospital stay,
reduced postoperative pain, increased patient satisfaction with the
procedure, and wound appearance. VATS has limitations in the treatment of
patients with stage III pleural infection, where delayed surgical referral
has been shown to increase the risk of intraoperative conversion to
thoracotomy. The data to date implies that debridement by VATS should be
proposed as soon as possible in stage II pleural infection and considered
in cases of stage III pleural infection. Copyright © Journal of
Thoracic Disease. All rights reserved.

<47>
Accession Number
2028808293
Title
Peripheral Regional Anesthetic Techniques in Cardiac Surgery: A Systematic
Review and Meta-Analysis.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2023.
Date of Publication: 2023.
Author
Schmedt J.; Oostvogels L.; Meyer-Friessem C.H.; Weibel S.; Schnabel A.
Institution
(Schmedt, Oostvogels, Schnabel) Department of Anesthesiology, Intensive
Care and Pain Medicine, University Hospital of Muenster,
Albert-Schweitzer-Campus 1, Muenster, Germany
(Meyer-Friesem) Department of Anesthesiology, Intensive Care Medicine and
Pain Medicine, BG-Universitatsklinikum Bergmannsheil gGmbH, Medical
Faculty of Ruhr University Bochum, Burkle-de-la-Camp-Platz 1, Bochum,
Germany
(Weibel) Department of Anesthesiology, Intensive Care, Emergency and Pain
Medicine, University Hospital Wuerzburg, Wuerzburg, Germany
Publisher
W.B. Saunders
Abstract
Objective: The aim of this systematic review was to investigate
postoperative pain outcomes and adverse events after peripheral regional
anesthesia (PRA) compared to no regional anesthesia (RA), placebo, or
neuraxial anesthesia in children and adults undergoing cardiac surgery.
 Design(s): A systematic review and meta-analysis with an assessment
of the risk of bias (Cochrane RoB 1) and certainty of evidence (Grading of
Recommendations, Assessment, Development, and Evaluation).
 Setting(s): Randomized controlled trials (RCTs). Participant(s):
Adults and children undergoing heart surgery. Intervention(s): Any
kind of PRA compared to no RA or placebo or neuraxial anesthesia.
 Measurements and Main Results: In total, 33 RCTs (2,044 patients)
were included-24 of these had a high risk of bias, and 28 were performed
in adults. Compared to no RA, PRA may reduce pain intensity at rest 24
hours after surgery (mean difference [MD] -0.81 points, 95% CI -1.51 to
-0.10; I2 = 92%; very low certainty evidence). Peripheral
regional anesthesia, compared to placebo, may reduce pain intensity at
rest (MD -1.36 points, 95% CI -1.59 to -1.13; I2 = 54%; very
low certainty evidence) and during movement (MD -1.00 points, 95% CI -1.34
to -0.67; I2 = 72%; very low certainty evidence) 24 hours after surgery.
No data after pediatric cardiac surgery could be meta-analyzed due to the
low number of included trials. Conclusion(s): Compared to no RA or
placebo, PRA may reduce pain intensity at rest and during movement.
However, these results should be interpreted cautiously because the
certainty of evidence is only very low. Copyright © 2023 Elsevier
Inc.

<48>
Accession Number
642888158
Title
Coronary Stent Infection: A Systematic Review of Literature.
Source
Cardiology in review. (no pagination), 2023. Date of Publication: 01 Dec
2023.
Author
Ayyubi S.A.S.; Rehman A.; Fatima L.; Ahmed M.; Rehman M.U.; Zameer R.;
Malik J.
Institution
(Ayyubi) From the Department of Cardiovascular Medicine, Cardiovascular
Analytics Group, Islamabad, Pakistan
Abstract
Coronary stent infection is a rare yet serious complication of coronary
artery stenting, with potentially significant morbidity and mortality.
This systematic review aimed to comprehensively assess the available
evidence on the diagnosis, management, and outcomes of coronary stent
infection. A comprehensive search of electronic databases, including
PubMed, Embase, Cochrane Library, and Scopus, was conducted from inception
until March 2023, in accordance with Preferred Reporting Items for
Systematic Reviews and Meta-Analyses guidelines. A total of 1 case series
and 41 case reports, covering a cumulative sample size of 44 patients,
were included in the analysis. The predominant stent types were
drug-eluting stents in 22 studies, bare-metal stents in 3 studies, and a
combination of drug-eluting stents and bare-metal stents in 4 studies.
Staphylococcus aureus was the predominant identified organism in
microbiological profiles. Primary outcomes, including mortality,
morbidity, and recurrence rates, were evaluated. The aggregate mortality
rate across studies was 18%, underscoring the severity of coronary stent
infections. Morbidity ranged from 3% to 60%, with a spectrum of
complications such as sepsis, heart failure, and embolic events.
Recurrence rates varied from 3% to 33%, emphasizing the importance of
effective management. Treatment strategies encompassed antibiotics alone,
antibiotics with stent removal, and antibiotics with stent retention, with
the duration of antibiotic therapy ranging from 2 weeks to 12 months. The
optimal management strategy remains uncertain due to limited high-quality
evidence. Early diagnosis and treatment were emphasized as critical
factors in improving outcomes. Prophylactic antibiotics during stenting
procedures and increased awareness among healthcare providers were
suggested as preventive measures. Copyright © 2023 Wolters Kluwer
Health, Inc. All rights reserved.

<49>
Accession Number
642887013
Title
Preoperative respiratory muscle training reduces the risk of pulmonary
complications and the length of hospital stay after cardiac surgery: a
systematic review.
Source
Journal of physiotherapy. (no pagination), 2023. Date of Publication: 29
Nov 2023.
Author
Cursino de Moura J.F.; Oliveira C.B.; Coelho Figueira Freire A.P.; Elkins
M.R.; Pacagnelli F.L.
Institution
(Cursino de Moura, Oliveira) Faculty of Medicine, University of Western
Sao Paulo (UNOESTE), Presidente Prudente, Brazil
(Coelho Figueira Freire) Department of Health Sciences, Central Washington
University, Ellensburg, United States
(Elkins) Faculty of Medicine and Health, University of Sydney, Sydney,
Australia; Sydney Education, Sydney Local Health District, Sydney,
Australia
(Pacagnelli) Physiotherapy Department, University of Western Sao Paulo
(UNOESTE), Presidente Prudente, Brazil
Abstract
QUESTIONS: What is the effect of preoperative respiratory muscle training
(RMT) on the incidence of postoperative pulmonary complications (PPCs)
after open cardiac surgery? What is the effect of RMT on the duration of
mechanical ventilation, postoperative length of stay and respiratory
muscle strength? DESIGN: Systematic review of randomised trials with
meta-analysis. PARTICIPANTS: Adults undergoing elective open cardiac
surgery. INTERVENTION: The experimental groups received preoperative RMT
and the comparison groups received no intervention. OUTCOME MEASURES: The
primary outcomes were PPCs, length of hospital stay, respiratory muscle
strength, oxygenation and duration of mechanical ventilation. The
methodological quality of studies was assessed using the PEDro scale and
the overall certainty of the evidence was assessed using the GRADE
approach. RESULT(S): Eight trials involving 696 participants were
included. Compared with the control group, the respiratory training group
had fewer PPCs (RR 0.51, 95% CI 0.38 to 0.70), less pneumonia (RR 0.44,
95% CI 0.25 to 0.78), shorter hospital stay (MD -1.7 days, 95% CI -2.4 to
-1.1) and higher maximal inspiratory pressure values at the end of the
training protocol (MD 12 cmH2O, 95% CI 8 to 16). The mechanical
ventilation time was similar in both groups. The quality of evidence was
high for pneumonia, length of hospital stay and maximal inspiratory
pressure. CONCLUSION(S): Preoperative RMT reduced the risk of PPCs
and pneumonia after cardiac surgery. The training also improved the
maximal inspiratory pressure and reduced hospital stay. The effects on
PPCs were large enough to warrant use of RMT in this population.
REGISTRATION: CRD42021227779. Copyright © 2023 Australian
Physiotherapy Association. Published by Elsevier B.V. All rights reserved.

<50>
Accession Number
642886850
Title
2023 ACC/AHA/ACCP/HRS Guideline for the Diagnosis and Management of Atrial
Fibrillation: A Report of the American College of Cardiology/American
Heart Association Joint Committee on Clinical Practice Guidelines.
Source
Circulation. (no pagination), 2023. Date of Publication: 30 Nov 2023.
Author
Joglar J.A.; Chung M.K.; Armbruster A.L.; Benjamin E.J.; Chyou J.Y.;
Cronin E.M.; Deswal A.; Eckhardt L.L.; Goldberger Z.D.; Gopinathannair R.;
Gorenek B.; Hess P.L.; Hlatky M.; Hogan G.; Ibeh C.; Indik J.H.; Kido K.;
Kusumoto F.; Link M.S.; Linta K.T.; Marcus G.M.; McCarthy P.M.; Patel N.;
Patton K.K.; Perez M.V.; Piccini J.P.; Russo A.M.; Sanders P.; Streur
M.M.; Thomas K.L.; Times S.; Tisdale J.E.; Valente A.M.; Van Wagoner D.R.
Institution
(Armbruster, Deswal) ACC/AHA Joint Committee on Clinical Practice
Guidelines liaison
(Hess) ACC/AHA Joint Committee on Performance Measures liaison
(Hogan, Linta) Lay stakeholder representative
(Kido) American College of Clinical Pharmacy representative, United States
(Russo) Heart Rhythm Society representative
(Times) Joint ACC/AHA staff representative
(Valente) ACC/AHA Joint Committee on Clinical Data Standards liaison
Abstract
AIM: The "2023 ACC/AHA/ACCP/HRS Guideline for the Diagnosis and Management
of Atrial Fibrillation" provides recommendations to guide clinicians in
the treatment of patients with atrial fibrillation. METHOD(S): A
comprehensive literature search was conducted from May 12, 2022, to
November 3, 2022, encompassing studies, reviews, and other evidence
conducted on human subjects that were published in English from PubMed,
EMBASE, the Cochrane Library, the Agency for Healthcare Research and
Quality, and other selected databases relevant to this guideline.
Additional relevant studies, published through November 2022, during the
guideline writing process, were also considered by the writing committee
and added to the evidence tables, where appropriate. STRUCTURE: Atrial
fibrillation is the most sustained common arrhythmia, and its incidence
and prevalence are increasing in the United States and globally.
Recommendations from the "2014 AHA/ACC/HRS Guideline for the Management of
Patients With Atrial Fibrillation" and the "2019 AHA/ACC/HRS Focused
Update of the 2014 AHA/ACC/HRS Guideline for the Management of Patients
With Atrial Fibrillation" have been updated with new evidence to guide
clinicians. In addition, new recommendations addressing atrial
fibrillation and thromboembolic risk assessment, anticoagulation, left
atrial appendage occlusion, atrial fibrillation catheter or surgical
ablation, and risk factor modification and atrial fibrillation prevention
have been developed.

<51>
Accession Number
642883543
Title
Reply: A need for randomized prospective trial for early aortic valve
repair in asymptomatic aortic regurgitation.
Source
The Journal of thoracic and cardiovascular surgery. (no pagination),
2023. Date of Publication: 28 Nov 2023.
Author
Hanet V.; Vancraeynest D.; Gerber B.L.
Institution
(Hanet, Vancraeynest, Gerber) Department of Cardiovascular Diseases,
Cliniques Universitaires St Luc, Pole de Recherche Cardiovasculaire
(CARD), Institut de Recherche Experimentale et Clinique IREC UCLouvain,
Brussels, Belgium

<52>
Accession Number
642883089
Title
Transcatheter aortic valve durability, predictors of bioprosthetic valve
dysfunction, longer-term outcomes - a review.
Source
Expert review of medical devices. (no pagination), 2023. Date of
Publication: 30 Nov 2023.
Author
Johanna SA.; Hana L.
Institution
(Johanna, Hana) Third Faculty of Medicine, Charles University, Prague,
Czechia
(Johanna, Hana) Department of Cardiology, University Hospital Kralovske
Vinohrady, Prague, Czechia
Abstract
INTRODUCTION: Transcatheter aortic valve implantation (TAVI) is one of the
most significant inventions in cardiology, as it provides a viable
minimally invasive treatment option for patients with aortic stenosis, the
most common valvular disease in the developed world and one with a poor
prognosis when left untreated. Using data available to date, this review
aims to discuss and identify possible predictors of TAVI valve durability
- an essential requirement for the device's wide-spread use, especially in
younger patients. AREAS COVERED: This article explores the main causes of
bioprosthetic valve dysfunction (BVD) based on pathophysiology and
available data, and reviews possible predictors of BVD including
prosthesis-related, procedure-related, and patient-related factors. An
emphasis is made on affectable predictors, which could potentially be
targeted with prevention management and improve valve durability. A
literature search of online medical databases was conducted using relevant
key words and dates; significant clinical trials were identified. A brief
overview of important randomized controlled trials with mid to long-term
follow-up is included in this article. EXPERT OPINION: Identifying
modifiable predictors of valve dysfunction presents an opportunity to
enhance and predict valve durability - a necessity as patients with longer
life-expectancies are being considered for the procedure.

<53>
Accession Number
642882889
Title
Non-dual antiplatelet therapy versus dual antiplatelet therapy prior to
transcatheter aortic valve replacement: A systematic review and
meta-analysis.
Source
Journal of cardiovascular pharmacology. (no pagination), 2023. Date of
Publication: 22 Nov 2023.
Author
Zhang M.; Peng W.; Yin S.; Zhao Y.; Lin Y.
Institution
(Zhang, Peng, Yin, Zhao, Lin) Department of Pharmacy, Beijing Anzhen
Hospital, Capital Medical University, Beijing, China
(Zhang, Yin, Zhao) School of Pharmaceutical Sciences, Capital Medical
University, Beijing, China
Abstract
ABSTRACT: Transcatheter aortic valve replacement (TAVR) is an
interventional procedure performed in patients with severe aortic stenosis
and often required perioperative antiplatelet therapy. Most previous
studies have focused on antiplatelet therapy following TAVR. However, few
studies have investigated the prognostic effect of preoperative
antiplatelet therapy in patients undergoing TAVR. This study aimed to
compare the efficacy and safety of non-dual antiplatelet therapy
(non-DAPT) and dual antiplatelet therapy (DAPT) before TAVR. We performed
a systematic search of Embase, PubMed, and web of science until February
2023. Studies were eligible if they compared non-DAPT (SAPT or no
antiplatelet therapy) with DAPT in patients before TAVR. A total of five
studies, including 2,329 patients, met the inclusion criteria and were
included in the meta-analysis. Preoperative non-DAPT significantly
decreased minor bleeding events compared with preoperative DAPT (OR 0.58;
95% CI: 0.44 - 0.76). There were no significant differences in the
incidence of other bleeding events, transfusions, stroke, myocardial
infarction, or all-cause death. Preoperative SAPT significantly decreased
the incidence of major bleeding compared with DAPT (OR 0.14; 95% CI: 0.04
- 0.48). Preoperative non-DAPT significantly reduced minor bleeding events
in patients undergoing TAVR, without increasing the risk of stroke and
myocardial infarction. Copyright © 2023 Wolters Kluwer Health,
Inc. All rights reserved.

<54>
Accession Number
2028654374
Title
Burden of elevated lipoprotein(a) among patients with atherosclerotic
cardiovascular disease: Evidence from a systematic literature review and
feasibility assessment of metaanalysis.
Source
PLoS ONE. 18(11 November) (no pagination), 2023. Article Number: e0294250.
Date of Publication: November 2023.
Author
Orfanos P.; Fonseca A.F.; Hu X.; Gautam R.; Montgomery G.; Studer R.; Kaur
J.; Saxena N.; Kaushik N.
Institution
(Orfanos, Fonseca, Montgomery, Studer) Value and Access, Novartis Pharma
AG, Basel, Switzerland
(Hu) Value and Access, Novartis Pharmaceutical Corporation, East Hanover,
New Jersey, United States
(Gautam, Kaur, Saxena, Kaushik) Value and Access, Novartis Healthcare Pvt.
Ltd., Hyderabad, India
Publisher
Public Library of Science
Abstract
Background Elevated lipoprotein(a) [Lp(a)] level is an independent genetic
risk factor that increases the risk of atherosclerotic cardiovascular
disease (ASCVD) by 2-4 fold. We aimed to report the burden of clinically
relevant elevated Lp(a) in secondary prevention ASCVD population as the
evaluation of such evidence is lacking. Methods A systematic literature
review (SLR) was conducted using Embase, MEDLINE, and MEDLINE In-Process
databases to identify studies reporting burden of elevated Lp(a) levels
from January 1, 2010, to March 28, 2022. Full-text, English-language
studies including >=500 participants with >=1 Lp(a) assessment were
included. Results Sixty-one studies reported clinical burden of elevated
Lp(a). Of these, 25 observational studies and one clinical trial reported
clinical burden of clinically relevant elevated Lp(a) levels. Major
clinical outcomes included major adverse cardiovascular event (MACE; n =
20), myocardial infarction (MI; n = 11), revascularization (n = 10),
stroke (n = 10), cardiovascular (CV) mortality (n = 9), and all-cause
mortality (n = 10). Elevated Lp(a) levels significantly increased the risk
of MACE (n = 15) and revascularization (n = 8), while they demonstrated a
trend for positive association with remaining CV outcomes. Meta-analysis
was not feasible for included studies due to heterogeneity in Lp(a)
thresholds, outcome definitions, and patient characteristics. Three
studies reported humanistic burden. Patients with elevated Lp(a) levels
had higher odds of manifesting cognitive impairment (odds ratio [OR] [95%
confidence interval; CI]: 1.62 [1.11-2.37]) and disability related to
stroke (OR [95% CI]:1.46 [1.23-1.72)]) (n = 2). Elevated Lp(a) levels
negatively correlated with health-related quality of life (R = -0.166, p =
0.014) (n = 1). A single study reported no association between elevated
Lp(a) levels and economic burden. Conclusions This SLR demonstrated a
significant association of elevated Lp(a) levels with major CV outcomes
and increased humanistic burden in secondary prevention ASCVD population.
These results reinforce the need to quantify and manage Lp(a) for CV risk
reduction and to perform further studies to characterize the economic
burden. Copyright © 2023 Orfanos et al. This is an open access
article distributed under the terms of the Creative Commons Attribution
License, which permits unrestricted use, distribution, and reproduction in
any medium, provided the original author and source are credited.

<55>
Accession Number
2028654362
Title
Intravenous acetaminophen for postoperative pain in the neonatal intensive
care unit: A protocol for a pilot randomized controlled trial (IVA POP).
Source
PLoS ONE. 18(11 November) (no pagination), 2023. Article Number: e0294519.
Date of Publication: November 2023.
Author
Archer V.A.; Samiee-Zafarghandy S.; Farrokyhar F.; Briatico D.; Braga
L.H.; Walton J.M.
Institution
(Archer) Division of General Surgery, Department of Surgery, McMaster
University, Hamilton, ON, Canada
(Samiee-Zafarghandy) Division of Neonatology, Department of Pediatrics,
McMaster University, Hamilton, ON, Canada
(Farrokyhar, Briatico) Department of Surgery, McMaster University,
Hamilton, ON, Canada
(Braga) Division of Urology, McMaster University, Hamilton, ON, Canada
(Walton) Division of Pediatric General Surgery, Department of Surgery,
McMaster University, Hamilton, ON, Canada
Publisher
Public Library of Science
Abstract
Background In neonates, uncontrolled pain and opioid exposure are both
correlated with short- and longterm adverse events. Therefore, managing
pain using opioid-sparing approaches is critical in neonatal populations.
Multimodal pain control offers the opportunity to manage pain while
reducing short- and long-term opioid-related adverse events. Intravenous
(IV) acetaminophen may represent an appropriate adjunct to opioid-based
postoperative pain control regimes. However, no trials assess this drug in
patients less than 36 weeks post-conceptual age or weighing less than 1500
g. Objective The proposed study aims to determine the feasibility of
conducting a randomized control trial to compare IV acetaminophen and
fentanyl to a saline placebo and fentanyl for patients admitted to the
neonatal intensive care unit (NICU) undergoing major abdominal or thoracic
surgery. Methods and design This protocol is for a single-centre, external
pilot randomized controlled trial (RCT). Infants in the NICU who have
undergone major thoracic or abdominal surgery will be enrolled. Sixty
participants will undergo 1:1 randomization to receive intravenous
acetaminophen and fentanyl or saline placebo and fentanyl. After surgery,
IV acetaminophen or placebo will be given routinely for eight days (192
hours). Appropriate dosing will be determined based on the participant's
gestational age. Patients will be followed for eight days after surgery
and will undergo a chart review at 90 days. Primarily feasibility outcomes
include recruitment rate, follow-up rate, compliance, and blinding index.
Secondary clinical outcomes will be collected as well. Conclusion This
external pilot RCT will assess the feasibility of performing a multicenter
RCT comparing IV acetaminophen and fentanyl to a saline placebo and
fentanyl in NICU patients following major abdominal and thoracic surgery.
The results will inform the design of a multicenter RCT, which will have
the appropriate power to determine the efficacy of this
treatment. Copyright © 2023 Archer et al. This is an open access
article distributed under the terms of the Creative Commons Attribution
License, which permits unrestricted use, distribution, and reproduction in
any medium, provided the original author and source are credited.

<56>
[Use Link to view the full text]
Accession Number
2028589573
Title
Early Left Ventricular Unloading or Conventional Approach after
Venoarterial Extracorporeal Membrane Oxygenation: The EARLY-UNLOAD
Randomized Clinical Trial.
Source
Circulation. 148(20) (pp 1570-1581), 2023. Date of Publication: 14 Nov
2023.
Author
Kim M.C.; Lim Y.; Lee S.H.; Shin Y.; Ahn J.H.; Hyun D.Y.; Cho K.H.; Sim
D.S.; Hong Y.J.; Kim J.H.; Jeong M.H.; Jung Y.H.; Jeong I.-S.; Ahn Y.
Institution
(Kim, Lim, Lee, Shin, Ahn, Hyun, Cho, Sim, Hong, Kim, Jeong, Ahn) Division
of Cardiology, Department of Internal Medicine, Chonnam National
University Hospital, Chonnam National University, Medical School, Gwangju,
South Korea
(Jung) Department of Emergency Medicine, Chonnam National University
Hospital, Chonnam National University, Medical School, Gwangju, South
Korea
(Jeong) Department of Thoracic and Cardiovascular Surgery, Chonnam
National University Hospital, Chonnam National University, Medical School,
Gwangju, South Korea
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND: Although venoarterial extracorporeal membrane oxygenation
(VA-ECMO) is beneficial for the treatment of profound cardiogenic shock,
peripheral VA-ECMO cannulation can increase left ventricular afterload,
thus compromising myocardial recovery. We investigated whether early
routine left ventricular unloading can reduce 30-day mortality compared
with the conventional approach in patients with cardiogenic shock
undergoing VA-ECMO. METHOD(S): This randomized clinical trial
involved 116 patients with cardiogenic shock undergoing VA-ECMO from March
2021 to September 2022 at Chonnam National University Hospital, Gwangju,
South Korea. The patients were randomly assigned to undergo either early
routine left ventricular unloading with transseptal left atrial
cannulation within 12 hours after randomization (n=58) or the conventional
approach, which permitted rescue transseptal left atrial cannulation in
case of an increased left ventricular afterload (n=58). The primary
outcome was all-cause mortality within 30 days. RESULT(S): All 116
randomized patients (mean age, 67.6+/-13.5 years; 34 [29.3%] women)
completed the trial. At 30 days, all-cause death had occurred in 27
(46.6%) patients in the early group and 26 (44.8%) patients in the
conventional group (hazard ratio, 1.02 [95% CI, 0.59-1.74]; P=0.942).
Crossover to rescue transseptal left atrial cannulation occurred in 29
patients (50%) in the conventional group according to a clear indication.
Time to rescue transseptal cannulation in the conventional group was a
median of 21.8 (interquartile range, 12.4-52.2) hours after randomization.
There were no significant differences in other secondary outcomes between
the 2 groups except for a shorter time to disappearance of pulmonary
congestion in the early group (median, 3 [interquartile range, 2-6] versus
5 [interquartile range, 3-7] days; P=0.027). CONCLUSION(S): Among
patients with cardiogenic shock undergoing VA-ECMO, early routine left
ventricular unloading with transseptal left atrial cannulation did not
reduce 30-day mortality compared with the conventional strategy, which
permitted rescue transseptal left atrial cannulation. These findings
should be cautiously interpreted until the results of multicenter trials
using other unloading modalities become available. REGISTRATION: URL:
https://www.clinicaltrials.gov; Unique identifier:
NCT04775472. Copyright © 2023 Lippincott Williams and Wilkins.
All rights reserved.

