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Accession Number
365787657
Title
Prasugrel versus clopidogrel for acute coronary syndromes without
revascularization.
Source
New England Journal of Medicine. 367(14) (pp 1297-1309), 2012. Date of
Publication: 04 Oct 2012.
Author
Roe M.T.; Armstrong P.W.; Fox K.A.A.; White H.D.; Prabhakaran D.; Goodman
S.G.; Cornel J.H.; Bhatt D.L.; Clemmensen P.; Martinez F.; Ardissino D.;
Nicolau J.C.; Boden W.E.; Gurbel P.A.; Dalby A.J.; McGuire D.K.;
Leiva-Pons J.L.; Parkhomenko A.; Gottlieb S.; Topacio G.O.; Hamm C.;
Pavlides G.; Goudev A.R.; Oto A.; Tseng C.-D.; Merkely B.; Gasparovic V.;
Corbalan R.; Cinteza M.; McLendon R.C.; Winters K.J.; Brown E.B.;
Lokhnygina Y.; Aylward P.E.; Huber K.; Hochman J.S.; Ohman E.M.; Van de
Werf F.; Budaj A.; Gersh B.J.; Montalescot G.; Pocock S.J.; Wilcox R.G.;
Williams D.O.; Wilson M.; Mehta R.H.; Alexander J.H.; Kong D.F.; Lopes R.;
Mahaffey K.W.; Melloni C.; Newby L.K.; Shah B.R.; Tricoci P.; George D.J.;
Beaven A.W.; Blackwell K.L.; Morse M.A.; Onken J.E.; Ready N.E.; Strickler
J.H.; Zafar S.Y.; Hafley G.; Pieper K.; Stevens S.; Schibler T.; Chan M.;
Chin C.T.; Gharacholou S.M.; Subherwal S.; Marshall D.; Macias W.; LeNarz
L.; Petijean H.; Plat F.; van Kranen R.; Zamoryakhin D.; Albisu J.;
Alvarez C.; Amuchastegui M.; Astesiano A.L.; Beloscar J.; Bergallo J.;
Bono J.; Bordonava A.; Botta C.E.; Budassi N.; Caccavo A.; Cartasegna L.;
Colombo H.; Costello R.; Covelli G.; De Valais F.; Dran R.; Duronto E.;
Forte E.H.; Garcia D.F.B.; Escudero A.G.; Hominal M.; Hrabar A.D.; Ibanez
B.A.J.O.; Jure H.; de la Fuente R.L.; Marquez L.L.; Luciardi H.; Luquez
H.; Marino J.; Martingano R.; Azize G.M.; Nul D.; Patocchi C.; Piombo A.;
Prado A.; Rodriguez M.; Acuna A.R.; Scaro G.B.; Liprandi A.S.; Varini
S.D.; Vigo S.J.; Aroney G.; Arstall M.; Blenkhorn A.; Chew D.; Collins N.;
Hammett C.; Lee A.; Marrinan M.; Roberts-Thomson P.; Waites J.; Benzer W.;
Lang I.; Podczeck-Schweighofer A.; Baetsle P.; Beauloye C.; De Tollenaere
M.; Lancellotti P.; Marechal P.; Van Dorpe A.; Albuquerque D.; Lotufo
P.A.; Ardnt M.; Arminio G.; da Cost F.A.A.; Baracioli L.M.; Precoma D.B.;
Neuenschwander F.C.; Seabra M.D.G.; De Souza J.; Duda N.T.; Dutra O.P.;
Feitosa A.; Filho H.; Finimundi H.C.; Gomes M.; Gubolino L.; Guimaraes
A.E.C.; Hernandes M.; Jardim C.A.P.; de Souza W.K.S.B.; Leaes P.E.; Maia
L.N.; Manenti E.; Neto J.A.M.; Marino R.; Michalaros Y.; Junior J.B.M.; de
Sousa L.N.L.; Filho P.P.; Polanczyk C.; Alves A.R.; Ramos R.; Reis G.;
Neto J.R.F.; dos Santos F.R.; Saporito W.; Saraiva J.F.; Sartori P.C.;
Issa J.S.; Junior D.S.; Sousa A.; Teixeira M.; Zimmermann S.L.; Lazov P.;
Tokmakova M.; Penchev K.; Petrov I.; Baldjiev E.; Hergeldjieva V.;
Manolova A.; Dimov B.; Mihov A.; Pencheva G.; Raev D.; Ramshev K.; Tumbev
H.; Tzekova M.; Boichev B.; Kadiiski A.; Devedzhiev T.; Bakbak A.;
Berlingieri J.; Burstein J.; Dery J.-P.; Heath J.; Huynh T.; Kassam S.;
Kostuk W.; Labonte R.; MacCallum C.; Nawaz S.; Quraishi A.-U.-R.;
Senaratne M.; Syan G.; Syan R.; Vizel S.; Castro P.; Florenzano F.; Lamich
R.; Manriquez L.; Potthoff S.; Stockins B.; Bugueno C.; Cobos J.;
Sepulveda P.; Opazo M.; Montecinos H.; Ge J.; Ke Y.; Chen Y.D.; Wang J.;
Li W.; Xu B.; Ma G.; Li Z.; Sun Y.; Tang J.; Yuan Z.; Tang L.; Zhou Y.; He
Q.; Xu J.; Zhang H.; Yang K.; Zhou S.; Chen J.; Zhao S.; Zheng Z.; Li X.;
Wang D.; Hong X.; Guan R.; Wang L.; Huang H.; Xia Y.; Hao Y.; Zhang S.;
Zhao X.; Liu X.; Yan J.; Huang Y.; Wang B.; Vallejo G.S.; Bohorquez R.;
Gomez N.I.J.; Fernandez R.; Mayorga L.E.; Gomez J.; Quintero A.; Figueredo
A.; Senior J.; Accini J.L.; Roncallo E.; Frischwasser S.; Sanchez M.S.;
Bouzid Y.; Ciglenecki N.; Certic J.F.; Grman J.; Sutalo K.; Bergovec M.;
Knezevic A.; Mirat J.; Padovan M.; Car S.; Samardzic P.; Bagatin J.; Kraus
L.; Coufal Z.; Janota T.; Kettner J.; Linhart A.; Hondl M.; Osmancik P.;
Padour M.; Telekes P.; Vojacek J.; Vojtisek P.; Francek L.; Sedlon P.;
Bronnum-Schou J.; Hansen P.; Nielsen H.; El-Etreby A.; Hawary A.E.; Rakshy
Y.E.; Mowafy A.; Ragy H.; Reda A.; Sabri S.; Nyman K.; Laine M.;
Bressollette E.; Rifai A.; Danchin N.; Ovize M.; Cottin Y.; Farah B.;
Furber A.; Coste P.; Elbaz M.; Morel O.; Schiele F.; Elhadad S.;
Belhassane A.; El Mansour N.; Leroy F.; Coisne D.; Ferrari E.; Nguyen-Khac
O.; Range G.; Moulin F.; Poulard J.-E.; Sechtem U.; Kaelsch T.; Ebelt H.;
Gawaz M.; Genth-Zotz S.; Moellmann H.; Heuer H.; Kadel C.; Klein H.;
Werner G.; Boudriot E.; Kruells-Muench J.; Baer F.; Alexopoulos D.;
Manolis A.; Platogiannis D.; Anastasiou-Nana M.; Nanas I.; Cokkinos D.;
Fotiadis I.; Koliopoulos N.; Moschos N.; Olympios C.; Ples Z.; Illyes L.;
Csikasz J.; Zolyomi S.; Kis E.; Kovacs Z.; Lupkovics G.; Nagy A.; Regos
L.; Tomcsanyi J.; Janosi A.; Medvegy M.; Szakal I.; Vertes A.; Szalai G.;
Banker D.; Dani S.; Sarna M.K.; Seerangachar R.K.Y.; Deshpande A.; Khan
I.A.; Gupta S.K.; Dharmadhikari A.; Babu P.; Fulwani M.; Kerkar P.G.;
Varma S.; Singh P.; Babu R.; Menon J.; Sengupta S.; Premchand R.K.; Kalra
R.; Kalashetti S.; Pai V.; Bose V.; Jain V.; Kale V.; Benjarge P.; Ghaisas
N.; Thanvi S.; Durgaprasad R.; Kulkarni R.L.; Joshi H.; Abyankar A.; Bisne
V.; Chopra V.; Reddy P.; Sarma R.; Garg N.; Agarwal D.K.; Arneja J.;
Bandyopadhyay S.; Bharani A.; Yadav R.; Dutta S.; Chidambaram N.; Dande
A.; Gadkari M.; Grant P.; Khan A.; Gupta R.; Gupta J.B.; Shetty G.G.;
Lavhe P.V.; Jain R.; Joseph J.; Calambur N.; Joseph S.; Mardikar H.;
Mathur A.; Mohanan P.P.; Kumbla M.; Nair T.; Nambiar A.; Jathappa N.;
Parale G.; Patel T.; Puri A.; Rao B.; Saligrama R.; Sathe S.; Sawhney
J.P.S.; Sethi S.; Singh B.; Kumar S.; Srinivas A.; Jagadesa B.S.; Foley
D.; Mahon N.; Mulvihill N.; Nash P.; Arad T.; Balkin J.; Francis A.;
Hammerman H.; Hasin Y.; Katz A.; Kracoff O.; Marmor A.; Mosseri M.; Atar
S.; Roth A.; Zahger D.; Turgeman Y.; Weiss A.; De Luca M.; Antonelli G.;
Piovaccari G.; Barbiero M.; Cuccia C.; De Servi S.; Fedele F.; Golino P.;
Manari A.; Menozzi A.; Berti S.; Moretti L.; Musumeci G.; Pajes G.;
Paloscia L.; Mos L.; Salvioni A.; Volpe M.; De Luca G.; Astarita C.;
Merlini P.; Di Lorenzo L.; Fattore L.; Ambrosio G.; Mircoli L.; Galvani
M.; Cavallini C.; Nassiacos D.; Scioli R.; Jeong M.H.; Yoon J.; Kim D.-K.;
Hur S.-H.; Bae J.H.; Rha S.W.; Lee S.R.; Kim K.S.; Ko Y.-G.; Jeong J.-O.;
Lee S.K.; Hong T.J.; Kim M.; Hwang J.Y.; Shin E.-K.; Kim S.-W.;
Anusauskiene J.; Dambrauskaite A.; Jarasuniene D.; Raugaliene R.;
Babarskiene M.R.; Petrauskiene B.; Wan Ahmad W.A.; Yusof Z.; Maskon O.;
Ong T.K.; Abdullah H.N.; Zambahari R.; Chandran A.; Chong Y.S.; Lee C.Y.;
Ramanathan L.; Sciberras R.; Xuereb R.G.; Fajardo P.; Ramos-Lopez G.;
Alcocer M.A.; Ramirez M.C.; de los Rios Ibarra M.O.; Esperon G.L.; Diaz
C.S.; Hamer A.; Harding S.; Hart H.; Castillo B.G.; Ortega R.N.; Frago G.;
Henriquez F.; Acosta D.C.; Zambrano E.C.; Mogrovejo W.; Chois A.; Gamio
C.F.; Barrera M.A.L.; Cabrera J.; Dextre L.Z.M.; Reyes M.; Tellez D.;
Castillo R.; Chavez C.; Godoy A.; Llerena N.; Morales C.A.P.; Habaluyas
R.; Rogelio G.; Ramos E.J.F.; Chua P.; Mendoza V.; Tirador L.; Abanilla
J.; Edmilao M.I.; Coching R.M.; Morales D.; Dalkowski M.; Sciborski R.;
Lewczuk J.; Hoffmann A.; Lesnik J.; Andruszkiewicz B.; Wojciechowski D.;
Kus W.; Jozwa R.; Kasprzak J.; Lubinski A.; Karczmarczyk A.; Wojcik J.;
Gruchala M.; Bartus S.; Bronisz M.; Mirek-Bryniarska E.; Dudek D.; Gorny
J.; Grzywna R.; Kawka-Urbanek T.; Niezgoda K.; Olszewski R.; Ogorek M.;
Gniot J.; Nessler J.; Ponikowski P.; Wita K.; Zinka E.; Zmudka K.; Ruzyllo
W.; Szelemej R.; Moreira J.; Bastos J.M.; Ferreira J.; Martins D.;
Providencia L.; Ribeiro V.G.; Silva G.; Seixo F.; Morais J.; Rinaldi R.;
Rodriguez-Ospina L.; Colon-Hernandez P.; Matei C.; Tatu-Chitoiu G.P.;
Iordachescu-Petica D.; Teodorescu I.; Ochean V.; Constantinescu M.C.;
Stanciulescu G.E.; Bobescu E.; Bolohan F.R.; Coman I.M.; Creteanu M.; Dan
G.A.; Dobre I.; Ionescu P.; Minescu B.; Olinic D.M.; Pop C.; Stamate S.C.;
Gurevich V.; Bichan N.; Baranov E.; Zateyshchikov D.; Barbarich V.;
Gordeev I.; Tereshchenko S.; Dovgalevskiy Y.; Boyarkin M.; Shogenov Z.;
Suprun E.; Shalaev S.; Arutyunov G.; Supryadkina T.; Perepech N.;
Nikolskaya I.; Rossovskaya M.; Khaisheva L.; Simanenkov V.; Boldueva S.;
Zrazhevskiy K.; Barbarash O.; Egorova L.; Gratsiansky N.; Valentin M.;
Novikova N.; Alexeeva N.; Ermoshkina L.; Ishmurzin G.; Miloradovic V.;
Pavlovic M.; Ilic S.; Krotin M.; Neskovic A.; Otasevic P.;
Vasiljevic-Pokrajcic Z.; Ostojic M.; Chua T.; Chan M.Y.Y.; Goh P.P.;
Kokles M.; Bugan V.; Urban M.; Sirotiakova J.; Belicova M.; Duris T.;
Poliacik P.; Slanina M.; Fridrich V.; Letcher G.; Abelson M.; Dalby A.;
Gould T.; Manga P.; Pillay T.; Theron H.; Venter T.; van Zyl L.; Essop M.;
van der Merwe N.; Alegret J.M.; Lopez Gomez D.; Vera T.R.; i Cortada J.B.;
Garcia J.H.; Dalli E.; Paz M.A.; Ridocci F.; Coronado J.L.B.; Romero C.;
Urbano R.H.; Carlsson R.; Erlinge D.; Falck G.; Gallino A.; Linka A.; Lai
W.-T.; Shyu K.-G.; Li A.-H.; Chiang C.-E.; Hou J.-Y.; Sritara P.;
Kuanprasert S.; Srimahachota S.; Wongvipaporn C.; Laothavorn P.;
Krittayaphong R.; Tangsuntornwiwat S.; Moleerergpoom W.; Kaewsuwanna P.;
Sakulsaengprapha T.; Viboolkitvarakul N.; Buakhamsri A.; Braam R.; Basart
D.C.G.; Troquay R.P.T.; Herrman J.P.R.; van der Heijden D.J.; Broeders M.;
Romer T.; Post J.C.; Viergever E.; Zwart P.; Cornel J.-H.; Groutars R.;
Breedveld R.; Ronner E.; Hoedemaker G.; van Kalmthout P.; Kuijper A.;
Geertman J.H.; Hamer B.; Werter C.; Westendorp I.; Kruik H.J.; Zouari
S.B.Y.; Boughzala E.; Boujnah R.; Gamra H.; Haouala H.; Kammoun S.;
Khalfallah A.B.; Maatouk F.; Ural D.; Kutlu M.; Sahin M.; Ebinc H.;
Kucukoglu S.; Demirtas M.; Kirma C.; Altun A.; Aydinlar A.; Aydogdu S.;
Cayli M.; Bozkurt E.; Buyukoner E.E.; Erdogan D.; Acikel M.; Ozdemir M.;
Ozdemir K.; Yazici M.; Goloborodko B.; Nykonov V.; Vakaliuk I.; Yagensky
A.; Vatutin M.; Shcherbak V.; Kovalskyy I.; Bagriy A.; Ushakov O.; Zhurba
S.; Sierkova V.; Bashkirtsev O.; Vasylenko A.; Karpenko Y.; Kaydashev I.;
Amosova K.; Batushkin V.; Faynyk A.; Horbach L.; Karpenko O.; Koval O.;
Kraiz I.; Potapenko P.; Rudenko L.; Malynovsky Y.; Tseluyko V.; Volkov V.;
Prokhorov O.; Sarkar D.; Moriarty A.; El-Harari M.; Brigden G.; Qureshi
N.; Alamgir F.; de Belder A.; Keeling P.; Cooke J.; Brown N.; Junejo S.;
Vuyyuru R.; Connolly D.; Kadr H.; Griffiths H.; Tang K.; Cotton J.; Barr
C.; Lindsay S.; Venkataraman A.; Rittoo D.; Jacob A.; Watkin R.; Lang C.;
Pye M.; Chambers J.; Mavromatis K.; Rossi P.; Ahmad A.; Anderson H.;
Roberts J.; Klugherz B.; Haidar A.; Downes T.; Russo D.; Wallace W.;
Bhagwat R.; Mathew T.; Jetty P.; Henderson D.; Dy J.; Isserman S.; Kondle
V.; Quintana O.; Brener S.; Masud Z.; Vijay N.; Jain M.; Longo J.; Safley
D.; Pancholy S.; Shaoulian E.; Allan J.; Bazzi A.; Chahin J.; Shurmur S.;
Santos R.; Goldberg J.; Gigliotti O.; Irimpen A.; Kusnick B.; Treasure C.;
Rogers J.; Zebrack J.; Turner M.; Adjei N.; Ingram C.; Mathis C.; Buchanan
W.; Heins G.; Ahsan C.; Anderson J.; Atassi K.; Bachinsky W.; Baig M.;
Rodriguez A.; Tang A.; Foreman R.; Berlin H.; Bouchard A.; Thew S.;
Borromeo S.; Bowden W.; Boyek T.; Arter J.; Blair J.; Chandna H.; Katz J.;
Conn E.; Connelly T.; Del Core M.; Shanes J.; Dotani I.; Drenning D.;
Bustros N.; Elliott J.; Fastabend C.; Flores E.; Goudreau E.; Gredler F.;
Greenfield R.; Guidera S.; Gogia H.; Hearne S.; Hermany P.; Taheri H.;
Izzo M.; Jaffrani N.; Johnson G.; Keedy D.; Waxman F.; Kesselbrenner M.;
Floro J.; Korban E.; Labroo A.; Lui H.; Georgeson S.; Breall J.; Baman R.;
Mandak J.; Marais H.; Meisner J.; Micale P.; Meymandi S.; Vicari R.;
Mouhaffel A.; Moscoso R.; Papademetriou V.; Piegari G.; Promisloff S.;
Rivera E.; Rogers W.; Roth D.; Sadler D.; Canto J.; Schmedtje J.; Shaikh
S.; Shalev Y.; Sharma M.; Rahman A.; Schwartz S.; Sporn D.; Staniloae C.;
Tami L.; Barnum O.; Tu T.; Tuma J.; Wali A.; Welka S.; Wilson V.; Younis
L.; Zakhary B.; Ziperman D.; Singh N.; Kukuy E.; Leimbach W.; Chang M.;
Carter M.; Simpson P.; Miklin J.; Niess G.; Schaefer S.; Lambert C.; Soh
E.; Heintz K.; Miller J.; Chandrashekhar Y.; Pappas J.; Rashid H.-U.;
Wright W.; Rees A.; Bach R.; Wu W.; Singhi S.; Quyyumi A.; Lau T.; Nobel
J.; Kamdar A.; Kabour A.; Stys T.; Keller N.; Kumar A.; Danisa K.; Smith
S.; Espinoza A.; Deac D.; Roberts D.; Gumm D.; Saucedo J.; Gimple L.;
Weinstein D.; Blonder R.; Moran M.; Iwaoka R.; Bayron C.; Tejada L.; White
L.; Ingersoll H.; Casterella P.; Chiaramida S.; Harris J.; Rodriguez R.;
Vo A.; Dave K.; Khan M.; Giacomini J.; Kotha P.; Park C.; Arif I.; McGrew
F.; Atieh M.; Huang X.; Zarrella G.; McGarvey J.; Koganti D.; Albirini A.;
Kozman H.; Slepian M.; Quion J.A.; Ramanathan K.; Bessen M.; Rafael A.;
Aycock G.; Lee D.
Institution
(Roe, McLendon, Lokhnygina, Ohman) Duke Clinical Research Institute, Duke
University Medical Center, Durham, NC, United States
(Roe, Ohman) The Division of Cardiology, Department of Medicine,
University of Alberta, Edmonton, Canada
(Armstrong) The Division of Cardiology, University of Alberta, Edmonton,
Canada
(Goodman) The Division of Cardiology, Department of Medicine, St.
Michael's Hospital, University of Toronto, Toronto, Canada
(Fox) Centre for Cardiovascular Science, University of Edinburgh,
Edinburgh, United Kingdom
(White) Auckland City Hospital, Green Lane Cardiovascular Service,
Auckland, New Zealand
(Prabhakaran) Center for Chronic Disease Control, New Delhi, India
(Cornel) The Department of Cardiology, Medical Center Alkmaar, Alkmaar,
Netherlands
(Bhatt) VA Boston Healthcare System, Brigham and Women's Hospital, Harvard
Medical School, Boston, United States
(Clemmensen) Rigshospitalet - Copenhagen University Hospital, Kobenhavn O,
Denmark
(Martinez) The Department of Cardiology, Cordoba National University,
Cordoba, Argentina
(Ardissino) The Division of Cardiology, Azienda Ospedaliero-Universitaria
di Parma, Parma, Italy
(Nicolau) Heart Institute (InCor), University of Sao Paulo Medical School,
Sao Paulo, Brazil
(Boden) The Department of Medicine, Stratton VA Medical Center, Albany
Medical College, Albany, NY, United States
(Hochman) Cardiovascular Clinical Research Center, Leon H. Charney
Division of Cardiology, New York University School of Medicine, NYU
Langone Medical Center, New York, United States
(Gurbel) Sinai Center for Thrombosis Research, Sinai Hospital of
Baltimore, Baltimore, United States
(Ruzyllo) The Department of Coronary Artery Disease, Institute of
Cardiology, Warsaw, Poland
(Dalby) Milpark Hospital, Johannesburg, South Africa
(McGuire) University of Texas, Southwestern Medical Center, Dallas, United
States
(Leiva-Pons) Cardiology Department, Hospital Central Ignacio Morones
Prieto, San Luis Potosi, Mexico
(Parkhomenko) Emergency Cardiology, M.D. Strazhesko Institute of
Cardiology AMS Ukraine, Kiev, Ukraine
(Gottlieb) The Department of Cardiology, Bikur Cholim Hospital, Israel
(Topacio) The Department of Medicine, Medical Center Manila, Manila,
Philippines
(Hamm) Kerckhoff Heart Center, Bad Nauheim, Germany
(Pavlides) Cardiology Division, Onassis Cardiac Surgery Center, Kallithea,
Greece
(Goudev) Cardiology Department, Queen Giovanna University Hospital, Sofia,
Bulgaria
(Oto) The Department of Cardiology, Hacettepe University Faculty of
Medicine, Ankara, Turkey
(Tseng) The Division of Cardiology, National Taiwan University College of
Medicine, Taipei, Taiwan (Republic of China)
(Merkely) Heart Center, Semmelweis University, Budapest, Hungary
(Gasparovic) The Department of Intensive Care Medicine, Clinical Hospital
Center Zagreb, Zagreb, Croatia
(Corbalan) Cardiovascular Division, Faculty of Medicine, Pontificia
Universidad Catolica de Chile, Santiago, Chile
(Cinteza) The Division of Cardiology, Emergency University Hospital of
Bucharest, Bucharest, Romania
(Winters, Brown, Marshall, Macias, LeNarz) Eli Lilly and Company,
Indianapolis, United States
(Aylward) South Australian Health and Medical Research Institute, Flinders
University Medical Centre, Adelaide, SA, Australia
(Huber) Third Department of Medicine, Cardiology and Emergency Medicine,
Wilhelminenhospital, Vienna, Austria
(Van de Werf) University Hospital Gasthuisberg, Leuven, Belgium
(Budaj) Grochowski Hospital, Warsaw, Poland
(Gersh) Mayo Clinic, Rochester, MN, United States
(Montalescot) Pitie-Salpetriere University Hospital, Paris, France
(Pocock) London School of Hygiene and Tropical Medicine, London, United
Kingdom
(Wilcox) University Hospital Nottingham, Nottingham, United Kingdom
(Williams) Rhode Island Hospital, Providence, RI, United States
(Wilson) IndianapolisINUnited States
(Mehta, Alexander, Kong, Lopes, Mahaffey, Melloni, Newby, Shah, Tricoci)
Clinical Events Classification Committee for Cardiovascular End Points,
Duke Clinical Research Institute, Durham, NC, United States
(George, Beaven, Blackwell, Morse, Onken, Ready, Strickler, Zafar)
Clinical Events Classification Committee for Neoplasm End Points, Duke
Clinical Research Institute, Durham, NC, United States
(Hafley, Pieper, Stevens, Schibler) Academic Coordinating Center
Statistical Analytic Group, Duke Clinical Research Institute, Durham, NC,
United States
(Chan, Chin, Gharacholou, Subherwal) Academic Coordinating Center
Physician Support, Duke Clinical Research Institute, Durham, NC, United
States
(Petijean, Plat, van Kranen, Zamoryakhin) Daiichi Sankyo, Ltd., Japan
(Albisu) Instituto Cardiovascular de San Luis, San Luis, Argentina
(Alvarez) Hospital Italiano Regional del Sur, Bahia Blanca, Argentina
(Amuchastegui) Hospital Privado Centro Medico de Cordoba S.A., Cordoba,
Argentina
(Astesiano) Hospital Espanol de Mendoza, Godoy Cruz, Argentina
(Beloscar) Hospital Provincial del Centenario, Rosario, Argentina
(Bergallo) Hospital Clemente Alvarez, Rosario, Argentina
(Bono) Sanatorio Allende, Cordoba, Argentina
(Bordonava) Clinica Privada Fusavim SRL, Villa Maria, Argentina
(Botta) Clinica de Nefrologia Urologia y Enf. Cardiovasculares S. A.,
Santa Fe, Argentina
(Budassi) Hospital Penna, Bahia Blanca, Argentina
(Caccavo) Clinica Coronel Suarez, Buenos Aires, Argentina
(Cartasegna) Hospital Italiano de La Plata, La Plata, Argentina
(Colombo) Clinica Colombo, Cordoba, Argentina
(Costello) Hospital de Alta Complejidad Presidente Juan Domingo Peron,
Formosa, Argentina
(Covelli) Clinica Privada del Prado, Cordoba, Argentina
(De Valais) Sanatorio San Jose, Capital Federal, Argentina
(Dran) Ricardo, Centro de Salud Norte Olivos, Buenos Aires, Argentina
(Duronto) Fundacion Favaloro, Ciudad Autonoma Buenos Aires, Argentina
(Forte) Instituto Medico Quirurgico Garat S.A., Concordia, Argentina
(Garcia) Hospital Italiano de Cordoba, Cordoba, Argentina
(Escudero) Gescudero Alejandro, Buenos Aires, Argentina
(Hominal) Sanatorio Medico de Diagnostico y Tratamiento, Santa Fe,
Argentina
(Hrabar) Sanatorio Modelo Quilmes S.A., Argentina
(Ibanez) Hospital Escuela de Corrientes - Jose de San Martin, Corrientes,
Argentina
(Jure) Clinica Chutro SRL, Cordoba, Argentina
(de la Fuente) Centro Cardiovascular Salta, Salta, Argentina
(Marquez) Instituto de Cardiologia S.R.L, San Miguel de Tucuman, Argentina
(Luciardi) Centro Modelo de Cardiologia, San Miguel de Tucuman, Argentina
(Luquez) Sanatorio Parque S.A. Privado, Cordoba, Argentina
(Marino) Centro Medico Alcorta, Buenos Aires, Argentina
(Martingano) Instituto Medico de Alta Complejidad, Capital Federal,
Argentina
(Azize) Clinica Privada Caraffa S.R.L., Villa Cabrera, Argentina
(Nul) Clinica Constituyentes, Moron, Argentina
(Patocchi) Hospital Regional Espanol Bahia Blanca, Bahia Blanca, Argentina
(Piombo) Hospital Gral. de Agudos Dr. Cosme Argerich, Ciudad Autonoma de
Bs. As., Argentina
(Prado) Inves Clinicas Tucuman, Tucuman, Argentina
(Rodriguez) Clinica Colon, Mar del Plata, Argentina
(Acuna) Instituto de Cardiologia 'Dr. Luis Gonzalez Sabathie', Rosario,
Argentina
(Scaro) Sanatorio Privado Jardin SRL, Cordoba, Argentina
(Liprandi) Sanatorio Guemes, Ciudad Autonoma de Bs. As., Argentina
(Varini) Centro Gallego de Buenos Aires, Capital Federal, Argentina
(Vigo) Instituto Cardiovascular W. Harvey, Sanatorio del Salvador,
Cordoba, Argentina
(Aroney) Gold Coast Hospital, Southport, Australia
(Arstall) Lyell McEwin Hospital, Elizabeth Vale, Australia
(Blenkhorn) Lismore Base Hospital, Lismorel Patrick Carroll, Redcliffe
Hospital, Redcliffe, Australia
(Chew) Flinders Medical Centre, Bedford Park, Australia
(Collins) John Hunter Hospital, New Lambton, Australia
(Hammett) Royal Brisbane and Women's Hospital, Herston, Australia
(Lee) Cardiac Diagnostic Centre, Wollongong, Australia
(Marrinan) Nambour General Hospital, Nambour, Australia
(Roberts-Thomson) Royal Hobart Hospital, Hobart, Australia
(Waites) Coffs Harbour Hospital, Coffs Harbour, Australia
(Benzer) Landeskrankenhaus Feldkirch, Feldkirch, Austria
(Lang) Univ. Klinik Wien, Wien, Austria
(Podczeck-Schweighofer) Sozialmedizinisches Zentrum Sued, Wien, Austria
(Baetsle) Heilig Hart Ziekenhuis, Mol, Belgium
(Beauloye) Cliniques Universitaires Saint-Luc, Brussels, Belgium
(De Tollenaere) Sint Augustinuskliniek, Veurne, Belgium
(Lancellotti) C. H. U. Sart-Tilman, Liege, Belgium
(Marechal) Centre Hospitalier Hutois, Huy, Belgium
(Van Dorpe) Maria Ziekenhuis Noord-Limburg vzw, Overpelt, Belgium
(Albuquerque) Hospital Universitario Pedro Ernesto da Univ Est do R.J.,
Rio de Janeiro, Brazil
(Lotufo) Hospital Universitario da USP, Sao Paulo, Brazil
(Ardnt) Marcelo Hospital Bruno Born, Lajeado, Brazil
(Arminio) Hospital Professor Edmundo Vasconcelos, Sao Paulo, Brazil
(da Cost) FGM Clin Paulista de Doencas Cardiov LTDA, Sao Paulo, Brazil
(Baracioli) Instituto do Coracao, INCOR, Sao Paulo, Brazil
(Precoma) Hospital Angelina Caron, Campina Grande do Sul, Brazil
(Neuenschwander) Nucleo de Pesquisa Clinica do Hospital Vera Cruz, Belo
Horizonte, Brazil
(Seabra) Instituto do Coracao do Triangulo Mineiro, Uberlandia, Brazil
(De Souza) Instituto de Cardiologia do Distrito Federal, Brasilia, Brazil
(Duda) Hospital Sao Vicente de Paulo, Passo Fundo, Brazil
(Dutra) Instituto de Cardiologia do Rio Grande do Sul, Porto Alegre,
Brazil
(Feitosa) Pronto Socorro Cardiologico de Pernambuco - PROCAPE, Recife,
Brazil
(Filho) Instituto de Cardiologia de Santa Catarina, San Jose, Brazil
(Finimundi) Instituto de Pesquisa de Estudos Multicentricos, Caxias do
Sul, Brazil
(Gomes) Clinicor - Clinica de Exames Cardiologicas e Ecografia LTDA,
Maceio, Brazil
(Gubolino) INCORPI -Hosp. dos Fornecedores de Cana de Piracicaba,
Piracicaba, Brazil
(Guimaraes) Hospital Geral de Bonsucesso, Rio de Janeiro, Brazil
(Hernandes) Santa Casa de Votuporanga, Votuporanga, Brazil
(Jardim) Instituto de Ensino e Pesquisa do Hospital do Coracao, Sao Paulo,
Brazil
(de Souza) Via Medica - Centro Clinico, Goiania, Brazil
(Leaes) Irmandade da Santa Casa de Misericordia de Porto Alegre, Porto
Alegre, Brazil
(Maia) Hospital de Base de Sao Jose do Rio Preto, Sao Jose do Rio Preto,
Brazil
(Manenti) Hospital Mae de Deus, Porto Alegre, Brazil
(Neto) Hospital das Clinicas da FMRP, Ribeirao Preto, Brazil
(Marino) Hospital Madre Teresa, Belo Horizonte, Brazil
(Michalaros) Hospital Governador Israel Pinheiro - IPSEMG, Belo Horizonte
Raul Mora Junior, Hospital Santa Rita - Associacao Bom Samaritano,
Maringa, Brazil
(Junior) Hospital Agamenon Magalhaes, Recife, Brazil
(de Sousa) Hospital do Coracao do Brasil, Brasilia, Brazil
(Filho) Hospital Nossa Senhora da Conceicao, Porto Alegre, Brazil
(Polanczyk) Hospital de Clinicas de Porto Alegre, Porto Alegre, Brazil
(Alves) Fundacao Bahiana de Cardiologia, Salvador, Brazil
(Ramos) Instituto Dante Pazzanese de Cardiologia (Coronaria), Sao Paulo,
Brazil
(Reis) Santa Casa de Misericordia de Belo Horizonte, Belo Horizonte,
Brazil
(Neto) Santa Casa de Misericordia de Curitiba, Curitiba, Brazil
(dos Santos) Loema - Instituto de Pesquisa Clinica, Campinas, Brazil
(Saporito) Hospital Estadual Mario Covas - SP, Santo Andre, Brazil
(Saraiva) Hospital e Maternidade Dr. Celso Pierro - PUC Campinas,
Campinas, Brazil
(Sartori) CEIC -Sociedade Portuguesa de Beneficencia de Sao Caetano d, Sao
Caetano do Sul, Brazil
(Issa) Instituto Jaqueline Scholz Issa e Mario Issa Cardiologia, Sao
Paulo, Brazil
(Junior) Hospital Universitario da UFMS, Campo Grande, Brazil
(Sousa) Hospital Sao Lucas, Aracaju, Brazil
(Teixeira) Hospital Portugues, Salvador, Brazil
(Zimmermann) Clinica Procardio, Blumenau, Brazil
(Lazov) MHAT - Pazardjik AD, Pazardzhik, Bulgaria
(Tokmakova) UMHAT 'Sv. Georgi' EAD, Plovdiv, Bulgaria
(Penchev) UMHATEM 'N.I. Pirogov' EAD - Sofia, Sofia, Bulgaria
(Petrov) MHAT 'Tokuda Hospital Sofia' AD, Sofia, Bulgaria
(Baldjiev) 2nd MHAT, Sofia Petyo Georgiev, MHAT 'Zdrave' - Pazardjik,
Pazardzhik, Bulgaria
(Hergeldjieva) MHAT 'Rouse AD', Ruse, Bulgaria
(Manolova) MHAT - Haskovo, Haskovo, Bulgaria
(Dimov) Fifth MHAT-Sofia AD, Sofia, Bulgaria
(Mihov) MHAT 'Sveta Ekaterina' EOOD, Dimitrovgrad, Bulgaria
(Pencheva) IV MHAT, Sofia, Bulgaria
(Raev) MI Central Clinical Base - Ministry of Interior, Sofia, Bulgaria
(Ramshev) Military Medical Academy, Sofia, Bulgaria
(Tumbev) DCC 'Chaika' EOOD, Varna, Bulgaria
(Tzekova) UMHAT 'Dr. Georgi Stranski', Pleven, Bulgaria
(Boichev) MHAT 'Kazanlak', Kazanlak, Bulgaria
(Kadiiski) MHAT 'Dr. Nikola Vasiliev - Kjustendil', Kjustendil, Bulgaria
(Devedzhiev) MHAT 'Sv. Mina' EOOD Plovdiv, Plovdiv, Bulgaria
(Bakbak) Oshawa Clinic, Oshawa, Canada
(Berlingieri) JBN Medical Diagnostic Services Inc., Burlington, Canada
(Burstein) Harwood Medical Center, Ajax, Canada
(Dery) IUCPQ (Hopital Laval), Sainte-Foy, Canada
(Heath) Alder Medical Centre, Campbell River, Canada
(Huynh) The Montreal General Hospital, Montreal, Canada
(Kassam) Scarborough Cardiology Research, Scarborough, Canada
(Kostuk) London Health Sciences Centre- University Campus, London, Canada
(Labonte) Dr. R. Labonte Professional Medicine Corporation, Sudbury,
Canada
(MacCallum) Health Sciences Centre, St. John's, Canada
(Nawaz) Sudbury Cardiac Research, Sudbury, Canada
(Quraishi) Queen Elizabeth II Health Sciences Centre, Halifax, Canada
(Senaratne) Dr. M.P.J. Senaratne Professional Corporation, Edmonton,
Canada
(Syan) G.S. Cardiac Lab Medicine Professional Corp., Sudbury, Canada
(Syan) The Office of Dr. Rajinder Syan, Sarnia, Canada
(Vizel) Dr. Saul Vizel Cardiac Research Office, Cambridge, Canada
(Castro) Hospital Clinico Pontificia Universidad Catolica de Chile,
Santiago, Chile
(Florenzano) Hospital del Salvador, Santiago, Chile
(Lamich) Hospital Barros Luco Trudeau, Santiago, Chile
(Manriquez) Hospital Regional de Rancagua, Rancagua, Chile
(Potthoff) Clinica Alemana de Osorno, Osorno, Chile
(Stockins) Hospital Dr. Hernan Henriquez Aravena, Temuco, Chile
(Bugueno) Hospital San Juan de Dios La Serena, La Serena, Chile
(Cobos) Hospital El Pino, Santiago, Chile
(Sepulveda) Clinica Tabancura, Santiago, Chile
(Opazo) Hospital Naval Almirante Nef, Vina del Mar, Chile
(Montecinos) Hospital Dr. Sotero del Rio, Santiago, Chile
(Ge) Zhongshan Hospital Fudan University, Shanghai, China
(Ke) China-Japan Friendship Hospital, Beijing, China
(Chen) China People Liberation Army General Hospital, Beijing, China
(Chen) Guangdong Province People's Hospital, Guangdong Province,
Guangzhou, China
(Wang) 2nd Affiliated Hospital College of Medicine Zhejiang University,
Hangzhou, China
(Li) The 1st Affiliated Hospital Harbin Medical University, Heilongjiang,
China
(Xu) The Affiliated DrumTower Hospital of Nanjing University, Nanjing,
China
(Ma) Zhong Da Hospital Southeast University, Jiangsu, China
(Li) People's Hospital of Liaoning Province, Liaoning, China
(Sun) The First Hospital of China Medical University, Shenyang, China
(Tang) The Second Affiliated Hospital & Yuying Children's Hospital,
Wenzhou, China
(Yuan) First Affiliated Hospital of Xi'an Jiaotong University, Xian, China
(Tang) Yuebei People's Hospital Guangdong, Shaoguan, China
(Zhou) Beijing Anzhen Hospital, Beijing, China
(He) Beijing Hospital, Beijing, China
(Xu) Tong Ji Hospital of Tongji University, Shanghai, China
(Zhang) The First Affiliated Hospital of Wenzhou Medical College, Wenzhou,
China
(Yang) The Third Xiangya Hospital of Central South University, Changsha,
China
(Zhou) Second Affiliated Hospital of Zhongshan University, Guangdong
Province, Guangzhou, China
(Chen) The First Affiliated Hospital Med, School Zhejiang University,
Hangzhou, China
(Zhao) The 2nd Xiangya Hospital, Central South University, Changsha, China
(Zheng) The First Affiliated Hospital of Nanchang University, Nanchang,
China
(Li) Shengjing Hospital of China Medical University, Shengyang, China
(Wang) Tongji Hospital, Tongji Medical Colllege, Huazhong University of
Science & Technology, Wuhan, China
(Hong) The Second Affiliated Hospital of Soochow University, Suzhou City,
China
(Guan) Fujian Province Hospital, Fujian Province, Fuzhou, China
(Wang) People's Hospital of Henan Province, Zhengzhou, China
(Huang) Renmin Hospital of Wuhan University, Wuhan, China
(Xia) The Affiliated Hospital of Xuzhou Medical College, Jiangsu Province,
Xuzhou, China
(Hao) The Second Hospital of Hebei Medical University, Shijiazhuang, China
(Zhang) Peking Union Medical College Hospital, Bejing, China
(Zhao) Beijing Tong Ren Hospital Capital Medical University, Beijing,
China
(Liu) Shanghai East Hospital, Shanghai, China
(Yan) Zhejiang Hospital, Hangzhou, China
(Huang) Beijing Shijitan Hospital, Beijing, China
(Wang) The Central Hospital of China Aerospace Corporation, Beijing, China
(Vallejo) Centro de Estudios Clinicos del Quindio, Armenia, Colombia
(Bohorquez) Hospital Universitario San Ignacio, Bogota, Colombia
(Gomez) Fundacion Ciencia Vital, Medellin, Colombia
(Fernandez) Clinica Cardiovascular Santa Maria, Medellin, Colombia
(Mayorga) Hospital Universitario Clinica San Rafael, Bogota, Colombia
(Gomez) Fundacion Valle de Lilli, Cali, Colombia
(Quintero) Fundacion BIOS, Barranquilla, Colombia
(Figueredo) Fundacion Cardiovascular de Colombia, Floridablanca, Colombia
(Senior) Hospital San Vicente de Paul, Medellin, Colombia
(Accini) Hospital Universitario CARI, Barranquilla, Colombia
(Roncallo) Clinica La Asuncion, Barranquilla, Colombia
(Frischwasser) Frischmed S.A., San Jose, Costa Rica
(Sanchez) Corporacion GIHEMA S.A., Costa Rica, Costa Rica
(Bouzid) Corporacion GIHEMA S.A., San Jose, Costa Rica
(Ciglenecki) Special Hospital for Medical Rehabilitation, Krapinske
Toplice, Croatia
(Certic) General Hospital Dubrovnik, Dubrovnik, Croatia
(Grman) General Hospital Karlovac, Karlovac, Croatia
(Sutalo) General Hospital 'Dr.Tomislav Bardek', Koprivnica, Croatia
(Bergovec) Clinical Hospital Dubrava, Zagreb, Croatia
(Knezevic) General Hospital Zadar, Zadar, Croatia
(Mirat) General Hospital Sveti Duh, Zagreb, Croatia
(Padovan) Clinical Hospital Centre Rijeka, Rijeka, Croatia
(Car) General Hospital Varazdin, Varazdin, Croatia
(Samardzic) General Hospital Dr. J. Bencevic, Slavonski Brod, Croatia
(Bagatin) Clinical Hospital Centre 'Split', Split, Croatia
(Kraus) Nemocnice s Poliklinikou v Novem Jicine, Novy Jicin, Czechia
(Coufal) Krajska Nemocnice T. Bati, Zlin, Czechia
(Janota, Linhart) Vseobecna Fakultni Nemocnice, Praha 02, Czechia
(Kettner) Institut Klinicke a Experimentalni Mediciny, Praha 04, Czechia
(Hondl) Krajska Zdravotni a.s.-Nemocnice Decin o.z., Decin 02, Czechia
(Osmancik) Fakultni Nemocnice Kralovske Vinohrady, Praha 10, Czechia
(Padour) Karlovarska Krajska Nemocnice a.s., Karlovy Vary, Czechia
(Telekes) Krajska Nemocnice Liberec a.s., Liberec, Czechia
(Vojacek) Fakultni Nemocnice Hradec Kralove, Hradec Kralove, Czechia
(Vojtisek) Pardubicka Krajska Nemocnice a.s., Pardubice, Czechia
(Francek) Kromerizska Nemocnice a.s., Kromeriz, Czechia
(Sedlon) Ustredni Vojenska Nemocnice Praha, Praha 06, Czechia
(Bronnum-Schou) Amager Hospital, Kobenhavn S, Denmark
(Hansen) Gentofte Amtssygehus, Hellerup, Denmark
(Nielsen) Bispebjerg Hospital, Kobenhavn NV, Denmark
(El-Etreby) Ain Shams University Hospital, Cairo, Egypt
(Hawary) Suez Canal University Hospital, Ismailia, Egypt
(Rakshy) Alexandria University New Hospital, Clinical Research Center,
Alexandria, Egypt
(Mowafy) Cairo University, El Kasr El Ainy- New French Building, Cairo,
Egypt
(Ragy) National Heart Institute, Cairo, Egypt
(Reda) Monofia University Hospital, Menofiya, Egypt
(Sabri) Bani Swaif University Hospital, Beni Suef, Egypt
(Nyman) Keski-Suomen Keskussairaala, Jyvaskyla, Finland
(Laine) Helsingin Yliopistollinen Keskussairaala, Helsinki, Finland
(Bressollette) Nouvelle Clinique Nantaise, Nantes Cedex 2, France
(Rifai) Centre Hospitalier d'Arras, Arras, France
(Danchin) Hopital Europeen Georges Pompidou, Paris, France
(Ovize) Hospices Civils de Lyon, Hopital Cardiologique Louis Pradel, Bron
Cedex, France
(Cottin) Hopital du Bocage, Dijon Cedex, France
(Farah) Clinique Pasteur, Toulouse Cedex 03, France
(Furber) CHU d'Angers, Angers Cedex 1, France
(Coste) Groupe Hospitalier Sud, Pessac, France
(Elbaz) CHU Hopital de Rangueil, Toulouse Cedex 9, France
(Morel) CHU Hautepierre - CHU des HUS, Strasbourg Cedex, France
(Schiele) CHU de Besancon Hopital Jean Minjoz, Besancon Cedex, France
(Elhadad) CH Lagny sur Marne, Lagny sur Marne, France
(Belhassane) Centre Hospitalier de Cambrai, Cambrai, France
(El Mansour) Centre Hospitalier General, Valenciennes Cedex, France
(Leroy) Centre Hospitalier de Douai, Douai Cedex, France
(Coisne) CHU Poitiers - Hopital de la Miletrie, Poitiers, France
(Ferrari) CHU de Nice, Nice, France
(Nguyen-Khac) Centre Hospitalier Les Oudairies, La Roche sur Yon, France
(Range) Centre Hospitalier Louis Pasteur, Chartres Cedex, France
(Moulin) CHU Brabois, Vandoeuvre les Nancy, France
(Poulard) Centre Hospitalier d'Abbeville, Abbeville, France
(Sechtem) Robert-Bosch-Krankenhaus, Stuttgart, Germany
(Kaelsch) Universitaetsklinikum Mannheim, Mannheim, Germany
(Ebelt) Universitaetsklinikum Halle (Saale), Halle, Germany
(Gawaz) Universitaetsklinikum Tuebingen, Tuebingen, Germany
(Genth-Zotz) Universitaetsklinikum Mainz - PS, Mainz, Germany
(Moellmann) Kerckhoff Klinik GmbH, Bad Nauheim, Germany
(Heuer) St. Johannes Hospital - PS, Dortmund, Germany
(Kadel) Staedtische Kliniken Frankfurt-Hoechst, Frankfurt, Germany
(Klein) Klinikum Idar-Oberstein GmbH, Idar Oberstein, Germany
(Werner) Klinikum Darmstadt, Darmstadt, Germany
(Boudriot) Herzzentrum Leipzig GmbH, Leipzig, Germany
(Kruells-Muench) Carl-Thiem-Klinikum, Cottbus, Germany
(Baer) St. Antonius Krankenhaus, Koeln, Germany
(Alexopoulos) University General Hospital of Patras, Patras, Greece
(Manolis) General Hospital of Voula 'Asklipiio, Athens, Greece
(Platogiannis) General Hospital of Trikala, Trikala, Greece
(Anastasiou-Nana) 'Attikon' University Hospital, Athens, Greece
(Nanas) General Hospital of Athens 'Alexandra, Athens, Greece
(Cokkinos) 'Onassion' Cardiosurgery Hospital, Kallithea, Greece
(Fotiadis) General Hospital of Athens 'G.Gennimatas, Athens, Greece
(Koliopoulos) General Hospital of Patra 'Agios Andreas, Patra, Greece
(Moschos) P.G. Hospital of Rhodos 'Andreas Papandreou, Rhodos, Greece
(Olympios) General Hospital of Elefsina 'Thriassio' Magoula, Athens,
Greece
(Ples) Dental-Med Co. Ltd., Satoraljaujhely, Hungary
(Illyes) Sono-X Med Bt., Miskolc, Hungary
(Csikasz) Rethy Pal Korhaz, Bekescsaba, Hungary
(Zolyomi) Varosi Onkormanyzat Korhaz-Rendelointezet Kalocsa, Kalocsa,
Hungary
(Kis) Tolna Megyei Onkormanyzat Balassa Janos Korhaza, Szekszard, Hungary
(Kovacs) Bajai Korhaz, Baja, Hungary
(Lupkovics) Zala Megyei Korhaz, Zalaegerszeg, Hungary
(Nagy) Bacs-Kiskun Megyei Onkormanyzat Korhaza, Kecskemet, Hungary
(Regos) Karolyi Sandor Korhaz, Budapest, Hungary
(Tomcsanyi) Budai Irgalmasrendi Kht., Budapest, Hungary
(Janosi) Fov.Onk.Szt Janos Korh. E-Budai Egyesitett Korhazai, Budapest,
Hungary
(Medvegy) Pest Megyei Flor Ferenc Korhaz, Kistarcsa, Hungary
(Szakal) Selye Janos Korhaz, Komarom, Hungary
(Vertes) Fov. Onk. Egyesitett Szt. Istvan es Szt Laszlo Korh.-Rend. Int.,
Budapest, Hungary
(Szalai) Erzsebet Korhaz DEOEC Oktatokorhaz, Sopron, Hungary
(Banker) Banker's Heart Institute, Vadodara, India
(Dani) Life Care Institute of Medical Sciences & Research, Ahmedabad,
India
(Kumar) Osmania General Hospital, Hyderabad, India
(Sarna) Monilek Hospital and Research Centre, Jaipur, India
(Seerangachar) J.S.S Hospital, Mysore, India
(Deshpande) Niramaya Medical Foundation and Research Centre, Baramati,
India
(Khan) Bombay Hospital, Indore, India
(Gupta) M.V. Hospital and Clinic, Lucknow, India
(Dharmadhikari) Shree Saibaba Heart Institute & Research Centre, NASIK,
India
(Babu) Dr. Ramesh Cardiac and Multispeciality Hospital Ltd., Vijayawada,
India
(Fulwani) Shri Krishna Hrudayalaya & Critical Care Centre, Nagpur, India
(Kerkar) King Edward Memorial Hospital, Mumbai, India
(Varma) Sadbhavna Medical and Heart Institute, Patiala, India
(Singh) Baroda Heart Institute, Baroda, India
(Babu) Medwin Hospital, Hyderabad, India
(Menon) Magj Hospital, Ernakulam, India
(Sengupta) Sengupta Hospital & Research Institute, Nagpur, India
(Sathe) Cardiac Care & Counseling Centre, Pune, India
(Premchand) Krishna Institute of Medical Sciences, Hyderabad, India
(Kalra) Kalra Hospital, New Delhi, India
(Kalashetti) Shree Samarth Hospital, Pune, India
(Pai) Pai Clinic and Diagnostic Centre, Pune, India
(Bose) Apollo Speciality Hospital, Madurai, India
(Jain) Choithram Hospital & Research Centre, Indore, India
(Kale) Lokmanya Hospital, Pune, India
(Benjarge) Krishna Hospital & ICU, Aurangabad, India
(Ghaisas) Shatabdi Hospital, Nashik, India
(Thanvi) Shree Krishna Hospital, Ahmedabad, India
(Durgaprasad) Sri Venkateshwara Institute of Medical Sciences, Tirupati,
India
(Kulkarni) Moraya Multispeciality Hospital, Pune, India
(Joshi) Apollo Hospitals International Ltd., Ahmedabad, India
(Abyankar) Heart First & Vascular Centre Hospital, Surat, India
(Bisne) Bisne's Heart Institute, Nagpur, India
(Chopra) Medanta-The Medicity, Gurgaon, India
(Reddy) Mediciti Hospital, Hyderabad, India
(Sarma) Lalitha Super Speciality Hospital, Guntur, India
(Garg) Tagore Heart Care and Research Centre, Jalandhar, India
(Agarwal) S. P. Medical College, Associated Group of Hospitals, Bikaner,
India
(Arneja) Arneja Heart Institute, Nagpur, India
(Bandyopadhyay) AMRI Hospital, Kolkata, India
(Bharani) MGM Hospital and Medical College, Indore, India
(Yadav) All India Institute of Medical Sciences, New Delhi, India
(Dutta) B. M. Birla Heart Research Centre, Kolkata, India
(Chidambaram) Rajah Muthiah Medical College & Hospital, Chidambaram, India
(Dande) Dande Diabetic, Aurangabad, India
(Gadkari) King Edward Memorial Hospital Research Centre, Pune, India
(Grant) Ruby Hall Clinic, Grant Medical Foundation, Pune, India
(Khan) Crescent Hospital & Heart Centre, Nagpur, India
(Gupta) Fortis Escort Hospital, Jaipur, India
(Gupta) S.R. Kalla Hospital, Jaipur, India
(Shetty) St. John's Medical College Hospital, Bangalore, India
(Lavhe) Avanti Institute of Cardiology, Nagpur, India
(Jain) CHL - Apollo Hospital, Indore, India
(Joseph) Caritas Hospital, Kottayam, India
(Calambur) Care Hospital, Hyderabad, India
(Joseph) Little Flower Hospital, Cochin, India
(Mardikar) Spandan Heart Institute, Nagpur, India
(Mathur) Escorts Heart Institute & Research Centre, New Delhi, India
(Mohanan) West Fort Hi-Tech Hospital Ltd., Thrissur, India
(Kumbla) Omega Hospital, Mangalore, India
(Nair) PRS Hospital, Trivandrum, India
(Nambiar) Baby Memorial Hospital, Calicut, India
(Jathappa) Nanjappa Life Care, Shivamogga, India
(Parale) Ashwini Cooperative Hospital, Solapur, India
(Patel) TCVS Pvt Ltd., Ahmedabad, India
(Puri) Chatrapati Shau Maharaj Medical University, Lucknow, India
(Rao) Care Hospital & Heart Institute, Vishakapatnam, India
(Saligrama) Bhagwan Mahavir Jain Heart Centre, Bangalore, India
(Sathe) Master Deenanath Mangeshkar Hospital, Pune, India
(Sawhney) Sir Gangaram Hospital, New Delhi, India
(Sethi) Max Super Speciality Hospital, New Delhi, India
(Singh) Indraprastha Apollo Hospital, New Delhi, India
(Kumar) Sanjay Gandhi Post Graduate Institute of Medical Sciences,
Lucknow, India
(Srinivas) Vikram Hospital & Heart Care, Mysore, India
(Jagadesa) PSG Hospitals, Coimbatore, India
(Foley) Beaumont Hospital, Dublin, Ireland
(Mahon) Mater University Hospital, Dublin, Ireland
(Mulvihill) St James's Hospital, Dublin, Ireland
(Nash) Galway University Hospital, Galway, Ireland
(Arad) Joseftal Medical Center, Eilat, Israel
(Balkin) Shaare Zedek Medical Center, Jerusalem, Israel
(Francis) Holy Family Hospital, Nazareth, Israel
(Hammerman) Rambam Health Care Campus, Haifa, Israel
(Hasin) The Baruch Padeh Medical Center PORIYA, Tiberias, Israel
(Katz) Barzilai Medical Center, Ashkelon, Israel
(Kracoff) Kaplan Medical Center, Rehovot, Israel
(Marmor) Sieff Government Hospital, Safed, Israel
(Mosseri) Meir Medical Center, Kfar Saba, Israel
(Atar) Western Galilee Hospital - Nahariya, Nahariya, Israel
(Roth) Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
(Zahger) Soroka Medical Center, Beer Sheva, Israel
(Turgeman) HaEmek Medical Center, Afula, Israel
(Weiss) Hadassah University Hospital - Mount Scopus, Jerusalem, Israel
(De Luca) Ospedale Sandro Pertini, Roma, Italy
(Antonelli) Azienda Ospedaliero Universitaria Consorziale Policlinico Di,
Bari, Italy
(Piovaccari) Ospedale degli Infermi, Rimini, Italy
(Barbiero) Ospedale Mater Salutis, Legnago, Italy
(Cuccia) Fondazione Poliambulanza Istituto Ospedaliero, Brescia, Italy
(De Servi) A.O. Ospedale Civile di Legnano, Legnano, Italy
(Fedele) Universita 'La Sapienza' Policlinico Umberto I, Roma, Italy
(Golino) Azienda Ospedaliera S. Anna e S. Sebastiano, Caserta, Italy
(Manari) Arcispedale Santa Maria Nuova, Reggio Emilia, Italy
(Menozzi) Azienda Ospedaliera di Parma, Parma, Italy
(Berti) Ospedale G. Pasquinucci, Massa, Italy
(Moretti) Ospedale Generale Provinciale Mazzoni, Ascoli Piceno, Italy
(Musumeci) Ospedali Riuniti di Bergamo, Bergamo, Italy
(Pajes) Ospedali Riuniti Albano-Genzano, Albano Laziale, Italy
(Paloscia) Ospedale Spirito Santo, Pescara, Italy
(Mos) Ospedale di Rete per Acuti di San Daniele, San Daniele del Friuli,
Italy
(Salvioni) Centro Cardiologico Monzino IRCCS, Milano, Italy
(Volpe) Universita degli Studi di Roma 'La Sapienza'-Ospedale Sant'A,
Roma, Italy
(De Luca) Ospedale Maggiore della Carita, Novara, Italy
(Astarita) Ospedale S. Maria della Misericordia, NA, Sorrento, Italy
(Merlini) Azienda Ospedaliera Ospedale Niguarda Ca Granda -2, Milano,
Italy
(Di Lorenzo) Ospedale San Rocco, Caserta, Italy
(Fattore) Ospedale San Giuseppe e Melorio, Santa Maria Capua Vetere, Italy
(Ambrosio) Azienda Ospedaliera S. Maria, Terni, Italy
(Mircoli) Ospedale Alessandro Manzoni-Azienda Ospedaliera di Lecco, Lecco,
Italy
(Galvani) Ospedale G.B. Morgagni-Pierantoni, Forli, Italy
(Cavallini) A.O. Perugia-Ospedale S.M. della Misericordia, Loc. S. Andrea
delle Fratte, Italy
(Nassiacos) Azienda Ospedaliera Ospedale di Circolo di Busto Arsizio-Pre,
Saronno, Italy
(Scioli) Policlinico Casilino, Roma, Italy
(Jeong) Chonnam National University Hospital, Gwangju, South Korea
(Yoon) Wonju Christian Hospital Yonsei University Wonju College,
Kangwon-do, South Korea
(Kim) Inje University Busan Paik Hospital, Busan, South Korea
(Hur) Keimyung University Dongsan Medical Center, Daegu, South Korea
(Bae) Konyang University Hospital, Daejon, South Korea
(Rha) Korea University Guro Hospital, Seoul, South Korea
(Lee) Chonbuk National University Hospital, Jeonju, South Korea
(Kim) Daegu Catholic University Medical Center, Daegu, South Korea
(Ko) Severance Hospital, Yonsei University College of Medicine, Seoul,
South Korea
(Jeong) Chungnam National University Hospital, Daejeon, South Korea
(Lee) Ulsan University Hospital, Ulsan, South Korea
(Hong) Pusan National University Hospital, Pusan, South Korea
(Kim) Dong-A University Medical Center, Busan, South Korea
(Hwang) Gyeongsang National University Hospital, Gyeongsangnam-do, South
Korea
(Shin) Gachon University Gil Hospital, Incheon, South Korea
(Kim) Chung-Ang University Hospital, Seoul, South Korea
(Anusauskiene) Klaipeda Republican Hospital Public Institution, Klaipeda,
Lithuania
(Dambrauskaite) Lithuania, Siauliai Hospital Public Institution, Siauliai,
Lithuania
(Jarasuniene) Klaipeda Seamen's Hospital Public Institution, Klaipeda,
Lithuania
(Raugaliene) Kaunas 2nd Clinical Hospital Public Institution, Kaunas,
Lithuania
(Babarskiene) Kaunas Medical University Hospital Public Institution,
Kaunas, Lithuania
(Petrauskiene) Vilnius University Hospital Santariskiu Clinic, Vilnius,
Lithuania
(Wan Ahmad) University Malaya Medical Centre, Kuala Lumpur, Malaysia
(Yusof) Hospital Universiti Sains Malaysia, Kelantan, Malaysia
(Maskon) Pusat-Perubatan University Kebangsaan Malaysia, Kuala Lumpur,
Malaysia
(Ong) Sarawak General Hospital Heart Centre, Kuching, Malaysia
(Abdullah) Hospital Tengku Ampuan Afzan, Pahang, Kuantan, Malaysia
(Zambahari) Institut Jantung Negara, Kuala Lumpur, Malaysia
(Chandran) Hospital Raja Permaisuri Bainun, Perak, Malaysia
(Chong) Hospital Serdang, Selangor, Malaysia
(Lee) Hospital Sultanah Aminah, Johor Bahru, Malaysia
(Ramanathan) Hospital Taiping, Perak, Taiping, Malaysia
(Sciberras) Gozo General Hospital, Gozo, Malta
(Xuereb) Mater Dei Hospital, Msida, Malta
(Fajardo) Clinica de Hipertension Arterial y Enfermedades Cardiovascul,
Baja California, Tijuana, Mexico
(Ramos-Lopez) Private Practice- Dr Gabriel Ramos Lopez, Guadalajara,
Mexico
(Alcocer) Instituto de Corazon de Queretaro, Santiago de Queretaro, Mexico
(Ramirez) Hospital General de Durango, Durango, Mexico
(de los Rios Ibarra) Hospital General de Culiacan Dr. Bernardo J.
Gastelum, Culiacan, Mexico
(Esperon) Hospital Cardiologica Aguascalientes, Aguascalientes, Mexico
(Diaz) Unidad de Investigacion Clinica en Medicina S.C., Mexico, Mexico
(Hamer) Nelson Hospital, Nelson, New Zealand
(Elliott) Christchurch Hospital, Christchurch, New Zealand
(Harding) Wellington Hospital, Wellington, New Zealand
(Hart) North Shore Hospital, Auckland, New Zealand
(Castillo) Consultorios America, Panama, Panama
(Ortega) Hospital Santo Tomas, Panama, Panama
(Frago) Consultorios Medicos Paitilla, Panama, Panama
(Henriquez) Hospital Nicolas A. Solano, Panama, Panama
(Acosta) Hospital Chiriqui, Chiriqui, David, Panama
(Zambrano) Hospital Aquilino Tejeira, Cocle, Panama
(Mogrovejo) Instituto Neuro Cardiovascular de las Americas, Lima, Peru
(Chois) Clinica Maison de Sante del Este, Lima, Peru
(Gamio) Hospital Nacional Adolfo Guevara Velasco, Cuzco, Peru
(Barrera) Clinica Divino Nino Jesus Orden de Malta, Lima, Peru
(Cabrera) Clinica Vesalio, Lima, Peru
(Dextre) Hospital Nacional Arzobispo Loayza, Lima, Peru
(Reyes) Hospital Nacional Edgardo Rebagliati Martins, Lima, Peru
(Tellez) Hospital Nacional Cayetano Heredia, Lima, Peru
(Castillo) Hospital IV Alberto Sabogal Sologuren, Callao, Peru
(Chavez) Hospital Nacional Daniel Alcides Carrion, Callao 02, Peru
(Godoy) Complejo Hospitalario San Pablo, Lima, Peru
(Llerena) SERMEDIAL SAC-Servicios Medicos y Dialysis, Arequipa, Peru
(Morales) Hospital Nacional Dos de Mayo, Lima, Peru
(Habaluyas) Amang Rodriguez Medical Center, Marikina City, Philippines
(Rogelio) St. Luke's Medical Center, Quezon City, Philippines
(Ramos) The Medical City, Pasig City, Philippines
(Chua) Cardinal Santos Medical Center, Metro Manila, Philippines
(Mendoza) De La Salle University Medical Center, Cavite City, Philippines
(Tirador) St. Paul Hospital, Iloilo City, Philippines
(Abanilla) Philippine Heart Center, Quezon City, Philippines
(Edmilao) Cagayan de Oro Medical Center, Cagayan de De Oro, Philippines
(Coching) Davao Doctors Hospital, Davao City, Philippines
(Morales) Manila Doctors Hospital, Manila, Philippines
(Dalkowski) Regionalny Osrodek Kardiologii Miedziowe Centrum Zdrowia SA,
Lubin, Poland
(Sciborski) Zespol Opieki Zdrowotnej w Olawie, Olawa, Poland
(Lewczuk) Wojewodzki Szpital Specjalistyczny we Wroclawiu, Wroclaw, Poland
(Hoffmann) Wielospecj. Szpital Miejski im.dr.E.Warminskiego-SPZOZ,
Bydgoszcz, Poland
(Lesnik) Kutnowski Szpital Samorzadowy Sp. z o.o., Kutno, Poland
(Andruszkiewicz) Szpital Specjalistyczny im.F.Ceynowy w Wejherowie,
Wejherowo, Poland
(Wojciechowski) Szpital Wolski im. A. Gostynskiej, Warszawa, Poland
(Kus) Indywidualna Specjalistyczna Praktyka Lekarska, Lodz, Poland
(Jozwa) Indywidualna Specjalistyczna Praktyka Lekarska B.Busz-Papiez,
Szczecin, Poland
(Kasprzak) Wojewodzki Specjalistyczny Szpital im.dr W.Bieganskiego, Lodz,
Poland
(Lubinski) Indywidualna Praktyka Lekarska Andrzej Lubinski, Lodz, Poland
(Karczmarczyk) Indywidualna Specjalistyczna Praktyka Lekarska, Szczecin,
Poland
(Wojcik) Samodz. Publi. Szpital Kliniczny nr 4 w Lublinie, Lublin, Poland
(Gruchala) Specjalistyczne Centrum Medyczne CORDIMED, Gdansk, Poland
(Bartus) NZOZ 'Intercard' Sp. z o.o., Nowy Sacz, Poland
(Bronisz) Publiczny Specjalistyczny ZOZ w Inowroclawiu, Inowroclaw, Poland
(Mirek-Bryniarska) Szpital Specjalistyczny im. J. Dietla, Krakow, Poland
(Dudek) Szpital Uniwersytecki w Krakowie, Krakow, Poland
(Gorny) Wojewodzki Specjalistyczny Szpital w Olsztynie, Olsztyn, Poland
(Grzywna) SP ZOZ Woj. Szpital Spec. im. Kardynala S. Wyszynskiego, Lublin,
Poland
(Kawka-Urbanek) Wojewodzki Szpital Zespolony, Skierniewice, Poland
(Niezgoda) Elblaski Szpital Specjalistyczny z Przychodnia, Elblag, Poland
(Olszewski) Wojskowy Instytut Medyczny, Warszawa, Poland
(Ogorek) Samodzielny Szpital Wojewodzki im. M. Kopernika, Piotrkow
Trybunalski, Poland
(Gniot) SPZOZ w Pulawach Szpital Specjalistyczny, Pulawy, Poland
(Nessler, Zmudka) SPZOZ Krakowski Szpital Specjalistyczny im.Jana Pawla
II, Krakow, Poland
(Ponikowski) 4 Wojskowy Szpital Kliniczny z Poliklinika SP ZOZ, Wroclaw,
Poland
(Wita) SPSK Nr 7 SUM w Katowicach Gornoslaskie CM im. Prof. Leszka,
Katowice, Poland
(Zinka) Szpital Wojewodzki, Koszalin, Poland
(Ruzyllo) Instytut Kardiologii, Warszawa, Poland
(Szelemej) Szpital Specjalistyczny im. dr A. Sokolowskiego, Walbrzych,
Poland
(Moreira) Hospital de Vila Real EPE, Vila Real, Portugal
(Bastos) Hospital Infante D. Pedro EPE, Aveiro, Portugal
(Ferreira) Hospital de Santa Cruz, Carnaxide, Portugal
(Martins) Hospital Espirito Santo, Ponta Delgada, Portugal
(Providencia) Hospitais da Universidade de Coimbra, Coimbra, Portugal
(Ribeiro) Centro Hospitalar Vila Nova de Gaia, Vila Nova de Gaia, Portugal
(Silva) Hosp. Distrital de Santarem, Santarem, Portugal
(Seixo) Hospital de Sao Bernardo, Setubal, Portugal
(Morais) Hospital de Santo Andre, Leiria, Portugal
(Rinaldi) Advanced Cardiology Center, Mayaguez, Puerto Rico
(Rodriguez-Ospina) VA Caribbean Healthcare System, San Juan, Puerto Rico
(Colon-Hernandez) Centro Cardiovascular de Puerto Rico y Del Caribe, Rio
Piedras, Puerto Rico
(Matei) Institutul de Urgenta pentru Boli Cardiovasculare Prof. Dr.,
Bucuresti, Romania
(Tatu-Chitoiu) Cardiomed SRL, Bucuresti, Romania
(Iordachescu-Petica) Spitalul Universitar de Urgenta Elias, Bucuresti,
Romania
(Teodorescu) Spitalul Clinic de Urgenta 'Sfantul Ioan', Bucuresti, Romania
(Ochean) Spitalul Judetean de Urgenta 'Sf. Pantelimon' Focsani, Judet
Vrancea, Focsani, Romania
(Constantinescu) Spitalul Judetean de Urgenta Buzau, Buzau, Romania
(Stanciulescu) Spitalul Judetean de Urgenta Pitesti, Pitesti, Romania
(Bobescu) Spitalul Clinic Judetean de Urgenta Brasov, Brasov, Romania
(Bolohan) Centrul Clinic de Urgenta de Boli Cardiovasculare al Armatei,
Bucuresti, Romania
(Coman) Inst. Urgenta Boli Cardiovasculare Prof. Dr. C.C. Iliescu,
Bucuresti, Romania
(Creteanu) Spitalul Judetean de Urgenta 'Sf. Ioan cel Nou' Suceava,
Suceava, Romania
(Dan) Spitalul Clinic Colentina Bucuresti, Bucuresti, Romania
(Dobre) Spitalul Judetean de Urgenta Targoviste, Targoviste, Romania
(Ionescu) Spitalul Clinic Judetean de Urgenta Bacau, Bacau, Romania
(Minescu) Spitalul Judetean de Urgenta Braila, Braila, Romania
(Olinic) Spitalul Clinic Judetean de Urgenta Cluj, Cluj-Napoca, Romania
(Pop) Spitalul Judetean de Urgenta 'Dr. Constantin Opris', Baia Mare,
Romania
(Stamate) Spitalul Clinic de Urgenta Sf. Pantelimon, Bucuresti, Romania
(Gurevich) FSHI "Clinical Hospital #122 of FMBA Russia n.a. L.G. Sokolov,
St. Petersburg, Russian Federation
(Bichan) MMPI City Clinical Hospital #1, Novokuznetsk, Russian Federation
(Baranov) MMI "City Clinical Hospital #5, Nizhny Novgorod, Russian
Federation
(Zateyshchikov) MSIH City Hospital #17, Moscow, Russian Federation
(Barbarich) MIH City Clinical Hospital #1, Novosibirsk, Russian Federation
(Gordeev) SIH City Clinical Hospital # 15 n.a. Filatov, Moscow, Russian
Federation
(Tereshchenko) FSI "Central Clinical Hospital of GAD of the President of
RF, Moscow, Russian Federation
(Dovgalevskiy) Saratov Institute of Cardiology, Saratov, Russian
Federation
(Boyarkin) Saint-Petersburg SIH Aleksandrovskaya City Hospital, St.
Petersburg, Russian Federation
(Shogenov) Moscow SHI City Clinical Hospital #81, Moscow, Russian
Federation
(Suprun) Municipal Healthcare Institution "Medicosanitary Unit #9, Omsk,
Russian Federation
(Shalaev) RAMS on bo Tyumen Regional Clinical Hospital, Tyumen, Russian
Federation
(Arutyunov) City Hospital #4, Moscow, Russian Federation
(Supryadkina) MIH "First City Clinical Emergency Hospital, Arkhangelsk,
Russian Federation
(Perepech) Saint-Petersburg SHI "City Clinical Hospital #31, St.
Petersburg, Russian Federation
(Nikolskaya) MBHI of Novosibirsk "City Clinical Hospital #25, Novosibirsk,
Russian Federation
(Rossovskaya) MIH City Clinical Hospital #6 n.a. N.S. Karpovich,
Krasnoyarsk, Russian Federation
(Khaisheva) MMI "City Emergency Hospital #2, Rostov-on-Don, Russian
Federation
(Simanenkov) City Hospital #26, St. Petersburg, Russian Federation
(Boldueva) St. Petersburg State Medical Academy n.a. I.I.Mechnikov, St.
Petersburg, Russian Federation
(Zrazhevskiy) Municipal Hospital #38 n.a. N.A. Semashko, Pushkin, Russian
Federation
(Barbarash) MIH Kemerovo Cardiology Dispensary, Kemerovo, Russian
Federation
(Egorova) St. Petersburg SHI Clinical Hospital of St. Luka, St.
Petersburg, Russian Federation
(Gratsiansky) Moscow City Hospital # 29, National Centre of
Atherosclerosis /Cardiology, Moscow, Russian Federation
(Valentin) SRI of Tomsk Research Center of Siberian Department of RAMS,
Tomsk, Russian Federation
(Novikova) Central Clinical Hospital of SB RAS Cardiovascular Disease,
Novosibirsk, Russian Federation
(Alexeeva) ZAO "Cardioclinica", St. Petersburg, Russian Federation
(Ermoshkina) Gatchinskaya Central Regional Clinical Hospital, Gatchina,
Russian Federation
(Ishmurzin) Scientific Research Medical Complex "Your Health", Kazan,
Russian Federation
(Miloradovic) Clinical Center Kragujevac, Kragujevac, Serbia
(Pavlovic) Clinical Center Nis, Nis, Serbia
(Ilic) Institute for Treatment and Rehabilitation 'Niska Banja', Niska
Banja, Serbia
(Krotin) Clinical Center Bezanijska Kosa, Zemun, Serbia
(Neskovic) Clinical Center Zemun, Zemun, Serbia
(Otasevic) Dedinje Cardiovascular Institute, Belgrade, Serbia
(Vasiljevic-Pokrajcic) Clinical Center of Serbia, Belgrade, Serbia
(Ostojic) Institute of CV Diseases Clinical Center of Serbia, Belgrade,
Serbia
(Chua) National Heart Centre, Singapore, Singapore
(Chan) National University Heart Centre, Singapore, Singapore
(Goh) Changi General Hospital, Singapore, Singapore
(Kokles) Fakultna NsP Bratislava Nemocnica Akad. L. Derera, Bratislava,
Slovakia
(Bugan) MEDIVASA s.r.o., Zilina, Slovakia
(Urban) Ustredna Vojenska Nemocnica SNP Ruzomberok, Ruzomberok, Slovakia
(Sirotiakova) Nemocnice s Poliklinikami n.o., Levice, Slovakia
(Belicova) Martinska Fakultna Nemocnica, Martin, Slovakia
(Duris) FNsP Nove Zamky, Nove Zamky, Slovakia
(Poliacik) Fakultna Nemocnica Nitra, Nitra, Slovakia
(Slanina) FNsP J. A. Reimana, Presov, Slovakia
(Fridrich) Narodny Ustav Srdcovych a Cievnych Chorob a.s., Bratislava,
Slovakia
(Letcher) Ethekwini Hospital and Heart Centre, Durban, South Africa
(Abelson) Vergelegen Medi-Clinic, Somerset West, South Africa
(Dalby) Milpark Hospital, Parktown West, South Africa
(Gould) Excellentis Clinical Trial Consultants, George, South Africa
(Manga) Wits Donald Gordon Clinical Trial Site, Johannesburg, South Africa
(Pillay) Vincent Pallotti Hospital, Cape Town, South Africa
(Theron) Netcare Private Hospital, Bloemfontein, South Africa
(Venter) Union Hospital, Alberton, South Africa
(van Zyl) Clinical Project Research, Worcester, South Africa
(Essop) Chris Hani Baragwanath Hospital, Baragwanath, Johannesburg, South
Africa
(van der Merwe) Medi-Clinic Bloemfontein, Bloemfontein, South Africa
(Alegret) Hospital Universitari Sant Joan de Reus, Tarragona, Spain
(Lopez Gomez) Hospital de Terrassa, Barcelona, Spain
(Vera) Hospital Son Llatzer, Palma de Mallorca, Spain
(i Cortada) Hospital del Mar, Barcelona, Spain
(Garcia) Hospital Clinico Universitari Virgen de la Victoria, Malaga,
Spain
(Dalli) Hospital Arnau de Vilanova, Valencia, Spain
(Paz) Hospital de Figueras, Girona, Spain
(Ridocci) Hospital General de Valencia, Valencia, Spain
(Coronado) Hospital Virgen del Mar, Almeria, Spain
(Romero) Hospital de Sant Boi, San Boi de Llobregat, Spain
(Urbano) Hospital Universitario Virgen Macarena, Sevilla, Spain
(Carlsson) Centralsjukhuset Karlstad, Karlstad, Sweden
(Erlinge) Universitetssjukhuset Lund, Lund, Sweden
(Falck) Bollnas Sjukhus, Bollnas, Sweden
(Gallino) Ospedale San Giovanni, Bellinzona, Switzerland
(Linka) Kantonsspital Winterthur, Winterthur, Switzerland
(Lai) Chung-Ho Memorial Hospital, Kaohsiung Medical University, Kaohsiung,
Taiwan (Republic of China)
(Shyu) Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan (Republic of
China)
(Li) Far Eastern Memorial Hospital, Taipei, Taiwan (Republic of China)
(Chiang) Taipei Veterans General Hospital, Taipei, Taiwan (Republic of
China)
(Hou) Mackay Memorial Hospital, Taipei, Taiwan (Republic of China)
(Sritara) Ramathibodi Hospital, Bangkok, Thailand
(Kuanprasert) Maharaj Nakorn Chiang Mai Hospital, Chiang Mai, Thailand
(Srimahachota) King Chulalongkorn Memorial Hospital, Bangkok, Thailand
(Wongvipaporn) Srinagarind Hospital, Khon Kaen, Thailand
(Laothavorn) Phramongkutklao Hospital, Bangkok, Thailand
(Krittayaphong) Siriraj Hospital, Bangkok, Thailand
(Tangsuntornwiwat) Udonthani Hospital, Udonthani, Thailand
(Moleerergpoom) Police General Hospital, Bangkok, Thailand
(Kaewsuwanna) Maharat Nakhonratchasima Hospital, Nakhonratchasima,
Thailand
(Sakulsaengprapha) Bhumibol Adulyadej Hospital, Bangkok, Thailand
(Viboolkitvarakul) Somdejprapinklao Hospital, Bangkok, Thailand
(Buakhamsri) Thammasat Chalermprakiat Hospital, Pathumthani, Thailand
(Braam) Gelre Ziekenhuizen, Apeldoorn, Netherlands
(Basart) Vasculair Onderzoek Centrum Hoorn, Hoorn, Netherlands
(Troquay) VieCuri Medisch Centrum Venlo, Venlo, Netherlands
(Herrman) Onze Lieve Vrouwe Gasthuis Oosterpark, Amsterdam, Netherlands
(van der Heijden) Rijnland Ziekenhuis Leiderdorp, Leiderdorp, Netherlands
(Broeders) Franciscus Ziekenhuis, Roosendaal, Netherlands
(Romer) Diaconessenhuis Leiden, Leiden, Netherlands
(Post) Catharina Ziekenhuis Eindhoven Cardiology, Eindhoven, Netherlands
(Viergever) Groene Hart Ziekenhuis Bleuland, Gouda, Netherlands
(Zwart) Ziekenhuis Bernhoven Oss, Oss, Netherlands
(Cornel) Medisch Centrum Alkmaar, Alkmaar, Netherlands
(Groutars) Sint Lucas Andreas Ziekenhuis, Amsterdam, Netherlands
(Breedveld) Medisch Centrum Leeuwarden, Leeuwarden, Netherlands
(Ronner) Reinier de Graaf Gasthuis, Delft, Netherlands
(Hoedemaker) Tergooiziekenhuizen Blaricum, Blaricum, Netherlands
(van Kalmthout) Gelderse Vallei Ziekenhuis Ede, Ede, Netherlands
(Kuijper) Spaarne Ziekenhuis Hoofddorp, Hoofddorp, Netherlands
(Geertman) Diaconessenhuis Meppel, Meppel, Netherlands
(Hamer) Meander Medisch Centrum Lichtenberg, Amersfoort, Netherlands
(Werter) Laurentius Ziekenhuis, Roermond, Netherlands
(Westendorp) Rode Kruis Ziekenhuis, Beverwijk, Netherlands
(Kruik) Ziekenhuisgroep Twente Almelo, Almelo, Netherlands
(Zouari) Hopital des Forces de Securite Interieur, La Marsa, Tunisia
(Boughzala) Hopital Sahloul, Sousse, Tunisia
(Boujnah) Hopital Mongi Slim, Tunis, Tunisia
(Gamra) University Hospital Fattouma Bourguiba, Monastir, Tunisia
(Haouala) Hopital Militaire, Monfleury, Tunis, Tunisia
(Kammoun) Hopital Hedi Chaker, Sfax, Tunisia
(Khalfallah) Hopital Regional de Menzel, Menzel Bourguiba, Tunisia
(Maatouk) Hopital Fattouma Bourguiba, Monastir, Tunisia
(Ural) Kocaeli University Medical Faculty, Kocaeli, Turkey
(Kutlu) Karadeniz Tecnical Uni. Med. Fac., Trabzon, Turkey
(Sahin) Ondokuz Mayis Univ. Med. Fac., Samsun, Turkey
(Ebinc) Kirikkale University Medical Faculty, Kirikkale, Turkey
(Kucukoglu) Istanbul University Cardiology Institute, Istanbul, Turkey
(Demirtas) Cukurova University Medical Faculty, Adana, Turkey
(Kirma) Kartal Kosuyolu Train. Res. Hospital, Cevizli Kartal, Istanbul,
Turkey
(Altun) Trakya University Medical Faculty, Edirne, Turkey
(Aydinlar) Uludag University Medical Faculty, Bursa, Turkey
(Aydogdu) Ankara Numune Train. & Res. Hosp, Ankara, Turkey
(Cayli) Adana Numune Training and Research Hospital, Adana, Turkey
(Bozkurt) Ankara Ataturk Training and Research Hospital, Ankara, Turkey
(Buyukoner) Yeditepe University Medical School Hospital, Istanbul, Turkey
(Erdogan) Suleyman Demirel Univ. Med. Fac., Isparta, Turkey
(Acikel) Ataturk University Medical Faculty, Erzurum, Turkey
(Ozdemir) Gazi University Medical Faculty, Ankara, Turkey
(Ozdemir) Selcuk University Meram Medical Faculty, Konya, Turkey
(Yazici) Duzce University Medical Faculty, Duzce, Turkey
(Goloborodko) Com. Instit. 'Municipal Clinical Hospital #3', Odessa,
Ukraine
(Nykonov) CCEH n.a. O.I. Meshchaninova, Department of Cardiology, Kharkiv
Med. ac. PGE, Kharkiv, Ukraine
(Vakaliuk) Ivano-Frankivsk Regional Clinical Cardiovascular Center,
Infarct. Dept #2, Ivano-Frankivsk SMU, Ivano-Frankivsk, Ukraine
(Yagensky) SI 'Lutsk CCH,' Volyn Regional Center of Cardiovascular
Pathology & Thrombosis, Lutsk, Ukraine
(Vatutin) DNMU n.a. M.G. Ch. of the H. Th.o.b.ofIn.of Ur.&Rec.Sur. n.a.
V.G., Donetsk, Ukraine
(Shcherbak) Vinnytsya City Clinical Hospital #1, Vinnitsya, Ukraine
(Kovalskyy) Mykolayiv City Hospital #1, Mykolayiv, Ukraine
(Bagriy) Central City Clinical Hospital #1, Donetsk, Ukraine
(Ushakov) CCH #6 of Emergency Medical Aid, Department of Inf., Crimea
State Medical University n.a. S.I. Georgiyevskyy, Simferopol, Ukraine
(Zhurba) Cherkaskiy Region Cardiological Center, Cherkasy, Ukraine
(Sierkova) M.I. Pyrogov Regional Clinical Hospital, Department of
Cardiology, Vinnytsya, Ukraine
(Bashkirtsev) Oleksandrivska Clinical Hospital, Kiev, Ukraine
(Vasylenko) Com. Inst. CH #9, Department of Cardiology for Patients with
Myocardial Infarction, DSMA, Kryvyi Rih, Ukraine
(Karpenko) Odessa Regional Clinical Hospital, Department of Cardiology,
Odessa State Medical University, Odessa, Ukraine
(Kaydashev) City Clinical Hospital #1 Therap, Department HESIU 'UMSA',
Poltava, Ukraine
(Amosova) Bogomolets NMU Ch. of Hosp. Ther. #1 b.o. Kyiv Oleksandr CH,
Kyiv, Ukraine
(Batushkin) Kiev Municipal Clinical Hospital #5, Kiev, Ukraine
(Faynyk) Lviv Regional State Clinical Treatment-and-Diagnosis
Cardiovascular Center, Lviv, Ukraine
(Horbach) Lviv Communal City Clinical Hospital #8, Lviv, Ukraine
(Karpenko) Kiev Municipal Clinical Hospital # 1, Kiev, Ukraine
(Koval) Dnipropetrovsk SMA Ch. of Hosp.Ther. #2 o.b. of City Joint
Emergency Hospital, Dnipropetrovsk, Ukraine
(Kraiz) Kharkiv Central Clinical Hospital 'Ukrzaliznitsy, Kharkiv, Ukraine
(Potapenko) Lugansk Multifield City Clinical Hospital # 1, Lugansk,
Ukraine
(Rudenko) Kiev Emergency Care Hospital, Kiev, Ukraine
(Malynovsky) MI RMC of Cardiovascular Diseases of Zaporizhzhia RC,
Zaporizhzhia, Ukraine
(Tseluyko) Department of Cardiology, Func. Diag. KMA Postg.Ed.o.t.b.of
Kharkiv City Clinical Hospital #8, Kharkiv, Ukraine
(Volkov) Institute of Therapy AMS Ukraine n.a. L.T. Malaya, Kharkiv,
Ukraine
(Prokhorov) Kharkiv City Clinical Hospital #27, Kharkiv, Ukraine
(Sarkar) Derriford Hospital, Plymouth, United Kingdom
(Moriarty) Craigavon Area Hospital, Craigavon, United Kingdom
(El-Harari) University Hospital of North Durham, Durham, United Kingdom
(Brigden) Yeovil District Hospital, Yeovil, United Kingdom
(Qureshi) Warwick Hospital, Warwick, United Kingdom
(Alamgir) Castle Hill Hospital, Cottingham, United Kingdom
(de Belder) Royal Sussex County Hospital, Brighton, United Kingdom
(Keeling) Torbay Hospital, Torquay, United Kingdom
(Cooke) Chesterfield Royal Hospital, Chesterfield, United Kingdom
(Brown) Royal Gwent Hospital, Gwent, Newport, United Kingdom
(Junejo) Sunderland Royal Hospital, Sunderland, United Kingdom
(Vuyyuru) Princess Royal University Hospital, Orpington, United Kingdom
(Connolly) Sandwell & West Birmingham Hospitals NHS Trust, West Bromwich,
United Kingdom
(Kadr) Queens Hospital, Romford, United Kingdom
(Griffiths) Queen Alexandra Hospital, Portsmouth, United Kingdom
(Tang) Colchester General Hospital, Colchester, United Kingdom
(Cotton) New Cross Hospital, Wolverhampton, United Kingdom
(Barr) Russells Hall Hospital, Dudley, United Kingdom
(Lindsay) Bradford Royal Infirmary, Bradford, United Kingdom
(Venkataraman) George Eliot Hospital, Nuneaton, United Kingdom
(Rittoo) Wirral Hospitals NHS Trust, Wirral, United Kingdom
(Jacob) St Johns Hospital at Howden, Livingston, United Kingdom
(Watkin) Good Hope District General Hospital, Birmingham, United Kingdom
(Lang) Ninewells Hospital, Dundee, United Kingdom
(Pye) York Hospital, York, United Kingdom
(Chambers) Ealing Hospital, Southall, United Kingdom
(Mavromatis) VA Medical Center - Atlanta, Decatur, GA, United States
(Rossi) Pasco Cardiology Center, Hudson, FL, United States
(Ahmad) East Texas Cardiology PA, Houston, TX, United States
(Anderson) University of Texas Medical School, Houston, TX, United States
(Roberts) South Florida Research LLC, Miami, FL, United States
(Klugherz) Abington Medical Specialists, Abington, PA, United States
(Haidar) Mississippi Medical Research LLC, Picayune, MS, United States
(Downes) Heart Center of the Rockies, Loveland, CO, United States
(Russo) Tennessee Heart and Vascular Institute, Hendersonville, TN, United
States
(Wallace) St. Joseph's/Candler Health System, Savannah, GA, United States
(Bhagwat) Cardiology Associates of Northwest Indiana PC, Hammond, IN,
United States
(Mathew) Dr. Thomas Mathew MD, New Hartford, CT, United States
(Jetty) Community Hospital Anderson, Anderson, IN, United States
(Henderson) Cardiology Research Associates, Daytona Beach, FL, United
States
(Dy) Clinical Trials of America Inc., Lenoir, NC, United States
(Isserman) Clinical Trials of America Inc, Hickory, NC, United States
(Kondle) North Valley Nephrology, Yuba City, CA, United States
(Quintana) Gamma Clinical Research Institute, McAllen, TX, United States
(Brener) New York Methodist Hospital, Brooklyn, New York, NY, United
States
(Masud) Buffalo Heart Group, Buffalo, NY, United States
(Vijay) Aurora Denver Cardiology Associates PC, Denver, CO, United States
(Jain) Southwest Clinical Research Centers LLC, Houston, TX, United States
(Longo) Cardiology PC, Syracuse, NY, United States
(Safley) Saint Luke's Health System, Kansas City, MO, United States
(Pancholy) Samir Pancholy LLC, Clarks Summit, PA, United States
(Shaoulian) Pacific Coast Cardiology, Newport Beach, CA, United States
(Allan) Statesville Cardiology, Statesville, NC, United States
(Bazzi) Miami International Cardiology Consultants, Aventura, FL, United
States
(Chahin) Westmoreland Regional Hospital, Greensburg, PA, United States
(Shurmur) University of Nebraska Medical Center, Omaha, NE, United States
(Santos) Wake Forest Baptist Medical Center, Winston-Salem, NC, United
States
(Goldberg) Louis Stokes Cleveland Department of VA Medical Center,
Cleveland, OH, United States
(Gigliotti) Seton Heart Institute, Austin, TX, United States
(Irimpen) Tulane University Medical Center, New Orleans, LA, United States
(Khan) Steward St. Elizabeth's Medical Center, Boston, MA, United States
(Kusnick) Cardiovascular Associates LLC, Covington, LA, United States
(Treasure) Cardiovascular Research of Knoxville, Knoxville, TN, United
States
(Rogers) University of California Davis Health System, Sacramento, CA,
United States
(Zebrack) Heart Center at St. Mark's, Salt Lake City, UT, United States
(Turner) Cardiovascular Specialists of SWLA, Lake Charles, LA, United
States
(Adjei) Sparks Regional Medical Center, Fort Smith, AR, United States
(Ingram) Natchitoches Parish Hospital, Natchitoches, LA, United States
(Mathis) Midwest Cardiovascular Specialists, Elkhart, IN, United States
(Buchanan) New Hanover Medical Research, Wilmington, NC, United States
(Heins) Mid Ohio Heart Clinic, Mansfield, OH, United States
(Ahsan) University of Nevada School of Medicine, Las Vegas, NV, United
States
(Anderson) INTEGRIS Cardiovascular Physicians LLC, Oklahoma City, OK,
United States
(Atassi) Northwest Indiana Cardiovascular Physicians, Valparaiso, IN,
United States
(Bachinsky) Moffitt Heart and Vascular Group, Wormleysburg, PA, United
States
(Baig) Internal Medicine & Cardiology Associates, Fall River, MA, United
States
(Rodriguez) Central Florida Cardiology Group PA, Orlando, FL, United
States
(Tang) Franklin County Heart Center, Chambersburg, PA, United States
(Foreman) St. Edward Mercy Medical Center, Fort Smith, AR, United States
(Berlin) Cardiovascular Consultants of South Florida, Hollywood, FL,
United States
(Bouchard) Cardiology PC, Birmingham, AL, United States
(Thew) Kootenai Heart Clinics LLC, Spokane, WA, United States
(Borromeo) Medical Research Incorporated of Las Vegas, Las Vegas, NV,
United States
(Bowden) Healdsburg Cardiology, Healdsburg, CA, United States
(Boyek) Chester County Hospital, West Chester, PA, United States
(Arter) CaroMont Medical Group Inc, Gastonia, NC, United States
(Blair) Wilford Hall Medical Center, Lackland AFB, TX, United States
(Chandna) Victoria Heart & Vascular Center, Victoria, TX, United States
(Katz) University of North Carolina at Chapel Hill, Chapel Hill, NC,
United States
(Conn) Chattanooga Heart Institute, Chattanooga, TN, United States
(Connelly) Charlotte Heart & Vascular Institute PA, Port Charlotte, FL,
United States
(Del Core) Creighton University, Omaha, NE, United States
(Shanes) Consultants in Cardiovascular Medicine, Melrose Park, IL, United
States
(Dotani) McFarland Clinic, Ames, IA, United States
(Drenning) Heart Center Research LLC, Huntsville, AL, United States
(Bustros) Lutheran Medical Center, Brooklyn, New York, NY, United States
(Elliott) Missouri Cardiovascular Specialists, Columbia, MO, United States
(Fastabend) Lake Charles Medical and Surgical Clinic, Lake Charles, LA,
United States
(Flores) Georgia Heart Specialists, Covington, GA, United States
(Goudreau) Virginia Commonwealth University, Richmond, VA, United States
(Gredler) Tallahassee Research Institute, Tallahassee, FL, United States
(Greenfield) National Institute of Clinical Research, Los Angeles, CA,
United States
(Guidera) Central Bucks Cardiology, Doylestown, PA, United States
(Gogia) Cardiology Consultants of Orange County Medical Group Inc.,
Anaheim, CA, United States
(Hearne) Delmarva Heart Research Foundation Inc, Salisbury, MD, United
States
(Hermany) Grand View - Lehigh Valley Health Services, Sellersville, PA,
United States
(Taheri) Virginia Cardiovascular Associates, Manassas, VA, United States
(Izzo) Saint Vincent Consultants in Cardiovascular Diseases Inc, Erie, PA,
United States
(Jaffrani) Alexandria Cardiology Clinic, Alexandria, VA, United States
(Johnson) Non-Invasive Cardiovascular PA, Houston, TX, United States
(Keedy) New Lexington Clinic P.S.C, Lexington, KY, United States
(Waxman) Deerfield Beach Cardiology Associates, Deerfield Beach, FL,
United States
(Kesselbrenner) Garden State Cardiology, Ridgewood, NJ, United States
(Floro) Pioneer Medical Group, Bellflower, CA, United States
(Korban) Kore Cardiology Research Institute, Lexington, KY, United States
(Labroo) Advanced Cardiovascular Consultants, Rock Island, IL, United
States
(Lui) Research Associates of Jackson, Jackson, MS, United States
(Georgeson) BridgewaterCTUnited States
(Breall) Krannert Institute of Cardiology, Indianapolis, IN, United States
(Baman) Pottstown Medical Specialists Inc, Pottstown, PA, United States
(Mandak) Moffitt Heart and Vascular Group, Wormleysburg, PA, United States
(Marais) Care Clinical Research Corporation, Banning, VT, United States
(Lee) Bay Regional Medical Center, Bay City, MI, United States
(Meisner) Jacobi Medical Center, The Bronx, New York, NY, United States
(Micale) Cardiovascular Research Center LLC, Newport News, VA, United
States
(Meymandi) UCLA Medical Center, Sylmar, CA, United States
(Vicari) MIMA - Melbourne Internal Medicine Associates, Melbourne, FL,
United States
(Mouhaffel) Medical Associates of Northeast Louisiana, West Monroe, LA,
United States
(Moscoso) Inland Heart Doctors Medical Group, Corona, CA, United States
(Papademetriou) VA Medical Center, Washington, Washington, DC, United
States
(Piegari) Berks Cardiologists, Wyomissing, PA, United States
(Promisloff) Hillsboro Cardiology, Hillsboro, OR, United States
(Rivera) Amarillo Heart Clinical Research Institute Inc, Amarillo, TX,
United States
(Rogers) UAB Medical Center, Birmingham, AL, United States
(Roth) Kalispell Regional Medical Center, Kalispell, MT, United States
(Sadler) Cardiology Associates of Palm Beach, Atlantis, FL, United States
(Canto) Watson Clinic, Lakeland, FL, United States
(Schmedtje) Roanoke Heart Institute PLC, Roanoke, VA, United States
(Shaikh) St. Francis Medical Group, Indianapolis, IN, United States
(Shalev) Aurora Medical Group, Milwaukee, WI, United States
(Sharma) Parkway Cardiology Associates PC, Oak Ridge, TN, United States
(Rahman) VA Pittsburgh Health System, Pittsburgh, PA, United States
(Schwartz) Lahey Cardiology, The Medical Center, Nashua, NH, United States
(Sporn) Donald Guthrie Foundation for Education and Research, Sayre, PA,
United States
(Staniloae) Gotham Cardiovascular Research PC, New York, NY, United States
(Tami) Heart and Vascular Center of South Florida, Hollywood, FL, United
States
(Barnum) Natchitoches Internal Medicine, Natchitoches, LA, United States
(Tu) Baptist Healthcare System Inc., Louisville, KY, United States
(Tuma) Rapid City Regional Hospital, Rapid City, SD, United States
(Wali) Spirit Physician Services Inc, Camp Hill, PA, United States
(Welka) Aurora Memorial Hospital of Burlington, Burlington, VT, United
States
(Wilson) Cardiology Consultants, Daytona Beach, FL, United States
(Younis) Gateway Cardiology, St. Louis, MO, United States
(Zakhary) Virginia Research Institute, Danville, VA, United States
(Ziperman) Community Hospitals of Indianapolis, Indianapolis, IN, United
States
(Singh) Atlanta Heart Specialists, Cumming, GA, United States
(Kukuy) Touro Infirmary, New Orleans, LA, United States
(Leimbach) Oklahoma Heart Institute, Tulsa, OK, United States
(Chang) Center for Cardiovascular Research, Johnson City, TN, United
States
(Carter) Central Utah Clinic PC, Provo, UT, United States
(Simpson) Pinehurst Medical Clinic Inc, Pinehurst, NC, United States
(Miklin) Exempla Rocky Mountain Cardiovascular Associates PC, Wheat Ridge,
CO, United States
(Niess) Mid Carolina Cardiology, Matthews, NC, United States
(Schaefer) VA Medical Center - Sacramento, Mather, CA, United States
(Lambert) Pepin Heart & Vascular Institute, University Community Hospital,
Tampa, FL, United States
(Soh) Brooke Army Medical Center, San Antonio, TX, United States
(Heintz) Cooper University Hospital, Camden, NJ, United States
(Miller) Johns Hopkins University, Baltimore, MD, United States
(Chandrashekhar) VA Medical Center - Minneapolis, Minneapolis, MN, United
States
(Pappas) Cardiology Associates of Corpus Christi, Corpus Christi, TX,
United States
(Rashid) Texas Heart Institute SLEH, Houston, TX, United States
(Wright) St. Anthony's Medical Center, St. Louis, MO, United States
(Rees) Cardiovascular Research Foundation of Louisiana, Baton Rouge, LA,
United States
(Bach) Washington University Medical Center, St. Louis, MO, United States
(Wu) Central Cardiovascular Research Foundation, San Antonio, TX, United
States
(Singhi) Carolina Cardiology Associates, Rock Hill, SC, United States
(Quyyumi) Emory University, Atlanta, GA, United States
(Lau) Franciscan Research Center, Tacoma, WA, United States
(Nobel) James A. Haley Veterans Hospital, Tampa, FL, United States
(Kamdar) Mid Carolina Cardiology, Salisbury, NC, United States
(Kabour) Toledo Cardiology Consultants, Toledo, OH, United States
(Stys) Sanford Research/USD, Sioux Falls, SD, United States
(Keller) New York University School of Medicine, New York, NY, United
States
(Kumar) Kumar Medical Corporation, Lancaster, CA, United States
(Danisa) VA Medical Center, Muskogee, OK, United States
(Smith) Memphis Heart Clinic, Memphis, TN, United States
(Espinoza) Hunterdon Cardiovascular Associates, Flemington, NJ, United
States
(Deac) Cardiology Associates of Palm Beach, West Palm Beach, FL, United
States
(Roberts) Cardiology Group of Western New York, Orchard Park, NY, United
States
(Gumm) HeartCare Midwest, Peoria, IL, United States
(Saucedo) The University of Oklahoma, Oklahoma City, OK, United States
(Gimple) University of Virginia Health System, Charlottesville, VA, United
States
(Weinstein) ZASA Clinical Research, Boynton Beach, FL, United States
(Blonder) Pikes Peak Cardiology LLP, Colorado Springs, CO, United States
(Moran) Medical Consultants, Muncie, IN, United States
(Iwaoka) Mid-Carolina Cardiology Consultants, Charlotte, NC, United States
(Bayron) Interventional Cardiac Consultants PLC, Trinity, FL, United
States
(Tejada) Advanced Cardiac Care, Bethlehem, PA, United States
(White) Eastern Carolina Cardiovascular, Elizabeth City, NC, United States
(Ingersoll) Sharp Rees-Stealy Medical Group, San Diego, CA, United States
(Casterella) Swedish Health Services, Seattle, WA, United States
(Chiaramida) Medical University of South Carolina (MUSC), Charleston, SC,
United States
(Harris) McLaren Regional Medical Center, Flint, MI, United States
(Rodriguez) Bay Area Cardiology Associates, Brandon, FL, United States
(Vo) VA Long Beach Healthcare System, Long Beach, CA, United States
(Dave) Heart Care Associates PC, Hopewell, VA, United States
(Khan) Springfield Medical Center, Panama City, FL, United States
(Giacomini) VA Palo Alto Health Care System, Palo Alto, CA, United States
(Kotha) Purushotham & Akther Kotha MD Inc, San Diego, CA, United States
(Park) New York Hospital Medical Center of Queens, Flushing, NY, United
States
(Arif) Cincinnati Veterans Affairs Medical Center, Cincinnati, OH, United
States
(McGrew) Stern Cardiovascular Foundation Inc, Germantown, PA, United
States
(Atieh) Pinehurst Medical Clinic Inc, Sanford, NC, United States
(Huang) Providence Heart Clinic, Portland, OR, United States
(Zarrella) South Jersey Heart Group, Cherry Hill, NJ, United States
(McGarvey) Central Bucks Specialists, Doylestown, PA, United States
(Koganti) Southern Heart Research Institute LLC, Riverdale, GA, United
States
(Albirini) Genesis Healthcare System, Zanesville, OH, United States
(Kozman) The Research Foundation of SUNY, Syracuse, NY, United States
(Slepian) The University of Arizona, Tuscon, AZ, United States
(Quion) Dominion BioMedical Research Alliance (DBRA Inc), Vienna, VA,
United States
(Ramanathan) VA Medical Center - Memphis, Memphis, TN, United States
(Bessen) Jewish Hospital Physicians Group, Louisville, KY, United States
(Rafael) Cardiovascular Consultants Ltd., Glendale, AZ, United States
(Aycock) Cardiology Consultants, Pensacola, FL, United States
(Lee) Hollywood Heart & Vascular, Los Angeles, CA, United States
Publisher
Massachussetts Medical Society
Abstract
BACKGROUND: The effect of intensified platelet inhibition for patients
with unstable angina or myocardial infarction without ST-segment elevation
who do not undergo revascularization has not been delineated.
<br/>METHOD(S): In this double-blind, randomized trial, in a primary
analysis involving 7243 patients under the age of 75 years receiving
aspirin, we evaluated up to 30 months of treatment with prasugrel (10 mg
daily) versus clopidogrel (75 mg daily). In a secondary analysis involving
2083 patients 75 years of age or older, we evaluated 5 mg of prasugrel
versus 75 mg of clopidogrel. <br/>RESULT(S): At a median follow-up of 17
months, the primary end point of death from cardiovascular causes,
myocardial infarction, or stroke among patients under the age of 75 years
occurred in 13.9% of the prasugrel group and 16.0% of the clopidogrel
group (hazard ratio in the prasugrel group, 0.91; 95% confidence interval
[CI], 0.79 to 1.05; P = 0.21). Similar results were observed in the
overall population. The prespecified analysis of multiple recurrent
ischemic events (all components of the primary end point) suggested a
lower risk for prasugrel among patients under the age of 75 years (hazard
ratio, 0.85; 95% CI, 0.72 to 1.00; P = 0.04). Rates of severe and
intracranial bleeding were similar in the two groups in all age groups.
There was no significant between-group difference in the frequency of
nonhemorrhagic serious adverse events, except for a higher frequency of
heart failure in the clopidogrel group. <br/>CONCLUSION(S): Among patients
with unstable angina or myocardial infarction without ST-segment
elevation, prasugrel did not significantly reduce the frequency of the
primary end point, as compared with clopidogrel, and similar risks of
bleeding were observed. (Funded by Eli Lilly and Daiichi Sankyo; TRILOGY
ACS ClinicalTrials.gov number, NCT00699998.) Copyright &#xa9; 2012
Massachusetts Medical Society.

