EPICORE Embase Updates: EMBASE Cardiac Update AutoAlert: EPICORE Cardiac Surgery Blogger2

Total documents retrieved: 69

Results Generated From:
Embase <1980 to 2024 Week 08>
Embase Weekly Updates (updates since 2024-02-16)

<1>
Accession Number
2028506322
Title
A Global Systematic Review of Open Heart Valvular Surgery in
Resource-Limited Settings.
Source
Annals of Thoracic Surgery. 117(3) (pp 652-660), 2024. Date of
Publication: March 2024.
Author
Rekhtman D.; Bermudez F.; Vervoort D.; Kaze L.; Patton-Bolman C.; Swain J.
Institution
(Rekhtman) Perelman School of Medicine, University of Pennsylvania,
Philadelphia, Pennsylvania, United States
(Bermudez) Georgetown University School of Medicine, Washington, DC,
United States
(Vervoort) Institute of Health Policy, Management and Evaluation,
University of Toronto, Toronto, ON, Canada
(Kaze) Graduate School of Social and Political Science, University of
Edinburgh, Edinburgh, United Kingdom
(Kaze, Patton-Bolman, Swain) Team Heart, Inc, Kigali, Rwanda
(Swain) Division of Cardiovascular Surgery, Hospital of the University of
Pennsylvania, Philadelphia, Pennsylvania, United States
Publisher
Elsevier Inc.
Abstract
Background: Many obstacles challenge the establishment and expansion of
cardiac surgery in low- and middle-income countries, despite the unmet
cardiac surgical needs. One challenge has been providing adequate
follow-up care to monitor anticoagulation, manage morbidity, and prevent
mortality. This systematic review describes outcomes after valvular
cardiac surgery and focuses on strategies for prolonged follow-up care in
resource-constrained settings. Method(s): Studies published between
2012 and 2022 were collected from Embase and the Cochrane Library. Article
inclusion criteria were adolescent and adult patients, open heart valvular
surgery, and analysis of at least 1 postoperative outcome at least 30 days
postoperatively. Studies that focused on pediatric patients, pregnant
patients, transcatheter procedures, in-hospital outcomes, and nonvalvular
surgical procedures were excluded. Descriptive statistics were assessed,
and articles were summarized after abstract screening, full-text review,
and data extraction. Result(s): Sixty-seven relevant publications
were identified after screening. The most commonly studied regions were
Asia (46%), Africa (36%), and Latin America (9%). Rheumatic heart disease
was the most commonly studied valvular disease (70%). Reported outcomes
included mortality, surgical reintervention, and thrombotic events.
Follow-up duration ranged from 30 days to 144 months; 11 studies reported
a follow-up length of 12 months. Conclusion(s): Addressing the unmet
cardiac care needs requires a multifaceted approach that leverages
telemedicine technology, enhances medical infrastructure, and aligns
advocacy efforts. Learning from the cost-effective establishment of
cardiac surgery in low- and middle-income countries, we can apply past
innovations to foster sustainable cardiac surgical capacity. Copyright
© 2024 The Society of Thoracic Surgeons

<2>
Accession Number
2027817804
Title
Analysis of Pain Management after Anatomic VATS Resection in Austrian
Thoracic Surgery Units.
Source
Journal of Clinical Medicine. 13(1) (no pagination), 2024. Article Number:
80. Date of Publication: January 2024.
Author
Ponholzer F.; Schweiger T.; Ghanim B.; Maier H.; Hutter J.; Tomaselli F.;
Krause A.; Muller M.; Lindenmann J.; Spruk G.; Augustin F.
Institution
(Ponholzer, Maier, Augustin) Department of Visceral, Transplant and
Thoracic Surgery, Center of Operative Medicine, Medical University of
Innsbruck, Innsbruck 6020, Austria
(Schweiger) Division of Thoracic Surgery, Department of Surgery, Medical
University of Vienna, Vienna 1090, Austria
(Ghanim) Department of General and Thoracic Surgery, University Hospital
Krems, Karl Landsteiner University of Health Sciences, Krems an der Donau
3500, Austria
(Hutter) Department of Surgery, Paracelsus Medical University, Salzburg
5020, Austria
(Tomaselli) Department of Cardiac-, Vascular-, and Thoracic Surgery,
Johannes Kepler University Linz, Linz 4020, Austria
(Krause) Department of Surgery, Elisabethinen Hospital, Linz 4020, Austria
(Muller) Department of Thoracic Surgery, Clinic Floridsdorf, Vienna 1210,
Austria
(Lindenmann) Division of Thoracic and Hyperbaric Surgery, Department of
Surgery, Medical University of Graz, Graz 8010, Austria
(Spruk) Department of Cardiac-, Thoracic- and Vascular Surgery, Klinikum
Klagenfurt am Worthersee, Klagenfurt 9020, Austria
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Background: Postoperative pain influences rehabilitation, postoperative
complications and quality of life. Despite its impact, there are no
uniform treatment guidelines. Different centers seem to use various
strategies. This study aims to analyze pain management regimens used after
anatomic VATS resections in Austrian thoracic surgery units, with a
special interest in opioid usage and strategies to avoid opioids.
 Method(s): A questionnaire was designed to assess the use of regional
anesthesia, postoperative pain medication and characteristics of
individual pain management regimens. The questionnaire was sent to all
thoracic surgery units in Austria, with nine out of twelve departments
returning them. Result(s): All departments use regional anesthesia
during the procedure. Four out of nine centers use epidural analgesia or
an intercostal catheter for postoperative regional anesthesia in at least
50% of patients. Two departments follow an opioid restrictive regimen,
five depend on the visual analogue scale (VAS) and two administer opioids
on a fixed schedule. Three out of nine departments use NSAIDs on a fixed
schedule. The most used medication is metamizole (eight out of nine
centers; six on a fixed schedule, two depending on VAS) followed by
piritramide (six out of nine centers; none as a fixed prescription).
 Conclusion(s): This study reflects the heterogeneity in postoperative
pain treatment after VATS anatomic lung resections. All departments use
some form of regional anesthesia in the perioperative period; prolonged
regional anesthesia is not utilized uniformly to reduce opioid
consumption, as suggested in enhanced recovery after surgery programs.
More evidence is needed to optimize and standardize postoperative pain
treatment. Copyright © 2023 by the authors.

<3>
Accession Number
2027776128
Title
Short-term antiplatelet versus anticoagulant therapy after left atrial
appendage closure: a systematic review and meta-analysis.
Source
Journal of Thrombosis and Thrombolysis. 57(2) (pp 194-203), 2024. Date of
Publication: February 2024.
Author
Zhou Q.; Liu X.; Gu Z.-C.; Yang X.; Huang X.-H.; Wu Y.-Z.; Tao Y.-Y.; Wei
M.
Institution
(Zhou, Huang, Wu, Tao, Wei) Department of Clinical Pharmacy, Jinling
Hospital, Medical School of Nanjing University, Nanjing 210002, China
(Liu) Department of Pharmacy and Traditional Chinese Pharmacy, Jiangsu
College of Nursing, Huaian, China
(Gu) Department of Pharmacy, Ren Ji Hospital, Shanghai Jiao Tong
University School of Medicine, Shanghai, China
(Yang) Department of Pharmacy, Nanjing Drum Tower Hospital, The Affiliated
Hospital of Nanjing University Medical School, Nanjing, China
Publisher
Springer
Abstract
This meta-analysis compared the efficacy and safety of different
antithrombotic regimens after left atrial appendage closure (LAAC).
PubMed, Embase, Medline, Cochrane Library databases were systematically
searched from their inception to March 2023. Patients were divided into
short-term oral anticoagulation (OAC) group and antiplatelet therapy (APT)
group. The incidence of events were performed using RevMan 5.4. The events
including device-related thrombus (DRT), ischemic stroke/systemic
embolization (SE), major bleeding, any bleeding, any major adverse event
and all-cause mortality. Subgroup analysis were based on OAC alone or OAC
plus single antiplatelet therapy (SAPT) in OAC group. Oral anticoagulants
include warfarin and direct oral anticoagulant (DOAC). Fourteen studies
with 35,166 patients were included. We found that the incidence of DRT (OR
= 0.49, 95% CI 0.36-0.66, P0.0001) and all-cause mortality (OR = 0.71, 95%
CI 0.57-0.89, P = 0.002) were significantly lower in OAC group than APT
group. However, there was no statistical differences in the incidence
rates of ischemic stroke/SE (OR = 0.77, 95% CI 0.49-1.20, P = 0.25), major
bleeding (OR = 0.84, 95% CI 0.55-1.27, P = 0.84), any bleeding (OR = 0.83,
95% CI 0.56-1.22, P = 0.34) and any major adverse event (OR = 0.56, 95% CI
0.30-1.03, P = 0.06) in the two groups. Subgroup analysis found that the
incidence of DRT, all-cause mortality and any major adverse event in OAC
monotherapy were lower than that in APT group (P0.05), but not
statistically different from other outcome. The incidence of DRT,
all-cause mortality, any major adverse event and any bleeding in DOAC were
significantly better than APT group (P0.05). While warfarin only has
better incidence of DRT than APT (P0.05), there was no statistical
difference between the two groups in other outcome (P0.05). The incidence
of DRT was significantly lower than APT group (P0.05), major bleeding were
higher, and the rest of the outcome did not show any statistically
significant differences(P0.05) when OAC plus SAPT. Based on the existing
data, short-term OAC may be favored over APT for patients who undergo
LAAC. DOAC monotherapy may be favored over warfarin monotherapy or OAC
plus APT, when selecting anticoagulant therapies. Copyright © The
Author(s), under exclusive licence to Springer Science+Business Media,
LLC, part of Springer Nature 2023.

<4>
Accession Number
2019193749
Title
Coronary artery bypass grafting versus medical therapy in patients with
stable coronary artery disease: An individual patient data pooled
meta-analysis of randomized trials.
Source
Journal of Thoracic and Cardiovascular Surgery. 167(3) (pp 1022-1032.e14),
2024. Date of Publication: March 2024.
Author
Gaudino M.; Audisio K.; Hueb W.A.; Stone G.W.; Farkouh M.E.; Di Franco A.;
Rahouma M.; Serruys P.W.; Bhatt D.L.; Biondi Zoccai G.; Yusuf S.; Girardi
L.N.; Fremes S.E.; Ruel M.; Redfors B.
Institution
(Gaudino, Audisio, Di Franco, Rahouma, Girardi) Department of
Cardiothoracic Surgery, Weill Cornell Medicine, New York, NY, United
States
(Hueb) Heart Institute of the University of Sao Paulo, Sao Paulo, Brazil
(Stone) The Zena and Michael A. Wiener Cardiovascular Institute, Icahn
School of Medicine at Mount Sinai, New York, NY, United States
(Farkouh) Peter Munk Cardiac Centre and the Heart and Stroke Richard Lewar
Centre, University of Toronto, Toronto, ON, Canada
(Serruys) International Centre for Circulatory Health, National Heart and
Lung Institute, Imperial College London, London, United Kingdom
(Bhatt) Brigham and Women's Hospital Heart and Vascular Center and Harvard
Medical School, Boston, Mass, United States
(Biondi Zoccai) Department of Medico-Surgical Sciences and
Biotechnologies, Sapienza University of Rome, Latina, Italy
(Biondi Zoccai) Mediterranea Cardiocentro, Napoli, Italy
(Yusuf) Population Health Research Institute, McMaster University,
Hamilton Health Sciences, Hamilton, ON, Canada
(Fremes) Schulich Heart Centre, Sunnybrook Health Sciences Centre,
University of Toronto, Toronto, ON, Canada
(Ruel) University of Ottawa Heart Institute, University of Ottawa, Ottawa,
ON, Canada
(Redfors) Department of Cardiology, Sahlgrenska University Hospital,
Gothenburg, Sweden
(Redfors) Clinical Trials Center, Cardiovascular Research Foundation, New
York, NY, United States
(Redfors) NewYork-Presbyterian Hospital/Columbia University Medical
Center, New York, NY, United States
Publisher
Elsevier Inc.
Abstract
Objectives: It is unclear whether coronary artery bypass grafting (CABG)
improves survival compared with medical therapy (MT) in patients with
stable coronary artery disease (CAD). The aim of this analysis was to
perform an individual-patient data-pooled meta-analysis of contemporary
randomized controlled trials that compared CABG and MT in patients with
stable CAD. Method(s): A systematic search was performed in January
2021 to identify randomized controlled trials enrolling adult patients
with stable CAD, randomized to CABG or MT. Only trials using at least
aspirin, beta-blockers, and statins in the MT arm were included.
Individual patient data were obtained from all eligible studies and
pooled. The primary outcome was all-cause mortality. Result(s): Four
trials involving 2523 patients (1261 CABG; 1262 MT) were included with a
median follow-up of 5.6 (4.0-9.2) years. CABG was associated with
increased risk of all-cause mortality within 30 days (hazard ratio [HR],
4.81; 95% confidence interval [CI], 1.95-11.83) but subsequent reduction
in the long-term risk of death (HR, 0.79; 95% CI, 0.69-0.89). As such, the
cumulative 10-year mortality rate was lower in patients treated with CABG
compared with MT (45.1% vs 51.7%, respectively; odds ratio, 0.70; 95% CI,
0.58-0.85). Age and race were significant treatment effect modifier
(interaction P = .003 for both). Conclusion(s): In patients with
stable CAD, initial allocation to CABG was associated with greater
periprocedural risk of death but improved long-term survival compared with
MT. The survival advantage for CABG became significant after the fourth
postoperative year and was particularly pronounced in younger and
non-White patients. Copyright © 2022 The American Association for
Thoracic Surgery

<5>
Accession Number
643406691
Title
Retrospective aprotinin cardiac surgical studies and their limitations:
time for a prospective randomized clinical trial.
Source
European journal of cardio-thoracic surgery : official journal of the
European Association for Cardio-thoracic Surgery. 65(2) (no pagination),
2024. Date of Publication: 01 Feb 2024.
Author
Erdoes G.; Koster A.; Levy J.H.
Institution
(Erdoes) Department of Anesthesiology and Pain Medicine, Inselspital,
University of Bern, University Hospital Bern, Bern, Switzerland
(Koster) Clinics of Anesthesiology and Intensive Care Medicine, Sana Heart
Center Cottbus, Cottbus, Germany
(Koster) Institute of Anesthesiology and Pain Therapy, Heart and Diabetes
Center North Rhine-Westphalia, Ruhr University Bochum, Bad Oeynhausen,
Germany
(Levy) Departments of Anesthesiology, Critical Care, Surgery, Duke
University School of Medicine, Durham, NC, United States

<6>
Accession Number
642535739
Title
The effect of fibrates on lowering low-density lipoprotein cholesterol and
cardiovascular risk reduction: a systemic review and meta-analysis.
Source
European journal of preventive cardiology. 31(3) (pp 291-301), 2024. Date
of Publication: 15 Feb 2024.
Author
Kim K.A.; Kim N.J.; Choo E.H.
Institution
(Kim, Choo) Division of Cardiology, Department of Internal Medicine, Seoul
St.Mary's Hospital, Catholic University of Korea, Seocho-gu, 222
Banpo-daero, Seoul 06591, South Korea
(Kim) Medical Library, Catholic University of Korea, Seocho-gu, 222
Banpo-daero, Seoul 06591, South Korea
Abstract
AIMS: The effect of fibrate treatment on cardiovascular risk is
inconsistent. This meta-analysis aimed to assess the effect of fibrates on
major adverse cardiovascular outcome (MACE) reduction. METHODS AND
RESULTS: PubMed, Embase, and Cochrane library databases were searched up
to February 2023 for randomized controlled trials comparing fibrate
therapy against placebo and reporting cardiovascular outcomes and lipid
profile changes. The primary outcome was the clinical outcomes of each
trial that most closely corresponding to MACE, a composite of
cardiovascular death, acute myocardial infarction, stroke, and coronary
revascularization. A pre-specified meta-regression analysis to examine the
relationship between the changes in lipid levels after fibrate treatment
and the risk of MACE was also performed. Twelve trials were selected for
final analysis, with 25 781 patients and 2741 MACEs in the fibrate group
and 27 450 patients and 3754 MACEs in the control group. Overall, fibrate
therapy was associated with decreased risk of MACE [RR 0.87, 95%
confidence interval (CI) 0.81-0.94] with moderate heterogeneity (I2 =
47%). In meta-regression analysis, each 1 mmol/L reduction in low-density
lipoprotein cholesterol (LDL-C) after fibrate treatment reduced MACE (RR
0.71, 95% CI 0.49-0.94, P = 0.01), while triglyceride level changes did
not show a significant association (RR per 1mmol/L reduction 0.96, 95% CI
0.53-1.40, P = 0.86). A sensitivity analysis with the composite outcome of
cardiovascular death or acute myocardial infarction produced similar
results. CONCLUSION(S): Treatment with fibrates was associated with
decreased risk of MACE. The reduction in MACE risk with fibrate therapy
appears to be attributable to LDL-C reduction rather than a decrease in
triglyceride levels. Copyright © The Author(s) 2023. Published by
Oxford University Press on behalf of the European Society of Cardiology.
All rights reserved. For permissions, please e-mail:
journals.permissions@oup.com.

<7>
Accession Number
2030479176
Title
The effect of pectointercostal fascial block on stress response in open
heart surgery.
Source
Saudi Journal of Anaesthesia. 18(1) (pp 70-76), 2024. Date of Publication:
January 2024.
Author
Fadhlurrahman A.F.; Setiawan P.; Sumartono C.; Perdhana F.; Husain T.A.
Institution
(Fadhlurrahman) Department of Anesthesiology and Intensive Therapy,
Medical Faculty of Airlangga University, Surabaya, Indonesia
(Fadhlurrahman) Department of Anesthesiology and Intensive Therapy,
Faculty of Medicine, Brawijaya University, Dr. Saiful Anwar General
Hospital, Malang, Indonesia
(Setiawan, Perdhana, Husain) Division of Cardiovascular and Thoracic
Anesthesia, Department of Anesthesiology and Intensive Therapy, Faculty of
Medicine, Airlangga University, Dr. Soetomo General Hospital, Indonesia
(Sumartono) Division of Regional Anesthesia, Department of Anesthesiology
and Intensive Theraoy, Faculty of Medicine, Airlangga University, Dr.
Soetomo General Hospital, Surabaya, Indonesia
Publisher
Wolters Kluwer Medknow Publications
Abstract
Background: Activation of the hypothalamus-pituitary-adrenal (HPA) axis
and inflammatory processes are common forms of stress response. The
increased stress response is associated with a higher chance of
complications. Open hearth surgery is one of the procedures with a
high-stress response. Pectointercostal fascial block (PIFB), as a new pain
management option in sternotomy, has the potential to modulate the stress
response. Objective(s): To determine the effect of PIFB on stress
response in open heart surgery. Method(s): This study was a
Randomized Controlled Trial on 40 open heart surgery. Patients were
divided into two groups, control (20 patients) and PIFB (20 patients).
Primary parameters included basal and postoperative TNF-alpha, basal and
post sternotomy ACTH, and basal, 0, and 24 hours postoperative NLR.
Secondary parameters include the amount of opioid use, length of the
post-operative ventilator, length of ICU stay, and Numeric Rating Scale
(NRS) 6, 12, 24, and 48 hours postoperative. Result(s): The PIFB
group had a decrease in ACTH levels with an average change that was not
significantly different from the control group (-57.71 +/- 68.03 vs.
-129.78 +/- 140.98). The PIFB group had an average change in TNFalpha
levels and an average increase in NLR 0 hours postoperative that was not
significantly lower than the control group (TNFalpha: -0.52 +/- 1.31 vs.
0.54 +/- 1.76; NLR: 12.80 +/- 3.51 vs. 14.82 +/- 4.23). PIFB significantly
reduced the amount of opioid use during surgery, NRS at 6, 12, and 24
hours, and the length of post-operative ventilator use (P < 0.05, CI:
95%). Conclusion(s): PIFB has a good role in reducing the stress
response of open heart surgery and producing good clinical
outcomes. Copyright © 2024 Wolters Kluwer Medknow Publications.
All rights reserved.

<8>
Accession Number
2028607267
Title
Systemic immune-inflammation index for predicting postoperative atrial
fibrillation following cardiac surgery: a meta-analysis.
Source
Frontiers in Cardiovascular Medicine. 11 (no pagination), 2024. Article
Number: 1290610. Date of Publication: 2024.
Author
Chen Y.-C.; Liu C.-C.; Hsu H.-C.; Hung K.-C.; Chang Y.-J.; Ho C.-N.; Hsing
C.-H.; Yiu C.-Y.
Institution
(Chen, Hung, Chang, Ho, Hsing) Department of Anesthesiology, Chi Mei
Medical Center, Tainan, Taiwan (Republic of China)
(Liu) Department of Anesthesiology, E-Da Hospital, I-Shou University,
Kaohsiung, Taiwan (Republic of China)
(Liu) Department of Nursing, College of Medicine, I-Shou University,
Kaohsiung, Taiwan (Republic of China)
(Liu) School of Medicine, I-Shou University, Kaohsiung, Taiwan (Republic
of China)
(Hsu) Department of Otolaryngology, Kuang Tien General Hospital, Taichung,
Taiwan (Republic of China)
(Chang) Department of Recreation and Health-Care Management, College of
Recreation and Health Management, Chia Nan University of Pharmacy and
Science, Tainan, Taiwan (Republic of China)
(Hsing) Department of Medical Research, Chi-Mei Medical Center, Tainan,
Taiwan (Republic of China)
(Yiu) Department of Otolaryngology, Chi Mei Medical Center, Liouying,
Tainan, Taiwan (Republic of China)
(Yiu) Department of Dental Laboratory Technology, Min-Hwei Junior College
of Health Care Management, Liouying, Tainan, Taiwan (Republic of China)
Publisher
Frontiers Media SA
Abstract
Background: Postoperative atrial fibrillation (POAF) is a frequent
complication that may increase morbidity and mortality risk following
cardiac surgery. The systemic immune-inflammation index (SII) is an
emerging biomarker that provides an integrated measure of inflammation by
incorporating neutrophil, lymphocyte, and platelet counts. Recent studies
have reported associations between elevated SII and increased POAF risk;
however, significant heterogeneity exists regarding its predictive
efficacy. This meta-analysis aimed to assess SII's diagnostic efficacy for
predicting POAF risk. Method(s): To synthesize existing evidence on
the ability of perioperative SII for predicting POAF in patients
undergoing cardiac surgery, a systematic review and meta-analysis was
conducted. In August 2023, a comprehensive literature search was performed
to identify relevant studies reporting SII cutoff values with
corresponding sensitivity and specificity. The primary aim was to evaluate
SII's diagnostic utility for predicting POAF, whereas secondary outcomes
included the pooled incidence of POAF and the relationship between the SII
and POAF. Result(s): Eight studies published between 2021 and 2023
with 3,245 patients were included. Six studies involved coronary artery
bypass grafting (CABG) surgery; one encompassed various cardiac
procedures, and another focused solely on mitral valve surgery. The pooled
incidence of POAF was 23.6% [95% confidence interval (CI), 18.7%-29.2%].
Elevated SII significantly increased the odds of POAF by 3.24-fold (odds
ratio, 3.24; 95% CI, 1.6-6.55; p = 0.001). SII's pooled sensitivity and
specificity for predicting POAF were 0.80 (95% CI, 0.68-0.89) and 0.53
(95% CI, 0.23-0.8), respectively. The SII had moderate predictive accuracy
based on a hierarchical summary receiver operating characteristic (HSROC)
area under the curve of 0.78 (95% CI, 0.74-0.81). Subgroup analyses,
whether focusing on CABG alone or CABG with cardiopulmonary bypass (CPB),
both indicated an area under the HSROC curve of 0.78 (95% CI, 0.74-0.81).
 Conclusion(s): Elevated SII is significantly correlated with an
increased POAF risk following cardiac surgery, highlighting its utility as
a predictive biomarker. Considering its moderate diagnostic accuracy,
further research is essential for clarifying SII's clinical effectiveness,
either as an independent predictor or combined with other risk factors,
for stratifying patients at high POAF risk. Systematic Review
Registration: https://www.crd.york.ac.uk/prospero/, identifier
[CRD42023456128]. Copyright 2024 Chen, Liu, Hsu, Hung, Chang, Ho,
Hsing and Yiu.

<9>
Accession Number
2028601091
Title
Diagnostic challenges between takotsubo cardiomyopathy and acute
myocardial infarction-where is the emergency?: a literature review.
Source
International Journal of Emergency Medicine. 17(1) (no pagination), 2024.
Article Number: 22. Date of Publication: December 2024.
Author
Scafa-Udriste A.; Horodinschi R.-N.; Babos M.; Dinu B.
Institution
(Scafa-Udriste, Horodinschi, Dinu) "Carol Davila" University of Medicine
and Pharmacy, Bucharest 050474, Romania
(Scafa-Udriste, Horodinschi) Department of Cardiology, Clinical Emergency
Hospital of Buchararest, Bucharest 014461, Romania
(Babos, Dinu) Department of Emergency Medicine, Clinical Emergency
Hospital of Buchararest, Bucharest 014461, Romania
Publisher
BioMed Central Ltd
Abstract
Background: Takotsubo cardiomyopathy (TC) is an emergency cardiovascular
disease, with clinical and paraclinical manifestations similar to acute
myocardial infarction (AMI), but it is characterized by reversible
systolic dysfunction of the left ventricle (LV) in the absence (most of
the time) of obstructive coronary artery disease (CAD). Management of
patients with TC: TC seems to be more frequent in post-menopausal women
and it is triggered by emotional or physical stress. The diagnosis of TC
is based on the Mayo Clinic criteria. Initially, patients with TC should
be treated as those with AMI and carefully monitored in intensive care
unit. Urgent clinical and paraclinical distinction between TC and AMI is
mandatory in all patients, because of the different therapeutical
management between the two diseases. Chest pain and dyspnea are the most
common symptoms in TC. Paraclinical diagnosis is based on cardiac
biomarkers, electrocardiogram (ST-segment elevation/T wave inversion in
precordial leads without reciprocal ST-segment depression in inferior
leads and absence of Q waves), echocardiography (LV systolic dysfunction,
regional wall motion abnormalities extended in more than one coronary
territory), cardiac magnetic resonance and in most of the cases the
positive diagnosis is established by performing CA to exclude obstructive
CAD. The prognosis of patients with TC is considered benign in most cases,
with a complete LV function recovery, but severe complications may occur,
such as cardiogenic shock, LV free wall rupture, life-threatening
arrhythmia, and cardiac arrest. Postoperative TC may develop after any
type of surgical intervention due to acute stress and it should be
differentiated from postoperative AMI. The management of patients with TC
is medical and it is based on supportive care and the treatment of heart
failure, while patients with AMI require myocardial revascularization.
 Conclusion(s): TC leads to transient LV dysfunction that mimics AMI
from which it should be differentiated for a good therapeutic approach.
Patients with TC should be carefully monitored during hospitalization
because they have a high recovery potential if optimally
treated. Copyright © The Author(s) 2024.

<10>
Accession Number
2028596782
Title
Complexity of coronary artery disease and the release of cardiac
biomarkers after CABG.
Source
Frontiers in Cardiovascular Medicine. 11 (no pagination), 2024. Article
Number: 1345439. Date of Publication: 2024.
Author
Polzl L.; Lohmann R.; Sterzinger P.; Nagele F.; Hirsch J.; Graber M.;
Engler C.; Eder J.; Abfalterer H.; Ulmer H.; Griesmacher A.; Grimm M.;
Bonaros N.; Ruttmann-Ulmer E.; Holfeld J.; Gollmann-Tepekoylu C.
Institution
(Polzl, Lohmann, Nagele, Hirsch, Graber, Engler, Eder, Abfalterer, Grimm,
Bonaros, Ruttmann-Ulmer, Holfeld, Gollmann-Tepekoylu) Department of
Cardiac Surgery, Medical University of Innsbruck, Innsbruck, Austria
(Sterzinger) Department of Statistics, University of Warwick, Coventry,
United Kingdom
(Ulmer) Department for Medical Statistics, Informatics and Health
Economics, Medical University of Innsbruck, Innsbruck, Austria
(Griesmacher) Central Institute of Clinical Chemistry and Laboratory
Medicine, Medical University of Innsbruck, Innsbruck, Austria
Publisher
Frontiers Media SA
Abstract
Objective: In patients with complex coronary artery disease (CAD)
undergoing cardiac surgery, myocardial protection might be impaired due to
microvascular obstruction, resulting in myocardial injury and subsequent
biomarker release. Therefore, this study investigated the correlation
between the complexity of CAD, reflected by the SYNTAX Score, and the
release of cardiac biomarkers after CABG. Method(s): In a consecutive
series of 919 patients undergoing isolated CABG SYNTAX scores I and II
were calculated to assess the complexity of CAD. Levels of high
sensitivity cardiac troponin T (hs-cTnT) and creatine kinase-myocardial
band (CK-MB) were routinely measured once before and serially after
surgery. Patients were divided into tertiles according to their SYNTAX
Scores I and II. Spearman correlations and regression models were
performed to measure the degree of association between the release of
hs-cTnT and CK-MB and the SYNTAX Scores. Result(s): Patients with a
higher SYNTAX Score I had more comorbidities reflected in a higher
EuroSCORE II. Preoperatively, higher levels of cardiac biomarkers were
found in patients with higher SYNTAX Score II. No correlation was observed
between hs-cTnT, CK-MB and SYNTAX Score I or II. Regression models did not
show any association between cardiac biomarkers and the complexity of CAD.
 Conclusion(s): The complexity of CAD is not associated with the
release of cardiac biomarkers after CABG. Factors influencing
postoperative biomarker release need to be elucidated in future trials to
include postoperative biomarker release into risk stratification models
predicting outcome after cardiac surgery. Copyright 2024 Polzl,
Lohmann, Sterzinger, Nagele, Hirsch, Graber, Engler, Eder, Abfalterer,
Ulmer, Griesmacher, Grimm, Bonaros, Ruttmann-Ulmer, Holfeld and
Gollmann-Tepekoylu.