<57>
Accession Number
2028551367
Title
The Efficacy of Erector Spinae Plane Block for Thoracoscopic Surgery: A
Meta-Analysis of Randomized Controlled Trials.
Source
Heart Surgery Forum. 26(5) (pp E621-E627), 2023. Date of Publication:
2023.
Author
Liu L.; Zhao Y.; He Y.; Peng W.; He H.; Liang L.
Institution
(Liu, He, Peng, He, Liang) Chongqing Key Laboratory of Translational
Research for Cancer Metastasis and Individualized Treatment, Chongqing
University Cancer Hospital, Chongqing 400030, China
(Zhao) Department of Orthopedics, The First Affiliated Hospital of Army
Medical University, Chongqing 400030, China
Publisher
Forum Multimedia Publishing LLC
Abstract
Background: The efficacy of erector spinae plane block for thoracoscopic
surgery remains controversial. We conducted a systematic review and
meta-analysis to explore the impact of erector spinae plane block on
thoracoscopic surgery. Method(s): We searched the PubMed, EMbase, Web
of science, EBSCO, and Cochrane library databases through February 2022
for randomized controlled trials (RCTs), assessing the effect of erector
spinae plane block on thoracoscopic surgery. This meta-analysis was
performed using the random-effect model. Result(s): Seven RCTs,
involving 439 patients, are included in the meta-analysis. Overall,
compared with the control group for thoracoscopic surgery, erector spinae
plane block (ESPB) results in significantly reduced pain scores at 1 h
(standard mean difference (SMD) = -4.26; 95% confidence interval (CI) =
-7.63 to -0.88; p = 0.01), 4 h (SMD = -4.08; 95% CI = -4.56 to -3.60; p <
0.00001), 8 h (SMD = -4.13; 95% CI = -4.62 to -3.65; p < 0.00001), and
postoperative anesthesia consumption (SMD = -3.04; 95% CI = -4.58 to
-1.50; p = 0.0001) and can decrease the incidence of nausea and vomiting
(odd ratio (OR) = 0.18; 95% CI = 0.08 to 0.39; p < 0.001).
 Conclusion(s): ESPB can substantially enhance pain relief for
thoracoscopic surgery. Copyright © 2023 Forum Multimedia
Publishing.

<58>
[Use Link to view the full text]
Accession Number
2028397994
Title
Timing of Complete Revascularization with Multivessel PCI for Myocardial
Infarction.
Source
New England Journal of Medicine. 389(15) (pp 1368-1379), 2023. Date of
Publication: 2023.
Author
Stahli B.E.; Varbella F.; Linke A.; Schwarz B.; Felix S.B.; Seiffert M.;
Kesterke R.; Nordbeck P.; Witzenbichler B.; Lang I.M.; Kessler M.; Valina
C.; Dibra A.; Rohla M.; Moccetti M.; Vercellino M.; Gaede L.; Bott-Flugel
L.; Jakob P.; Stehli J.; Candreva A.; Templin C.; Schindler M.;
Wischnewsky M.; Zanda G.; Quadri G.; Mangner N.; Toma A.; Magnani G.;
Clemmensen P.; Luscher T.F.; Munzel T.; Schulze P.C.; Laugwitz K.-L.;
Rottbauer W.; Huber K.; Neumann F.-J.; Schneider S.; Weidinger F.;
Achenbach S.; Richardt G.; Kastrati A.; Ford I.; Maier W.; Ruschitzka F.
Institution
(Stahli, Kesterke, Jakob, Stehli, Candreva, Templin, Schindler,
Wischnewsky, Maier, Ruschitzka) Department of Cardiology, University Heart
Center, University Hospital Zurich, The Center for Translational and
Experimental Cardiology, Faculty of Medicine, Switzerland
(Luscher) Center for Molecular Cardiology, University of Zurich, Zurich,
Switzerland
(Rohla) Department of Cardiology, Bern University Hospital, University of
Bern, Bern, Switzerland
(Moccetti) Cardiocentro Ticino Institute, Ente Ospedaliero Cantonale,
Lugano, Switzerland
(Varbella, Zanda, Quadri) Department of Internal Medicine, Cardiology
Unit, Rivoli Hospital, Turin, Italy
(Vercellino) Department of Internal Medicine, Santi Antonio e Biagio e
Cesare Arrigo Hospital, Alessandria, Italy
(Magnani) Division of Cardiology, Parma University Hospital, Parma, Italy
(Linke, Mangner) Technische Universitat Dresden, Department of Internal
Medicine and Cardiology, Herzzentrum Dresden, University Clinic, Dresden,
Germany
(Schwarz, Richardt) Heart Center, Segeberger Kliniken, Academic Teaching
Hospital for the Universities of Kiel, Lubeck and Hamburg, Bad Segeberg,
Germany
(Felix) Department of Internal Medicine B, University Medicine Greifswald,
The German Center for Cardiovascular Research (DZHK) Partner Site
Greifswald, Greifswald, Germany
(Seiffert, Clemmensen) Department of Cardiology, University Heart and
Vascular Center Hamburg, Center for Population Health Innovation,
University Clinic Hamburg-Eppendorf, Dzhk Partner Site
Hamburg/Kiel/Lubeck, Hamburg, Germany
(Nordbeck) Department of Internal Medicine, University Hospital Wurzburg,
Wurzburg, Germany
(Witzenbichler) Department of Cardiology and Pneumology, Helios
Amper-Klinikum, Dachau, Germany
(Gaede, Achenbach) Department of Cardiology,
Friedrich-Alexander-University Erlangen Nurnberg, Erlangen, Germany
(Bott-Flugel) Cardiology and Pneumology, Klinikum Landkreis Erding,
Erding, Germany
(Wischnewsky) Fb Mathematics and Computer Science, University of Bremen,
Bremen, Germany
(Kessler, Rottbauer) Department of Cardiology, Ulm University Heart
Center, Ulm, Germany
(Valina, Neumann) Department of Cardiology and Angiology, University of
Freiburg Medical Center, The Faculty of Medicine, University of Freiburg,
Freiburg, Germany
(Munzel) Department of Cardiology, University Medical Center Mainz, The
Center for Cardiovascular Research, Johannes Gutenberg University Partner
Site Rhine Main, Mainz, Germany
(Schulze) Department of Internal Medicine, Division of Cardiology,
Pneumology, and Angiology, The Intensive Medical Care, University Hospital
Jena, Friedrich-Schiller-University, Jena, Germany
(Laugwitz) Clinic and Policlinic Internal Medicine I, Cardiology and
Angiology, Klinikum Rechts der Isar, Germany
(Kastrati) Klinik fur Herz und Kreislauferkrankungen, Deutsches
Herzzentrum Munchen, Technische Universitat Munchen, Dzhk, partner site
Munich Heart Alliance, Munich, Germany
(Schneider) Institut fur Herzinfarktforschung, Ludwigshafen, Germany
(Lang, Toma) Department of Internal Medicine Ii, Division of Cardiology,
Medical University of Vienna, Vienna, Austria
(Rohla, Huber) 3rd Department of Medicine, Cardiology, and Intensive Care
Medicine, Clinic Ottakring and Sigmund Freud University Medical School,
Vienna, Austria
(Weidinger) 2nd Medical Department with Cardiology and Intensive Care
Medicine, Klinik Landstrasse, Vienna, Austria
(Dibra) Department of Cardiovascular Diseases, University of Medicine,
University Hospital Mother Teresa, Tirana, Albania
(Clemmensen) Department of Medicine, Nykobing Falster Hospital, Nykobing
Falster, Denmark
(Luscher) Heart Division, Royal Brompton and Harefield Hospitals, National
Heart and Lung Institute, Imperial College London, London, United Kingdom
(Ford) Robertson Centre for Biostatistics, University of Glasgow, Glasgow,
United Kingdom
Publisher
Massachussetts Medical Society
Abstract
Background In patients with ST-segment elevation myocardial infarction
(STEMI) with multivessel coronary artery disease, the time at which
complete revascularization of nonculprit lesions should be performed
remains unknown. Methods We performed an international, open-label,
randomized, noninferiority trial at 37 sites in Europe. Patients in a
hemodynamically stable condition who had STEMI and multivessel coronary
artery disease were randomly assigned to undergo immediate multivessel
percutaneous coronary intervention (PCI; immediate group) or PCI of the
culprit lesion followed by staged multivessel PCI of nonculprit lesions
within 19 to 45 days after the index procedure (staged group). The primary
end point was a composite of death from any cause, nonfatal myocardial
infarction, stroke, unplanned ischemia-driven revascularization, or
hospitalization for heart failure at 1 year after randomization. The
percentages of patients with a primary or secondary end-point event are
provided as Kaplan-Meier estimates at 6 months and at 1 year. Results We
assigned 418 patients to undergo immediate multivessel PCI and 422 to
undergo staged multivessel PCI. A primary end-point event occurred in 35
patients (8.5%) in the immediate group as compared with 68 patients
(16.3%) in the staged group (risk ratio, 0.52; 95% confidence interval,
0.38 to 0.72; P<0.001 for noninferiority and P<0.001 for superiority).
Nonfatal myocardial infarction and unplanned ischemia-driven
revascularization occurred in 8 patients (2.0%) and 17 patients (4.1%),
respectively, in the immediate group and in 22 patients (5.3%) and 39
patients (9.3%), respectively, in the staged group. The risk of death from
any cause, the risk of stroke, and the risk of hospitalization for heart
failure appeared to be similar in the two groups. A total of 104 patients
in the immediate group and 145 patients in the staged group had a serious
adverse event. Conclusions Among patients in hemodynamically stable
condition with STEMI and multivessel coronary artery disease, immediate
multivessel PCI was noninferior to staged multivessel PCI with respect to
the risk of death from any cause, nonfatal myocardial infarction, stroke,
unplanned ischemia-driven revascularization, or hospitalization for heart
failure at 1 year. (Supported by Boston Scientific; MULTISTARS AMI
ClinicalTrials.gov number, NCT03135275.) Copyright © 2023
Massachusetts Medical Society.

<59>
Accession Number
2028073090
Title
Traditional Chinese Medicine Compound (Tongxinluo) and Clinical Outcomes
of Patients with Acute Myocardial Infarction: The CTS-AMI Randomized
Clinical Trial.
Source
JAMA. 330(16) (pp 1534-1545), 2023. Date of Publication: 24 Oct 2023.
Author
Li X.; Chen G.; Xian Y.; Zhang H.; Wu Y.; Yang Y.; Wu J.; Wang C.; He S.;
Wang Y.; Wang Z.; Liu H.; Wang X.; Zhang M.; Zhang J.; Li J.; An T.; Guan
H.; Li L.; Shang M.; Yao C.; Han Y.; Zhang B.; Gao R.; Peterson E.D.
Institution
(Yang, Li, Chen, Zhang, Wu, Zhang, Li, An, Guan, Li, Gao) State Key
Laboratory of Cardiovascular Disease, Department of Cardiology, Fuwai
Hospital, National Center for Cardiovascular Diseases, Chinese Academy of
Medical Sciences, Peking Union Medical College, Beijing, China
(Xian) Department of Neurology and Population and Data Science, University
of Texas Southwestern Medical Center, Dallas, United States
(Yang) Emergency Center, Fuwai Hospital, National Center for
Cardiovascular Disease, Chinese Academy of Medical Sciences, Peking Union
Medical College, Beijing, China
(Wu) Department of Cardiology, Xiuyan Manchu Autonomous County Central
People's Hospital, Liaoning, Anshan, China
(Wang) Department of Cardiology, Xihua County People's Hospital, Henan,
Zhoukou, China
(He) Department of Cardiology, Northern Jiangsu People's Hospital,
Jiangsu, Yangzhou, China
(Wang) Department of Cardiology, The First Affiliated Hospital of the
Medical College, Shihezi University, Xinjiang, Shihezi, China
(Wang) Department of Cardiology, Xiajin People's Hospital of Shandong
Province, Shandong, Xiajin, China
(Wang) Department of Cardiology, Xinxiang Central Hospital, Henan,
Xinxiang, China
(Liu) Department of Cardiology, Anyang District Hospital, Henan, Anyang,
China
(Wang) Department of Cardiology, Shihezi People's Hospital, Xinjiang,
Shihezi, China
(Zhang) Department of Cardiology, The Second Affiliated Hospital of
Guangzhou Medical University, Guangdong, Guangzhou, China
(Shang, Yao) Department of Biostatistics, Peking University Clinical
Research Institute, Peking University First Hospital, Beijing, China
(Han) Department of Cardiology, General Hospital of Northern Theater
Command, Liaoning, Shenyang, China
(Zhang) State Key Laboratory of Component-Based Chinese Medicine, Tianjin
University of Traditional Chinese Medicine, Tianjin, China
(Peterson) Department of Medicine, University of Texas Southwestern
Medical Center, Dallas, United States
Publisher
American Medical Association
Abstract
Importance: Tongxinluo, a traditional Chinese medicine compound, has shown
promise in in vitro, animal, and small human studies for myocardial
infarction, but has not been rigorously evaluated in large randomized
clinical trials. Objective(s): To investigate whether Tongxinluo
could improve clinical outcomes in patients with ST-segment elevation
myocardial infarction (STEMI). Design, Setting, and Participant(s):
Randomized, double-blind, placebo-controlled clinical trial was conducted
among patients with STEMI within 24 hours of symptom onset from 124
hospitals in China. Patients were enrolled from May 2019 to December 2020;
the last date of follow-up was December 15, 2021. Intervention(s):
Patients were randomized 1:1 to receive either Tongxinluo or placebo
orally for 12 months (a loading dose of 2.08 g after randomization,
followed by the maintenance dose of 1.04 g, 3 times a day), in addition to
STEMI guideline-directed treatments. Main Outcomes and Measures: The
primary end point was 30-day major adverse cardiac and cerebrovascular
events (MACCEs), a composite of cardiac death, myocardial reinfarction,
emergent coronary revascularization, and stroke. Follow-up for MACCEs
occurred every 3 months to 1 year. Result(s): Among 3797 patients who
were randomized, 3777 (Tongxinluo: 1889 and placebo: 1888; mean age, 61
years; 76.9% male) were included in the primary analysis. Thirty-day
MACCEs occurred in 64 patients (3.4%) in the Tongxinluo group vs 99
patients (5.2%) in the control group (relative risk [RR], 0.64 [95% CI,
0.47 to 0.88]; risk difference [RD], -1.8% [95% CI, -3.2% to -0.6%]).
Individual components of 30-day MACCEs, including cardiac death (56 [3.0%]
vs 80 [4.2%]; RR, 0.70 [95% CI, 0.50 to 0.99]; RD, -1.2% [95% CI, -2.5% to
-0.1%]), were also significantly lower in the Tongxinluo group than the
placebo group. By 1 year, the Tongxinluo group continued to have lower
rates of MACCEs (100 [5.3%] vs 157 [8.3%]; HR, 0.64 [95% CI, 0.49 to
0.82]; RD, -3.0% [95% CI, -4.6% to -1.4%]) and cardiac death (85 [4.5%] vs
116 [6.1%]; HR, 0.73 [95% CI, 0.55 to 0.97]; RD, -1.6% [95% CI, -3.1% to
-0.2%]). There were no significant differences in other secondary end
points including 30-day stroke; major bleeding at 30 days and 1 year;
1-year all-cause mortality; and in-stent thrombosis (<24 hours; 1-30 days;
1-12 months). More adverse drug reactions occurred in the Tongxinluo group
than the placebo group (40 [2.1%] vs 21 [1.1%]; P =.02), mainly driven by
gastrointestinal symptoms. Conclusions and Relevance: In patients
with STEMI, the Chinese patent medicine Tongxinluo, as an adjunctive
therapy in addition to STEMI guideline-directed treatments, significantly
improved both 30-day and 1-year clinical outcomes. Further research is
needed to determine the mechanism of action of Tongxinluo in STEMI. Trial
Registration: ClinicalTrials.gov Identifier: NCT03792035. Copyright
© 2023 American Medical Association. All rights reserved.

<60>
Accession Number
2026424044
Title
Landiolol for the prevention of postoperative atrial fibrillation after
cardiac surgery: a systematic review and meta-analysis.
Source
Canadian Journal of Anesthesia. 70(11) (pp 1828-1838), 2023. Date of
Publication: November 2023.
Author
Cafaro T.; Allwood M.; McIntyre W.F.; Park L.J.; Daza J.; Ofori S.N.; Ke
Wang M.; Borges F.K.; Conen D.; Marcucci M.; Healey J.S.; Whitlock R.P.;
Lamy A.; Belley-Cote E.P.; Spence J.D.; McGillion M.; Devereaux P.J.
Institution
(Cafaro, McIntyre, Ofori, Ke Wang, Borges, Conen, Marcucci, Healey,
Whitlock, Lamy, Belley-Cote, Spence, McGillion, Devereaux) Population
Health Research Institute, McMaster University, Hamilton, ON, Canada
(Cafaro) Division of Internal Medicine, Jewish General Hospital, McGill
University, Montreal, QC, Canada
(Cafaro) Department of Medicine, Jewish General Hospital, McGill
University, Montreal, QC, Canada
(Cafaro) Lady Davis Institute, Jewish General Hospital, Montreal, QC,
Canada
(Allwood) Department of Anesthesia, McMaster University, Hamilton, ON,
Canada
(McIntyre, Ofori, Ke Wang, Borges, Conen, Marcucci, Healey, Whitlock,
Lamy, Belley-Cote, Spence, McGillion, Devereaux) Health Research Methods,
Evidence, and Impact (HEI), Faculty of Health Sciences, McMaster
University, Hamilton, ON, Canada
(Park) Division of General Surgery, Department of Surgery, McMaster
University, Hamilton, ON, Canada
(Daza) Division of General Surgery, Department of Surgery, University of
Toronto, Toronto, ON, Canada
(Cafaro) David Braley Research Institute, C1-109, 237 Barton Street East,
Hamilton, ON L8L 2X2, Canada
Publisher
Springer
Abstract
Purpose: Postoperative atrial fibrillation (POAF) is a common complication
following cardiac surgery. Although the evidence suggests that beta
blockers prevent POAF, they often cause hypotension. Landiolol, an
ultra-short-acting beta<inf>1</inf> blocker, may prevent POAF, without
adverse hemodynamic consequences. Source: We searched MEDLINE, CENTRAL,
Embase, and trial registries between January 1970 and March 2022. We
included randomized controlled trials (RCTs) that evaluated the effect of
landiolol for the prevention of POAF after cardiac surgery. Two reviewers
independently assessed eligibility, extracted data, and assessed risk of
bias using the Risk of Bias 2.0 tool. We pooled data using random-effects
models. We used the Grading of Recommendations, Assessment, Development
and Evaluations framework to assess certainty of evidence. Principal
findings: Nine RCTs including 868 participants met the eligibility
criteria. Patients randomized to landiolol (56/460) had less POAF compared
with controls (133/408) with a relative risk (RR) of 0.40 (95% confidence
interval [CI], 0.30 to 0.54; I2 = 0%;) and an absolute risk of
12.2% vs 32.6% (absolute risk difference, 20.4%; 95% CI, 15.0 to 25.0).
Landiolol resulted in a shorter hospital length-of-stay (LOS) (268
patients; mean difference, -2.32 days; 95% CI, -4.02 to -0.57;
I2 = 0%). We found no significant difference in bradycardia
(RR, 1.11; 95% CI, 0.48 to 2.56; I2 = 0%). No hypotension was
reported with landiolol. We judged the certainty of evidence as moderate
for POAF (because of indirectness as outcomes were not clearly defined)
and low for LOS (because of imprecision and concern of reporting bias).
 Conclusion(s): In patients undergoing cardiac surgery, landiolol
likely reduces POAF and may reduce LOS. A definitive large RCT is needed
to confirm these findings. Study registration: PROSPERO (CRD42021262703);
registered 25 July 2021. Copyright © 2023, The Author(s).

<61>
Accession Number
2025730305
Title
Human Albumin Infusion in Critically Ill and Perioperative Patients:
Narrative Rapid Review of Meta-Analyses from the Last Five Years.
Source
Journal of Clinical Medicine. 12(18) (no pagination), 2023. Article
Number: 5919. Date of Publication: September 2023.
Author
Wiedermann C.J.
Institution
(Wiedermann) Institute of General Practice and Public Health,
Claudiana-College of Health Professions, Bolzano 39100, Italy
(Wiedermann) Department of Public Health, Medical Decision Making and HTA,
University of Health Sciences, Medical Informatics and Technology-Tyrol,
Hall 6060, Austria
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Background: Human albumin, a vital plasma protein with diverse molecular
properties, has garnered interest for its therapeutic potential in various
diseases, including critical illnesses. However, the efficacy of albumin
infusion in critical care and its associated complications remains
controversial. To address this, a review of recent meta-analyses was
conducted to summarize the evidence pertaining to albumin use in critical
illness. Method(s): Adhering to the rapid review approach, designed
to provide a concise synthesis of existing evidence within a short
timeframe, relevant meta-analyses published in the last five years were
identified and analyzed. PubMed, Embase, and Cochrane databases of
systematic reviews were searched using pre-defined search terms. Eligible
studies included meta-analyses examining the association between albumin
infusion and outcomes in critically ill and perioperative patients.
 Result(s): Twelve meta-analyses were included in the review, covering
diverse critical illnesses and perioperative scenarios such as sepsis,
cardiothoracic surgery, and acute brain injury. The analyses revealed
varying levels of evidence for the effects of albumin use on different
outcomes, ranging from no significant associations to suggestive and
convincing. Conclusion(s): Albumin infusion stabilizes hemodynamic
resuscitation endpoints, improves diuretic resistance, and has the
potential to prevent hypotensive episodes during mechanical ventilation in
hypoalbuminemic patients and improve the survival of patients with septic
shock. However, caution is warranted due to the methodological limitations
of the included studies. Further high-quality research is needed to
validate these findings and inform clinical decision-making regarding
albumin use in critical care. Copyright © 2023 by the author.

