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

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<1>
Accession Number
2032319093
Title
Cardiovascular outcomes of sodium-glucose Co-transporter 2 inhibitors use
after myocardial infarction: A systematic review and meta-analysis of
randomized controlled trials.
Source
Current Problems in Cardiology. 49(8) (no pagination), 2024. Article
Number: 102648. Date of Publication: August 2024.
Author
Idowu A.; Adebolu O.; Wattanachayakul P.; Obomanu E.; Shah S.; Lo K.B.;
Pressman G.
Institution
(Idowu, Adebolu, Wattanachayakul, Obomanu) Department of Medicine,
Jefferson-Einstein Medical Center, Philadelphia, PA, United States
(Shah, Pressman) Department of Cardiology, Jefferson-Einstein Medical
Center, Philadelphia, PA, United States
(Lo) Department of Cardiology, Brigham and Women's Hospital, Boston, MA,
United States
Publisher
Elsevier Inc.
Abstract
Background: Patients who had acute myocardial infarction are at high risk
of negative cardiac outcomes and previous SGLT2i landmark trials excluded
these patients. It therefore remains unclear if SGLT2i is safe and confers
beneficial cardiovascular outcomes after acute myocardial infarction.
 Method(s): We systematically reviewed randomized controlled trials
that evaluated the outcomes of adding SGLT2i to conventional
post-myocardial infarction care. Random-effects model meta-analysis via
RevMan 5.4 was done on data extracted from pooled 11,204 patients.
 Result(s): SGLT2i use after acute myocardial infarction was
significantly associated with reduced heart failure hospitalization (OR:
0.77, 95%CI: 0.62-0.96, p=0.02), but was not associated with a reduction
in all-cause mortality (OR: 1.05, 95%CI: 0.77-1.43, p=0.75),
cardiac-related death (OR: 1.04, 95%CI: 0.83-1.30, p=0.76), or major
adverse cardiac events (OR: 0.90, 95%CI: 0.77-1.05, p=0.18).
 Conclusion(s): SGLT2 inhibitor therapy after acute myocardial
infarction is safe and is associated with a reduced risk of heart failure
hospitalization, but not with all-cause mortality. Copyright ©
2024 Elsevier Inc.

<2>
Accession Number
2030972726
Title
Impact of maintaining serum potassium concentration >= 3.6mEq/L versus >=
4.5mEq/L for 120 hours after isolated coronary artery bypass graft surgery
on incidence of new onset atrial fibrillation: Protocol for a randomized
non-inferiority trial.
Source
PLoS ONE. 19(3 March) (no pagination), 2024. Article Number: e0296525.
Date of Publication: March 2024.
Author
Campbell N.G.; Allen E.; Evans R.; Jamal Z.; Opondo C.; Sanders J.;
Sturgess J.; Montgomery H.E.; Elbourne D.; O'Brien B.
Institution
(Campbell) Faculty of Biology, Division of Cardiovascular Sciences, School
of Medical Sciences, Medicine and Health, University of Manchester,
Manchester Academic Health Science Centre, Manchester, United Kingdom
(Campbell) Manchester Heart Institute, Manchester University Foundation
NHS Trust, Manchester, United Kingdom
(Allen, Evans, Jamal, Opondo, Sturgess, Elbourne) Clinical Trials Unit,
London School of Hygiene and Tropical Medicine, London, United Kingdom
(Sanders) William Harvey Research Institute, Queen Mary University of
London, London, United Kingdom
(Montgomery) Division of Medicine and Institute for Sport, Exercise and
Health, University College London, London, United Kingdom
(O'Brien) Department of Cardiac Anesthesiology and Intensive Care
Medicine, Deutsches Herzzentrum der Charite, Berlin, Germany
(O'Brien) Department of Perioperative Medicine, St Bartholomew's Hospital,
Barts Health NHS Trust, London, United Kingdom
(O'Brien) Outcomes Research Consortium, Cleveland, OH, United States
Publisher
Public Library of Science
Abstract
Background Atrial Fibrillation After Cardiac Surgery (AFACS) occurs in
about one in three patients following Coronary Artery Bypass Grafting
(CABG). It is associated with increased short- and long-term morbidity,
mortality and costs. To reduce AFACS incidence, efforts are often made to
maintain serum potassium in the high-normal range (>= 4.5mEq/L). However,
there is no evidence that this strategy is efficacious. Furthermore, the
approach is costly, often unpleasant for patients, and risks causing harm.
We describe the protocol of a planned randomized non-inferiority trial to
investigate the impact of intervening to maintain serum potassium >= 3.6
mEq/L vs >= 4.5 mEq/L on incidence of new-onset AFACS after isolated
elective CABG. Methods Patients undergoing isolated CABG at sites in the
UK and Germany will be recruited, randomized 1:1 and stratified by site to
protocols maintaining serum potassium at either >= 3.6 mEq/L or >= 4.5
mEq/L. Participants will not be blind to treatment allocation. The primary
endpoint is AFACS, defined as an episode of atrial fibrillation, flutter
or tachycardia lasting >= 30 seconds until hour 120 after surgery, which
is both clinically detected and electrocardiographically confirmed.
Assuming a 35% incidence of AFACS in the 'tight control group', and
allowing for a 10% loss to follow-up, 1684 participants are required to
provide 90% certainty that the upper limit of a one-sided 97.5% confidence
interval (CI) will exclude a > 10% difference in favour of tight potassium
control. Secondary endpoints include mortality, use of hospital resources
and incidence of dysrhythmias not meeting the primary endpoint (detected
using continuous heart rhythm monitoring). Discussion The Tight K Trial
will assess whether a protocol to maintain serum potassium >= 3.6 mEq/L is
non inferior to maintaining serum potassium >= 4.5 mEq/L in preventing
new-onset AFACS after isolated CABG. Copyright © 2024 Campbell et
al.

<3>
Accession Number
2032047782
Title
Effect of Reconstituted Human Apolipoprotein A-I on Recurrent Ischemic
Events in Survivors of Acute MI.
Source
Journal of the American College of Cardiology. 83(22) (pp 2163-2174),
2024. Date of Publication: 04 Jun 2024.
Author
Povsic T.J.; Korjian S.; Bahit M.C.; Chi G.; Duffy D.; Alexander J.H.;
Vinereanu D.; Tricoci P.; Mears S.J.; Deckelbaum L.I.; Bonaca M.; Ridker
P.M.; Goodman S.G.; Cornel J.H.; Lewis B.S.; Parkhomenko A.; Lopes R.D.;
Aylward P.; Lincoff A.M.; Heise M.; Sacks F.; Nicolau J.C.; Merkely B.;
Trebacz J.; Libby P.; Nicholls S.J.; Pocock S.; Bhatt D.L.; Kastelein J.;
Bode C.; Mahaffey K.W.; Steg P.G.; Tendera M.; Bainey K.R.; Harrington
R.A.; Mehran R.; Duerschmied D.; Kingwell B.A.; Gibson C.M.
Institution
(Povsic, Alexander, Lopes) Duke Clinical Research Institute/Duke
University Medical Center, Durham, NC, United States
(Korjian, Chi, Gibson) PERFUSE Study Group, Division of Cardiovascular
Medicine, Department of Medicine, Beth Israel Deaconess Medical Center,
Harvard Medical School, Boston, MA, United States
(Bahit) INECO Neurociencias, Rosario, Argentina
(Duffy, Tricoci, Mears, Deckelbaum, Heise) CSL Behring, King of Prussia,
PA, United States
(Vinereanu) University of Medicine and Pharmacy Carol Davila, University
and Emergency Hospital, Bucharest, Romania
(Bonaca) University of Colorado School of Medicine, Anschutz Medical
Campus, Aurora, CO, United States
(Ridker, Libby) Brigham and Women's Hospital, Harvard Medical School,
Boston, MA, United States
(Goodman, Bainey) Canadian VIGOUR Centre, University of Alberta, Edmonton,
Alberta, Canada
(Cornel) Radboud University Medical Center, Nijmegen and Noordwest
Ziekenhuisgroep, Alkmaar, Netherlands
(Lewis) Lady Davis Carmel Medical Center and the Technion-Israel Institute
of Technology, Aurora, Colorado, United States
(Parkhomenko) National Scientific Center, Kyiv, Ukraine
(Aylward) South Australian Health and Medical Research Institute/SAHMRI,
Adelaide, SA, Australia
(Lincoff) Cleveland Clinic Coordinating Center for Clinical Research,
Cleveland, OH, United States
(Sacks) Department of Nutrition, Harvard School of Public Health, Harvard
Medical School, Boston, MA, United States
(Nicolau) Instituto do Coracao (InCor), Hospital das Clinicas HCFMUSP,
Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
(Merkely) Heart and Vascular Center of Semmelweis University, Budapest,
Hungary
(Trebacz) Krakowski Szpital Specjalistyczny im. Jana Pawla II, Krakow,
Poland
(Nicholls) Victorian Heart Hospital, Monash Heart and Intensive Care,
Clayton, VIC, Australia
(Pocock) London School of Hygiene and Tropical Medicine, London, United
Kingdom
(Bhatt) Mount Sinai Fuster Heart Hospital, Icahn School of Medicine at
Mount Sinai, New York, NY, United States
(Kastelein) Academic Medical Centre/University of Amsterdam, Amsterdam,
Netherlands
(Bode, Mehran) University of Freiburg, Freiburg, Germany
(Mahaffey) Stanford Center for Clinical Research, Stanford University
School of Medicine, Stanford, CA, United States
(Steg) Universite Paris-Cite, INSERM 1148, FACT, and AP-HP, Hopital
Bichat, Paris, France
(Tendera) Department of Cardiology and Structural Heart Disease, School of
Medicine in Katowice, Medical University of Silesia, Katowice, Poland
(Harrington) Weill Cornell Medicine, New York, NY, United States
(Duerschmied) Cardiology, Angiology, Haemostaseology, and Medical
Intensive Care, Medical Centre Mannheim, Medical Faculty Mannheim,
Heidelberg University, Heidelberg, Germany
(Kingwell) CSL Limited, Melbourne, VIC, Australia
Publisher
Elsevier Inc.
Abstract
Background: The AEGIS-II trial hypothesized that CSL112, an intravenous
formulation of human apoA-I, would lower the risk of plaque disruption,
decreasing the risk of recurrent events such as myocardial infarction (MI)
among high-risk patients with MI. Objective(s): This exploratory
analysis evaluates the effect of CSL112 therapy on the incidence of
cardiovascular (CV) death and recurrent MI. Method(s): The AEGIS-II
trial was an international, multicenter, randomized, double-blind,
placebo-controlled trial that randomized 18,219 high-risk acute MI
patients to 4 weekly infusions of apoA-I (6 g CSL112) or placebo.
 Result(s): The incidence of the composite of CV death and type 1 MI
was 11% to 16% lower in the CSL112 group over the study period (HR: 0.84;
95% CI: 0.7-1.0; P = 0.056 at day 90; HR: 0.86; 95% CI: 0.74-0.99; P =
0.048 at day 180; and HR: 0.89; 95% CI: 0.79-1.01; P = 0.07 at day 365).
Similarly, the incidence of CV death or any MI was numerically lower in
CSL112-treated patients throughout the follow-up period (HR: 0.92; 95% CI:
0.80-1.05 at day 90, HR: 0.89; 95% CI: 0.79-0.996 at day 180, HR: 0.91;
95% CI: 0.83-1.01 at day 365). The effect of CSL112 treatment on MI was
predominantly observed for type 1 MI and type 4b (MI due to stent
thrombosis). Conclusion(s): Although CSL112 did not significantly
reduce the occurrence of the primary study endpoints, patients treated
with CSL112 infusions had numerically lower rates of CV death and MI,
type-1 MI, and stent thrombosis-related MI compared with placebo. These
findings could suggest a role of apoA-I in reducing subsequent plaque
disruption events via enhanced cholesterol efflux. Further prospective
data would be needed to confirm these observations. Copyright ©
2024 The Authors

<4>
Accession Number
2032090076
Title
Adjunctive Cilostazol in Patients with High Residual Platelet Reactivity
after Drug-Eluting Stent Implantation: A Randomized, Open-Label,
Single-Center, Prospective Study (ADJUST-HPR).
Source
American Journal of Therapeutics. 31(3) (pp E229-E236), 2024. Date of
Publication: 25 May 2024.
Author
Long Zhe G.; Hau Yu L.; Lee D.-H.; Kim M.H.; Serebruany V.
Institution
(Long Zhe, Hau Yu, Kim) Department of Cardiology, Dong-A University
Hospital, Busan, South Korea
(Long Zhe) Department of Cardiology, Affiliated Qiqihar Hospital, Southern
Medical University, China
(Hau Yu) Department of Cardiology, Guilin Medical University, China
(Lee) Department of Intensive Care Medicine, Dong-A University Hospital,
Busan, South Korea
(Serebruany) Division of Neurology, Department of Medicine, Johns Hopkins
University, Baltimore, MD, United States
Publisher
Lippincott Williams and Wilkins
Abstract
Background:Cilostazol as an adjunct to dual antiplatelet therapy (DAPT)
postcoronary stenting may further reduce vascular occlusion risks. The aim
of this study was to assess the impact of cilostazol on high residual
platelet reactivity (HRPR) in patients undergoing drug-eluting coronary
stent implantation. Method(s):In a randomized, open-label,
single-center, prospective study, the degree of platelet inhibition by
cilostazol 100 mg twice daily was assessed on top of conventional DAPT
compared with standard clopidogrel and low-dose aspirin combination in
poststent patients with HRPR. HRPR was defined as P2Y12 units (PRU) > 240
as measured by the VerifyNow P2Y12 assay. In addition, the platelet
activity was assessed by light transmittance aggregometry (LTA) and
Multiplate electrode analyzer (MEA). Result(s):The total of 148
patients were screened, and HRPR was observed in 64 (43.2%). Those were
randomized for DAPT versus triple therapy (TAPT). After 30 days, TAPT
group exhibited significantly lower rate of HRPR when assessed by all 3
devices (VerifyNow: 40.0 vs. 66.7% P = 0.04, LTA: 6.7 vs. 30.0% P = 0.02,
MEA: 10.0 vs. 30.0% P = 0.05 L all vs. DAPT). Also, higher absolute mean
difference in TAPT versus DAPT group after 30 days (VerifyNow: 71.3 +/-
38.2 vs. 24.6 +/- 40.2 P < 0.001, LTA: 23.9 +/- 15.1 vs. 9.4 +/- 11.8 P <
0.001, MEA: 9.3 +/- 12.9 vs. 2.4 +/- 17.3 P = 0.08) was observed.
 Conclusion(s):Cilostazol in addition to standard DAPT reduces the
incidence of HRPR and diminishes further platelet activity in poststent
patients. Whether this favorable laboratory finding will affect clinical
outcomes requires an adequately powered randomized trial. Copyright
© 2024 Lippincott Williams and Wilkins. All rights reserved.

