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<1>
Accession Number
2027733817
Title
A systematic review of present and future pharmaco-structural therapies
for hypertrophic cardiomyopathy.
Source
Clinical Cardiology. 47(1) (no pagination), 2024. Article Number: e24207.
Date of Publication: January 2024.
Author
Sawan M.A.; Prabakaran S.; D'Souza M.; Behbahani-Nejad O.; Gold M.E.;
Williams B.R.; Bilen O.
Institution
(Sawan, D'Souza, Gold, Williams, Bilen) Division of Cardiology, Emory
University School of Medicine, Atlanta, GA, United States
(Prabakaran, Behbahani-Nejad) Department of Internal Medicine, Emory
University School of Medicine, Atlanta, GA, United States
Publisher
John Wiley and Sons Inc
Abstract
Hypertrophic cardiomyopathy (HCM) is a common contemporary, treatable,
genetic disorder that can be compatible with normal longevity. While
current medical therapies are ubiquitous, they are limited by a lack of
solid evidence, are often inadequate, poorly tolerated, and do not alter
the natural disease course. As such, there has long been a need for
effective, evidence-based, and targeted disease-modifying therapies for
HCM. In this review, we redefine HCM as a treatable condition, evaluate
current strategies for therapeutic intervention, and discuss novel myosin
inhibitors. The majority of patients with HCM have elevated left
ventricular outflow tract gradients, which predicts worse symptoms and
adverse outcomes. Conventional pharmacological therapies for symptomatic
HCM can help improve symptoms but are often inadequate and poorly
tolerated. Septal reduction therapies (surgical myectomy and alcohol
septal ablation) can safely and effectively reduce refractory symptoms and
improve outcomes in patients with obstructive HCM. However, they require
expertise that is not universally available and are not without risks.
Currently, available therapies do not alter the disease course or the
progressive cardiac remodeling that ensues, nor subsequent heart failure
and arrhythmias. This has been regarded as an unmet need in the care of
HCM patients. Novel targeted pharmacotherapies, namely cardiac myosin
inhibitors, have emerged to reverse key pathophysiological changes and
alter disease course. Their favorable outcomes led to the early Food and
Drug Administration approval of mavacamten, a first-in-class myosin
modulator, changing the paradigm for the pharmacological treatment of
HCM.<br/>Copyright &#xa9; 2024 The Authors. Clinical Cardiology published
by Wiley Periodicals LLC.

<2>
Accession Number
642129548
Title
Quality and transparency of evidence for implantable cardiovascular
medical devices assessed by the CORE-MD consortium.
Source
European heart journal. 45(3) (pp 161-177), 2024. Date of Publication: 14
Jan 2024.
Author
Siontis G.C.M.; Coles B.; Haner J.D.; McGovern L.; Bartkowiak J.; Coughlan
J.J.; Spirito A.; Galea R.; Haeberlin A.; Praz F.; Tomii D.; Melvin T.;
Frenk A.; Byrne R.A.; Fraser A.G.; Windecker S.
Institution
(Siontis, Haner, Bartkowiak, Galea, Haeberlin, Praz, Tomii, Frenk,
Windecker) Department of Cardiology, Bern University Hospital,
Inselspital, University of Bern, Freiburgstrasse 18, Bern CH-3010,
Switzerland
(Coles) Velindre University NHS Trust Library and Knowledge Service,
Cardiff, United Kingdom
(McGovern, Coughlan, Byrne) Department of Cardiology and Cardiovascular
Research Institute (CVRI) Dublin, Mater Private Network, Dublin, Ireland
(Coughlan) School of Pharmacy and Biomolecular Sciences, RCSI University
of Medicine and Health Sciences, Dublin, Ireland
(Spirito) Zena and Michael A. Wiener Cardiovascular Institute, Icahn
School of Medicine at Mount Sinai, New York, NY, USA
(Melvin) School of Medicine, Trinity College Dublin, Ireland
(Fraser) Department of Cardiology, University Hospital of Wales, Cardiff,
United Kingdom
Abstract
BACKGROUND AND AIMS: The European Union Medical Device Regulation 2017/745
challenges key stakeholders to follow transparent and rigorous approaches
to the clinical evaluation of medical devices. The purpose of this study
is a systematic evaluation of published clinical evidence underlying
selected high-risk cardiovascular medical devices before and after market
access in the European Union (CE-marking) between 2000 and 2021.
<br/>METHOD(S): Pre-specified strategies were applied to identify
published studies of prospective design evaluating 71 high-risk
cardiovascular devices in seven different classes (bioresorbable coronary
scaffolds, left atrial appendage occlusion devices, transcatheter aortic
valve implantation systems, transcatheter mitral valve repair/replacement
systems, surgical aortic and mitral heart valves, leadless pacemakers,
subcutaneous implantable cardioverter-defibrillator). The search time span
covered 20 years (2000-21). Details of study design, patient population,
intervention(s), and primary outcome(s) were summarized and assessed with
respect to timing of the corresponding CE-mark approval. <br/>RESULT(S):
At least one prospective clinical trial was identified for 70% (50/71) of
the pre-specified devices. Overall, 473 reports of 308 prospectively
designed studies (enrolling 97 886 individuals) were deemed eligible,
including 81% (251/308) prospective non-randomized clinical trials (66 186
individuals) and 19% (57/308) randomized clinical trials (31 700
individuals). Pre-registration of the study protocol was available in 49%
(150/308) studies, and 16% (48/308) had a peer-reviewed publicly available
protocol. Device-related adverse events were evaluated in 82% (253/308) of
studies. An outcome adjudication process was reported in 39% (120/308) of
the studies. Sample size was larger for randomized in comparison to
non-randomized trials (median of 304 vs. 100 individuals, P < .001). No
randomized clinical trial published before CE-mark approval for any of the
devices was identified. Non-randomized clinical trials were predominantly
published after the corresponding CE-mark approval of the device under
evaluation (89%, 224/251). Sample sizes were smaller for studies published
before (median of 31 individuals) than after (median of 135 individuals)
CE-mark approval (P < .001). Clinical trials with larger sample sizes (>50
individuals) and those with longer recruitment periods were more likely to
be published after CE-mark approval, and were more frequent during the
period 2016-21. <br/>CONCLUSION(S): The quantity and quality of publicly
available data from prospective clinical investigations across selected
categories of cardiovascular devices, before and after CE approval during
the period 2000-21, were deemed insufficient. The majority of studies was
non-randomized, with increased risk of bias, and performed in small
populations without provision of power calculations, and none of the
reviewed devices had randomized trial results published prior to CE-mark
certification.<br/>Copyright &#xa9; 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.

<3>
Accession Number
2026760173
Title
Enhanced recovery after thoracic surgery in low- and middle-income
countries: Feasibility and outcomes.
Source
Asian Cardiovascular and Thoracic Annals. 32(1) (pp 27-35), 2024. Date of
Publication: January 2024.
Author
Hentati A.; Ayed A.B.; Jdidi J.; Chaari Z.; Halima G.B.; Frikha I.
Institution
(Hentati, Ayed, Jdidi, Chaari, Halima, Frikha) University of Sfax, Faculty
of Medicine of Sfax, Sfax, Tunisia
(Hentati, Chaari, Halima, Frikha) Department of Cardiovascular and
Thoracic Surgery, Habib Bourguiba University Hospital, Sfax, Tunisia
(Ayed) Surgery Department, Gabes University Hospital, Gabes, Tunisia
(Jdidi) Community Medicine Department, Hedi Chaker University Hospital,
Sfax, Tunisia
Publisher
SAGE Publications Inc.
Abstract
Background: Enhanced Recovery After Surgery (ERAS) applies multimodal,
perioperative, and evidence-based practices to decrease postoperative
morbi-mortality, the length of hospital stay, and hospitalization costs.
Implementing enhanced recovery after thoracic surgery (ERATS) in low- and
middle-income countries (LMIC) is problematic. This randomized controlled
trial evaluated the feasibility and effectiveness of an ERATS protocol
adapted to LMIC conditions in Tunisia. <br/>Material(s) and Method(s): We
conducted this randomized controlled trial between December 2015 and
August 2017 in the Thoracic and Cardiovascular Surgery Department at Habib
Bourguiba University Hospital of Sfax, Tunisia. <br/>Result(s): One
hundred patients undergoing thoracic surgery were randomly allocated to
the ERATS group or Control group. During the postoperative phase, 13
patients (13%) were excluded secondary. These complication rates were
lower in the ERATS group: lack of reexpansion (14.63% vs 16.10%: p =
0.72), pleural effusion (0% vs 10.86%, p = 0.05), and prolonged air leak
(17.07% vs 30.43%, p = 0.14). The pain level decreased significantly in
the ERATS group from postoperative H3 (p = 0.006). This difference was
significant at H6 (p = 0.001), H24 (p = 0.05), H48 (p = 0.01), discharge
(p = 0.002), and after 15 days (p = 0.01), with a decreased analgesic
consumption. The length of hospital stay was shorter in the ERAS group
(median six days vs seven days, p = 0.17). <br/>Conclusion(s): This study
provides an adapted ERATS protocol, applicable regardless of the surgical
approach or the type of resection and suitable for LMIC hospital's
conditions. This protocol can improve the postoperative outcomes of
thoracic surgery.<br/>Copyright &#xa9; The Author(s) 2023.

<4>
Accession Number
643006100
Title
Residual leaks following percutaneous left atrial appendage occlusion and
outcomes: a meta-analysis.
Source
European heart journal. 45(3) (pp 214-229), 2024. Date of Publication: 14
Jan 2024.
Author
Samaras A.; Papazoglou A.S.; Balomenakis C.; Bekiaridou A.; Moysidis D.V.;
Patsiou V.; Orfanidis A.; Giannakoulas G.; Kassimis G.; Fragakis N.; Saw
J.; Landmesser U.; Alkhouli M.A.; Tzikas A.
Institution
(Samaras, Moysidis, Kassimis, Fragakis, Tzikas) Second Department of
Cardiology, Faculty of Health Sciences, School of Medicine, General
Hospital 'Hippokration', Aristotle University of Thessaloniki,
Konstantinoupoleos 49, Thessaloniki 54642, Greece
(Papazoglou, Balomenakis, Bekiaridou, Moysidis, Patsiou, Orfanidis)
Faculty of Health Sciences, School of Medicine, Aristotle University of
Thessaloniki, Thessaloniki, Greece
(Bekiaridou) Institute of Bioelectronic Medicine, Feinstein Institutes for
Medical Research, Manhasset, NY, United States
(Patsiou, Giannakoulas) First Department of Cardiology, Faculty of Health
Sciences, School of Medicine, AHEPA University Hospital, Aristotle
University of Thessaloniki, Thessaloniki, Greece
(Saw) Division of Cardiology, Vancouver General Hospital, University of
British Columbia, Vancouver, Canada
(Landmesser) Department of Cardiology, Charite Universitatsmedizin,
Berlin, Germany
(Alkhouli) Department of Cardiovascular Disease, Mayo Clinic, Rochester,
MN, United States
(Tzikas) European Interbalkan Medical Center, Department of Cardiology,
Asklipiou 10, Pylaia, Thessaloniki 57001, Greece
Abstract
BACKGROUND AND AIMS: Residual leaks are not infrequent after left atrial
appendage occlusion. However, there is still uncertainty regarding their
prognostic implications. The aim of this study is to evaluate the impact
of residual leaks after left atrial appendage occlusion. <br/>METHOD(S): A
literature search was conducted until 19 February 2023. Residual leaks
comprised peri-device leaks (PDLs) on transoesophageal echocardiography
(TEE) or computed tomography (CT), as well as left atrial appendage
patency on CT. Random-effects meta-analyses were performed to assess the
clinical impact of residual leaks. <br/>RESULT(S): Overall 48 eligible
studies (44 non-randomized/observational and 4 randomized studies)
including 61 666 patients with atrial fibrillation who underwent left
atrial appendage occlusion were analysed. Peri-device leak by TEE was
present in 26.1% of patients. Computed tomography-based left atrial
appendage patency and PDL were present in 54.9% and 57.3% of patients,
respectively. Transoesophageal echocardiography-based PDL (i.e. any
reported PDL regardless of its size) was significantly associated with a
higher risk of thromboembolism [pooled odds ratio (pOR) 2.04, 95%
confidence interval (CI): 1.52-2.74], all-cause mortality (pOR 1.16, 95%
CI: 1.08-1.24), and major bleeding (pOR 1.12, 95% CI: 1.03-1.22), compared
with no reported PDL. A positive graded association between PDL size and
risk of thromboembolism was noted across TEE cut-offs. For any PDL of >0,
>1, >3, and >5 mm, the pORs for thromboembolism were 1.82 (95% CI:
1.35-2.47), 2.13 (95% CI: 1.04-4.35), 4.14 (95% CI: 2.07-8.27), and 4.44
(95% CI: 2.09-9.43), respectively, compared with either no PDL or PDL
smaller than each cut-off. Neither left atrial appendage patency, nor PDL
by CT was associated with thromboembolism (pOR 1.45 and 1.04, 95% CI:
0.84-2.50 and 0.52-2.07, respectively). <br/>CONCLUSION(S): Peri-device
leak detected by TEE was associated with adverse events, primarily
thromboembolism. Residual leaks detected by CT were more frequent but
lacked prognostic significance.<br/>Copyright &#xa9; 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.

<5>
Accession Number
2028674342
Title
Sepsis in cardiothoracic surgery.
Source
Surgery (United States). 175(2) (pp 556-558), 2024. Date of Publication:
February 2024.
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.<br/>Copyright &#xa9; 2023 Elsevier Inc.

<6>
Accession Number
2027900388
Title
Development and Validation of a Nomogram for Predicting Acute Kidney
Injury in Pediatric Patients Undergoing Cardiac Surgery.
Source
Pediatric Cardiology. (no pagination), 2024. Date of Publication: 2024.
Author
Shi S.; Xiong C.; Bie D.; Li Y.; Wang J.
Institution
(Shi, Xiong, Bie, Li, Wang) Department of Anesthesiology, National Center
of Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical
Sciences and Peking Union Medical College, Beijing, China
Publisher
Springer
Abstract
Acute kidney injury (AKI) is a common complication after cardiac surgery
and associated with adverse outcomes. The purpose of this study is to
construct a nomogram to predict the probability of postoperative AKI in
pediatric patients undergoing cardiac surgery. We conducted a
single-center retrospective cohort study of 1137 children having cardiac
surgery under cardiopulmonary bypass. We randomly divided the included
patients into development and validation cohorts at a ratio of 7:3. The
least absolute shrinkage and selection operator regression model was used
for feature selection. We constructed a multivariable logistic regression
model to select predictors and develop a nomogram to predict AKI risk.
Discrimination, calibration and clinical benefit of the final prediction
model were evaluated in the development and validation cohorts. A simple
nomogram was developed to predict risk of postoperative AKI using six
predictors including age at operation, cyanosis, CPB duration longer than
120 min, cross-clamp time, baseline albumin and baseline creatinine
levels. The area under the receiver operator characteristic curve of the
nomogram was 0.739 (95% CI 0.693-0.786) and 0.755 (95% CI 0.694-0.816) for
the development and validation cohort, respectively. The calibration curve
showed a good correlation between predicted and observed risk of
postoperative AKI. Decision curve analysis presented great clinical
benefit of the nomogram. This novel nomogram for predicting AKI after
pediatric cardiac surgery showed good discrimination, calibration and
clinical practicability.<br/>Copyright &#xa9; 2024, The Author(s), under
exclusive licence to Springer Science+Business Media, LLC, part of
Springer Nature.

<7>
Accession Number
2027819374
Title
Comparison of mid-term mortality after surgical, supported or unsupported
percutaneous revascularization in patients with severely reduced ejection
fraction: A direct and network meta-analysis of adjusted observational
studies and randomized-controlled.
Source
International Journal of Cardiology. 396 (no pagination), 2024. Article
Number: 131428. Date of Publication: 01 Feb 2024.
Author
Iannaccone M.; Barbero U.; Franchin L.; Montabone A.; De Filippo O.;
D'ascenzo F.; Boccuzzi G.; Panoulas V.; Hill J.; Brilakis E.S.; Chieffo A.
Institution
(Iannaccone, Montabone, Boccuzzi) Division of Cardiology, San Giovanni
Bosco Hospital, ASL Citta di Torino, Turin, Italy
(Barbero) Division of Cardiology, SS. Annunziata Savigliano, ASL CN 1,
Savigliano, Italy
(Franchin) Cardiothoracic Department, Division of Cardiology, Azienda
Sanitaria Universitaria Friuli Centrale, Udine, Italy
(De Filippo, D'ascenzo) Cardiovascular and Thoracic Department, Division
of Cardiology, A. O. U. Citta della Salute e della Scienza, Turin, Italy
(Panoulas, Hill) Department of Cardiology, Royal Brompton and Harefield
Hospitals, Guy's and St Thomas' NHS Foundation Trust, Harefield Hospital,
Harefield, London UB9 6BJ, United Kingdom
(Brilakis) Minneapolis Heart Institute and Minneapolis Heart Institute
Foundation, Minneapolis, MN, United States
(Chieffo) Vita-Salute San Raffaele University, Milan, Italy
(Chieffo) Interventional Cardiology Unit, IRCCS San Raffaele Scientific
Institute, Milan, Italy
Publisher
Elsevier Ireland Ltd
Abstract
Introduction: The optimal revascularization strategy in patients with
heart failure with reduced ejection fraction (HFrEF) remains to be
elucidated. The aim of this paper is to compare the mid-term mortality
rate among patients with severely reduced ejection fraction (EF) and
complex coronary artery disease who underwent coronary artery bypass
grafting (CABG), percutaneous coronary intervention (PCI) with Impella
support, or without. <br/>Method(s): Randomized control trials and
propensity-adjusted observational studies including patients with ischemic
cardiomyopathy (ICM) and severe EF reduction undergoing revascularization
were selected. Different revascularization strategies (CABG, supported
PCI, and PCI without Impella) were compared in pairwise and network
meta-analysis. The primary endpoint was mid-term mortality (within the
first year after revascularization). <br/>Result(s): Fifteen studies,
mostly observational (17,841 patients; 6779 patients treated with CABG,
8478 treated with PCI without Impella, and 2584 treated with
Impella-supported PCI) were included in this analysis. The median age was
67.8 years (IQR 65-70.1), 21.2% (IQR 16.4-26%) of patients were female
sex, and a high prevalence of cardiovascular risk factors was noted across
the entire population. At pairwise analysis, CABG and PCI without Impella
showed similar one-year all-cause mortality (10.6% [IQR 7.5-12.6%] vs 12%
[IQR 8.4-11.5%]) RR 0.85 CI 0.67-1.09, while supported PCI reduced
one-year all-cause mortality compared to PCI without Impella (9.4% [IQR
5.7-12.5%] vs 10.6% [IQR 8.9-10.7%]) RR 0.77 CI 0.6-0.89. At network
meta-analysis, supported PCI showed better results (RR 0.75, 95% CI
0.59-0.94) compared to CABG. <br/>Conclusion(s): Our analysis found that
supported PCI may have a benefit over standard PCI in patients in direct
comparison, and over CABG from indirect comparison, and with HFrEF
undergoing revascularization. Further RCTs are needed to confirm this
result. (PROSPERO CRD42023425667).<br/>Copyright &#xa9; 2023 Elsevier B.V.

<8>
Accession Number
2027806767
Title
Temporary mechanical circulatory support with Impella in cardiac surgery:
A systematic review.
Source
International Journal of Cardiology. 396 (no pagination), 2024. Article
Number: 131418. Date of Publication: 01 Feb 2024.
Author
Pieri M.; D'Andria Ursoleo J.; Nardelli P.; Ortalda A.; Ajello S.; Delrio
S.; Fominskiy E.; Scandroglio A.M.
Institution
(Pieri, D'Andria Ursoleo, Nardelli, Ortalda, Delrio, Fominskiy,
Scandroglio) Department of Anesthesia and Intensive Care, IRCCS San
Raffaele Scientific Institute, Via Olgettina 60, Milan 20132, Italy
(Pieri) Vita-Salute San Raffaele University, Via Olgettina 58, Milan
20132, Italy
(Ajello) Department of Cardiology, IRCCS San Raffaele Scientific
Institute, Via Olgettina 60, Milan 20132, Italy
Publisher
Elsevier Ireland Ltd
Abstract
Introduction: Perioperative cardiogenic shock (CS) in cardiac surgery is
still burdened by a high mortality risk. The introduction of Impella pumps
in the therapeutic armory of temporary mechanical circulatory support
(tMCS) has potential implications to improve the management of complex
cases, although it has never been systematically addressed. We performed a
systematic review of the reported use of tMCS with Impella in cardiac
surgery. <br/>Method(s): We searched PubMed for all original studies on
the Impella use in adult patients in cardiac surgery. <br/>Result(s):
Nineteen studies (out of 151 identified by search string) were included.
All studies were observational and all but one (95%) were retrospective.
Seven studies focused on the implantation of Impella in the pre-operative
setting (coronary or valvular surgery), either as a prophylactic device in
high-risk cases (3 studies) or in patients with CS as stabilization tool
prior to cardiac surgery procedure (4 studies). Three studies reported the
use of Impella as periprocedural support for percutaneous valvular
procedure, three as bridge to heart replacement, and six for
postcardiotomy CS. Impella support had a low complication rate and was
successful in supporting hemodynamics pre-, intra- and postoperatively.
Most consistently reported data were left-ventricular ejection fraction at
implant, short-term survival and weaning rate. <br/>Conclusion(s): tMCS
with Impella in cardiac surgery patients is feasible and successful. It
can be applied in selected cardiac surgery patients and presents
advantages over other types of support. Systematic prospective studies are
needed to standardize indications for implant and management of surgical
issues, and to identify which patients may benefit.<br/>Copyright &#xa9;
2023 Elsevier B.V.

<9>
Accession Number
632570384
Title
Influence of Valve Type and Antiplatelet Regimen on Platelet Reactivity
After TAVI: Subanalysis of the REAC-TAVI Trial.
Source
The Journal of invasive cardiology. 32(12) (pp 446-452), 2020. Date of
Publication: 01 Dec 2020.
Author
Trejo-Velasco B.; Cruz-Gonzalez I.; Tello-Montoliu A.; Baz-Alonso J.A.;
Salvadores P.J.; Moreno R.; Romaguera R.; Molina-Navarro E.; Paredes-Galan
E.; De-Miguel-Castro A.; Bastos-Fernandez G.; Ortiz-Saez A.;
Fernandez-Barbeira S.; Iniguez-Romo A.; Jimenez-Diaz V.A.
Institution
(Jimenez-Diaz) Cardiovascular Research Unit & Cardiology Department,
Hospital Alvaro Cunqueiro, University Hospital of Vigo, Estrada de Clara
Campoamor, 341, 36312, Vigo, Spain. sooner_79@hotmail.com or
victor.alfonso.jimenez.diaz@sergas.es
Publisher
NLM (Medline)
Abstract
OBJECTIVES: Ticagrelor has proven more effective than clopidogrel at
attaining a maintained suppression of high platelet reactivity (HPR) in
aortic stenosis patients undergoing transcatheter aortic valve
implantation (TAVI). This study aims to assess the influence of implanted
valve type on the degree of platelet reactivity (PR) after TAVI.
<br/>METHOD(S): This study is a prespecified analysis of REAC-TAVI, a
prospective, multicenter study that included patients on dual-antiplatelet
therapy with aspirin and clopidogrel before TAVI. Patients with HPR (n =
48) were randomized to aspirin and clopidogrel or aspirin and ticagrelor
for 3 months, while those without HPR (n = 20) were continued on aspirin
and clopidogrel. PR was measured 6 hours, 24 hours, 5 days, 30 days, and
90 days after TAVI with VerifyNow assay. Bioprosthetic valves were
classified as balloon-expandable valve (BEV), self-expandable valve (SEV),
or other. <br/>RESULT(S): Sixty-eight patients comprising 32 BEVs, 28
SEVs, and 8 other valves were included. Devices were larger and
postdilation was more frequent in the SEV group. Follow-up PR was lower in
patients treated with ticagrelor vs those treated with clopidogrel at all
time points after TAVI, including patients without baseline HPR (P<.001).
PR after TAVI was similar in the three groups. Major cardiovascular
adverse events, stroke, and hemorrhagic complications were comparable
across the different bioprosthesis groups at 4-month follow-up.
<br/>CONCLUSION(S): The effect of valve type on PR after TAVI is similar
across the spectrum of most transcatheter valves. In our sample,
ticagrelor achieved a faster and more effective reduction in PR than
clopidogrel in patients with HPR undergoing TAVI, irrespective of valve
type.

<10>
Accession Number
628024479
Title
Pharmacological Prophylaxis of Atrial Fibrillation After Surgical
Myocardial Revascularization.
Source
Medical archives (Sarajevo, Bosnia and Herzegovina). 73(1) (pp 19-22),
2019. Date of Publication: 01 Feb 2019.
Author
Osmanovic E.; Ostojic M.; Avdic S.; Djedovic S.; Delic A.; Kadric N.;
Terzic A.; Avdic-Salihovic A.
Institution
(Osmanovic, Avdic, Djedovic, Kadric, Terzic, Avdic-Salihovic) Heart Center
BH Tuzla, Tuzla, Bosnia and Herzegovina
(Ostojic) School of Medicine University of Belgrade, Serbia
(Delic) SarajevoBosnia and Herzegovina
Publisher
NLM (Medline)
Abstract
Introduction: Postoperative Atrial Fibrillation (POAF) is associated with
a higher rate of postoperative complications and mortality, as well as
with longer hospitalization and increased treatment costs. We have
designed and performed a randomized, trial of pharmacological prophylaxis
in which the event of interest is POAF. <br/>Aim(s): The aim of this study
is to reduce the risk of postoperative, complications associated with this
arrhythmia. <br/>Method(s): We included 240 stable patients with a
coronary heart disease, who were referred to elective surgical
revascularization of the myocardium. The patients were assigned into three
groups of 80 patients each: group A (BB, beta blocker, comparator), group
B (BB+ Amiodarone) and group C (BB + Rosuvastatin). The goal was to
establish whether intervention by combination therapy was more useful than
a comparator. <br/>Result(s): An event of interest (POAF) has occurred in
66 of the total 240 patients. Number of new POAF cases is the lowest in
Group B, 14 (17.5%) compared to 25 (31.25%) new cases in the comparator
group, and 27 new cases (33.75%) in group C. Absolute risk reduction was
13.75%, =14% less POAF in group B compared to comparator. Relative risk
reduction was 56% (RR 0.56, p = 0.04). Number Needed to Treat was 7.27. In
group C, 33.75% of patients developed POAF. Absolute risk was
insignificantly higher in group C (2.5%, NS) compared to the comparator
.The number needed to harm was high, 40. <br/>Conclusion(s): The results
of our research show that prophylaxis of POAF with combined therapy BB +
Amiodarone was the most efficient one.

<11>
Accession Number
643235765
Title
Non-pharmacological interventions to support coronary artery bypass graft
(CABG) patient recovery following discharge: protocol for a scoping
review.
Source
BMJ open. 14(1) (pp e075830), 2024. Date of Publication: 11 Jan 2024.
Author
Billard J.N.; Wells R.; Farrell A.; Curran J.A.; Sheppard G.
Institution
(Billard, Sheppard) Faculty of Medicine, Memorial University of
Newfoundland and Labrador, St. John's ,Newfoundland and Labrador, Canada
(Wells) Patient Partner, Ottawa, ON, Canada
(Farrell) Health Sciences Library, Memorial University of Newfoundland and
Labrador, St. John's ,Newfoundland and Labrador, Canada
(Curran) School of Nursing, Dalhousie University, Halifax, NS, Canada
Abstract
BACKGROUND: In Canada, approximately 15000 people undergo coronary artery
bypass grafting (CABG) each year. However, 9.5% of these patients are
urgently readmitted to hospital within 30 days of surgery. Postoperative
interventions following discharge play an important role in reducing
readmissions and improving CABG patient outcomes. Therefore, it is
important to determine effective interventions available to enhance CABG
patient recovery following postoperative discharge. <br/>OBJECTIVE(S): Our
scoping review aims to identify non-pharmacological interventions
available to support recovery of patients who are discharged after CABG in
the community setting. <br/>METHOD(S): The methodological framework
described by Arksey and O'Malley will be applied to this review. Our
search strategy will include electronic databases (Medline, Embase,
Cochrane Library and CINAHL), and studies will be screened and reviewed by
two independent reviewers. Studies looking at non-pharmacological
interventions targeting patients who are discharged after CABG will be
included. Preliminary searches were conducted March 2022 and following
abstract screening, full-text screening was completed May 2023. Data
extraction is planned to begin September 2023 with an expected finish date
of October 2023. The study is expected to be completed by January 2024.
ETHICS AND DISSEMINATION: This scoping review will retrieve and analyse
previously published studies in which informed consent was obtained by
primary investigators. Therefore, no ethical review or approval will be
required. This scoping review aims to enumerate available
non-pharmacological interventions to support recovery of patients who are
discharged after CABG and identify gaps in postoperative recovery after
discharge to support the development of innovative and targeted
interventions. On completion of this review, we will ensure broad
dissemination of our findings through peer-reviewed, open-access journals,
conference presentations and hold meetings to engage stakeholders,
including clinicians, policy makers and others.<br/>Copyright &#xa9;
Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No
commercial re-use. See rights and permissions. Published by BMJ.

<12>
Accession Number
643230631
Title
Systematic review and meta-analysis for the value of cardiac magnetic
resonance strain to predict cardiac outcomes.
Source
Scientific reports. 14(1) (pp 1094), 2024. Date of Publication: 11 Jan
2024.
Author
Korosoglou G.; Sagris M.; Andre F.; Steen H.; Montenbruck M.; Frey N.;
Kelle S.
Institution
(Korosoglou) Departments of Cardiology, Vascular Medicine and Pneumology,
GRN Academic Teaching Hospital Weinheim, Roentgenstrasse 1, Weinheim
69469, Germany
(Korosoglou) Cardiac Imaging Center Weinheim, Hector Foundations,
Weinheim, Germany
(Sagris) Hippokration General Hospital, National and Kapodistrian
University of Athens, School of Medicine, Athens, Greece
(Andre, Steen, Frey) Departments of Cardiology, Angiology and Pneumology,
Heidelberg University, Heidelberg, Germany
(Andre, Steen, Frey) DZHK (German Centre for Cardiovascular Research),
Partner Site Heidelberg/Mannheim, Heidelberg, Germany
(Montenbruck) Department of Cardiology, Marien Hospital Hamburg, Hamburg,
Germany
(Kelle) Department of Cardiology, Angiology and Intensive Care Medicine,
Berlin, Germany
(Kelle) DZHK (German Centre for Cardiovascular Research), Partner Site
Berlin, Berlin, Germany
Abstract
Cardiac magnetic resonance (CMR) is the gold standard for the diagnostic
classification and risk stratification in most patients with cardiac
disorders. The aim of the present study was to investigate the ability of
Strain-encoded MR (SENC) for the prediction of major adverse
cardiovascular events (MACE). A systematic review and meta-analysis was
performed according to the PRISMA Guidelines, including patients with or
without cardiovascular disease and asymptomatic individuals. Myocardial
strain by HARP were used as pulse sequences in 1.5 T scanners. Published
literature in MEDLINE (PubMed) and Cochrane's databases were explored
before February 2023 for studies assessing the clinical utility of
myocardial strain by Harmonic Phase Magnetic Resonance Imaging (HARP),
Strain-encoded MR (SENC) or fast-SENC. In total, 8 clinical trials (4
studies conducted in asymptomatic individuals and 4 in patients with
suspected or known cardiac disease) were included in this systematic
review, while 3 studies were used for our meta-analysis, based on
individual patient level data. Kaplan-Meier analysis and Cox proportional
hazard models were used, testing the ability of myocardial strain by HARP
and SENC/fast-SENC for the prediction of MACE. Strain enabled risk
stratification in asymptomatic individuals, predicting MACE and the
development of incident heart failure. Of 1332 patients who underwent
clinically indicated CMR, including SENC or fast-SENC acquisitions, 19
patients died, 28 experienced non-fatal infarctions, 52 underwent coronary
revascularization and 86 were hospitalized due to heart failure during
median 22.4 (17.2-28.5) months of follow-up. SENC/fast-SENC, predicted
both all-cause mortality and MACE with high accuracy (HR=3.0, 95%
CI=1.2-7.6, p=0.02 and HR=4.1, 95% CI=3.0-5.5, respectively, p<0.001).
Using hierarchical Cox-proportional hazard regression models,
SENC/fast-SENC exhibited incremental value to clinical data and
conventional CMR parameters. Reduced myocardial strain predicts of
all-cause mortality and cardiac outcomes in symptomatic patients with a
wide range of ischemic or non-ischemic cardiac diseases, whereas in
asymptomatic individuals, reduced strain was a precursor of incident heart
failure.<br/>Copyright &#xa9; 2024. The Author(s).

<13>
Accession Number
2029718541
Title
Evaluating registry-based trial economics: Results from the STRESS
clinical trial.
Source
Contemporary Clinical Trials Communications. 38 (no pagination), 2024.
Article Number: 101257. Date of Publication: April 2024.
Author
Eisenstein E.L.; Hill K.D.; Wood N.; Kirchner J.L.; Anstrom K.J.; Granger
C.B.; Rao S.V.; Baldwin H.S.; Jacobs J.P.; Jacobs M.L.; Kannankeril P.J.;
Graham E.M.; O'Brien S.M.; Li J.S.
Institution
(Eisenstein, Hill, Wood, Kirchner, O'Brien, Li) Duke Clinical Research
Institute, Durham, NC, United States
(Hill, Li) Duke Pediatric and Congenital Heart Center, Durham, NC, United
States
(Anstrom) Collaborative Studies Coordinating Center, Chapel Hill, NC,
United States
(Anstrom) Department of Biostatistics, University of North Carolina,
Chapel Hill, NC, United States
(Granger) Department of Cardiology, Duke University School of Medicine,
Durham, NC, United States
(Rao) NYU Langone Health, New York, NY, United States
(Baldwin, Kannankeril) Department of Pediatrics, Vanderbilt University
Medical Center, Nashville, TN, United States
(Jacobs) University of Florida Congenital Heart Center, Gainesville, FL,
United States
(Jacobs) Johns Hopkins University School of Medicine, Baltimore, MD,
United States
(Graham) Medical University of South Carolina, Charleston, SC, United
States
Publisher
Elsevier Inc.
Abstract
Background: Registry-based trials have the potential to reduce randomized
clinical trial (RCT) costs. However, observed cost differences also may be
achieved through pragmatic trial designs. A systematic comparison of trial
costs across different designs has not been previously performed.
<br/>Method(s): We conducted a study to compare the current Steroids to
Reduce Systemic inflammation after infant heart surgery (STRESS)
registry-based RCT vs. two established designs: pragmatic RCT and
explanatory RCT. The primary outcome was total RCT design costs. Secondary
outcomes included: RCT duration and personnel hours. Costs were estimated
using the Duke Clinical Research Institute's pricing model.
<br/>Result(s): The Registry-Based RCT estimated duration was 31.9 weeks
greater than the other designs (259.5 vs. 227.6 weeks). This delay was
caused by the Registry-Based design's periodic data harvesting that
delayed site closing and statistical reporting. Total personnel hours were
greatest for the Explanatory design followed by the Pragmatic design and
the Registry-Based design (52,488 vs 29,763 vs. 24,480 h, respectively).
Total costs were greatest for the Explanatory design followed by the
Pragmatic design and the Registry-Based design ($10,140,263 vs. $4,164,863
vs. $3,268,504, respectively). Thus, Registry-Based total costs were 32 %
of the Explanatory and 78 % of the Pragmatic design. <br/>Conclusion(s):
Total costs for the STRESS RCT with a registry-based design were less than
those for a pragmatic design and much less than an explanatory design.
Cost savings reflect design elements and leveraging of registry resources
to improve cost efficiency, but delays to trial completion should be
considered.<br/>Copyright &#xa9; 2024 The Authors

<14>
Accession Number
2029718444
Title
Clinical characteristics and surgical outcomes of cardiac myxoma: A
meta-analysis of worldwide experience.
Source
European Journal of Surgical Oncology. 50(2) (no pagination), 2024.
Article Number: 107940. Date of Publication: February 2024.
Author
Oktaviono Y.H.; Saputra P.B.T.; Arnindita J.N.; Afgriyuspita L.S.;
Kurniawan R.B.; Pasahari D.; Milla C.; Wungu C.D.K.; Susilo H.; Multazam
C.E.C.Z.; Alkaff F.F.
Institution
(Oktaviono, Saputra, Pasahari) Department of Cardiology and Vascular
Medicine, Faculty of Medicine, Universitas Airlangga - General Academic
Hospital Dr. Soetomo, Surabaya, Indonesia
(Oktaviono, Saputra, Arnindita) Cardiovascular Research and Innovation
Center, Universitas Airlangga, Surabaya, Indonesia
(Arnindita, Afgriyuspita, Kurniawan, Milla) Faculty of Medicine,
Universitas Airlangga, Indonesia
(Wungu) Department of Physiology and Medical Biochemistry, Faculty of
Medicine, Universitas Airlangga, Surabaya, Indonesia
(Wungu) Institute of Tropical Disease, Universitas Airlangga, Surabaya,
Indonesia
(Susilo) Department of Cardiology and Vascular Medicine, Faculty of
Medicine, Universitas Airlangga - Universitas Airlangga Hospital, East
Java, Surabaya, Indonesia
(Multazam) National Heart and Lung Institute, Imperial College London,
London, United Kingdom
(Alkaff) Division of Nephrology, Department of Internal Medicine,
University Medical Center Groningen, Groningen, Netherlands
(Alkaff) Division of Pharmacology and Therapy, Department of Anatomy,
Histology, and Pharmacology, Faculty of Medicine, Universitas Airlangga,
Surabaya, Indonesia
Publisher
W.B. Saunders Ltd
Abstract
Cardiac myxoma is the most common primary cardiac tumor. However, existing
literature mainly consists of single-center experiences with limited
subjects. This systematic review aimed to provide data on clinical
characteristics and surgical outcomes of cardiac myxoma. We performed a
thorough literature search on May 23, 2023 on PubMed, ProQuest,
ScienceDirect, Scopus, and Web of Science. The inclusion criteria were
English full-text, observational studies, and included >20 subjects. From
the search, 112 studies with a total of 8150 patients were included in the
analysis. The mean age was 51 years (95 % confidence interval [95%CI] =
49.1-52.3), and the majority were females (64.3 % [95 % CI = 62.8-65.8
%]). The most common clinical manifestation was cardiovascular symptoms.
Echocardiography can diagnose almost all cases (98.1 % [95 % CI =
95.8-99.6 %]). Cardiac myxoma was mostly prevalent in left atrium (85.3 %
[95%CI = 83.3-87 %]) and predominantly with pedunculated morphology (75.6
% [95%CI = 64.1-84.3 %]). Post-tumor excision outcomes were excellent,
with an early mortality of 1.27 % (95 % CI = 0.8-1.8 %), late mortality
rate of 4.7 (95 % CI = 2.5-7.4) per 1000 person-years, and recurrence rate
at 0.5 (95 % CI = 0.0-1.1) per 1000 person-years. Tumor excision is
warranted in a timely manner once the cardiac myxoma diagnosis is
established.<br/>Copyright &#xa9; 2023 The Authors

<15>
Accession Number
2029726384
Title
Using noninvasive clinical parameters to predict mortality and morbidity
after cardiac interventions in patients with cirrhosis: A systematic
review.
Source
Saudi Journal of Gastroenterology. 30(1) (pp 14-22), 2024. Date of
Publication: 2024.
Author
Mathew C.; Patel A.; Cholankeril G.; Flores A.; Hernaez R.
Institution
(Mathew, Patel, Cholankeril, Flores, Hernaez) Department of Internal
Medicine, Baylor College of Medicine, Houston, TX, United States
(Cholankeril) Department of Medicine, Section of Gastroenterology and
Hepatology, Baylor College of Medicine, Baylor St. Luke's Medical Center,
Houston, TX, United States
(Flores, Hernaez) Department of Medicine, Section of Gastroenterology and
Hepatology, Baylor College of Medicine, Michael E DeBakey Veterans Affairs
Medical Center, Houston, TX, United States
Publisher
Wolters Kluwer Medknow Publications
Abstract
Background: Cardiovascular disease commonly affects advanced liver disease
patients. They undergo cardiac interventions to improve cardiac outcomes.
Cirrhosis increases complication risk, including bleeding, renal and
respiratory failure, and further decompensation, including death, posing a
clinical dilemma to proceduralists. Predicting outcomes is crucial in
managing patients with cirrhosis. Our aim was to systematically review
clinical parameters to assess the mortality and complication risk in
patients with cirrhosis undergoing cardiac interventions. <br/>Method(s):
We searched cirrhosis and cardiovascular intervention terminology in
PubMed and Excerpta Medica Database (EMBASE) from inception to January 8,
2023. We included studies reporting clinical scores (e.g. Model for
End-stage Liver Disease (MELD), Child-Pugh-Turcotte (CPT), cardiovascular
interventions, mortality, and morbidity outcomes). We independently
abstracted data from eligible studies and performed qualitative summaries.
<br/>Result(s): Eight studies met the inclusion criteria. Procedures
included tricuspid valve surgery, catheterization-related procedures,
aortic valve replacement (AVR), pericardiectomy, and left ventricular
assist device (LVAD) placement. MELD primarily predicted mortality (n =
4), followed by CPT (n = 2). Mortality is significantly increased for MELD
> 15 after tricuspid valve surgery. Albumin, creatinine, and MELD were
significantly associated with increased mortality after transcatheter AVR
(TAVR), although specific values lacked stratification. CPT was
significantly associated with increased mortality after cardiac
catheterization or pericardiectomy. In LVAD placement, increasing MELD
increased the unadjusted odds for perioperative mortality.
<br/>Conclusion(s): Our systematic review showed that clinical parameters
predict mortality and morbidity risk in patients with cirrhosis undergoing
cardiac procedures.<br/>Copyright &#xa9; 2023 Saudi Journal of
Gastroenterology.