<62>
Accession Number
642579423
Title
Home-based versus centre-based cardiac rehabilitation.
Source
Cochrane Database of Systematic Reviews. 2023(10) (no pagination), 2023.
Article Number: CD007130. Date of Publication: 27 Oct 2023.
Author
McDonagh S.T.J.; Dalal H.; Moore S.; Clark C.E.; Dean S.G.; Jolly K.;
Cowie A.; Afzal J.; Taylor R.S.
Institution
(McDonagh, Dalal, Moore, Clark, Dean) Department of Health and Community
Sciences, University of Exeter Medical School, Faculty of Health and Life
Sciences, St Luke's Campus, University of Exeter, Exeter, United Kingdom
(Jolly) Institute of Applied Health Research, University of Birmingham,
Birmingham, United Kingdom
(Cowie) Cardiac Rehabilitation, University Hospital Crosshouse, NHS
Ayrshire and Arran, Kilmarnock, United Kingdom
(Afzal) Flat 1/1,14 Willowbank Crescent, Glasgow, United Kingdom
(Taylor) MRC/CSO Social and Public Health Sciences Unit & Robertson Centre
for Biostatistics, Institute of Health and Well Being, University of
Glasgow, Glasgow, United Kingdom
Publisher
John Wiley and Sons Ltd
Abstract
Background: Cardiovascular disease is the most common cause of death
globally. Traditionally, centre-based cardiac rehabilitation programmes
are offered to individuals after cardiac events to aid recovery and
prevent further cardiac illness. Home-based and technology-supported
cardiac rehabilitation programmes have been introduced in an attempt to
widen access and participation, especially during the SARS-CoV-2 pandemic.
This is an update of a review previously published in 2009, 2015, and
2017. Objective(s): To compare the effect of home-based (which may
include digital/telehealth interventions) and supervised centre-based
cardiac rehabilitation on mortality and morbidity, exercise-capacity,
health-related quality of life, and modifiable cardiac risk factors in
patients with heart disease. Search Method(s): We updated searches
from the previous Cochrane Review by searching the Cochrane Central
Register of Controlled Trials (CENTRAL), MEDLINE (Ovid), Embase (Ovid),
PsycINFO (Ovid) and CINAHL (EBSCO) on 16 September 2022. We also searched
two clinical trials registers as well as previous systematic reviews and
reference lists of included studies. No language restrictions were
applied. Selection Criteria: We included randomised controlled trials
that compared centre-based cardiac rehabilitation (e.g. hospital,
sports/community centre) with home-based programmes (+/-
digital/telehealth platforms) in adults with myocardial infarction,
angina, heart failure, or who had undergone revascularisation. Data
Collection and Analysis: Two review authors independently screened all
identified references for inclusion based on predefined inclusion
criteria. Disagreements were resolved through discussion or by involving a
third review author. Two authors independently extracted outcome data and
study characteristics and assessed risk of bias. Certainty of evidence was
assessed using GRADE. Main Result(s): We included three new trials in
this update, bringing a total of 24 trials that have randomised a total of
3046 participants undergoing cardiac rehabilitation. A further nine
studies were identified and are awaiting classification. Manual searching
of trial registers until 16 September 2022 revealed a further 14 clinical
trial registrations - these are ongoing. Participants had a history of
acute myocardial infarction, revascularisation, or heart failure. Although
there was little evidence of high risk of bias, a number of studies
provided insufficient detail to enable assessment of potential risk of
bias; in particular, details of generation and concealment of random
allocation sequencing and blinding of outcome assessment were poorly
reported. No evidence of a difference was seen between home- and
centre-based cardiac rehabilitation in our primary outcomes up to 12
months of follow-up: total mortality (risk ratio [RR] = 1.19, 95%
confidence interval [CI] 0.65 to 2.16; participants = 1647; studies =
12/comparisons = 14; low-certainty evidence) or exercise capacity
(standardised mean difference (SMD) = -0.10, 95% CI -0.24 to 0.04;
participants = 2343; studies = 24/comparisons = 28; low-certainty
evidence). The majority of evidence (N=71 / 77 comparisons of either total
or domain scores) showed no significant difference in health-related
quality of life up to 24 months follow-up between home- and centre-based
cardiac rehabilitation. Trials were generally of short duration, with only
three studies reporting outcomes beyond 12 months (exercise capacity: SMD
0.11, 95% CI -0.01 to 0.23; participants = 1074; studies = 3;
moderate-certainty evidence). There was a similar level of trial
completion (RR 1.03, 95% CI 0.99 to 1.08; participants = 2638; studies =
22/comparisons = 26; low-certainty evidence) between home-based and
centre-based participants. The cost per patient of centre- and home-based
programmes was similar. Authors' conclusions: This update supports
previous conclusions that home- (+/- digital/telehealth platforms) and
centre-based forms of cardiac rehabilitation formally supported by
healthcare staff seem to be similarly effective in improving clinical and
health-related quality of life outcomes in patients after myocardial
infarction, or revascularisation, or with heart failure. This finding
supports the continued expansion of healthcare professional supervised
home-based cardiac rehabilitation programmes (+/- digital/telehealth
platforms), especially important in the context of the ongoing global
SARS-CoV-2 pandemic that has much limited patients in face-to-face access
of hospital and community health services. Where settings are able to
provide both supervised centre- and home-based programmes, consideration
of the preference of the individual patient would seem appropriate.
Although not included in the scope of this review, there is an increasing
evidence base supporting the use of hybrid models that combine elements of
both centre-based and home-based cardiac rehabilitation delivery. Further
data are needed to determine: (1) whether the short-term effects of
home/digital-telehealth and centre-based cardiac rehabilitation models of
delivery can be confirmed in the longer term; (2) the relative clinical
effectiveness and safety of home-based programmes for other heart
patients, e.g. post-valve surgery and atrial fibrillation. Copyright
© 2023 The Cochrane Collaboration. Published by John Wiley & Sons,
Ltd.

<63>
Accession Number
2027813148
Title
Intravenous iron administration before cardiac surgery reduces red blood
cell transfusion in patients without anaemia.
Source
British Journal of Anaesthesia. 131(6) (pp 981-988), 2023. Date of
Publication: December 2023.
Author
Friedman T.; Dann E.J.; Bitton-Worms K.; Makhoul M.; Glam R.; Weis A.; Tam
D.Y.; Bolotin G.
Institution
(Friedman, Bitton-Worms, Makhoul, Glam, Weis, Bolotin) Department of
Cardiac Surgery, Rambam Health Care Campus, Haifa, Israel
(Dann) Blood Bank and Apheresis Unit, Rambam Health Care Campus, Haifa,
Israel
(Dann) Department of Hematology and Bone Marrow Transplantation, Rambam
Health Care Campus, Haifa, Israel
(Friedman, Dann, Bolotin) Ruth and Bruce Rappaport Faculty of Medicine,
Technion, Haifa, Israel
(Tam) Division of Cardiac Surgery, University of Toronto, Toronto, ON,
Canada
Publisher
Elsevier Ltd
Abstract
Background: Reducing the need for blood transfusion among patients
undergoing cardiac surgery FLA reduce postoperative complications and
mortality. Our study aimed to assess the effects of administering
preoperative i.v. ferric carboxymaltose on postoperative red cell
transfusion requirements in patients without anaemia undergoing on-pump
cardiac surgery. Method(s): This double-blind, randomised,
placebo-controlled trial was conducted between October 2016 and November
2019, with a follow-up period of up to 6 weeks after surgery. Patients
without anaemia who underwent on-pump cardiac surgery were included as
participants and administered i.v. iron in the form of ferric
carboxymaltose or placebo once, 24-72 h before surgery. The primary
outcome was the number of red cell units transfused during the first four
postoperative days, and the secondary outcome measures were blood
haemoglobin concentrations at 4 days and 6 weeks after surgery.
 Result(s): The 200 patients included were randomly assigned to the
ferric carboxymaltose (n=102) and placebo (n=98) groups. By postoperative
Day 4, a significantly lower mean number of red cell units were transfused
in the ferric carboxymaltose than in the placebo group, 0.3 (0.8) vs 1.6
(4.4), respectively; P=0.007. The mean haemoglobin concentrations on
postoperative Day 4 were 9.7 (1) g dl-1 and 9.3 (1) g
dl-1, respectively (P=0.03). Corresponding values at 6 weeks
after surgery were 12.6 (1.4) g dl-1 and 11.8 (1.5) g
dl-1, respectively (P=0.012). Conclusion(s): In patients
without anaemia undergoing on-pump cardiac surgery, treatment with a
single dose of 1000 mg ferric carboxymaltose i.v. 1-3 days before surgery
significantly reduced the need for red cell transfusions and increased the
postoperative haemoglobin concentration. Clinical trial registration:
NCT02939794. Copyright © 2023 British Journal of Anaesthesia

<64>
Accession Number
2026845646
Title
Safety and efficacy of bempedoic acid: a systematic review and
meta-analysis of randomised controlled trials.
Source
Cardiovascular Diabetology. 22(1) (no pagination), 2023. Article Number:
324. Date of Publication: December 2023.
Author
De Filippo O.; D'Ascenzo F.; Iannaccone M.; Bertaina M.; Leone A.;
Borzillo I.; Ravetti E.; Solano A.; Pagliassotto I.; Nebiolo M.; Bruno F.;
Giacobbe F.; Muscoli S.; Monticone S.; Brizzi M.F.; Biondi Zoccai G.; De
Ferrari G.M.
Institution
(De Filippo, D'Ascenzo, Borzillo, Ravetti, Solano, Pagliassotto, Nebiolo,
Bruno, Giacobbe, De Ferrari) Division of Cardiology, Cardiovascular and
Thoracic Department, "Citta Della Salute e Della Scienza" Hospital, Turin,
Italy
(D'Ascenzo, Borzillo, Ravetti, Solano, Pagliassotto, Nebiolo, Giacobbe,
Monticone, De Ferrari) Department of Medical Sciences, University of
Turin, Corso Bramante 88, Turin 10126, Italy
(Iannaccone, Bertaina) Division of Cardiology, San Giovanni Bosco
Hospital, ASL Citta Di Torino, Turin, Italy
(Leone) Department of Advanced Biomedical Sciences, University of Naples
"Federico II", Naples, Italy
(Muscoli) Division of Cardiology, Fondazione Policlinico "Tor Vergata",
Rome, Italy
(Brizzi) Division of Internal Medicine and Hypertension, Department of
Medical Sciences, University of Turin, Turin, Italy
(Biondi Zoccai) Department of Medical-Surgical Sciences and
Biotechnologies, Sapienza University of Rome, Latina, Italy
Publisher
BioMed Central Ltd
Abstract
Background and aims: Bempedoic Acid (BA) is a novel Lipid-Lowering Therapy
(LLT). We performed a systematic review and meta-analysis to assess the
efficacy and safety of BA in patients with hypercholesterolemia.
 Method(s): PubMed, Scopus, and Cochrane library databases were
searched for randomised controlled trials evaluating the efficacy and/or
safety of BA compared with placebo. Trials investigating dosages other
than 180 mg/die were excluded. Major adverse cardiovascular events (MACE)
were the primary efficacy endpoint. LDL-cholesterol reduction was the
primary laboratory endpoint. Pre-specified safety endpoints included
muscle-related adverse events, new-onset diabetes, and gout. The protocol
was registered on PROSPERO (temporary ID:399,867). Result(s): Study
search identified 275 deduplicated results. 11 studies, encompassing
18,315 patients (9854 on BA vs 8461 on placebo/no treatment) were
included. BA was associated with a reduced risk of MACE (OR 0.86, 95% CI
0.79-0.95), myocardial infarction (OR 0.76, 95% CI 0.64-0.88) and unstable
angina (OR 0.69, 95% CI 0.54-0.88) compared to control, over a median
follow up of 87 (15-162) weeks. BA was associated with a reduction of
LDL-Cholesterol (mean difference [MD]-22.42,95% CI - 24.02% to - 20.82%),
total cholesterol (- 16.50%,95% - 19.21% to - 13.79%), Apo-B lipoprotein
(- 19.55%, - 22.68% to - 16.42%) and high-sensitivity CRP (- 27.83%, -
31.71% to - 23.96%) at 12 weeks. BA was associated with a higher risk of
gout (OR 1.55, 95% CI 1.27-1.90) as compared with placebo. Efficacy on
laboratory endpoints was confirmed, with a variable extent, across
patients on statin or ezetimibe background therapy. Conclusion(s):
The improved cholesterol control achieved with BA translates into a
reduced risk of MACE, including myocardial infarction and coronary
revascularisation. The drug has a satisfactory safety profile except for
an increased risk of gout. Copyright © 2023, The Author(s).

<65>
Accession Number
2028609363
Title
Clinical outcomes of rifampicin combination therapy in implant-associated
infections due to staphylococci and streptococci: A systematic review and
meta-analysis.
Source
International Journal of Antimicrobial Agents. 63(1) (no pagination),
2024. Article Number: 107015. Date of Publication: January 2024.
Author
Yusuf E.; Bramer W.; Anas A.A.
Institution
(Yusuf, Anas) Department of Medical Microbiology and Infectious Diseases,
Erasmus University Medical Center, Rotterdam, Netherlands
(Bramer) Medical Library, Erasmus University Medical Center, Rotterdam,
Netherlands
(Anas) Department of Internal Medicine, Section of Infectious Diseases,
Erasmus University Medical Center, Rotterdam, Netherlands
Publisher
Elsevier B.V.
Abstract
Objectives: Adjunctive rifampicin for implant-associated infections is
controversial. This study investigated the clinical outcomes of rifampicin
combination therapy compared with monotherapy in treating prosthetic joint
infection (PJI) or prosthetic valve endocarditis (PVE) due to
staphylococci and streptococci. Method(s): A systematic search was
performed from inception to 13 June 2022 in Embase, MEDLINE, Cochrane and
Web of Science to investigate the clinical outcomes of rifampicin
combination therapy compared with monotherapy in treating staphylococcal
and streptococcal PJI or PVE. Randomised controlled trials (RCTs) and
observational studies were included in the systematic review and
meta-analysis. Result(s): Fourteen studies were included. A moderate
quality of evidence was found in favour of rifampicin in patients with
staphylococcal PJI who underwent a debridement, antibiotics and implant
retention (DAIR) procedure [odds ratio = 2.49, 95% confidence interval
(CI) 1.93-3.23]. Including the two RCTs only, adding rifampicin to the
antibiotic regimen after DAIR was also in favour of rifampicin, but this
was not statistically significant (risk ratio = 1.27, 95% CI 0.79-2.04; n
= 126). Pooling data for patients with staphylococcal PJI who underwent a
two-stage procedure showed that adding rifampicin was not associated with
therapeutic success. Limited evidence was found for the use of rifampicin
for PVE caused by staphylococci. Conclusion(s): Adding rifampicin in
the treatment of staphylococcal PJI treated by DAIR clearly increased the
likelihood for therapeutic success. The clinical benefit of adjunctive
rifampicin in the treatment of other staphylococci and streptococci
implant-associated infections is still unclear. Copyright © 2023
The Author(s)

<66>
Accession Number
2028788327
Title
Mental health and transcatheter aortic valve replacement: A scoping
systematic review.
Source
General Hospital Psychiatry. 86 (pp 10-23), 2024. Date of Publication: 01
Jan 2024.
Author
Suen W.-L.; Bhasin S.; Betti V.; Bruckel J.T.; Oldham M.A.
Institution
(Suen, Oldham) Department of Psychiatry, University of Rochester Medical
Center, United States
(Bhasin, Betti) School of Medicine & Dentistry, University of Rochester
Medical Center, United States
(Bruckel) Department of Medicine, University of Rochester Medical Center,
United States
Publisher
Elsevier Inc.
Abstract
Objective: To systematically review the literature on mental health
symptoms before and after transcatheter aortic valve replacement (TAVR)
and describe reported clinical associations with these symptoms.
 Method(s): Using the Preferred Reporting Items for Systematic reviews
and Meta-Analysis extension for Scoping Reviews (PRISMA-ScR) guidelines,
we reviewed studies involving pre- or post-TAVR mental health assessments
or psychiatric diagnoses. Result(s): Eighteen studies were included.
Before TAVR, clinically significant depression and anxiety prevalence is
15-30% and 25-30%, respectively, with only a third of these meeting
diagnostic thresholds. These symptoms generally improve over the year
post-TAVR. Depression is associated with functional impairment,
multimorbidity, and lower physical activity; few associations have been
described in relation to anxiety. Inconsistent evidence finds depression
associated with post-TAVR mortality. One notable study found persistent
depression independently predictive of 12-month mortality, and another
found depression and cognition to have additive value in predicting
mortality risk. Conclusion(s): Mental health symptoms occur in a
significant proportion of the TAVR population. Although symptoms tend to
improve, the associations with depression, particularly persistent
depression, call for further investigation to examine their associated
outcomes. Research is also needed to understand the relationships between
mental health conditions and cognition in TAVR-related
outcomes. Copyright © 2023 Elsevier Inc.

<67>
Accession Number
2028791026
Title
1-Year Outcomes From the CLASP IID Randomized Trial for Degenerative
Mitral Regurgitation.
Source
JACC: Cardiovascular Interventions. 16(23) (pp 2803-2816), 2023. Date of
Publication: 11 Dec 2023.
Author
Zahr F.; Smith R.L.; Gillam L.D.; Chadderdon S.; Makkar R.; von Bardeleben
R.S.; Ruf T.F.; Kipperman R.M.; Rassi A.N.; Szerlip M.; Goldman S.;
Inglessis-Azuaje I.; Yadav P.; Lurz P.; Davidson C.J.; Mumtaz M.; Gada H.;
Kar S.; Kodali S.K.; Laham R.; Hiesinger W.; Fam N.P.; Kessler M.; O'Neill
W.W.; Whisenant B.; Kliger C.; Kapadia S.; Rudolph V.; Choo J.; Hermiller
J.; Morse M.A.; Schofer N.; Gafoor S.; Latib A.; Mahoney P.; Kaneko T.;
Shah P.B.; Riddick J.A.; Muhammad K.I.; Boekstegers P.; Price M.J.; Praz
F.; Koulogiannis K.; Marcoff L.; Hausleiter J.; Lim D.S.
Institution
(Zahr, Chadderdon) Oregon Health and Science University, Portland, OR,
United States
(Smith, Szerlip) Baylor Scott and White the Heart Hospital Plano, Plano,
TX, United States
(Gillam, Kipperman, Koulogiannis, Marcoff) Atlantic Health System
Morristown Medical Center, Morristown, NJ, United States
(Makkar) Cedars-Sinai Medical Center, Los Angeles, CA, United States
(von Bardeleben, Ruf) University Medical Centre Mainz, Mainz, Germany
(Rassi) Kaiser Permanente San Francisco Medical Center, San Francisco, CA,
United States
(Goldman) Lankenau Medical Center, Wynnewood, PA, United States
(Inglessis-Azuaje) Massachusetts General Hospital, Boston, MA, United
States
(Yadav) Piedmont Heart Institute, Atlanta, GA, United States
(Lurz) University of Leipzig, Leipzig, Germany
(Davidson) Northwestern University, Chicago, IL, United States
(Mumtaz, Gada) UPMC Pinnacle, Harrisburg, PA, United States
(Kar) Los Robles Regional Medical Center, Thousand Oaks, CA, United States
(Kodali) Columbia University Medical Center, New York, NY, United States
(Laham) Beth Israel Deaconess Medical Center, Boston, MA, United States
(Hiesinger) Stanford University Medical Center, Palo Alto, CA, United
States
(Fam) St. Michael's Hospital, Toronto, ON, Canada
(Kesler) University of Ulm, Ulm, Germany
(O'Neill) Henry Ford Hospital, Detroit, MI, United States
(Whisenant) Intermountain Medical Center, Salt Lake City, UT, United
States
(Kliger) Northwell-Lenox Hill, New York, NY, United States
(Kapadia) Cleveland Clinic Foundation, Cleveland, OH, United States
(Rudolph) Ruhr-Universitat Bochum, Bad Oeynhausen, Bochum, Germany
(Choo) The Christ Hospital, Cincinnati, OH, United States
(Hermiller) St. Vincent Heart Center of Indiana, Indianapolis, IN, United
States
(Morse) Ascension Saint Thomas Hospital, Nashville, TN, United States
(Schofer) University Heart and Vascular Center Hamburg, Hamburg, Germany
(Gafoor) Swedish Medical Center, Seattle, WA, United States
(Latib) Montefiore Medical Center, Bronx, NY, United States
(Mahoney) Sentara Norfolk General Hospital, Norfolk, VA, United States
(Kaneko, Shah) Brigham and Women's Hospital, Boston, MA, United States
(Riddick) Tristar Centennial Medical Center, Nashville, TN, United States
(Muhammad) Oklahoma Heart Institute, Tulsa, OK, United States
(Boekstegers) Helios Clinic, Siegburg, Germany
(Price) Scripps Clinic, La Jolla, CA, United States
(Praz) University Hospital Bern, Bern, Switzerland
(Hausleiter) Klinikum der Universitat Munchen, Munich, Germany
(Lim) University of Virginia Health System Hospital, Charlottesville, VA,
United States
Publisher
Elsevier Inc.
Abstract
Background: The CLASP IID (Edwards PASCAL TrAnScatheter Valve RePair
System Pivotal Clinical) trial is the first randomized controlled trial
comparing the PASCAL system and the MitraClip system in prohibitive risk
patients with significant symptomatic degenerative mitral regurgitation
(DMR). Objective(s): This study sought to report primary and
secondary endpoints and 1-year outcomes for the full cohort of the CLASP
IID trial. Method(s): Prohibitive-risk patients with 3+/4+ DMR were
randomized 2:1 (PASCAL:MitraClip). The 1-year assessments included
secondary effectiveness endpoints (mitral regurgitation [MR] <=2+ and MR
<=1+), and clinical, echocardiographic, functional, and quality-of-life
outcomes. Primary safety (30-day composite major adverse events [MAEs])
and effectiveness (6-month MR <=2+) endpoints were assessed for the full
cohort. Result(s): A total of 300 patients were randomized (PASCAL: n
= 204; MitraClip: n = 96). At 1 year, differences in survival, freedom
from heart failure hospitalization, and MAE were nonsignificant (P > 0.05
for all). Noninferiority of the PASCAL system compared with the MitraClip
system persisted for the primary endpoints in the full cohort (for PASCAL
vs MitraClip, the 30-day MAE rates were 4.6% vs 5.4% with a rate
difference of -0.8% and 95% upper confidence bound of 4.6%. The 6-month MR
<=2+ rates were 97.9% vs 95.7% with a rate difference of 2.2% and 95%
lower confidence bound (LCB) of -2.5%, respectively). Noninferiority was
met for the secondary effectiveness endpoints at 1 year (MR <=2+ rates for
PASCAL vs MitraClip were 95.8% vs 93.8% with a rate difference of 2.1% and
95% LCB of -4.1%. The MR <=1+ rates were 77.1% vs 71.3% with a rate
difference of 5.8% and 95% LCB of -5.3%, respectively). Significant
improvements in functional classification and quality of life were
sustained in both groups (P < 0.05 for all vs baseline).
 Conclusion(s): The CLASP IID trial full cohort met primary and
secondary noninferiority endpoints, and at 1 year, the PASCAL system
demonstrated high survival, significant MR reduction, and sustained
improvements in functional and quality-of-life outcomes. Results affirm
the PASCAL system as a beneficial therapy for prohibitive-surgical-risk
patients with significant symptomatic DMR. Copyright © 2023
American College of Cardiology Foundation

<68>
Accession Number
2028775430
Title
Early 6 months usage of single anTiplAtelet OR anTicoAgulant followed by
single antiplatelet after transcatheter aortic valve replacement: protocol
for a multicentre, open-label, randomised controlled clinical trial.
Source
BMJ Open. 13(11) (no pagination), 2023. Article Number: e076781. Date of
Publication: 21 Nov 2023.
Author
Hu X.; Xu H.; Wang C.; Wang Y.; Zhou D.; Zhu Q.; Xu K.; Yang J.; Zhang H.;
Jiang N.; Zhang J.; Fang Z.; Fu G.; Guo Y.; Li Y.; Wang M.; Feng D.; Niu
G.; Zhang E.; Chen Y.; Ye Y.; Wu Y.
Institution
(Hu, Xu, Wang, Wang, Feng, Niu, Zhang, Chen, Ye, Wu) Department of
Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases,
Chinese Academy of Medical Sciences and Peking Union Medical College,
Beijing, China
(Wang) Medical Research & Biometrics Center, Fuwai Hospital, National
Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences
and Peking Union Medical College, Beijing, China
(Wang) Department of Cardiology, Xiamen Cardiovascular Hospital, Xiamen
University, Fujian, Xiamen, China
(Zhou) Department of Cardiology, Zhongshan Hospital, Fudan University,
Shanghai, China
(Zhu) Department of Cardiology, The Second Affiliated Hospital Zhejiang
University, School of Medicine, Zhejiang, Hangzhou, China
(Xu) Department of Cardiology, General Hospital of Northern Theater
Command, Liaoning, Shenyang, China
(Yang) Department of Cardiovascular Surgery, Xijing Hospital, Air Force
Medical University, Shaanxi, Xi'an, China
(Zhang) Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital
Medical University, Beijing, China
(Jiang) Department of Cardiovascular Surgery, Tianjin Chest Hospital,
Tianjin Medical University, Tianjin, China
(Zhang) Department of Cardiology, Nanjing First Hospital, Nanjing Medical
University, Jiangsu, Nanjing, China
(Fang) Department of Cardiovascular Medicine, The Second Xiangya Hospital,
Central South University, Hunan, Changsha, China
(Fu) Department of Cardiology, Sir Run Run Shaw Hospital, Zhejiang
University School of Medicine, Zhejiang, Hangzhou, China
(Guo) Department of Cardiovascular Surgery, West China Hospital of Sichuan
University, Sichuan, Chengdu, China
(Li) Department of Cardiology, The First Affiliated Hospital, Sun Yat-sen
University, Guangdong, Guangzhou, China
Publisher
BMJ Publishing Group
Abstract
Introduction The strategy for initiating antithrombotic therapy to prevent
bioprosthetic valve thrombosis (BPVT) after transcatheter aortic valve
replacement (TAVR) remains uncertain. There is still lacking evidence on
the efficacy and safety of early 6 months usage of single-antiplatelet
therapy (SAPT) or oral anticoagulant (OAC) after TAVR in patients without
anticoagulant indications. Methods and analysis This is a multicentre,
randomised controlled, open-label trial, and 650 patients undergoing TAVR
from 13 top TAVR centres in China will be recruited. Each eligible
participant will be randomly assigned to two groups (1:1 ratio) as (1)
SAPT (aspirin 75-100 mg for 6 months) group or (2) OAC group (warfarin,
therapeutic international normalised ratio at 1.8-2.5 for 6 months), both
followed by sequential aspirin 75-100 mg for 6 months. Participants in
both groups will be invited for three follow-up visits of 1, 6 and 12
months after discharge. We will use both the net clinical benefit endpoint
(composite of all-cause mortality, myocardial infarction, stroke/transient
ischaemic attacks, peripheral artery thrombosis, intracardiac thrombosis
and major bleeding and disabling or life-threatening bleeding) and the
BPVT endpoint evaluated by four-dimensional CT as our primary endpoints. P
value of <0.05 of two-sided test will be considered statistically
significant. Ethics and dissemination The present study was approved by
the Institutional Review Boards at Fuwai Hospital, National Center for
Cardiovascular Diseases of China (Approval No. 2023-1947). All patients
will be informed of the details of the study and will sign an informed
consent prior to inclusion in the study. Results of this study will be
published in a peer-reviewed journal. Trial registration number
NCT05375474. Copyright © Author(s) (or their employer(s)) 2023.
Re-use permitted under CC BY-NC. No commercial re-use. See rights and
permissions. Published by BMJ.