<2>
Accession Number
2030889192
Title
Sacubitril/Valsartan in Patients Hospitalized With Decompensated Heart
Failure.
Source
Journal of the American College of Cardiology. 83(12) (pp 1123-1132),
2024. Date of Publication: 26 Mar 2024.
Author
Morrow D.A.; Velazquez E.J.; Desai A.S.; DeVore A.D.; Lepage S.; Park
J.-G.; Sharma K.; Solomon S.D.; Starling R.C.; Ward J.H.; Williamson K.M.;
Zieroth S.; Hernandez A.F.; Mentz R.J.; Braunwald E.
Institution
(Morrow, Park, Braunwald) TIMI Study Group, Brigham and Women's Hospital
and Harvard Medical School, Boston, MA, United States
(Morrow, Desai, Solomon, Braunwald) Cardiovascular Division, Department of
Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston,
MA, United States
(Velazquez) Section of Cardiovascular Medicine, Department of Internal
Medicine, Yale School of Medicine, New Haven, CT, United States
(DeVore, Hernandez, Mentz) Duke Clinical Research Institute, Duke
University, Durham, NC, United States
(Lepage) Department of Cardiology, Universite de Sherbrooke, Sherbrooke,
QC, Canada
(Sharma) Division of Cardiology, Johns Hopkins University School of
Medicine, Baltimore, MD, United States
(Starling) Department of Cardiovascular Medicine, Cleveland Clinic,
Cleveland, OH, United States
(Ward, Williamson) Novartis Pharmaceuticals Corporation, East Hanover, NJ,
United States
(Zieroth) Section of Cardiology, Max Rady College of Medicine, University
of Manitoba, Winnipeg, MB, Canada
Publisher
Elsevier Inc.
Abstract
Background: The efficacy and safety of sacubitril/valsartan in patients
hospitalized with heart failure (HF) across the spectrum of left
ventricular ejection fraction (EF) has not been described.
<br/>Objective(s): Data from randomized trials of sacubitril/valsartan in
HF patients with EF <=40% (PIONEER-HF [Comparison of Sacubitril/Valsartan
Versus Enalapril on Effect of NT-proBNP in Patients Stabilized From an
Acute Heart Failure Episode] trial) and >40% (PARAGLIDE-HF [Prospective
comparison of ARNI with ARB Given following stabiLization In DEcompensated
HFpEF] trial) following recent worsening heart failure (WHF) were pooled
to examine treatment effect across the EF spectrum. <br/>Method(s): The
PIONEER-HF and PARAGLIDE-HF trials were double-blind, randomized trials of
sacubitril/valsartan vs control therapy (enalapril or valsartan,
respectively). All participants in the PIONEER-HF trial and 69.5% in the
PARAGLIDE-HF trial were enrolled during hospitalization for HF after
stabilization. The remainder in the PARAGLIDE-HF trial were enrolled <=30
days after a WHF event. The primary endpoint of both trials was
time-averaged proportional change in N-terminal pro-B-type natriuretic
peptide (NT-proBNP) from baseline through weeks 4 and 8. Adjudicated
clinical endpoints were analyzed through the end of follow-up, adjusting
for trial. <br/>Result(s): The pooled analysis included 1,347 patients
(881 from PIONEER-HF, 466 from PARAGLIDE-HF). Baseline characteristics
included median age 66 years, 36% women, 31% Black, 34% de novo HF, and
median EF 30%. The reduction in NT-proBNP was 24% greater with
sacubitril/valsartan vs control therapy (n = 1,130; ratio of change =
0.76; 95% CI: 0.69-0.83; P < 0.0001). Cardiovascular death or
hospitalization for HF was reduced by 30% with sacubitril/valsartan vs
control therapy (HR: 0.70; 95% CI: 0.54-0.91; P = 0.0077). This effect was
consistent across the spectrum of EF <=60%. Sacubitril/valsartan increased
symptomatic hypotension (risk ratio: 1.35; 95% CI: 1.05-1.72).
<br/>Conclusion(s): In patients stabilized after WHF, sacubitril/valsartan
led to a greater reduction in plasma NT-proBNP and improved clinical
outcome compared with control therapy, in particular across the spectrum
of EF <=60%. (Comparison of Sacubitril/Valsartan Versus Enalapril on
Effect of NT-proBNP in Patients Stabilized From an Acute Heart Failure
Episode [PIONEER-HF]; NCT02554890; Changes in NT-proBNP, Safety, and
Tolerability in HFpEF Patients With a WHF Event [HFpEF Decompensation] Who
Have Been Stabilized and Initiated at the Time of or Within 30 Days
Post-decompensation [PARAGLIDE-HF]; NCT03988634)<br/>Copyright &#xa9; 2024
American College of Cardiology Foundation

<3>
Accession Number
2030256123
Title
Methylprednisolone Does Not Enhance Paraoxonase 1 Activity During
Cardiopulmonary Bypass Surgery-A Randomized, Controlled Clinical Trial.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 38(4) (pp 946-956),
2024. Date of Publication: April 2024.
Author
Taleska Stupica G.; Sostaric M.; Jenko M.; Podbregar M.
Institution
(Taleska Stupica, Sostaric, Jenko, Podbregar) University Medical Center
Ljubljana, Clinical Department of Anesthesiology and Perioperative
Intensive Therapy, Ljubljana, Slovenia
(Taleska Stupica, Sostaric, Jenko, Podbregar) University of Ljubljana,
Faculty of Medicine, Ljubljana, Slovenia
(Podbregar) General Hospital Celje, Department of Internal Intensive
Medicine, Celje, Slovenia
Publisher
W.B. Saunders
Abstract
Objectives: Cardiopulmonary bypass (CPB) is linked to systemic
inflammatory responses and oxidative stress. Paraoxonase 1 (PON1) is an
antioxidant enzyme with a cardioprotective role whose activity is
decreased in systemic inflammation and in patients with acute myocardial
and global ischemia. Glucocorticoids counteract the effect of oxidative
stress by upregulating PON1 gene expression. The authors aimed to
determine the effect of methylprednisolone on PON1 activity during cardiac
surgery on CPB. <br/>Design(s): Prospective, randomized, controlled
clinical trial. <br/>Setting(s): The University Medical Center Ljubljana,
Slovenia. <br/>Participant(s): Forty adult patients who underwent complex
cardiac surgery on CPB between February 2016 and December 2017 were
randomized into methylprednisolone and control groups (n = 20 each).
<br/>Intervention(s): Patients in the methylprednisolone group received 1
g of methylprednisolone in the CPB priming solution, whereas patients in
the control group were not given methylprednisolone during CPB.
<br/>Measurements and Main Results: The effect of methylprednisolone from
the CPB priming solution was compared with standard care during CPB on
PON1 activity until postoperative day 5. Correlations of PON1 activity
with lipid status, mediators of inflammation, and hemodynamics were
analyzed also. No significant differences were found between study groups
for PON1 activity, high-density lipoprotein, and low-density lipoprotein
in any of the measurement intervals (p > 0.016). The methylprednisolone
group had significantly lower tumor necrosis factor alpha (p < 0.001) and
interleukin-6 (p < 0.001), as well as C-reactive protein and procalcitonin
(p < 0.016) after surgery. No significant difference was found between
groups for hemodynamic parameters. A positive correlation existed between
PON1 and lipid status, whereas a negative correlation was found between
PON1 activity and tumor necrosis factor alpha, interleukin-6, and CPB
duration. <br/>Conclusion(s): Methylprednisolone does not influence PON1
activity during cardiac surgery on CPB.<br/>Copyright &#xa9; 2023 The
Author(s)

<4>
Accession Number
2029066699
Title
Randomized clinical trial of continuous transversus thoracis muscle plane
block for patients undergoing open heart valve replacement surgery.
Source
Journal of Cellular and Molecular Medicine. 28(7) (no pagination), 2024.
Article Number: e18184. Date of Publication: April 2024.
Author
Zhan Y.; Li L.; Chen S.; Peng Y.; Zhang Y.
Institution
(Zhan, Li, Chen, Zhang) Department of Anaesthesiology, First Affiliated
Hospital of Nanchang University, Nanchang, China
(Peng) Department of Anaesthesiology, Jiangxi Maternal and Child Health
Hospital, Nanchang, China
Publisher
John Wiley and Sons Inc
Abstract
The optimal analgesia regimen after open cardiac surgery is unclear. The
aim of this study was to investigate the beneficial effects of continuous
transversus thoracis muscle plane (TTMP) blocks initiated before surgery
on open cardiac surgery outcomes. A group of 110 patients were randomly
allocated to either receive bilateral continuous TTMP blocks (TTP group)
or no nerve block (SAL group). The primary endpoint was post-operative
pain at 4, 8, 16, 24, 48 and 72 h after extubation at rest and exercise.
The secondary outcome measures included analgesia requirements (sufentanil
and flurbiprofen axetil administration), time to extubation, incidence of
reintubation, length of stay in the ICU, incidence of post-operative
nausea and vomiting (PONV), time until return of bowel function, time to
mobilization, urinary catheter removal and length of hospital stay. The
length of stay in the ICU and length of hospital stay were significantly
longer in the SAL group than in the TTP group. NRS scores at rest and
exercise were significantly lower in the TTP group than in the SAL group
at all time points. The TTP group required significantly less
intraoperative and post-operative sufentanil and post-operative dynastat
consumption than the SAL group. Time to extubation, time to first flatus,
time until mobilization and time until urinary catheter removal were
significantly earlier in the TTP group than in the SAL group. The
incidence of PONV was significantly lower in the TTP group. Bilateral
continuous TTMP blocks provide effective analgesia and accelerate recovery
in patients undergoing open heart valve replacement surgery.<br/>Copyright
&#xa9; 2024 The Authors. Journal of Cellular and Molecular Medicine
published by Foundation for Cellular and Molecular Medicine and John Wiley
& Sons Ltd.

<5>
Accession Number
2028891312
Title
The role of perioperative sedative anesthetics in preventing postoperative
delirium: a systematic review and network-meta analysis including 6679
patients.
Source
BMC Cardiovascular Disorders. 24(1) (no pagination), 2024. Article Number:
147. Date of Publication: December 2024.
Author
Huang J.-X.; Zhang S.-S.; Wang S.-X.; Xi D.-S.; Luo F.-R.; Liu C.-J.; Li
H.
Institution
(Huang, Zhang, Wang, Xi, Luo, Li) Department of Anesthesiology, Second
Affiliated Hospital of Army Medical University, Chongqing, China
(Liu) Department of General Medicine, Affiliated Anqing First People's
Hospital of Anhui Medical University, Anqing, China
Publisher
BioMed Central Ltd
Abstract
Objective: Postoperative delirium is a common and debilitating
complication that significantly affects patients and their families. The
purpose of this study is to investigate whether there is an effective
sedative that can prevent postoperative delirium while also examining the
safety of using sedatives during the perioperative period. <br/>Method(s):
The net-meta analysis was used to compare the incidence of postoperative
delirium among four sedatives: sevoflurane, propofol, dexmedetomidine, and
midazolam. Interventions were ranked according to their surface under the
cumulative ranking curve (SUCRA). <br/>Result(s): A total of 41 RCT
studies involving 6679 patients were analyzed. Dexmedetomidine can
effectively reduce the incidence of postoperative delirium than propofol
(OR 0.47 95% CI 0.25-0.90), midazolam (OR 0.42 95% CI 0.17-1.00), normal
saline (OR 0.42 95% CI 0.33-0.54) and sevoflurane (OR 0.39 95% CI
0.18-0.82). The saline group showed a significantly lower incidence of
bradycardia compared to the group receiving dexmedetomidine (OR 0.55 95%
CI 0.37-0.80). In cardiac surgery, midazolam (OR 3.34 95%CI 2.04-5.48) and
normal saline (OR 2.27 95%CI 1.17-4.39) had a higher rate of postoperative
delirium than dexmedetomidine, while in non-cardiac surgery, normal saline
(OR 1.98 95%CI 1.44-2.71) was more susceptible to postoperative delirium
than dexmedetomidine. <br/>Conclusion(s): Our analysis suggests that
dexmedetomidine is an effective sedative in preventing postoperative
delirium whether in cardiac surgery or non-cardiac surgery. The preventive
effect of dexmedetomidine on postoperative delirium becomes more apparent
with longer surgical and extubation times. However, it should be
administered with caution as it was found to be associated with
bradycardia.<br/>Copyright &#xa9; The Author(s) 2024.

<6>
Accession Number
2028756491
Title
Mortality and Heart Transplantation After Hybrid Palliation of Hypoplastic
Left Heart Syndrome: A Systematic Review and Meta-Analysis.
Source
World Journal for Pediatric and Congenital Heart Surgery. 15(2) (pp
215-223), 2024. Date of Publication: March 2024.
Author
Jacquemyn X.; Singh T.P.; Gossett J.G.; Averin K.; Kutty S.; Zuhlke L.J.;
Abdullahi L.H.; Kulkarni A.
Institution
(Jacquemyn, Kutty) Helen B. Taussig Heart Center, Department of
Pediatrics, Johns Hopkins Hospital, Baltimore, MD, United States
(Jacquemyn) Department of Cardiovascular Sciences, KU Leuven, Leuven,
Belgium
(Singh) Department of Cardiology, Boston Children's Hospital, Boston, MA,
United States
(Gossett, Averin, Kulkarni) Cohen Children's Heart Center, Donald and
Barbara Zucker School of Medicine at Hofstra/ Northwell, New Hyde Park,
NY, United States
(Zuhlke) President's Office, South African Medical Research Council, Cape
Town, South Africa
(Zuhlke) Division of Paediatric Cardiology, Department of Paediatrics,
Institute of Child Health, Faculty of Health Sciences, University of Cape
Town, Cape Town, South Africa
(Abdullahi) Save the Children International (SCI), Somalia/Somaliland
Country Office, Nairobi, Kenya
Publisher
SAGE Publications Inc.
Abstract
Background: Newborns with hypoplastic left heart syndrome (HLHS) who are
considered at increased risk for death following Norwood/Sano surgery
often undergo hybrid palliation (HP) as initial surgery. We aimed to
compile the HP experience in HLHS and its variants and assess the rates
of, and risk factors for, death and heart transplantation. <br/>Method(s):
CINAHL, CINAHL PLUS, PubMed/MEDLINE, and SCOPUS were systematically
searched for HP outcome studies of death or heart transplantation in HLHS
between 1998 and 2022. Pooled incidence was estimated, and potential risk
factors were identified using random-effects meta-analysis and
reconstructed time-to-event data from Kaplan-Meier curves. <br/>Result(s):
Thirty-three publications were included in our review. Overall, of 1,162
patients 417 died and 57 underwent heart transplantation, resulting in a
combined outcome of 40.7%, (474/1,162). There was a trend toward
decreasing mortality risk across the stages of palliation. Pooled
mortality between HP and comprehensive stage 2 palliation was 25%, after
stage 2 up to Fontan palliation was 16%, and 6% post-Fontan. The incidence
of death or heart transplantation was higher in high-risk patients-43%
died and 10% received heart transplantation. <br/>Conclusion(s): Our
systematic review and meta-analysis found high rates of death or heart
transplantation in HP of HLHS patients between HP and Fontan surgeries.
All patients should be closely followed during the initial interstage
period, which is associated with the highest hazard. Prospective studies
on appropriate patient selection, indications, and / or alternatives, as
well as refining HP strategies for managing newborns with HLHS are needed
to improve outcomes.<br/>Copyright &#xa9; The Author(s) 2024.

<7>
Accession Number
2028506849
Title
Comparative Study on I Gel Insertion Conditions using
Dexmedetomidine-Propofol versus Fentanyl Propofol.
Source
International Journal of Toxicological and Pharmacological Research. 14(3)
(pp 41-44), 2024. Date of Publication: 2024.
Author
Subrahmaneyswari K.V.; Ramesh V.V.; Mylabathula N.J.; Mahanthi K.S.
Institution
(Subrahmaneyswari, Ramesh, Mylabathula, Mahanthi) Department of
Anaesthesiology, Rangaraya Medical College, Kakinada, India
Publisher
Dr. Yashwant Research Labs Pvt. Ltd.
Abstract
Introduction: The hypothesis posited that the use of dexmedetomidine and
propofol would yield superior i-gel insertion conditions when compared to
the combination of fentanyl and propofol. The objective of the study was
to assess and compare i-gel insertion conditions. <br/>Method(s): It was a
hospital based prospective double-blinded randomised control study,
conducted in Rangaraya Medical College. Individuals of both gender posted
for short surgical procedure under general anaesthesia aged 18 - 60 years,
ASA grade I & II and MPG I & II were included. The study was explained,
pre anaesthetic evaluation was carried as per the protocol. Randomly,
participants were divided two groups; group D members received 1mcg/kg
Dexmedetomidine and Fentanyl 1 mcg/kg for group F members. After
successful administration of medicament i gel was inserted; the ease of
insertion was assed as per the guidelines, removed at the end of surgery.
Heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure
(DBP), and mean arterial blood pressure (MAP) were monitored, recorded at
baseline, after study drug infusion, propofol induction and 1, 3, 5 and 10
minutes after insertion: Student t-test and chi square test was used, P<
0.05 was considered statistically significant. <br/>Result(s): As per the
degree of jaw relaxation (DOJ), the acceptability was 90% and 100%,
respectively in the groups, statistically there was no significant
difference. In group F, 36 members had grade 1 movement, and it was 38 in
group D; statistically there was no significant difference. Statistically
there was no significant difference between in coughing, gagging, overall
conditions and number of i gel insertion. Statistically there was
significant difference in the mean HR, SBP, DBP, MAP. <br/>Conclusion(s):
The combination of Dexmedetomidine with propofol offers superior insertion
conditions for the i-gel compared to the combination of fentanyl with
propofol. This is accompanied by stable hemodynamics and minimal adverse
effects.<br/>Copyright &#xa9; 2024, Dr. Yashwant Research Labs Pvt. Ltd.
All rights reserved.