<16>
Accession Number
2027916851
Title
Early tirofiban versus heparin for bridging dual antiplatelet therapy in
patients undergoing coronary endarterectomy combined with coronary artery
bypass grafting: a multicenter randomized controlled trial protocol (the
THACE-CABG trial).
Source
Trials. 25(1) (no pagination), 2024. Article Number: 52. Date of
Publication: December 2024.
Author
Chen L.; Gao M.-X.; Du X.; Wang C.; Yu W.-Y.; Liu H.-L.; Ding X.-H.; Wang
B.-L.; Zhang K.; Xu D.; Han Z.; Xie B.-D.; Dong R.; Yu Y.
Institution
(Chen, Gao, Yu, Liu, Ding, Wang, Zhang, Dong, Yu) Department of
Cardiovascular Surgery, Beijing Anzhen Hospital, Capital Medical
University, No.2 Anzhen Road, Chaoyang District, Beijing, China
(Chen) Department of Cardiovascular Surgery, Shanghai Deltahealth
Hospital, Shanghai, China
(Du) Department of Cardiology, Beijing Anzhen Hospital, Capital Medical
University, Beijing, China
(Du) National Clinical Research Centre for Cardiovascular Diseases,
Beijing, China
(Du) The George Institute for Global Health, University of New South
Wales, Sydney, NSW, Australia
(Du, Wang) Heart Health Research Center, Beijing, China
(Xu) Department of Cardiovascular Surgery, Beijing Tiantan Hospital,
Capital Medical University, Beijing, China
(Han) Department of Cardiovascular Surgery, Peking University Shenzhen
Hospital, Guangdong Province, Shenzhen, China
(Xie) Department of Cardiovascular Surgery, The First Affiliated Hospital
of Harbin Medical University, Heilongjiang Province, Harbin, China
Publisher
BioMed Central Ltd
Abstract
Background: For complete revascularization, patients with diffuse coronary
artery disease should have a coronary endarterectomy and a coronary artery
bypass graft (CE-CABG). Sadly, CE can lead to a lack of endothelium, which
raises the risk of thrombotic events. Even though daily dual antiplatelet
therapies (DAPT) have been shown to reduce thrombotic events, the risk of
perioperative thrombotic events is high during the high-risk period after
CE-CABG, and there is no consistent protocol to bridge DAPT. This trial
aims to compare safety and efficacy between tirofiban and heparin as DAPT
bridging strategies after CE-CABG. <br/>Method(s): In phase I, 266
patients undergoing CE-CABG will be randomly assigned to tirofiban and
heparin treatment groups to compare the two treatments in terms of the
primary safety endpoint, chest tube drainage in the first 24 h. If the
phase I trial shows tirofiban non-inferiority, phase II will commence, in
which an additional 464 patients will be randomly assigned. All 730
patients will be studied to compare major cardiovascular and
cerebrovascular events (MACCEs) between the groups in the first 30 days
after surgery. <br/>Discussion(s): Given the possible benefits of
tirofiban administration after CE-CABG, this trial has the potential to
advance the field of adult coronary heart surgery. Trial registration:
chictr.org.cn, ChiCTR2200055697. Registered 6 January 2022.
https://www.chictr.org.cn/com/25/showproj.aspx?proj=149451 . Current
version: 20,220,620.<br/>Copyright &#xa9; 2024, The Author(s).

<17>
Accession Number
2027916585
Title
Efficacy and safety of add-on mirogabalin to conventional therapy for the
treatment of peripheral neuropathic pain after thoracic surgery: the
multicenter, randomized, open-label ADMIT-NeP study.
Source
BMC Cancer. 24(1) (no pagination), 2024. Article Number: 80. Date of
Publication: December 2024.
Author
Miyazaki T.; Matsumoto K.; Sato T.; Sano I.; Furukawa K.; Shimoyama K.;
Kamohara R.; Suzuki M.; Kondou M.; Ikeda N.; Tabata S.; Shiosakai K.;
Nagayasu T.
Institution
(Miyazaki, Matsumoto, Nagayasu) Department of Surgical Oncology, Nagasaki
University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto,
Nagasaki 852-8501, Japan
(Miyazaki) Department of Thoracic Surgery, Sasebo City General Hospital,
Sasebo, Japan
(Sato) Department of General Thoracic, Breast, and Pediatric Surgery,
Fukuoka University School of Medicine, Fukuoka, Japan
(Sano) Department of Respiratory Surgery, The Japanese Red Cross Nagasaki
Genbaku Hospital, Nagasaki, Japan
(Furukawa) Department of Thoracic Surgery, Ehime Prefectural Central
Hospital, Matsuyama, Japan
(Shimoyama) Chest Surgery, National Hospital Organization Nagasaki Medical
Center, Omura, Japan
(Kamohara) Department of Thoracic Surgery, Oita Prefectural Hospital,
Oita, Japan
(Suzuki) Department of Thoracic Surgery, Kumamoto University Hospital,
Kumamoto, Japan
(Kondou) Department of Thoracic and Breast Surgery, Ureshino Medical
Center, Ureshino, Japan
(Ikeda) Department of Surgery, Tokyo Medical University, Tokyo, Japan
(Tabata) Primary Medical Science Department, Daiichi Sankyo Co., Ltd,
Tokyo, Japan
(Shiosakai) Data Intelligence Department, Daiichi Sankyo Co., Ltd, Tokyo,
Japan
Publisher
BioMed Central Ltd
Abstract
Background: For chronic pain after thoracic surgery, optimal timing of its
diagnosis and effective treatment remains unresolved, although several
treatment options are currently available. We examined the efficacy and
safety of mirogabalin, in combination with conventional pain therapy
(nonsteroidal anti-inflammatory drugs and/or acetaminophen), for treating
peripheral neuropathic pain (NeP) after thoracic surgery. <br/>Method(s):
In this multicenter, randomized, open-label, parallel-group study,
patients with peripheral NeP were randomly assigned 1:1 to mirogabalin as
add-on to conventional therapy or conventional treatment alone.
<br/>Result(s): Of 131 patients of consent obtained, 128 were randomized
(mirogabalin add-on group, 63 patients; conventional treatment group, 65
patients). The least squares mean changes (95% confidence interval [CI])
in Visual Analogue Scale (VAS) score for pain intensity at rest from
baseline to Week 8 (primary endpoint) were - 51.3 (- 54.9, - 47.7) mm in
the mirogabalin add-on group and - 47.7 (- 51.2, - 44.2) mm in the
conventional group (between-group difference: - 3.6 [95% CI: - 8.7, 1.5],
P = 0.161). However, in patients with Self-administered Leeds Assessment
of Neuropathic Symptoms and Signs (S-LANSS) score (used for the screening
of NeP) >= 12 at baseline, the greater the S-LANSS score at baseline, the
greater the decrease in VAS score in the mirogabalin add-on group, while
no such trend was observed in the conventional treatment group (post hoc
analysis). This between-group difference in trends was statistically
significant (interaction P value = 0.014). Chronic pain was recorded in
7.9% vs. 16.9% of patients (P = 0.171) at Week 12 in the mirogabalin
add-on vs. conventional treatment groups, respectively. Regarding
activities of daily living (ADL) and quality of life (QOL), changes in
Pain Disability Assessment Scale score and the EQ-5D-5L index value from
baseline to Week 8 showed significant improvement in the mirogabalin
add-on group vs. conventional treatment group (P < 0.001). The most common
adverse events (AEs) in the mirogabalin add-on group were dizziness
(12.7%), somnolence (7.9%), and urticaria (3.2%). Most AEs were mild or
moderate in severity. <br/>Conclusion(s): Addition of mirogabalin to
conventional therapy did not result in significant improvement in pain
intensity based on VAS scores, but did result in significant improvement
in ADL and QOL in patients with peripheral NeP after thoracic surgery.
Trial registration: Japan Registry of Clinical Trials jRCTs071200053
(registered 17/11/2020).<br/>Copyright &#xa9; 2024, The Author(s).

<18>
Accession Number
2027915341
Title
Effects of quality nursing on the surgical site wound infections in
patients undergoing cardiothoracic surgery: A meta-analysis.
Source
International Wound Journal. 21(1) (no pagination), 2024. Article Number:
e14553. Date of Publication: January 2024.
Author
Lv X.; Zhou A.; Chen M.; Qi C.; Zhang Q.
Institution
(Lv, Chen, Qi) Department of Cardiothoracic Surgery, People's Hospital
Affiliated to Shandong First Medical University, Jinan, China
(Zhou) Department of Hepatobiliary Surgery, People's Hospital Affiliated
to Shandong First Medical University, Jinan, China
(Zhang) Department of Thyroid and Breast Surgery, People's Hospital
Affiliated to Shandong First Medical University, Jinan, China
Publisher
John Wiley and Sons Inc
Abstract
The aim of this study is to systematically evaluate the effects of quality
nursing on wound infections and postoperative complications in patients
undergoing cardiothoracic surgery. Computerised searches of the PubMed,
Web of Science, Cochrane Library, Embase, China Biomedical Literature
Database, China National Knowledge Infrastructure and Wanfang databases
were conducted from database inception to October 2023 for randomised
controlled trials (RCTs) on the application of quality nursing to patients
undergoing cardiothoracic surgery. The studies were screened and evaluated
by two researchers based on the inclusion and exclusion criteria, and data
were extracted from the included studies. Stata software (version 17.0)
was used for all analyses performed. A total of 18 RCTs and 1742 patients
were included, including 972 in the quality nursing group and 870 in the
routine nursing group. The analysis revealed that compared with routine
nursing, patients undergoing cardiothoracic surgery who received quality
nursing care were significantly less likely to experience postoperative
wound infections (OR = 0.31, 95% CI: 0.19-0.51, p < 0.001) and
complications (OR = 0.24. 95% CI: 0.17-0.33, p < 0.001). The
implementation of quality nursing in clinical care after cardiothoracic
surgery can effectively reduce the incidence of wound infections and
postoperative complications, and is worthy of promotion and clinical
application.<br/>Copyright &#xa9; 2024 The Authors. International Wound
Journal published by Medicalhelplines.com Inc and John Wiley & Sons Ltd.

<19>
Accession Number
2029760308
Title
The impact of early in-hospital use of PCSK9 inhibitors on cardiovascular
outcomes in acute coronary syndrome patients: A systematic review and
meta-analysis.
Source
International Journal of Cardiology. (no pagination), 2024. Article
Number: 131775. Date of Publication: 2024.
Author
Yifan D.; Yue M.; Yubin Z.; Jiapei G.; Xun S.; Shenghu H.; Li Z.; Jing Z.
Institution
(Yifan, Yue, Yubin, Jiapei, Xun, Shenghu, Li, Jing) Clinical Medical
College, Yangzhou University, Yangzhou 225001, China
(Yifan, Li) Taizhou People's Hospital affiliated to Nanjing Medical
University, Tai zhou 225300, China
(Yifan, Jiapei) Medical College of Yangzhou University, Yang zhou 225001,
China
(Yue) Medical School of Nanjing University, Nanjing 21000, China
(Yubin, Xun) Dalian Medical University, Dalian 116000, China
(Shenghu, Jing) Department of Cardiology, Northern Jiangsu People's
Hospital, Yangzhou 225001, China
Publisher
Elsevier Ireland Ltd
Abstract
Objective: To explore the safety and assess the cardiovascular impact of
early in-hospital administration of PCSK9 inhibitors in patients with
acute coronary syndrome (ACS). <br/>Method(s): A systematic search of
PubMed, Web of Science, and Embase databases was conducted for studies
involving the use of PCSK9 inhibitors in ACS patients from inception to
October 2023. Two independent researchers screened the literature,
extracted data, and assessed the risk of bias in the included studies.
Meta-analysis was performed using STATA 16.0 software. <br/>Result(s):
Nine studies, encompassing a total of 2896 ACS patients, were included in
the analysis. When compared to statin monotherapy, early administration of
PCSK9 inhibitors during hospitalization for ACS proved effective in
reducing the incidence of major adverse cardiovascular events (MACEs).
This encompassed a decrease in coronary revascularization [Relative Risk
(RR) = 0.78, 95% CI (0.62, 0.98), P < 0.05], recurrent ACS [RR = 0.62, 95%
CI (0.42, 0.94), P < 0.05], readmissions due to unstable angina [RR =
0.71, 95% CI (0.59, 0.85), P < 0.01], and strokes [RR = 0.31, 95% CI
(0.09, 1.04), P = 0.058]. There was no significant difference in the
incidence of death between the two groups.The use of PCSK9 inhibitors
notably hastened the reduction of LDL-C, TG, and Non HDL-C levels in the
short term. Additionally, it increased HDL-C levels and the number of
individuals meeting LDL-C compliance criteria. Importantly, the risk of
adverse drug events, such as ALT increase >3xULN, allergies, and
musculoskeletal pain, did not significantly elevate with PCSK9 inhibitor
use. <br/>Conclusion(s): The early administration of PCSK9 inhibitors has
been found to safely and effectively lower diverse lipid levels in
patients with ACS. This reduction is associated with a noteworthy decrease
in MACEs, encompassing revascularization, recurrent ACS, and hospital
readmissions.<br/>Copyright &#xa9; 2024 Elsevier B.V.

<20>
Accession Number
643237231
Title
Assessment of microcirculatory alteration by a vascular occlusion test
using near-infrared spectroscopy in pediatric cardiac surgery: effect of
cardiopulmonary bypass.
Source
Expert review of medical devices. (no pagination), 2024. Date of
Publication: 13 Jan 2024.
Author
Savluk O.F.; Yilmaz A.A.; Yavuz Y.; Arisut S.; Ukil Isildak F.; Turkmen
Karaagac A.; Ozbek B.; Cine N.; Tuncer E.; Ceyran H.
Institution
(Savluk, Yavuz, Arisut, Ukil Isildak, Turkmen Karaagac) Anesthesiology and
Reanimation Clinic, Kartal Kosuyolu High Education and Training Hospital,
Istanbul, Turkey
(Yilmaz, Ozbek, Cine, Tuncer, Ceyran) Pediatric Cardiac Surgery Clinic,
Kartal Kosuyolu High Education and Training Hospital, Istanbul, Turkey
Abstract
OBJECTIVES: Cardiopulmonary bypass cause microcirculatory alterations.
Near infrared spectroscopic measurement of tissue oxygen saturation and
vascular occlusion test are novel technologies for assessing the
microcirculatory function of peripheral tissue specifically in patients
undergoing cardiac surgery with cardiopulmonary bypass.Our study aimed to
evaluate dynamic microcirculatory function using the vascular occlusion
testing during cardiac surgery in pediatric patients. <br/>METHOD(S): 120
pediatric patients were scheduled. Children had continuous regional oxygen
saturation monitoring using near infrared spectroscopy and vascular
occlusion test. Vascular occlusion test was performed five times;before
induction (T1),after induction (T2), then during cardiopulmonary bypass
with full flow (T3),after the termination of CPB (T4) and after sternum
closure (T5). <br/>RESULT(S): Basal value was the lowest at T3 and this
value was significantly different among measurements (p<0,01).Values for
maximum and minimum tissue oxygen saturation were the lowest at T3 (83,4
and 52,9%).The occlusion slope varied significantly among measurements
(p<0,01).Reperfusion slopes were significantly different among
measurements (p<0,01) with a further progressive decrease in reperfusion
slope with duration of cardiopulmonary bypass. <br/>CONCLUSION(S):
Microcirculatory function can assessed using VOT with forearm
Near-infrared spectroscopy derived variables during cardiopulmonary bypass
in pediatric cardiac surgery. Noninvasive assessment of microcirculatory
perfusion during cardiopulmonary bypass can further help evaluate and
improve circulatory support techniques. TRIAL REGISTRATION: The research
Project was registered at ClinicalTrials.gov (NCT06191913).

<21>
Accession Number
2026289177
Title
Dapagliflozin-Induced Myocardial Flow Reserve Improvement is not
Associated with HDL Ability to Stimulate Endothelial Nitric Oxide
Production.
Source
Diabetes Therapy. 15(1) (pp 257-268), 2024. Date of Publication: January
2024.
Author
Capece U.; Pavanello C.; Cinti F.; Leccisotti L.; Mezza T.; Ciccarelli G.;
Moffa S.; Di Giuseppe G.; Soldovieri L.; Brunetti M.; Giordano A.;
Giaccari A.; Calabresi L.; Ossoli A.
Institution
(Capece, Cinti, Mezza, Ciccarelli, Moffa, Di Giuseppe, Soldovieri,
Brunetti, Giaccari) Dipartimento di Scienze Mediche e Chirurgiche, Centro
Malattie Endocrine e Metaboliche, Fondazione Policlinico Universitario A.
Gemelli IRCCS-Universita Cattolica del Sacro Cuore, Rome, Italy
(Pavanello, Calabresi, Ossoli) Centro Grossi Paoletti, Dipartimento di
Scienze Farmacologiche e Biomolecolari, Universita degli Studi di Milano,
Milan, Italy
(Leccisotti, Giordano) Radioterapia Oncologica ed Ematologia, UOC di
Medicina Nucleare, Fondazione Policlinico Universitario A. Gemelli
IRCCS-Universita Cattolica del Sacro Cuore, Rome, Italy
Publisher
Adis
Abstract
Background: Sodium-glucose cotransporter-2 (SGLT2) inhibitors have shown
controversial results in modulating plasma lipids in clinical trials. Most
studies found slight increases in high-density lipoprotein (HDL)
cholesterol but few have provided evidence on HDL functionality with
disappointing results. However, there is broad agreement that these drugs
provide cardiovascular protection through several mechanisms. Our group
demonstrated that dapagliflozin improves myocardial flow reserve (MFR) in
patients with type 2 diabetes (T2D) with coronary artery disease (CAD).
The underlying mechanisms are still unknown, although in vitro studies
have suggested the involvement of nitric oxide (NO). <br/>Aim(s): To
investigate changes in HDL-mediated modulation of NO production with
dapagliflozin and whether there is an association with MFR.
<br/>Method(s): Sixteen patients with CAD-T2D were enrolled and randomized
1:1 to dapagliflozin or placebo for 4 weeks. Blood samples were collected
before and after treatment for each group. The ability of HDL to stimulate
NO production in endothelial cells was tested in vitro by incubating human
umbilical vein endothelial cells (HUVEC) with apoB-depleted (apoB-D) serum
of these patients. The production of NO was assessed by fluorescent assay,
and results were expressed as fold versus untreated cells. <br/>Result(s):
Change in HDL-mediated NO production remained similar in dapagliflozin and
placebo group, even after adjustment for confounders. There were no
significant correlations between HDL-mediated NO production and MFR either
at baseline or after treatment. No changes were found in HDL cholesterol
in either group, while low-density lipoprotein cholesterol (LDL
cholesterol) significantly decreased compared to baseline only in
treatment group (p = 0.043). <br/>Conclusion(s): In patients with T2D-CAD,
beneficial effects of dapagliflozin on coronary microcirculation seem to
be unrelated to HDL functions. However, HDL capacity to stimulate NO
production is not impaired at baseline; thus, the effect of drug
treatments would be negligible. To conclude, we can assume that
HDL-independent molecular pathways are involved in the improvement of MFR
in this population. Trial Registration: EudraCT No. 2016-003614-27;
ClinicalTrials.gov Identifier: NCT03313752.<br/>Copyright &#xa9; 2023, The
Author(s).

<22>
Accession Number
2025159834
Title
Effect of right anterolateral thoracotomy versus median sternotomy on
postoperative wound tissue repair in patients with congenital heart
disease: A meta-analysis.
Source
International Wound Journal. 21(1) (no pagination), 2024. Article Number:
e14343. Date of Publication: January 2024.
Author
He R.; Zhang K.; Zhou C.; Pei C.
Institution
(He, Zhang, Zhou, Pei) Maternal and Child Health Hospital of Hubei
Province, Wuhan, China
Publisher
John Wiley and Sons Inc
Abstract
Right anterolateral thoracotomy (RAT) and median sternotomy (MS) are two
major methods for treatment of congenital cardiac disease. But there are
various types of surgery that provide a better operative outcome for the
patient. Therefore, we carried out a meta-analysis to investigate the
effects of these two methods in the treatment of wound tissue,
hospitalization and so on, to find out which surgery method could provide
the best short-term effect. In this research, we chose an English
controlled trial from 2003 to 2022 to evaluate the influence of right
anterolateral thoracotomy and median sternotomy on the short-term outcome
of Cardiopulmonary bypass (CPB), time of operation, time spent in the
hospital, and the time of scar formation. Our findings suggest that the
RAT method was associated with a shorter surgical scars for congenital
heart disease operations compared to MS with respect to post-operation
scars (WMD, 3.55; 95% CI, 0.04, 7.05; p = 0.05). The RAT method is better
suited to the needs of patients who care about their injuries.
Nevertheless, in addition to other surgery related factors which might
affect post-operative wound healing, we discovered that MS took a shorter
time to perform CPB compared with RAT surgery (WMD, - 1.94; 95% CI, -3.39,
-0.48; p = 0.009). Likewise, when it comes to the time taken to perform
surgery, MS needs less operational time compared to RAT methods (WMD,
-12.84; 95% CI, -25.27, -0.42; p = 0.04). On the other hand, the time
needed for MS to recover was much longer compared to the RAT (WMD, 0. 60;
95% CI, 0.02, 1.18; p = 0.04). This indicates that while RAT is
advantageous in terms of shortening the duration of post-operative scar,
it also increases the time needed for surgical operations and
CPB.<br/>Copyright &#xa9; 2023 The Authors. International Wound Journal
published by Medicalhelplines.com Inc and John Wiley & Sons Ltd.

<23>
Accession Number
2029551685
Title
Design and rationale of the evaluation of transcatheter aortic valve
replacement compared to surveillance for patients with asymptomatic severe
aortic stenosis: The EARLY TAVR trial.
Source
American Heart Journal. 268 (pp 94-103), 2024. Date of Publication:
February 2024.
Author
Genereux P.; Schwartz A.; Oldemeyer B.; Cohen D.J.; Redfors B.; Prince H.;
Zhao Y.; Lindman B.R.; Pibarot P.; Leon M.B.
Institution
(Genereux) Gagnon Cardiovascular Institute, Morristown Medical Center,
Morristown, NJ, United States
(Schwartz, Leon) Columbia University Medical Center/NewYork-Presbyterian
Hospital, New York, NY, United States
(Oldemeyer) University of Colorado Health, Loveland, CO, United States
(Cohen, Redfors, Leon) Cardiovascular Research Foundation, New York, NY,
United States
(Cohen) St. Francis Hospital and Heart Center, Roslyn, NY, United States
(Redfors) Sahlgrenska University Hospital, University of Gothenburg,
Gothenburg, Sweden
(Pibarot) Quebec Heart & Lung Institute, Laval University, Quebec City,
QC, Canada
(Prince, Zhao) Edwards Lifesciences, Irvine, CA, United States
(Lindman) Vanderbilt University Medical Center, Nashville, TN, United
States
Publisher
Elsevier Inc.
Abstract
Background: For patients with asymptomatic, severe aortic stenosis (AS)
and preserved left ventricular ejection fraction, current guidelines
recommend clinical surveillance every 6 to 12 months. To date, no
randomized trials have examined whether an early intervention with
transcatheter aortic valve replacement (TAVR) will improve outcomes among
these patients. Study design and objectives: EARLY TAVR is a prospective,
randomized, controlled, and multicenter trial, with an event-based design.
Asymptomatic severe AS patients (n = 900) are randomized 1:1 to either
clinical surveillance or TAVR with the Edwards SAPIEN 3/SAPIEN 3 Ultra
transcatheter heart valve. Patients are stratified by whether they are
able to perform a treadmill stress test. The primary end point is death,
stroke, or unplanned cardiovascular hospitalization. Patients who are
asymptomatic but have a positive stress test will be followed in a
registry and undergo aortic valve replacement as per current guidelines.
<br/>Conclusion(s): EARLY TAVR is the largest randomized trial to date
assessing the role of early intervention among patients with asymptomatic
severe AS compared to clinical surveillance and the first to study the
role of TAVR. Trial registration number: NCT03042104<br/>Copyright &#xa9;
2023 Elsevier Inc.

<24>
[Use Link to view the full text]
Accession Number
2029550335
Title
Survival with Favorable Neurologic Outcome and Quality of Cardiopulmonary
Resuscitation Following In-Hospital Cardiac Arrest in Children with
Cardiac Disease Compared with Noncardiac Disease*.
Source
Pediatric Critical Care Medicine. 25(1) (pp 4-14), 2024. Date of
Publication: 01 Jan 2024.
Author
Federman M.; Sutton R.M.; Reeder R.W.; Ahmed T.; Bell M.J.; Berg R.A.;
Bishop R.; Bochkoris M.; Burns C.; Carcillo J.A.; Carpenter T.C.; Dean
J.M.; Diddle J.W.; Fernandez R.; Fink E.L.; Franzon D.; Frazier A.H.;
Friess S.H.; Graham K.; Hall M.; Hehir D.A.; Horvat C.M.; Huard L.L.;
Kirkpatrick T.; Maa T.; Maitoza L.A.; Manga A.; McQuillen P.S.; Meert
K.L.; Morgan R.W.; Mourani P.M.; Nadkarni V.M.; Notterman D.; Palmer C.A.;
Pollack M.M.; Sapru A.; Schneiter C.; Sharron M.P.; Srivastava N.; Tilford
B.; Viteri S.; Wessel D.; Wolfe H.A.; Yates A.R.; Zuppa A.F.; Naim M.Y.
Institution
(Federman, Huard, Kirkpatrick, Maitoza, Sapru, Srivastava) Department of
Pediatrics, Mattel Children's Hospital, University of California Los
Angeles, Los Angeles, CA, United States
(Sutton, Berg, Graham, Hehir, Morgan, Nadkarni, Wolfe, Zuppa, Naim)
Department of Anesthesiology and Critical Care Medicine, The Children's
Hospital of Philadelphia, University of Pennsylvania, Philadelphia, PA,
United States
(Reeder, Dean, Palmer) Department of Pediatrics, University of Utah, Salt
Lake City, UT, United States
(Ahmed, Meert, Tilford) Department of Pediatrics, Children's Hospital of
Michigan, Central Michigan University, Detroit, MI, United States
(Bell, Diddle, Pollack, Sharron, Wessel) Department of Pediatrics,
Children's National Hospital, George Washington University School of
Medicine, Washington, DC, United States
(Bishop, Carpenter, Schneiter) Department of Pediatrics, University of
Colorado School of Medicine, Aurora, CO, United States
(Carpenter) Department of Pediatrics, Children's Hospital Colorado,
Aurora, CO, United States
(Bochkoris, Carcillo, Fink, Horvat) Department of Critical Care Medicine,
UPMC Children's Hospital of Pittsburgh, University of Pittsburgh,
Pittsburgh, PA, United States
(Burns) Department of Pediatrics and Human Development, Michigan State
University, Grand Rapids, MI, United States
(Fernandez, Hall, Maa, Yates) Department of Pediatrics, Nationwide
Children's Hospital, The Ohio State University, Columbus, OH, United
States
(Franzon, McQuillen) Department of Pediatrics, Benioff Children's S,
University of California, San Francisco, San Francisco, CA, United States
(Frazier) Nemours Cardiac Center, Nemours Children's Hospital, Wilmington,
DE, United States
(Frazier) Department of Pediatrics, Sidney Kimmel Medical College, Thomas
Jefferson University, Philadelphia, PA, United States
(Friess, Manga, Mourani) Department of Pediatrics, Washington University
School of Medicine, St. Louis, MO, United States
(Mourani) Department of Pediatrics, University of Arkansas for Medical
Sciences and Arkansas Children's Hospital, Little Rock, AR, United States
(Notterman) Department of Molecular Biology, Princeton University,
Princeton, NJ, United States
(Viteri) Department of Pediatrics, Nemours Children's Hospital, Delaware
and Thomas Jefferson University, Wilmington, DE, United States
Publisher
Lippincott Williams and Wilkins
Abstract
OBJECTIVES: To assess associations between outcome and cardiopulmonary
resuscitation (CPR) quality for in-hospital cardiac arrest (IHCA) in
children with medical cardiac, surgical cardiac, or noncardiac disease.
DESIGN: Secondary analysis of a multicenter cluster randomized trial, the
ICU-RESUScitation Project (NCT02837497, 2016-2021). SETTING: Eighteen
PICUs. PATIENTS: Children less than or equal to 18 years old and greater
than or equal to 37 weeks postconceptual age receiving chest compressions
(CC) of any duration during the study. INTERVENTIONS: None MEASUREMENTS
AND MAIN RESULTS: Of 1,100 children with IHCA, there were 273 medical
cardiac (25%), 383 surgical cardiac (35%), and 444 noncardiac (40%) cases.
Favorable neurologic outcome was defined as no more than moderate
disability or no worsening from baseline Pediatric Cerebral Performance
Category at discharge. The medical cardiac group had lower odds of
survival with favorable neurologic outcomes compared with the noncardiac
group (48% vs 55%; adjusted odds ratio [aOR] [95% CI], aOR 0.59 [95% CI,
0.39-0.87], p = 0.008) and surgical cardiac group (48% vs 58%; aOR 0.64
[95% CI, 0.45-0.9], p = 0.01). We failed to identify a difference in
favorable outcomes between surgical cardiac and noncardiac groups. We also
failed to identify differences in CC rate, CC fraction, ventilation rate,
intra-Arrest average target diastolic or systolic blood pressure between
medical cardiac versus noncardiac, and surgical cardiac versus noncardiac
groups. The surgical cardiac group had lower odds of achieving target CC
depth compared to the noncardiac group (OR 0.15 [95% CI, 0.02-0.52], p =
0.001). We failed to identify a difference in the percentage of patients
achieving target CC depth when comparing medical cardiac versus noncardiac
groups. <br/>CONCLUSION(S): In pediatric IHCA, medical cardiac patients
had lower odds of survival with favorable neurologic outcomes compared
with noncardiac and surgical cardiac patients. We failed to find
differences in CPR quality between medical cardiac and noncardiac
patients, but there were lower odds of achieving target CC depth in
surgical cardiac compared to noncardiac patients.<br/>Copyright &#xa9;
2024 Lippincott Williams and Wilkins. All rights reserved.

<25>
Accession Number
2029536878
Title
Respect Versus Resect Approaches for Mitral Valve Repair: A Meta-Analysis
of Reconstructed Time-to-Event Data.
Source
American Journal of Cardiology. 213 (pp 5-11), 2024. Date of Publication:
15 Feb 2024.
Author
Caldonazo T.; Sa M.P.; Jacquemyn X.; Van den Eynde J.; Kirov H.; Harik L.;
Fischer J.; Vervoort D.; Bonatti J.; Sultan I.; Doenst T.
Institution
(Caldonazo, Kirov, Fischer, Doenst) Department of Cardiothoracic Surgery,
Jena University Hospital, Jena, Germany
(Sa, Bonatti, Sultan) Department of Cardiothoracic Surgery, University of
Pittsburgh, Pittsburgh, PA, United States
(Sa, Bonatti, Sultan) UPMC Heart and Vascular Institute, University of
Pittsburgh Medical Center, Pittsburgh, PA, United States
(Jacquemyn, Van den Eynde) Department of Cardiovascular Sciences, KU
Leuven, Leuven, Belgium
(Harik) Department of Cardiothoracic Surgery, Weill Cornell Medicine, New
York City, New York, United States
(Vervoort) Division of Cardiac Surgery, University of Toronto, Toronto,
ON, Canada
(Vervoort) Institute of Health Policy, Management and Evaluation,
University of Toronto, Toronto, ON, Canada
Publisher
Elsevier Inc.
Abstract
Mitral valve repair (MVr) has been associated with superior long-term
survival and freedom from valve-related complications compared with mitral
valve replacement for primary mitral regurgitation (MR). The 2 main
approaches for MVr are chordal replacement ("respect approach") and
leaflet resection ("resect approach"). We performed a systematic review
and a meta-analysis using 3 search databases to compare the long-term end
points between both approaches. The primary end point was long-term
survival. The secondary end points were long-term MR recurrence and
reoperation. After reconstruction of time-to-event data for the individual
survival analysis, pooled Kaplan-Meier curves for the end points were
generated. A total of 14 studies (5,565 patients) were included in the
analysis. The respect approach was associated with superior survival
compared with the resect approach in the overall sample (hazard ratio [HR]
0.73, 95% confidence interval [CI] 0.56 to 0.96, p = 0.024, n = 3,901
patients) but not in the risk-adjusted sample (HR 1.00, 95% CI 0.55 to
1.82, p = 0.991, n = 620 patients). There was no difference between the
approaches in the rate of MR recurrence in the overall sample (HR 1.39,
95% CI 0.92 to 2.08, p = 0.116, n = 1,882 patients) or in the
risk-adjusted sample (HR 1.62, 95% CI 0.76 to 3.47, p = 0.211, n = 288
patients). The data for reoperation were only available in the overall
sample and did not reveal a difference (HR 0.92, 95% CI 0.62 to 1.35, p =
0.663, n = 3,505 patients). In conclusion, the current evidence suggests
no difference in long-term mortality, MR recurrence, or reoperation
between the resect and respect approaches for MVr after adjusting for
patient risk factors. More long-term follow-up data are
warranted.<br/>Copyright &#xa9; 2023 The Author(s)

<26>
Accession Number
2024958257
Title
Sternal wound infections following internal mammary artery grafts for a
coronary bypass: A meta-analysis.
Source
International Wound Journal. 21(1) (no pagination), 2024. Article Number:
e14349. Date of Publication: January 2024.
Author
Li M.; Yu Z.; Chen Q.; Zhao Q.; Chen X.; Lei C.; Wang X.; Yang R.
Institution
(Li) Department of Nephrology, Erqiao Street Community Health Service
Cente affiliated of the Fifth Hospital of Wuhan, Wuhan, China
(Yu) Department of Respiratory and Critical Care Medicine, Wuhan Jinyintan
Hospital, Wuhan, China
(Chen) Department of Infectious Immunolog, Wuhan Jinyintan Hospital,
Wuhan, China
(Zhao, Yang) Department of Thoracic and Cardiovascular Surgery, The Fifth
Hospital of Wuhan, Wuhan, China
(Chen) Department of Health Management Center, Affiliated Hospital of
Guangdong Medical University, Zhanjiang, China
(Lei) Department of Oncology, The Fifth Hospital of Wuhan, Wuhan, China
(Wang) Department of Nephrology, The Fifth Hospital of Wuhan, Wuhan, China
Publisher
John Wiley and Sons Inc
Abstract
The meta-analysis aims to evaluate and compare the sternal wound
infections following internal mammary artery grafts for a coronary bypass.
Examinations comparing bilateral internal mammary artery to single
internal mammary artery for coronary artery bypass grafting were among the
meta-analyses from various languages that met the inclusion criteria.
Using dichotomous random- or fixed-effect models, the results of these
investigations were examined, and the Odd Ratio (OR) with 95% confidence
intervals (CIs) was computed. A total of 31 examinations from 2001 to 2023
were recruited for the current analysis including 181 503 personals with
coronary artery bypass grafting. Bilateral internal mammary artery had
significantly higher sternal wound infection (OR, 1.51; 95% CI, 1.37-1.68,
p < 0.001), superficial sternal wound infection (OR, 1.72; 95% CI,
1.16-2.56, p = 0.007), deep sternal wound infection (OR, 1.62; 95% CI,
1.41-1.86, p < 0.001), sternal wound infection in diabetics (OR, 1.48; 95%
CI, 1.16-1.90, p = 0.002), sternal wound infection in elderly (OR, 1.38;
95% CI, 1.22-1.57, p < 0.001), sternal wound infection in pedicled
preparation (OR, 1.70; 95% CI, 1.30-2.23, p < 0.001) and sternal wound
infection in skeletonized preparation (OR, 1.40; 95% CI, 1.09-1.81, p =
0.009) compared to single internal mammary artery in personals with
coronary artery bypass grafting. Bilateral internal mammary artery
grafting is linked to a higher risk of impaired wound healing,
particularly in diabetic individuals, elderly, pedicled preparation, and
skeletonized preparation. Nevertheless, caution should be exercised while
interacting with its values since examinations were performed by different
surgeons with different skills on different types of
personals.<br/>Copyright &#xa9; 2023 The Authors. International Wound
Journal published by Medicalhelplines.com Inc and John Wiley & Sons Ltd.

<27>
Accession Number
2029586037
Title
Optimal treatment of asymptomatic patients with severe aortic stenosis:
Protocol of a prospective, multicentre, registry study.
Source
BMJ Open. 13(12) (no pagination), 2023. Article Number: e078061. Date of
Publication: 18 Dec 2023.
Author
Xia C.; Li Y.-M.; Xiong W.; Ma L.; Xiong T.-Y.; Zhao Z.-G.; Peng Y.; Wei
J.; Feng Y.; Chen M.
Institution
(Xia, Li, Xiong, Zhao, Peng, Wei, Feng, Chen) Department of Cardiology,
West China Hospital, Sichuan University, Chengdu, China
(Xiong, Ma) Department of Medical Affairs, Venus Medtech (Hangzhou) Inc,
Hangzhou, China
Publisher
BMJ Publishing Group
Abstract
Introduction Decisions regarding the optimal timing of intervention for
asymptomatic aortic stenosis (AS) are controversial. The study aims to
identify potential risk factors for asymptomatic patients with severe AS
that are associated with worse prognosis and to evaluate the benefits of
early interventions for asymptomatic patients presenting with one or more
additional risk factors. Methods and analysis This is a
non-interventional, prospective, open-label, multicentre registry study
across China. A total of 1000 patients will be enrolled and categorised as
symptomatic or asymptomatic. The primary endpoint is the occurrence of
all-cause mortality, stroke, acute myocardial infarction and heart
failure-related hospitalisation at 1-year follow-up. In asymptomatic
severe AS patients presenting with one or more risk factors, the
occurrence rate of the primary endpoint between those who undergo
transcatheter aortic valve replacement (TAVR) and those who do not will be
compared. We will also compare the occurrence rate of the primary endpoint
for asymptomatic severe AS patients with additional risk factors who
undergo TAVR with those presenting with symptoms. This study is believed
to provide additional evidence to help clinicians identify and refer
severe AS patients who are asymptomatic but present with additional risk
factors for early intervention of TAVR. Ethics and dissemination The study
protocol has been approved by the local ethics committee of each
participating site: West China Hospital, Sichuan University; Sir Run Run
Shaw Hospital, Zhejiang University School of Medicine; Second Hospital of
Hebei Medical University; Tianjin Chest Hospital; and First Affiliated
Hospital of Nanchang University. All participants will provide written
informed consent. Study results will be published through academic
conferences and peer-reviewed journals. Trial registration This study was
registered at the Chinese Clinical Trial Registry (https://
www.chictr.org.cn), with the registration number
ChiCTR2200064853.<br/>Copyright &#xa9; Author(s) (or their employer(s))
2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights
and permissions. Published by BMJ.