<11>
[Use Link to view the full text]
Accession Number
2030501443
Title
Platelet Transfusion in Cardiac Surgery: An Entropy-Balanced, Weighted,
Multicenter Analysis.
Source
Anesthesia and Analgesia. 138(3) (pp 542-551), 2024. Date of Publication:
01 Mar 2024.
Author
Fletcher C.M.; Hinton J.V.; Xing Z.; Perry L.A.; Greifer N.; Karamesinis
A.; Shi J.; Penny-Dimri J.C.; Ramson D.; Liu Z.; Williams-Spence J.; Segal
R.; Smith J.A.; Coulson T.G.; Bellomo R.
Institution
(Fletcher, Coulson) Department of Anaesthesiology and Perioperative
Medicine, The Alfred Hospital, Melbourne, VIC, Australia
(Hinton, Xing, Perry, Karamesinis, Shi, Liu, Segal, Coulson) Department of
Anaesthesia and Pain Management, Royal Melbourne Hospital, Parkville, VIC,
Australia
(Perry, Segal, Bellomo) Department of Critical Care, University of
Melbourne, Parkville, VIC, Australia
(Greifer) Harvard University, Institute for Quantitative Social Science,
Cambridge, MA, United States
(Penny-Dimri, Ramson, Smith) Department of Surgery, School of Clinical
Sciences, Monash Health, Monash University, Melbourne, VIC, Australia
(Williams-Spence) Department of Epidemiology and Preventive Medicine,
Monash University, Melbourne, VIC, Australia
(Smith) Department of Cardiothoracic Surgery, Monash Health, Clayton, VIC,
Australia
(Coulson) Department of Anaesthesiology and Perioperative Medicine, Monash
Universityc, Melbourne, VIC, Australia
(Bellomo) Department of Intensive Care, Austin Hospital, Melbourne, VIC,
Australia
(Bellomo) Australian and New Zealand Intensive Care Research Centre,
Monash University, Melbourne, VIC, Australia
(Bellomo) Department of Intensive Care, Royal Melbourne Hospital,
Melbourne, VIC, Australia
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND: Platelet transfusion is common in cardiac surgery, but some
studies have suggested an association with harm. Accordingly, we
investigated the association of perioperative platelet transfusion with
morbidity and mortality. METHOD(S): We conducted a retrospective
analysis of prospectively collected data from the Australian Society of
Cardiac and Thoracic Surgeons National Cardiac Surgery Database. We
included consecutive adults from 2005 to 2018 across 40 centers. We used
inverse probability of treatment weighting via entropy balancing to
investigate the association of perioperative platelet transfusion with our
2 primary outcomes, operative mortality (composite of both 30-day and
in-hospital mortality) and 90-day mortality, as well as multiple other
clinically relevant secondary outcomes. RESULT(S): Among 119,132
eligible patients, 25,373 received perioperative platelets and 93,759 were
considered controls. After entropy balancing, platelet transfusion was
associated with reduced operative mortality (odds ratio [OR], 0.63; 99%
confidence interval [CI], 0.47-0.84; P <.0001) and 90-day mortality (OR,
0.66; 99% CI, 0.51-0.85; P <.0001). Moreover, it was associated with
reduced odds of deep sternal wound infection (OR, 0.57; 99% CI, 0.36-0.89;
P =.0012), acute kidney injury (OR, 0.84; 99% CI, 0.71-0.99; P =.0055),
and postoperative renal replacement therapy (OR, 0.71; 99% CI, 0.54-0.93;
P =.0013). These positive associations were observed despite an
association with increased odds of return to theatre for bleeding (OR,
1.55; 99% CI, 1.16-2.09; P <.0001), pneumonia (OR, 1.26; 99% CI,
1.11-1.44; P <.0001), intubation for longer than 24 hours postoperatively
(OR, 1.13; 99% CI, 1.03-1.24; P =.0012), inotrope use for >4 hours
postoperatively (OR, 1.14; 99% CI, 1.11-1.17; P <.0001), readmission to
hospital within 30 days of surgery (OR, 1.22; 99% CI, 1.11-1.34; P
<.0001), as well as increased drain tube output (adjusted mean difference,
89.2 mL; 99% CI, 77.0 mL-101.4 mL; P <.0001). CONCLUSION(S): In
cardiac surgery patients, perioperative platelet transfusion was
associated with reduced operative and 90-day mortality. Until randomized
controlled trials either confirm or refute these findings, platelet
transfusion should not be deliberately avoided when considering odds of
death. Copyright © 2024 Lippincott Williams and Wilkins. All
rights reserved.

<12>
Accession Number
2030500211
Title
Sequential hybrid ablation vs. surgical CryoMaze alone for treatment of
atrial fibrillation: results of multicentre randomized controlled trial.
Source
Europace. 26(2) (no pagination), 2024. Article Number: euae040. Date of
Publication: 01 Feb 2024.
Author
Bulava A.; Wichterle D.; Mokracek A.; Osmancik P.; Budera P.; Kacer P.;
Veteskova L.; Nemec P.; Skala T.; Santavy P.; Chovancik J.; Branny P.;
Rizov V.; Kolesar M.; Safarikova I.; Rybar M.
Institution
(Bulava, Mokracek, Safarikova) Faculty of Health and Social Sciences,
University of South Bohemia in Ceske Budejovice and Cardiac Centre, Ceske
Budejovice Hospital, B. Nemcove 54, Ceske Budejovice 370 01, Czechia
(Wichterle, Budera) Cardiology Department, Institute for Clinical and
Experimental Medicine, Prague, Czechia
(Osmancik, Kacer) Third Faculty of Medicine, Charles University,
University Hospital Kralovske Vinohrady, Prague, Czechia
(Veteskova, Nemec) Centre of Cardiovascular Surgery and Transplantation,
Brno, Czechia
(Skala, Santavy) Faculty of Medicine and Dentistry, Palacky University,
University Hospital Olomouc, Olomouc, Czechia
(Chovancik, Branny) Cardilogy Department, Hospital Agel Trinec-Podlesi,
Trinec, Czechia
(Rizov, Kolesar) Cardilogy Department, Masaryk Hospital, Usti nad Labem,
Czechia
(Rybar) Faculty of Biomedical Engineering, Czech Technical University in
Prague, Kladno, Czechia
Publisher
Oxford University Press
Abstract
Aims Data on the hybrid atrial fibrillation (AF) treatment are lacking in
patients with structural heart disease undergoing concomitant CryoMaze
procedures. The aim was to assess whether the timely pre-emptive catheter
ablation would achieve higher freedom from AF or atrial tachycardia (AT)
and be associated with better clinical outcomes than surgical ablation
alone. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . Methods The trial investigated patients with non-paroxysmal AF
undergoing coronary artery bypass grafting and/or valve repair/ and
results replacement with mandatory concomitant CryoMaze
procedure who were randomly assigned to undergo either radiofrequency
catheter ablation [Hybrid Group (HG)] or no further treatment (Surgery
Group). The primary efficacy endpoint was the first recurrence of AF/AT
without class I or III antiarrhythmic drugs as assessed by implantable
cardiac monitors. The primary clinical endpoint was a composite of
hospitalization for arrhythmia recurrence, worsening of heart failure,
cardioembolic event, or major bleeding. We analysed 113 and 116 patients
in the Hybrid and Surgery Groups, respectively, with a median follow-up of
715 (IQR: 528-1072) days. The primary efficacy endpoint was significantly
reduced in the HG [41.1% vs. 67.4%, hazard ratio (HR) = 0.38, 95%
confidence interval (CI): 0.26-0.57, P < 0.001] as well as the primary
clinical endpoint (19.9% vs. 40.1%, HR = 0.51, 95% CI: 0.29-0.86, P =
0.012). The trial groups did not differ in all-cause mortality (10.6% vs.
8.6%, HR = 1.17, 95%CI: 0.51-2.71, P = 0.71). The major complications of
catheter ablation were infrequent (1.9%). . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . Conclusion
Pre-emptively performed catheter ablation after the CryoMaze procedure was
safe and associated with higher freedom from AF/AT and improved clinical
outcomes. Copyright © The Author(s) 2024. Published by Oxford
University Press on behalf of the European Society of Cardiology.

<13>
Accession Number
2030292671
Title
Alcohol septal ablation versus surgical septal myectomy of obstructive
hypertrophic cardiomyopathy: systematic review and meta-analysis.
Source
European Journal of Cardio-thoracic Surgery. 63(3) (no pagination), 2023.
Article Number: ezad043. Date of Publication: 01 Mar 2023.
Author
Yokoyama Y.; Shimoda T.; Shimada Y.J.; Shimamura J.; Akita K.; Yasuda R.;
Takayama H.; Kuno T.
Institution
(Yokoyama) Department of Surgery, St. Luke's University Health Network,
Bethlehem, PA, United States
(Shimoda) School of Medicine, University of Tsukuba, Ibaraki, Japan
(Shimada, Akita, Yasuda) Division of Cardiology, Department of Medicine,
Columbia University Irving Medical Center, New York, NY, United States
(Shimamura) Department of Surgery, Division of Cardiothoracic Surgery,
Emory University, Atlanta, GA, United States
(Takayama) Department of Surgery, Columbia University Irving Medical
Center, New York, NY, United States
(Kuno) Department of Cardiology, Montefiore Medical Center, Albert
Einstein College of Medicine, Bronx, NY, United States
Publisher
European Association for Cardio-Thoracic Surgery
Abstract
OBJECTIVES: To elucidate the optimal septal reduction therapy for
obstructive hypertrophic cardiomyopathy, we conducted a metaanalysis
comparing alcohol septal ablation (ASA) and septal myectomy.
 METHOD(S): MEDLINE, EMBASE and Cochrane CENTRAL were searched to
identify studies investigating the outcomes of ASA and septal myectomy in
patients with obstructive hypertrophic cardiomyopathy in January 2023. The
primary outcome of interest was all-cause mortality in studies with >=1
year of follow-up. The secondary outcomes of interest comprised left
ventricular outflow tract (LVOT) pressure gradient reduction and
reoperations of LVOT. A subgroup analysis of all-cause mortality including
studies with follow-up >=5 years was performed. RESULT(S): 27
observational studies were included (15 968 patients). Analysis
demonstrated similar all-cause mortality [hazard ratio (HR) (95%
confidence interval) (CI) 1.24 (0.88-1.76); P = 0.21; I2 =
56%]. In contrast, ASA was associated with less reduction of LVOT pressure
gradient and a reoperation rate [weighted mean difference (95% CI)
11.04mmHg (5.60-16.48); P < 0.01; I2 = 64%, HR (95% CI) 9.14
(6.55-12.75); P < 0.001; I2 = 0%, respectively]. The subgroup
analysis with follow-up >=5 years revealed higher long-term mortality with
ASA [HR (95% CI) 1.50 (1.04-2.15); P = 0.03; I2 = 52%].
 CONCLUSION(S): Although both septal reduction therapies were
associated with similar all-cause mortality, ASA was associated with a
higher rate of reoperation and less reduction of LVOT pressure gradient.
Furthermore, all-cause mortality with follow-up >=5 years showed
favourable outcomes with septal myectomy, although the result is only
hypothesis-generating given a subgroup analysis. Copyright © 2023
European Association for Cardio-Thoracic Surgery. All rights reserved.

<14>
Accession Number
2030423047
Title
Clinical Outcomes of Erector Spinae Plane Block for Midline Sternotomy in
Cardiac Surgery: A Systematic Review and Meta-Analysis.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2024.
Date of Publication: 2024.
Author
Greene J.J.; Chao S.; Tsui B.C.H.
Institution
(Greene, Chao, Tsui) Department of Anesthesiology, Perioperative and Pain
Medicine, Stanford University School of Medicine, Stanford, CA, United
States
(Greene) University of California - San Francisco School of Medicine,
University of California - San Francisco, San Francisco, CA, United States
Publisher
W.B. Saunders
Abstract
Objectives: To evaluate the benefit of single-shot erector spinae plane
block (ESPB) on pain at postoperative hours 4 and 12, duration of
mechanical ventilation, hospital length of stay, intensive care unit (ICU)
length of stay, cumulative postoperative opioid usage, and incidence of
postoperative nausea and vomiting (PONV) after cardiac surgery via
sternotomy Design: A systematic review and meta-analysis of randomized
controlled trials and prospective clinical trials. Setting(s):
Studies were identified through the search of PubMed and EMBASE on July
19, 2023. Participant(s): Adults and children undergoing cardiac
surgery via sternotomy. Intervention(s): Single-shot ESPB versus
standard-of-care analgesia. Measurements and Main Results: A
systematic review and meta-analysis of 10 studies (N = 695 patients). The
single-shot ESPB arm exhibited statistically significant reductions in
pain score at postoperative hour 4 (standardized mean difference [SMD]
-2.95, 95% CI -5.86 to -0.04, p = 0.0466), duration of mechanical
ventilation (SMD -1.23, 95% CI -2.21 to -0.24, p = 0.0145), cumulative
postoperative opioid usage (SMD -1.48, 95% CI -2.46 to -0.49, p = 0.0033),
and PONV incidence (risk ratio 0.4358, 95% CI 0.2105-0.9021, p = 0.0252).
The single-shot ESPB arm did not exhibit a statistically significant
reduction in pain score at postoperative hour 12, length of hospital stay,
and length of ICU stay. Conclusion(s): Single-shot ESPB improves
near-term clinical outcomes in patients undergoing cardiac surgery via
sternotomy. More randomized controlled trials are needed to validate these
findings. Copyright © 2023 Elsevier Inc.

<15>
Accession Number
2028081789
Title
Role of Cerebral Embolic Protection Devices in Patients Undergoing
Transcatheter Aortic Valve Replacement: An Updated Meta-Analysis.
Source
Journal of the American Heart Association. 13(3) (no pagination), 2024.
Article Number: e030587. Date of Publication: 2024.
Author
Kaur A.; Dhaliwal A.S.; Sohal S.; Gwon Y.; Gupta S.; Bhatia K.; Dominguez
A.C.; Basman C.; Tamis-Holland J.
Institution
(Kaur, Gupta) Department of Medicine, Icahn School of Medicine at Mount
Sinai Morningside West-New York, New York, NY, United States
(Dhaliwal) Population Health Science and Policy, Icahn School of Medicine
at Mount Sinai-New York, New York, NY, United States
(Sohal) Division of Cardiovascular Medicine, Newark Beth Israel Medical
Center-Newark, Newark, NJ, United States
(Gwon) Department of Biostatistics, University of Nebraska Medical Center,
Omaha, NE, United States
(Bhatia, Dominguez) Division of Cardiology, Icahn School of Medicine at
Mount Sinai Morningside-New York, New York, NY, United States
(Dominguez, Basman) Division of Cardiology, Lenox Hill Hospital New York,
New York, NY, United States
(Tamis-Holland) Department of Cardiovascular Medicine, Cleveland Clinic
Main Campus, Cleveland, OH, United States
Publisher
American Heart Association Inc.
Abstract
BACKGROUND: Cerebral embolic protection devices (CEPD) capture embolic
material in an attempt to reduce ischemic brain injury during
transcatheter aortic valve replacement. Prior reports have indicated mixed
results regarding the benefits of these devices. With new data emerging,
we performed an updated meta-analysis examining the effect of CEPD during
transcatheter aortic valve replacement on various clinical, neurological,
and safety parameters. METHODS AND RESULTS: A comprehensive review of
electronic databases was performed comparing CEPD and no-CEPD in
transcatheter aortic valve replacement. Primary clinical outcome was
all-cause stroke. Secondary clinical outcomes were disabling stroke and
all-cause mortality. Neurological outcomes included worsening of the
National Institutes of Health Stroke Scale score, Montreal Cognitive
Assessment score from baseline at discharge, presence of new ischemic
lesions, and total lesion volume on neuroimaging. Safety outcomes included
major or minor vascular complications and stage 2 or 3 acute kidney
injury. Seven randomized controlled trials with 4016 patients met the
inclusion criteria. There was no statistically significant difference in
the primary clinical outcome of all-cause stroke; secondary clinical
outcomes of disabling stroke, all-cause mortality, neurological outcomes
of National Institutes of Health Stroke Scale score worsening, Montreal
Cognitive Assessment worsening, presence of new ischemic lesions, or total
lesion volume on diffusion-weighted magnetic resonance imaging between
CEPD versus control groups. There was no statistically significant
difference in major or minor vascular complications or stage 2 or 3 acute
kidney injury between the groups. CONCLUSION(S): The use of CEPD in
transcatheter aortic valve replacement was not associated with a
statistically significant reduction in the risk of clinical, neurological,
and safety outcomes. Copyright © 2024 The Authors. Published on
behalf of the American Heart Association, Inc., by Wiley.

<16>
Accession Number
2028592410
Title
Risk factors and incidence of postoperative delirium after cardiac surgery
in children: a systematic review and meta-analysis.
Source
Italian Journal of Pediatrics. 50(1) (no pagination), 2024. Article
Number: 24. Date of Publication: December 2024.
Author
Fu M.; Yuan Q.; Yang Q.; Song W.; Yu Y.; Luo Y.; Xiong X.; Yu G.
Institution
(Fu, Yuan, Yang, Song, Yu, Luo, Xiong, Yu) Department of Nursing, Tongji
Hospital, Tongji Medical College, Huazhong University of Science and
Technology, 1095 Jiefang Road, Qiaokou District, Hubei, Wuhan, China
(Fu, Yuan, Yang, Song, Yu) School of Nursing, Tongji Medical College,
Huazhong University of Science and Technology, Hubei, Wuhan, China
Publisher
BioMed Central Ltd
Abstract
Delirium, a form of acute cerebral dysfunction, is a common complication
of postoperative cardiac surgery in children. It is strongly associated
with adverse outcomes, including prolonged hospitalization, increased
mortality, and cognitive dysfunction. This study aimed to identify risk
factors and incidence of delirium after cardiac surgery in children to
facilitate early identification of delirium risk and provide a reference
for the implementation of effective prevention and management. A
systematic literature search was conducted in PubMed, Web of Science,
Embase, Cochrane Library, Scopus, CNKI, Sinomed, and Wanfang for studies
published in English or Chinese from the inception of each database to
November 2023. The PRISMA guidelines were followed in all phases of this
systematic review. The Risk of Bias Assessment for Nonrandomized Studies
tool was used to assess methodological quality. A total of twelve studies
were included in the analysis, with four studies classified as overall low
risk of bias, seven studies as moderate risk of bias, and one study as
high risk of bias. The studies reported 39 possible predictors of
delirium, categorized into four broad groups: intrinsic and parent-related
factors, disease-related factors, surgery and treatment-related factors,
and clinical scores and laboratory parameters. By conducting qualitative
synthesis and quantitative meta-analysis, we identified two definite
factors, four possible factors, and 32 unclear factors related to
delirium. Definite risk factors included age and mechanical ventilation
duration. Possible factors included developmental delay, cyanotic heart
disease, cardiopulmonary bypass time, and pain score. With only a few
high-quality studies currently available, well-designed and more extensive
prospective studies are still needed to investigate the risk factors
affecting delirium and explore delirium prevention strategies in high-risk
children. Copyright © The Author(s) 2024.

<17>
Accession Number
2028063119
Title
Effect of Music Therapy in Relieving the Symptom Experiences and Improving
Outcomes of Critical Care Patients: A Systematic Review.
Source
Open Access Macedonian Journal of Medical Sciences. Part F. 11 (pp
180-195), 2023. Date of Publication: 04 Jan 2023.
Author
Widiastuti L.; Atrie U.Y.; Wati L.; Sitindaon S.H.; Arianingsih T.;
Mulyana B.
Institution
(Widiastuti, Atrie, Wati, Sitindaon, Arianingsih) Department of Nursing,
Stikes Hang Tuah Tanjungpinang, Tanjung Pinang, Indonesia
(Mulyana) Department of Nursing, Universitas Esa Unggul, Jakarta,
Indonesia
Publisher
Scientific Foundation SPIROSKI
Abstract
BACKGROUND: The critical care patients often have unpleasant experiences
while facing critical care activities that may impact on physiological and
psychological changes. Music therapy is a simple complementary therapy
that can promote relaxation, potentially affecting some outcomes for
critical care patients. However, a systematic review related to the
application of music therapy and the results obtained from music therapy
is still limited. AIM: This systematic review aimed to explore and
evaluate the effectiveness of music therapy interventions in relieving
symptom experiences and improving outcomes of critical care patients.
 METHOD(S): We conducted a systematic review of research articles
focused on music therapy in critical care areas using three electronic
databases, namely PubMed, CINAHL, and Science Direct. We selected English
articles that had a Randomized Control Trial (RCT) design and published
from 2005 to 2020. PICO format used to search literature; "Adult, Critical
Care, Intensive Care Unit (ICU), Critically Ill Patients, Intensive Care,
Surgical ICU, Cardiac Surgical ICU, Medical-Surgical ICU, Therapy Music,
Music Therapy, Pain, Agitation, Stress. Anxiety, Delirium, Mobility,
Sleep, Physiological, and Psychological. The risk of bias from 19 articles
was evaluated by JBI. Furthermore, we assessed the manner and effect of
music therapy on various symptoms. RESULT(S): The researchers found
743 articles. After manual review, 19 RCTs (1711 participants) were
identified and assessed. Based on the review, it was reported that music
with a relaxed rhythm, soft tone, slow rhythm; duration from 15 to 60 min;
60-80 beats/min, and using headphones, has a significant effect on pain,
anxiety, stress, delirium, mobilization, sleep quality, sedation levels,
and physiological parameters. CONCLUSION(S): Music therapy has proved
effective in reducing symptoms experiences of critical care patients. It
is suggested to be used as a viable option in symptoms management of
patients in ICU. Copyright © 2023 Linda Widiastuti, Utari Yunie
Atrie, Liza Wati, Soni Hendra Sitindaon, Tri Arianingsih, Budi Mulyana.

<18>
Accession Number
2018969425
Title
Does prophylactic low-dose amiodarone decrease the incidence of
postoperative atrial fibrillation after coronary artery bypass graft
surgery? A randomized controlled trial.
Source
Cardiothoracic Surgeon. 30(1) (no pagination), 2022. Article Number: 24.
Date of Publication: December 2022.
Author
Ahmed M.A.; Ghoneim A.E.; Abdel Wahab A.A.E.; Mahmoud A.B.
Institution
(Ahmed, Ghoneim, Abdel Wahab, Mahmoud) Faculty of Medicine, Tanta
University, Tanta 31527, Egypt
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Background: Postoperative atrial fibrillation (POAF) occurs within 1 to 5
days after coronary artery bypass grafting (CABG), with a peak occurrence
on the second day. This research aimed to assess the role of dose-low
amiodarone in the prevention of POAF after CABG. Method(s): This
randomized controlled blind-single study was carried out on 150 patients
undergoing elective CABG with sinus rhythm. Cases were randomized into two
equal groups. The placebo group received matching placebo tablets. The
amiodarone group received a prophylactic oral amiodarone 5 mg/kg/day for 6
days before and 6 days after surgery. Result(s): The incidence of
POAF was significantly lower in the amiodarone group compared to the
placebo group (16% vs 33.3%, P = 0.013) with a relative risk of 0.48 times
(95% confidence interval: 0.26-0.88). The onset of POAF, percent of
patients responded to medication, and time elapsed to respond to
medication were insignificantly different between both groups. The mean
(+/- SD) of ICU stay was 2.51 +/- 1.11 days in the amiodarone group versus
3.31 +/- 1.83 days in the placebo group, and the mean (+/- SD) of hospital
stay duration was 10 +/- 1.99 days in the amiodarone group versus 12.72
+/- 2.23 days in the placebo group. The length of ICU admission and
hospital stay was significantly lower in the amiodarone group than in the
placebo group (P = 0.002 and < 0.001, respectively). Conclusion(s):
Low-dose oral amiodarone was effective in POAF prevention after CABG with
a lower length of ICU admission and hospital stay. Trial registration: Pan
African Clinical Trials Register PACTR202101651961317. Registered on 21
January 2021 Copyright © The Author(s) 2022.

<19>
Accession Number
643493198
Title
Enhanced recovery after surgery (ERAS ) Society abdominal and
thoracic surgery recommendations: A systematic review and comparison of
guidelines for perioperative and pharmacotherapy core items.
Source
World journal of surgery. (no pagination), 2024. Date of Publication: 13
Feb 2024.
Author
Powers B.K.; Ponder H.L.; Findley R.; Wolfe R.; Patel G.P.; Parrish R.H.
Institution
(Powers, Ponder, Parrish) Mercer University School of Medicine, Columbus,
GA, United States
(Findley) Faculty of Medicine, Dalhousie University, Halifax, NS, Canada
(Findley, Wolfe, Patel, Parrish) Enhanced Recovery Comparative
Pharmacotherapy Collaborative, Perioperative Care Practice and Research
Network, American College of Clinical Pharmacy, Hermitage, TN, United
States
(Wolfe) Department of Pharmacy Services, Barners-Jewish Hospital, St.
Louis, MO, United States
(Patel) Department of Pharmacy Services, University of Chicago Hospitals,
Chicago, IL, United States
Abstract
INTRODUCTION: Worldwide, ERAS Society guidelines have ushered in a new era
of perioperative care. The purpose of this systematic review is to compare
published core elements and pharmacotherapy recommendations embedded
within ERAS Society abdominal and thoracic surgery (ATS) guidelines.
Determining whether a consensus exists for pharmacological core items
would make future guideline preparation for similar surgeries more
standardized and could improve patient care by reducing unnecessary
protocol variations. METHOD(S): From the ERAS Society website as of
May 2023, 16 current ERAS published ATS guidelines were included in the
analysis to determine consensus and differing statements regarding each
ERAS perioperative and pharmacotherapy-related item. The aims were to (a)
determine whether a consensus for each item could be derived, (b) identify
gaps in ERAS protocol development, and (c) propose potential research
directions for addressing the identified gaps in the literature.
 RESULT(S): Core items with consensus included: preoperative smoking
and alcohol cessation; avoiding bowel reparation and fasting; multimodal
preanesthetic, perioperative analgesia, and postoperative nausea and
vomiting regimens; low molecular weight heparins for in-hospital and
at-home venous thromboembolism prophylaxis; antibiotic prophylaxis; skin
preparation; goal-directed perioperative fluid management with balanced
crystalloids; perioperative nutrition care; ileus prevention with
peripherally-acting mu receptor antagonists; and glucose control.
 CONCLUSION(S): While consensus was found for aspects of 21 current
ERAS guideline core items related to pharmacotherapy choice, details
related to doses, regimen, timing of administration as well as unique
aspects pertaining to specific surgeries remain to be researched and
harmonized to promote guideline consistency and further optimize patient
outcomes. Copyright © 2024 International Society of
Surgery/Societe Internationale de Chirurgie (ISS/SIC).