<8>
Accession Number
2027969121
Title
Assessment of microcirculatory alteration by a vascular occlusion test
using near-infrared spectroscopy in pediatric cardiac surgery: effect of
cardiopulmonary bypass.
Source
Expert Review of Medical Devices. 21(3) (pp 249-255), 2024. Date of
Publication: 2024.
Author
Savluk O.F.; Yilmaz A.A.; Yavuz Y.; Arisut S.; Ukil Isildak F.; Turkmen
Karaagac A.; Ozbek B.; Cine N.; Tuncer E.; Ceyran H.
Institution
(Savluk, Yavuz, Arisut, Ukil Isildak, Turkmen Karaagac) Anesthesiology and
Reanimation Clinic, Kartal Kosuyolu High Education and Training Hospital,
Istanbul, Turkey
(Yilmaz, Ozbek, Cine, Tuncer, Ceyran) Pediatric Cardiac Surgery Clinic,
Kartal Kosuyolu High Education and Training Hospital, Istanbul, Turkey
Publisher
Taylor and Francis Ltd.
Abstract
Objectives: Cardiopulmonary bypass cause microcirculatory alterations.
Near infrared spectroscopic measurement of tissue oxygen saturation and
vascular occlusion test are novel technologies for assessing the
microcirculatory function of peripheral tissue specifically in patients
undergoing cardiac surgery with cardiopulmonary bypass.Our study aimed to
evaluate dynamic microcirculatory function using the vascular occlusion
testing during cardiac surgery in pediatric patients. <br/>Method(s): 120
pediatric patients were scheduled. Children had continuous regional oxygen
saturation monitoring using near infrared spectroscopy and vascular
occlusion test. Vascular occlusion test was performed five times; before
induction (T1), after induction (T2), then during cardiopulmonary bypass
with full flow (T3), after the termination of CPB (T4) and after sternum
closure (T5). <br/>Result(s): Basal value was the lowest at T3 and this
value was significantly different among measurements (p < 0,01).Values for
maximum and minimum tissue oxygen saturation were the lowest at T3 (83,4
and 52,9%).The occlusion slope varied significantly among measurements (p
< 0,01).Reperfusion slopes were significantly different among measurements
(p < 0,01) with a further progressive decrease in reperfusion slope with
duration of cardiopulmonary bypass. <br/>Conclusion(s): Microcirculatory
function can assessed using VOT with forearm Near-infrared spectroscopy
derived variables during cardiopulmonary bypass in pediatric cardiac
surgery. Noninvasive assessment of microcirculatory perfusion during
cardiopulmonary bypass can further help evaluate and improve circulatory
support techniques. Trial Registration: The research Project was
registered at ClinicalTrials.gov (NCT06191913).<br/>Copyright &#xa9; 2024
Informa UK Limited, trading as Taylor & Francis Group.

<9>
Accession Number
2026873667
Title
Postoperative anemia in cardiac surgery patients: a narrative review.
Source
Canadian Journal of Anesthesia. 71(3) (pp 408-421), 2024. Date of
Publication: March 2024.
Author
Li M.M.; Miles S.; Callum J.; Lin Y.; Karkouti K.; Bartoszko J.
Institution
(Li, Karkouti, Bartoszko) Institute of Medical Science, University of
Toronto, Toronto, ON, Canada
(Li, Miles, Karkouti, Bartoszko) Department of Anesthesia and Pain
Management, Sinai Health System, Women's College Hospital, University
Health Network, Toronto, ON, Canada
(Callum, Lin, Karkouti, Bartoszko) University of Toronto Quality in
Utilization, Education and Safety in Transfusion Research Program,
Toronto, ON, Canada
(Callum) Department of Pathology and Molecular Medicine, Kingston Health
Sciences Centre and Queen's University, Kingston, ON, Canada
(Lin) Precision Diagnostics and Therapeutics Program, Sunnybrook Health
Sciences Centre, Toronto, ON, Canada
(Lin) Department of Laboratory Medicine and Pathobiology, University of
Toronto, Toronto, ON, Canada
(Karkouti, Bartoszko) Department of Anesthesiology and Pain Medicine,
University of Toronto, Toronto, ON, Canada
(Karkouti, Bartoszko) Peter Munk Cardiac Centre, University Health
Network, Toronto, ON, Canada
(Karkouti, Bartoszko) Institute for Health Policy, Management, and
Evaluation, University of Toronto, Toronto, ON, Canada
(Karkouti, Bartoszko) Interdepartmental Division of Critical Care,
Department of Medicine, University of Toronto, Toronto, ON, Canada
Publisher
Springer
Abstract
Purpose: Anemia reduces the blood's ability to carry and deliver oxygen.
Following cardiac surgery, anemia is very common and affects up to 90% of
patients. Nevertheless, there is a paucity of data examining the
prognostic value of postoperative anemia. In this narrative review, we
present findings from the relevant literature on postoperative anemia in
cardiac surgery patients, focusing on the incidence, risk factors, and
prognostic value of postoperative anemia. We also explore the potential
utility of postoperative anemia as a therapeutic target to improve
clinical outcomes. Source: We conducted a targeted search of MEDLINE,
Embase, and the Cochrane Database of Systematic Reviews up to September
2022, using a combination of search terms including postoperative
(post-operative), perioperative (peri-operative), anemia (anaemia), and
cardiac surgery. Principal findings: The reported incidence of
postoperative anemia varied from 29% to 94% across the studies, likely
because of variations in patient inclusion criteria and classification of
postoperative anemia. Nonetheless, the weight of the evidence suggests
that postoperative anemia is common and is an independent risk factor for
adverse postoperative outcomes such as acute kidney injury, stroke,
mortality, and functional outcomes. <br/>Conclusion(s): In cardiac surgery
patients, postoperative anemia is a common and prognostically important
risk factor for postoperative morbidity and mortality. Nevertheless, there
is a lack of data on whether active management of postoperative anemia is
feasible or effective in improving patient outcomes.<br/>Copyright &#xa9;
Canadian Anesthesiologists' Society 2023.

<10>
Accession Number
2029083961
Title
Plasma hyperosmolality during cardiopulmonary bypass is a risk factor for
postoperative acute kidney injury: Results from double blind randomised
controlled trial.
Source
Perfusion (United Kingdom). (no pagination), 2024. Date of Publication:
2024.
Author
Svenmarker S.; Claesson Lingehall H.; Malmqvist G.; Appelblad M.
Institution
(Svenmarker, Malmqvist) Department of Public Health and Clinical Medicine,
Umea University, Umea, Sweden
(Claesson Lingehall) Department of Nursing, Umea University, Umea, Sweden
(Appelblad) Department of Public Health and Clinical Medicine, Heart
Centre, Umea University, Umea, Sweden
Publisher
SAGE Publications Ltd
Abstract
Introduction: The study objective was to investigate whether a Ringer's
acetate based priming solution with addition of Mannitol and sodium
concentrate increases the risk of cardiac surgery associated kidney injury
(CSA-AKI). <br/>Method(s): This is a double blind, prospective randomized
controlled trial from a single tertiary teaching hospital in Sweden
including patients aged >=65 years (n = 195) admitted for routine cardiac
surgery with cardiopulmonary bypass. Patients in the study group received
Ringer's acetate 1000 mL + 400 mL Mannitol (60 g) + sodium chloride 40 mL
(160 mmol) and heparin 2 mL (10 000 IU) 966 mOsmol (n = 98), while
patients in the control group received Ringer's acetate 1400 mL + heparin
2 mL (10 000 IU), 388 mOsmol (n = 97) as pump prime. Acute kidney injury
was analysed based on the Kidney Disease Improving Outcomes (KDIGO 1-3)
definition. <br/>Result(s): The overall incidence of CSA-AKI (KDIGO stage
1) was 2.6% on day 1 in the ICU and 5.6% on day 3, postoperatively. The
serum creatinine level did not show any postoperative intergroup
differences, when compared to baseline preoperative values. Six patients
in the Ringer and five patients in the Mannitol group developed CSA-AKI
(KDIGO 1-3), all with glomerular filtration rates <60 mL/min/1.73
m². These patients showed significantly higher plasma
osmolality levels compared to preoperative values. Hyperosmolality
together with patient age and the duration of the surgery were independent
risk factors for postoperative acute kidney injury (KDIGO 1-3).
<br/>Conclusion(s): The use of a hyperosmolar prime solution did not
increase the incidence of postoperative CSA-AKI in this study, while high
plasma osmolality alone increased the associated risk by 30%. The data
suggests further examination of plasma hyperosmolality as a relative risk
factor of CSA-AKI.<br/>Copyright &#xa9; The Author(s) 2024.

<11>
Accession Number
2027197590
Title
Use of intraoperative haemoadsorption in patients undergoing heart
transplantation: a proof-of-concept randomized trial.
Source
ESC Heart Failure. 11(2) (pp 772-782), 2024. Date of Publication: April
2024.
Author
Nemeth E.; Soltesz A.; Kovacs E.; Szakal-Toth Z.; Tamaska E.; Katona H.;
Racz K.; Csikos G.; Berzsenyi V.; Fabry S.; Ulakcsai Z.; Tamas C.; Nagy
B.; Varga M.; Merkely B.
Institution
(Nemeth, Soltesz, Kovacs, Szakal-Toth, Tamaska, Katona, Racz, Csikos,
Berzsenyi, Fabry, Ulakcsai, Tamas, Merkely) Heart and Vascular Center,
Semmelweis University, Budapest, Hungary
(Nemeth, Soltesz, Kovacs, Tamaska, Katona, Racz, Csikos, Berzsenyi, Fabry,
Ulakcsai) Department of Anaesthesiology and Intensive Therapy, Semmelweis
University, Budapest, Hungary
(Nagy) Department of Pathology and Experimental Cancer Research,
Semmelweis University, Budapest, Hungary
(Varga) Department of Laboratory Medicine, Semmelweis University,
Budapest, Hungary
Publisher
John Wiley and Sons Inc
Abstract
Aims: The aim of this trial was to compare the clinical effects of
intraoperative haemoadsorption versus standard care in patients undergoing
orthotopic heart transplantation (OHT). <br/>Methods and Results: In a
randomized, controlled trial, OHT recipients were randomized to receive
intraoperative haemoadsorption or standard care. Outcomes were
vasoactive-inotropic score (VIS), frequency of vasoplegic syndrome (VS) in
the first 24 h; post-operative change in procalcitonin (PCT) and
C-reactive protein (CRP) levels; intraoperative change in mycophenolic
acid (MPA) concentration; frequency of post-operative organ dysfunction,
major complications, adverse immunological events and length of
in-hospital stay and 1-year survival. Sixty patients were randomized
(haemoadsorption group N = 30, control group N = 25 plus 5 exclusions).
Patients in the haemoadsorption group had a lower median VIS and rate of
VS (VIS: 27.2 [14.6-47.7] vs. 41.9 [22.4-63.2], P = 0.046, and VS: 20.0%
vs. 48.0%, P = 0.028, respectively), a 6.4-fold decrease in the odds of
early VS (OR: 0.156, CI: 0.029-0.830, P = 0.029), lower PCT levels,
shorter median mechanical ventilation (MV: 25 [19-68.8] hours vs. 65
[23-287] hours, P = 0.025, respectively) and intensive care unit stay (ICU
stay: 8.5 [8.0-10.3] days vs. 12 [8.5-18.0] days, P = 0.022, respectively)
than patients in the control group. Patients in the haemoadsorption versus
control group experienced lower rates of acute kidney injury (AKI: 36.7%
vs. 76.0%, P = 0.004, respectively), renal replacement therapy (RRT: 0%
vs. 16.0%, P = 0.037, respectively) and lower median per cent change in
bilirubin level (PCB: 2.5 [-24.6 to 71.1] % vs. 72.1 [11.2-191.4] %, P =
0.009, respectively) during the post-operative period. MPA concentrations
measured at pre-defined time points were comparable in the haemoadsorption
compared to control groups (MPA pre-cardiopulmonary bypass: 2.4
[1.15-3.60] mug/mL vs. 1.6 [1.20-3.20] mug/mL, P = 0.780, and MPA 120 min
after cardiopulmonary bypass start: 1.1 [0.58-2.32] mug/mL vs. 0.9
[0.45-2.10] mug/mL, P = 0.786). The rates of cardiac allograft rejection,
30-day mortality and 1-year survival were similar between the groups.
<br/>Conclusion(s): Intraoperative haemoadsorption was associated with
better haemodynamic stability, mitigated PCT response, lower rates of
post-operative AKI and RRT, more stable hepatic bilirubin excretion, and
shorter durations of MV and ICU stay. Intraoperative haemoadsorption did
not show any relevant adsorption effect on MPA. There was no increase in
the frequency of early cardiac allograft rejection related to
intraoperative haemoadsorption use.<br/>Copyright &#xa9; 2023 The Authors.
ESC Heart Failure published by John Wiley & Sons Ltd on behalf of European
Society of Cardiology.

<12>
Accession Number
643817572
Title
Interpapillary muscle distance independently predicts recurrent mitral
regurgitation.
Source
Journal of cardiothoracic surgery. 19(1) (pp 147), 2024. Date of
Publication: 20 Mar 2024.
Author
Gambardella I.; Spadaccio C.; Singh S.S.A.; Shingu Y.; Kunihara T.; Wakasa
S.; Nappi F.
Institution
(Gambardella) Department of Cardiothoracic Surgery, Weill Cornell
Medicine, NY, United States
(Spadaccio) Department of Cardiothoracic Surgery, Mayo Clinic, Rochester,
United States
(Singh) Department of Cardiothoracic Surgery, Royal Infirmary of
Edinburgh, Edinburgh, United Kingdom
(Shingu, Wakasa) Department of Cardiovascular Surgery, Faculty of Medicine
and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
(Kunihara) Department of Cardiac Surgery, Jikei University School of
Medicine, Tokyo, Japan
(Nappi) Department of Cardiac Surgery, Centre Cardiologique du Nord,
Saint-Denis, France
Abstract
OBJECTIVE: Ischaemic secondary mitral regurgitation (ISMR) after surgery
is due to the displacement of papillary muscles resulting from progressive
enlargement of the left ventricle end-diastolic diameter (LVEDD). Our aim
was to prove that if the interpapillary muscle distance (IPMD) is
surgically stabilized, an increase in LVEDD will not lead to a recurrence
of ischaemic mitral regurgitation (MR). <br/>METHOD(S): Ninety-six
patients with ISMR, who underwent surgical revascularisation and
annuloplasty, were randomly assigned in a 1:1 ratio to undergo papillary
muscle approximation (PMA). At the 5-year follow-up, we assessed the
correlation between PMA and echocardiographic improvements, the effect
size of PMA on echocardiographic improvements, and a prediction model for
recurrent MR using inferential tree analysis. <br/>RESULT(S): There was a
significant correlation between PMA and enhancements in both the alpha and
beta angles (Spearman's rho>0.7, p<0.01). The alpha angle represents the
angle between the annular plane and either the A2 annular-coaptation line
or the P2 annular-coaptation line. The beta angle indicates the angle
between the annular plane and either the A2 annular-leaflet tip line or
the P2 annular-leaflet tip line. PMA led to substantial improvements in
LVEDD, tenting area, alpha and beta angles, with a large effect size
(Hedge's g>=8, 95% CI ORs1). The most reliable predictor of recurrent MR
grade was the interpapillary distance, as only patients with an
interpapillary distance greater than 40 mm developed>=3+grade MR. For
patients with an IPMD of 40 mm or less, the best predictor of recurrent MR
grade was LVEDD. Among the patients, only those with LVEDD greater than 62
mm showed moderate (2+) MR, while only those with LVEDD less than or equal
to 62 mm had absent to mild (1+) MR. <br/>CONCLUSION(S): Prediction of
recurrent ischaemic MR is not independent of progressive LVEDD increase.
PMA-based surgical procedure stabilises IPMD.<br/>Copyright &#xa9; 2024.
The Author(s).

<13>
Accession Number
641863917
Title
Evaluation of the efficacy and safety of robot-assisted and video assisted
thoracic surgery for early non-small cell lung cancer: A meta-analysis.
Source
Technology and health care : official journal of the European Society for
Engineering and Medicine. 32(2) (pp 511-523), 2024. Date of Publication:
2024.
Author
Wang P.; Fu Y.-H.; Qi H.-F.; He P.; Wang H.-F.; Li C.; Liu X.-C.
Institution
(Wang, Qi, He, Wang, Li, Liu) Department of Cardiothoracic Surgery, 82nd
Group Military Hospital of PLA, Baoding, Hebei, China
(Fu) Department of Rheumatology and Immunology, Baoding Children's
Hospital, Baoding, Hebei, China
Abstract
BACKGROUND: Radical resection of lung cancer and chemotherapy are the main
methods for the treatment of early lung cancer, but surgical treatment is
still the key and preferred method. <br/>OBJECTIVE(S): To evaluate the
efficacy and safety of robotic-assisted thoracic surgery (RATS) and video
assisted thoracic surgery (VATS) for non-small cell lung cancer (NSCLC).
<br/>METHOD(S): The clinical cohort studies on the comparison of the
effects of RATS and VATS in the treatment of NSCLC published in Web of
Science, PubMed, The National Library of Medicine (NLM), China National
Knowledge Infrastructure (CNKI) and Wanfang database from January 1, 2015
to December 31, 2022 were searched. Two researchers independently screened
the literature, extracted the data, such as operation time, intraoperative
conversion rate, intraoperative blood loss, number of lymph nodes
dissected, and evaluated the quality of the included literature based on
the Newcastle-Ottawa Scale (NOS). RevMan 5.3 software was used for Meat
analysis. <br/>RESULT(S): A total of 18 articles and 21,802 subjects were
included. The results of the meta-analysis showed that the intraoperative
blood loss of RATS was significantly less than that of VAS, and the
difference was statistically significant [MD =-38.43 (95% CI: -57.71,
-19.15, P< 0.001)]. Compared with VATS, the number of lymph nodes
dissected in RATS was significantly higher [MD = 2.61 (95% CI: 0.47, 4.76,
P= 0.02)]. The rate of conversion to thoracotomy in RATS was lower, and
the difference was statistically significant [OR = 0.59 (95% CI: 0.50,
0.70, P< 0.001)]. There was no significant difference between RATS and
VATS in operation time [MD =-9.34 (95% CI: -28.72, 10.04, P= 0.34)],
postoperative thoracic drainage time [MD =-0.08 (95% CI: -0.42, 0.26, P=
0.64)], postoperative hospital stay [MD =-0.05 (95% CI: -0.19, 0.08, P=
0.42)], postoperative mortality [OR = 0.88 (95% CI: 0.56, 1.36, P= 0.56)]
and postoperative complications [OR = 1.03 (95% CI: 0.93, 1.13, P= 0.57)].
<br/>CONCLUSION(S): Compared with VATS, the number of lymph nodes
dissected in RATS was significantly more, and the removal of lesions and
lymph nodes was more thorough and accurate. More flexible and precise
operation avoids the injury of important blood vessels during operation,
effectively reduces the amount of blood loss during operation, shortens
the indwelling time of thoracic drainage tube, and is conducive to
postoperative rehabilitation of patients.

<14>
Accession Number
2031230645
Title
Lifetime effects and cost-effectiveness of standard and higher-intensity
statin therapy across population categories in the UK: a microsimulation
modelling study.
Source
The Lancet Regional Health - Europe. 40 (no pagination), 2024. Article
Number: 100887. Date of Publication: May 2024.
Author
Mihaylova B.; Wu R.; Zhou J.; Williams C.; Schlackow I.; Emberson J.;
Reith C.; Keech A.; Robson J.; Parnell R.; Armitage J.; Gray A.; Simes J.;
Baigent C.
Institution
(Mihaylova, Zhou, Williams, Schlackow, Gray) Health Economics Research
Centre, Nuffield Department of Population Health, University of Oxford,
Oxford, United Kingdom
(Mihaylova, Wu) Health Economics and Policy Research Unit, Wolfson
Institute of Population Health, Queen Mary University of London, London,
United Kingdom
(Emberson, Reith, Armitage, Baigent) Clinical Trial Service Unit and
Epidemiological Studies Unit, Nuffield Department of Population Health,
University of Oxford, Oxford, United Kingdom
(Emberson, Armitage, Baigent) MRC Population Health Research Unit,
University of Oxford, United Kingdom
(Keech, Simes) NHMRC Clinical Trials Centre, University of Sydney, Sydney,
Australia
(Robson) Clinical Effectiveness Group, Wolfson Institute of Population
Health, Queen Mary University of London, London, United Kingdom
(Parnell) Patient and Public Representative, United Kingdom
Publisher
Elsevier Ltd
Abstract
Background: Cardiovascular disease incidence and mortality have declined
across developed economies and granular up-to-date cost-effectiveness
evidence is required for treatments targeting large populations. To assess
the health benefits and cost-effectiveness of standard and higher
intensity statin therapy in the contemporary UK population 40-70 years
old. <br/>Method(s): A cardiovascular disease microsimulation model,
developed using the Cholesterol Treatment Trialists' Collaboration data
(117,896 participants; 5 years follow-up), and calibrated in the UK
Biobank cohort (501,854 participants; 9 years follow-up), projected risks
of myocardial infarction, stroke, coronary revascularization, diabetes,
cancer and vascular and nonvascular death for all UK Biobank participants
without and with statin treatment. Meta-analyses of trials and cohort
studies informed statins' relative effects on cardiovascular events,
incident diabetes, myopathy and rhabdomyolysis. UK healthcare perspective
was taken (2020/2021 UK) with costs per 28 tablets of 1.10 for standard
(35%-45% LDL cholesterol (LDL-C) reduction) and 1.68 for higher intensity
(>=45% LDL-C reduction) generic statin. <br/>Finding(s): Across categories
by sex, age, LDL-C, and cardiovascular disease history/10-year
cardiovascular risk, lifetime standard statin increased survival by
0.28-1.85 years (0.20-1.09 quality-adjusted life years (QALYs)), and
higher intensity statin by further 0.06-0.40 years (0.03-0.20 QALYs) per
person. Standard statin was cost-effective across all categories with
incremental cost per QALY from 280 to 8530, with higher intensity statin
cost-effective at higher cardiovascular risks and higher LDL-C levels.
Stopping statin early reduced benefits and was not cost-effective.
<br/>Interpretation(s): Lifetime low-cost statin therapy is cost-effective
across all 40-70 years old in UK. Strengthening and widening statin
treatment could cost-effectively improve population health.
<br/>Funding(s): UK NIHR Health Technology Assessment Programme
(17/140/02).<br/>Copyright &#xa9; 2024 The Authors

<15>
Accession Number
2031220195
Title
One-month DAPT with ticagrelor and aspirin for patients undergoing
coronary artery bypass grafting: rationale and design of the randomised,
multicentre, double-blind, placebo-controlled ODIN trial.
Source
EuroIntervention. 20(5) (pp e322-e328), 2024. Date of Publication: March
2024.
Author
Sandner S.; Gaudino M.; Redfors B.; Angiolillo D.J.; Ben-Yehuda O.; Bhatt
D.L.; Fremes S.E.; Lamy A.; Marano R.; Mehran R.; Pocock S.; Rao S.V.;
Spertus J.A.; Weinsaft J.W.; Wells G.; Ruel M.
Institution
(Sandner) Department of Cardiac Surgery, Medical University of Vienna,
Vienna, Austria
(Gaudino) Department of Cardiothoracic Surgery, Weill Cornell Medicine,
New York, NY, United States
(Redfors) Department of Cardiology, Sahlgrenska University Hospital,
Gothenburg, Sweden
(Redfors) Department of Molecular and Clinical Medicine, Institute of
Medicine, Gothenburg University, Gothenburg, Sweden
(Angiolillo) Division of Cardiology, University of Florida College of
Medicine, Jacksonville, FL, United States
(Ben-Yehuda) University of California San Diego, San Diego, CA, United
States
(Bhatt) Mount Sinai Heart, Icahn School of Medicine at Mount Sinai, New
York, NY, United States
(Fremes) Division of Cardiac Surgery, Schulich Heart Centre, Sunnybrook
Health Sciences Centre, University of Toronto, Toronto, ON, Canada
(Lamy) Division of Cardiac Surgery, Population Health Research Institute,
McMaster University, Hamilton, ON, Canada
(Marano) Department of Radiological and Hematological Sciences, Section of
Radiology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS,
Universita Cattolica del Sacro Cuore, Rome, Italy
(Mehran) The Zena and Michael A. Wiener Cardiovascular Institute, Icahn
School of Medicine at Mount Sinai, New York, NY, United States
(Pocock) Department of Medical Statistics, London School of Hygiene and
Tropical Medicine, London, United Kingdom
(Rao) New York University Langone Health System, New York, NY, United
States
(Spertus) University of Missouri-Kansas City's Healthcare Institute for
Innovations in Quality, Kansas City, MO, United States
(Spertus) Saint Luke's Mid America Heart Institute, Kansas City, MO,
United States
(Weinsaft) Department of Medicine, Greenberg Cardiology Division, Weill
Cornell Medical College, New York, NY, United States
(Wells) Heart Institute, School of Epidemiology and Public Health,
University of Ottawa, Ottawa, ON, Canada
(Ruel) Division of Cardiac Surgery, University of Ottawa Heart Institute,
Ottawa, ON, Canada
Publisher
Europa Group
Abstract
The optimal antiplatelet strategy after coronary artery bypass graft
(CABG) surgery in patients with chronic coronary syndromes (CCS) is
unclear. Adding the P2Y<inf>12</inf> inhibitor, ticagrelor, to low-dose
aspirin for 1 year is associated with a reduction in graft failure,
particularly saphenous vein grafts, at the expense of an increased risk of
clinically important bleeding. As the risk of thrombotic graft failure and
ischaemic events is highest early after CABG surgery, a better
risk-to-benefit profile may be attained with short-term dual antiplatelet
therapy followed by single antiplatelet therapy. The One Month Dual
Antiplatelet Therapy With Ticagrelor in Coronary Artery Bypass Graft
Patients (ODIN) trial is a prospective, randomised, double-blind,
placebo-controlled, international, multicentre study of 700 subjects that
will evaluate the effect of short-term dual antiplatelet therapy with
ticagrelor plus low-dose aspirin after CABG in patients with CCS. Patients
will be randomised 1:1 to ticagrelor 90 mg twice daily or matching
placebo, in addition to aspirin 75-150 mg once daily for 1 month; after
the first month, antiplatelet therapy will be continued with aspirin
alone. The primary endpoint is a hierarchical composite of all-cause
death, stroke, myocardial infarction, revascularisation and graft failure
at 1 year. The key secondary endpoint is a hierarchical composite of
all-cause death, stroke, myocardial infarction, Bleeding Academic Research
Consortium (BARC) type 3 bleeding, revascularisation and graft failure at
1 year (net clinical benefit). ODIN will report whether the addition of
ticagrelor to low-dose aspirin for 1 month after CABG reduces ischaemic
events and provides a net clinical benefit in patients with CCS.
(ClinicalTrials.gov: NCT05997693).<br/>Copyright &#xa9; Europa Digital &
Publishing 2024. All rights reserved.

<16>
[Use Link to view the full text]
Accession Number
2031208166
Title
Cardiovascular Outcomes in GRADE (Glycemia Reduction Approaches in Type 2
Diabetes: A Comparative Effectiveness Study).
Source
Circulation. 149(13) (pp 993-1003), 2024. Date of Publication: 26 Mar
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.; Crandall J.P.; McKee M.D.;
Behringer-Massera S.; Brown-Friday J.; Xhori E.; Ballentine-Cargill K.;
Duran S.; Estrella H.; Gonzalez De La Torre S.; Lukin J.; Phillips L.S.;
Burgess E.; Olson D.; Rhee M.; Wilson P.; Raines T.S.; Boers J.; Costello
J.; Maher-Albertelli M.; Mungara R.; Savoye L.; White C.A.; Gullett C.;
Holloway L.; Morehead F.; Person S.; Sibymon M.; Tanukonda S.; Adams C.;
Ross A.; Balasubramanyam A.; Gaba R.; Gonzalez Hattery E.; Ideozu A.;
Jimenez J.; Montes G.; Wright C.; Hollander P.; Roe E.; Jackson A.; Smiley
A.; Burt P.; Estrada L.; Chionh K.; Ismail-Beigi F.; Falck-Ytter C.;
Sayyed Kassem L.; Sood A.; Kulow T.; Newman C.; Stancil K.A.; Cramer B.;
Iacoboni J.; Kononets M.V.; Sanders C.; Tucker L.; Werner A.; Maxwell A.;
McPhee G.; Patel C.; Colosimo L.; Krol A.; Goland R.; Pring J.; Alfano L.;
Kringas P.; Hausheer C.; Tejada J.; Gumpel K.; Kirpitch A.; Schneier H.;
Abouassi H.; Chatterjee R.; Feinglos M.N.; English Jones J.; Khan S.A.;
Kimpel J.B.; Zimmer R.P.; Furst M.; Satterwhite B.M.; Thacker C.R.; Evans
Kreider K.; Mariash C.N.; Mather K.J.; Ismail H.M.; Lteif A.; Hamilton T.;
Patel N.; Riera G.; Jackson M.; Pirics V.; Aguillar D.; Howard D.; Hurt
S.; Bergenstal R.; Carlson A.; Martens T.; Johnson M.; Hill R.; Hyatt J.;
Jensen C.; Madden M.; Willis H.; Konerza W.; Yang S.; Kleeberger K.; Passi
R.; Fortmann S.; Herson M.; Mularski K.; Glauber H.; Prihoda J.; Ash B.;
Carlson C.; Ramey P.A.; Schield E.; Torgrimson-Ojerio B.; Arnold K.;
Kauffman B.; Panos E.; Sahnow S.; Bays K.; Berame K.; Cook J.; Ghioni D.;
Gluth J.; Schell K.; Criscola J.; Friason C.; Jones S.; Nazarov S.;
Rassouli N.; Puttnam R.; Ojoawo B.; Nelson R.; Curtis M.; Hollis B.;
Sanders-Jones C.; Stokes K.; El-Haqq Z.; Kolli A.; Tran T.; Meigs J.;
Chambers B.; Dushkin A.; Rocchio G.; Yepes M.; Steiner B.; Dulin H.;
Cayford M.; Chu K.; Demanbey A.; Hillard M.; Martin K.; Thangthaeng N.;
Gurry L.; Kochis R.; Raymond E.; Ripley V.; Stevens C.; Park J.; Aroda V.;
Ghazi A.; Magee M.; Ressing A.; Loveland A.; Hamm M.; Hurtado M.; Kuhn A.;
Leger J.; Manandhar L.; Mwicigi F.; Sanchez O.; Young T.; Garg R.;
Lagari-Libhaber V.; Florez H.J.; Valencia W.M.; Marks J.; Casula S.;
Oropesa-Gonzalez L.; Hue L.; Cuadot A.; Nieto-Martinez R.; Riccio Veliz
A.K.; Gutt M.; Kendal Y.J.; Veciana B.; Ahmann A.; Aby-Daniel D.; Joarder
F.; Morimoto V.; Sprague C.; Yamashita D.; Cady N.; Rivera-Eschright N.;
Kirchhoff P.; Morales Gomez B.; Adducci J.; Goncharova A.; Hox S.H.;
Petrovitch H.; Matwichyna M.; Jenkins V.; Broadwater L.; Ishii R.R.;
Bermudez N.O.; Hsia D.S.; Greenway F.L.; Waguespack C.; King E.; Fry G.;
Dragg A.; Gildersleeve B.; Arceneaux J.; Haynes N.; Thomassie A.;
Pavlionis M.; Bourgeois B.; Hazlett C.; Henry R.; Boeder S.; Pettus J.;
Garcia-Acosta D.; Maggs S.; Delue C.; Stallings A.; Castro E.; Hernandez
S.; Krakoff J.; Curtis J.M.; Killean T.; Khalid M.; Joshevama E.; Diaz E.;
Martin D.; Tsingine K.; Karshner T.; Albu J.; Pi-Sunyer F.X.; Frances S.;
Maggio C.; Ellis E.; Bastawrose J.; Gong X.; Banerji M.A.; August P.; Lee
M.; Lorber D.; Brown N.M.; Josephson D.H.; Thomas L.L.; Tsovian M.;
Cherian A.; Jacobson M.H.; Mishko M.M.; Kirkman M.S.; Diner J.; Dostou J.;
MacHineni S.; Young L.; Bergamo K.; Goley A.; Kerr J.; Largay J.F.; Guarda
S.; Cuffee J.; Culmer D.; Fraser R.; Almeida H.; Coffer S.; Debnam E.;
Kiker L.; Morton S.; Josey K.; Fuller G.; Garvey W.T.; Cherrington A.L.;
Dyer D.; Lawson M.C.R.; Griffith O.; Agne A.; McCullars S.; Cohen R.M.;
Craig J.; Rogge M.C.; Burton K.; Kersey K.; Wilson C.; Lipp S.; Vonder
Meulen M.B.; Adkins C.; Onadeko T.; Rasouli N.; Baker C.; Schroeder E.;
Razzaghi M.; Lyon C.; Penaloza R.; Underkofler C.; Lorch R.; Douglass S.;
Steiner S.; Sivitz W.I.; Cline E.; Knosp L.K.; McConnell J.; Lowe T.;
Pop-Busui R.; Katona A.; Goodhall L.; Eggleston R.; Bojescu S.; Bule S.;
Kessler N.; Lasalle E.; Whitley K.; Seaquist E.R.; Bantle A.;
Harindhanavudhi T.; Kumar A.; Redmon B.; Bantle J.; Coe M.; Mech M.;
Taddese A.; Lesne L.; Smith S.; Kuechenmeister L.; Shivaswamy V.; Burbach
S.; Rodriguez M.G.; Seipel K.; Alfred A.; Morales A.L.; Eggert J.; Lord
G.; Taylor W.; Tillson R.; Adolphe A.; Burge M.; Duran-Valdez E.; Martinez
J.; Bancroft A.; Kunkel S.; Ali Jamaleddin Ahmad F.; Hernandez McGinnis
D.; Pucchetti B.; Scripsick E.; Zamorano A.; Defronzo R.A.; Cersosimo E.;
Abdul-Ghani M.; Triplitt C.; Juarez D.; Mullen M.; Garza R.I.; Verastiqui
H.; Wright K.; Puckett C.; Raskin P.; Rhee C.; Abraham S.; Jordan L.F.;
Sao S.; Morton L.; Smith O.; Osornio Walker L.; Schnurr-Breen L.; Ayala
R.; Kreymer R.B.; Sturgess D.; Alarcon-Casas Wright L.; Boyko E.J.; Tsai
E.C.; Trence D.L.; Trikudanathan S.; Fattaleh B.N.; Montgomery B.K.;
Atkinson K.M.; Kozedub A.; Concepcion T.; Moak C.; Prikhodko N.; Rhothisen
S.; Elasy T.A.; Martin S.; Shackelford L.; Goidel R.; Hinkle N.; Lovell
C.; Myers J.; Lipps Hogan J.; McGill J.B.; Salam M.; Schweiger T.; Kissel
S.; Recklein C.; Clifton M.J.; Tamborlane W.; Camp A.; Gulanski B.; Pham
K.; Alguard M.; Gatcomb P.; Lessard K.; Perez M.; Iannone L.; Magenheimer
E.; Montosa A.; Cefalu W.T.; Fradkin J.; Nathan D.M.; Buse J.B.; Kahn
S.E.; Larkin M.E.; Tiktin M.; Wexler D.; Burch H.B.; Bremer A.A.; Lachin
J.M.; Bebu I.; Butera N.; Buys C.J.; Fagan A.; Gao Y.; Gramzinski M.R.;
Hall S.D.; Kazemi E.; Legowski E.; Liu H.; Suratt C.; Tripputi M.; Arey
A.; Backman M.; Bethepu J.; Lund C.; Mangat Dhaliwal P.; McGee P.; Mesimer
E.; Ngo L.; Steffes M.; Seegmiller J.; Saenger A.; Arends V.; Gabrielson
D.; Conner T.; Warren S.; Day J.; Huminik J.; Soliman E.Z.; Zhang Z.M.;
Campbell C.; Hu J.; Keasler L.; Hensley S.; Li Y.; Herman W.H.; Kuo S.;
Martin C.; Waltje A.; Mihalcea R.; Min D.J.; Perez-Rosas V.; Prosser L.;
Resnicow K.; Ye W.; Shao H.; Zhang P.; Luchsinger J.; Sanchez D.; Assuras
S.; Groessl E.; Sakha F.; Chong H.; Hillery N.; Abdouch I.; Bahtiyar G.;
Brantley P.; Broyles F.E.; Canaris G.; Copeland P.; Craine J.J.; Fein
W.L.; Gliwa A.; Hope L.; Lee M.S.; Meiners R.; Meiners V.; O'Neal H.; Park
J.E.; Sacerdote A.; Sledge E.; Soni L.; Steppel-Reznik J.; Turchin A.
Institution
(Green) Duke Clinical Research Institute, Duke University School of
Medicine, Durham, NC, United States
(Everett) Divisions of Cardiovascular and Preventive Medicine, Brigham and
Women's Hospital and Harvard Medical School, Boston, MA, United States
(Ghosh, Younes, Krause-Steinrauf) The Biostatistics Center, Department of
Biostatistics and Bioinformatics, Milken Institute School of Public
Health, George Washington University, Rockville, MD, United States
(Barzilay) Division of Endocrinology, Kaiser Permanente of Georgia,
Atlanta, United States
(Barzilay) Department of Endocrinology, Emory University School of
Medicine, Atlanta, GA, United States
(Desouza) Division of Diabetes, Endocrinology and Metabolism, University
of Nebraska Medical Center, Omaha Va Medical Center, United States
(Inzucchi) Section of Endocrinology, Yale School of Medicine, New Haven,
CT, United States
(Pokharel) Division of Cardiology, Wake Forest University School of
Medicine, Winston-Salem, NC, United States
(Schade) Division of Endocrinology, University of New Mexico School of
Medicine, Albuquerque, United States
(Scrymgeour) Va Cooperative Studies Program Clinical Research Pharmacy
Coordinating Center, Albuquerque, NM, United States
(Tan) Division of Metabolism, Endocrinology and Diabetes, Department of
Internal Medicine, University of Michigan, Ann Arbor, United States
(Utzschneider) Department of Medicine, Va Puget Sound and University of
Washington, Seattle, United States
(Mudaliar) Va San Diego Healthcare System and University of California,
San Diego, United States
Publisher
Lippincott Williams and Wilkins
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).
<br/>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. <br/>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]).
<br/>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.<br/>Copyright &#xa9; 2024 Lippincott Williams and Wilkins.
All rights reserved.

<17>
Accession Number
2029133219
Title
Efficacy of ultrasound-guided pecto-intercostal fascial block and
transversus thoracis muscle plane block for postoperative analgesia in
cardiac surgery in adult patients: A randomized study.
Source
Egyptian Journal of Anaesthesia. 40(1) (pp 201-208), 2024. Date of
Publication: 2024.
Author
Eloraby A.N.; El Mourad M.B.; Elatafy E.E.; Marouf H.M.; Ibrahim M.A.
Institution
(Eloraby, El Mourad, Marouf, Ibrahim) Anesthesiology, Surgical Intensive
Care and Pain Medicine Department, Faculty of Medicine, Tanta, Egypt
(Elatafy) Cardiothoracic Surgery Department, Faculty of Medicine, Tanta
University, Tanta, Egypt
Publisher
Taylor and Francis Ltd.
Abstract
Background: Insufficient management of postoperative pain is a notable
issue encountered by individuals after open-heart operations. The study
aimed to evaluate the effect of ultrasound-guided pecto-intercostal
fascial block (PIFB) and transversus thoracis muscle plane (TTB) on the
analgesic efficacy in adult patients undergoing open-heart operations and
the duration of mechanical ventilation (MV). <br/>Method(s): A randomized
double-blind controlled trial was conducted on a cohort of 90 adult
patients with elective open-heart surgery, namely valve replacement, with
midline sternotomy. Patients were divided into three groups of similar
size. The first group (control group) received conventional systemic
analgesia alone, while the second group received bilateral TTB and the
third group received bilateral PIFB, using ultra-sound guided technique.
<br/>Result(s): A significant reduction in NRS (Numeric Rating Scale)
values was observed in both the TTB group and the PIFB group as compared
to the control group at zero, three and 6-hour postoperative. The PIFB and
TTB group exhibited an important delay in the initiation of first rescue
analgesia, as well as a reduction in the overall intake of fentanyl for
rescue purposes during a twenty-four-hour period. Additionally, the TTB
group and the PIFB group demonstrated considerably shorter durations of
mechanical ventilation as compared to the control group.
<br/>Conclusion(s): The utilization of ultrasound TTB and PIFB
demonstrated efficacy in providing postoperative analgesia compared to the
control group. This was evidenced by the less requirement for additional
analgesic medication, reducing postoperative pain scores and a shorter
duration of mechanical ventilation.<br/>Copyright &#xa9; 2024 The
Author(s). Published by Informa UK Limited, trading as Taylor & Francis
Group.

<18>
Accession Number
2028553086
Title
Comparative effects of moderate-intensity interval training on sleep
quality and functional capacity in atrial fibrillation patients with two
types of sleep apnea.
Source
Physiotherapy Quarterly. 32(1) (pp 93-99), 2024. Date of Publication:
2024.
Author
Atef H.; Muka T.; Elansary D.; Ali H.M.; Ahmad A.M.
Institution
(Atef, Ahmad) Department of Physical Therapy for Cardiovascular and
Respiratory Disorders, Faculty of Physical Therapy, Cairo University,
Cairo, Egypt
(Atef, Muka) Institute of Social and Preventive Medicine (ISPM),
University of Bern, Bern, Switzerland
(Elansary) Department of Nursing and Allied Health, School of Health
Sciences, Swinburne University of Technology, Melbourne, Australia
(Ali) Department of Physical Therapy for Cardiovascular and Respiratory
Disorders, Faculty of Physical Therapy, Beni-Suef University, Beni Suef,
Egypt
Publisher
Wroclaw University of Health and Sport Sciences
Abstract
Introduction. This study aimed to examine the effects of
moderate-intensity interval training (MIIT) on the quality of sleep and
functional capacity in atrial fibrillation (AF) patients with different
presentations of sleep apnoea after coronary artery bypass graft (CABG)
surgery. Methods. 18 participants with AF and sleep apnoea aged 45-65
years were assigned into two groups: AF with obstructive sleep apnoea
group (group A, n<inf>1</inf> = 9) and AF with mixed sleep apnoea group
(group B, n<inf>2</inf> = 9). Both groups received MIIT for ten weeks (3
sessions / week) and medical treatment (i.e., Continuous Positive Airway
Pressure and drug therapy). Exclusion criteria were unstable cardiac
comorbidities and neurological/musculoskeletal limitations to exercise
intervention. Outcome measures included sleep parameters collected from
the actigraphy, overall sleep quality rating domain of the Pittsburgh
Sleep Quality Index (PSQI), and six-minute walk distance (6-MWD). Results.
Significant changes were present in the means of all outcomes in group A
(p < 0.05) and two outcomes (i.e., cut points & 6-MWD) in group B compared
to baseline (p < 0.05). Also, there were significant differences in the
absolute mean changes from baseline () between the two groups, in favour
of group A, in sleep latency (p < 0.001), total sleep duration (p =
0.026), sleep efficiency (p < 0.001), overall sleep quality rating item of
the PSQI (p = 0.001), and 6-MWD (p = 0.008). Conclusions. MIIT can be a
supplementary therapeutic intervention that could contribute to greater
positive changes in sleep quality and functional capacity in AF patients
with obstructive sleep apnoea rather than in AF patients with mixed sleep
ap-noea post-CABG. MIIT could enhance the functional capacity independent
of improving sleep quality in patients with AF and mixed sleep apnoea
post-CABG.<br/>Copyright &#xa9; 2024 Wroclaw University of Health and
Sport Sciences.

<19>
Accession Number
2029137386
Title
Triiodothyronine Supplementation for Children Undergoing Cardiopulmonary
Bypass: A Meta-Analysis.
Source
Pediatric Cardiology. (no pagination), 2024. Date of Publication: 2024.
Author
Radman M.R.; Slee A.E.; Marwali E.M.; Portman M.A.
Institution
(Radman) Division of Cardiac Critical Care, Department of Pediatrics,
Seattle Children's Hospital, University of Washington, 4800 Sand Point Way
NE, RC.2.820, Seattle, WA 98105, United States
(Slee) New Arch Consulting, Issaquah, WA, United States
(Marwali) Division of Pediatric Cardiac Intensive Care, National
Cardiovascular Center Harapan Kita, Jakarta, Indonesia
(Portman) Division of Cardiology, Department of Pediatrics, Seattle
Children's Hospital, University of Washington, Seattle, WA, United States
Publisher
Springer
Abstract
Specific pediatric populations have exhibited disparate responses to
triiodothyronine (T3) repletion during and after cardiopulmonary bypass
(CPB). <br/>Objective(s): To determine if T3 supplementation improves
outcomes in children undergoing CPB. We searched randomized controlled
trials (RCT) evaluating T3 supplementation in children aged 0-3 years
undergoing CPB between 1/1/2000 and 1/31/2022. We calculated Hazard ratios
(HR) for time to extubation (TTE), ICU length of stay (LOS), and hospital
LOS. 5 RCTs met inclusion criteria with available patient-level data. Two
were performed in United States (US) and 3 in Indonesia with 767 total
subjects (range 29- 220). Median (IQR) age 4.1 (1.6, 8.0) months; female
43%; RACHS-1 scores: 1-1%; 2-55%; 3-27%; 4-13%; 5-0.1%; 6-3.9%; 54% of
subjects in US vs 46% in Indonesia. Baseline TSH and T3 were lower in
Indonesia (p < 0.001). No significant difference occurred in TTE between
treatment groups overall [HR 1.09 (CI, 0.94-1.26)]. TTE numerically
favored T3-treated patients aged 1-5 months [HR 1.24 (CI, 0.97-1.60)]. TTE
HR for the Indonesian T3 group was 1.31 (CI, 1.04-1.65) vs. 0.95 (CI,
0.78-1.15) in US. The ICU LOS HR for the Indonesian T3 group was 1.19 vs.
0.89 in US (p = 0.046). There was a significant T3 effect on hospital LOS
[HR 1.30 (CI, 1.01-1.67)] in Indonesia but not in US [HR 0.99 (CI,
0.78-1.23)]. T3 supplementation in children undergoing CPB is simple,
inexpensive, and safe, showing benefit in resource-limited settings.
Differences in effects between settings likely relate to depression in
baseline thyroid function often associated with
malnutrition.<br/>Copyright &#xa9; The Author(s), under exclusive licence
to Springer Science+Business Media, LLC, part of Springer Nature 2024.

<20>
Accession Number
643827589
Title
Untangling the Complex Multidimensionality of the Social Determinants of
Cardiovascular Health: A systematic review.
Source
The Canadian journal of cardiology. (no pagination), 2024. Date of
Publication: 19 Mar 2024.
Author
Vyas N.; Zaheer A.; Wijeysundera H.C.
Institution
(Vyas, Zaheer) Schulich Heart Program, Sunnybrook Health Sciences Centre,
University of Toronto, Toronto, Canada
(Wijeysundera) Schulich Heart Program, Sunnybrook Health Sciences Centre,
University of Toronto, Toronto, Canada; Temerty Faculty of Medicine,
University of Toronto, Toronto, Canada; ICES, Toronto, Canada; Institute
of Health Policy, Management and Evaluation, University of Toronto,
Toronto, Canada
Abstract
BACKGROUND: The cardiovascular literature is limited by the lack of
consensus on what are the best metrics for reporting social determinants
of health (SDH)/social deprivation and if they should be reported as a
single metric or separately by their domains. <br/>METHOD(S): A systematic
review of the literature on cardiovascular surgeries and procedures was
conducted, identifying articles from January 1st 2010 to December 31st,
2023 that studied the relationship between health outcomes post
cardiovascular procedures and/or surgeries and SDH/social deprivation. The
cardiovascular procedures/surgeries of interest were coronary and valve
surgeries and procedures including Coronary Artery Bypass Grafting (CABG),
percutaneous coronary intervention (PCI), valve replacement/repair and
transcatheter aortic valve intervention (TAVI). <br/>RESULT(S): After
screening 638 articles, we identified 47 papers that met our inclusion and
exclusion criteria. The most common procedure evaluated was CABG and PCI -
46 of the studies focused on these 2 procedures. Almost all the articles
reported a different metric for SDH/social deprivation (41 different
metrics); despite this, all the metrics showed a consistent relationship
with worse outcomes associated with greater degrees of SDH/deprivation.
Only 9 reported on the individual domains of SDH/social deprivation; 3
studies showed a discordant relationship. <br/>CONCLUSION(S): Although our
systematic review identified numerous articles evaluating the relationship
between SDH/social deprivation in cardiovascular disease, there was
substantial heterogeneity in which metric was used and how it was
reported. This reinforces the need for standards as to what are the best
metrics for SDH/social deprivation as well as best practice for
reporting.<br/>Copyright &#xa9; 2024. Published by Elsevier Inc.

<21>
Accession Number
2031147092
Title
Effectiveness of virtual reality on pain and anxiety in patients
undergoing cardiac procedures: A systematic review and meta-analysis of
randomized controlled trials.
Source
Current Problems in Cardiology. 49(5) (no pagination), 2024. Article
Number: 102532. Date of Publication: May 2024.
Author
Micheluzzi V.; Burrai F.; Casula M.; Serra G.; Al Omary S.; Merella P.;
Casu G.
Institution
(Micheluzzi, Casula, Serra, Al Omary, Merella, Casu) Clinical and
interventional cardiology, University Hospital, Sassari, Italy
(Burrai, Casula, Serra, Al Omary, Casu) Department of Medicine, Surgery
and Pharmacy, University of Sassari, Sassari, Italy
Publisher
Elsevier Inc.
Abstract
Background: Cardiac procedures often induce pain and anxiety in patients,
adversely impacting recovery. Pharmachological approaches have
limitations, prompting exploration of innovative digital solutions like
virtual reality (VR). Although early evidence suggests a potential
favourable benefit with VR, it remains unclear whether the implementation
of this technology can improve pain and anxiety. We aimed to assess by a
systematic review and meta-analysis the effectiveness of VR in alleviating
anxiety and pain on patients undergoing cardiac procedures.
<br/>Method(s): Our study adhered to the PRISMA method and was registered
in PROSPERO under the code CRD42024504563. The search was carried out in
the PubMed, Web of Science, Scopus, and the Cochrane Library databases in
January 2024. Four randomized controlled trials were included (a total of
382 patients). Risk of bias was employed to assess the quality of
individual studies, and a random-effects model was utilized to examine the
overall effect. <br/>Result(s): The results showed that VR, when compared
to the standard of care, had a statistically significant impact on anxiety
(SMD = -0.51, 95 % CI: -0.86 to -0.16, p = 0.004), with a heterogeneity I2
= 57 %. VR did not show a significant difference in terms of pain when
compared to standard care (SMD= -0.34, 95 % CI: -0.75 to -0.07, p = 0.10).
The included trials exhibited small sample sizes, substantial
heterogeneity, and variations in VR technology types, lengths, and
frequencies. <br/>Conclusion(s): VR effectively lowers anxiety levels in
patients undergoing cardiac procedures, however, did not show a
statistically significant difference on pain.<br/>Copyright &#xa9; 2024
The Authors

<22>
Accession Number
2031106524
Title
A study of bailout plug-based closure after failed suture-based closure in
patients undergoing transfemoral TAVI.
Source
EuroIntervention. 20(6) (pp E344-E353), 2024. Date of Publication: 2024.
Author
Dumpies O.; Abdelhafez A.; Loria J.R.D.; Richter I.; Feistritzer H.-J.;
Majunke N.; Desch S.; Noack T.; Thiele H.; Abdel-Wahab M.
Institution
(Dumpies, Abdelhafez, Loria, Richter, Feistritzer, Majunke, Desch, Thiele,
Abdel-Wahab) Department of Structural Heart Disease/Cardiology, Heart
Center Leipzig, University of Leipzig, Leipzig, Germany
(Noack) Department of Structural Heart Disease/Cardiac Surgery, Heart
Center Leipzig, University of Leipzig, Leipzig, Germany
Publisher
Europa Group
Abstract
BACKGROUND: Percutaneous suture-based arterial access site closure
(ProGlide) is commonly applied in patients undergoing transfemoral
transcatheter aortic valve implantation (TAVI). However, the failure of a
suture-based vascular closure device (VCD) may require additional
treatment. AIMS: We aimed to evaluate the efficacy and safety of bailout
access site closure using a large-bore plug-based device (MANTA) in
patients with failed suture-based closure during transfemoral TAVI.
<br/>METHOD(S): Patients undergoing a bailout attempt with the MANTA VCD
were identified from a prospectively enrolling, institutional registry.
Efficacy was defined as haemostasis at the access site without the need
for alternative treatment other than manual compression or endovascular
ballooning. Safety was defined as freedom from vascular dissection,
stenosis and occlusion requiring intervention. <br/>RESULT(S): Of 2,505
patients, 66 underwent a bailout attempt with MANTA as a result of
ProGlide failure, which occurred before the large-bore sheath insertion in
16.7% of patients and after the sheath removal in 83.3% of patients.
Bailout MANTA was deemed effective in 75.8% of patients (50/66), and the
technique was considered safe in 86.4% (57/66) of patients. Failure of
bailout MANTA occurred because of its superficial application, resulting
in persistent bleeding in 18.2% of patients (12/66), and because of its
deep application, resulting in stenosis or occlusion in 6.1% of patients
(4/66). Operator experience with the technique (odds ratio [OR] 12.29, 95%
confidence interval [CI]: 1.99-75.99; p=0.007) and prior use of three
ProGlides (OR 0.02, 95% CI: <0.01-0.39; p=0.010) were the only independent
predictors of the efficacy endpoint. <br/>CONCLUSION(S): Bailout MANTA
after ProGlide failure was effective and safe, but operator experience
seems to be crucial. Further technological refinements to facilitate
accurate placement appear necessary.<br/>Copyright &#xa9; Europa Digital &
Publishing 2024. All rights reserved.

<23>
[Use Link to view the full text]
Accession Number
2031021752
Title
Impact of Incomplete Revascularization After PCI in Left Main Disease: The
EXCEL Trial.
Source
Circulation: Cardiovascular Interventions. 17(3) (pp E013192), 2024. Date
of Publication: March 2024.
Author
Ali Z.A.; Garcia J.J.; Galougahi K.K.; Horst J.; Gallo A.; Shin D.;
Ben-Yehuda O.; Chen S.; Redfors B.; Kappetein A.P.; Sabik J.F.; Serruys
P.W.; Stone G.W.
Institution
(Ali, Garcia, Horst, Gallo, Ben-Yehuda, Redfors) Cardiovascular Research
Foundation, New York, NY, United States
(Ali, Galougahi, Shin) St Francis Hospital and Heart Center, Roslyn, NY,
United States
(Chen) Weill-Cornell Medical Center, New York-Presbyterian Hospital, NY,
United States
(Kappetein) Erasmus Medical Center, Rotterdam, Netherlands
(Sabik) University Hospitals Cleveland Medical Center, OH, United States
(Serruys) University of Galway, Ireland
(Stone) The Zena and Michael A. Wiener Cardiovascular Institute, Icahn
School of Medicine at Mount Sinai, New York, NY, United States
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND: The importance of complete revascularization after
percutaneous coronary intervention (PCI) in patients with left main
coronary artery disease is uncertain. We investigated the clinical impact
of complete revascularization in patients with left main coronary artery
disease undergoing PCI in the EXCEL trial (Evaluation of XIENCE Versus
Coronary Artery Bypass Surgery for Effectiveness of Left Main
Revascularization). <br/>METHOD(S): Composite rates of death or myocardial
infarction (MI) following PCI during 5-year follow-up were examined in 903
patients based on core laboratory definitions of anatomic and functional
complete revascularization, residual SYNTAX score (The Synergy Between
Percutaneous Coronary Intervention With Taxus and Cardiac Surgery), and
residual Jeopardy Score (rJS). <br/>RESULT(S): The risk of death or MI did
not vary based on anatomic, functional, or residual SYNTAX score complete
revascularization but did differ according to the rJS (5-year rates 17.6%,
19.5%, and 38.9% with rJS 0, 2, and >=4, respectively; P=0.006). The
higher rate of death or MI with rJS>=4 versus rJS<=2 was driven conjointly
by increased mortality (adjusted hazard ratio, 2.29 [95% CI, 1.11-4.71];
P=0.02) and spontaneous MI (adjusted hazard ratio, 2.89 [95% CI,
1.17-7.17]; P=0.02). The most common location for untreated severe
stenoses in the rJS>=4 group was the left circumflex artery (LCX), and the
post-PCI absence, compared with the presence, of any untreated lesion with
diameter stenosis >=70% in the LCX was associated with reduced 5-year
rates of death or MI (18.9% versus 35.2%; hazard ratio, 0.48 [95% CI,
0.32-0.74]; P<0.001). The risk was the highest for residual
ostial/proximal LCX lesions. <br/>CONCLUSION(S): Among patients undergoing
PCI in EXCEL trial, incomplete revascularization according to the rJS was
associated with increased rates of death and spontaneous MI. Post-PCI
untreated high-grade lesions in the LCX (especially the ostial/proximal
LCX) drove these outcomes. REGISTRATION: URL:
https://www.clinicaltrials.gov; Unique identifier: NCT01205776. GRAPHIC
ABSTRACT: A graphic abstract is available for this article.<br/>Copyright
&#xa9; 2024 Lippincott Williams and Wilkins. All rights reserved.

<24>
Accession Number
2029037245
Title
The efficacy and safety of modified ultraearly oral hydration for
alleviating thirst in patients after thoracoscopic surgery: a prospective
randomized controlled trial.
Source
BMC Anesthesiology. 24(1) (no pagination), 2024. Article Number: 105. Date
of Publication: December 2024.
Author
Xue Y.; Wang Q.; Zhao H.; Pan R.; Xia Y.; Wang H.; Qin X.
Institution
(Xue, Wang, Zhao, Xia, Wang, Qin) Department of Anesthesiology, Zhejiang
Hospital, Zhejiang Province, Hangzhou 310013, China
(Pan) Department of Pain Management, Dongguan Songshan LakeCentral
Hospital, Guangdong Province, Dongguan 523320, China
Publisher
BioMed Central Ltd
Abstract
Objective: Postoperative fasting following thoracoscopic surgery can cause
intense thirst and oral discomfort. However, there is currently no
research on ultraearly oral hydration (UEOH) in middle-aged or elderly
patients after thoracoscopic surgery. The aim of this study was to
investigate the effectiveness and safety of UEOH for improving oral
discomfort after thoracoscopic surgery. <br/>Method(s): This single-center
prospective double-blind randomized controlled trial was conducted from
April 2022 to November 2023. A total of 64 middle-aged and elderly
patients who underwent the first thoracoscopic surgery on the day were
enrolled at our institution. Postoperatively, in the Postanesthesia Care
Unit (PACU), patients were randomly assigned at a 1:1 ratio to either the
UEOH group or the standard care (SC) group. The primary outcome was the
patient's thirst score at 6 h after surgery. Secondary outcomes included
the incidence of postoperative oral discomfort; pain scores; the
occurrence of adverse reactions such as nausea, vomiting, regurgitation
and aspiration; anxiety scores on the first postoperative day; the time to
first flatus; and recovery satisfaction scores. <br/>Result(s): The
demographic and surgical characteristics were similar between the two
groups. Patients in the UEOH group had lower thirst scores 6 h after
surgery than did those in the SC group(16.1 +/- 6.70 vs. 78.4 +/- 8.42, P
< 0.01). The incidence of postoperative oral discomfort (P < 0.01),
anxiety scores on the first postoperative day (P<0.05), and time to first
flatus (P<0.05) were better in the UEOH group. Additionally, the
incidences of adverse reactions, such as postoperative nausea, vomiting,
regurgitation and aspiration, were similar between the two groups
(P>0.05). <br/>Conclusion(s): For middle-aged and elderly patients
undergoing thoracoscopic surgery, the use of a modified UEOH protocol
postoperatively can improve thirst and promote gastrointestinal recovery
without increasing complications. Trial registration: This single-center,
prospective, RCT has completed the registration of the Chinese Clinical
Trial Center at 07/12/2023 with the registration number
ChiCTR2300078425.<br/>Copyright &#xa9; The Author(s) 2024.