<28>
Accession Number
2027877382
Title
Core outcome sets for myocardial infarction in clinical trials of
traditional Chinese medicine and Western medicine.
Source
Journal of Evidence-Based Medicine. (no pagination), 2024. Date of
Publication: 2024.
Author
Qiu R.; Wan S.; Zhong C.; Han S.; He T.; Huang Y.; Wei X.; Li M.; Guan Z.;
Zhang X.; Wu H.; Shang H.
Institution
(Qiu, Wan, Zhong, Han, He, Huang, Wei, Guan, Zhang, Shang) Key Laboratory
of Chinese Internal Medicine of Ministry of Education and Beijing, Beijing
University of Chinese Medicine Affiliated Dongzhimen Hospital, Beijing,
China
(Qiu) Department of Health Data Science, University of Liverpool,
Liverpool, United Kingdom
(Li, Wu) Department of Cardiology, Beijing University of Chinese Medicine
Affiliated Dongzhimen Hospital, Beijing, China
Publisher
John Wiley and Sons Inc
Abstract
Background: Clinical trials of traditional Chinese medicine (TCM) and
Western medicine showed there was heterogeneity of outcome reporting in
myocardial infarction (MI). Developing a core outcome set (COS) might
improve the consistency of outcome reporting in future clinical trials.
<br/>Method(s): A list of outcomes was developed based on a systematic
review of randomized controlled trials (RCTs) of MI and semistructured
interviews with MI patients. Two rounds of Delphi survey for clinicians,
researchers, journal editors, and methodologists were conducted. An online
questionnaire sent to nurses. After an online consensus meeting, a COS for
MI RCTs was developed. <br/>Result(s): After extracted data from clinical
trials and discussed, 216 outcomes were included in round 1 of the Delphi
survey. Seventy-four participants completed round 1 of the Delphi survey.
Sixty-five participants completed round 2 of the Delphi survey. Twenty-two
nurses completed the online questionnaire. Fifteen participants attended
the online consensus meeting, and 14 of them voted and determined the
final COS. For all types of MI, it was recommended that left ventricular
ejection fraction and quality of life be measured and reported. For acute
MI, the participants in the consensus meeting recommended the following
core outcomes: death from cardio-cerebrovascular disease, cardiogenic
shock, heart failure, troponin I, troponin T, creatine kinase isoenzyme,
Killip class, target vessel revascularization, and emergency CABG. For
previous MI, recurrent MI, recurrent angina pectoris, and heart failure
readmission were recommended. <br/>Conclusion(s): The COS for MI in RCTs
provides recommendations for clinical trials that seek to improve outcomes
for patients with MI.<br/>Copyright &#xa9; 2024 Chinese Cochrane Center,
West China Hospital of Sichuan University and John Wiley & Sons Australia,
Ltd.

<29>
Accession Number
2029659901
Title
Conduit Choice in Coronary Artery Bypass Grafting: Insights From an Expert
Systematic Review Endorsed by the European Association for Cardio-Thoracic
Surgery and the Society of Thoracic Surgeons.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2024.
Date of Publication: 2024.
Author
Patel K.M.; Desai R.G.; Krishnan S.
Institution
(Patel, Desai) Adult Cardiothoracic Anesthesiology, Cooper University
Healthcare, Cooper Medical School of Rowan University, Camden, NJ, United
States
(Krishnan) Adult Cardiothoracic Anesthesiology, Wayne State University
School of Medicine, St. Joseph Mercy Oakland Medical Office Building,
Pontiac, MI, United States
Publisher
W.B. Saunders

<30>
Accession Number
2028352177
Title
Bioprosthetic leaflet thrombosis and reduced leaflet motion after
transcatheter aortic valve replacement: A systematic review and
meta-analysis.
Source
Archives of Cardiovascular Diseases. 116(12) (pp 563-571), 2023. Date of
Publication: December 2023.
Author
Roule V.; Guedeney P.; Silvain J.; Beygui F.; Zeitouni M.; Sorrentino S.;
Kerneis M.; Barthelemy O.; Beaupre F.; Portal J.-J.; Vicaut E.;
Montalescot G.; Collet J.-P.
Institution
(Roule, Guedeney, Silvain, Zeitouni, Kerneis, Barthelemy, Beaupre,
Montalescot, Collet) ACTION Study Group, Sorbonne Universite, UMRS 1166,
Institut de Cardiologie, Pitie-Salpetriere Hospital (AP-HP), Paris 75013,
France
(Roule, Beygui) Service de Cardiologie, CHU de Caen Normandie, Normandie
Universite, Caen 14000, France
(Sorrentino) Division of Cardiology, Department of Medical and Surgical
Science, Magna Graecia University, Catanzaro 88100, Italy
(Portal, Vicaut) ACTION Study Group, Unite de Recherche Clinique,
Lariboisiere Hospital, AP-HP, Paris 75010, France
Publisher
Elsevier Masson s.r.l.
Abstract
Background: Leaflet thrombosis and reduced leaflet motion have become a
concern with the expanding use of transcatheter aortic valve replacement
in lower-risk patients. <br/>Aim(s): To assess the proportions, predictors
and clinical impact of leaflet thrombosis and reduced leaflet motion after
transcatheter aortic valve replacement. <br/>Method(s): We performed a
meta-analysis of studies assessing the proportions of and/or clinical
outcomes according to the presence of leaflet thrombosis after
transcatheter aortic valve replacement identified with computed tomography
and/or echocardiography. <br/>Result(s): Fifty-three studies, representing
25,258 patients undergoing transcatheter aortic valve replacement, were
considered. The proportion of leaflet thrombosis was 5.2% overall, and was
higher in computed tomography versus echocardiography (16.4% vs. 1.1%,
respectively); reduced leaflet motion was identified in 11% of patients
with four-dimensional computed tomography. Intra-annular bioprostheses
were associated with a higher proportion of leaflet thrombosis, whereas
chronic oral anticoagulation was protective for leaflet thrombosis in both
computed tomography and echocardiographic studies (9.7% vs. 17.5%;
relative risk [RR]: 0.51, 95% confidence interval [95% CI]: 0.37-0.71 and
0.9% vs. 2.7%; RR: 0.22, 95% CI: 0.06-0.79, respectively) and for reduced
leaflet motion (2.5% vs. 12.4%; RR: 0.32, 95% CI: 0.13-0.76). Leaflet
thrombosis was not associated with an increased risk of death, but with a
higher risk of stroke in computed tomography studies (2.8% vs. 2.4%; RR:
1.63, 95% CI: 1.05-2.55), a difference more pronounced when considering
reduced leaflet motion (3.5% vs. 1.7%; RR: 2.39, 95% CI: 0.63-8.34).
<br/>Conclusion(s): The proportion of leaflet thrombosis is highly
variable according to the screening approach, the type of valve and the
use of oral anticoagulation. The occurrence of cerebral events is
increased when leaflet thrombosis and/or reduced leaflet motion are
diagnosed, but leaflet thrombosis has no impact on survival.<br/>Copyright
&#xa9; 2023 Elsevier Masson SAS

<31>
Accession Number
642596093
Title
Surgical management of atrial fibrillation in patients undergoing cardiac
surgery: a systematic review of clinical practice guidelines and
recommendations.
Source
European heart journal. Quality of care & clinical outcomes. 10(1) (pp
14-24), 2024. Date of Publication: 12 Jan 2024.
Author
Kumar N.S.; Khanji M.Y.; Patel K.P.; Ricci F.; Providencia R.; Chahal A.;
Sohaib A.; Awad W.I.
Institution
(Kumar, Khanji, Patel, Awad) Barts Heart Centre, St. Bartholomew's
Hospital, London, United Kingdom
(Kumar) National Medical Research Association, London, United Kingdom
(Khanji) Newham University Hospital, Barts Health NHS Trust, London,
United Kingdom
(Khanji) NIHR Barts Biomedical Research Centre, William Harvey Research
Institute, Queen Mary University of London, London, United Kingdom
(Patel) Institute of Cardiovascular Sciences, University College London,
United Kingdom
(Ricci) Department of Neuroscience, Imaging and Clinical Sciences,
G.d'Annunzio University of Chieti-Pescara, Chieti, Italy
(Providencia) Department of Cardiac Electrophysiology, Barts Heart Centre,
Barts Health NHS Trust, St. Bartholomew's Hospital, London, United Kingdom
(Chahal) Division of Cardiology, Hospital of the University of
Pennsylvania, Philadelphia, PA, United States
(Sohaib) NHLI, Imperial College London, London, United Kingdom
(Awad) Centre for Cardiovascular Medicine and Devices, William Harvey
Research Institute, Queen Mary University of London, London, United
Kingdom
(Awad) University of South Wales, Cardiff, United Kingdom
Abstract
AIMS: Surgical ablation of atrial fibrillation (AF) has been demonstrated
to be a safe procedure conducted concomitantly alongside cardiac surgery.
However, there are conflicting guideline recommendations surrounding
indications for surgical ablation. We conducted a systematic review of
current recommendations on concomitant surgical AF ablation. METHODS AND
RESULTS: We identified publications from MEDLINE and EMBASE between
January 2011 and December 2022 and additionally searched Guideline
libraries and websites of relevant organizations in accordance with
Preferred Reporting Items for Systematic Reviews and Meta-Analyses
guidelines. Of 895 studies screened, 4 were rigorously developed (AGREE-II
> 50%) and included. All guidelines agreed on the definitions of
paroxysmal, persistent, and longstanding AF based on duration and
refraction to current treatment modalities. In the Australia-New Zealand
(CSANZ) and European (EACTS) guidelines, opportunistic screening for
patients >65 years is recommended. The EACTS recommends systematic
screening for those aged >75 or at high stroke risk (Class IIa, Level B).
However, this was not recommended by American Heart Association or Society
of Thoracic Surgeons guidelines. All guidelines identified surgical AF
ablation during concomitant cardiac surgery as safe and recommended for
consideration by a Heart Team with notable variation in recommendation
strength and the specific indication (three guidelines fail to specify any
indication for surgery). Only the STS recommended left atrial appendage
occlusion (LAAO) alongside surgical ablation (Class IIa, Level C).
<br/>CONCLUSION(S): Disagreements exist in recommendations for specific
indications for concomitant AF ablation and LAAO, with the decision
subject to Heart Team assessment. Further evidence is needed to develop
recommendations for specific indications for concomitant AF procedures and
guidelines need to be made congruent.<br/>Copyright &#xa9; The Author(s)
2023. Published by Oxford University Press on behalf of the European
Society of Cardiology.

<32>
Accession Number
641212231
Title
Benefits of Using Smartphones and Other Digital Methods in Achieving
Better Cardiac Rehabilitation Goals: A Systematic Review and
Meta-Analysis.
Source
Medical science monitor : international medical journal of experimental
and clinical research. 29 (pp e939132), 2023. Date of Publication: 05 May
2023.
Author
Popovici M.; Ursoniu S.; Feier H.; Mocan M.; Tomulescu O.M.G.; Kundnani
N.R.; Valcovici M.; Dragan S.R.
Institution
(Popovici, Feier, Tomulescu, Kundnani, Valcovici, Dragan) Department VI
Cardiology, "Victor Babes" University of Medicine and Pharmacy, Timisoara,
Romania
(Ursoniu) Department of Functional Sciences, Discipline of Public Health,
"Victor Babes" University of Medicine and Pharmacy, Timisoara, Romania
(Ursoniu) Center for Translational Research and Systems Medicine, "Victor
Babes" University of Medicine and Pharmacy, Timisoara, Romania
(Feier, Kundnani, Valcovici, Dragan) Department of Cardiology, Institute
of Cardiovascular Diseases, Timisoara, Romania
(Mocan) Department of Internal Medicine, Iuliu Hatieganu University of
Medicine and Pharmacy, Cluj-Napoca, Romania
Publisher
NLM (Medline)
Abstract
BACKGROUND The importance of introducing digital technology as an
alternative to classical cardiac rehabilitation has been discussed in
several reviews. The purpose of this systematic review and meta-analysis
was to analyze the effectiveness of digital technology use in cardiac
rehabilitation to determine whether digital methods like use of
smartphones, compared to traditional rehabilitation methods, can improve
the overall quality of life and exercise capacity of cardiac patients.
MATERIAL AND METHODS PubMed, EMBASE, and ScienceDirect were systematically
searched in a randomized manner, resulting in 11 randomized controlled
trials (RCTs) that met all the inclusion criteria. The inclusion criteria
were patients with coronary heart disease, valvular surgery, or post-
myocardial revascularization that were in a technology-assisted cardiac
rehabilitation program vs traditional standard physical follow-up
protocol. RESULTS Seven eligible trials including a total of 802
participants examined the effect of interventions on VO2 peak. One of the
studies comprised 2-stage analysis for this parameter. We found that VO2
peak was significantly higher in the intervention group. Three studies
analyzed the 6-minute walk test (6MWT) results; significant differences
were reported, with better results in the interventional group.
CONCLUSIONS The results of our meta-analysis support conducting further
randomized trials, considering that the development of technology is on
the rise. In the past decade there has been an immense increase in the use
of smartphones, which can widely be used in healthcare, with promising
benefits in having efficient home-based monitoring of the patients and in
reducing financial burden.

<33>
Accession Number
2025620507
Title
The percutaneous management of pulmonary metastases.
Source
Journal of Medical Imaging and Radiation Oncology. 67(8) (pp 870-875),
2023. Date of Publication: December 2023.
Author
de Baere T.; Bonnet B.; Tselikas L.; Deschamps F.
Institution
(de Baere, Bonnet, Tselikas, Deschamps) Department of Interventional
Radiology, Gustave Roussy, Villejuif, France
(de Baere, Tselikas) University of Paris-Saclay, UFR Medecine Le
Kremlin-Bicetre, Le Kremlin-Bicetre, France
(de Baere, Tselikas) Centre d'Investigation Clinique BIOTHERIS, INSERM
CIC1428, Villejuif, France
Publisher
John Wiley and Sons Inc
Abstract
Local treatment of lung metastases has been in the front scene since late
90s when an international registry of thoracic surgery reported a median
overall survival of 35 months in resected patients versus 15 months in
non-resected patients. Today, other local therapies are available for
patients with oligometastatic lung disease, including image guided thermal
ablation, such as ablation, microwave ablation, and cryoablation.
Image-guided ablation is increasingly offered, and now recommended in
guidelines as option to surgery. Today, the size of the target tumour
remains the main driver of success and selection of patients with limited
tumour size allowing for local tumour control in the range of 90% in most
recent and larger series targeting lung metastases up to 3.5 cm. Overall
survival exceeding five-years in large series of thermal ablation for lung
metastases from colorectal origin are align with outcome of same patients
treated with surgical resection. Moreover, thermal ablation in such
population allows for one-year chemotherapy holidays in all comers and
over 18 months in lung only metastatic patients, allowing for improved
patient quality of life and preserving further lines of systemic treatment
when needed. Tolerance of thermal ablation is excellent and better than
surgery with no lost in respiratory function, allowing for repeated
treatment when needed. In the future, it is likely that practice of lung
surgery for small oligometastatic lung disease will decrease, and that
minimally invasive techniques will replace surgery in such indications.
Randomized study will be difficult to obtain as demonstrated by
discontinuation of many studies testing the hypothesis of surgery versus
observation, or surgery versus SBRT.<br/>Copyright &#xa9; 2023 Royal
Australian and New Zealand College of Radiologists.

<34>
Accession Number
632956813
Title
A Randomized Controlled Trial of Prasugrel for Prevention of Early
Saphenous Vein Graft Thrombosis.
Source
The Journal of invasive cardiology. 32(12) (pp E305-E312), 2020. Date of
Publication: 01 Dec 2020.
Author
Danek B.A.; Karatasakis A.; Abdullah K.; Iwnetu R.; Kalsaria P.; Shunk K.;
Zimmet J.; Vidovich M.; Bavry A.A.; Rangan B.V.; Roesle M.; Griza D.;
Stanley K.; Banerjee S.; Khalili H.; Brilakis E.S.; Abdullah S.M.
Institution
(Abdullah) Shuaib Abdullah, MD, Veterans Affairs North Texas Health Care
System, 4500 South Lancaster, 111A, Dallas, TX 75216 USA
Publisher
NLM (Medline)
Abstract
OBJECTIVES: To test whether administration of prasugrel after coronary
artery bypass grafting (CABG) reduces saphenous vein graft (SVG)
thrombosis. Use of aspirin after CABG improves graft patency, but
administration of other antiplatelet agents has yielded equivocal results.
<br/>METHOD(S): We performed a double-blind trial randomizing patients to
prasugrel or placebo after CABG at four United States centers. Almost all
patients were receiving aspirin. Follow-up angiography, optical coherence
tomography (OCT), intravascular ultrasound (IVUS), and near-infrared
spectroscopy (NIRS) were performed at 12 months. The primary efficacy
endpoint was prevalence of OCT-detected SVG thrombus. The primary safety
endpoint was incidence of Global Utilization of Streptokinase and t-PA for
Occluded Coronary Arteries (GUSTO) severe bleeding. <br/>RESULT(S): The
study was stopped early due to slow enrollment after randomizing 84
patients. Mean age was 64 +/- 6 years; 98% of the patients were men.
Follow-up angiography was performed in 59 patients. IVUS was performed in
52 patients, OCT in 53 patients, and NIRS in 33 patients. Thrombus was
identified by OCT in 56% vs 50% of patients in the prasugrel vs placebo
groups, respectively (P=.78). Angiographic SVG failure occurred in 24% of
patients in the prasugrel arm vs 40% in the placebo arm (P=.19). The
1-year incidence of major adverse cardiovascular events was 14.3% vs 2.4%
in the prasugrel and placebo groups, respectively (P=.20), without
significant differences in GUSTO severe bleeding (P=.32).
<br/>CONCLUSION(S): Early SVG failure occurred in approximately one-third
of patients. Prasugrel did not decrease prevalence of SVG thrombus 12
months after CABG.

<35>
Accession Number
631972714
Title
Cochrane corner: transcatheter aortic valve implantation versus surgical
aortic valve replacement for severe aortic stenosis in people with low
surgical risk.
Source
Heart (British Cardiac Society). 106(14) (pp 1043-1045), 2020. Date of
Publication: 01 Jul 2020.
Author
Kolkailah A.A.; Doukky R.; Pelletier M.P.; Volgman A.S.; Kaneko T.; Nabhan
A.F.
Institution
(Kolkailah, Doukky) Department of Medicine, Cook County Health, Chicago,
IL, United States
(Pelletier) Division of Cardiac Surgery, Case Western Reserve University,
University Hospitals, Cleveland, OH, United States
(Volgman) Division of Cardiology, Rush University Medical Center, Chicago,
IL, United States
(Kaneko) Division of Cardiac Surgery, Brigham and Women's Hospital,
Harvard Medical School, Boston, MA, United States
(Nabhan) Department of Obstetrics and Gynaecology, Faculty of Medicine,
Ain Shams University, Cairo, Egypt
Publisher
NLM (Medline)

<36>
Accession Number
643218471
Title
Efficacy of electroacupuncture on myocardial protection and postoperative
rehabilitation in patients undergoing cardiac surgery with cardiopulmonary
bypass: a systematic review and Meta-analysis.
Source
Journal of traditional Chinese medicine = Chung i tsa chih ying wen pan.
44(1) (pp 1-15), 2024. Date of Publication: 01 Feb 2024.
Author
Xiaoyu Q.; Chunai W.; Jianjun X.; Jie Z.; Xiaoting L.U.; Shengshuang D.;
Long G.E.; Minzhen W.
Institution
(Xiaoyu, Jie, Xiaoting, Shengshuang) First Clinical Medical College, Gansu
University of Chinese Medicine, Lanzhou 730030, China
(Chunai, Jianjun, Jie) Department of Anesthesiology, Gansu Provincial
Hospital of Traditional Chinese Medicine, Lanzhou 730050, China
(Long) Evidence-based Medicine Center, Lanzhou University, Lanzhou 730030,
China
(Minzhen) Institute of Epidemiology and Statistics, School of Public
Health, Lanzhou University, Lanzhou 730030, China
Abstract
OBJECTIVE: To evaluate the efficacy of electroacupuncture (EA)
intervention on myocardial protection and postoperative rehabilitation in
patients undergoing cardiac surgery with cardiopulmonary bypass (CPB).
<br/>METHOD(S): Eight databases, including PubMed, Embase, the Cochrane
Library, Web of Science, Chinese BioMedical Literature Database, China
National Knowledge Infrastructure Database, Wanfang Data, China Science
and Technology Journal Database, and two clinical trial registries, were
searched. All randomized controlled trials (RCTs) related to EA
intervention in cardiac surgery with CPB were collected. Based on the
inclusion and exclusion criteria, two researchers independently screened
articles and extracted data. After the quality evaluation, RevMan 5.3
software was used for analysis. <br/>RESULT(S): Fourteen RCTs involving
836 patients were included. Compared with the control treatment, EA
significantly increased the incidence of cardiac automatic rebeat after
aortic unclamping [relative risk (RR) = 1.15, 95% confidence interval (CI)
(1.01, 1.31), P < 0.05; moderate]. Twenty-four hours after aortic
unclamping, EA significantly increased the superoxide dismutase
[standardized mean difference (SMD) = 0.96, 95% CI(0.32, 1.61), P < 0.05;
low], and interleukin (IL)-2 [SMD = 1.33, 95% CI(0.19, 2.47), P < 0.05;
very low] expression levels and decreased the malondialdehyde [SMD =-1.62,
95% CI(-2.15, -1.09), P < 0.05; moderate], tumour necrosis factor-alpha
[SMD = -1.28, 95% CI(-2.37, -0.19), P < 0.05; moderate], and cardiac
troponin I [SMD = -1.09, 95% CI(-1.85, -0.32), P < 0.05; low] expression
levels as well as the inotrope scores [SMD = -0.77, 95% CI(-1.22, -0.31),
P < 0.05; high]. There was no difference in IL-6 and IL-10 expression
levels. The amount of intraoperative sedative [SMD = -0.31, 95% CI(-0.54,
-0.09), P < 0.05; moderate] and opioid analgesic [SMD = -0.96, 95%
CI(-1.53, -0.38), P < 0.05; low] medication was significantly lower in the
EA group than in the control group. Moreover, the postoperative tracheal
intubation time [SMD = -0.92, 95% CI(-1.40, -0.45), P < 0.05; low] and
intensive care unit stay [SMD = -1.71, 95% CI(-3.06, -0.36), P < 0.05;
low] were significantly shorter in the EA group than in the control group.
There were no differences in the time to get out of bed for the first
time, total days of antibiotic use after surgery, or postoperative
hospital stay. No adverse reactions related to EA were reported in any of
the included studies. <br/>CONCLUSION(S): In cardiac surgery with CPB, EA
may be a safe and effective strategy to reduce myocardial
ischaemia-reperfusion injury and speed up the recovery of patients after
surgery. These findings must be interpreted with caution, as most of the
evidence was of low or moderate quality. More RCTs with larger sample
sizes and higher quality are needed to provide more convincing evidence.

<37>
Accession Number
2027876486
Title
The effect of histidine-tryptophan-ketoglutarate cardioplegia alone or
combined with preoperative infusion of levosimendan on vasoactive
inotropic score in patients with poor cardiac function undergoing coronary
artery bypass grafting.
Source
Egyptian Journal of Anaesthesia. 40(1) (pp 89-95), 2024. Date of
Publication: 2024.
Author
Elkotb Ghoniem M.F.; Ali N.M.; Kamal M.M.; Abdelaziz F.K.E.; Haiba D.M.
Institution
(Elkotb Ghoniem, Ali, Kamal, Abdelaziz, Haiba) Department of
Anesthesiology, Intensive care and Pain Management, Faculty of Medicine,
Ain-Shams University, Cairo, Egypt
Publisher
Taylor and Francis Ltd.
Abstract
Background: Patients with poor left ventricular function undergoing
cardiac surgery frequently require inotropic drug support immediately
after cardiopulmonary bypass. Levosimendan is an effective agent that acts
via two complementary mechanisms. It enhances cardiac contractility and
reduces cardiac workload. <br/>Aim(s): to assess the effect of
histidine-tryptophan-ketoglutarate cardioplegia (HTK cardioplegia) alone
or combined with preoperative infusion of levosimendan on the vasoactive
inotropic score in patients with poor left ventricular function undergoing
coronary artery bypass grafting. <br/>Material(s) and Method(s): this
double-blinded randomized controlled trial was carried on 100 patients,
divided into two groups; Levosimendan group (n = 49): patients received
0.1ug/kg/min levosimendan without loading, 12 hours preoperatively and
continued for a total of 24 hours. Control group (n = 51): patients
received a placebo 12 hours before surgery and continued for a total 24
hours. Both groups received HTK cardioplegia after cross-clamping of the
aorta approximately 20 ml/kg into the ascending aorta over 6-8 minutes at
a temperature of 4-10degreeC. <br/>Result(s): Levosimendan group was
superior to control group with statistical significance regarding the need
of intraaortic balloon pump (IABP), vasoactive inotropic score over the
first 24 hours, troponin levels over the first 72 hours, ICU stays,
hospital stay, and cumulative hospital costs. Although the incidence of
postoperative low Cardiac output syndrome (LCOS), atrial fibrillation
(AF), acute kidney injury (AKI), and overall mortality was lower in
levosimendan group, but all were not statistically significant.
<br/>Conclusion(s): Preoperative infusion of levosimendan combined with
HTK cardioplegia in patients with poor cardiac function decreased
vasoactive inotropic score and lowered the costs of hospital
stay.<br/>Copyright &#xa9; 2024 The Author(s). Published by Informa UK
Limited, trading as Taylor & Francis Group.

<38>
Accession Number
2029692223
Title
Health-related quality of life following TAVI or cardiac surgery in
patients at intermediate and low risk: a systematic review and
meta-analysis.
Source
Clinical Medicine, Journal of the Royal College of Physicians of London.
23(6) (pp 594-605), 2023. Date of Publication: November 2023.
Author
Gonnah A.R.; Abdelwahab M.; Taylor R.; Labib A.; Masoud O.; Debski M.;
Abdelaziz H.K.; Roberts D.H.
Institution
(Gonnah) Imperial College Healthcare NHS Trust, London, United Kingdom
(Abdelwahab) Boston University, Boston, MA, United States
(Taylor) Blackpool Teaching Hospitals NHS Foundation Trust, Blackpool,
United Kingdom
(Labib) Southport and Ormskirk NHS Foundation Trust, Southport, United
Kingdom
(Masoud) University College London Hospitals NHS Foundation Trust, London,
United Kingdom
(Debski) University of East Anglia, Norwich, United Kingdom
(Debski) Norfolk and Norwich University Hospital, Norwich, United Kingdom
(Abdelaziz, Roberts) Lancashire Cardiac Centre, Blackpool, United Kingdom
(Roberts) University of Liverpool, Merseyside, Liverpool, United Kingdom
Publisher
Royal College of Physicians
Abstract
Recent randomised trials have shown that clinical outcomes with
transcatheter aortic valve implantation (TAVI) are non-inferior to
surgical aortic valve replacement (SAVR) in patients with symptomatic
aortic stenosis at intermediate to low risk. Health-related quality of
life (HrQoL) outcomes in these patient groups remain uncertain. A
systematic search of the literature was conducted that included nine
trials and 11,295 patients. Kansas City Cardiomyopathy Questionnaire
(KCCQ), a heart-failure-specific measure and EuroQol-5D (EQ-5D) (a generic
health status tool) changes were the primary outcomes. New York Heart
Association (NYHA) classification was the secondary outcome. Improvement
in KCCQ scores was greater with TAVI (mean difference (MD)=13.56, 95%
confidence interval (CI) 11.67-15.46, p<0.001) at 1 month, as was the
improvement in EQ-5D (MD=0.07, 95% CI 0.05-0.08, p<0.001). There was no
difference in KCCQ (MD=1.05, 95% CI -0.11 to 2.21, p=0.08) or EQ-5D
(MD=-0.01, 95% CI -0.03 to 0.01), p=0.37) at 12 months. NYHA functional
class 3/4 was lower in patients undergoing TAVI at 1 month (MD=0.51, 95%
CI 0.34-0.78, p=0.002), but there was no difference at 12 months (MD=1.10;
95% CI 0.87-1.38, p=0.43). Overall, TAVI offers early benefit in HRQoL
outcomes compared with SAVR, but they are equivalent at 12
months.<br/>Copyright &#xa9; Royal College of Physicians 2023. All rights
reserved.

<39>
Accession Number
643226936
Title
A double-blind, randomised, placebo-controlled trial of the coronary sinus
Reducer in refractory angina: design and rationale of the ORBITA-COSMIC
trial.
Source
EuroIntervention : journal of EuroPCR in collaboration with the Working
Group on Interventional Cardiology of the European Society of Cardiology.
(no pagination), 2024. Date of Publication: 10 Jan 2024.
Author
Foley M.J.; Rajkumar C.A.; Ahmed-Jushuf F.; Simader F.; Pathimagaraj R.H.;
Nijjer S.; Sen S.; Petraco R.; Clesham G.; Johnson T.; Harrell F.E.;
Kellman P.; Francis D.; Shun-Shin M.; Howard J.; Cole G.D.; Al-Lamee R.
Institution
(Foley, Rajkumar, Ahmed-Jushuf, Simader, Pathimagaraj, Nijjer, Sen,
Petraco, Francis, Shun-Shin, Howard, Cole, Al-Lamee) National Heart and
Lung Institute, Imperial College London, London, United Kingdom
(Foley, Rajkumar, Pathimagaraj, Nijjer, Sen, Petraco, Francis, Shun-Shin,
Howard, Cole, Al-Lamee) Imperial College Healthcare NHS Trust, London,
United Kingdom
(Clesham) Essex Cardiothoracic Centre, Basildon, United Kingdom
(Johnson) Bristol Heart Institute, University Hospitals Bristol NHS
Foundation Trust, Bristol, United Kingdom
(Harrell) Vanderbilt University School of Medicine, Nashville, TN, United
States
(Kellman) National Heart, Lung, Blood Institute, National Institutes of
Health, Department of Health and Human Services, Bethesda, MD, United
States
Abstract
The coronary sinus Reducer (CSR) is an hourglass-shaped device which
creates an artificial stenosis in the coronary sinus. Whilst
placebo-controlled data show an improvement in angina, these results are
unreplicated and are the subject of further confirmatory research. The
mechanism of action of this unintuitive therapy is unknown. The Coronary
Sinus Reducer Objective Impact on Symptoms, MRI Ischaemia, and
Microvascular Resistance (ORBITA-COSMIC) trial is a randomised,
placebo-controlled, double-blind trial investigating the efficacy of the
CSR. Patients with (i) established epicardial coronary artery disease,
(ii) angina on maximally tolerated antianginal medication, (iii) evidence
of myocardial ischaemia and (iv) no further options for percutaneous
coronary intervention or coronary artery bypass grafting will be enrolled.
Upon enrolment, angina and quality-of-life questionnaires, treadmill
exercise testing and quantitative stress perfusion cardiac magnetic
resonance (CMR) imaging will be performed. Participants will record their
symptoms daily on a smartphone application throughout the trial. After a
2-week symptom assessment phase, participants will be randomised in the
cardiac catheterisation laboratory to CSR or a placebo procedure. After 6
months of blinded follow-up, all prerandomisation tests will be repeated.
A prespecified subgroup will undergo invasive coronary physiology
assessment at prerandomisation and follow-up. The primary outcome is
stress myocardial blood flow on CMR. Secondary outcomes include angina
frequency, quality of life and treadmill exercise time.
(ClinicalTrials.gov: NCT04892537).

<40>
Accession Number
643225386
Title
Development and validation of a nomogram for predicting intraoperative
hypotension in cardiac valve replacement.
Source
Biomarkers in medicine. (no pagination), 2024. Date of Publication: 12
Jan 2024.
Author
Wang L.; Xiao L.; Hu L.; Chen X.; Wang X.
Institution
(Wang, Xiao, Hu, Chen, Wang) Department of Thoracic & Cardiovascular
Surgery, Nanjing First Hospital, Nanjing Medical University, Nanjing,
China
Abstract
Background: Cardiac valve replacement risks include intraoperative
hypotension, endangering organ perfusion. Our nomogram predicted
hypotension risk in valve surgery, guiding early intervention.
<br/>Method(s): Analyzing 561 patients from July to November 2022, we
developed a nomogram to predict hypotension in valve replacement patients,
validated using data from December 2022 to January 2023 on 241 patients,
with robust statistical confirmation. <br/>Result(s): Our study identified
age, hypertension, left ventricular ejection fraction and serum creatinine
as hypotension predictors. The resulting nomogram, validated with high
concordance index and area under the curve scores, provided a clinically
useful tool for managing intraoperative risk. <br/>Conclusion(s): For
valve replacement patients, factors like age, hypertension, low left
ventricular ejection fraction and high serum creatinine predicted
hypotension risk. Our nomogram enabled clinicians to quantify this risk
and proactively manage it.

<41>
Accession Number
2029353960
Title
Deep Parasternal Intercostal Plane Block for Intraoperative Pain Control
in Cardiac Surgical Patients for Sternotomy: A Prospective Randomized
Controlled Trial.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2023.
Date of Publication: 2023.
Author
Wong H.M.K.; Chen P.Y.; Tang G.C.C.; Chiu S.L.C.; Mok L.Y.H.; Au S.S.W.;
Wong R.H.L.
Institution
(Wong, Chen, Tang, Mok, Au) Department of Anesthesia and Intensive Care,
Prince of Wales Hospital, New Territories, Hong Kong
(Chiu) Department of Anesthesia and Intensive Care, the Chinese University
of Hong Kong, Hong Kong
(Wong) Division of Cardiothoracic Surgery, Department of Surgery, Prince
of Wales Hospital, New Territories, Hong Kong
Publisher
W.B. Saunders
Abstract
Objectives: Sternotomy pain is common after cardiac surgery. The deep
parasternal intercostal plane (DPIP) block is a novel technique that
provides analgesia to the anterior chest wall. The aim of this study was
to investigate the analgesic effect of bilateral DPIP blocks on
intraoperative pain control in cardiac surgery. <br/>Design(s): This is a
double-blinded, prospective randomized controlled trial (Oct 2020-Dec
2022). <br/>Setting(s): This study was conducted in a single institution,
which is an academic university hospital. <br/>Participant(s): Eighty-six
elective cardiac surgical patients with median sternotomy were recruited.
<br/>Intervention(s): Patients were randomly divided into DPIP or control
group. Either 20ml 0.25% levobupivacaine or 0.9% normal saline was
injected for the DPIP under ultrasound guidance after induction of general
anaesthesia. <br/>Measurements and Main Results: The primary outcome was
intraoperative opioids consumption and hemodynamic changes at sternotomy.
Secondary outcomes included postoperative morphine consumption,
postoperative pain and time to tracheal extubation. Intraoperative opioids
requirement was reduced from a median (IQR) intravenous morphine
equivalence of 21.4mg (13.8-24.3mg) in control group to 9.5mg (7.3-11.2mg)
in the DPIP group (P<0.001). Hemodynamic parameters were more stable in
DPIP group at sternotomy, as evidenced by lower percentage increase in
systolic, diastolic and mean arterial blood pressure from baseline. No
difference was observed in time to tracheal extubation, postoperative
morphine consumption, postoperative pain score and spirometry.
<br/>Conclusion(s): Bilateral DPIP block provides effective intraoperative
analgesia and opioid-sparing. It may be included as part of the multimodal
analgesia for enhanced recovery in cardiac surgery.<br/>Copyright &#xa9;
2023 The Author(s)

<42>
Accession Number
2026377784
Title
Double-Outlet Left Ventricle: Case Series and Systematic Review of the
Literature.
Source
Diagnostics. 13(20) (no pagination), 2023. Article Number: 3175. Date of
Publication: October 2023.
Author
Lioncino M.; Calcagni G.; Badolato F.; Antonelli G.; Leonardi B.; de Zorzi
A.; Secinaro A.; Brancaccio G.; Albanese S.; Carotti A.; Drago F.; Rinelli
G.
Institution
(Lioncino, Calcagni, Badolato, Antonelli, Leonardi, de Zorzi, Drago,
Rinelli) Pediatric Cardiology and Cardiac Arrhythmias and Syncope Unit,
Bambino Gesu Children's Hospital, IRCSS, Rome 00146, Italy
(Secinaro) Advanced Cardiothoracic Imaging Unit, Bambino Gesu Children's
Hospital, IRCSS, Rome 00165, Italy
(Brancaccio, Albanese, Carotti) Cardiac Surgery Unit, Department of
Pediatric Cardiology and Cardiac Surgery, Bambino Gesu Children's
Hospital, IRCCS, Rome 00165, Italy
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Double-outlet left ventricle (DOLV) is an abnormal ventriculo-arterial
connection characterized by the origin of both great arteries from the
morphological left ventricle. The aim of our paper is to describe the
morphological and imaging features of DOLV and to assess the prevalence of
the associated malformations and their surgical outcomes. METHODS From
2011 to 2022, we retrospectively reviewed the electronic case records of
patients diagnosed with DOLV at the Bambino Gesu Children's Hospital. A
systematic search was developed in MEDLINE, Web of Science, and EMBASE
databases to identify reports assessing the morphology and outcomes of
DOLV between 1975 and 2023. <br/>RESULT(S): Over a median follow-up of 9.9
years (IQR 7.8-11.7 y), four cases of DOLV were identified at our
institution. Two patients were diagnosed with (S,D,D) DOLV subaortic VSD
and pulmonary stenosis (PS): one patient had (S,D,D) DOLV with doubly
committed VSD and hypoplastic right ventricle, and another patient had
(S,D,L) DOLV with subaortic VSD and PS (malposition type). Pulmonary
stenosis was the most commonly associated lesion (75%). LITERATURE REVIEW:
After systematic evaluation, a total of 12 reports fulfilled the
eligibility criteria and were included in our analysis. PS or right
ventricular outflow tract obstruction was the most commonly associated
lesion (69%, 95% CI 62-76%). The most common locations of VSD were
subaortic (pooled prevalence: 75%, 95% CI 68-81), subpulmonary (15%, 95%
CI 10-21), and doubly committed (7%, 95% CI 4-12). The position of the
great arteries showed that d-transposition of the aorta was present in 128
cases (59% 95% CI 42-74), and l-transposition was present in 77 cases
(35%, 95% CI 29-43).<br/>Copyright &#xa9; 2023 by the authors.