<20>
Accession Number
643489215
Title
Cardiovascular Outcomes in GRADE (Glycemia Reduction Approaches in Type 2
Diabetes: A Comparative Effectiveness Study).
Source
Circulation. (no pagination), 2024. Date of Publication: 12 Feb 2024.
Author
Green J.B.; Everett B.M.; Ghosh A.; Younes N.; Krause-Steinrauf H.;
Barzilay J.; Desouza C.; Inzucchi S.E.; Pokharel Y.; Schade D.; Scrymgeour
A.; Tan M.H.; Utzschneider K.M.; Mudaliar S.
Institution
(Green) Duke Clinical Research Institute, Duke University School of
Medicine, Durham, United Kingdom
(Everett) Divisions of Cardiovascular and Preventive Medicine, Brigham and
Women's Hospital and Harvard Medical School, Boston, United States
(Ghosh, Younes, Krause-Steinrauf) Biostatistics Center, Department of
Biostatistics and Bioinformatics, Milken Institute School of Public
Health, George Washington University, Rockville, N.Y, United States
(Barzilay) Division of Endocrinology, Kaiser Permanente of Georgia,
Georgia
(Barzilay) Department of Endocrinology, Emory University School of
Medicine, Atlanta, United States
(Desouza) Division of Diabetes, Endocrinology & Metabolism, University of
Nebraska Medical Center, Omaha VA Medical Center (C.D.)
(Inzucchi) Section of Endocrinology, Yale School of Medicine, CT (S.E.I.),
New Haven, United States
(Pokharel) Division of Cardiology, Wake Forest University School of
Medicine, Winston-Salem
(Schade) Division of Endocrinology, University of New Mexico School of
Medicine, Mexico
(Scrymgeour) VA Cooperative Studies Program Clinical Research Pharmacy
Coordinating Center, Albuquerque, United States
(Tan) Division of Metabolism, Endocrinology & Diabetes, Department of
Internal Medicine, University of Michigan
(Utzschneider) Department of Medicine, VA Puget Sound and University of
Washington
(Mudaliar) VA San Diego Healthcare System and University of California,
San Diego (S.M.)
Abstract
BACKGROUND: Cardiovascular disease is a major cause of morbidity and
mortality in patients with type 2 diabetes. The effects of
glucose-lowering medications on cardiovascular outcomes in individuals
with type 2 diabetes and low cardiovascular risk are unclear. We
investigated cardiovascular outcomes by treatment group in participants
randomly assigned to insulin glargine, glimepiride, liraglutide, or
sitagliptin, added to baseline metformin, in GRADE (Glycemia Reduction
Approaches in Type 2 Diabetes: A Comparative Effectiveness Study).
 METHOD(S): A total of 5047 participants with a mean+/-SD age of
57.2+/-10.0 years, type 2 diabetes duration of 4.0+/-2.7 years, and low
baseline prevalence of cardiovascular disease (myocardial infarction,
5.1%; cerebrovascular accident, 2.0%) were followed for a median of 5
years. Prespecified outcomes included between-group time-to-first event
analyses of MACE-3 (composite of major adverse cardiovascular events:
cardiovascular death, myocardial infarction, and stroke), MACE-4
(MACE-3+unstable angina requiring hospitalization or revascularization),
MACE-5 (MACE-4+coronary revascularization), MACE-6 (MACE-5+hospitalization
for heart failure), and the individual components. MACE outcomes and
hospitalization for heart failure in the liraglutide-treated group were
compared with the other groups combined using Cox proportional hazards
models. MACE-6 was also analyzed as recurrent events using a proportional
rate model to compare all treatment groups. RESULT(S): We observed no
statistically significant differences in the cumulative incidence of first
MACE-3, MACE-4, MACE-5, or MACE-6, or their individual components, by
randomized treatment group. However, when compared with the other
treatment groups combined, the liraglutide-treated group had a
significantly lower risk of MACE-5 (adjusted hazard ratio, 0.70 [95% CI,
0.54-0.91]; P=0.021), MACE-6 (adjusted hazard ratio, 0.70 [95% CI,
0.55-0.90]; P=0.021), and hospitalization for heart failure (adjusted
hazard ratio, 0.49 [95% CI, 0.28-0.86]; P=0.022). Compared with the
liraglutide group, significantly higher rates of recurrent MACE-6 events
occurred in the groups treated with glimepiride (rate ratio, 1.61 [95% CI,
1.13-2.29]) or sitagliptin (rate ratio 1.75; [95% CI, 1.24-2.48]).
 CONCLUSION(S): This comparative effectiveness study of a contemporary
cohort of adults with type 2 diabetes, largely without established
cardiovascular disease, suggests that liraglutide treatment may reduce the
risk of cardiovascular events in patients at relatively low risk compared
with other commonly used glucose-lowering medications. REGISTRATION: URL:
https://www.clinicaltrials.gov; Unique identifier: NCT01794143.

<21>
Accession Number
643520219
Title
Plasma: indications, controversies, and opportunities.
Source
Postgraduate medicine. (no pagination), 2024. Date of Publication: 16 Feb
2024.
Author
Benson M.A.; Tolich D.; Callum J.L.; Auron M.
Institution
(Benson) Department of General Anesthesiology, Cleveland Clinic,
Cleveland, OH, United States
(Tolich) Blood Management, Pathology and Laboratory Medicine Institute,
Cleveland Clinic, Cleveland, OH, United States
(Callum) Department of Laboratory Medicine and Pathobiology, Queens
University, Kingston, ON, Canada
(Auron) Department of Hospital Medicine and Department of Pediatric
Hospital Medicine, Cleveland Clinic, Outcomes Research Consortium,
Cleveland, OH, United States
Abstract
Plasma is overused as a blood product worldwide; however, data supporting
appropriate use of plasma is scant. Its most common utilization is for
treatment of coagulopathy in actively bleeding patients; it is also used
for coagulation optimization prior to procedures with specific coagulation
profile targets. A baseline literature review in PUBMED and Google Scholar
was done (1 January 2000 to 1 June 2023), utilizing the following search
terms: plasma, fresh frozen plasma, lyophilized plasma, indications,
massive transfusion protocol, liver disease, warfarin reversal,
cardiothoracic surgery, INR<2. An initial review of the titles and
abstracts excluded all articles that were not focused on transfusional
medicine. Additional references were obtained from citations within the
retrieved articles. This narrative review discusses the main indications
for appropriate plasma use, mainly coagulation factor replacement, major
hemorrhage protocol, coagulopathy in liver disease, bleeding in the
setting of vitamin K antagonists, among others. The correlation between
concentration of coagulation factors and INR, as well as the proper plasma
dosing with its volume being weight-based is also discussed. A high value
approach to plasma utilization is supported with a review of the clinical
situations where plasma is overutilized or unnecessary. Finally, a
discussion of novel plasma products is presented for enhanced awareness.

<22>
Accession Number
643520095
Title
Glucagon-like Peptide 1 Receptor Agonists and Cardiovascular Outcomes in
Solid Organ Transplant Recipients With Diabetes Mellitus.
Source
Transplantation. (no pagination), 2024. Date of Publication: 16 Feb 2024.
Author
Dotan I.; Rudman Y.; Turjeman A.; Akirov A.; Steinmetz T.; Calvarysky B.;
Diker Cohen T.
Institution
(Dotan, Rudman, Akirov, Diker Cohen) Institute of Endocrinology, Diabetes
and Metabolism, Beilinson Hospital, Rabin Medical CenterPetah Tikva,
Israel
(Dotan, Rudman, Turjeman, Akirov, Steinmetz, Diker Cohen) Sackler Faculty
of Medicine, Tel Aviv University, Tel Aviv, Israel
(Turjeman) Research Authority, Beilinson Hospital, Rabin Medical
CenterPetah Tikva, Israel
(Steinmetz) Institute of Nephrology, Beilinson Hospital, Rabin Medical
CenterPetah Tikva, Israel
(Calvarysky) Pharmacy, Beilinson Hospital, Rabin Medical CenterPetah
Tikva, Israel
(Calvarysky) Faculty of Medicine, Hebrew University of Jerusalem,
Jerusalem, Israel
Abstract
BACKGROUND: Glucagon-like peptide 1 receptor agonists (GLP1-RAs) reduce
cardiovascular events and mortality in type 2 diabetes. Limited data are
available on diabetes treatment after solid organ transplantation. We
aimed to explore the effect of GLP1-RAs on cardiovascular outcomes in
transplanted recipients with diabetes. METHOD(S): We extracted data
on adult transplant recipients (kidney, lungs, liver, heart) insured in a
large health maintenance organization. Death-censored patients with
diabetes treated with GLP1-RAs were matched with nonusers. The primary
outcome was a composite of major cardiovascular events (MACEs): a nonfatal
cardiac event (myocardial infarction, stable/unstable angina, coronary
bypass, and coronary angiography), ischemic stroke and all-cause
mortality. Secondary outcomes were MACE or peripheral vascular disease
(MACE-PVD), and all-cause mortality. Safety outcomes included
biliopancreatic adverse events. RESULT(S): We included 318 patients
(69% males, average age 58.3 +/- 11.0 y) with a 3.1-y median follow-up.
The incidence of MACE was 101 of 1000 patient-years in GLP1-RAs users
compared with 134 of 1000 in controls (hazard ratio [HR] 0.46; 95%
confidence interval [CI], 0.27-0.78). GLP1-RAs similarly reduced the risk
of MACE-PVD (HR 0.53; 95% CI, 0.33-0.88) and the risk of all-cause
mortality (HR 0.39; 95% CI, 0.18-0.84). Biliopancreatic adverse events
occurred less in GLP1-RA users. CONCLUSION(S): Transplant recipients
with diabetes who used GLP1-RAs had lower risks for MACE and all-cause
mortality. These results may profoundly implicate the daily management of
posttransplant recipients with diabetes, a population with a high
prevalence of cardiometabolic risk factors and cardiovascular death.
Transplant patients are usually excluded from randomized controlled trials
and, hence might be undertreated with disease-modifying drugs. Larger
prospective studies are needed in this unique population. Copyright
© 2024 Wolters Kluwer Health, Inc. All rights reserved.

<23>
Accession Number
643512775
Title
Renin as a Prognostic Marker in Intensive Care and Perioperative Settings:
A Scoping Review.
Source
Anesthesia and analgesia. (no pagination), 2023. Date of Publication: 23
Oct 2023.
Author
Kotani Y.; Belletti A.; Maiucci G.; Lodovici M.; Fresilli S.; Landoni G.;
Bellomo R.; Zarbock A.
Institution
(Kotani, Belletti, Maiucci, Lodovici, Fresilli, Landoni) From the
Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific
Institute, Milan, Italy
(Kotani, Landoni) School of Medicine, Vita-Salute San Raffaele University,
Milan, Italy
(Kotani) Department of Intensive Care Medicine, Kameda Medical Center,
Kamogawa, Japan
(Bellomo) Department of Critical Care, University of Melbourne, Melbourne,
VIC, Australia
(Bellomo) Department of Critical Care, Australian and New Zealand
Intensive Care Research Centre, Monash University, Melbourne, VIC,
Australia
(Zarbock) Department of Anesthesiology, Intensive Care Medicine and Pain
Therapy, University Hospital Muenster, Muenster, Germany
Abstract
Serum renin increases in response to sympathetic nerve activation and
hypotension. Recent studies have reported the association of serum renin
levels with adverse clinical outcomes in acute care settings. This scoping
review aimed to systematically review the available literature on renin as
a prognostic marker in intensive care and perioperative patients. We
searched for studies published since inception until March 31, 2023, which
assessed the association between serum renin levels and clinical outcomes
or the effect of synthetic angiotensin II administration on serum renin
levels in critically ill and perioperative patients in PubMed, Embase, and
the Cochrane Library. The primary outcome was mortality at the longest
follow-up; the secondary outcomes were adverse renal outcomes (ie, acute
kidney injury, the need for renal replacement therapy, and major adverse
kidney events), hemodynamic instability, outcomes to angiotensin II
administration, and prognostic performance for mortality when compared
with lactate. Among the 2081 studies identified, we included 16 studies
with 1573 patients (7 studies on shock, 5 on nonspecific critical illness,
2 on cardiac surgery, 1 on noncardiac surgery, and 1 on coronavirus
disease 2019). A significant association between serum renin levels and
poor outcomes was identified in 14 studies, with 10 studies demonstrating
an association with mortality. One post hoc analysis found that
angiotensin II administration reduced mortality in patients with markedly
elevated renin values. Two studies showed that renin was superior to
lactate as a prognostic marker of mortality. Our scoping review showed
that elevated serum renin levels may be associated with clinically
relevant outcomes among various perioperative and intensive care
populations. Increased serum renin levels may identify patients in which
synthetic angiotensin II administration improves clinical outcomes and may
outperform serum lactate in predicting mortality. Copyright ©
2023 International Anesthesia Research Society.

<24>
Accession Number
2027658181
Title
Infarct-related structural disconnection and delirium in surgical aortic
valve replacement patients.
Source
Annals of Clinical and Translational Neurology. 11(2) (pp 263-277), 2024.
Date of Publication: February 2024.
Author
Browndyke J.N.; Tomalin L.E.; Erus G.; Overbey J.R.; Kuceyeski A.;
Moskowitz A.J.; Bagiella E.; Iribarne A.; Acker M.; Mack M.; Mathew J.;
O'Gara P.; Gelijns A.C.; Suarez-Farinas M.; Messe S.R.
Institution
(Browndyke) Division of Behavioral Medicine and Neurosciences, Department
of Psychiatry and Behavioral Sciences, Duke University Medical Center,
Durham, NC, United States
(Browndyke) Division of Cardiovascular and Thoracic Surgery, Department of
Surgery, Duke University Medical Center, Durham, NC, United States
(Tomalin, Overbey, Moskowitz, Bagiella, Gelijns, Suarez-Farinas)
Department of Population Health Science and Policy, Icahn School of
Medicine at Mount Sinai, New York, NY, United States
(Erus) Department of Radiology, University of Pennsylvania, Philadelphia,
PA, United States
(Kuceyeski) Department of Radiology, Weill Cornell Medical College, New
York, NY, United States
(Kuceyeski) Brain and Mind Research Institute, Weill Cornell Medical
College, New York, NY, United States
(Iribarne) Department of Cardiothoracic Surgery, Staten Island University
Hospital, Northwell Health Staten Island, New York, NY, United States
(Acker) Division of Cardiovascular Surgery, Department of Surgery,
University of Pennsylvania School of Medicine, Philadelphia, PA, United
States
(Mack) Department of Cardiothoracic Surgery, Baylor Research Institute,
Baylor Scott and White Health, Plano, TX, United States
(Mathew) Department of Anesthesiology, Duke University Medical Center,
Durham, NC, United States
(O'Gara) Cardiovascular Division, Department of Medicine, Brigham and
Women's Hospital, Boston, MA, United States
(Messe) Department of Neurology, University of Pennsylvania School of
Medicine, Philadelphia, PA, United States
Publisher
John Wiley and Sons Inc
Abstract
Objective: Although acute brain infarcts are common after surgical aortic
valve replacement (SAVR), they are often unassociated with clinical stroke
symptoms. The relationship between clinically "silent" infarcts and
in-hospital delirium remains uncertain; obscured, in part, by how infarcts
have been traditionally summarized as global metrics, independent of
location or structural consequence. We sought to determine if infarct
location and related structural connectivity changes were associated with
postoperative delirium after SAVR. Method(s): A secondary analysis of
a randomized multicenter SAVR trial of embolic protection devices
(NCT02389894) was conducted, excluding participants with clinical stroke
or incomplete neuroimaging (N = 298; 39% female, 7% non-White, 74 +/- 7
years). Delirium during in-hospital recovery was serially screened using
the Confusion Assessment Method. Parcellation and tractography atlas-based
neuroimaging methods were used to determine infarct locations and cortical
connectivity effects. Mixed-effect, zero-inflated gaussian modeling
analyses, accounting for brain region-specific infarct characteristics,
were conducted to examine for differences within and between groups by
delirium status and perioperative neuroprotection device strategy.
 Result(s): 23.5% participants experienced postoperative delirium.
Delirium was associated with significantly increased lesion volumes in the
right cerebellum and temporal lobe white matter, while diffusion weighted
imaging infarct-related structural disconnection (DWI-ISD) was observed in
frontal and temporal lobe regions (p-FDR < 0.05). Fewer brain regions
demonstrated DWI-ISD loss in the suction-based neuroprotection device
group, relative to filtration-based device or standard aortic cannula.
 Interpretation(s): Structural disconnection from acute infarcts was
greater in patients who experienced postoperative delirium, suggesting
that the impact from covert perioperative infarcts may not be as
clinically "silent" as commonly assumed. Copyright © 2023 The
Authors. Annals of Clinical and Translational Neurology published by Wiley
Periodicals LLC on behalf of American Neurological Association.

<25>
Accession Number
2017861659
Title
The impact of perioperative stroke and delirium on outcomes after surgical
aortic valve replacement.
Source
Journal of Thoracic and Cardiovascular Surgery. 167(2) (pp 624-633.e4),
2024. Date of Publication: February 2024.
Author
Messe S.R.; Overbey J.R.; Thourani V.H.; Moskowitz A.J.; Gelijns A.C.;
Groh M.A.; Mack M.J.; Ailawadi G.; Furie K.L.; Southerland A.M.; James
M.L.; Gupta L.; Voisine P.; Perrault L.P.; Bowdish M.E.; Gillinov A.M.;
O'Gara P.T.; Ouzounian M.; Whitson B.A.; Mullen J.C.; Miller M.A.; Gammie
J.S.; Pan S.; Erus G.; Browndyke J.N.; Taddei-Peters W.C.; Jeffries N.O.;
Buxton D.; Geller N.L.; Gordon D.; Burke C.; Lee A.; Smith T.; Moy C.S.;
Gombos I.K.; Weisel R.; Gardner T.J.; Rose E.A.; Parides M.K.; Ascheim
D.D.; Bagiella E.; Moquete E.; Shah K.; Chang H.; Chase M.; Goldfarb S.;
Kirkwood K.; Dobrev E.; Levitan R.; O'Sullivan K.; Santos M.; Ye X.; Mack
M.; Winkle R.; Boswell H.; Fenlon A.; Johnson M.; Jones J.; Kolb M.; Lam
S.; Miranda L.; Ward J.; Whitman R.; Zingler B.; Ryan W.; Smith R.L.;
Grayburn P.; Nosnik P.; Blackstone E.H.; Moazami N.; Starling R.C.;
Barzilai B.; Grimm R.A.; Soltesz E.G.; Katzan I.; Strippy B.; Smith S.;
Garcia M.; Alice bowman M.; Geither C.; Wang R.; Argenziano M.; Borger M.;
Takayama H.; Leon M.B.; Goldsmith L.; Schwartz A.; Sookraj N.;
McCright-Gill T.; Sreekanth S.; McCullough J.N.; Iribarne A.; DeSimone
J.P.; DiScipio A.W.; Stokes H.; Ivany A.S.; Petty G.; Smith P.K.;
Alexander J.H.; Milano C.A.; Glower D.D.; Huber J.; Morganlander J.;
Mathew J.P.; Welsh S.; Casalinova S.; Johnson V.; Lane K.; Smith D.;
Tipton G.; Berry M.F.; Williams J.B.; Englum B.; Hartwig M.; Guyton R.;
Lattouf O.; Chen E.; Vega J.D.; Baer J.; Nguyen D.; Halkos M.; Baio K.;
Prince T.; Cook N.; Neill A.A.; Senechal M.; Dagenais F.; Laforce R.;
O'Connor K.; Dussault G.; Caouette M.; Tremblay H.; Gagne N.; Dumont J.;
Landry P.; Trichon B.H.; Binns O.A.; Ely S.W.; Johnson A.M.; Hansen T.H.;
Short J.G.; Taylor R.D.; Mangusan R.; Nanney T.; Aubart H.; Cross K.;
McPeters L.; Riggsbee C.; Rixey L.; Michler R.E.; DeRose J.J.; Goldstein
D.J.; Bello R.A.; Taub C.; Spevack D.; Kirchoff K.; Meli R.; Garcia J.;
Goldenberg J.; Kealy L.; Bouchard D.; Tanguay J.F.; O'Meara E.; Lacharite
J.; Robichaud S.; Horvath K.A.; Corcoran P.C.; Siegenthaler M.P.; Murphy
M.; Iraola M.; Greenberg A.; Kumkumian G.; Milner M.; Nadareishvili Z.;
Hasan A.; McDavid A.; Fadorsen D.; Yau T.; Farkouh M.; Woo A.; Cusimano
R.J.; David T.; Feindel C.; Fumakia N.; Christie S.; Bissonauth A.; Hripko
A.; Noor Z.; Mackowick K.; Deasey S.; Al-Suqi M.; Collins J.; Acker M.A.;
Messe S.; Kirkpatrick J.; Mayer M.L.; McDonald C.; Fok H.; Maffei B.;
Cresse S.; Gepty C.; Bowdish M.; Starnes V.A.; Shavalle D.; Heck C.;
Hackmann A.; Baker C.; Fleischman F.; Cunningham M.; Lozano E.; Hernandez
M.; Kron I.L.; Johnston K.; Ghanta R.K.; Dent J.M.; Kern J.; Yarboro L.;
Ragosta M.; Annex B.; Bergin J.; Burks S.; Cosner M.; Green C.; Loya S.;
Kim H.R.; Bull D.A.; Desvigne-Nickens P.; Dixon D.O.; Gottesman R.;
Haigney M.; Holubkov R.; Iadecola C.; Jacobs A.; Meslin E.M.; Murkin J.M.;
Spertus J.A.; Sellke F.; McDonald C.L.; Canty J.; Dickert N.; Ikonomidis
J.S.; Kim K.; Williams D.O.; Yancy C.W.; Chaturvedi S.; Chimowitz M.; Fang
J.C.; Richenbacher W.; Rao V.; Miller R.; Cook J.; D'Alessandro D.; Han
F.; Pinney S.; Walsh M.N.; Greer D.; Ishida K.; Stapf C.; Hung J.; Zeng
X.; Hung D.; Satitthummanid S.; Billelo M.; Davatzikos C.; Karpf L.;
Desiderio L.; Toulgoat-Dubois Y.; Brassard R.; Virmanu R.; Romero M.E.;
Braumann R.
Institution
(Messe) Department of Stroke and Neurocritical Care, Perelman School of
Medicine University of Pennsylvania, Philadelphia, Pa, United States
(Overbey, Moskowitz, Gelijns, Gupta, Pan) International Center for Health
Outcomes and Innovation Research (InCHOIR), The Department of Population
Health Science and Policy, Icahn School of Medicine at Mount Sinai, New
York, NY, United States
(Thourani) Marcus Valve Center, Department of Cardiovascular Surgery,
Piedmont Heart Institute, Atlanta, Ga, United States
(Groh) Asheville Heart, Mission Health and Hospitals, Asheville, NC,
United States
(Mack) Cardiovascular Surgery, Baylor Scott & White Health, Plano, Tex,
United States
(Ailawadi) Departments of Cardiac Surgery and Surgery, University of
Michigan Health System, Ann Arbor, Mich, United States
(Furie) Department of Neurology, Alpert Medical School of Brown
University, Providence, RI, United States
(Southerland) Division of Vascular Neurology, University of Virginia
Health System, Charlottesville, VA, United States
(James) Department of Anesthesiology, Duke University Medical Center,
Durham, NC, United States
(James) Department of Neurology, Duke University Medical Center, Durham,
NC, United States
(Moy) Division of Clinical Research, National Institute of Neurological
Disorders and Stroke, National Institutes of Health, Bethesda, Md, United
States
(Voisine) Department of Surgery, Institut de Cardiologie et Pneumologie de
Quebec, Quebec, Canada
(Perrault) Department of Surgery, Montreal Heart Institute, Quebec, Canada
(Bowdish) Surgery and Preventive Medicine, Keck School of Medicine,
University of Southern California, Los Angeles, Calif, United States
(Gillinov) Department of Thoracic and Cardiovascular Surgery, Cleveland
Clinic, Cleveland, Ohio, United States
(O'Gara) Cardiovascular Division, Brigham and Women's Hospital, Boston,
Mass, United States
(Ouzounian) Division of Cardiac Surgery, Department of Surgery, Peter Munk
Cardiac Centre, UHN-Toronto General Hospital, Toronto, ON, Canada
(Whitson) Division of Cardiac Surgery, Department of Surgery, The Ohio
State University, Columbus, OH, United States
(Mullen) Division of Cardiac Surgery, University of Alberta, Edmonton, AB,
Canada
(Miller) Division of Cardiovascular Sciences, National Heart, Lung, and
Blood Institute, National Institutes of Health, Bethesda, Md, United
States
(Gammie) Department of Cardiac Surgery, Johns Hopkins Heart and Vascular
Institute, Baltimore, Md, United States
(Erus) Department of Radiology, Perelman School of Medicine University of
Pennsylvania, Philadelphia, Pa, United States
(Browndyke) Department of Psychiatry & Behavioral Sciences, Duke
University Medical Center, Durham, NC, United States
Publisher
Elsevier Inc.
Abstract
Objective: The effects of stroke and delirium on postdischarge cognition
and patient-centered health outcomes after surgical aortic valve
replacement (SAVR) are not well characterized. Here, we assess the impact
of postoperative stroke and delirium on these health outcomes in SAVR
patients at 90 days. Method(s): Patients (N = 383) undergoing SAVR
(41% received concomitant coronary artery bypass graft) enrolled in a
randomized trial of embolic protection devices underwent serial neurologic
and delirium evaluations at postoperative days 1, 3, and 7 and magnetic
resonance imaging at day 7. Outcomes included 90-day functional status,
neurocognitive decline from presurgical baseline, and quality of life.
 Result(s): By postoperative day 7, 25 (6.6%) patients experienced
clinical stroke and 103 (28.5%) manifested delirium. During index
hospitalization, time to discharge was longer in patients experiencing
stroke (hazard ratio, 0.62; 95% confidence interval [CI], 0.42-0.94; P =
.02) and patients experiencing delirium (hazard ratio, 0.68; 95% CI,
0.54-0.86; P = .001). At day 90, patients experiencing stroke were more
likely to have a modified Rankin score >2 (odds ratio [OR], 5.9; 95% CI,
1.7-20.1; P = .01), depression (OR, 5.3; 95% CI, 1.6-17.3; P = .006), a
lower 12-Item Short Form Survey physical health score (adjusted mean
difference -3.3 +/- 1.9; P = .08), and neurocognitive decline (OR, 7.8;
95% CI, 2.3-26.4; P = .001). Delirium was associated with depression (OR,
2.2; 95% CI, 0.9-5.3; P = .08), lower 12-Item Short Form Survey physical
health (adjusted mean difference -2.3 +/- 1.1; P = .03), and
neurocognitive decline (OR, 2.2; 95% CI, 1.2-4.0; P = .01).
 Conclusion(s): Stroke and delirium occur more frequently after SAVR
than is commonly recognized, and these events are associated with
disability, depression, cognitive decline, and poorer quality of life at
90 days postoperatively. These findings support the need for new
interventions to reduce these events and improve patient-centered
outcomes. Copyright © 2022 The American Association for Thoracic
Surgery

<26>
Accession Number
632388414
Title
Tranexamic acid and rosuvastatin in patients at risk of cardiovascular
events after noncardiac surgery: a pilot of the POISE-3 randomized
controlled trial.
Source
Pilot and Feasibility Studies. 6(1) (no pagination), 2020. Article Number:
104. Date of Publication: 21 Jul 2020.
Author
Marcucci M.; Duceppe E.; Le Manach Y.; Kearon C.; Eikelboom J.W.; Pohl K.;
Vincent J.; Darvish-Kazem S.; Srinathan S.K.; Neary J.D.D.; Parlow J.L.;
Kurz A.; Gross P.L.; Mrkobrada M.; Balasubramanian K.; Sessler D.I.;
Devereaux P.J.
Institution
(Marcucci, Duceppe, Le Manach, Kearon, Devereaux) Department of Health
Research Methods Evidence, and Impact, McMaster University, Hamilton, ON,
Canada
(Marcucci, Kearon, Eikelboom, Darvish-Kazem, Neary, Devereaux) Department
of Medicine, McMaster University, Hamilton, ON, Canada
(Marcucci, Duceppe, Le Manach, Pohl, Vincent, Balasubramanian, Devereaux)
Population Health Research Institute, Hamilton, ON, Canada
(Duceppe, Gross) Department of Medicine, University of Montreal, Montreal,
QC, Canada
(Le Manach) Department of Anesthesia, McMaster University, Hamilton, ON,
Canada
(Darvish-Kazem) William Osler Health System, Brampton, ON, Canada
(Srinathan) Department of Surgery, University of Manitoba, Winnipeg, MB,
Canada
(Parlow) Department of Anesthesiology and Perioperative Medicine, Kingston
General Hospital and Queen's University, Kingston, ON, Canada
(Kurz, Sessler) Department of Outcomes Research, Anesthesiology Institute,
Cleveland Clinic, Cleveland, OH, United States
(Mrkobrada) Department of Medicine, University of Western Ontario, London,
ON, Canada
Publisher
BioMed Central Ltd
Abstract
Background: Surgical bleeding is associated with postoperative
cardiovascular complications. The efficacy and safety of tranexamic acid
(TXA) in noncardiac surgery are still uncertain. Statins may prevent
perioperative cardiovascular complications. We conducted a pilot to assess
the feasibility of a perioperative trial of TXA and rosuvastatin.
 Method(s): Using a factorial design, we randomized patients at
cardiovascular risk undergoing noncardiac surgery to intravenous TXA (1 g
at the start and end of surgery) or placebo, and oral rosuvastatin (40 mg
before and 20 mg daily for 30 days after surgery) or placebo. Feasibility
outcomes included recruitment rates, follow-up, and compliance to
interventions. Clinical outcomes were secondarily explored.
 Result(s): After 3 months, we changed the design to a partial
factorial due to the difficult recruitment of statin-naive patients. Over
6 months, 100 patients were randomized in the TXA trial (49 TXA, 51
placebo), 34 in the rosuvastatin trial (18 rosuvastatin, 16 placebo).
Ninety-two percent (95% CI 80-98) of TXA and 86% (95% CI 74-94) of
TXA-placebo patients received the 2 study doses. Thirty-three percent (95%
CI 13-59) of rosuvastatin patients and 37% (95% CI 15-65) of
rosuvastatin-placebo patients discontinued the study drug. A major
cardiovascular complication occurred at 30 days in 1 TXA and 6 TXA-placebo
patients, and 1 rosuvastatin and no rosuvastatin-placebo patients.
 Conclusion(s): Our pilot study supports the feasibility of a
perioperative TXA trial in noncardiac surgery. Feasibility of a
perioperative rosuvastatin trial is uncertain because of a high prevalence
of statin use in the target population and concerns about
compliance. Copyright © 2020 The Author(s).