<5>
Accession Number
2032351077
Title
Evaluation of the effectiveness of curcumin and piperine
co-supplementation on inflammatory factors, cardiac biomarkers, atrial
fibrillation, and clinical outcomes after coronary artery bypass graft
surgery.
Source
Clinical Nutrition ESPEN. 62 (pp 57-65), 2024. Date of Publication: August
2024.
Author
Tehrani S.D.; Hosseini A.; Shahzamani M.; Heidari Z.; Askari G.; Majeed
M.; Sahebkar A.; Bagherniya M.
Institution
(Tehrani, Askari, Bagherniya) Nutrition and Food Security Research Center
and Department of Community Nutrition, School of Nutrition and Food
Science, Isfahan University of Medical Sciences, Isfahan, Iran, Islamic
Republic of
(Hosseini, Shahzamani) Department of Cardiovascular Surgery, School of
Medicine, Isfahan University of Medical Sciences, Isfahan, Iran, Islamic
Republic of
(Heidari) Department of Biostatistics and Epidemiology, School of Health,
Isfahan University of Medical Sciences, Isfahan, Iran, Islamic Republic of
(Askari, Bagherniya) Anesthesia and Critical Care Research Center, Isfahan
University of Medical Sciences, Isfahan, Iran, Islamic Republic of
(Majeed) Sami-Sabinsa Group Limited, 19/1&19/2, I Main, II Phase, Peenya
Industrial Area, Bengaluru, Karnataka 560 058, India
(Sahebkar) Center for Global Health Research, Saveetha Medical College and
Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha
University, Chennai, India
(Sahebkar) Applied Biomedical Research Center, Mashhad University of
Medical Sciences, Mashhad, Iran, Islamic Republic of
(Sahebkar) Biotechnology Research Center, Pharmaceutical Technology
Institute, Mashhad University of Medical Sciences, Mashhad, Iran, Islamic
Republic of
Publisher
Elsevier Ltd
Abstract
Background: Coronary artery bypass graft (CABG) is one of the preferred
treatments for patients with heart problems, especially in individuals
with other comorbidities and when multiple arteries are narrowed. This
study aimed to assess the effects of administrating curcumin-piperine on
patients who underwent CABG surgery. Method(s): This was a
randomized, double-blind, placebo-controlled clinical trial, in which 80
eligible adults who underwent CABG surgery, were randomized into 4 groups.
Patients received 3 tablets daily for 5 days after the surgery, which
contained curcumin-piperine (each tablet contained 500 mg curcumin +5 mg
piperine) or a placebo (each tablet contained 505 mg maltodextrin). Group
A received 3 placebo tablets, group B received 2 placebos and one
curcumin-piperine tablet, group C received 1 placebo and 2
curcumin-piperine tablets, and group D received 3 curcumin-piperine
tablets. Before and after the intervention, C-reactive protein (CRP),
total antioxidant capacity (TAC), cardiometabolic factors, clinical
outcomes, and 28-day mortality were evaluated. Result(s):
Between-group analysis showed that CRP significantly decreased (P =
0.028), and TAC significantly increased (P = 0.033) after the intervention
(Post hoc analysis showed that for CRP, the difference was between group B
and D, and for TAC was between group C and D). Between-group analysis also
showed that creatine kinase mono-phosphate (CK-MB) marginally reduced (P =
0.077); however, changes for troponin I (P = 0.692), lactate dehydrogenase
(LDH) (P = 0.668), ejection fraction (P = 0.340), and arterial
fibrillation (P = 0.99) were not significant. Blood urea nitrogen (P =
0.820) and serum creatinine (P = 0.244) did not show notable changes
between groups. Conclusion(s): Supplementation with curcumin-piperine
had a promising effect on serum CRP and TAC. It also had a favorable
impact on CK-MB among patients who underwent CABG surgery. Trial
registration: IRCT20201129049534N4, available on
https://en.irct.ir/trial/56930. Copyright © 2024 European Society
for Clinical Nutrition and Metabolism

<6>
Accession Number
2032313460
Title
The safety and efficacy of balanced crystalloid vs. normal saline in
non-cardiac surgeries - A systematic review and meta-analysis.
Source
European Review for Medical and Pharmacological Sciences. 28(9) (pp
3347-3364), 2024. Date of Publication: 2024.
Author
Cao Q.; Pang Q.-Y.; Sun S.-F.; Jiang Y.; Liu H.-L.
Institution
(Cao) Department of Anesthesiology, Dazhou Dachuan District People's
Hospital, Sichuan Province, Dazhou, China
(Pang, Sun, Jiang, Liu) Department of Anesthesiology, Chongqing University
Cancer Hospital, Shapingba District, Chongqing City, China
Publisher
Verduci Editore s.r.l
Abstract
OBJECTIVE: Balanced crystalloid and normal saline are routinely used in
clinical anesthesia, but their safety and efficacy in non-cardiac
surgeries are still unclear. MATERIALS AND METHODS: PubMed, Embase, Web of
Science, Cochrane Library, Wanfang, and CNKI, from January 1980 to March
2023, were searched. Studies comparing balanced crystalloid (BC) with
normal saline (NS) during non-cardiac surgeries were included. The primary
outcomes were clinical outcomes (acidosis, renal insufficiency, and
mortality), and the secondary outcomes were pH value, Na+, Cl- and
creatinine levels, and vasopressor requirement. RESULT(S):
Forty-three RCTs were included in this meta-analysis. Low evidence
revealed that the development of acidosis was lower in the BC group than
in the NS group (OR: 0.05, 95% CI: 0.01-0.43, I2=80.8%, p=0.00), and no
between- group difference exists in renal insufficiency and mortality. At
the end of surgery and on postoperative day 1 (POD 1), the pH value was
higher, and the levels of Na+ and Cl- were lower in the BC group. No
between-group difference exists in creatinine level and vasopressor
requirement. CONCLUSION(S): Perioperative balanced crystalloids can
maintain the stability of acid-base and electrolyte balance and reduce
acidosis compared with saline, but they cannot reduce postoperative renal
insufficiency and mortality. Copyright © 2024 Verduci Editore
s.r.l. All rights reserved.

<7>
Accession Number
2032302433
Title
Evaluating the safety and efficacy of a novel polysaccharide hemostatic
system during surgery: A multicenter multispecialty prospective randomized
controlled trial: Novel topical hemostatic system for surgery.
Source
Surgery Open Science. 19 (pp 205-211), 2024. Date of Publication: June
2024.
Author
House M.G.; Kim R.; Tseng E.E.; Kaufman R.P.; Moon M.R.; Yopp A.; Master
V.A.
Institution
(House) Indiana University, Indianapolis, IN, United States
(Kim) University of Utah Hospital, Salt Lake City, UT, United States
(Tseng) San Francisco Veterans Affairs Healthcare System, San Francisco,
CA, United States
(Kaufman) Albany Medical College, Albany, NY, United States
(Moon) Baylor College of Medicine, Houston, TX, United States
(Yopp) University of Texas Southwestern, Dallas, TX, United States
(Master) Emory University, Atlanta, GA, United States
Publisher
Elsevier B.V.
Abstract
Background: Operative blood loss is associated with postoperative
morbidity and mortality in surgery. Hemostatic agents are used as adjuncts
for hemostasis during surgery and help to prevent postoperative bleeding.
We evaluated the safety and efficacy of an investigational polysaccharide
hemostatic (PH) topical product compared to a U.S. Food and Drug
Administration (FDA)-approved control in clinical use comprising
microporous polysaccharide hemospheres (MPH) to achieve hemostasis of
bleeding surfaces during surgery. Study design: This prospective
multicenter trial enrolled patients undergoing open elective cardiac,
general, or urologic surgery. Patients were stratified by bleeding
severity and therapeutic area, then randomized 1:1 to receive PH or MPH.
Bleeding assessments occurred intraoperatively using a novel bleeding
assessment methodology. Primary endpoint was noninferiority as compared
with control via effective hemostasis at 7 min. Patients were monitored
and followed daily in the postoperative period until time of discharge and
again at 6 weeks. Overall survival was assessed in oncology patients at 24
months. Safety of PH vs. MPH was determined by comparing relative
incidence of adverse events. Result(s): Across 19 centers, 324 (161
PH, 163 MPH) patients were randomized (48 % general surgery, 27 % cardiac
surgery, and 25 % urologic surgery). PH was noninferior to MPH and met the
primary endpoint of hemostatic success at 7 min at a non-inferiority
margin of 10 %. No significant differences were found in adverse event
rates. Six deaths were reported within the 6-week follow-up period. No
difference in overall survival was observed at 2 years (76 % PH vs. 74 %
MPH, P = .66) for patients undergoing cancer operations.
 Conclusion(s): Across three therapeutic areas, PH was noninferior to
MPH at all hemostasis assessment time points with no safety concerns. PH
is an effective alternative to MPH for hemostasis during surgery.
ClinicalTrials.gov Identifier: NCT02359994 Copyright © 2024 The
Authors

<8>
Accession Number
2029557875
Title
Systematic Literature Review on the Incidence of Herpes Zoster in
Populations at Increased Risk of Disease in the EU/EEA, Switzerland, and
the UK.
Source
Infectious Diseases and Therapy. 13(5) (pp 1083-1104), 2024. Date of
Publication: May 2024.
Author
Marijam A.; Vroom N.; Bhavsar A.; Posiuniene I.; Lecrenier N.; Vroling H.
Institution
(Marijam, Bhavsar, Posiuniene, Lecrenier) GSK, Av. Fleming 20, Wavre 1300,
Belgium
(Vroom, Vroling) Pallas Health Research & amp; Consultancy, A P95 Company,
Rotterdam, Netherlands
Publisher
Adis
Abstract
Introduction: Older adults and patients with underlying conditions such as
immunocompromised (IC) populations (e.g., due to medical conditions or
immunosuppressive medication) are at increased risk for herpes zoster
(HZ). The first HZ recombinant vaccine for IC patients was approved in
2020. Limited evidence exists to inform decision-makers on HZ incidence in
high-risk patients in Europe. This systematic literature review (SLR)
assessed HZ incidence across 14 high-risk populations in the European
Union/European Economic Area, Switzerland, and the United Kingdom.
 Method(s): An SLR (Embase, Medline, 2002-2022, observational studies)
was performed to identify HZ incidence (i.e., primary outcomes: rate or
cumulative; secondary: relative incidence) in type 1 and 2 diabetes
mellitus (DM); chronic obstructive pulmonary disease and asthma;
depression; rheumatic disorders (RD); multiple sclerosis (MS);
inflammatory bowel diseases (IBD); psoriasis; lupus; human
immunodeficiency virus (HIV); solid organ transplantation (SOT); solid
organ malignancy (SOM); hematologic malignancy (HM); and stem cell
transplantation (SCT). Result(s): Of 776 unique records screened, 59
studies were included (24 reported incidence rate per 1000 person-years;
two, cumulative incidence per 1000 persons; and 33, relative incidence).
The highest incidence rates were reported for SOT (12.1-78.8) and SCT
(37.2-56.1); HM (2.9-32.0); RD (0.41-21.5); lupus (11.0-16.5); IC mixed
population (11.3-15.5); HIV/AIDS (11.8-13.0); chronic respiratory diseases
(4.7-11.4); SOM (8.8-11.0); IBD (7.0-10.8); DM (4.3-9.4); depression
(7.2-7.6); MS (5.7-6.3); and psoriasis (5.3-6.1). In many high-risk
populations, HZ incidence was higher for older age groups, women, and some
treatments. Conclusion(s): The HZ incidence rate in Europe increased
with age and varied across high-risk populations, with high rates for
solid organ and stem cell transplants, cancer, and rheumatoid arthritis.
Most studies were retrospective with methodological differences affecting
generalizability and comparability. Future studies should stratify data by
IC population, age, sex, severity, medication, and study
timeframe. Copyright © GSK 2024.