<43>
Accession Number
2022580270
Title
Combined CT Coronary Artery Assessment and TAVI Planning.
Source
Diagnostics. 13(7) (no pagination), 2023. Article Number: 1327. Date of
Publication: April 2023.
Author
Renker M.; Schoepf U.J.; Kim W.K.
Institution
(Renker, Kim) Department of Cardiology, Campus Kerckhoff of the Justus
Liebig University Giessen, Bad Nauheim 61231, Germany
(Renker, Kim) Department of Cardiac Surgery, Campus Kerckhoff of the
Justus Liebig University Giessen, Bad Nauheim 61231, Germany
(Renker, Kim) German Centre for Cardiovascular Research (DZHK), Partner
Site Rhine-Main, Bad Nauheim 61231, Germany
(Schoepf) Heart & Vascular Center, Medical University of South Carolina,
Charleston, SC 29425, United States
(Kim) Department of Cardiology, Justus Liebig University Giessen, Giessen
35392, Germany
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Computed tomography angiography (CTA) of the aorta and the iliofemoral
arteries is crucial for preprocedural planning of transcatheter aortic
valve implantation (TAVI) in patients with severe aortic stenosis (AS),
because it provides details on a variety of aspects required for heart
team decision-making. In addition to providing relevant diagnostic
information on the degree of aortic valve calcification, CTA allows for a
customized choice of the transcatheter heart valve system and the TAVI
access route. Furthermore, current guidelines recommend the exclusion of
relevant coronary artery disease (CAD) prior to TAVI. The feasibility of
coronary artery assessment with CTA in patients scheduled for TAVI has
been established previously, and accumulating data support its value. In
addition, fractional flow reserve determined from CTA (CT-FFR) and machine
learning-based CT-FFR were recently shown to improve its diagnostic yield
for this purpose. However, the utilization of CTA for coronary artery
evaluation remains limited in this specific population of patients due to
the relatively high risk of CAD coexistence with severe AS. Therefore, the
current diagnostic work-up prior to TAVI routinely includes invasive
catheter coronary angiography at most centers. In this article, the
authors address technological prerequisites and CT protocol
considerations, discuss pitfalls, review the current literature regarding
combined CTA coronary artery assessment and preprocedural TAVI evaluation,
and provide an overview of unanswered questions and future research goals
within the field.<br/>Copyright &#xa9; 2023 by the authors.

<44>
Accession Number
2015702271
Title
The Prognostic Performance of Ferritin in Patients with Acute Myocardial
Infarction: A Systematic Review.
Source
Diagnostics. 12(2) (no pagination), 2022. Article Number: 476. Date of
Publication: February 2022.
Author
Brinza C.; Floria M.; Popa I.V.; Burlacu A.
Institution
(Brinza, Floria, Popa, Burlacu) Faculty of Medicine, University of
Medicine and Pharmacy, Iasi 700115, Romania
(Brinza, Burlacu) Institute of Cardiovascular Diseases, Iasi 700503,
Romania
(Floria) Military Emergency Clinical Hospital, Iasi 700483, Romania
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
The potential benefit of ferritin evaluation resides in its association
with adverse outcomes in patients with various pathological conditions. We
aimed to conduct the first systematic review evaluating the association
between ferritin levels and adverse cardiovascular outcomes in patients
with acute myocardial infarction (AMI) during short-or long-term
follow-up. Seven studies investigating various endpoints (mortality, major
adverse cardiovascular events-MACE, the decline of the left ventricular
ejection fraction-LVEF, left ventricular aneurysm development-LVA) were
included. AMI patients with low or increased ferritin values tended to
have higher in-hospital and 30-day mortality rates. Low and high ferritin
levels and chronic kidney disease were independently associated with
increased risk of LVA formation. High ferritin concentrations were linked
to an accentuated LVEF decline in ST-elevation myocardial infarction
patients treated by percutaneous coronary intervention. Both low and high
ferritin values were also associated with the duration of hospitalization
in patients with AMI during hospital stay and at more extended follow-up.
Ferritin evaluation represents a simple investigation that could identify
high-risk patients with AMI who might benefit from closer monitoring and
specific therapeutic interventions. These data should be confirmed in
large trials in the context of currently available therapies for heart
failure and AMI.<br/>Copyright &#xa9; 2022 by the authors. Licensee MDPI,
Basel, Switzerland.

<45>
Accession Number
2020779694
Title
Left Atrial Appendage Closure for Atrial Fibrillation in the Elderly >75
Years Old: A Meta-Analysis of Observational Studies.
Source
Diagnostics. 12(12) (no pagination), 2022. Article Number: 3174. Date of
Publication: December 2022.
Author
Han S.; Jia R.; Zhao S.; Chan J.; Bai Y.; Cui K.
Institution
(Han, Jia, Zhao, Chan, Bai, Cui) Department of Cardiology, West China
Hospital, Sichuan University, Chengdu 610041, China
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Background: Left atrial appendage closure (LAAC) is an established therapy
for patients with atrial fibrillation (AF); however, there is a limited
understanding of LAAC in elderly patients (>=75 years old). We conducted a
meta-analysis to investigate the procedural complications and long-term
outcomes after LAAC in the elderly versus the non-elderly. <br/>Method(s):
We screened PubMed, EMBASE, Cochrane Library, and Web of Science.
Procedural endpoints of interest included successful implantation LAAC
rates, in-hospital mortality, major bleeding events, pericardial
effusion/tamponade, stroke, and vascular access complications related to
LAAC. Long-term outcomes included all-cause mortality, major bleeding
events, and stroke/transient ischemic attack (TIA) during follow-up.
<br/>Result(s): Finally, 12 studies were included in the analysis; these
included a total of 25,094 people in the elderly group and 36,035 people
in the non-elderly group. The successful implantation LAAC rates did not
differ between the groups, while the elderly patients experienced more
periprocedural mortality (OR 2.62; 95% CI 1.79-3.83, p < 0.01;
I² = 0%), pericardial effusion/tamponade (OR 1.39; 95% CI:
1.06-1.82, p < 0.01; I² = 0%), major bleeding events (OR 1.32;
95% CI 1.17-1.48, p < 0.01; I² = 0%), and vascular access
complications (OR 1.34; 95% CI 1.16-1.55, p < 0.01; I² = 0%)
than the non-elderly patients. The long-term stroke/TIA rates did not
differ between the elderly and the non-elderly at least one year after
follow-up. <br/>Conclusion(s): Even though successful implantation LAAC
rates are similar, elderly patients have a significantly higher incidence
of periprocedural mortality, major bleeding events, vascular access
complications, and pericardial effusion/tamponade after LAAC than
non-elderly patients. The stroke/TIA rates did not differ between both
groups after at least one-year follow-up.<br/>Copyright &#xa9; 2022 by the
authors.

<46>
[Use Link to view the full text]
Accession Number
2029550341
Title
Dexmedetomidine Withdrawal Syndrome in Children in the PICU: Systematic
Review and Meta-Analysis.
Source
Pediatric Critical Care Medicine. 25(1) (pp 62-71), 2024. Date of
Publication: 01 Jan 2024.
Author
Knapp T.; Dileonardo O.; Maul T.; Hochwald A.; Li Z.; Hossain J.; Lowry
A.; Parker J.; Baker K.; Wearden P.; Nelson J.
Institution
(Knapp) University of Central Florida, College of Medicine, Orlando, FL,
United States
(Dileonardo) Department of Medical Education, Nemours Children's Health,
Orlando, FL, United States
(Maul, Lowry, Parker, Baker, Wearden, Nelson) Department of Cardiovascular
Services, Nemours Children's Health, Florida, Orlando, FL, United States
(Hochwald, Li) Division of Clinical Trials and Biostatistics, Mayo Clinic,
Jacksonville, FL, United States
(Hossain) Department of Biomedical Research, Nemours Children's Health,
Wilmington, DE, United States
(Nelson) Department of Surgery, University of Central Florida College of
Medicine, Orlando, FL, United States
Publisher
Lippincott Williams and Wilkins
Abstract
OBJECTIVES: To systematically review literature describing the clinical
presentation, risk factors, and treatment for dexmedetomidine withdrawal
in the PICU (PROSPERO: CRD42022307178). DATA SOURCES: MEDLINE/PubMed,
Cochrane, Web of Science, and Scopus databases were searched. STUDY
SELECTION: Eligible studies were published from January 2000 to January
2022 and reported clinical data for patients younger than 21 years old
following discontinuation of dexmedetomidine after greater than or equal
to 24 hours of infusion. DATA EXTRACTION: Abstracts identified during an
initial search were screened and data were manually abstracted after
full-text review of eligible articles. The Newcastle-Ottawa Scale was used
to assess study quality. Summary statistics were provided and Spearman
rank correlation coefficient was used to identify relationships between
covariates and withdrawal signs. A weighted prevalence for each withdrawal
sign was generated using a random-effects model. DATA SYNTHESIS:
Twenty-three studies (22 of which were retrospective cohort studies)
containing 28 distinct cohorts were included. Median cumulative
dexmedetomidine exposure by dose was 105.95 mug/kg (range, 30-232.7
mug/kg), median dexmedetomidine infusion duration was 131.75 hours (range,
20.5-525.6 hr). Weighted estimates for proportion (95% CI) of subjects
experiencing withdrawal signs across all cohorts were: hypertension 0.34
(range, 0.0-0.92), tachycardia 0.26 (range, 0.0-0.87), and agitation 0.26
(range, 0.09-0.77). Meta-analysis revealed no correlation between
dexmedetomidine exposure variables and withdrawal signs. A moderate
negative monotonic relationship existed between the proportion of patients
who had undergone cardiac surgery and the proportion experiencing
hypertension (correlation coefficient, -0.47; p = 0.048) and tachycardia
(correlation coefficient, -0.57; p = 0.008), indicating that in cohorts
with a higher proportion of patients who were postcardiac surgery, there
were fewer occurrences of hypertension and or tachycardia.
<br/>CONCLUSION(S): On review of the 2000-2022 literature, dexmedetomidine
withdrawal may be characterized by tachycardia, hypertension, or
agitation, particularly with higher cumulative doses or prolonged
durations. Since most studies included in the review were retrospective,
prospective studies are needed to further clarify risk factors, establish
diagnostic criteria, and identify optimal management
strategies.<br/>Copyright &#xa9; 2024 Lippincott Williams and Wilkins. All
rights reserved.

<47>
Accession Number
2029543859
Title
Effect of intubation in lateral position on placement of a double-lumen
tube in patients undergoing unilateral video-assisted thoracic surgery: a
randomied clinical trial.
Source
eClinicalMedicine. 67 (no pagination), 2024. Article Number: 102402. Date
of Publication: January 2024.
Author
Zhang X.; Wang D.; Zhang Z.; Tang Y.; Zhang Q.; Tong F.; Hu Y.; Lu X.; Liu
H.; Hu S.
Institution
(Zhang, Wang, Zhang, Tang, Zhang, Tong, Hu, Lu, Liu, Hu) Department of
Anesthesiology & Clinical Research Center for Anesthesia and Perioperative
Medicine, Huzhou Central Hospital, Huzhou, China
(Zhang, Wang, Zhang, Tang, Zhang, Tong, Hu, Lu, Liu, Hu) Department of
Anesthesiology & Clinical Research Center for Anesthesia and Perioperative
Medicine, The Affiliated Huzhou Hospital, Zhejiang University School of
Medicine, Huzhou, China
(Zhang, Wang, Zhang, Tang, Zhang, Tong, Hu, Lu, Liu, Hu) Department of
Anesthesiology & Clinical Research Center for Anesthesia and Perioperative
Medicine, The Fifth School of Clinical Medicine of Zhejiang Chinese
Medical University, Huzhou, China
(Zhang, Wang, Zhang, Tang, Zhang, Tong, Hu, Lu, Liu, Hu) Department of
Anesthesiology & Clinical Research Center for Anesthesia and Perioperative
Medicine, The Affiliated Central Hospital, Huzhou University, Huzhou,
China
(Zhang) Department of Anaesthesiology, The First Affiliated Hospital,
Zhejiang University School of Medicine, Hangzhou, China
Publisher
Elsevier Ltd
Abstract
Background: Approximately one-third of patients who undergo double-lumen
tube (DLT) intubation in the conventional supine position experience DLT
malposition. No randomized study investigates the effect of DLT intubation
in the lateral position. We therefore aimed to evaluate the effect of
intubation in lateral position on placement of a DLT compared to supine
intubation, and to test primary hypothesis that lateral DLT intubation
could reduce the incidence of DLT malposition. <br/>Method(s): We randomly
allocated 108 patients undergoing video-assisted thoracic surgery to
receive DLT intubation in the comfortable and surgically required lateral
position (lateral group) or in the supine position (supine group) from
October to December 2022. The primary outcome was the incidence of DLT
malposition defined as movement >1.0 cm to correct the DLT position. The
secondary outcomes included intubation time, the frequency and duration of
fibreoptic bronchoscopy, the need for re-intubation, intra-operative vital
signs, and post-operative recovery. This trial is registered with the
Chinese Clinical Trial Registry (ChiCTR2200060794). <br/>Finding(s): The
incidence of DLT malposition was significantly lower in the lateral group
(1/53 [2%]) than that in the supine group (16/53 [30%]; RR [95% confidence
interval] of 0.06 [0.01-0.46]; P < 0.001). Lateral DLT intubation
decreased the intubation time, the frequency and duration of fibreoptic
bronchoscopy. The incidence of hypotension, post-operative sore throat,
and upper-arm discomfort was lower in the lateral group. Other secondary
outcomes were similar between groups. <br/>Interpretation(s): Lateral DLT
intubation reduced the incidence of DLT malposition for patients
undergoing video-assisted thoracic surgery. These results support that
lateral DLT intubation offers more benefits and may be a superior option
compared to conventional supine intubation. <br/>Funding(s): National
Natural Science Foundation of China and of Zhejiang
Province.<br/>Copyright &#xa9; 2023 The Author(s)

<48>
[Use Link to view the full text]
Accession Number
2029388560
Title
Inflammation and Cholesterol as Predictors of Cardiovascular Events among
13 970 Contemporary High-Risk Patients with Statin Intolerance.
Source
Circulation. 149(1) (pp 28-35), 2024. Date of Publication: 02 Jan 2024.
Author
Ridker P.M.; Lei L.; Louie M.J.; Haddad T.; Nicholls S.J.; Lincoff A.M.;
Libby P.; Nissen S.E.
Institution
(Ridker, Libby) Center for Cardiovascular Disease Prevention, Division of
Preventive Medicine and the Division of Cardiovascular Medicine, Brigham
and Women's Hospital, Boston, MA, United States
(Lei, Louie) Esperion Therapeutics, Ann Arbor, MI, United States
(Haddad) Inova Heart and Vascular Institute, Falls Church, VA, United
States
(Nicholls) Victorian Heart Institute, Monash University, Melbourne,
Australia
(Lincoff, Nissen) The Cleveland Clinic Heart and Vascular Institute, OH,
United States
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND: Among patients treated with statin therapy to
guideline-recommended cholesterol levels, residual inflammatory risk
assessed by high-sensitivity C-reactive protein (hsCRP) is at least as
strong a predictor of future cardiovascular events as is residual risk
assessed by low-density lipoprotein cholesterol (LDLC). Whether these
relationships are present among statin-intolerant patients with higher
LDLC levels is uncertain but has implications for the choice of preventive
therapies, including bempedoic acid, an agent that reduces both LDLC and
hsCRP. <br/>METHOD(S): The multinational CLEAR-Outcomes trial (Cholesterol
Lowering via Bempedoic Acid, an ACL-Inhibiting Regimen Outcomes Trial)
randomly allocated 13 970 statin-intolerant patients to 180 mg of oral
bempedoic acid daily or matching placebo and followed them for a
4-component composite of incident myocardial infarction, stroke, coronary
revascularization, or cardiovascular death, and for all-cause mortality.
Quartiles of increasing baseline hsCRP and LDLC were assessed as
predictors of future adverse events after adjustment for traditional risk
factors and randomized treatment assignment. <br/>RESULT(S): Compared with
placebo, bempedoic acid reduced median hsCRP by 21.6% and mean LDLC levels
by 21.1% at 6 months. Baseline hsCRP was significantly associated with the
primary composite end point of major cardiovascular events (highest versus
lowest hsCRP quartile; hazard ratio [HR], 1.43 [95% CI, 1.24-1.65]),
cardiovascular mortality (HR, 2.00 [95% CI, 1.53-2.61]), and all-cause
mortality (HR, 2.21 [95% CI, 1.79-2.73]). By contrast, the relationship of
baseline LDLC quartile (highest versus lowest) to future events was
smaller in magnitude for the primary composite cardiovascular end point
(HR, 1.19 [95% CI, 1.04-1.37]) and neutral for cardiovascular mortality
(HR, 0.90 [95% CI, 0.70-1.17]) and all-cause mortality (HR, 0.95 [95% CI,
0.78-1.16]). Risks were high for those with elevated hsCRP irrespective of
LDLC level. Bempedoic acid demonstrated similar efficacy in reducing
cardiovascular events across all levels of hsCRP and LDLC.
<br/>CONCLUSION(S): Among contemporary statin-intolerant patients,
inflammation assessed by hsCRP predicted risk for future cardiovascular
events and death more strongly than hyperlipidemia assessed by LDLC.
Compared with placebo, bempedoic acid had similar efficacy for reducing
cardiovascular risk across hsCRP and LDLC strata. REGISTRATION: URL:
https://www.clinicaltrials.gov; Unique identifier:
NCT02993406.<br/>Copyright &#xa9; 2024 Lippincott Williams and Wilkins.
All rights reserved.

<49>
Accession Number
2024272698
Title
Ultrasound-guided erector spinae plane block in coronary artery bypass
surgery: the role of local anesthetic volume-a prospective, randomized
study.
Source
General Thoracic and Cardiovascular Surgery. 72(1) (pp 1-7), 2024. Date of
Publication: January 2024.
Author
Demir Z.A.; Aydin M.E.; Balci E.; Ozay H.Y.; Ozgok A.; Ahiskalioglu A.
Institution
(Demir, Balci, Ozay, Ozgok) Anesthesiology Department, Ankara City
Hospital, Health Sciences University, Ankara, Turkey
(Aydin, Ahiskalioglu) Department of Anaesthesiology and Reanimation,
Ataturk University School of Medicine, Erzurum 25070, Turkey
(Aydin, Ahiskalioglu) Clinical Research, Development and Design
Application and Research Center, Ataturk University School of Medicine,
Erzurum 25240, Turkey
Publisher
Springer
Abstract
Background: Erector spinae plane block has been shown to help with pain
management in different regions and many areas with different indications.
However, the effectiveness of this block in cardiac surgery has been shown
in the literature, the optimal volume remains unclear. The aim of this
study is to determine the analgesic efficacy of two different volumes of
local anesthetic injection used in ultrasound-guided bilateral-thoracic
erector spinae plane block in patients undergoing coronary artery bypass
graft. <br/>Method(s): This study was conducted on adult patients
undergoing surgery with coronary artery bypass graft, and 70 patients were
analyzed in each group. Group 20 received erector spinae plane block with
20 ml of 0.25% bupivacaine, Group 30 received 30 ml of 0.25% bupivacaine
bilaterally. Postoperative sternotomy and chest tube-related pain were
evaluated using the numerical rating scale (NRS) at rest and during
movement. <br/>Result(s): There were significant differences between the
groups regarding rescue tramadol consumption was higher in Group 20 than
in Group 30 (25/35 vs. 2/35, p < 0.001). In addition, there were
substantial differences between the two groups concerning the time of the
first-rescue analgesic requirement. The mean time +/- standard deviation
was 11.26 +/- 9.57 h and 24.03 +/- 4.12 h in Groups 20 and 30 (p < 0.001).
The median scores, both at sternotomy and chest tubes, were significantly
lower in Group 30 than in Group 20 at the different time points after the
surgery (p < 0.05). <br/>Conclusion(s): In coronary artery bypass graft
surgery, erector spinae plane block performed with 30 ml instead of 20 ml
on each side resulted in less pain in the sternum and chest tube region,
less need for rescue analgesics, and delayed first-rescue analgesic
requirement.<br/>Copyright &#xa9; 2023, The Author(s), under exclusive
licence to The Japanese Association for Thoracic Surgery.

<50>
Accession Number
2029647557
Title
Effects of renin-angiotensin system blockers on outcomes from COVID-19: a
systematic review and meta-analysis of randomized controlled trials.
Source
European Heart Journal - Cardiovascular Pharmacotherapy. 10(1) (pp 68-80),
2024. Date of Publication: 01 Jan 2024.
Author
Lee M.M.Y.; Kondo T.; Campbell R.T.; Petrie M.C.; Sattar N.; Solomon S.D.;
Vaduganathan M.; Jhund P.S.; McMurray J.J.V.
Institution
(Lee, Kondo, Campbell, Petrie, Sattar, Jhund, McMurray) British Heart
Foundation Cardiovascular Research Centre, University of Glasgow, Glasgow
G12 8TA, United Kingdom
(Kondo) Department of Cardiology, Nagoya University Graduate School of
Medicine, Nagoya, Japan
(Solomon, Vaduganathan) Cardiovascular Division, Brigham and Women's
Hospital, Harvard Medical School, Boston, MA 02115, United States
Publisher
Oxford University Press
Abstract
Background Randomized controlled trials (RCTs) have assessed the effects
of renin-angiotensin system (RAS) blockers in adults with and aims
coronavirus disease 2019 (COVID-19). This meta-analysis provides estimates
of the safety and efficacy of treatment with (vs. without) RAS blockers
from these trials. Methods PubMed, Web of Science, and ClinicalTrials.gov
were searched (1 March-12 April 2023). Event/patient numbers were
extracted, comparing angiotensin-converting enzyme (ACE)
inhibitor/angiotensin-receptor blocker (ARB) treatment with no treatment,
for the outcomes: intensive care unit (ICU) admission, mechanical
ventilation, vasopressor use, acute kidney injury (AKI), renal replacement
therapy (RRT), acute myocardial infarction, stroke/transient ischaemic
attack, heart failure, thromboembolic events, and all-cause death.
Fixed-effects meta-analysis estimates were pooled. Results Sixteen RCTs
including 3492 patients were analysed. Compared with discontinuation of
RAS blockers, continuation was not associated with increased risk of ICU
[risk ratio (RR) 0.96, 0.66-1.41], ventilation (RR 0.77, 0.55-1.09),
vasopressors (RR 0.92, 0.58-1.44), AKI (RR 1.01, 0.40-2.56), RRT (RR 1.01,
0.46-2.21), or thromboembolic events (RR 1.07, 0.36-3.19). RAS blocker
initiation was not associated with increased risk of ICU (RR 0.71,
0.47-1.08), ventilation (RR 1.12, 0.91-1.38), AKI (RR 1.28, 0.89-1.86),
RRT (RR 1.66, 0.89-3.12), or thromboembolic events (RR 1.20, 0.06-23.70),
although vasopressor use increased (RR 1.27, 1.02-1.57). The RR for
all-cause death in the continuation/discontinuation trials was 1.24
(0.80-1.92), and 1.22 (0.96-1.55) in the initiation trials. In patients
with severe/critical COVID-19, RAS blocker initiation increased the risk
of all-cause death (RR 1.31, 1.01-1.72). Conclusion ACE inhibitors and
ARBs may be continued in non-severe COVID-19 infection, where indicated.
Conversely, initiation of RAS blockers may be harmful in critically ill
patients. PROSPERO registration number: CRD42023408926.<br/>Copyright
&#xa9; The Author(s) 2023.

<51>
Accession Number
2027778970
Title
Incidence of renal cell carcinoma after solid organ transplantation: a
systematic review and meta-analysis.
Source
BMC Urology. 24(1) (no pagination), 2024. Article Number: 11. Date of
Publication: December 2024.
Author
Xu C.; Geng H.; Li Y.; Sun F.; Sun H.; Zhang Y.; Zhao Q.
Institution
(Xu, Geng, Zhang, Zhao) Teaching Hospital of Shenyang Pharmaceutical
University, General Hospital of Northern Theater Command, Shenyang 100083,
China
(Xu, Geng, Li, Zhang, Zhao) Department of Clinical Pharmacy, Shenyang
Pharmaceutical University, Shenyang 110016, China
(Sun, Sun) Institute of Infectious Disease, Department of Infectious
Disease, The Fifth Medical Center of Chinese PLA General Hospital, Beijing
100039, China
Publisher
BioMed Central Ltd
Abstract
Background: The incidence rate of malignant tumors after solid organ
transplantation is higher than the normal population. The aim of our study
is to identify the risk of renal cell carcinoma (RCC) after liver, kidney,
heart and lung transplantation, respectively, and suggest that transplant
patients can be screened early for tumors to avoid risk. <br/>Method(s):
PubMed, Embase and the Cochrane Library from their inception until August
16,2023. Retrospective and cohort studies which focus on the statistical
data of standardized incidence ratios (SIRs) of RCC after solid organ
transplantation (SOT) more than one year have been included and extracted.
The study was registered with PROSPERO, CRD4202022343633. <br/>Result(s):
Sixteen original studies have been included for meta-analysis. Liver
transplantation could increase the risk of RCC (SIR = 0.73, 95%CI: 0.53 to
0.93) with no heterogeneity(P = 0.594, I ² = 0.0%). And kidney
transplantation could increase the risk of RCC(8.54, 6.68 to 10.40;
0.000,90.0%). Besides, heart and lung transplantation also could increase
the risk of RCC(SIR = 0.73, 95%CI: 0.53 to 0.93; SIR = 1.61, 95%CI:0.50 to
2.71). Moreover, significance could also be found in most subgroups,
especially the European group and retrospective study group. What's more,
after removing studies which have a greater impact on the overall outcome
in RCC rate after kidney transplantation, heterogeneity did not solve and
significant different was also observed in the European group (7.15, 5.49
to 8.81; 0.000, 78.6%). <br/>Conclusion(s): Liver, kidney, heart and lung
transplantation patients have an increased risk of processing RCC compared
to the general population and most subgroups, especially in geographic
location of European subgroup, which suggested that patients should be
screened frequently after transplantation.<br/>Copyright &#xa9; 2023, The
Author(s).

<52>
Accession Number
2027353998
Title
Evaluation of Chrisofix Chest Orthosis Application in Patients with
Traumatic Rib Fractures.
Source
Bangladesh Journal of Medical Science. 23(1) (pp 83-88), 2024. Date of
Publication: 01 Jan 2024.
Author
Isikli A.G.; Yanik F.; Karamustafaoglu Y.A.; Yoruk Y.
Institution
(Isikli) Rakya University, Health Research and Application Center, Edirne,
Turkey
(Yanik, Karamustafaoglu, Yoruk) Department of Thoracic Surgery, Trakya
University Faculty of Medicine, Edirne, Turkey
Publisher
Ibn Sina Trust
Abstract
Background: The Chrisofix Chest Orthosis is an effective and easy to use
device for the treatment of rib fractures. It is used as a supportive
treatment to reduce the pain levels and complication risks of the
patients. <br/>Method(s): Patients hospitalized with the diagnosis of rib
fractures in the Thoracic Surgery Service of a university hospital were
retrospectively scanned in an online computer program between October 2018
and October 2021. The study sample consisted of patients with the
treatment (30) and control (30) groups. <br/>Result(s): Visual Analog
Scale and incidence of atelectasis of the patients in the experimental
group (The Chrisofix Chest Orthosis) is statistically significantly lower
than the control group (P < 0.05). In both the experimental and control
groups, no statistically significant difference was found between the
variables of patient's demographic and clinical characteristics (p >
0.05). <br/>Conclusion(s): In the study, with the use of The Chrisofix
Chest Orthosis, a significant decrease was observed in the Visual Analog
Scale and the incidence of atelectasis.<br/>Copyright &#xa9; 2024, Ibn
Sina Trust. All rights reserved.

<53>
Accession Number
2028974110
Title
Effectiveness of Surgeon-Performed Paravertebral Block Analgesia for
Minimally Invasive Thoracic Surgery: A Randomized Clinical Trial.
Source
JAMA Surgery. 158(12) (pp 1255-1263), 2023. Date of Publication: 13 Dec
2023.
Author
Chenesseau J.; Fourdrain A.; Pastene B.; Charvet A.; Rivory A.; Baumstarck
K.; Bouabdallah I.; Trousse D.; Boulate D.; Brioude G.; Gust L.; Vasse M.;
Braggio C.; Mora P.; Labarriere A.; Zieleskiewicz L.; Leone M.; Thomas
P.A.; D'Journo X.-B.
Institution
(Chenesseau, Fourdrain, Bouabdallah, Trousse, Boulate, Brioude, Gust,
Vasse, Braggio, Thomas, D'Journo) Department of Thoracic Surgery Diseases
of the Esophagus and Lung Transplantation, North Hospital, Aix Marseille
University, Assistance Publique-Hopitaux de Marseille, Marseille, France
(Pastene, Charvet, Rivory, Mora, Labarriere, Zieleskiewicz, Leone)
Department of Anesthesiology and Intensive Care Medicine, North Hospital,
Aix Marseille University, Assistance Publique-Hopitaux de Marseille,
Marseille, France
(Baumstarck) Departement of Biostatistics, Aix Marseille University,
Assistance Publique-Hopitaux de Marseille, Marseille, France
Publisher
American Medical Association
Abstract
Importance: In minimally invasive thoracic surgery, paravertebral block
(PVB) using ultrasound (US)-guided technique is an efficient postoperative
analgesia. However, it is an operator-dependent process depending on
experience and local resources. Because pain-control failure is highly
detrimental, surgeons may consider other locoregional analgesic options.
<br/>Objective(s): To demonstrate the noninferiority of PVB performed by
surgeons under video-assisted thoracoscopic surgery (VATS), hereafter
referred to as PVB-VATS, as the experimental group compared with PVB
performed by anesthesiologists using US-guided technique (PVB-US) as the
control group. <br/>Design, Setting, and Participant(s): In this
single-center, noninferiority, patient-blinded, randomized clinical trial
conducted from September 8, 2020, to December 8, 2021, patients older than
18 years who were undergoing a scheduled minimally invasive thoracic
surgery with lung resection including video-assisted or robotic approaches
were included. Exclusion criteria included scheduled open surgery, any
antalgic World Health Organization level greater than 2 before surgery, or
a medical history of homolateral thoracic surgery. Patients were randomly
assigned (1:1) to an intervention group after general anesthesia. They
received single-injection PVB before the first incision was made in the
control group (PVB-US) or after 1 incision was made under thoracoscopic
vision in the experimental group (PVB-VATS). <br/>Intervention(s):
PVB-VATS or PVB-US. <br/>Main Outcomes and Measures: The primary end point
was mean 48-hour post-PVB opioid consumption considering a noninferiority
range of less than 7.5 mg of opioid consumption between groups. Secondary
outcomes included time of anesthesia, surgery, and operating room
occupancy; 48-hour pain visual analog scale score at rest and while
coughing; and 30-day postoperative complications. <br/>Result(s): A total
of 196 patients were randomly assigned to intervention groups: 98 in the
PVB-VATS group (mean [SD] age, 64.6 [9.5] years; 53 female [54.1%]) and 98
in the PVB-US group (mean [SD] age, 65.8 [11.5] years; 62 male [63.3%]).
The mean (SD) of 48-hour opioid consumption in the PVB-VATS group (33.9
[19.8] mg; 95% CI, 30.0-37.9 mg) was noninferior to that measured in the
PVB-US group (28.5 [18.2] mg; 95% CI, 24.8-32.2 mg; difference: -5.4 mg;
95% CI, - to -0.93; noninferiority Welsh test, P <=.001). Pain score at
rest and while coughing after surgery, overall time, and postoperative
complications did not differ between groups. <br/>Conclusions and
Relevance: PVB placed by a surgeon during thoracoscopy was noninferior to
PVB placed by an anesthesiologist using ultrasonography before incision in
terms of opioid consumption during the first 48 hours. Trial Registration:
ClinicalTrials.gov Identifier: NCT04579276.<br/>Copyright &#xa9; 2023
American Medical Association. All rights reserved.

<54>
Accession Number
2029585988
Title
Protocol for the PORT study: short-term perioperative rehabilitation to
improve outcomes in cardiac valvular surgery - a randomised control trial.
Source
BMJ Open. 13(12) (no pagination), 2023. Article Number: e074837. Date of
Publication: 21 Dec 2023.
Author
Zhou H.; Liu F.; Liu Y.; He X.; Ma H.; Xu M.; Wang H.; Zhang G.; Cai X.;
Chen J.-Y.; Guo L.; Chen J.
Institution
(Zhou, Ma, Wang, Zhang, Cai, Guo) Guangdong Cardiovascular Institute,
Guangdong Provincial People's Hospital, Guangdong Academy of Medical
Sciences, Guangdong, Guangzhou, China
(Liu, Xu) School of Medicine, South China University of Technology,
Guangdong, Guangzhou, China
(Liu) Department of Cardiology, Guangdong Cardiovascular Institute,
Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention,
Guangdong Provincial People's Hospital, Guangdong Academy of Medical
Sciences, Guangdong, Guangzhou, China
(He) Department of Cardiology, Guangdong Provincial People's Hospital,
Guangdong Academy of Medical Sciences, Guangdong, Guangzhou, China
(Chen) Department of Cardiology, Guangdong Cardiovascular Institute,
Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention,
Guangdong General Hospital, Guangdong Academy of Medical Sciences,
Guangdong, Guangzhou, China
(Chen) Guangdong Cardiovascular Institute, Guangdong Provincial People's
Hospital, Guangdong Academy of Medical Sciences, Southern Medical
University, Guangdong, Guangzhou, China
Publisher
BMJ Publishing Group
Abstract
Introduction Perioperative rehabilitation (PORT) has shown a positive
effect on patients undergoing cardiac surgery. However, there are minimal
data on the impact of short-term PORT in cardiac surgery, which is
associated with higher postoperative morbidity and mortality. The trial
will assess the efficacy of short-term PORT in reducing in-hospital
mortality, postoperative pulmonary complications and length of stay,
compared with the usual care in cardiac surgical patients. Methods and
analysis This is a single-centre prospective, randomised, open, controlled
trial with a 1:1 ratio. Consecutive 800 adult patients undergoing elective
valve surgery will be randomised to either usual care or in-hospital
short-term PORT that consists of education, inspiratory muscle training,
active cycle of breathing techniques and early mobilisation. The primary
outcome of this study will be a composite of in-hospital all-cause
mortality, incidence of postoperative pulmonary complications and the
ratio of postoperative hospitalisation >7 days. Ethics and dissemination
The PORT study was granted by the Medical Research Ethics Committee of
Guangdong Provincial People's Hospital in August 2018. Findings will be
disseminated to patients, clinicians and commissioning groups through
peer-reviewed publication. Trial registration number
NCT03709511.<br/>Copyright &#xa9; 2023 BMJ Publishing Group. All rights
reserved.

<55>
[Use Link to view the full text]
Accession Number
2029443643
Title
Home-Based Cardiac Rehabilitation among Patients Unwilling to Participate
in Hospital-Based Programs.
Source
Journal of Cardiopulmonary Rehabilitation and Prevention. 44(1) (pp
33-39), 2024. Date of Publication: 01 Jan 2024.
Author
Nabutovsky I.; Breitner D.; Heller A.; Levine Y.; Moreno M.; Scheinowitz
M.; Levin C.; Klempfner R.
Institution
(Nabutovsky, Breitner, Heller, Levine, Moreno, Scheinowitz, Levin,
Klempfner) Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
(Nabutovsky, Moreno, Klempfner) Cardiac Prevention and Rehabilitation,
Institute Leviev Heart Center, Sheba Medical Center, Tel HaShomer 5265601,
Israel
(Scheinowitz) Department of Biomedical Engineering, Faculty of
Engineering, Sylvan Adams Sports Institute School for Public Health,
Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
(Scheinowitz) Neufeld Cardiac Research Institute, Sheba Medical Center,
Tel-Hashomer, Israel
(Levin) Faculty of School of Life and Health Sciences, Jerusalem College
of Technology, Jerusalem, Israel
Publisher
Lippincott Williams and Wilkins
Abstract
Purpose: Asynchronous home-based cardiac rehabilitation (HBCR) is a viable
alternative to center-based cardiac rehabilitation (CBCR). However, to
achieve significant functional improvement, a high level of adherence and
activity must be achieved. The effectiveness of HBCR among patients who
actively avoid CBCR has not been effectively investigated. This study
aimed to investigate the effectiveness of the HBCR program among patients
unwilling to participate in CBCR. <br/>Method(s): A randomized prospective
study enrolled 45 participants to a 6-mo HBCR program and the remaining 24
were allocated to regular care. Both groups were digitally monitored for
physical activity (PA) and self-reported outcomes. Change in peak oxygen
uptake (VO<inf>2peak</inf>), the primary study outcome, was measured by
the cardiopulmonary exercise test, immediately before program start and 4
mo thereafter. <br/>Result(s): The study included 69 patients, 81% men,
aged 55.9 +/-12 yr, enrolled in a 6-mo HBCR program to follow a myocardial
infarction (25.4%) or coronary interventions (41.3%), heart failure
hospitalization (29%), or heart transplantation (10%). Weekly aerobic
exercise totaled a median of 193.2 (110.2-251.5) min (129% of set exercise
goal), of which 112 (70-150) min was in the heart rate zone recommended by
the exercise physiologist. After 4 mo, VO<inf>2peak</inf> improved by
10.2% in the intervention group versus -2.7% in the control group (+2.46
+/- 2.67 vs -0.72 +/- 3.02 mL/kg/min; P <.001). <br/>Conclusion(s): The
monthly PA of patients in the HBCR versus conventional CBCR group were
well within guideline recommendations, showing a significant improvement
in cardiorespiratory fitness. Risk level, age, and lack of motivation at
the beginning of the program did not prevent achieving goals and
maintaining adherence.<br/>Copyright &#xa9; 2024 Lippincott Williams and
Wilkins. All rights reserved.

<56>
[Use Link to view the full text]
Accession Number
2029443641
Title
Effectiveness of Telehealth Cardiac Rehabilitation Programs on Health
Outcomes of Patients with Coronary Heart Diseases: An Umbrella Review.
Source
Journal of Cardiopulmonary Rehabilitation and Prevention. 44(1) (pp
15-25), 2024. Date of Publication: 01 Jan 2024.
Author
Shi W.; Green H.; Sikhosana N.; Fernandez R.
Institution
(Shi, Green, Sikhosana, Fernandez) Centre for Research in Nursing and
Health, St George Hospital, Kogarah, NSW, Australia
(Shi) Charles Perkins Centre, Faculty of Medicine and Health, University
of Sydney, Susan Wakil School of Nursing and Midwifery, Faculty of
Medicine and Health University of Sydney, Camperdown, NSW, Australia
(Sikhosana, Fernandez) Faculty of Medicine and Health, University of
Newcastle, Callaghan, NSW, Australia
(Green) School of Health and Society, Faculty of the Arts Social Sciences
and Humanities, University of Wollongong, Centre for Evidence Based
Initiatives in Health Care, A JBI Centre for Excellence, Wollongong, NSW,
Australia
Publisher
Lippincott Williams and Wilkins
Abstract
Purpose: The aim of this study was to conduct an umbrella review
summarizing the evidence from existing systematic reviews of telehealth
cardiac rehabilitation (CR) on health outcomes of patients with coronary
heart disease (CHD). Review Methods: An umbrella review of systematic
reviews was undertaken in accordance with the PRISMA and JBI guidelines. A
systematic search was conducted in Medline, APA PsycINFO, Embase, CINAHL,
Web of Science, Cochrane database of systematic reviews, JBI evidence
synthesis, Epistemonikos, and PROSPERO, searching for systematic reviews
published from 1990 to current and was limited to the language source of
English and Chinese. Outcomes of interest were health behaviors and
modifiable CHD risk factors, psychosocial outcomes, and other secondary
outcomes. Study quality was appraised using the JBI checklist for
systematic reviews. A narrative analysis was conducted, and meta-analysis
results were synthesized. <br/>Summary: From 1301 identified reviews, 13
systematic reviews (10 meta-analyses) comprised 132 primary studies
conducted in 28 countries. All the included reviews have high quality,
with scores ranging 73-100%. Findings to the health outcomes remained
inconclusive, except solid evidence was found in the significant
improvement in physical activity (PA) levels and behaviors from telehealth
interventions, exercise capacity from mobile health (m-health) only and
web-based only interventions, and medication adherence from m-health
interventions. Telehealth CR programs, work adjunct or in addition to
traditional CR and standard care, are effective in improving health
behaviors and modifiable CHD risk factors, particularly in PA. In
addition, it does not increase the incidence in terms of mortality,
adverse events, hospital readmission, and revascularization.<br/>Copyright
&#xa9; 2024 Lippincott Williams and Wilkins. All rights reserved.