<27>
Accession Number
632335055
Title
Biochemical response to cryothermal and radiofrequency exposure of the
human myocardium at surgical ablation of atrial fibrillation: A randomized
controlled trial.
Source
Translational Medicine Communications. 5(1) (no pagination), 2020. Article
Number: 11. Date of Publication: 13 Jul 2020.
Author
Boano G.; Aneq M.A.; Spyrou G.; Enocsson H.; Charitakis E.; Vanky F.
Institution
(Boano, Vanky) Department of Health, Medicine and Caring Sciences,
Linkoping University, Department of Thoracic and Vascular Surgery in
Ostergotland, Linkoping, Sweden
(Aneq) Department of Health, Medicine and Caring Sciences, Linkoping
University, Department of Clinical Physiology in Linkoping, Linkoping,
Sweden
(Spyrou) Division of Clinical Chemistry, Department of Biomedical and
Clinical Sciences, Linkoping University, Linkoping, Sweden
(Enocsson) Department of Biomedical and Clinical Sciences, Linkoping
University, Division of Inflammation and Infection, Linkoping, Sweden
(Charitakis) Department of Cardiology in Linkoping, Department of Health,
Medicine and Caring Sciences, Linkoping University, Linkoping, Sweden
Publisher
BioMed Central Ltd
Abstract
Background: Surgical cryothermia and radiofrequency (RF) ablations for
atrial fibrillation (AF) seem to result in similar sinus rhythm
restoration, but the biochemical consequences of the two methods are
unclear. We aimed to compare the biochemical responses to the two ablative
methods in concomitant mitral valve surgery (MVS). Method(s): Sixty
mitral valve surgery patients with AF were prospectively included.
Forty-one patients planned for ablation were randomized to cryothermia (n
= 20) or radiofrequency (n = 21) ablation and 19 served as controls.
Markers for myocardial injury, inflammation, cell stress, apoptosis, and
heart failure were analyzed pre- and postoperatively at different time
points. Result(s): Troponin T and creatine kinase isoenzyme MB
(CK-MB) peak levels were significantly higher in the cryothermia group
compared with the RF group (12,805 [6140-15,700] vs. 2790 [1880-4180]
ng/L; P = 0.002 and 271 [217-357] vs. 79 [66-93] mug/L; P < 0.001,
respectively). Both groups had significantly higher levels than the
no-ablation group. There were no group differences in C-reactive protein
(CRP) and N-terminal pro-B-type natriuretic peptide (NT-proBNP), but there
were correlations between pre- and postoperative levels of both CRP (r s =
0.41, P = 0.001) and NT-proBNP (r s = 0.48, P < 0.001). Protease-activated
receptor 1 (PAR-1) and heat shock protein 27 (HSP27) were significantly
increased in the cryoablation group. Conclusion(s): Cryoablation
results in a larger myocardial injury and possibly more elevated apoptotic
activity and cell stress compared with the RF technique. The type of
ablation device did not have any significant influence on the
postoperative inflammatory response nor on the early postoperative levels
of NT-proBNP. Copyright © 2020 The Author(s).

<28>
Accession Number
2030443273
Title
Safety and efficacy of percutaneous Watchman 2.5 device versus Amplatzer
Amulet for left atrial appendage closure in patients with non-valvular
atrial fibrillation: A systematic review and study-level meta-analysis.
Source
PLoS ONE. 19(2 February) (no pagination), 2024. Article Number: e0295804.
Date of Publication: February 2024.
Author
Yasmin F.; Ali E.; Moeed A.; Zaidi F.; Umar M.; Virwani V.
Institution
(Yasmin) Yale University School of Medicine, New Haven, CT, United States
(Ali, Moeed, Zaidi) Department of Medicine, Dow University of Health
Sciences, Karachi, Pakistan
(Umar) IU Health Ball Memorial Hospital, Muncie, IN, United States
(Virwani) Medical College, Aga Khan University, Karachi, Pakistan
Publisher
Public Library of Science
Abstract
In patients with non-valvular atrial fibrillation (NVAF), mechanical
occlusion of the left atrial appendage (LAA) using a permanently implanted
device may be an effective alternative to oral anti-coagulants (OAC). To
facilitate left atrial appendage closure (LAAC), multiple percutaneous
devices have been proposed. Watchman Generation 2.5 and Amplatzer Amulet
are the two most popular used devices for preventing stroke in patients
with NVAF. We sought to compare safety and efficacy outcomes between
Watchman 2.5 and Amplatzer Amulet in patients undergoing LAAC procedure.
Methods We carried out a comprehensive and systematic search of the
databases PubMed and Scopus, for all studies that compared the safety and
efficacy of Watchman 2.5 and Amplatzer Amulet devices, from inception,
till June 2023. We performed the statistical analysis using Review Manager
(V.5.4.1 Cochrane Collaboration, London, United Kingdom). The safety
outcomes of interest included device success, device-related thrombus,
device embolization perioperatively and at follow-up, perioperative
pericardial perfusion events, and perioperative cardiac tamponade events.
Efficacy outcomes were all-cause mortality perioperatively and at
follow-up, cardiovascular (CV) mortality at follow-up, stroke, major and
minor bleeding events at follow-up, transient ischemic attack (TIA) in
follow-up period, thromboembolic events in follow-up period, and
peri-device leakage in perioperative period. All data was analysed using a
random-effects model, and presented as risk ratios (RRs) with 95%
confidence intervals (95%CIs). Results Regarding safety outcomes, device
success was non-significantly reduced in Watchman group when compared with
Amulet (RR 0.99, p = 0.57; I2 = 34%). In contrast,
device-related thrombus was non-significantly increased in Watchman 2.5
group in comparison to Amulet (RR 1.44, p = 0.11; I2 = 0%).
There was no significant difference between the devices in terms of device
embolization in the perioperative (RR 0.36, p = 0.38; I2 = 22%) and
followup (RR 2.24, p = 0.13; I2 = 0%) periods. Likewise, there
was no significant difference in the risks of pericardial effusion (RR
0.98, p = 0.98; I2 = 0%), and cardiac tamponade (RR 0.65, p =
0.76; I2 = 62%) perioperatively. Regarding efficacy outcomes, no
significant difference was observed in all-cause mortality between devices
perioperatively (RR 0.51, p = 0.32; I2 = 0%) and at follow-up
(RR 1.08, p = 0.56; I2 = 0%). CV-mortality was
non-significantly reduced in Watchman group when compared with Amulet (RR
0.57, p = 0.20; I2 = 0%). The Amulet device was not superior to
the Watchman device in terms of stroke at follow-up (RR 1.13, p = 0.63;
I2 = 0%). Sub-group analysis showed comparable ischaemic and
haemorrhagic stroke events between two devices. Furthermore, at follow-up,
there was no significant difference in major (RR 1.06, p = 0.63;
I2 = 0%) and minor bleeding events (RR 1.81, p = 0.17;
I2 = 0%) between the two devices. No difference was observed
for trans-ischemic attack (RR 1.89, p = 0.24; I2 = 0%) and
thromboembolic events (RR 0.96, p = 0.96; I2 = 0%) at
follow-up. No significant difference was observed between devices for
peri-device leakage in perioperative period (RR 2.16, p = 0.05;
I2 = 0%). Conclusion The data suggested that LAAC is safe and
efficacious procedure irrespective of device used, with generally low
complication rates. Watchman generation 2.5 remains non-superior to
Amplatzer Amulet in terms of safety and efficacy outcomes. Copyright:
© 2024 Yasmin et al.

<29>
Accession Number
2021977033
Title
Medical Therapy After CABG: the Known Knowns, the Known Unknowns, and the
Unknown Unknowns.
Source
Cardiovascular Drugs and Therapy. 38(1) (pp 141-149), 2024. Date of
Publication: February 2024.
Author
Barron L.K.; Moon M.R.
Institution
(Barron, Moon) Division of Cardiothoracic Surgery, Michael E. DeBakey
Department of Surgery, Baylor College of Medicine and Texas Heart
Institute, Houston, TX, United States
Publisher
Springer
Abstract
Purpose: Medical therapies play a central role in secondary prevention
after surgical revascularization. While coronary artery bypass grafting is
the most definitive treatment for ischemic heart disease, progression of
atherosclerotic disease in native coronary arteries and bypass grafts
result in recurrent adverse ischemic events. The aim of this review is to
summarize the recent evidence regarding current therapies in secondary
prevention of adverse cardiovascular outcomes after CABG and review the
existing recommendations as they pertain to the CABG subpopulations.
Recent Findings: There are many pharmacologic interventions recommended
for secondary prevention in patients after coronary artery bypass
grafting. Most of these recommendations are based on secondary outcomes
from trials which include but did not focus on surgical patients as a
cohort. Even those designed with CABG in mind lack the technical and
demographic scope to provide universal recommendations for all CABG
patients. Conclusion(s): Recommendations for medical therapy after
surgical revascularization are chiefly based on large-scale randomized
controlled trials and meta-analyses. Much of what is known about medical
management after surgical revascularization results from trials comparing
surgical to non-surgical approaches and important characteristics of the
operative patients are omitted. These omissions create a group of patients
who are relatively heterogenous making solid recommendations elusive.
While advances in pharmacologic therapies are clearly adding to the
armamentarium of options for secondary prevention, knowing what patients
benefit most from each therapeutic option remains challenging and a
personalized approach is still required. Copyright © The
Author(s), under exclusive licence to Springer Science+Business Media,
LLC, part of Springer Nature 2023.

<30>
Accession Number
642788640
Title
Heart Rate Variability in Surgical Patients Experiencing Live Bedside
Music; An Explorative Study.
Source
Applied psychophysiology and biofeedback. 49(1) (pp 157-166), 2024. Date
of Publication: 01 Mar 2024.
Author
van der Wal-Huisman H.; Soer R.; Sidorenkov G.; Heineman E.; de Graeff P.;
van Leeuwen B.L.
Institution
(van der Wal-Huisman) Department of Surgery, University of Groningen,
University Medical Center Groningen, P.O. Box 30.001, Groningen RB 9700,
Netherlands
(Soer) Department of Anesthesiology, Pain Center, University of Groningen,
University Medical Center Groningen, Groningen, Netherlands
(Soer) Saxion University of Applied Science, Enschede, Netherlands
(Sidorenkov) Department of Epidemiology, University of Groningen,
University Medical Center Groningen, Groningen, Netherlands
(Heineman) Department of Surgery, University of Groningen, University
Medical Center Groningen, P.O. Box 30.001, Groningen RB 9700, Netherlands
(de Graeff) University Center for Geriatric Medicine, University of
Groningen, University Medical Center Groningen, Groningen, Netherlands
(van Leeuwen) Department of Surgical Oncology, University of Groningen,
University Medical Center Groningen, Groningen, Netherlands
Abstract
It's known that surgery elicits a stress response involving the autonomic
nervous system (ANS) which is important in general recovery but can also
have detrimental effects in older patients. Music seems to positively
effect postoperative recovery, although the mechanism requires further
unravelling. Our objective was to explore the response of the ANS to live
bedside music in older surgical patients, by using heart rate variability
(HRV) as a proxy. This explorative prospective non-randomized controlled
cohort study included 101 older non-cardiac surgical patients, with a
median age of 70 (range 60-88 years). HRV was measured in a cohort
receiving live bedside music provided by professional musicians and in a
control group that did not receive music. HRV was measured
pre-intervention, during the intervention, 30 min after the intervention,
and again after three hours. Mixed linear modelling was used to assess the
effect of the intervention compared to the control group over time. A
significant change in both the low and high frequency bands (p=0.041) and
(p=0.041) respectively, was found over time in the music group compared to
the control group indicating relaxation and increased parasympathetic
activity in the music group. Other measures revealed a trend but no
significant effect was shown. These results provide a first glance and
contribute to a better understanding of the effect of music on the
recovery of older surgical patients. Copyright © 2023. The
Author(s), under exclusive licence to Springer Science+Business Media,
LLC, part of Springer Nature.

<31>
Accession Number
642688050
Title
Application of three-dimensional printing in cardiovascular diseases: a
bibliometric analysis.
Source
International journal of surgery (London, England). 110(2) (pp 1068-1078),
2024. Date of Publication: 01 Feb 2024.
Author
Zhang X.; Yi K.; Xu J.-G.; Wang W.-X.; Liu C.-F.; He X.-L.; Wang F.-N.;
Zhou G.-L.; You T.
Institution
(Zhang, Wang, He, Wang) First School of Clinical Medicine of Gansu
University of Chinese Medicine, China
(Zhang, Yi, Wang, Liu, He, Wang, Zhou, You) Gansu International Scientific
and Technological Cooperation Base of Diagnosis and Treatment of
Congenital Heart Disease
(Yi, Zhou, You) Department of Cardiovascular Surgery, Gansu Provincial
Hospital
(Xu) Evidence-Based Medicine Center, School of BasicMedical Sciences,
Lanzhou University
(Liu) First Clinical Medical College of Lanzhou University, Lanzhou, China
Abstract
AIM: This paper aimed to explore the application of three-dimensional (3D)
printing in cardiovascular diseases, to reach an insight in this field and
prospect the future trend. METHOD(S): The articles were selected from
the Web of Science Core Collection database. Excel 2019, VOSviewer 1.6.16,
and CiteSpace 6.1.R6 were used to analyze the information. RESULT(S):
A total of 467 papers of 3D printing in cardiovascular diseases were
identified, and the first included literature appeared in 2000. A total of
692 institutions from 52 countries participated in the relevant research,
while the United States of America contributed to 160 articles and were in
a leading position. The most productive institution was Curtin University
, and Zhonghua Sun who has posted the most articles ( n =8) was also from
there. The Frontiers in Cardiovascular Medicine published most papers ( n
=25). The Journal of Thoracic and Cardiovascular Surgery coveted the most
citations ( n =520). Related topics of frontiers will still focus on
congenital heart disease, valvular heart disease, and left atrial
appendage closure. CONCLUSION(S): The authors summarized the
publication information of the application of 3D printing in
cardiovascular diseases related literature from 2000 to 2023, including
country and institution of origin, authors, and publication journal. This
study can reflect the current hotspots and novel directions for the
application of 3D printing in cardiovascular diseases. Copyright
© 2023 The Author(s). Published by Wolters Kluwer Health, Inc.

<32>
Accession Number
2028748276
Title
Tranexamic Acid for Trauma Care: An Updated Meta-Analysis of Mortality and
Thromboembolic Events in Severely Injured Patients.
Source
Blood. Conference: 65th ASH Annual Meeting. San Diego United States.
142(Supplement 1) (pp 5570), 2023. Date of Publication: 28 Nov 2023.
Author
Shafique N.; Akbar U.A.; Umer A.M.; Kumar B.; Muhibullah F.; Siddiqui F.;
Vikash S.; Nethagani S.; Rizwan U.
Institution
(Shafique) University of Louisville, Louisville, KY, United States
(Akbar) Camden Clark Medical Center, West Virginia University,
Parkersburg, WV, United States
(Umer, Kumar, Muhibullah, Siddiqui, Nethagani, Rizwan) West Virginia
University Camden Clark Medical Center, Parkersburg, WV, United States
(Vikash) Jacobi Medical Center, Albert Einstein college of medicine,
Bronx, NY, United States
Publisher
Elsevier B.V.
Abstract
Introduction : Tranexamic Acid (TXA) is an anti-fibrinolytic agent that
inhibits fibrinolysis and prevents blood clot breakdown. Widely used to
manage hemorrhage in various clinical scenarios, including trauma,
menorrhagia, bleeding in hemophilia, cardiac surgery, and orthopedic
surgery, its impact on morbidity and mortality in severely injured
patients necessitates an updated systematic review and meta-analysis. Our
study aimed to evaluate the association of TXA with mortality and
thromboembolic events in trauma patients. Method(s): We conducted a
comprehensive literature search on PubMed, EMBASE, CENTRAL, and Google
Scholar up to July 2023, focusing on randomized controlled trials (RCTs)
involving adult trauma patients receiving Tranexamic Acid (TXA) compared
to standard care or placebo. Primary outcomes included mortality rates and
thromboembolic event incidence. Statistical analyses used Review Manager
Software (RevMan, version 5.3) with the Mantel-Haenszel random-effect
model. Results : A total of 8 randomized controlled trials (RCTs) with
36,416 patients were included in this meta-analysis, comparing Tranexamic
Acid (TXA) to control (placebo or standard care). The mean age of the
included patients was 39 years. The analysis focused on various patient
categories, including multiple trauma versus predominantly traumatic brain
injury (TBI) patients, severely injured ( Injury Severity Score, ISS >=
16, massive transfusion requirement, signs of shock) versus non-severely
injured patients, blunt versus penetrating versus burn trauma, in-hospital
versus prehospital TXA administration, and TXA administration within 3
hours versus beyond 3 hours of injury. The meta-analysis showed that TXA
administration was not significantly associated with mortality (odds
ratio: 0.98, 95% CI: 0.76 to 1.27, p = 0.89), with moderate heterogeneity
observed (I 2 = 56%). However, TXA use demonstrated a
significant reduction in the incidence of thromboembolic events (odds
ratio: 0.90, 95% CI: 0.84 to 0.95, p = 0.0002), with no significant
heterogeneity (I 2 = 0%). (Figure 1 & 2) Conclusion TXA
administration was not significantly associated with mortality in patients
with significant trauma; however, it significantly reduced thromboembolic
events, suggesting its potential benefit in preventing such complications.
Further research is needed to explore its efficacy and safety in specific
patient categories and administration settings to optimize its use in
trauma care. Copyright © 2023 The American Society of Hematology

<33>
Accession Number
2028733631
Title
Randomized, Active-Control Phase 3 Study of Four-Factor Prothrombin
Complex Concentrate Versus Frozen Plasma in Bleeding Adult Cardiac Surgery
Patients.
Source
Blood. Conference: 65th ASH Annual Meeting. San Diego United States.
142(Supplement 1) (pp 5515), 2023. Date of Publication: 28 Nov 2023.
Author
Karkouti K.; Callum J.; Tanaka K.; Grewal D.; Solomon C.; Knaub S.; Werner
S.; Levy J.H.
Institution
(Karkouti, Grewal) University Health Network, Toronto, Canada
(Karkouti) University of Toronto, Toronto, Canada
(Callum) Kingston Health Sciences Centre, Kingston, Canada
(Callum) Queen's University, Kingston, Canada
(Tanaka) University of Oklahoma Health Sciences Center, Oklahoma City,
United Kingdom
(Solomon, Knaub) Octapharma AG, Lachen, Switzerland
(Werner) Octapharma USA, Paramus, NJ, United States
(Levy) Duke University, Durham, NC, United States
Publisher
Elsevier B.V.
Abstract
Background and Significance: Patients following cardiac surgery often
develop coagulopathic bleeding and associated poor outcomes. The
development of coagulopathy is multifactorial, including anticoagulation,
hemorrhage, hemodilution and consumptive losses after tissue injury and
during cardiopulmonary bypass (CPB). Reduced thrombin generation due to
coagulation factor deficiency is an important contributor to post-CPB
bleeding. Prothrombin complex concentrate (PCC; off-label) and frozen
plasma (FP) are administered for coagulation factor replacement during
surgery. The LEX-211 (FARES-II) study will determine if four-factor PCC
(4F-PCC, Octaplex, Octapharma) is clinically non-inferior to FP regarding
hemostatic effectiveness in cardiac surgery patients requiring coagulation
factor replacement. Study Design and Methods: LEX-211 (FARES-II;
NCT05523297) is a multicenter, randomized, active-control, prospective,
Phase 3 trial that is being conducted at 13 hospitals in Canada and the
United States. The study is being conducted in accordance with the
Declaration of Helsinki. The study includes patients >=18 years old
undergoing cardiac surgery with CPB who require coagulation factor
replacement due to bleeding and known (e.g., as indicated by international
normalized ratio) or suspected coagulation factor deficiency. Exclusion
criteria include heart transplant, insertion/removal of ventricular assist
devices, high probability of death within 24 hours, severe right heart
failure, heparin contraindications, thromboembolic events within the prior
3 months, and IgA deficiency. Patients will be randomized to 4F-PCC or FP
when the blood bank receives the first order for coagulation factor
replacement (Figure 1). For 4F-PCC dosing, patients weighing <=60 kg will
receive 1,500 international units (IU), and those >60 kg will receive 2000
IU. For FP, patients weighing <=60 kg will receive 3 U and patients
weighing >60 kg will receive 4 U. Patients are treated according to their
assigned group until a maximum of 2 doses of 4F-PCC/FP have been
administered during the treatment period (24 hours after initiation). If
additional treatment is required, patients in both groups receive FP. The
primary endpoint is the hemostatic response to 4F-PCC vs. FP, rated
'effective' if no further hemostatic intervention (systemic hemostatic
agents, i.e., platelets, cryoprecipitate, other coagulation factor
products, or a second dose of study drug, or surgical re-opening for
bleeding) is required within 60 minutes to 24 hours after initiation of
the first dose. Secondary and safety endpoints, with their timings, are
described in Table 1. An unblinded interim analysis (100 evaluable
patients/group) will test sample size assumptions and enable re-estimation
if necessary. Depending upon the interim results, and accounting for
dropouts (20% anticipated), the total sample size will range between
513-1,250 patients. The non-inferiority of the primary endpoint of
'haemostatic response' will be tested for 4F-PCC vs. FP using a
Farrington-Manning score test with a non-inferiority margin of 0.10 at a
one-sided significance level alpha of 2.5%. If non-inferiority is
demonstrated, the superiority of 4F-PCC with regard to the primary
endpoint will be investigated. LEX-211 (FARES-II) is in progress, with the
first study site initiated in Q4 2022. Currently, >150 patients have been
included in the study. Completion is expected in Q4 2024. The results of
this study will inform clinical practice for bleeding cardiac surgery
patients requiring coagulation factor replacement, potentially reducing
allogeneic blood product usage and improving patient
outcomes. Copyright © 2023 The American Society of Hematology

<34>
Accession Number
2028733097
Title
Atrial Fibrillation Patients with Immune Thrombocytopenia: A Review of
Management Options and Bleeding Risks.
Source
Blood. Conference: 65th ASH Annual Meeting. San Diego United States.
142(Supplement 1) (pp 5425), 2023. Date of Publication: 28 Nov 2023.
Author
Metwalli O.; Rahhal A.; Badr A.; Elsherif R.; Elshoeibi A.; Elhadary M.;
Elsayed B.; Alshurafa A.; Al-Rasheed M.; Yassin M.A.
Institution
(Metwalli, Badr, Elshoeibi) CMED, Qatar University, Doha, Qatar
(Rahhal) Department of Pharmacy, Heart Hospital, Doha, Qatar
(Elsherif, Elhadary, Elsayed) Qatar University, Doha, Qatar
(Alshurafa) Department of Hematology and Bone Marrow Transplant, National
Center for Cancer Care Research, Doha, Qatar
(Al-Rasheed) Hematology section, Aladan Hospital, Kuwait, Kuwait
(Yassin) Hematology-BMT, National Centre For Cancer Care & Research, Doha,
Qatar
Publisher
Elsevier B.V.
Abstract
Aim : The objective of this research is to review the bleeding risks in
patients with atrial fibrillation (Afib) and immune thrombocytopenia (ITP)
and explore various management strategies to formulate an optimal
therapeutic approach that improves the prognosis of these patients.
 Method(s): In this study, we devised our search approach by utilizing
PubMed's Medical Subject Headings (MeSH) terms and incorporating pertinent
keywords extracted from article titles and abstracts. To ensure a
comprehensive scope, we integrated terms associated with immune
thrombocytopenia purpura, such as "Immune Thrombocytopenia," and similar
expressions. Additionally, terms related to atrial fibrillation, including
"atrial fibrillation," were included to identify articles discussing
atrial fibrillation in the context of immune thrombocytopenia. To adapt
the initial search strategy for Embase, Web of Science, and Scopus
databases, we employed a polyglot translator. All identified studies
resulting from the search strategy were imported into EndNote, where
duplicate articles were meticulously removed. The remaining studies were
then transferred to Rayyan for further duplicate elimination and to
initiate the screening process. The study incorporates full-text articles,
submitted abstracts, and conference abstracts. Excluded from this analysis
were studies falling into the following categories: (1) animal studies,
(2) reviews or non-original articles, and (3) non-English articles.
 Result(s): A total of 1891 articles were retrieved from four
databases, and after careful selection, 14 relevant full-text articles
were analyzed. Among these, 12 studies investigated the efficacy of
anticoagulants in managing cases of concurrent Afib and ITP as well as
their bleeding risks. Comparing bleeding risk between groups was usually
done through measuring by CHA <inf>2</inf>DS <inf>2</inf> VASc or HAS BLED
scoring systems and survival was also compared by using Kaplan-Meier
curves A few of them also compared the efficacy and safety of warfarin
against Non-Vitamin K Antagonists which has shown that Non-Vitamin K
Antagonists have a lower event rate of major bleeding, lower hazard ration
of systemic embolism and higher survival rate compared to warfarin The
remaining two papers explored the efficacy and safety of surgical
interventions, specifically left atrial appendage closure. Many studies
reported that anticoagulant therapies were associated with reduced
bleeding risk and have shown promising outcomes in managing patients with
Afib and ITP. Additionally, percutaneous left atrial appendage closure has
been reported to be a potentially safe management option for atrial
fibrillation in patients with primary hemostatic disorders, including
thrombocytopenia. Conclusion(s): In essence, this review focused on
investigating the bleeding risk associated with atrial fibrillation (Afib)
in patients with immune thrombocytopenia (ITP) and examining available
management strategies. While the precise pathophysiological mechanisms
linking atrial fibrillation and ITP remain incompletely understood, the
review emphasized the intricate interplay between thromboembolic risk and
bleeding complications in this specific patient group. The findings
suggest that certain anticoagulation regimens and also left atrial
appendage closure have shown promising safety and effectiveness in Afib
patients with thrombocytopenia. Nevertheless, further research with larger
sample sizes and diverse populations is needed to enhance our
understanding of the Afib-ITP relationship. Such studies will yield more
definitive conclusions and valuable insights into optimal anticoagulation
approaches and alternative therapies for patients with both Afib and
ITP. Copyright © 2023 The American Society of Hematology

<35>
Accession Number
2028733053
Title
Phenotypes Associated with HFE p.C282Y Homozygosity, the Main Hereditary
Hemochromatosis Genotype, in Four Large Genetic Cohorts.
Source
Blood. Conference: 65th ASH Annual Meeting. San Diego United States.
142(Supplement 1) (pp 1088), 2023. Date of Publication: 28 Nov 2023.
Author
Geirsdottir I.S.; Lund S.H.; Saevarsdottir S.; Vidarsson B.; Rigas A.S.;
Holm H.; Glenthoj A.; Ullum H.; Sulem P.; Gudbjartsson D.; Magnusson M.K.;
Stefansson K.
Institution
(Geirsdottir) deCODE Genetics/Amgen, Reykjavik, Iceland
(Lund) University of Iceland, Reykjavik, Iceland
(Lund, Saevarsdottir, Magnusson) deCODE Genetics, Reykjavik, Iceland
(Vidarsson) Landspitali, The National University Hospital of Iceland,
Reykjavik, Iceland
(Rigas) Department of Clinical Immunology, Copenhagen University Hospital,
Copenhagen, Denmark
(Holm, Sulem, Gudbjartsson) Decode Genetics, Reykjavik, Iceland
(Glenthoj) Hematology, Rigshospitalet, Copenhagen University Hospital,
Copenhagen, Denmark
(Ullum) Rigshospitalet, Copenhagen, Denmark
(Magnusson) University of Iceland, Faculty of Medicine, Reykjavik, Iceland
(Stefansson) Decode Genetics /AMGEN, Reykjavik, Iceland
Publisher
Elsevier B.V.
Abstract
Introduction Hereditary hemochromatosis (HH) is the most common known
recessive hereditary disease in people of northern European descent. HH is
most commonly caused by the HFE-C282Y homozygosity. Disease penetrance is
highly variable (1-20%). We have examined the association between C282Y
homozygosity and multiple phenotypes, both case-control and quantitative,
across 4 international cohorts (deCODE genetics, UK Biobank, Denmark
(Copenhagen Hospital Biobank / Danish Blood Donor Study) and Intermountain
Healthcare) in an effort to shed a new light on the pathophysiology of
this common hereditary disease. Methods We preformed a phenome wide
association study meta-analyses for C282Y homozygosity across the 4
beforementioned cohorts, comprising around 970.000 individuals, of those
5928 were homozygous for the C282Y mutation (746 in deCODE/Iceland MAF
6.71%, 2865 in UK Biobank MAF 7.94%, 1703 in CHB MAF 5.6% and 614 in
Intermountain Healthcare MAF 6.19%). The analyses comprised both
case-control phenotypes (approximately 7000), cases being defined by
ICD-10 codes, and continuous quantitative phenotypes (approximately 5500),
both results from blood tests and proteome data from deCODE and UK
Biobank. Results C282Y homozygotes had a higher prevalence of the
following liver, hematological and rheumatic diseases compared to a
control group with no copy of the C282Y variant. Diagnosed fibrosis and
cirrhosis of liver (odds ratio 4.30, 95% confidence interval 3.35 to 5.51,
p=1.77x10 -30), liver cell carcinoma (9.04, 6.01 to 13.58,
p=3.24x10 -26) and fatty liver disease (1.75, 1.45 to 2.11,
p=5.42x10 -09) were strikingly more common in C282Y
homozygotes. Unsurprisingly C282Y homozygotes also had higher liver
parameters. Notably C282Y homozygotes had a higher prevalence of diagnosed
polycythemia vera (7.24, 4.93 to 10.62, p=4.37x10 -24) yet no
association was found with clonal hematopoiesis (1.09, 0.88 to 1.34,
p=4.47x10 -01). Strong association was found between C282Y
homozygosity and increased hemoglobin (0.41 standard deviations, 95%
confidence interval 0.38 to 0.45, p=6.84x10 -142), MCH (0.98,
0.93 to 1.03, p=<1.00x10 -300) and MCV (0.82, 0.78 to 0.86,
p=<1.00x10 -300). Red blood cell count (RBC) was decreased
(-0.27, -0.30 to -0.23, p=1.06x10 -50), while reticulocyte
count (0.30, 0.26 to 0.34, p=1.42x10 -54) and percentage (0.36,
0.32 to 0.40, p=7.91x10 -79) were increased. Erythropoietin
(EPO) measurements were markedly decreased in C282Y homozygotes (-0.31,
-0.40 to -0.22, p=1.77x10 -11). Homozygous individuals had an
increased risk of being diagnosed with osteoarthritis of hip (1.83, 1.63
to 2.07, p=4.30x10 -23) and were more likely to undergo total
hip replacement (2.00, 1.69 to 2.29, p=5.81x10 -18). In
contrast to these risk enhancing effects C282Y homozygotes had a lower
prevalence of cardiovascular disease (CVD). C282Y homozygotes had
decreased risk of coronary artery disease (CAD) (0.79, 0.72 to 0.86,
p=4.26x10 -07) and angina pectoris (0.77, 0.69 to 0.86,
p=4.28x10 -06) and were less likely to undergo coronary artery
bypass graft (0.60, 0.49 to 0.74, p=2.39x10 -06). Pure
hypercholesterolemia (0.76, 0.69 to 0.83, p=2.52x10 -09) and
disorders of lipoprotein metabolism (0.75, 0.66 to 0.85, p=8.41x10
-06) was less commonly diagnosed. C282Y homozygotes were less
likely to take cholesterol lowering statin drugs (0.74, 0.67 to 0.81,
p=1.45x10 -09). Unsurprisingly with regard to these results
strong association was found with lower cholesterol measurements in C282Y
homozygotes, the effects being most pronounced on LDL cholesterol (-0.38,
-0.42 to -0.35, p=1.61x10 -99). Total cholesterol was also
markedly lowered (-0.35, -0.38 to -0.31, p=1.38x10 -91), as
well as non HDL cholesterol (-0.34, -0.37 to -0.30, p=2.36x10
-81). No significant association was found with HDL cholesterol
and triglyceride measurements. Conclusions C282Y homozygosity was
associated with significantly increased risk of liver disease, liver cell
carcinoma and osteoarthritis of hip. Homozygous individuals had increased
risk of non-clonal primary polycythemia, association with polycythemia
vera likely due to misdiagnosis or early diagnosis exacerbated by
significantly increased hemoglobin. C282Y homozygotes had a significant
decrease in LDL, non-HDL and total cholesterol measurements and were
protected against cardiovascular disease. Copyright © 2023 The
American Society of Hematology