<69>
Accession Number
2028775387
Title
Early offering transcatheter aortic valve replacement to patients with
moderate aortic stenosis: quantifying costs and benefits - a Markov
model-based simulation study.
Source
BMJ Open. 13(11) (no pagination), 2023. Article Number: e073254. Date of
Publication: 22 Nov 2023.
Author
Nguyen D.; Marwick T.; Moodie M.; Gao L.
Institution
(Nguyen, Moodie, Gao) Deakin Health Economics, Institute for Health
Transformation, School of Health and Social Development, Deakin University
Faculty of Health, Geelong, VIC, Australia
(Marwick) Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
Publisher
BMJ Publishing Group
Abstract
Objective Aortic stenosis (AS) is one of the most common acquired cardiac
valvular diseases. The success of transcatheter aortic valve implantation
(TAVI) for severe AS has led to increasing interest in its use to earlier
disease - moderate AS (MAS). Design Model-based study using a Markov
microsimulation technique to evaluate the long-term costs and benefits
associated with 'early' TAVI. Key data inputs were sourced from the
international literature and costs were obtained from Australian sources.
Setting Australian health care system perspective. Participants 10 000
hypothetical MAS patients with or without left ventricular diastolic
dysfunction or impaired left ventricular ejection fraction. Intervention
Comparing early TAVI to medical management over a life time horizon for
MAS patients aged >65 years. We evaluated the cost-effectiveness of
offering early TAVI in five scenarios (10%, 25%, 50%, 75% and 90% take-up
rates). Primary and secondary outcome measures The primary outcome measure
is quality-adjusted life years (QALY) gained and the incremental
cost-utility ratio (ICUR). Secondary outcomes are life-years gained and
the number of heart failure case avoided. Results Offering early TAVI for
MAS patients resulted in both higher healthcare costs and greater benefits
(an increase of 3.02 QALYs or 3.99 life-years) per person treated. The
ICUR was around A10 867 and A11 926 per QALY gained for all five
scenarios, with the total cost of early TAVI to the healthcare system
being anticipated to be up to A3.66 billion. Sensitivity analyses
indicated a 100% probability of being cost-effective with a willingness to
pay threshold of A50 000/QALY. The benefits remained, even with
assumptions of high levels of repeat valve replacement after TAVI.
Conclusion While ongoing randomised controlled trials will define the
benefit of TAVI to MAS patients, these results suggest that this
intervention is likely to be cost-effective. Copyright ©
Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No
commercial re-use. See rights and permissions. Published by BMJ.

<70>
[Use Link to view the full text]
Accession Number
2028764689
Title
Are congenital heart defects connected to more severe
attention-deficit/hyperactivity disorder?: A systematic review and
meta-analysis.
Source
Medicine (United States). 102(47) (pp E36193), 2023. Date of Publication:
24 Nov 2023.
Author
Hasan M.T.; Shaban Abdelgalil M.; Elbadawy M.A.; Mahmoud Elrosasy A.;
Elkhadragy A.; El Garhy M.; Awad A.K.
Institution
(Hasan) Faculty of Medicine, Al-Azhar University, Cairo, Egypt
(Shaban Abdelgalil, Elbadawy, El Garhy, Awad) Faculty of Medicine, Ain
Shams University, Cairo 11835, Egypt
(Mahmoud Elrosasy) Helwan University Hospital, Cairo, Egypt
(Elkhadragy) Alexandria University, Faculty of Medicine, Cairo, Egypt
Publisher
Lippincott Williams and Wilkins
Abstract
Background: Congenital heart defects (CHDs) are the most common cause of
birth defect-related infant morbidity and mortality, affecting 1% of
40,000 births per year in the United States. On the other side, the
etiology of attention-deficit/hyperactivity disorder (ADHD) is
multifactorial. Multiple studies have found that cardiac surgery patients
have higher morbidity of having this disorder. Many studies have
investigated the prevalence of ADHD in different subtypes of CHD, but few
have focused on the severity of ADHD symptoms. Thus, we conducted this
systematic review and meta-analysis to investigate the severity of ADHD
symptoms in CHD patients. Method(s): We searched PubMed, Embase,
Scopus, and Web of Science were searched from inception to March 6, 2023
without any restrictions. We included observational studies published in
English language that evaluated burden of symptom of ADHD in CHD patients.
Moreover, the standardized mean difference (SMD) for continuous outcomes
with 95% confidence interval (CI) was pooled. P-values <.05 are considered
as significant, and we performed all statistical analyses using RevMan
software Version 5.4.1. Result(s): Eight studies were included in our
review with a total number of 120,158 patients. CHD was associated with a
statistically significant increase in both ADHD index T score and ADHD
Hyperactivity-Impulsivity Subscale (informant) with (SMD=0.65, 95% CI
[0.40, 0.90], P<.00001, I2=81%) and (SMD=0.16, 95% CI [0.04,
0.28], P=.008, I2=0%). Regarding ADHD Inattention Subscale
(informant), the pooled data showed that a significant increase of this
score in the CHD group (SMD=0.25, 95% CI [0.13, 0.37], P<.001,
I2=0%), and ADHD Combined Score (informant) showed a
significant increase of this score in the CHD group (SMD=0.23, 95% CI
[0.11, 0.35], P=.0002, I2=0%). Conclusion(s): Our study
revealed a strong association between CHD and not only ADHD, but also the
severity of ADHD, making early diagnosis of ADHD in children with CHD a
mandatory step in the clinical evaluation practice to improve these
children on both clinical and psychological aspects. Copyright ©
2023 Lippincott Williams and Wilkins. All rights reserved.

<71>
Accession Number
2028763030
Title
Volatiles Benefit on Postoperative Cognitive Outcomes in Older Patients
with Cardiovascular Surgery: A Systematic Review and Meta-Analysis.
Source
International Journal of Gerontology. 17(4) (pp 212-219), 2023. Date of
Publication: 2023.
Author
Yang Y.-J.; Chang J.-Y.; Lin Y.-C.
Institution
(Yang, Lin) MacKay Medical College, New Taipei City, Taiwan (Republic of
China)
(Yang, Lin) Department of Anesthesia, MacKay Memorial Hospital, Taipei,
Taiwan (Republic of China)
(Chang) BinKun Women's Children's Hospital, Taoyuan City, Taiwan (Republic
of China)
(Lin) Institute of Epidemology and Preventive Medicine, National Taiwan
University, College of Public Health, Taipei, Taiwan (Republic of China)
Publisher
Taiwan Society of Geriatric Emergency and Critical Care Medicine (TSGECM)
Abstract
Total intravenous anesthesia (TIVA) has a lower incidence of postoperative
cognitive dysfunction (POCD) compared with inhalation agents in older
patients undergoing non-cardiac surgery. This systematic review aimed to
investigate the postoperative cognitive function in elderly patients
following cardiac surgery with TIVA versus inhalation anesthesia. We
searched the databases, Cochrane, MED-LINE, and EMBASE, up to May 2022 and
selected relevant randomized controlled trials. For the meta-analysis, the
random-effects model on the standardized mean difference for continuous
outcomes and risk ratio for dichotomous outcomes were used. Five RCTs (590
participants) were included in the final analysis. The result showed that
the cognitive score reduced less after the operation in patients receiving
volatile anesthesia compared with those receiving propofol-based TIVA,
three days (SMD -2.31, 95% CI: [-4.63, 0.01], I2 = 96%, p <
0.01) and five days later (SMD -2.29, 95% CI: [-3.90, -0.68),
I2 = 97%, p < 0.01). In contrast, The POCD five days after the
operation did not lower significantly in patient receiving volatile
anesthesia (RR 2.25, 95% CI: [0.51, 10.02], I2 = 61%, p =
0.11). Our findings indicated that for elderly patients undergoing
elective cardiac surgery, the cognitive assessment score was reduced less
with volatile anesthetics than with TIVA. The incidence of POCD was not
significantly different. More studies to verify these
results. Copyright © 2023, Taiwan Society of Geriatric Emergency
& Critical Care Medicine.

<72>
[Use Link to view the full text]
Accession Number
2028718517
Title
The Effect of CytoSorb on Inflammatory Markers in Critically Ill Patients:
A Systematic Review and Meta-Analysis of Randomized Controlled Trials.
Source
Critical Care Medicine. 51(12) (pp 1659-1673), 2023. Date of Publication:
01 Dec 2023.
Author
Heymann M.; Schorer R.; Putzu A.
Institution
(Heymann, Schorer, Putzu) Division of Anesthesiology, Department of
Anesthesiology, Pharmacology, Intensive Care and Emergency Medicine,
Geneva University Hospitals, Geneva, Switzerland
Publisher
Lippincott Williams and Wilkins
Abstract
OBJECTIVES: The effectiveness of CytoSorb at removing inflammatory
mediators in critically ill patients is controversial. DATA SOURCES:
Electronic databases were searched from inception to May 2023. STUDY
SELECTION: Randomized controlled trials reporting the effects of CytoSorb
therapy on inflammatory parameters in critically ill patients with
hyperinflammatory conditions were included. DATA EXTRACTION: Two authors
screened articles for eligibility, extracted data, and assessed the risk
of bias, conflicts of interest, and certainty of evidence (CoE). The
primary outcome was interleukin (IL)-6 at 1 day after initiation of the
therapy. Secondary outcomes included various inflammatory markers at 1, 2,
3, and 5 days and mortality. Data were pooled if at least three trials
reported the outcome of interest. We conducted meta-analyses of the data
using a random-effects model. DATA SYNTHESIS: Seventeen trials (n = 855)
were included. Fourteen trials were judged to have notable concern about
conflicts of interest. Seven trials were performed in medical ICU patients
with hyperinflammatory conditions and 10 in complex cardiovascular surgery
under cardiopulmonary bypass. Hemoadsorption with CytoSorb was not
associated with lower IL-6 at 1 day (mean difference -5.98 [95% CI, -30.44
to 18.48] pg/mL), 2 days, 3 days, or 5 days after initiation of the
treatment, as well as the concentration of procalcitionin. The levels of
C-reactive protein were not lower with CytoSorb at 1, 2, and 3 days. The
use of CytoSorb was associated with higher mortality at latest follow-up
(relative risk = 1.22 [95% CI, 1.02-1.45]) and at 30 days. CoE ranged from
low to very low. CONCLUSION(S): The use of CytoSorb hemoadsorption in
a mixed population of critically ill patients with hyperinflammatory
conditions does not exhibit a consistent decrease in IL-6 and other
inflammatory parameters within the first 5 days of treatment. The
significant uncertainty surrounding these findings highlights the need for
further investigations. Copyright © 2023 Lippincott Williams and
Wilkins. All rights reserved.

<73>
[Use Link to view the full text]
Accession Number
2028718420
Title
Association between Intraoperative Landiolol Use and In-Hospital Mortality
after Coronary Artery Bypass Grafting: A Nationwide Observational Study in
Japan.
Source
Anesthesia and Analgesia. 137(6) (pp 1208-1215), 2023. Date of
Publication: 01 Dec 2023.
Author
Iwasaki Y.; Ohbe H.; Nakajima M.; Sasabuchi Y.; Ikumi S.; Kaiho Y.;
Yamauchi M.; Fushimi K.; Yasunaga H.
Institution
(Iwasaki, Ikumi, Kaiho, Yamauchi) Department of Anesthesiology and
Perioperative Medicine, Tohoku University Graduate School of Medicine,
Miyagi, Japan
(Ohbe, Nakajima, Yasunaga) Department of Clinical Epidemiology and Health
Economics, School of Public Health, The University of Tokyo, Tokyo, Japan
(Nakajima) Emergency Life-Saving Technique Academy of Tokyo, Foundation
for Ambulance Service Development, Tokyo, Japan
(Nakajima) Emergency and Critical Care Center, Tokyo Metropolitan Hiroo
Hospital, Tokyo, Japan
(Sasabuchi) Data Science Center, Jichi Medical University, Tochigi, Japan
(Fushimi) Department of Health Policy and Informatics, Tokyo Medical and
Dental University Graduate School of Medicine, Tokyo, Japan
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND: Ischemic heart disease is a leading cause of death worldwide,
and coronary artery bypass grafting (CABG) is a major treatment. Landiolol
is an ultra-short-acting beta-antagonist known to prevent postoperative
atrial fibrillation. However, the effectiveness of intraoperative
landiolol on mortality remains unknown. This study aimed to evaluate the
association between intraoperative landiolol use and the in-hospital
mortality in patients undergoing CABG. METHOD(S): To conduct this
retrospective cohort study, we used data from the Japanese Diagnosis
Procedure Combination inpatient database. All patients who underwent CABG
during hospitalization between July 1, 2010, and March 31, 2020, were
included. Patients who received intraoperative landiolol were defined as
the landiolol group, whereas the other patients were defined as the
control group. The primary outcome was in-hospital mortality. Propensity
score matching was used to compare the landiolol and control groups.
 RESULT(S): In total, 118,506 patients were eligible for this study,
including 25,219 (21%) in the landiolol group and 93,287 (79%) in the
control group. One-to-one propensity score matching created 24,893 pairs.
After propensity score matching, the in-hospital mortality was
significantly lower in the landiolol group than that in the control group
(3.7% vs 4.3%; odds ratio 0.85; 95% confidence interval 0.78 to 0.94; P
=.010). CONCLUSION(S): Intraoperative landiolol use was associated
with decreased in-hospital mortality in patients undergoing CABG. Further
randomized controlled trials are required to confirm these
findings. Copyright © 2023 Lippincott Williams and Wilkins. All
rights reserved.

<74>
Accession Number
2028717994
Title
Stroke reduction by cerebral embolic protection devices in transcatheter
aortic valve implantation: A systematic review and Bayesian meta-analysis.
Source
Heart. (no pagination), 2023. Date of Publication: 2023.
Author
Heuts S.; Gabrio A.; Veenstra L.; Maesen B.; Kats S.; Maessen J.G.; Walton
A.S.; Nanayakkara S.; Lansky A.J.; Van 'T Hof A.W.J.; Vriesendorp P.A.
Institution
(Heuts, Maesen, Kats, Maessen) Cardiothoracic Surgery, Maastricht
University Medical Center+, Maastricht, Netherlands
(Heuts, Maesen, Maessen, Van 'T Hof, Vriesendorp) Cardiovascular Research
Institute Maastricht (CARIM), Maastricht University, Maastricht,
Netherlands
(Gabrio) Methodology and Statistics, Maastricht University, Maastricht,
Netherlands
(Gabrio) Care and Public Health Research Institute (CAPHRI), Maastricht
University, Maastricht, Netherlands
(Veenstra, Van 'T Hof, Vriesendorp) Cardiology, Maastricht University,
Medical Center+, Maastricht, Netherlands
(Veenstra, Van 'T Hof) Cardiology, Zuyderland Medical Center, Heerlen,
Netherlands
(Walton, Nanayakkara) Cardiovascular Medicine, Alfred Hospital, Victoria,
Melbourne, Australia
(Walton, Nanayakkara) Heart Failure Research Group, Baker Heart & Diabetes
Institute, Melbourne, VIC, Australia
(Nanayakkara) Faculty of Medicine Nursing and Health Sciences, Monash
University, Melbourne, VIC, Australia
(Lansky) Yale Cardiovascular Research Group, Yale Medical School, New
Haven, CT, United States
Publisher
BMJ Publishing Group
Abstract
Objectives: The use of cerebral embolic protection (CEP) during
transcatheter aortic valve implantation (TAVI) has been studied in several
randomised trials. We aimed to perform a systematic review and Bayesian
meta-analysis of randomised CEP trials, focusing on a clinically relevant
reduction in disabling stroke. Method(s): A systematic search was
applied to three electronic databases, including trials that randomised
TAVI patients to CEP versus standard treatment. The primary outcome was
the risk of disabling stroke. Outcomes were presented as relative risk
(RR), absolute risk differences (ARDs), numbers needed to treat (NNTs) and
the 95% credible intervals (CrIs). The minimal clinically important
difference was determined at 1.1% ARD, per expert consensus (NNT 91). The
principal Bayesian meta-analysis was performed under a vague prior, and
secondary analyses were performed under two informed literature-based
priors. Result(s): Seven randomised studies were included for
meta-analysis (n=3996: CEP n=2126, control n=1870). Under a vague prior,
the estimated median RR of CEP use for disabling stroke was 0.56 (95% CrI
0.28 to 1.19, derived ARD 0.56% and NNT 179, I2=0%). Although the
estimated posterior probability of any benefit was 94.4%, the probability
of a clinically relevant effect was 0-0.1% under the vague and informed
literature-based priors. Results were robust across multiple sensitivity
analyses. Conclusion(s): There is a high probability of a beneficial
CEP treatment effect, but this is unlikely to be clinically relevant.
These findings suggest that future trials should focus on identifying TAVI
patients with an increased baseline risk of stroke, and on the development
of new generation devices. PROSPERO registration number: CRD42023407006.
 Copyright © Author(s) (or their employer(s)) 2023. No commercial
re-use. See rights and permissions. Published by BMJ.

<75>
Accession Number
642878511
Title
The Coronary Reperfusion Effect and Safety of Prehospital P2Y12 Inhibitor
in Primary-PCI STEMI Patients: A systematic review and Meta-analysis.
Source
Prehospital emergency care. (pp 1-24), 2023. Date of Publication: 29 Nov
2023.
Author
Chou Y.-H.; Huang C.-C.; Chang C.-K.; Huang J.-L.; Jang B.-H.; Lee T.-H.;
Lin K.-T.; Chen W.-L.; Chou C.-C.; Lin Y.-R.
Institution
(Chou, Huang, Jang) Fire Bureau of Changhua County Government, Changhua,
Taiwan (Republic of China)
(Chou, Lee, Lin, Chou, Lin) National Changhua University of Education,
Changhua, Taiwan (Republic of China)
(Huang, Chang) Department of Emergency and Critical Care Medicine,
Changhua Christian Hospital, Changhua, Taiwan (Republic of China)
(Huang, Lee, Chen) Department of Biological Science and Technology,
National Yang Ming Chiao Tung University, Hsinchu, Taiwan (Republic of
China)
(Chou, Lin) Department of Post Baccalaureate Medicine, College of
Medicine, National Chung Hsing University, Taichung, Taiwan (Republic of
China)
(Chou, Lin) School of Medicine, Chung Shan Medical University, Taichung,
Taiwan (Republic of China)
Abstract
BACKGROUND: The concept of early administration of P2Y12 inhibitor in
ST-elevation myocardial infarction (STEMI) patients undergoing primary
percutaneous coronary intervention (PCI) is widely accepted, but whether
prehospital administration results in greater coronary reperfusion remains
unclear. Our study aims to analyze the benefit and safety of prehospital
P2Y12 inhibitor compared to in-hospital P2Y12 inhibitor administration.
 METHOD(S): Three databases (PubMed, EMBASE, and Cochrane Library)
were searched from database inception to June 2023. We included all types
of studies except for conference publications, abstract presentations,
reviews, and case reports. The primary outcomes were pre-PCI TIMI flow
grade 2-3 (TIMI=Thrombolysis in Myocardial Infarction) and major bleeding.
The secondary outcomes included post-PCI TIMI flow grade 2-3, major
adverse cardiac events (MACE), recurrent myocardial infarction (MI), and
short-term (30-day) mortality. RESULT(S): Eight individual studies
with a total of 10823 patients were included in our meta-analysis.
Compared with in-hospital P2Y12 inhibitor, prehospital P2Y12 inhibitor
were associated with significantly higher rates of pre-PCI TIMI flow grade
2-3 (OR 1.32, 95% CI: 1.09-1.61, p=0.005) and post-PCI TIMI flow grade 2-3
(OR 1.43, 95% CI: 1.04-1.97, p=0.03), and a significantly lower risk of
recurrent MI (OR 0.69, 95% CI: 0.49-0.96, p=0.03). There were no
significant difference in the risk of major bleeding (OR 1.00, 95% CI:
0.75-1.32, p=0.98), MACE (OR 0.94, 95% CI: 0.70-1.25, p=0.65), or
short-term mortality (OR 0.87, 95% CI: 0.50-1.51, p=0.61).
 CONCLUSION(S): Prehospital P2Y12 inhibitor compared to in-hospital
P2Y12 inhibitor is associated with a significantly higher rate of pre-PCI
and post-PCI TIMI flow grade 2-3, a reduced risk of recurrent MI, and no
increase in major bleeding in STEMI patients undergoing primary PCI.

<76>
Accession Number
642876868
Title
The Danish-Norwegian randomized trial on beta-blocker therapy after
myocardial infarction: Design, rationale, and baseline characteristics.
Source
European heart journal. Cardiovascular pharmacotherapy. (no pagination),
2023. Date of Publication: 28 Nov 2023.
Author
Kristensen A.M.D.; Munkhaugen J.; Halvorsen S.; Olsen M.H.; Bakken A.;
Sehested T.S.G.; Ruddox V.; Lange T.; Fagerland M.W.; Torp-Pedersen C.;
Prescott E.; Atar D.
Institution
(Kristensen, Prescott) Department of Cardiology, Copenhagen University
Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark
(Munkhaugen) Department of Medicine, Drammen Hospital, Vestre Viken Trust,
Institute of Behavioural Medicine, University of Oslo, Drammen, Norway
(Halvorsen, Bakken, Atar) Department of Cardiology, Oslo University
Hospital Ulleval, University of Oslo, Norway
(Olsen) Department of Regional Health Research, University of Southern
Denmark, Department of Internal Medicine 1, Holbaek Hospital, Denmark
(Sehested) Department of Cardiology, Zealand University Hospital Roskilde,
Roskilde, Denmark
(Ruddox) Department of Cardiology, Vestfold Hospital Trust, Tonsberg,
Norway
(Lange) Section of Biostatistics, Department of Public Health, University
of Copenhagen, Copenhagen, Denmark
(Fagerland) Oslo Centre for Biostatistics and Epidemiology, Oslo
University Hospital, Oslo, Norway
(Torp-Pedersen) Department of Cardiology, Copenhagen University Hospital -
North Zealand Hospital, Denmark
Abstract
AIM: The evidence for beta-blocker therapy after myocardial infarction
(MI) is randomized trials conducted more than 30 years ago, and the
continued efficacy has been questioned. DESIGN AND METHODS: The ongoing
Danish (DANBLOCK) and Norwegian (BETAMI) randomized beta-blocker trials
are joined to evaluate the effectiveness and risks of long-term
beta-blocker therapy after MI. Patients with normal or mildly reduced left
ventricular ejection fraction (LVEF>=40%) will be randomized to open-label
treatment with beta-blockers or no such therapy. This event-driven trial
will randomize ~5700 patients and continue until 950 primary endpoints
have occurred. As of July 2023, 5228 patients have been randomized. Of the
first 4000 patients randomized, median age was 62 years, 79% were men, 48%
had a STEMI, and 84% had a normal LVEF. The primary endpoint is a
composite of adjudicated recurrent MI, incident heart failure, coronary
revascularization, ischemic stroke, all-cause mortality, malignant
ventricular arrhythmia, or resuscitated cardiac arrest. The primary safety
endpoint includes a composite of recurrent MI, heart failure, all-cause
mortality, malignant ventricular arrhythmia, or resuscitated cardiac
arrest 30 days after randomization. Secondary endpoints include each of
the components of the primary endpoint, patient-reported outcomes, and
other clinical outcomes linked to beta-blocker therapy. The primary
analysis will be conducted according to the intention-to-treat principle
using a Cox proportional hazards regression model. End of follow-up is
expected in December 2024. CONCLUSION(S): The combined
BETAMI-DANBLOCK trial will have the potential to affect current clinical
practice for beta-blocker therapy in patients with normal or mildly
reduced LVEF after MI. Copyright © The Author(s) 2023. Published
by Oxford University Press on behalf of the European Society of
Cardiology.