<57>
[Use Link to view the full text]
Accession Number
2029349541
Title
Stroke Prevention in Atrial Fibrillation: Our Current Failures and
Required Research.
Source
Stroke. 55(1) (pp 214-225), 2024. Date of Publication: 01 Jan 2024.
Author
Gurol M.E.; Wright C.B.; Janis S.; Smith E.E.; Gokcal E.; Reddy V.Y.;
Merino J.G.; Hsu J.C.
Institution
(Gurol, Gokcal) Department of Neurology, Massachusetts General Hospital,
Harvard Medical School, Boston, United States
(Wright, Janis) Division of Clinical Research, NINDS, Bethesda, MD, United
States
(Smith) Department of Clinical Neurosciences, University of Calgary, AB,
Canada
(Reddy) Helmsley Trust Electrophysiology Center, Icahn School of Medicine,
Mount Sinai, NY, United States
(Merino) Department of Neurology, Georgetown University, Medical Center,
United States
(Hsu) Department of Cardiology, University of California, San Diego,
United States
Publisher
Wolters Kluwer Health
Abstract
Nonvalvular atrial fibrillation is a common rhythm disorder of middle-aged
to older adults that can cause ischemic strokes and systemic embolism.
Lifelong use of oral anticoagulants reduces the risk of these ischemic
events but increases the risk of major and clinically relevant
hemorrhages. These medications also require strict compliance for
efficacy, and they have nontrivial failure rates in higher-risk patients.
Left atrial appendage closure is a nonpharmacological method to prevent
ischemic strokes in atrial fibrillation without the need for lifelong
anticoagulant use, but this procedure has the potential for complications
and residual embolic events. This workshop of the Roundtable of Academia
and Industry for Stroke Prevention discussed future research needed to
further decrease the ischemic and hemorrhagic risks among patients with
atrial fibrillation. A direct thrombin inhibitor, factor Xa inhibitors,
and left atrial appendage closure are FDA-approved approaches whereas
factor XIa inhibitors are currently being studied in phase 3 randomized
controlled trials for stroke prevention. The benefits, risks, and
shortcomings of these treatments and future research required in different
high-risk patient populations are reviewed in this consensus
statement.<br/>Copyright &#xa9; 2024 Lippincott Williams and Wilkins. All
rights reserved.

<58>
[Use Link to view the full text]
Accession Number
2029388738
Title
Clinical and functional effects of beta-blocker therapy discontinuation in
patients with biventricular heart failure.
Source
Journal of Cardiovascular Medicine. 25(2) (pp 141-148), 2024. Date of
Publication: 01 Feb 2024.
Author
Slavich M.; Ricchetti G.; Demarchi B.; Cavalli G.; Spoladore R.; Federico
A.; Federico F.; Bezzi C.; Margonato A.; Fragasso G.
Institution
(Slavich, Ricchetti, Demarchi, Spoladore, Federico, Margonato, Fragasso)
Department of Cardiology, IRCCS San Raffaele Scientific Institute
(Cavalli) Immunology, Rheumatology, Allergology and Rare Diseases Unit,
IRCCS Ospedale San Raffaele
(Bezzi) Nuclear Medicine Department, IRCCS San Raffaele Scientific
Institute
(Federico) Faculty of Medicine and Surgery, Vita-Salute San Raffaele
University, Milan, Italy
Publisher
Lippincott Williams and Wilkins
Abstract
Background Nearly two-thirds of patients with heart failure with reduced
ejection fraction (HFrEF) have right ventricular dysfunction, previously
identified as an independent predictor of reduced functional capacity and
poor prognosis. Beta-blocker therapy (b-BT) reduces mortality and
hospitalizations in patients with HFrEF and is approved as first-line
therapy regardless of concomitant right ventricular function. However, the
exact role of sympathetic nervous system activation in right ventricular
dysfunction and the potential usefulness (or harmfulness) of b-BT in these
patients are still unclear. Objectives The aim of the study is to evaluate
the medium-term effect of b-BT discontinuation on functional capacity and
right ventricular remodelling based on cardiopulmonary exercise testing
(CPET), echocardiography and serum biomarkers in patients with clinically
stable biventricular dysfunction. Methods In this single-centre,
open-label, prospective trial, 16 patients were enrolled using the
following criteria: patients were clinically stable without signs of
peripheral congestion; NYHA II-III while on optimal medical therapy
(including b-BT); LVEF 40% or less; echocardiographic criteria of right
ventricular dysfunction. Patients were randomized 1: 1 either to withdraw
(group 0) or continue (group 1) b-BT. In group 0, optimal heart rate was
obtained with alternative rate-control drugs. Echo and serum biomarkers
were performed at baseline, after 3 and 6 months; CPET was performed at
baseline and 6 months. Mann-Whitney U test was adopted to determine the
relationships between b-BT discontinuation and effects on right
ventricular dysfunction. Results At 6 months' follow up, S' DTI improved
(DS': 1.01 vs. S0.92 cm/s; P U 0.03), while estimated PAPs (DPAPs: 0.8 vs.
S7.5 mmHg; P U 0.04) and echo left ventricular-remodelling (DEDVi: 19.55
vs. S0.96 ml/mq; P U 0.03) worsened in group 0. In absolute terms, the
only variables significantly affected by b-BT withdrawal were left
ventricular EDV and ESV, appearing worse in group 0 (mean EDVi 115 vs. 84
ml/mq; mean ESVi 79 vs. 53.9 ml/mq, P U 0.03). No significant changes in
terms of functional capacity were observed after b-BT withdrawal.
Conclusion In HFrEF patients with concomitant right ventricular
dysfunction, b-BT discontinuation did not produce any beneficial effects.
In addition, despite maintenance of optimal heart rate control, b-BT
discontinuation induced worsening of left ventricular remodelling. Our
study corroborates the hypothesis that improvement in left ventricular
function may likewise be a major determinant for improvement in right
ventricular function, reducing pulmonary wedge pressure and right
ventricular afterload, with only a marginal action of its negative
inotropic effect. In conclusion, b-BT appears beneficial also in heart
failure patients with biventricular dysfunction.<br/>Copyright &#xa9; 2023
Italian Federation of Cardiology - I.F.C. All rights reserved.

<59>
Accession Number
2029641445
Title
Coronary Physiology Guidance vs Conventional Angiography for Optimization
of Percutaneous Coronary Intervention: The AQVA-II Trial.
Source
JACC: Cardiovascular Interventions. 17(2) (pp 277-287), 2024. Date of
Publication: 22 Jan 2024.
Author
Biscaglia S.; Verardi F.M.; Erriquez A.; Colaiori I.; Cocco M.; Cantone
A.; Pompei G.; Marrone A.; Caglioni S.; Tumscitz C.; Penzo C.; Manfrini
M.; Leone A.M.; Versaci F.; Campo G.
Institution
(Biscaglia, Verardi, Erriquez, Cocco, Cantone, Pompei, Marrone, Caglioni,
Tumscitz, Penzo, Campo) Cardiology Unit, Azienda Ospedaliero Universitaria
di Ferrara, Cona, Italy
(Colaiori, Versaci) UOC UTIC Emodinamica e Cardiologia, Ospedale Santa
Maria Goretti, Latina, Italy
(Manfrini) Department of Medical Sciences, University of Ferrara, Ferrara,
Italy
(Leone) Center of Excellence in Cardiovascular Sciences, Ospedale
Fatebenefratelli Isola Tiberina, Gemelli Isola, Rome, Italy
Publisher
Elsevier Inc.
Abstract
Background: The debate surrounding the efficacy of coronary physiological
guidance compared with conventional angiography in achieving optimal
post-percutaneous coronary intervention (PCI) fractional flow reserve
(FFR) values persists. <br/>Objective(s): The primary aim of this study
was to demonstrate the superiority of physiology-guided PCI, using either
angiography or microcatheter-derived FFR, over conventional
angiography-based PCI in complex high-risk indicated procedures (CHIPs).
The secondary aim was to establish the noninferiority of
angiography-derived FFR guidance compared with microcatheter-derived FFR
guidance. <br/>Method(s): Patients with obstructive coronary lesions and
meeting CHIP criteria were randomized 2:1 to receive undergo physiology-
or angiography-based PCI. Those assigned to the former were randomly
allocated to angiography- or microcatheter-derived FFR guidance. CHIP
criteria were long lesion (>28 mm), tandem lesions, severe calcifications,
severe tortuosity, true bifurcation, in-stent restenosis, and left main
stem disease. The primary outcome was invasive post-PCI FFR value. The
optimal post-PCI FFR value was defined as >0.86. <br/>Result(s): A total
of 305 patients (331 study vessels) were enrolled in the study (101
undergoing conventional angiography-based PCI and 204 physiology-based
PCI). Optimal post-PCI FFR values were more frequent in the
physiology-based PCI group compared with the conventional
angiography-based PCI group (77% vs 54%; absolute difference 23%, relative
difference 30%; P < 0.0001). The occurrence of the primary outcome did not
differ between the 2 physiology-based PCI subgroups, demonstrating the
noninferiority of angiography- vs microcatheter-derived FFR (P < 0.01).
<br/>Conclusion(s): In CHIP patients, procedural planning and guidance on
the basis of physiology (through either angiography- or
microcatheter-derived FFR) are superior to conventional angiography for
achieving optimal post-PCI FFR values. (Physiology Optimized Versus
Angio-Guided PCI [AQVA-II]; NCT05658952)<br/>Copyright &#xa9; 2024
American College of Cardiology Foundation

<60>
Accession Number
2027327118
Title
Association between Non-Lipid Residual Risk Factors and Cardiovascular
Events in Patients with Stable Coronary Artery Disease Treated with
Pitavastatin: An Observation from the REAL-CAD Study.
Source
Journal of Atherosclerosis and Thrombosis. 31(1) (pp 61-80), 2024. Date of
Publication: 2024.
Author
Kamiya K.; Takei M.; Nagai T.; Miyoshi T.; Ito H.; Fukumoto Y.; Obara H.;
Kakuma T.; Sakuma I.; Daida H.; Iimuro S.; Shimokawa H.; Kimura T.; Nagai
R.; Anzai T.
Institution
(Kamiya, Nagai, Anzai) Department of Cardiovascular Medicine, Faculty of
Medicine and Graduate School of Medicine, Hokkaido University, Sapporo,
Japan
(Takei) Department of Cardiology, Saiseikai Central Hospital, Tokyo, Japan
(Miyoshi) Department of Cardiovascular Medicine, Okayama University
Graduate School of Medicine, Dentistry and Pharmaceutical Sciences,
Okayama, Japan
(Ito) Department of General Internal Medicine 3, Kawasaki Medical School,
Okayama, Japan
(Fukumoto) Division of Cardiovascular Medicine, Department of Internal
Medicine, Kurume University School of Medicine, Fukuoka, Japan
(Obara, Kakuma) Biostatistics Center, Kurume University, Fukuoka, Japan
(Sakuma) Caress Sapporo Hokko Memorial Clinic, Sapporo, Japan
(Daida) Department of Cardiovascular Medicine, Juntendo University
Graduate School of Medicine, Tokyo, Japan
(Iimuro) Innovation and Research Support Center, International University
of Health and Welfare, Tokyo, Japan
(Shimokawa) Graduate School, International University of Health and
Welfare, Chiba, Japan
(Shimokawa) Tohoku University Graduate School of Medicine, Sendai, Japan
(Kimura) Hirakata Kohsai Hospital, Department of Cardiology, Osaka, Japan
(Nagai) Jichi Medical University, Tochigi, Japan
Publisher
Japan Atherosclerosis Society
Abstract
Aims: We aimed to investigate the association between non-lipid residual
risk factors and cardiovascular events in patients with stable coronary
artery disease (CAD) who achieved low-density lipoprotein cholesterol
(LDL-C) 100 mg/dL from the Randomized Evaluation of Aggressive or Moderate
Lipid Lowering Therapy with Pitavastatin in Coronary Artery Disease
(REAL-CAD) study. <br/>Method(s): The REAL-CAD study was a prospective,
multicenter, open-label trial. As a sub-study, we examined the prognostic
impact of non-lipid residual risk factors, including blood pressure,
glucose level, and renal function, in patients who achieved LDL-C 100
mg/dL at 6 months after pitavastatin therapy. Each risk factor was
classified according to severity. The primary outcome was a composite of
cardiovascular death, nonfatal myocardial infarction, nonfatal ischemic
stroke, and unstable angina requiring emergency hospitalization.
<br/>Result(s): Among 8,743 patients, the mean age was 68+/-8.2 years, and
the mean LDL-C level was 84.4+/-18 mg/ dL. After adjusting for the effects
of confounders, an estimated glomerular filtration rate (eGFR) <= 60 mL/
min/1.73 m² showed the highest risk of the primary outcome
(hazard ratio [HR] 1.92; 95% confidence interval [CI] 1.45-2.53). The
combination of eGFR <= 60 and hemoglobin A1c (HbA1c) >= 6.0% also showed
the highest risk of all-cause death (HR, 2.42; 95% CI, 1.72-3.41).
<br/>Conclusion(s): In patients with stable CAD treated with pitavastatin
and who achieved guidelines-directed levels of LDL-C, eGFR and HbA1c were
independently associated with adverse events, suggesting that renal
function and glycemic control could be residual non-lipid therapeutic
targets after statin therapy.<br/>Copyright &#xa9; 2024 Japan
Atherosclerosis Society.

<61>
Accession Number
2029566821
Title
When Direct Oral Anticoagulants Should Not Be Standard Treatment: JACC
State-of-the-Art Review.
Source
Journal of the American College of Cardiology. 83(3) (pp 444-465), 2024.
Date of Publication: 23 Jan 2024.
Author
Bejjani A.; Khairani C.D.; Assi A.; Piazza G.; Sadeghipour P.; Talasaz
A.H.; Fanikos J.; Connors J.M.; Siegal D.M.; Barnes G.D.; Martin K.A.;
Angiolillo D.J.; Kleindorfer D.; Monreal M.; Jimenez D.; Middeldorp S.;
Elkind M.S.V.; Ruff C.T.; Goldhaber S.Z.; Krumholz H.M.; Mehran R.;
Cushman M.; Eikelboom J.W.; Lip G.Y.H.; Weitz J.I.; Lopes R.D.; Bikdeli B.
Institution
(Bejjani, Khairani, Piazza, Goldhaber, Bikdeli) Thrombosis Research Group,
Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United
States
(Bejjani, Khairani, Piazza, Ruff, Goldhaber, Bikdeli) Cardiovascular
Medicine Division, Brigham and Women's Hospital, Harvard Medical School,
Boston, MA, United States
(Bejjani) Department of Medicine, University of Pittsburgh Medical Center,
Pittsburgh, PA, United States
(Assi, Piazza) Department of Medicine, Brigham and Women's Hospital,
Harvard Medical School, Boston, MA, United States
(Sadeghipour) Rajaie Cardiovascular, Medical, and Research Center, Iran
University of Medical Sciences, Tehran, Iran, Islamic Republic of
(Sadeghipour) Clinical Trial Center, Rajaie Cardiovascular, Medical, and
Research Center, Iran University of Medical Sciences, Tehran, Iran,
Islamic Republic of
(Talasaz) Tehran Heart Center, Tehran University of Medical Sciences,
Tehran, Iran, Islamic Republic of
(Talasaz) Virginia Commonwealth University, Richmond, VA, United States
(Fanikos) Department of Pharmacy, Brigham and Women's Hospital, Harvard
Medical School, Boston, MA, United States
(Connors) Hematology Division, Department of Medicine, Brigham and Women's
Hospital, Harvard Medical School, Boston, MA, United States
(Siegal) Division of Hematology, Department of Medicine, University of
Ottawa, Ottawa, ON, Canada
(Barnes) Frankel Cardiovascular Center, Department of Internal Medicine,
University of Michigan, Ann Arbor, MI, United States
(Martin) Division of Hematology/Oncology, Department of Medicine,
Northwestern University Feinberg School of Medicine, Chicago, IL, United
States
(Angiolillo) Division of Cardiology, University of Florida College of
Medicine, Jacksonville, FL, United States
(Kleindorfer) University of Cincinnati, Cincinnati, OH, United States
(Monreal) Catedra de Enfermedad Tromboembolica, Universidad Catolica San
Antonio de Murcia, Spain
(Jimenez) Respiratory Department, Hospital Ramon y Cajal and Medicine
Department, Universidad de Alcala (Instituto de Ramon y Cajal de
Investigacion Sanitaria), Centro de Investigacion Biomedica en Red de
Enfermedades Respiratorias (CIBERES), Madrid, Spain
(Middeldorp, Bikdeli) Department of Internal Medicine, Radboud University
Medical Center, Nijmegen, Netherlands
(Elkind) Department of Neurology, Vagelos College of Physicians and
Surgeons, New York, NY, United States
(Elkind) Department of Epidemiology, Mailman School of Public Health,
Columbia University, New York, NY, United States
(Krumholz) Yale New Haven Hospital/Yale Center for Outcomes Research and
Evaluation, New Haven, CT, United States
(Krumholz) Department of Health Policy and Management, Yale School of
Public Health, New Haven, CT, United States
(Krumholz) Section of Cardiovascular Medicine, Department of Internal
Medicine, Yale School of Medicine, New Haven, CT, United States
(Mehran) Zena and Michael A. Wiener Cardiovascular Institute, Icahn School
of Medicine at Mount Sinai, New York, NY, United States
(Cushman) Department of Medicine, Larner College of Medicine at the
University of Vermont, Burlington, VT, United States
(Cushman) Department of Pathology and Laboratory Medicine, Larner College
of Medicine at the University of Vermont, Burlington, VT, United States
(Eikelboom) Population Health Research Institute, Hamilton Health
Sciences, McMaster University, Hamilton, ON, Canada
(Lip) Liverpool Centre for Cardiovascular Science at University of
Liverpool, Liverpool John Moores University and Liverpool Heart and Chest
Hospital, Liverpool, United Kingdom
(Lip) Danish Center for Clinical Health Services Research, Department of
Clinical Medicine, Aalborg University, Aalborg, Denmark
(Weitz) McMaster University, Hamilton, ON, Canada
(Weitz) Thrombosis and Atherosclerosis Research Institute, Hamilton, ON,
Canada
(Lopes) Duke Clinical Research Institute, Duke University Medical Center,
Durham, NC, United States
(Lopes) Brazilian Clinical Research Institute, Sao Paulo, Brazil
(Bikdeli) Cardiovascular Research Foundation, New York, NY, United States
Publisher
Elsevier Inc.
Abstract
For most patients, direct oral anticoagulants (DOACs) are preferred over
vitamin K antagonists for stroke prevention in atrial fibrillation and for
venous thromboembolism treatment. However, randomized controlled trials
suggest that DOACs may not be as efficacious or as safe as the current
standard of care in conditions such as mechanical heart valves, thrombotic
antiphospholipid syndrome, and atrial fibrillation associated with
rheumatic heart disease. DOACs do not provide a net benefit in conditions
such as embolic stroke of undetermined source. Their efficacy is uncertain
for conditions such as left ventricular thrombus, catheter-associated deep
vein thrombosis, cerebral venous sinus thrombosis, and for patients with
atrial fibrillation or venous thrombosis who have end-stage renal disease.
This paper provides an evidence-based review of randomized controlled
trials on DOACs, detailing when they have demonstrated efficacy and
safety, when DOACs should not be the standard of care, where their safety
and efficacy are uncertain, and areas requiring further
research.<br/>Copyright &#xa9; 2024 American College of Cardiology
Foundation

<62>
Accession Number
2026676175
Title
How Do Patients With Type 2 Diabetes Mellitus Value the Importance of
Outcomes? An Overview of Reviews.
Source
Value in Health. 26(12) (pp 1782-1794), 2023. Date of Publication:
December 2023.
Author
Nino-de-Guzman E.; Bracchiglione J.; Vasquez-Mejia A.; de Graaf G.; Rocha
Calderon C.; Alonso-Coello P.
Institution
(Nino-de-Guzman, Bracchiglione, Rocha Calderon, Alonso-Coello)
Iberoamerican Cochrane Centre, Sant Pau Biomedical Research Institute
(IIB-Sant Pau), Barcelona, Spain
(Nino-de-Guzman) Cancer Prevention and Control Programme, Catalan
Institute of Oncology, IDIBELL, Hospitalet de Llobregat, Barcelona, Spain
(Nino-de-Guzman) Department of Pediatrics, Obstetrics, Gynecology and
Preventive Medicine, Universitat Autonoma de Barcelona, Barcelona, Spain
(Bracchiglione) Interdisciplinary Centre for Health Studies (CIESAL),
Universidad de Valparaiso, Valparaiso, Chile
(Bracchiglione, Alonso-Coello) CIBER de Epidemiologia y Salud Publica
(CIBERESP), Madrid, Spain
(Vasquez-Mejia) Facultad de Medicina Humana, Universidad Nacional Mayor de
San Marcos, Lima, Peru
(de Graaf) Institute for Medical Technology Assessment, Erasmus University
Rotterdam, Rotterdam, Netherlands
Publisher
Elsevier Ltd
Abstract
Objectives: We aimed to assess how patients value the importance of type 2
diabetes mellitus (T2DM) related outcomes. <br/>Method(s): Overview of
systematic reviews (SRs) reporting patients' utilities or disutilities for
T2DM outcomes. We searched 3 databases from inception until June 2021.
Study selection and data extraction were conducted in pairs. We evaluated
the quality of SRs with the Joanna Briggs Institute Checklist, and the
overlap with the corrected covered area. We estimated descriptive
statistics, and, when possible, conducted metanalysis. <br/>Result(s): We
identified 11 SRs, including 119 studies and 70 outcomes. Most reviews
were high-quality SRs. The outcomes with the lowest utilities were
hypoglycemia with very severe symptoms (acute complications), stroke
(macrovascular complications), diabetic peripheral neuropathy with severe
pain (microvascular complications), extreme obesity (comorbidities), and
insulin only or combined (management of diabetes). Good/excellent glucose
control and noninsulin injectable showed higher values than T2DM without
complications. The outcomes with the highest disutilities were amputation,
depression, major hypoglycemia, stroke, and management using only insulin.
<br/>Conclusion(s): We provide standardized, reliable utility values (or
associated disutilities) for T2DM, acute, microvascular and macrovascular
complications, related comorbidities and treatments that may support
judgments when making clinical recommendations, designing decision support
tools, and developing interventions and economic analysis.<br/>Copyright
&#xa9; 2023 International Society for Pharmacoeconomics and Outcomes
Research, Inc.

<63>
Accession Number
2029585969
Title
Non-ischaemic preservation of the donor heart in heart transplantation:
protocol design and rationale for a randomised, controlled, multicentre
clinical trial across eight European countries.
Source
BMJ Open. 13(12) (no pagination), 2023. Article Number: e073729. Date of
Publication: 28 Dec 2023.
Author
Brouckaert J.; Dellgren G.; Wallinder A.; Rega F.
Institution
(Brouckaert, Rega) Cardiac Surgery, University Hospitals Leuven, Leuven,
Belgium
(Dellgren) Cardiothoracic Surgery, Sahlgrenska University Hospital,
Gothenburg, Sweden
(Wallinder) XVIVO Perfusion AB, Gothenburg, Sweden
Publisher
BMJ Publishing Group
Abstract
Introduction Ischaemic cold static storage (ICSS) is the gold standard in
donor heart preservation. This ischaemic time frame renders a time
constraint and risk for primary graft dysfunction. Cold oxygenated heart
perfusion, known as non-ischaemic heart preservation (NIHP), theoretically
limits the ischaemic time, while holding on to the known advantage of
hypothermia and cardioplegia, a low metabolic rate. Methods and analysis
The NIHP 2019 study is an international, randomised, controlled, open,
multicentre clinical trial in 15 heart transplantation centres in 8
European countries and includes 202 patients undergoing heart
transplantation, allocated 1:1 to NIHP or ICSS. Enrolment is estimated to
be 30 months after study initiation. The patients are followed for 12
months after transplantation. The primary objective is to evaluate the
effect of NIHP on survival, allograft function and rejection episodes
within the first 30 days after transplantation. The secondary objectives
are to compare treatment groups with respect to survival, allograft
function, cardiac biomarkers, rejection episodes, allograft vasculopathy,
adverse events and adverse device effects within 12 months. Ethics and
dissemination This protocol was approved by the Ethics Committee (EC) for
Research UZ/KU Leuven, Belgium, the coordinating EC in Germany (Bei Der
LMU Munchen), the coordinating EC in the UK (West Midlands - South
Birmingham Research), the EC of Hospital Puerta de Hierro, Madrid, Spain,
the EC of Goteborg, Sweden, the coordinating EC in France, the EC of
Padova, Italy and the EC of the University of Vienna, Austria. This study
will be conducted in accordance with current local regulations and
international applicable regulatory requirements according to the
principles of the Declaration of Helsinki and ISO14155:2020. Main primary
and secondary outcomes will be published on modified intention-to-treat
population and per-protocol population. Trial registration number
NCT03991923.<br/>Copyright &#xa9; 2023 BMJ Publishing Group. All rights
reserved.

<64>
Accession Number
643205108
Title
Hybrid Cardiac Rehabilitation Program in a Low-Resource Setting: A
Randomized Clinical Trial.
Source
JAMA network open. 7(1) (pp e2350301), 2024. Date of Publication: 02 Jan
2024.
Author
Seron P.; Oliveros M.J.; Marzuca-Nassr G.N.; Morales G.; Roman C.; Munoz
S.R.; Galvez M.; Latin G.; Marileo T.; Molina J.P.; Navarro R.; Sepulveda
P.; Lanas F.; Saavedra N.; Ulloa C.; Grace S.L.
Institution
(Seron, Oliveros, Marzuca-Nassr, Sepulveda, Ulloa) Facultad de Medicina,
Departamento de Ciencias de la Rehabilitacion, Universidad de La Frontera,
Temuco, Chile
(Seron, Oliveros, Lanas) Centro de Excelencia CIGES, Universidad de La
Frontera, Temuco, Chile
(Morales, Munoz) Facultad de Medicina, Departamento de Salud Publica,
Universidad de La Frontera, Temuco, Chile
(Roman) Facultad de Medicina, Escuela de Kinesiologia, Pontificia
Universidad Catolica de Chile, Santiago, Chile
(Galvez) Unidad de Kinesiologia, Complejo Hospitalario San Jose, Santiago,
Chile
(Latin) Servicio de Medicina Fisica y Rehabilitacion, Hospital Clinico,
Hospital San Borja Arriaran, Santiago, Chile
(Marileo) Unidad de Rehabilitacion Cardiaca, Hospital Regional de
Antofagasta, Antofagasta, Chile
(Molina) Servicio de Medicina Fisica y Rehabilitacion, Hospital San Juan
de Dios, Santiago, Chile
(Navarro) Servicio de Medicina Fisica y Rehabilitacion, Hospital Clinico
Universidad de Chile, Santiago, Chile
(Lanas) Facultad de Medicina, Departamento de Medicina Interna,
Universidad de La Frontera, Temuco, Chile
(Saavedra) Facultad de Medicina, Departamento de Ciencias Basicas,
Universidad de La Frontera, Temuco, Chile
(Grace) York University & University Health Network, University of
Toronto, Toronto, ON, Canada
Abstract
Importance: While effective, cardiovascular rehabilitation (CR) as
traditionally delivered is not well implemented in lower-resource
settings. <br/>Objective(s): To test the noninferiority of hybrid CR
compared with traditional CR in terms of cardiovascular events.
<br/>Design, Setting, and Participant(s): This pragmatic, multicenter,
parallel arm, open-label randomized clinical trial (the Hybrid Cardiac
Rehabilitation Trial [HYCARET]) with blinded outcome assessment was
conducted at 6 referral centers in Chile. Adults aged 18 years or older
who had a cardiovascular event or procedure, no contraindications to
exercise, and access to a mobile telephone were eligible and recruited
between April 1, 2019, and March 15, 2020, with follow-up until July 29,
2021. <br/>Intervention(s): Participants were randomized 1:1 in permuted
blocks to the experimental arm, which received 10 center-based supervised
exercise sessions plus counseling in 4 to 6 weeks and then were supported
at home via telephone calls and text messages through weeks 8 to 12, or
the control arm, which received the standard CR of 18 to 22 sessions with
exercises and education in 8 to 12 weeks. <br/>Main Outcomes and Measures:
The primary outcome was cardiovascular events or mortality. Secondary
outcomes were quality of life, return to work, and lifestyle behaviors
measured with validated questionnaires; muscle strength and functional
capacity, measured through physical tests; and program adherence and
exercise-related adverse events, assessed using checklists.
<br/>Result(s): A total of 191 participants were included (mean [SD] age,
58.74 [9.80] years; 145 [75.92%] male); 93 were assigned to hybrid CR and
98 to standard CR. At 1 year, events had occurred in 5 unique participants
in the hybrid CR group (5.38%) and 9 in the standard CR group (9.18%). In
the intention-to-treat analysis, the hybrid CR group had 3.80% (95% CI,
-11.13% to 3.52%) fewer cardiovascular events than the standard CR group,
and relative risk was 0.59 (95% CI, 0.20-1.68) for the primary outcome. In
the per-protocol analysis at different levels of adherence to the
intervention, all 95% CIs crossed the noninferiority boundary (eg, 20%
adherence: absolute risk difference, -0.35% [95% CI, -7.56% to 6.85%]; 80%
adherence: absolute risk difference, 3.30% [95% CI, -3.70% to 10.31%]). No
between-group differences were found for secondary outcomes except
adherence to supervised CR sessions (79.14% [736 of 930 supervised
sessions] in the hybrid CR group vs 61.46% [1201 of 1954 sessions] in the
standard CR group). <br/>Conclusions and Relevance: The results suggest
that a hybrid CR program is noninferior to standard center-based CR in a
low-resource setting, primarily in terms of recurrent cardiovascular
events and potentially in terms of intermediate outcomes. Hybrid CR may
induce superior adherence to supervised exercise. Clinical factors and
patient preferences should inform CR model allocation. Trial Registration:
ClinicalTrials.gov Identifier: NCT03881150.

<65>
Accession Number
2028974251
Title
Long-Term Clinical and Echocardiographic Outcomes Following the Ross
Procedure.
Source
JAMA Cardiology. (no pagination), 2023. Date of Publication: 2023.
Author
Notenboom M.L.; Melina G.; Veen K.M.; De Robertis F.; Coppola G.; De Siena
P.; Navarra E.M.; Gaer J.; Ibrahim M.E.K.; El-Hamamsy I.; Takkenberg
J.J.M.; Yacoub M.H.
Institution
(Notenboom, Veen, Takkenberg) Department of Cardiothoracic Surgery,
Erasmus University Medical Center, Rotterdam, Netherlands
(Melina, Navarra) Department of Cardiac Surgery, Sant'Andrea Hospital,
Sapienza University of Rome, Rome, Italy
(De Robertis, Coppola, De Siena, Gaer) Department of Cardiothoracic
Surgery and Transplantation, Royal Brompton & Harefield Hospitals, Guy's
and St Thomas' NHS Foundation Trust, London, United Kingdom
(Ibrahim) Division of Cardiovascular Surgery, University of Pennsylvania,
Philadelphia, United States
(El-Hamamsy) Department of Cardiovascular Surgery, The Mount Sinai
Hospital, Icahn School of Medicine at Mount Sinai, New York, NY, United
States
(Yacoub) National Heart and Lung Institute, Imperial College London,
London, United Kingdom
(Yacoub) Cardiac Surgery Department, Aswan Heart Centre, Magdi Yacoub
Foundation, Aswan, Egypt
Publisher
American Medical Association
Abstract
IMPORTANCE The Ross procedure as treatment for adults with aortic valve
disease (AVD) has been the subject of renewed interest. OBJECTIVE To
evaluate the long-term clinical and echocardiographic outcomes following
the Ross procedure for the treatment of adults with AVD. DESIGN, SETTING,
AND PARTICIPANTS This post hoc analysis of a randomized clinical trial
included adult patients (age <69 years) who underwent a Ross procedure for
the treatment of AVD, including those with active endocarditis, rheumatic
AVD, decreased ejection fraction, and previous cardiac surgery. The trial,
conducted from September 1, 1994, to May 31, 2001, compared homograft root
replacement with the Ross procedure at a single center. Data after 2010
were collected retrospectively in November and December 2022. EXPOSURE
Ross procedure. MAIN OUTCOMES AND MEASURES The primary end point was
long-term survival among patients who underwent the Ross procedure
compared with that in the age-, country of origin- and sex-matched general
population. Secondary end points were freedom from any reintervention,
autograft reintervention, or homograft reintervention and time-related
valve function, autograft diameter, and functional status. RESULTS This
study included 108 adults (92 [85%] male) with a median age of 38 years
(range, 19-66 years). Median duration of clinical follow-up was 24.1 years
(IQR, 22.6-26.1 years; 2488 patient-years), with 98% follow-up
completeness. Of these patients, 9 (8%) had active endocarditis and 45
(42%) underwent reoperations. The main hemodynamic lesion was stenosis in
30 (28%) and regurgitation in 49 (45%). There was 1 perioperative death
(0.9%). Twenty-five year survival was 83.0% (95% CI, 75.5%-91.2%),
representing a relative survival of 99.1% (95% CI, 91.8%-100%) compared
with the general population (83.7%). At 25 years, freedom from any
reintervention was 71.1% (95% CI, 61.6%-82.0%); from autograft
reintervention, 80.3% (95% CI, 71.9%-89.6%); and from homograft
reintervention, 86.3% (95% CI, 79.0%-94.3%). Thirty-day mortality after
the first Ross-related reintervention was 0% and after all Ross-related
reinterventions was 3.8% (n = 1); 10-year survival after reoperation was
96.2% (95% CI, 89.0%-100%). CONCLUSIONS AND RELEVANCE This study found
that the Ross procedure provided excellent survival into the third decade
postoperatively that was comparable to that in the general population.
Long-term freedom from reintervention demonstrated that the Ross procedure
may be a durable substitute into late adulthood, showing a delayed but
progressive functional decline.<br/>Copyright &#xa9; 2024 American Medical
Association. All rights reserved.

<66>
Accession Number
2029529947
Title
Atrial fibrillation therapy and stroke prevention in hemodialysis
patients.
Source
Kardiologia Polska. 81(12) (pp 1193-1204), 2023. Date of Publication:
2023.
Author
Melenovsky V.; Osmancik P.
Institution
(Melenovsky, Osmancik) Department of Cardiology, Kralovske Vinohrady
University Hospital, Prague, Czechia
(Melenovsky, Osmancik) Department of Cardiology, 3rd Faculty of Medicine,
Charles University, Prague, Czechia
Publisher
Via Medica
Abstract
The prevalence of atrial fibrillation (AF) in patients with chronic kidney
disease (CKD), especially on hemodialysis (HD) is higher compared to the
general population without CKD and reaches ~20%. The risk of ischemic
stroke in CKD patients is also significantly increased. However, since the
risk of bleeding is also significantly increased in CKD patients and the
number of bleeding events exceeds the number of thrombotic events, there
are great concerns regarding the routine use of anticoagulation in this
patient population. No randomized studies were performed to compare
anticoagulation with placebo in patients with advanced CKD and AF. This
lack of knowledge is reflected in international guidelines which refrain
from clear recommendations. The use of anticoagulation for stroke
prevention in HD patients with AF should be strictly individualized for
each patient. Anticoagulation for stroke prevention in HD patients with AF
seems justified only in selected patients with high stroke and low
bleeding risk. Reduced-dose direct oral anticoagulants (especially
apixaban) may prove beneficial. In patients with high thrombotic and
bleeding risk, left atrial appendage closure could be considered. In this
article, the results of the most relevant observational studies with
anticoagulation in CKD/HD patients with AF have been presented and
discussed. Furthermore, results of randomized studies comparing vitamin K
antagonists with non-vitamin K antagonists in CKD patients have been
discussed in detail. Finally, ongoing randomized studies with reduced
doses of apixaban, factor XI inhibitors, and left atrial appendage closure
in CKD patients are mentioned. A brief summary of rhythm control
strategies in AF is given.<br/>Copyright by the Author(s), 2023.

<67>
Accession Number
2027792011
Title
Systematic review and meta-analysis comparing Manta device and Perclose
device for closure of large bore arterial access.
Source
Journal of Vascular Access. (no pagination), 2024. Date of Publication:
2024.
Author
Cheema T.; Venero C.; Champaneria S.; Younas S.; Hadeed Khan M.A.; Anjum
I.; Ijaz U.; Haider S.; Akbar M.S.; Abdul-Waheed M.; Saleem S.
Institution
(Cheema) West Suburban Medical Center, Oak Park, IL, United States
(Venero, Champaneria, Haider, Akbar, Abdul-Waheed, Saleem) University of
Kentucky College of Medicine, Lexington, KY, United States
(Younas, Ijaz) Khyber Medical College, Khyber Pakhtunkhwa, Peshawar,
Pakistan
(Hadeed Khan) Peshawar Medical College, Khyber Pakhtunkhwa, Peshawar,
Pakistan
(Anjum) Vassar Brothers Medical Center, Poughkeepsie, NY, United States
Publisher
SAGE Publications Ltd
Abstract
Data comparing MANTA device with Perclose device for large bore arterial
access closure is limited. We performed meta-analysis to compare safety
and efficacy of the two devices in large (14 Fr sheath) arteriotomy
closure post-TAVR. Relevant studies were identified via PubMed, Cochrane,
and EMBASE databases until June, 2022. Data was analyzed using random
effect model to calculate relative odds of VARC-2 defined access-site
complications and short-term (in-hospital or 30-day) mortality. A total of
12 studies (2 RCT and 10 observational studies) comprising 2339 patients
were included. The odds of major vascular complications (OR 0.99, 95% CI
0.51-1.92; p = 0.98); life threatening and major bleeding (OR 0.77, 95% CI
0.45-1.33; p = 0.35); minor vascular complications (OR 1.37, 95% CI
0.63-2.99; p = 0.43); minor bleeding (OR 0.94, 95% CI 0.57-1.56; p =
0.82); device failure (OR 0.74, 95% CI 0.49-1.11; p = 0.14); hematoma
formation (OR 0.76, 95% CI 0.33-1.75; p = 0.52); dissection, stenosis,
occlusion, or pseudoaneurysm (OR 1.08, 95% CI 0.71-1.62; p = 0.73) and
short-term mortality (OR 1.01, 95% CI 0.55-1.84; p = 0.98) between both
devices were similar. MANTA device has a similar efficacy and safety
profile compared to Perclose device.<br/>Copyright &#xa9; The Author(s)
2024.

<68>
Accession Number
2026449270
Title
Impact of intracardiac echocardiography versus transesophageal
echocardiography guidance on left atrial appendage occlusion procedures: A
meta-analysis.
Source
Journal of Cardiovascular Electrophysiology. 35(1) (pp 44-57), 2024. Date
of Publication: January 2024.
Author
Diaz J.C.; Bastidas O.; Duque M.; Marin J.E.; Aristizabal J.; Nino C.D.;
Hoyos C.; Matos C.D.; Gabr M.; Steiger N.A.; Kapur S.; Sauer W.H.; Romero
J.E.
Institution
(Diaz) Cardiac Arrhythmia and Electrophysiology Service, Universidad CES
Medical School, Division of Cardiology, Clinica Las Vegas, Medellin,
Colombia
(Bastidas, Nino) Cardiac Arrhythmia and Electrophysiology Service,
Hospital Pablo Tobon Uribe, Medellin, Colombia
(Duque, Aristizabal) Cardiac Electrophysiology Service, Hospital San
Vicente Fundacion, Rionegro, Colombia
(Marin) Department of Medicine, Cardiac Arrhythmia and Electrophysiology
Service, Division of Cardiology, Clinica Las Americas, Medellin, colombia,
Medellin, Colombia
(Hoyos, Matos, Gabr, Steiger, Kapur, Sauer, Romero) Cardiac Arrhythmia
Service, Brigham and Women's Hospital, Harvard Medical School, Boston, MA,
United States
Publisher
John Wiley and Sons Inc
Abstract
Background: Intracardiac echocardiography (ICE) is increasingly used
during left atrial appendage occlusion (LAAO) as an alternative to
transesophageal echocardiography (TEE). The objective of this study is to
evaluate the impact of ICE versus TEE guidance during LAAO on procedural
characteristics and acute outcomes, as well the presence of peri-device
leaks and residual septal defects during follow-up. <br/>Method(s): All
studies comparing ICE-guided versus TEE-guided LAAO were identified. The
primary outcomes were procedural efficacy and occurrence of
procedure-related complications. Secondary outcomes included lab
efficiency (defined as a reduction in in-room time), procedural time,
fluoroscopy time, and presence of peri-device leaks and residual
interatrial septal defects (IASD) during follow-up. <br/>Result(s): Twelve
studies (n = 5637) were included. There were no differences in procedural
success (98.3% vs. 97.8%; OR 0.73, 95% CI 0.42-1.27, p =.27; I²
= 0%) or adverse events (4.5% vs. 4.4%; OR 0.81 95% CI 0.56-1.16, p =.25;
I² = 0%) between the ICE-guided and TEE-guided groups. ICE
guidance reduced in in-room time (mean-weighted 28.6-min reduction in
in-room time) without differences in procedural time or fluoroscopy time.
There were no differences in peri-device leak (OR 0.93, 95% CI 0.68-1.27,
p = 0.64); however, an increased prevalence of residual IASD was observed
with ICE-guided versus TEE-guided LAAO (46.3% vs. 34.2%; OR 2.23, 95% CI
1.05-4.75, p = 0.04). <br/>Conclusion(s): ICE guidance is associated with
similar procedural efficacy and safety, but could result in improved lab
efficiency (as established by a significant reduction in in-room time). No
differences in the rate of periprocedural leaks were found. A higher
prevalence of residual interatrial septal defects was observed with ICE
guidance.<br/>Copyright &#xa9; 2023 Wiley Periodicals LLC.