<36>
Accession Number
2028519706
Title
Comparison of the effects of transversus thoracic muscle plane block and
pecto-intercostal fascial block on postoperative opioid consumption in
patients undergoing open cardiac surgery: a prospective randomized study.
Source
BMC Anesthesiology. 24(1) (no pagination), 2024. Article Number: 63. Date
of Publication: December 2024.
Author
Mansour M.A.; Mahmoud H.E.; Fakhry D.M.; Kassim D.Y.
Institution
(Mansour, Mahmoud, Fakhry, Kassim) Department of Anesthesiology, Surgical
Intensive Care and Pain Management, Faculty of Medicine, Beni-Suef
University, Beni-Suef, Egypt
Publisher
BioMed Central Ltd
Abstract
Background: There is an association exists between cardiac surgery,
performed through median sternotomy, and a considerable postoperative
pain. Objective(s): The aim of the current study is to compare the
effects of transversus thoracic muscle plane block (TTMPB) and
pecto-intercostal fascial plane block (PIFB) upon postoperative opioid
consumption among the patients who underwent open cardiac surgery.
 Method(s): The present prospective, randomized, comparative study was
conducted among 80 patients who underwent elective on-pump cardiac surgery
with sternotomy. The subjects were randomly assigned to two groups with
each group containing 40 individuals. For the TTMPB group, bilateral
ultrasound-guided TTMPB was adopted in which 20 ml of 0.25% bupivacaine
was used on each side. In case of PIFB group, bilateral ultrasound-guided
PIFB was adopted with the application of 20 ml of 0.25% bupivacaine on
each side. The researchers recorded the first time for rescue analgesia,
the overall dosage of rescue analgesia administered in the first 24 h
after the operation and the postoperative complications. Result(s):
The PIFB group took significantly longer time to raise the first request
for rescue analgesia (7.8 +/- 1.7 h) than the TTMPB group (6.7 +/- 1.4 h).
Likewise, the PIFB group subjects had a remarkably lower 'overall morphine
usage' in the first 24 h after the operation (4.8 +/- 1.0 mg) than TTMPB
group (7.8 +/- 2.0 mg). Conclusion(s): Bilateral ultrasound-guided
PIFB provided a longer time for the first analgesic demand than bilateral
ultrasound-guided TTMPB in patients undergoing open cardiac surgery. In
addition to this, the PIFB reported less postoperative morphine usage than
the TTMPB and increases satisfaction in these patients. Trial
registration: This study was registered at Clinical Trials.gov on
28/11/2022 (registration number: NCT05627869). Copyright © The
Author(s) 2024.

<37>
Accession Number
2028498688
Title
Procalcitonin for the diagnosis of postoperative bacterial infection after
adult cardiac surgery: a systematic review and meta-analysis.
Source
Critical Care. 28(1) (no pagination), 2024. Article Number: 44. Date of
Publication: December 2024.
Author
Nicolotti D.; Grossi S.; Palermo V.; Pontone F.; Maglietta G.; Diodati F.;
Puntoni M.; Rossi S.; Caminiti C.
Institution
(Nicolotti, Grossi, Palermo, Pontone, Rossi) Department of Anesthesia and
Intensive Care Medicine, University Hospital of Parma, Parma, Italy
(Maglietta, Diodati, Puntoni, Caminiti) Clinical and Epidemiological
Research Unit, University Hospital of Parma, Parma, Italy
Publisher
BioMed Central Ltd
Abstract
Background and aims: Patients undergoing cardiac surgery are subject to
infectious complications that adversely affect outcomes. Rapid
identification is essential for adequate treatment. Procalcitonin (PCT) is
a noninvasive blood test that could serve this purpose, however its
validity in the cardiac surgery population is still debated. We therefore
performed a systematic review and meta-analysis to estimate the accuracy
of PCT for the diagnosis of postoperative bacterial infection after
cardiac surgery. Method(s): We included studies on adult cardiac
surgery patients, providing estimates of test accuracy. Search was
performed on PubMed, EmBase and WebOfScience on April 12th, 2023 and rerun
on September 15th, 2023, limited to the last 10 years. Study quality was
assessed with the QUADAS-2 tool. The pooled measures of performance and
diagnostic accuracy, and corresponding 95% Confidence Intervals (CI), were
calculated using a bivariate regression model. Due to the variation in
reported thresholds, we used a multiple-thresholds within a study random
effects model for meta-analysis (diagmeta R-package). Result(s):
Eleven studies were included in the systematic review, and 10 (2984
patients) in the meta-analysis. All studies were single-center with
observational design, five of which with retrospective data collection.
Quality assessment highlighted various issues, mainly concerning lack of
prespecified thresholds for the index test in all studies. Results of
bivariate model analysis using multiple thresholds within a study
identified the optimal threshold at 3 ng/mL, with a mean sensitivity of
0.67 (0.47-0.82), mean specificity of 0.73 (95% CI 0.65-0.79), and AUC of
0.75 (IC95% 0.29-0.95). Given its importance for practice, we also
evaluated PCT's predictive capability. We found that positive predictive
value is at most close to 50%, also with a high prevalence (30%), and the
negative predictive value was always > 90% when prevalence was < 20%.
 Conclusion(s): These results suggest that PCT may be used to help
rule out infection after cardiac surgery. The optimal threshold of 3 ng/mL
identified in this work should be confirmed with large, well-designed
randomized trials that evaluate the test's impact on health outcomes and
on the use of antibiotic therapy. PROSPERO Registration number
CRD42023415773. Registered 22 April 2023. Graphical abstract: (Figure
presented.) Copyright © The Author(s) 2024.

<38>
Accession Number
2028034868
Title
Short term outcomes of carotid surgery: the real-world experience of a
single teaching center.
Source
Jornal Vascular Brasileiro. 23 (no pagination), 2024. Article Number:
e20230033. Date of Publication: 2024.
Author
Oliveira T.F.; Centellas C.D.R.; Dalio M.B.; Joviliano E.E.
Institution
(Oliveira, Centellas, Dalio, Joviliano) Universidade de Sao Paulo - USP,
Faculdade de Medicina de Ribeirao Preto, SP, Ribeirao Preto, Brazil
Publisher
Sociedade Brasileira de Angiologia e Cirurgia Vascular
Abstract
Background: Surgical treatment of symptomatic extracranial carotid
stenosis is well established for preventing neurological events and should
adhere to optimal quality standards. However, there is growing concern as
to whether results of controlled trials are replicable in real-world
settings. Objective(s): To assess a symptomatic carotid stenosis
population that underwent surgery and its short-term outcomes in a
real-world context at a professional training center. Method(s):
Observational study using data collected from medical records from January
2012 to January 2023. Patients undergoing operations for other carotid
diseases and with concomitant heart surgery were excluded. Result(s):
A total of 70 patients undergoing angioplasty or carotid endarterectomy
were included. Population subsets undergoing angioplasty or endarterectomy
were similar. Differences in anesthetic modality and a longer operative
time in the carotid endarterectomy subgroup were statistically
significant. There were 4 cases of stroke, only 3 of which (2 minor and 1
major) were related to the index lesion. Thus, the rate of major
operation-related stroke was 1.43% and the rate of any lesion-related
stroke was 4.29%. There was 1 case of AMI in the angioplasty group and
there were no deaths in the sample. The overall rate of major adverse
cardiovascular events was 5.71%. There were no statistical differences
between the endarterectomy and angioplasty groups regarding the main
outcomes. Conclusion(s): The rates of outcomes of ischemic stroke,
acute myocardial infarction, death, and major adverse cardiovascular
events at this center are in line with the rates reported by randomized
controlled trials, demonstrating the feasibility of carotid surgery in
centers with teaching programs. Copyright © 2024 The authors.

<39>
[Use Link to view the full text]
Accession Number
2030372728
Title
Effect of Remifentanil on Acute and Chronic Postsurgical Pain in Patients
Undergoing Cardiac Surgery: A Systematic Review and Meta-analysis.
Source
Clinical Journal of Pain. 40(3) (pp 187-195), 2024. Date of Publication:
06 Mar 2024.
Author
Zhang B.; Cai C.; Pan Z.; Zhuang L.; Qi Y.
Institution
(Zhang, Cai, Pan, Zhuang, Qi) Department of Anesthesia, Ningbo Medical
Center, Li Huili Hospital, Zhejiang, Ningbo, China
Publisher
Lippincott Williams and Wilkins
Abstract
Objectives: Our purpose was to explore the effect of remifentanil on acute
and chronic postsurgical pain after cardiac surgery. Material(s) and
Method(s): Randomized controlled trials were retrieved from electronic
databases, such as PubMed, Cochrane Library, China National Knowledge
Internet databases, Scopus, and Web of Science. A systematic review,
meta-analysis, and trial sequential analysis (TSA) were performed. Basic
information and outcomes were extracted from the included studies. The
primary outcome was chronic postsurgical pain. Secondary outcomes were
scores of postsurgical pain and morphine consumption within 24 hours after
cardiac surgery. Risk of bias (ROB) assessment was based on the Cochrane
ROB tool version 2. The overall quality of the evidence was rated using
the Grading of Recommendations Assessment, Development, and Evaluation
(GRADE) system. Result(s): Seven studies consisting of 658 patients
were enrolled in the meta-analysis. A single study had a high ROB and 2
studies had a moderate ROB. The incidence of chronic postsurgical pain (4
studies [415 patients]; risk ratio: 1.02 [95% CI: 0.53 to 1.95]; P = 0.95;
I2 = 59%; TSA-adjusted CI: 0.78 to 1.20) and the postsurgical pain score
(2 studies [196 patients]; mean difference: 0.09 [95% CI: -0.36 to 0.55];
P = 0.69; I2 = 0%; TSA-adjusted CI: -0.36 to 0.55) were not statistically
different between the 2 groups. However, morphine consumption (6 studies
[569 patients]; mean difference: 6.94 [95% CI: 3.65 to 10.22]; P < 0.01;
I2 = 0%; TSA-adjusted CI: 0.00 to 0.49) was higher in the remifentanil
group than in the control group. Conclusion(s): There was not enough
evidence to prove that remifentanil can increase the incidence of chronic
postsurgical pain after cardiac surgery, but interestingly, the results
tended to support a trend toward increased complications in the
intervention group. However, there was moderate certainty evidence that
the use of remifentanil increases the consumption of morphine for
analgesia, and more direct comparison trials are needed to inform clinical
decision-making with greater confidence. Copyright © 2023 Wolters
Kluwer Health, Inc. All rights reserved.

<40>
Accession Number
2030345108
Title
Long-term follow-up of balloon-expandable valves according to the
implantation strategy: insight from the DIRECTAVI trial.
Source
American Heart Journal. 270 (pp 13-22), 2024. Date of Publication: April
2024.
Author
Jammoul N.; Dupasquier V.; Akodad M.; Meunier P.-A.; Moulis L.; Soltani
S.; Macia J.-C.; Robert P.; Schmutz L.; Steinecker M.; Piot C.; Targosz
F.; Benkemoun H.; Lattuca B.; Roubille F.; Cayla G.; Leclercq F.
Institution
(Jammoul, Dupasquier, Meunier, Soltani, Macia, Steinecker, Roubille,
Leclercq) Department of Cardiology, CHU Montpellier, Montpellier
University, Montpellier, France
(Akodad) Institut Cardiovasculaire Paris Sud, Hopital Prive
Jacques-Cartier, Massy, France
(Moulis) Epidemiological and Clinical Research Unit, CHU Montpellier,
Montpellier, France
(Robert, Schmutz, Lattuca, Cayla) Department of cardiology, CHU Nimes,
Montpellier University, Nimes, France
(Piot) Millenaire Clinic, Montpellier, France
(Targosz) Perpignan hospital, Perpignan, France
(Benkemoun) St Pierre Clinic, Perpignan, France
(Roubille) PhyMedExp, INSERM U1046, CNRS UMR 9214, Montpellier, France
Publisher
Elsevier Inc.
Abstract
Background: Safety and feasibility of transcatheter aortic valve
replacement (TAVR) without balloon aortic valvuloplasty (BAV) using the
SAPIEN 3 balloon-expandable device has been previously demonstrated. The
impact on long-term valve hemodynamic performances and outcomes remains
however unknown. We evaluate long-term clinical and hemodynamic results
according to the implant strategy (direct TAVR vs BAV pre-TAVR) in
patients included in the DIRECTAVI randomized trial (NCT02729519).
 Method(s): Clinical and echocardiographic follow-up until January
2023 was performed for all patients included in the DIRECTAVI trial since
2016 (n = 228). The primary endpoint was incidence of moderate/severe
hemodynamic valve deterioration (HVD), according to the Valve Academic
Research defined Consortium-3 criteria (increase in mean gradient >=10
mmHg resulting in a final mean gradient >=20 mmHg, or new/worsening aortic
regurgitation of 1 grade resulting in >= moderate aortic regurgitation).
 Result(s): Median follow-up was 3.8 (2.2-4.7) years. Mean age at
follow-up was 87 +/- 6.7 years. No difference in incidence of HVD in the
direct implantation group compared to the BAV group was found (incidence
of 1.97 per 100 person-years and 1.45 per 100 person-years, respectively,
P = 0.6). Prevalence of predicted prothesis-patient mismatch was low (n =
13 [11.4%] in the direct TAVR group vs n = 15 [13.2%] in BAV group) and
similar between both groups (P = .7). Major outcomes including death,
stroke, hospitalization for heart failure and pacemaker implantation were
similar between both groups, (P = .4, P = .7, P = .3, and P = .3
respectively). Conclusion(s): Direct implantation of the
balloon-expandable device in TAVR was not associated with an increased
risk of moderate/severe HVD or major outcomes up to 6-year follow-up.
These results guarantee wide use of direct balloon-expandable valve
implantation, when feasible. Clinical trials registration number:
NCT05140317. Copyright © 2024 Elsevier Inc.

<41>
Accession Number
2029954432
Title
Protein and Exercise to Reverse Frailty in Older Men and Women Undergoing
Transcatheter Aortic Valve Replacement: Design of the PERFORM-TAVR Trial.
Source
Canadian Journal of Cardiology. 40(2) (pp 267-274), 2024. Date of
Publication: February 2024.
Author
Fountotos R.; Lauck S.; Piazza N.; Martucci G.; Arora R.; Asgar A.;
Forcillo J.; Kouz R.; Labinaz M.; Lamy A.; Peterson M.; Wijeysundera H.;
Masse L.; Ouimet M.-C.; Polderman J.; Webb J.; Afilalo J.
Publisher
Elsevier Inc.
Abstract
Despite the high procedural success of transcatheter aortic valve
replacement (TAVR), 2 out of 5 older adults report poor physical
performance and health-related quality of life (HRQOL) in the ensuing
months, particularly those with frailty. There has yet to be a trial
examining the synergistic effects of exercise and protein supplementation
to counteract frailty and improve patient-centred outcomes following TAVR.
The PERFORM-TAVR trial is a multicentre parallel-group randomised clinical
trial that is enrolling 200 frail older adults >= 70 years of age
undergoing TAVR. Patients will be randomly allocated to 1 of 2 treatment
groups: standard-of-care lifestyle education (control group) or
protein-rich oral nutritional supplement for 4 weeks before TAVR with the
addition of home-based supervised exercise sessions for 12 weeks after
TAVR (intervention group). The primary outcome will be physical
performance as measured by a blinded observer using the Short Physical
Performance Battery at 3 months. Secondary outcomes at 3, 6, and 12 months
will include HRQOL, as measured by the Short-Form 36 Physical and Mental
Component summary scores, and a composite safety end point. The
PERFORM-TAVR trial is testing a novel frailty intervention in older adults
undergoing TAVR to optimise recovery and downstream HRQOL. This represents
a potential paradigm shift that highlights the value of assessing and
treating patients' frailty in parallel with their underlying heart valve
disease. Clinical Trial Registration: URL: https://www.clinicaltrials.gov.
Unique identifier: NCT03522454. Copyright © 2023 Canadian
Cardiovascular Society

<42>
Accession Number
2028594005
Title
Comparison of remimazolam-based and propofol-based total intravenous
anesthesia on hemodynamics during anesthesia induction in patients
undergoing transcatheter aortic valve replacement: a randomized controlled
trial.
Source
Journal of Anesthesia. (no pagination), 2024. Date of Publication: 2024.
Author
Kotani T.; Ida M.; Naito Y.; Kawaguchi M.
Institution
(Kotani, Ida, Naito, Kawaguchi) Department of Anesthesiology, Nara Medical
University Kashihara, Shijo 840, Nara 634-8522, Japan
Publisher
Springer
Abstract
Purpose: This study aimed to compare the hemodynamic effects of
remimazolam- and propofol-based total intravenous anesthesia in patients
who underwent transcatheter aortic valve replacement. Method(s): This
was a single-center, single-blind, randomized controlled trial set at Nara
Medical University, Kashihara, Japan. We included 36 patients aged >= 20
years scheduled to undergo elective transfemoral transcatheter aortic
valve replacement (TAVR) under general anesthesia. The participants were
randomly assigned to the remimazolam and propofol groups (n = 18 each).
Remimazolam- or propofol-based total intravenous anesthesia was initiated
at 12 mg/kg/min or 2.5 mcg/mL via target-controlled infusion,
respectively, along with remifentanil. After confirming the loss of
consciousness, the administration rate was adjusted using
electroencephalographic monitoring. The primary outcome was the rate of
arterial hypotension, defined as a mean arterial pressure < 60 mmHg, from
anesthesia induction until the beginning of the surgical incision. The
total doses of ephedrine and phenylephrine were also assessed.
 Result(s): During anesthesia induction, the arterial hypotension
rates were 11.9% and 21.6% in the remimazolam and propofol groups,
respectively (P = 0.01). The total dose of ephedrine was higher in the
propofol group (14.4 mg) than in the remimazolam group (1.6 mg) (P <
0.001); however, the total dose of phenylephrine was not significantly
different between the two groups (propofol 0.31 mg vs. remimazolam: 0.17
mg, P = 0.10). Conclusion(s): Remimazolam-based total intravenous
anesthesia resulted in a lower hypotension rate than propofol-based total
intravenous anesthesia during induction in patients undergoing TAVR.
Remimazolam-based total intravenous anesthesia can be used safely during
anesthetic induction in patients with severe aortic
stenosis. Copyright © The Author(s) under exclusive licence to
Japanese Society of Anesthesiologists 2024.

<43>
Accession Number
643493363
Title
A commentary on "Transversus thoracic muscle plane block for pain during
cardiac surgery: a systematic review and meta-analysis".
Source
International journal of surgery (London, England). (no pagination),
2024. Date of Publication: 12 Feb 2024.
Author
Zhong W.; Zhao B.; Liu L.; Xi G.; Zhou J.
Institution
(Zhong) Department of Anesthesia, Henan Provincial Chest Hospital (Chest
Hospital of Zhengzhou University), Zhengzhou, Henan 450000, China

<44>
Accession Number
2030218234
Title
Comparative evaluation of dexamethasone and dexmedetomidine as adjuvants
for bupivacaine in ultrasound guided PEC blocks in patients undergoing
modified radical mastectomy under general anaesthesia: A prospective
randomized control trial.
Source
International Journal of Life Sciences Biotechnology and Pharma Research.
12(4) (pp 1122-1126), 2023. Date of Publication: October 2023.
Author
Mallikarjuna; Deshpande N.; Alwandikar V.; Hatti P.; Gowda V.B.
Institution
(Mallikarjuna, Hatti) Department of Anaesthesiology, VTSM Peripheral
Cancer Centre, Branch of Kidwai Memorial Institute of Oncology, Bangalore,
Kalaburagi, India
(Deshpande) Department of Anaesthesiology, K.B.N University, Faculty of
Medical Sciences, Kalaburagi, India
(Alwandikar) Department of Anaesthesiology, Gulbarga Insititute of Medical
Sciences, Kalaburagi, India
(Gowda) Department of Anesthesiology, Kidwai Memorial Institute of
Oncology, Karnataka, Bangalore, India
Publisher
International Journal of Life Sciences Biotechnology and Pharma Research
Abstract
Background: The most common surgical procedure for breast cancer is
modified radical mastectomy (MRM), associated with severe acute
postoperative pain. With the advent of ultrasonography regional
anaesthesia techniques have developed considerably. Present study was
aimed to compare dexamethasone and dexmedetomidine as adjuvants for
Bupivacaine in ultrasound guided PEC blocks in patients undergoing
Modified Radical Mastectomy under General anaesthesia at a tertiary
hospital. Material(s) and Method(s): Present study was single-center,
prospective, clinical study, conducted in patients aged between 18 - 65
years, belonging to ASA Grade l and ll, underwent Modified Radical
Mastectomy under General anaesthesia, followed by ultrasound guided PEC
blocks. 60 patients were randomly distributed in two groups (30 patients
each) by random chit method as group A (Bupivacaine with Dexamethasone) &
group B (Bupivacaine with Dexmedetomidine). Result(s): In present
study, 60 patients were divided in group A (n=30) & group B (n=30).
General characteristics such as age (years), ASA (I/II), weight (kg),
height (cm), BMI (kg/m2), mean duration of surgery (min), baseline heart
rate & baseline MAP were comparable among both groups & difference was not
statistically significant. In present study, group B (dexmedetomidine) had
prolonged duration of analgesia, late requirement of rescue analgesia as
compared to group A (dexamethasone), and difference was statistically
significant. The VAS pain score was lower in patients of group A as
compared to patients in group B up to at 6th postoperative hour and this
difference in pain score was statistically significant. Increased
incidence of postoperative nausea and vomiting was noted in group B as
compared to group A, difference was not statistically significant
(p-0.407). Conclusion(s): Dexmedetomidine has advantages over
dexamethasone regarding longer duration of the block and lesser rescue
analgesic requirement. Copyright © 2023Int. J.
LifeSci.Biotechnol.Pharma.Res.

<45>
Accession Number
2030096251
Title
Safety and effectiveness of neuromuscular electrical stimulation in
cardiac surgery: A systematic review.
Source
World Journal of Cardiology. 16(1) (pp 27-39), 2024. Date of Publication:
26 Jan 2024.
Author
Kourek C.; Kanellopoulos M.; Raidou V.; Karatzanos E.; Dimopoulos S.;
Antonopoulos M.; Patsaki I.
Institution
(Kourek) Medical School of Athens, National and Kapodistrian University of
Athens, Athens 15772, Greece
(Kanellopoulos, Raidou, Karatzanos, Dimopoulos) Clinical Ergospirometry,
Exercise and Rehabilitation Laboratory, Evangelismos Hospital, Athens
10676, Greece
(Dimopoulos, Antonopoulos) Intensive Care Unit, Onassis Cardiac Surgery
Center, Kallithea 17674, Greece
(Patsaki) Department of Physiotherapy, University of West Attica, Athens
12243, Greece
Publisher
Baishideng Publishing Group Inc
Abstract
BACKGROUND Lack of mobilization and prolonged stay in the intensive care
unit (ICU) are major factors resulting in the development of ICU-acquired
muscle weakness (ICUAW). ICUAW is a type of skeletal muscle dysfunction
and a common complication of patients after cardiac surgery, and may be a
risk factor for prolonged duration of mechanical ventilation, associated
with a higher risk of readmission and higher mortality. Early mobilization
in the ICU after cardiac surgery has been found to be low with a
significant trend to increase over ICU stay and is also associated with a
reduced duration of mechanical ventilation and ICU length of stay.
Neuromuscular electrical stimulation (NMES) is an alternative modality of
exercise in patients with muscle weakness. A major advantage of NMES is
that it can be applied even in sedated patients in the ICU, a fact that
might enhance early mobilization in these patients. AIM To evaluate
safety, feasibility and effectiveness of NMES on functional capacity and
muscle strength in patients before and after cardiac surgery. METHODS We
performed a search on Pubmed, Physiotherapy Evidence Database (PEDro),
Embase and CINAHL databases, selecting papers published between December
2012 and April 2023 and identified published randomized controlled trials
(RCTs) that included implementation of NMES in patients before after
cardiac surgery. RCTs were assessed for methodological rigor and risk of
bias via the PEDro. The primary outcomes were safety and functional
capacity and the secondary outcomes were muscle strength and function.
RESULTS Ten studies were included in our systematic review, resulting in
703 participants. Almost half of them performed NMES and the other half
were included in the control group, treated with usual care. Nine studies
investigated patients after cardiac surgery and 1 study before cardiac
surgery. Functional capacity was assessed in 8 studies via 6MWT or other
indices, and improved only in 1 study before and in 1 after cardiac
surgery. Nine studies explored the effects of NMES on muscle strength and
function and, most of them, found increase of muscle strength and
improvement in muscle function after NMES. NMES was safe in all studies
without any significant complication. CONCLUSION NMES is safe, feasible
and has beneficial effects on muscle strength and function in patients
after cardiac surgery, but has no significant effect on functional
capacity. Copyright © 2024 Baishideng Publishing Group Co. All
rights reserved.

<46>
Accession Number
2028106383
Title
The Impact of Transcutaneous Electrical Nerve Stimulation (TENS) on Acute
Pain and Other Postoperative Outcomes: A Systematic Review with
Meta-Analysis.
Source
Journal of Clinical Medicine. 13(2) (no pagination), 2024. Article Number:
427. Date of Publication: January 2024.
Author
Viderman D.; Nabidollayeva F.; Aubakirova M.; Sadir N.; Tapinova K.;
Tankacheyev R.; Abdildin Y.G.
Institution
(Viderman, Aubakirova, Sadir, Tapinova) Department of Surgery, School of
Medicine, Nazarbayev University, Astana 010000, Kazakhstan
(Viderman) Department of Anesthesiology, Intensive Care and Pain Medicine,
National Research Oncology Center, Astana 010000, Kazakhstan
(Nabidollayeva, Abdildin) Department of Mechanical and Aerospace
Engineering, School of Engineering and Digital Sciences, Nazarbayev
University, Astana 010000, Kazakhstan
(Tankacheyev) Department of Minimally Invasive Surgery, National Research
Neurosurgery Center, Astana 010000, Kazakhstan
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
This study aimed to investigate the efficacy and safety of transcutaneous
electrical nerve stimulation (TENS) in postoperative acute pain control.
PubMed, Scopus, and Cochrane Library were searched on 1-8 December 2022,
for randomized controlled trials on the analgesic effects of TENS. The
outcomes were pain intensity and opioid use (primary), and postoperative
(PO) adverse events, blood pressure, and the duration of hospital stay
(secondary); PROSPERO CRD42022333335. A total of 40 articles were included
in the meta-analysis. Pain intensity at rest and during coughing for all
types of surgeries combined was lower in the TENS group (standardized mean
difference (SMD) = -0.51 [-0.61, -0.41], p < 0.00001, 29 studies, and
-1.28 [-2.46, -0.09], p-value = 0.03, six studies, respectively). There
was a statistically significant decrease in morphine requirements, as well
as in the incidence of postoperative nausea and vomiting, dizziness, and
pruritus. There was no difference between the groups in postoperative pain
intensity during walking, in blood pressure, and only a borderline
difference in the length of hospital stay. The subgroup analysis by
surgery type did not show significant differences between the groups in
pain severity at rest. Thus, TENS has a potential for pain control and
postoperative recovery outcomes. Copyright © 2024 by the authors.