<25>
Accession Number
2020309335
Title
Staged Revascularization for Chronic Total Occlusion in the Non-IRA in
Patients with ST-segment Elevation Myocardial Infarction Undergoing
Primary Percutaneous Coronary Intervention: An Updated Systematic Review
and Meta-analysis.
Source
Cardiovascular Innovations and Applications. 6(4) (pp 209-218), 2022. Date
of Publication: 2022.
Author
Geng Y.; Wang Y.; Liu L.; Miao G.; Zhang O.; Xue Y.; Zhang P.
Institution
(Geng, Wang, Liu, Miao, Zhang, Xue, Zhang) Department of Cardiology,
Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua
University, Beijing, China
Publisher
Compuscript Ltd
Abstract
Objectives: Meta-analysis was performed to evaluate the effect of staged
revascularization with concomitant chronic total occlusion (CTO) in the
non-infarct-associated artery (non-IRA) in patients with ST-segment
elevation myocardial infarction (STEMI) treated with primary percutaneous
coronary intervention (p-PCI). <br/>Method(s): Various electronic
databases were searched for studies published from inception to June,
2021. The primary endpoint was all-cause death, and the secondary endpoint
was a composite of major adverse cardiac events (MACEs). Odds ratios (ORs)
were pooled with 95% confidence intervals (CIs) for dichotomous data.
<br/>Result(s): Seven studies involving 1540 participants were included in
the final analysis. Pooled analyses revealed that patients with successful
staged revascularization for CTO in non-IRA with STEMI treated with p-PCI
had overall lower all-cause death compared with the occluded CTO group
(OR, 0.46; 95% CI, 0.23-0.95), cardiac death (OR, 0.43; 95% CI,
0.20-0.91), MACEs (OR, 0.47; 95% CI, 0.32-0.69) and heart failure (OR,
0.57; 95% CI, 0.37-0.89) compared with the occluded CTO group. No
significant differences were observed between groups regarding myocardial
infarction and repeated revascularization. <br/>Conclusion(s): Successful
revascularization of CTO in the non-IRA was associated with better
outcomes in patients with STEMI treated with p-PCI.<br/>Copyright &#xa9;
2022 Cardiovascular Innovations and Applications. Creative Commons
Attribution-NonCommercial 4.0 International License

<26>
Accession Number
2031083005
Title
Outcomes of early ventricular septal surgical repair in patients with
post-myocardial infarction: A systematic review.
Source
International Journal of Academic Medicine and Pharmacy. 6(1) (pp
1539-1545), 2024. Date of Publication: 2024.
Author
Manimaran S.; Narasimhan A.; Lakshmanan S.K.
Institution
(Manimaran, Narasimhan, Lakshmanan) Institute of Cardiovascular and
Thoracic Surgery, Madras Medical College, Tamilnadu, India
Publisher
Society for Healthcare and Research Development
Abstract
Background: Post-myocardial infarction ventricular septal rupture (VSR)
poses a significant clinical challenge, with high mortality rates. This
systematic review and meta-Analysis aimed to comprehensively evaluate
surgical outcomes, risk factors, and associated factors in patients with
post-MI VSR. <br/>Material(s) and Method(s): A systematic literature
search was conducted in the PubMed, Scopus, Cochrane, and Google Scholar
databases for studies published between 2015 and 2024. Fourteen studies
comprising 1,380 patients were included in the analysis. Data on
demographics, risk factors, anatomical considerations, and clinical
outcomes were extracted and analysed. <br/>Result(s): The mean age of the
cohort was 69.5 years, with a male predominance. Anterior and apical
regions were predominantly affected, and cardiogenic shock, older age,
smoking, and preoperative IABP usage were identified as significant risk
factors for mortality. Early intervention following diagnosis is
associated with improved survival rates. The mortality rate within 30 days
of VSR closure ranged from 42.9% to 70%, with delayed closure, VSR
diameter, and elevated serum creatinine levels contributing to adverse
outcomes. <br/>Conclusion(s): Post-MI VSR remains a formidable challenge
with high mortality rates, despite advancements in surgical techniques and
perioperative care. Timely intervention and careful patient selection are
crucial for optimising the outcomes in this patient population. Early
intervention following diagnosis is associated with improved survival
rates, emphasising the importance of timely surgical
management.<br/>Copyright &#xa9; 2024 Society for Healthcare and Research
Development. All rights reserved.

<27>
Accession Number
2030994893
Title
Strategy to optimize PeriproCeduraL AnticOagulation in structural
transseptal interventions: Design and rationale of the STOP CLOT trial.
Source
American Heart Journal. 271 (pp 68-75), 2024. Date of Publication: May
2024.
Author
Pregowski J.; Pracon R.; Mioduszewska A.; Skowronski J.; Sondergaard L.;
Mintz G.S.; Capodanno D.; Kim S.-W.; De Baker O.; Wacinski P.; Wojakowski
W.; Rdzanek A.; Grygier M.; Chmielecki M.; Franco L.N.; Stoklosa P.; Firek
B.; Marczak M.; Milosz B.; Chmielak Z.; Demkow M.; Witkowski A.
Institution
(Pregowski, Pracon, Mioduszewska, Skowronski, Stoklosa, Firek, Marczak,
Milosz, Chmielak, Demkow, Witkowski) National Institute of Cardiology,
Warsaw, Poland
(Sondergaard) Abbott, Santa Clara, CA, United States
(Mintz) Cardiovascular Research Foundation, New York, NY, United States
(Capodanno) Policlinico "G. Rodolico-San Marco", University of Catania,
Catania, Italy
(Kim) Chung-Ang University Hospital, Seoul, South Korea
(De Baker) Rigshospitalet - Copenhagen University Hospital, Copenhagen,
Denmark
(Wacinski) Samodzielny Publiczny Szpital Kliniczny 4 w Lublinie, Lublin,
Poland
(Wojakowski) Gornoslaskie Centrum Medyczne im prof. L. Gieca Slaskiego
Uniwersytetu Medycznego, Katowice, Poland
(Rdzanek) Uniwersyteckie Centrum Medyczne Warszawskiego Uniwersytetu
Medycznego, Warsaw, Poland
(Grygier) Uniwersytecki Szpital Kliniczny w Poznaniu, Poznan, Poland
(Chmielecki) Kliniczne Centrum Kardiologii, Uniwersyteckie, Centrum
Kliniczne, Gdanski, Poland
(Franco) Hospital Clinico San Carlos, Madrid, Spain
Publisher
Elsevier Inc.
Abstract
Background: Both transcatheter edge-to-edge repair (TEER) of mitral
regurgitation or left atrial appendage closure (LAAC) require
periprocedural anticoagulation with unfractionated heparin (UFH) that is
administered either before or immediately after transseptal puncture
(TSP). The optimal timing of UFH administration (before or after TSP) is
unknown. The Strategy To Optimize PeriproCeduraL AnticOagulation in
Structural Transseptal Interventions trial (STOP CLOT Trial) was designed
to determine if early anticoagulation is effective in reducing ischemic
complications without increasing the risk of periprocedural bleeding.
<br/>Method(s): The STOP CLOT trial is a multicenter, prospective,
double-blind, placebo-controlled, randomized trial. A total of 410
patients scheduled for TEER or LAAC will be randomized 1:1 either early
UFH administration (iv. bolus of 100 units/kg UFH or placebo, given after
obtaining femoral vein access and at least 5 minutes prior to the start of
the TSP) or late UFH administration (iv. bolus of 100 units/kg UFH or
placebo given immediately after TSP). Prespecified preliminary statistical
analysis will be performed after complete follow-up of the first 196
randomized subjects. To ensure blinding, a study nurse responsible for
randomization and UFH/placebo preparation is not involved in the care of
the patients enrolled into the study. The primary study endpoint is a
composite of (1) major adverse cardiac and cerebrovascular events (death,
stroke, TIA, myocardial infarction, or peripheral embolization) within 30
days post-procedure, (2) intraprocedural fresh thrombus formation in the
right or left atrium as assessed with periprocedural transesophageal
echocardiography, or (3) occurrence of new ischemic lesions (diameter >=4
mm) on brain magnetic resonance imaging performed 2 to 5 days after the
procedure. The safety endpoint is the occurrence of moderate or severe
bleeding complications during the index hospitalization.
<br/>Conclusion(s): Protocols of periprocedural anticoagulation
administration during structural interventions have never been tested in a
randomized clinical trial. The Stop Clot trial may help reach consensus on
the optimal timing of initiation of periprocedural anticoagulation.
Clinical trials registration number: The study protocol is registered at
ClinicalTrials.gov, identifier NCT05305612.<br/>Copyright &#xa9; 2024
Elsevier Inc.

<28>
Accession Number
2030640962
Title
Lung cancer in females-sex-based differences from males in epidemiology,
biology, and outcomes: a narrative review.
Source
Translational Lung Cancer Research. 13(1) (pp 163-178), 2024. Date of
Publication: 2024.
Author
Gee K.; Yendamuri S.
Institution
(Gee, Yendamuri) Department of Thoracic Surgery, Roswell Park
Comprehensive Cancer Center, Buffalo, NY, United States
(Gee) Department of Surgery, University of Tennessee Graduate School of
Medicine, Knoxville, TN, United States
(Yendamuri, Yendamuri) Jacobs School of Medicine and Biomedical Sciences,
State University of New York, Buffalo, NY, United States
Publisher
AME Publishing Company
Abstract
Background and Objective: The role of biological sex is seldom considered
in characterizing lung cancer, the deadliest cancer in both the United
States and the world. Lung cancer has traditionally been regarded as a
male disease; as such, research in female-specific phenomena is frequently
conflicting or absent. Currently, disparities in lung cancer incidence are
primarily driven by females, especially non-smokers and those of younger
age. This narrative review provides insight into sex-specific
characteristics of lung cancer, highlighting risk factors, diagnosis
patterns, carcinogenesis, and treatment outcomes in females.
<br/>Method(s): The PubMed database was searched on July 26, 2023 to
identify research published between 2013 and 2023 in English. Sixty-three
articles were considered relevant, and their full texts and citations were
studied to compile information for this narrative review. Key Content and
Findings: Exposure-related risk factors, including personal tobacco use,
are thought to impact female lung cancer risk more profoundly. However,
studies on occupational exposures are underpowered to conclude risk in
females. Data characterizing the effect of endogenous and exogenous
hormonal exposures on female lung cancer risk remain two-sided. Screening
guidelines are tailored to white males, exacerbating sex and race
disparities. The effect of biological sex on carcinogenesis and the immune
system response to cancer is not fully understood, though the female
immune system clearly reacts more aggressively to lung cancer. In
early-stage disease, females have greater survival in the perioperative
setting and during follow-up of several years, attributed to favorable
histopathology and healthier baseline status. Sex-specific response to
systemic treatment continues to be optimized as lack of standardization in
randomized trials makes interpreting results difficult when aggregated.
<br/>Conclusion(s): Biological sex plays a critical role in non-small cell
lung cancer (NSCLC), though further study is needed to depict the complex
web of factors that affect lung cancer risk, development, and outcomes.
Female underrepresentation in studies has contributed to this lack of
understanding. As these disparities are eliminated, we can move towards
more effective treatment for both sexes in this pervasive yet deadly
disease.<br/>Copyright &#xa9; Translational Lung Cancer Research. All
rights reserved.

<29>
Accession Number
2029997706
Title
Effect of Retrograde Autologous Priming on Coagulation Assessed by
Rotation Thromboelastometry in Patients Undergoing Valvular Cardiac
Surgery.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 38(4) (pp 939-945),
2024. Date of Publication: April 2024.
Author
Ko S.H.; Nan Z.; Soh S.; Shim J.-K.; Lee H.W.; Kwak Y.L.; Song J.W.
Institution
(Ko, Nan, Soh, Shim, Lee, Kwak, Song) Department of Anesthesiology and
Pain Medicine, Yonsei University College of Medicine, Seoul, South Korea
(Ko, Nan, Soh, Shim, Lee, Kwak, Song) Anesthesia and Pain Research
Institute, Yonsei University College of Medicine, Seoul, South Korea
Publisher
W.B. Saunders
Abstract
Objectives: To investigate the effect of retrograde autologous priming
(RAP) on coagulation function using rotation thromboelastometry (ROTEM) in
patients undergoing valvular cardiac surgery. <br/>Design(s): A
prospective, randomized, patient- and outcome assessor-blinded study.
<br/>Setting(s): At a single-center university hospital.
<br/>Participant(s): Patients aged 20 years or older undergoing valvular
cardiac surgery. <br/>Intervention(s): A total of 104 patients were
allocated to the RAP or control group (1:1 ratio). In the RAP group, the
prime was displaced into the collection bag before bypass initiation.
ROTEM was performed at the induction of anesthesia, at the beginning of
rewarming, and after the reversal of heparinization. Allogeneic plasma
products and platelet concentrates were transfused according to
ROTEM-based algorithms. <br/>Measurements and Main Results: An average
volume of 635 +/- 114 mL was removed using RAP (from the 1,600 mL initial
prime volume). The hematocrit 10 minutes after cardiopulmonary bypass
(CPB) was 24.7 +/- 3.5% in the control group, and 26.1 +/- 4.1% in the RAP
group (p = 0.330). ROTEM, including EXTEM, INTEM, and FIBTEM, showed
prolonged clotting time and decreased maximal clot firmness after CPB in
both groups without intergroup differences. The number of patients who
received intraoperative erythrocytes (27% v 25%, control versus RAP, p =
0.823), fresh frozen plasma (14% v 8%, control versus RAP, p = 0.339),
cryoprecipitate (21% v 12%, control versus RAP, p = 0.185), or platelet
concentrate transfusion (19% v 12%, control versus RAP, p = 0.277) did not
differ between the groups. <br/>Conclusion(s): Cardiopulmonary bypass
induced impaired coagulation function on ROTEM. However, RAP did not
improve coagulation function when compared with conventional priming in
patients undergoing valvular cardiac surgery.<br/>Copyright &#xa9; 2023
Elsevier Inc.

<30>
Accession Number
2029031330
Title
Effects of different rehabilitation modality on cardiopulmonary function
in patients with acute coronary syndrome after revascularization.
Source
Frontiers in Cardiovascular Medicine. 10 (no pagination), 2023. Article
Number: 1120665. Date of Publication: 2023.
Author
Chen W.; Feng Y.; Yu M.; Zhang Z.; Wu J.; Liu W.; Gu W.
Institution
(Chen, Feng, Wu, Liu) Cardiac Rehabilitation Center, Department of
Cardiology, Beijing Anzhen Hospital, Capital Medical University, School of
General Practice and Continuing Education, Capital Medical University,
Beijing, China
(Yu, Zhang) Cardiac Rehabilitation Center, Beijing Hospital of Integrated
Traditional Chinese and Western Medicine, Beijing, China
(Gu) Coronary Heart Disease Center, Department of Cardiology, Beijing
Anzhen Hospital, Capital Medical University, Beijing, China
Publisher
Frontiers Media SA
Abstract
Objective: To investigate the effects of different rehabilitation
modalities on cardiopulmonary function in patients with acute coronary
syndrome after revascularization. <br/>Method(s): Two randomized
controlled trials were conducted. All patients were stable for more than
48 h and less than 1 week after revascularization for acute coronary
syndrome and were randomly assigned to Group A (home-based rehabilitation
group) or Group B (center guided home-based rehabilitation group). The
cardiopulmonary exercise test was mainly performed before and 3 months
after cardiac rehabilitation (at the end of intervention). The primary
endpoints of the study were peak oxygen uptake (VO2peak), and the
secondary endpoints were maximum metabolic equivalents (METs), anaerobic
threshold exercise load (Load AT), maximal workload (Load max), and
anaerobic threshold oxygen uptake (VO2 AT). <br/>Result(s): A total of 106
patients were included in the study, with 47 patients in Group A (with 6
losses) and 50 patients in Group B (with 3 losses). There were no
significant difference between the two groups in terms of age, gender,
body mass index (BMI), left ventricular ejection fraction(LVEF),
low-density lipoprotein cholesterol(LDL-C),cardiovascular risk factors. In
Group A, no significant differences in CPET indices were observed before
and after the intervention. In Group B, values of maximum metabolic
equivalents (METs), peak heart rate (PHR), anaerobic threshold exercise
load (Load AT), maximal workload (Load max), maximum ventilation per
minute (VE max), peak oxygen uptake (VO2peak), anaerobic threshold oxygen
uptake (VO2 AT) and maximum oxygen pulse (VO2/HRmax) were higher than
those before the intervention (P < 0.05). In addition, METs (max), Load
AT, Load max, VO2 AT, and VO2peak in Group B were higher than those in
group A (P < 0.05). The change rates of VO2peak, METs(max), PHR, Load max,
VO2 AT, VE max, VO2/HR(max) in the two groups were significantly different
before and after intervention (P < 0.05). <br/>Conclusion(s): Cardiac
exercise rehabilitation is helpful for improving patients' cardiopulmonary
endurance and quality of life. Moreover, rehabilitation modalities with
regular hospital guidance can improve cardiopulmonary function in a
shorter period,which seems to be more effective than a complete home-based
rehabilitation model. Clinical Trial Registration:
http://www.chictr.org.cn, identifier (ChiCTR2400081034).<br/>Copyright
2024 Chen, Feng, Yu, Zhang, Wu, Liu and Gu.

<31>
Accession Number
2029025348
Title
Contemporary evaluation and treatment of tricuspid regurgitation.
Source
Frontiers in Cardiovascular Medicine. 11 (no pagination), 2024. Article
Number: 1350536. Date of Publication: 2024.
Author
Minciunescu A.; Emaminia A.
Institution
(Minciunescu, Emaminia) Department of Cardiovascular Disease, Inova Schar
Heart and Vascular, Falls Church, VA, United States
Publisher
Frontiers Media SA
Abstract
Valvular heart disease is a global health burden with substantial
mortality. The left-sided valvular diseases have been extensively
described using the robust treatment strategies available. By contrast,
the right-sided diseases, particularly the tricuspid valve (TV) and
associated regurgitation, still have much to be delineated. Worsening
tricuspid regurgitation (TR) is associated with increased mortality; the
non-invasive management is suboptimal; and surgical approaches carry
significant risk. With advances in multimodality imaging, 3D
echocardiography, improved understanding of TV anatomy, and
pathophysiological mechanisms of primary and secondary regurgitation, as
well as favorable data with transcatheter therapies, the field of TV
management is rapidly evolving. This review aims to highlight
pathophysiological mechanisms of TR, describe echocardiographic approaches
to diagnosis and TV interrogation, and outline the latest transcatheter
developments.<br/>Copyright 2024 Minciunescu and Emaminia.

<32>
Accession Number
2028910355
Title
The efficacy of different types of cerebral embolic protection device
during transcatheter aortic valve implantation: a meta-analysis.
Source
Frontiers in Cardiovascular Medicine. 11 (no pagination), 2024. Article
Number: 1205943. Date of Publication: 2024.
Author
Wang C.; Han J.; Lu L.; Qiu J.; Fu Y.; Zheng J.
Institution
(Wang, Lu, Qiu, Fu, Zheng) Department of Cardiovascular Surgery, Sun
Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
(Wang, Han) Department of Thoracic and Cardiac Surgery, The Eighth
Affiliated Hospital, Sun Yat-Sen University, Shenzhen, China
Publisher
Frontiers Media SA
Abstract
Aims: Perioperative stroke remains a devastating complication after
transcatheter aortic valve implantation (TAVI), and using a cerebral
embolic protection device (CEPD) during TAVI may reduce the occurrence of
stroke according to some studies. Therefore, we conducted this
meta-analysis to determine whether CEPD should be routinely used during
TAVI. <br/>Methods and Results: The inclusion criteria for this study were
randomized controlled trials (RCTs) that examined the outcome of stroke
with or without CEPD during TAVI, with a minimum follow-up period of 30
days. The primary endpoint was the occurrence of stroke (including both
cerebrovascular accidents and death due to cerebrovascular accidents). The
risk of stroke was lower in the CEPD group: RR 0.68, 95% CI 0.49-0.96, p =
0.03, I²= 0%. A subgroup analysis was conducted according to
the type of CEPD. The risk of stroke was lower in the I&LCCA (filter cover
the innominate and the left common carotid arteries) type CEPD group: RR
0.66, 95% CI 0.49-0.96, p = 0.03, I²= 36%. However, there was
no statistically significant difference in the risk of stroke in the TMCA
[filter cover the three major cerebral arteries (innominate, left common
carotid, and subclavian arteries)] type CEPD group: RR 0.81, 95% CI
0.36-1.80, p = 0.60, I²= 0%. <br/>Conclusion(s): In this
meta-analysis, the I&LCCA-type CEPD can reduce the risk of stroke within
30 days following TAVI, but the TMCA type cannot.<br/>Copyright 2024 Wang,
Han, Lu, Qiu, Fu and Zheng.

<33>
Accession Number
2028475332
Title
Critical Illness-Related Corticosteroid Insufficiency (CIRCI) After
Pediatric Cardiac Surgery.
Source
World Journal for Pediatric and Congenital Heart Surgery. 15(2) (pp
209-214), 2024. Date of Publication: March 2024.
Author
Ahmed A.; Kesman R.; Lee M.E.
Institution
(Ahmed) Section of Critical Care Medicine, Department of Pediatrics, Yale
School of Medicine, New Haven, CT, United States
(Kesman) Section of Neonatology, Department of Pediatrics, Yale School of
Medicine, New Haven, CT, United States
(Lee) Division of Cardiac Surgery, Department of Surgery, Yale School of
Medicine, New Haven, CT, United States
Publisher
SAGE Publications Inc.
Abstract
Although current studies do not support the routine use of corticosteroids
after cardiopulmonary bypass in pediatric patients, there is incomplete
understanding of the potential hemodynamic contribution of postoperative
critical illness-related corticosteroid insufficiency in the intensive
care unit. By reviewing the available studies and underlying
pathophysiology of these phenomena in critically ill neonates, we can
identify a subset of patients that may benefit from optimal diagnosis and
treatment of receiving postoperative steroids. A suggested algorithm used
at our institution is provided as a guideline for treatment of this
high-risk population.<br/>Copyright &#xa9; The Author(s) 2024.

<34>
Accession Number
2031183225
Title
Utility of coronary revascularization in patients with ischemic left
ventricular dysfunction.
Source
Cardiovascular Revascularization Medicine. (no pagination), 2024. Date of
Publication: 2024.
Author
Al-Sadawi M.; Tao M.; Dhaliwal S.; Radakrishnan A.; Liu Y.; Gier C.;
Masson R.; Rahman T.; Tam E.; Mann N.
Institution
(Al-Sadawi) Division of Cardiology, University of Michigan Hospital, Ann
Arbor, MI, United States
(Tao, Dhaliwal, Radakrishnan, Liu, Gier, Masson, Rahman, Tam, Mann)
Department of Medicine, Division of Cardiology, Stony Brook University
Hospital, Stony Brook, NY, United States
Publisher
Elsevier Inc.
Abstract
Background: Revascularization in patients with left ventricular (LV)
dysfunction has been a subject of ongoing uncertainty and conflicting
results. This is further complicated by factors including viability,
severity of LV dysfunction, and method of revascularization using
percutaneous coronary intervention (PCI) versus coronary-artery bypass
grafting (CABG). <br/>Objective(s): The purpose of this meta-analysis is
to evaluate the association of coronary revascularization with outcomes in
patients with ischemic LV dysfunction. <br/>Method(s): A literature search
was conducted for studies reporting on cardiovascular outcomes after
revascularization compared to optimal medical therapy (OMT) in patients
with ischemic LV dysfunction. <br/>Result(s): A total of 23 studies with
10,110 participants met inclusion criteria. Revascularization was
significantly associated with lower all-cause mortality and CV mortality
compared to OMT. The association was statistically significant regardless
of severity of LV dysfunction or method of revascularization. Subgroup
analysis demonstrated that revascularization was significantly associated
with lower all-cause and CV mortality compared to OMT for patients with
viable myocardium and mixed cohorts with variable viability, but not
patients without viable myocardium. Revascularization was not associated
with a significant difference in risk of heart failure (HF)
hospitalization or acute myocardial infarction (AMI) compared to OMT.
<br/>Conclusion(s): Revascularization in patients with ischemic LV
dysfunction is associated with lower risk of all-cause and CV mortality
independent of severity of LV dysfunction or method of revascularization.
Revascularization is not associated with lower risk of mortality in
patients without evidence of viable myocardium and is not associated with
lower risk of AMI or HF hospitalization.<br/>Copyright &#xa9; 2024
Elsevier Inc.

<35>
Accession Number
2031082475
Title
Secondary stroke prevention in people with atrial fibrillation: treatments
and trials.
Source
The Lancet Neurology. 23(4) (pp 404-417), 2024. Date of Publication: April
2024.
Author
Seiffge D.J.; Cancelloni V.; Raber L.; Paciaroni M.; Metzner A.; Kirchhof
P.; Fischer U.; Werring D.J.; Shoamanesh A.; Caso V.
Institution
(Seiffge, Fischer) Department of Neurology, Inselspital University
Hospital Bern and University of Bern, Switzerland
(Raber) Department of Cardiology, Inselspital University Hospital Bern and
University of Bern, Switzerland
(Cancelloni, Paciaroni, Caso) Stroke Unit, Santa Maria della Misericordia
Hospital, University of Perugia, Perugia, Italy
(Metzner, Kirchhof) Department of Cardiology, University Heart and
Vascular Center Hamburg, University Center Hamburg Eppendorf, Hamburg,
Germany
(Metzner, Kirchhof) German Center for Cardiovascular Research, partner
site Hamburg, Kiel, and Lubeck, Germany
(Kirchhof) Institute of Cardiovascular Sciences, University of Birmingham,
Birmingham, United Kingdom
(Fischer) Department of Neurology, University Hospital Basel, Switzerland
(Werring) Stroke Research Centre, UCL Queen Square Institute of Neurology,
London, United Kingdom
(Shoamanesh) Division of Neurology, Department of Medicine, Population
Health Research Institute, McMaster University, Hamilton, ON, Canada
Publisher
Elsevier Ltd
Abstract
Atrial fibrillation is one of the most common cardiac arrhythmias and is a
major cause of ischaemic stroke. Recent findings indicate the importance
of atrial fibrillation burden (device-detected, subclinical, or paroxysmal
and persistent or permanent) and whether atrial fibrillation was known
before stroke onset or diagnosed after stroke for the risk of recurrence.
Secondary prevention in patients with atrial fibrillation and stroke aims
to reduce the risk of recurrent ischaemic stroke. Findings from randomised
controlled trials assessing the optimal timing to introduce direct oral
anticoagulant therapy after a stroke show that early start (ie, within 48
h for minor to moderate strokes and within 4-5 days for large strokes)
seems safe and could reduce the risk of early recurrence. Other promising
developments regarding early rhythm control, left atrial appendage
occlusion, and novel factor XI inhibitor oral anticoagulants suggest that
these therapies have the potential to further reduce the risk of stroke.
Secondary prevention strategies in patients with atrial fibrillation who
have a stroke despite oral anticoagulation therapy is an unmet medical
need. Research advances suggest a heterogeneous spectrum of causes, and
ongoing trials are investigating new approaches for secondary prevention
in this vulnerable patient group. In patients with atrial fibrillation and
a history of intracerebral haemorrhage, the latest data from randomised
controlled trials on stroke prevention shows that oral anticoagulation
reduces the risk of ischaemic stroke but more data are needed to define
the safety profile.<br/>Copyright &#xa9; 2024 Elsevier Ltd

<36>
Accession Number
2029068341
Title
Perioperative Pain Management for Thoracic Surgery: A Multi-Layered
Approach.
Source
Seminars in Cardiothoracic and Vascular Anesthesia. (no pagination),
2024. Date of Publication: 2024.
Author
Tong L.; Solla C.; Staack J.B.; May K.; Tran B.
Institution
(Tong, Tran) Virginia Commonwealth University, Richmond, VA, United States
(Solla, Staack, May) University of Tennessee, Knoxville, TN, United States
Publisher
SAGE Publications Inc.
Abstract
Cardiothoracic surgeries frequently pose unique challenges in the
management of perioperative acute pain that require a multifaceted and
personalized approach in order to optimize patient outcomes. This article
discusses various analgesic strategies including regional anesthesia
techniques such as thoracic epidurals, erector spinae plane blocks, and
serratus anterior plane blocks and underscores the significance of
perioperative multimodal medications, while providing nuanced
recommendations for their use. This article further attempts to provide
evidence for the efficacy of the different modalities and compares the
effectiveness of the choice of analgesia. The roles of Acute Pain Services
(APS) and Transitional Pain Services (TPS) in mitigating opioid dependence
and chronic postsurgical pain are also discussed. Precision medicine is
also presented as a potential way to offer a patient tailored analgesic
strategy. Supported by various randomized controlled trials and
meta-analyses, the article concludes that an integrated, patient-specific
approach encompassing regional anesthesia and multimodal medications,
while also utilizing the services of the Acute Pain Service can help to
enhance pain management outcomes in cardiothoracic surgery.<br/>Copyright
&#xa9; The Author(s) 2024.

<37>
Accession Number
2029067318
Title
Ferroptosis mechanisms and regulations in cardiovascular diseases in the
past, present, and future.
Source
Cell Biology and Toxicology. 40(1) (no pagination), 2024. Article Number:
17. Date of Publication: December 2024.
Author
Fang W.; Xie S.; Deng W.
Institution
(Fang, Xie, Deng) Department of Cardiology, Renmin Hospital of Wuhan
University, Jiefang Road 238, Wuhan 430060, China
(Fang, Xie, Deng) Hubei Key Laboratory of Metabolic and Chronic Diseases,
Wuhan 430060, China
Publisher
Springer Science and Business Media B.V.
Abstract
Cardiovascular diseases (CVDs) are the main diseases that endanger human
health, and their risk factors contribute to high morbidity and a high
rate of hospitalization. Cell death is the most important pathophysiology
in CVDs. As one of the cell death mechanisms, ferroptosis is a new form of
regulated cell death (RCD) that broadly participates in CVDs (such as
myocardial infarction, heart transplantation, atherosclerosis, heart
failure, ischaemia/reperfusion (I/R) injury, atrial fibrillation,
cardiomyopathy (radiation-induced cardiomyopathy, diabetes cardiomyopathy,
sepsis-induced cardiac injury, doxorubicin-induced cardiac injury, iron
overload cardiomyopathy, and hypertrophic cardiomyopathy), and pulmonary
arterial hypertension), involving in iron regulation, metabolic mechanism
and lipid peroxidation. This article reviews recent research on the
mechanism and regulation of ferroptosis and its relationship with the
occurrence and treatment of CVDs, aiming to provide new ideas and
treatment targets for the clinical diagnosis and treatment of CVDs by
clarifying the latest progress in CVDs research. Graphical Abstract: * The
identification, development history and characterization of ferroptosis. *
The role of different subcellular organelles and organelle-specific
regulators in ferroptosis. * The mechanism of ferroptosis includes iron
metabolism, amino acid metabolism, and lipid metabolism. * The role of
ferroptosis in different cardiovascular cells and cardiovascular diseases.
* The treatment efficacy and pathological mechanism involved in
ferroptosis and cardiovascular diseases. (Figure
presented.).<br/>Copyright &#xa9; The Author(s) 2024.

<38>
Accession Number
2029065018
Title
Neuraxial Anesthesia and Analgesia During Cardiothoracic Surgery: A
Narrative Review.
Source
Current Pain and Headache Reports. (no pagination), 2024. Date of
Publication: 2024.
Author
Chen K.; Gashler K.; Li T.; Nguyen A.
Institution
(Chen, Gashler, Li, Nguyen) Baylor College of Medicine, Houston, TX 77030,
United States
Publisher
Springer
Abstract
Purpose of Review: The purpose of this review is to synthesize and examine
the literature on the use of neuraxial anesthesia and analgesia during
cardiothoracic surgery. As cardiothoracic procedures often require
systemic anticoagulation, neuraxial techniques are quite often
underutilized due to the theoretical risk of epidural hematoma. In this
review, we seek to examine the literature to review the indications and
contraindications and to explore if neuraxial anesthesia and analgesia has
a role in cardiothoracic surgery. Recent Findings: Neuraxial techniques
have multiple advantages during cardiothoracic surgery including coronary
vasodilation, decreased sympathetic surge, and a decreased cortisol level
leading to overall reduction in stress response. Multiple studies have
shown an improvement in pain scores, reduction in pulmonary complications,
faster extubation times, with minimal complications when neuraxial
techniques are utilized in cardiothoracic surgeries. <br/>Summary: Given
the numerous advantages and minimal complications of neuraxial techniques
in cardiothoracic surgeries, we hope its utilization continues to
increase. Moving forward, we hope additional studies continue to reaffirm
the benefits of neuraxial anesthesia and analgesia for cardiothoracic
surgeries to improve its utilization.<br/>Copyright &#xa9; The Author(s),
under exclusive licence to Springer Science+Business Media, LLC, part of
Springer Nature 2024.

<39>
Accession Number
2029061292
Title
The Diaphragmatic Initiated Ventilatory Assist (DIVA) trial: study
protocol for a randomized controlled trial comparing rates of extubation
failure in extremely premature infants undergoing extubation to
non-invasive neurally adjusted ventilatory assist versus non-synchronized
nasal intermittent positive pressure ventilation.
Source
Trials. 25(1) (no pagination), 2024. Article Number: 201. Date of
Publication: December 2024.
Author
Matlock D.N.; Ratcliffe S.J.; Courtney S.E.; Kirpalani H.; Firestone K.;
Stein H.; Dysart K.; Warren K.; Goldstein M.R.; Lund K.C.; Natarajan A.;
Demissie E.; Foglia E.E.
Institution
(Matlock) University of Arkansas for Medical Sciences, 4301 W. Markham
St., Slot 512-5B, Little Rock, AR 72205, United States
(Matlock, Courtney) University of Arkansas for Medical Sciences, Little
Rock, AR, United States
(Ratcliffe) University of Virginia, Charlottesville, VA, United States
(Kirpalani, Foglia) University of Pennsylvania Perelman School of
Medicine, Philadelphia, PA, United States
(Kirpalani) McMaster University, Hamilton, ON, Canada
(Firestone) Akron Children's Hospital, Akron, OH, United States
(Stein) Ebeid Children's Hospital, Toledo, OH, United States
(Dysart) Nemours Children's Health Wilmington, Philadelphia, PA, United
States
(Warren, Foglia) The Children's Hospital of Philadelphia, Philadelphia,
PA, United States
(Goldstein) Loma Linda University School of Medicine, Loma Linda, CA,
United States
(Lund) University of Utah, Salt Lake City, UT, United States
(Natarajan, Demissie) National Heart, Lung and Blood Institute, National
Institutes of Health, Bethesda, MD, United States
Publisher
BioMed Central Ltd
Abstract
Background: Invasive mechanical ventilation contributes to
bronchopulmonary dysplasia (BPD), the most common complication of
prematurity and the leading respiratory cause of childhood morbidity.
Non-invasive ventilation (NIV) may limit invasive ventilation exposure and
can be either synchronized or non-synchronized (NS). Pooled data suggest
synchronized forms may be superior. Non-invasive neurally adjusted
ventilatory assist (NIV-NAVA) delivers NIV synchronized to the neural
signal for breathing, which is detected with a specialized catheter. The
DIVA (Diaphragmatic Initiated Ventilatory Assist) trial aims to determine
in infants born 24^0/7-27^6/7 weeks' gestation
undergoing extubation whether NIV-NAVA compared to non-synchronized nasal
intermittent positive pressure ventilation (NS-NIPPV) reduces the
incidence of extubation failure within 5 days of extubation.
<br/>Method(s): This is a prospective, unblinded, pragmatic, multicenter
phase III randomized clinical trial. Inclusion criteria are preterm
infants 24-27^6/7 weeks gestational age who were intubated
within the first 7 days of life for at least 12 h and are undergoing
extubation in the first 28 postnatal days. All sites will enter an initial
run-in phase, where all infants are allocated to NIV-NAVA, and an
independent technical committee assesses site performance. Subsequently,
all enrolled infants are randomized to NIV-NAVA or NS-NIPPV at extubation.
The primary outcome is extubation failure within 5 days of extubation,
defined as any of the following: (1) rise in FiO<inf>2</inf> at least 20%
from pre-extubation for > 2 h, (2) pH <= 7.20 or pCO<inf>2</inf> >= 70
mmHg; (3) > 1 apnea requiring positive pressure ventilation (PPV) or >= 6
apneas requiring stimulation within 6 h; (4) emergent intubation for
cardiovascular instability or surgery. Our sample size of 478 provides 90%
power to detect a 15% absolute reduction in the primary outcome. Enrolled
infants will be followed for safety and secondary outcomes through 36
weeks' postmenstrual age, discharge, death, or transfer.
<br/>Discussion(s): The DIVA trial is the first large multicenter trial
designed to assess the impact of NIV-NAVA on relevant clinical outcomes
for preterm infants. The DIVA trial design incorporates input from
clinical NAVA experts and includes innovative features, such as a run-in
phase, to ensure consistent technical performance across sites. Trial
registration: www.ClinicalTrials.gov, trial identifier NCT05446272,
registered July 6, 2022.<br/>Copyright &#xa9; The Author(s) 2024.

<40>
Accession Number
643815014
Title
Safety and efficacy of Cox-Maze procedure for atrial fibrillation during
mitral valve surgery: a meta-analysis of randomized controlled trials.
Source
Journal of cardiothoracic surgery. 19(1) (pp 140), 2024. Date of
Publication: 19 Mar 2024.
Author
Gao Y.; Luo H.; Yang R.; Xie W.; Jiang Y.; Wang D.; Cao H.
Institution
(Gao, Luo, Yang, Xie, Jiang, Wang, Cao) Department of Cardio-Thoracic
Surgery, Nanjing Drum Tower Hospital, Affiliated Hospital of Nanjing
University Medical School, Nanjing, Jiangsu 210008, China
(Gao, Luo, Xie, Wang) Institute of Cardiothoracic Vascular Disease,
Nanjing University, Nanjing, Jiangsu, China
(Yang, Jiang, Cao) Nanjing Drum Tower Hospital Clinical College of Nanjing
University of Chinese Medicine, Nanjing, Jiangsu, China
Abstract
BACKGROUND: Cox-Maze procedure is currently the gold standard treatment
for atrial fibrillation (AF). However, data on the effectiveness of the
Cox-Maze procedure after concomitant mitral valve surgery (MVS) are not
well established. The aim of this study was to assess the safety and
efficacy of Cox-Maze procedure versus no-maze procedure n in AF patients
undergoing mitral valve surgery through a systematic review of the
literature and meta-analysis. <br/>METHOD(S): A systematic search on
PubMed/MEDLINE, EMBASE, and Cochrane Central Register of Clinical Trials
(Cochrane Library, Issue 02, 2017) databases were performed using three
databases from their inception to March 2023, identifying all relevant
randomized controlled trials (RCTs) comparing Cox-Maze procedure versus no
procedure in AF patients undergoing mitral valve surgery. Data were
extracted and analyzed according to predefined clinical endpoints.
<br/>RESULT(S): Nine RCTs meeting the inclusion criteria were included in
this systematic review with 663 patients in total (341 concomitant
Cox-Maze with MVS and 322 MVS alone). Across all studies with included AF
patients undergoing MV surgery, the concomitant Cox-Maze procedure was
associated with significantly higher sinus rhythm rate at discharge, 6
months, and 12 months follow-up when compared with the no-Maze group.
Results indicated that there was no significant difference between the
Cox-Maze and no-Maze groups in terms of 1 year all-cause mortality,
pacemaker implantation, stroke, and thromboembolism. <br/>CONCLUSION(S):
Our systematic review suggested that RCTs have demonstrated the addition
of the Cox-Maze procedure for AF leads to a significantly higher rate of
sinus rhythm in mitral valve surgical patients, with no increase in the
rates of mortality, pacemaker implantation, stroke, and
thromboembolism.<br/>Copyright &#xa9; 2024. The Author(s).

<41>
Accession Number
643777408
Title
Prophylactic corticosteroids for cardiopulmonary bypass in adult cardiac
surgery.
Source
Cochrane Database of Systematic Reviews. 2024(3) (no pagination), 2024.
Article Number: CD005566. Date of Publication: 20 Mar 2024.
Author
Abbasciano R.G.; Olivieri G.M.; Chubsey R.; Gatta F.; Tyson N.;
Easwarakumar K.; Fudulu D.P.; Marsico R.; Kofler M.; Elshafie G.; Lai F.;
Loubani M.; Kendall S.; Zakkar M.; Murphy G.J.
Institution
(Abbasciano, Zakkar, Murphy) Department of Cardiovascular Sciences,
University of Leicester, Leicester, United Kingdom
(Olivieri) Niguarda Hospital, Milan, Italy
(Chubsey, Easwarakumar, Marsico) University Hospitals of Leicester NHS
Trust, Leicester, United Kingdom
(Gatta) Department of Cardiothoracic Surgery, Liverpool Heart and Chest
Hospital, Liverpool, United Kingdom
(Tyson) Department of Cardiac Surgery, University Hospitals of Leicester,
Leicester, United Kingdom
(Fudulu) Department of Cardiac Surgery, University Hospital Bristol NHS
Trust, Bristol, United Kingdom
(Kofler) Deutsches Herzzentrum Berlin, Berlin, Germany
(Elshafie, Loubani) Department of Cardiothoracic Surgery, Hull and East
Yorkshire Hospitals NHS Trust, Hull, United Kingdom
(Lai) Leicester Clinical Trials Unit, University of Leicester, Glenfield
Hospital, Leicester, United Kingdom
(Kendall) James Cook University Hospital, Middlesbrough, United Kingdom
Publisher
John Wiley and Sons Ltd
Abstract
Background: Cardiac surgery triggers a strong inflammatory reaction, which
carries significant clinical consequences. Corticosteroids have been
suggested as a potential perioperative strategy to reduce inflammation and
help prevent postoperative complications. However, the safety and
effectiveness of perioperative corticosteroid use in adult cardiac surgery
is uncertain. This is an update of the 2011 review with 18 studies added.
<br/>Objective(s): <br/>Primary Objective: to estimate the effects of
prophylactic corticosteroid use in adults undergoing cardiac surgery with
cardiopulmonary bypass on the: - co-primary endpoints of mortality,
myocardial complications, and pulmonary complications; and- secondary
outcomes including atrial fibrillation, infection, organ injury, known
complications of steroid therapy, prolonged mechanical ventilation,
prolonged postoperative stay, and cost-effectiveness. Secondary objective:
to explore the role of characteristics of the study cohort and specific
features of the intervention in determining the treatment effects via a
series of prespecified subgroup analyses. <br/>Search Method(s): We used
standard, extensive Cochrane search methods to identify randomised studies
assessing the effect of corticosteroids in adult cardiac surgery. The
latest searches were performed on 14 October 2022. <br/>Selection
Criteria: We included randomised controlled trials in adults (over 18
years, either with a diagnosis of coronary artery disease or cardiac valve
disease, or who were candidates for cardiac surgery with the use of
cardiopulmonary bypass), comparing corticosteroids with no treatments.
There were no restrictions with respect to length of the follow-up period.
All selected studies qualified for pooling of results for one or more
endpoints. <br/>Data Collection and Analysis: We used standard Cochrane
methods. Our primary outcomes were all-cause mortality, and cardiac and
pulmonary complications. Secondary outcomes were infectious complications,
gastrointestinal bleeding, occurrence of new post-surgery atrial
fibrillation, re-thoracotomy for bleeding, neurological complications,
renal failure, inotropic support, postoperative bleeding, mechanical
ventilation time, length of stays in the intensive care unit (ICU) and
hospital, patient quality of life, and cost-effectiveness. We used GRADE
to assess the certainty of evidence for each outcome. <br/>Main Result(s):
This updated review includes 72 randomised trials with 17,282 participants
(all 72 trials with 16,962 participants were included in data synthesis).
Four trials (6%) were considered at low risk of bias in all the domains.
The median age of participants included in the studies was 62.9 years.
Study populations consisted mainly (89%) of low-risk, first-time coronary
artery bypass grafting (CABG) or valve surgery. The use of perioperative
corticosteroids may result in little to no difference in all-cause
mortality (risk with corticosteroids: 25 to 36 per 1000 versus 33 per 1000
with placebo or no treatment; risk ratio (RR) 0.90, 95% confidence
interval (CI) 0.75 to 1.07; 25 studies, 14,940 participants; low-certainty
evidence). Corticosteroids may increase the risk of myocardial
complications (68 to 86 per 1000) compared with placebo or no treatment
(66 per 1000; RR 1.16, 95% CI 1.04 to 1.31; 25 studies, 14,766
participants; low-certainty evidence), and may reduce the risk of
pulmonary complications (risk with corticosteroids: 61 to 77 per 1000
versus 78 per 1000 with placebo/no treatment; RR 0.88, 0.78 to 0.99; 18
studies, 13,549 participants; low-certainty evidence). Analyses of
secondary endpoints showed that corticosteroids may reduce the incidence
of infectious complications (risk with corticosteroids: 94 to 113 per 1000
versus 123 per 1000 with placebo/no treatment; RR 0.84, 95% CI 0.76 to
0.92; 28 studies, 14,771 participants; low-certainty evidence).
Corticosteroids may result in little to no difference in incidence of
gastrointestinal bleeding (risk with corticosteroids: 9 to 17 per 1000
versus 10 per 1000 with placebo/no treatment; RR 1.21, 95% CI 0.87 to
1.67; 6 studies, 12,533 participants; low-certainty evidence) and renal
failure (risk with corticosteroids: 23 to 35 per 1000 versus 34 per 1000
with placebo/no treatment; RR 0.84, 95% CI 0.69 to 1.02; 13 studies,
12,799; low-certainty evidence). Corticosteroids may reduce the length of
hospital stay, but the evidence is very uncertain (-0.5 days, 0.97 to 0.04
fewer days of length of hospital stay compared with placebo/no treatment;
25 studies, 1841 participants; very low-certainty evidence). The results
from the two largest trials included in the review possibly skew the
overall findings from the meta-analysis. Authors' conclusions: A
systematic review of trials evaluating the organ protective effects of
corticosteroids in cardiac surgery demonstrated little or no treatment
effect on mortality, gastrointestinal bleeding, and renal failure. There
were opposing treatment effects on cardiac and pulmonary complications,
with evidence that corticosteroids may increase cardiac complications but
reduce pulmonary complications; however, the level of certainty for these
estimates was low. There were minor benefits from corticosteroid therapy
for infectious complications, but the evidence on hospital length of stay
was very uncertain. The inconsistent treatment effects across different
outcomes and the limited data on high-risk groups reduced the
applicability of the findings. Further research should explore the role of
these drugs in specific, vulnerable cohorts.<br/> Copyright &#xa9; 2024
The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.

<42>
Accession Number
643804802
Title
Integrative oncology research in action: Stimulating dialogue and
collaboration between health care providers.
Source
Journal of Complementary and Integrative Medicine. Conference: 2016 INCAM
Research Symposium: Expanding Person-Centred Care through Integrative
Health Research. Toronto, ON Canada. 13(4) (pp eA11), 2016. Date of
Publication: 2016.
Author
Seely D.; Seely A.; Asmis T.; Auer R.; Thavorn K.; Fergusson D.; Ramsay
T.; Maziak D.; Laurie S.; Ennis J.; McDonell E.; Zhao L.; Fazekas A.
Institution
(Seely, Ennis, McDonell, Zhao) Ottawa Integrative Cancer Centre, Ottawa,
ON, Canada
(Seely, Seely, Asmis, Auer, Thavorn, Fergusson, Ramsay, Maziak, Laurie,
Fazekas) Ottawa Hospital Research Institute, Ottawa, ON, Canada
(Seely, Asmis, Auer, Maziak, Laurie) Ottawa Hospital, General Campus,
Ottawa, ON, Canada
(Seely, Asmis, Auer, Thavorn, Fergusson, Ramsay, Maziak, Laurie)
University of Ottawa, Ottawa, ON, Canada
Publisher
Walter de Gruyter GmbH
Abstract
Background: The Thoracic Peri-Operative Integrative Surgical Care
Evaluation (POISE) Trial is a three-stage project culminating in a
pragmatic randomized controlled trial (RCT) for people with thoracic
cancer. The trial will evaluate a multi-agent integrative care palette
delivered by naturopathic doctors alongside standard care.
<br/>Objective(s): To create a process for defining the protocol and
integrative interventions through collaboration amongst a
multidisciplinary team of complementary and conventional health care
providers. <br/>Method(s): The co-principal investigators (naturopathic
doctor and surgeon) assembled a multidisciplinary team to serve on
Steering and Intervention Development Committees (SC and IDC). These
committees include representatives from naturopathic medicine, surgery,
anaesthesiology, medical oncology, radiation oncology, heath economics,
research, pharmacy, psychology and physiotherapy. A series of SC meetings
and IDC consultations were conducted to develop a systematic method for
defining interventions and the study protocol. <br/>Result(s): Potential
interventions were identified from a practice review, evidence review, and
expert opinion and scored on practical usage, safety, goals,
feasibility/scalability and evidence. SC and IDC voted on interventions to
include/exclude. The resulting interventions will be piloted in a
single-arm study prior to the RCT. The study population includes gastric,
esophageal and lung cancer patients eligible for complete resection
randomized to standard care with or without integrative care. Trial
outcomes include quality of life, side effects, cost effectiveness,
overall survival, recurrence, biological impact, safety, adherence and
qualitative outcomes. <br/>Conclusion(s): Engaging a multidisciplinary
team of naturopathic and conventional practitioners and researchers has
enabled an effective means of collaboration for the development of the
Thoracic POISE Trial.

<43>
Accession Number
643804951
Title
Development of an intervention palette of natural health products for a
pragmatic integrative thoracic cancer trial.
Source
Journal of Complementary and Integrative Medicine. Conference: 2016 INCAM
Research Symposium: Expanding Person-Centred Care through Integrative
Health Research. Toronto, ON Canada. 13(4) (pp eA23), 2016. Date of
Publication: 2016.
Author
McDonell E.; Seely D.; Seely A.; Spooner C.; Ennis J.; Zhao L.
Institution
(McDonell, Seely, Ennis, Zhao) Ottawa Integrative Cancer Centre, Ottawa,
ON, Canada
(Seely, Seely) Ottawa Hospital Research Institute, Ottawa, ON, Canada
(Seely) Ottawa Hospital, General Campus, Ottawa, ON, Canada
(Spooner) Paradigm Naturopathic Medicine, Vernon, BC, Canada
Publisher
Walter de Gruyter GmbH
Abstract
Background: The Thoracic Peri-Operative Integrative Surgical Care
Evaluation (POISE) Trial aims to improve thoracic cancer care. The trial
will evaluate a multi-agent integrative care program delivered by
naturopathic doctors (NDs) in conjunction with standard care for thoracic
cancer patients undergoing curative surgery. Natural Health Products (NHP)
constitute one of four domains included in the integrative care program.
<br/>Objective(s): Develop a systematic process to establish consensus
among a multidisciplinary team of health care providers and researchers on
the NHPs to be considered. <br/>Method(s): NHPs were identified through a
clinical practice survey and systematic literature review and scored on
practical usage, safety, goals, feasibility/scalability and evidence base.
The trial's Steering Committee then selected the NHPs to be piloted as
part of a protocolized palette including standard core interventions and
optional interventions to manage specific symptoms. Safety, known risks
and drug interactions were evaluated using industry and professional
monographs, a literature review and consultations with pharmacists.
<br/>Result(s): This process resulted in a palette of NHPs adapted to four
phases of standard care (neo-adjuvant, perioperative, adjuvant and
long-term maintenance). The palette is designed to address patient needs
and include agents targeting inflammation, immune function, nutritional
deficiencies, side effects, surgical complications, wound healing, and
direct anti-neoplastic actions. <br/>Conclusion(s): The multidisciplinary
approach has fostered a strong collaboration between conventional and
complementary care providers. The process has identified NHPs expected to
benefit patients with thoracic cancers, and could serve as a model for the
development of clinical practice guidelines for integrative cancer
management.

<44>
Accession Number
2031163781
Title
The impact of frailty as a critical mediator causing postoperative
neurocognitive disorders in postoperative cardiac patients.
Source
Current Problems in Cardiology. 49(5) (no pagination), 2024. Article
Number: 102528. Date of Publication: May 2024.
Author
Li H.; Li J.; Huang X.; Bhushan S.; Yang J.
Institution
(Li, Huang, Yang) Department of Anesthesiology, West China Hospital of
Sichuan University, No. 37 Wainan Guoxue Road, Chengdu, Sichuan 610041,
China
(Li) Department of Anesthesiology, School of Medicine, Sichuan Provincial
People's Hospital, University of Electronic Science and Technology of
China, Sichuan, Chengdu 610072, China
(Li) Department of Anesthesiology, Chengdu Seventh People's Hospital,
Sichuan, Chengdu 610072, China
(Bhushan) Department of Cardio-Thoracic Surgery, Chengdu Second People's
Hospital, Sichuan, Chengdu 610017, China
Publisher
Elsevier Inc.
Abstract
Frailty is prevalent in elderly cardiac patients and may be a critical
predictor of post-operative neurocognitive disorders (PND). The aim of
this review was to demonstrate the correlation of frailty with PND in
postsurgical elder patients. A review of published literature and
bibliometric analysis was undertaken. Electronic databases from 2009 to
2022 were searched to identify articles that evaluated the relationship
between frailty and PND in aging populations. Demographic data, type of
surgery performed, frailty measurement, and impact of frailty on PND were
extracted from the selected studies. The quality of the studies and risk
of bias were assessed by the Newcastle-Ottawa Quality Assessment Scale,
and the included articles were assessed as medium to high quality.
Eighty-one studies were selected for the Bibliometric review in terms of
research trends and hotpots. Additionally, 35 observational studies
(prospective and retrospective cohorts) were selected for this review. The
mean age ranged from 63 to 84 years and included patients undergoing
cardiac, orthopedic, and other surgeries who had cardiac symptoms.
Regardless of how frailty was measured, the strongest evidence in terms of
numbers of studies, consistency of results, and study quality was for
associations between frailty and PND. This analysis found a steadily
growing focus on frailty and PND research in cardiac and other patients.
The observational studies account for the majority of this area, and
frailty occurred in the older cardiac patients over 60 years of age, and
pre-screening of frailty can be predictive of PND and
mortality.<br/>Copyright &#xa9; 2024

<45>
Accession Number
2031195706
Title
Effects of esketamine on postoperative negative emotions and early
cognitive disorders in patients undergoing non-cardiac thoracic surgery: A
randomized controlled trial.
Source
Journal of Clinical Anesthesia. 95 (no pagination), 2024. Article Number:
111447. Date of Publication: August 2024.
Author
Luo T.; Deng Z.; Ren Q.; Mu F.; Zhang Y.; Wang H.
Institution
(Luo, Deng, Ren, Mu, Zhang, Wang) Department of Anesthesiology, Affiliated
Hospital of Zunyi Medical University, Zunyi 563100, China
(Luo, Wang) Guizhou Key Laboratory of Anesthesia and Organ Protection,
Zunyi 563100, China
Publisher
Elsevier Inc.
Abstract
Study objective: To investigate whether a single dosage of esketamine
injection in the anesthesia period could improve postoperative negative
emotions and early cognitive function in patients undergoing non-cardiac
thoracic surgery. <br/>Design(s): A prospective single center double
blinded randomized placebo-controlled trial. <br/>Setting(s):
Perioperative period; operating room, post anesthesia care unit and
hospital ward. <br/>Patient(s): 129 adult patients that underwent elective
non-cardiac thoracic surgery under general anesthesia.
<br/>Intervention(s): During the operation, pharmacologic prevention of
postoperative negative emotion and early cognitive disorder with 0.2 mg/kg
(Low esketamine group) and 0.5 mg/kg esketamine (High esketamine group)
vs. placebo. Measurements: Emotion and early cognitive performance were
assessed on the day before surgery (POD-1), postoperative day 1 (POD1) and
day 3 (POD3) using HADS-A, HADS-D, Pain Visual Analogue Scale (VAS),
Confusion Assessment Method (CAM), Mini-Mental State Examination (MMSE),
and serum biomarkers (S100beta, BDNF, IL-6, acetylcholine, and
norepinephrine). <br/>Main Result(s): The high esketamine group showed
significantly lower HADS-A and HADS-D scores than control group on POD1
and POD3. No significant differences were observed between the low
esketamine group and the control group. The esketamine-treated groups
showed lower pain VAS scores than the control group at 2 h and on the
first day after operation. There were no significant differences among the
three groups in CAM and MMSE scores. However, the high esketamine group
had lower S100beta and IL-6 levels, and higher BDNF levels
postoperatively, while serum acetylcholine and norepinephrine were not
significantly different. <br/>Conclusion(s): A single intraoperative
injection of 0.5 mg/kg esketamine can alleviate postoperative anxiety,
depression, and pain to some extent. Although cognitive function
behavioral evaluation did not show obvious benefits, it can also reduce
the production of pro-inflammatory and brain injury-related factors while
promoting the generation of brain-derived neurotrophic factor.
Registration Trial registry: http://www.chictr.org.cn/; Identifier:
ChiCTR2100047067.<br/>Copyright &#xa9; 2024 The Authors

<46>
Accession Number
2029132820
Title
Amino acids to prevent cardiac surgery-associated acute kidney injury: a
randomized controlled trial.
Source
JA Clinical Reports. 10(1) (no pagination), 2024. Article Number: 19. Date
of Publication: December 2024.
Author
Kazawa M.; Kabata D.; Yoshida H.; Minami K.; Maeda T.; Yoshitani K.;
Matsuda H.; Shintani A.
Institution
(Kazawa, Minami) Department of Critical Care Medicine, National Cerebral
and Cardiovascular Center, 6-1, Kishibe-Shinmachi, Osaka, Suita, Japan
(Kazawa, Kabata, Yoshida, Shintani) Department of Medical Statistics,
Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan
(Matsuda) Department of Cardiovascular Surgery, National Cerebral and
Cardiovascular Center, Osaka, Japan
(Maeda, Yoshitani) Department of Anesthesiology, National Cerebral and
Cardiovascular Center, Osaka, Japan
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Background: This study aimed to examine the preventive effect of amino
acids on postoperative acute kidney injury (AKI). <br/>Method(s): This was
single-center, patient- and assessor-blinded, randomized controlled trial.
Patients who underwent aortic surgery with cardiopulmonary bypass were
included. The intervention group received 60 g/day of amino acids for up
to 3 days. The control group received standard care. The primary outcome
was the incidence of AKI. We assessed the effect of amino acids on AKI
using a Cox proportional hazards regression model. <br/>Result(s):
Sixty-six patients were randomly assigned to the control or intervention
group. One patient in the control group withdrew consent after
randomization. The incidence of AKI was 10 patients (30.3%) in the
intervention group versus 18 patients (56.2%) in the control group
(adjusted hazard ratio, 0.44; 95% confidence interval, 0.20-0.95; P =
0.04). <br/>Conclusion(s): This trial demonstrated a significant reduction
in AKI incidence with amino acid supplementation. Trial registration:
jRCT, jRCTs051210154. Registered 31 December 2021,
https://jrct.niph.go.jp/re/reports/detail/69916.<br/>Copyright &#xa9; The
Author(s) 2024.

<47>
Accession Number
2031181937
Title
The outcomes of aortic arch repair between open surgical repair and
debranching endovascular hybrid surgical repair: a systematic review and
meta-analysis.
Source
Journal of Vascular Surgery. (no pagination), 2024. Date of Publication:
2024.
Author
Chen C.W.; Hu J.; Li Y.Y.; Chen G.X.; Zhang W.; Chen X.Y.
Institution
(Chen) Division of Liver Surgery, Department of General Surgery, West
China Hospital, Sichuan University, Chengdu, China
(Hu) Division of Health Management Centre, West China Fourth Hospital,
Sichuan University, Chengdu, China
(Li, Chen, Chen) Division of Vascular Surgery, Department of General
Surgery, West China Hospital, Sichuan University, Chengdu, China
(Zhang) Division of Vascular and Endovascular Surgery, Department of
Surgery, University of Washington and Puget Sound VA Health Care System,
Seattle, WA, United States
Publisher
Elsevier Inc.
Abstract
Background: At present, open surgical aortic arch repair (OAR) and
debranching hybrid surgical aortic arch repair (HAR) serve as significant
therapeutic approaches for aortic arch aneurysm or dissection. It remains
unclear which technique is preferable. Our study aimed to compare the
short-term and long-term outcomes of these two procedures. <br/>Method(s):
To identify comparison studies of debranching HAR and OAR, a systematic
search of the PubMed, Embase, Web of Science, and Cochrane Library
databases was performed from January 2002 to April 2022. This study was
registered on PROSPERO (CRD42020218080). <br/>Result(s): Sixteen
publications (1316 patients), including six propensity score-matching
(PSM) analysis papers, were included in this study. Compared with the HAR
group, the patients who underwent OAR were younger (OAR vs HAR: 67.53 +/-
12.81 vs 71.29 +/- 11.0; P <.00001), had less coronary artery disease (OAR
vs HAR: 22.45% vs 32.6%; P =.007), less chronic obstructive pulmonary
disease (OAR vs HAR: 16.16% vs 23.92%; P =.001), lower rates of previous
stroke (OAR vs HAR: 12.46% vs 18.02%; P =.05), and a lower EuroSCORE
(European System for Cardiac Operative Risk Evaluation) score (OAR vs HAR:
6.27 +/- 1.04 vs 6.9 +/- 3.76; P <.00001). HAR was associated with less
postoperative blood transfusion (OAR vs HAR: 12.23% vs 7.91%; P =.04),
shorter length of intensive care unit stays (OAR vs HAR: 5.92 +/- 7.58
days vs 4.02 +/- 6.60 days; P <.00001) and hospital stays (OAR vs HAR:
21.59 +/- 17.54 days vs 16.49 +/- 18.45 days; P <.0001), lower incidence
of reoperation for bleeding complications (OAR vs HAR: 8.07% vs 3.96%; P
=.01), fewer postoperative pulmonary complication (OAR vs HAR: 14.75% vs
5.02%; P <.0001), and acute renal failure (OAR vs HAR: 7.54% vs 5.17%; P
=.03). In the PSM subgroup, the rates of spinal cord ischemic (OAR vs HAR:
5.75% vs 11.49%; P =.02), stroke (OAR vs HAR: 5.1% vs 17.35%; P =.01), and
permanent paraplegia (OAR vs HAR: 2.79% vs 6.08%; P =.006) were lower in
the OAR group than that in the HAR group. Although there was no
statistically significant difference in 1-year survival rates (HAR vs OAR:
hazard ratio [HR]: 1.54; P =.10), the 3-year and 5-year survivals were
significantly higher in the OAR group than that in the HAR group (HAR vs
OAR: HR: 1.69; P =.01; HAR vs OAR: HR: 1.68; P =.01). In the PSM subgroup,
the OAR group was also significantly superior to the HAR group in terms of
3-year and 5-year survivals (HAR vs OAR: HR: 1.73; P =.04; HAR vs OAR: HR:
1.67; P =.04). The reintervention rate in the HAR group was significantly
higher than that in the OAR group (OAR vs HAR: 8.24% vs 16.01%; P =.01).
The most common reintervention was postoperative bleeding (8.07%) in the
OAR group and endoleak (9.67%) in the HAR group. <br/>Conclusion(s): Our
meta-analysis revealed that debranching HAR was associated with fewer
perioperative complications than the OAR group, except for postoperative
permanent paraplegia, reintervention, and stroke events. The OAR group
demonstrated better 3-year and 5-year survivals than the debranching HAR
group. However, patients in the OAR group had fewer comorbid factors and
were younger than those in the HAR group. High-quality studies and
well-powered randomized trials are needed to further evaluate this
evolving field.<br/>Copyright &#xa9; 2023 Society for Vascular Surgery

<48>
Accession Number
643814644
Title
Efficacy of mitral valve repair in combination with coronary
revascularization for moderate ischaemic mitral regurgitation: a
systematic review and meta-analysis of randomized controlled trials.
Source
International journal of surgery (London, England). (no pagination),
2024. Date of Publication: 19 Mar 2024.
Author
Li X.; Hou B.; Hou S.; Zhang H.; Liu Y.; Jiang W.
Institution
(Li, Hou, Zhang, Jiang) Department of Cardiac Surgery Center, Beijing
Anzhen Hospital, Beijing Institute of Heart, Lung, Blood Vascular
Diseases, Capital Medical University, Chaoyang district, Beijing, China
(Hou, Liu) Department of Cardiovascular Surgery, First Affiliated Hospital
of Anhui Medical University, Hefei, China
Abstract
BACKGROUND: The efficacy of mitral valve repair (MVR) in combination with
coronary artery bypass grafting (CABG) for moderate ischaemic mitral
regurgitation (IMR) remains unclear. To evaluate whether MVR + CABG is
superior to CABG alone, the authors conducted a systematic review and
meta-analysis of existing randomized controlled trials (RCTs).
<br/>METHOD(S): The authors searched PubMed, Web of Science, and the
Cochrane Central Register of Controlled Trials for eligible RCTs from the
date of their inception to October 2023. The primary outcomes were
operative (in-hospital or within 30 days) and long-term (>= 1 year)
mortality. The secondary outcomes were postoperative stroke, worsening
renal function (WRF), and reoperation for bleeding or tamponade. The
authors performed random-effects meta-analyses and reported the results as
risk ratios (RRs) with 95% CIs. <br/>RESULT(S): Six RCTs were eligible for
inclusion. Compared with CABG alone, MVR + CABG did not increase the risk
of operative mortality (RR, 1.244; 95% CI, 0.514-3.014); however, it was
also not associated with a lower risk of long-term mortality (RR, 0.676;
95% CI, 0.417-1.097). Meanwhile, there was no difference between the two
groups in terms of postoperative stroke (RR, 2.425; 95% CI, 0.743-7.915),
WRF (RR, 1.257; 95% CI, 0.533-2.964), and reoperation for bleeding or
tamponade (RR, 1.667; 95% CI, 0.527-5.270). <br/>CONCLUSION(S): The
findings of this meta-analysis suggest that MVR + CABG fails to improve
the clinical outcomes of patients with moderate IMR compared to CABG
alone.<br/>Copyright &#xa9; 2024 The Author(s). Published by Wolters
Kluwer Health, Inc.