<9>
Accession Number
2029271036
Title
Cardiovascular outcomes of emergent vs elective transcatheter aortic valve
replacement in severe aortic stenosis: regression matched meta-analysis.
Source
American Journal of Cardiovascular Disease. 14(2) (pp 54-69), 2024.
Article Number: AJCD0154771. Date of Publication: 2024.
Author
Sattar Y.; Hamza M.; Yasmin F.; Jabeen S.; Patel N.; Ishaq S.; Alyami B.;
Hussain H.U.; Rehan S.T.; Shuja S.H.; Khan Z.; Bahar Y.; Elgendy I.Y.;
Gonuguntla K.; Thyagaturu H.; Kawsara A.; Felpel K.; Daggubati R.; Alraies
M.C.
Institution
(Sattar, Alyami, Gonuguntla, Thyagaturu, Kawsara, Felpel, Daggubati)
Department of Cardiology, West Virginia University, Morgantown, WV 26506,
United States
(Hamza) Department of Internal Medicine, Albany Medical Center, Albany, NY
12208, United States
(Yasmin) Yale School of Medicine, New Haven, CT 06519, United States
(Jabeen) Liaquat National Hospital and Medical College, Karachi 74800,
Pakistan
(Patel) Department of Internal Medicine, New York Medical College,
Landmark Medical Center, Woonsocket, RI 02895, United States
(Ishaq) Sinai Hospital of Baltimore, Life Bridge Health, Baltimore, MD
21215, United States
(Hussain, Rehan, Shuja, Khan) Department of Internal Medicine, Dow
University of Health Sciences, Karachi 74200, Pakistan
(Bahar) Wayne State University, Detroit, MI 48201, United States
(Elgendy) University of Kentucky, Lexington, KY 40506, United States
(Alraies) Detroit Medical Center, Wayne State University, Detroit, MI
48201, United States
Publisher
E-Century Publishing Corporation
Abstract
Background: Transcatheter aortic valve replacement (TAVR) has been highly
increased as the recommended option for patients with a high surgical
risk. This study aims to commit a systematic review and meta-analysis to
assess the outcomes in severe aortic stenosis patients following emergency
transcatheter aortic valve replacement (emergent TAVR) compared to
elective TAVR or eBAV followed by elective TAVR. Method(s): We
conducted a systematic literature search of PubMed, Embase, Cochrane
CENTRAL, CINAHL, Science Direct, and Google Scholar. We included nine
studies in the latest analysis that reported the desired outcomes.
Outcomes were classified into primary outcomes: 30-day all-cause mortality
and 30-day readmission rate, and secondary outcomes, which were further
divided into (a) peri-procedural outcomes, (b) vascular outcomes, and (c)
renal outcomes. Statistical analysis was performed using Stata v.17
(College State, TX) software. Result(s): A total of 44,731 patients
with severe aortic stenosis were included (emergent TAVR n = 4502; control
n = 40045). 30-day mortality was significantly higher in the emergent TAVR
group (OR: 2.62; 95% CI = 1.76-3.92; P < 0.01). Regarding post-procedural
outcomes, the length of stay was significantly higher in the emergent TAVR
group (Hedges's g: +4.73 days; 95% CI = +3.35 to +6.11; P < 0.01). With
respect to vascular outcomes, they were similar in both groups. Regarding
renal outcomes, both acute kidney injury (OR: 2.52; 95% CI = 1.59-4.00; P
< 0.01) and use of renal replacement therapy (OR: 2.33; 95% CI =
1.87-2.91; P < 0.01) were significantly higher in emergent TAVR group as
compared to the control group. Conclusion(s): Our study demonstrated
that despite increased 30-day mortality and worse renal outcomes, the
post-procedural outcomes were similar in emergent and elective TAVR
groups. The increased mortality and worse renal outcomes are likely due to
hemodynamic instability in the emergent group. The similarity of
post-procedural outcomes is evidence of the safety of TAVR even in
emergent settings. Copyright © 2024, E-Century Publishing
Corporation. All rights reserved.

<10>
Accession Number
2029148064
Title
On the Operating Table: A Student's Experience in Surgery.
Source
American Surgeon. 90(6) (pp 1827-1828), 2024. Date of Publication: June
2024.
Author
Rabin E.E.; Kirkendoll S.; Tatebe L.C.
Institution
(Rabin, Tatebe) Department of Surgery, Northwestern University Feinberg
School of Medicine, Chicago, IL, United States
(Kirkendoll) Department of General Surgery, Valley Health System, Las
Vegas, NV, United States
Publisher
SAGE Publications Inc.
Abstract
The role of medical students in patient care is complex. Students suggest
plans but are not responsible for enacting them. We are anticipated to
make mistakes but expected to perform tasks with excellence. Regardless of
the field, physicians are tasked with the responsibility and burden of
making decisions. Students are at the interface between the patient and
the surgical team; their interactions with the patient can be
life-changing and potentially lifesaving. Choosing to not operate on
patients, deemed inoperable, can be morally challenging. As students, we
may not have the power to make decisions but can be present and learn from
our patients. Copyright © The Author(s) 2024.

<11>
Accession Number
2028143730
Title
The Use of Brief Mindfulness Interventions in the Context of Perioperative
Care.
Source
American Surgeon. 90(6) (pp 1657-1665), 2024. Date of Publication: June
2024.
Author
Palmer Kelly E.; McGee J.; Klatt M.; Beckers G.; Pawlik T.M.
Institution
(Palmer Kelly, Beckers, Pawlik) The Ohio State University Wexner Medical
Center, The James Comprehensive Cancer Center, Department of Surgery,
Columbus, OH, United States
(McGee) Department of Surgery, Tulane University School of Medicine, New
Orleans, LA, United States
(Klatt) Center for Integrative Health, Department of Family and Community
Medicine, The Ohio State University College of Medicine, Columbus, OH,
United States
Publisher
SAGE Publications Inc.
Abstract
The purpose of this review was to synthesize and categorize the literature
on the use of brief mindfulness interventions for both patients and
physicians across the spectrum of perioperative care. Web-based discovery
services and discipline-specific databases were queried. Brief mindfulness
interventions were defined as sessions lasting 30 min or less on any
single occasion, with a total practice accumulation not exceeding 100 min
per week, and a duration of up to 4 weeks. Study screening and data
extraction were facilitated through the Covidence software platform. After
screening 1047 potential studies, 201 articles were identified based on
initial abstract and title screening; 10 studies ultimately met inclusion
criteria. All ten studies were published between 2019 and 2023; most (n =
9) reports focused on patients (total joint arthroplasty, n = 3;
stereotactic breast biopsy, n = 2; minimally invasive foregut surgery, n =
1; septorhinoplasty, n = 1; cardiac surgery, n = 1; and other/multiple
procedures, n = 1); one studied investigated mindfulness interventions
among surgeons. The duration of the interventions varied (3 min to 29
min). The most common issue that the mindfulness intervention aimed to
address was pain (n = 6), followed by narcotic use (n = 3), anxiety (n =
2), delirium (n = 1), or patient satisfaction (n = 1). While most studies
included a small sample size and had inconclusive results, brief
mindfulness interventions were noted to impact various health-related
outcomes, including mental health outcomes, anxiety, and pain perception.
Mindfulness interventions may be a scalable, low-cost, time-limited
intervention that has the potential to optimize well-being and surgical
outcomes broadly construed. Copyright © The Author(s) 2024.

<12>
Accession Number
2032076178
Title
360degree Virtual reality to improve patient education and reduce anxiety
towards atrial fibrillation ablation.
Source
Europace. 25(3) (pp 855-862), 2023. Date of Publication: 01 Mar 2023.
Author
Hermans A.N.L.; Betz K.; Verhaert D.V.M.; den Uijl D.W.; Clerx K.; Debie
L.; Lahaije M.; Vernooy K.; Linz D.; Weijs B.
Institution
(Hermans, Betz, Verhaert, den Uijl, Clerx, Debie, Lahaije, Vernooy, Linz,
Weijs) Department of Cardiology, Maastricht University Medical Center,
Cardiovascular Research Institute Maastricht, P. Debyelaan 25, Maastricht
6229, Netherlands
(Verhaert, Linz) Department of Cardiology, Radboud University Medical
Center, Geert Grooteplein Zuid 10, Nijmegen 6525 GA, Netherlands
(Linz) Department of Biomedical Sciences, Faculty of Health and Medical
Sciences, University of Copenhagen, Norregade 10, Kobenhavn 1165, Denmark
(Linz) Center for Heart Rhythm Disorders, University of Adelaide, Royal
Adelaide Hospital, Port Rd, Adelaide, SA 5000, Australia
(Weijs) Department of Cardiology and Electrophysiology, Katholische
Stiftung Marien hospital Aachen, Zeise 4, Aachen 52066, Germany
Publisher
Oxford University Press
Abstract
Methods and results In this prospective observational cohort study,
patients were alternatively assigned in a 1:1 ratio to the control or VR
group. Controls received standard preprocedural information. VR group
received standard information and a VR video (via in-hospital VR headset
and disposable cardboard). The Amsterdam Preoperative Anxiety and
Information Scale (APAIS) together with additional questions concerning
procedural experience and satisfaction was completed pre- and
post-ablation. Of 134 patients [38.1% female, aged 66 (58-72) years]
included, 49.2% were assigned to the control and 50.7% to the VR group.
The number of patients that worried about the ablation procedure was lower
in VR than in control patients (19.1% vs. 40.9%, P = 0.006). More VR
females than males had worries about the procedure (34.8% vs. 11.1%, P =
0.026). The number of VR patients that were satisfied with the
preprocedural information provision was higher post-ablation than
pre-ablation (83.3% vs. 60.4%, P = 0.007). In total, 59.4% reported that
the disposable cardboard was easy to use and led to a discussion with
relatives in 68.8%.
Aims Evaluation of (i) the effects of a virtual reality (VR) preprocedural
patient education video on information provision, procedure-related
knowledge, satisfaction, and the level of worries in patients planned for
atrial fibrillation (AF) ablation and (ii) the feasibility of a disposable
cardboard VR viewer for home use in this setting.
Conclusion In patients scheduled for AF ablation, a VR preprocedural
educational video led to better information provision and
procedure-related knowledge, higher satisfaction, and less worries
regarding the procedure. The disposable cardboard was feasible for home
use. Copyright © 2023 Oxford University Press. All rights
reserved.

<13>
Accession Number
2031674650
Title
The Evolving Concept of Secondary Mitral Regurgitation Phenotypes: Lessons
From the M-TEER Trials.
Source
JACC: Cardiovascular Imaging. 17(6) (pp 659-668), 2024. Date of
Publication: June 2024.
Author
Stolz L.; Doldi P.M.; Sannino A.; Hausleiter J.; Grayburn P.A.
Institution
(Stolz, Doldi, Hausleiter) Medizinische Klinik und Poliklinik I, Klinikum
der Universitat Munchen, Munich, Germany
(Sannino, Grayburn) Division of Cardiology, Department of Internal
Medicine, Baylor Scott and White The Heart Hospital, Plano, TX, United
States
(Sannino) Department of Advanced Biomedical Sciences, Division of
Cardiology, Federico II University, Naples, Italy
(Hausleiter) German Center for Cardiovascular Research (DZHK), Partner
Site Munich Heart Alliance, Munich, Germany
Publisher
Elsevier Inc.
Abstract
Conflicting results from 2 randomized clinical trials of transcatheter
mitral valve edge-to-edge repair in secondary mitral regurgitation (SMR)
have led to the recognition that SMR is a heterogeneous disease entity
presenting with different functional and morphological phenotypes. This
review summarizes the current knowledge on SMR caused primarily by atrial
secondary mitral regurgitation (aSMR) and ventricular SMR pathology.
Although aSMR is generally characterized by severe left atrial enlargement
in the setting of preserved left ventricular anatomy and function,
different patterns of mitral annular distortion cause different phenotypes
of aSMR. In ventricular SMR, the relation of SMR severity to left
ventricular dilation as well as the degree of pulmonary hypertension and
right ventricular dysfunction are important phenotypic characteristics,
which are key for a better understanding of prognosis and treatment
response. Copyright © 2024 The Authors