<69>
Accession Number
2025690821
Title
Lung Ultrasound Reduces Chest X-rays in Postoperative Care after Thoracic
Surgery: Is There a Role for Artificial Intelligence?-Systematic Review.
Source
Diagnostics. 13(18) (no pagination), 2023. Article Number: 2995. Date of
Publication: September 2023.
Author
Malik M.; Dzian A.; Stevik M.; Veteskova S.; Al Hakim A.; Hliboky M.;
Magyar J.; Kolarik M.; Bundzel M.; Babic F.
Institution
(Malik, Dzian, Al Hakim) Department of Thoracic Surgery, Jessenius Faculty
of Medicine in Martin, Comenius University in Bratislava and University
Hospital in Martin, Kollarova 4248/2, Martin 036 59, Slovakia
(Stevik, Veteskova) Radiology Department, Jessenius Faculty of Medicine in
Martin, Comenius University in Bratislava and University Hospital in
Martin, Kollarova 4248/2, Martin 036 59, Slovakia
(Hliboky, Magyar, Kolarik, Bundzel, Babic) Department of Cybernetics and
Artificial Intelligence, Faculty of Electrical Engineering and
Informatics, Technical University of Kosice, Letna 9, Kosice 040 01,
Slovakia
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Background: Chest X-ray (CXR) remains the standard imaging modality in
postoperative care after non-cardiac thoracic surgery. Lung ultrasound
(LUS) showed promising results in CXR reduction. The aim of this review
was to identify areas where the evaluation of LUS videos by artificial
intelligence could improve the implementation of LUS in thoracic surgery.
<br/>Method(s): A literature review of the replacement of the CXR by LUS
after thoracic surgery and the evaluation of LUS videos by artificial
intelligence after thoracic surgery was conducted in Medline.
<br/>Result(s): Here, eight out of 10 reviewed studies evaluating LUS in
CXR reduction showed that LUS can reduce CXR without a negative impact on
patient outcome after thoracic surgery. No studies on the evaluation of
LUS signs by artificial intelligence after thoracic surgery were found.
<br/>Conclusion(s): LUS can reduce CXR after thoracic surgery. We presume
that artificial intelligence could help increase the LUS accuracy,
objectify the LUS findings, shorten the learning curve, and decrease the
number of inconclusive results. To confirm this assumption, clinical
trials are necessary. This research is funded by the Slovak Research and
Development Agency, grant number APVV 20-0232.<br/>Copyright &#xa9; 2023
by the authors.

<70>
Accession Number
2029712234
Title
Risk Assessment of Permanent Pacemaker Implantation After Transcatheter
Aortic Valve Implantation in Patients With Preexisting Right Bundle Branch
Block.
Source
American Journal of Cardiology. 213 (pp 151-160), 2024. Date of
Publication: 15 Feb 2024.
Author
Sugiyama Y.; Miyashita H.; Yokoyama H.; Ochiai T.; Shishido K.; Jalanko
M.; Yamanaka F.; Vahasilta T.; Saito S.; Laine M.; Moriyama N.
Institution
(Sugiyama, Miyashita, Yokoyama, Ochiai, Shishido, Yamanaka, Saito,
Moriyama) Department of Cardiology and Catheterization Laboratories,
Shonan Kamakura General Hospital, Kamakura City, Japan
(Sugiyama, Jalanko, Vahasilta, Laine) Department of Cardiology, Heart and
Lung Center, Helsinki University and Helsinki University Central Hospital,
Helsinki, Finland
Publisher
Elsevier Inc.
Abstract
Preexisting right bundle branch block (RBBB) is the strongest predictor
for permanent pacemaker implantation (PPI) after transcatheter aortic
valve implantation (TAVI). However, the risk assessment for new PPI and
effective procedural strategy for preventing new PPI in patients with
preexisting RBBB are still unclear. This study stratified the new PPI risk
after TAVI and investigated the impact of implantation strategy in a
preexisting RBBB cohort. We analyzed 237 patients with preexisting RBBB
who underwent TAVI. The primary endpoint was the incidence of new PPI.
Multivariate analyses investigating predictors for new PPI were performed.
The overall PPI rate was 33.3%. Significant baseline predictors for new
PPI were combination of RBBB, left anterior or posterior fascicular block,
and first-degree atrioventricular block (odds ratio [OR] 2.55, 95%
confidence interval [CI] 1.09 to 5.04), high calcium volume of noncoronary
cusp (OR 2.08, 95% CI 1.05 to 4.10), and membranous septum (MS) length <2
mm (OR 2.02, 95% CI 1.09 to 3.75) in the univariate analysis and MS length
<2 mm (OR 2.25, 95% CI 1.06 to 4.82) in the multivariate analysis. On the
multivariate analysis including procedural variables, predilatation (OR
2.41, 95% CI 1.01 to 5.83), self-expanding valves (Corevalve, Evolut R,
and Evolut Pro/Pro+; Medtronic Inc., Minneapolis, Minnesota) or mechanical
expanding valves (Lotus/Lotus Edge; Boston Scientifics, Marlborough,
Massachusetts) (OR 3.00, 95% CI 1.31 to 6.91), and implantation depth > MS
length (OR 4.27, 95% CI 1.81 to 10.08) were significantly associated with
new PPI. The incidence of new PPI increased according to the number of
baseline predictors (0: 20.9%, 1: 34.3%, and >=2: 52.0%) and procedural
predictors (0: 3.7%, 1: 20.9%, 2: 40.5%, and 3: 60.0%). New PPI risk in a
preexisting RBBB subset could be stratified by baseline factors. Device
selection and implantation strategy considering MS length could prevent
new PPI even in these high-risk population.<br/>Copyright &#xa9; 2023 The
Authors

<71>
Accession Number
2029709148
Title
Mitochondrial Fusion Promoter Given During Ischemia Has Greater
Neuroprotective Efficacy Than When Given at Onset of Reperfusion in Rats
with Cardiac Ischemia/Reperfusion Injury.
Source
Journal of Alzheimer's Disease. 97(1) (pp 205-217), 2024. Date of
Publication: 02 Jan 2024.
Author
Chunchai T.; Apaijai N.; Janjek S.; Arunsak B.; Nipon C.; Chattipakorn
S.C.
Institution
(Chunchai, Apaijai, Janjek, Arunsak, Nipon, Chattipakorn) Neurophysiology
Unit, Cardiac Electrophysiology Research and Training Center, Faculty of
Medicine, Chiang Mai University, Chiang Mai, Thailand
(Chunchai, Apaijai, Janjek, Arunsak, Nipon, Chattipakorn) Center of
Excellence in Cardiac Electrophysiology Research, Chiang Mai University,
Chiang Mai, Thailand
(Apaijai, Nipon) Cardiac Electrophysiology Unit, Department of Physiology,
Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
(Chattipakorn) Department of Oral Biology and Diagnostic Sciences, Faculty
of Dentistry, Chiang Mai University, Chiang Mai, Thailand
Publisher
IOS Press BV
Abstract
Background: Cardiac ischemia/reperfusion (I/R) injury has been shown to
impose deleterious effects not only on the heart but also on the brain.
Our previous study demonstrated that pretreatment with a mitochondrial
fusion promoter (M1) provided central neuroprotective effects following
cardiac I/R injury. <br/>Objective(s): To investigate the effects of M1
given during the ischemic phase and M1 given at the beginning of
reperfusion on brain pathologies following cardiac I/R. <br/>Method(s):
Male Wistar rats were randomly divided into either a sham operation (n=6)
or cardiac I/R injury (n = 18) group. Rats with cardiac I/R injury were
then randomly divided into 3 subgroups: 1) Control, 2) M1 treatment during
cardiac ischemia (2 mg/kg, intravenous (i.v.)), and 3) M1 treatment at the
beginning of reperfusion (2 mg/kg, i.v.). After euthanasia, the brain of
each rat was removed for further analysis. <br/>Result(s): Cardiac I/R
injury caused brain mitochondrial dynamic imbalance, brain mitochondrial
dysfunction, brain apoptosis, microglial dysmorphology, brain
inflammation, tau hyperphosphorylation, and synaptic dysplasticity. M1
treatment at both time points effectively improved these parameters. M1
given during the ischemic phase had greater efficacy with regard to
preventing brain mitochondrial dysfunction and suppressing brain
inflammation, when compared to M1 given at the beginning of reperfusion.
<br/>Conclusion(s): Our findings suggest that treatment with this
mitochondrial fusion promoter prevents mitochondrial dynamic imbalance in
the brain of rats with cardiac I/R injury, thereby attenuating brain
pathologies. Interestingly, giving the mitochondrial fusion promoter
during the ischemic phase exerted greater neuroprotection than if given at
the beginning of reperfusion.<br/>Copyright &#xa9; 2024 - IOS Press. All
rights reserved.

<72>
Accession Number
2029626198
Title
Clinical application of esketamine-induced mild sedation technique in
outpatient oral surgery.
Source
Anaesthesia, Pain and Intensive Care. 27(6) (pp 715-720), 2023. Date of
Publication: 01 Dec 2023.
Author
Xin Z.; Yu T.; Wang L.L.; Qu W.; Wang N.; Yao M.
Institution
(Xin, Wang, Wang) Department of Anesthesiology, Yantai Stomatology
Hospital of Binzhou Medical University, Shandong, Yantai 264000, China
(Yu, Qu) Department of Oral and Maxillofacial Surgery, Yantai Stomatology
Hospital of Binzhou Medical University, Shandong, Yantai 264000, China
(Yao) Department of Clinical laboratory, Yantai Stomatology Hospital of
Binzhou Medical University, Shandong, Yantai 264000, China
Publisher
Faculty of Anaesthesia, Pain and Intensive Care, AFMS
Abstract
Background & Objective: Sedation is often required in outpatient surgical
procedures, performed under local analgesia, to allay the anxiety of the
patient, which may lead to involuntary movements of the patient, thus
interfering in the smooth course of the surgery. Various sedative drugs
have been used by the anesthetists. We compared the effects of mild
sedation techniques induced by remifentanil combined with propofol and
esketamine combined with propofol on the cardiopulmonary indices of
intraoperative patients, and to explore the application of mild sedation
techniques in oral outpatient surgery. Methodology: A total of 62 patients
undergoing oral surgery were randomly divided into a control group (31
cases, receiving remifentanil combined with propofol) and an observation
group (31 cases, receiving esketamine combined with propofol). The vital
signs of the patients were monitored at five time points: admission (T0),
anesthesia induction (T1), local anesthesia (T2), the beginning of surgery
(T3), and the end of surgery (T4), including heart rate (HR), mean
arterial pressure(MAP), bispectral index (BIS), respiratory rate, and
oxygen saturation(SPO2). Postoperative memory of each step was recorded,
and the sedative effect was evaluated by physician and patient using the
visual analogue scale (VAS). <br/>Result(s): During surgery, 6 patients in
the control group had SpO2 < 90%, and 8 patients experienced coughing or
tongue fall, while 1 patient in the observation group had a transient
increase in blood pressure. After intravenous administration, all patients
had a decrease in HR, and the decrease in the observation group was
significantly less than that in the control group (P < 0.05). The BIS
values in the observation group were significantly higher than those in
the control group during T2 and T3. <br/>Conclusion(s): In oral outpatient
surgery, the combination of propofol and esketamine-induced mild sedation
can stabilize the hemodynamic indices of patients during surgery, reduce
the incidence of complications, and improve patient
satisfaction.<br/>Copyright &#xa9; 2023 Faculty of Anaesthesia, Pain and
Intensive Care, AFMS. All rights reserved.

<73>
Accession Number
2029699272
Title
Systematic review and meta-analysis of early aortic valve replacement
versus conservative therapy in patients with asymptomatic aortic valve
stenosis with preserved left ventricle systolic function.
Source
Open Heart. 11(1) (no pagination), 2024. Article Number: e002511. Date of
Publication: 08 Jan 2024.
Author
Senguttuvan N.B.; Srinivasan N.V.; Panchanatham M.; Abdulkader R.S.;
Anandaram A.; Polareddy D.R.; Ramesh S.; Singh H.; Yallanki H.;
Kaliyamoorthi D.; Chidambaram S.; Ramalingam V.; Rajendran R.;
Muralidharan T.R.; Rao R.; Seth A.; Claessen B.; Krishnamoorthy P.
Institution
(Senguttuvan, Panchanatham, Polareddy, Ramesh, Singh, Muralidharan)
Department of Cardiology, SRIHER (Deemed to Be University), Tamil Nadu,
Chennai, India
(Srinivasan, Anandaram) Department of Clinical Research, SRIHER (Deemed to
Be University), Tamil Nadu, Chennai, India
(Abdulkader) Department of Statistics, National Institute of Epidemiology,
Tamil Nadu, Chennai, India
(Yallanki) Department of Medicine, SRIHER (Deemed to Be University), Tamil
Nadu, Chennai, India
(Kaliyamoorthi) Cardiology, Apollo Hospitals, Tamil Nadu, Chennai, India
(Chidambaram) Department of Cardiology, Kauvery Hospital, Chennai, India
(Ramalingam) Department of Cardiology, Velammal Medical College Hospital
and Research Institute, Tamil Nadu, Madurai, India
(Rajendran) Department of Cardiology, Apollo Hospitals, Tamil Nadu,
Trichy, India
(Rao) Department of Cardiology, Rajasthan University of Health Sciences,
Rajasthan, Jaipur, India
(Seth) Department of Cardiology, Fortis Escorts Heart Institute and
Research Centre, Delhi, New Delhi, India
(Claessen) Department of Cardiology, Amsterdam University Medical Centres,
Amsterdam, Netherlands
(Krishnamoorthy) Cardiology, Icahn School of Medicine at Mount Sinai Zena,
Michael A Wiener Cardiovascular Institute, New York, NY, United States
Publisher
BMJ Publishing Group
Abstract
Background A quarter of patients with severe aortic stenosis (AS) were
asymptomatic, and only a third of them survived at the end of 4 years.
Only a select subset of these patients was recommended for aortic valve
replacement (AVR) by the current American College of Cardiology/American
Heart Association guidelines. We intended to study the effect of early AVR
(eAVR) in this subset of asymptomatic patients with preserved left
ventricle function. Methods and results We searched PubMed and Embase for
randomised and observational studies comparing the effect of eAVR versus
conservative therapy in patients with severe, asymptomatic AS and normal
left ventricular function. The primary outcome was all-cause mortality.
The secondary outcomes were composite major adverse cardiac events (MACE)
(study defined), myocardial infarction (MI), stroke, cardiac death, sudden
death, the development of symptoms, heart failure hospitalisations and
major bleeding. We used GRADEPro to assess the certainty of the evidence.
In the randomised controlled trial (RCT) only analysis, we found no
significant difference in all-cause mortality between the early aortic
intervention group versus the conservative arm (CA) (incidence rate ratio,
IRR (CI): 0.5 (0.2 to 1.1), I 2 =31%, p=0.09). However, in the overall
cohort, we found mortality benefit for eAVR over CA (IRR (CI): 0.4 (0.3 to
0.7), I 2 =84%, p<0.01). There were significantly lower MACE, cardiac
death, sudden death, development of symptoms and heart failure
hospitalisations in the eAVR group. We noticed no difference in MI, stroke
and major bleeding. Conclusion We conclude that there is no reduction in
all-cause mortality in the eAVR arm in patients with asymptomatic AS with
preserved ejection fraction. However, eAVR reduces heart failure related
hospitalisations and death or heart failure hospitalisations. PROSPERO
registration number CRD42022306132.<br/>Copyright &#xa9; Author(s) (or
their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial
re-use. See rights and permissions. Published by BMJ.

<74>
Accession Number
2029699263
Title
Pain and sleep after open-heart surgery-inhalation peppermint essence:
Double-blind randomized clinical trial.
Source
BMJ Supportive and Palliative Care. 13(e3) (pp E1318-E1325), 2023. Date of
Publication: 03 Aug 2023.
Author
Pour-Abbasi M.-S.; Yadollahi S.; Maghami M.; Azizi-Fini I.; Afazel M.-R.
Institution
(Maghami, Yadollahi, Azizi-Fini, Afazel) Trauma Nursing Research Center,
Kashan University of Medical Sciences, Kashan, Iran, Islamic Republic of
(Pour-Abbasi) Cardiac Surgery Department, Kashan University of Medical
Sciences, Kashan, Iran, Islamic Republic of
(Maghami) Biostatics and Epidemiology Department, Isfahan University of
Medical Sciences, Isfahan, Iran, Islamic Republic of
Publisher
BMJ Publishing Group
Abstract
Objective The aim of this study was to determine the effect of inhaling
peppermint essence on pain relief and sleep quality after open-heart
surgery. Methods In a double-blind randomised clinical trial carried out
in Iran in 2020, 64 cardiac patients were selected by convenience sampling
and randomly allocated to aromatherapy (n=32) and placebo (n=32) groups.
The aromatherapy and control groups received inhaled aromatherapy using
peppermint essence and distilled water, respectively. Data gathering tools
were the Numeric Pain Rating Scale and St Mary's Hospital Sleep
Questionnaire. Data were analysed using an independent t-test, chi 2 test,
Mann-Whitney U test and generalised estimating equation analysis. Results
The mean severity of pain in the aromatherapy and placebo groups was
3.22+/-0.88 and 4.56+/-0.90, respectively, which was a statistically
significant difference (p=0.0001). The mean sleep scores after the
intervention on day 1 were 20.10+/-4.90 and 25.76+/-6.36 in the
aromatherapy and placebo groups, respectively, and 18.63+/-5.56 and
22.62+/-5.69, respectively, on day 2. The difference between the two
groups was statistically significantly different after the intervention in
terms of sleep quality (p<0.05). Conclusion Aromatherapy attenuated pain
and improved sleep quality after open-heart surgery. Peppermint essence
aromatherapy is therefore recommended after surgery.<br/>Copyright &#xa9;
Author(s) (or their employer(s)) 2023. No commercial re-use. See rights
and permissions. Published by BMJ.

<75>
Accession Number
2029649283
Title
Bayesian interpretation of non-inferiority in transcatheter versus
surgical aortic valve replacement trials: a systematic review and
meta-analysis.
Source
Interdisciplinary cardiovascular and thoracic surgery. 37(5) (no
pagination), 2023. Article Number: ivad185. Date of Publication: 01 Nov
2023.
Author
Heuts S.; Kawczynski M.J.; Sardari Nia P.; Maessen J.G.; Biondi-Zoccai G.;
Gabrio A.
Institution
(Heuts, Kawczynski, Sardari Nia, Maessen) Department of Cardiothoracic
Surgery, Maastricht University Medical Centre+, Maastricht, Netherlands
(Heuts, Kawczynski, Sardari Nia, Maessen) Cardiovascular Research
Institute Maastricht (CARIM), Maastricht University, Maastricht,
Netherlands
(Biondi-Zoccai) Department of Medical-Surgical Sciences and
Biotechnologies, Sapienza University of Rome, Rome, Italy
(Biondi-Zoccai) Mediterranea Cardiocentro, Napoli, Italy
(Gabrio) Department of Methodology and Statistics, Maastricht University,
Maastricht, Netherlands
Publisher
Oxford University Press
Abstract
Objectives: The concept of non-inferiority is widely adopted in randomized
trials comparing transcatheter aortic valve replacement (TAVR) and
surgical aortic valve replacement (SAVR). However, uncertainty exists
regarding the long-term outcomes of TAVR, and non-inferiority may be
difficult to assess. We performed a systematic review and meta-analysis of
randomized trials comparing TAVR and SAVR, with a specific emphasis on the
non-inferiority margin for 5-year all-cause mortality. <br/>Method(s): A
systematic search was applied to 3 electronic databases. Randomized trials
comparing TAVR and SAVR were included. Bayesian methods were implemented
to evaluate the posterior probability of non-inferiority at different
trial non-inferiority margins under either a vague, Cauchy, or a
literature-based prior. Primary outcomes were 5-year actuarial all-cause
mortality, and the probability of non-inferiority at various transformed
trial non-inferiority margins. Secondary outcomes were long-term survival
and 1- and 2-year actuarial survival. <br/>Result(s): Eight trials (n =
8698 patients) were included. Kaplan-Meier-derived 5-year survival was
61.6% (95% CI 59.8-63.5%) for TAVR, and 63.7% (95% CI 61.9-65.6%) for
SAVR. Six trials (n = 6370 patients) reported all-cause mortality at
5-year follow-up. Under a vague prior, the posterior median relative risk
for all-cause mortality of TAVR was 1.14, compared to SAVR (95% credible
interval 1.06-1.22, probability of relative risk <1.00 = 0.01%,
I² = 0%). Similar results in terms of point estimate and
uncertainty measures were obtained using frequentist methods. Based on the
various trial non-inferiority margins, the results of the analysis suggest
that non-inferiority at 5 years is no longer likely. <br/>Conclusion(s):
It is unlikely that TAVR is still non-inferior to SAVR at 5 years in terms
of all-cause mortality. <br/>Copyright &#xa9; 2023 The Author(s).

<76>
Accession Number
2029649214
Title
Simulation-based training in cardiac surgery: A systematic review.
Source
Interdisciplinary cardiovascular and thoracic surgery. 37(2) (no
pagination), 2023. Article Number: ivad079. Date of Publication: 01 Aug
2023.
Author
Arjomandi Rad A.; Hajzamani D.; Sardari Nia P.
Institution
(Arjomandi Rad) Medical Sciences Division, University of Oxford, Oxford,
United Kingdom
(Arjomandi Rad, Hajzamani, Sardari Nia) Department of Cardiothoracic
Surgery, Maastricht University Medical Center, Maastricht, Netherlands
Publisher
Oxford University Press
Abstract
OBJECTIVES: The increase in the complexity of operations, the rising quest
for improved outcomes and the scrutiny of surgical practice and its
associated complications have led to a decreased educational value of
in-patient surgical training within cardiac surgery. Simulation-based
training has emerged as an adjunct to the apprenticeship model. In the
following review, we aimed to evaluate the currently available evidence
regarding simulation-based training in cardiac surgery. <br/>METHOD(S): A
systematic database search was conducted as per PRISMA guidelines, of
original articles that explored the use of simulation-based training in
adult cardiac surgery programs in EMBASE, MEDLINE, Cochrane database and
Google Scholar, from inception to 2022. Data extraction covered the study
characteristics, simulation modality, main methodology and main outcomes.
<br/>RESULT(S): Our search yielded 341 articles, of which 28 studies were
included in this review. Three main areas of focus were identified: (i)
validity testing of the models; (ii) impact on surgeons' skills; and (iii)
impact on clinical practice. Fouteen studies reported animal-based models
and 14 reported on non-Tissue-based models covering a wide spectrum of
surgical operations. The results of the included studies suggest that
validity assessment is scarce within the field, being carried out for only
4 of the models. Nonetheless, all studies reported improvement in
trainees' confidence, clinical knowledge and surgical skills (including
accuracy, speed, dexterity) of trainees both at senior and junior levels.
The direct clinical impact included initiation of minimally invasive
programmes and improved board exam pass rates, and creating positive
behavioural changes to minimize further cardiovascular risk.
<br/>CONCLUSION(S): Surgical simulation has been shown to provide
substantial benefits to trainees. Further evidence is needed to explore
its direct impact on clinical practice. <br/>Copyright &#xa9; 2023 The
Author(s). Published by Oxford University Press on behalf of the European
Association for Cardio-Thoracic Surgery.

<77>
Accession Number
2027847758
Title
Application of Speckle Tracking Echocardiography for Evaluating
Ventricular Function after Transcatheter Pulmonary Valve Replacement.
Source
Diagnostics. 14(1) (no pagination), 2024. Article Number: 88. Date of
Publication: January 2024.
Author
Ji M.; Zhang L.; Gao L.; Lin Y.; He Q.; Xie M.; Li Y.
Institution
(Ji, Zhang, Gao, Lin, He, Xie, Li) Department of Ultrasound Medicine,
Union Hospital, Tongji Medical College, Huazhong University of Science and
Technology, Wuhan 430022, China
(Ji, Zhang, Gao, Lin, He, Xie, Li) Clinical Research Center for Medical
Imaging in Hubei Province, Wuhan 430022, China
(Ji, Zhang, Gao, Lin, He, Xie, Li) Hubei Province Key Laboratory of
Molecular Imaging, Wuhan 430022, China
(Xie) Shenzhen Huazhong University of Science and Technology Research
Institute, Shenzhen 518057, China
(Xie) Tongji Medical College and Wuhan National Laboratory for
Optoelectronics, Huazhong University of Science and Technology, Wuhan
430022, China
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Pulmonary regurgitation usually leads to right heart dilatation and
eventually right heart dysfunction, which is associated with a poor
prognosis. Transcatheter pulmonary valve replacement is a developing
treatment for pulmonary valve dysfunction that can take the place of
traditional surgery and make up for the shortcomings of a large injury.
Echocardiography plays a significant role in assessing ventricular
function; however, conventional echocardiographic parameters have several
limitations. Speckle tracking echocardiography has been regarded as a more
accurate tool for quantifying cardiac function than conventional
echocardiography. Therefore, the aim of this review was to summarize the
application of speckle tracking echocardiography for evaluating right and
left ventricular functions in patients after transcatheter pulmonary valve
replacement.<br/>Copyright &#xa9; 2023 by the authors.

<78>
Accession Number
2027353990
Title
Beyond the Vapor: Exploring Hemodynamic Parameters and Recovery
Characteristics in Valvular Cardiac Surgery with Sevoflurane and
Isoflurane.
Source
International Journal of Pharmaceutical and Clinical Research. 15(12) (pp
1498-1501), 2023. Date of Publication: 2023.
Author
Meena D.K.; Charan P.; Sharma A.; Somani M.
Institution
(Meena, Sharma) Department of Anaesthesiology, RVRS Government Medical
College, Rajasthan, Bhilwara, India
(Charan) Department of Anaesthesiology, SMS Medical College, Rajasthan,
Jaipur, India
(Somani) Department of Anaesthesiology, RNT Medical college, Rajasthan,
Udaipur, India
Publisher
Dr. Yashwant Research Labs Pvt. Ltd.
Abstract
Background: For patients with valvular heart disorders, valve cardiac
surgery is a vital intervention that requires careful evaluation of
anesthetic drugs to maximize perioperative results. This study
investigates how hemodynamic parameters and recovery characteristics
following valvular heart surgery are affected by sevoflurane and
isoflurane. <br/>Method(s): Seventy participants were randomly assigned to
receive either isoflurane (Group B) or sevoflurane (Group A) in a
hospital-based, randomized, comparative trial. Assessments were made of
hemodynamic parameters such as cardiac output, pulmonary vascular
resistance, and systemic vascular resistance. Sevoflurane or isoflurane
anesthesia regimes were customized to meet the needs of each individual
patient. Comprehensive research was done on recovery features such time to
extubation, emergence from anesthesia, and postoperative problems. The two
groups' findings were compared using statistical techniques.
<br/>Result(s): Comparable hemodynamic stability was observed between the
isoflurane and sevoflurane groups, which is an important factor in
valvular heart surgery. There were no discernible variations in diastolic
blood pressure (D.B.P.) at different intervals, suggesting that both
medications could offer comparable intraoperative hemodynamic stability.
Furthermore, similar values were seen in the trend of stroke volume
variation (SVV), which confirms the hemodynamic neutrality of the drugs
during surgery. <br/>Conclusion(s): The present study provides significant
insights into the administration of sevoflurane and isoflurane during
valvular heart surgery. Similar hemodynamic stability was shown by both
drugs, highlighting the significance of customizing anesthetic regimes to
meet the demands of each patient. The thorough investigation of recovery
traits improves perioperative care tactics even more. These results will
help anesthesiologists make wise judgments that will eventually benefit
patients having valvular heart surgery.<br/>Copyright &#xa9; Meena et al.

<79>
Accession Number
2029649278
Title
Pain management after pneumothorax surgery: intercostal nerve block or
thoracic epidural analgesia.
Source
Interdisciplinary cardiovascular and thoracic surgery. 37(5) (no
pagination), 2023. Article Number: ivad180. Date of Publication: 01 Nov
2023.
Author
Spaans L.N.; Van Steenwijk Q.C.A.; Seiranjan A.; Janssen N.; De Loos E.R.;
Susa D.; Eerenberg J.P.; Bouwman R.A.; Dijkgraaf M.G.; Van Den Broek
F.J.C.
Institution
(Spaans, Van Steenwijk, Seiranjan, Van Den Broek) Department of Surgery,
Maxima Medical Center, Eindhoven, Netherlands
(Spaans, Dijkgraaf) Department of Epidemiology and Data Science, Amsterdam
University Medical Centers, University of Amsterdam, Amsterdam,
Netherlands
(Spaans, Dijkgraaf) Amsterdam Public Health, Amsterdam, Netherlands
(Janssen, De Loos) Department of Surgery, Zuyderland Medical Centre,
Heerlen, Netherlands
(Susa) Department of Surgery, Bravis Hospital, Bergen op Zoom, Netherlands
(Eerenberg) Department of Surgery, Tergooi Medical Centre, Hilversum,
Netherlands
(Bouwman) Department of Anesthesiology and Pain Medicine, Catharina
Hospital, Eindhoven, Netherlands
(Bouwman) Department of Electrical Engineering, Signal Processing Systems,
Eindhoven Technical University, Eindhoven, Netherlands
Publisher
Oxford University Press
Abstract
Objectives: In patients undergoing video-assisted thoracoscopic surgery
for pneumothorax, the benefits and risks of single-shot intercostal nerve
block as loco-regional analgesia are not well known. We retrospectively
compared the effectiveness of intercostal nerve blocks as a viable
alternative to thoracic epidural analgesia (TEA) regarding pain control
and enhanced recovery. <br/>Method(s): A retrospective multicentre
analysis with single-centre propensity score matching was performed in
patients undergoing video-assisted thoracoscopic surgery for pneumothorax
receiving either TEA or intercostal nerve block. The primary outcome was a
proportion of pain scores >=4 (scale 0-10) until postoperative day (POD)
3. Secondary outcomes included variation in pain over time, additional
opioid use, length of stay, mobility, complications and recurrence rate.
<br/>Result(s): In 218 patients, TEA was compared to intercostal nerve
block and showed no difference in the proportion of pain scores >=4 {14.3%
[interquartile range (IQR) 0.0-33.3] vs 11.1% (IQR 0.0-27.3) respectively,
P = 0.24}, more frequently needed additional opioids on the day of surgery
(18% vs 48%) and first POD (20% vs 42%), had a shorter length of stay (4.0
days [IQR 3.0-7.0] vs 3.0 days [IQR 2.8-4.0]) and were significantly more
mobile until POD 3, while having similar recurrences. Intercostal nerve
block had higher pain scores early in the course whereas TEA had higher
late (rebound) pain scores. <br/>Conclusion(s): In a multimodal analgesic
setting with additional opioids, intercostal nerve block shows comparable
moments of unacceptable pain from POD 0-3 compared to TEA and is linked to
improved mobility. Results require randomized confirmation. <br/>Copyright
&#xa9; 2023 The Author(s).

<80>
Accession Number
2029649264
Title
The impact of perioperative non-steroidal anti-inflammatory drugs use on
pleurodesis following thoracic surgery.
Source
Interdisciplinary cardiovascular and thoracic surgery. 37(5) (no
pagination), 2023. Article Number: ivad107. Date of Publication: 01 Nov
2023.
Author
Kutywayo K.; Habib A.A.; Caruana E.J.
Institution
(Kutywayo, Habib, Caruana) Department of Thoracic Surgery, Glenfield
Hospital, University Hospitals Leicester, Leicester, United Kingdom
Publisher
Oxford University Press
Abstract
A best evidence topic in thoracic surgery was written according to a
structured protocol. The question addressed was: in patients who have had
{visceral and parietal pleural symphysis}, {do NSAIDs reduce} {the
efficacy of pleurodesis}? Sixteen papers were discovered in the search. Of
these, 3 human studies were included in the analysis. None showed a
significantly higher rate of pleurodesis failure in patients given
perioperative NSAIDs. The results from the largest study met criteria for
noninferiority. Within the constraints of the study, the results suggest
that systemic administration of nonsteroidal anti-inflammatory medication
in the perioperative period does not necessarily attenuate effective
pleurodesis. However, further study is needed as there is a clear paucity
of human-based studies. <br/>Copyright &#xa9; 2023 The Author(s).

<81>
Accession Number
2029649217
Title
Reasons and predictors of non-participation in a personalized digital
prehabilitation care trial for patients undergoing elective cardiothoracic
surgery.
Source
Interdisciplinary cardiovascular and thoracic surgery. 37(2) (no
pagination), 2023. Article Number: ivad123. Date of Publication: 01 Aug
2023.
Author
Scheenstra B.; Bongers B.C.; Broeders B.; Imkamp M.; Van Susante L.;
Kietselaer B.; Maessen J.; Van'T Hof A.; Sardari Nia P.
Institution
(Scheenstra, Broeders, Van Susante, Maessen, Van'T Hof, Sardari Nia)
Department of Cardiothoracic Surgery, Heart and Vascular Center,
Maastricht University Medical Center, Maastricht, Netherlands
(Scheenstra, Maessen, Van'T Hof, Sardari Nia) Department of Cardiothoracic
Surgery, Cardiovascular Research Institute Maastricht (CARIM), Maastricht
University, Maastricht, Netherlands
(Bongers) Department of Nutrition and Movement Sciences, Nutrition and
Translational Research in Metabolism (NUTRIM), Maastricht University,
Maastricht, Netherlands
(Bongers) Department of Surgery, Nutrition and Translational Research in
Metabolism (NUTRIM), Maastricht University, Maastricht, Netherlands
(Imkamp) Department of Clinical Epidemiology and Medical Technology
Assessment, Maastricht University Medical Center, Maastricht, Netherlands
(Kietselaer) Department of Cardiovascular Disease, Mayo Clinic, Rochester,
MN, United States
(Van'T Hof) Department of Cardiology, Zuyderland Medical Center, Heerlen,
Netherlands
Publisher
Oxford University Press
Abstract
OBJECTIVES: Prehabilitation through a digital platform could
preoperatively improve the physical and mental fitness of patients
undergoing cardiothoracic surgery, thereby improving treatment outcomes.
This study aimed to describe the reasons and predictors of
non-participation in a personalized digital prehabilitation care trial
(Digital Cardiac Counseling randomized controlled trial) for patients
undergoing elective cardiothoracic surgery. <br/>METHOD(S): Adult patients
scheduled for elective cardiothoracic surgery at the Maastricht University
Medical Center+ were approached to participate in a digital
prehabilitation care trial, in which patients were informed about their
care pathway, monitored for symptom progression and screened for
preoperative modifiable risk factors. Baseline characteristics of all
eligible patients and reasons of non-participation were registered
prospectively. Predictors of non-participation were determined using
logistic regression. <br/>RESULT(S): Between May 2020 and August 2022, 815
patients were eligible for participation; 421 (52%) did not participate in
the personalized digital prehabilitation care trial. Reasons for
non-participation were 'lack of internet access or insufficient digital
skills' (32%), 'wishing no participation' (39%) and 'other reasons' (30%;
e.g. vision or hearing impairments, analphabetism, language barriers).
Independent predictors of non-participation were age [odds ratio (OR)
1.024 (1.003-1.046), P = 0.024], socioeconomic status [OR 0.267
(0.133-0.536), P < 0.001], current smoker [OR 1.823 (1.124-2.954), P =
0.015] and EuroSCORE II [OR 1.160 (1.042-1.292), P = 0.007].
<br/>CONCLUSION(S): Half of the eligible patients did not participate in a
personalized digital prehabilitation care trial. Non-participants were
vulnerable patients, with a more unfavourable risk profile and more
modifiable risk factors, who could potentially benefit the most from
prehabilitation. <br/>Copyright &#xa9; 2023 The Author(s). Published by
Oxford University Press on behalf of the European Association for
Cardio-Thoracic Surgery.

<82>
Accession Number
2029649104
Title
Effect of intraoperative haemoadsorption therapy on cardiac surgery for
active infective endocarditis with confirmed Staphylococcus aureus
bacteraemia.
Source
Interdisciplinary cardiovascular and thoracic surgery. 36(1) (no
pagination), 2023. Article Number: ivad010. Date of Publication: 01 Jan
2023.
Author
Haidari Z.; Leiler S.; Mamdooh H.; Fittkau M.; Boss K.; Tyczynski B.;
Thielmann M.; Bagaev E.; El Gabry M.; Wendt D.; Kribben A.; Bertsch T.;
Ruhparwar A.; Fischlein T.; Kalisnik J.M.
Institution
(Haidari, Thielmann, El Gabry, Wendt, Ruhparwar) Department of Thoracic
and Cardiovascular Surgery, West German Heart and Vascular Center Essen,
University Hospital Essen, Essen, Germany
(Leiler, Mamdooh, Fittkau, Bagaev, Fischlein, Kalisnik) Department of
Cardiac Surgery, Klinikum Nurnberg, Paracelsus Medical University,
Nuremberg, Germany
(Boss, Tyczynski, Kribben, Bertsch) Department of Nephrology, University
Hospital Essen, Essen, Germany
(Wendt) Cytosorbents Inc., Princeton, NJ, United States
Publisher
Oxford University Press
Abstract
OBJECTIVES: Sepsis caused by infective endocarditis (IE), due to
Staphylococcus aureus, is associated with significant morbidity and
mortality. Blood purification using haemoadsorption (HA) may attenuate the
inflammatory response. We investigated the effect of intraoperative HA on
postoperative outcomes in S. aureus IE. <br/>METHOD(S): Patients with
confirmed S. aureus IE undergoing cardiac surgery were included in a
dual-centre study between January 2015 and March 2022. Patients treated
with intraoperative HA (HA group) were compared to patients not treated
with HA (control group). The primary outcome was vasoactive-inotropic
score within the first 72 h postoperatively and secondary outcomes were
sepsis-related mortality (SEPSIS-3 definition) and overall mortality at 30
and 90 days. <br/>RESULT(S): No differences in baseline characteristics
were observed between groups (haemoadsorption group, n = 75, control
group, n = 55). Significantly decreased vasoactive-inotropic score was
observed in the haemoadsorption group at all time points [6 h: 6.0 (0-17)
vs 17 (3-47), P = 0.0014; 12 h: 2 (0-8.3) vs 5.9 (0-37), P = 0.0138; 24 h:
0 (0-5) vs 4.9 (0-23), P = 0.0064; 48 h: 0 (0-2.1) vs 0.1 (0-13), P =
0.0192; 72 h: 0 (0) vs 0 (0-5), P = 0.0014]. Importantly, sepsis-related
mortality (8.0% vs 22.8%, P = 0.02) and 30-day (17.3% vs 32.7%, P = 0.03)
and 90-day overall mortality (21.3% vs 40%, P = 0.03) were also
significantly lower with haemoadsorption. <br/>CONCLUSION(S):
Intraoperative HA during cardiac surgery for S. aureus IE was associated
with significantly lower postoperative vasopressor and inotropic
requirements and resulted in lower sepsis-related and overall 30-and
90-day mortality. In this high-risk population, improved postoperative
haemodynamic stabilization by intraoperative HA appears to improve
survival and should be further tested in future randomized trials.
<br/>Copyright &#xa9; 2023 The Author(s). Published by Oxford University
Press on behalf of the European Association for Cardio-Thoracic Surgery.