<49>
Accession Number
643813187
Title
Efficacy and safety of Tongxin formula after stent implantation for acute
coronary syndrome: A multicenter, double-blind, placebo-controlled
randomized trial.
Source
Explore (New York, N.Y.). (no pagination), 2024. Date of Publication: 01
Mar 2024.
Author
Zhu W.; Wang S.; Zhang L.; Xie F.-Q.; Cheng J.; Li X.-K.; Chen W.; Yan
S.-Y.; Feng Q.-M.
Institution
(Zhu, Wang, Zhang, Xie, Cheng, Feng) Department of Cardiology, Shanghai
Municipal Hospital of Traditional Chinese Medicine, Shanghai University of
Traditional Chinese Medicine, 274 Zhijiang Middle Road Jing 'an District,
Shanghai 200071, China
(Li) Department of Cardiology, Tenth People's Hospital, Tongji University,
Shanghai 200072, China
(Chen) Department of Cardiology, Changzheng Hospital, Second Military
Medical University, Shanghai 200003, China
(Yan) Institute of Science, Technology and Humanities, Shanghai University
of Traditional Chinese Medicine, Shanghai 201203, China
Abstract
OBJECTIVE: The aim of this study is to comprehensively evaluate both the
efficacy and safety profile of integrating the Tongxin formula with
optimal medical therapy (OMT) for patients experiencing acute coronary
syndromes subsequent to coronary stenting, over the course of one year.
<br/>METHOD(S): We enrolled 150 patients diagnosed with acute coronary
syndromes who had received stent placement within one month and exhibited
a TCM syndrome characterized by Qi deficiency and blood stasis. This group
comprised patients with unstable angina, non-ST-segment elevation
myocardial infarction, and ST-segment elevation myocardial infarction. The
participants were divided equally, allocating 75 to the Tongxin formula
group and 75 to a placebo-controlled group. After undergoing percutaneous
coronary intervention (PCI) surgery, both groups received conventional
Western medical care, including dual antiplatelet therapy and
lipid-lowering medications. The placebo-controlled group received a
placebo, while the Tongxin formula group were administered Tongxin formula
granules orally. Both study cohorts were monitored for a duration of 6
months. The primary endpoints included the occurrence of major adverse
cardiovascular events and the rate of lumen diameter reduction
post-treatment in both groups, with the Seattle Angina Scale serving as a
secondary assessment tool. Safety evaluations encompassed the measurement
of liver and kidney function, coagulation parameters, and other relevant
indicators. <br/>RESULT(S): The rate of adverse cardiovascular events in
the placebo-controlled group was 42.46 % within a year of surgery, whereas
it was 16.90 % in the Tongxin formula group (P < 0.05). Comparing the
Tongxin formula group to the placebo-controlled group, there was a
decrease in the frequency of unstable angina and readmission due to
cardiovascular events (P < 0.05). Coronary angiography performed 6 months
after surgery revealed that the Tongxin formula group had considerably
less lumen loss than the placebo-controlled group in a number of segments,
including the entire segment, within the stent, at the proximal end, and
at the distal end (P < 0.05). Six months after surgery, the Seattle angina
score was higher in the Tongxin formula group than in the
placebo-controlled group (P < 0.05). There were no significant changes in
indicators such as liver and renal function as well as coagulation indexes
in both groups within the first 12 months after surgery (P > 0.05).
<br/>CONCLUSION(S): Tongxin formula has been shown to lower the occurrence
of major adverse cardiovascular events, minimize narrowing of blood vessel
lumen, enhance clinical symptoms, and enhance the quality of life of
patients following PCI surgery, all while maintaining a good safety
profile.<br/>Copyright &#xa9; 2024. Published by Elsevier Inc.

<50>
Accession Number
2029566821
Title
When Direct Oral Anticoagulants Should Not Be Standard Treatment: JACC
State-of-the-Art Review.
Source
Journal of the American College of Cardiology. 83(3) (pp 444-465), 2024.
Date of Publication: 23 Jan 2024.
Author
Bejjani A.; Khairani C.D.; Assi A.; Piazza G.; Sadeghipour P.; Talasaz
A.H.; Fanikos J.; Connors J.M.; Siegal D.M.; Barnes G.D.; Martin K.A.;
Angiolillo D.J.; Kleindorfer D.; Monreal M.; Jimenez D.; Middeldorp S.;
Elkind M.S.V.; Ruff C.T.; Goldhaber S.Z.; Krumholz H.M.; Mehran R.;
Cushman M.; Eikelboom J.W.; Lip G.Y.H.; Weitz J.I.; Lopes R.D.; Bikdeli B.
Institution
(Bejjani, Khairani, Piazza, Goldhaber, Bikdeli) Thrombosis Research Group,
Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United
States
(Bejjani, Khairani, Piazza, Ruff, Goldhaber, Bikdeli) Cardiovascular
Medicine Division, Brigham and Women's Hospital, Harvard Medical School,
Boston, MA, United States
(Bejjani) Department of Medicine, University of Pittsburgh Medical Center,
Pittsburgh, PA, United States
(Assi, Piazza) Department of Medicine, Brigham and Women's Hospital,
Harvard Medical School, Boston, MA, United States
(Sadeghipour) Rajaie Cardiovascular, Medical, and Research Center, Iran
University of Medical Sciences, Tehran, Iran, Islamic Republic of
(Sadeghipour) Clinical Trial Center, Rajaie Cardiovascular, Medical, and
Research Center, Iran University of Medical Sciences, Tehran, Iran,
Islamic Republic of
(Talasaz) Tehran Heart Center, Tehran University of Medical Sciences,
Tehran, Iran, Islamic Republic of
(Talasaz) Virginia Commonwealth University, Richmond, VA, United States
(Fanikos) Department of Pharmacy, Brigham and Women's Hospital, Harvard
Medical School, Boston, MA, United States
(Connors) Hematology Division, Department of Medicine, Brigham and Women's
Hospital, Harvard Medical School, Boston, MA, United States
(Siegal) Division of Hematology, Department of Medicine, University of
Ottawa, Ottawa, ON, Canada
(Barnes) Frankel Cardiovascular Center, Department of Internal Medicine,
University of Michigan, Ann Arbor, MI, United States
(Martin) Division of Hematology/Oncology, Department of Medicine,
Northwestern University Feinberg School of Medicine, Chicago, IL, United
States
(Angiolillo) Division of Cardiology, University of Florida College of
Medicine, Jacksonville, FL, United States
(Kleindorfer) University of Cincinnati, Cincinnati, OH, United States
(Monreal) Catedra de Enfermedad Tromboembolica, Universidad Catolica San
Antonio de Murcia, Spain
(Jimenez) Respiratory Department, Hospital Ramon y Cajal and Medicine
Department, Universidad de Alcala (Instituto de Ramon y Cajal de
Investigacion Sanitaria), Centro de Investigacion Biomedica en Red de
Enfermedades Respiratorias (CIBERES), Madrid, Spain
(Middeldorp, Bikdeli) Department of Internal Medicine, Radboud University
Medical Center, Nijmegen, Netherlands
(Elkind) Department of Neurology, Vagelos College of Physicians and
Surgeons, New York, NY, United States
(Elkind) Department of Epidemiology, Mailman School of Public Health,
Columbia University, New York, NY, United States
(Krumholz) Yale New Haven Hospital/Yale Center for Outcomes Research and
Evaluation, New Haven, CT, United States
(Krumholz) Department of Health Policy and Management, Yale School of
Public Health, New Haven, CT, United States
(Krumholz) Section of Cardiovascular Medicine, Department of Internal
Medicine, Yale School of Medicine, New Haven, CT, United States
(Mehran) Zena and Michael A. Wiener Cardiovascular Institute, Icahn School
of Medicine at Mount Sinai, New York, NY, United States
(Cushman) Department of Medicine, Larner College of Medicine at the
University of Vermont, Burlington, VT, United States
(Cushman) Department of Pathology and Laboratory Medicine, Larner College
of Medicine at the University of Vermont, Burlington, VT, United States
(Eikelboom) Population Health Research Institute, Hamilton Health
Sciences, McMaster University, Hamilton, ON, Canada
(Lip) Liverpool Centre for Cardiovascular Science at University of
Liverpool, Liverpool John Moores University and Liverpool Heart and Chest
Hospital, Liverpool, United Kingdom
(Lip) Danish Center for Clinical Health Services Research, Department of
Clinical Medicine, Aalborg University, Aalborg, Denmark
(Weitz) McMaster University, Hamilton, ON, Canada
(Weitz) Thrombosis and Atherosclerosis Research Institute, Hamilton, ON,
Canada
(Lopes) Duke Clinical Research Institute, Duke University Medical Center,
Durham, NC, United States
(Lopes) Brazilian Clinical Research Institute, Sao Paulo, Brazil
(Bikdeli) Cardiovascular Research Foundation, New York, NY, United States
Publisher
Elsevier Inc.
Abstract
For most patients, direct oral anticoagulants (DOACs) are preferred over
vitamin K antagonists for stroke prevention in atrial fibrillation and for
venous thromboembolism treatment. However, randomized controlled trials
suggest that DOACs may not be as efficacious or as safe as the current
standard of care in conditions such as mechanical heart valves, thrombotic
antiphospholipid syndrome, and atrial fibrillation associated with
rheumatic heart disease. DOACs do not provide a net benefit in conditions
such as embolic stroke of undetermined source. Their efficacy is uncertain
for conditions such as left ventricular thrombus, catheter-associated deep
vein thrombosis, cerebral venous sinus thrombosis, and for patients with
atrial fibrillation or venous thrombosis who have end-stage renal disease.
This paper provides an evidence-based review of randomized controlled
trials on DOACs, detailing when they have demonstrated efficacy and
safety, when DOACs should not be the standard of care, where their safety
and efficacy are uncertain, and areas requiring further
research.<br/>Copyright &#xa9; 2024 American College of Cardiology
Foundation

<51>
Accession Number
2031057773
Title
Mitral Transcatheter Edge-to-Edge Repair in Patients With Atrial
Functional Mitral Regurgitation.
Source
Journal of the American College of Cardiology. 83(13) (pp 1253-1255),
2024. Date of Publication: 02 Apr 2024.
Author
Moras E.; Gandhi K.; Koshy A.N.; Bhatia K.; Krittanawong C.; Dominguez
A.C.; Argulian E.; Stone G.W.
Institution
(Moras, Gandhi) Icahn School of Medicine at Mount Sinai, New York, NY,
United States
(Koshy) Royal Melbourne Hospital, University of Melbourne, Melbourne,
Australia
(Bhatia, Dominguez, Argulian) Mount Sinai Heart, Mount Sinai Morningside
Hospital, New York, NY, United States
(Krittanawong) NYU Langone Health and NYU School of Medicine, New York,
NY, United States
(Stone) The Zena and Michael A. Wiener Cardiovascular Institute, Icahn
School of Medicine at Mount Sinai, New York, NY, United States
Publisher
Elsevier Inc.

<52>
Accession Number
2031019077
Title
Comparison of ultrasound-guided subtransverse process interligamentary
plane block with paravertebral block for postoperative analgesia in
thoracic surgery: Protocol for a randomised non-inferiority trial.
Source
BMJ Open. 14(3) (no pagination), 2024. Article Number: e082135. Date of
Publication: 13 Mar 2024.
Author
Wu W.; Wang D.; Liu Y.; Zhu T.; He W.; Shi H.
Institution
(Wu, Wang, Liu, Shi) Department of Anesthesiology, Shanghai Pulmonary
Hospital, School of Medicine, Tongji University, Shanghai, China
(Zhu) School of Medicine, Tongji University, Shanghai, China
(He) Department of Thoracic Surgery, Shanghai Pulmonary Hospital, School
of Medicine, Tongji University, Shanghai, China
Publisher
BMJ Publishing Group
Abstract
Introduction The subtransverse process interligamentary (STIL) plane block
is an emerging interfascial plane block that has garnered attention for
its potential to provide effective postoperative analgesia for breast and
thoracic surgeries. However, a direct comparative assessment between the
STIL plane block and the paravertebral block is currently lacking.
Consequently, our study aims to assess the analgesic efficacy of the STIL
block in comparison to paravertebral block for patients undergoing
video-assisted thoracoscopic surgery (VATS). Methods and analysis This
study is a randomised, parallel-controlled, double-blind, non-inferiority
trial, with the goal of enrolling 114 participants scheduled for uniportal
VATS at Shanghai Pulmonary Hospital. Participants will be randomly
assigned in a 1:1 ratio through block randomisation to receive either the
STIL plane block (n=57) or the paravertebral block (n=57). The primary
outcome of the study is the area under the curve of Numerical Rating
Scale(NRS) scores recorded over a 48-hour period following the surgical
procedure. Secondary outcomes encompass the evaluation of Quality of
Recovery-40, cumulative sufentanil consumption, serum inflammatory
factors, rescue medication usage, the incidence of adverse events and the
patient satisfaction scores. Ethics and dissemination This study has
received approval from the Medical Ethics Committee of Shanghai Pulmonary
Hospital (approval no. L22-329). Written informed consent will be obtained
from all participants. The findings will be submitted for publication in
peer-reviewed journals. Trial registration number
ChiCTR2200066909.<br/>Copyright &#xa9; Author(s) (or their employer(s))
2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights
and permissions. Published by BMJ.

<53>
Accession Number
2031019070
Title
High-flow nasal oxygenation versus face mask oxygenation for
preoxygenation in patients undergoing double-lumen endobronchial
intubation: Protocol of a randomised controlled trial.
Source
BMJ Open. 14(3) (no pagination), 2024. Article Number: e080422. Date of
Publication: 14 Mar 2024.
Author
He R.; Fang Y.; Jiang Y.; Yao D.; Li Z.; Zheng W.; Liu Z.; Luo N.
Institution
(He, Fang, Jiang, Liu, Luo) Department of Anesthesiology, Shenzhen Second
People's Hospital, The First Affiliated Hospital of Shenzhen University,
Guangdong, Shenzhen, China
(Yao) Department of Thoracic Surgery, Shenzhen Second People's Hospital,
The First Affiliated Hospital of Shenzhen University, Guangdong, Shenzhen,
China
(Li) Department of Anesthesiology, Second People' S Hospital of Futian
District, Shenzhen, China
(Zheng) School of Public Health, Zhejiang Chinese Medical University,
Zhejiang, Hangzhou, China
Publisher
BMJ Publishing Group
Abstract
Introduction With the growing emphasis on swift recovery, minimally
invasive thoracic surgery has advanced significantly. Video-assisted
thoracoscopic surgery (VATS) has seen rapid development, and the
double-lumen tube (DLT) remains the most dependable method for tracheal
intubation in VATS. However, hypoxaemia during DLT intubation poses a
threat to the perioperative safety of thoracic surgery patients. Recently,
transnasal high-flow nasal oxygen (HFNO) has shown promise in anaesthesia,
particularly in handling short-duration hypoxic airway emergencies. Yet,
its application in the perioperative period for patients undergoing
pulmonary surgery with compromised cardiopulmonary function lacks
evidence, and there are limited reliable clinical data. Methods and
analysis A prospective, randomised, controlled, single-blind design will
be employed in this study. 112 patients aged 18-60 years undergoing
elective VATS-assisted pulmonary surgery will be enrolled and randomly
divided into two groups: the nasal high-flow oxygen group (H group) and
the traditional mask transnasal oxygen group (M group) in a 1:1 ratio.
HFNO will be used during DLT intubation for the prevention of asphyxia in
group H, while conventional intubation procedures will be followed by
group M. Comparison will be made between the two groups in terms of
minimum oxygen saturation during intubation, hypoxaemia incidence during
intubation, perioperative complications and postoperative hospital days.
Ethics and dissemination Approval for this study has been granted by the
local ethics committee at Shenzhen Second People's Hospital. The trial
results will be disseminated through peer-reviewed journals and scientific
conferences. Trial registration number NCT05666908.<br/>Copyright &#xa9;
Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No
commercial re-use. See rights and permissions. Published by BMJ.

<54>
Accession Number
2030840049
Title
Concomitant tricuspid valve repair for mild-moderate tricuspid
regurgitation patients undergoing mitral valve surgery? A meta-analysis
and meta-regression.
Source
Journal of Cardiovascular Surgery. 64(4) (pp 657-667), 2023. Date of
Publication: December 2023.
Author
Awad A.K.; Sayed A.; Elbadawy M.A.; Ahmed A.; Ming Wang T.K.; Elgharably
H.
Institution
(Awad, Sayed, Elbadawy) Faculty of Medicine, Ain-shams University, Cairo,
Egypt
(Ahmed) CUNY School of Medicine, New York, NY, United States
(Ming Wang) Department of Cardiovascular Medicine, Heart Vascular and
Thoracic Institute, Cleveland Clinic, Cleveland, OH, United States
(Elgharably) Department of Thoracic and Cardiovascular Surgery, Heart
Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, OH, United
States
Publisher
Edizioni Minerva Medica
Abstract
The development of tricuspid regurgitation (TR) is a common complication
of mitral valve disease. Although severe TR is usually operated on at the
same time of mitral valve surgery (MVS), controversies remain regarding
whether mild to moderate TR patients should be operated. Concomitant
tricuspid valve repair with MVS for mild-moderate TR patients. Electronic
databases were searched from inception to November 20, 2022 to include any
observational or randomized controlled trials (RCT) that compare
concomitant tricuspid repair with MVS versus MVS alone. Mantel-Haenszel
method was used to pool study estimates and calculate odds ratios (OR)
with 95% confidence intervals (CI). A total of 9813 patients from 25
studies were included. Regarding primary outcomes, concomitant repair
group had significantly lower 30 days mortality (OR: 0.66; 95% CI 0.45 to
0.96), all-cause mortality-based on RCTs- (OR: 0.40; 95% CI 0.22 to 0.71),
cardiovascular mortality (OR: 0.53; 95% CI: 0.33 to 0.86) and heart
failure hospitalizations (OR: 0.41; 95% CI: 0.26 to 0.63). However, was
associated with higher permanent pacemaker implantation rates (OR: 2.09;
95% CI: 1.45 to 3.00). There were no significant differences in terms of
secondary outcomes: tricuspid valve re-interventions, stroke and acute
kidney injury. Furthermore, repair group showed lower risk for TR
progression degrees (OR 0.08; 95% CI 0.05 to 0.16) and decreased mean of
TR progression (MD -1.85; 95% CI -1.92 to -1.77). Concomitant tricuspid
valve repair in mild or moderate TR at time of MVS appears to reduce not
only 30 days but also long-term all-cause and cardiovascular mortality
weighed against the increased risk of pacemaker
implantation.<br/>Copyright &#xa9; 2023 EDIZIONI MINERVA MEDICA.

<55>
Accession Number
2030627365
Title
The effect of reflexology on pain, anxiety, fatigue, and sleep in patients
undergoing coronary artery bypass graft surgery: A randomized controlled
trial.
Source
European Journal of Integrative Medicine. 66 (no pagination), 2024.
Article Number: 102342. Date of Publication: February 2024.
Author
Gunes K.; Gezginci E.; Tok M.
Institution
(Gunes) Department of Cardiovascular Surgery, Uludag University Health
Application and Research Center, Bursa, Turkey
(Gezginci) Department of Surgical Nursing, Hamidiye Faculty of Nursing,
University of Health Sciences Turkey, Istanbul, Turkey
(Tok) Department of Cardiovascular Surgery, Uludag University Faculty of
Medicine, Bursa, Turkey
Publisher
Elsevier GmbH
Abstract
Introduction: Reflexology is a non-pharmacological method that helps
normalization of bodily functions by applying pressure to the reflex
points on the hands, feet and ears, which correspond to all the organs and
glands in the body. This study aimed to evaluate the effect of reflexology
on pain, anxiety, fatigue, and sleep in patients undergoing cardiovascular
surgery. <br/>Method(s): This open-label, randomized parallel-group
controlled trial was conducted between September 2020 to May 2021 in a
university hospital in Turkey. Seventy eligible patients who underwent
cardiovascular surgery were randomized into reflexology group (n = 35) or
control group (n = 35). While foot reflexology was applied to the
reflexology group for 40 min in the first three days after surgery, no
intervention was applied to control group. The primary outcome was pain
severity, assessed using the Visual Analog Scale, in the first three
postoperative days. The other outcomes were anxiety level assessed using
the State-Trait Anxiety Inventory, fatigue level assessed using the Visual
Analog Scale in the first three postoperative days, and sleep quality
assessed using the Richards-Campbell Sleep Questionnaire in the first four
postoperative days. <br/>Result(s): After applying reflexology on the
first, second, and third postoperative days, pain scores (d=-2.736, 95%
Cl=-3.388 to -2.084) (d=-7.954, 95% Cl=-9.352 to -6.555) (d=-7.528, 95%
Cl=-8.860 to -6.196), anxiety scores (d=-3.462, 95% Cl=-4.202 to -1.721)
(d=-6.077, 95% Cl=-7.187 to -4.967) (d=-6.537, 95% Cl=-7.717 to -5.357),
and fatigue scores (d=-2.490, 95% Cl=-3.115 to -1.866) (d=-6.245, 95%
Cl=-7.380 to -5.109) (d=-8.223, 95% Cl=-9.675 to -6.791, respectively)
were statistically significantly lower in reflexology group compared to
control group. On the second, third, and fourth postoperative days, sleep
scores in reflexology group were statistically significantly higher than
control group (d = 3.230, 95% Cl=2.519 to 3.941) (d = 4.280, 95% Cl=3.431
to 5.130) (d = 6.106, 95% Cl=4.992 to 7.221, respectively). During the
study period, no adverse events were noted in either groups.
<br/>Conclusion(s): This study showed that applying foot reflexology to
patients undergoing cardiovascular surgery reduced pain, anxiety, and
fatigue and improved sleep quality. Further studies on reflexology
practice are recommended to be conducted with larger sample sizes and
different groups. Trial registration Clinical: Trials.gov
NCT04473287.<br/>Copyright &#xa9; 2024 Elsevier GmbH

<56>
Accession Number
2030543289
Title
Perioperative Apixaban: Bleeding, Clotting, or Both?.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 38(4) (pp 865-867),
2024. Date of Publication: April 2024.
Author
Shapeton A.D.; Kinlay S.; Geahchan C.; Ortoleva J.
Institution
(Shapeton) Department of Anesthesia, Critical Care and Pain Medicine,
Boston Veterans Affairs Healthcare System, West Roxbury, MA, United States
(Kinlay) Cardiovascular Division, Boston Veterans Affairs Healthcare
System, Harvard Medical School, Brigham and Women's Hospital, Boston, MA,
United States
(Geahchan) Department of Anesthesiology and Perioperative Medicine, Tufts
Medical Center, Boston, MA, United States
(Ortoleva) Department of Anesthesiology, Boston Medical Center, Boston,
MA, United States
Publisher
W.B. Saunders

<57>
Accession Number
2028423624
Title
Efficacy of Respiratory Muscle Training in the Immediate Postoperative
Period of Cardiac Surgery: A Systematic Review and Meta-Analysis.
Source
Brazilian Journal of Cardiovascular Surgery. 39(1) (no pagination), 2024.
Article Number: e20220165. Date of Publication: 2024.
Author
Aquino T.N.; Prado J.P.; Crisafulli E.; Clini E.M.; Galdino G.
Institution
(Aquino, Prado, Galdino) Instituto de Ciencias da Motricidade,
Universidade Federal de Alfenas, Minas Gerais, Alfenas, Brazil
(Aquino) Department of Rehabilitation and Cardiology, Hospital Santa
Lucia, Minas Gerais, Pocos de Caldas, Brazil
(Crisafulli) Department of Medicine and Surgery, Respiratory Disease and
Lung Function Unit, University of Parma, Parma, Italy
(Clini) Department of Medical and Surgical Sciences, University of Modena
and Reggio Emilia and University Hospital of Modena Policlinico, Modena,
Italy
Publisher
Sociedade Brasileira de Cirurgia Cardiovascular
Abstract
Introduction: This study aimed to evaluate the efficacy of respiratory
muscle training during the immediate postoperative period of cardiac
surgery on respiratory muscle strength, pulmonary function, functional
capacity, and length of hospital stay. <br/>Method(s): This is a
systematic review and meta-analysis. A comprehensive search on PubMed,
Excerpta Medica Database (or Embase), Cumulative Index of Nursing and
Allied Health Literature (or CINAHL), Latin American and Caribbean Health
Sciences Literature (or LILACS), Scientific Electronic Library Online (or
SciELO), Physiotherapy Evidence Database (or PEDro), and Cochrane Central
Register of Controlled Trials databases was performed. A combination of
free-text words and indexed terms referring to cardiac surgery, coronary
artery bypass grafting, respiratory muscle training, and clinical trials
was used. A total of 792 studies were identified; after careful selection,
six studies were evaluated. <br/>Result(s): The studies found significant
improvement after inspiratory muscle training (IMT) (n = 165, 95%
confidence interval [CI] 9.68, 21.99) and expiratory muscle training (EMT)
(n = 135, 95% CI 8.59, 27.07) of maximal inspiratory pressure and maximal
expiratory pressure, respectively. Also, IMT increased significantly (95%
CI 19.59, 349.82, n = 85) the tidal volume. However, no differences were
found in the peak expiratory flow, functional capacity, and length of
hospital stay after EMT and IMT. <br/>Conclusion(s): IMT and EMT
demonstrated efficacy in improving respiratory muscle strength during the
immediate postoperative period of cardiac surgery. There was no evidence
indicating the efficacy of IMT for pulmonary function and length of
hospital stay and the efficacy of EMT for functional
capacity.<br/>Copyright &#xa9; 2024, Sociedade Brasileira de Cirurgia
Cardiovascular. All rights reserved.

<58>
Accession Number
2028163418
Title
Outcomes of delayed chest closure after congenital heart surgery in
neonates.
Source
Pediatria Medica e Chirurgica. 46(1) (no pagination), 2024. Article
Number: 328. Date of Publication: 2024.
Author
Kanakis M.; Samanidis G.; Kolovou K.; Katsaridis S.; Sait A.M.; Kourelis
G.; Giannopoulos N.; Bobos D.
Institution
(Kanakis, Samanidis, Katsaridis, Giannopoulos, Bobos) Department of
Pediatric and Congenital Heart Surgery, Onassis Cardiac Surgery Center,
Athens, Greece
(Samanidis) Department of Adult Cardiac Surgery, Onassis Cardiac Surgery
Center, 356 Leoforos Syggrou, Athens 17674, Greece
(Kolovou) Department of Cardiac Surgery Intensive Care, Onassis Cardiac
Surgery Center, Athens, Greece
(Sait, Kourelis) Department of Pediatric Cardiac and Cardiac Surgery
Intensive Care, Onassis Cardiac Surgery Center, Athens, Greece
Publisher
Page Press Publications
Abstract
We present the outcomes of delayed chest closure in neonates who underwent
congenital heart surgery under cardiopulmonary bypass. Eighty-one
consecutive neonatal patients (age <= 28 days) with congenital heart
diseases who underwent heart operations and after surgery, chest remained
open in the intensive care unit until DCC. Correction of transposition of
the great arteries pathology was the most common surgical procedure (48.1%
of patients). Median sternal closure time from surgery was 3 (2-4) days.
Median age of neonates was 9 (5-12) days. In addition, in 4 cases (4.9%)
there was secretion from the surgical site after DCC and after taking
cultures, in 2 (2.4%) of the cases a pathogen was identified.
Multivariable linear regression analysis (adjusted to gender and CPB)
showed that only the age-predicted the sternum closure time (beta=-0.09,
95%CI: - 0.16 to -0.02, p=0.02). In-hospital mortality was 6 (7.4%)
patients. Although the DCC in neonates who underwent CHD surgical
correction was related to a high mortality rate, only the age of neonates
predicted the sternum closure time in the ICU.<br/>Copyright &#xa9; 2024,
Page Press Publications. All rights reserved.

<59>
Accession Number
2020657805
Title
Outcomes of coronary artery bypass grafting with coronary endarterectomy:
A systematic review and meta-analysis of recent studies.
Source
Perfusion (United Kingdom). 39(3) (pp 489-498), 2024. Date of Publication:
April 2024.
Author
Zhang W.; Wu H.
Institution
(Zhang, Wu) Department of Cardiothoracic Surgery, Changzhi People's
Hospital, Changzhi, China
Publisher
SAGE Publications Ltd
Abstract
Objective: The aim of this systematic review and meta-analysis was to
evaluate the short-term and long-term outcomes of coronary artery bypass
grafting (CABG) with coronary endarterectomy (CE) versus isolated CABG.
<br/>Method(s): Studies evaluating outcomes of CABG with CE (CE-CABG) were
searched from 1 January 2000 to 30 September 2022, on PubMed, Embase, and
Cochrane databases. The primary outcome was 30 -days mortality. Secondary
outcomes were postoperative myocardial infraction, low output syndrome,
cardiac arrhythmia, renal dysfunction, and 5 years survival.
<br/>Result(s): A total of 12 observational studies including 114,319
patients assessing CE-CABG (n = 35,174) versus isolated CABG (n = 79,145)
were included. Compared to isolated CABG alone, CE-CABG was significantly
associated with increased incidences of 30-days mortality (RR, 1.87; 95%
CI, 1.73-2.07; p < 0.01), postoperative myocardial infraction (RR, 1.61;
95% CI, 1.26-2.05; p < 0.01), low output syndrome (RR, 1.54; 95% CI,
1.17-2.02; p < 0.01), and renal dysfunction (RR, 1.56; 95% CI, 1.44-1.69;
p < 0.01). However, there was no difference in either rate of cardiac
arrhythmia (RR, 1.06; 95% CI, 0.97-1.15; p = 0.20) or 5 years survival
(RR, 1.05; 95% CI, 0.95-1.16; p = 0.34) between the CE-CABG group and the
control group. Subgroup analysis on CE technique showed that CE-CABG was
also associated with 30 days mortality in patients undergoing closed CE
(RR, 1.49; 95% CI, 1.09-2.03), whereas this association between CE and 30
days mortality was not observed in patients undergoing open CE (RR, 1.76;
95% CI, 0.58-5.32). <br/>Conclusion(s): Despite poor short-term outcomes,
CE-CABG appeared to offer satisfactory long-term survival in patients with
diffuse coronary artery disease.<br/>Copyright &#xa9; The Author(s) 2022.

<60>
Accession Number
2027251621
Title
Impact of preoperative chemotherapy on cutaneous wound healing in lung
cancer patients: A meta-analysis.
Source
International Wound Journal. 21(4) (no pagination), 2024. Article Number:
e14518. Date of Publication: April 2024.
Author
Zhao J.; Cui H.; Qu M.; Xu Z.; Zhang Y.; Ma C.
Institution
(Zhao, Qu, Xu, Zhang, Ma) Department of Cardiothoracic Surgery,
Heilongjiang Provincial Hospital, Harbin, China
(Cui) Department of Respiratory Medicine, Heilongjiang Provincial
Hospital, Harbin, China
Publisher
John Wiley and Sons Inc
Abstract
As part of their treatment, lung cancer patients frequently endure
thoracic oncological surgery, with preoperative chemotherapeutic
interventions being the common approach. However, the potential impact of
these chemotherapeutic regimens on cutaneous wound healing outcomes
following surgery remains the topic of considerable clinical interest.
This meta-analysis sought to evaluate comprehensively the effect of
preoperative chemotherapeutic regimens on cutaneous wound healing in lung
cancer patients following thoracic oncological surgery. Extensive
literature searches were conducted using the leading databases PubMed,
Embase, Cochrane Library and Scopus. Eight studies out of 1342 identified
satisfied the inclusion criteria. Consideration was given to both
randomized controlled trials (RCTs) and observational studies. Data
pertaining to study characteristics, patient demographics,
chemotherapeutic regimens and wound healing outcomes were extracted with
great attention to detail. The examination of these varied studies
provided insights into the fluctuations in rates of recovery following
treatment, incidences of wound infections and frequencies of surgical
complications. The research studies provided odds ratios for recovery that
varied significantly in magnitude from 0.95 to 0.38, with regard to the
probability of wound infection. Furthermore, a range of odds ratios for
complications were disclosed, with certain odds ratios displaying narrow
confidence intervals. The complexity of the effect of preoperative
chemotherapy on wound closure subsequent to thoracic oncologic surgery is
highlighted by our findings. The results underscore the need for
individualized treatment strategies for lung cancer patients undergoing
surgical procedures that strike a balance between patient safety and
optimal clinical outcomes.<br/>Copyright &#xa9; 2023 The Authors.
International Wound Journal published by Medicalhelplines.com Inc and John
Wiley & Sons Ltd.

<61>
Accession Number
2027173493
Title
Risk factors associated with surgical site infections in patients
undergoing cardiothoracic surgery: A systematic review and meta-analysis.
Source
International Wound Journal. 21(4) (no pagination), 2024. Article Number:
e14573. Date of Publication: April 2024.
Author
Zhang Y.; Tan S.; Chen S.; Fan X.
Institution
(Zhang, Tan, Fan) Department of Cardiovascular Surgery, Guangdong
Provincial Hospital of Chinese Medicine, Guangdong Province, Guangzhou,
China
(Chen) Department of Cardiology, Shengjing Hospital of China Medical
University, Liaoning Province, Shenyang, China
Publisher
John Wiley and Sons Inc
Abstract
Surgical site infections (SSIs) following cardiothoracic surgery can pose
significant challenges to patient recovery and outcome. This systematic
review and meta-analysis aim to identify and quantify the risk factors
associated with SSIs in patients undergoing cardiothoracic surgery. A
comprehensive literature search adhering to Preferred Reporting Items for
Systematic Reviews and Meta-Analyses (PRISMA) guidelines and based on the
PICO paradigm was conducted across four databases: PubMed, Embase, Web of
Science and the Cochrane Library, without any temporal restrictions. The
meta-analysis incorporated studies detailing the risk factors for
post-operative sternal infections, especially those reporting odds ratios
(OR) or relative risks with 95% confidence intervals (CI). Quality
assessment of the studies was done using the Newcastle-Ottawa Scale.
Statistical analysis was executed using the chi-square tests for
inter-study heterogeneity, with further analyses depending on
I² values. Sensitivity analyses were performed, and potential
publication bias was also assessed. An initial dataset of 2442 articles
was refined to 21 articles after thorough evaluations based on inclusion
and exclusion criteria. Patients with diabetes mellitus have an OR of 1.80
(95% CI: 1.40-2.20) for the incidence of SSIs, while obese patients
demonstrate an OR of 1.63 (95% CI: 1.40-1.87). Individuals who undergo
intraoperative blood transfusion present an OR of 1.13 (95% CI:
1.07-1.18), and smokers manifest an OR of 1.32 (95% CI: 1.03-1.60). These
findings unequivocally indicate a pronounced association between these
factors and an elevated risk of SSIs post-operatively. This meta-analysis
confirms that diabetes, obesity, intraoperative transfusion and smoking
heighten the risk of SSIs post-cardiac surgery. Clinicians should be alert
to these factors to optimise patient outcomes.<br/>Copyright &#xa9; 2023
The Authors. International Wound Journal published by Medicalhelplines.com
Inc and John Wiley & Sons Ltd.

<62>
Accession Number
643781940
Title
Health-related quality of life following TAVI or cardiac surgery in
patients at intermediate and low risk: a systematic review and
meta-analysis.
Source
Clinical medicine (London, England). 23(6) (pp 594-605), 2023. Date of
Publication: 01 Nov 2023.
Author
Gonnah A.R.; Abdelwahab M.; Taylor R.; Labib A.; Masoud O.; Debski M.;
Abdelaziz H.K.; Roberts D.H.
Institution
(Gonnah) Imperial College Healthcare NHS Trust, London, United Kingdom
(Abdelwahab) Boston University, Boston, MA, United States
(Taylor) Blackpool Teaching Hospitals NHS Foundation Trust, Blackpool,
United Kingdom
(Labib) Southport and Ormskirk NHS Foundation Trust, Southport, United
Kingdom
(Masoud) University College London Hospitals NHS Foundation Trust, London,
United Kingdom
(Debski) University of East Anglia, Norwich, UK; Norfolk and Norwich
University Hospital, Norwich, UK
(Abdelaziz) Lancashire Cardiac Centre, Blackpool, United Kingdom
(Roberts) Lancashire Cardiac Centre, Blackpool, UK; University of
Liverpool, Merseyside Liverpool
Abstract
Recent randomised trials have shown that clinical outcomes with
transcatheter aortic valve implantation (TAVI) are non-inferior to
surgical aortic valve replacement (SAVR) in patients with symptomatic
aortic stenosis at intermediate to low risk. Health-related quality of
life (HrQoL) outcomes in these patient groups remain uncertain. A
systematic search of the literature was conducted that included nine
trials and 11,295 patients. Kansas City Cardiomyopathy Questionnaire
(KCCQ), a heart-failure-specific measure and EuroQol-5D (EQ-5D) (a generic
health status tool) changes were the primary outcomes. New York Heart
Association (NYHA) classification was the secondary outcome. Improvement
in KCCQ scores was greater with TAVI (mean difference (MD)=13.56, 95%
confidence interval (CI) 11.67-15.46, p<0.001) at 1 month, as was the
improvement in EQ-5D (MD=0.07, 95% CI 0.05-0.08, p<0.001). There was no
difference in KCCQ (MD=1.05, 95% CI -0.11 to 2.21, p=0.08) or EQ-5D
(MD=-0.01, 95% CI -0.03 to 0.01), p=0.37) at 12 months. NYHA functional
class 3/4 was lower in patients undergoing TAVI at 1 month (MD=0.51, 95%
CI 0.34-0.78, p=0.002), but there was no difference at 12 months (MD=1.10;
95% CI 0.87-1.38, p=0.43). Overall, TAVI offers early benefit in HRQoL
outcomes compared with SAVR, but they are equivalent at 12
months.<br/>Copyright &#xa9; 2023 &#xa9; 2023 THE AUTHORS. Published by
Elsevier Limited on behalf of the Royal College of Physicians. Published
by Elsevier Ltd.. All rights reserved.

<63>
Accession Number
2031126619
Title
USE OF CCTA AND CT-FFR FOR EVALUATION OF CAD IN TAVR PATIENTS: A
META-ANALYSIS.
Source
Journal of the American College of Cardiology. Conference: American
College of Cardiology 73rd Annual Scientific Session & Expo. Atlanta
United States. 83(13 Supplement) (pp 1565), 2024. Date of Publication: 02
Apr 2024.
Author
Baig M.S.; Rojulpote C.; Mikhalkova D.; Verma D.
Institution
(Baig, Rojulpote, Mikhalkova, Verma) SSM Health St. Louis University
Hospital, St. Louis, MO, United States
Publisher
Elsevier Inc.
Abstract
Background For patients undergoing transcatheter aortic valve replacement
(TAVR) for severe aortic stenosis, coronary artery disease (CAD) often
co-exists. Pre-TAVR evaluation routinely includes cardiac computed
tomography to assess anatomy and invasive coronary angiography (ICA) to
assess for significant CAD. Prior studies show cardiac computed tomography
angiography (CCTA) has adequate negative predictive value but limited
specificity for detecting significant CAD, which may improve with the
addition of CT-fractional flow reserve (CT-FFR). The aim of this
meta-analysis was to assess the performance of CCTA and CT-FFR compared
with ICA for evaluating for CAD in pre-TAVR workup. Methods Search
strategy included PubMed, Medline, Cochrane and Google Scholar. Results A
total of 12 studies with 1810 patients looking at the diagnostic
performance of CCTA and CT-FFR compared with ICA. Eight studies evaluated
CCTA and 4 studies evaluated CT-FFR compared to ICA. Sensitivity of CCTA
was 0.93 (95% 0.87-0.96, p=0.2). Sensitivity of CT-FFR was 0.91 (95% CI
0.80-0.96, p=0.2). Overall, specificity increased with the use of CT-FFR
(0.77, 95% CI 0.67-0.84, p<0.01) over CCTA (0.62, 95% CI 0.52-0.71,
p<0.01). Conclusion CT-FFR significantly improves specificity and
diagnostic accuracy of CCTA for detecting significant CAD without the need
for additional testing. The combined use of CCTA and CT-FFR can be
utilized in the clinical work up for TAVR, thus avoiding invasive coronary
angiography in certain cases. [Formula presented]<br/>Copyright &#xa9;
2024 American College of Cardiology Foundation

<64>
Accession Number
2031126544
Title
BIVALIRUDIN AND HEPARIN INDUCED THROMBOCYTOPENIA IN MITRAL AND AORTIC
VALVE PROSTHESES.
Source
Journal of the American College of Cardiology. Conference: American
College of Cardiology 73rd Annual Scientific Session & Expo. Atlanta
United States. 83(13 Supplement) (pp 2971), 2024. Date of Publication: 02
Apr 2024.
Author
Elkholy E.M.; Alshammari A.
Institution
(Elkholy, Alshammari) King Abdullah Medical City, Makkah, Saudi Arabia
Publisher
Elsevier Inc.
Abstract
Background To report the successful use of bivaluridin for bridging in a
patient with HIT soon after replacing the aortic and mitral heart valves
and repairing the tricuspid valve. Case In addition to the tricuspid
repair, AF maze, and Left Atrial Appendage Closure (LAAC) procedure, a
35-year-old male had aortic and mitral valve replacements using St. Jude
medical leaflet prosthesis. Due to thrombocytopenia, the significant
volume of chest tube drainage (1 L/day), and worries about postoperative
hemorrhage, anticoagulation was first avoided after the surgery. The
thrombocytopenia (platelet count at baseline: 196x10³/L;
postoperative platelet count: 48x10³/L) was believed to be due
to the cardiopulmonary bypass effect. The team decided against using
heparin products and began a BIVALURIDIN infusion on the postoperative day
eight when the patient's platelet count had recovered to
>100x10³/L. The BIVALURIDIN was bridged to warfarin and the
patient was discharged after taking bivalirudin for 13 days. During the
patient's hospitalization and at the 31-day postoperative follow-up, no
thromboembolic episodes or bleeding were seen. Decision-making
Unfractionated or low-molecular-weight heparin is used to bridge patients
with mechanical heart valve replacement (MHVR) to warfarin, No RCTs have
not been established on the use of bivalirudin after MHVR. studies support
the effectiveness of fondaparinux in preventing thrombus development on
mechanical heart valves. Nevertheless, only three case reports are
available as human data. Two of these case reports show the effective use
of fondaparinux for anticoagulation in an aortic valve replacement
patient. The patient in the third case report had aortic and mitral valve
replacements. This case report is interesting because it highlights the
use of BIVALURIDIN early after MHVR, the most crucial time period for
successful thromboprophylaxis. Conclusion Bivalirudin was successful for
postoperative bridging in our patient's early-altered combination of
aortic and mitral MHVR. More studies are needed to confirm effectiveness
and safety of bivalirudin in MHVR, its use should only be explored if
heparin-containing medications are contraindicated<br/>Copyright &#xa9;
2024 American College of Cardiology Foundation

<65>
Accession Number
2031125974
Title
IMPACT OF PALLIATIVE CARE CONSULTATION ON CARDIOGENIC SHOCK MANAGEMENT AND
OUTCOMES: A SYSTEMATIC REVIEW.
Source
Journal of the American College of Cardiology. Conference: American
College of Cardiology 73rd Annual Scientific Session & Expo. Atlanta
United States. 83(13 Supplement) (pp 2630), 2024. Date of Publication: 02
Apr 2024.
Author
Vora N.; Chiang J.; Mallidi J.R.
Institution
(Vora, Chiang, Mallidi) University of California, San Francisco, San
Francisco, CA, United States
(Vora, Chiang, Mallidi) University of Washington, Seattle, WA, United
States
Publisher
Elsevier Inc.
Abstract
Background Cardiogenic shock (CS) requires a multidisciplinary approach
that necessitates involvement of palliative care (PC) due to its high
morbidity and mortality. While guidelines advocate for early integration
of PC, the ideal timing and impact of consultation remains unclear. This
review examines current literature regarding utilization of PC in CS and
how PC impacts the management and outcomes of acute CS. Methods A
systematic review was conducted of PubMed, Embase and Cochrane of studies
conducted in the US between 2010-2023 that investigated or stratified
utilization trends and impacts of PC in adults >18 years in CS. Search
terms included palliative care, cardiogenic shock, palliation, cardiac
intensive care unit, hospice, end-of-life, and goals-of-care. Results A
total of 17 studies were identified that met the search criteria. PC
consultation was initiated for 4.5 - 48% of patients depending on
institution and clinical scenario (i.e., use of extracorporeal membrane
oxygenation or mechanical circulatory support). Major themes regarding the
impact of PC on CS outcomes include: 1. Procedural and Mortality Outcomes:
PC consultation is associated with fewer invasive procedures in advanced
heart failure complicated by CS. Timing of consultation influenced life
support duration. 2. Quality of Life and Communication: PC enhanced
communication and transitions to less aggressive measures, including
increased transition to do-not-resuscitate and shorter hospital stays. 3.
Healthcare Utilization: PC reduced readmission rates and lowered
hospitalization costs in CS. 4. Access to Palliative Care: Demographic
disparities, including age, sex, race and insurance status influenced
access to PC in CS Conclusion PC is underutilized in CS management. It
reduces unnecessary procedures, enhances quality of life, improves
communication and reduces healthcare costs. Further research is necessary
to evaluate optimal timing and disparities in access to PC involvement
among patients with CS. Consideration should be given into integrating
palliative care into multidisciplinary shock teams for comprehensive
management.<br/>Copyright &#xa9; 2024 American College of Cardiology
Foundation

<66>
Accession Number
2031125918
Title
USE OF TRANSCATHETER EDGE TO EDGE REPAIR TO TREAT CARDIOGENIC SHOCK
SECONDARY TO SEVERE MITRAL REGURGITATION COULD BE LIFESAVING!.
Source
Journal of the American College of Cardiology. Conference: American
College of Cardiology 73rd Annual Scientific Session & Expo. Atlanta
United States. 83(13 Supplement) (pp 3042), 2024. Date of Publication: 02
Apr 2024.
Author
Elgwairi E.; Eshcol J.O.; Friedman B.M.
Institution
(Elgwairi, Eshcol, Friedman) HCA Healthcare, Overland Park, KS, United
States
Publisher
Elsevier Inc.
Abstract
Background Recent data suggest that the use of transcatheter edge to edge
repair (TEER) using MitraClip in patients with severe mitral regurgitation
(MR), presenting with cardiogenic shock is increasing and is associated
with improved in-hospital and 1year survival. Case An 86-year-old female
presented to the ER with progressive shortness of breath and orthopnea.
She was found to be tachycardic, hypotensive and hypoxic. Clinical
evaluation, radiological studies and laboratory data were consistent with
heart failure and pulmonary edema. The echocardiogram showed reduced
ejection fraction with severe MR secondary to posterior leaflet prolapse.
She required vasopressor support and intra-aortic balloon
counterpulsation. Due to lack of improvement, mitral valve repair was
considered but she was deemed to be at high risk for surgery. She
underwent a successful TEER. Her hemodynamics improved dramatically and
she was subsequently discharged. Decision-making Management of significant
MR in patients with cardiogenic shock remains challenging. The utilization
of inotropic and mechanical circulatory support has the potential to be
treat cardiogenic shock. However, it is important to note that in
conditions such as MR, shock may persist in the absence of definitive
therapy. Despite the potential efficacy of mitral valve surgery as a
definitive treatment, many patients with critical illnesses and multiorgan
dysfunction are deemed unsuitable candidates for surgical intervention,
like in our case. The MitraClip procedure, while infrequently utilized in
patients with cardiogenic shock, is increasingly being contemplated as a
prospective therapeutic alternative. In this regard, some retrospective
data showed promising results. Conclusion It is recommended that
randomized clinical trials be conducted to investigate the utilization of
TEER in the context of cardiogenic shock. The optimization of procedural
timing and patient selection holds promise for improving outcomes in this
context.<br/>Copyright &#xa9; 2024 American College of Cardiology
Foundation

<67>
Accession Number
2031125785
Title
CHARACTERISTICS AND OUTCOMES FOR STATIN-INTOLERANT WOMEN RECEIVING
BEMPEDOIC ACID IN THE CLEAR OUTCOMES TRIAL.
Source
Journal of the American College of Cardiology. Conference: American
College of Cardiology 73rd Annual Scientific Session & Expo. Atlanta
United States. 83(13 Supplement) (pp 1751), 2024. Date of Publication: 02
Apr 2024.
Author
Cho L.; Plutzky J.; Brennan D.; Louie M.; Lei L.; Robinson P.; Powell H.;
Nicholls S.J.; Lincoff A.M.; Nissen S.E.
Institution
(Cho, Plutzky, Brennan, Louie, Lei, Robinson, Powell, Nicholls, Lincoff,
Nissen) Cleveland Clinic, Cleveland, OH, United States
Publisher
Elsevier Inc.
Abstract
Background Cardiovascular (CV) risk reduction data for bempedoic acid (BA)
compared with placebo (PBO) in the CLEAR Outcomes trial, stratified by
sex, have been previously reported. However, a complete description of
efficacy and safety based on participant sex have not been described.
Methods CLEAR Outcomes (N=13,970) randomized participants with, or at high
risk of, CV disease and statin intolerance to BA or PBO (median 3.4 years
follow-up) with the primary endpoint of MACE-4 (CV death, nonfatal
myocardial infarction, nonfatal stroke, or coronary revascularization). An
analysis of baseline characteristics, additional secondary efficacy
outcomes, and tolerability based on participant sex was performed. Results
The trial enrolled 48% (N=6,740) women. At baseline women were older, had
more diabetes, peripheral and cerebrovascular disease, and higher LDL-C
and hsCRP; less coronary artery disease and use of lipid lowering
therapies. The proportion of primary prevention participants was higher in
women. Efficacy and safety are summarized in Table 1. Conclusion CLEAR
Outcomes provides insight into the characteristics and CV outcomes of
women with statin intolerance, a historically underrepresented population
in randomized control trials and a population experiencing more statin
intolerance compared with men. Overall, bempedoic acid reduced CV risk and
was well-tolerated in both sexes. [Formula presented]<br/>Copyright &#xa9;
2024 American College of Cardiology Foundation

<68>
Accession Number
2031125419
Title
PALLIATIVE CARE IN THE CARDIOVASCULAR INTENSIVE CARE UNIT: A SYSTEMATIC
REVIEW.
Source
Journal of the American College of Cardiology. Conference: American
College of Cardiology 73rd Annual Scientific Session & Expo. Atlanta
United States. 83(13 Supplement) (pp 2631), 2024. Date of Publication: 02
Apr 2024.
Author
Mehta A.; Bansal M.; Belur A.D.; Vallabhajosyula S.
Institution
(Mehta, Bansal, Belur, Vallabhajosyula) Warren Alpert Medical School of
Brown University, Providence, RI, United States
(Mehta, Bansal, Belur, Vallabhajosyula) University of Connecticut School
of Medicine, Hartford, CT, United States
Publisher
Elsevier Inc.
Abstract
Background Despite the strong role of palliative care in critical care
medicine, there is limited data on the role of palliative care in the
cardiovascular intensive care unit (CICU). Methods Between 12/01/2000 and
08/08/2022, a systematic search of Central (clinical trial register),
CINAHL, EMBASE, Medline, Cochrane Library, Scopus, and Web of Science
databases was performed for acute cardiovascular conditions (acute
myocardial infarction, cardiogenic shock, cardiac arrest, advanced heart
failure, post-cardiac surgery, spontaneous coronary artery dissection,
takotsubo cardiomyopathy, and pulmonary embolism), all CICU literature and
cardiothoracic ICU literature reporting on palliative care. The primary
outcome of interest was in-hospital mortality and secondary outcomes
included hospital length of stay, use of mechanical ventilation, and total
hospitalization costs. Results Of the 5,711 search results, 30 studies (27
retrospective, 2 randomized trials, and 1 observational) were included.
Only 11 studies compared outcomes between standard care and palliative
care. 15 studies analyzed data from the National Inpatient Sample
database. The primary diagnosis leading to admission in 13 studies was
acute heart failure. The most common outcome that was evaluated was
inhospital mortality. Studies reported the prevalence of palliative care
consultation in various patient populations (e.g. patients on mechanical
circulatory support, homeless veterans, etc.) which ranged from 2.8% to
92% in one of the analyses. Some studies reported the variation in
palliative care consultation across different ICU while some compared it
with surgical or cardiothoracic ICU. Conclusion Despite growing
recognition of the role of palliative care, there remains significant
heterogeneity in the utilization, involvement, and impact on outcomes in
the contemporary CICU population.<br/>Copyright &#xa9; 2024 American
College of Cardiology Foundation

<69>
Accession Number
2031125338
Title
CARDIOGENIC UNILATERAL PULMONARY EDEMA: A SYSTEMATIC REVIEW OF 192 CASES.
Source
Journal of the American College of Cardiology. Conference: American
College of Cardiology 73rd Annual Scientific Session & Expo. Atlanta
United States. 83(13 Supplement) (pp 2633), 2024. Date of Publication: 02
Apr 2024.
Author
Shrestha B.; Nguyen B.; Poudel B.; Donato A.
Institution
(Shrestha, Nguyen, Poudel, Donato) Reading Hospital Tower Health, West
Reading, PA, United States
Publisher
Elsevier Inc.
Abstract
Background Cardiogenic unilateral pulmonary edema (UPE) is an unusual
clinical presentation representing only 2.1% of all cardiogenic pulmonary
edema cases with atypical presentation and often misdiagnosed as
pneumonia. Methods We systematically reviewed all studies with case
descriptions of UPE reported as cardiogenic in human adults with no
language restriction. Results We identified 152 articles with 192 patients
for the study. The cases reported per decade increased from 2 in 1951-1961
to 71 in 2012-2022. The mean age of the patient was 60.25 years (range:
57.49-63.01 years) Right-sided UPE (80.73%; 155/192) was significantly
more common than left-sided (19.27%; 37/192). Dyspnea was the most common
reported symptom in 88.96% (145/163), followed by cough (28.29%, 43/152).
The most common finding reported on examination was lung crepitation in
67.61% (96/143), followed by systolic murmur (51.13%, 68/133). Brain
Natriuretic Peptide (BNP) was found to be elevated in 97.56% of cases
(40/41). Echocardiography found mitral regurgitation (MR) in 67.35%
(99/147). In 37 patients with MR with a specified direction, the jet
direction was more commonly toward the right pulmonary vein at 83.78%
(31/37). The regurgitation jet involving the pulmonary vein correlated to
the side of the lung infiltrates in 100% of cases. Most (58.10%) were
initially treated as pneumonia with antibiotics with no response. Valvular
heart disease was the most commonly cited etiology of UPE at 56.77%
(109/192), followed by cardiomyopathy at 10.42% (20/192). Patients were
ill, requiring vasopressors in 41.54% and mechanical ventilation in 60%.
Mitral valve surgery was performed in 30% (50/164). In-hospital mortality
was 15.17% (27/178). Patients with in-hospital mortality were noted to be
older (69.40 vs. 58.71, p=0.004). We did not find any difference in
mortality based on the mechanism of cardiogenic UPE, the lung side
involved, or the gender of the patient. Conclusion Cardiogenic UPE is
rare, often misdiagnosed as pneumonia, and more commonly affects the right
side of the lung. It should be suspected in afebrile patients with murmurs
on examination who are not responding to initial antibiotic therapy with
elevated BNP.<br/>Copyright &#xa9; 2024 American College of Cardiology
Foundation

<70>
Accession Number
2031124559
Title
EFFECT OF PRE-REPERFUSION SODIUM-GLUCOSE COTRANSPORTER 2 INHIBITOR ON
MYOCARDIAL INFARCT SIZE AND MITOCHONDRIAL FUNCTION IN PATIENTS WITH ACUTE
MYOCARDIAL INFARCTION: A RANDOMIZED CONTROL TRIAL.
Source
Journal of the American College of Cardiology. Conference: American
College of Cardiology 73rd Annual Scientific Session & Expo. Atlanta
United States. 83(13 Supplement) (pp 1208), 2024. Date of Publication: 02
Apr 2024.
Author
Suwannasom P.; Leemasawat K.; Apaijai N.; Thonusin C.; Phrommintikul A.;
Chattipakorn S.; Chattipakorn N.
Institution
(Suwannasom, Leemasawat, Apaijai, Thonusin, Phrommintikul, Chattipakorn,
Chattipakorn) Chiang Mai University, Chiang Mai, Thailand
Publisher
Elsevier Inc.
Abstract
Background Pre-reperfusion of sodium-glucose cotransporter 2 inhibitor
(SGLT2i) prior to myocardium revascularization reduced myocardial infarct
(MI) size in animal models. Methods In a single-center, double-blind,
randomized trial, patients who underwent primary percutaneous coronary
intervention (PPCI) within 12 hours after symptom onset were randomly
assigned to receive dapagliflozin 20 mg (n=12) before PPCI followed by
dapagliflozin 10 mg once daily or matching placebo (n=14) for 12 weeks.
The primary outcome was the infarct size expressed as area under the curve
(AUC) of troponin I (TnI) over 3 days. The secondary endpoint was
mitochondria function between the two groups over 12 weeks. Results The
median AUC for TnI release was 2457485 arbitrary units (interquartile
range, 2014533 to 3066578) in the SGLT2i group versus 2712613
(interquartile range, 746823 to 3261956) in the control group (p=0.76).
Receiving SGLT2i significantly increased the percentage of live cells at
6- and 12-week whereas this observation was not found in the control group
(Fig A). No differences of mitochondrial oxidative stress,
nonmitochondrial respiration and spare respiratory capacity (Fig B-D).
Conclusion In this small pilot study, administration of SGLT2i
pre-reperfusion did not show in limiting reperfusion injury after PPCI.
However, SGLT2i effectively increased the percentage of live cells
compared with the control group. [Formula presented]<br/>Copyright &#xa9;
2024 American College of Cardiology Foundation

<71>
Accession Number
2031124523
Title
CHARACTERISTICS AND OUTCOMES FOR STATIN-INTOLERANT HISPANIC/LATINX
PATIENTS RECEIVING BEMPEDOIC ACID: RESULTS FROM A CLEAR OUTCOMES
PRE-SPECIFIED SUBANALYSIS.
Source
Journal of the American College of Cardiology. Conference: American
College of Cardiology 73rd Annual Scientific Session & Expo. Atlanta
United States. 83(13 Supplement) (pp 1811), 2024. Date of Publication: 02
Apr 2024.
Author
Rodriguez F.; Brennan D.; Lei L.; Nissen S.E.; Powell H.; Plutzky J.
Institution
(Rodriguez, Brennan, Lei, Nissen, Powell, Plutzky) Stanford University
School of Medicine, Stanford, CA, United States
(Rodriguez, Brennan, Lei, Nissen, Powell, Plutzky) Brigham and Women's
Medicine, Boston, MA, United States
Publisher
Elsevier Inc.
Abstract
Background Bempedoic acid (BA) reduces LDL cholesterol (LDL-C) and CV risk
in patients at high CV risk with statin intolerance (SI). Questions exist
regarding SI and CV risk management in specific ethnic subgroups,
including Hispanic individuals - who represented a significant segment of
CLEAR Outcomes participants. Methods CLEAR Outcomes randomized SI
participants at high CV risk to BA or placebo (PBO, median 3.4 years of
follow up). A prespecified comparison of treatment effect by ethnicity was
performed for the primary MACE-4 endpoint (CV death, nonfatal myocardial
infarction, nonfatal stroke, or coronary revascularization). Results CLEAR
Outcomes participants identifying as Hispanic/LatinX comprised 17.0% of
the study and were more likely to be women, had diabetes, and used statins
at baseline (Table 1). At Month 6, PBO-corrected LDL-C change from
baseline was similar in Hispanic/ LatinX and non-Hispanic/LatinX (-21%
[95% CI: -23, -19]) and -21% [95% CI: -22, -20], respectively). BA reduced
CV risk similarly in Hispanic/LatinX vs Non-Hispanics/LatinX participants,
MACE-4: HR 0.77 (0.58, 1.02) vs HR 0.89 (0.80, 0.98), respectively. Lower
rates of serious adverse events were reported in Hispanic/LatinX (18%)
compared to Non-Hispanic/LatinX participants (31%) receiving BA.
Conclusion CLEAR Outcomes enrolled a significant number of Hispanic/LatinX
participants. Among Hispanic/LatinX participants with SI, BA was
well-tolerated, lowered LDL-C, and reduced CV events similarly. [Formula
presented]<br/>Copyright &#xa9; 2024 American College of Cardiology
Foundation