<77>
Accession Number
642874647
Title
Prospective, Randomized Study of Fibrinogen Concentrate Versus
Cryoprecipitate for Correcting Hypofibrinogenemia in Cardiac Surgery
Patients.
Source
Journal of cardiothoracic and vascular anesthesia. (no pagination), 2023.
Date of Publication: 27 Oct 2023.
Author
Ayaganov D.; Kuanyshbek A.; Vakhrushev I.; Li T.
Institution
(Ayaganov, Kuanyshbek, Vakhrushev) NJSC "National Research Cardiac Surgery
Center", Astana, Kazakhstan
(Li) NJSC "National Research Cardiac Surgery Center", Astana, Kazakhstan
Abstract
OBJECTIVE: Cardiac surgery with cardiopulmonary bypass (CPB) is associated
with hypofibrinogenemia and severe bleeding requiring transfusion.
Guidelines recommend cryoprecipitate or fibrinogen concentrate (FC) for
the treatment of acquired hypofibrinogenemia. This study compared
cryoprecipitate and FC for the correction of acquired hypofibrinogenemia
and the associated costs. DESIGN: A single-center, prospective, randomized
study evaluating patients with hypofibrinogenemia after cardiac surgery.
The primary endpoint was direct treatment cost. Secondary endpoints
included the change in fibrinogen level after FC and/or cryoprecipitate
dosing. SETTING: A single-center study in Astana, Kazakhstan.
PARTICIPANTS: Participants who underwent CPB from 2021 to 2022 and
developed clinically significant bleeding and hypofibrinogenemia.
INTERVENTIONS: Patients were randomized to receive cryoprecipitate or FC.
MEASUREMENTS AND MAIN RESULTS: Eighty-eight adult patients with acquired
hypofibrinogenemia (<2.0 g/L) after CPB were randomized to receive
cryoprecipitate (N = 40) or FC (N = 48), with similar demographics between
groups. Overall, mean +/- SD 9.33 +/- 0.94 units (range, 8-10)
cryoprecipitate or 1.40 +/- 0.49 g (1-2) FC was administered to the 2
groups. From before administration to 24 hours after, mean plasma
fibrinogen increased by a mean +/- SD of 125 +/- 65 and 96 +/- 65 mg/dL in
the cryoprecipitate and FC groups, respectively. At 48 hours after
administration, there was no significant difference in fibrinogen levels
between groups. The mean direct cost of treatment with FC was
significantly lower than with cryoprecipitate (p < 0.0001): $1,505.06 +/-
$152.40 and $631.75 +/- $223.67 per patient for cryoprecipitate and FC,
respectively. CONCLUSION(S): Analysis of plasma fibrinogen
concentration showed that cryoprecipitate and FC had comparable
effectiveness. However, FC is advantageous over cryoprecipitate due to its
ease of handling, lower cost, and high purity. Copyright © 2023
The Authors. Published by Elsevier Inc. All rights reserved.

<78>
Accession Number
642874584
Title
Intracranial Atherosclerosis Increases the Risk of Postoperative Stroke
After Cardiac Surgery: A Review and Meta-Analysis.
Source
Heart, lung & circulation. (no pagination), 2023. Date of Publication: 27
Nov 2023.
Author
Yang A.; Nguyenhuy M.; Seevanayagam S.
Institution
(Yang, Seevanayagam) Brian F. Buxton Department of Cardiac and Thoracic
Aortic Surgery, Austin Health, Melbourne, Vic, Australia
(Nguyenhuy) Department of Radiology, Western Health, Melbourne, Vic,
Australia
Abstract
BACKGROUND: Postoperative stroke is a devastating complication of cardiac
surgery with high morbidity, mortality, and health care cost. Extracranial
carotid atherosclerosis (ECAS) is a known risk factor for stroke; however,
the impact of intracranial atherosclerosis (ICAS) remains unclear. To our
knowledge, this is the first literature review of ICAS in cardiac surgery.
We aimed to assess the prevalence, association with postoperative stroke,
and perioperative management of ICAS in cardiac surgery. METHOD(S): A
search was performed to identify studies reporting rates of ICAS and
stroke after cardiac surgery. Data extraction and primary outcomes for
meta-analysis included the prevalence of preoperative ICAS and the
association between ICAS and stroke. Risk ratios (RRs) and 95% confidence
intervals (CIs) were pooled by random-effects modelling. RESULT(S):
Seventeen studies were reviewed and seven were included in the
meta-analysis, comprising 4,936 patients. Prevalence of intracranial
atherosclerosis (ICAS) among cardiac surgery patients was 21% (95% CI
13%-32%). Patients with ICAS were more likely to develop postoperative
stroke (RR 3.61; 95% CI 2.30-5.67; p<0.001). ICAS was more closely
associated with stroke than ECAS. Preoperative brain perfusion
single-photon emission computed tomography with acetazolamide challenge,
staged intracerebral revascularisation, or conversion to off-pump coronary
artery bypass grafting are described management options for ICAS.
 CONCLUSION(S): Patients with ICAS are 3.61 times more likely to
develop stroke after cardiac surgery. Known predictors for ICAS can be
used to develop risk stratification screening tools. Further research with
diverse cohorts is required to develop evidence-based guidelines for
screening and management of ICAS in cardiac surgery. Crown Copyright
© 2023. Published by Elsevier B.V. All rights reserved.

<79>
Accession Number
642868297
Title
Angioplasty Guidewire-Assisted Versus Conventional Transseptal Puncture
for Left Atrial Appendage Occlusion (ADVANCE-LAAO): A Multicenter
Randomized Controlled Trial.
Source
Europace : European pacing, arrhythmias, and cardiac electrophysiology :
journal of the working groups on cardiac pacing, arrhythmias, and cardiac
cellular electrophysiology of the European Society of Cardiology. (no
pagination), 2023. Date of Publication: 27 Nov 2023.
Author
Hu F.; Xu B.; Qiao Z.; Cheng F.; Zhou Z.; Zou Z.; Zang M.; Ding S.; Hong
J.; Xie Y.; Zhou Y.; Huang J.; Pu J.
Institution
(Hu, Xu, Qiao, Cheng, Zhou, Zou, Zang, Ding, Xie, Zhou, Huang, Pu)
Department of Cardiology, Ren Ji Hospital, School of Medicine, Shanghai
Jiao Tong University, Shanghai, China
(Hong, Xie) Department of Cardiology, Ningbo Hangzhou Bay Hospital,
Ningbo, Zhejiang, China
(Zhou) Department of Cardiology, Punan Hospital, Pudong New District,
Shanghai, China
(Huang) Department of Cardiology, Dachang Hospital, Baoshan District,
Shanghai, China
Abstract
BACKGROUND AND AIMS: This study was performed to compare the usability,
efficiency, and safety of a modified angioplasty guidewire-assisted
transseptal puncture (TSP) technique versus the conventional approach in
facilitating access to the left atrium during left atrial appendage
occlusion (LAAO) procedures for treatment of atrial fibrillation.
 METHOD(S): The ADVANCE-LAAO trial (Angioplasty Guidewire-Assisted
Versus Conventional Transseptal Puncture for Left Atrial Appendage
Occlusion) was an investigator-initiated, prospective, multicenter,
randomized controlled trial (NCT05125159). Patients with atrial
fibrillation who underwent LAAO were prospectively enrolled from four
centers and randomly assigned to an angioplasty guidewire-assisted TSP
group (n=131) or to a conventional Brockenbrough needle TSP group (n=132).
The primary endpoint was the one-time success rate of TSP. We also
analyzed the TSP procedure time, failure rate of the assigned TSP type,
radiation dose, contrast dose, and procedural complications in both
groups. RESULT(S): All patients in the guidewire-assisted group
underwent successful TSP, whereas five in the standard conventional group
switched to the guidewire-assisted approach. Guidewire-assisted puncture
improved the one-time success rate (92.4% vs. 77.3%, P=0.001), shortened
the TSP procedure time (109.2+/-48.2 s vs. 120.5+/-57.6 s, P=0.023), and
tended to have a higher rate of good coaxial orientation of the sheath
with the left atrial appendage during LAAO (66.4% vs. 54.5%, P=0.059). No
TSP-related complications occurred in the guidewire-assisted TSP group
whereas two occurred in the conventional TSP group. There was no
significant difference in the failure rate of the assigned TSP type, total
procedure time, total radiation dose, rate of successful LAAO
implantation, or the procedural complication rate between the two groups
(all P>0.05). CONCLUSION(S): This study confirmed that angioplasty
guidewire-assisted puncture can effectively improve the success rate of
TSP during LAAO. This novel technique has high potential for application
in interventional therapies requiring TSP. Copyright © The
Author(s) 2023. Published by Oxford University Press on behalf of the
European Society of Cardiology.

<80>
Accession Number
2028627476
Title
Effect of coronary artery bypass grafting on quality of life: a
meta-analysis of randomized trials.
Source
European Heart Journal - Quality of Care and Clinical Outcomes. 8(3) (no
pagination), 2022. Article Number: qcab075. Date of Publication: May 2022.
Author
Creber R.M.; Dimagli A.; Spadaccio C.; Myers A.; Moscarelli M.; Demetres
M.; Little M.; Fremes S.; Gaudino M.
Institution
(Creber, Myers) Division of Health Informatics, Department of Healthcare
Policy and Research, Weill Cornell Medicine, New York, NY, United States
(Dimagli) Bristol Heart Institute, University of Bristol, Bristol, United
Kingdom
(Spadaccio) Institute of Cardiovascular and Medical Sciences, University
of Glasgow, United Kingdom
(Spadaccio) Lancashire Cardiac Center, Blackpool Victoria Teaching
Hospital, Blackpool, United Kingdom
(Moscarelli) Department of Cardiac Surgery, Imperial College London,
London, United Kingdom
(Demetres) Samuel J. Wood Library and C.V. Starr Biomedical Information
Center, Weill Cornell Medicine, New York, NY, United States
(Little) Health Economics Research Centre, Nuffield Department of
Population Health, University of Oxford, United Kingdom
(Fremes) Sunnybrook Health Sciences Center, University of Toronto,
Toronto, Canada
(Gaudino) Department of Cardiothoracic Surgery, Weill Cornell Medicine,
New York, NY, United States
Publisher
Oxford University Press
Abstract
Aims We conducted a systematic review and meta-analysis to evaluate
temporal trends in quality of life (QoL) after coronary artery bypass
grafting (CABG) surgery in randomized clinical trials, and a quantitative
comparison from before surgery to up to 5 years after surgery.Methods and
results We searched MEDLINE, CINAHL, EMBASE, Cochrane Library, and
PsycINFO from 2010 to 2020 to identify studies that included the
measurement of QoL in patients undergoing CABG. The primary outcome was
the Seattle Angina Questionnaire (SAQ), and secondary outcomes were the
36-item Short Form Health Survey (SF-36) and EuroQol Questionnaire
(EQ-5D). We pooled the means and the weighted mean differences over the
follow-up period. In the meta-analysis, 2586 studies were screened and 18
full-text studies were included. There was a significant trend towards
higher QoL scores from before surgery to 1 year post-operatively for the
SAQ angina frequency (AF), SAQ QoL, SF-36 physical component (PC), and
EQ-5D, whereas the SF-36 mental component (MC) did not improve
significantly. The weighted mean differences from before surgery to 1 year
after was 24 [95% confidence interval (CI): 21.6-26.4] for the SAQ AF, 31
(95% CI: 27.5-34.6) for the SAQ QoL, 9.8 (95% CI: 7.1-12.8) for the SF-36
PC, 7.1 (95% CI: 4.2-10.0) for the SF-36 MC, and 0.1 (95% CI: 0.06-0.14)
for the EQ-5D. There was no evidence of publication bias or small-study
effect.Conclusion CABG had both short- and long-term improvements in
disease-specific QoL and generic QoL, with the largest improvement in
angina frequency. Copyright © The Author(s) 2021. Published by
Oxford University Press on behalf of the European Society of Cardiology.
All rights reserved.

<81>
Accession Number
2028627474
Title
Tricuspid regurgitation management: a systematic review of clinical
practice guidelines and recommendations.
Source
European Heart Journal - Quality of Care and Clinical Outcomes. 8(3) (no
pagination), 2022. Article Number: qcab081. Date of Publication: May 2022.
Author
Ricci F.; Bufano G.; Galusko V.; Sekar B.; Benedetto U.; Awad W.I.; Mauro
M.D.; Gallina S.; Ionescu A.; Badano L.; Khanji M.Y.
Institution
(Ricci, Bufano, Benedetto, Mauro, Gallina) Department of Neuroscience,
Imaging and Clinical Sciences, G.d' Annunzio University of Chieti-Pescara,
Chieti 66100, Italy
(Ricci) Department of Clinical Sciences, Lund University, Jan
Waldenstromsgata 35-205, Malmo 22100, Sweden
(Ricci) Casa di Cura Villa Serena, Pescara, Citta Sant'Angelo 65013, Italy
(Galusko) Department of Cardiology, King's College Hospital, London SE5
9RS, United Kingdom
(Sekar, Ionescu) Morriston Cardiac Regional Centre, Swansea Bay Health
Board, Swansea SA6 6NL, United Kingdom
(Awad) Barts Heart Centre, Barts Health NHS Trust, West Smithfield, London
EC1A 7BE, United Kingdom
(Badano) Department of Medicine and Surgery, University of Milano Bicocca,
Milan 20126, Italy
(Badano) Department of Cardiological, Metabolic and Neural Sciences,
Istituto Auxologico Italiano, IRCCS, Milan 20149, Italy
(Khanji) Department of Cardio-Thoracic Surgery, Maastricht University
Medical Centre, HX, Maastricht 6229, Netherlands
(Khanji) NIHR Barts Biomedical Research Centre, William Harvey Research
Institute, Queen Mary University of London EC1A 7BE, United Kingdom
(Khanji) Department of Cardiology, Newham University Hospital, Barts
Health NHS Trust, Glen Road, London E13 8SL, United Kingdom
Publisher
Oxford University Press
Abstract
Tricuspid regurgitation (TR) is a highly prevalent condition and an
independent risk factor for adverse outcomes. Multiple clinical guidelines
exist for the diagnosis and management of TR, but the recommendations may
sometimes vary. We systematically reviewed high-quality guidelines with a
specific focus on areas of agreement, disagreement, and gaps in evidence.
We searched MEDLINE and EMBASE (1 January 2011 to 30 August 2021), the
Guidelines International Network International, Guideline Library,
National Guideline Clearinghouse, National Library for Health Guidelines
Finder, Canadian Medical Association Clinical Practice Guidelines
Infobase, Google Scholar, and websites of relevant organizations for
contemporary guidelines that were rigorously developed (as assessed by the
Appraisal of Guidelines for Research and Evaluation II tool). Three
guidelines were finally retained. There was consensus on a TR grading
system, recognition of isolated functional TR associated with atrial
fibrillation, and indications for valve surgery in symptomatic vs.
asymptomatic patients, primary vs. secondary TR, and isolated TR forms.
Discrepancies exist in the role of biomarkers, complementary multimodality
imaging, exercise echocardiography, and cardiopulmonary exercise testing
for risk stratification and clinical decision-making of progressive TR and
asymptomatic severe TR, management of atrial functional TR, and choice of
transcatheter tricuspid valve intervention (TTVI). Risk-based thresholds
for quantitative TR grading, robust risk score models for TR surgery,
surveillance intervals, population-based screening programmes, TTVI
indications, and consensus on endpoint definitions are
lacking. Copyright © The Author(s) 2021. Published by Oxford
University Press on behalf of the European Society of Cardiology. All
rights reserved.

<82>
Accession Number
2028591322
Title
Impact of afterload and infiltration on coexisting aortic stenosis and
transthyretin amyloidosis.
Source
Heart. 108(1) (pp 67-72), 2022. Date of Publication: January 2022.
Author
Patel K.P.; Scully P.R.; Nitsche C.; Kammerlander A.A.; Joy G.; Thornton
G.; Hughes R.; Williams S.; Tillin T.; Captur G.; Chacko L.; Kelion A.;
Sabharwal N.; Newton J.D.; Kennon S.; Ozkor M.; Mullen M.; Hawkins P.N.;
Gillmore J.D.; Menezes L.; Pugliese F.; Hughes A.D.; Fontana M.; Lloyd G.;
Treibel T.A.; Mascherbauer J.; Moon J.C.
Institution
(Patel, Scully, Thornton, Hughes, Captur, Treibel, Moon) Institute of
Cardiovascular Science, University College London, London, United Kingdom
(Patel, Scully, Kennon, Ozkor, Mullen, Menezes, Pugliese, Lloyd, Treibel,
Moon) Department of Cardiology, Barts Heart Centre, London, United Kingdom
(Nitsche) Department of Internal Medicine, Medical University of Vienna,
Wien, Austria
(Kammerlander, Mascherbauer) Department of Cardiology, Medical University
of Vienna, Vienna, Austria
(Joy, Thornton, Hughes) Cardiac Imaging Department, Barts Heart Centre,
London, United Kingdom
(Williams, Tillin, Captur, Hughes) MRC Unit for Lifelong Health and
Ageing, London, United Kingdom
(Chacko, Hawkins, Gillmore, Fontana) National Amyloidosis Centre, London,
United Kingdom
(Kelion, Sabharwal, Newton) Department of Cardiology, Oxford University
Hospitals NHS Foundation Trust, Oxford, United Kingdom
(Pugliese) Advanced Cardiovascular Imaging, William Harvey Research
Institute, The London Chest Hospital, London, United Kingdom
Publisher
BMJ Publishing Group
Abstract
Objective The coexistence of wild-type transthyretin cardiac amyloidosis
(ATTR) is common in patients with severe aortic stenosis (AS) undergoing
transcatheter aortic valve implantation (TAVI). However, the impact of
ATTR and AS on the resultant AS-ATTR is unclear and poses diagnostic and
management challenges. We therefore used a multicohort approach to
evaluate myocardial structure, function, stress and damage by assessing
age-related, afterload-related and amyloid-related remodelling on the
resultant AS-ATTR phenotype. Methods We compared four samples (n=583): 359
patients with AS, 107 with ATTR (97% Perugini grade 2), 36 with AS-ATTR
(92% Perugini grade 2) and 81 age-matched and ethnicity-matched controls.
99mTc-3,3-diphosphono-1,2-propanodicarboxylic acid (DPD)
scintigraphy was used to diagnose amyloidosis (Perugini grade 1 was
excluded). The primary end-point was NT-pro Brain Natriuretic Peptide
(BNP) and secondary end-points related to myocardial structure, function
and damage. Results Compared with older age controls, the three disease
cohorts had greater cardiac remodelling, worse function and elevated
NT-proBNP/high-sensitivity Troponin-T (hsTnT). NT-proBNP was higher in
AS-ATTR (2844 (1745, 4635) ng/dL) compared with AS (1294 (1077,
1554)ng/dL; p=0.002) and not significantly different to ATTR (3272 (2552,
4197) ng/dL; p=0.63). Diastology, hsTnT and prevalence of carpal tunnel
syndrome were statistically similar between AS-ATTR and ATTR and higher
than AS. The left ventricular mass indexed in AS-ATTR was lower than ATTR
(139 (112, 167) vs 180 (167, 194) g; p=0.013) and non-significantly
different to AS (120 (109, 130) g; p=0.179). Conclusions The AS-ATTR
phenotype likely reflects an early stage of amyloid infiltration, but the
combined insult resembles ATTR. Even after treatment of AS, ATTR-specific
therapy is therefore likely to be beneficial. Copyright ©
Author(s) (or their employer(s)) 2022.

<83>
Accession Number
2028569120
Title
Percutaneous Coronary Intervention versus Coronary Artery Bypass Grafting
for Chronic Total Occlusion of Coronary Arteries: A Systematic Review and
Meta-Analysis.
Source
Journal of Interventional Cardiology. 2023 (no pagination), 2023. Article
Number: 9928347. Date of Publication: 2023.
Author
Wang C.; Liu S.; Kamronbek R.; Ni S.; Cheng Y.; Yan H.; Zhang M.
Institution
(Wang, Liu, Kamronbek, Ni, Zhang) Center for Coronary Heart Disease,
Beijing Anzhen Hospital, Capital Medical University, Beijing, China
(Cheng) Key Laboratory on Assisted Circulation, Ministry of Health,
Department of Cardiology, First Affiliated Hospital, Sun Yat-Sen
University, Guangzhou, China
(Yan) Department of Cardiology, Hangjinqi People's Hospital, Hangjinqi
Mongolia, China
Publisher
Hindawi Limited
Abstract
Introduction. Chronic total occlusion (CTO) of coronary arteries
constitutes a substantial clinical challenge and has historically been
managed through medical management and coronary artery bypass grafting
(CABG). However, with the advancement in interventional technology, the
success rate of percutaneous treatment has been significantly improved,
and percutaneous coronary intervention (PCI) has emerged as a primary mode
of treatment for CTOs, demonstrating remarkable clinical efficacy. The
objective of this systematic review and meta-analysis is to evaluate and
contrast the outcomes of PCI and CABG in patients with CTO. Methods and
Results. A systematic search was conducted in the databases of PubMed,
Embase, and Web of Science. The primary endpoints evaluated in this
meta-analysis were the occurrence of major adverse cardiac events (MACE)
and all-cause mortality. Secondary endpoints included myocardial
infarction (MI), cardiac death, and the need for repeat revascularization.
Nine studies, encompassing a total of 8,674 patients, were found to meet
the criteria for inclusion and had a mean follow-up duration of 4.3 years.
The results of the meta-analysis revealed that compared to CABG, PCI was
associated with a lower incidence of all-cause mortality (RR: 0.78, 95%
CI: 0.66-0.92; P = 0.003) and cardiac death (RR: 0.55; 95% CI: 0.31-0.96;
P < 0.05), but an increased risk of myocardial infarction (MI) (RR: 1.96;
95%CI: 1.07-3.62; P < 0.05) and repeat revascularization (RR: 7.13; 95%
CI: 5.69-8.94; P < 0.00001). There was no statistically significant
difference in MACE (RR: 1.11; 95% CI: 0.69-1.81; P = 0.66) between the PCI
and CABG groups. Conclusion. In the present meta-analysis comparing PCI
and CABG in patients with chronic total occlusion of the coronary
arteries, the results indicated that PCI was superior to CABG in reducing
all-cause mortality and cardiac death but inferior in decreasing
myocardial infarction and repeat revascularization. There was no
statistically significant difference in MACE between the two
groups. Copyright © 2023 Chenyang Wang et al.