<14>
Accession Number
2030253544
Title
Transcarotid versus transthoracic transcatheter aortic valve replacement:
A systematic review and meta-analysis.
Source
Cardiovascular Revascularization Medicine. 63 (pp 8-13), 2024. Date of
Publication: June 2024.
Author
Munguti C.; Ndunda P.; Vindhyal M.R.; Abukar A.; Abdel-Jawad M.; Fanari Z.
Institution
(Munguti, Ndunda, Vindhyal, Abdel-Jawad) Internal Medicine, University of
Kansas School of Medicine - Wichita, KS, United States
(Abdel-Jawad) Internal Medicine, Ascension Via Christi St Francis
Hospital, Wichita, KS, United States
(Abukar) Internal Medicine, University of California San Francisco, San
Francisco, CA, United States
(Fanari) Internal Medicine/Cardiology, University of California San
Francisco, Fresno, CA, United States
Publisher
Elsevier Inc.
Abstract
Background: Transthoracic approaches may be contraindicated in some
patients and may be associated with poorer outcomes. Therefore other
alternative access routes are increasingly being performed. We conducted a
systematic review of the literature on Transcarotid transcatheter aortic
valve replacement (TC-TAVR) and meta-analysis comparing outcomes of
TC-TAVR and other access routes. Method(s): We comprehensively
searched for controlled randomized and non-randomized studies from 4
online databases. We presented data using risk ratios (95 % confidence
intervals) and measured heterogeneity using Higgins' I2.
 Result(s): Sixteen observational studies on Transcarotid TAVR were
included in the analysis; 4 studies compared 180 TC-TAVR patients vs 524
TT-TAVR patients. The mean age and STS score for patients undergoing
TC-TAVR were 80 years and 7.6 respectively. For TT-TAVR patients, the mean
age and STS score were 79.7 years and 8.7 respectively. TC-TAVR patients
had lower 30-day MACE [7.8 % vs 13.7 %; OR 0.54 (95 % CI 0.29-0.99, P =
0.05)] and major or life-threatening bleeding [4.0 % vs 14.2 %; OR 0.25
(95 % CI 0.09-0.67, P = 0.006)]. There was no significant difference in
30-day: mortality [5.0 % vs 8.6 %; OR 0.61 (95 % CI 0.29-1.30, P = 0.20)],
stroke or transient ischemic attack [2.8 % vs 4.0 %; OR 0.65 (95 % CI
0.25-1.73, P = 0.39)] and moderate or severe aortic valve regurgitation
[5.0 % vs 4.6 %; OR 1.14. (95 % CI 0.52-2.52, P = 0.75)]. There was a
trend towards fewer major vascular complications in TC-TAVR [3.0 % vs 7.8
%; OR 0.42 (95 % CI 0.16-1.12, P = 0.08)]. Conclusion(s): Compared
with transthoracic TAVR, TC-TAVR patients had lower odds of 30-day MACE
and life-threatening bleeding and no differences in 30-day mortality,
stroke or TIA, aortic valve regurgitation. Copyright © 2024 The
Authors

<15>
Accession Number
644300244
Title
Strategies to address recruitment to a randomised trial of surgical and
non-surgical treatment for cancer: results from a complex recruitment
intervention within the Mesothelioma and Radical Surgery 2 (MARS 2) study.
Source
BMJ open. 14(5) (pp e079108), 2024. Date of Publication: 16 May 2024.
Author
Mills N.; Farrar N.; Warnes B.; Ashton K.E.; Harris R.; Rogers C.A.; Lim
E.; Elliott D.
Institution
(Mills, Farrar, Warnes, Ashton, Harris, Rogers, Elliott) Bristol Medical
School, University of Bristol Faculty of Health Sciences, Bristol, United
Kingdom
(Lim) Academic Division of Thoracic Surgery, Royal Brompton Hospital,
London, United Kingdom
(Lim) National Heart and Lung Institute, Imperial College London Faculty
of Medicine, London, United Kingdom
Abstract
OBJECTIVES: Recruiting to randomised trials is often challenging
particularly when the intervention arms are markedly different. The
Mesothelioma and Radical Surgery 2 randomised controlled trial (RCT)
compared standard chemotherapy with or without (extended) pleurectomy
decortication surgery for malignant pleural mesothelioma. Anticipating
recruitment difficulties, a QuinteT Recruitment Intervention was embedded
in the main trial phase to unearth and address barriers. The trial
achieved recruitment to target with a 4-month COVID-19 pandemic-related
extension. This paper presents the key recruitment challenges, and the
strategies delivered to optimise recruitment and informed consent. DESIGN:
A multifaceted, flexible, mixed-method approach to investigate recruitment
obstacles drawing on data from staff/patient interviews, audio recorded
study recruitment consultations and screening logs. Key findings were
translated into strategies targeting identified issues. Data collection,
analysis, feedback and strategy implementation continued cyclically
throughout the recruitment period. SETTING: Secondary thoracic cancer
care. RESULT(S): Respiratory physicians, oncologists, surgeons and
nursing specialists supported the trial, but recruitment challenges were
evident. The study had to fit within a framework of a thoracic cancer
service considered overstretched where patients encountered multiple
healthcare professionals and treatment views, all of which challenged
recruitment. Clinician treatment biases, shaped in part by the wider
clinical and research context alongside experience, adversely impacted
several aspects of the recruitment process by restricting referrals for
study consideration, impacting eligibility decisions, affecting the
neutrality in which the study and treatment was presented and shaping
patient treatment expectations and preferences. Individual and group
recruiter feedback and training raised awareness of key equipoise issues,
offered support and shared good practice to safeguard informed consent and
optimise recruitment. CONCLUSION(S): With bespoke support to overcome
identified issues, recruitment to a challenging RCT of surgery versus no
surgery in a thoracic cancer setting with a complex recruitment pathway
and multiple health professional involvement is possible. TRIAL
REGISTRATION NUMBER: ISRCTN ISRCTN44351742, Clinical Trials.gov
NCT02040272. Copyright © Author(s) (or their employer(s)) 2024.
Re-use permitted under CC BY. Published by BMJ.

<16>
Accession Number
2032384438
Title
Comprehensive analysis of donor-site chest deformities after autologous
costal cartilage microtia reconstruction: A systematic review.
Source
Journal of Plastic, Reconstructive and Aesthetic Surgery. 94 (pp 128-140),
2024. Date of Publication: July 2024.
Author
Kim J.; Park C.; Oh K.S.; Lim S.Y.
Institution
(Kim, Park, Lim) Department of Plastic Surgery, Samsung Medical Center,
Sungkyunkwan University School of Medicine, Seoul, South Korea
(Oh) Department of Plastic surgery, Kangbuk Samsung Hospital, Sungkyunkwan
University School of Medicine, Seoul, South Korea
Publisher
Churchill Livingstone
Abstract
Background: Autologous costal cartilage has gained widespread acceptance
as an important material for ear reconstruction in patients with microtia.
Despite its recognition as being "worth the trade-off," attention should
be directed toward donor-site deformities. This systematic review focused
on existing English literature related to microtia reconstruction and
aimed to reveal the incidence of chest wall deformities and assess the
effectiveness of the various proposed surgical techniques aimed at
reducing donor-site morbidities. Method(s): A comprehensive search
was conducted on Pubmed and OVID using the keywords "microtia," and "chest
deformity" or "rib harvest." Articles were screened based on predefined
inclusion and exclusion criteria. Data acquisition encompassed patient
demographics, employed surgical techniques, methods for evaluating chest
deformity, and incidence of associated complications. Result(s):
Among the 362 identified articles, 21 met the inclusion criteria. A total
of 2600 cases involving 2433 patients with microtia were analyzed in this
review. Perichondrium preservation during cartilage harvesting led to a
significant reduction in chest deformities. However, the wide incidence
range (0% to 50%) and the lack of specific assessment methods suggested
potential underestimation. Computed tomography revealed reduced chest wall
growth in the transverse and sagittal directions, resulting in decreased
thoracic area. Innovative surgical techniques have shown promising results
in reducing chest deformities. Conclusion(s): Although a quantitative
analysis was not feasible, objective evidence of deformities was
established through computed tomography scans. This analysis highlighted
the need for dedicated studies with larger sample sizes to further advance
our understanding of chest wall deformities in microtia
reconstruction. Copyright © 2024

<17>
Accession Number
2032350869
Title
Use of standard Del Nido cardioplegia for the intracardiac repair of
tetralogy of Fallot: A systematic review and meta-analysis of randomized
controlled trials.
Source
Health Sciences Review. 11 (no pagination), 2024. Article Number: 100179.
Date of Publication: June 2024.
Author
Usmani S.U.R.; Hasan S.U.; Ahmed S.H.; Pervez N.; Zia A.; Chen Q.; Gill
G.; Rowe G.; Alvi S.; Zubair M.M.
Institution
(Usmani, Hasan, Pervez, Zia) Department of Surgery, Dow University of
Health Sciences, Baba-e-Urdu Rd, Karachi 74200, Pakistan
(Ahmed) Division of Plastic and Reconstructive Surgery, Department of
Surgery, University of Florida, Gainesville, FL 32610, United States
(Chen, Gill, Rowe) Department of Cardiac Surgery, Cedars-Sinai Hospital,
8700 Beverly Blvd, Los Angeles, CA 90048, United States
(Alvi) Tufts Medical Centre, 800 Washington St, Boston, MA 02111, United
States
(Zubair) Department of Pediatric Cardiac Surgery, C.S. Mott Children's
Hospital, University of Michigan Health, 1540 E Hospital Dr, Ann Arbor, MI
48109, United States
Publisher
Elsevier Ltd
Abstract
This meta-analysis compares the efficacy of the standard Del Nido
cardioplegia with other agents during intra-cardiac tetralogy of Fallot
repair. Meta-analysis was performed on studies comparing standard Del Nido
cardioplegia with other types of cardioplegia. Outcomes were pooled using
inverse variance and random effects analysis models to calculate the
standardized mean difference (SMD) and odds ratio (OR). The SMD for ICU
length of stay, duration of mechanical ventilation, and time taken for the
heart to return to normal rhythm were -0.06 (P = 0.67), -0.21 (P = 0.06),
and 0.23 (P = 0.48), respectively. The OR for the incidence of
postoperative arrhythmias was 0.65 (P = 0.32). The standardized mean
differences for twenty-four-hour post-operative IL-6, TNF-alpha, and cTnI
levels were 0.29 (P = 0.16), -0.27 (P = 0.01), and -0.60 (P = 0.01),
respectively. Del Nido cardioplegia is protective on the myocardium, with
lower levels of inflammatory cytokines 24 h post-operation and a
significantly reduced incidence of post-operative
arrhythmias. Copyright © 2024

<18>
Accession Number
2032344775
Title
Benefits of using a support bra in women undergoing coronary artery bypass
graft surgery: A randomized trial.
Source
Clinics. 79 (no pagination), 2024. Article Number: 100370. Date of
Publication: 01 Jan 2024.
Author
Silva T.R.D.A.; Ono J.N.; Miname F.C.B.R.; Gowdak L.H.W.; Mioto B.M.;
Santos R.B.D.; Dallan L.R.P.; Machado Cesar L.A.
Institution
(Silva, Ono, Miname, Gowdak, Mioto, Santos, Dallan, Machado Cesar)
Instituto do Coracao (InCor), Faculdade de Medicina da Universidade de Sao
Paulo (FMUSP), SP, Sao Paulo, Brazil
Publisher
Universidade de Sao Paulo. Museu de Zoologia
Abstract
Background: Approximately 30 % of cardiac surgeries are conducted on women
by median sternotomy, which often causes discomfort such as pain, affects
quality of life, and delayed recovery compared with men. Breast size is
related to operative wound complications, such as incisional pain, sternum
dehiscence, and infection, which may affect hospital costs due to
prolonged hospital stays. Objective(s): To evaluate breast size and
operative wound complications and the effect of breast support on the
incidence of pain, infection, and quality of life in women after coronary
artery bypass grafting. Method(s): Women were randomly assigned to
one of three groups: group A (surgical breast support), group B (ordinary
breast support), and group C (no-support). Observations were taken daily
between the second and seventh postoperative days and at 30, 60, and 180
days. Pain was assessed using the Short-Form 36 Health Survey (SF36) for
quality of life and a verbal numerical scale. The authors used the
nonparametric Kruskal-Wallis and Friedman tests to examine variance. The
authors used the Pearson correlation coefficient or the Spearman
correlation for correlations between variables. A multivariate study was
conducted to evaluate the occurrence of infection, and the logistic
regression model with "stepwise" variable selection was used. A linear
regression model with the "stepwise" variable selection was also used for
hospitalization. The authors used SPSS 17.0 software for Windows, with a
significance level of p < 0.05. Result(s): There was no difference in
pain evaluation between the groups in 190 women (p > 0.05). When comparing
quality of life, there was a statistically significant difference in the
functional capacity domain at 30 and 60 days, with group A having the best
functional capacity (p < 0.05). The larger the breast size, the longer the
hospital stay (p < 0.001) and the higher the probability of infection (p =
0.032). Patients with a history of stroke had a 3.8 higher incidence of
infection (p = 0.040). Conclusion(s): The use of surgical support did
not affect acute pain or sternal infection rate in the 6-month follow-up.
However, it was effective in the functional capacity domain 30 days after
surgery and maintained at 60 days. Copyright © 2024 HCFMUSP

<19>
Accession Number
2029870651
Title
Difference in coagulation systems of large animal species used in
cardiovascular research: a systematic review.
Source
Journal of Artificial Organs. (no pagination), 2024. Date of Publication:
2024.
Author
Staelens L.; Langenaeken T.; Rega F.; Meuris B.
Institution
(Staelens, Langenaeken, Rega, Meuris) Department of Cardiovascular
Diseases, Research Unit of Cardiac Surgery, University Hospitals Leuven,
Herestraat 49, Leuven 3000, Belgium
Publisher
Springer
Abstract
Preclinical testing using animal models is indispensable in cardiovascular
research. However, the translation to clinical practice of these animal
models is questionable since it is not always clear how representative
they are. This systematic review intends to summarize the interspecies
differences in the coagulation profile of animal models used in
cardiovascular research. It aims to guide future research in choosing the
optimal animal species. A literature search of PubMed, Embase, Web of
Science (Core Collection) and Cochrane Library was performed using a
search string that was well defined and not modified during the study. An
overview of the search terms used in each database can be found in the
appendix. Articles describing coagulation systems in large animals were
included. We identified 30 eligible studies of which 15 were included.
Compared to humans, sheep demonstrated a less active external pathway of
coagulation. Sheep had a higher platelet count but the platelet
activatability and response to biomaterials were lower. Both sheep and
pigs displayed no big differences in the internal coagulation system
compared to humans. Pigs showed results very similar to those of humans,
with the exception of a higher platelet count and stronger platelet
aggregation in pigs. Coagulation profiles of different species used for
preclinical testing show strong variation. Adequate knowledge of these
differences is key in the selection of the appropriate species for
preclinical cardiovascular research. Future thrombogenicity research
should compare sheep to pig in an identical experimental
setup. Copyright © The Author(s) 2024.