<72>
Accession Number
2031123632
Title
IVUS GUIDED PCI: A METHOD TO IMPROVE OUTCOMES FOR PATIENTS WITH
MULTIVESSEL DISEASE.
Source
Journal of the American College of Cardiology. Conference: American
College of Cardiology 73rd Annual Scientific Session & Expo. Atlanta
United States. 83(13 Supplement) (pp 1128), 2024. Date of Publication: 02
Apr 2024.
Author
Powell J.A.; Saganowich J.R.; Otsuki H.; Zimmermann F.; Widmer R.J.
Institution
(Powell, Saganowich, Otsuki, Zimmermann, Widmer) Texas A&M SOM, College
Station, TX, United States
Publisher
Elsevier Inc.
Abstract
Background CAD occurs when atherosclerotic plaque formation creates
variable degrees of stenosis in the coronary arteries. If the stenosis is
severe or sudden, myocardial injury or infarction can result. The primary
goal of interventional treatment is to restore adequate blood flow to
myocardial tissue. Two invasive methods are currently available,
percutaneous coronary intervention (PCI) and coronary artery bypass
(CABG). PCI can be accompanied by intravascular imaging using
intravascular ultrasound (IVUS), which aims to increase physicians'
understanding of vessel characteristics to optimize stent implantation. It
is currently unknown if IVUS-guided PCI (IGP) technology will improve
one-year outcomes when compared to PCI standard of care and CABG in
patients with multivessel disease. Methods Our team completed a
meta-analysis of selected clinical trials studying one year outcomes of
patients with multivessel CAD who received PCI, IGP, or CABG. These three
procedural groups composed our study arms. Three trials were selected
based on study arm criteria: FAME 3, BEST, and Syntax II. From these
studies, one primary endpoint, Death from any cause, MI, stroke, or repeat
revascularization (MACE) and two secondary endpoints, death from any cause
and repeat revascularization, were compared between each arms. Results IGP
significantly reduced death from any cause (OR 0.45, CI 0.272-0.733,
p=0.001) and repeat revascularization (OR 0.623, CI 0.41-0.95, p=0.03),
and showed a non-significant reduction in MACE (OR.736, CI 0.54-1.01,
p=0.05) when compared to CABG. IGP significantly reduced MACE (OR 0.52, CI
0.38-0.72, p<0.001), and showed a non-significant reduction in death (OR
0.66, CI 0.36-1.18, p=0.16) and reduced repeat revascularization (OR 0.66,
CI95 0.431-1.02, p=0.06) when compared to PCI without IVUS. Conclusion IGP
demonstrates significant reductions in death from any cause and repeat
revascularization compared to CABG and reduced MACE compared to standard
PCI without IVUS. These results build on an emerging evidence base
underscoring the benefit of IGP to reduce outcomes.<br/>Copyright &#xa9;
2024 American College of Cardiology Foundation

<73>
Accession Number
2031123418
Title
A META-ANALYSIS COMPARING HYBRID CORONARY REVASCULARIZATION (HCR) VERSUS
PERCUTANEOUS CORONARY REVASCULARIZATION (PCI) FOR MULTI-VESSEL CORONARY
ARTERY DISEASE (CAD).
Source
Journal of the American College of Cardiology. Conference: American
College of Cardiology 73rd Annual Scientific Session & Expo. Atlanta
United States. 83(13 Supplement) (pp 1078), 2024. Date of Publication: 02
Apr 2024.
Author
Patel A.; Seetharam K.; Thyagaturu H.; Ferreira G.L.; Nabi W.; Ali R.Z.;
Acosta C.; Nahidi S.M.; San N.W.; Alhudairy M.; Wong S.A.; Campos F.N.;
Mirza N.; Zahid R.; Gulas J.; Suleiman A.; Mir P.; Thet Z.; Elahi A.
Institution
(Patel, Seetharam, Thyagaturu, Ferreira, Nabi, Ali, Acosta, Nahidi, San,
Alhudairy, Wong, Campos, Mirza, Zahid, Gulas, Suleiman, Mir, Thet, Elahi)
Wyckoff Heights Medical Center, Brooklyn, NY, United States
Publisher
Elsevier Inc.
Abstract
Background Hybrid Coronary revascularization (HCR) is an emerging
treatment approach for multi-vessel coronary artery disease which utilizes
left internal mammary artery (LIMA) to the left anterior descending artery
(LAD) and non-LAD lesions are treated with drug eluting stents. Though
percutaneous intervention is well-established, repeat revascularization is
a common and frequent complication. We sought to conduct a meta-analysis
comparing various outcomes between HCR and PCI. Methods We performed a
broad comprehensive review of the current literature for all eligible
studies comparing HCR and PCI in PubMed, EMBASE, SCOPUS, and google
scholar. Clinical outcomes consisted of short term and long term outcomes.
Results Four center studies were considered eligible which encompassed 266
HCR and 308 PCI patients. There were no differences between either
approach for 30 day-Mortality, Myocardial Infarction, cerebrovascular
accident and long term mortality. HCR had a significantly lower long term
major adverse cardiovascular and cerebrovascular events (MAACE) (OR =
0.48, p = 0.001) and target vessel revascularization (TVR) (OR =0.5, p =
0.004) Conclusion For long term outcomes, HCR had lower MAACE and target
vessel revascularization in comparison to PCI. Further evaluation is
required. [Formula presented]<br/>Copyright &#xa9; 2024 American College
of Cardiology Foundation

<74>
Accession Number
2031123130
Title
COMPARATIVE ANALYSIS OF OUTCOMES OF TRANSCATHETER AORTIC VALVE REPLACEMENT
(TAVR) VERSUS SURGICAL AORTIC VALVE REPLACEMENT (SAVR) AMONG HOSPITALIZED
PATIENTS AGED LESS THAN 65 YEARS WITH SEVERE AORTIC STENOSIS: A 5-YEAR
NATIONAL INPATIENT SAMPLE (NIS) STUDY.
Source
Journal of the American College of Cardiology. Conference: American
College of Cardiology 73rd Annual Scientific Session & Expo. Atlanta
United States. 83(13 Supplement) (pp 1096), 2024. Date of Publication: 02
Apr 2024.
Author
Etuk A.S.; Olafimihan A.; Thakur A.; Aguilar R.; Olanipekun O.; Ajenifuja
A.; Olubowale O.; Badr S.
Institution
(Etuk, Olafimihan, Thakur, Aguilar, Olanipekun, Ajenifuja, Olubowale,
Badr) Thomas Hospital, Infirmary Health, Fairhope, AL, United States
(Etuk, Olafimihan, Thakur, Aguilar, Olanipekun, Ajenifuja, Olubowale,
Badr) Marshall University, Huntington, WV, United States
Publisher
Elsevier Inc.
Abstract
Background Outcomes of transcatheter aortic valve replacement (TAVR)
compared to surgical aortic valve replacement (SAVR) have been reported
among patients with severe aortic stenosis. However, limited studies have
been conducted among patients less than 65 years of age. We compared the
outcomes of TAVR versus SAVR among hospitalized patients aged less than 65
years. Methods Retrospective Cohort analyses were conducted using the
National Inpatient Sample (NIS) data collected from 2016 - 2020.
Multivariate logistic and linear regression modelling were used to examine
the outcomes of TAVR among hospitalized patients with severe aortic
stenosis aged less than 65 years compared to those that had SAVR. Results
Out of 139,945 hospitalizations, 87.50% of patients less than 65 years old
that underwent aortic valve replacement had SAVR. In the adjusted
analyses, patients with TAVR (AOR: 0.32; CI: 0.23-0.45) had lower odds of
mortality compared to those that had SAVR. Length of hospital stay
(beta;;: -6.94; CI: -7.38 - - 6.50) was found to be shorter among those
with TAVR relative to their counterparts that underwent SAVR. Furthermore,
patients that had TAVR (beta;;: -$69840.08; CI: -83750.80 - -55929.37)
were found to have lower hospital charges when compared to those with
SAVR. Conclusion Severe aortic stenosis patients aged less than 65 years
that underwent TAVR were found to have better outcomes as evidenced by
lower rates of mortality, lengths of hospital stay, and hospital charges
compared to those that had SAVR. Randomized controlled trials are needed
to validate these findings, and to engage further discussions on the
possibility of TAVR use in patients with severe aortic stenosis
irrespective of associated comorbidities.<br/>Copyright &#xa9; 2024
American College of Cardiology Foundation

<75>
Accession Number
2031122741
Title
SURGICAL AORTIC VALVE REPLACEMENT IN PATIENTS WITH HYPERTROPHIC
CARDIOMYOPATHY.
Source
Journal of the American College of Cardiology. Conference: American
College of Cardiology 73rd Annual Scientific Session & Expo. Atlanta
United States. 83(13 Supplement) (pp 2178), 2024. Date of Publication: 02
Apr 2024.
Author
Roma N.; Desai S.; Shah K.; Krinock M.; Shirani J.
Institution
(Roma, Desai, Shah, Krinock, Shirani) St. Luke's University Health
Network, Bethlehem, PA, United States
Publisher
Elsevier Inc.
Abstract
Background Surgical aortic valve replacement (SAVR) improves survival in
severe symptomatic aortic valve stenosis (class I indication). Patients
with hypertrophic cardiomyopathy (HCM) have been excluded from pivotal
randomized controlled trials of SAVR. SAVR is also recommended for
moderate aortic stenosis in patients who undergo cardiac surgery for other
reasons such as surgical myectomy for (HCM). We aimed to evaluate
in-hospital outcomes of SAVR in HCM. Methods National Inpatient Sample was
queried from 2016-2019. Results National Inpatient Sample contained
252,110 patients who underwent SAVR between 2016-2019. Of these, 2650
(1.05%) had a concurrent diagnosis of HCM (61% obstructive, 32%
concomitant myectomy). Patients with HCM were more often female
(53%-vs-32%, p<0.001) and had lower overall prevalence of comorbid
conditions (Table). However, in-hospital outcomes were significantly worse
in HCM than non-HCM patients (Table), including mortality (8.3 vs. 3.4%,
p<0.001), cardiogenic shock (9.8% vs. 7.6%, p<0.001), vasopressor use
(10.02% vs. 6.73%, p<0.001) and admission to the ICU (21.2% vs. 15.7%,
p<0.001). Conclusion SAVR in patients with HCM is associated with higher
complication rates compared to patients with valvular aortic stenosis and
no HCM. Length of hospital stay and hospital cost is also higher in those
with HCM undergoing SAVR. [Formula presented]<br/>Copyright &#xa9; 2024
American College of Cardiology Foundation

<76>
Accession Number
2031115542
Title
DIRECT ORAL ANTICOAGULATION VS VITAMIN K ANTAGONISTS AFTER TRANSCATHETER
AORTIC VALVE REPLACEMENT: A MULTIVARIABLE-ADJUSTED SYSTEMATIC REVIEW AND
META-ANALYSIS.
Source
Journal of the American College of Cardiology. Conference: American
College of Cardiology 73rd Annual Scientific Session & Expo. Atlanta
United States. 83(13 Supplement) (pp 1042), 2024. Date of Publication: 02
Apr 2024.
Author
Gonzalez M.E.B.; DE PAULA CARVALHO P.E.; Guida C.M.; Ferreira A.L.C.;
Neves H.A.; Lima A.E.; GAROT P.
Institution
(Gonzalez, DE PAULA CARVALHO, Guida, Ferreira, Neves, Lima, GAROT)
Advocate Illinois Masonic Medical Center, Chicago, IL, United States
Publisher
Elsevier Inc.
Abstract
Background The potential benefit and safety of direct oral anticoagulants
(DOAC) over vitamin K antagonists (VKA) in patients undergoing
Transcatheter Aortic Valve Replacement (TAVR) with previous indications of
anticoagulation remain a topic of ongoing debate. Methods We conducted a
systematic review and meta-analysis comparing clinical outcomes (all-cause
mortality, major bleeding, and stroke) of patients with prior indications
for oral anticoagulation undergoing TAVR. We searched PubMed, Embase, and
Cochrane Central for studies with multivariable-adjusted comparisons
between DOACs vs. VKA in this population. We used random effects to derive
the hazard ratio (HR) with a 95% confidence interval (CI). Statistical
analysis was performed using Review Manager 5.4.1. Results We included 11
studies, of which 2 were randomized controlled trials (RCTs). Among 38,948
patients, 16,684 (42.8%) received DOAC and 22,264 (57.2%) received VKA.
Overall DOAC was associated with a reduction in all-cause mortality (HR
0.87; 95% CI 0.78-0.98; p=0.02; Figure 1A). However, there was no
statistical difference between groups in the incidence of stroke (HR 0.95;
95% CI 0.79-1.13; p=0.55; Figure 1B) and major bleeding (HR 0.88; 95% CI
0.62-1.25; p=0.48; Figure 1C). Conclusion In multivariable-adjusted
analyses of patients who underwent TAVR with an indication for
anticoagulation, DOACs was associated with a decrease in all-cause
mortality and demonstrated to be a safe and effective strategy compared to
VKA. [Formula presented]<br/>Copyright &#xa9; 2024 American College of
Cardiology Foundation

<77>
Accession Number
2031115420
Title
IMPACT OF FRAILTY ON POST-TMVR OUTCOMES: A SYSTEMATIC REVIEW AND
META-ANALYSIS OF 36,963 PATIENTS UNDERGOING TMVR.
Source
Journal of the American College of Cardiology. Conference: American
College of Cardiology 73rd Annual Scientific Session & Expo. Atlanta
United States. 83(13 Supplement) (pp 1048), 2024. Date of Publication: 02
Apr 2024.
Author
Srikanth S.; Subramanian L.; Dadana S.; Liu J.; Parekh R.; Jindal U.; Zou
Y.; Singh P.; Chinthapalli M.T.; Desai R.
Institution
(Srikanth, Subramanian, Dadana, Liu, Parekh, Jindal, Zou, Singh,
Chinthapalli, Desai) East Carolina University, Brody School of Medicine,
Greenville, NC, United States
Publisher
Elsevier Inc.
Abstract
Background Frailty represents decreased physiologic reserves and is
associated with adverse outcomes. The effect of frailty on transcatheter
mitral valve repair (TMVr) outcomes is not yet understood. We conducted a
systematic review (SR) and meta-analysis (MA) to evaluate the effect of
frailty on post-TMVr outcomes. Methods PubMed, SCOPUS and Google Scholar
were comprehensively searched till October 2023 for studies reporting
frailty and post-TMVr outcomes. The random-effects model was used to
estimate the pooled effect size of frailty on post-TMVr outcomes.
Heterogeneity was assessed using the I2 statistic. Results Seven studies
(three prospective and four retrospective studies with a total of 36,963
patients) were included for the purpose of our SR and MA. The mean
follow-up duration was 378 days. The study population predominantly
consisted of males (54%) with a mean age of 77 years. Frailty was
associated with significantly higher odds of all-cause mortality (aOR:
2.75; 95% CI: 2.03-3.74) and acute kidney injury (AKI) (aOR: 3.37; 95% CI:
2.66-4.25) (Fig 1). Leave-one-out sensitivity analysis showed stability in
OR. The funnel plot was symmetrical on visual inspection, suggesting
minimal publication bias. Conclusion Our large SR and MA of 36,963
patients revealed that frailty was associated with a significantly
increased risk of all-cause mortality and AKI after TMVr. Further
prospective studies must be done to validate this risk and incorporate it
into future risk models. [Formula presented]<br/>Copyright &#xa9; 2024
American College of Cardiology Foundation

<78>
Accession Number
2031115010
Title
SAFETY AND EFFICACY OF PROTAMINE IN THE REVERSAL OF HEPARIN IN
TRANSCATHETER AORTIC VALVE REPLACEMENT: A META-ANALYSIS.
Source
Journal of the American College of Cardiology. Conference: American
College of Cardiology 73rd Annual Scientific Session & Expo. Atlanta
United States. 83(13 Supplement) (pp 1099), 2024. Date of Publication: 02
Apr 2024.
Author
Lee P.Y.; Viswanathan R.; Chaudhry T.; Hossain A.; Lee T.; Allencherril J.
Institution
(Lee, Viswanathan, Chaudhry, Hossain, Lee, Allencherril) Rutgers New
Jersey Medical School, Newark, NJ, United States
(Lee, Viswanathan, Chaudhry, Hossain, Lee, Allencherril) University of
Texas Medical Branch, Galveston, TX, United States
Publisher
Elsevier Inc.
Abstract
Background Heparin is routinely used for anticoagulation during TAVR.
Large-bore transfemoral catheters are generally used, which can predispose
to bleeding. Protamine can be useful to reverse the effects of heparin
after TAVR, however it poses the theoretical risk of ischemic events such
as stroke and MI. Methods Relevant studies published in English were
searched for in PubMed, Embase, and Cochrane databases from inception to
November 14, 2022. Our primary outcomes of interest were ischemic events
(a composite of stroke, TIA, and MI), major bleeding events, and 30-day
mortality. Dichotomous outcomes were analyzed using a Mantel-Haenszel
random-effects model and expressed as odds ratios (OR) with their 95%
confidence intervals (CI). Results Four studies were included in our
analysis, one of which was a randomized controlled trial. One study
compared low dose to high dose protamine dosing, which we pooled with the
control and intervention groups respectively. Protamine was not associated
with an increased risk of ischemic events (OR 0.83; 95% CI 0.37, 1.88).
Protamine administration was associated with a decrease in major bleeding
events (OR 0.48; 95% CI 0.27, 0.84). Lastly, protamine was not associated
an increase in mortality (OR 1.13; 95% CI 0.68, 1.90). Conclusion
Protamine for the reversal of heparin in TAVR is associated with a
decreased incidence of major bleeding without an increased risk of
ischemic events nor mortality. [Formula presented]<br/>Copyright &#xa9;
2024 American College of Cardiology Foundation

<79>
Accession Number
2031114804
Title
RIGHT VENTRICULAR DYSFUNCTION IN PERIPARTUM CARDIOMYOPATHY IS ASSOCIATED
WITH ADVERSE CARDIOVASCULAR OUTCOMES AND LOWER LIKELIHOOD OF LEFT
VENTRICULAR SYSTOLIC FUNCTION RECOVERY: A META-ANALYSIS.
Source
Journal of the American College of Cardiology. Conference: American
College of Cardiology 73rd Annual Scientific Session & Expo. Atlanta
United States. 83(13 Supplement) (pp 2426), 2024. Date of Publication: 02
Apr 2024.
Author
Khan A.A.; Fayad F.; Kim C.W.; Ataklte F.; Poppas A.; Arany Z.P.; Wu
W.-C.H.; Choudhary G.; Imran T.F.
Institution
(Khan, Fayad, Kim, Ataklte, Poppas, Arany, Wu, Choudhary, Imran) Warren
Alpert Medical School of Brown University, Providence, RI, United States
(Khan, Fayad, Kim, Ataklte, Poppas, Arany, Wu, Choudhary, Imran)
Providence VA Medical Center, Providence, RI, United States
Publisher
Elsevier Inc.
Abstract
Background Peripartum cardiomyopathy (PPCM) is a type of heart failure
with reduced ejection fraction occurring during late pregnancy or
postpartum. Studies have been inconsistent in the prognostic relevance of
right ventricular (RV) dysfunction in PPCM. Methods We conducted a
meta-analysis to identify studies with assessment of RV dysfunction,
adverse cardiovascular outcomes and LV systolic function recovery in PPCM.
The primary outcomes were LV systolic function recovery (LVEF>=50%) and
adverse events (left ventricular assist device, recurrent heart failure
hospitalization, orthotopic heart transplantation, or death). Pooled odds
ratios (ORs) and 95% confidence intervals (CIs) were calculated using
fixed-effect models. Results A total of 6 studies (n=468, 1188
person-years) met criteria. Participants had a mean age of 30.4 years.
After a median follow-up of 15.5 months (IQR 5.3 - 36.9), RV dysfunction
in PPCM was significantly associated with a decreased likelihood of LV
systolic function recovery (OR: 0.38, 95% CI: 0.21 - 0.69, p=0.001) as
compared to those without RV dysfunction at diagnosis. With a median
follow-up of 41 months (IQR 25 - 43.2), those with RV dysfunction were 3.6
times more likely to experience adverse cardiovascular events (OR: 3.63,
95% CI: 1.85 - 7.09, p<0.001) (Fig 1). Conclusion Our findings suggest
that RV dysfunction at diagnosis is associated with higher risk of adverse
cardiovascular outcomes and lower likelihood of LV systolic function
recovery in PPCM. [Formula presented]<br/>Copyright &#xa9; 2024 American
College of Cardiology Foundation

<80>
Accession Number
2031114555
Title
RENAL OUTCOMES AFTER MITRAL VALVE REPAIR VERSUS MITRAL VALVE REPLACEMENT:
A META-ANALYSIS.
Source
Journal of the American College of Cardiology. Conference: American
College of Cardiology 73rd Annual Scientific Session & Expo. Atlanta
United States. 83(13 Supplement) (pp 2196), 2024. Date of Publication: 02
Apr 2024.
Author
Ahmed H.; Ismayl M.; Palicherla A.; Ahmed O.; Kabach A.; Aboeata A.S.A.
Institution
(Ahmed, Ismayl, Palicherla, Ahmed, Kabach, Aboeata) Creighton University
School of Medicine, Omaha, NE, United States
Publisher
Elsevier Inc.
Abstract
Background Mitral regurgitation remains the most common valvular disease
in the United States. Mitral valve repair (MVr) has become increasingly
performed, serving as an alternative treatment modality for symptomatic
individuals who are not appropriate for surgery. In contrast, mitral Valve
Replacement (MVR) is performed in those for whom valvular repair would
yield poor outcomes. Research on the comparative interventions of MVr and
MVR, with respect to renal outcomes, remains limited. We aimed to perform
a meta-analysis to assess and compare renal outcomes of MVr and MVR.
Methods We conducted a comprehensive search of multiple databases to
evaluate clinical trials and observational studies that directly compared
MVr to MVR in adult patients. A random-effects model was used to calculate
risk ratios (RRs) with 95% confidence intervals. The outcome assessed was
renal failure. Results A total of 4 studies were included in the analysis
encompassing 12,906 individuals. 9,026 underwent MVr and 3,880 underwent
MVR. Compared to MVR, MVr was associated with a significantly decreased
risk of renal failure (RR 0.52; 95% CI.29-.95; P =.03). Conclusion The
current meta-analysis suggests that MVr is associated with a lower
incidence of renal failure when compared to MVR. The decision to proceed
with either MVr or MVR should be evaluated in the context of the patient's
age and comorbidities, especially with respect to their kidney function.
[Formula presented]<br/>Copyright &#xa9; 2024 American College of
Cardiology Foundation

<81>
Accession Number
2031113959
Title
CLINICAL OUTCOMES OF PCI IN HOSPITALS WITH OR WITHOUT SURGICAL BACKUP: A
META-ANALYSIS.
Source
Journal of the American College of Cardiology. Conference: American
College of Cardiology 73rd Annual Scientific Session & Expo. Atlanta
United States. 83(13 Supplement) (pp 1064), 2024. Date of Publication: 02
Apr 2024.
Author
Haddad T.A.; Toubasi A.; Fahmawi A.; Zaid A.
Institution
(Haddad, Toubasi, Fahmawi, Zaid) University of Jordan, Amman, Jordan
Publisher
Elsevier Inc.
Abstract
Background Recent guidelines established that PCIs conducted at
non-surgical on-site (NSOS) facilities have outcomes comparable to
surgical on-site (SOS) centers. However, there is still growing literature
with differing perspectives, resulting in an ongoing controversy. Methods
A thorough literature review was conducted across four databases,
including PubMed, Cochrane Library, Scopus and Web of Science to identify
studies comparing outcomes in SOS and NSOS hospitals. Studies were
selected based on a strict inclusion criteria. The primary endpoints were:
30-day mortality, MI, CVA, the need for emergency CABG (eCABG), rePCI and
total vessel revascularization (TVR). Results The final search yielded 26
studies, encompassing a total of 1,205,851 patients. The majority of
patients (81.2%) underwent PCI in SOS hospitals. There was a significant
association with increased eCABG (OR=2.03; 95%CI: 1.14-3.62) and rePCI
(OR=1.62; 95%CI: 1.37-1.91) rates in SOS hospitals. Conversely, 30-day
mortality (OR=0.91; 95%CI: 0.53-1.54), MI (OR=1.08; 95%CI: 0.92-1.27), CVA
(OR=1.13; 95%CI: 0.69-1.86) and TVR (OR=1.06; 95%CI: 0.92-1.21) showed no
significant difference between hospitals. Subgroup analyses were performed
among clinical trials and STEMI patients; no associations were found with
the outcomes. Conclusion In conclusion, this meta-analysis provides
updated insights into the impact of surgical backup on PCI outcomes. It
suggests no disparity in outcomes, except for eCABG and rePCI rates.
[Formula presented]<br/>Copyright &#xa9; 2024 American College of
Cardiology Foundation

<82>
Accession Number
2031113934
Title
ANTITHROMBOTIC THERAPY POST SURGICAL MITRAL VALVE REPAIR WITHOUT ATRIAL
FIBRILLATION: A SYSTEMATIC REVIEW AND META-ANALYSIS.
Source
Journal of the American College of Cardiology. Conference: American
College of Cardiology 73rd Annual Scientific Session & Expo. Atlanta
United States. 83(13 Supplement) (pp 2203), 2024. Date of Publication: 02
Apr 2024.
Author
Rahhal A.; Ferih K.; Elsabagh A.; Al-Maraghi F.; Kasem M.; Omar A.
Institution
(Rahhal, Ferih, Elsabagh, Al-Maraghi, Kasem, Omar) Hamad Medical
Corporation, Doha, Qatar
(Rahhal, Ferih, Elsabagh, Al-Maraghi, Kasem, Omar) Qatar University
College of Medicine, Doha, Qatar
Publisher
Elsevier Inc.
Abstract
Background Vitamin K antagonist (VKA) use post surgical mitral valve
repair (MVr) demonstrated conflicting benefits in observational studies at
reducing thromboembolic events among patients without atrial fibrillation
(AF), which precluded strong guidelines recommendations on VKA use.
Therefore, we conducted a systematic review and meta-analysis to assess
the clinical outcomes of VKA use post MVr in comparison to conventional
therapy of no anticoagulation. Methods We performed a systematic review
and meta-analysis following the Preferred Reporting Items for Systematic
Reviews and MetaAnalyses (PRISMA) guidelines. We searched PubMed and
EMBASE for the studies published in English exploring the clinical
outcomes of VKA post MVr versus non-VKA use without co-existing AF, till
25/07/2023. The comparator arm (non-VKA use) comprised aspirin use or no
antithrombotic therapy. Two independent reviewers assessed the quality and
risk of bias of the included studies. A random-effects model was used to
combine data. The primary outcomes were ischemic stroke and major bleeding
associated with VKA in comparison to nonVKA use, while the secondary
outcomes were thromboembolic events and all-cause mortality. Heterogeneity
was assessed using Q test and I², with I² > 50%
indicating marked heterogeneity. Results A total of six observational
studies (n=20196) were included in the analysis of the primary outcomes.
VKA use post MVr was associated with similar ischemic stroke incidence in
comparison to non-VKA use (Risk Ratio [RR]= 0.96; 95% CI, 0.75-1.24,
I²= 0%). Likewise, major bleeding was comparable between the
two groups (RR= 0.99, 95% Cl, 0.58-1.68, I²= 84%). Similarly,
MVr use was associated with similar event rates of thromboembolism and
all-cause mortality at six months (thromboembolism: RR= 1.01, 95% Cl,
0.75-1.36, I²= 21%; mortality: RR 0.78, 95% Cl, 0.16-3.87,
I²= 81%). Conclusion Among patients who don't have AF, VKA use
post MVr demonstrated similar effectiveness and safety compared to non-VKA
use, which provides reassurance of VKA use in this
population.<br/>Copyright &#xa9; 2024 American College of Cardiology
Foundation

<83>
Accession Number
2031113787
Title
NOT ON OUR WATCH: WATCHMAN DEVICE EFFICACY IN ISCHEMIC STROKE PREVENTION-
SYSTEMATIC REVIEW AND METAANALYSIS.
Source
Journal of the American College of Cardiology. Conference: American
College of Cardiology 73rd Annual Scientific Session & Expo. Atlanta
United States. 83(13 Supplement) (pp 2081), 2024. Date of Publication: 02
Apr 2024.
Author
Joseph C.; Romano C.; Varughese V.J.; Mohyuddin M.
Institution
(Joseph, Romano, Varughese, Mohyuddin) Prisma Health, Columbia, SC, United
States
Publisher
Elsevier Inc.
Abstract
Background Many patients with atrial fibrillation are high risk for
adverse events due to anticoagulation; the modern answer to this conundrum
is a left atrial appendage occlusion (LAAO) device, the most common being
the Watchman. In this systematic review and metaanalysis, the efficacy of
Watchman, defined by prevention of ischemic strokes, is compared to other
LAAO devices and anticoagulation. Methods 132 articles across three
databases-Pubmed, Google scholar and Embase- were identified using PRISMA
protocol; this included larger randomized control trials such as Protect
AF, Prevail, and Salute. The end point measured was cardioembolic ischemic
stroke in AF patients with a CHADS2VASC of 1-3. Watchman device was the
experimental group; control groups included 1)other LAAO devices or 2)
anticoagulation with either direct oral anticoagulants or warfarin.
Statistics were calculated with RevMan 5.4 software. Results Odds Ratio
for incidence of ischemic stroke events was 1.11 (0.78 -1.57), proving no
statistical difference in safety endpoints between the experimental and
control groups. Conclusion Watchman was shown to be noninferior to other
LAAO devices and chronic anticoagulation, proving it is equally
efficacious to the current standard of care (anticoagulation) in
preventing cardioembolic events. [Formula presented]<br/>Copyright &#xa9;
2024 American College of Cardiology Foundation

<84>
Accession Number
2031112490
Title
GENDER-BASED DISPARITIES IN OUTCOME OF CORONARY BIFURCATION STENTING IN
PATIENTS UNDERGOING PERCUTANEOUS CORONARY INTERVENTION: A SYSTEMATIC
REVIEW AND META-ANALYSIS.
Source
Journal of the American College of Cardiology. Conference: American
College of Cardiology 73rd Annual Scientific Session & Expo. Atlanta
United States. 83(13 Supplement) (pp 1059), 2024. Date of Publication: 02
Apr 2024.
Author
Khanal R.; Najam M.; Rashdi A.; Basit S.A.; Wajid Z.; Patel N.N.; Razzaq
S.; Ali S.; Naeem M.; Shah R.P.; Oli S.; Alyami B.; Patel B.; Aamir M.;
Hamza M.; Sattar Y.; Alraies M.C.
Institution
(Khanal, Najam, Rashdi, Basit, Wajid, Patel, Razzaq, Ali, Naeem, Shah,
Oli, Alyami, Patel, Aamir, Hamza, Sattar, Alraies) Wayne State Univeristy,
Detroit, MI, United States
Publisher
Elsevier Inc.
Abstract
Background Around 15-20% of lesions necessitating percutaneous coronary
interventions (PCI) are attributed to coronary bifurcation lesions. We aim
to study gender-based differences in PCI outcomes among bifurcation
stents. Methods 3 studies were included after thorough systematic search
using MEDLINE (EMBASE and PubMed). CRAN-R software using the Metabin
module was used for statistical analysis. Pooled odds ratios (OR) were
calculated using the random effect model and the Mantel-Haenszel method,
with a 95% confidence interval (CI) used to determine statistical
significance. Heterogeneity was assessed using Higgins I2. Results Women
exhibited a higher risk of in-hospital mortality (OR 0.67, 95% CI
0.58-0.76, I2= 0%, p<.0.0001), post-procedural bleeding (OR 0.53, 95% CI
0.47- 0.6, I2 =0.%, p< 0.0001) and post-procedure stroke (OR 0.72, 95% CI
0.52-1.0, I2= 0%, p<0.06) as compared to men. However, there was no
significant differences in terms of myocardial infarction (OR 0.84, 95% CI
0.22- 3.27, I2 = 49.4%, p< 0.80) and cardiac tamponade (OR 0.63, 95% CI
0.06; 5.72, I2 = 0%, p < 0.6821) in both groups. Conclusion Our study
reveals a noteworthy increase in in-hospital mortality in women which
could be attributed to higher rate of major bleeding, advance age,
increased co-morbidities and complex pathophysiology of the lesion in
comparison to men. Further studies are required to gain a better
understanding of the precise mechanisms thus enhancing procedural
outcomes. [Formula presented]<br/>Copyright &#xa9; 2024 American College
of Cardiology Foundation

<85>
Accession Number
2031082915
Title
CONCOMITANT TR ANNULOPLASTY IN PATIENTS UNDERGOING MITRAL REGURGITATION
SURGERY: A META-ANALYSIS OF RANDOMIZED CONTROLLED TRIALS.
Source
Journal of the American College of Cardiology. Conference: American
College of Cardiology 73rd Annual Scientific Session & Expo. Atlanta
United States. 83(13 Supplement) (pp 954), 2024. Date of Publication: 02
Apr 2024.
Author
Abdelaziz A.; Atta K.; Hafez A.; Diab R.A.; Abdellatif M.; Elsayed H.;
Suppah M.; Ghaly R.; Abdelaziz M.; Ali S.; Abdelazeem B.
Institution
(Abdelaziz, Atta, Hafez, Diab, Abdellatif, Elsayed, Suppah, Ghaly,
Abdelaziz, Ali, Abdelazeem) West Virginia University, Morgantown, WV,
United States
Publisher
Elsevier Inc.
Abstract
Background Tricuspid regurgitation (TR) is a common valve lesion in
patients with mitral valve regurgitation (MV). The indication of
concomitant TR annuloplasty during MV surgery in patients with less severe
TR remains a debate. We aimed to study the benefits of TR annuloplasty on
clinical outcomes. Methods We searched PubMed, Scopus, WOS, and the
Cochrane Library for RCTs comparing TR annuloplasty with MV surgery versus
isolated MV surgery until October 2023. The endpoints of interest were
all-cause mortality, TR progression, and NYHA classes III and IV.
Dichotomous data were pooled as OR and 95% CI and analyzed in a random
effect model using STATA 17 MP. Results Five RCTs comprising 818 patients
(mean follow-up four years) were included. Concomitant TR annuloplasty was
associated with a lower risk of all-cause mortality (OR: 0.52, 95% CI:
0.32 to 0.84, p< 0.001; 2 = 0%) and TR progression (OR: 0.44, 95% CI: 0.3
to 0.63; p< 0.001; 2 = 0%). Comparable NYHA classes III and IV were
identified in both concomitant TR annuloplasty and isolated MV surgery
(OR: 0.66, 95% CI: 0.4 to 1.1, p= 0.12; 2 = 0%). Conclusion Compared to
isolated MV surgery, concomitant TR annuloplasty during MV surgery was
associated with lower risk of all-cause mortality and TR progression,
which opens the door to further consider TR annuloplasty as an additional
approach during MV surgery in patients with less severe TR. [Formula
presented]<br/>Copyright &#xa9; 2024 American College of Cardiology
Foundation

<86>
Accession Number
643786369
Title
Pancreatic injury in acute illnesses is associated with worse clinical
outcomes.
Source
Pancreas. Conference: American Psychiatric Association Annual Meeting, APA
2023. San Francisco, CA United States. 53(1) (pp e95), 2024. Date of
Publication: February 2024.
Author
Jahangir S.; Rajalingamgari P.; Morsy M.; Smichi N.; Narayana Pillai A.;
McFayden B.; Summers M.; Khatua B.; Kostenko S.; Singh V.
Institution
(Jahangir, Rajalingamgari, Morsy, Smichi, Narayana Pillai, McFayden,
Summers, Khatua, Kostenko, Singh) Mayo Clinic, Scottsdale, AZ, United
States
Publisher
Lippincott Williams and Wilkins
Abstract
Background: Previous studies suggest acute illnesses associated with
pancreatic enzyme elevation may have worse outcomes. These include burns,
critical illness, surgery, trauma, traumatic brain injury, cardiovascular
events and COVID-19. We therefore conducted a comprehensive literature
search for acute illnesses to look for objective evidence of pancreatic
injury and the associated outcomes. <br/>Method(s): PubMed search was done
for terms critical illness, burns, surgery, heart failure, trauma,
traumatic brain injuryandamylase or lipase or hyperamylasemia or
hyperlipasemia or pancreatic injury or pancreatitis or autopsy or imaging
or mortality. Included were articles with primary patient data,
prospective and retrospective studies, meta-analysis. Excluded were case
reports and literature reviews. <br/>Result(s): 13 studies ranging from
89-3244 patients associated elevated serum lipase (n = 13) or amylase (n =
6) with worse outcomes. These included one study each for burns (3.5x
increased mortality), cardiac arrest (3.7x increased mortality),
neurosurgery (39.5% vs 17.4% mortality), critical illness (2.3 fold
increased mortality), heart failure (higher inflammatory markers).
COVID-19 with lipase elevation (n = 3 included a metanalysis with 21
studies) showed significantly increased (24.6%vs. 6.4%; p < 0.05)
mortality. The proportion of patients with hyperlipasemia ranged from
20-50%. Similar patterns were noted in trauma, traumatic brain injury, and
cardiovascular surgery (2 studies). Abdominal imaging showed pancreatitis
in 11/25 (44%) critically ill neurosurgery patients, 4/13 (31%) burns,
11/50 (22%) critically ill patients, with frank pancreatitis diagnosed in
58/986 (6%) of cardiac valve surgery cases. Additionally, 5/11 (45%)
patients dying with COVID-19, 41/79 (52%) children dying of critical
illnesses and 22/95 (23%) patients dying after 24 hours of undergoing
emergent surgery had pancreatic injury on autopsy. <br/>Conclusion(s):
Elevated pancreatic enzymes are associated with poor outcomes in several
acute illnesses, the pathophysiology of which needs to be further
explored. Future studies that incorporate serum lipase, as part of
prognostic scoring systems in these illnesses could be considered.

<87>
Accession Number
2029091732
Title
Use of cardiac contractility modulation combined with left bundle branch
pacing CRT-P in a female with a 22-year history of non-ischemic dilated
cardiomyopathy: A case report.
Source
Echocardiography. 41(3) (no pagination), 2024. Article Number: e15762.
Date of Publication: March 2024.
Author
Fang L.; Ma Y.; Wu Y.; Ge Y.; Liang X.; Tang R.
Institution
(Fang) Department of Laboratory Medicine, The First Affiliated Hospital of
Xiamen University, Xiamen, China
(Fang, Ma, Wu, Ge, Tang) The School of Clinical Medicine, Fujian Medical
University, Xiamen, China
(Fang) Xiamen Key Laboratory of Genetic Testing, Xiamen, China
(Fang) School of Public Health, Xiamen University, Xiamen, China
(Ma, Tang) Department of Cardiology, The First Affiliated Hospital of
Xiamen University, Xiamen, China
(Wu, Ge) Department of Medical Ultrasound, The First Affiliated Hospital
of Xiamen University, Xiamen, China
(Liang) Center of Clinical Laboratory, Zhongshan Hospital, School of
Medicine, Xiamen University, Xiamen, China
(Liang) Institute of Infectious Disease, School of Medicine, Xiamen
University, Xiamen, China
Publisher
John Wiley and Sons Inc
Abstract
Cardiac contractility modulation (CCM) is a novel device-based therapy
used to treat patients with heart failure with reduced ejection fraction
(HFrEF). In both randomized clinical trials and real-life studies, CCM has
been shown to improve exercise tolerance and quality of life, reverse left
ventricular remodeling, and reduce hospitalization in patients with HFrEF.
In this case report, we describe for the first time the use of CCM
combined with left bundle branch pacing (LBBP) cardiac resynchronization
therapy pacemaker (CRT-P) implantation therapy in a female with a 22-year
history of non-ischemic dilated cardiomyopathy. With the optimal medical
therapy and cardiac resynchronization therapy (CRT) strategies, the
patient's quality of life initially recovered to some extent, but began to
deteriorate in the past year. Additionally, heart transplantation was not
considered due to economic reasons and late stage systolic heart failure.
This is the first case of CCM implantation in Fujian Province and the
first report of a combined CCM and left bundle branch pacing CRT-P
implantation strategy in a patient with non-ischemic etiology dilated
cardiomyopathy in China.<br/>Copyright &#xa9; 2024 Wiley Periodicals LLC.

<88>
Accession Number
2031193614
Title
Midterm Survival of Low-Risk Patients Treated With Transcatheter Versus
Surgical Aortic Valve Replacement: Meta-Analysis of Reconstructed
Time-to-Event Data.
Source
Journal of the American Heart Association. 12(21) (no pagination), 2023.
Article Number: e030012. Date of Publication: 07 Nov 2023.
Author
Sa M.P.; Jacquemyn X.; Van den Eynde J.; Serna-Gallegos D.; Chu D.; Clavel
M.-A.; Pibarot P.; Sultan I.
Institution
(Sa, Serna-Gallegos, Chu) Department of Cardiothoracic Surgery, University
of Pittsburgh, PA, United States
(Sa, Serna-Gallegos, Chu) UPMC Heart and Vascular Institute, University of
Pittsburgh Medical Center, Pittsburgh, PA, United States
(Jacquemyn, Van den Eynde) Department of Cardiovascular Sciences, KU
Leuven, Leuven, Belgium
(Clavel, Pibarot, Sultan) Centre de Recherche de l'Institut Universitaire
de Cardiologie et de Pneumologie de Quebec, Quebec City, QC, Canada
(Clavel, Pibarot, Sultan) Department of Medicine, Faculty of Medicine,
Universite Laval, Quebec City, QC, Canada
Publisher
American Heart Association Inc.
Abstract
BACKGROUND: We performed a meta-analysis of reconstructed time-to-event
data from randomized controlled trials (RCTs) and propensity-score matched
(PSM) studies comparing transcatheter versus surgical aortic valve
replacement (TAVR versus SAVR) to evaluate midterm outcomes in patients
considered low risk for SAVR. METHODS AND RESULTS: Study-level
meta-analysis of reconstructed time-to-event data from Kaplan- Meier
curves of RCTs and PSM studies published by December 31, 2022 was
conducted. Eight studies (3 RCTs, 5 PSM studies) met our eligibility
criteria and included 5444 patients; 2639 patients underwent TAVR, and
2805 patients underwent SAVR. TAVR showed a higher risk of all-cause
mortality at 8 years of follow-up (hazard ratio [HR] 1.22, [95% CI,
1.03-1.43], P=0.018). Up to 2 years of follow-up, TAVR was not inferior to
SAVR (HR, 1.08 [95% CI, 0.89-1.31], P=0.448); however, we observed a
statistically significant difference after 2 years with higher mortality
with TAVR (HR, 1.51 [95% CI, 1.14-2.00]; P=0.004). This difference was
driven by PSM studies; our sensitivity analysis showed a statistically
significant difference between TAVR and SAVR when we included only PSM
studies (HR, 1.41 [95% CI, 1.16-1.72], P=0.001) but no statistically
significant difference when we included only RCTs (HR, 0.89 [95% CI,
0.69-1.16], P=0.398). <br/>CONCLUSION(S): In comparison with TAVR, SAVR
appeared to be associated with improved survival beyond 2 years in
low-risk patients. However, the survival benefit of SAVR was observed only
in PSM studies and not in RCTs. The addition of data from ongoing RCTs as
well as longer follow-up in previous RCTs will help to confirm if there is
a difference in mid-and long-term survival between TAVR versus SAVR in the
low-risk population.<br/>Copyright &#xa9; 2023 The Authors.

<89>
Accession Number
2031132479
Title
Recurrence of new-onset post-operative AF after cardiac surgery: detected
by implantable loop recorders: A systematic review and Meta-analysis.
Source
International Journal of Cardiology. (no pagination), 2024. Article
Number: 131930. Date of Publication: 2024.
Author
Kaur H.; Tao B.; Silverman M.; Healey J.S.; Belley-Cote E.P.; Islam S.;
Whitlock R.P.; Devereaux P.J.; Conen D.; Bidar E.; Kawczynski M.;
Ayala-Paredes F.; Ayala-Valani L.M.; Sandgren E.; El-Chami M.F.; Jorgensen
T.H.; Thyregod H.G.H.; Sabbag A.; McIntyre W.F.
Institution
(Kaur, Silverman) Michael G. DeGroote School of Medicine, Hamilton, ON,
Canada
(Tao) University of British Columbia, BC, Canada
(Healey, Belley-Cote, Islam, Whitlock, Devereaux, Conen, McIntyre)
Population Health Research Institute, ON, Canada
(Bidar, Kawczynski) Maastricht University Medical Centre (MUMC),
Maastricht, Netherlands
(Bidar, Kawczynski) CardioVascular Research Institute Maastricht (CARIM),
Netherlands
(Ayala-Paredes, Ayala-Valani) Sherbrooke University, Quebec, Canada
(Sandgren) Department of Medicine, Halland Hospital Varberg, Varberg,
Sweden
(El-Chami) Department of Medicine, Emory University School of Medicine,
Atlanta, United States
(Jorgensen, Thyregod) Department of Cardiovascular Surgery, Copenhagen
University Hospital, Copenhagen, Denmark
(Sabbag) Davidai Arrhythmia Center, Sheba Medical Center, Ramat Gan and
the Faculty of Median, Tel-Aviv University, Israel
Publisher
Elsevier Ireland Ltd
Abstract
Background: Atrial fibrillation (AF) is one of the most common
complications after cardiac surgery. New-onset post-operative AF may
signal an elevated risk of AF and associated outcomes in long-term
follow-up. We aimed to estimate the rate of AF recurrence as detected by
an implantable loop recorder (ILR) in patients experiencing post-operative
AF within 30 days after cardiac surgery. <br/>Method(s): We searched
MEDLINE, Embase and Cochrane CENTRAL to April 2023 for studies of adults
who did not have known AF, experienced new-onset AF within 30 days of
cardiac surgery and received an ILR. We pooled individual participant data
on timing of AF recurrence using a random-effects model with a frailty
model applied to a Cox proportional hazard analysis. <br/>Result(s): From
8671 citations, 8 single-centre prospective cohort studies met eligibility
criteria. Data were available from 185 participants in 7 studies, with a
median follow-up of 1.7 (IQR: 1.3-2.8) years. All included studies were at
a low risk of bias. Pooled AF recurrence rates following 30 post-operative
days were 17.8% (95% CI 11.9%-23.2%) at 3 months, 24.4% (17.7%-30.6%) at 6
months, 30.1% (22.8%-36.7%) at 12 months and 35.3% (27.6%-42.2%) at 18
months. <br/>Conclusion(s): In patients who experience new-onset
post-operative AF after cardiac surgery, AF recurrence lasting at least 30
s occurs in approximately 1 in 3 in the first year after surgery. The
optimal frequency and modality to use for monitoring for AF recurrence in
this population remain uncertain.<br/>Copyright &#xa9; 2024 The Authors

<90>
Accession Number
2031113223
Title
Dexmedetomidine and acute kidney injury after non-cardiac surgery: A
meta-analysis with trial sequential analysis.
Source
Anaesthesia Critical Care and Pain Medicine. 43(3) (no pagination), 2024.
Article Number: 101359. Date of Publication: June 2024.
Author
Zhuang K.; Yang H.-T.; Long Y.-Q.; Liu H.; Ji F.-H.; Peng K.
Institution
(Zhuang, Yang, Long, Ji, Peng) Department of Anaesthesiology, First
Affiliated Hospital of Soochow University, Jiangsu, Suzhou, China
(Zhuang, Yang, Long, Ji, Peng) Institute of Anaesthesiology, Soochow
University, Jiangsu, Suzhou, China
(Liu) Department of Anaesthesiology and Pain Medicine, University of
California Davis Health, Sacramento, CA, United States
Publisher
Elsevier Masson s.r.l.
Abstract
Background: Acute kidney injury (AKI) is a common complication after
surgery and is associated with detrimental outcomes. This systematic
review and meta-analysis evaluated perioperative dexmedetomidine on AKI
and renal function after non-cardiac surgery. <br/>Method(s): PubMed,
Embase, and Cochrane Library databases were searched until August 2023 for
randomised trials comparing dexmedetomidine with normal saline on AKI and
renal function in adults undergoing non-cardiac surgery. The primary
outcome was the incidence of AKI (according to Kidney Disease Improving
Global Outcomes or Acute Kidney Injury Network criteria). Meta-analysis
was performed using a random-effect model. We conducted sensitivity
analysis, trial sequential analysis (TSA), and Grading of Recommendations
Assessment, Development and Evaluation level of evidence. <br/>Result(s):
Twenty-three trials involving 2440 patients were included. Dexmedetomidine
administration, as compared to normal saline, significantly reduced the
incidence of AKI (7.4% vs. 13.2%; risk ratio = 0.57, 95% CI = 0.40-0.83, P
= 0.003, I² = 0%; a high level of evidence); TSA and
sensitivity analyses suggested the robustness of this outcome. For the
renal function and inflammation parameters, dexmedetomidine decreased
serum creatinine, blood urea nitrogen, cystatin C, tumour necrosis
factor-alpha, and interleukin-6, and increased urine output and estimated
glomerular filtration rate. Additionally, dexmedetomidine reduced
postoperative nausea and vomiting and length of hospital stay.
Dexmedetomidine was associated with an increased rate of bradycardia, but
not hypotension. <br/>Conclusion(s): Dexmedetomidine administration
reduced the incidence of AKI and improved renal function after non-cardiac
surgery. Based on a high level of evidence, dexmedetomidine is recommended
as a component of perioperative renoprotection. Registration:
International Prospective Register of Systematic Reviews; Registration
number: CRD42022299252.<br/>Copyright &#xa9; 2024 Societe francaise
d'anesthesie et de reanimation (Sfar)

<91>
Accession Number
2030918896
Title
Epicardial left atrial appendage clipping versus direct oral anticoagulant
to reduce stroke risk in non-paroxysmal atrial fibrillation (LAA-CLIP):
rationale, design and study protocol for a multicentre randomised
controlled trial.
Source
BMJ Open. 14(3) (no pagination), 2024. Article Number: e083153. Date of
Publication: 05 Mar 2024.
Author
Yu C.; Li H.; Lei C.; Wang Y.; Chen S.; Zhao Y.; Zheng Z.
Institution
(Yu, Li, Lei, Zhao, Zheng) State Key Laboratory of Cardiovascular Disease,
Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese
Academy of Medical Sciences, Peking Union Medical College, Beijing, China
(Yu, Li, Lei, Zheng) Department of Cardiovascular Surgery, Fuwai Hospital,
National Center for Cardiovascular Diseases, Chinese Academy of Medical
Sciences, Peking Union Medical College, Beijing, China
(Wang) Medical Research & Biometrics Center, State Key Laboratory of
Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular
Diseases, Chinese Academy of Medical Sciences, Peking Union Medical
College, Beijing, China
(Chen) Department of Information Center, Fuwai Hospital, National Center
for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking
Union Medical College, Beijing, China
Publisher
BMJ Publishing Group
Abstract
Introduction The prevalence of atrial fibrillation (AF) is increasing
globally, and stroke prevention is the key to reduce the morbidity and
mortality related to AF. Currently, direct oral anticoagulants (DOACs) are
the primary options for stroke prevention, while it increases risk of
bleeding. Left atrial appendage (LAA) is suspected as a vital source of
cerebral emboli and may lead to ischaemic stroke, and thoracoscopic LAA
clipping procedure provides an alternative option for stroke prevention in
high-risk patients. However, high-quality evidence comparing LAA clipping
to DOACs in terms of stroke prevention is lacking. This trial is designed
to assess whether the efficacy of thoracoscopic LAA clipping is superior
to DOACs for stroke prevention in AF patients at high risk of thrombosis
(CHA<inf>2</inf>DS<inf>2</inf>-VASc>=2 in men and >=3 in
women)[CHA2DS2-VASc stands for "congestive heart failure, hypertension,
age >=75 (doubled), diabetes, stroke (doubled), vascular disease, age 65
to 74 and sex category (female)"]. Methods and analysis This is a
prospective, multicentre, open-labelled, randomised controlled study. This
trial will randomly assign 290 patients with non-paroxysmal AF to
thoracoscopic LAA clipping group or DOAC therapy group in a 1:1
randomisation. The primary endpoint is defined as a composite endpoint
event consisting of stroke, systemic embolism, all-cause mortality, major
bleeding events and clinically relevant non-major bleeding events at 24
months after randomisation. The secondary endpoints consist of the
components of the primary composite endpoint, surgery-related adverse
events and minor bleeding events. Ethics and dissemination The central
ethics committee at Fuwai Hospital approved the trial entitled "Epicardial
left atrial appendage clipping versus direct oral anticoagulant to reduce
stroke risk in non-paroxysmal atrial fibrillation (LAA-CLIP trial)". The
results of this study will be disseminated through publications in
peer-reviewed journals and conference presentations.<br/>Copyright &#xa9;
Author(s) (or their employer(s)) 2024.

<92>
Accession Number
2030256469
Title
Exogenous Transforming Growth Factor-beta1 and Its Helminth-Derived Mimic
Attenuate the Heart's Inflammatory Response to Ischemic Injury and Reduce
Mature Scar Size.
Source
American Journal of Pathology. 194(4) (pp 562-573), 2024. Date of
Publication: April 2024.
Author
Redgrave R.E.; Singh E.; Tual-Chalot S.; Park C.; Hall D.; Bennaceur K.;
Smyth D.J.; Maizels R.M.; Spyridopoulos I.; Arthur H.M.
Institution
(Redgrave, Singh, Tual-Chalot, Park, Hall, Arthur) Faculty of Medical
Sciences, Biosciences Institute, Newcastle University, Newcastle, United
Kingdom
(Bennaceur, Spyridopoulos) Faculty of Medical Sciences, Translational
Research Institute, Newcastle University, Newcastle, United Kingdom
(Smyth, Maizels) Wellcome Centre for Integrative Parasitology, School of
Infection and Immunity, University of Glasgow, Glasgow, United Kingdom
Publisher
Elsevier Inc.
Abstract
Coronary reperfusion after acute ST-elevation myocardial infarction
(STEMI) is standard therapy to salvage ischemic heart muscle. However,
subsequent inflammatory responses within the infarct lead to further loss
of viable myocardium. Transforming growth factor (TGF)-beta1 is a potent
anti-inflammatory cytokine released in response to tissue injury. The aim
of this study was to investigate the protective effects of TGF-beta1 after
MI. In patients with STEMI, there was a significant correlation (P =
0.003) between higher circulating TGF-beta1 levels at 24 hours after MI
and a reduction in infarct size after 3 months, suggesting a protective
role of early increase in circulating TGF-beta1. A mouse model of cardiac
ischemia reperfusion was used to demonstrate multiple benefits of
exogenous TGF-beta1 delivered in the acute phase. It led to a
significantly smaller infarct size (30% reduction, P = 0.025), reduced
inflammatory infiltrate (28% reduction, P = 0.015), lower intracardiac
expression of inflammatory cytokines IL-1beta and chemokine (C-C motif)
ligand 2 (>50% reduction, P = 0.038 and 0.0004, respectively) at 24 hours,
and reduced scar size at 4 weeks (21% reduction, P = 0.015) after
reperfusion. Furthermore, a low-fibrogenic mimic of TGF-beta1, secreted by
the helminth parasite Heligmosomoides polygyrus, had an almost identical
protective effect on injured mouse hearts. Finally, genetic studies
indicated that this benefit was mediated by TGF-beta signaling in the
vascular endothelium.<br/>Copyright &#xa9; 2024 American Society for
Investigative Pathology

<93>
Accession Number
2029997426
Title
Effects of Cardiopulmonary Bypass on Antibody Levels After SARS-CoV-2
Vaccination: A Meta-Analysis.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 38(4) (pp 1058-1059),
2024. Date of Publication: April 2024.
Author
Chen I.-W.; Yu T.-S.; Hung K.-C.
Institution
(Chen) Department of Anesthesiology, Chi Mei Medical Center, Liouying,
Tainan City, Taiwan (Republic of China)
(Yu) Department of Anesthesiology, E-Da Hospital, I-Shou University,
Kaohsiung City, Taiwan (Republic of China)
(Hung) Department of Anesthesiology, Chi Mei Medical Center, Tainan City,
Taiwan (Republic of China)
Publisher
W.B. Saunders

<94>
Accession Number
2029003305
Title
Cardiovascular safety of febuxostat versus allopurinol among the Asian
patients with or without gout: A systematic review and meta-analysis.
Source
Clinical and Translational Science. 17(3) (no pagination), 2024. Article
Number: e13757. Date of Publication: March 2024.
Author
Deng J.-H.; Lai P.-H.; Xie L.-S.; Qiu S.-S.; Qiu D.-S.; Zhang J.-X.
Institution
(Deng, Lai, Xie, Qiu) Pharmacy Department, Longyan Second Hospital,
Longyan, China
(Qiu) Neurology Department, Longyan Second Hospital, Longyan, China
(Zhang) Pharmacy Department, Guizhou Provincial People's Hospital,
Guiyang, China
Publisher
John Wiley and Sons Inc
Abstract
The cardiovascular (CV) safety of febuxostat compared to allopurinol for
the treatment of hyperuricemia among Asian patients is uncertain. In this
study, we conducted a systematic review and meta-analysis to compare the
CV safety profiles of febuxostat with allopurinol in Asian patients with
hyperuricemia. A total of 13 studies were included. On the basis of the
pooled results of cohort studies, febuxostat users were at a significantly
higher risk for acute coronary syndrome (ACS; hazard ratio [HR]: 1.06, 95%
confidence interval [CI]: 1.03-1.09, p < 0.01), atrial fibrillation (HR:
1.19, 95% CI: 1.05-1.35, p < 0.01) than allopurinol users, whereas no
significant difference between febuxostat and allopurinol existed for
urgent coronary revascularization (HR: 1.07, 95% CI: 0.98-1.16, p = 0.13),
and stroke (HR: 0.96, 95% CI: 0.91-1.01, p = 0.13). Nevertheless, that
difference in results of acute decompensated heart failure (ADHF; HR:
0.73, 95% CI: 0.35-1.53, p = 0.40) and all-cause death (HR = 0.86, 95% CI:
0.49-1.51, p = 0.60) was not significant based on randomized controlled
trials. In the Chinese subgroup, febuxostat could increase the risk of
ADHF (HR: 1.22, 95% CI: 1.01-1.48, p < 0.05), CV death (HR: 1.25, 95% CI:
1.03-1.50, p < 0.05), and all-cause mortality (HR: 1.07, 95% CI:
1.01-1.14, p < 0.05) compared to allopurinol. In conclusion, the use of
febuxostat, compared with allopurinol among Asian patients, was associated
with a significantly increased risk of adverse CV events.<br/>Copyright
&#xa9; 2024 The Authors. Clinical and Translational Science published by
Wiley Periodicals LLC on behalf of American Society for Clinical
Pharmacology and Therapeutics.

<95>
Accession Number
2028829660
Title
Efficacy of propofol-supplemented cardioplegia on biomarkers of organ
injury in patients having cardiac surgery using cardiopulmonary bypass: a
statistical analysis plan for the ProMPT-2 randomised controlled trial.
Source
Trials. 25(1) (no pagination), 2024. Article Number: 153. Date of
Publication: December 2024.
Author
Smartt H.; Angelini G.D.; Gibbison B.; Rogers C.A.
Institution
(Smartt, Rogers) Bristol Trials Centre, Bristol Medical School, University
of Bristol, Bristol, United Kingdom
(Angelini) National Institute for Health Research Bristol Biomedical
Research Centre, University Hospitals Bristol and Weston NHS Foundation
Trust and University of Bristol, Bristol, United Kingdom
(Angelini) Bristol Heart Institute, University of Bristol, Bristol, United
Kingdom
(Gibbison) Department of Anaesthesia, University Hospitals Bristol and
Weston NHS Foundation Trust, Bristol, United Kingdom
Publisher
BioMed Central Ltd
Abstract
Background: The ProMPT-2 trial (Propofol for Myocardial Protection Trial
#2) aims to compare the safety and efficacy of low- and high-dose propofol
supplementation of the cardioplegia solution during adult cardiac surgery
versus sham supplementation. This update presents the statistical analysis
plan, detailing how the trial data will be analysed and presented.
Outlined analyses are in line with the Consolidated Standards of Reporting
Trials and the statistical analysis plan has been written prior to
database lock and the final analysis of trial data to avoid reporting bias
(following recommendations from the International Conference on
Harmonisation of Good Clinical Practice). Methods/design: ProMPT-2 is a
multi-centre, blinded, parallel three-group randomised controlled trial
aiming to recruit 240 participants from UK cardiac surgery centres to
either sham cardioplegia supplementation, low dose (6 microg/ml) or high
dose (12 microg/ml) propofol cardioplegia supplementation. The primary
outcome is cardiac-specific troponin T levels (a biomarker of cardiac
injury) measured during the first 48 h following surgery. The statistical
analysis plan describes the planned analyses of the trial primary and
secondary outcomes in detail, including approaches to deal with missing
data, multiple testing, violation of model assumptions, withdrawals from
the trial, non-adherence with the treatment and other protocol deviations.
It also outlines the planned sensitivity analyses and exploratory analyses
to be performed. <br/>Discussion(s): This manuscript prospectively
describes, prior to the completion of data collection and database lock,
the analyses to be undertaken for the ProMPT-2 trial to reduce risk of
reporting and data-driven analyses. Trial registration: ISRCTN
ISRCTN15255199. Registered on 26 March 2019.<br/>Copyright &#xa9; The
Author(s) 2024.