<84>
Accession Number
2028562787
Title
Epigenetic MicroRNAs as Prognostic Markers of Postoperative Atrial
Fibrillation: A Systematic Review.
Source
Current Problems in Cardiology. Part C. 49(1) (no pagination), 2024.
Article Number: 102106. Date of Publication: January 2024.
Author
Lee J.; Lee H.; Sherbini A.E.; Baghaie L.; Leroy F.; Abdel-Qadir H.;
Szewczuk M.R.; El-Diasty M.
Institution
(Lee, Lee, Sherbini) Faculty of Health Sciences, Queen's University,
Kingston, ON, Canada
(Baghaie, Leroy, Szewczuk) Department of Biomedical & Molecular Sciences,
Queen's University, Kingston, ON, Canada
(Leroy) Faculte de Medecine, Maieutique et Sciences de la Sante,
Universite de Strasbourg, Strasbourg, France
(Abdel-Qadir) Women's College Hospital, Peter Munk Cardiac Center,
Toronto, ON, Canada
(El-Diasty) Department of Cardiac Surgery, Harrington Heart and Vascular
Institute, University Hospitals Cleveland Medical Center, Cleveland, OH,
United States
Publisher
Elsevier Inc.
Abstract
Postoperative atrial fibrillation (POAF) is a common complication after
cardiac surgery, increasing the risk for adverse outcomes such as
perioperative and long-term mortality, stroke, myocardial infarction, and
other thromboembolic events. Epigenetic biomarkers show promise as
prognostic tools for POAF. Epigenetic changes, such as DNA methylation,
histone modification, and microRNAs (miRNA), can result in altered gene
expression and the development of various pathological conditions. This
systematic review aims to present the current literature on the
association between various epigenetic markers and the development of POAF
following cardiac surgery. Here, an electronic literature search was
performed using MEDLINE, EMBASE, Cochrane Central Register of Controlled
Trials, ClinicalTrials.gov, and Google Scholar to identify studies that
reported the role of epigenetic markers in the development of POAF. Five
of the 6 studies focused on miRNAs and their association with POAF. In
POAF patients, the expression of miR-1 and miR-483-5p were upregulated in
the right atrial appendage (RAA), while the levels of miR-133A, miR-208a,
miR-23a, miR-26a, miR-29a, miR-29b, and miR-29c were decreased in the RAA
and venous blood. One study examined cytosines followed by guanines (CpGs)
as DNA methylation markers. Across all studies, 488 human subjects who had
undergone cardiac surgery were investigated, and 195 subjects (39.9%)
developed new-onset POAF. The current literature suggests that miRNAs may
play a role in predicting the development of atrial fibrillation after
cardiac surgery. However, more robust clinical data are required to
justify their role in routine clinical practice. Copyright © 2023
Elsevier Inc.

<85>
Accession Number
2028560797
Title
Skeletonized versus Pedicled harvesting of internal mammary artery: A
systematic review and Meta-analysis.
Source
Current Problems in Cardiology. Part B. 49(1) (no pagination), 2024.
Article Number: 102160. Date of Publication: January 2024.
Author
Shafiq A.; Maniya M.T.; Duhan S.; Jamil A.; Hirji S.A.
Institution
(Shafiq, Jamil) Department of Medicine, Dow University of Health Sciences,
Karachi, Pakistan
(Maniya) Department of Medicine, Ziauddin Medical University, Karachi,
Pakistan
(Duhan) Department of Medicine, Sinai Hospital of Baltimore, MD, United
States
(Hirji) Division of Thoracic and Cardiac Surgery, Department of Surgery,
Brigham and Women's Hospital, Harvard Medical School, Boston, Mass, United
States
Publisher
Elsevier Inc.
Abstract
There are two recognized internal mammary artery (IMA) harvesting
techniques during coronary artery bypass grafting (CABG): pedicled and
skeletonized. This systematic review and meta-analysis sought to compare
the clinical outcomes of the two harvesting techniques. A comprehensive
electronic literature search of PubMed, Scopus, and Embase was conducted
from inception till June 2023. Thirty-one studies with a total of 13005
patients met our inclusion criteria. The results from the included studies
were presented as weighted mean difference (WMD) with its relevant
standard deviation (SD) for continuous variables, while Odds Ratio (OR)
was used for dichotomous variables. A 95% confidence interval (CI) was
used, and the results were pooled using a random effects model. The
skeletonized IMA demonstrated a significantly reduced risk of sternal
wound infection (SWI) compared to the pedicled IMA (OR = 0.45 [95% CI,
0.32-0.66]; p = 0.0001). The conduit length used was significantly longer
in the skeletonized IMA (WMD -2.48, 95% CI, [-3.75, -1.20], P = 0.0001)
and a significantly higher postoperative flow rate was observed while
using skeletonization compared to the pedicled harvesting (WMD -13.11, 95%
CI, [-22.52, -3.70], P = 0.006). However, no significant difference was
seen in mortality between the two techniques (OR = 1.19 [95% CI,
1.00-1.41]; p = 0.05). Pedicled harvesting demonstrated significantly
reduced incidents of MI (OR = 1.38 [95% CI, 1.13-1.69]; p = 0.002), while
significant results in graft patency were observed favoring pedicled
harvesting over skeletonization (OR = 0.63 [95% CI, 0.40-0.98]; p =
0.04). Copyright © 2023

<86>
Accession Number
2028557351
Title
Very Long-term Outcome of Bilateral Internal Thoracic Artery in Diabetic
Patients: A Systematic Review and Reconstructed Time-To-Event
Meta-analysis.
Source
Current Problems in Cardiology. Part C. 49(1) (no pagination), 2024.
Article Number: 102135. Date of Publication: January 2024.
Author
Formica F.; Gallingani A.; Tuttolomondo D.; Hernandez-Vaquero D.;
D'Alessandro S.; Singh G.; Grassa G.; Pattuzzi C.; Nicolini F.
Institution
(Formica, Grassa, Pattuzzi, Nicolini) Department of Medicine and Surgery,
University of Parma, Parma, Italy
(Gallingani, Grassa, Pattuzzi, Nicolini) Cardiac Surgery Unit, University
Hospital of Parma, Parma, Italy
(Tuttolomondo) Cardiology Unit, University Hospital of Parma, Parma, Italy
(Hernandez-Vaquero) Cardiac Surgery Department, Hospital Universitario
Central de Asturias, Oviedo, Spain
(D'Alessandro) Cardiac Surgery Unit, San Giovanni Bosco Hospital, Turin,
Italy
(Singh) Department of Critical Care Medicine and Division of Cardiac
Surgery, Mazankowski Alberta Heart Institute, University of Alberta,
Edmonton, Canada
Publisher
Elsevier Inc.
Abstract
The benefits of single (SITA) and bilateral internal thoracic arteries
(BITA) in diabetics undergoing coronary bypass grafting (CABG) are
conflicting. We undertook a study-level meta-analysis to compare early and
long-term outcomes of both CABG configurations. PubMed, CENTRAL, and
EMBASE were searched for studies comparing BITA versus SITA for isolated
CABG surgery in diabetics. Randomized trials or observational studies were
considered eligible for the analysis. Kaplan-Meier curves of long-term
survival were reconstructed and compared with Cox linear regression;
incidence rate ratios (IRR) with 95% confidence intervals (CI) for
long-term survival were calculated. Landmark analysis and time-varying
hazard ratio (HR) were analyzed. Odds ratios (OR) were extracted for early
mortality, postoperative stroke, deep sternal wound infection (DSWI), and
myocardial infarction (MI). A random effects meta-analysis was performed.
Sensitivity analyses included leave-one-out-analyses and meta-regression.
Thirteen studies (7332 patients) were included. Overall, at 20-year
follow-up, BITA was associated with higher survival (HR = 0.77; 95% CI,
0.71-0.84; P < 0.0001). Time-varying HR and landmark analysis reported
BITA was associated with a higher rate of 10-year survival (HR = 0.75, 95%
CI 0.68-0.82, P < 0.0001), while from 10 to 20-year follow-up no
difference was revealed (HR = 0.99, 95% CI 0.82-1.19, P = 0.93). There was
no increase in early mortality, postoperative MI, stroke, or DSWI between
the groups. At meta-regression, the higher the age, the higher the
long-term overall survival in patients with BITA. In diabetics, the BITA
approach is associated with improved 10-year survival with no increase in
early mortality, MI, stroke, or DSWI. In the 10-20-year timeframe, BITA
and SITA showed comparable survival. Copyright © 2023 Elsevier
Inc.

<87>
Accession Number
2028108119
Title
Risk Scores for Prediction of Postoperative Atrial Fibrillation After
Cardiac Surgery: A Systematic Review and Meta-Analysis.
Source
American Journal of Cardiology. 209 (pp 232-240), 2023. Date of
Publication: 15 Dec 2023.
Author
Pandey A.; Okaj I.; Ichhpuniani S.; Tao B.; Kaur H.; Spence J.D.; Young
J.; Healey J.S.; Devereaux P.J.; Um K.J.; Benz A.P.; Conen D.; Whitlock
R.P.; Belley-Cote E.P.; McIntyre W.F.
Institution
(Pandey, Okaj, Ichhpuniani, Kaur) Michael G. DeGroote School of Medicine,
McMaster University, Hamilton, ON, Canada
(Tao) Faculty of Medicine, University of British Columbia, Vancouver, BC,
Canada
(Spence, Healey, Devereaux, Benz, Conen, Whitlock, Belley-Cote, McIntyre)
Population Health Research Institute, Hamilton, ON, Canada
(Young) Health Sciences Library, McMaster University, Hamilton, ON, Canada
(Healey, Devereaux, Um, Conen, Belley-Cote, McIntyre) Division of
Cardiology, McMaster University, Hamilton, ON, Canada
Publisher
Elsevier Inc.
Abstract
Postoperative atrial fibrillation (POAF) is a common complication after
cardiac surgery and is associated with poor clinical outcomes. The
objective of this systematic review and meta-analysis was to assess the
performance of risk scores to predict POAF in cardiac surgery patients. We
searched MEDLINE, Embase, and Cochrane CENTRAL for studies that
developed/evaluated a POAF risk prediction model. Pairs of reviewers
independently screened studies and extracted data. We pooled area under
the receiver operating curves (AUCs), sensitivity and specificity, and
adjusted odds ratios from multivariable regression analyses using the
generic inverse variance method and random effects models. Forty-three
studies (n = 63,847) were included in the quantitative synthesis. Most
scores were originally developed for other purposes but evaluated for
predicting POAF. Pooled AUC revealed moderate POAF discrimination for the
EuroSCORE II (AUC 0.59, 95% confidence interval [CI] 0.54 to 0.65),
Society of Thoracic Surgeons (AUC 0.60, 95% CI 0.56 to 0.63), EuroSCORE
(AUC 0.63, 95% CI 0.58 to 0.68), CHADS<inf>2</inf> (AUC 0.66, 95% CI 0.57
to 0.75), POAF Score (AUC 0.66, 95% CI 0.63 to 0.68), HATCH (AUC 0.67, 95%
CI 0.57 to 0.75), CHA<inf>2</inf>DS<inf>2</inf>-VASc (AUC 0.68, 95% CI
0.60 to 0.75) and SYNTAX scores (AUC 0.74, 95% CI 0.71 to 0.78). Pooled
analyses at specific cutoffs of the CHA<inf>2</inf>DS<inf>2</inf>-VASc,
CHADS<inf>2</inf>, HATCH, and POAF scores demonstrated moderate-to-high
sensitivity (range 46% to 87%) and low-to-moderate specificity (range 31%
to 70%) for POAF prediction. In conclusion, existing clinical risk scores
offer at best moderate prediction for POAF after cardiac surgery. Better
models are needed to guide POAF risk stratification in cardiac surgery
patients. Copyright © 2023 Elsevier Inc.

<88>
Accession Number
2028083649
Title
Secondary Prevention of Cryptogenic Stroke and Outcomes Following Surgical
Patent Foramen Ovale Closure Plus Medical Therapy vs. Medical Therapy
Alone: An Umbrella Meta-Analysis of Eight Meta-Analyses Covering Seventeen
Countries.
Source
Cardiology Research. 14(5) (pp 342-350), 2023. Date of Publication: 2023.
Author
Patel U.; Dengri C.; Pielykh D.; Baskar A.; Tar M.I.; Patel G.; Patel N.;
Kothari N.; Renu; Selvam S.A.; Sharma A.M.; Venkata V.S.; Shah S.; Mahmood
S.N.; Peela A.S.
Institution
(Patel) Department of Neurology and Public Health, Icahn School of
Medicine at Mount Sinai, New York, NY 10029, United States
(Dengri) Department of Neurology, Cleveland Clinic Florida, Weston, FL
33331, United States
(Pielykh) Odessa National Medical University, Valikhovskiy Lane 2, Odessa
65000, Ukraine
(Baskar) K.A.P. Viswanatham Government Medical College, Tamilnadu, Musiri,
Trichy 621006, India
(Tar) Touro University Nevada College of Osteopathic Medicine, Henderson,
NV 89014, United States
(Patel) B.J. Medical College, Ahmedabad 380016, India
(Patel) Department of Public Health, Icahn School of Medicine at Mount
Sinai, New York, NY 10029, United States
(Kothari) Dartmouth Hitchcock Medical Center, Lebanon, NH 03766, United
States
(Renu) Department of Medicine, Sarojini Naidu Medical College, Uttar
Pradesh, Agra 282003, India
(Selvam) Department of Internal Medicine, St Mary Medical Center,
Langhorne, PA 19047, United States
(Sharma) Department of Medicine, Geisinger Commonwealth School of
Medicine, Scranton, PA 18510, United States
(Venkata) Department of Medicine, Cheshire Medical Center, Keene, NH
03431, United States
(Shah) Department of Neurology, Stormont Vail Health, Topeka, KS, United
States
(Mahmood) Department of Medicine, Section of Pulmonary/Critical Care,
MedStar Washington Hospital Center, Washington, DC 5333, United States
(Peela) Department of Family Medicine, UNC Health Southeastern, Lumberton,
NC 28358, United States
Publisher
Elmer Press
Abstract
Background: Cryptogenic stroke (CS) is an exclusion diagnosis that
accounts for 10-40% of all ischemic strokes. Patent foramen ovale (PFO) is
found in 66% of patients with CS, while having a prevalence of 25-30% in
the general population. The primary aim was to evaluate the risk of
recurrent stroke following surgical PFO closure plus medical therapy vs.
medical therapy alone amongst CS, an embolic stroke of undetermined source
(ESUS), or transient ischemic attack (TIA). The secondary aim was to
evaluate new-onset non-valvular atrial fibrillation, mortality, and major
bleeding. Method(s): We conducted an umbrella meta-analysis using
PRISMA guidelines on English studies comparing surgical PFO closure plus
medical therapy versus medical therapy alone for managing CS. We extracted
data on interventions and outcomes and used random-effects models with
generic inverse variance to calculate relative risks (RRs) with 95%
confidence intervals for outcome calculations. Result(s): A
comprehensive search yielded 54,729 articles on CS and 65,001 on surgical
PFO closure, with 1,591 studies focusing on PFO closure and medical
therapy for secondary CS, ESUS, or TIA prevention. After excluding
non-meta-analyses, 52 eligible meta-analyses were identified, and eight
studies were selected for outcome evaluation, excluding non-English,
non-human, and studies before January 2019 as of August 31, 2021. Among a
total of 41,880 patients, 14,942 received PFO closure + medical therapy,
while 26,938 patients received medical therapy alone. Our umbrella
meta-analysis showed that PFO closure plus medical therapy had a 64% lower
risk of recurrent strokes than medical therapy alone (pooled RR: 0.36).
PFO closure plus medical therapy was associated with 4.94 times higher
risk of atrial fibrillation. There was no difference in the risk of death
or bleeding between both groups. Conclusion(s): In patients with CS,
PFO closure, in addition to medical therapy, reduces the risk of
recurrence. More research is needed to assess the efficacy of early
closure as well as specific risk profiles that would benefit from early
intervention to reduce the burden of stroke. Copyright © The
authors Journal compilation

<89>
Accession Number
2026797086
Title
Physical Image Quality Metrics for the Characterization of X-ray Systems
Used in Fluoroscopy-Guided Pediatric Cardiac Interventional Procedures: A
Systematic Review.
Source
Children. 10(11) (no pagination), 2023. Article Number: 1784. Date of
Publication: November 2023.
Author
Nocetti D.; Villalobos K.; Wunderle K.
Institution
(Nocetti, Villalobos) Departamento de Tecnologia Medica, Facultad de
Ciencias de la Salud, Universidad de Tarapaca, Arica 1010069, Chile
(Wunderle) Department of Radiology, Cleveland Clinic, Cleveland, OH 44195,
United States
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Pediatric interventional cardiology procedures are essential in diagnosing
and treating congenital heart disease in children; however, they raise
concerns about potential radiation exposure. Managing radiation doses and
assessing image quality in angiographs becomes imperative for safe and
effective interventions. This systematic review aims to comprehensively
analyze the current understanding of physical image quality metrics
relevant for characterizing X-ray systems used in fluoroscopy-guided
pediatric cardiac interventional procedures, considering the main factors
reported in the literature that influence this outcome. A search in Scopus
and Web of Science, using relevant keywords and inclusion/exclusion
criteria, yielded 14 relevant articles published between 2000 and 2022.
The physical image quality metrics reported were noise, signal-to-noise
ratio, contrast, contrast-to-noise ratio, and high-contrast spatial
resolution. Various factors influencing image quality were investigated,
such as polymethyl methacrylate thickness (often used to simulate water
equivalent tissue thickness), operation mode, anti-scatter grid presence,
and tube voltage. Objective evaluations using these metrics ensured
impartial assessments for main factors affecting image quality, improving
the characterization of fluoroscopic X-ray systems, and aiding informed
decision making to safeguard pediatric patients during
procedures. Copyright © 2023 by the authors.

<90>
Accession Number
2026749349
Title
Effect of pre-use of Dexmedetomidine on the effective inhibitory dose of
remimazolam tosilate on positive cardiovascular response in double-lumen
endobronchial intubation: a clinical study.
Source
BMC Anesthesiology. 23(1) (no pagination), 2023. Article Number: 382. Date
of Publication: December 2023.
Author
Wei S.; Liu X.; Chang R.; Chen X.; Zheng T.; Wang J.; Liu H.; Zhang F.;
Song J.; Lv X.
Institution
(Wei, Liu, Chen, Zheng, Wang, Liu, Zhang, Song, Lv) Department of
Anesthesiology, Shanghai Pulmonary Hospital, School of Medicine, Tongji
University, 507 Zhengmin Rd, Shanghai 200433, China
(Chang) Medical department, Shanghai Pulmonary Hospital, School of
Medicine, Tongji University, 507 Zhengmin Rd, Shanghai 200433, China
Publisher
BioMed Central Ltd
Abstract
Background: Herein, the effect of pre-use of Dexmedetomidine(Dex) on the
half-effective dose (ED50) and 95%-effective dose (ED95) of Remimazolam
tosilate(RT) in inhibiting the positive cardiovascular response(CR) which
means blood pressure or heart rate rises above a critical threshold
induced by double-lumen bronchial intubation was evaluated.
 Method(s): Patients who underwent video-assisted thoracic surgery
were divided into groups A (0), B (0.5 microg/kg), and C (1 microg/kg)
based on different Dex doses. Group A included subgroups comprising young
(A-Y) and elderly (A-O) patients. Neither groups B nor C included elderly
patients due of the sedative effect of Dex. Based on the previous
subject's CR, the dose of RT was increased or decreased in the next
patient using the sequential method. This trial would be terminated when
the seventh crossover occurred, at which point the sample size met the
stable estimate of the target dose. Heart rate (HR) and mean arterial
pressure (MAP) were monitored throughout the trial, and sedation was
assessed using the Modified Observer's Assessment of Alertness/Sedation
(MOAA/S) scale. HR and MAP were recorded at baseline (T1), the end of Dex
(T2), and the end of RT (T3), the maximum HR and MAP were recorded within
3 min of intubation from beginning to end (T4). There was a positive CR
when the T4 levels rose above 15% of the baseline. The ED50/ED95 and
corresponding confidence interval were calculated using probability
regression. Result(s): In total, 114 patients completed the trial.
Without the use of Dex, the ED50/ED95 of TR inhibiting the positive CR
caused by double-lumen bronchial intubation was 0.198/0.227 and
0.155/0.181 mg/kg in groups A-Y and A-O, respectively. The changes in
vital signs from T1 to T3 were similar in the subgroups, indicating that
the elderly patients were more sensitive to the dose of RT. The ED50/ED95
of RT inhibiting the positive CR caused by double-lumen endobronchial
intubation was 0.122/0.150 and 0.068/0.084 mg/kg in groups B and C,
respectively. And, the fluctuation of blood pressure from T3 to T4 was
reduced by using Dex. RT was 100% effective in sedation with no
significant inhibition of circulation. Apart from one case of hypotension
occurred in group A-Y, two cases of low HR in group B, and one case of low
HR in group C, no other adverse events were noted. Conclusion(s): The
optimal dose of RT to inhibit positive CR induced by double-lumen
bronchial intubation in elderly patients was 0.18 mg/kg and 0.23 mg/kg in
younger patients. When the pre-use dose of Dex was 0.5 microg/kg, the
optimal dose to inhibit positive CR of RT was 0.15 mg/kg. And, when the
pre-use dose of Dex was 1 microg/kg, the optimal dose of RT was 0.9 mg/kg.
Clinical trial registration: NCT05631028. Copyright © 2023, The
Author(s).

<91>
Accession Number
2025811220
Title
Acute Glycemic Variability and Early Outcomes after Cardiac Surgery: A
Meta-Analysis.
Source
Hormone and Metabolic Research. 55(11) (pp 771-780), 2023. Date of
Publication: 20 Apr 2023.
Author
Chang S.; Xu M.; Wang Y.; Zhang Y.
Institution
(Chang, Zhang) Surgery ICU Cardiac Surgery, Fuwai Hospital, State Key
Laboratory of Cardiovascular Disease, Beijing, China
(Xu, Wang) Surgery ICU, Cardiac Surgery, Fuwai Yunnan Cardiovascular
Hospital, Kunming, China
Publisher
Georg Thieme Verlag
Abstract
The influence of acute glycemic variability (GV) on early outcomes of
patients after cardiac surgery remains not fully determined. We performed
a systematic review and meta-analysis to evaluate the association between
acute GV and in-hospital outcomes of patients after cardiac surgery.
Relevant observational studies were obtained by search of electronic
databases including Medline, Embase, Cochrane Library, and Web of Science.
A randomized-effects model was selected to pool the data by incorporating
the influence of potential heterogeneity. Nine cohort studies involving 16
411 patients after cardiac surgery were included in this meta-analysis.
Pooled results showed that a high acute GV was associated with an
increased risk of major adverse events (MAE) during hospitalization for
patients after cardiac surgery [odds ratio [OR]: 1.29, 95% CI: 1.15 to
1.45, p<0.001, I22=38%]. Sensitivity analysis limited to studies of
on-pump surgery and GV evaluated by coefficient of variation of blood
glucose showed similar results. Subgroup analysis suggested that a high
acute GV was related to an increased incidence of MAE in patients after
coronary artery bypass graft, but not for those after isolated valvular
surgery (p=0.04), and the association was weakened after adjustment of
glycosylated hemoglobin (p=0.01). Moreover, a high acute GV was also
related to an increased risk of in-hospital mortality (OR: 1.55, 95% CI:
1.15 to 2.09, p=0.004; I22=0%). A high acute GV may be associated with
poor in-hospital outcomes in patients after cardiac surgery. Copyright
© 2023 Georg Thieme Verlag. All rights reserved.

<92>
Accession Number
2026815230
Title
Comparison of amiodarone and esmolol for prevention of reperfusion
ventricular fibrillation in individuals undergoing heart valve or aortic
surgery: a study protocol for a randomized controlled clinical trial.
Source
Trials. 24(1) (no pagination), 2023. Article Number: 758. Date of
Publication: December 2023.
Author
Zhu D.; Li Y.; Tian A.-Y.; Wang H.-N.
Institution
(Zhu, Li, Tian, Wang) Department of Anesthesiology, The First Hospital of
China Medical University, 155 Nanjing North Street, Heping District,
Liaoning Province, Shenyang City, China
Publisher
BioMed Central Ltd
Abstract
Background: Amiodarone and esmolol can help to prevent and treat
post-cardiac surgery reperfusion ventricular fibrillation. However, the
relative efficacies of these two drugs remain unknown. The aim of the
current trial is to compare the performances of amiodarone and esmolol for
preventing reperfusion ventricular fibrillation following open heart
surgery. Methods/design: This is a single-center, prospective,
double-blind, controlled clinical trial. A total of 260 patients
undergoing heart valve or aortic surgery will be assigned randomly to
treatment with prophylactic esmolol (intervention group) or amiodarone
(control group). The main outcome is the incidence of reperfusion
ventricular fibrillation following aortic opening during extracorporeal
circulation. The secondary outcomes are the rate of automatic cardiac
resuscitation, energy and frequency of electrical defibrillation, number
of electrical defibrillations, and pacemaker use in the two groups of
patients. Information on the patients' general condition and the durations
of anesthesia, extracorporeal circulation, aortic occlusion, and operation
time will be recorded. We will also compare the heart rate, mean arterial
pressure, and central venous pressure between the two groups of patients
at induction of anesthesia (T1), start of surgery (T2), start of
extracorporeal circulation (T3), aortic block (T4), aortic opening (T5),
after opening for 10 (T6), 20 (T7), and 30 min (T8), at cessation of
extracorporeal circulation (T9), and at the end of surgery (T10) and
compare blood gas analysis results at T1, T5, T9, and T10.
 Discussion(s): This study will determine if prophylactic esmolol is
more effective than amiodarone for reducing the incidence of reperfusion
ventricular fibrillation in patients undergoing heart valve or aortic
surgery. Trial registration: China Clinical Trials Registry
ChiCTR1900026429. Registered on 2019.10.9. Copyright © 2023, The
Author(s).