<20>
Accession Number
2031053987
Title
Quantitative Coronary Angiography vs Intravascular Ultrasonography to
Guide Drug-Eluting Stent Implantation: A Randomized Clinical Trial.
Source
JAMA Cardiology. 9(5) (pp 428-435), 2024. Date of Publication: 08 May
2024.
Author
Lee P.H.; Hong S.J.; Kim H.-S.; Yoon Y.W.; Lee J.-Y.; Oh S.-J.; Lee J.S.;
Kang S.-J.; Kim Y.-H.; Park S.-W.; Lee S.-W.; Lee C.W.
Institution
(Lee, Kang, Kim, Park, Lee, Lee) Division of Cardiology, Department of
Internal Medicine, Asan Medical Center, University of Ulsan College of
Medicine, Seoul, South Korea
(Hong) Cardiovascular Center, Department of Cardiology, Korea University,
Anam Hospital, Seoul, South Korea
(Kim) Department of Cardiology, Hallym University Sacred Heart Hospital,
Anyang, South Korea
(Yoon) Division of Cardiology, Gangnam Severance Hospital, Yonsei
University College of Medicine, Seoul, South Korea
(Lee) Division of Cardiology, Department of Internal Medicine, Kangbuk
Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South
Korea
(Oh) Department of Cardiology, National Health Insurance Service, Ilsan
Hospital, Gyeonggi-do, South Korea
(Lee) Clinical Research Center, Asan Institute for Life Sciences, Asan
Medical Center, University of Ulsan College of Medicine, Seoul, South
Korea
Publisher
American Medical Association
Abstract
Importance: Although intravascular ultrasonography (IVUS) guidance
promotes favorable outcomes after percutaneous coronary intervention
(PCI), many catheterization laboratories worldwide lack access.
 Objective(s): To investigate whether systematic implementation of
quantitative coronary angiography (QCA) to assist angiography-guided PCI
could be an alternative strategy to IVUS guidance during stent
implantation. Design, Setting, and Participant(s): This randomized,
open-label, noninferiority clinical trial enrolled adults (aged >=18
years) with chronic or acute coronary syndrome and angiographically
confirmed native coronary artery stenosis requiring PCI. Patients were
enrolled in 6 cardiac centers in Korea from February 23, 2017, to August
23, 2021, and follow-up occurred through August 25, 2022. All principal
analyses were performed according to the intention-to-treat principle.
 Intervention(s): After successful guidewire crossing of the first
target lesion, patients were randomized in a 1:1 ratio to receive either
QCA- or IVUS-guided PCI. Main Outcomes and Measures: The primary
outcome was target lesion failure at 12 months, defined as a composite of
cardiac death, target vessel myocardial infarction, or ischemia-driven
target lesion revascularization. The trial was designed assuming an event
rate of 8%, with the upper limit of the 1-sided 97.5% CI of the absolute
difference in 12-month target lesion failure (QCA-guided PCI minus
IVUS-guided PCI) to be less than 3.5 percentage points for noninferiority.
 Result(s): The trial included 1528 patients who underwent PCI with
QCA guidance (763; mean [SD] age, 64.1 [9.9] years; 574 males [75.2%]) or
IVUS guidance (765; mean [SD] age, 64.6 [9.5] years; 622 males [81.3%]).
The post-PCI mean (SD) minimum lumen diameter was similar between the QCA-
and IVUS-guided PCI groups (2.57 [0.55] vs 2.60 [0.58] mm, P =.26). Target
lesion failure at 12 months occurred in 29 of 763 patients (3.81%) in the
QCA-guided PCI group and 29 of 765 patients (3.80%) in the IVUS-guided PCI
group (absolute risk difference, 0.01 percentage points [95% CI, -1.91 to
1.93 percentage points]; hazard ratio, 1.00 [95% CI, 0.60-1.68]; P =.99).
There was no difference in the rates of stent edge dissection (1.2% vs
0.7%, P =.25), coronary perforation (0.2% vs 0.4%, P =.41), or stent
thrombosis (0.53% vs 0.66%, P =.74) between the QCA- and IVUS-guided PCI
groups. The risk of the primary end point was consistent regardless of
subgroup, with no significant interaction. Conclusions and Relevance:
Findings of this randomized clinical trial indicate that QCA and IVUS
guidance during PCI showed similar rates of target lesion failure at 12
months. However, due to the lower-than-expected rates of target lesion
failure in this trial, the findings should be interpreted with caution.
Trial Registration: ClinicalTrials.gov Identifier:
NCT02978456. Copyright © 2024 American Medical Association. All
rights reserved.

<21>
Accession Number
2032283530
Title
The left atrial appendage: An enigmatic friend or foe and implications of
closure.
Source
Current Problems in Cardiology. 49(8) (no pagination), 2024. Article
Number: 102620. Date of Publication: August 2024.
Author
Benson J.-M.; Keesee J.; Smith L.; Navarro J.; Khouzam R.N.
Institution
(Benson, Keesee, Smith, Khouzam) Grand Strand Medical Center, Department
of Internal Medicine, Myrtle Beach, SC, United States
(Navarro, Khouzam) Edward Via College of Osteopathic Medicine,
Spartanburg, SC, United States
(Khouzam) University of South Carolina (USC) School of Medicine, SC,
United States
(Khouzam) Mercer School of Medicine, GA, United States
(Khouzam) University of Tennessee Health Science Center, TN, United States
Publisher
Elsevier Inc.
Abstract
The left atrial appendage (LAA) is often thought of as a vestigial organ
serving as a nidus for clot formation in those with atrial fibrillation
(A-fib). The LAA, however, has unique anatomy which allows it to serve
special functions in the human body. Closing the LAA has been shown to
decrease the risk of thromboembolic events in patients who cannot tolerate
anticoagulation. Several methods of closure exist including percutaneous
endocardial closure, epicardial closure, and surgical clipping. In
addition to decreasing stroke risk, there appears to be physiologic
changes that occur after LAA closure. This comprehensive review aims to
describe the functions of the LAA, compare the different methods of
closure, and propose a new method for identifying which patients may
benefit from LAA closure versus anticoagulation based on each patients'
individual comorbidities rather than their
contraindications. Copyright © 2024

<22>
Accession Number
2028610818
Title
Early left ventricular unloading via active transseptal left atrial
venting in case of cardiogenic shock under veno-arterial extracorporeal
membrane oxygenation: A meta-analysis.
Source
European Journal of Heart Failure. 26(3) (pp 701-703), 2024. Date of
Publication: March 2024.
Author
Ughetto A.; Aouinti S.; Molinari N.; Roubille F.; Delmas C.
Institution
(Ughetto) Anesthesia and Intensive Cardiac Care Unit, Montpellier
University Hospital, Montpellier, France
(Aouinti, Molinari) Clinical Research and Epidemiology Unit, Montpellier
University Hospital, Montpellier, France
(Roubille) Intensive Cardiac Care Unit, Cardiology Department, Montpellier
University Hospital, Montpellier, France
(Delmas) Intensive Cardiac Care Unit, Cardiology Department, Rangueil
University Hospital, Toulouse, France
(Delmas) Recherche et Enseignement en Insuffisance Cardiaque Avancee,
Assistance et Transplantation (REICATRA), Institut Saint Jacques, CHU de
Toulouse, Toulouse, France
Publisher
John Wiley and Sons Ltd

<23>
Accession Number
2023893715
Title
Randomized feasibility trial of prophylactic radiofrequency ablation to
prevent atrial fibrillation after cardiac surgery.
Source
Journal of Thoracic and Cardiovascular Surgery. 167(6) (pp 2129-2135.e1),
2024. Date of Publication: June 2024.
Author
Willekes C.L.; Fanning J.S.; Heiser J.C.; Wai Sang S.L.; Timek T.A.;
Parker J.; Ragagni M.K.
Institution
(Willekes, Fanning, Heiser, Wai Sang, Timek) Department of Cardiothoracic
Surgery, Corewell Health Hospital, Grand Rapids, Mich, United States
(Willekes, Fanning, Heiser, Wai Sang, Timek) College of Human Medicine,
Michigan State University, Grand Rapids, Mich, United States
(Parker) Office of Research and Education, Corewell Health Hospital, Grand
Rapids, Mich, United States
(Ragagni) Department of Cardiovascular Research, Corewell Health Hospital,
Grand Rapids, Mich, United States
Publisher
Elsevier Inc.
Abstract
Objective: To evaluate the feasibility of prophylactic radiofrequency
isolation of the pulmonary veins, with left atrial appendage amputation,
to reduce the incidence of postoperative atrial fibrillation after cardiac
surgery in patients aged 70 years and older. Method(s): The Federal
Food and Drug Administration granted an investigational device exemption
to utilize a bipolar radiofrequency clamp for prophylactic pulmonary vein
isolation in a limited feasibility trial. Sixty-two patients without prior
dysrhythmias were prospectively randomized to undergo either their index
cardiac surgical procedure or bilateral pulmonary vein isolation and left
atrial appendage amputation during their cardiac operation. The primary
outcome was occurrence of in-hospital postoperative atrial fibrillation.
Subjects were on 24-hour telemetry until discharge. Dysrhythmias, any
episode of atrial fibrillation >30 seconds, were confirmed by
electrophysiologists blinded to the study. Result(s): Sixty patients,
mean age 75 years and mean Congestive heart failure, Hypertension, Age
(>65 = 1, >75 = 2 points), Diabetes, previous Stroke/Transient ischemic
attack (2 points), Vascular disease, Gender (female) score of 4, were
analyzed. Thirty-one patients randomized to control and 29 to the
treatment group. The majority of patients in each group underwent isolated
coronary artery bypass grafting. No perioperative complications related to
the treatment procedure, need for permanent pacemaker, or mortality
occurred. The in-hospital incidence of postoperative atrial fibrillation
was 55% (17 out of 31) in the control group and 7% (2 out of 29) in the
treatment group (P < .001) The control group had a significantly higher
requirement for antiarrhythmic medications at discharge: 45% (14 out of
31) versus 7% (2 out of 29) in the treatment group (P < .001).
 Conclusion(s): Prophylactic radiofrequency isolation of the pulmonary
veins with left atrial appendage amputation during the primary cardiac
surgical operation reduced the incidence of postoperative atrial
fibrillation in patients aged 70 years and older with no history of atrial
arrhythmias. Copyright © 2023 The American Association for
Thoracic Surgery

<24>
Accession Number
2032245257
Title
An update on the management of symptomatic extracranial carotid artery
stenosis, CEAvs. TFCASvs. TCAR.
Source
Italian Journal of Vascular and Endovascular Surgery. 31(1) (pp 35-41),
2024. Date of Publication: March 2024.
Author
Aburahma A.
Institution
(Aburahma) Department of Surgery, Charleston Area Medical Center, West
Virginia University, Charleston, WV, United States
Publisher
Edizioni Minerva Medica
Abstract
The management of patients with significant carotid stenosis has been
somewhat controversial. This update is a review article on the management
of significant carotid stenosis in role of carotid endarterectomy (CEA)
vs. transfemoral carotid artery stenting (TFCAS) vs. transcarotid artery
revascularization (TCAR). A systemic review and meta-analysis was
conducted by the Mayo Clinic Evidence Practice Center on behalf of the
Society for Vascular Surgery for their 2022 carotid guidelines. The two
commonly quoted randomized trials comparing medical therapy vs. CEA for
symptomatic >50% and >70% stenosis, both North American Symptomatic
Carotid Endarterectomy Trial (NASCET) and European Carotid Surgery Trial
(ECST) showed superiority of CEA with best medical therapy vs. best
medical therapy. The NASCETshowed relative risk stroke reduction of 65%
and absolute risk reduction of 17% at two years for those with >=70%
carotid stenosis. Similar findings were also found on ECST. Pooled
analysis of the four commonly quoted randomized trials compared CEA vs.
TFCASin treating patients with >50% carotid stenosis who are standard risk
for CEAshowed superiority of CEA30-day rate of stroke/death with relative
risk reduction of 0.68. Long-term data of these trials, with a median
follow-up 2-6.9 years showed risk of stroke/death within 120 days was
significantly better for CEA vs. CAS(5.5% vs. 8.7%). After which there was
no differences in the annual rate of late ipsilateral stroke. A
meta-analysis of the four commonly quoted randomized trials showed that
the five-year risk of any stroke favoring CEA over stenting with relative
risk of 0.79. However, real world data for TFCASwas not encouraging. More
recently, TCARprocedure showed very satisfactory results of perioperative
stroke/death, superior to TFCAS and equivalent to CEA. Long-term data is
needed. CEA is preferred over TFCAS in symptomatic patients with >=50%
stenosis. TCAR is preferred over CEAin the presence of
anatomical/physiological comorbidities. TFCASis preferred in patients with
severe uncorrectable CAD, CHF, or COPD. Copyright © 2024 Edizioni
Minerva Medica. All rights reserved.