<96>
Accession Number
2027897619
Title
Efficacy and Safety of Ketamine-Dexmedetomidine Versus Ketamine-Propofol
Combination for Periprocedural Sedation: A Systematic Review and
Meta-analysis.
Source
Current Pain and Headache Reports. 28(4) (pp 211-227), 2024. Date of
Publication: April 2024.
Author
Elsaeidy A.S.; Ahmad A.H.M.; Kohaf N.A.; Aboutaleb A.; Kumar D.; Elsaeidy
K.S.; Mohamed O.S.; Kaye A.D.; Shehata I.M.
Institution
(Elsaeidy) Faculty of Medicine, Benha University, Benha, Egypt
(Ahmad, Shehata) Anesthesia Department, Faculty of Medicine, Ain Shams
University, Cairo, Egypt
(Kohaf) Clinical Pharmacy, Faculty of Pharmacy (Girls), Al-Azhar
University, Cairo, Egypt
(Aboutaleb) Faculty of Medicine, Zagazig University, Zagazig, Egypt
(Kumar) Dow Medical College, Dow University of Health Sciences, Karachi,
Pakistan
(Elsaeidy) Faculty of Medicine, Mansoura University, Mansoura, Egypt
(Mohamed) Critical Care Medicine, Menofia University, Shibin El Kom,
Menofia, Egypt
(Kaye) Pharmacology, Toxicology, and Neurosciences, LSU School of
Medicine, 1501 Kings Hwy, Shreveport, LA 71103, United States
(Kaye) Anesthesiology and Pharmacology, LSU School of Medicine, New
Orleans, LA, United States
(Kaye) Anesthesiology and Pharmacology, Tulane School of Medicine, New
Orleans, LA, United States
Publisher
Springer
Abstract
Purpose of Review: The combination of ketamine with propofol and
dexmedetomidine has gained popularity for sedation and general anesthesia
in different populations. In our meta-nalysis, we helped the
anesthesiologists to know the efficiency and the efficacy of both
combinations in adult and pediatric patients. <br/>Method(s): We searched
PubMed, CENTRAL, Web of Science, and Scopus from inception to August 1,
2023. Our outcome parameters for efficacy were recovery time, pain score,
and physician satisfaction while for safety were the related
cardiorespiratory, neurological, and gastrointestinal adverse events.
Recent Findings: Twenty-two trials were included with a total of 1429
patients. We found a significantly longer recovery time in the ketadex
group of 7.59 min (95% CI, 4.92, 10.26; I² = 94%) and a
significantly less pain score of - 0.72 (95% CI, - 1.10, - 0.34;
I² = 0%). Adults had a significantly better physician
satisfaction score with the ketofol group, odds ratio of 0.29 (95% CI,
0.12, 0.71; I² = 0%). Recovery agitations were higher in the
ketofol group with an odds ratio of 0.48 (95% CI, 0.24, 0.98;
I² = 36%). Furthermore, we found a significant difference
between the combinations with a higher incidence in the ketadex group with
pooled odds ratio of 1.75 (95% CI, 1.06, 2.88; I² = 15%).
<br/>Summary: Ketadex was associated with lower pain scores, hypoxic
events and airway obstruction, and emergence agitation. At the same time,
ketofol had much more clinician satisfaction which might be attributed to
the shorter recovery time and lower incidence of nausea and vomiting.
Therefore, we suppose that ketadex is the better combination in
periprocedural sedation for both adult and pediatric patients who are not
at greater risk for postoperative nausea and vomiting.<br/>Copyright
&#xa9; The Author(s) 2024.

<97>
Accession Number
2026141662
Title
Antithrombotic therapy after heart valve intervention: review of
mechanisms, evidence and current guidance.
Source
Heart. 110(2) (pp 87-93), 2023. Date of Publication: 12 Jul 2023.
Author
Cheng A.; Malkin C.; Paul Briffa N.
Institution
(Cheng, Paul Briffa) Infection Immunity and cardiovascular Disease, The
University of Sheffield, Sheffield, United Kingdom
(Cheng, Paul Briffa) Cardiothoracic Surgery, Sheffield Teaching Hospitals
NHS Foundation Trust, Sheffield, United Kingdom
(Malkin) Cardiology, Leeds Teaching Hospitals NHS Trust, Leeds, United
Kingdom
Publisher
BMJ Publishing Group
Abstract
As the population ages and treatment options for heart valve disease
increase, the number of patients with intracardiac valve prostheses is
growing rapidly. Although all devices have the potential to cause thrombus
formation, the propensity depends on the type of prosthesis as well as
risk of the individual patient. Mechanical valve prostheses carry the
highest (and persistent) risk of thromboembolism, and these patients
require anticoagulation with vitamin K antagonists (warfarin). Required
international normalised ratio levels are dependent on the location of the
valve (mitral>aortic), type of valve (ball and cage vs bilealfet vs On-X
bilealfet) and rhythm. The risk of tissue (biological) prosthesis is
highest soon after surgery and is dependent on individual patient risk
including age, valve location (mitral>aortic), history of thromboembolic
events and rhythm. In patients with no other indication for
anticoagulation, there is uncertainty on the benefits of anticoagulation
versus antiplatelet therapy in patients with tissue prostheses or repaired
native valves. Patients with an a priori indication for anticoagulation
with a direct oral anticoagulant can continue taking this class of drug.
Patients with transcatheter aortic valve implantation devices and no
additional evidence-based indication for dual antiplatelet therapy or
anticoagulation can be maintained on aspirin monotherapy. Patients
undergoing transcatheter instrumentation in the mitral valve position
should be anticoagulated, although there is currently no published
evidence for antithrombotic management in this group of patients. Patients
with thrombosed devices (commonly mitral mechanical) should preferably be
treated surgically. Patients at high risk of thromboembolism (with
mechanical prostheses) should undergo bridging therapy when undergoing
surgery.<br/>Copyright &#xa9; 2023 BMJ Publishing Group. All rights
reserved.

<98>
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. <br/>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. <br/>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). <br/>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.<br/>Copyright &#xa9; 2022 The American Association for
Thoracic Surgery

<99>
Accession Number
2026445986
Title
Cardiovascular anomalies in patients with Tessier syndrome: a systematic
review.
Source
European Journal of Pediatrics. 183(1) (pp 73-82), 2024. Date of
Publication: January 2024.
Author
Nazari S.; Vaezi A.; Mossavarali S.; Ghanavati K.; Shafiee A.
Institution
(Nazari) Pediatric Congenital Hematologic Disorders Research Center,
Research Institute for Children Health, Shahid Beheshti University of
Medical Sciences, Tehran, Iran, Islamic Republic of
(Vaezi, Mossavarali) Tehran Heart Center, Cardiovascular Diseases Research
Institute, Tehran University of Medical Sciences, Tehran, Iran, Islamic
Republic of
(Ghanavati) School of Medicine, Iran University of Medical Sciences,
Tehran, Iran, Islamic Republic of
(Shafiee) Cardiac Primary Prevention Research Center, Cardiovascular
Diseases Research Institute, Tehran University of Medical Sciences,
Tehran, Iran, Islamic Republic of
(Shafiee) Department of Cardiovascular Research, Tehran Heart Center,
North Kargar Ave., Tehran 1411713138, Iran, Islamic Republic of
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Tessier clefts are skeletal and soft tissue abnormalities of a neonate's
facial structures. They could be classified as syndromic and non-syndromic
clefts, which can be attributed to disruptions in fetal development and
genetic mutations, respectively. Reported cases of these clefts typically
document the presence of additional abnormalities associated with these
clefts. In this systematic review, we analyzed reports of Tessier clefts
accompanied by cardiovascular anomalies, as one of the commonly
encountered anomalies. We systematically searched PubMed (MEDLINE),
Scopus, Web of Science, Science Direct, and Google Scholar. We selected
and included case reports, case series, and case reviews on patients with
Tessier cleft and cardiovascular anomalies. The critical appraisal of the
included studies was performed by two independent investigators using the
Consensus-based Clinical Case Reporting Guideline Development (CARE)
checklist. Overall, 20 reports (18 case reports and 2 case series) were
eligible for inclusion in this review. Tessier clefts 3 and 30 were the
most commonly observed. In addition, the most prevalent cardiovascular
anomalies consisted of the ventricular septal defect (VSD), double-outlet
right ventricle, and atrial septal defect (ASD). Most of the patients
received cosmetic and cardiovascular surgeries. However, some were not
proper candidates for cardiovascular surgery because of their unstable
condition and therefore did not survive. <br/>Conclusion(s): Regardless of
the focus placed on the cleft and subsequent plastic surgery procedures in
these cases, it is important to prioritize other abnormalities that may be
associated with mortality. A complete cardiovascular system and associated
disorders assessment should be performed before facial cosmetic surgeries.
(Table presented.)<br/>Copyright &#xa9; The Author(s), under exclusive
licence to Springer-Verlag GmbH Germany, part of Springer Nature 2023.

<100>
Accession Number
2031135889
Title
Bartonella quintana Endocarditis: A Systematic Review of Individual Cases.
Source
Clinical Infectious Diseases. 78(3) (pp 554-561), 2024. Date of
Publication: 15 Mar 2024.
Author
Boodman C.; Gupta N.; Nelson C.A.; van Griensven J.
Institution
(Boodman) Division of Infectious Diseases, Department of Internal
Medicine, University of Manitoba, Winnipeg, MB, Canada
(Boodman, van Griensven) Unit of HIV and Neglected Tropical Diseases,
Institute of Tropical Medicine, Antwerp, Belgium
(Gupta) Department of Infectious Disease, Kasturba Medical College,
Manipal Academy of Higher Education, Manipal, India
(Nelson) Division of Vector-Borne Diseases, Centers for Disease Control
and Prevention, Fort Collins, CO, United States
Publisher
Oxford University Press
Abstract
Background. Bartonella quintana is a louse-borne bacterium that remains a
neglected cause of endocarditis in low-resource settings. Our
understanding of risk factors, clinical manifestations, and treatment of
B. quintana endocarditis are biased by older studies from high-income
countries. Methods. We searched Pubmed Central, Medline, Scopus, Embase,
EBSCO (CABI) Global Health, Web of Science and international trial
registers for articles published before March 2023 with terms related to
Bartonella quintana endocarditis. We included articles containing
case-level information on B. quintana endocarditis and extracted data
related to patient demographics, clinical features, diagnostic testing,
treatment, and outcome. Results. A total of 975 records were identified,
of which 569 duplicates were removed prior to screening. In total, 84
articles were eligible for inclusion, describing a total of 167 cases.
Infections were acquired in 40 different countries; 62 cases (37.1%) were
acquired in low- and middle-income countries (LMICs). Disproportionately
more female and pediatric patients were from LMICs. More patients
presented with heart failure (n = 70/167 [41.9%]) than fever (n = 65/167
[38.9%]). Mean time from symptom onset to presentation was 5.1 months.
Also, 25.7% of cases (n = 43/167) were associated with embolization, most
commonly to the spleen and brain; 65.5% of antimicrobial regimens included
doxycycline. The vast majority of cases underwent valve replacement
surgery (n = 154/167, [98.0%]). Overall case fatality rate was 9.6% (n =
16/167). Conclusions. B. quintana endocarditis has a global distribution,
and long delays between symptom onset and presentation frequently occur.
Improved clinician education and diagnostic capacity are needed to screen
at-risk populations and identify infection before endocarditis
develops.<br/>Copyright &#xa9; The Author(s) 2023. Published by Oxford
University Press on behalf of Infectious Diseases Society of America. All
rights reserved.

<101>
Accession Number
2029076323
Title
Overcoming barriers for left atrial appendage thrombus: a systematic
review of left atrial appendage closure.
Source
BMC Cardiovascular Disorders. 24(1) (no pagination), 2024. Article Number:
175. Date of Publication: December 2024.
Author
Zhang Z.; Zhou J.; Lin Q.; Wang C.; Huang Y.; Dai Y.; Zuo W.; Liu N.; Xiao
Y.; Liu Q.
Institution
(Zhang, Zhou, Lin, Huang, Liu, Xiao, Liu) Department of Cardiovascular
Medicine, The Second Xiangya Hospital, Central South University, 139
Renmin Road, Furong District, Hunan Province, Changsha 410011, China
(Wang) Department of Metabolic Endocrinology, The Second Xiangya Hospital,
Central South University, Hunan Province, Changsha 410011, China
(Dai) Department of Pharmacology, Wuhan University TaiKang Medical School
(School of Basic Medical Sciences), Hubei Province, Wuhan 430071, China
(Zuo) Department of Hematology, The Second Xiangya Hospital, Central South
University, Hunan Province, Changsha 410011, China
Publisher
BioMed Central Ltd
Abstract
Background: Approximately 90% of intracardial thrombi originate from the
left atrial appendage in non-valvular atrial fibrillation patients. Even
with anticoagulant therapy, left atrial appendage thrombus (LAAT) still
occurs in 8% of patients. While left atrial appendage closure (LAAC) could
be a promising alternative, the current consensus considers LAAT a
contraindication to LAAC. However, the feasibility and safety of LAAC in
patients with LAAT have yet to be determined. <br/>Method(s): This
systematic review synthesizes published data to explore the feasibility
and safety of LAAC for patients with LAAT. <br/>Result(s): This study
included a total of 136 patients with LAATs who underwent successful LAAC.
The Amulet Amplatzer device was the most frequently utilized device
(48.5%). Among these patients, 77 (56.6%) had absolute contraindications
to anticoagulation therapy. Cerebral protection devices were utilized by
47 patients (34.6%). Transesophageal echocardiography (TEE) is the primary
imaging technique used during the procedure. Warfarin and novel oral
anticoagulants were the main anticoagulant medications used prior to the
procedure, while dual antiplatelet therapy was primarily used
post-procedure. During a mean follow-up period of 13.2 +/- 11.5 months,
there was 1 case of fatality, 1 case of stroke, 3 major bleeding events, 3
instances of device-related thrombus, and 8 cases of peri-device leakage.
<br/>Conclusion(s): This review highlights the preliminary effectiveness
and safety of the LAAC procedure in patients with persistent LAAT. Future
large-scale RCTs with varied LAAT characteristics and LAAC device types
are essential for evidence-based decision-making in clinical
practice.<br/>Copyright &#xa9; The Author(s) 2024.

<102>
Accession Number
2031106937
Title
Multimodal Opioid-Free Anesthesia Versus Opioid-Based Anesthesia for
Patients Undergoing Cardiac Valve Surgeries: A Randomized Controlled
Trial.
Source
Bali Journal of Anesthesiology. 8(1) (pp 33-39), 2024. Date of
Publication: 01 Jan 2024.
Author
Elgendy M.; El-Ashmawi H.; Said A.; Mortada A.; Soliman D.
Institution
(Elgendy, El-Ashmawi, Said, Mortada, Soliman) Department of Anesthesia,
Surgical Intensive Care, and Pain Management, Faculty of Medicine, Cairo
University, Cairo, Egypt
Publisher
Wolters Kluwer Medknow Publications
Abstract
Background: Opioid-based anesthesia (OA) is the cornerstone of cardiac
anesthesia. <br/>Objective(s): The aim of this study was to assess safety
and efficacy of multimodal opioid-free anesthesia (OFA) regimen as an
alternative to the conventional OA regimen in adult patients undergoing
cardiac valve surgeries. <br/>Material(s) and Method(s): A total of 60
patients were randomly assigned to two groups: group F (received OFA) and
group O (received OA). Group F received oral pregabalin plus intravenous
(IV) infusion of ketorolac, acetaminophen, dexmedetomidine, and lidocaine
preoperatively. Lidocaine and dexmedetomidine were continuously infused
throughout the procedure. In group O, patients received placebo in the
form of oral pills plus IV infusion of normal saline preoperatively. After
anesthesia induction, group F received a bolus dose of ketamine, whereas
group O received fentanyl. The study outcomes were extubation time,
arterial blood pressure (systolic, diastolic, and mean), heart rate (HR),
visual analog scale (VAS), length of intensive care unit (ICU) stay,
postoperative morphine consumption, and postoperative complications.
<br/>Result(s): Extubation time was significantly shorter in the group F
[4.5 (3-6) vs. 10 (8-12), P < 0.001]. The VAS over 24 h was also lower in
group F [2 (0-3) vs. 3 (3-3.5), P < 0.001]. Furthermore, OFA was
associated with significantly lower postoperative morphine intake, shorter
stays in the ICU, and lower intraoperative HR and mean arterial pressure.
<br/>Conclusion(s): In valve surgeries, a multimodal OFA regimen might be
a good substitute for the standard opioid-based regimen. In addition, OFA
can have the added benefit of a more rapid recovery and a shorter ICU
stay, making it more feasible to be considered in patients with a history
of previous opioid addiction or Parkinsonian patients.<br/>Copyright
&#xa9; 2024 Bali Journal of Anesthesiology <br/> Published by Wolters
Kluwer - Medknow.

<103>
Accession Number
2031106936
Title
A Randomized Controlled Study of the Effect of Perioperative Pregabalin in
Acute and Chronic Pain in Postoperative Patients of Off-Pump Coronary
Artery Bypass Grafting.
Source
Bali Journal of Anesthesiology. 8(1) (pp 26-32), 2024. Date of
Publication: 01 Jan 2024.
Author
Singh G.; Patel R.; Arora V.; Pandya H.
Institution
(Singh, Patel, Arora, Pandya) Department of Cardiac Anaesthesia, U. N.
Mehta Institute of Cardiology and Research Center, Asarwa, Gujarat,
Ahmadabad, India
Publisher
Wolters Kluwer Medknow Publications
Abstract
Background: This study evaluates the efficacy of perioperative pregabalin
in reducing acute and chronic postoperative pain and opioid consumption in
patients undergoing off-pump coronary artery bypass grafting (OPCABG).
<br/>Material(s) and Method(s): A total of 150 patients, aged 30-70 years
underwent elective OPCABG and were randomized into two groups of 75.
Patients in Group P received 150 mg of pregabalin 2 h before induction of
anesthesia and were given pregabalin 75 mg every 12 h for two
postoperative days. Patients in Group C received a placebo at similar time
intervals. Recorded outcome variables were the Visual Analog Scale (VAS)
at rest and during deep breathing from the postoperative period until 3
months after hospital discharge. The time to extubation, hemodynamic
parameters, and episodes of breakthrough pain till 48 h were also noted.
<br/>Result(s): VAS during rest and on deep breathing were significantly
less in group P compared with group C from extubation up to 48 h
postoperative. The difference in VAS at rest between both the groups was
also significant at 1 month (0.32 +/- 0.46 vs. 0.56 +/- 0.49, P = 0.003)
but was insignificant at 3 months (0.10 +/- 0.31 vs. 0.13 +/- 0.34, P =
0.618). The sedation score was comparable in both groups.
<br/>Conclusion(s): Perioperative pregabalin reduces the pain scores at
rest and on deep breathing in patients undergoing elective OPCABG up to 72
h postsurgery. Furthermore, the significance was still showing at 1-month
postsurgery but diminished at 3-month postsurgery.<br/>Copyright &#xa9;
2024 Bali Journal of Anesthesiology <br/> Published by Wolters Kluwer -
Medknow.

<104>
Accession Number
2030998603
Title
Surgical training of minimally invasive mitral valve repair on a
patient-specific simulator improves surgical skills.
Source
European Journal of Cardio-thoracic Surgery. 65(3) (no pagination), 2024.
Article Number: ezad387. Date of Publication: 01 Mar 2024.
Author
Wang C.; Karl R.; Sharan L.; Grizelj A.; Fischer S.; Karck M.; De Simone
R.; Romano G.; Engelhardt S.
Institution
(Wang, Karl, Sharan, Grizelj, Fischer, Karck, De Simone, Romano,
Engelhardt) University Hospital Heidelberg, Department of Cardiac Surgery,
Heidelberg, Germany
(Karl, Sharan, Engelhardt) University Hospital Heidelberg, Department of
Internal Medicine III, Heidelberg, Germany
Publisher
European Association for Cardio-Thoracic Surgery
Abstract
OBJECTIVES: Minimally invasive mitral valve repair (MVR) is considered one
of the most challenging operations in cardiac surgery and requires much
practice and experience. Simulation-based surgical training might be a
method to support the learning process and help to flatten the steep
learning curve of novices. The purpose of this study was to show the
possible effects on learning of surgical training using a high-fidelity
simulator with patient-specific mitral valve replicas. <br/>METHOD(S):
Twenty-five participants were recruited to perform MVR on anatomically
realistic valve models during different training sessions. After every
session their performance was evaluated by a surgical expert regarding
accuracy and duration for each step. A second blinded rater similarly
assessed the performance after the study. Through repeated documentation
of those parameters, their progress in learning was analysed, and gains in
proficiency were evaluated. <br/>RESULT(S): Participants showed
significant performance enhancements in terms of both accuracy and time.
Their surgical skills showed sizeable improvements after only 1 session.
For example, the time to implant neo-chordae decreased by 24.64% (354
s-264 s, P < 0.001) and the time for annuloplasty by 4.01% (54 s-50 s, P =
0.165), whereas the number of irregular stitches for annuloplasty
decreased from 52% to 24%. The significance of simulation-based surgical
training as a tool for acquiring and training surgical skills was reviewed
positively. <br/>CONCLUSION(S): The results of this study indicate that
simulation-based surgical training is a valuable and effective method for
learning reconstructive techniques of minimally invasive MVR and overall
general dexterity. The novel learning and training options should be
implemented in the surgical traineeship for systematic teaching of various
surgical skills.<br/>Copyright # The Author(s) 2023.

<105>
Accession Number
2030749857
Title
Incidence, Predictors, and Impact of Hospital Readmission After
Revascularization for Left Main Coronary Disease.
Source
Journal of the American College of Cardiology. 83(11) (pp 1073-1081),
2024. Date of Publication: 19 Mar 2024.
Author
Kosmidou I.; Shahim B.; Dressler O.; Redfors B.; Morice M.-C.; Puskas
J.D.; Kandzari D.E.; Karmpaliotis D.; Brown W.M.; Lembo N.J.; Banning
A.P.; Kappetein A.P.; Serruys P.W.; Sabik J.F.; Stone G.W.
Institution
(Kosmidou, Lembo) Memorial Sloan Kettering Cancer Center, New York and
Weill Cornell College of Medicine, New York, NY, United States
(Kosmidou, Shahim, Dressler, Redfors, Lembo) Clinical Trials Center,
Cardiovascular Research Foundation, New York, NY, United States
(Redfors) Department of Cardiology, Sahlgrenska University Hospital,
Gothenburg, Sweden
(Morice) Hopital prive Jacques Cartier, Ramsay Generale de Sante, Massy,
France
(Puskas) Mount Sinai Heart at Mount Sinai Saint Luke's, New York, NY,
United States
(Kandzari, Brown) Piedmont Heart Institute, Atlanta, GA, United States
(Karmpaliotis) Gagnon Cardiovascular Institute, Morristown Medical Center,
Morristown, NJ, United States
(Banning) John Radcliffe Hospital, Oxford, United Kingdom
(Kappetein) Thoraxcenter, Erasmus MC, Rotterdam, Netherlands
(Serruys) Department of Cardiology, NUIG, National University of Ireland,
Galway, Ireland
(Serruys) Imperial College of Science, Technology and Medicine, London,
United Kingdom
(Sabik) Department of Surgery, UH Cleveland Medical Center, Cleveland, OH,
United States
(Stone) The Zena and Michael A. Wiener Cardiovascular Institute, Icahn
School of Medicine at Mount Sinai, New York, NY, United States
Publisher
Elsevier Inc.
Abstract
Background: The frequency of and relationship between hospital
readmissions and outcomes after revascularization for left main coronary
artery disease (LMCAD) are unknown. <br/>Objective(s): The purpose of this
study was to study the incidence, predictors, and clinical impact of
readmissions following percutaneous coronary intervention (PCI) and
coronary artery bypass grafting (CABG) for LMCAD. <br/>Method(s): In the
EXCEL (XIENCE Versus Coronary Artery Bypass Surgery for Effectiveness of
Left Main Revascularization) trial, 1,905 patients with LMCAD were
randomized to PCI vs CABG. The cumulative incidence of readmissions was
analyzed with multivariable Anderson-Gill and joint frailty models to
account for recurrent events and the competing risk of death. The impact
of readmission on subsequent mortality within 5-year follow-up was
determined in a time-adjusted Cox proportional hazards model.
<br/>Result(s): Within 5 years, 1,868 readmissions occurred in 851 of
1,882 (45.2%) hospital survivors (2.2 +/- 1.9 per patient with
readmission[s], range 1-16), approximately one-half for cardiovascular
causes and one-half for noncardiovascular causes (927 [49.6%] and 941
[50.4%], respectively). One or more readmissions occurred in 463 of 942
(48.6%) PCI patients vs 388 of 940 (41.8%) CABG patients (P = 0.003).
After multivariable adjustment, PCI remained an independent predictor of
readmission (adjusted HR: 1.22; 95% CI: 1.10-1.35; P < 0.0001), along with
female sex, comorbidities, and the extent of CAD. Readmission was
independently associated with subsequent all-cause death, with interaction
testing indicating a higher risk after PCI than CABG (adjusted HR: 5.72;
95% CI: 3.42-9.55 vs adjusted HR: 2.72; 95% CI: 1.64-4.88, respectively;
P<inf>int</inf> = 0.03). <br/>Conclusion(s): In the EXCEL trial,
readmissions during 5-year follow-up after revascularization for LMCAD
were common and more frequent after PCI than CABG. Readmissions were
associated with an increased risk of all-cause death, more so after PCI
than with CABG.<br/>Copyright &#xa9; 2024 American College of Cardiology
Foundation

<106>
Accession Number
2030259898
Title
Wearable heart rate variability and atrial fibrillation monitoring to
improve clinically relevant endpoints in cardiac surgery -a systematic
review.
Source
mHealth. 10 (no pagination), 2024. Article Number: 8. Date of Publication:
30 Jan 2024.
Author
Zillner L.; Andreas M.; Mach M.
Institution
(Zillner, Andreas, Mach) Department of Cardiac Surgery, Medical University
of Vienna, Vienna, Austria
(Mach) Department of Cardiac Surgery, Medical University of Vienna,
Wahringer Gurtel 18-20, Vienna 1090, Austria
Publisher
AME Publishing Company
Abstract
Background: This systematic review aims to highlight the untapped
potential of heart rate variability (HRV) and atrial fibrillation (AF)
monitoring by wearable health monitoring devices as a critical diagnostic
tool in cardiac surgery (CS) patients. We reviewed established predictive
capabilities of HRV and AF monitoring in specific cardiosurgical scenarios
and provide a perspective on additional predictive properties of wearable
health monitoring devices that need to be investigated. <br/>Method(s):
After screening most relevant databases, we included 33 publications in
this review. Perusing these publications on HRV's prognostic value, we
could identify HRV as a predictor for sudden cardiac death, mortality
after acute myocardial infarction (AMI), and post operative atrial
fibrillation (POAF). With regards to standard AF assessment, which
typically includes extensive periods of unrecorded cardiac activity, we
demonstrated that continuous monitoring via wearables recorded significant
cardiac events that would otherwise have been missed. <br/>Result(s):
Photoplethysmography and single-lead electrocardiogram (ECG) were
identified as the most useful and convenient technical assessment
modalities, and their advantages and disadvantages were described in
detail. As a call to further action, we observed that the scientific
community has relatively extensively explored wearable AF screening,
whereas HRV assessment to improve relevant clinical outcomes in CS is
rarely studied; it still has great potential to be leveraged.
<br/>Conclusion(s): Therefore, risk assessment in CS would benefit greatly
from earlier preoperative and postoperative AF detection, comprehensive
and accurate assessment of cardiac health through HRV metrics, and
continuous long-term monitoring. These should be achievable via
commercially available wearables.<br/>Copyright &#xa9; mHealth. All rights
reserved.

<107>
Accession Number
2028685026
Title
Comparison between a Novel Radiofrequency-Balloon and a Standard
Cryo-Balloon in Pulmonary Vein Isolation: A Propensity-Score-Matched
Analysis.
Source
Journal of Clinical Medicine. 13(4) (no pagination), 2024. Article Number:
963. Date of Publication: February 2024.
Author
Teumer Y.; Miesbichler C.; Katov L.; Mayer B.; Rottbauer W.; Bothner C.;
Weinmann K.
Institution
(Teumer, Miesbichler, Katov, Rottbauer, Bothner, Weinmann) Department of
Cardiology, Ulm University Heart Center, Albert-Einstein-Allee 23, Ulm
89081, Germany
(Mayer) Institute for Epidemiology and Medical Biometry, Ulm University,
Schwabstrase 13, Ulm 89075, Germany
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Background/Objectives: Single-shot devices are important tools for
efficient pulmonary vein isolation (PVI) in atrial fibrillation (AF). In
addition to the standard cryo-balloon (CB) catheter, a novel
multi-electrode radiofrequency balloon-catheter (RFB, Heliostar, Biosense
Webster, Irvine, CA, USA) with 3D-mapping-integration is available.
Currently, there is no evidence allowing for a direct comparison between
RFB-PVI and CB-PVI in a matched population. The study aimed to assess the
procedural data, safety profiles, and outcomes of RFB-PVI versus CB-PVI.
<br/>Method(s): In this prospective registry study, symptomatic AF
patients undergoing first-time PVI from January 2019 to April 2023, using
RFB or CB, were included, with patients matched in a 1:2 ratio to reduce
potential confounders. <br/>Result(s): The results from 171 consecutive
RFB patients and 342 matched CB patients showed comparable recurrence-free
survival after 12 months (81.3% RFB vs. 76.8% CB, p = 0.359). The RFB
group had a longer procedure duration (88 vs. 73 min, p < 0.001) and
longer fluoroscopy time (18.9 vs. 14.5 min, p < 0.001).
<br/>Conclusion(s): In conclusion, the novel RFB system enables efficient
and safe PVI, which is broadly comparable to the established CB system.
However, the 3D-mapping integration in RFB did not reduce fluoroscopy time
compared to CB.<br/>Copyright &#xa9; 2024 by the authors.

<108>
Accession Number
2028242122
Title
Role of Cognitive Frailty in Older Adults With Cardiovascular Disease.
Source
Journal of the American Heart Association. 13(4) (no pagination), 2024.
Article Number: e033594. Date of Publication: 20 Feb 2024.
Author
Ijaz N.; Jamil Y.; Brown C.H.; Krishnaswami A.; Orkaby A.; Stimmel M.B.;
Gerstenblith G.; Nanna M.G.; Damluji A.A.
Institution
(Ijaz) Thomas Jefferson University Hospital, Philadelphia, PA, United
States
(Jamil, Nanna) Yale University School of Medicine, New Haven, CT, United
States
(Brown, Gerstenblith, Damluji) Johns Hopkins University School of
Medicine, Baltimore, MD, United States
(Krishnaswami) Kaiser Permanente, San Jose, CA, United States
(Orkaby) New England GRECC, VA Boston Healthcare System, Boston, MA,
United States
(Orkaby) Division of Aging, Brigham & Women's Hospital, Harvard Medical
School, Boston, MA, United States
(Stimmel) Montefiore Medical Center, Bronx, NY, United States
(Damluji) The Inova Center of Outcomes Research, Inova Heart and Vascular
Institute, Falls Church, VA, United States
Publisher
American Heart Association Inc.
Abstract
As the older adult population expands, an increasing number of patients
affected by geriatric syndromes are seen by cardiovascular clinicians. One
such syndrome that has been associated with poor outcomes is cognitive
frailty: the simultaneous presence of cognitive impairment, without
evidence of dementia, and physical frailty, which results in decreased
cognitive reserve. Driven by common pathophysiologic underpinnings (eg,
inflammation and neurohormonal dysregulation), cardiovascular disease,
cognitive impairment, and frailty also share the following risk factors:
hypertension, diabetes, obe-sity, sedentary behavior, and tobacco use.
Cardiovascular disease has been associated with the onset and progression
of cognitive frailty, which may be reversible in early stages, making it
essential for clinicians to diagnose the condition in a timely manner and
prescribe appropriate interventions. Additional research is required to
elucidate the mechanisms underlying the development of cognitive frailty,
establish preventive and therapeutic strategies to address the needs of
older patients with cardiovascular disease at risk for cognitive frailty,
and ultimately facilitate targeted intervention studies.<br/>Copyright
&#xa9; 2024 The Authors.

<109>
Accession Number
2025921921
Title
Safety and efficacy of tenecteplase versus alteplase in stroke patients
with carotid tandem lesions: Results from the AcT trial.
Source
International Journal of Stroke. 19(3) (pp 322-330), 2024. Date of
Publication: March 2024.
Author
Bala F.; Almekhlafi M.; Singh N.; Alhabli I.; Ademola A.; Coutts S.B.;
Deschaintre Y.; Khosravani H.; Appireddy R.; Moreau F.; Phillips S.;
Gubitz G.; Tkach A.; Catanese L.; Dowlatshahi D.; Medvedev G.; Mandzia J.;
Pikula A.; Shankar J.; Williams H.; Field T.S.; Manosalva A.; Siddiqui M.;
Zafar A.; Imoukhoude O.; Hunter G.; Benali F.; Horn M.; Hill M.D.; Shamy
M.; Sajobi T.T.; Buck B.H.; Swartz R.H.; Menon B.K.; Poppe A.Y.
Institution
(Bala, Almekhlafi, Singh, Alhabli, Ademola, Coutts, Benali, Horn, Hill,
Sajobi, Menon) Department of Clinical Neurosciences, University of
Calgary, Calgary, AB, Canada
(Bala) Diagnostic and Interventional Neuroradiology Department, University
Hospital of Tours, Tours, France
(Singh) Rady Faculty of Health Sciences, University of Manitoba, Winnipeg,
MB, Canada
(Deschaintre, Poppe) Centre Hospitalier de l'Universite de Montreal
(CHUM), Montreal, QC, Canada
(Khosravani, Swartz) Sunnybrook Health Sciences Centre, University of
Toronto, Toronto, ON, Canada
(Appireddy) Division of Neurology, Department of Medicine, Queen's
University, Kingston, ON, Canada
(Moreau) Universite de Sherbrooke, Sherbrooke, QC, Canada
(Phillips, Gubitz) Queen Elizabeth II Health Sciences Centre, Halifax, NS,
Canada
(Tkach) Kelowna General Hospital, Kelowna, BC, Canada
(Catanese) Hamilton Health Sciences, McMaster University, Hamilton, ON,
Canada
(Dowlatshahi, Shamy) Department of Medicine, University of Ottawa, Ottawa,
ON, Canada
(Medvedev) The University of British Columbia, Vancouver, BC, Canada
(Medvedev) Fraser Health Authority, New Westminster, BC, Canada
(Mandzia) London Health Sciences Centre, Western University, London, ON,
Canada
(Pikula) Toronto Western Hospital, University of Toronto, Toronto, ON,
Canada
(Shankar) University of Manitoba, Winnipeg, MB, Canada
(Williams) Queen Elizabeth Hospital, Charlottetown, PE, Canada
(Field) Vancouver Stroke Program, Division of Neurology, The University of
British Columbia, Vancouver, BC, Canada
(Manosalva) Medicine Hat Regional Hospital, Medicine Hat, AB, Canada
(Siddiqui) Grey Nuns Community Hospital, Edmonton, AB, Canada
(Zafar) St. Michael's Hospital, Toronto, ON, Canada
(Imoukhoude) Red Deer Regional Hospital Centre, Red Deer, AB, Canada
(Hunter) University of Saskatchewan, Saskatoon, SK, Canada
(Buck) Division of Neurology, Department of Medicine, University of
Alberta, Edmonton, AB, Canada
Publisher
SAGE Publications Inc.
Abstract
Background: Carotid tandem lesions ((TL) 70% stenosis or occlusion)
account for 15-20% of acute stroke with large vessel occlusion.
<br/>Aim(s): We investigated the safety and efficacy of intravenous
tenecteplase (0.25 mg/kg) versus intravenous alteplase (0.9 mg/kg) in
patients with carotid TL. <br/>Method(s): This is a substudy of the
alteplase compared with the tenecteplase trial. Patients with 70% stenosis
of the extracranial internal carotid artery (ICA) and concomitant
occlusion of the intracranial ICA, M1 or M2 segments of the middle
cerebral artery on baseline computed tomography angiography (CTA) were
included. Primary outcome was 90-day-modified Rankin Scale (mRS) 0-1.
Secondary outcomes were mRS 0-2, mortality, and symptomatic ICH (sICH).
Angiographic outcomes were successful recanalization (revised Arterial
Occlusive Lesion (rAOL) 2b-3) on first and successful reperfusion (eTICI
2b-3) on final angiographic acquisitions. Multivariable mixed-effects
logistic regression was performed. <br/>Result(s): Among 1577 alteplase
versus tenecteplase randomized controlled trial (AcT) patients, 128
(18.8%) had carotid TL. Of these, 93 (72.7%) underwent intravenous
thrombolysis plus endovascular thrombectomy (IVT + EVT), while 35 (27.3%)
were treated with IVT alone. In the IVT + EVT group, tenecteplase was
associated with higher odds of 90-day-mRS 0-1 (46.0% vs. 32.6%, adjusted
OR (aOR) 3.21; 95% CI = 1.06-9.71) compared with alteplase. No
statistically significant differences in rates of mRS 0-2 (aOR 1.53; 95%
CI = 0.51-4.55), initial rAOL 2b-3 (16.3% vs. 28.6%), final eTICI 2b-3
(83.7% vs. 85.7%), and mortality (18.0% vs. 16.3%) were found. SICH only
occurred in one patient. There were no differences in outcomes between
thrombolytic agents in the IVT-only group. <br/>Conclusion(s): In patients
with carotid TL treated with EVT, intravenous tenecteplase may be
associated with similar or better clinical outcomes, similar angiographic
reperfusion rates, and safety outcomes as compared with
alteplase.<br/>Copyright &#xa9; 2023 World Stroke Organization.

<110>
Accession Number
2020509523
Title
Should moderate ischemic mitral regurgitation be corrected during coronary
artery bypass grafting? a systematic review and meta-analysis.
Source
Perfusion (United Kingdom). 39(2) (pp 373-381), 2024. Date of Publication:
March 2024.
Author
Wu H.; Zhang W.
Institution
(Wu, Zhang) Department of Cardiothoracic Surgery, Changzhi People's
Hospital, Changzhi, China
Publisher
SAGE Publications Ltd
Abstract
Objective: Ischemic mitral regurgitation (IMR) is associated with
increased risks of mortality and heart failure. However, the optimal
management of moderate IMR remains controversial. We conducted a
meta-analysis to appraise whether moderate IMR should be corrected during
coronary artery bypass grafting (CABG). <br/>Method(s): We searched
PubMed, Embase, and Cochrane databases from its inception up to 15 October
2022 for studies that assessed CABG alone versus CABG with mitral valve
(MV) surgery in patients with moderate IMR. The primary outcome was
perioperative mortality. <br/>Result(s): Four randomized controlled trials
and three observational studies with propensity-matched data including
1209 patients assessing CABG alone (n = 598) versus CABG with MV surgery
(n = 611) were included. Compared to CABG alone, the addition of MV
surgery did not significantly increase perioperative mortality (RR, 1.01;
95% CI, 0.52-1.96; p = 0.98) and stroke (RR, 2.14; 95% CI, 0.97-4.72; p =
0.06), whereas a longer cardiopulmonary bypass duration (MD, 54.91; 95%
CI, 42.13-67.68; p < 0.01) and an increased incidence of renal failure
were observed in the combined-procedure group. At follow-up, the addition
of MV surgery was significantly associated with reduced rates of residual
MR (RR, 0.26; 95% CI, 0.13-0.51; p < 0.01) and NYHA class III-IV (RR,
0.54; 95% CI, 0.37-0.78; p < 0.01). However, there was no difference in
either mid-term mortality (RR, 1.05; 95% CI, 0.65-1.70; p = 0.82) or late
mortality (RR, 91; 95% CI, 0.49-1.71; p = 0.78) between the CABG alone
group and the combined-procedure group. <br/>Conclusion(s): In patients
with moderate IMR, the addition of MV surgery to CABG did not increase
perioperative mortality. Despite the reduced rates of moderate MR and NYHA
class III-IV at follow-up, the addition of MV surgery did not translate in
a reduction in mid-term or late mortality.<br/>Copyright &#xa9; The
Author(s) 2022.

<111>
Accession Number
2020215914
Title
Preoperative ultrasound-guided bilateral thoracic erector spinae plane
block within an enhanced recovery program is associated with decreased
intraoperative lactate levels in cardiac surgery.
Source
Perfusion (United Kingdom). 39(2) (pp 324-333), 2024. Date of Publication:
March 2024.
Author
Demir A.Z.; Ozgok A.; Balci E.; Karaca O.G.; Simsek E.; Gunaydin S.
Institution
(Demir, Ozgok, Balci) Anesthesiology Department, The University of Health
Sciences, Ankara City Hospital, Ankara, Turkey
(Karaca, Simsek, Gunaydin) Cardiovascular Surgery Department, The
University of Health Sciences, Ankara City Hospital, Ankara, Turkey
Publisher
SAGE Publications Ltd
Abstract
Introduction: In the perioperative period, regional analgesia techniques
may play an increasingly important role in "Enhanced Recovery After
Surgery (ERAS)" programs, as they can facilitate recovery. We hypothesized
that Erector Spinae Plane (ESP) block could improve regional perfusion,
thereby limiting blood lactate increase. Therefore, we aimed to evaluate
the effect of ESP block on intraoperative blood lactate levels in patients
scheduled for elective on-pump cardiac surgery with ERAS protocol.
<br/>Method(s): A total of 68 adult patients scheduled for on-pump cardiac
surgery were included. All patients were randomized to the ESP group and
the non-ESP group. Blood lactate analyses were performed at intraoperative
five-time points. C-Reactive protein (CRP) values were also measured.
<br/>Result(s): Blood lactate values were significantly lower in the ESP
group than in the Non-ESP group, at the end of CPB [1.78 (1.23-2.78) mmol
L^-1 to 2.63 (1.70-3.12) mmol L^-1] and during the
sternal closure period [1.78 (1.27-2.42) mmol L^-1 to 2.40
(2.14-2.80) mmol L^-1] (p = 0.039, p = 0.009). In addition, CRP
values were significantly lower in the ESP group in the postoperative
period [0.048 (0.036-0.105) g L^-1 to 0.090 (0.049-0.154) g
L^-1] (p = 0.035). <br/>Conclusion(s): This study showed that
preoperative bilateral single-shot ESP block significantly reduces
intraoperative final blood lactate and postoperative CRP values. We
consider that these results are related to the attenuation of
intraoperative hypoperfusion and the alleviation of surgery-related
postoperative inflammation. ERAS programs aim to achieve the rapid
recovery of patients, a decrease in inflammation, and high-quality
analgesia with less opioid consumption. Therefore, our results also prove
that it is easier to reach the primary goals of ERAS programs with the
application of ESP block in cardiac surgery.<br/>Copyright &#xa9; The
Author(s) 2022.

<112>
Accession Number
2031053935
Title
Video Laryngoscopy vs Direct Laryngoscopy for Endotracheal Intubation in
the Operating Room: A Cluster Randomized Clinical Trial.
Source
JAMA. (no pagination), 2024. Date of Publication: 2024.
Author
Ruetzler K.; Bustamante S.; Schmidt M.T.; Almonacid-Cardenas F.; Duncan
A.; Bauer A.; Turan A.; Skubas N.J.; Sessler D.I.
Institution
(Ruetzler, Schmidt, Almonacid-Cardenas, Duncan, Turan, Sessler) Outcomes
Research Consortium, Department of Anesthesiology, Cleveland Clinic,
Cleveland, OH, United States
(Ruetzler, Turan) Division of Multi-Specialty Anesthesiology, Department
of Anesthesiology, Cleveland Clinic, Cleveland, OH, United States
(Bustamante, Duncan, Bauer, Skubas) Division of Cardiothoracic
Anesthesiology, Department of Anesthesiology, Cleveland Clinic, Cleveland,
OH, United States
Publisher
American Medical Association
Abstract
Importance: Endotracheal tubes are typically inserted in the operating
room using direct laryngoscopy. Video laryngoscopy has been reported to
improve airway visualization; however, whether improved visualization
reduces intubation attempts in surgical patients is unclear.
<br/>Objective(s): To determine whether the number of intubation attempts
per surgical procedure is lower when initial laryngoscopy is performed
using video laryngoscopy or direct laryngoscopy. <br/>Design, Setting, and
Participant(s): Cluster randomized multiple crossover clinical trial
conducted at a single US academic hospital. Patients were adults aged 18
years or older having elective or emergent cardiac, thoracic, or vascular
surgical procedures who required single-lumen endotracheal intubation for
general anesthesia. Patients were enrolled from March 30, 2021, to
December 31, 2022. Data analysis was based on intention to treat.
<br/>Intervention(s): Two sets of 11 operating rooms were randomized on a
1-week basis to perform hyperangulated video laryngoscopy or direct
laryngoscopy for the initial intubation attempt. <br/>Main Outcomes and
Measures: The primary outcome was the number of operating room intubation
attempts per surgical procedure. Secondary outcomes were intubation
failure, defined as the responsible clinician switching to an alternative
laryngoscopy device for any reason at any time, or by more than 3
intubation attempts, and a composite of airway and dental injuries.
<br/>Result(s): Among 8429 surgical procedures in 7736 patients, the
median patient age was 66 (IQR, 56-73) years, 35% (2950) were women, and
85% (7135) had elective surgical procedures. More than 1 intubation
attempt was required in 77 of 4413 surgical procedures (1.7%) randomized
to receive video laryngoscopy vs 306 of 4016 surgical procedures (7.6%)
randomized to receive direct laryngoscopy, with an estimated proportional
odds ratio for the number of intubation attempts of 0.20 (95% CI,
0.14-0.28; P <.001). Intubation failure occurred in 12 of 4413 surgical
procedures (0.27%) using video laryngoscopy vs 161 of 4016 surgical
procedures (4.0%) using direct laryngoscopy (relative risk, 0.06; 95% CI,
0.03-0.14; P <.001) with an unadjusted absolute risk difference of -3.7%
(95% CI, -4.4% to -3.2%). Airway and dental injuries did not differ
significantly between video laryngoscopy (41 injuries [0.93%]) vs direct
laryngoscopy (42 injuries [1.1%]). Conclusion and Relevance: In this study
among adults having surgical procedures who required single-lumen
endotracheal intubation for general anesthesia, hyperangulated video
laryngoscopy decreased the number of attempts needed to achieve
endotracheal intubation compared with direct laryngoscopy at a single
academic medical center in the US. Results suggest that video laryngoscopy
may be a preferable approach for intubating patients undergoing surgical
procedures. Trial Registration: ClinicalTrials.gov Identifier:
NCT04701762.<br/>Copyright &#xa9; 2024 American Medical Association. All
rights reserved.

<113>
Accession Number
2029904499
Title
Impact of Bempedoic Acid on Total Cardiovascular Events: A Prespecified
Analysis of the CLEAR Outcomes Randomized Clinical Trial.
Source
JAMA Cardiology. 9(3) (pp 245-253), 2024. Date of Publication: 13 Mar
2024.
Author
Nicholls S.J.; Nelson A.J.; Lincoff A.M.; Brennan D.; Ray K.K.; Cho L.;
Menon V.; Li N.; Bloedon L.; Nissen S.E.
Institution
(Nicholls, Nelson) The Victorian Heart Institute, Monash University,
Melbourne, VIC, Australia
(Lincoff, Brennan, Cho, Menon, Nissen) Cleveland Clinic Coordinating
Center for Clinical Research, Cleveland, OH, United States
(Ray) School of Public Health, Imperial College London, London, United
Kingdom
(Li, Bloedon) Esperion Therapeutics, Ann Arbor, MI, United States
Publisher
American Medical Association
Abstract
Importance: The ATP citrate lyase (ACL) inhibitor, bempedoic acid, reduces
low-density lipoprotein cholesterol (LDL-C) level and major adverse
cardiovascular events (MACE) by 13% in patients at high cardiovascular
risk with intolerance of statin and high-intensity statin medications. The
effects of bempedoic acid on total cardiovascular events remain unknown.
<br/>Objective(s): To determine the impact of bempedoic acid on the total
incidence of MACE. <br/>Design, Setting, and Participant(s): Included in
this prespecified analysis of the Cholesterol Lowering via Bempedoic Acid,
an ACL-Inhibiting Regimen (CLEAR) Outcomes trial were patients with, or at
high risk for, cardiovascular disease, with hypercholesterolemia and
inability to take guideline-recommended statins. Study data were analyzed
from December 2016 to November 2022. <br/>Intervention(s): Patients were
randomly assigned to treatment with bempedoic acid or placebo daily.
<br/>Main Outcomes and Measures: The primary end point was the time to
first event for a composite of cardiovascular death, nonfatal myocardial
infarction, nonfatal stroke, or coronary revascularization (MACE-4). The
key secondary end point was time to first event for cardiovascular death,
nonfatal myocardial infarction, and nonfatal stroke (MACE-3). This
prespecified analysis compared the total number of cardiovascular events
in the treatment groups. <br/>Result(s): A total of 13970 patients (mean
[SD] age, 65 [9] years; 7230 male [51.8%]) were included in the study. A
total of 9764 participants (69.9%) had prior atherosclerotic
cardiovascular disease and a baseline LDL-C level of 139 mg/dL; treatment
with bempedoic acid resulted in a 21% reduction in LDL-C level and a 22%
reduction in high-sensitivity C-reactive protein (hsCRP) level at 6
months. Median (IQR) follow-up was 3.4 (3.1-3.9) years. A total of 1746
positively adjudicated first MACE-4 events and 915 additional MACE events
in 612 patients were recorded, with coronary revascularization
representing 32.8% (573 of 1746) of first events and 69.4% (635 of 915) of
additional events. For the total incidence of cardiovascular events,
treatment with bempedoic acid was associated with a reduction in risk of
MACE-4 (hazard ratio [HR], 0.80; 95% CI, 0.72-0.89; P <.001), MACE-3 (HR,
0.83; 95% CI, 0.73-0.93; P =.002), myocardial infarction (HR, 0.69; 95%
CI, 0.58-0.83; P <.001), and coronary revascularization (HR, 0.78; 95% CI,
0.68-0.89; P <.001), although no statistically significant difference was
observed for stroke (HR, 0.80; 95% CI, 0.63-1.03). A lower HR for
protection with bempedoic acid was observed with increasing number of MACE
events experienced by patients. Conclusion and Relevance: Lowering LDL-C
level with bempedoic acid reduced the total number of cardiovascular
events in patients with high cardiovascular risk, statin therapy
intolerance, and elevated LDL-C levels..<br/>Copyright &#xa9; 2024
American Medical Association. All rights reserved.

<114>
Accession Number
2023336557
Title
Effects of levosimendan on the outcome of veno-arterial extracorporeal
membrane oxygenation: a systematic review and meta-analysis.
Source
Clinical Research in Cardiology. 113(4) (pp 509-521), 2024. Date of
Publication: April 2024.
Author
Liu Y.; Zhang L.; Yao Y.; Qin W.; Li Y.; Xue W.; Li P.; Chen Y.; Chen X.;
Guo H.
Institution
(Liu, Zhang, Yao, Li, Qin, Li, Xue, Li, Chen, Guo) Department of Critical
Care Medicine, Qilu Hospital, Cheeloo College of Medicine, Shandong
University, 107 Wenhua Xi Road, Shandong, Jinan 250012, China
(Liu, Zhang, Yao, Li, Qin, Li, Xue, Li, Chen, Chen, Guo) The Key
Laboratory of Emergency and Critical Care Medicine of Shandong Province,
Qilu Hospital, Cheeloo College of Medicine, Shandong University, Shandong,
Jinan, China
(Liu, Zhang, Yao, Li, Qin, Li, Xue, Li, Chen, Chen, Guo) The Key
Laboratory of Cardiovascular Remodeling and Function Research, Chinese
Ministry of Education and Chinese Ministry of Health, Qilu Hospital,
Cheeloo College of Medicine, Shandong University, Shandong, Jinan, China
(Chen) Department of Emergency Medicine and Chest Pain Center, Qilu
Hospital, Cheeloo College of Medicine, Shandong University, Shandong,
Jinan, China
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Objectives: For patients with severe cardiopulmonary failure, such as
cardiogenic shock, veno-arterial extracorporeal membrane oxygenation
(VA-ECMO) is primarily utilized to preserve their life by providing
continuous extracorporeal respiration and circulation. However, because of
the complexity of patients' underlying diseases and serious complications,
successful weaning from ECMO is often difficult. At present, there have
been limited studies on ECMO weaning strategies, so the principal purpose
of this meta-analysis is to examine how levosimendan contributes to the
weaning of extracorporeal membrane oxygenation. <br/>Method(s): The
Cochrane Library, Embase, Web of Science, and PubMed were browsed for all
potentially related research about clinical benefits of levosimendan in
weaning patients receiving VA-ECMO and included 15 of them. The main
outcome is success of weaning from extracorporeal membrane oxygenation,
with the secondary outcomes of 1-month mortality (28 or 30 days), ECMO
duration, hospital or intensive care unit (ICU) length of stay, and use of
vasoactive drugs. <br/>Result(s): 1772 patients altogether from 15
publications were incorporated in our meta-analysis. We used fixed and
random-effect models to combine odds ratio (OR) and 95% confidence
interval (CI) for dichotomous outcomes and standardized mean difference
(SMD) for continuous outcomes. The weaning success rate in the
levosimendan group was considerably higher in contrast to the comparison
(OR = 2.78, 95% CI 1.80-4.30; P < 0.00001; I² = 65%), and
subgroup analysis showed that there was less heterogeneity in patients
after cardiac surgery (OR = 2.06, 95% CI, 1.35-3.12; P = 0.0007;
I² = 17%). In addition, the effect of levosimendan on improving
weaning success rate was statistically significant only at 0.2 mcg/kg/min
(OR = 2.45, 95% CI, 1.11-5.40; P = 0.03; I² = 38%). At the same
time, the 28-day or 30-day proportion of deaths in the sample receiving
levosimendan also decreased (OR = 0.47, 95% CI, 0.28-0.79; P = 0.004;
I² = 73%), and the difference was statistically significant. In
terms of secondary outcomes, we found that individuals undergoing
levosimendan treatment had a longer duration of VA-ECMO support.
<br/>Conclusion(s): In patients receiving VA-ECMO, levosimendan treatment
considerably raised the weaning success rate and helped lower mortality.
Since most of the evidence comes from retrospective studies, more
randomized multicenter trials are required to verify the conclusion.
Graphical abstract: (Figure presented.).<br/>Copyright &#xa9; The
Author(s), under exclusive licence to Springer-Verlag GmbH Germany 2023.

<115>
[Use Link to view the full text]
Accession Number
643086024
Title
Pulmonary vagus nerve transection for chronic cough after video-assisted
lobectomy: a randomized controlled trial.
Source
International journal of surgery (London, England). 110(3) (pp 1556-1563),
2024. Date of Publication: 01 Mar 2024.
Author
Zhang Q.; Ge Y.; Sun T.; Feng S.; Zhang C.; Hong T.; Liu X.; Han Y.; Cao
J.-L.; Zhang H.
Institution
(Zhang, Cao) Jiangsu Province Key Laboratory of Anesthesiology, Xuzhou
Medical University
(Zhang) Department of Anesthesiology, Yancheng Third People's Hospital,
Yancheng, Jiangsu, China
(Ge, Sun, Feng, Zhang, Hong, Liu, Zhang) Thoracic Surgery Laboratory,
Xuzhou Medical University
(Ge, Sun, Feng, Zhang, Hong, Liu, Zhang) Department of Thoracic Surgery,
Affiliated Hospital of Xuzhou Medical University
(Han) Department of Anesthesiology, Eye & ENT Hospital of Fudan
University, Shanghai, China
(Cao) Department of Anesthesiology, Affiliated Hospital of Xuzhou Medical
University, Jiangsu, China
Abstract
BACKGROUND: Chronic cough is common after lobectomy. Vagus nerves are part
of the cough reflex. Accordingly, transection of the pulmonary branches of
vagus nerve may prevent chronic cough. And there are no clear
recommendations on the management of the pulmonary branches of vagus in
any thoracic surgery guidelines. <br/>METHOD(S): This is a single-center,
randomized controlled trial. Adult patients undergoing elective
video-assisted thoracoscopic lobectomy and lymphadenectomy were randomized
at a 1:1 ratio to undergo a sham procedure (control group) or transection
of the pulmonary branches of the vagus nerve that innervate the bronchial
stump plus the caudal-most large pulmonary branch of the vagus nerve. The
primary outcome was the rate of chronic cough, as assessed at 3 months
after surgery in the intent-to-treat population. <br/>RESULT(S): Between 1
February 2020 and 1 August 2020, 116 patients (59.6+/-10.1 years of age;
45 men) were randomized (58 in each group). All patients received
designated intervention. The rate of chronic cough at 3 months was 19.0%
(11/58) in the vagotomy group versus 41.4% (24/58) in the control group
(OR=0.332, 95% CI: 0.143-0.767; P =0.009). In the 108 patients with 2-year
assessment, the rate of persistent cough was 12.7% (7/55) in the control
and 1.9% (1/53) in the vagotomy group ( P =0.032). The two groups did not
differ in postoperative complications and key measures of pulmonary
function, for example, maximal voluntary ventilation, diffusing capacity
of the lungs for carbon monoxide, and forced expiratory volume.
<br/>CONCLUSION(S): Transecting the pulmonary branches of vagus nerve that
innervate the bronchial stump plus the caudal-most large pulmonary branch
decreased the rate of chronic cough without affecting pulmonary function
in patients undergoing video-assisted lobectomy and
lymphadenectomy.<br/>Copyright &#xa9; 2023 The Author(s). Published by
Wolters Kluwer Health, Inc.