<83>
Accession Number
2029490000
Title
Betamethasone as an Adjuvant in Paravertebral Block, A Double Blinded
Randomized Controlled Trial in Laparoscopic Cholecystectomy.
Source
Journal of Cardiovascular Disease Research. 14(8) (pp 2689-2697), 2023.
Date of Publication: 2023.
Author
Selvakumar R.; Sivaprasath S.; Sudhakar D.S.; Agalya I.
Institution
(Selvakumar) Department of Anaesthesiology, Government medical College
Hospital, Karur, India
(Sivaprasath) Department of Anaesthesiology, Madurai Medical College,
Madurai, India
(Sudhakar) Department of Anaesthesiology, Government Pudukottai Medical
College, Pudukottai, India
(Agalya) Kalaiyarkoil Government Hospital, Tamil Nadu, Sivagangai, India
Publisher
EManuscript Technologies
Abstract
Background: Despite its wide use in thoracic procedures, effectiveness of
unilateral paravertebral block for laparoscopic cholecystectomy yet to be
studied widely. This study is to assess the effectiveness of PVB with
additives for acute postoperative pain management. Materials And Methods:
Eligible patients were divided into two groups randomly. One group
received Ropivacaine alone and other group received Ropivacaine with
betamethasone. Both groups were given USG PVB at T7 level and induced
general anaesthesia. Primary outcome was to measure the duration of TPVB.
Secondary outcome was to assess post of pain relief, intra operative
hemodynamics and time to rescue analgesia. <br/>Result(s): The
betamethasone-Ropivacaine group had a much more prolonged duration pain
relief than the plain Ropivacaine group. The duration of analgesia was
significantly prolonged in group receiving betamethasone -Ropivacaine
thoracic paravertebral block. The amount of rescue analgesia, frequency of
analgesics and total dosage of drugs were significantly lower with
betamethasone Ropivacaine group when compared with Ropivacaine group.
<br/>Conclusion(s): Betamethasone sodium phosphate with Ropivacaine in
ultrasound guided thoracic paravertebral block provides significantly
better analgesia postoperatively in laparoscopic cholecystectomy surgeries
in comparison with plain Ropivacaine.<br/>Copyright &#xa9; 2023
EManuscript Technologies. All rights reserved.

<84>
Accession Number
2029659713
Title
Thoracic endovascular aortic repair for hyperacute, acute, subacute and
chronic type B aortic dissection: Meta-analysis of reconstructed
time-to-event data.
Source
Trends in Cardiovascular Medicine. (no pagination), 2024. Date of
Publication: 2024.
Author
Sa M.P.; Jacquemyn X.; Brown J.A.; Ahmad D.; Serna-Gallegos D.;
Arnaoutakis G.J.; Singh M.J.; Sultan I.
Institution
(Sa, Brown, Ahmad, Serna-Gallegos, Sultan) Department of Cardiothoracic
Surgery, University of Pittsburgh, Pittsburgh, PA, United States
(Sa, Brown, Ahmad, Serna-Gallegos, Singh, Sultan) UPMC Heart and Vascular
Institute, University of Pittsburgh Medical Center, Pittsburgh, PA, United
States
(Jacquemyn) Department of Cardiovascular Sciences, KU Leuven, Leuven,
Belgium
(Arnaoutakis) Division of Cardiovascular and Thoracic Surgery, Dell
Medical School, Austin, TX, United States
(Singh) Division of Vascular Surgery, University of Pittsburgh Medical
Centre, Pittsburgh, PA, United States
Publisher
Elsevier Inc.
Abstract
Since the optimal timing for thoracic endovascular aortic repair (TEVAR)
in the context of type B aortic dissections (TBAD) remains an open
question, we performed a systematic review with meta-analysis to evaluate
outcomes of TEVAR according to the phases of TBAD - hyperacute, acute,
subacute and chronic. We carried out a pooled meta-analysis of
time-to-event data extracted from studies published by June 2023 for the
following outcomes: all-cause mortality, aortic-related mortality, and
late aortic reinterventions. Thirteen studies met our eligibility
criteria, comprising 4,793 patients (10.3 % hyperacute, 51.9 % acute, 25.9
% subacute, 11.9 % chronic). Considering the overall population, we
observed a statistically significant difference between the groups
(Log-rank test, P < 0.0001) and the main differences were found in the
following comparisons: hyperacute versus acute (HR 1.61; 95 %CI 1.21-2.13;
P = 0.001); hyperacute versus chronic (HR 1.70; 95 %CI 1.17-2.46; P =
0.005); subacute versus acute (HR 0.78; 95 %CI 0.63-0.98; P = 0.032).
Considering the population with uncomplicated TBAD, we also observed a
statistically significant difference for all-cause death between the
groups (Log-rank test, P < 0.0001) and the main differences were found in
the comparisons for subacute versus acute (HR 0.72; 95 %CI 0.58-0.88; P =
0.002). Furthermore, we observed statistically significant differences
between the groups for aortic-related death (Log-rank test, P < 0.0001)
and late aortic reintervention (Log-rank test, P < 0.0001), all favoring
mostly the subacute phase as the optimal timing for TEVAR. In conclusion,
there seems to be a timing-specific difference in the outcomes of TEVAR
for TBAD pointing to the subacute phase as the optimal timing to achieve
better long-term outcomes.<br/>Copyright &#xa9; 2023 Elsevier Inc.

<85>
Accession Number
643203496
Title
One-Year Mortality and Causes of Death after Stereotactic Radiation
Therapy for Refractory Ventricular Arrhythmias: A Systematic Review and
Pooled Analysis.
Source
Trends in cardiovascular medicine. (no pagination), 2024. Date of
Publication: 06 Jan 2024.
Author
Benali K.; Zei P.C.; Lloyd M.; Kautzner J.; Guenancia C.; Ninni S.; Rigal
L.; Simon A.; Bellec J.; Vlachos K.; Sacher F.; Hammache N.; Sellal J.-M.;
de Crevoisier R.; Da Costa A.; Martins R.
Institution
(Benali) Section of Cardiac Electrophysiology, Saint-Etienne University,
Saint-Etienne, France; IHU LIRYC, Electrophysiology and Heart Modeling
Institute, Bordeaux, France; INSERM-LTSI, U1099, Rennes, France
(Zei) Department of Cardiovascular Medicine, Brigham and Women's Hospital,
Boston, United States
(Lloyd) Section of Cardiac Electrophysiology, Emory University, Atlanta,
United States
(Kautzner) Institute for Clinical and Experimental Medicine, Prague,
Czechia
(Guenancia) Section of Cardiac Electrophysiology, Dijon University, Dijon,
France
(Ninni) Heart and Lung Institute, Lille University, Lille, France
(Rigal, Simon) Rennes U1099, France
(Bellec, de Crevoisier) Department of Radiation Oncology, Centre Eugene
Marquis, Rennes, France
(Vlachos, Sacher) IHU LIRYC, Electrophysiology and Heart Modeling
Institute, Bordeaux, France
(Hammache, Sellal) Section of Cardiac Electrophysiology, Nancy University,
Nancy, France
(Da Costa) Section of Cardiac Electrophysiology, Saint-Etienne University,
Saint-Etienne, France
(Martins) INSERM-LTSI, U1099, Rennes, France; Section of Cardiac
Electrophysiology, Rennes University, Rennes, France
Abstract
Patients treated with cardiac stereotactic body radiation therapy
(radioablation) for refractory ventricular arrhythmias are patients with
advanced structural heart disease and significant comorbidities. However,
data regarding 1-year mortality after the procedure are scarce. This
systematic review and pooled analysis aimed at determining 1-year
mortality after cardiac radioablation for refractory ventricular
arrhythmias and investigating leading causes of death in this population.
MEDLINE/EMBASE databases were searched up to January 2023 for studies
including patients undergoing cardiac radioablation for the treatment of
refractory ventricular arrhythmias. Quality of included trials was
assessed using the NIH Tool for Case Series Studies (PROSPERO
CRD42022379713). A total of 1,151 references were retrieved and evaluated
for relevance. Data were extracted from 16 studies, with a total of 157
patients undergoing cardiac radioablation for refractory ventricular
arrhythmias. Pooled 1-year mortality was 32% (95%CI: 23-41), with almost
half of the deaths occurring within three months after treatment. Among
the 157 patients, 46 died within the year following cardiac radioablation.
Worsening heart failure appeared to be the leading cause of death (52%),
although non-cardiac mortality remained substantial (41%) in this
population. Age>=70yo was associated with a significantly higher 12-month
all-cause mortality (p<0.022). Neither target volume size nor radiotherapy
device appeared to be associated with 1-year mortality (p=0.465 and
p=0.199, respectively). About one-third of patients undergoing cardiac
stereotactic body radiation therapy for refractory ventricular arrhythmias
die within the first year after the procedure. Worsening heart failure
appears to be the leading cause of death in this population.<br/>Copyright
&#xa9; 2024. Published by Elsevier Inc.

<86>
Accession Number
643203104
Title
Loss-of-Resistance Versus Dynamic Pressure-Sensing Technology for
Successful Placement of Thoracic Epidural Catheters: A Randomized Clinical
Trial.
Source
Anesthesia and analgesia. (no pagination), 2024. Date of Publication: 08
Jan 2024.
Author
Ranganath Y.S.; Ramanujam V.; Al-Hassan Q.; Sibenaller Z.; Seering M.S.;
Singh T.S.S.; Punia S.; Parra M.C.; Wong C.A.; Sondekoppam R.V.
Institution
(Ranganath) From the Department of Anesthesia, Indiana University School
of Medicine, Indianapolis, IN, United States
(Ramanujam) Department of Anesthesiology, Warren Alpert Medical School of
Brown University, Providence, RI, United States
(Al-Hassan) Almoosa Specialist Hospital, Saudi Arabia
(Sibenaller, Seering, Singh, Punia, Parra, Wong, Sondekoppam) Department
of Anesthesia, University of Iowa Carver College of Medicine, Iowa City,
IA, United States
Abstract
BACKGROUND: The traditional loss-of-resistance (LOR) technique for
thoracic epidural catheter placement can be associated with a high primary
failure rate. In this study, we compared the traditional LOR technique and
dynamic pressure-sensing (DPS) technology for primary success rate and
secondary outcomes pertinent to identifying the thoracic epidural space.
<br/>METHOD(S): This pragmatic, randomized, patient- and assessor-blinded
superiority trial enrolled patients ages 18 to 75 years, scheduled for
major thoracic or abdominal surgeries at a tertiary care teaching
hospital. Anesthesiology trainees (residents and fellows) placed thoracic
epidural catheters under faculty supervision and rescue. The primary
outcome was the success rate of thoracic epidural catheter placement,
evaluated by the loss of cold sensation in the thoracic dermatomes 20
minutes after injecting the epidural test dose. Secondary outcomes
included procedural time, ease of catheter placement, the presence of a
positive falling meniscus sign, early hemodynamic changes, and unintended
dural punctures. Additionally, we explored outcomes that included number
of attempts, needle depth to epidural space, need for faculty to rescue
the procedure from the trainee, patient-rated procedural discomfort, pain
at the epidural insertion site, postoperative pain scores, and opioid
consumption over 48 hours. <br/>RESULT(S): Between March 2019 and June
2020, 133 patients were enrolled; 117 were included in the final analysis
(n = 57 for the LOR group; n = 60 for the DPS group). The primary success
rate of epidural catheter placement was 91.2% (52 of 57) in the LOR group
and 96.7% (58 of 60) in the DPS group (95% confidence interval [CI] of
difference in proportions: -0.054 [-0.14 to 0.03]; P = .264). No
difference was observed in procedural time between the 2 groups (median
interquartile range [IQR] in minutes: LOR 5.0 [7.0], DPS 5.5 [7.0]; P =
.982). The number of patients with epidural analgesia onset at 10 minutes
was 49.1% (28 of 57) in the LOR group compared to 31.7% (19 of 60) in the
DPS group (P = .062). There were 2 cases of unintended dural punctures in
each group. Other secondary or exploratory outcomes were not significantly
different between the groups. <br/>CONCLUSION(S): Our trial did not
establish the superiority of the DPS technique over the traditional LOR
method for identifying the thoracic epidural space (Clinicaltrials.gov
identifier: NCT03826186).<br/>Copyright &#xa9; 2024 International
Anesthesia Research Society.

<87>
Accession Number
2027775781
Title
The protocol of Enhanced Recovery After Cardiac Surgery (ERACS) in
congenital heart disease: a stepped wedge cluster randomized trial.
Source
BMC Pediatrics. 24(1) (no pagination), 2024. Article Number: 22. Date of
Publication: December 2024.
Author
Dou D.; Jia Y.; Yuan S.; Wang Y.; Li Y.; Wang H.; Ding J.; Wu X.; Bie D.;
Liu Q.; An R.; Yan H.; Yan F.
Institution
(Dou, Jia, Yuan, Li, Wang, Ding, Wu, Bie, Liu, An, Yan, Yan) Department of
Anesthesiology, State Key Laboratory of Cardiovascular Disease, Fuwai
Hospital, National Center for Cardiovascular Diseases, Chinese Academy of
Medical Sciences & Peking Union Medical College, No. 167 BeilishiRd,
Xicheng District, Beijing 100037, China
(Wang) Department of Medical Research & Biometrics Center, State Key
Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for
Cardiovascular Diseases, Chinese Academy of Medical Sciences & Peking
Union Medical College, No. 167 BeilishiRd, Xicheng District, Beijing
100037, China
Publisher
BioMed Central Ltd
Abstract
Background: The Enhanced Recovery After Cardiac Surgery (ERACS) programs
are comprehensive multidisciplinary interventions to improve patients'
recovery. The application of the ERAS principle in pediatric patients has
not been identified completely. <br/>Method(s): This study is a
multicenter, stepwise design, cluster randomized controlled trial. 3030
patients presenting during control and intervention periods are eligible
if they are aged from 28 days to 6 years old and awaiting elective
correction surgery of congenital heart disease with cardiopulmonary
bypass. 5 centers are randomly assigned to staggered start dates for
one-way crossover from the control phase to the intervention phase. In the
intervention periods, patients will receive a bundle strategy including
preoperative, intraoperative, and postoperative approaches. During the
control phase, patients receive the usual care. The primary outcome
consists of major adverse cardiac and cerebrovascular events (MACCEs),
postoperative pulmonary complications (PPCs), and acute kidney injury
(AKI). <br/>Discussion(s): This study aims to explore whether the bundle
of ERAS measurements could improve patients' recovery in congenital heart
surgery. Trial registration: http://www.clinicaltrials.gov .
(NCT05914103).<br/>Copyright &#xa9; 2023, The Author(s).

<88>
[Use Link to view the full text]
Accession Number
2007317674
Title
Aortic annular sizing using novel software in three-dimensional
transesophageal echocardiography for transcatheter aortic valve
replacement: A systematic review and meta-analysis.
Source
Diagnostics. 11(5) (no pagination), 2021. Article Number: 751. Date of
Publication: 22 Apr 2021.
Author
Mork C.; Wei M.; Jiang W.; Ren J.; Ran H.
Institution
(Mork, Wei, Jiang, Ren, Ran) Department of Ultrasound, The Second
Affiliated Hospital of Chongqing Medical University, Chongqing 400010,
China
(Jiang, Ren, Ran) Chongqing Key Laboratory of Ultrasound Molecular
Imaging, Chongqing 400010, China
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
(1) Background: We performed this study to evaluate the agreement between
novel automated software of three-dimensional transesophageal
echocardiography (3D-TEE) and multidetector computed tomography (MDCT) for
aortic annular measurements of preprocedural transcatheter aor-tic valve
replacement (TAVR); (2) Methods: PubMed, EMBASE, Web of Science, and
Cochrane Library (Wiley) databases were systematically searched for
studies that compared 3D-TEE and MDCT as the reference standard for aortic
annular measurement of the following parameters: annular area, annular
perimeter, area derived-diameter, perimeter derived-diameter, maximum and
minimum diameter. Meta-analytic methods were utilized to determine the
pooled correlations and mean differences between 3D-TEE and MDCT.
Heterogeneity and publication bias were also assessed. Meta-regression
analyses were performed based on the potential factors affecting the
correlation of aortic annular area; (3) Results: A total of 889 patients
from 10 studies were included in the meta-analysis. Pooled correlation
coefficients between 3D-TEE and MDCT of annulus area, perimeter, area
derived-diameter, perimeter derived-diameter, maximum and minimum diameter
measurements were strong 0.89 (95% CI: 0.84-0.92), 0.88 (95% CI:
0.83-0.92), 0.87 (95% CI: 0.77-0.93), 0.87 (95% CI: 0.77-0.93), 0.79 (95%
CI: 0.64-0.87), and 0.75 (95% CI: 0.61-0.84) (Overall p < 0.0001),
respectively. Pooled mean differences between 3D-TEE and MDCT of annulus
area, perimeter, area derived-diameter, perimeter derived-diameter,
maximum and minimum diameter measurements were -20.01 mm² ((95%
CI: -35.37 to -0.64), p = 0.011), -2.31 mm ((95% CI: -3.31 to -1.31), p <
0.0001), -0.22 mm ((95% CI: -0.73 to 0.29), p = 0.40), -0.47 mm ((95% CI:
-1.06 to 0.12), p = 0.12), -1.36 mm ((95% CI: -2.43 to -0.30), p = 0.012),
and 0.31 mm ((95% CI: -0.15 to 0.77), p = 0.18), respectively. There were
no statistically significant associations with the baseline patient
characteristics of sex, age, left ventricular ejection fraction, mean
transaortic gradient, and aortic valve area to the correlation between
3D-TEE and MDCT for aortic annular area sizing; (4) <br/>Conclusion(s):
The present study implies that 3D-TEE using novel software tools,
automatically analysis, is feasible to MDCT for annulus sizing in clinical
practice.<br/>Copyright &#xa9; 2021 by the authors. Licensee MDPI, Basel,
Switzerland.

<89>
Accession Number
2007728961
Title
Association of excessive daytime sleepiness with the zung self-rated
depression subscales in adults with coronary artery disease and
obstructive sleep apnea.
Source
Diagnostics. 11(7) (no pagination), 2021. Article Number: 1176. Date of
Publication: July 2021.
Author
Celik Y.; Yapici-Eser H.; Balcan B.; Peker Y.
Institution
(Celik, Yapici-Eser, Peker) School of Medicine, Koc University Research
Center for Translational Medicine (KUTTAM), Istanbul 34450, Turkey
(Celik) Graduate School of Health Sciences, Koc University, Istanbul
34450, Turkey
(Yapici-Eser) Department of Psychiatry, School of Medicine, Koc
University, Istanbul 34450, Turkey
(Balcan) Department of Pulmonary Medicine, School of Medicine, Marmara
University, Istanbul 34722, Turkey
(Peker) Department of Clinical Sciences, Respiratory Medicine and
Allergology, School of Medicine, Lund University, Lund 22185, Sweden
(Peker) Department of Molecular and Clinical Medicine/Cardiology,
Institute of Medicine, Sahlgrenska Academy, University of Gothenburg,
Gothenburg 40530, Sweden
(Peker) Division of Pulmonary, Allergy, and Critical Care Medicine,
University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, United
States
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Excessive daytime sleepiness (EDS) is a factor associated with both
obstructive sleep apnea (OSA) and depressive symptoms. Continuous positive
airway pressure (CPAP) treatment may decrease EDS in adults with OSA;
however, the modulatory role of depressive symptoms on the improvement of
EDS is not known. We aimed to explore the association between subscales of
the Zung Self-rated Depression Scale (SDS) and Epworth Sleepiness Scale
(ESS) over a 2-year period in coronary artery disease (CAD) patients with
OSA. This was a post-hoc analysis of the RICCADSA cohort, in which 399
adults with CAD (155 sleepy OSA [apnea-hypopnea index >= 15/h] and ESS
score >= 10, who were offered CPAP; and 244 nonsleepy OSA [ESS < 10]),
randomized to CPAP [n = 122] or no-CPAP [n = 122]) were included. Three
factors were extracted from the Zung SDS, based on the principal component
analysis: F1, cognitive symptoms and anhedonia; F2, negative mood; and F3,
appetite. In a mixed model, the ESS score decreased by 3.4 points (p <
0.001) among the sleepy OSA phenotype, which was predicted by the decline
in the F2, but not in the F1 and F3 scores. The fixed effects of time were
not significant in the nonsleepy OSA groups, and thus, further analyses
were not applicable. Additional within-group analyses showed a significant
decrease in all subscales over time both in the sleepy and nonsleepy OSA
patients on CPAP whereas there was a significant increase in the nonsleepy
OSA group randomized to no-CPAP. We conclude that the improvement in
negative mood symptoms of depression, but not changes in cognitive
symptoms and anhedonia as well as appetite, was a significant predictor of
decline in the ESS scores over a 2-year period in this CAD cohort with
sleepy OSA on CPAP treatment.<br/>Copyright &#xa9; 2021 by the authors.
Licensee MDPI, Basel, Switzerland.

<90>
Accession Number
2014746627
Title
Comparison of Efficacy and Safety of Recombinant Human Prourokinase and
Alteplase in the Treatment of STEMI and Analysis of Influencing Factors of
Efficacy.
Source
Evidence-based Complementary and Alternative Medicine. 2021 (no
pagination), 2021. Article Number: 6702965. Date of Publication: 2021.
Author
Liu Y.; Yang Y.; Li Y.; Peng X.
Institution
(Liu, Peng) Affiliated Nanhua Hospital, Department of Cardiology, Hengyang
Medical School, University of South China, Hunan, Hengyang 421001, China
(Yang) Affiliated Nanhua Hospital, Department of Recovery from Anesthesia,
Hengyang Medical School, University of South China, Hunan, Hengyang
421001, China
(Li) Affiliated Nanhua Hospital, Department of Nursing Teaching and
Research, Hengyang Medical School, University of South China, Hunan,
Hengyang 421001, China
Publisher
Hindawi Limited
Abstract
Objective. To compare the efficacy and safety of recombinant human
prourokinase (rhPro-UK) and alteplase for thrombolytic therapy in acute
ST-segment elevation myocardial infarction (STEMI) and to analyze the
related factors affecting efficacy. Methods. From January 2017 to December
2019, 100 patients diagnosed with STEMI were selected and randomly divided
into the control group (n = 50) and the observation group (n = 50). Based
on conventional treatments, the control group was treated with alteplase,
and the observation group was treated with rhPro-UK, and both were treated
for 7 days. After treatment, the vascular recanalization, left ventricular
end-systolic diameter (LVESD), left ventricular end-diastolic diameter
(LVEDD), and left ventricular ejection fraction (LVEF) were compared. The
bleeding and major adverse cardiovascular events (MACE) were recorded in
both groups. According to the patient's vascular recanalization, it was
divided into two subgroups: recanalization group and occlusion group.
Multiple logistic regression models were used to analyze the related
factors that affect the efficacy. Results. The recanalization rate of the
observation group (96.00%) was higher than that of the control group
(84.00%) (P<0.05). After treatment, LVDs and LVEDD in both groups were
lower than those before treatment, and LVEF was higher than that before
treatment. The LVDs and LVEDD in the observation group were lower than
those in the control group, and the LVEF was higher than that in the
control group (P<0.05). The incidence of bleeding in the observation group
(2.00%) was lower than that in the control group (12.00%), and the
incidence of MACE (4.00%) was lower than that in the control group
(16.00%) (P<0.05). Univariate analysis showed that age, smoking history,
diabetes history, myocardial infarction history, infarct location, and
intravenous thrombolysis time were related to the efficacy after treatment
(P<0.05). Multivariate logistic analysis showed that age, history of
diabetes, vascular infarction site, and venous thrombolysis time were
independent influencing factors after treatment (P<0.05). Conclusion. Both
rhPro-UK and alteplase thrombolytic therapy can effectively recanalize
blood vessels and improve the cardiac function of patients with STEMI.
However, rhPro-UK has better effect than alteplase and is safer and worth
promoting. The curative effect is related to age, diabetes history,
vascular infarction site, and venous thrombolysis time.<br/>Copyright
&#xa9; 2021 Yizhou Liu et al.

<91>
Accession Number
2007324281
Title
Influence of internal thoracic artery harvesting on sternal osteoblastic
activity and perfusion.
Source
Diagnostics. 10(11) (no pagination), 2020. Article Number: 921. Date of
Publication: November 2020.
Author
Mamchur S.; Vecherskii Y.; Chichkova T.
Institution
(Mamchur, Chichkova) Department of Cardiovascular Surgery, Research
Institute for Complex Issues of Cardiovascular Diseases, Kemerovo 650002,
Russian Federation
(Vecherskii) Department of Cardiovascular Surgery, Research Institute of
Cardiology, Tomsk 634012, Russian Federation
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
The purpose of this study was to assess the sternal osteoblastic activity
and perfusion in the early period after a coronary artery bypass graft
(CABG) using single-photon emission computed tomography (SPECT) and
three-phasic dynamic scintigraphy (3PDS) with 99mTc methylene
diphosphonate (MDP). <br/>Method(s): The study group consisted of 57 male
patients that were 57.3 +/- 6.6 years of age. Thirty-six of them were
randomized into two groups: in group I (n = 18), the internal thoracic
artery (ITA) was skeletonized, and in group II (n = 18), the ITA was
pedicled. All the patients in groups I and II underwent an off-pump CABG
using 1.7 +/- 0.3 grafts, including one anastomosis of the ITA to the left
anterior descending coronary artery. The control group III (n = 21)
consisted of patients that underwent mitral valve repair surgery, in whom
the sternotomy without the ITA harvesting was performed. The 3PDS and
SPECT of the thorax with 99mTc MDP were performed 2 weeks after surgery.
<br/>Result(s): The sternal phosphates uptake in group I was approximately
twice as high as in group II and approximately 1.5 times higher than in
group III (p < 0.05). The MDP uptake asymmetry after the ITA
skeletonization was the same as in the group with both intact ITAs. In
contrast, after the pedicled ITA harvesting, the osteoblastic activity of
the ipsilateral side of the sternum was lower than in the contralateral
one. There was no statistically significant difference in scintillation
count in the xiphoid process between groups I and II (p > 0.05); however,
we observed a significant difference in the manubrium and body (p < 0.05).
<br/>Conclusion(s): The main factor that improved the sternal perfusion
after a CABG was the preservation of branches supplying the sternum using
the skeletonization technique of ITA harvesting.<br/>Copyright &#xa9; 2020
by the authors. Licensee MDPI, Basel, Switzerland.

<92>
Accession Number
2005907951
Title
Biomarkers of muscle metabolism in peripheral artery disease: A dynamic
NIRS-assisted study to detect adaptations following revascularization and
exercise training.
Source
Diagnostics. 10(5) (no pagination), 2020. Article Number:
diagnostics10050312. Date of Publication: 01 May 2020.
Author
Manfredini F.; Lamberti N.; Ficarra V.; Tsolaki E.; Straudi S.; Zamboni
P.; Basaglia N.; Gasbarro V.
Institution
(Manfredini, Lamberti) Section of Sports Sciences, Department of
Biomedical and Surgical Specialties Sciences, University of Ferrara,
Italy-Via Luigi Borsari 46, Ferrara 44121, Italy
(Manfredini, Straudi, Basaglia) Unit of Physical Medicine and
Rehabilitation, Department of Neurosciences/Rehabilitation, University
Hospital of Ferrara, Via Aldo Moro 8, Ferrara 44124, Italy
(Ficarra, Tsolaki, Gasbarro) Unit of Vascular and Endovascular Surgery,
University Hospital of Ferrara, Via Aldo Moro 8, Ferrara 44124, Italy
(Zamboni) Vascular Diseases Center, University of Ferrara, Italy-Via Aldo
Moro 8, Ferrara 44124, Italy
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
We assessed whether muscle metabolism biomarkers (MMb) identified by
near-infrared spectroscopy (NIRS) are valid for determining adaptations
following revascularization or exercise training in peripheral artery
disease (PAD). Eighteen patients (males n = 13; 69 +/- 7 years) were
randomized to receive revascularization (Rev = 6) or pain-free home-based
exercise (Ex = 12). MMb were safely collected via a NIRS-assisted
treadmill test as area-under-curve for the spectra of oxygenated (-oxy),
deoxygenated (-deoxy), differential (-diff) and total (-tot) hemoglobin
traces. MMb, ankle-brachial index (ABI), pain-free (PFWD) and 6-minute
(6MWD) walking distances were assessed at baseline and after four months.
MMb were correlated at baseline with ABI (MMb-oxy r = 0.46) and 6MWD
(MMb-tot r = 0.51). After treatments, MMb-oxy showed an expected increase,
which was more relevant for Rev group than the Ex (56% vs. 20%), with
trends towards normalization for the other MMb. These changes were
significantly correlated with variations in ABI (MMb-oxy r = 0.71; p =
0.002) and 6MWD (MMb-tot r = 0.58; p = 0.003). The MMb-diff in Rev group
and MMb-deoxy in Ex group at baseline predicted clinical outcomes being
correlated with PFWD improvements after 4-month (r=-0.94; p = 0.005 and r
= -0.57; p = 0.05, respectively). A noninvasive NIRS-based test, feasible
in a clinical setting, identified muscle metabolism biomarkers in PAD. The
novel MMb were associated with validated outcome measures, selectively
modified after different interventions and able to predict long-term
functional improvements after surgery or exercise training.<br/>Copyright
&#xa9; 2020 by the authors.

<93>
Accession Number
2024564763
Title
Myeloperoxidase Inhibition in Heart Failure With Preserved or Mildly
Reduced Ejection Fraction: SATELLITE Trial Results.
Source
Journal of Cardiac Failure. 30(1) (pp 104-110), 2024. Date of Publication:
January 2024.
Author
Lam C.S.P.; LUND L.H.; SHAH S.J.; VOORS A.A.; ERLINGE D.; SARASTE A.;
PIRAZZI C.; GROVE E.L.; BARASA A.; SCHOU M.; AZIZ A.; SVEDLUND S.A.R.A.;
WIJNGAARDEN J.V.; LINDSTEDT E.V.A.-L.O.T.T.E.; GUSTAVSSON A.; NELANDER K.;
GARKAVIY P.; GAN L.I.-M.I.N.G.; GABRIELSEN A.
Institution
(Lam) National Heart Centre Singapore and Duke National University of
Singapore, Singapore
(Lam, VOORS) University of Groningen and University Medical Centre
Groningen, Groningen, Netherlands
(LUND) Department of Medicine, Karolinska Institute, and Heart, Vascular
and Neuro Theme, Karolinska University Hospital, Stockholm, Sweden
(SHAH) Northwestern University Feinberg School of Medicine, Chicago,
Illinois, United States
(ERLINGE) Skane University Hospital, Lund, Sweden
(SARASTE) Heart Centre, Turku University Hospital and University of Turku,
Turku, Finland
(PIRAZZI, GAN) Department of Cardiology, Sahlgrenska University Hospital
and Department of Molecular and Clinical Medicine, Sahlgrenska Academy,
University of Gothenburg, Gothenburg, Sweden
(GROVE) Department of Cardiology, Aarhus University Hospital, Aarhus,
Denmark
(BARASA) Glostrup Hospital, Copenhagen, Denmark
(SCHOU) Department of Cardiology, Herlev and Gentofte Hospital,
Copenhagen, Denmark
(AZIZ) Odense University Hospital, Odense, Denmark
(SVEDLUND) Department of Clinical Physiology, Sahlgrenska University
Hospital and Department of Molecular and Clinical Medicine, Sahlgrenska
Academy, University of Gothenburg, Gothenburg, Sweden
(WIJNGAARDEN) Department of Cardiology, Deventer Hospital, Deventer,
Netherlands
(LINDSTEDT, GARKAVIY, GABRIELSEN) Research and Early Clinical Development,
Cardiovascular, Renal and Metabolic, BioPharmaceuticals R&D, AstraZeneca,
Gothenburg, Sweden
(GUSTAVSSON, NELANDER) Early Biometrics and Statistical Innovation, Data
Science and AI, BioPharmaceuticals R&D, AstraZeneca, Gothenburg, Sweden
Publisher
Elsevier B.V.
Abstract
Background: Inflammation is a key driver of heart failure with preserved
left ventricular ejection fraction. AZD4831 inhibits extracellular
myeloperoxidase, decreases inflammation, and improves microvascular
function in preclinical disease models. <br/>Methods and Results: In this
double-blind phase 2a study (Safety and Tolerability Study of AZD4831 in
Patients With Heart Failure [SATELLITE]; NCT03756285), patients with
symptomatic heart failure, left ventricular ejection fraction of >=40%,
and elevated B-type natriuretic peptides were randomized 2:1 to once-daily
oral AZD4831 5 mg or placebo for 90 days. We aimed to assess target
engagement (primary end point: myeloperoxidase specific activity) and
safety of AZD4831. Owing to coronavirus disease 2019, the study was
terminated early after randomizing 41 patients (median age 74.0 years,
53.7% male). Myeloperoxidase activity was decreased by more than 50% from
baseline to day 30 and day 90 in the AZD4831 group, with a
placebo-adjusted decreased of 75% (95% confidence interval, 48, 88,
nominal P < .001). No improvements were noted in secondary or exploratory
end points, apart from a trend in Kansas City Cardiomyopathy Questionnaire
overall summary score. No deaths or treatment-related serious adverse
events occurred. AZD4831 treatment-related adverse events were generalized
maculopapular rash, pruritus, and diarrhea (all n = 1).
<br/>Conclusion(s): AZD4831 inhibited myeloperoxidase and was well
tolerated in patients with heart failure and left ventricular ejection
fraction of 40% or greater. Efficacy findings were exploratory owing to
early termination, but warrant further clinical investigation of AZD4831.
Lay Summary: Few treatments are available for patients with the forms of
heart failure known as heart failure with preserved or mildly reduced
ejection fraction. Current treatments do not target inflammation, which
may play an important role in this condition. We tested a new drug called
AZD4831 (mitiperstat), which decreases inflammation by inhibiting the
enzyme myeloperoxidase. Among the 41 patients in our clinical trial,
AZD4831 had a good safety profile and inhibited myeloperoxidase by the
expected amount. Results mean we can conduct further trials to see whether
AZD4831 decreases the symptoms of heart failure and improves patients'
ability to participate in physical exercise.<br/>Copyright &#xa9; 2023 The
Authors

<94>
Accession Number
2029533197
Title
Effects of epidurally administered dexmedetomidine and dexamethasone on
postoperative pain, analgesic requirements, inflammation, and oxidative
stress in thoracic surgery.
Source
Acta Pharmaceutica. 73(4) (pp 691-708), 2023. Date of Publication: 01 Dec
2023.
Author
Persec J.; Sribar A.; Ilic M.; Mamic I.; Kifer D.; Domijan A.-M.; Males
Z.; Turcic P.
Institution
(Persec, Sribar, Ilic) Clinical Department for Anesthesiology
Reanimatology and Intensive Care Medicine, University Hospital Dubrava
Zagreb, Croatia
(Persec, Sribar) School of Dental Medicine, University of Zagreb, Zagreb,
Croatia
(Mamic, Turcic) University of Zagreb, Faculty of Pharmacy and
Biochemistry, Department of Pharmacology, Zagreb, Croatia
(Kifer) University of Zagreb, Faculty of Pharmacy and Biochemistry,
Department of Biophysics, Zagreb, Croatia
(Domijan, Males) University of Zagreb, Faculty of Pharmacy and
Biochemistry, Department of Pharmaceutical Botany, Zagreb, Croatia
Publisher
Hrvatsko Farmaceutsko Drustvo
Abstract
The aim of this study was to compare the effects of dexmedetomidine and
dexamethasone as adjuvants to preoperative epidural administration of
local anesthetic (ropivacaine) in thoracic surgery on the postoperative
level of pain, use of analgesics, inflammation, and oxidative stress. The
study enrolled 42 patients who underwent elective thoracic surgery in a
one-year period at the University Hospital Dubrava (Zagreb, Croatia).
Based on a computer-generated randomization list the patients were
assigned to the dexmedetomidine (n = 18) or dexamethasone (n = 24) group.
Postoperatively, patients of dexmedetomidine group reported lower pain
(VAS value 1 h post surgery, 3.4 +/- 2.7 vs. 5.4 +/- 1.8, dexmedetomidine
vs. dexamethasone, p < 0.01) and had lower analgesic requirements in
comparison with dexamethasone group. Thus, dexmedetomidine in comparison
with dexamethasone was more efficient in lowering pain and analgesia
requirements 24 h after the surgery. On the contrary, dexamethasone had
better anti-inflammatory properties (CRP level 24 h post surgery, 131.9
+/- 90.7 vs. 26.0 +/- 55.2 mg L^-1, dexmedetomidine vs.
dexamethasone, p < 0.01). Both dexmedetomidine and dexamethasone exhibited
antioxidant effects, however, their antioxidant properties should be
further explored. The results of this study improve current knowledge of
pain control in thoracic surgery.<br/>Copyright &#xa9; 2023 Sciendo. All
rights reserved.

<95>
Accession Number
2027315833
Title
Evidence-based Practice Interventions for Reducing Postoperative Pulmonary
Complications: A Narrative Review.
Source
Open Respiratory Medicine Journal. 17 (no pagination), 2023. Article
Number: e18743064271499. Date of Publication: 2023.
Author
Dhillon G.; Buddhavarapu V.S.; Grewal H.; Munjal R.; Verma R.K.; Surani
S.; Kashyap R.
Institution
(Dhillon) Department of Internal Medicine, University of Maryland
Baltimore Washington Medical Center, Glen Burnie, MD, United States
(Buddhavarapu) Banner Baywood Medical Center, Banner Health, Mesa, AZ,
United States
(Grewal) Radiology Associates of Florida, Pensacola, FL, United States
(Munjal) Touro University College of Osteopathic Medicine, CA, United
States
(Verma) Department of Sleep Medicine, Parkview Health System, Fort Wayne,
IN, United States
(Surani) Department of Anesthesiology and Critical Care Medicine, Mayo
Clinic, Rochester, MN, United States
(Surani, Kashyap) Texas A&M, College Station, TX, United States
(Kashyap) Department of Research, WellSpan Health, York, PA, United States
Publisher
Bentham Science Publishers
Abstract
Background: Specific surgical procedures, such as upper abdominal and
thoracic surgery, are connected to an increased predisposition of
postoperative pulmonary complications (PPCs). The incidence of PPCs could
vary approximately between 20-90% with upper abdominal surgery, which can
be minimized by using treatment procedures that increase lung capacity and
encourage inspiration. This review aims to examine the effectiveness of
already existing evidence-based interventions that promote lung expansion,
thereby preventing PPCs. <br/>Method(s): We mainly focused on the existing
evidence of preoperative education on the incentive spirometer, early
mobilization, directed coughing, deep breathing exercises, chest
physiotherapy, and inspiratory muscle training (IMT) to prevent PPCs. The
literature search was limited to experimental, observational studies,
systemic reviews, and articles published in the last 15 years, January
2007-Dec. 2022, in PubMed and Google Scholar. <br/>Result(s): This initial
search yielded a total of 5301 articles. All articles with titles not
related to the topic were eliminated. 1050 records were screened, and the
final review was conducted with 22 articles, including 13 randomized
controlled trials (RCTs), four systemic reviews, one retrospective review,
three observational studies, and one non-experimental study. Our review
reveals mixed evidence for individual interventions, including but not
limited to incentive spirometry, inspiratory muscle training, early
mobilization, cough, deep breathing, etc. Some studies maintain that
intervention is effective; others imply there is no substantial difference
in the choice of intervention. <br/>Conclusion(s): The literature review
concluded that patients who received multiple interventions showed
significant improvement in pulmonary function postoperatively. However,
definitive studies need to be conducted to solidify this
conclusion.<br/>Copyright &#xa9; 2023 The Author(s).