<25>
Accession Number
2032244876
Title
The Effects of Propafenone on Postoperative Atrial Fibrillation in Adult
Patients Undergoing Cardiac Surgery: A Meta-Analysis of Randomized
Controlled Trials.
Source
Journal of Cardiac Surgery. 2024 (no pagination), 2024. Article Number:
5579727. Date of Publication: 2024.
Author
Deng J.-H.; Li J.; He F.-R.; Yao Y.-T.
Institution
(Deng) Department of Anesthesiology, The Second Affiliated Hospital of
Guangzhou University of Chinese Medicine, Guangdong Province, Guangzhou
510000, China
(Li) Department of Anesthesiology, Binzhou Medical University Hospital,
Shandong, Binzhou 256603, China
(He) Department of Gynecology and Obstetrics, The Air Force Hospital of
Southern Theater Command, Guangdong Province, Guangzhou 510000, China
(Yao) Department of Anaesthesiology, Fuwai Hospital, National Center for
Cardiovascular Diseases, Peking Union Medical College and Chinese Academy
of Medical Sciences, Beijing 100037, China
Publisher
Wiley-Hindawi
Abstract
Background. Previous research has only conducted a restricted amount of
investigations on the effectiveness of propafenone in preventing and
treating of atrial fibrillation (AF) after cardiac surgery. Hence, a
comprehensive evaluation and meta-analysis were performed to evaluate the
effectiveness and safety of propafenone in individuals undergoing cardiac
surgery for postoperative atrial fibrillation (POAF). Methods. A
meta-analysis of randomized controlled trials was conducted. Until
September 15th, 2023, various databases were searched. The main focal
points consisted of the presence of POAF, transition from AF to sinus
rhythm, and reappearance of AF. The odds ratios (ORs) for treatment
effects on dichotomous variables were calculated. Results. The analysis of
data included 9 controlled trials that were randomized and had 1014
patients. The findings indicated that propafenone has a significant impact
on reducing the occurrence of POAF in adult patients who undergo cardiac
surgery (OR, 0.52; 95% CI: 0.30, 0.89; P=0.02). In addition, it was
observed that propafenone significantly increase the rate of conversion to
sinus rhythm from AF within 20 min (OR, 5.39; 95% CI: 2.25, 12.91;
P=0.0002) and 1 hour (OR, 2.89; 95% CI: 1.50, 5.57; P=0.002) after
administration. Surprisingly, the administration of propafenone treatment
did not have a significant impact on the rate of conversion to sinus
rhythm from AF within 24 hours (OR, 0.63; 95% CI: 0.38, 1.04; P=0.07)
after administration. Conclusions. The present study suggests that the
postoperative administration of propafenone to adult cardiac surgery
patients is both safe and effective for preventing and treating
POAF. Copyright © 2024 Jin-He Deng et al.

<26>
Accession Number
2029826399
Title
Efficacy and safety of perioperative melatonin for postoperative delirium
in patients undergoing surgery: a systematic review and meta-analysis.
Source
Journal of International Medical Research. 52(5) (no pagination), 2024.
Date of Publication: May 2024.
Author
Shin H.W.; Kwak J.S.; Choi Y.J.; Kim J.W.; You H.S.; Shin H.J.; Jang Y.K.
Institution
(Shin, Kwak, Kim, You, Shin, Jang) Department of Anesthesiology and Pain
Medicine, College of Medicine, Korea University Anam Hospital, Seoul,
South Korea
(Choi) Department of Anesthesiology and Pain Medicine, College of
Medicine, Korea University Ansan Hospital, Gyeonggi-do Province, South
Korea
Publisher
SAGE Publications Ltd
Abstract
Objective: To assess the efficacy and safety of perioperative melatonin
and melatonin agonists in preventing postoperative delirium (POD).
 Method(s): We conducted a systematic search for randomized controlled
trials (RCTs) published through December 2022. The primary outcome was
efficacy based on the incidence of POD (POD-I). Secondary outcomes
included efficacy and safety according to the length of hospital or
intensive care unit stay, in-hospital mortality, and adverse events.
Subgroup analyses of POD-I were based on the type and dose of drug (low-
and high-dose melatonin, ramelteon), the postoperative period (early or
late), and the type of surgery. Result(s): In the analysis (16 RCTs,
1981 patients), POD-I was lower in the treatment group than in the control
group (risk ratio [RR] = 0.57). POD-I was lower in the high-dose melatonin
group than in the control group (RR = 0.41), whereas no benefit was
observed in the low-dose melatonin and ramelteon groups. POD-I was lower
in the melatonin group in the early postoperative period (RR = 0.35) and
in patients undergoing cardiopulmonary surgery (RR = 0.54).
 Conclusion(s): Perioperative melatonin or melatonin agonist treatment
suppressed POD without severe adverse events, particularly at higher
doses, during the early postoperative period, and after cardiopulmonary
surgery. Copyright © The Author(s) 2024.

<27>
Accession Number
2029820332
Title
A Year of Changes: The End of the Pandemic Marks the Beginning of New
Priorities.
Source
Seminars in Cardiothoracic and Vascular Anesthesia. 28(2) (pp 61-65),
2024. Date of Publication: June 2024.
Author
Krause M.; Tzeng E.; Kertai M.D.; Abrams B.A.
Institution
(Krause, Tzeng) Department of Anesthesiology, University of California San
Diego, San Diego, CA, United States
(Kertai) Department of Anesthesiology, Vanderbilt University Medical
Center, Nashville, TN, United States
(Abrams) Department of Anesthesiology, University of Colorado, Aurora, CO,
United States
Publisher
SAGE Publications Inc.

<28>
Accession Number
2029466280
Title
Intravascular Imaging-Guided Versus Coronary Angiography-Guided Complex
PCI: A Meta-analysis of Randomized Controlled Trials.
Source
Cardiology and Therapy. 13(2) (pp 379-399), 2024. Date of Publication:
June 2024.
Author
Hamed M.; Mohamed S.; Mahmoud M.; Kahan J.; Mohsen A.; Rahman F.; Kayani
W.; Alfonso F.; Brilakis E.S.; Elgendy I.Y.; Mamas M.A.; Elbadawi A.
Institution
(Hamed, Kahan) Division of Cardiology, Florida Atlantic University, Boca
Raton, FL, United States
(Mohamed) Department of Cardiology, Ain Shams University, Cairo, Egypt
(Mahmoud) Division of Cardiology, University of Texas Health Science
Center at Houston, Houston, TX, United States
(Mohsen) Division of Cardiology, Loma Linda University, Loma Linda, CA,
United States
(Rahman) Division of Cardiology, Johns Hopkins University, Baltimore, MD,
United States
(Kayani) Division of Cardiology, Baylor College of Medicine, Houston, TX,
United States
(Alfonso) Department of Cardiology, Hospital Universitario de La Princesa,
IIS-IP, CIBER-CV, Madrid, Spain
(Brilakis) Division of Cardiology, Minneapolis Heart Institute,
Minneapolis, MN, United States
(Elgendy) Division of Cardiovascular Medicine, Gill Heart Institute,
University of Kentucky, Lexington, KY, United States
(Mamas) Keele Cardiovascular Research Group, Keele University, Keele,
United Kingdom
(Elbadawi) Division of Cardiology, Christus Good Shepherd Medical Center,
Longview, TX, United States
(Elbadawi) Texas A & amp;M School of Medicine, Bryan, TX, United States
Publisher
Adis
Abstract
Introduction: Trials evaluating the role of intravascular imaging in
percutaneous coronary intervention (PCI) for complex coronary artery
disease have yielded mixed results. This study aimed to compare the
outcomes of intravascular imaging specifically intravascular ultrasound
(IVUS) with those from conventional coronary angiography in complex PCI.
 Method(s): Comprehensive electronic search of MEDLINE, EMBASE, and
Cochrane databases was performed until March 2023 for randomized clinical
trials (RCTs) comparing intravascular imaging with coronary angiography in
patients undergoing complex PCI. Complex PCI was defined per each study,
and included PCI for American College of Cardiology/American Heart
Association (ACC/AHA) type B2/C lesions, unprotected left main coronary
artery disease, or multivessel stenting. The primary study outcome was
major adverse clinical events (MACE). Result(s): The meta-analysis
included 10 RCTs with a total of 6615 patients (3576 in the intravascular
imaging group and 3039 in the coronary angiography group). The weighted
mean-follow up was 28.9 months. Compared with coronary angiography,
intravascular imaging reduced MACE (8% vs. 13.3%; relative risk [RR] 0.63;
95% confidence interval [CI] 0.54-0.73), cardiac death (RR 0.47; 95% CI
0.31-0.73), definite/probable stent thrombosis (RR 0.48; 95% CI
0.24-0.97), target vessel revascularization (RR 0.62; 95% CI 0.46-0.83),
and target lesion revascularization (RR 0.61; 95% CI 0.47-0.79). There was
no difference between both groups in all-cause death (RR 0.79; 95% CI
0.53-1.18) and myocardial infarction (RR 0.80; 95% CI 0.61-1.04).
 Conclusion(s): In patients undergoing complex PCI, intravascular
imaging-specifically IVUS-reduced MACE by decreasing the incidence of
cardiac death, stent thrombosis, and target vessel and target lesion
revascularization. Copyright © The Author(s) 2024.

<29>
Accession Number
2029225003
Title
Effect of pacifier and pacifier with dextrose in reducing pain during
orogastric tube insertion in newborns: a randomized controlled trial*.
Source
Journal of Perinatology. 44(5) (pp 717-723), 2024. Date of Publication:
May 2024.
Author
Akkaya-Gul A.; Ozyazicioglu N.
Institution
(Akkaya-Gul) Department of Child Health and Diseases Nursing, Health
Sciences Institute, Bursa Uludag University, Bursa, Turkey
(Akkaya-Gul) Department of First and Emergency Aid, Vocational School of
Health Services, Fenerbahce University, Istanbul, Turkey
(Ozyazicioglu) Department of Child Health and Diseases Nursing, Faculty of
Health Sciences, Bursa Uludag University, Bursa, Turkey
Publisher
Springer Nature
Abstract
Objective: This study aimed to assess the efficacy of pacifier use, with
and without 25% dextrose, in reducing pain during orogastric tube
insertion in newborns. Study design: In a randomized controlled trial
involving 60 newborns at a public hospital from April to December 2019,
participants were divided into three groups: pacifier (n = 20), pacifier
with 25% dextrose (n = 20), and control (n = 20). A pacifier, with and
without dextrose, was used for the experimental groups, while the control
group performed a routine procedure. Neonatal infant pain scale, crying
duration, heart rate (HR), and oxygen saturation (SpO2) were evaluated.
 Result(s): Results indicated that the control group experienced
significantly higher pain levels, elevated HRs, decreased SpO2, and
prolonged crying. Conversely, the pacifier with 25% dextrose group showed
a notable reduction in crying duration. Conclusion(s): A pacifier,
with and without 25% dextrose, effectively reduces pain and improves
physiological and behavioral parameters during orogastric tube insertion.
Clinical trial number: NCT05462964 Clinical trial registration: The
protocol for this randomized controlled experimental trial is registered
on ClinicalTrials.gov. The clinical trial registration number is
https://clinicaltrials.gov; NCT05462964. Copyright © The
Author(s) 2024.