<93>
Accession Number
2028633747
Title
Tight perioperative blood pressure management to reduce complications: A
randomised feasibility trial.
Source
BMJ Open. 13(11) (no pagination), 2023. Article Number: e071328. Date of
Publication: 17 Nov 2023.
Author
Li K.; Hu Z.; Li W.; Shah K.; Sessler D.
Institution
(Li, Hu, Li) Department of Anesthesiology, China-Japan Union Hospital of
Jilin University, Jilin, Changchun, China
(Shah) Department of Quantitative Health Sciences, Cleveland Clinic,
Cleveland, OH, United States
(Shah, Sessler) Outcomes Research, Cleveland Clinic, Cleveland, OH, United
States
Publisher
BMJ Publishing Group
Abstract
Objective Evaluate the feasibility of a trial of perioperative hypotension
and serious complications. Design A patient and assessor-blinded
randomised feasibility trial. Setting We included patients in a tertiary
university hospital. Participants We enrolled 80 adults scheduled for
major non-cardiac surgery. Interventions In patients randomised to tight
blood pressure control, intraoperative mean arterial pressure (MAP) was
targeted to >=85 mm Hg maintained with norepinephrine infusion, and
restarting chronic antihypertensive medications was delayed until the
third postoperative day. In the reference group, intraoperative blood
pressure was managed per routine and antihypertensive medications were
restarted immediately after surgery. Primary and secondary outcome
measures Our first co-primary outcome was the fraction of time when
intraoperative MAP was >85 mm Hg, intraoperative area (time integral) of
MAP >85 mm Hg and MAP <65 mm Hg. The second co-primary outcome was time
until antihypertensive medications were restarted after surgery. Secondary
outcomes were time-weighted average intraoperative MAP, cumulative minimum
MAP for 10 min, average postoperative systolic blood pressure (SBP) and
mean of the lowest three postoperative SBPs. Results Forty patients in
each group were analysed. The median for intraoperative area of MAP >85 mm
Hg was 1303 (772-2419) mm Hg*min in routine blood pressure (BP) cases and
2425 (1926-3545) mm Hg*min in tight BP control. The area for
intraoperative MAP <65 mm Hg was 7 (0-40) mm Hg*min with routine BP
management, and 0 (0-0) mm Hg*min with tight BP control. The fraction of
time with MAP >85 mm Hg was 0.52 (0.25) and 0.87 (0.15). Antihypertensive
medications were restarted 2 (1-3) days later in tight BP control cases.
However, postoperative SBPs were similar. Conclusions Tight BP management
markedly increased intraoperative MAP and reduced the amount of
hypotension. In contrast, delaying chronic antihypertensive medications
had little effect on postoperative SBP. The full trial appears feasible
and remains necessary but should not include postoperative
antihypertensive management. Trial registration NCT04789733.
 Copyright © 2023 Author(s). Published by BMJ.

<94>
Accession Number
2026845142
Title
The effect of intravenous and inhalation anesthesia in general on the
cognition of elderly patients undergoing non-cardiac surgery: a systematic
review and meta-analysis.
Source
Frontiers in Medicine. 10 (no pagination), 2023. Article Number: 1280013.
Date of Publication: 2023.
Author
Huang L.; Zhang Y.
Institution
(Huang, Zhang) Department of Anesthesiology, The First Affiliated Hospital
of Guangzhou University of Chinese Medicine, Guangdong, Guangzhou, China
Publisher
Frontiers Media SA
Abstract
Background: Postoperative cognitive dysfunction (POCD) is a postoperative
complication that often occurs in the elderly. This systematic review and
meta-analysis aimed to compare intravenous anesthetics (propofol) with
inhalation anesthetics (sevoflurane) regarding the occurrence of POCD in
the elderly who underwent non-cardiac surgery. Method(s): The
investigators searched for published articles from the PubMed, Embase, Web
of Science, Scopus, Cochrane, and Clinicalkey databases. Clinical studies
comparing the incidence of POCD in elderly patients undergoing intravenous
or inhalation anesthesia in general were selected. Primary outcomes
included the occurrence of POCD at 1, 3, and 7 days. The secondary
outcomes were the patient's plasma S-100beta protein levels
(pg*mL-1) and delayed neurocognitive recovery incidence 5-7
days after surgery. Result(s): Fifteen studies including 3,817
patients were enrolled in the systematic review. Ten studies involving
1,829 patients were enrolled in the meta-analysis. The results demonstrate
that there was no difference between the intravenous and inhalation groups
in the incidence of POCD within 1-7 days (95% CI 0.73-1.26, p = 0.77) and
the occurrence of delayed neurocognitive recovery 5-7 days after surgery
(95% CI -353.15 to -295.44, p = 0.28). Plasma S-100beta protein levels in
the intravenous anesthesia group were lower than those in the inhalation
group (95% CI 0.48-1.24, p < 0.001). Conclusion(s): For elderly
patients undergoing non-cardiac surgery, inhalation anesthesia was
comparable to intravenous anesthesia in terms of the occurrence of
short-term POCD. Inhalation anesthesia may cause greater damage to the
nervous system, with delayed recovery of cognitive function after 5-7 days
showing no difference. Systematic review: identifier
(CRD42021251317). Copyright © 2023 Huang and Zhang.

<95>
[Use Link to view the full text]
Accession Number
2028687309
Title
Influence of Baseline Diastolic Blood Pressure on the Effects of Intensive
Blood Pressure Lowering: Results from the STEP Randomized Trial.
Source
Hypertension. 80(12) (pp 2572-2580), 2023. Date of Publication: 01 Dec
2023.
Author
Yang R.; Huang R.; Zhang L.; Li D.; Luo J.; Cai J.
Institution
(Yang, Cai) Hypertension Center, Fuwai Hospital, State Key Laboratory of
Cardiovascular Disease, National Center for Cardiovascular Diseases,
Peking Union Medical College & Chinese Academy of Medical Sciences,
Beijing, China
(Huang) Department of Cardiology, The First Affiliated Hospital of Guangxi
Medical University, Nanning, China
(Zhang) Department of Cardiology, Shanxi Cardiovascular Hospital, Taiyuan,
China
(Li) Department of Cardiology, Wuxiang People's Hospital, Changzhi, China
(Luo) Department of Cardiology, Huizhou Municipal Central Hospital,
Huizhou, China
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND: The STEP (Strategy of Blood Pressure Intervention in the
Elderly Hypertensive Patients) trial demonstrated that intensive systolic
blood pressure (SBP) lowering has cardiovascular benefits. However, the
influence of baseline diastolic blood pressure (DBP) on the effects of
intensive blood pressure lowering on cardiovascular outcomes has not been
fully elucidated. METHOD(S): We performed a post hoc analysis of the
STEP trial. Participants were randomly allocated to intensive (110 to <130
mm Hg) or standard (130 to <150 mm Hg) treatment groups. The effects of
intensive SBP lowering on the primary composite outcome (stroke, acute
coronary syndrome, acute decompensated heart failure, coronary
revascularization, atrial fibrillation, and cardiovascular death), major
adverse cardiac event (a composite of the individual components of the
primary outcome except for stroke), and all-cause mortality were analyzed
according to baseline DBP as both a categorical and a continuous variable.
 RESULT(S): The 8259 participants had a mean age of 66.2+/-4.8 years,
and 46.5% were men. Participants with lower DBP were slightly older and
had greater histories of cardiovascular disease, diabetes, and
hyperlipidemia. Within each baseline DBP quartile, the mean achieved DBP
was lower in the intensive versus standard group. The effects of intensive
SBP lowering were not modified by baseline DBP as a continuous variable or
as a categorical variable (quartiles, or <70, 70 to <80, and >=80 mm Hg;
all P value for interaction >0.05). CONCLUSION(S): The beneficial
effects of intensive SBP lowering on cardiovascular outcomes were
unaffected by baseline DBP. Lower DBP should not be an obstacle to
intensive SBP control. REGISTRATION: URL: https://www.clinicaltrials.gov;
Unique identifier: NCT03015311. Copyright © 2023 Lippincott
Williams and Wilkins. All rights reserved.

<96>
Accession Number
2028711729
Title
Transcatheter valvular interventions after heart transplantation: A
systematic review.
Source
Trends in Cardiovascular Medicine. (no pagination), 2023. Date of
Publication: 2023.
Author
Cuko B.; Baudo M.; Busuttil O.; Taymoor S.; Nubret K.; Lafitte S.; Beurton
A.; Ouattara A.; De Vincentiis C.; Labrousse L.; Pernot M.; Leroux L.;
Modine T.
Institution
(Cuko, Busuttil, Taymoor, Nubret, Lafitte, Labrousse, Pernot, Leroux,
Modine) Department of Cardiology and Cardio-Vascular Surgery, Hopital
Cardiologique de Haut-Leveque, Bordeaux University Hospital, Pessac,
France
(Baudo) Department of Cardiac Surgery, ASST Spedali Civili di Brescia,
University of Brescia, Brescia, Italy
(Baudo) Department of Cardiac Surgery, University Hospitals Leuven,
Leuven, Belgium
(Beurton, Ouattara) Department of Cardiovascular Anesthesia and Critical
Care, Hopital Cardiologique de Haut-Leveque, Bordeaux University Hospital,
Pessac, France
(De Vincentiis) Department of Cardiac Surgery, IRCCS Policlinico San
Donato, Milan, Italy
Publisher
Elsevier Inc.
Abstract
An increasing number of patients experience late valvular disease after
heart transplantation (HTx). While mostly being primarily addressed
through surgical interventions, transcatheter valve procedures to treat
these conditions are rising, particularly for unsuitable surgical
candidates. This review aims at analyzing the outcomes of transcatheter
valvular procedures in this subset of patients. A systematic review was
conducted including studies reporting on adult patients requiring any form
of transcatheter valvular intervention after a previous HTx. Studies
involving a surgical approach, heterotopic heart transplants, or
concomitant procedures performed during the transplant itself were
excluded. Twenty-five articles with a total of 33 patients met the
inclusion criteria, 10 regarding the aortic valve (14 patients), 5 the
mitral valve (6 patients), and 6 the tricuspid valve (13 patients). In two
cases, the procedure was recommended to stabilize the valvular lesion
before re-transplantation, as both were very young patients. Overall, the
mean time from heart transplantation to reintervention was 14.7 +/- 9.5
years. The mean follow-up was 15.5 +/- 13.5 months, and only one patient
died 22.3 months after the intervention. There is a growing emergence of
transcatheter interventions for valvular disease after heart
transplantation, especially in cases where surgery is deemed high-risk or
prohibitive. A different strategy may also be considered in young patients
to permit longer allograft life before later re-transplantation. Although
encouraging outcomes have been documented, additional research is required
to establish the most appropriate approach within this specific subset of
patients. Copyright © 2023 Elsevier Inc.

<97>
Accession Number
618763459
Title
Randomized comparison of balloon aortic valvuloplasty performed with or
without rapid cardiac pacing: The pacing versus no pacing (PNP) study.
Source
Journal of Interventional Cardiology. 31(1) (pp 51-59), 2018. Date of
Publication: February 2018.
Author
Dall'Ara G.; Marzocchi A.; Taglieri N.; Moretti C.; Rodino G.; Chiarabelli
M.; Bottoni P.; Marrozzini C.; Sabattini M.R.; Bacchi-Reggiani M.-L.;
Rapezzi C.; Saia F.
Institution
(Dall'Ara, Marzocchi, Taglieri, Moretti, Rodino, Chiarabelli, Bottoni,
Marrozzini, Sabattini, Bacchi-Reggiani, Rapezzi, Saia) Cardiology Unit,
Cardio-Thoraco-Vascular Department, University Hospital of Bologna,
Policlinico S. Orsola-Malpighi, Bologna, Italy
(Dall'Ara) Dottorato di ricerca XXXdegreeciclo, Scienze
Cardio-Nefro-Toraciche, University of Bologna, Bologna, Italy
Publisher
John Wiley and Sons Inc
Abstract
Objectives: To compare the effectiveness and safety of balloon aortic
valvuloplasty (BAV) performed with or without rapid ventricular pacing
(RP). Background(s): BAV technique is poorly standardized.
 Method(s): One hundred consecutive patients were randomly assigned
1:1 between BAV performed with or without RP. Exclusion criteria were an
immediate indication for surgical or transcatheter aortic valve
replacement, presentation in cardiogenic shock or pulmonary edema
refractory to medical stabilization. Result(s): There were 51
patients in the BAV group performed with RP, 49 in the BAV group without
RP (noRP). Procedural success (50% hemodynamic gradient reduction) was
achieved in 37.3% and 55.1%, respectively (P = 0.16). Fewer people in the
noRP group complained of poor tolerance to the procedure (16% vs 41%). The
primary efficacy endpoint, a 50% reduction in the mean echocardiographic
trans-aortic gradient, was met in 21/49 patients in the noRP group
compared to 20/51 in the RP (42.9% vs 39.2%; P = 0.84). No significant
difference between the groups was observed in the primary safety endpoint,
a 30-day composite of death, myocardial infarction, stroke, acute aortic
regurgitation, and BARC bleeding >=3 (8.2% noRP vs 13.7%; P = 0.53). The
noRP group required fewer bailout temporary pacemakers (P = 0.048) and had
a lower incidence of moderate/severe renal function worsening (4.1% vs
17.6%; P = 0.052). Conclusion(s): Rapid ventricular pacing did not
influence BAV efficacy or safety and tolerance was slightly
worse. Copyright © 2017, Wiley Periodicals, Inc.

<98>
Accession Number
2026762821
Title
Impact of periprocedural myocardial injury after transcatheter aortic
valve implantation on long-term mortality: a meta-analysis of Kaplan-Meier
derived individual patient data.
Source
Frontiers in Cardiovascular Medicine. 10 (no pagination), 2023. Article
Number: 1228305. Date of Publication: 2023.
Author
de Sa Marchi M.F.; Calomeni P.; Gauza M.D.M.; Kanhouche G.; Ravani L.V.;
Rodrigues C.V.F.; Tarasoutchi F.; de Brito F.S.; Rodes-Cabau J.; Van
Mieghem N.M.; Abizaid A.; Ribeiro H.B.
Institution
(de Sa Marchi, Calomeni, Kanhouche, Ravani, Rodrigues, de Brito, Abizaid,
Ribeiro) Departamento de Cardiologia Intervencionista e Hemodinamica,
Instituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Faculdade de
Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
(de Sa Marchi, Van Mieghem) Department of Interventional Cardiology,
Erasmus Medical Center, Rotterdam, Netherlands
(Gauza) Universidade Regional de Joinville, Joinville, Brazil
(Tarasoutchi) Unidade Clinica de Valvopatias, Instituto do Coracao
(InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina,
Universidade de Sao Paulo, Sao Paulo, Brazil
(Rodes-Cabau) Department of Cardiovascular Medicine, Quebec Heart and Lung
Institute, Laval University, Quebec City, QC, Canada
(Rodes-Cabau) Department of Cardiovascular Medicine, Institut Clinic
Cardiovascular, Hospital Clinic de Barcelona, Barcelona, Spain
Publisher
Frontiers Media SA
Abstract
Background: Periprocedural myocardial injury (PPMI) frequently occurs
after transcatheter aortic valve implantation (TAVI), although its impact
on long-term mortality is uncertain. Method(s): We performed a pooled
analysis of Kaplan-Meier-derived individual patient data to compare
survival in patients with and without PPMI after TAVI. Flexible parametric
models with B-splines and landmark analyses were used to determine PPMI
prognostic value. Subgroup analyses for VARC-2, troponin, and creatine
kinase-MB (CK-MB)-defined PPMI were also performed. Result(s):
Eighteen observational studies comprising 10,094 subjects were included.
PPMI was associated with lower overall survival (OS) after two years (HR =
1.46, 95% CI 1.30-1.65, p < 0.01). This was also observed when restricting
the analysis to overall VARC-2-defined PPMI (HR = 1.23, 95% CI 1.07-1.40,
p < 0.01). For VARC-2 PPMI criteria and VARC-2 troponin-only, higher
mortality was restricted to the first 2 months after TAVI (HR = 1.64, 95%
CI 1.31-2.07, p < 0.01; and HR = 1.32, 95% CI 1.05-1.67, p = 0.02,
respectively), while for VARC-2 defined CK-MB-only the increase in
mortality was confined to the first 30 days (HR = 7.44, 95% CI 4.76-11.66,
p < 0.01). Conclusion(s): PPMI following TAVI was associated with
lower overall survival compared with patients without PPMI. PPMI
prognostic impact is restricted to the initial months after the procedure.
The analyses were consistent for VARC-2 criteria and for both biomarkers,
yet CK-MB was a stronger prognostic marker of mortality than
troponin. Copyright 2023 de Sa Marchi, Calomeni, Gauza, Kanhouche,
Ravani, Rodrigues, Tarasoutchi, de Brito, Rodes-Cabau, Van Mieghem,
Abizaid and Ribeiro.

<99>
Accession Number
2026620147
Title
Effectiveness of Early Mobilization in Prevention and Rehabilitation of
Functional Impairment After Myocardial Revascularization Surgery: A
Systematic Review.
Source
International Journal of Cardiovascular Sciences. 36 (no pagination),
2023. Article Number: e20210166. Date of Publication: 2023.
Author
Das Judas M.C.L.; Fontes R.F.; de Moura R.; Dos Santos L.; de Almeida M.;
Gomes V.
Institution
(Das Judas) Centro Universitario Ruy Barbosa Wyden, BA, Salvador, Brazil
(Fontes) Faculdade Social da Bahia, BA, Salvador, Brazil
(de Moura) Unifacs, BA, Salvador, Brazil
(Dos Santos) Universidade Federal da Bahia (UFBA), BA, Salvador, Brazil
(de Almeida, Gomes) Escola Bahiana de Medicina e Saude Publica, BA,
Salvador, Brazil
Publisher
Sociedade Brasileira de Cardiologia
Abstract
Introduction: Myocardial revascularization surgery is associated with high
morbidity and mortality, due to factors like the general anesthesia and
the surgical procedure itself. Physiotherapy, combined with early
mobilization (EM), can provide the patient with better functional
parameters. Objective(s): To review, identify and describe the
effectiveness of EM in the prevention and rehabilitation of functional
parameters of coronary artery bypass graft surgery. Methodology: This is a
systematic review conducted between February 2020 and 2021 of randomized
clinical trials (RCTs) published in the Cochrane databases Library,
LILACS, Scielo and Medline / PubMed. The Physiotherapy Evidence Database
(PEDro) scale was used for assessment of the methodological quality of
studies included. Result(s): Four studies were reviewed. Two articles
assessed functional capacity, one using the cycle ergometer and one with
inspiratory muscle training (IMT) together with active exercises and early
walking. One article reported a reduction in the incidence of atelectasis
and pleural effusion with EM and one article reported improvements in the
alveolus-artery gradient and inspiratory muscle power using an inspiratory
muscle trainer combined with EM. Conclusion(s): EM is effective in
the prevention and rehabilitation of functional parameters after CABG
surgery, by improving functional capacity, respiratory muscle power,
quality of life and gas exchange, and reducing the incidence of
atelectasis and pleural effusion. Copyright © 2023, Sociedade
Brasileira de Cardiologia. All rights reserved.

<100>
Accession Number
2026760737
Title
Rationale and design of a randomized clinical trial evaluating the
efficacy of mechanical neuroprotection in reducing the risk of silent
brain infarcts associated with percutaneous left atrial appendage closure:
study protocol for a LAAC-SBI trial.
Source
Trials. 24(1) (no pagination), 2023. Article Number: 749. Date of
Publication: December 2023.
Author
Streb W.; Lasek-Bal A.; Mitrega K.; Kowalczyk J.; Podolecki T.; Kowalska
W.; Olma A.; Sobczyk A.; Kalarus Z.
Institution
(Streb, Kowalczyk, Podolecki, Kowalska, Sobczyk, Kalarus) Department of
Cardiology, Congenital Heart Diseases and Electrotherapy, Faculty of
Medical Sciences in Zabrze, Medical University of Silesia, Katowice,
Poland
(Streb, Mitrega, Kowalczyk, Podolecki, Kowalska, Olma, Sobczyk, Kalarus)
Silesian Centre for Heart Diseases in Zabrze, Curie-Sklodowskiej 9, Zabrze
41-800, Poland
(Lasek-Bal) Department of Neurology, Faculty of Health Sciences in
Katowice, Medical University of Silesia, Katowice, Poland
Publisher
BioMed Central Ltd
Abstract
Background: Left atrial appendage closure (LAAC) procedures prevent
cardioembolic stroke in patients with atrial fibrillation who have
contraindications to oral anticoagulant medications. However, these
procedures carry certain risks of peri-procedural complications. One such
complication is silent brain infarcts (SBI), which can lead to cognitive
impairment and mood disturbances. The implementation of mechanical
neuroprotection systems during LAAC procedures may reduce the risk of SBI
and associated cognitive and mood disorders. Method(s): The LAAC-SBI
trial is a prospective, multicenter, randomized, and double-blind
interventional study. The study aims to enroll a total of 240 patients,
with 120 patients allocated to each group. The study group will evaluate
the use of the Sentinel CPS during LAAC, while the control group will
undergo LAAC procedures without the Sentinel CPS. The primary endpoint of
the study is the number of new SBIs or stroke foci detected by
diffusion-weighted magnetic resonance imaging (DW MRI). Secondary
endpoints include deterioration of cognitive function, development of
dementia syndrome, and occurrence of depressive disorders. These endpoints
will be assessed using questionnaire tools such as the Montreal Cognitive
Assessment (MoCA), Trail Making Test (TMT), Controlled Oral Word
Association Test (COWAT), and Hospital Anxiety and Depression Scale
(HADS). The observational period for patients in the study is 2 years.
 Discussion(s): If the study demonstrates a favorable outcome with
reduced incidence of SBI and improved cognitive and mood outcomes in
patients receiving cerebral protection devices during LAAC, it will have
significant implications for clinical management standards. This would
support the use of neuroprotection devices not only for LAAC but also in
procedures such as atrial fibrillation ablation or transcatheter mitral
valve interventions, where the risk of embolic events and subsequent brain
injury may also be present. Trial registration: ClinicalTrials.gov
NCT05369195. Registration on 11.05.2022. Copyright © 2023, The
Author(s).

<101>
Accession Number
2026392898
Title
The Effect of Bariatric Surgery on Patients with Heart Failure: a
Systematic Review and Meta-analysis.
Source
Obesity Surgery. 33(12) (pp 4125-4136), 2023. Date of Publication:
December 2023.
Author
Esparham A.; Mehri A.; Hadian H.; Taheri M.; Anari Moghadam H.; Kalantari
A.; Fogli M.J.; Khorgami Z.
Institution
(Esparham, Anari Moghadam) School of Medicine, Mashhad University of
Medical Sciences, Mashhad, Iran, Islamic Republic of
(Mehri) Endoscopic and Minimally Invasive Surgery Research Center, Mashhad
University of Medical Sciences, Mashhad, Iran, Islamic Republic of
(Hadian) Heshmatieh Hospital, Naieen City, Iran, Islamic Republic of
(Taheri, Fogli) Department of Cardiology, Ascension St. John Medical
Center, Tulsa, OK, United States
(Kalantari, Khorgami) Department of Surgery, University of Oklahoma School
of Community Medicine, Tulsa, OK, United States
(Khorgami) Harold Hamm Diabetes Center, University of Oklahoma Health
Sciences Center, Oklahoma City, OK, United States
(Fogli) Department of Internal Medicine, University of Oklahoma School of
Community Medicine, Tulsa, Oklahoma, United States
Publisher
Springer
Abstract
The current study aims to evaluate the effect of bariatric metabolic
surgery (BMS) on the New York Heart Association (NYHA) class and left
ventricular ejection fraction (LVEF) in patients with diagnosed heart
failure (HF). Fourteen related articles with 217 patients were included in
the final analysis. LVEF significantly improved after BMS in patients with
HF with a mean difference of 7.78% (CI 95%: 3.72, 11.84, I 2 =
83.75, p-value < 0.001). Also, the NYHA class significantly decreased
after BMS with a mean difference of - 0.40 (CI 95%: - 0.62, - 0.19, I
2: 47.03, p-value < 0.001). A total of 27 patients with obesity
and HF were listed for cardiac transplantation after BMS. Of those, 20
patients successfully underwent heart transplantation after
BMS. Copyright © 2023, The Author(s), under exclusive licence to
Springer Science+Business Media, LLC, part of Springer Nature.