<116>
Accession Number
2031127940
Title
REPRESENTATION OF OLDER ADULTS IN THE CURRENT ACC/AHA/SCAI GUIDELINE FOR
CORONARY ARTERY REVASCULARIZATION.
Source
Journal of the American College of Cardiology. Conference: American
College of Cardiology 73rd Annual Scientific Session & Expo. Atlanta
United States. 83(13 Supplement) (pp 852), 2024. Date of Publication: 02
Apr 2024.
Author
Jamil Y.; Sibindi C.; Park D.Y.; Frampton J.; Damluji A.; Nanna M.
Institution
(Jamil, Sibindi, Park, Frampton, Damluji, Nanna) Yale New Haven Program,
New Haven, CT, United States
Publisher
Elsevier Inc.
Abstract
Background Older adults suffer the heaviest burden of coronary artery
disease. We set out to assess the representation of older adults in the
2021 ACC/AHA/SCAI Guideline for Coronary Artery Revascularization Methods
We included studies from the 2021 ACC/AHA/SCAI Guideline, noting the
number of participants, mean age, and geriatric considerations. We
considered inclusion of older adults based on eligibility criteria,
subgroup analyses, and mean age with an interquartile range (IQR)/standard
deviation (SD) above >=75 or >=80. We excluded studies unrelated to
cardiovascular conditions and those that didn't report age Results A total
of 33,520,661 individuals from 623 studies (mean age = 65.9 years) were
assessed, including 238 randomized controlled trials, 330 observational
studies, and 55 meta-analyses/systematic reviews. Among these, 131 studies
(21.0%) explicitly reported the inclusion of adults aged >=75 years, and
81 studies (13.0%) included adults >=80 years. Additionally, 161 studies
(26.5%) had a mean age with the first IQR/SD >=75 years, and 38 studies
(6.1%) had a mean age with IQR/SD >=80 years (38 studies). Conversely, 26
studies (4.2%) actively excluded adults >=75 years, and 46 studies (7.4%)
excluded adults >= 80 years. Only 1.4% of studies reported
geriatric-centered outcomes (Figure 1) Conclusion The evidence base
underlying the latest revascularization guideline inadequately represents
older adults, thus compromising the guideline's applicability to the
geriatric population [Formula presented]<br/>Copyright &#xa9; 2024
American College of Cardiology Foundation

<117>
Accession Number
2031126026
Title
COMPARING INVASIVE VS CONSERVATIVE MANAGEMENT STRATEGIES OF NON ST-SEGMENT
ELEVATION MYOCARDIAL INFARCTION IN THE VERY ELDERLY: A META- ANALYSIS OF
RANDOMIZED CONTROLLED TRIALS.
Source
Journal of the American College of Cardiology. Conference: American
College of Cardiology 73rd Annual Scientific Session & Expo. Atlanta
United States. 83(13 Supplement) (pp 856), 2024. Date of Publication: 02
Apr 2024.
Author
Balboul Y.; Kaur A.; Dhaliwal A.; Bhatia K.; Dominguez A.C.
Institution
(Balboul, Kaur, Dhaliwal, Bhatia, Dominguez) Icahn School of Medicine at
Mount Sinai, New York, NY, United States
(Balboul, Kaur, Dhaliwal, Bhatia, Dominguez) Icahn School of Medicine at
Mount Sinai at Morningside/West, New York, NY, United States
Publisher
Elsevier Inc.
Abstract
Background Data is limited on optimal treatment strategies for non
ST-segment myocardial infarction (NSTEMI) in patients >=80 years of age.
Methods We performed a meta-analysis of all published RCTs comparing
initial invasive (coronary angiography and if needed: percutaneous
revascularization or CABG) vs. conservative therapies for NSTEMI whose
participants had a mean age of >=80. Results Six RCTs involving a total of
1479 patients with a follow up of at least 12 months were included. The
mean age of included patients was 83.7 years (SD 4.3 years). Compared with
conservative management, the invasive strategy was associated with a
significant reduction in trial - defined composite endpoints (these
included: all-cause mortality, non-fatal MI, major adverse cardiac and
cerebrovascular events) (I²=0.0%; RR 0.74, 95% CI 0.64 to 0.86
p <0.001) and the need for revascularization (I²=0.0%; RR 0.30,
95% CI 0.18 to 0.52). No differences were found in all-cause mortality
(I²=0.0%; RR 0.94, 95% CI 0.77 to 1.14 p=0.52), cardiac death
(I²=0.0%; RR 0.86, 95% CI 0.55 to 1.34 p=0.51), MI
(I²=42%; RR 0.71 95% CI 0.50 to 1.01 p=0.06) or bleeding events
(I²=46%; RR 1.64, 95% CI 0.67 to 4.02 p=0.28) between both
strategies. Conclusion Our analysis is the largest cohort of RCTs
representing patients >=80 years of age presenting with NSTEMIs. Compared
with conservative strategy, invasive treatment could reduce the incidence
of composite endpoint and the need for revascularization in the very
elderly. [Formula presented]<br/>Copyright &#xa9; 2024 American College of
Cardiology Foundation

<118>
Accession Number
2031125329
Title
SYSTEMIC INFLAMMATORY RESPONSE SYNDROME IS ASSOCIATED WITH ADVERSE
PROGNOSIS IN PATIENTS AFTER TRANSCATHETER AORTIC VALVE REPLACEMENT. A
META-ANALYSIS.
Source
Journal of the American College of Cardiology. Conference: American
College of Cardiology 73rd Annual Scientific Session & Expo. Atlanta
United States. 83(13 Supplement) (pp 993), 2024. Date of Publication: 02
Apr 2024.
Author
Ang S.P.; Chia J.E.; Jaiswal V.; Song D.; Singh R.; Shah V.N.; Hanif M.;
Thachil R.; Shabani J.; Alraies M.C.
Institution
(Ang, Chia, Jaiswal, Song, Singh, Shah, Hanif, Thachil, Shabani, Alraies)
Rutgers Health/Community Medical Center, Toms River, NJ, United States
(Ang, Chia, Jaiswal, Song, Singh, Shah, Hanif, Thachil, Shabani, Alraies)
Texas Tech University Health Science Center, El Paso, TX, United States
Publisher
Elsevier Inc.
Abstract
Background Post-operative Systemic Inflammatory Response Syndrome (SIRS)
is frequently observed following Transcatheter Aortic Valve Replacement
(TAVR). Yet, the impact of post-TAVR SIRS on patient outcomes remains
unclear due to conflicting results. This study aims to assess the
association between post-TAVR SIRS and patient outcomes via a
meta-analysis. Methods We conducted a comprehensive search to identify
relevant studies across various electronic databases, including PubMed,
Embase, and the Cochrane Library from its inception till August 2023. The
endpoints were pooled using the DerSimonian-and-Laird random-effects
model, and the results were presented as odds ratios (OR) or hazard ratio
(HR) with 95% confidence intervals (CI). Results Six studies involving
1,568 (379 SIRS, 1,189 non-SIRS) patients were included in the final
analysis. Both patient groups were comparable in age (median 80.1 vs 80
years). A higher proportion of male patients (52% vs 45%) and
comorbidities (diabetes: 34% vs 25%, CAD: 63% vs 55%, PAD: 27% vs 21%) was
observed in the SIRS group. Post-TAVR SIRS was associated with a higher
risk of short-term mortality (OR 5.30, 95%CI: 2.41-11.65; p<0.001), major
vascular complications (OR 3.36; 95%CI: 1.38-8.19; p=0.01), major bleeding
(OR 3.62; 95%CI: 1.22-5.60; p=0.01), and acute kidney injury (OR 3.93;
95%CI: 1.65-9.39; p=0.002). The risk of stroke (OR 1.50; 95%CI: 0.51-4.39;
p=0.46), and pacemaker implantation (OR 1.34; 95%CI: 0.74-2.41; p=0.33)
did not significantly differ between the two groups. Over a mean follow-up
of 1.2+/-0.4 years, the risk of all-cause mortality using adjusted
estimates (HR 2.56; 95%CI: 1.96-3.35; p<0.001) was significantly higher in
the SIRS cohort. Conclusion Post-TAVR SIRS was associated with unfavorable
short and long-term prognosis compared to those without SIRS, highlighting
the importance of vigilant monitoring in this patient cohort following
TAVR.<br/>Copyright &#xa9; 2024 American College of Cardiology Foundation

<119>
Accession Number
2031125320
Title
ORAL ANTICOAGULANTS VERSUS VITAMIN K ANTAGONISTS IN PATIENTS WITH AN
INDICATION OF ANTI-COAGULANTS AFTER TAVR: A META-ANALYSIS OF 21,446
PATIENTS.
Source
Journal of the American College of Cardiology. Conference: American
College of Cardiology 73rd Annual Scientific Session & Expo. Atlanta
United States. 83(13 Supplement) (pp 986), 2024. Date of Publication: 02
Apr 2024.
Author
Elaraby A.; Abdelaziz A.; Elsayed H.; Bakr A.; Atta K.; Elkasaby M.H.;
Ramadan S.M.; Suppah M.; Abdelaziz M.; Ali S.; Abdelazeem B.
Institution
(Elaraby, Abdelaziz, Elsayed, Bakr, Atta, Elkasaby, Ramadan, Suppah,
Abdelaziz, Ali, Abdelazeem) West Virginia University, Morgantown, WV,
United States
Publisher
Elsevier Inc.
Abstract
Background Recent studies reported unfavorable outcomes of oral
anticoagulant (OAC) post-TAVR in patients without an indication for OAC.
However, in patients with an indication for OAC, there is no current
evidence established on OAC and VKA. We aimed to highlight the clinical
benefits of OAC in patients with an indication for OAC post-TAVR. Methods
PubMed, Scopus, WOS, and the Cochrane Library were screened for relevant
studies comparing OAC versus VKA post-TAVT in patients with an indication
for OAC. The primary efficacy endpoint was all-cause mortality, while the
safety outcome was major bleeding. Other secondary outcomes were MACE,
cardiac mortality, MI, stroke, valve thrombosis, and thromboembolism.
Dichotomous data were pooled as OR with 95% CI and analyzed using a
random-effect model. Results Seven studies (21,446 patients, mean
follow-up 12 months) were analyzed. No significant difference was reported
between OAC and VKA regarding all-cause mortality (OR: 0.9, 95% CI: 0.62
to 1.31) or major bleeding (OR: 0.86, 95% CI: 0.63 to 1.17). Moreover, the
incidence of MACE, cardiac mortality, MI, stroke, valve thrombosis, and
thromboembolism were comparable between OAC and VKA. Conclusion OAC and
VKA had similar efficacy and safety profiles in post-TAVR patients with an
indication for OAC, suggesting that OAC could be safely used to manage
this sitting. Further large-volume RCTs are needed to validate these
results. [Formula presented]<br/>Copyright &#xa9; 2024 American College of
Cardiology Foundation

<120>
Accession Number
2031124571
Title
OPTIMAL TIMING FOR PERCUTANEOUS CORONARY INTERVENTION IN PATIENTS
UNDERGOING TRANSCATHETER AORTIC VALVE REPLACEMENT: A BAYESIAN NETWORK
META-ANALYSIS.
Source
Journal of the American College of Cardiology. Conference: American
College of Cardiology 73rd Annual Scientific Session & Expo. Atlanta
United States. 83(13 Supplement) (pp 981), 2024. Date of Publication: 02
Apr 2024.
Author
DE PAULA CARVALHO P.E.; Gewehr D.M.; Rivera A.; Clemente M.; Braga M.;
Pansani L.N.; Almeidinha L.; Veiga T.; Cardoso R.; Taramasso M.; Garot P.
Institution
(DE PAULA CARVALHO, Gewehr, Rivera, Clemente, Braga, Pansani, Almeidinha,
Veiga, Cardoso, Taramasso, Garot) Federal University of Minas Gerais, Belo
Horizonte, Brazil
Publisher
Elsevier Inc.
Abstract
Background The optimal timing for percutaneous coronary intervention (PCI)
in patients undergoing transcatheter aortic valve replacement (TAVR) is
uncertain. Methods MEDLINE, Embase, and Cochrane were systematically
searched for studies comparing different timings of PCI in patients with
aortic stenosis (AS) and coronary artery disease (CAD) undergoing TAVR.
PCI performed before, concomitantly, and after TAVR were compared with
TAVR alone without PCI. A Bayesian random-effects network meta-analysis
calculates the odds ratio (OR) with a 95% credibility interval (CrI).
Treatments were ranked using surface under the cumulative ranking (SUCRA).
Results Nineteen studies comprising 9,506 patients with AS and CAD were
included. Staged PCI performed after TAVR was associated with lower
all-cause mortality rates compared with PCI before TAVR (OR 0.32; 95% CrI
0.16-0.60), PCI concomitant with TAVR (OR 0.40; 95% CrI 0.22-0.73), and
TAVR alone without PCI (OR 0.33; 95% CrI 0.17-0.65). In addition, PCI
after TAVR was associated with lower rates of stroke (OR 0.22; 95% CrI
0.04-0.94) compared with PCI concomitant TAVR. There was no difference
between PCI timings in the incidence of myocardial infarction and major
bleeding. In SUCRA analysis, PCI after TAVR presented the highest
likelihood of preventing all-cause mortality and stroke. Conclusion In
patients with AS and CAD undergoing TAVR, PCI performed after TAVR is
associated with lower all-cause mortality and stroke rates compared with
other timings. [Formula presented]<br/>Copyright &#xa9; 2024 American
College of Cardiology Foundation

<121>
Accession Number
2031124312
Title
TRANSCATHETER AORTIC VALVE-IN-VALVE IMPLANTATION USING A
BALLOON-EXPANDABLE VALVE IN PATIENTS WITH DEGENERATED STENTED VERSUS
STENTLESS AORTIC BIOPROSTHESIS.
Source
Journal of the American College of Cardiology. Conference: American
College of Cardiology 73rd Annual Scientific Session & Expo. Atlanta
United States. 83(13 Supplement) (pp 996), 2024. Date of Publication: 02
Apr 2024.
Author
Moubarak G.; El Shami M.; Eisenga J.; McCullough K.; Banwait J.K.; Szerlip
M.
Institution
(Moubarak, El Shami, Eisenga, McCullough, Banwait, Szerlip) Baylor Scott &
White Research Institute, Plano, TX, United States
Publisher
Elsevier Inc.
Abstract
Background Valve-in-valve (ViV) transcatheter aortic replacement (TAVR)
has been mostly performed in failing stented bioprosthetic valves;
stentless bioprostheses are more challenging for transcatheter therapy. We
sought to compare outcomes after TAVR in stented vs. stentless
bioprosthesis. Methods All patients undergoing ViV-TAVR using a
balloon-expandable valve between 2013 and 2021 in a single healthcare
system were reviewed. Procedural complications, and survival rate were
analyzed and reported. Results Of 118 patients, 76 (64.4%) underwent
stented and 42 (35.6%) stentless ViV-TAVR. Baseline characteristics were
similar between both groups. Mean transaortic gradient has significantly
decreased for stented and stentless from baseline to 1-year (37.9 vs. 17.2
mmHg, p<0.01; 27.5 vs. 14.8 mmHg, p= 0.002; respectively). Coronary
obstruction (5.3% vs. 2.4%; p= 0.46), the need for second transcatheter
device (2.6% vs. 0%; p= 0.29), and residual mild or greater paravalvular
leak (6.6% vs. 4.8%; p= 0.689) were numerically higher, but not
statistically different, after stented ViV-TAVR. Thirty-day rates of
stroke (2.6% vs. 4.8%; p= 0.54) and new pacemaker implantation (3.39% vs.
7.1%; p= 0.45) were numerically lower, but not statistically different,
after stented ViV-TAVR. There was no difference in survival, up to 3
years, between both groups (log rank p= 0.8). Conclusion In patients with
stentless bioprosthetic valve failure, performing TAVR is relatively safe
with favorable outcomes. [Formula presented]<br/>Copyright &#xa9; 2024
American College of Cardiology Foundation

<122>
Accession Number
2031123465
Title
PROPHYLACTIC ATRIAL ABLATION DURING CARDIAC SURGERY TO PREVENT ATRIAL
FIBRILLATION: A SYSTEMATIC REVIEW AND META-ANALYSIS OF RANDOMIZED TRIALS.
Source
Journal of the American College of Cardiology. Conference: American
College of Cardiology 73rd Annual Scientific Session & Expo. Atlanta
United States. 83(13 Supplement) (pp 132), 2024. Date of Publication: 02
Apr 2024.
Author
Visanji M.; Belley-Cote E.P.; Pandey A.; Amit Y.; McClure G.; Young J.S.;
Healey J.S.; Whitlock R.; McIntyre W.F.
Institution
(Visanji, Belley-Cote, Pandey, Amit, McClure, Young, Healey, Whitlock,
McIntyre) McMaster University, Hamilton, Canada
Publisher
Elsevier Inc.
Abstract
Background Atrial fibrillation (AF) is the most common complication of
cardiac surgery and is associated with significant morbidity and costs.
Ablation lesions created during surgery may prevent early post-operative
AF (POAF) and incident clinical AF over longer-term followup. Methods We
searched Cochrane CENTRAL, MEDLINE, and Embase to July 2023. We included
randomized trials of prophylactic ablation (any lesion set) concomitant to
cardiac surgery, compared to no ablation, in adults with no history of AF.
The primary outcome was POAF within 30 days of surgery. The key secondary
outcome was incident AF at longest follow-up (beyond 30 days). We combined
data using random effects models and rated the quality of evidence using
GRADE. PROSPERO Pre-Registration: CRD42023439701. Results We included
seven randomized trials (687 participants). Six isolated pulmonary veins
and one ablated ganglion plexi. All studies were open label and 3 did not
have a protocol for antiarrhythmic drug use. Compared to no ablation,
patients who received prophylactic ablation were less likely to have POAF
(21% vs 37%, RR 0.50, 95% CI 0.32-0.80, I² = 64%) or AF at
longest follow-up (range 6 months - 2 years; 3% vs 10%, RR 0.33, 95% CI
0.15-0.71, I² = 0%). The quality of evidence was low due to
risk of bias and inconsistency or indirectness. Conclusion Prophylactic
ablation concomitant to cardiac surgery might prevent POAF and incident AF
over long-term follow-up. A definitive randomized trial is needed.
[Formula presented]<br/>Copyright &#xa9; 2024 American College of
Cardiology Foundation

<123>
Accession Number
2031123431
Title
TRANSCATHETER AORTIC VALVE REPLACEMENT AND CARDIOVASCULAR OUTCOMES IN
PATIENTS WITH CARDIOGENIC SHOCK: A META-ANALYSIS OF 25,512 PATIENTS.
Source
Journal of the American College of Cardiology. Conference: American
College of Cardiology 73rd Annual Scientific Session & Expo. Atlanta
United States. 83(13 Supplement) (pp 984), 2024. Date of Publication: 02
Apr 2024.
Author
Diab R.A.; Abdelaziz A.; Hafez A.; Abdellatif M.; Desouki M.; Ellabban M.;
Elsayed H.; Ramadan S.M.; Abdelaziz M.; Ali S.; Abdelazeem B.
Institution
(Diab, Abdelaziz, Hafez, Abdellatif, Desouki, Ellabban, Elsayed, Ramadan,
Abdelaziz, Ali, Abdelazeem) West Virginia University, Morgantown, WV,
United States
Publisher
Elsevier Inc.
Abstract
Background Transcatheter aortic valve replacement (TAVR) is the standard
approach for aortic stenosis. However, TAVR in patients presenting with
aortic stenosis (AS) and cardiogenic shock (CS) is a big debate, and its
efficacy and safety are poorly evaluated. We aimed to highlight the
possible cardiovascular risks of TAVR in the setting of AS and CS
patients. Methods We retrieved PubMed, Scopus, WOS, and the Cochrane
Library for relevant studies assessing cardiovascular outcomes post-TAVR
in cardiogenic shock. All-cause mortality was the primary endpoint, while
secondary endpoints were MI, stroke, permanent pacemaker implantation,
major bleeding, vascular complications, and AKI. We studied our outcomes
of interest at the 30-day follow-up and at the longest follow-up period.
Results Four studies comprising 25512 participants were included. Patients
with CS undergoing TAVR were at higher risk of all-cause mortality
compared to patients undergoing TAVR without CS (OR: 3.08, 95% CI: 2.25 to
4.22 for 30-days; OR: 1.35, 95% CI: 1.16 to 1.57 for longest follow-up).
Also, TAVR in CS patients was associated with a higher risk of stroke, MI,
major bleeding, vascular complications, and AKI at 30 days and longest
follow-up periods. Conclusion In patients with AS complicated by CS, TAVR
strategy remains a viable treatment as its higher risk of cardiovascular
events. Interventional cardiologists should implement a structured
strategy, and further experience is needed. [Formula
presented]<br/>Copyright &#xa9; 2024 American College of Cardiology
Foundation

<124>
Accession Number
2031123372
Title
OUTCOMES OF STROKE WITH VARIOUS ANTICOAGULATION STRATEGIES AFTER
TRANSCATHETER AORTIC VALVE REPLACEMENT IN PATIENTS WITHOUT AN INDICATION
OF ORAL ANTICOAGULANTS: A SYSTEMATIC REVIEW AND NETWORK META-ANALYSIS.
Source
Journal of the American College of Cardiology. Conference: American
College of Cardiology 73rd Annual Scientific Session & Expo. Atlanta
United States. 83(13 Supplement) (pp 922), 2024. Date of Publication: 02
Apr 2024.
Author
Adhikari G.; Abuelazm M.; Awad A.; Amin A.M.; Elhady M.M.; Awad A.K.;
Mahmoud A.; Abdelazeem B.
Institution
(Adhikari, Abuelazm, Awad, Amin, Elhady, Awad, Mahmoud, Abdelazeem) Banner
University Medical Center, Tucson, AZ, United States
(Adhikari, Abuelazm, Awad, Amin, Elhady, Awad, Mahmoud, Abdelazeem) West
Virginia university, Morgantown, VA, United States
Publisher
Elsevier Inc.
Abstract
Background It is well known that transcatheter aortic valve replacement
(TAVR) is associated with both thrombotic and bleeding risk. We seek to
investigate the incidence of stroke in patients after TAVR, receiving
different anticoagulant strategies, direct oral anticoagulants (DOACs),
single-antiplatelet therapy (SAPT), dual-antiplatelet therapy (DAPT), or
vitamin K antagonists (VKAs). Methods We performed a systematic review and
network meta-analysis synthesizing evidence from randomized controlled
trials (RCTs) obtained from PubMed, Embase, Cochrane, Scopus, and WoS
until June 2023. We used the fixed-effects model to report dichotomous
outcomes using a risk ratio (RR) with a 95% confidence interval (CI).
Results Nine RCTs with 4,193 patients were included. 567 patients were in
the VKA group, 591 patients in the SAPT group, 1,571 patients in the DAPT
group with either clopidogrel or ticagrelor plus aspirin, and 1,464
patients in the DOACs group (apixaban, edoxaban, or rivaroxaban). There
was no significant difference between VKA and other arms regarding the
incidence of any stroke, ischemic stroke, hemorrhagic stroke, disabling
stroke, or non-disabling stroke. Conclusion None of the anticoagulant
strategies increased or decreased the risk of stroke incidence after TAVR.
Therefore, any strategy could be considered safe regarding outcomes of
stroke, and the choice of anticoagulant strategy may be determined by the
bleeding risk. [Formula presented]<br/>Copyright &#xa9; 2024 American
College of Cardiology Foundation

<125>
Accession Number
2031123042
Title
ASSOCIATION OF SPECKLE TRACKING ECHOCARDIOGRAPHY WITH ACUTE CELLULAR
REJECTION IN CARDIAC TRANSPLANT PATIENTS: A SYSTEMATIC REVIEW AND
META-ANALYSIS.
Source
Journal of the American College of Cardiology. Conference: American
College of Cardiology 73rd Annual Scientific Session & Expo. Atlanta
United States. 83(13 Supplement) (pp 394), 2024. Date of Publication: 02
Apr 2024.
Author
RAVEN M.; Tao M.; Tam E.; Goldschmidt M.; Mann N.N.; Kort S.
Institution
(RAVEN, Tao, Tam, Goldschmidt, Mann, Kort) Stony Brook University
Hospital, Stony Brook, NY, United States
Publisher
Elsevier Inc.
Abstract
Background Myocardial strain imaging by speckle tracking echocardiography
has demonstrated significant prognostic utility in several diseases.
However, the association of strain measurements with acute cellular
rejection (ACR) after cardiac transplantation has not been well
established. The purpose of this meta-analysis is to establish whether
such an association exists. Methods A literature search was conducted
using the databases Ovid MEDLINE, EMBASE, and Web of Science for studies
reporting on the association of left ventricular global longitudinal
(GLS), radial (GRS), and circumferential (GCS) strain in cardiac
transplant patients with and without ACR. Subgroup analysis was performed
by ISHLT standardized ACR grading to compare grade 1R versus Grade 2R and
higher. Studies reporting on antibody mediated rejection and studies that
did not confirm transplant rejection by endomyocardial biopsy were
excluded. The search was not restricted to time or publication status.
Results 21 studies with 2502 transplant patients (1465 without ACR versus
1037 with ACR) were included. 56.4% of patients were men. The average left
ventricular ejection fraction was 62%. Patients with ACR had lower GLS
compared to those without ACR on biopsy (MD 2.84, 95% CI 1.5-4.18;
p<0.01). Subgroup analysis demonstrated that patients with ACR grade >=2R
had lower GLS compared to those with ACR grade 1R (MD 2.36, 95% CI
1.49-3.23; p<0.01). Patients with ACR had a lower GCS compared to patients
without ACR and subgroup analysis also demonstrated a lower GCS in
patients with ACR grade >=2R compared to those with ACR grade 1R (MD 2.29,
95% CI 1.08, 3.51; MD 2.83, 95% CI 0.08-5.59; p=0.04). GRS measurements
were not significantly different in patients with ACR compared to patients
without ACR (MD -0.19, 95% CI -4.93 - 4.53; p = 0.94). Conclusion GLS and
GCS measurements by speckle-tracking echocardiography may represent useful
non-invasive markers to identify ACR after cardiac transplant. Further
studies are needed to identify whether reduced myocardial strain
measurements can prognosticate treatment response and whether these
associations are seen cardiac magnetic resonance imaging.<br/>Copyright
&#xa9; 2024 American College of Cardiology Foundation

<126>
Accession Number
2031115273
Title
EFFICACY AND SAFETY OF COLCHICINE FOR THE PREVENTION OF POSTOPERATIVE
ATRIAL FIBRILLATION AMONG PATIENTS UNDERGOING MAJOR CARDIOTHORACIC
SURGERY: A META-ANALYSIS AND META- REGRESSION OF RANDOMIZED CONTROLLED
TRIALS.
Source
Journal of the American College of Cardiology. Conference: American
College of Cardiology 73rd Annual Scientific Session & Expo. Atlanta
United States. 83(13 Supplement) (pp 108), 2024. Date of Publication: 02
Apr 2024.
Author
Jariyatamkitti S.; Rivera F.; Mamas M.A.; Aparece J.P.B.; Cha S.W.
Institution
(Jariyatamkitti, Rivera, Mamas, Aparece, Cha) Lincoln Medical Center, New
York, NY, United States
(Jariyatamkitti, Rivera, Mamas, Aparece, Cha) Cebu Institute of Medicine,
Cebu, Philippines
Publisher
Elsevier Inc.
Abstract
Background Studies exploring the use of colchicine to prevent
postoperative atrial fibrillation (POAF) following cardiothoracic surgery
is limited. We aimed to evaluate its potential in preventing this serious
complication using data from randomized controlled trials (RCTs). Methods
A literature search was performed to identify studies reporting POAF as an
outcome after cardiac or thoracic surgery in adult patients randomized to
either colchicine or placebo. Primary outcome measured was incidence of
POAF. Secondary outcomes included gastrointestinal (GI) adverse effects,
sepsis, and length of stay (LOS). Subgroup analyses based on treatment
durations and type of surgery were also performed, as well as regression
analyses to control for covariates. Results From 10 eligible RCTs, we
identified a total of 5,377 patients (colchicine = 2,689, placebo =
2,688). While colchicine use was associated with a significantly reduced
risk for POAF (OR:0.72, 95% CI 0.55-0.90, p<0.01), risk for GI adverse
effects were significantly higher (OR:3.24, 95% CI 2.16-4.33, p<0.01).
Rates of infection and LOS were similar across the groups. Subgroup
analyses showed that colchicine was effective for POAF prevention in
cardiac surgery (OR: 0.63, 95% CI 0.40-0.86, p<0.01) but not in thoracic
surgery (OR: 0.84, 95% CI 0.57-1.10, p=0.19). Prevention of PAOF and
incidence of GI adverse effects were similar in short-term and long-term
colchicine treatment. Conclusion Colchicine significantly reduces the
incidence of POAF in patients undergoing cardiac surgery, but not in
thoracic surgery. Regardless of treatment duration, the use of colchicine
is associated with significantly increased risk for GI adverse
effects.<br/>Copyright &#xa9; 2024 American College of Cardiology
Foundation

<127>
Accession Number
2031114648
Title
DAYS AT HOME AFTER TRANSCATHETER MITRAL VALVE REPAIR VS. MEDICAL THERAPY
ALONE IN PATIENTS WITH HEART FAILURE.
Source
Journal of the American College of Cardiology. Conference: American
College of Cardiology 73rd Annual Scientific Session & Expo. Atlanta
United States. 83(13 Supplement) (pp 834), 2024. Date of Publication: 02
Apr 2024.
Author
Chung M.; Almarzooq Z.; Tale A.P.; Song Y.; Kazi D.; Baron S.; Yeh R.W.
Institution
(Chung, Almarzooq, Tale, Song, Kazi, Baron, Yeh) Beth Israel Deaconess
Medical Center, Boston, MA, United States
(Chung, Almarzooq, Tale, Song, Kazi, Baron, Yeh) Massachusetts General
Hospital, Boston, MA, United States
Publisher
Elsevier Inc.
Abstract
Background Days at Home (DAH) is a patient-centered outcome that
quantifies time spent at home after a medical event but has not been fully
evaluated for transcatheter mitral valve repair. We sought to compare 1-
and 2-year DAH (DAH<inf>365</inf>, DAH<inf>730</inf>) among patients with
functional mitral regurgitation and heart failure randomized to mitral
valve transcatheter edge-to-edge repair (TEER) plus medical therapy vs.
medical therapy alone (Control) in the COAPT Trial. Methods We linked
individual-level data from participants in the COAPT trial to Medicare
fee-for-service claims. DAH was calculated as the number of days alive and
spent outside of a hospital, skilled nursing facility (SNF), inpatient
rehabilitation, long-term acute care hospital, emergency department, or
observation stay after randomization, and compared between treatment
groups. Results Of 614 COAPT trial participants, we linked 271 patients
(TEER 136/Control 135) initially for a 2-year follow-up. Mean+/-SD
DAH<inf>365</inf> was 310.7+/-97.7 in TEER compared with 298.1+/-107.5 in
the Control group (difference 12.6 days [95% CI -12.1, 37.3], p=0.32). The
index length of stay in the TEER group was 3.2+/-2.1 days. The largest
home time losses were due to mortality days (TEER: 39.4+/-91.9, Control:
51.3+/-99.7, difference -11.9 days [95% CI -34.9, 11.2], p=0.31) and
readmission days (TEER: 7.6+/-13.3, Control: 9.7+/-12.2, difference -2.1
days [95% CI -5.2, 1.0], p=0.18). There was a strong trend towards a
higher mean DAH<inf>730</inf> in TEER vs. Control (575.1+/-238.4 vs.
518.2+/-253.0, difference 56.9 days [95% CI -2.7, 116.6], p=0.06)
primarily due to mortality days (TEER: 133.5+/-232.7, Control:
187.4+/-248.0, difference -53.9 days [95% CI -112.2, 4.4], p=0.07) and
readmission days (TEER: 11.9+/-16.6, Control: 15.6+/-17.3, difference -3.7
days [95% CI-7.9, 0.4], p=0.08). Conclusion In the COAPT trial linked to
Medicare, patients with heart failure and functional mitral regurgitation
randomized to transcatheter edge-to-edge repair spent a numerically
greater number of days at home at 1- and 2-years compared with the control
group, but the differences were not statistically significant. These
trends were largely driven by mortality days and, to a lesser extent,
readmission days.<br/>Copyright &#xa9; 2024 American College of Cardiology
Foundation

<128>
Accession Number
2031114605
Title
COMPARATIVE EFFICACY AND SAFETY OF AMPLATZER AMULET VS WATCHMAN FOR LEFT
ATRIAL APPENDAGE OCCLUSION: A SYSTEMATIC REVIEW AND META-ANALYSIS.
Source
Journal of the American College of Cardiology. Conference: American
College of Cardiology 73rd Annual Scientific Session & Expo. Atlanta
United States. 83(13 Supplement) (pp 47), 2024. Date of Publication: 02
Apr 2024.
Author
Farooq O.; Ghani U.; Akbar M.S.; Saudye H.; Mutti S.
Institution
(Farooq, Ghani, Akbar, Saudye, Mutti) Ascension St. Francis Hospital,
Evanston, IL, United States
Publisher
Elsevier Inc.
Abstract
Background Left atrial appendage occlusion has become an increasingly
common procedure in atrial fibrillation patients who cannot undergo
anticoagulation. We wanted to compare the efficacy and safety of the two
devices most commonly in use today, the Amplatzer Amulet and the Watchman.
Methods We included a total of 20 studies in our meta-analysis, 3 of which
were randomized controlled trials. A total of 6165 patients (Amulet
n=2914; Watchman n=3251) were included. Random-effects model was used to
calculate pooled odds-ratios to determine the outcome difference. Results
There was no difference in the incidence of stroke and systemic emboli
between the two groups (OR=0.82; 95% confidence interval (CI)=0.60-1.13)
(Figure 1). Post-procedure complications, which included minor
complications, were higher in the Amulet group (OR=1.60; 95% CI=1.25-2.05)
(Figure 2). There was no significant difference observed in all-cause
mortality (OR=1.06; 95% CI=0.80-1.40), cardiovascular mortality (OR=0.70;
95% CI=0.45-1.08), peri-device leakage (OR=0.50; 95% CI=0.16-1.55) or
device-related thrombosis (OR=0.75; 95% CI=0.54-1.03) (Figure 3).
Conclusion Both devices appear to have comparable efficacy with the Amulet
having a higher incidence of post-procedure complications. Notably, the
composite of complications includes minor complications, some of which may
be clinically insignificant. [Formula presented] [Formula
presented]<br/>Copyright &#xa9; 2024 American College of Cardiology
Foundation

<129>
Accession Number
2031114423
Title
COMPARISON BETWEEN WATCHMAN DEVICE VS. AMPLATZER AMULET FOR PERCUTANEOUS
LEFT ATRIAL APPENDAGE CLOSURE IN NON-VALVULAR ATRIAL FIBRILLATION - A
SYSTEMATIC REVIEW AND META-ANALYSIS.
Source
Journal of the American College of Cardiology. Conference: American
College of Cardiology 73rd Annual Scientific Session & Expo. Atlanta
United States. 83(13 Supplement) (pp 953), 2024. Date of Publication: 02
Apr 2024.
Author
Patel R.; Mistry A.; Mulukutla V.
Institution
(Patel, Mistry, Mulukutla) Texas Tech University Health Sciences Center El
Paso Transmountain, El Paso, TX, United States
Publisher
Elsevier Inc.
Abstract
Background Existing meta-analyses comparing the Watchman and Amplatzer
Amulet devices for left atrial appendage occlusion (LAAO) are scant and
mainly limited to specific countries or regions. This investigation aims
to conduct a meta-analysis of previously published systematic reviews that
have compared the Amplatzer Amulet to the Watchman device for patients
with non-valvular atrial fibrillation to identify an ideal device for
LAAO. Methods The present investigation was assessed using the standard of
the Preferred Reporting Items for Systematic Reviews and Meta-Analyses
(PRISMA). Data collection was performed by utilizing electronic databases
including PubMed, Google Scholar, MEDLINE, Web of Science, Cochrane
Central Register of Controlled Trials on The Cochrane Library, EMBASE,
Science-direct, with keywords such as 'Amplatzer amulet', 'Watchman',
'LAAO', 'Atrial Fibrillation', 'Left atrial appendage occlusion'. The
study articles for analyses were considered based on the pre-specified
inclusion and exclusion criteria. Results As compared to the Watchman
device, there was no statistically significant difference in stroke
occurrence (OR:0.53, 95% CI:0.11-2.43, p=0.041) or systemic embolism
incident (OR:0.97, 95% CI 0.49-1.92, p=0.98) with Amplatzer Amulet. The
study also indicates that the Watchman device is associated with fewer
post-procedural pericardial effusions (OR (0.32, 95% CI 0.13-0.75,
p=0.009), along with an overall decreased incidence of all post-procedural
complications (OR 0.49, 95% CI 0.26-0.91, p=0.008) and both the results
were statistically significant. There was no statistically significant
difference for all-cause mortality (OR=0.88, 95% CI 0.74-1.06, p=0.18) or
cardiovascular death (OR=0.87, 95% CI 0.68-1.13, p=0.30). Conclusion This
systematic review concludes that the Watchman device is preferred over
Amplatzer regarding its safety outcomes as it has fewer post-procedural
complications including pericardial effusions. However, neither Amplatzer
Amulet nor Watchman device have demonstrated better outcomes with regard
to efficacy. Hence, we recommend further investigations with more RCTs to
address these concerns better.<br/>Copyright &#xa9; 2024 American College
of Cardiology Foundation

<130>
Accession Number
2031114380
Title
COMPARING EFFICACY AND SAFETY OF LEFT ATRIAL APPENDAGE CLOSURE DEVICES: A
NETWORK META-ANALYSIS OF RANDOMIZED CONTROLLED TRIALS.
Source
Journal of the American College of Cardiology. Conference: American
College of Cardiology 73rd Annual Scientific Session & Expo. Atlanta
United States. 83(13 Supplement) (pp 917), 2024. Date of Publication: 02
Apr 2024.
Author
Mai S.L.; Reisler J.; Harmouch W.; Davis J.W.
Institution
(Mai, Reisler, Harmouch, Davis) University of Texas Medical Branch at
Galveston, Galveston, TX, United States
Publisher
Elsevier Inc.
Abstract
Background Left atrial appendage closure (LAAC) devices have become more
ubiquitous in patients with atrial fibrillation (AF) and a
contraindication for anticoagulation (AC). Despite few head-to-head
comparisons of these devices, such as Watchman and Amulet, there remains
an uncertainty regarding their comparative efficacy and safety. A network
meta-analysis (NMA) allows for head-to-head comparison of interventions by
evaluating indirect evidence across trials. Methods MEDLINE, Web of
Science, and Cochrane databases were searched from inception until 5/2023.
Any randomized controlled trial with a LAAC device that compared either
another device or AC, was eligible for inclusion. Outcomes assessed were
stroke, embolism, death, pericardial effusion, and device embolization.
Risk ratios via Mantel-Haenszel random effects models were estimated.
Heterogeneity was assessed via I² statistics. Jadad score was
utilized to assess quality of trials with a score range of 0-5. Results A
total of 5 trials were included with 3,264 patients, 35.3% females, mean
age of 74.8 years, and an average Jadad score of 4. All trials assessed
Watchman, Amulet, or both. Paroxysmal, persistent, and permanent AF were
approximately equal in each group. In the NMA, risk was significantly
lower for death with Amulet vs AC (RR=0.45, p=0.03) and trended towards
significantly lower vs Watchman (RR=0.65,p=0.06). Further, device
embolization risk was non-significantly lower (RR=0.32,p=0.47) with
Amulet. However, risk of pericardial effusion was significantly increased
with Amulet vs AC (RR=29.5,p=0.002) and vs Watchman (RR=10.8,p=0.02). For
stroke, Amulet vs AC RR was 1.27 (p=0.64), Watchman vs AC RR was 1.60
(p=0.28), and Amulet vs Watchman RR was 0.79 (p=0.37). For embolic events,
Amulet vs AC RR was 2.62 (p=0.47), and Watchman vs AC RR was 2.04
(p=0.52), Amulet vs Watchman RR was 1.28 (p=0.73). I² estimates
were all 0%. Conclusion In this study, Amulet decreased risk of death
compared to both AC and Watchman. The Amulet also demonstrated increased
risk of pericardial effusion. Findings were otherwise similar across
groups. More direct comparison evidence is warranted from these
findings.<br/>Copyright &#xa9; 2024 American College of Cardiology
Foundation

<131>
Accession Number
2031114172
Title
MAZE PROCEDURE HALTS TRICUSPID REGURGITATION PROGRESSION: A SYSTEMATIC
REVIEW.
Source
Journal of the American College of Cardiology. Conference: American
College of Cardiology 73rd Annual Scientific Session & Expo. Atlanta
United States. 83(13 Supplement) (pp 830), 2024. Date of Publication: 02
Apr 2024.
Author
Sulague R.M.; Khan F.; Santos J.D.; Crestanello J.
Institution
(Sulague, Khan, Santos, Crestanello) Cedars-Sinai Medical Center, Los
Angeles, CA, United States
(Sulague, Khan, Santos, Crestanello) Mayo Clinic, Rochester, MN, United
States
Publisher
Elsevier Inc.
Abstract
Background Tricuspid regurgitation can be worsened by long-standing atrial
fibrillation. This study seeks to determine if the Cox-Maze procedure,
known to correct atrial fibrillation (AF), can effectively halt the
progression of tricuspid regurgitation (TR). Methods A systematic
literature search was conducted on Pubmed, Google Scholar, Web of Science,
and Embase using a combination of key terms such as "Maze procedure",
"atrial fibrillation", and "tricuspid regurgitation". Only cohort studies
that included patients who had tricuspid regurgitation prior to undergoing
the Maze procedure for atrial fibrillation were included. Clinical
outcomes included tricuspid regurgitation progression and its associated
risk factors. Studies were assessed for risk of bias using the Joanna
Briggs Institute critical appraisal tool. A review was done to synthesize
the findings. This study was registered on Prospero (CRD42022375703).
Results From 1249 initial studies, only 7 studies were eligible for
systematic review (4.0- to 8.3-year follow-up). This included a total of
3256 patients(median age range, 45-65 years and female percentage,
36.4%-65.6%). Performing Maze procedure was found to be protective of
tricuspid regurgitation progression as TR grade worsened to 2.7+/-0.8 in
45% of patients in the no-Maze group(p<0.001) with 8 years follow up. In
another study, non-ablated group showed higher risk of progression to
moderate-severe TR(HR 1.436; 95% CI 1.059-1.948; p=0.020) with 5 years
follow up. The progression of TR was associated with older age(HR 1.05;
95% CI 1.02 to 1.08), absence of Maze operation(HR 7.90; 95% CI, 1.90 to
32.86), male gender(HR 3.83; 95% CI, 1.28-11.40), and post-operative AF(HR
14.56; 95% CI 4.46-47.58, p<0.001). Patients who had Maze procedures had
higher freedom from major adverse cardiovascular and cerebrovascular event
rates at 10 years(55.6% vs 36.2%; p=0.047). Conclusion This study has
identified that performing Maze procedure for atrial fibrillation with
pre-existing TR halts its progression and reduces post-operative
complications. However, clinical trials or prospective studies may have to
be done to clearly demonstrate the benefits.<br/>Copyright &#xa9; 2024
American College of Cardiology Foundation

<132>
Accession Number
2031114094
Title
ANTERO-POSTERIOR MITRAL ANNULAR DIAMETERS AND CLINICAL OUTCOMES IN THE
COAPT TRIAL.
Source
Journal of the American College of Cardiology. Conference: American
College of Cardiology 73rd Annual Scientific Session & Expo. Atlanta
United States. 83(13 Supplement) (pp 835), 2024. Date of Publication: 02
Apr 2024.
Author
Rogers J.H.; Smith T.W.; Bax J.; Asch F.M.; Lim S.; Wong N.; Mack M.J.;
Stone G.W.; Bolling S.F.
Institution
(Rogers, Smith, Bax, Asch, Lim, Wong, Mack, Stone, Bolling) University of
California, Davis, Davis, CA, United States
Publisher
Elsevier Inc.
Abstract
Background In the randomized COAPT trial, mitral transcatheter
edge-to-edge repair (TEER) reduced mitral regurgitation, heart failure
hospitalizations (HFH), and mortality and improved quality of life in
patients with severe secondary mitral regurgitation (SMR) compared with
guideline-directed medical therapy (GDMT) alone through 5 years. A prior
posthoc analysis of baseline echocardiographic mitral valve geometric
parameters showed that increasing anteroposterior mitral annular diameter
(APMAD) was the sole independent predictor of the composite endpoint of
all-cause mortality or HFH at 2 years. Given the relationship between the
mitral annulus and leaflets, and that annuloplasty can be a surgical
treatment for SMR, we examined the association of baseline APMAD on
long-term clinical outcomes and change in annular dimensions. Methods A
total of 614 patients with 3+/4+ SMR despite maximally tolerated GDMT were
randomized to TEER + GDMT (n=302) vs. GDMT alone (n=312) at 78 centers in
the US and Canada. Per the baseline APMAD measurements, subjects were
stratified into quintiles. Results Subjects with larger baseline APMAD
were more often male with a more frequent history of atrial fibrillation
or arrhythmias, larger ventricles, and larger mitral orifice areas. At 24
months, there were no significant differences in MR severity, quality of
life, and functional class improvement between quintiles. However,
subjects with larger baseline APMAD (5^th quintile) experienced
a higher occurrence of the composite death or HFH outcome compared to
subjects with smaller baseline APMAD (1^st - 4^th
quintiles). The treatment effect of TEER + GDMT vs GDMT alone on 5-year
outcomes by baseline APMAD for these subjects and the change in annular
dimensions will be presented. Conclusion In the COAPT trial, subjects
experienced significant improvements in MR severity, functional class, and
quality of life post-procedure regardless of baseline APMAD. However,
subjects with a larger baseline APMAD (5^th quintile)
experienced higher rates of death or HFH. Future analysis will investigate
the effect of treatment and baseline APMAD on 5-year outcomes and annular
remodeling in subjects in the COAPT trial.<br/>Copyright &#xa9; 2024
American College of Cardiology Foundation

<133>
Accession Number
2031113807
Title
TEMPORAL CHANGE OF MITRAL STENOSIS IN PATIENTS WITH MAC AFTER SUCCESSFUL
AORTIC VALVE INTERVENTION.
Source
Journal of the American College of Cardiology. Conference: American
College of Cardiology 73rd Annual Scientific Session & Expo. Atlanta
United States. 83(13 Supplement) (pp 952), 2024. Date of Publication: 02
Apr 2024.
Author
Ansani T.; Nguyen J.; Olson S.D.; Bergstedt S.; Olson M.; Nguyen L.; Wong
K.; Goessl M.
Institution
(Ansani, Nguyen, Olson, Bergstedt, Olson, Nguyen, Wong, Goessl)
Minneapolis Heart Institute Foundation, Minneapolis, MN, United States
Publisher
Elsevier Inc.
Abstract
Background Patients with severe aortic valve stenosis and concomitant mild
to moderate mitral stenosis (MS) from mitral annular calcification (MAC)
often undergo aortic valve replacement (AVR) while sparing the mitral
valve. This study aimed to analyze the rate of progression of MS in MAC in
patients undergoing AVR. Methods A retrospective cohort study was
conducted on 209 patients with MS and MAC undergoing AVR at Allina in
2012-2022. The rate of progression for mitral valve regurgitation (MR),
MS, left ventricular dysfunction, and survival probability were analyzed
by serial echocardiography. Results Among the 209 patients with MAC, most
patients had similar demographics and cardiac comorbidities (Table 1).
There was no significant change in MS severity (Figure 1) and survival
within 5 years (Figure 2). However, as MR severity increased (Figure 3),
left ventricular ejection fraction decreased (Figure 4). MR was correlated
with a decrease in ejection fraction (Figure 5). Conclusion Patients with
MAC will not experience a significant change to their MS after AVR but may
experience increased MR and decreased left ventricular function. [Formula
presented]<br/>Copyright &#xa9; 2024 American College of Cardiology
Foundation

<134>
Accession Number
2031112871
Title
TRANSCATHETER EDGE-TO-EDGE MITRAL VALVE REPAIR FOR MITRAL REGURGITATION IN
PATIENTS WITH CARDIOGENIC SHOCK: A SYSTEMATIC REVIEW AND META-ANALYSIS.
Source
Journal of the American College of Cardiology. Conference: American
College of Cardiology 73rd Annual Scientific Session & Expo. Atlanta
United States. 83(13 Supplement) (pp 838), 2024. Date of Publication: 02
Apr 2024.
Author
Kuno T.; Saito T.; Ueyama H.; Kampaktsis P.; Kolte D.; Misumida N.; Takagi
H.; Aikawa T.; Latib A.
Institution
(Kuno, Saito, Ueyama, Kampaktsis, Kolte, Misumida, Takagi, Aikawa, Latib)
Montefiore Medical Center, Bronx, NY, United States
Publisher
Elsevier Inc.
Abstract
Background Evidence for transcatheter edge-to-edge mitral valve repair
(TEER) for mitral regurgitation (MR) in patients with cardiogenic shock
(CS) is limited. We aimed to investigate the characteristics and outcomes
of CS patients who underwent TEER for MR. Methods PubMed, EMBASE were
searched in July 2023. Case series and observational studies reporting
clinical characteristics and outcomes in CS patients with MR who underwent
TEER were included. We performed a one-group meta-analysis using a random
effects model. Results A total of 4,060 patients from 7 case series and 5
observational studies were included. The mean age was 68.2 (95% confidence
interval [CI], 64.1-72.2) years, and 41.4% of patients (95% CI, 39.1% -
43.7%) were female. Pre-TEER, severe MR was present in 85.3% (95% CI,
76.1%-91.3%) of patients. Mean left ventricular ejection fraction was
36.7% (95% CI, 29.2%-44.2%), and 54.6% (95% CI, 36.9%-71.2%) of patients
received mechanical circulatory support. The severity of MR post-TEER was
less than 2+ in 88% (95% CI, 87% - 89%) of patients (Figure). In-hospital
mortality was 11% (95% CI, 10% - 13%) (Figure), whereas 30-day and 1-year
mortality rates were 15% (95% CI, 13% - 16%), and 36% (95% CI, 21% - 54%)
respectively. Conclusion This systematic review and meta-analysis assessed
the clinical characteristics and outcomes of TEER in CS patients with MR.
TEER for MR in patients with CS has been successful in reducing MR in most
of the patients, but with a high mortality rate. [Formula
presented]<br/>Copyright &#xa9; 2024 American College of Cardiology
Foundation

<135>
Accession Number
2030847679
Title
Novel Modified Inner Branched Arch Endograft for Pseudoaneurysm Post Type
A Dissection Repair.
Source
EJVES Vascular Forum. Conference: The European Society for Vascular
Surgery 37th Annual Meeting 2023. Belfast United Kingdom. 61(Supplement 1)
(pp S1-S2), 2024. Date of Publication: January 2024.
Author
Lim E.; Benson R.; Lyons O.; Laing A.; Khanafer A.
Institution
(Lim, Lyons, Khanafer) Te Whatu Ora Health New Zealand, Vascular,
Endovascular and Transplant Surgery, New Zealand
(Benson, Laing) Te Whatu Ora Health New Zealand, Radiology, New Zealand
Publisher
Elsevier Ltd
Abstract
Objective: Pseudoaneurysm formation post type A aortic dissection repair
is rare. Revision surgical repair is challenging, with a risk of death
from haemorrhage. <br/>Method(s): A 56 year old man presented with a
rapidly enlarging distal ascending aortic anastomotic pseudoaneurysm
following a recent ascending and hemi-arch replacement for acute type A
aortic dissection. A tight kink in the ascending aortic graft precluded an
endovascular repair utilising two antegrade branches, and so a novel
custom made three inner branched aortic endograft was designed, with an
antegrade brachiocephalic inner branch and retrograde left common carotid
and subclavian artery inner branches. <br/>Result(s): The patient required
an angioplasty to dilate the kinked/coarcted surgical graft, but made an
uneventful recovery. <br/>Conclusion(s): An aortic arch inner branch
design with an antegrade brachiocephalic branch but retrograde left common
carotid and left subclavian branches was feasible, and may prove
particularly useful when there is limited space in the ascending aorta.
REFERENCES 1. Quevedo HC, Santiago-Trinidad R, Castellanos J, Atianzar K,
Anwar A, Abi Rafeh N. Systematic review of interventions to repair
ascending aortic pseudoaneurysms. Ochsner J 2014;14:576-85. 2. Navaravong
L, Saab F, Cook JR, Peterman M, Flack J. Ascending aortic pseudoaneurysm,
a ticking bomb after cardiac surgery. Cardiovasc Revasc Med
2011;12:177-80. 3. Jung TE, Lee DH. Surgery for pseudoaneurysm of the
ascending aorta under moderate hypothermia. J Cardiothorac Surg
2011;6:125. 4. Sullivan KL, Steiner RM, Smullens SN, Griska L, Meister SG.
Pseudoaneurysm of the ascending aorta following cardiac surgery. Chest
1988;93:138-43. 5. Malvindi PG, van Putte BP, Sonker U, Heijmen RH,
Schepens MA, Morshuis WJ. Reoperation after acute type A aortic dissection
repair: a series of 104 patients. Ann Thorac Surg 2013;95:922-7. 6.
Katsumata T, Moorjani N, Vaccari G, Westaby S. Mediastinal false aneurysm
after thoracic aortic surgery. Ann Thorac Surg 2000;70:547-52. 7. Garg N,
Bacharach JM, Reynolds TR. Endovascular repair of ascending aortic
pseudoaneurysm. Ann Vasc Surg 2011;25:696. 8. Tsilimparis N, Detter C,
Heidemann F, Spanos K, Rohlffs F, von Kodolitsch Y, et al. Branched
endografts in the aortic arch following open repair for DeBakey Type I
aortic dissection. Eur J Cardiothorac Surg 2018;54:517-23. 9. Nomura Y,
Koide Y, Kawasaki R, Murakami H. Endovascular repair for ascending aortic
graft side branch pseudoaneurysm: a report of two cases. EJVES Vasc Forum
2022;55:48-51. 10. Czerny M, Schmidli J, Adler S, van den Berg JC,
Bertoglio L, Carrel T, et al. Editor's Choice - Current options and
recommendations for the treatment of thoracic aortic pathologies involving
the aortic arch: an expert consensus document of the European Association
for Cardio-Thoracic Surgery (EACTS) & the European Society for Vascular
Surgery (ESVS). Eur J Vasc Endovasc Surg 2019;57:165-98. [Formula
presented] [Formula presented]<br/>Copyright &#xa9; 2023

<136>
Accession Number
643777734
Title
The Role of ECMO in Anesthetic Practice: A Systematic Review of
Perioperative Outcomes and Management Strategies.
Source
ASAIO Journal. Conference: 10th SWAAC Extracorporeal Life Support
Organization Conference , SWAACELSO 2024. Kuwait City Kuwait.
70(Supplement 1) (pp 28), 2024. Date of Publication: February 2024.
Author
Alotaibi S.; Alnouri M.; Sulaiman R.; Abduljaleel A.; Bogari A.; Mufti H.
Institution
(Alotaibi, Alnouri) KFAFH, MOD, Jeddah, Saudi Arabia
(Sulaiman) Dr. Sulaiman Fakeeh Hospital, Jeddah, Saudi Arabia
(Abduljaleel, Bogari) King Fahad Hospital, Jeddah, Saudi Arabia
(Mufti) KFCC, KAMC, MNGHA, Jeddah, Saudi Arabia
(Mufti) KAIMRC, MNGHA, Jeddah, Saudi Arabia
(Mufti) COM, KSAU-HS, MNGHA, Jeddah, Saudi Arabia
Publisher
Lippincott Williams and Wilkins
Abstract
Background: Extracorporeal membrane oxygenation (ECMO) has become a
well-recognized technique for managing patients undergoing cardiac
surgery. However, its perioperative outcomes and the best evidence for
management remain unclear. Therefore, this systematic review aims to
clarify the ECMO perioperative outcomes and the best evidence management
practices. Methodology: PubMed and Embase were searched for research
articles published between 2013 and 2023 with evidence relevant to the
purpose of this review. The research articles were screened based on
predetermined inclusion and exclusion criteria. Data were extracted and
the results and key findings were systematically summarized. Quality
assessment was conducted using CASP's and Kmet et al.'s checklists.
<br/>Result(s): 2495 research articles (1407 from Embase and 1088 from
PubMed were retrieved. After a thorough screening protocol, five research
articles, including two RCTs, two case-control studies, and one cohort
study, were included in this systematic review. The CASP's and Kmet et al.
checklists indicated that the five research articles were quality.
Levosimendan administration in ECMO was not associated with better patient
outcomes - not improving ECMO success and patient survival. Peripheral
ECMO (pECMO) was associated with reduced complications and improved
patient survival compared to Central ECMO (cECMO). Complications,
especially bleeding, have a significant negative impact on ECMO success
and contribute to high mortality rates. <br/>Conclusion(s): pECMO
cannulation technique is associated with less complications and better
outcomes and should be considered the primary cannulation approach for
patients requiring ECMO. However, prospective multicenter RCTs need to
establish the evidence.

<137>
Accession Number
2029060973
Title
Fractional flow reserve and instantaneous wave-free ratio in coronary
artery bypass grafting: a meta-analysis and practice review.
Source
Frontiers in Cardiovascular Medicine. 11 (no pagination), 2024. Article
Number: 1348341. Date of Publication: 2024.
Author
Abbasciano R.G.; Layton G.R.; Torre S.; Abbaker N.; Copperwheat A.;
Lucarelli C.; Bhandari S.; Nijjer S.; Mikhail G.; Casula R.; Zakkar M.;
Viviano A.
Institution
(Abbasciano, Abbaker, Lucarelli, Nijjer, Mikhail, Casula, Viviano)
Department of Cardiothoracic Surgery, Imperial College Healthcare NHS
Trust, London, United Kingdom
(Layton, Zakkar) Department of Cardiovascular Sciences, University of
Leicester, Leicester, United Kingdom
(Layton, Copperwheat, Zakkar) Department of Cardiac Surgery, University
Hospitals of Leicester NHS Trust, Leicester, United Kingdom
(Torre) Cardiac Surgery Unit, Giaccone Hospital, Palermo, Italy
(Bhandari) Department of Cardiology, University Hospitals of Leicester NHS
Trust, Leicester, United Kingdom
Publisher
Frontiers Media SA
Abstract
Objective: Fractional flow reserve (FFR) and instantaneous wave-free ratio
(iFR) are invasive methods to assess the functional significance of
intermediate severity coronary lesions. Both indexes have been extensively
validated in clinical trials in guiding revascularisation in patients with
stable ischaemic heart disease undergoing percutaneous coronary
intervention (PCI) with improved clinical outcomes. However, the role of
these tools in coronary artery bypass grafting (CABG) is less clear.
<br/>Method(s): A meta-analysis of randomised trials and observational
studies was carried out to help in determining the optimal strategy for
assessing lesion severity and selecting graft targets in patients
undergoing CABG. Electronic searches were carried out on Embase, MEDLINE,
and Web of Science. A group of four authors independently screened and
then assessed the retrieved records. Cochrane's Risk of Bias and Robins-I
tools were used for bias assessment. A survey was conducted among surgeons
and cardiologists to describe current attitudes towards the preoperative
use of functional coronary investigations in practice. <br/>Result(s):
Clinical outcomes including mortality at 30 days, perioperative myocardial
infarction, number of grafts, incidence of stroke, rate of further need
for revascularisation, and patient-reported quality of life did not differ
in CABG guided by functional testing from those guided by traditional
angiography. The survey revealed that in half of the surgical and
cardiology units functional assessment is performed in CABG patients;
there is a general perception that functional testing has improved patient
care and its use would clarify the role of moderate coronary lesions that
often need multidisciplinary rediscussions; moderate stenosis are felt to
be clinically relevant; and anatomical considerations need to be taken
into account together with functional assessment. <br/>Conclusion(s): At
present, the evidence to support the routine use of functional testing in
intermediate lesions for planning CABG is currently insufficient. The
pooled data currently available do not show an increased risk in
mortality, myocardial injury, and stroke in the FFR/iFR-guided group.
Further trials with highly selected populations are needed to clarify the
best strategy. Systematic Review Registration: ClinicalTrials.gov,
identifier (CRD42023414604).<br/>Copyright 2024 Abbasciano, Layton, Torre,
Abbaker, Copperwheat, Lucarelli, Bhandari, Nijjer, Mikhail, Casula, Zakkar
and Viviano.

<138>
Accession Number
2031106151
Title
Vasoplegic syndrome during heart transplantation: A systematic review and
meta-analysis.
Source
Journal of Heart and Lung Transplantation. (no pagination), 2024. Date of
Publication: 2024.
Author
Kumar N.; Fitzsimons M.G.; Iyer M.H.; Essandoh M.; Kumar J.E.; Dalia A.A.;
Osho A.; Sawyer T.R.; Bardia A.
Institution
(Kumar, Fitzsimons, Dalia, Bardia) Department of Anesthesia, Critical
Care, and Pain Medicine, Massachusetts General Hospital, Harvard Medical
School, Boston, Massachusetts, United States
(Iyer, Essandoh) Department of Anesthesiology, The Ohio State University
Wexner Medical Center, Columbus, OH, United States
(Kumar) University of Cincinnati College of Medicine, Cincinnati, Ohio,
United States
(Osho) Division of Cardiac Surgery, Department of Surgery, Massachusetts
General Hospital, Harvard Medical School, Boston, Massachusetts, United
States
(Sawyer) Central Michigan University College of Medicine, Mt. Pleasant,
Michigan, United States
Publisher
Elsevier Inc.
Abstract
Background: Vasoplegic syndrome (VS) is a common occurrence during heart
transplantation (HT). It currently lacks a uniform definition between
transplant centers, and its pathophysiology and treatment remain
enigmatic. This systematic review summarizes the available published
clinical data regarding VS during HT. <br/>Method(s): We searched
databases for all published reports on VS during HT. Data collected
included the incidence of VS in the HT population, patient and
intraoperative characteristics, and postoperative outcomes.
<br/>Result(s): Twenty-two publications were included in this review. The
prevalence of VS during HT was 28.72% (95% confidence interval: 27.37%,
30.10%). Factors associated with VS included male sex, higher body mass
index, hypothyroidism, pre-HT left ventricular assist device or
venoarterial extracorporeal membrane oxygenation (VA-ECMO), pre-HT calcium
channel blocker or amiodarone usage, longer cardiopulmonary bypass time,
and higher blood product transfusion requirement. Patients who developed
VS were more likely to require postoperative VA-ECMO support, renal
replacement therapy, reoperation for bleeding, longer mechanical
ventilation, and a greater 30-day and 1-year mortality.
<br/>Conclusion(s): The results of our systematic review are an initial
step for providing clinicians with data that can help identify high-risk
patients and avenues for potential risk mitigation. Establishing
guidelines that officially define VS will aid in the precise diagnosis of
these patients during HT and guide treatment. Future studies of treatment
strategies for refractory VS are needed in this high-risk patient
population.<br/>Copyright &#xa9; 2024 International Society for the Heart
and Lung Transplantation

<139>
Accession Number
643767531
Title
Prospective randomized double-blind study to evaluate the superiority of
Vasopressin versus Norepinephrine in the management of the patient at
renal risk undergoing cardiac surgery with cardiopulmonary bypass (NOVACC
trial).
Source
American heart journal. (no pagination), 2024. Date of Publication: 14
Mar 2024.
Author
Guinot P.-G.; Desebbe O.; Besch G.; Guerci P.; Gaudard P.; Lena D.; Mertes
P.M.; Abou-Arab O.; Bouhemad B.
Institution
(Guinot, Bouhemad) Department of Anaesthesiology and Critical Care
Medicine, Dijon University Medical Centre, 21000 Dijon, France; University
of Burgundy and Franche-Comte, LNC UMR1231, F-21000 Dijon, France
(Desebbe) Ramsay Sante, Lyon, France
(Besch) Department of Anaesthesiology and Critical Care Medicine, Besancon
Regional University Medical Centre, Besancon, France; EA3920, University
of Franche-Comte, Besancon, France
(Guerci) Department of Anesthesia and Critical Care, University Hospital
of Nancy, Nancy, France
(Gaudard) Department of Anesthesia and Critical Care, University Hospital
of Montpellier, France
(Lena) Institut Arnault Tzanck, Saint Laurent du Var, France
(Mertes) Department of Anesthesia and Critical Care, University Hospital
of Strasbourg, Strasbourg, France
(Abou-Arab) Department of Anesthesia and Critical Care, University
Hospital of Amiens, Amiens, France
Abstract
BACKGROUND: Cardiac surgery-associated acute kidney injury (CS-AKI)
affects up to 30% of patients, increasing morbidity and healthcare costs.
This condition results from complex factors like ischemia-reperfusion
injury and renal hemodynamic changes, often exacerbated by surgical
procedures. Norepinephrine, commonly used in cardiac surgeries, may
heighten the risk of CS-AKI. In contrast, vasopressin, a
non-catecholaminergic agent, shows potential in preserving renal function
by favorably affecting renal hemodynamic. Preliminary findings, suggest
vasopressin could reduce the incidence of CS-AKI compared to
norepinephrine. Additionally, vasopressin is linked to a lower incidence
of post-operative atrial fibrillation, another factor contributing to
longer hospital stays and higher costs. This study hypothesizes that
vasopressin could effectively reduce CS-AKI occurrence and severity by
optimizing renal perfusion during cardiac surgeries. STUDY DESIGN: The
NOVACC trial (NCT05568160) is a multicenter, randomized, double blinded
superiority-controlled trial testing the superiority of vasopressin over
norepinephrine in patients scheduled for cardiac surgery with
cardiopulmonary bypass (CPB). The primary composite end point is the
occurrence of acute kidney injury and death. The secondary end points are
neurological, cardiologic, digestive, and vasopressor related
complications at day 7, day 30, day 90, hospital and intensive care unit
lengths of stay, medico-economic costs at day 90. <br/>CONCLUSION(S): The
NOVACC trial will assess the effectiveness of vasopressin in cardiac
surgery with CPB in reducing acute kidney injury, mortality, and medical
costs. CLINICAL TRIAL REGISTRATION: NCT05568160.<br/>Copyright &#xa9; 2024
The Author(s). Published by Elsevier Inc. All rights reserved.