<47>
Accession Number
2028068007
Title
Arrhythmogenic Right Ventricular Cardiomyopathy in Children: A Systematic
Review.
Source
Diagnostics. 14(2) (no pagination), 2024. Article Number: 175. Date of
Publication: January 2024.
Author
Moisa S.M.; Spoiala E.L.; Cinteza E.; Vatasescu R.; Butnariu L.I.; Brinza
C.; Burlacu A.
Institution
(Moisa, Spoiala) Pediatrics Department, Faculty of Medicine, "Grigore T.
Popa" University of Medicine and Pharmacy, Iasi 700115, Romania
(Moisa, Butnariu) Sfanta Maria" Clinical Emergency Hospital for Children,
Iasi 700309, Romania
(Cinteza) Pediatrics Department, Faculty of Medicine, "Carol Davila"
University of Medicine and Pharmacy, Bucharest 700115, Romania
(Cinteza) Marie Curie" Clinical Emergency Hospital for Children, Bucharest
41451, Romania
(Vatasescu) Cardio-Thoracic Department, "Carol Davila" University of
Medicine and Pharmacy, Bucharest 020021, Romania
(Vatasescu) Clinical Emergency Hospital, Bucharest 050098, Romania
(Butnariu) Genetics Department, Faculty of Medicine, "Grigore T. Popa"
University of Medicine and Pharmacy, Iasi 700115, Romania
(Brinza, Burlacu) Faculty of Medicine, "Grigore T. Popa" University of
Medicine and Pharmacy, Iasi 700115, Romania
(Brinza, Burlacu) Institute of Cardiovascular Diseases "Prof. Dr. George
I.M. Georgescu", Iasi 700503, Romania
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Arrhythmogenic right ventricular cardiomyopathy (ARVC) is an inherited
disease characterized by the progressive replacement of the normal
myocardium by fibroadipocytic tissue. The importance of an early diagnosis
is supported by a higher risk of sudden cardiac death in the pediatric
population. We reviewed the literature on diagnosis, risk stratification,
and prognosis in the pediatric population with ARVC. In case reports which
analyzed children with ARVC, the most common sign was ventricular
tachycardia, frequently presenting as dizziness, syncope, or even cardiac
arrest. Currently, there is no gold standard for diagnosing ARVC in
children. Nevertheless, genetic analysis may provide a proper diagnosis
tool for asymptomatic cases. Although risk stratification is recommended
in patients with ARVC, a validated prediction model for risk
stratification in children is still lacking; thus, it is a matter of
further research. In consequence, even though ARVC is a relatively rare
condition in children, it negatively impacts the survival and clinical
outcomes of the patients. Therefore, appropriate and validated diagnostic
and risk stratification tools are crucial for the early detection of
children with ARVC, ensuring a prompt therapeutic
intervention. Copyright © 2024 by the authors.

<48>
Accession Number
2027351046
Title
Antithrombotic Management for Transcatheter Aortic Valve Implantation.
Source
Journal of Clinical Medicine. 12(24) (no pagination), 2023. Article
Number: 7632. Date of Publication: December 2023.
Author
Ya'Qoub L.; Arnautovic J.; Sharkawi M.; AlAasnag M.; Jneid H.; Elgendy
I.Y.
Institution
(Ya'Qoub) Division of Structural Heart Disease, University of California
(San Francisco), San Francisco, CA 93106, United States
(Arnautovic) Division of Interventional Cardiology, Henry Ford Macomb
Hospital, Clinton Twp, MI 48038, United States
(Sharkawi) Division of Structural Heart Disease, Medical College of
Georgia, Augusta, GA 30912, United States
(AlAasnag) Department of Cardiology, King Fahd Medical Center, Jeddah
21589, Saudi Arabia
(Jneid) Department of Cardiology, Saint Luke's Baylor Medical Center,
Houston, TX 77030, United States
(Elgendy) Division of Cardiovascular Medicine, Gill Heart Institute,
University of Kentucky, Lexington, KY 40506, United States
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Background: There have been significant changes in the optimal
antithrombotic regimen post transcatheter aortic valve implantation (TAVI)
after the results of major clinical trials in the past few years. Given
the clinical importance of the optimal antithrombotic therapy post TAVI,
we performed a narrative description of the major clinical trials behind
the scientific evidence supporting these changes, as well the current
guideline recommendations and knowledge gaps. Method(s): We performed
a narrative description of the major clinical trials behind the scientific
evidence supporting these changes. We used PubMed as a major source to
collect the major clinical trials including the following key words:
"transcatheter aortic valve replacement", "transcatheter aortic valve
implantation", "antithrombotic", "antiplatelet" and "anticoagulation". We
selected the major clinical trials on this topic. This is not a systematic
review or meta-analysis. Result(s): We describe the results of the
major clinical trials on antithrombotic therapy post TAVI: POPULAR-TAVI A,
POPULAR-TAVI B, ENVISAGE-TAVI AF, GALILEO, ATLANTIS and ADAPT-TAVR trials.
Based on the results of these trials, single antiplatelet therapy is
recommended post TAVI in patients without concomitant indication for oral
anticoagulation or dual antiplatelet therapy, especially in elderly
patients. In younger patients, it is advised to evaluate the patient's
bleeding and thrombotic risk, and dual antiplatelet therapy may be
reasonable in patients with a high thrombotic risk and low bleeding risk.
In patients with a concurrent indication for oral anticoagulation or dual
antiplatelet therapy, it is recommended to continue oral anticoagulation
or dual antiplatelet therapy post TAVI. Conclusion(s): In most
patients without concomitant indication for oral anticoagulation, single
antiplatelet therapy is recommended post TAVI. Copyright © 2023
by the authors.

<49>
Accession Number
2026602374
Title
The effects of tranexamic acid on platelets in patients undergoing cardiac
surgery: a systematic review and meta-analysis.
Source
Journal of Thrombosis and Thrombolysis. 57(2) (pp 235-247), 2024. Date of
Publication: February 2024.
Author
Zou Z.-Y.; He L.-X.; Yao Y.-T.
Institution
(Zou, He) Department of Anesthesiology, Fuwai Yunnan Cardiovascular
Hospital, Yunnan Province, Kunming 650000, China
(Yao) Department of Anesthesiology, Fuwai Hospital, National Center for
Cardiovascular Diseases, Peking Union Medical College and Chinese Academy
of Medical Sciences, Beijing 100037, China
Publisher
Springer
Abstract
Abstract: This meta-analysis was designed to evaluate the effects of
tranexamic acid (TXA) on platelets in patients undergoing cardiac surgery
(CS). Relevant trials were identified by computerized searches of PUBMED,
Cochrane Library, EMBASE, OVID, China National Knowledge Infrastructure
(CNKI), Wanfang Data and VIP Data till Jun 4th, 2022, were searched using
search terms "platelet", "Tranexamic acid", "cardiac surgery", "randomized
controlled trial" database search was updated on Jan 1st 2023. Primary
outcomes included platelet counts, function and platelet membrane
proteins. Secondary outcome included postoperative bleeding. Search
yielded 49 eligible trials, which were finally included in the current
study. As compared to Control, TXA did not influence post-operative
platelet counts in adult patients undergoing on- or off-pump CS, but
significantly increased post-operative platelet counts in pediatric
patients undergoing on-pump CS [(WMD = 16.72; 95% CI 6.33 to 27.10; P =
0.002)], significantly increased post-operative platelet counts in adults
valvular surgery [(WMD = 14.24; 95% CI 1.36 to 27.12; P = 0.03).
Additionally, TXA improved ADP-stimulated platelet aggression [(WMD =
1.88; 95% CI 0.93 to 2.83; P = 0.0001)] and improved CD63 expression on
platelets [(WMD = 0.72; 95% CI 0.29 to 1.15; P = 0.001)]. The current
study demonstrated that TXA administration did not affect post-operative
platelet counts in adult patients undergoing either on- or off-pump CABG,
but significantly increased post-operative platelet counts in pediatric
patients undergoing on-pump CS and adults valvular surgery. Furthermore,
TXA improved ADP-stimulated platelet aggression and improved CD63
expression on platelets. To further confirm this, more well designed and
adequately powered randomized trials are needed. Graphical abstract:
(Figure presented.). Copyright © The Author(s), under exclusive
licence to Springer Science+Business Media, LLC, part of Springer Nature
2023.

<50>
Accession Number
2029157674
Title
Effect of Mechanical Ventilation Mode Type on Postoperative Pulmonary
Complications After Cardiac Surgery: A Randomized Controlled Trial.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 38(2) (pp 437-444),
2024. Date of Publication: February 2024.
Author
Li X.-F.; Mao W.-J.; Jiang R.-J.; Zhang M.-Q.; Yu H.
Institution
(Li, Yu, Zhang, Yu) Department of Anesthesiology, West China Hospital,
Sichuan University, Chengdu, China
(Mao) Department of Anesthesiology, Jianyang People's Hospital, Jianyang,
China
(Jiang) Department of Anesthesiology, Chengdu Second People's Hospital,
Chengdu, China
Publisher
W.B. Saunders
Abstract
Objectives: It is unknown whether there is a difference in pulmonary
outcome in different intraoperative ventilation modes for cardiac surgery
with cardiopulmonary bypass (CPB). The aim of this trial was to determine
whether patients undergoing cardiac surgery with CPB could benefit from
intraoperative optimal ventilation mode. Design(s): This was a
single-center, prospective, randomized controlled trial. Setting(s):
The study was conducted at a single-center tertiary-care hospital.
 Participant(s): A total of 1,364 adults undergoing cardiac surgery
with CPB participated in this trial. Intervention(s): Patients were
assigned randomly (1:1:1) to receive 1 of 3 ventilation modes:
volume-controlled ventilation (VCV), pressure-controlled ventilation
(PCV), and pressure-controlled ventilation-volume guaranteed (PCV-VG). All
arms of the study received the lung-protective ventilation strategy.
 Measurements and Main Results: The primary outcome was a composite of
postoperative pulmonary complications (PPCs) within the first 7
postoperative days. Pulmonary complications occurred in 168 of 455
patients (36.9%) in the PCV-VG group, 171 (37.6%) in the PCV group, and
182 (40.1%) in the VCV group, respectively. There was no statistical
difference in the risk of overall pulmonary complications among groups (p
= 0.585). There were no significant differences in the severity grade of
PPCs within 7 days, postoperative ventilation duration, intensive care
unit stay, postoperative hospital stay, or 30-day postoperative mortality.
 Conclusion(s): Among patients scheduled for cardiac surgery with CPB,
intraoperative ventilation mode type did not affect the risk of
postoperative pulmonary complications. Copyright © 2023

<51>
Accession Number
643472998
Title
Nonpharmacologic Therapies for Postoperative Pain in Cardiac Surgery: A
Systematic Review.
Source
Pain management nursing : official journal of the American Society of Pain
Management Nurses. (no pagination), 2024. Date of Publication: 08 Feb
2024.
Author
de Andrade EV.; Oliveira L.M.; Dos Santos Felix M.M.; Raponi M.B.G.; de
Faria M.F.; Calegari I.B.; da Silva K.F.N.; Barbosa M.H.
Institution
(de Andrade, Dos Santos Felix, de Faria, Calegari) Stricto sensu Graduate
Program Health Care, Federal University of Triangulo Mineiro. Av. Getulio
Guarita, Uberaba, Minas Gerais, Brazil
(Oliveira) Undergraduate Program in Nursing, Federal University of
Triangulo Mineiro, Uberaba, Minas Gerais, Brazil
(Raponi) Faculty of Medicine, Federal University of Uberlandia. Av. Para,
Minas Gerais, Brazil
(da Silva) Professional Education Center, Federal University of Triangulo
Mineiro. Av. Getulio Guarita, Minas Gerais, Brazil
(Barbosa) Teaching and Scientific Department of Nursing in Hospital Care,
Institute of Health Sciences, Federal University of Triangulo Mineiro. Av.
Getulio Guarita, Minas Gerais, Brazil
Abstract
OBJECTIVES: To search for studies that address the efficacy of
nonpharmacologic methods for pain relief in adults undergoing cardiac
surgeries. DESIGN: A systematic review registered in the International
Prospective Register of Systematic Reviews (PROSPERO) under number
CRD42020168681. DATA SOURCE: PubMed, LILACS, CINAHL, the Web of Science,
Scopus, and the Cochrane Central Register of Controlled Trials.
REVIEW/ANALYSIS METHODS: The review used a PRISMA guideline that selected
primary randomized controlled trials on the efficacy of nonpharmacologic
pain relief therapies in patients undergoing cardiac surgery, with no time
or language restrictions. The Joanna Briggs Institute Critical Appraisal
Checklist for Randomized Clinical Trials was used to assess methodological
rigor. RESULT(S): After screening, 23 of the 140 studies found in the
databases were selected. The studies examined the efficacy of 13 different
nonpharmacologic therapies, as well as a combination of therapies, with
massage therapy being the most commonly examined, followed by musical
intervention and hypnosis. CONCLUSION(S): Some interventions, when
combined with pharmacologic therapy, were effective in relieving
postoperative pain after cardiac surgeries, according to the studies
analyzed. However, most studies had significant methodological flaws, and
further studies with high methodological quality are needed. Copyright
© 2024 American Society for Pain Management Nursing. Published by
Elsevier Inc. All rights reserved.

<52>
Accession Number
2028539213
Title
Very long-term outlook of acute coronary syndromes after percutaneous
coronary intervention with implantation of polymer-free versus
durable-polymer new-generation dmg-eluting stents.
Source
Minerva Medica. 114(5) (pp 590-600), 2023. Date of Publication: 2023.
Author
Francesco V.; Sebastian K.; Salvatore C.; Michael J.; Katharina M.; Erion
X.; Tobias K.; Jens W.; Tareq I.; Karl-Ludwig L.; Heribert S.; Adnan K.;
Robert A.B.; Alessandra S.; Marco B.; Luigi S.; Giuseppe B.-Z.
Institution
(Francesco) UOCUTICEmodinamica E Cardiologia, Santa Maria Goretti
Hospital, Latina, Italy
(Sebastian, Salvatore, Michael, Katharina, Erion, Tobias, Jens, Heribert,
Adnan) Technische Universitat Munchen (TUM), Germany, Deutsches
Herzzentrum M nchen, Munich, Germany
(Michael, Karl-Ludwig, Heribert, Adnan) German Center for Cardiovascular
Research, Germany
(Tareq, Karl-Ludwig) Klinik Und Poliklinik Innere Medizin I, Kardiologie,
Angiologie und Pneumologie, Rechts der Isar Hospital, Technische Universit
t M nchen TUM, Angiologie und Pneumologie), Munich, Germany
(Robert) Dublin Cardiovascular Research Institute, Mater Private Hospital,
Dublin, Ireland
(Robert) School of Pharmacy and Biomolecular Sciences, Royal College of
Surgeons in Ireland, Dublin, Ireland
(Alessandra) Department of Public Health and Infectious Disease, Section
of BioMedical Statistics, Sapienza University, Rome, Italy
(Marco, Luigi) Department of Clinical, Internal Medicine, Anesthesiology
and Cardiovascular Sciences, Sapienza University, Rome, Italy
(Giuseppe) Department of Medical-Surgical Sciences and Biotechnologies,
Sapienza University, Latina, Naples, Italy
(Giuseppe) Mediterranea Cardiocentro, Naples, Italy
Publisher
Edizioni Minerva Medica
Abstract
BACKGROUND: Detailed long-term follow-up data on patients with acute
coronary syndromes (ACS) in general, and those with ST-elevation
myocardial infarction (STEMI) in particular, are limited. We aimed to
appraise the long-term outlook of patients undergoing percutaneous
coronary intervention (PCI) with state-of-the-art coronary stents for
STEMI, other types of ACS and stable coronary artery disease (CAD), and
also explore the potential beneficial impact of new-generation
polymer-free drug-eluting stents (DES) in this setting. METHOD(S):
Baseline, procedural and very long-term outcome data on patients
undergoing PCIand randomized to implantation of new-generation
polymer-free vs. durable polymer DES were systematically collected,
explicitly distin guishing subjects with admission diagnosis of STEMI,
non-ST-elevation ACS (NSTEACS), and stable CAD. Outcomes of interest
included death, myocardial infarction, revascularization (i.e.
patient-oriented composite endpoints [POCE]), major adverse cardiac events
(MACE), and device-oriented composite endpoints (DOCE). RESULT(S):
Atotal of 3002 patients were included, 1770 (59.0%) with stable CAD, 921
(30.7%) with NSTEACS, and 311 (10.4%) with STEMI. At long-term follow-up
(7.5+/-3.1 years), all clinical events were significantly more common in
the NSTEACS group and, to a lesser extent, in the stable CADgroup (e.g.
POCEoccurred in, respectively, 637 [44.7%] vs. 964 [37.9%] vs. 133
[31.5%], P<0.001). While these differences were largely attributable to
adverse coexisting features in patients with NSTEACS (e.g. advanced age,
insulin-dependent diabetes, and extent of CAD), the unfavorable outlook of
patients presenting with NSTEACS persisted even after multivariable
adjustment including several prognostically relevant factors (hazard ratio
[HR] of NSTEACS vs. stable CAD 1.19 [95% confidence interval 1.03-1.38],
P=0.016). Notably, even after encompassing all prognostically impactful
features, no difference between polymer-free and perma nent polymer
drug-eluting stents appeared (HR=0.96 [0.84-1.10], P=0.560).
 CONCLUSION(S): Unstable coronary artery disease, especially when
presenting without ST-elevation, represents an in formative marker of
adverse long-term prognosis in current state-of-the-art invasive
cardiology practice. Even consider ing admission diagnosis, and despite of
using no polymer, polymer-free DES showed similar results with regards to
safety and efficacy when compared with DES with permanent
polymer. Copyright © 2023 Edizioni Minerva Medica. All rights
reserved.