<102>
Accession Number
642853554
Title
Long-Term Outcomes after Hybrid Coronary Revascularization versus Coronary
Artery Bypass Grafting: Meta-Analysis of Kaplan-Meier-Derived Data.
Source
The American journal of cardiology. (no pagination), 2023. Date of
Publication: 24 Nov 2023.
Author
Shimamura J.; Miyamoto Y.; Hibino M.; Fukuhara S.; Takayama H.; Itagaki
S.; Takagi H.; Kuno T.
Institution
(Shimamura) Division of Cardiothoracic Surgery, Westchester Medical
Center, Valhalla, NY, United States
(Miyamoto) Division of Nephrology and Endocrinology, University of Tokyo,
Tokyo, Japan
(Hibino) Division of Cardiothoracic Surgery, Emory University, Atlanta,
GA, United States
(Fukuhara) Department of Cardiac Surgery, University of Michigan, Ann
Arbor, United States
(Takayama) Division of Cardiothoracic Surgery, Department of Surgery, New
York Presbyterian Hospital, Columbia University Medical Center, New York,
NY, USA
(Itagaki) Department of Cardiovascular Surgery, Icahn School of Medicine
at Mount Sinai, New York NY
(Takagi) Department of Cardiovascular Surgery, Shizuoka Medical Center,
Japan
(Kuno) Division of Cardiology, Montefiore Medical center, Albert Einstein
Medical College, NY, United States
Abstract
Hybrid coronary revascularization (HCR) is an alternative option to
conventional coronary artery bypass grafting (CABG), but the long-term
outcomes of HCR versus CABG remain unclear. We aimed to analyze the
long-term outcomes following HCR and CABG for patients with multivessel
coronary artery disease (MVCAD) using meta-analysis. Systemic literature
search was performed with PubMed and EMBASE up to March 2023. Studies
reporting Kaplan-Meier curves with follow-up >= one year were included.
The primary outcome was all-cause mortality, and the secondary outcomes
were major adverse cardiac and cerebrovascular events (MACCEs) and repeat
revascularization. 13 studies (1 randomized controlled trial [RCT] and 12
propensity-score matched observational studies) were analyzed. The mean
follow-up period was 5.1 +/- 3.1 years. HCR was associated with similar
overall mortality (hazard ratio [HR] 1.09, 95% confidence interval [CI]
0.87-1.36), significantly higher incidence of MACCEs (HR 1.49, 95% CI
1.07-2.06) and repeat revascularization (HR 2.01, 95% CI 1.53 to 2.64)
compared to CABG. In phase-specific analysis, mortality rate was similar,
and the incidence of repeat revascularization was higher in HCR regardless
of phases. The incidence of MACCEs was higher in HCR during the mid-term
phase (1-5 years), but it was similar during the long-term phase
(long-term: >= 5 years). In conclusion, despite the higher incidence of
MACCEs and repeat revascularization compared with CABG, HCR offered a
similar long-term survival. Even longer-term follow-up and RCT with a
large population are warranted to investigate the role of HCR for
MVCAD. Copyright © 2023. Published by Elsevier Inc.

<103>
Accession Number
642841484
Title
Thoracic day surgery versus thoracic inpatient surgery for treatment of
patients with lung cancer: a systematic review and meta-analysis.
Source
Journal of cardiothoracic surgery. 18(1) (pp 341), 2023. Date of
Publication: 25 Nov 2023.
Author
Shen C.; Che G.
Institution
(Shen, Che) Department of Thoracic Surgery, West-China Hospital, Sichuan
University, Chengdu 610041, China
Abstract
BACKGROUND: The successful implementation of the Enhanced recovery after
surgery (ERAS) concept in thoracic surgery has made it possible to
complete the surgery in the day surgery unit. However, it is still unclear
whether day surgery for lung cancer patients can achieve the same or even
better results. METHOD(S): A systematic literature search was
completed in common databases for studies published before May 2022 and
the data analyzed using the Review Manager 5.3 software. RESULT(S):
We ultimately included 7 retrospective articles that met our criteria for
the study. The results of age, smoking status, comorbidity and pulmonary
function tests in day surgery group were better than in inpatient surgery
group. Minimally invasive surgical method with segmentectomy was more used
in day surgery group than in normal surgery group. The 30-day mortality
was also lower in Day surgery group and it displayed that early discharged
patients had fewer overall complications than the inpatient surgery group.
 CONCLUSION(S): We demonstrate that younger patients, patients
receiving segmental resections by VATS, and those with better pulmonary
function tests or without comorbidity can be discharged early with low
rates of complications and 30-day mortality, especial with ERAS
program. Copyright © 2023. The Author(s).

<104>
[Use Link to view the full text]
Accession Number
2028589518
Title
Robotic Lobectomy Is Cost-effective and Provides Comparable Health Utility
Scores to Video-assisted Lobectomy: Early Results of the RAVAL Trial.
Source
Annals of Surgery. 278(6) (pp 841-849), 2023. Date of Publication: 01 Dec
2023.
Author
Patel Y.S.; Baste J.-M.; Shargall Y.; Waddell T.K.; Yasufuku K.; Machuca
T.N.; Xie F.; Thabane L.; Hanna W.C.
Institution
(Patel, Shargall, Hanna) Department of Surgery, Division of Thoracic
Surgery, McMaster University, Hamilton, ON, Canada
(Baste) Department of Surgery, Division of Thoracic Surgery, Rouen
Normandy University, Rouen Cedex, France
(Waddell, Yasufuku) Department of Surgery, Division of Thoracic Surgery,
University of Toronto, Toronto, ON, Canada
(Machuca) Department of Surgery, Division of Thoracic and Cardiovascular
Surgery, University of Florida, Gainesville, FL, United States
(Xie, Thabane) Department of Epidemiology and Biostatistics, McMaster
University, Hamilton, ON, Canada
Publisher
Wolters Kluwer Health
Abstract
Objective: The aim of this study was to determine if robotic-assisted
lobectomy (RPL-4) is cost-effective and offers improved patient-reported
health utility for patients with early-stage non-small cell lung cancer
when compared with video-assisted thoracic surgery lobectomy
(VATS-lobectomy). Background(s): Barriers against the adoption of
RPL-4 in publicly funded health care include the paucity of high-quality
prospective trials and the perceived high cost of robotic surgery.
 Method(s): Patients were enrolled in a blinded, multicentered,
randomized controlled trial in Canada, the United States, and France, and
were randomized 1:1 to either RPL-4 or VATS-lobectomy. EuroQol 5 Dimension
5 Level (EQ-5D-5L) was administered at baseline and postoperative day 1;
weeks 3, 7, 12; and months 6 and 12. Direct and indirect costs were
tracked using standard methods. Seemingly Unrelated Regression was applied
to estimate the cost effect, adjusting for baseline health utility. The
incremental cost-effectiveness ratio was generated by 10,000 bootstrap
samples with multivariate imputation by chained equations. Result(s):
Of 406 patients screened, 186 were randomized, and 164 analyzed after the
final eligibility review (RPL-4: n=81; VATS-lobectomy: n=83). Twelve-month
follow-up was completed by 94.51% (155/164) of participants. The median
age was 68 (60-74). There were no significant differences in body mass
index, comorbidity, pulmonary function, smoking status, baseline health
utility, or tumor characteristics between arms. The mean 12-week health
utility score was 0.85 (0.10) for RPL-4 and 0.80 (0.19) for VATS-lobectomy
(P=0.02). Significantly more lymph nodes were sampled [10 (8-13) vs 8
(5-10); P=0.003] in the RPL-4 arm. The incremental cost/quality-adjusted
life year of RPL-4 was $14,925.62 (95% CI: $6843.69, $23,007.56) at 12
months. Conclusion(s): Early results of the RAVAL trial suggest that
RPL-4 is cost-effective and associated with comparable short-term
patient-reported health utility scores when compared with
VATS-lobectomy. Copyright © 2023 Lippincott Williams and Wilkins.
All rights reserved.

<105>
Accession Number
2026795118
Title
Analysis of Different Tidal Volumes on Ventilatory Mechanics and Arterial
Blood Gas Variables in Patients Undergoing Cardiac Surgery.
Source
Indian Journal of Critical Care Medicine. 27(12) (pp 930-933), 2023. Date
of Publication: December 2023.
Author
Cordeiro A.L.; Souza A.; de Brito Lima C.R.; Araujo J.; Mascarenhas H.;
Guimaraes A.
Institution
(Cordeiro, Souza, de Brito Lima, Araujo, Mascarenhas) Department of
Physiotherapy, Faculdade Nobre, Bahia, Feira de Santana, Brazil
(Guimaraes) Department of Medicine, Instituto Nobre de Cardiologia, Bahia,
Feira de Santana, Brazil
Publisher
Jaypee Brothers Medical Publishers (P) Ltd
Abstract
Introduction: Cardiovascular diseases have been increasing gradually each
year, and their incidence has reached 80%. Mechanical ventilation (MV) is
essential in the postoperative period of cardiac surgery (CS) due to
anesthetic induction. The tidal volume (TV) is a parameter that depends on
the conditions of the respiratory system mechanics, aiming at the
reduction of dynamic hyperinflation. Objective(s): Analyze the effect
of different TVs on blood gas analysis variables and respiratory mechanics
in patients submitted to CS. Material(s) and Method(s): This was an
uncontrolled randomized clinical trial. Patients were randomized by
lottery into the following two groups: One group was ventilated with a TV
of 6 mL/kg; while the other received a TV of 8 mL/kg. After 30 minutes of
admission with the VT, blood gas analysis data were evaluated, such as pH,
oxygen arterial pressure (PaO<inf>2</inf>), arterial pressure of carbon
dioxide (PaCO<inf>2</inf>), and peripheral oxygen saturation
(SpO<inf>2</inf>). The evaluation of respiratory mechanics was composed of
static and dynamic compliance, airway resistance, and driving pressure.
 Result(s): A total of 78 patients were included, 58% of whom were
males with a mean age of 55 +/- 13 years. It was observed that there were
no significant differences regarding respiratory mechanics, only the
driving pressure presented statistical significance, the group 6 mL/kg was
8.3 +/- 2.5 in the group 8 mL/kg 10.4 +/- 2.1 presenting a value of (p <
0.001). Conclusion(s): Based on the findings of the present study, we
conclude that different TVs do not significantly alter the blood gas
variables and do not influence the respiratory mechanics of patients
undergoing CS. Copyright © The Author(s). 2023.

<106>
[Use Link to view the full text]
Accession Number
2028665046
Title
Effects of music therapy on pain relief during fundus screening in infants
Randomized controlled clinical trial.
Source
Medicine (United States). 102(44) (pp E35878), 2023. Date of Publication:
03 Nov 2023.
Author
Chen R.; Duan S.; Wang Y.; He F.; Ren L.; Peng W.
Institution
(Chen, Duan, Wang, He, Ren, Peng) Department of Nursing, West China Second
University Hospital, Sichuan University, Key Laboratory of Birth Defects
and Related Diseases of Women and Children (Sichuan University, Ministry
of Education, Sichuan, Chengdu, China
(Chen, Peng) West China School of Nursing, Sichuan University, Sichuan,
Chengdu, China
Publisher
Lippincott Williams and Wilkins
Abstract
Background: To determine the efficacy of music therapy on pain relief
during fundus screening in infants. Method(s): The sample consisted
of infants aged 0 to 3 months who required fundus screening. Infants were
randomized to fast music, slow music, and control groups. All groups
underwent fundus screening under topical anesthesia. Music therapy was
provided to the music groups prior to, during, and after the operation.
The patient's heart rate (HR), transcutaneous oxygen saturation, and
crying decibel were measured. The Face, Legs, Activity, Cry, Consolability
scale was used for pain measurement. Result(s): A total of 300
subjects' data were collected. The quantitative analysis revealed that in
both music groups, peripheral capillary oxygen saturation and satisfaction
levels increased while pain scores decreased (P < .05). The slow music
group's HR was shown to have significantly decreased (P < .05).
 Conclusion(s): Music therapy can effectively reduce pain and crying,
and increase blood oxygen saturation during fundus examination of infants.
Music with a rhythm of 60 to 80 beats per minute can decrease HR. Music
therapy must be remembered to increase infants' comfort during fundus
examination. Abbreviations: FLACC = Face, Legs, Activity, Cry,
Consolability, HR = heart rate, ROP = retinopathy of prematurity,
SpO<inf>2</inf> = peripheral capillary oxygen saturation. Copyright
© 2023 the Author(s). Published by Wolters Kluwer Health, Inc.

<107>
[Use Link to view the full text]
Accession Number
2028664829
Title
Surgical site infection prophylaxis: What have we learned and are we
making progress?.
Source
Current Opinion in Infectious Diseases. 36(6) (pp 450-461), 2023. Date of
Publication: 01 Dec 2023.
Author
Ierano C.; Hall L.; James R.
Institution
(Ierano, James) National Centre for Antimicrobial Stewardship (NCAS),
Department of Infectious Diseases, University of Melbourne, Australia
(Ierano, Hall, James) Royal Melbourne Hospital Guidance Group, Royal
Melbourne Hospital, Melbourne, Australia
(Hall) School of Public Health, University of Queensland, Brisbane,
Australia
Publisher
Lippincott Williams and Wilkins
Abstract
Purpose of reviewThis review aims to discuss the current state of surgical
antimicrobial prophylaxis (SAP) evidence for surgical site infection
prevention. Despite decades of research, knowledge gaps persist in
identifying optimal SAP regimens.Recent findingsRecent randomised
controlled trials highlight ongoing heterogeneity in study design. Key new
findings support the use of oral preoperative SAP for colorectal surgery
and advise against the use of SAP for transperineal prostate biopsy. There
is growing evidence for culture-based SAP over empiric use for transrectal
prostate biopsy.Contentious issues remain regarding topical antimicrobials
for cardiac procedures involving sternotomy, the necessity of SAP for wire
lumpectomy and laparoscopic cholecystectomy for both mild or moderate
acute cholecystitis. Procedures where SAP is not indicated, yet research
is still being conducted on this topic include dental implants and clean
orthopaedic procedures.SummaryResearch efforts continue with numerous
trials published and registered to determine optimal SAP regimens.
However, many efforts are suboptimal due to poor statistical design and
redundant questions already answered by existing literature. To improve
practice and influence surgeons prescribing behaviour future RCTs should
be well powered, with large sample sizes across multiple sites, focusing
on clinically relevant questions. Copyright © 2023 Lippincott
Williams and Wilkins. All rights reserved.

<108>
Accession Number
2028633742
Title
The risk factors for and the frequency and outcomes of subsyndromal
delirium among patients who have undergone cardiac surgery: A protocol for
systematic review and meta-analysis.
Source
BMJ Open. 13(11) (no pagination), 2023. Article Number: e070624. Date of
Publication: 15 Nov 2023.
Author
Gao Y.; Bai X.; Zhang H.; Yang L.; Wu T.; Gan X.
Institution
(Gao, Bai, Zhang, Yang, Wu, Gan) Nursing Department, Second Affiliated
Hospital of Chongqing Medical University, Chongqing, China
Publisher
BMJ Publishing Group
Abstract
Introduction Several key symptoms must be present for the accurate
diagnosis of patients with postoperative cardiac delirium. Some patients
present with symptoms of delirium but do not meet the diagnostic criteria
for delirium; such individuals are considered to have having subsyndromal
delirium (SSD). SSD is associated with misdiagnosis and poor outcomes.
However, to date, no systematic review (SR) has examined the frequency of,
risk factors for, and outcomes of SSD among adults who have undergone
cardiac surgery. Methods and analysis The aim of this SR is to identify
those studies that have explored SSD after cardiac surgery. MeSH and free
entry terms associated with "subsyndromal delirium"and "subclinical
delirium"will be used to search for relevant studies. The PubMed, Web of
Science, OVID, Cochrane Library, CINAHL, EMBASE, PsycINFO, China National
Knowledge Infrastructure, Wanfang data, VIP database and SinoMed will be
searched from inception to the date of retrieval without any restrictions.
The primary outcomes will be the frequency of SSD, the risk factors for
SSD, and the outcomes of SSD. Analyses will be performed using STATA
V.16.0, and descriptive analyses will be performed if the data are not
suitable for meta-analysis (ie, data with significant heterogeneity or
from different comparisons). Ethics and dissemination The SR will examine
the frequency of, risk factors for and outcomes of SSD in adults who have
undergone cardiac surgery. The results will provide guidance for the
identification of knowledge gaps in this field, and areas for further
research will be highlighted. The review protocol will be submitted for
publication in peer-reviewed journals for dissemination of the findings.
Individual patient data will not be included in this protocol, so ethical
approval will not be needed. PROSPERO registration number CRD42022379211.
 Copyright © 2023 Author(s). Published by BMJ.

<109>
Accession Number
2028633737
Title
Postoperative stellate ganglion block to reduce myocardial injury after
laparoscopic radical resection for colorectal cancer: Protocol for a
randomised trial.
Source
BMJ Open. 13(11) (no pagination), 2023. Article Number: 069183. Date of
Publication: 17 Nov 2023.
Author
Hu Z.; Li W.; Zhao G.; Liang C.; Li K.
Institution
(Hu) Department of Anesthesiology, Hospital of Chengdu University of
Traditional Chinese Medicine, Sichuan, Chengdu, China
(Li) Department of Pain Management, Fujian Provincial Hospital, Shengli
Clinical Medical College of Fujian Medical University, Fujian, Fuzhou,
China
(Zhao) Jilin University, Jilin, Changchun, China
(Liang) New York University, New York, NY, United States
(Li) Department of Anesthesiology, China-Japan Union Hospital of Jilin
University, Jilin, Changchun, China
Publisher
BMJ Publishing Group
Abstract
Introduction Stellate ganglion block (SGB) is usually used in the
department of algiatry. But preoperative SGB may reduce adverse
cardiovascular events in high-risk patients, although evidence remains
sparse. Therefore, we aim to determine whether a single-shot postoperative
SGB can reduce the incidence of myocardial injury after non-cardiac
surgery (MINS) and improve recovery in patients undergoing laparoscopic
radical resection for colorectal cancer. Methods and analysis This is an
investigator-initiated, single-centre, randomised, two-arm clinical trial
enrolling patients aged over 45 years and scheduled for elective
laparoscopic radical colorectal surgery with at least one risk factor for
MINS. A total of 950 eligible patients will be randomised into a routine
or block groups. The primary outcome is the incidence of MINS. The
secondary outcomes include the Visual Analogue Scale of pain during rest
and movement, the incidence of delirium, quality of recovery (QOR)
assessed by QOR-15, and sleep quality assessed by Richards Campbell Sleep
Questionnaire. Tertiary outcomes include time to first flatus,
gastrointestinal complications such as anastomotic leak or ileus, length
of hospital stay, collapse incidence of severe cardiovascular and
cerebrovascular complications of myocardial infarction, cardiac arrest,
ischaemic or haemorrhagic stroke, and all-cause mortality within 30 days
after the operation. Ethics and dissemination The protocol was approved by
Medical Ethics Committee of the China-Japan Union Hospital, Jilin
University (Approval number: 2021081018) prior to recruitment. The study
will be performed according to the guidelines of the Declaration of
Helsinki. The findings of this study will be published and presented
through various scientific forums. Trial registration number
ChiCTR2200055319. Copyright © 2023 Author(s). Published by BMJ.

<110>
Accession Number
2028674342
Title
Sepsis in cardiothoracic surgery.
Source
Surgery (United States). (no pagination), 2023. Date of Publication:
2023.
Author
Napoli F.; Aleman R.; Zadneulitca N.; Navia J.; Brozzi N.A.
Institution
(Napoli, Aleman, Zadneulitca, Navia, Brozzi) Heart, Vascular & Thoracic,
Cleveland Clinic Florida, Weston, FL, United States
Publisher
Elsevier Inc.
Abstract
Sepsis is a life-changing condition that can occur in patients undergoing
cardiothoracic surgery. It is characterized by a dysregulated inflammatory
response to infection, often leading to higher rates of organ dysfunction
and mortality. The importance of early recognition and prompt intervention
in managing sepsis-related complications in cardiothoracic surgery is
pivotal to adequate surgical practice. Due to the multiple subsections
that construct the broad spectrum of cardiothoracic surgery, it is
important to address the presence of sepsis in elective cardiothoracic
surgery, urgent/emergency cardiothoracic surgery, solid organ
transplantation, and both temporary and permanent mechanical circulatory
support (ie, left ventricular assist devices, extracorporeal membrane
oxygenation, and percutaneous temporary devices [eg, Impella series]).
Exploring the incidence, prevalence, and risk factors of said subsections
can lead to improvement in postoperative outcomes. The impact of
accompanying infections can progress into further operative morbidity and
mortality. To this effect, the perioperative management of cardiothoracic
surgery transcends surgical techniques and should undergo additional
recognition of other occurrences such as wound infections, bloodstream
infections, urinary tract infections, and pneumonia. Sepsis remains a
concern in cardiothoracic surgery, as it can lead to devastating
consequences. Hence, there is an evident need for heightened vigilance,
early recognition, and effective management strategies to mitigate the
risk of sepsis in this patient population. The purpose of this article is
to provide an overview of sepsis in the different cardiothoracic surgery
areas. Copyright © 2023 Elsevier Inc.

<111>
Accession Number
642857702
Title
Effects of virtual exercise on cardio-pulmonary performance and depression
in cardiac rehabilitation phase I: A randomized control trial.
Source
Physiotherapy research international : the journal for researchers and
clinicians in physical therapy. (pp e2066), 2023. Date of Publication: 27
Nov 2023.
Author
Yuenyongchaiwat K.; Boonkawee T.; Pipatsart P.; Tavonudomgit W.;
Sermsinsaithong N.; Songsorn P.; Charususin N.; Harnmanop S.; Namdaeng P.;
Kulchanarat C.; Thanawattano C.
Institution
(Yuenyongchaiwat, Boonkawee, Pipatsart, Tavonudomgit, Sermsinsaithong,
Songsorn, Charususin, Harnmanop, Namdaeng) Physiotherapy Department,
Faculty of Allied Health Sciences, Thammasat University, Thailand
(Yuenyongchaiwat, Songsorn, Charususin) Thammasat University Research Unit
for Physical Therapy in Respiratory and Cardiovascular Systems, Thammasat
University, Thailand
(Kulchanarat) Physical Therapy Center, Thammasat University Hospital,
Thailand
(Thanawattano) National Science and Technology Development Agency (NSTDA),
Thailand
Abstract
BACKGROUND: Cardiac rehabilitation is recommended for patients undergoing
open-heart surgery (OHS). During the hospital admission, these patients
suffer from reduced cardiopulmonary performance and decreased
psychological health, leading to poor physical function, depression, and
morbidity. To prevent post-operative pulmonary complications, a pre and
post-operative physical therapy intervention is recommended for patients
undergoing heart surgery. Virtual reality (VR) promotes the health status
of healthy individuals and those with health conditions. However, few
studies have reported the beneficial effects of VR exercise programs on
the pulmonary performance and mental health status of patients undergoing
OHS. OBJECTIVE(S): To determine whether by using training enhanced by
VR, patients who have undergone OHS can more effectively attain
cardiopulmonary performance and improve depression than through
conventional physical therapy. METHOD(S): 60 participants were
randomly assigned to a conventional physical therapy and VR exercise
program. Each session was conducted once daily until discharge from the
hospital. Cardiorespiratory performance and depression were evaluated
before surgery and at the time of discharge from the hospital. A two-way
mixed ANOVA was performed to compare within (i.e., pre and post-operation)
and between (i.e., VR and conventional physical therapy) groups.
 RESULT(S): No significant cardiopulmonary performance gains were
detected in patients receiving the VR exercise program when compared with
those who participated in conventional physical therapy prior to
post-operative OHS (p > 0.05). However, the conventional physical therapy
group showed significantly higher depression scores than the VR group
(4.00 +/- 0.98 vs. 1.68 +/- 0.92). However, cardiopulmonary performance
did not differ in both VR exercise and conventional physical
therapy. Copyright © 2023 John Wiley & Sons Ltd.

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