<30>
Accession Number
2032301993
Title
Effect of a 3D-printed reconstruction automated matching system for
selecting the size of a left double-lumen tube: a study protocol for a
prospective randomised controlled trial.
Source
BMJ Open. 14(5) (no pagination), 2024. Article Number: e085503. Date of
Publication: 15 May 2024.
Author
Li L.; Zhu Y.; Yin F.; Yu H.; Wang H.; Xu Y.; Fei F.; Liu W.; Duan B.;
Wang F.; Jia Y.; Zhang H.
Institution
(Li, Zhu, Wang, Zhang) Department of Anesthesiology, Sichuan Clinical
Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan
Cancer Center, Affiliated Cancer Hospital, University of Electronic
Science and Technology of China, Sichuan, Chengdu, China
(Yin, Yu, Xu, Fei) Department of Anesthesiology, West China Hospital of
Sichuan University, Sichuan, Chengdu, China
(Liu, Duan) Department of Endoscopy, Sichuan Clinical Research Center for
Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center,
Affiliated Cancer Hospital, University of Electronic Science and
Technology of China, Sichuan, Chengdu, China
(Wang) Department of Anesthesiology, Sichuan Academy of Medical Sciences,
Sichuan People's Hospital, Sichuan, Chengdu, China
(Jia) Department of Stomatology, Chengdu Medical College, The First
Affiliated Hospital, Sichuan, Chengdu, China
Publisher
BMJ Publishing Group
Abstract
Introduction Lung isolation is primarily accomplished using a double-lumen
tube (DLT) or bronchial blocker. A precise and accurate size of the DLT is
a prerequisite for ensuring its accurate placement. Three-dimensional (3D)
reconstruction technology can be used to accurately reproduce
tracheobronchial structures to improve the accuracy of DLT size selection.
Therefore, we have developed automatic comparison software for 3D
reconstruction based on CT data (3DRACS). In this study, we aimed to
evaluate the efficiency of using 3DRACS to select the DLT size for
endobronchial intubation in comparison with using the 'blind' DLT
intubation method to determine the DLT size, which is based on height and
sex. Methods and analysis This is a prospective, single-centre,
double-blind randomised controlled trial. In total, 200 patients scheduled
for lung resection using a left DLT will be randomly allocated to the 3D
group or the control group at a 1:1 ratio. A 3DRACS will be used for the
3D group to determine the size of the DLT, while in the case of the
control group, the size of the DLT will be determined according to patient
height and sex. The primary outcome is the success rate of placement of
the left DLT without fibreoptic bronchoscopy (FOB). The secondary outcomes
include the following: successful intubation time, degree of pulmonary
atrophy, grade of airway injury, oxygenation during one-lung ventilation,
postoperative sore throat and hoarseness, and number of times FOB is used.
Ethics and dissemination Ethical approval has been obtained from our local
ethics committee (approval number: SCCHEC-02-2022-155). Written informed
consent will be obtained from all participants before randomisation,
providing them with clear instructions about the purpose of the study. The
results will be disseminated through peer-reviewed publications and
conferences. Trial registration number NCT06258954. Copyright ©
2024 BMJ Publishing Group. All rights reserved.

<31>
Accession Number
2029850361
Title
Comparison of apixaban versus aspirin for the prevention of latent
bioprosthetic aortic valve thrombosis: study protocol for a prospective
randomized trial.
Source
Trials. 25(1) (no pagination), 2024. Article Number: 324. Date of
Publication: December 2024.
Author
Kopjar T.; Gasparovic H.; Paar M.H.; Lovric D.; Cerina P.; Tokic T.;
Milicic D.
Institution
(Kopjar, Gasparovic, Cerina, Tokic) Department of Cardiac Surgery,
University Hospital Center Zagreb, Kispaticeva 12, Zagreb 10000, Croatia
(Paar) Department of Radiology, University Hospital Center Zagreb, Zagreb,
Croatia
(Lovric, Milicic) Department of Cardiovascular Diseases, University
Hospital Center Zagreb, Zagreb, Croatia
(Kopjar, Gasparovic, Paar, Milicic) University of Zagreb School of
Medicine, Zagreb, Croatia
Publisher
BioMed Central Ltd
Abstract
Background: The optimal antithrombotic strategy early after aortic valve
replacement surgery with a biological valve remains controversial due to
lack of high-quality evidence. Either oral anticoagulants or
acetylsalicylic acid should be considered for the first 3 months.
Hypo-attenuated leaflet thickening on cardiac computed tomography has been
associated with latent bioprosthetic valve thrombosis and may be prevented
with anticoagulation. We hypothesize that anticoagulation with apixaban is
superior to single antiplatelet therapy with acetylsalicylic acid in
reducing hypo-attenuated leaflet thickening of bioprosthetic aortic valve
prostheses. Method(s): In this prospective, open-label, randomized
trial, patients undergoing isolated aortic valve replacement surgery with
rapid deployment bioprosthetic valves will be randomized. The treatment
group will receive 5 mg of apixaban twice a day for the first 3 months and
100 mg of acetylsalicylic acid thereafter. The control group will be
administered 100 mg of acetylsalicylic acid once a day, indefinitely.
After the 3-month treatment period, a contrast-enhanced
electrocardiogram-gated cardiac computed tomography will be performed to
identify hypo-attenuated leaflet thickening of the bioprosthetic valve.
The primary objective of the study is to assess the impact of apixaban on
the prevention of hypo-attenuated leaflet thickening at 3 months. The
secondary and exploratory endpoints will be clinical outcomes and safety
profiles of the two strategies. Discussion(s): Antithrombotic therapy
after aortic valve replacement is used to prevent valve thrombosis and
systemic thromboembolism. Latent bioprosthetic valve thrombosis is a
precursor of clinically significant prosthetic valve dysfunction or
thromboembolic events. The hallmark feature of latent bioprosthetic valve
thrombosis is hypo-attenuated leaflet thickening on cardiac computed
tomography. Subclinical leaflet thrombosis occurs frequently in
bioprosthetic aortic valves, more commonly in transcatheter than in
surgical valves. There is no evidence on the effect of direct oral
anticoagulants on the incidence of hypo-attenuated leaflet thickening
after surgical aortic valve replacement with rapid deployment
bioprostheses. Trial registration: ClinicalTrials.gov NCT06184113.
Registered on December 28, 2023 Copyright © The Author(s) 2024.

<32>
Accession Number
2029232716
Title
Year in Review 2023: Noteworthy Literature in Cardiothoracic
Transplantation.
Source
Seminars in Cardiothoracic and Vascular Anesthesia. 28(2) (pp 106-112),
2024. Date of Publication: June 2024.
Author
Saleem F.; Liang H.; Martin A.K.
Institution
(Saleem, Liang, Martin) Division of Cardiovascular and Thoracic
Anesthesiology, Department of Anesthesiology and Perioperative Medicine,
Mayo Clinic, Jacksonville, FL, United States
Publisher
SAGE Publications Inc.
Abstract
This review highlights key studies examining perioperative management of
cardiothoracic transplantation published in 2023. Articles were manually
screened after searching Scopus, PubMed, and Google Scholar databases for
manuscripts related to cardiothoracic transplantation, which yielded 343
papers with 15 qualitatively selected as the most salient for readers.
Overarching themes include differences in outcomes across the various
etiologies of end-stage lung disease, novel developments to expand the
donor pool, and multi-organ transplantation. Copyright © The
Author(s) 2024.

<33>
Accession Number
2032275585
Title
A Prospective Randomized Trial of Renal Ischemic Preconditioning for
Reducing Nephropathy Risk Following Fenestrated Endovascular Aortic
Aneurysm Repair.
Source
Journal of Vascular Surgery. Conference: 2024 Vascular Annual Meeting.
Chicago United States. 79(6) (pp e145-e146), 2024. Date of Publication:
June 2024.
Author
Tran K.; Dossabhoy S.S.; Adkar S.; Deslarzes-Dubuis C.; Lee J.T.
Institution
(Tran, Adkar, Deslarzes-Dubuis, Lee) Stanford University, Palo Alto, CA
(Dossabhoy) Stanford University, Palo Alto, CA
Publisher
Elsevier Inc.
Abstract
Objectives: Prior studies have shown a possible benefit of remote renal
preconditioning for reducing ischemic and contrast nephropathy after
high-risk cardiovascular surgery. This study determined whether renal
ischemic preconditioning using remote arm ischemia is effective for
reducing postoperative acute kidney injury (AKI) and mid-term renal
function decline in patients undergoing elective fenestrated endovascular
repair (FEVAR) of juxtarenal aortic aneurysms. Method(s): We
performed a single-site, blinded, prospective randomized trial of a renal
ischemic preconditioning intervention using arm ischemia, consisting of
manual inflation of arm blood pressure cuff to 50 mmHg above patient's
last known systolic blood pressure for 10 minutes, followed by rapid
deflation of the cuff to 0 mmHg and cuff deflation for 10 minutes, with
the 10-minute on/off cycle repeated for a total of two cycles (40 minutes
total). We evaluated 30-day AKI, determined using RIFLE classification
(risk, injury, failure, loss of function, and end-stage kidney disease)
and 2-year freedom-from renal function deterioration, defined as >30%
decline in baseline estimated glomerular function (eGFR). The study was
powered to detect a >25% difference in renal injury incidence.
 Result(s): We enrolled 80 patients (80% male; mean aneurysm diameter,
6.1 cm), who were undergoing elective FEVAR using commercially-available
Cook ZFEN devices between July 2018 and August 2023. The 30-day follow-up
rate was 95.0%, and mean follow-up duration was 20.2 +/- 14.6 months.
Although there was a trend to older patient age in the treatment group
(77.4 +/- 7.8 years vs 74.1 +/- 7.0 years), this difference did not reach
statistical significance (P =.05). The mean baseline eGFR and creatinine
were 69.8 +/- 21.0 mL/min/1.73m2 and 1.1 +/- 0.4 mg/dL
respectively, and 30.0% had chronic kidney disease stage >=3. There were
no differences in any other baseline or operative metrics between groups.
The rate of AKI at 30 days was 11.3% overall (risk 7.5%, injury 2.5%,
failure 1.3%) and did not differ between groups (Table I). There were no
30-day deaths. On Kaplan-Meier analysis, 2-year freedom from renal
function decline trended lower for the treatment group (56.2% vs 81.1%;
log-rank P =.12), but this difference was not statistically significant.
 Conclusion(s): Renal ischemic preconditioning using arm ischemia did
not confer a 30-day AKI or mortality or long-term renal protection benefit
in patients undergoing elective FEVAR. [Formula presented] [Formula
presented] Copyright © 2024

<34>
Accession Number
2029868121
Title
Efficacy and safety of video double-lumen tube intubation in lateral
position in patients undergoing thoracic surgery: a randomized controlled
trial.
Source
BMC Anesthesiology. 24(1) (no pagination), 2024. Article Number: 179. Date
of Publication: December 2024.
Author
Rao Q.; Li P.; Zhang G.; Zeng J.; Pu Q.; Yu H.
Institution
(Rao, Yu, Zeng, Yu) Department of Anesthesiology, West China Hospital,
Sichuan University, Chengdu 610041, China
(Li) Department of Anesthesiology, Wu'an First People's Hospital, Handan,
China
(Zhang) Department of Anesthesiology, West China (Airport) Hospital,
Sichuan University, Chengdu, China
(Pu) Department of Thoracic Surgery, West China Hospital, Sichuan
University, Chengdu, China
Publisher
BioMed Central Ltd
Abstract
Background: Video double-lumen tube (VDLT) intubation in lateral position
is a potential alternative to intubation in supine position in patients
undergoing thoracic surgery. This non-inferiority trial assessed the
efficacy and safety of VDLT intubation in lateral position.
 Method(s): Patients (18-70 yr) undergoing right thoracoscopic lung
surgery were randomized to either the left lateral position group (group
L) or the supine position group (group S). The VDLT was placed under video
larygoscopy. The primary endpoint was the intubation time. Secondary
endpoints included VDLT displacement rate, intubation failure rate, the
satisfaction of surgeon and nurse, and intubation-related adverse events.
 Result(s): The analysis covered 80 patients. The total intubation
time was 52.0 [20.4]s in group L and 34.3 [13.2]s in group S, with a mean
difference of 17.6 s [95% confidence interval (CI): 9.9 s to 25.3 s; P =
0.050], failing to demonstrate non-inferiority with a non-inferiority
margin of 10 s. Group L, compared with group S, had significantly lower
VDLT displacement rate (P = 0.017) and higher nurse satisfaction (P =
0.026). No intubation failure occurred in any group. Intubation
complications (P = 0.802) and surgeon satisfaction (P = 0.415) were
comparable between two groups. Conclusion(s): The lateral VDLT
intubation took longer time than in the supine position, and
non-inferiority was not achieved. The incidence of displacement as the
secondary endpoint was lower in the L group, possibly due to changing body
positions beforehand. The indication of lateral VDLT intubation should be
based on a balance between the safety of airway management and the lower
incidence of displacement. Trial registration: The study was registered at
Chictr.org.cn with the number ChiCTR2200064831 on
19/10/2022. Copyright © The Author(s) 2024.