<96>
Accession Number
642431349
Title
Effectiveness of acupuncture for postoperative gastrointestinal recovery
in patients undergoing thoracoscopic surgery: a prospective randomized
controlled study.
Source
Acupuncture in medicine : journal of the British Medical Acupuncture
Society. 42(1) (pp 14-22), 2024. Date of Publication: 01 Feb 2024.
Author
Zhang Y.; Ou C.; Luo X.; Kang Y.; Jiang L.; Wu S.; Ouyang H.
Institution
(Zhang, Ou, Luo, Kang, Wu, Ouyang) Department of Anesthesiology, State Key
Laboratory of Oncology in Southern China, Sun Yat-sen University Cancer
Center, Collaborative Innovation Center for Cancer Medicine, Guangzhou,
China
(Jiang) Department of Integrative Medicine, State Key Laboratory of
Oncology in Southern China, Sun Yat-sen University Cancer Center,
Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
Abstract
BACKGROUND: Postoperative gastrointestinal dysfunction (PGD) is one of the
most common complications among patients who have undergone thoracic
surgery. Acupuncture has long been used in traditional Chinese medicine to
treat gastrointestinal diseases and has shown benefit as an alternative
therapy for the management of digestive ailments. This study aimed to
explore the therapeutic effectiveness of acupuncture as a means to aid
postoperative recovery of gastrointestinal function in patients undergoing
thoracoscopic surgery. <br/>METHOD(S): In total, 112 patients aged
18-70years undergoing thoracoscopic surgery between 15 June 2022 and 30
August 2022 were randomized into two groups. Patients in the acupuncture
group (AG) first received acupuncture treatment 4h after surgery, and
treatment was repeated at 24 and 48h. Patients in the control group (CG)
did not receive any acupuncture treatment. Both groups received the same
anesthetic protocol. Ultrasound-guided thoracic paravertebral block (TPVB)
was performed in the paravertebral spaces between T4 and T5 with
administration of 20mL of 0.33% ropivacaine. All patients received
patient-controlled intravenous analgesia (PCIA) after surgery.
<br/>RESULT(S): Median time to first flatus [interquartile range] in the
AG was significantly less than in the CG (23.25 [18.13, 29.75] vs 30.75
[24.13, 45.38]h, p<0.001). Time to first fluid intake after surgery was
significantly less in the AG, as compared with the CG (4 [3, 7] vs 6.5
[4.13, 10.75]h, p=0.003). Static pain, measured by visual analog scale
(VAS) score, was significantly different on the third day after surgery
(p=0.018). Dynamic pain VAS scores were lower in the AG versus CG on the
first three postoperative days (p=0.014, 0.003 and 0.041, respectively).
<br/>CONCLUSION(S): Addition of acupuncture appeared to improve recovery
of postoperative gastrointestinal function and alleviate posteoperative
pain in patients undergoing thoracoscopic surgery. Acupuncture may
represent a feasible strategy for the prevention of PGD occurrence. TRIAL
REGISTRATION NUMBER: ChiCTR2200060888 (Chinese Clinical Trial Registry).

<97>
Accession Number
2029596346
Title
Effect of six month's treatment with omega-3 acid ethyl esters on
long-term outcomes after acute myocardial infarction: The OMEGA-REMODEL
randomized clinical trial.
Source
International Journal of Cardiology. (no pagination), 2024. Article
Number: 131698. Date of Publication: 2024.
Author
Bernhard B.; Heydari B.; Abdullah S.; Francis S.A.; Lumish H.; Wang W.;
Jerosch-Herold M.; Harris W.S.; Kwong R.Y.
Institution
(Bernhard, Heydari, Abdullah, Jerosch-Herold, Kwong) Cardiovascular
Division, Department of Medicine, Brigham and Women's Hospital, Boston,
MA, United States
(Heydari) Stephenson Cardiac Imaging Center, University of Calgary,
Calgary, AB, Canada
(Abdullah) VA North Texas Medical Center and University of
Texas-Southwestern Medical School, Dallas, TX, United States
(Francis) Department of Cardiovascular Medicine, Maine Medical Center,
Portland, United States
(Lumish) Division of Cardiology, Department of Medicine, Columbia
University Irving Medical Center, New York, NY, United States
(Wang) Division of Sleep Medicine, Brigham and Women's Hospital, Boston,
MA, United States
(Harris) Fatty Acid Research Institute, Sioux Falls, SD 57106, United
States
(Harris) Sanford School of Medicine, University of South Dakota, Sioux
Falls, SD 57105, United States
Publisher
Elsevier Ireland Ltd
Abstract
Background: Omega-3 polyunsaturated fatty acids (O3-FA) have been shown to
reduce inflammation and adverse cardiac remodeling after acute myocardial
infarction (AMI). However, the impact of O3-FA on long-term clinical
outcomes remains uncertain. <br/>Aim(s): To investigate the impact of
O3-FA on adverse cardiac events in long-term follow up post AMI in a
pilot-study. <br/>Method(s): Consecutive patients with AMI were randomized
1:1 to receive 6 months of O3-FA (4 g/daily) or placebo in the
prospective, multicenter OMEGA-REMODEL trial. Primary endpoint was a
composite of major adverse cardiovascular events (MACE) encompassing
all-cause death, heart failure hospitalizations, recurrent acute coronary
syndrome, and late coronary artery bypass graft (CABG). <br/>Result(s): A
total of 358 patients (62.8% male; 48.1 +/- 16.1 years) were followed for
a median of 6.6 (IQR: 5.0-9.1) years. Among those receiving O3-FA (n =
180), MACE occurred in 65 (36.1%) compared to 62 (34.8%) of 178 assigned
to placebo. By intention-to-treat analysis, O3-FA treatment assignment did
not reduce MACE (HR = 1.014; 95%CI = 0.716-1.436; p = 0.938), or its
individual components. However, patients with a positive response to O3-FA
treatment (n = 43), defined as an increase in the red blood cell omega-3
index (O3[sbnd]I) >=5% after 6 months of treatment, had lower annualized
MACE rates compared to those without (2.9% (95%CI = 1.2-5.1) vs 7.1%
(95%CI = 5.7-8.9); p = 0.001). This treatment benefit persisted after
adjustment for baseline characteristics (HR<inf>adjusted</inf> = 0.460;
95%CI = 0.218-0.970; p = 0.041). <br/>Conclusion(s): In long-term
follow-up of the OMEGA-REMODEL randomized trial, O3-FA did not reduce MACE
after AMI by intention to treat principle, however, patients who achieved
a >= 5% increase of O3[sbnd]I subsequent to treatment had favorable
outcomes.<br/>Copyright &#xa9; 2023 Elsevier B.V.

<98>
Accession Number
2027776069
Title
Risk factors, clinical implications, and management of peridevice leak
following left atrial appendage closure: A systematic review.
Source
Journal of Interventional Cardiac Electrophysiology. (no pagination),
2024. Date of Publication: 2024.
Author
Helal B.; Khan J.; AlJayar D.; Khan M.S.; Alabdaljabar M.S.; Asad Z.U.A.;
DeSimone C.V.; Deshmukh A.
Institution
(Helal, Khan, AlJayar, Khan) College of Medicine, Alfaisal University,
Riyadh, Saudi Arabia
(Alabdaljabar) Department of Internal Medicine, Mayo Clinic, Rochester,
MN, United States
(Asad) Department of Medicine, University of Oklahoma Health Sciences
Center, Oklahoma City, OK, United States
(DeSimone, Deshmukh) Department of Cardiovascular Medicine, 200 1St Street
SW, Rochester, MN 55905, United States
Publisher
Springer
Abstract
Background: Left atrial appendage closure (LAAC) is a treatment modality
for stroke prevention in patients with atrial fibrillation (AF). One of
the potential complications of LAAC is a peri-device leak (PDL), which
could potentially increase the risk of thromboembolism formation.
<br/>Method(s): This systematic review was done according to PRISMA
guidelines. Using four databases, all primary studies through April 2022
that met selection criteria were included. Outcomes of interest were
studies reporting on PDL characteristics, risk factors and management.
<br/>Result(s): A total of 116 studies met selection criteria (97 original
studies and 19 case reports/series). In the original studies (n = 30,133
patients), the weighted mean age was 72.0 +/- 7.4 years (57% females) with
a HAS-BLED and CHA2DS2-VASc weighted means of 2.8 +/- 1.1 and 3.8 +/- 1.3,
respectively. The most common definition of PDL was based on size; 5 mm:
major, 3-5 mm: moderate, < 1 mm minor, or trivial. Follow up time for PDL
detection was 7.15 +/- 9.0 months. 33% had PDL, irrespective of PDL
severity/size, and only 0.9% had PDL of greater than 5 mm. The main risk
factors for PDL development included lower degree of over-sizing, lower
left ventricular ejection fraction, device/LAA shape mismatch, previous
radiofrequency ablation, and male sex. The most common methods to screen
for PDL included transesophageal echocardiogram and cardiac CT. PDL
Management approaches include Amplatzer Patent Foramen Ovale occluder,
Hookless ACP, Amplatzer vascular plug II, embolic coils, and detachable
vascular coils; removal or replacement of the device; and left atriotomy.
<br/>Conclusion(s): Following LAAC, the emergence of a PDL is a
significant complication to be aware of. Current evidence suggests
possible risk factors that are worth assessing in-depth. Additional
research is required to assess suitable candidates, timing, and strategies
to managing patients with PDL.<br/>Copyright &#xa9; 2024, The Author(s),
under exclusive licence to Springer Science+Business Media, LLC, part of
Springer Nature.

<99>
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. 70(1) (pp 16-24), 2024. Date of Publication: 01
Jan 2024.
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. <br/>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. <br/>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.<br/>Copyright &#xa9; 2023 Australian
Physiotherapy Association. Published by Elsevier B.V. All rights reserved.

<100>
Accession Number
637015901
Title
Transcatheter Aortic Valve Implantation With or Without Predilation: A
Meta-Analysis.
Source
The Journal of invasive cardiology. 34(2) (pp E104-E113), 2022. Date of
Publication: 01 Feb 2022.
Author
Conrotto F.; D'Ascenzo F.; Franchin L.; Bruno F.; Mamas M.A.; Toutouzas
K.; Cuisset T.; Leclercq F.; Dumonteil N.; Latib A.; Nombela-Franco L.;
Schaefer A.; Anderson R.D.; Marruncheddu L.; Gallone G.; De Filippo O.; La
Torre M.; Rinaldi M.; Omede P.; Salizzoni S.; De Ferrari G.M.
Institution
(D'Ascenzo) Division of Cardiology, Department of Medical Science,
University of Turin, Corso Bramante 88/90, Turin, Italy
Publisher
NLM (Medline)
Abstract
AIMS: To evaluate the impact of systematic predilation with balloon aortic
valvuloplasty (BAV) on transcatheter aortic valve implantation (TAVI).
METHODS AND RESULTS: We performed a systematic meta-analysis investigating
patients undergoing TAVI with systematic BAV vs no BAV in RCT or in
adjusted studies. Device success was the primary endpoint, while all-cause
mortality, 30-day moderate/severe aortic regurgitation (AR), stroke,
permanent pacemaker implantation (PPI) and acute kidney injury (AKI) were
the secondary endpoints. Subanalysis according to design of the study (RCT
and adjusted analysis) and to the type of valve (balloon-expandable [BE]
vs self-expanding [SE]) were conducted. We obtained data from 15 studies,
comprising 16,408 patients: 10,364 undergoing BAV prior to TAVI and 6,044
in which direct TAVI has been performed. At 30-day follow-up, BAV did not
improve the rate of device success in the overall population (OR, 1.09;
95% CI, 0.90-1.31), both in SE (OR, 0.93; 95% CI, 0.60-1.45) and in BE
(OR, 1.16; 95% CI, 0.88-1.52) valves. Between BAV and direct TAVI, no
differences in secondary outcomes were observed neither in overall
population nor according to valve type between BAV and direct TAVI
strategies. All endpoints results were consistent between RCTs and
adjusted studies except for postdilation rate that did not differ in
observational studies (OR, 0.70; 95% CI, 0.47-1.04), while it was lower in
BAV when only RCTs were included in the analysis (OR, 0.48; 95% CI,
0.24-0.97). <br/>CONCLUSION(S): Direct TAVI is feasible and safe compared
to predilation approach with similar device success rates and clinical
outcomes. Direct TAVI could represent a first-choice approach in
contemporary TAVI procedures.

<101>
Accession Number
632196787
Title
Efficacy and safety outcomes in novel oral anticoagulants versus vitamin-K
antagonist on post-TAVI patients: a meta-analysis.
Source
BMC cardiovascular disorders. 20(1) (pp 307), 2020. Date of Publication:
26 Jun 2020.
Author
Liang H.; He Q.; Zhang Q.; Liu X.; Cui K.; Chen G.; Xiu J.
Institution
(Liang, Zhang, Liu, Cui, Chen, Xiu) Department of Cardiology, Nanfang
Hospital, Southern Medical University, Guangzhou, Guangdong, China
(He) Pediatric Cardiac Surgery Center, National Center for Cardiovascular
Disease and Fuwai Hospital, Chinese Academy of Medical Sciences, Peking
Union Medical College, Beijing, China
(He) Faculty of Medicine, International School, Jinan University,
Guangzhou, China
Publisher
NLM (Medline)
Abstract
BACKGROUND: Transcatheter aortic valve implantation (TAVI) has been a
favored option for the patient who suffered from symptomatic aortic
stenosis. However, the efficacy and safety outcomes in novel oral
anticoagulants (NOACs) versus Vitamin-K antagonist (VKA) for post-TAVI
patients are still controversial. This meta-analysis aims at comparing the
clinical outcome and safety of NOACs and VKA in the patients after
receiving TAVI. <br/>METHOD(S): We searched literature articles in all
reachable databases, and observational study as well as randomized
controlled trial would be included in order to perform a comprehensive
analysis. All-cause mortality, major or life-threatening bleeding,
disabling or nondisabling stroke were main pooled outcome measures.
Subgroup analysis and meta-regression were adopted to explore
heterogeneity. Assessment of bias was performed under the suggestion of
Cochrane's Collaboration Tool. <br/>RESULT(S): We collected 3841
non-duplicate citations from PubMed, Embase, Cochrane and
ClinicalTrials.gov, and eventually 7 studies were included for this
meta-analysis. As a result, VKA showed priority against NOACs in the field
of anti-thromboembolism (4435 participants, RR:1.44, 95% CI: 1.05 to 1.99,
I2 =0%, P=0.02). <br/>CONCLUSION(S): With corroborative analysis of severe
complications, VKA is shown to be more protective on post-TAVI patients in
disabling or nondisabling stroke scenario but not in mortality or bleeding
event.

<102>
[Use Link to view the full text]
Accession Number
629716439
Title
Fresh Frozen Plasma versus Crystalloid Priming of Cardiopulmonary Bypass
Circuit in Pediatric Surgery: A Randomized Clinical Trial.
Source
Anesthesiology. 132(1) (pp 95-106), 2020. Date of Publication: 01 Jan
2020.
Author
Dieu A.; Rosal Martins M.; Eeckhoudt S.; Matta A.; Kahn D.; Khalifa C.;
Rubay J.; Poncelet A.; Haenecour A.; Derycke E.; Thiry D.; Gregoire A.;
Momeni M.
Institution
(Dieu) From the Departments of Anesthesiology (A.D., M.R.M., C.K., M.M.)
Hematology (S.E.) Cardiac Surgery (J.R., A.P.) Perfusion Services (D.T.,
A.G.) the Pediatric Intensive Care Unit (A.H., University Hospital Saint
Luc, Catholic University of Louvain (Cliniques Universitaires Saint Luc,
Universite Catholique de Louvain), A.M., Brussels, Belgium
Publisher
NLM (Medline)
Abstract
BACKGROUND: In congenital cardiac surgery, priming cardiopulmonary bypass
(CPB) with fresh frozen plasma (FFP) is performed to prevent coagulation
abnormalities. The hypothesis was that CPB priming with crystalloids would
be different compared with FFP in terms of bleeding and/or need for blood
product transfusion. <br/>METHOD(S): In this parallel-arm double-blinded
study, patients weighing between 7 and 15 kg were randomly assigned to a
CPB priming with 15 ml . kg PlasmaLyte or 15 ml . kg FFP in addition to a
predefined amount of packed red blood cells used in all patients. The
decision to transfuse was clinical and guided by point-of-care tests. The
primary endpoints included postoperative bleeding tracked by chest tubes,
number of patients transfused with any additional blood products, and the
total number of additional blood products administered intra- and
postoperatively. The postoperative period included the first 6 h after
intensive care unit arrival. <br/>RESULT(S): Respectively, 30 and 29
patients in the FFP and in the crystalloid group were analyzed in an
intention-to-treat basis. Median postoperative blood loss was 7.1 ml . kg
(5.1, 9.4) in the FFP group and 5.7 ml . kg (3.8, 8.5) in the crystalloid
group (P = 0.219); difference (95% CI): 1.2 (-0.7 to 3.2). The proportion
of patients additionally transfused was 26.7% (8 of 30) and 37.9% (11 of
29) in the FFP and the crystalloid groups, respectively (P = 0.355; odds
ratio [95% CI], 1.7 [0.6 to 5.1]). The median number of any blood products
transfused in addition to priming was 0 (0, 1) and 0 (0, 2) in the FFP and
crystalloid groups, respectively (P = 0.254; difference [95% CI], 0 [0 to
0]). There were no study-related adverse events. <br/>CONCLUSION(S): The
results demonstrate that in infants and children, priming CPB with
crystalloids does not result in a different risk of postoperative bleeding
and need for transfusion of allogeneic blood products.

<103>
[Use Link to view the full text]
Accession Number
625621581
Title
Fish Oil and Perioperative Bleeding.
Source
Circulation. Cardiovascular quality and outcomes. 11(11) (pp e004584),
2018. Date of Publication: 01 Nov 2018.
Author
Akintoye E.; Sethi P.; Harris W.S.; Thompson P.A.; Marchioli R.; Tavazzi
L.; Latini R.; Pretorius M.; Brown N.J.; Libby P.; Mozaffarian D.
Institution
(Akintoye) Division of Cardiovascular Medicine, University of Iowa
Hospitals and Clinics (E.A.)
(Sethi, Harris, Thompson) Department of Internal Medicine, Sanford School
of Medicine, University of South Dakota
(Harris) OmegaQuant, LLC, Sioux Falls
(Marchioli) Cardiovascular Renal Metabolic Therapeutic Area, Medical
Strategy and Science, Therapeutic Science and Strategy Unit, Milan, United
States
(Tavazzi) Maria Cecilia Hospital, GVM Care & Research, Cotignola, Italy
(Latini) Department of Cardiovascular Research, IRCCS Istituto di Ricerche
Farmacologiche "Mario Negri", Milan, United States
(Pretorius) Division of Cardiothoracic Anesthesiology, Department of
Anesthesiology, Vanderbilt University Medical Center, Nashville, United
States
(Brown) Department of Pharmacology (N.B.) and Department of Medicine
(N.B.), Vanderbilt University School of Medicine, TN, Nashville, United
States
(Libby) Division of Cardiovascular Medicine, Department of Medicine,
Brigham and Women's Hospital, Harvard Medical School, Boston
(Mozaffarian) Friedman School of Nutrition Science and Policy, Tufts
University, Boston
Publisher
NLM (Medline)
Abstract
Background Fish oil is among the most common natural supplements for
treatment of hypertriglyceridemia or prevention of cardiovascular disease.
However, concerns about theoretical bleeding risk have led to
recommendations that patients should stop taking fish oil before surgery
or delay in elective procedures for patients taking fish oil by some
health care professionals. Methods and Results We tested the effect of
fish oil supplementation on perioperative bleeding in a multinational,
placebo-controlled trial involving 1516 patients who were randomized to
perioperative fish oil (eicosapentaenoic acid+docosahexaenoic acid; 8-10 g
for 2-5 days preoperatively, and then 2 g/d postoperatively) or placebo.
Primary outcome was major perioperative bleeding as defined by the
Bleeding Academic Research Consortium. Secondary outcomes include
perioperative bleeding per thrombolysis in myocardial infarction and
International Society on Thrombosis and Hemostasis definitions, chest tube
output, and total units of blood transfused. Participants' mean (SD) age
was 63 (13) years, and planned surgery included coronary artery bypass
graft (52%) and valve surgery (50%). The primary outcome occurred in 92
patients (6.1%). Compared with placebo, risk of Bleeding Academic Research
Consortium bleeding was not higher in the fish oil group: odds ratio,
0.81; 95% CI, 0.53-1.24; absolute risk difference, 1.1% lower (95% CI,
-3.0% to 1.8%). Similar findings were seen for secondary bleeding
definitions. The total units of blood transfused were significantly lower
in the fish oil group compared with placebo (mean, 1.61 versus 1.92;
P<0.001). Evaluating achieved plasma phospholipid omega-3 polyunsaturated
fatty acids levels with supplementation (on the morning of surgery),
higher levels were associated with lower risk of Bleeding Academic
Research Consortium bleeding, with substantially lower risk in the third
(odds ratio, 0.30 [95% CI, 0.11-0.78]) and fourth (0.36 [95% CI,
0.15-0.87]) quartiles, compared with the lowest quartile. Conclusions Fish
oil supplementation did not increase perioperative bleeding and reduced
the number of blood transfusions. Higher achieved n-3-PUFA levels were
associated with lower risk of bleeding. These novel findings support the
need for reconsideration of current recommendations to stop fish oil or
delay procedures before cardiac surgery. Clinical Trial Registration URL:
https://www.clinicaltrials.gov . Unique identifier: NCT00970489.

<104>
Accession Number
643180000
Title
INNOMINATE VS AXILLARY ARTERY CANNULATION IN THORACIC AORTIC SURGERY: A
SYSTEMATIC REVIEW AND META-ANALYSIS.
Source
International Journal of Surgery. Conference: ASiT International Surgical
Conference, ASiT 2018. Edinburgh United Kingdom. 55(Supplement 1) (pp
S20), 2018. Date of Publication: July 2018.
Author
Bashir M.; Harky A.; Ahmad M.; Shipolini A.; Uppal R.
Institution
(Bashir, Harky, Ahmad, Shipolini, Uppal) Department of Cardiac Surgery,
Barts Heart Centre, London, United Kingdom
(Ahmad) School of Medicine, University of Liverpool, Liverpool, United
Kingdom
Publisher
Elsevier Ltd
Abstract
Aim: To investigate whether axillary artery cannulation has supremacy over
innominate artery cannulation during hypothermic circulatory arrest during
thoracic aortic surgery. <br/>Method(s): A comprehensive systematic
literature search was undertaken among the four major databases to
identify all published data. <br/>Result(s): A total of 4325 patients were
analysed from across 23 studies that were included in the quantitative
analysis of the parameters of interest. Additionally, three studies
fulfilled the criteria for meta-analysis. Cardiopulmonary bypass time is
significantly shorter in the innominate group in comparison to the
axillary group (P = 0.0027; 95% CI: -0.6 to e 0.12). Further analysis
revealed no significant difference between the innominate and axillary
group for DHCA time (P = 0.093). The relative risks for neurological
deficits as well as in-hospital mortality were the same for both groups
(p=0.63, p=0.567 respectively). Length of hospital stay was similar for
both groups. <br/>Conclusion(s): There is no superiority of axillary over
innominate artery cannulation in thoracic aortic surgery in term of
perioperative outcomes, however as the studies were limited, therefore a
larger scale comparative study is required to provide a solid base for
choosing the arterial cannulation site.

<105>
[Use Link to view the full text]
Accession Number
643179983
Title
IS MITRAL VALVE REPAIR SUPERIOR TO MITRAL VALVE REPLACEMENT IN PATIENTS
WITH NATIVE MITRAL VALVE ENDOCARDITIS? A SYSTEMATIC REVIEW AND
META-ANALYSIS.
Source
International Journal of Surgery. Conference: ASiT International Surgical
Conference, ASiT 2018. Edinburgh United Kingdom. 55(Supplement 1) (pp
S20), 2018. Date of Publication: July 2018.
Author
Harky A.; MacCarthy-Ofosu B.; Bashir M.; Garner M.; Roberts N.; Shipolini
A.; Uppal R.
Institution
(Harky, MacCarthy-Ofosu, Bashir, Garner, Roberts, Shipolini, Uppal)
Department of Cardiac Surgery, Barts Heart Centre, St Bartholomew's
Hospital, London, United Kingdom
Publisher
Elsevier Ltd
Abstract
Aim: The objective of this study is to systematically review the rate of
morbidity and mortality associated with mitral valve repair or replacement
in infective endocarditis. <br/>Method(s): A comprehensive search was
undertaken among the four major databases to identify all randomized and
nonrandomized controlled trials comparing mitral valve repair or
replacement in infective endocarditis. Databases where evaluated and
assessed to March 2017. <br/>Result(s): A total of 8978 patients were
analysed and in total 14 articles were included in the synthesis of the
meta-analysis. Average age of the cohort was 53 years. Post-operative
bleeding and recurrence of IE were significantly lower in the MV repair
group (p=0.005, p=0.004 respectively). Beyond 30 days, recurrence of IE
was higher in MV replacement group (P < 0.0001). Additionally, there are
significantly less reoperation rates in the MV repair group (P = 0.0021).
MV repair group seems to have a significantly better mortality profile at
1 and 5 years post op (p=0.03, p<0.0001) <br/>Conclusion(s): The present
meta-analysis shows that mitral valve repair has a good clinical outcomes
both while in-hospital and at 1 and 5 years of follow up, and is superior
to mitral valve replacement in patients that undergo mitral valve surgery
for native mitral valve endocarditis.

<106>
Accession Number
643179947
Title
STENTED VS STENTLESS AORTIC VALVE REPLACEMENT IN PATIENTS WITH SMALL
AORTIC ROOT: A SYSTEMATIC REVIEW AND META-ANALYSIS.
Source
International Journal of Surgery. Conference: ASiT International Surgical
Conference, ASiT 2018. Edinburgh United Kingdom. 55(Supplement 1) (pp
S19-S20), 2018. Date of Publication: July 2018.
Author
Harky A.; Bashir M.; Francis N.; Roberts N.; Uppal R.
Institution
(Harky, Bashir, Francis, Roberts, Uppal) Department of Cardiac Surgery,
Barts Heart Centre, St Bartholomew's Hospital, London, United Kingdom
Publisher
Elsevier Ltd
Abstract
Aim: To determine whether stentless bioprosthetic aortic valve
replacement( AVR) improve clinical outcomes compared to stented AVR in
patients with small aortic roots. <br/>Method(s): A systematic search was
undertaken over the four major electronic databases to identify all
published data up to March 2017. Coxproportional hazard ratio aligning
Odds ratios, weighted mean differences, or standardized mean differences
and their 95% confidence intervals were analysed. <br/>Result(s): A total
of 965 patients from 7 studies conformed to our inclusion criterion. Mean
age of the cohort was 73 yrs. There was no difference observed for CPB
time (P=0.54), aortic cross clamp time (P=0.89), ICU stay (P=0.57), rate
of PPM insertion (0.74) and rates of sternal wound infections (0.97) post
operatively. Length of stay was significantly shorter in the stentless
group (P=0.02). There was a significant increased risk of reoperation in
the stented group (P=0.001). <br/>Conclusion(s): The present meta-analysis
shows that there are no significant peri-operative differences in using
stented or stentless aortic valve bioprosthesis in the cohort of small
aortic root patients.

<107>
Accession Number
2029626480
Title
Erratum: 2023 ESC Guidelines for the management of endocarditis: Developed
by the task force on the management of endocarditis of the European
Society of Cardiology (ESC) Endorsed by the European Association for
Cardio-Thoracic Surgery (EACTS) and the European Association of Nuclear
Medicine (EANM) (European Heart Journal (2023) 44: 39 (3948-4042) DOI:
10.1093/eurheartj/ehad193).
Source
European Heart Journal. 45(1) (pp 56), 2024. Date of Publication: 01 Jan
2024.
Author
Anonymous
Publisher
Oxford University Press
Abstract
In the originally published version of this guidelines paper, reference
479 was incorrectly given as: Yanagawa B, Pettersson GB, Habib G, Ruel M,
Saposnik G, Latter DA, et al. Surgical management of infective
endocarditis complicated by embolic stroke: practical recommendations for
clinicians. Circulation 2016;134:1280-1292.
https://doi.org/10.1161/CIRCULATIONAHA.116.024156 The reference has been
corrected online to read as follows: Yanagawa B, Elbatarny M, Verma S,
Hill S, Mazine A, Puskas JD, et al. Surgical management of tricuspid valve
infective endocarditis: a systematic review and meta-analysis. Ann Thorac
Surg 2018;106:708-714. https://doi.org/10.1016/j.athoracsur.2018.04.012 In
Table 3 New recommendations, under the heading Section 5. Recommendation
Table 6 - Recommendations for the role of computed tomography, nuclear
imaging, and magnetic resonance in infective endocarditis, the
recommendation '[18F]FDG-PET/CT(A) may be considered in possible
CIED-related IE to confirm the diagnosis of IE' has been corrected to
match Recommendation Table 6. In Recommendation Table 7, under the heading
'Penicillin-susceptible oral streptococci and Streptococcus gallolyticus
group' 'Standard treatment: 2-week duration (not applicable to PVE)', the
information regarding 'Paediatric antibiotic dosage and route' for
Penicillin G has been corrected. In Table 14, under the heading
'Penicillin-susceptible oral streptococci and Streptococcus gallolyticus
group' 'Standard treatment: 2-week duration (not applicable to PVE)', the
information regarding 'Paediatric antibiotic dosage and route' for
Penicillin G has been corrected.<br/>Copyright &#xa9; The European Society
of Cardiology 2023.

<108>
Accession Number
2029536865
Title
Midterm Clinical Outcomes of Reimplantation Versus Remodeling
Valve-Sparing Aortic Root Replacement in Patients With Connective Tissue
Disorders: A Meta-Analysis.
Source
American Journal of Cardiology. 213 (pp 28-35), 2024. Date of Publication:
15 Feb 2024.
Author
Burton S.; Reynolds A.C.; King N.; Modi A.; Asopa S.
Institution
(Burton) Faculty of Health Sciences, University of Bristol, Bristol,
United Kingdom
(Reynolds) Swansea University Medical School, Swansea, United Kingdom
(King) Faculty of Health, University of Plymouth, Plymouth, United Kingdom
(Modi) Wessex Cardiac Centre, Southampton, United Kingdom
(Asopa) Southwest Cardiothoracic Centre, Plymouth, United Kingdom
Publisher
Elsevier Inc.
Abstract
This meta-analysis aimed to compare the midterm clinical outcomes of
reimplantation versus remodeling techniques for valve-sparing aortic root
replacement (VSARR) in patients with connective tissue disorders (CTDs).
Studies were screened and identified after the Preferred Reporting Items
for Systematic Review and Meta-Analysis (PRISMA) guidelines from the
PubMed, Web of Science, and Embase databases. Forest plots were produced
using Review Manager 5.3 (Cochrane, UK). Studies comparing early and
midterm clinical outcomes of reimplantation versus remodeling VSARR in
patients with CTD with a mean age >=18 years were included. The
sensitivity analysis excluded studies and subgroups of patients that
received ring or suture annuloplasty in addition to remodeling surgery.
The study selection identified 9 eligible studies. After analysis of the
study period and location for patient crossover, 7 retrospective studies
consisting of 597 patients (301 reimplantation and 296 remodeling) were
pooled. The pooling revealed no significant difference in postoperative
mortality (estimated mean follow-up of 10.5 years) (odds ratio [OR] 0.66,
95% confidence interval [CI] 0.30 to 1.48, I² = 30%, p = 0.32),
reoperation (OR 0.35, CI 0.04 to 3.30, I² = 81%, p = 0.36), or
occurrence of postoperative aortic regurgitation of >=2 (OR 0.56, CI 0.31
to 1.02, I² = 47%, p = 0.06). The sensitivity analysis
excluding annuloplasty demonstrated improved mortality (OR 0.19, CI 0.06
to 0.64, I² = 0%, p = 0.007) and decreased aortic regurgitation
of >=2 (OR 0.23, CI 0.10 to 0.53, I² = 47%, p = 0.0005) in
reimplantation VSARR. The rates of reoperation remained insignificant in
the sensitivity analysis (OR 0.43, CI 0.05 to 3.53, I² = 71%, p
= 0.43). In conclusion, this meta-analysis has demonstrated no significant
difference in the midterm clinical outcomes of reimplantation versus
remodeling techniques of VSARR. The sensitivity analysis excluding studies
and patient subgroups that received remodeling and annuloplasty suggests
remodeling alone to be inferior to reimplantation in patients with CTDs.
Further research is required to assess remodeling and annuloplasty against
reimplantation in patients of this demographic because the current body of
knowledge does not allow sufficient analysis.<br/>Copyright &#xa9; 2023
The Author(s)

<109>
Accession Number
2027798266
Title
High-Flow Nasal Cannula Therapy as an Adjuvant Therapy for Respiratory
Support during Endoscopic Techniques: A Narrative Review.
Source
Journal of Clinical Medicine. 13(1) (no pagination), 2024. Article Number:
81. Date of Publication: January 2024.
Author
Corral-Blanco M.; Sayas-Catalan J.; Hernandez-Voth A.; Rey-Terron L.;
Villena-Garrido V.
Institution
(Corral-Blanco, Sayas-Catalan, Hernandez-Voth, Rey-Terron,
Villena-Garrido) Avenue de Cordoba, s/n, Madrid 28041, Spain
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
High-flow nasal cannula (HFNC) is a respiratory support technique that
delivers a controlled concentration of oxygen with high flow, heat, and
humidity via the nasal pathway. As it has many physiological effects, its
use has increased for a variety of clinical indications; however, there is
limited guidance on using HFNC as a respiratory support tool during
endoscopic procedures. We conducted a narrative review to evaluate the
effect of HFNC as an adjuvant tool during fiberoptic bronchoscopy (FOB),
upper gastrointestinal tract endoscopy, and surgical procedures in adults.
A search of the PubMed and Cochrane databases were performed.
Approximately 384 publications were retrieved, and 99 were selected (93
original works and 6 case reports with a literature review). In patients
who underwent FOB, HFNC appears to be superior to conventional oxygen
therapy (COT) in preventing hypoxaemia. In contrast, for gastrointestinal
endoscopy, the current evidence is insufficient to recommend HFNC over COT
in a cost-effective manner. Finally, in surgical procedures such as
laryngeal microsurgery or thoracic surgery, HFNC has been shown to be a
safe and effective alternative to orotracheal intubation. As the results
are heterogeneous, we advocate for the need for more quality studies to
understand the effectiveness of HFNC during endoscopic
procedures.<br/>Copyright &#xa9; 2023 by the authors.

<110>
Accession Number
2027345636
Title
Ultrasound Guided Bilateral Transverse Thoracic Plane Block for Patient
Undergoing Cardiac Surgery.
Source
International Journal of Pharmaceutical and Clinical Research. 15(12) (pp
1321-1325), 2023. Date of Publication: 2023.
Author
Azmi N.; Bhalerao V.P.; Chouhan R.S.; Singh A.
Institution
(Azmi, Singh) Department of Anaesthesia, SAMC and PGI, MP, Indore, India
(Bhalerao) Department of Forensic Medicine, Government Medical College,
Maharashtra, Nagpur, India
(Chouhan) District Hospital, MP, Shivpuri, India
Publisher
Dr. Yashwant Research Labs Pvt. Ltd.
Abstract
Background and Objectives: The management of postoperative pain in
patients following cardiac surgery mostly relied on opioids. However, the
desired outcomes could not be attained due to the adverse consequences
associated with opioids. The implementation of the multimodal analgesic
strategy has been developed to mitigate the undesirable consequences of
opioids and provide optimal pain relief. The objective of this study was
to assess the impact of ultrasound-guided bilateral thoracic plane block
on patients having cardiac surgery. <br/>Material(s) and Method(s): This
prospective, randomized, double-blind study was conducted in the
Department of Anesthesiology and Critical Care, Sri Aurobindo Institute of
Medical Sciences Hospital, Indore (M.P) among 100 Patients of 18-70 years
scheduled for elective cardiac surgeries. After explaining the protocol to
all patients, a written and informed consent was taken from all patients.
The patients were allocated into two groups using computer-generated
random numbers: the Intervention group [Group T], that had a bilateral
transversus thoracic muscle plane block guided by ultrasonography with
20ml of 0.25% ropivacaine, and the Control group [Group C], which
underwent a sham block. Primary outcome was to observe the pain score and
first need of rescue analgesic inj. Tramadol. The secondary outcomes were
pain score, Total analgesic requirement in 24 hr, time to extubation, and
ICU stays. <br/>Result(s): The control group had a considerably shorter
time prior to the first request for pain management (median 3 hours)
compared to group T (median 14 hours). Within the 0.5-24 hour period after
surgery, the group T observed a decrease of 1.86 units in pain scores at
rest. The estimated decrease was-1.80, with a 95% confidence interval
ranging from-2.14 to-1.45. The t-value was-10.323, and the p-value was
less than 0.0001. Postoperative tramadol consumption was found to be
significantly lower in Group T (p < 0.001). <br/>Conclusion(s): The
bilateral transversus thoracic muscle plane block (TTMPB) is a very
promising and successful method for minimizing opioid consumption and
managing post-sternotomy pain in patients who underwent cardiac
surgery.<br/>Copyright &#xa9; 2023, Dr. Yashwant Research Labs Pvt. Ltd..
All rights reserved.

<111>
Accession Number
2029632752
Title
Comparison of Ticagrelor and Clopidogrel in Elective Coronary Stenting: A
Double Blind Randomized Clinical Trial.
Source
Journal of Interventional Cardiology. 2023 (no pagination), 2023. Article
Number: 5544440. Date of Publication: 2023.
Author
Mehdizadeh Parizi M.; Golchin Vafa R.; Ahmadi A.; Heydarzade R.; Sadeghi
M.; Khademolhossseini A.; Amiri F.; Khoshnood Mansorkhani S.; Tavan A.;
Hosseini N.; Montaseri M.; Hosseini S.A.; Kojuri J.
Institution
(Mehdizadeh Parizi, Golchin Vafa, Ahmadi, Heydarzade, Sadeghi,
Khademolhossseini, Amiri, Khoshnood Mansorkhani, Tavan, Hosseini,
Montaseri, Hosseini, Kojuri) Professor Kojuri Cardiology Clinic, Shiraz,
Iran, Islamic Republic of
(Kojuri) Cardiology Department, Shiraz University of Medical Sciences,
Shiraz, Iran, Islamic Republic of
(Kojuri) Clinical Education Research Center, Shiraz University of Medical
Sciences, Shiraz, Iran, Islamic Republic of
Publisher
Hindawi Limited
Abstract
Background. Dual antiplatelet therapy with a P2Y12 inhibitor (e.g.,
clopidogrel and ticagrelor) and aspirin is recommended for at least one
year after percutaneous coronary intervention (PCI) to prevent further
myocardial infarction and stent thrombosis as the major adverse effects of
PCI. Methods. This randomized clinical trial was conducted from October
2022 to March 2023. Patients who had undergone elective PCI were included
in the study. Patients were randomized into two different groups. One
group took ASA 80 mg and clopidogrel 75 mg once daily, while the other
took ASA 80 mg once daily and ticagrelor 90 mg twice daily. After six
months of close follow-up, patients were asked to score their dyspnea on a
10-point Likert scale. They were also asked about dyspnea on exertion,
paroxysmal nocturnal dyspnea (PND), bleeding, and the occurrence of major
adverse cardiovascular events (MACEs). Results. 223 patients were
allocated to the clopidogrel group and 214 to the ticagrelor group. In the
ticagrelor group, 95 patients (44.3%) reported dyspnea at rest, compared
with only 44 patients (19.7%) in the clopidogrel group (P < 0.001). MACEs
occurred in 7 patients (2.8%) in the ticagrelor group, compared with 16
(7.6%) in the clopidogrel group (P = 0.031). Eight patients (3.8%)
reported bleeding with ticagrelor, as did seven (3.2%) with clopidogrel (P
= 0.799). Conclusions. New-onset dyspnea was recorded more frequently with
ticagrelor than clopidogrel, yet fewer MACEs occurred with ticagrelor
(ClinicalTrials.gov number: NCT05858918). <br/>Copyright &#xa9; 2023
Mohammadjavad Mehdizadeh Parizi et al.