<53>
Accession Number
619230288
Title
Rivaroxaban with or without aspirin in patients with stable coronary
artery disease: an international, randomised, double-blind,
placebo-controlled trial.
Source
The Lancet. 391(10117) (pp 205-218), 2018. Date of Publication: 20 - 26
January 2018.
Author
Connolly S.J.; Eikelboom J.W.; Bosch J.; Dagenais G.; Dyal L.; Lanas F.;
Metsarinne K.; O'Donnell M.; Dans A.L.; Ha J.-W.; Parkhomenko A.N.; Avezum
A.A.; Lonn E.; Lisheng L.; Torp-Pedersen C.; Widimsky P.; Maggioni A.P.;
Felix C.; Keltai K.; Hori M.; Guzik T.J.; Bhatt D.L.; Branch K.R.H.; Cook
Bruns N.; Berkowitz S.D.; Anand S.S.; Varigos J.D.; Fox K.A.A.; Yusuf S.;
SALA J.; CARTASEGNA L.U.I.S.; VICO M.; HOMINAL M.A.; HASBANI E.; CACCAVO
A.; ZAIDMAN C.; VOGEL D.; HRABAR A.; SCHYGIEL P.O.; CUNEO C.; LUQUEZ
H.U.G.O.; MACKINNON I.J.; AHUAD GUERRERO R.A.; COSTABEL J.P.; BARTOLACCI
I.P.; MONTANA O.; BARBIERI M.; GOMEZ VILAMAJO O.; GARCIA DURAN R.O.;
SCHIAVI L.B.; GARRIDO M.; INGARAMO A.; BORDONAVA A.P.; PELAGAGGE M.J.;
NOVARETTO L.; ALBISU DI GENNERO J.P.; IBANEZ SAGGIA L.M.; ALVAREZ M.; VITA
N.A.; MACIN S.M.; DRAN R.D.; CARDONA M.; GUZMAN L.U.I.S.; SARJANOVICH
R.J.; CUADRADO J.; NANI S.; LITVAK BRUNO M.R.; CHACON C.; MAFFEI L.E.;
GRINFELD D.; VENSENTINI N.; MAJUL C.R.; LUCIARDI H.L.; GONZALEZ COLASO
P.D.C.; FERRE PACORA F.A.; VAN DEN HEUVEL P.A.U.L.; VERHAMME P.; ECTOR
B.A.V.O.; DEBONNAIRE P.; VAN DE BORNE P.; LEROY J.E.A.N.; SCHROE H.;
VRANCKX P.; ELEGEERT I.V.A.N.; HOFFER E.; DUJARDIN K.A.R.L.; INDIO DO
BRASIL C.; PRECOMA D.; ABRANTES J.A.; MANENTI E.; REIS G.; SARAIVA
J.O.S.E.; MAIA L.; HERNANDES M.; ROSSI P.; ROSSI DOS SANTOS F.; ZIMMERMANN
S.L.; RECH R.; ABIB E.; LEAES P.; BOTELHO R.; DUTRA O.; SOUZA W.; BRAILE
M.; IZUKAWA N.I.L.O.; NICOLAU J.C.; TANAJURA L.F.; SERRANO JUNIOR C.V.;
MINELLI C.; NASI L.A.; OLIVEIRA L.; DE CARVALHO CANTARELLI M.J.; TYTUS R.;
PANDEY S.; LONN E.V.A.; CHA J.; VIZEL S.A.U.L.; BABAPULLE M.; LAMY A.;
SAUNDERS K.; BERLINGIERI J.; KIAII B.O.B.; BHARGAVA R.; MEHTA P.; HILL L.;
FELL D.; LAM A.N.D.Y.; AL-QOOFI F.; BROWN C.; PETRELLA R.; RICCI J.A.;
GLANZ A.; NOISEUX N.; BAINEY K.; MERALI F.; HEFFERNAN M.; DELLA SIEGA A.;
DAGENAIS G.R.; DAGENAIS F.; BRULOTTE S.; NGUYEN M.; HARTLEIB M.; GUZMAN
R.; BOURGEOIS R.; RUPKA D.; KHAYKIN Y.; GOSSELIN G.; HUYNH T.H.A.O.; PILON
C.; CAMPEAU J.E.A.N.; PICHETTE F.; DIAZ A.; JOHNSTON J.; SHUKLE P.; HIRSCH
G.; RHEAULT P.A.U.L.; CZARNECKI W.; ROY A.; NAWAZ S.H.A.H.; FREMES S.;
SHUKLA D.; JANO G.; COBOS J.L.; CORBALAN R.; MEDINA M.; NAHUELPAN L.;
RAFFO C.; PEREZ L.U.I.S.; POTTHOFF S.; STOCKINS B.; SEPULVEDA P.; PINCETTI
C.; VEJAR M.; TIAN H.; WU X.; KE Y.; JIA K.; YIN P.; WANG Z.; YU L.; WU
S.; WU Z.; LIU S.W.; BAI X.J.; ZHENG Y.A.N.G.; YANG P.I.N.G.; YANG Y.M.;
ZHANG J.; GE J.; CHEN X.P.; HU T.H.; ZHANG R.; ZHENG Z.H.E.; CHEN X.I.N.;
TAO L.; LI J.; HUANG W.; FU G.; LI C.; DONG Y.; WANG C.; ZHOU X.; KONG
Y.E.; SOTOMAYOR A.; ACCINI MENDOZA J.L.; CASTILLO H.; URINA M.; AROCA G.;
PEREZ M.; MOLINA DE SALAZAR D.I.; SANCHEZ VALLEJO G.; FERNANDO M.J.;
GARCIA H.; GARCIA L.H.; ARCOS E.; GOMEZ J.U.A.N.; CUERVO MILLAN F.;
TRUJILLO DADA F.A.; VESGA B.; MORENO SILGADO G.A.; ZIDKOVA E.V.A.; LUBANDA
J.-C.; KALETOVA M.; KRYZA R.; MARCINEK G.; RICHTER M.; SPINAR J.; MATUSKA
J.I.R.I.; TESAK M.; MOTOVSKA Z.; BRANNY M.; MALY J.I.R.I.; MALY M.; WIENDL
M.; FOLTYNOVA CAISOVA L.; SLABY J.; VOJTISEK P.E.T.R.; PIRK J.A.N.;
SPINAROVA L.; BENESOVA M.; CANADYOVA J.; HOMZA M.; FLORIAN J.; POLASEK R.;
COUFAL Z.; SKALNIKOVA V.; BRAT R.; BRTKO M.; JANSKY P.E.T.R.; LINDNER J.;
MARCIAN P.; STRAKA Z.; TRETINA M.; DUARTE Y.C.; POW CHON LONG F.; SANCHEZ
M.; LOPEZ J.O.S.E.; PERUGACHI C.; MARMOL R.; TRUJILLO F.; TERAN P.;
TUOMILEHTO J.; TUOMILEHTO H.; TUOMINEN M.-L.; KANTOLA I.; STEG G.; ABOYANS
V.; LECLERCQ F.; FERRARI E.; BOCCARA F.; MESSAS E.; MISMETTI P.; SEVESTRE
M.A.; CAYLA G.; MOTREFF P.; STOERK S.; DUENGEN H.A.N.S.-D.I.R.K.;
STELLBRINK C.; GUEROCAK O.; KADEL C.; BRAUN-DULLAEUS R.; JESERICH M.;
OPITZ C.; VOEHRINGER H.-F.; APPEL K.-F.; WINKELMANN B.; DORSEL T.; NIKOL
S.; DARIUS H.; RANFT J.; SCHELLONG S.; JUNGMAIR W.; DAVIERWALA P.; VORPAHL
M.A.R.C.; BAJNOK L.; LASZLO Z.; NOORI E.; VERESS G.; VERTES A.; ZSARY A.;
KIS E.R.N.O.; KORANYI L.; BAKAI J.; BODA Z.; POOR F.; JARAI Z.; KEMENY V.;
BARTON J.O.H.N.; MCADAM B.; MURPHY A.; CREAN P.; MAHON N.; CURTIN R.;
MACNEILL B.; DINNEEN S.E.A.N.; HALABI M.; ZIMLICHMAN R.; ZELTSER D.;
TURGEMAN Y.O.A.V.; KLAINMAN E.; LEWIS B.; KATZ A.M.O.S.; ATAR S.; NIKOLSKY
E.; BOSI S.; NALDI M.; FAGGIANO P.; ROBBA D.; MOS L.; SINAGRA G.; COSMI
F.; OLTRONA VISCONTI L.; CARMINE D.M.; DI PASQUALE G.; DI BIASE M.;
MANDORLA S.A.R.A.; BERNARDINANGELI M.; PICCINNI G.C.; GULIZIA M.M.;
GALVANI M.; VENTURI F.; MOROCUTTI G.; BALDIN M.G.; OLIVIERI C.; PERNA
G.P.; CIRRINCIONE V.; KANNO T.; DAIDA H.; OZAKI Y.; MIYAMOTO N.; HIGASHIUE
S.; DOMAE H.; HOSOKAWA S.; KOBAYASHI H.; KURAMOCHI T.; FUJII K.; MIZUTOMI
K.; SAKU K.; KIMURA K.; HIGUCHI Y.; ABE M.; OKUDA H.; NODA T.; MITA T.;
HIRAYAMA A.; ONAKA H.; INOKO M.; HIROKAMI M.; OKUBO M.; AKATSUKA Y.;
IMAMAKI M.; KAMIYA H.; MANITA M.; HIMI T.; UENO H.; HISAMATSU Y.U.J.I.;
AKO J.; NISHINO Y.; KAWAKAMI H.; YAMADA Y.; KORETSUNE Y.; YAMADA T.;
YOSHIDA T.; SHIMOMURA H.; KINOSHITA N.; TAKAHASHI A.; YUSOFF K.; WAN AHMAD
W.A.; ABU HASSAN M.R.; KASIM S.; ABDUL RAHIM A.A.; MOHD ZAMRIN D.; MACHIDA
M.; HIGASHINO Y.; UTSU N.; NAKANO A.; NAKAMURA S.; HASHIMOTO T.; ANDO K.;
SAKAMOTO T.; PRINS F.J.; LOK D.I.R.K.; MILHOUS J.G.-J.; VIERGEVER
E.R.I.C.; WILLEMS F.; SWART H.E.N.K.; ALINGS M.; BREEDVELD R.O.B.; DE
VRIES K.E.E.S.-J.A.N.; VAN DER BORGH R.; OEI F.; ZOET-NUGTEREN S.; KRAGTEN
H.A.N.S.; HERRMAN J.P.; VAN BERGEN P.A.U.L.; GOSSELINK M.; HOEKSTRA E.;
ZEGERS E.; RONNER E.; DEN HARTOG F.; BARTELS G.; NIEROP P.; VAN DER ZWAAN
C.O.E.N.; VAN ECK J.; VAN GORSELEN E.; GROENEMEIJER B.; HOOGSLAG P.; DE
GROOT M.R.; LOYOLA A.; SULIT D.J.; REY N.; ABOLA M.T.; MORALES D.;
PALOMARES E.; ABAT M.E.; ROGELIO G.; CHUA P.; DEL PILAR J.C.; ALCARAZ
J.D.; EBO G.; TIRADOR L.; CRUZ J.; ANONUEVO J.O.H.N.; PITARGUE A.; JANION
M.; GUZIK T.; GAJOS G.; ZABOWKA M.; RYNKIEWICZ A.; BRONCEL M.; SZUBA A.;
CZARNECKA D.; MAGA P.; STRAZHESKO I.; VASYUK Y.U.R.Y.; SIZOVA Z.;
POZDNYAKOV Y.U.R.Y.; BARBARASH O.L.G.A.; VOEVODA M.; POPONINA T.; REPIN
A.; OSIPOVA I.; EFREMUSHKINA A.N.N.A.; NOVIKOVA N.I.N.A.; AVERKOV
O.L.E.G.; ZATEYSHCHIKOV D.; VERTKIN A.; AUSHEVA A.Z.A.; COMMERFORD P.;
SEEDAT S.; VAN ZYL L.; ENGELBRECHT J.A.N.; MAKOTOKO E.M.; PRETORIUS C.E.;
MOHAMED Z.A.I.D.; HORAK A.; MABIN T.; KLUG E.R.I.C.; BAE J.A.N.G.-H.O.;
KIM C.; KIM C.H.O.N.G.-J.I.N.; KIM D.O.N.G.-S.O.O.; KIM Y.J.; JOO S.; HA
J.O.N.G.-W.O.N.; PARK C.S.; KIM J.Y.; KIM Y.O.U.N.G.-K.W.O.N.; JARNERT C.;
MOOE T.; DELLBORG M.; TORSTENSSON I.; ALBERTSSON P.E.R.; JOHANSSON
L.A.R.S.; AL-KHALILI F.; ALMROTH H.; ANDERSSON T.; PANTEV E.M.I.L.;
TENGMARK B.E.N.G.T.-O.L.O.V.; LIU B.O.; RASMANIS G.; WAHLGREN C.-M.;
MOCCETTI T.; TSELUYKO V.I.R.A.; VOLKOV V.; KOVAL O.; KONONENKO L.;
PROKHOROV O.; VDOVYCHENKO V.; BAZYLEVYCH A.; RUDENKO L.; VIZIR V.;
KARPENKO O.; MALYNOVSKY Y.; KOVAL V.; STOROZHUK B.; COTTON J.;
VENKATARAMAN A.S.O.K.; MORIARTY A.; CONNOLLY D.; DAVEY P.; SENIOR
R.O.X.Y.; BIRDI I.; CALVERT J.O.H.N.; DONNELLY P.; TREVELYAN J.; CARTER
J.; PEACE A.; AUSTIN D.; KUKREJA N.; HILTON T.; SRIVASTAVA S.; WALSH R.;
FIELDS R.; HAKAS J.; PORTNAY E.; GOGIA H.; SALACATA A.; HUNTER J.J.;
BACHARACH J.M.; SHAMMAS N.; SURESH D.; SCHNEIDER R.; GURBEL P.A.U.L.;
BANERJEE S.; GRENA P.A.U.L.; BEDWELL N.O.E.L.; SLOAN S.; LUPOVITCH S.;
SONI A.; GIBSON K.; SANGRIGOLI R.; MEHTA R.; I-HSUAN TSAI P.; GILLESPIE
E.V.E.; DEMPSEY S.; HAMROFF G.; BLACK R.; LADER E.; KOSTIS J.B.; BITTNER
V.E.R.A.; MCGUINN W.; BRANCH K.; MALHOTRA V.; MICHAELSON S.; VACANTE M.;
MCCORMICK M.; ARIMIE R.; CAMP A.L.A.N.; DAGHER G.; KOSHY N.M.; THEW S.;
COSTELLO F.; HEIMAN M.A.R.K.; CHILTON R.; MORAN M.; ADLER F.; COMEROTA A.;
SEIWERT A.; FRENCH W.; SEROTA H.; HARRISON R.; BAKAEEN F.; OMER S.;
CHANDRA L.; WHELAN A.L.A.N.; BOYLE A.; ROBERTS-THOMSON P.; ROGERS J.;
CARROLL P.; COLQUHOUN D.; SHAW J.; BLOMBERY P.; AMERENA J.O.H.N.; HII C.;
ROYSE A.; SINGH B.; SELVANAYAGAM J.; JANSEN S.; LO W.; HAMMETT C.; POULTER
R.; NARASIMHAN S.; WIGGERS H.; NIELSEN H.; GISLASON G.; KOBER L.A.R.S.;
HOULIND K.I.M.; BOENELYKKE SOERENSEN V.; DIXEN U.; REFSGAARD J.E.N.S.;
ZEUTHEN E.; SOEGAARD P.; HRANAI M.; GASPAR L.; PELLA D.; HATALOVA K.;
DROZDAKOVA E.; COMAN I.O.A.N.; DIMULESCU D.; VINEREANU D.; CINTEZA M.;
SINESCU C.; ARSENESCU C.; BENEDEK I.M.R.E.; BOBESCU E.; DOBREANU D.A.N.;
GAITA D.A.N.; IANCU A.; ILIESIU A.; LIGHEZAN D.; PETRESCU L.; PIRVU O.;
TEODORESCU I.; TESLOIANU D.A.N.; VINTILA M.M.; CHIONCEL O.
Institution
(Connolly, Eikelboom, Dyal, Lonn, Anand, Yusuf) Population Health Research
Institute, McMaster University and Hamilton Health Sciences, Hamilton, ON,
Canada
(Bosch) School of Rehabilitation Science, McMaster University, Hamilton,
ON, Canada
(Dagenais) Institut Universitaire de Cardiologie et Pneumologie de Quebec,
Quebec, QC, Canada
(Lanas) Universidad de la Frontera, Temuco, Chile
(Metsarinne) Department of Medicine, Turku University Central Hospital and
Turku University, Turku, Finland
(O'Donnell) Department of Medicine, National University of Ireland,
Galway, Ireland
(Dans) Department of Medicine, University of Philippines, Manila,
Philippines
(Ha) Yonsei University College of Medicine, Seoul, South Korea
(Parkhomenko) Institute of Cardiology, Kiev, Ukraine
(Avezum) Instituto Dante Pazzanese de Cardiologia & University Santo
Amaro, Sao Paulo, Brazil
(Lisheng) FuWai Hospital, CAMS, Beijing, China
(Torp-Pedersen) University of Aalborg, Aalborg, Denmark
(Widimsky) Charles University, Prague, Czechia
(Maggioni) ANMCO Research Center, Florence, Italy
(Felix) Universidad Tecnologica Equinoccial, Facultad de Ciencias de la
Salud Eugenio, Espejo, Quito, Ecuador
(Keltai) Department of Medicine, Semmelweis University, Budapest, Hungary
(Hori) Osaka International Cancer Institute, Osaka, Japan
(Yusoff) Universiti Teknologi Mara, Selangor, Malaysia
(Guzik) Collegium Medicum Jagiellonian University, Krakow, Poland
(Guzik) University of Glasgow, Glasgow, United Kingdom
(Bhatt) Brigham and Women's Hospital Heart & Vascular Center and Harvard
Medical School, Boston, MA, United States
(Branch) Department of Medicine, University of Washington Medical Centre,
Seattle, WA, United States
(Cook Bruns) Bayer AG, Wuppertal, Germany
(Berkowitz) Bayer AG, Parsippany, NJ, United States
(Varigos) Monash University, Melbourne, VIC, Australia
(Fox) Department of Medicine, University of Edinburgh, Edinburgh, United
Kingdom
Publisher
Lancet Publishing Group
Abstract
Background: Coronary artery disease is a major cause of morbidity and
mortality worldwide, and is a consequence of acute thrombotic events
involving activation of platelets and coagulation proteins. Factor Xa
inhibitors and aspirin each reduce thrombotic events but have not yet been
tested in combination or against each other in patients with stable
coronary artery disease. Method(s): In this multicentre,
double-blind, randomised, placebo-controlled, outpatient trial, patients
with stable coronary artery disease or peripheral artery disease were
recruited at 602 hospitals, clinics, or community centres in 33 countries.
This paper reports on patients with coronary artery disease. Eligible
patients with coronary artery disease had to have had a myocardial
infarction in the past 20 years, multi-vessel coronary artery disease,
history of stable or unstable angina, previous multi-vessel percutaneous
coronary intervention, or previous multi-vessel coronary artery bypass
graft surgery. After a 30-day run in period, patients were randomly
assigned (1:1:1) to receive rivaroxaban (2.5 mg orally twice a day) plus
aspirin (100 mg once a day), rivaroxaban alone (5 mg orally twice a day),
or aspirin alone (100 mg orally once a day). Randomisation was computer
generated. Each treatment group was double dummy, and the patients,
investigators, and central study staff were masked to treatment
allocation. The primary outcome of the COMPASS trial was the occurrence of
myocardial infarction, stroke, or cardiovascular death. This trial is
registered with ClinicalTrials.gov, number NCT01776424, and is closed to
new participants. Finding(s): Between March 12, 2013, and May 10,
2016, 27 395 patients were enrolled to the COMPASS trial, of whom 24 824
patients had stable coronary artery disease from 558 centres. The
combination of rivaroxaban plus aspirin reduced the primary outcome more
than aspirin alone (347 [4%] of 8313 vs 460 [6%] of 8261; hazard ratio
[HR] 0.74, 95% CI 0.65-0.86, p<0.0001). By comparison, treatment with
rivaroxaban alone did not significantly improve the primary outcome when
compared with treatment with aspirin alone (411 [5%] of 8250 vs 460 [6%]
of 8261; HR 0.89, 95% CI 0.78-1.02, p=0.094). Combined rivaroxaban plus
aspirin treatment resulted in more major bleeds than treatment with
aspirin alone (263 [3%] of 8313 vs 158 [2%] of 8261; HR 1.66, 95% CI
1.37-2.03, p<0.0001), and similarly, more bleeds were seen in the
rivaroxaban alone group than in the aspirin alone group (236 [3%] of 8250
vs 158 [2%] of 8261; HR 1.51, 95% CI 1.23-1.84, p<0.0001). The most common
site of major bleeding was gastrointestinal, occurring in 130 [2%]
patients who received combined rivaroxaban plus aspirin, in 84 [1%]
patients who received rivaroxaban alone, and in 61 [1%] patients who
received aspirin alone. Rivaroxaban plus aspirin reduced mortality when
compared with aspirin alone (262 [3%] of 8313 vs 339 [4%] of 8261; HR
0.77, 95% CI 0.65-0.90, p=0.0012). Interpretation(s): In patients
with stable coronary artery disease, addition of rivaroxaban to aspirin
lowered major vascular events, but increased major bleeding. There was no
significant increase in intracranial bleeding or other critical organ
bleeding. There was also a significant net benefit in favour of
rivaroxaban plus aspirin and deaths were reduced by 23%. Thus, addition of
rivaroxaban to aspirin has the potential to substantially reduce morbidity
and mortality from coronary artery disease worldwide. Funding(s):
Bayer AG. Copyright © 2018 Elsevier Ltd

<54>
Accession Number
2029462697
Title
Preoperative B-Type Natriuretic Peptides to Predict Postoperative Atrial
Fibrillation in Cardiac Surgery: A Systematic Review and Meta-Analysis.
Source
Heart Lung and Circulation. 33(1) (pp 23-32), 2024. Date of Publication:
January 2024.
Author
Thet M.S.; Hlwar K.E.; Thet K.S.; Han K.P.P.; Oo A.Y.
Institution
(Thet) Department of Surgery and Cancer, Imperial College London, United
Kingdom
(Hlwar, Thet, Han) Department of Medicine, Mandalay General Hospital,
University of Medicine, Mandalay, Myanmar
(Oo) Department of Cardiothoracic Surgery, St Bartholomew's Hospital,
London, United Kingdom
Publisher
Elsevier Ltd
Abstract
Background: Post-operative atrial fibrillation (AF) is the most common
complication following cardiac surgery. There has been extensive
exploration of clinical variables, imaging, and biomarkers to predict its
occurrence after cardiac surgery. In this study, we examine the emerging
biomarkers B-type natriuretic peptide (BNP) and N-terminal proBNP
(NT-proBNP) to assess their pre-operative values and correlations with the
occurrence of post-operative AF in patients undergoing cardiac surgery.
 Method(s): A comprehensive literature search was conducted using
PubMed, EMBASE, MEDLINE via Ovid, ClinicalTrials.Gov, Scopus, and Cochrane
Central Register of Controlled Trials (CENTRAL) to identify studies
published until March 2023. The studies were included if they reported
pre-operative BNP or NT-proBNP values and the development of
post-operative AF in cardiac surgery patients. Subsequently, data were
extracted, and a meta-analysis was performed using Review Manager 5.4 4
(The Cochrane Collaboration, 2020) and SPSS version 28 (IBM Corp, Armonk,
NY, USA) to assess the difference between pre-operative BNP and NT-proBNP
levels between patients with post-operative AF (AF group) and those
without (No-AF group) using a random-effect model. Further analysis was
performed in three subgroups: isolated coronary artery bypass grafting,
isolated valve, and combined/mixed surgery group. Result(s): A total
of 20 studies, including 9,079 participants were identified and included
in the systematic review and meta-analysis. Pre-operative BNP levels were
reported in 11 studies, and NT-proBNP levels were reported in 10 studies,
of which one study reported both BNP and NT-proBNP levels. There is an
overall significant difference between pre-operative levels of BNP
(p=0.03, I2=95%) and NT-proBNP (p<0.001, I2=65%)
when compared between AF and No-AF groups. Nonetheless, subgroup analysis
showed there is no significant difference in pre-operative BNP levels,
except in isolated valve surgery (p<0.001), whereas all subgroups showed
significantly different pre-operative levels of NT-proBNP.
 Conclusion(s): Elevated levels of both BNP and NT-proBNP were
observed in patients who developed post-operative AF after undergoing
cardiac surgery. In particular, pre-operative NT-proBNP levels were
elevated in all patients irrespective of the type of surgical procedure,
but elevated pre-operative BNP was only seen in valve surgery patients.
These findings suggest the potential usefulness of NT-proBNP as a
promising biomarker for predicting the occurrence of post-operative AF
following cardiac surgery. Copyright © 2023 The Author(s)

<55>
Accession Number
2026333633
Title
Effects of perioperative vitamin E and zinc co-supplementation on systemic
inflammation and length of stay following coronary artery bypass graft
surgery: a randomized controlled trial.
Source
European Journal of Clinical Nutrition. 78(2) (pp 120-127), 2024. Date of
Publication: February 2024.
Author
Makiabadi E.; Nakhaeizadeh R.; Soleimani M.; Nasrollahzadeh J.
Institution
(Makiabadi, Nasrollahzadeh) Department of Clinical Nutrition & Dietetics,
Faculty of Nutrition Sciences and Food Technology, National Nutrition and
Food Technology Research Institute, Shahid Beheshti University of Medical
Sciences, No. 7, Hafezi St., Farahzadi Blvd., Qods Town, Tehran, Iran,
Islamic Republic of
(Nakhaeizadeh) Department of Surgery, School of Medicine, Shafa Hospital,
Kerman University of Medical Sciences, Kerman, Iran, Islamic Republic of
(Soleimani) Department of Cardiac Intensive Care Unit, School of Medicine,
Shafa Hospital, Kerman University of Medical Sciences, Kerman, Iran,
Islamic Republic of
Publisher
Springer Nature
Abstract
Objectives: Coronary artery bypass graft (CABG) surgery has been reported
to be associated with lower postoperative plasma antioxidant and zinc
levels. We hypothesized that perioperative supplementation of vitamin E
and zinc might improve short-term postoperative outcomes. Method(s):
In this placebo-controlled double-blind, randomized study, patients
undergoing CABG performed with cardiopulmonary bypass were recruited. The
intervention group received zinc and vitamin E supplementation (1200 IU
vitamin E and 120 mg elemental zinc) the day before surgery, followed by
postoperative daily supplementation of 30 mg zinc and 200 IU vitamin E
from the 2nd day after surgery to 3 weeks. The control group received
placebos. Length of stay (LOS) in the intensive care unit and hospital,
sequential organ failure assessment score on 3rd day after surgery, and
plasma inflammatory markers on days 3 and 21 post-surgery were evaluated.
 Result(s): Seventy-eight patients completed the study (40 in the
intervention group and 38 in the placebo group). The hospital LOS was
significantly shorter (p < 0.05) in the intervention group. Postoperative
changes in plasma albumin levels were not different between the two
groups. The plasma zinc level was higher (p < 0.0001), but plasma
C-reactive protein (p = 0.01), pentraxin 3 (p < 0.0001), interferon gamma
(p < 0.05), malondialdehyde (p < 0.05), and aspartate aminotransferase (p
< 0.01) were lower in the intervention group compared to the placebo
group. Conclusion(s): Perioperative vitamin E and zinc
supplementation significantly reduced hospital LOS and the inflammatory
response in CABG surgery patients. In these patients, the optimal
combination and dose of micronutrients need further study but could
include zinc and vitamin E. Clinical trial registry: This trial was
registered at ClinicalTrials.gov website (NCT05402826). Copyright
© The Author(s), under exclusive licence to Springer Nature Limited
2023.

<56>
Accession Number
2026207153
Title
Intravenous Diltiazem Versus Metoprolol in Acute Rate Control of Atrial
Fibrillation/Flutter and Rapid Ventricular Response: A Meta-Analysis of
Randomized and Observational Studies.
Source
American Journal of Cardiovascular Drugs. 24(1) (pp 103-115), 2024. Date
of Publication: January 2024.
Author
Bolton A.; Paudel B.; Adhaduk M.; Alsuhaibani M.; Samuelson R.; Schweizer
M.L.; Hodgson-Zingman D.
Institution
(Bolton) Department of Epidemiology, College of Public Health, University
of Iowa, Iowa City, IA 52242, United States
(Paudel, Adhaduk) Department of General Internal Medicine, University of
Iowa Hospitals and Clinics, Iowa City, IA, United States
(Alsuhaibani) Department of Pediatrics, King Faisal Specialist Hospital
and Research Centre, Riyadh, Saudi Arabia
(Alsuhaibani) College of Medicine, Alfaisal University, Riyadh, Saudi
Arabia
(Samuelson) Hardin Library for the Health Sciences, University of Iowa,
Iowa City, IA, United States
(Schweizer) Division of Infectious Disease, University of Wisconsin School
of Medicine and Public Health, Madison, WI, United States
(Hodgson-Zingman) Department of Cardiology, University of Iowa Hospitals
and Clinics, Iowa City, IA, United States
Publisher
Adis
Abstract
Background: Atrial fibrillation (AF) and/or atrial flutter (AFL) with
rapid ventricular response (RVR) is a condition that often requires urgent
treatment. Although guidelines have recommendations regarding chronic rate
control therapy, recommendations on the best choice for acute heart rate
(HR) control in RVR are unclear. Method(s): A systematic search
across multiple databases was performed for studies evaluating the outcome
of HR control (defined as HR less than 110 bpm and/or 20% decrease from
baseline HR). Included studies evaluated AF and/or AFL with RVR in a
hospital setting, with direct comparison between intravenous (IV)
diltiazem and metoprolol and excluded cardiac surgery and catheter
ablation patients. Hypotension (defined as systolic blood pressure less
than 90 mmHg) was measured as a secondary outcome. Two authors performed
full-text article review and extracted data, with a third author mediating
disagreements. Random effects models utilizing inverse variance weighting
were used to calculate odds ratios (OR) and 95% confidence intervals (CI).
Heterogeneity was assessed using the I 2 test. Result(s):
A total of 563 unique titles were identified through the systematic
search, of which 16 studies (7 randomized and 9 observational) were
included. In our primary analysis of HR control by study type, IV
diltiazem was found to be more effective than IV metoprolol for HR control
in randomized trials (OR 4.75, 95% CI 2.50-9.04 with I 2 =
14%); however, this was not found for observational studies (OR 1.26, 95%
CI 0.89-1.80 with I 2 = 55%). In an analysis of observational
studies, there were no significant differences between the two drugs in
odds of hypotension (OR 1.12, 95% CI 0.51-2.45 with I 2 = 18%).
 Conclusion(s): While there was a trend toward improved HR control
with IV diltiazem compared with IV metoprolol in randomized trials, this
was not seen in observational studies, and there was no observed
difference in hypotension between the two drugs. Copyright ©
2023, The Author(s), under exclusive licence to Springer Nature
Switzerland AG.

<57>
Accession Number
2028851784
Title
Development and Validation of Scores to Predict Prolonged Mechanical
Ventilation after Cardiac Surgery.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 38(2) (pp 430-436),
2024. Date of Publication: February 2024.
Author
O'Brien Z.; Bellomo R.; Williams-Spence J.; Reid C.M.; Coulson T.
Institution
(O'Brien, Bellomo, Coulson) Australian and New Zealand Intensive Care
Research Centre, School of Public Health and Preventive Medicine, Monash
University, Melbourne, VIC, Australia
(O'Brien, Bellomo, Coulson) Department of Critical Care, University of
Melbourne, Melbourne, VIC, Australia
(O'Brien, Bellomo) Department of Intensive Care, Austin Hospital,
Heidelberg, Melbourne, VIC, Australia
(Bellomo) Data Analytics, Research, and Evaluation Centre, Austin
Hospital, University of Melbourne, Melbourne, VIC, Australia
(Williams-Spence, Reid) Department of Epidemiology and Preventive
Medicine, Monash University, Melbourne, VIC, Australia
(Reid) School of Public Health, Curtin University, Perth, Australia
(Coulson) Department of Anaesthesia, The Alfred Hospital, Melbourne, VIC,
Australia
Publisher
W.B. Saunders
Abstract
Objectives: To optimize the early prediction of prolonged postoperative
mechanical ventilation after cardiac surgery (>24 hours postoperatively).
 Design(s): The authors performed a retrospective analysis.
 Setting(s): The Australian and New Zealand Society of Cardiac and
Thoracic Surgeons (ANZSCTS) database was utilized. Participant(s):
All patients included in the ANZSCTS database between January 2015 and
December 2018 were analyzed. Intervention(s): No interventions were
performed in this observational study. Measurements and Main Results:
A previously developed model was modified to allow retrospective risk
calculation and model assessment (Modified Hessels score). The database
was split into development and validation sets. A new risk model was
developed using forward and backward stepwise elimination (ANZ-PreVent
score). The authors assessed 48,382 patients, of whom 5004 (10.3%) were
ventilated mechanically for >24 hours post-operatively. The Modified
Hessels score demonstrated good performance in this database, with a
c-index of 0.78 (95% CI 0.77-0.78) and a Brier score of 0.08. The newly
developed ANZ-PreVent score demonstrated better performance (validation
cohort, n = 12,229), with a c-index of 0.84 (95% CI 0.83-0.85) (p <
0.0001) and a Brier score of 0.07. Both scores performed better than the
severity of illness scores commonly used to predict outcomes in intensive
care. Conclusion(s): The authors validated a modified version of an
existing prediction score and developed the ANZ-PreVent score, with
improved performance for identifying patients at risk of ventilation for
>24 hours. The improved score can be used to identify high-risk patients
for targeted interventions in future randomized controlled
trials. Copyright © 2023 The Authors

<58>
Accession Number
2027022728
Title
Updates in the management of atrial fibrillation: Emerging therapies and
treatment.
Source
Disease-a-Month. 70(2) (no pagination), 2024. Article Number: 101633. Date
of Publication: February 2024.
Author
Bista I.; Al-Ezzi M.M.; Prajjwal P.; Al-Ezzi S.M.S.; Pattani H.H.; Amiri
B.; Marsool M.D.M.
Institution
(Al-Ezzi) Internal Medicine, Lugansk State Medical University, Lugansk,
Ukraine
(Bista) Mechi Eye Hospital, Birtamode, Nepal
(Al-Ezzi) Internal Medicine, October 6 University, Giza, Egypt
(Prajjwal) Internal Medicine, Bharati Vidyapeeth University Medical
College, Pune, India
(Al-Ezzi) Internal Medicine, Hashemite University of Jordan, Zarqa, Jordan
(Pattani) Internal Medicine, Narendra Modi Medical College, Gujarat
University, India
(Amiri) Tabriz University of Medical Sciences, Cardiovascular Research
Center, Tabriz, Iran, Islamic Republic of
(Marsool) Al-kindy College of Medicine/University of Baghdad, Iraq
Publisher
Elsevier Inc.
Abstract
Objective: The most common and clinically important cardiac arrhythmia is
atrial fibrillation (AF), which has a large negative impact on public
health due to higher fatalities, morbidity, and healthcare expenditure
rates. This study aims to provide valuable insights into the effectiveness
and outcomes of various treatment approaches and interventions for AF.
Study design: Systematic review. Method(s): The most pertinent
published research (original papers and reviews) in the scientific
literature were searched for and critically assessed using the online,
internationally indexed databases PubMed, Medline, and Cochrane Reviews.
These studies are summarised in this review. Keywords like "Atrial
Fibrillation", "emerging therapies", "treatment", "catheter ablation", and
"atrial appendage" were used to search the papers. The papers were
researched and examined to be relevant to the topic. Conclusion(s): A
lot of work has gone into enhancing AF management to deal with this
expanding public health concern. Significant developments and advances in
the treatment of AF during the past few years have aided clinicians in
giving AF patients better care. The most recent treatments for AF include
medication, catheter ablation, cryo-balloon ablation, and left atrial
appendage closure. Copyright © 2023 Elsevier Inc.

<59>
Accession Number
2013947873
Title
Hemodynamic impact of increasing time between fentanyl and propofol
administration during anesthesia induction: a randomised, clinical trial.
Source
Brazilian Journal of Anesthesiology (English Edition). 74(1) (no
pagination), 2024. Article Number: 744230. Date of Publication: 01 Jan
2024.
Author
Vullo P.A.; Real Navacerrada M.I.I.; Navarro Suay R.
Institution
(Vullo, Navarro Suay) Hospital Central de la Defensa G..mez Ulla-IMIDEF,
Critical Care and Pain Unit, Department of Anesthesia, Madrid, Spain
(Real Navacerrada) Hospital Universitario 12 de Octubre, Critical Care and
Pain Unit, Department of Anesthesia, Madrid, Spain
Publisher
Elsevier Editora Ltda
Abstract
Background and objective: Anesthesia induction can produce severe propofol
dose-dependent hypotension. Fentanyl coadministration reduces the
catecholaminergic response to orotracheal intubation allowing propofol
dose reduction. The aim of this study is to determine whether the
hemodynamic response is improved by increasing the time between fentanyl
and propofol administration and reducing the dose of the latter without
increasing the time to achieve optimal hypnosis. Method(s): After
approval by the Research Ethics Committee, patients undergoing non-cardiac
surgery with endotracheal intubation were randomized by a
computer-generated table into six time-dose groups (1 or 2...minutes/1,
1.5, or 2...mg.kg-1 of propofol). Patients with high
bronchoaspiration risk, a difficult airway, hemodynamic instability, or
anesthetic allergies were excluded. After giving intravenous fentanyl
(2.....g.kg-1), each group received different doses of propofol
after 1 or 2...minutes. Noninvasive blood pressure (BP) and heart rate
(HR) were measured at pre-induction, pre-intubation, and post-intubation.
Time to hypnosis (bispectral index < 60) was also recorded.
 Result(s): Of the 192 recruited patients, 186 completed the study
(1...min group n...=...94; 2...min group n...=...92). It was observed that
HR and BP decreased after propofol administration and increased after
intubation in all groups (p...<...0.0001). In patients over 55 years, the
2 min .. 2 mg.kg-1 group showed the greatest systolic BP
reduction (36........12%) at pre-intubation, while the
1...min.........1.5...mg.kg-1 group showed the least
hemodynamic alteration between pre- and post-intubation (-4........13%).
No significant differences were found in younger patients or in the time
to reach hypnosis between the six groups. While no cases of severe
bradycardia were recorded, 5,4% of the sample required vasopressors.
 Conclusion(s): Increasing the time between the administration of
fentanyl and propofol by up to two minutes results in greater hypotension
in patients over 55 years. Copyright © 2021 Sociedade Brasileira
de Anestesiologia

<60>
[Use Link to view the full text]
Accession Number
2022080804
Title
Survival after Invasive or Conservative Management of Stable Coronary
Disease.
Source
Circulation. 147(1) (pp 8-19), 2023. Date of Publication: 03 Jan 2023.
Author
Hochman J.S.; O'Brien S.M.; Rosenberg Y.; Kirby R.; Lopez-Sendon J.;
Maggioni A.P.; Newman J.D.; Berger J.S.; Sidhu M.S.; White H.D.;
Harrington R.A.; Boden W.E.; Stone G.W.; Mark D.B.; Spertus J.A.; Maron
D.J.; Reynolds H.R.; Bangalore S.; Mavromichalis S.; Chang M.; Contreras
A.; Esquenazi-Karonika S.; Gilsenan M.; Gwiszcz E.; Mathews P.; Mohamed
S.; Naumova A.; Roberts A.; Vanloo K.; Anthopolos R.; Xu Y.; Troxel A.B.;
Lu Y.; Huang Z.; Broderick S.; Selvanayagam J.; Lopes R.D.; Goodman S.G.;
Steg G.; Juliard J.-M.; Doerr R.; Keltai M.; Bhargava B.; Thomas B.;
Sharir T.; Nikolsky E.; Kohsaka S.; Escobedo J.; Pracon R.; Bockeria O.;
Senior R.; Banfield A.; Shaw L.J.; Phillips L.; Berman D.; Kwong R.Y.;
Picard M.H.; Chaitman B.R.; Ali Z.; Min J.; Mancini G.B.J.; Leipsic J.;
Guzman L.; Hillis G.; Thambar S.; Joseph M.; Selvnayagam J.; Beltrame J.;
Lang I.; Schuchlenz H.; Huber K.; Goetschalckx K.; Hueb W.; Caramori P.R.;
De Quadros A.; Smanio P.; Mesquita C.; Lopas R.D.; Vitola J.; Marin-Neto
J.; Da Silva E.R.; Tumelero R.; Andrade M.; Alves A.R.; Dall'Orto F.;
Polanczyk C.; Figueiredo E.; Howarth A.; Gosselin G.; Cheema A.; Bainey
K.; Phaneuf D.; Diaz A.; Garg P.; Mehta S.; Wong G.; Lam A.; Cha J.;
Galiwango P.; Uxa A.; Chow B.; Hameed A.; Udell J.; Chema A.; Hamid M.;
Hauguel-Moreau M.; Furber A.; Goube P.; Steg P.-G.; Barone-Rochette G.;
Thuaire C.; Slama M.; Doer R.; Nickenig G.; Bekeredjian R.; Schulze P.C.;
Merkely B.; Fontos G.; Vertes A.; Varga A.; Bhargva B.; Kumar A.; Nair
R.G.; Grant P.; Manjunath C.; Moorthy N.; Satheesh S.; Nath R.K.; Wander
G.; Christopher J.; Dwivedi S.; Oomman A.; Mathur A.; Gadkari M.; Naik S.;
Punnoose E.; Kachru R.; Christophar J.; Kaul U.; Sharer T.; Kerner A.;
Tarantini G.; Perna G.P.; Racca E.; Mortara A.; Monti L.; Briguori C.;
Leone G.; Amati R.; Salvatori M.; Di Chiara A.; Calabro P.; Galvani M.;
Provasoli S.; Fukuda K.; Koshaka S.; Nakano S.; Laucevicius A.; Kedev S.;
Khairuddin A.; Escobdo J.; Riezebos R.; Timmer J.; Heald S.; Stewart R.;
Ramos W.M.; Demkow M.; Mazurek T.; Drozdz J.; Szwed H.; Witkowski A.;
Ferreira N.; Pinto F.; Ramos R.; Popescu B.; Pop C.; Bockeria L.; Bockerya
O.; Demchenko E.; Romanov A.; Bershtein L.; Jizeeri A.; Stankovic G.;
Apostolovic S.; Adjic N.C.; Zdravkovic M.; Beleslin B.; Dekleva M.;
Davidovic G.; Chua T.; Foo D.; Poh K.K.; Ntsekhe M.; Sionis A.; Marin F.;
Miro V.; Blancas M.G.; Gonzalez-Juanatey J.; Fernandez-Aviles F.; Peteiro
J.; Luena J.E.C.; Held C.; Aspberg J.; Rossi M.; Kuanprasert S.; Yamwong
S.; Johnston N.; Donnelly P.; Moriarty A.; Roxy R.; Elghamaz A.;
Gurunathan S.; Karogiannis N.; Shah B.N.; Trimlett R.H.J.; Rubens M.B.;
Nicol E.D.; Mittal T.K.; Hampson R.; Gamma R.; De Belder M.; Nageh T.;
Lindsay S.; Mavromatis K.; Miller T.; Banerjee S.; Reynolds H.; Nour K.;
Stone P.
Institution
(Hochman, Anthopolos, Reynolds, Bangalore, Xu, Mavromichalis, Chang,
Contreras, Newman, Berger, Troxel) NYU Grossman School of Medicine, New
York, NY, United States
(O'Brien, Lopes, Mark) Duke Clinical Research Institute, Durham, NC,
United States
(Rosenberg, Kirby) National Institutes of Health, Bethesda, MD, United
States
(Bhargava) All India Institute of Medical Sciences, New Delhi, India
(Senior, Banfield) Northwick Park Hospital, London, United Kingdom
(Senior) Imperial College London, Royal Brompton Hospital, United Kingdom
(Goodman) St Michael's Hospital, University of Toronto, Canada
(Pracon) Department of Coronary and Structural Heart Diseases, National
Institute of Cardiology, Warsaw, Poland
(Lopez-Sendon) IdiPaz Research Institute and Hospital, Universitario la
Paz, Madrid, Spain
(Maggioni) Associazione Nazionale Medici Cardiologi Ospedalieri (ANMCO)
Research Center, Florence, Italy
(Sidhu) Albany Medical College, NY, United States
(White) Te Whatu Ora Health New Zealand, Te Toki Tumai, Green Lane
Cardiovascular Services, University of Auckland, New Zealand
(Harrington, Maron) Stanford University, Department of Medicine, CA,
United States
(Boden) Veterans Affairs New England Healthcare System, Boston University
School of Medicine, MA, United States
(Stone) Zena and Michael A. Wiener Cardiovascular Institute, Icahn School
of Medicine at Mount Sinai, New York, NY, United States
(Spertus) Saint Luke's Mid America Heart Institute, University of
Missouri, Kansas City, United States
Publisher
Lippincott Williams and Wilkins
Abstract
Background: The ISCHEMIA trial (International Study of Comparative Health
Effectiveness With Medical and Invasive Approaches) compared an initial
invasive versus an initial conservative management strategy for patients
with chronic coronary disease and moderate or severe ischemia, with no
major difference in most outcomes during a median of 3.2 years. Extended
follow-up for mortality is ongoing. Method(s): ISCHEMIA participants
were randomized to an initial invasive strategy added to
guideline-directed medical therapy or a conservative strategy. Patients
with moderate or severe ischemia, ejection fraction >=35%, and no recent
acute coronary syndromes were included. Those with an unacceptable level
of angina were excluded. Extended follow-up for vital status is being
conducted by sites or through central death index search. Data obtained
through December 2021 are included in this interim report. We analyzed
all-cause, cardiovascular, and noncardiovascular mortality by randomized
strategy, using nonparametric cumulative incidence estimators, Cox
regression models, and Bayesian methods. Undetermined deaths were
classified as cardiovascular as prespecified in the trial protocol.
 Result(s): Baseline characteristics for 5179 original ISCHEMIA trial
participants included median age 65 years, 23% women, 16% Hispanic, 4%
Black, 42% with diabetes, and median ejection fraction 0.60. A total of
557 deaths accrued during a median follow-up of 5.7 years, with 268 of
these added in the extended follow-up phase. This included a total of 343
cardiovascular deaths, 192 noncardiovascular deaths, and 22 unclassified
deaths. All-cause mortality was not different between randomized treatment
groups (7-year rate, 12.7% in invasive strategy, 13.4% in conservative
strategy; adjusted hazard ratio, 1.00 [95% CI, 0.85-1.18]). There was a
lower 7-year rate cardiovascular mortality (6.4% versus 8.6%; adjusted
hazard ratio, 0.78 [95% CI, 0.63-0.96]) with an initial invasive strategy
but a higher 7-year rate of noncardiovascular mortality (5.6% versus 4.4%;
adjusted hazard ratio, 1.44 [95% CI, 1.08-1.91]) compared with the
conservative strategy. No heterogeneity of treatment effect was evident in
prespecified subgroups, including multivessel coronary disease.
 Conclusion(s): There was no difference in all-cause mortality with an
initial invasive strategy compared with an initial conservative strategy,
but there was lower risk of cardiovascular mortality and higher risk of
noncardiovascular mortality with an initial invasive strategy during a
median follow-up of 5.7 years. Registration: URL:
https://www.clinicaltrials.gov; Unique identifier:
NCT04894877. Copyright © 2023 Lippincott Williams and Wilkins.
All rights reserved.

<61>
Accession Number
628528012
Title
A randomized, controlled pilot clinical trial of cryopreserved platelets
for perioperative surgical bleeding: the CLIP-I trial (Editorial, p.
2759).
Source
Transfusion. 59(9) (pp 2794-2804), 2019. Date of Publication: 01 Sep 2019.
Author
Reade M.C.; Marks D.C.; Bellomo R.; Deans R.; Faulke D.J.; Fraser J.F.;
Gattas D.J.; Holley A.D.; Irving D.O.; Johnson L.; Pearse B.L.; Royse
A.G.; Wong J.; Weinberg L.; Eastwood G.; Peck L.; Young H.; Sidiropoulos
S.; Baulch S.; Dalyell A.; Kolar D.; Martinelli T.; Reidy Y.; Caldwell N.;
Royse A.; Tivendale L.; Bisignano M.; Hausler M.; Williams Z.; Dong N.;
Buhr H.; Bannon P.; Cartwright B.; Turner L.; Gibson J.; Blayney B.;
Beattie L.; Hutch D.; Wun Jennifer Coles J.; Pearse B.; Faulke D.;
Zeigenfuss M.; Tesar P.; Perel J.; Kahn C.; Vincent B.; O'Brien D.; Holley
A.; Irving D.
Institution
(Reade) Joint Health Command, Australian Defence Force, Canberra, ACT,
Australia
(Reade, Deans, Holley) University of Queensland, Brisbane, QLD, Australia
(Marks, Irving, Johnson, Wong) Australian Red Cross Blood Service, Sydney,
NSW, Australia
(Bellomo) Austin Hospital, Melbourne, VIC, Australia
(Faulke, Fraser, Pearse) The Prince Charles Hospital, Brisbane, QLD,
Australia
(Gattas) Royal Prince Alfred Hospital, Sydney, NSW, Australia
(Royse) Royal Melbourne Hospital, Melbourne, VIC, Australia
Publisher
John Wiley and Sons Inc
Abstract
BACKGROUND: Cryopreservation extends platelet (PLT) shelf life from 5 to 7
days to 2 to 4 years. However, only 73 patients have been transfused
cryopreserved PLTs in published randomized controlled trials (RCTs),
making safety data insufficient for regulatory approval. STUDY DESIGN AND
METHODS: The Cryopreserved vs. Liquid Platelet (CLIP) study was a
double-blind, pilot, multicenter RCT involving high-risk cardiothoracic
surgical patients in four Australian hospitals. The objective was to test,
as the primary outcome, the feasibility and safety of the protocol.
Patients were allocated to study group by permuted block randomization,
with patients and clinicians blinded by use of an opaque shroud placed
over each study PLT unit. Up to 3 units of cryopreserved or liquid-stored
PLTs were administered per patient. No other aspect of patient care was
affected. Adverse events were actively sought. RESULT(S): A total of
121 patients were randomized, of whom 23 received cryopreserved PLTs and
18 received liquid-stored PLTs. There were no differences in blood loss
(median, 715 mL vs. 805 mL at 24 hr; difference between groups 90 mL [95%
CI, -343.8 to 163.8 mL], p = 0.41), but the Bleeding Academic Research
Consortium criterion for significant postoperative hemorrhage in cardiac
surgery composite bleeding endpoint occurred in nearly twice as many
patients in the liquid-stored group (55.6% vs. 30.4%, p = 0.10). Red blood
cell transfusion requirements were a median of 3 units in the
cryopreserved group versus 4 units with liquid-stored PLTs (difference
between groups, 1 unit [95% CI, -3.1 to 1.1 units]; p = 0.23). Patients in
the cryopreserved group were more likely to be transfused fresh-frozen
plasma (78.3% vs. 27.8%, p = 0.002) and received more study PLT units
(median, 2 units vs. 1 unit; difference between groups, 1 unit [95% CI,
-0.03 to 2.0 units]; p = 0.012). There were no between-group differences
in potential harms including deep venous thrombosis, myocardial
infarction, respiratory function, infection, and renal function. No
patient had died at 28 days, and postoperative length of stay was similar
in each group. CONCLUSION(S): In this pilot RCT, compared to
liquid-stored PLTs, cryopreserved PLTs were associated with no evidence of
harm. A definitive study testing safety and hemostatic effectiveness is
warranted. Copyright © 2019 AABB

<62>
Accession Number
602082333
Title
The REDUCED(A RandomisED stUdy Comparing standard systemic anticoagulation
thErapy to low Dose intracoronary anticoagulation therapy for elective
percutaneous coronary intervention) trial. A novel pharmacologic regime
for elective percutaneous coronary intervention.
Source
Acta Cardiologica. 69(6) (pp 619-627), 2014. Date of Publication: 2014.
Author
Ari H.; Kivac E.; Ari S.; Emlek N.; Cetinkaya S.; Celiloglu N.; Yasar
Sarigul O.; Aydin C.; Akkaya M.; Koca V.; Bozat T.; Gurdogan M.
Institution
(Ari, Kivac, Ari, Emlek, Cetinkaya, Celiloglu, Yasar Sarigul, Aydin,
Akkaya, Koca, Bozat) Dept. of Cardiology, Bursa Postgraduate Hospital,
Bursa, Turkey
(Gurdogan) Dept. of Cardiology, Pasabahce State Hospital, Istanbul, Turkey
Publisher
Acta Cardiologica
Abstract
Aim: This study tried to determine the efficacy and safety of low-dose
intracoronary unfractionated heparin (UFH) in elective percutaneous
coronary intervention (PCI). Method(s): Two-hundred patients who
underwent elective PCI of an uncomplicated lesion were included into the
study. The patients were assigned to either a control group (70-100 IU/kg
intravenous UFH) or a low-dose intracoronary UFH (1,000 IU intracoronary
UFH) group. Result(s): At 30 days, the primary end point (composite
of death, myocardial infarction, or urgent target vessel
revascularization) was similar in both groups [intracoronary UFH group,
1.0%; control group, 2.0%; odds ratio; 0.49 (95% CI: 0.04 - 5.54), P =
0.56]. Post-procedural myocardial injury (according to CK-MB, P = 0.91;
according to Tn I, P = 0.81) and bleeding events (based on TIMI criteria,
P = 0.33; based on STEEPLE criteria, P = 0.20) were similar in the control
and intracoronary groups. The primary end point at 6 months was also
similar between the two groups (P = 0.33). Moreover, the health care cost
at 30 days of follow-up was lower in the intracoronary group than in the
control group (1,016 +/- 54 $/patient vs 1,110 +/- 102 $/patient, P <
0.001). Conclusion(s): This pilot study suggests that elective PCI
could be safely performed with low-dose intracoronary UFH in the treatment
of uncomplicated lesions and at a lower cost as compared to standard
systemic anticoagulation. These results should be confirmed by further
studies. Copyright © 2014, Acta Cardiologica. All rights
reserved.

<63>
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. 399 (no pagination), 2024. Article
Number: 131698. Date of Publication: 15 Mar 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. Aim(s): To investigate the impact of
O3-FA on adverse cardiac events in long-term follow up post AMI in a
pilot-study. 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). 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). 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. Copyright © 2023 Elsevier B.V.

<64>
Accession Number
2028935596
Title
Meta-analysis of direct endovascular thrombectomy vs bridging therapy in
the management of acute ischemic stroke with large vessel occlusion.
Source
Clinical Neurology and Neurosurgery. 236 (no pagination), 2024. Article
Number: 108070. Date of Publication: January 2024.
Author
Shafique M.A.; Ali S.M.S.; Mustafa M.S.; Aamir A.; Khuhro M.S.; Arbani N.;
Raza R.A.; Abbasi M.B.; Lucke-Wold B.
Institution
(Shafique, Mustafa) Department of Medicine, Jinnah Sindh Medical
University, Pakistan
(Ali, Khuhro, Arbani, Raza, Abbasi) Department of Medicine, Liaquat
National Hospital and Medical College, Pakistan
(Aamir) Department of Medicine, Dow University of Health Sciences,
Pakistan
(Lucke-Wold) Department of Neurosurgery, University of Florida, United
States
Publisher
Elsevier B.V.
Abstract
Background: Debates persist when using intravenous thrombolysis (IVT)
before mechanical thrombectomy (MT) for acute ischemic stroke (AIS) due to
large-vessel occlusion (LVO). This systematic review and meta-analysis
synthesized evidence on outcomes in patients with acute ischemic stroke
due to large vessel occlusion (AIS-LVO), comparing bridging therapy (BT)
with MT alone. Method(s): We conducted searches of PubMed, Scopus,
Web of Science, and the Cochrane Central Register of Controlled Trials
from inception to July 2023 to identify pertinent clinical trials and
observational studies. Result(s): 76 studies, involving 37,658
patients, revealed no significant difference in 90-day functional
independence between DEVT and BT. However, a trend favoring BT for
achieving functional independence with a modified Rankin Scale (mRS) of
0-1 was observed, having Odds ratio (OR) of 0.75 (95% CI 0.66-0.86; p <
0.001). DEVT was associated with higher postprocedural mortality (OR
1.44;95% CI 1.25-1.65; p < 0.001), but a lower risk of symptomatic
intracranial hemorrhage compared to BT (OR 0.855; 95% CI 0.621-1.177; p =
0.327). Successful recanalization rates favored BT, emphasizing the
importance of individualized treatment decisions (OR 0.759; 95% CI
0.594-0.969; p = 0.027). Sensitivity analyses were conducted to identify
key contributors to heterogeneity. Conclusion(s): Our meta-analysis
underscores the intricate equilibrium between functional efficacy and
safety in the evaluation of DEVT and BT for ACS-LVO. Fundamentally, while
BT appears more efficacious, concerns about safety arise due to the
superior safety profile demonstrated by DEVT. Individualized treatment
decisions are imperative, and further trials are warranted to enhance
precision in clinical guidance. Copyright © 2023 Elsevier B.V.

<65>
Accession Number
2028201416
Title
Valve-Sparing Aortic Root Replacement With Reimplantation vs Remodeling: A
Meta-analysis.
Source
Annals of Thoracic Surgery. 117(3) (pp 501-507), 2024. Date of
Publication: March 2024.
Author
Sa M.P.; Jacquemyn X.; Awad A.K.; Brown J.A.; Chu D.; Serna-Gallegos D.;
Kari F.A.; Sultan I.
Institution
(Sa, Brown, Chu, Serna-Gallegos, Sultan) Department of Cardiothoracic
Surgery, University of Pittsburgh, Pittsburgh, PA, United States
(Sa, Brown, Chu, Serna-Gallegos, Sultan) UPMC Heart and Vascular
Institute, University of Pittsburgh Medical Center, Pittsburgh, PA, United
States
(Jacquemyn) Department of Cardiovascular Sciences, KU Leuven, Leuven,
Belgium
(Awad) Faculty of Medicine, Ain Shams University, Cairo, Egypt
(Kari) Section of Pediatric and Congenital Cardiac Surgery, European
Pediatric Heart Center, Ludwig Maximilian University (LMU) University
Hospital and German Heart Center, Munich, Germany
Publisher
Elsevier Inc.
Abstract
Background: Long-term outcomes of valve-sparing aortic root replacement
(VSARR) with reimplantation vs remodeling in patients undergoing aortic
root surgery remains a controversial subject. Method(s): This study
was a pooled meta-analysis of Kaplan-Meier-derived data from comparative
studies published by December 31, 2022. Result(s): Fifteen studies
met our eligibility criteria, comprising 3044 patients (1991 in the
reimplantation group and 2018 in the remodeling group). Patients who
underwent VSARR with remodeling had a higher risk of all-cause death
(hazard ratio [HR], 1.54; 95% CI, 1.16-2.03; P = .002, log-rank test P <
.001). Landmark analysis (with 4 years as the landmark time point)
demonstrated that survival was lower in patients who underwent VSARR with
remodeling (HR, 2.15; 95% CI, 1.43-3.24; P < .001) in the first 4 years.
Beyond the 4-year time point, no difference in survival was observed (HR,
1.04; 95% CI, 0.72-1.50; P = .822). The risk for need of aortic valve
and/or root reintervention was higher in patients undergoing VSARR with
remodeling (HR, 1.49; 95% CI, 1.07-2.07; P = .019, log-rank test P <
.001). We did not find statistically significant coefficients for the
covariates of age, female sex, connective tissue disorders, bicuspid
aortic valve, aortic dissection, coronary bypass surgery, total arch
replacement, or annular stabilization, which means that these covariates
did not modulate the effects observed in our pooled analyses.
 Conclusion(s): VSARR with reimplantation is associated with better
overall survival and lower risk of need for reintervention over time
compared with VSARR with remodeling. Regarding overall survival, we
observed a time-varying effect that favored the reimplantation technique
up to 4 years of follow-up, but not beyond this time point. Copyright
© 2024 The Society of Thoracic Surgeons

<66>
Accession Number
2027587197
Title
A Perioperative Mental Health Intervention for Depressed and Anxious Older
Surgical Patients: Results From a Feasibility Study.
Source
American Journal of Geriatric Psychiatry. 32(2) (pp 205-219), 2024. Date
of Publication: February 2024.
Author
Abraham J.; Holzer K.J.; Lenard E.M.; Meng A.; Pennington B.R.T.; Wolfe
R.C.; Haroutounian S.; Calfee R.; Hammil C.W.; Kozower B.D.; Cordner T.A.;
Schweiger J.; McKinnon S.; Yingling M.; Baumann A.A.; Politi M.C.;
Kannampallil T.; Miller J.P.; Avidan M.S.; Lenze E.J.
Institution
(Abraham, Holzer, Meng, Pennington, Haroutounian, Cordner, McKinnon,
Kannampallil, Avidan) Department of Anesthesiology (JA, KJH, AM, BRTP, SH,
TAC, SM, TK, MSA), Washington University School of Medicine, St. Louis, MO
(Abraham, Kannampallil, Miller) Institute for Informatics (JA, TK, JPM),
Data Science and Biostatistics, Washington University School of Medicine,
St. Louis, MO
(Lenard, Schweiger, Yingling, Lenze) Department of Psychiatry (EML, JS,
MY, EJ), Washington University School of Medicine, St. Louis, MO
(Wolfe) Department of Pharmacy (RCW), Barnes-Jewish Hospital, St. Louis,
MO
(Calfee) Department of Orthopaedic Surgery (RC), Washington University
School of Medicine, St. Louis, MO
(Hammil, Kozower, Baumann, Politi) Department of Surgery (CWH, BDK, AAB,
MCP), Washington University School of Medicine, St. Louis, MO
Publisher
Elsevier B.V.
Abstract
Objectives: The perioperative period is challenging and stressful for
older adults. Those with depression and/or anxiety have an increased risk
of adverse surgical outcomes. We assessed the feasibility of a
perioperative mental health intervention composed of medication
optimization and a wellness program following principles of behavioral
activation and care coordination for older surgical patients.
 Method(s): We included orthopedic, oncologic, and cardiac surgical
patients aged 60 and older. Feasibility outcomes included study reach, the
number of patients who agreed to participate out of the total eligible;
and intervention reach, the number of patients who completed the
intervention out of patients who agreed to participate. Intervention
efficacy was assessed using the Patient Health Questionnaire for Anxiety
and Depression (PHQ-ADS). Implementation potential and experiences were
collected using patient surveys and qualitative interviews. Complementary
caregiver feedback was also collected. Result(s): Twenty-three out of
28 eligible older adults participated in this study (mean age 68.0 years,
65% women), achieving study reach of 82% and intervention reach of 83%. In
qualitative interviews, patients (n = 15) and caregivers (complementary
data, n = 5) described overwhelmingly positive experiences with both the
intervention components and the interventionist, and reported improvement
in managing depression and/or anxiety. Preliminary efficacy analysis
indicated improvement in PHQ-ADS scores (F = 12.13, p <0.001).
 Conclusion(s): The study procedures were reported by participants as
feasible and the perioperative mental health intervention to reduce
anxiety and depression in older surgical patients showed strong
implementation potential. Preliminary data suggest its efficacy for
improving depression and/or anxiety symptoms. A randomized controlled
trial assessing the intervention and implementation effectiveness is
currently ongoing. Copyright © 2023 American Association for
Geriatric Psychiatry

<67>
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.
20(3) (pp e216-e223), 2024. Date of Publication: 05 Feb 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).

<68>
Accession Number
2026066325
Title
Impact of Additional Administration of von Willebrand Factor Concentrates
to Thrombocyte Transfusion in Perioperative Bleeding in Cardiac Surgery.
Source
Transfusion Medicine and Hemotherapy. 51(1) (pp 22-31), 2024. Date of
Publication: 11 Feb 2024.
Author
Ledergerber K.; Hollinger A.; Zimmermann S.; Todorov A.; Trutmann M.;
Gallachi L.; Gschwandtner L.A.; Ryser L.A.; Gebhard C.E.; Bolliger D.;
Buser A.; Tsakiris D.A.; Siegemund M.
Institution
(Ledergerber, Hollinger, Zimmermann, Trutmann, Gallachi, Gschwandtner,
Ryser, Gebhard, Siegemund) Intensive Care Unit, University Hospital Basel,
Basel, Switzerland
(Hollinger, Gebhard, Bolliger, Buser, Tsakiris, Siegemund) Medical
Faculty, University of Basel, Basel, Switzerland
(Todorov) Cardiovascular Gender Medicine, University Hospital Zurich,
Zurich, Switzerland
(Bolliger, Buser) Department of Anesthesiology, University Hospital Basel,
Basel, Switzerland
(Tsakiris) Department of Transfusion Medicine and Hematology, Basel
University Hospital, Basel, Switzerland
(Siegemund) Department of Clinical Research, University of Basel, Basel,
Switzerland
(Buser) Regional Blood Transfusion Service of the Swiss Red Cross, Basel,
Switzerland
Publisher
S. Karger AG
Abstract
Background: Von Willebrand factor (vWF) is an important part of blood
coagulation since it binds platelets to each other and to endothelial
cells. In traumatic and surgical haemorrhage, both blood cells and
plasmatic factors are consumed, leading to consumption coagulopathy and
fluid resuscitation. This often results in large amounts of crystalloids
and blood products being infused. Additional administration of vWF complex
and platelets might mitigate this problem. We hypothesize that
administration of vWF concentrate additionally to platelet concentrates
reduces blood loss and the amount of blood products (platelets, red blood
cells [RBC], fresh frozen plasma [FFP]) administered. Method(s): We
conducted a monocentric 6-year retrospective data analysis of cardiac
surgery patients. Included were all patients receiving platelet
concentrates within 48 h postoperatively. Patients who additionally
received vWF concentrates were allocated to the intervention group and all
others to the control group. Groups were compared in mixed regression
models correcting for known confounders, based on nearest neighbour
propensity score matching. Primary endpoints were loss of blood (day one
and two) and amount of needed blood products on day one and two
(platelets, RBC, FFP). Secondary endpoints were intensive care unit (ICU)
and in-hospital length of stay, ICU and in-hospital mortality, and
absolute difference of platelet counts before and after treatment.
 Result(s): Of 497 patients analysed, 168 (34%) received vWF
concentrates. 121 patients in both groups were considered for nearest
neighbour matching. Patients receiving additional vWF were more likely to
receive more blood products (RBC, FFP, platelets) in the first 24 h after
surgery and had around 200 mL more blood loss at the same time.
 Conclusion(s): In this retrospective analysis, no benefit in
additional administration of vWF to platelet concentrates on perioperative
blood loss, transfusion requirement (platelets, RBC, FFP), length of stay,
and mortality could be found. These findings should be verified in a
prospective randomized controlled clinical trial. Copyright ©
2023 The Author(s). Published by S. Karger AG, Basel.

<69>
Accession Number
641030757
Title
Multimodal Analgesic Effectiveness on Acute Postoperative Pain Management
After Adult Cardiac Surgery: Protocol for a Systematic Review.
Source
The Journal of cardiovascular nursing. 39(2) (pp E21-E28), 2024. Date of
Publication: 01 Mar 2024.
Author
Wynne R.; Fredericks S.; Hyde E.K.; Matthews S.; Bowden T.;
O'Keefe-McCarthy S.; Martorella G.; Magboo R.; Gjeilo K.H.; Jedwab R.M.;
Keeping-Burke L.; Murfin J.; Bruneau J.; Lie I.; Sanders J.
Abstract
BACKGROUND: Many patients report moderate to severe pain in the acute
postoperative period. Enhanced recovery protocols recommend multimodal
analgesics, but the optimal combination of these is unknown. PURPOSE: The
aim of this study was to synthesize the best available evidence about
effectiveness of multimodal analgesics on pain after adult cardiac
surgery. METHOD(S): A systematic review to determine the effect of
multimodal postoperative analgesics is proposed (International Prospective
Register of Systematic Reviews Registration CRD42022355834). Multiple
databases including the Cochrane Library, Cochrane Central Register of
Controlled Trials, Cumulative Index to Nursing and Allied Health
Literature, American Psychological Association, the Education Resources
Information Centre, the Excerpta Medica database, the Medical Literature
Analysis and Retrieval System Online, Scopus, Web of Science, and clinical
trials databases will be searched. Screening in Covidence and quality
assessment will be conducted by 2 authors. A grading of recommendations,
assessment, development, and evaluation summary of findings will be
presented if meta-analysis is possible. Copyright © 2023 Wolters
Kluwer Health, Inc. All rights reserved.

EPICORE Embase Updates

Saturday, February 24, 2024

EMBASE Cardiac Update AutoAlert: EPICORE Cardiac Surgery Blogger2

No comments:

Post a Comment

Followers

Blog Archive

About Me