<35>
Accession Number
2029864026
Title
The role of hemoadsorption in cardiac surgery - a systematic review.
Source
BMC Cardiovascular Disorders. 24(1) (no pagination), 2024. Article Number:
258. Date of Publication: December 2024.
Author
Matejic-Spasic M.; Lindstedt S.; Lebreton G.; Dzemali O.; Suwalski P.;
Folliguet T.; Geidel S.; Klautz R.J.M.; Baufreton C.; Livi U.; Gunaydin
S.; Deliargyris E.N.; Wendt D.; Thielmann M.
Institution
(Matejic-Spasic, Wendt) CytoSorbents Europe GmbH, Berlin, Germany
(Lindstedt) Department of Cardiothoracic Surgery and Transplantation,
Skane University Hospital, Lund, Sweden
(Lebreton) Thoracic and Cardiovascular Surgery Department,
Pitie-Salpetriere University Hospital, Paris, France
(Dzemali) Department of Cardiac Surgery, University Hospital Zurich,
Zurich, Switzerland
(Dzemali) Department of Cardiac Surgery, City Hospital Triemli, Zurich,
Switzerland
(Suwalski) Department of Cardiac Surgery, Central Clinical Hospital of the
Ministry of the Interior and Administration, Warsaw, Poland
(Folliguet) Department of Cardiac Surgery, Henri Mondor Hospital, Paris,
France
(Geidel) Department of Cardiac Surgery, Asklepios Klinik St. Georg,
Hamburg, Germany
(Klautz) Department of Cardio-Thoracic Surgery, University Medical Center,
Leiden, Netherlands
(Baufreton) Department of Cardiovascular and Thoracic Surgery, University
Hospital, Angers, France
(Livi) Department of Cardiothoracic Surgery, University Hospital, Udine,
Italy
(Gunaydin) Department of Cardiovascular Surgery, University of Health
Sciences, Ankara City Hospital Campus, Ankara, Turkey
(Deliargyris) CytoSorbents Inc, Princeton, NJ, United States
(Wendt, Thielmann) Department of Thoracic- and Cardiovascular Surgery,
Westgerman Heart and Vascular Center, University Duisburg-Essen, Essen,
Germany
Publisher
BioMed Central Ltd
Abstract
Background: Extracorporeal blood purification has been widely used in
intensive care medicine, nephrology, toxicology, and other fields. During
the last decade, with the emergence of new adsorptive blood purification
devices, hemoadsorption has been increasingly applied during CPB in
cardiac surgery, for patients at different inflammatory risks, or for
postoperative complications. Clinical evidence so far has not provided
definite answers concerning this adjunctive treatment. The current
systematic review aimed to critically assess the role of perioperative
hemoadsorption in cardiac surgery, by summarizing the current knowledge in
this clinical setting. Method(s): A literature search of PubMed,
Cochrane library, and the database provided by CytoSorbents was conducted
on June 1st, 2023. The search terms were chosen by applying neutral search
keywords to perform a non-biased systematic search, including language
variations of terms "cardiac surgery" and "hemoadsorption". The screening
and selection process followed scientific principles (PRISMA statement).
Abstracts were considered for inclusion if they were written in English
and published within the last ten years. Publications were eligible for
assessment if reporting on original data from any type of study (excluding
case reports) in which a hemoadsorption device was investigated during or
after cardiac surgery. Results were summarized according to sub-fields and
presented in a tabular view. Result(s): The search resulted in 29
publications with a total of 1,057 patients who were treated with
hemoadsorption and 988 control patients. Articles were grouped and
descriptively analyzed due to the remarkable variability in study designs,
however, all reported exclusively on CytoSorb therapy. A total
of 62% (18/29) of the included articles reported on safety and no
unanticipated adverse events have been observed. The most frequently
reported clinical outcome associated with hemoadsorption was reduced
vasopressor demand resulting in better hemodynamic stability.
 Conclusion(s): The role of hemoadsorption in cardiac surgery seems to
be justified in selected high-risk cases in infective endocarditis, aortic
surgery, heart transplantation, and emergency surgery in patients under
antithrombotic therapy, as well as in those who develop a dysregulated
inflammatory response, vasoplegia, or septic shock postoperatively. Future
large randomized controlled trials are needed to better define proper
patient selection, dosing, and timing of the therapy. Copyright ©
The Author(s) 2024.

<36>
Accession Number
2029856609
Title
Immune checkpoint inhibitors and pericardial disease: a systematic review.
Source
Cardio-Oncology. 10(1) (no pagination), 2024. Article Number: 29. Date of
Publication: December 2024.
Author
Mudra S.E.; Rayes D.L.; Agrawal A.; Kumar A.K.; Li J.Z.; Njus M.; McGowan
K.; Kalam K.A.; Charalampous C.; Schleicher M.; Majid M.; Syed A.;
Yesilyaprak A.; Klein A.L.
Institution
(Mudra, Rayes, Kumar, Li, Njus, McGowan, Kalam, Charalampous) Department
of Internal Medicine, MedStar Georgetown University Hospital, MedStar
Health, Washington, DC, United States
(Agrawal, Kumar, Majid, Syed, Yesilyaprak, Klein) Center for the Diagnosis
and Treatment of Pericardial Diseases, Section of Cardiovascular Imaging,
Department of Cardiovascular Medicine, Heart, Vascular, and Thoracic
Institute, Cleveland Clinic, 9500 Euclid Ave., Desk J1-5, Cleveland, OH
44195, United States
(Schleicher) Floyd D. Loop Memorial Library, Cleveland Clinic, Cleveland,
OH, United States
Publisher
BioMed Central Ltd
Abstract
Introduction: Despite the growing use of immune checkpoint inhibitors
(ICI) in cancer treatment, data regarding ICI-associated pericardial
disease are primarily derived from case reports and case series. ICI
related pericardial disease can be difficult to diagnose and is associated
with significant morbidity. We conducted a systematic review to further
characterize the epidemiology, clinical presentation, and outcomes of this
patient population. Method(s): A search of four databases resulted in
31 studies meeting inclusion criteria. Patients > 18 years old who
presented with ICI mediated pericardial disease were included.
Intervention was medical + surgical therapy and outcomes were development
of cardiac tamponade, morbidity, and mortality. Result(s): Thirty-
eight patients across 31 cases were included. Patients were majority male
(72%) with a median age of 63. Common symptoms included dyspnea (59%) and
chest pain (32%), with 41% presenting with cardiac tamponade. Lung cancer
(81%) was the most prevalent, and nivolumab (61%) and pembrolizumab (34%)
were the most used ICIs. Pericardiocentesis was performed in 68% of
patients, and 92% experienced symptom improvement upon ICI cessation.
Overall mortality was 16%. Discussion(s): This study provides the
most comprehensive analysis of ICI-mediated pericardial disease to date.
Patients affected were most commonly male with lung cancer treated with
either Nivolumab or Pembrolizumab. Diagnosis may be challenging in the
setting of occult presentation with normal EKG and physical exam as well
as delayed onset from therapy initiation. ICI-associated pericardial
disease demonstrates high morbidity and mortality, as evidenced by a
majority of patients requiring pericardiocentesis. Copyright ©
The Author(s) 2024.

<37>
Accession Number
2029871101
Title
Managing chronic coronary syndrome: how do we achieve optimal patient
outcomes?.
Source
Expert Review of Cardiovascular Therapy. (no pagination), 2024. Date of
Publication: 2024.
Author
Manolis A.A.; Manolis T.A.; Manolis A.S.
Institution
(Manolis) Department of Medicine, Elpis General Hospital, Athens, Greece
(Manolis) Department of Psychiatry, Aiginiteio University Hospital,
Athens, Greece
(Manolis) First Department of Cardiology, Ippokrateio University Hospital,
Athens, Greece
Publisher
Taylor and Francis Ltd.
Abstract
Introduction: Chronic coronary syndrome (CCS) remains the leading cause of
death worldwide with high admission/re-admission rates. Medical databases
were searched on CCS & its management. Areas covered: This review
discusses phenotypes per stress-echocardiography, noninvasive/invasive
testing (coronary computed-tomography angiography-CCTA; coronary artery
calcium-CAC score; echocardiography assessing wall-motion, LV function,
valvular disease; biomarkers), multidisciplinary management (risk
factors/anti-inflammatory/anti-ischemic/antithrombotic therapies and
revascularization), newer treatments
(colchicine/ivabradine/ranolazine/melatonin), cardiac
rehabilitation/exercise improving physical activity and quality-of-life,
use of the implantable-defibrillator, and treatment with extracorporeal
shockwave-revascularization for refractory symptoms. Expert opinion: CCS
is age-dependent, leading cause of death worldwide with high
hospitalization rates. Stress-echocardiography defines phenotypes and
guides prophylaxis and management. CAC is a surrogate for atherosclerosis
burden, best for patients of intermediate/borderline risk. Higher
CAC-scores indicate more severe coronary abnormalities. CCTA is preferred
for noninvasive detection of CAC and atherosclerosis burden, determining
stenosis' functional significance, and guiding management. Combining CAC
score with CCTA improves diagnostic yield and assists prognosis.
Echocardiography assesses LV wall-motion and function and valvular
disease. Biomarkers guide diagnosis/prognosis. CCS management is
multidisciplinary: risk-factor management,
anti-inflammatory/anti-ischemic/antithrombotic therapies, and
revascularization. Newer therapies comprise colchicine, ivabradine,
ranolazine, melatonin, glucagon-like peptide-1-receptor antagonists.
Cardiac rehabilitation/exercise improves physical activity and
quality-of-life. An ICD protects from sudden death. Extracorporeal
shockwave-revascularization treats refractory symptoms. Copyright
© 2024 Informa UK Limited, trading as Taylor & Francis Group.

<38>
Accession Number
2029866482
Title
Does remote ischemic preconditioning affect the systemic inflammatory
response by modulating presepsin levels?.
Source
International Journal of Artificial Organs. (no pagination), 2024. Date
of Publication: 2024.
Author
Bayram B.; Senarslan D.A.; Sengel A.; Ozturk T.; Onur E.; Iskesen I.
Institution
(Bayram, Senarslan, Iskesen) Department of Cardiovascular Surgery, Faculty
of Medicine, Manisa Celal Bayar University, Manisa, Turkey
(Sengel, Ozturk) Department of Anesthesiology and Reanimation, Faculty of
Medicine, Manisa Celal Bayar University, Manisa, Turkey
(Onur) Department of Medical Biochemistry, Faculty of Medicine, Manisa
Celal Bayar University, Manisa, Turkey
Publisher
SAGE Publications Ltd
Abstract
Objective: We investigated the effect of Remote Ischemic Preconditioning
(RIPC) on the inflammatory response during CPB by means of serum presepsin
levels at preoperative and postoperative 1st and 24th h. Method(s):
In this prospective, randomized, cross-sectional study we included 81
patients undergoing coronary artery bypass graft surgery with
cardiopulmonary bypass (CPB). Patients were randomized and RIPC was
applied to 40 patients in the study group before anesthesia. The remaining
41 patients were determined as the control group. The relationships
between RIPC and factors such as presepsin, C-reactive protein (CRP), and
leukocyte levels were investigated. Result(s): There was no
significant difference between the groups in postoperative leukocyte and
CRP values (p = 0.52, p = 0.13, respectively). When the preoperative and
postoperative first hour presepsin values of the patients were compared,
no significant difference was found in the control group (p = 0.17), but a
significant difference was found in the study group (p < 0.05). When the
presepsin values were compared between the groups, a significant
difference was found only in the postoperative first hour value (p <
0.05). Conclusion(s): It was observed that RIPC application caused to
increase the presepsin levels in the postoperative first hour
significantly in the study group (p < 0.05). Copyright © The
Author(s) 2024.

<39>
Accession Number
644289840
Title
Staged Versus Concomitant TAVI and PCI for the Treatment of Coexisting
Aortic Stenosis and Coronary Artery Disease.
Source
Cardiology in review. (no pagination), 2024. Date of Publication: 17 May
2024.
Author
Shirke M.M.; Wang W.; Welch J.; Faisal F.; Nguyen D.; Harky A.
Institution
(Shirke) From the Department of Medicine, University Hospitals NHS Trust,
Nottingham, United Kingdom
(Wang) Department of Medicine, Queen Mary University Of London, Barts and
The London School of Medicine and Dentistry, London, United Kingdom
(Welch) Department of General Surgery, Sandwell General Hospital, Sandwell
and West Birmingham NHS Trust, Birmingham, United Kingdom
(Faisal) Department of Medicine, New Vision University, Tbilisi, Georgia
(Nguyen) Department of Cardiology, Massachusetts General Hospital,
Corrigan Minehan Heart Center, Harvard Medical School, Boston, MA, United
States
(Harky) Department of Cardiothoracic Surgery, Liverpool Heart and Chest,
Liverpool, United Kingdom
Abstract
Aortic stenosis (AS) is one of the most common valvular pathologies.
Severe coronary artery disease (CAD) often coexists with AS. Transcatheter
aortic valve implantation (TAVI) and percutaneous coronary intervention
(PCI) have been established as alternatives to open surgical
interventions. The data on the timing for the treatment of the 2
conditions are scarce and depend on multiple factors. This review compares
the clinical outcomes of the concomitant versus staged PCI and TAVI for
the treatment of AS and CAD. A systematic, electronic search was performed
according to Preferred Reporting Items for Systematic Reviews and
Meta-analysis (PRISMA) guidelines to identify relevant articles that
compared outcomes of the staged versus concomitant approaches for the TAVI
and PCI. Seven studies were included involving 3745 patients. We found no
statistically significant difference in primary outcomes such as 30-day
mortality [odds ratio (OR) = 0.78; 95% confidence interval (CI):
0.39-1.57] and secondary outcomes including length of hospital stay (mean
difference = -4.74, 95% CI: -10.96 to 1.48), new-onset renal failure (OR =
0.83, 95% CI: 0.22-3.13), cerebrovascular accidents (OR = 1.28, 95% CI:
0.64-2.57), and intraoperative blood loss (OR = 0.83, 95% CI: 0.32-2.12).
New pacemaker insertion was statistically significant in favor of the
concomitant approach (OR = 0.78, 95% CI: 0.63-0.96). This analysis
suggests that while the 2 approaches are largely comparable in terms of
most outcomes, patients at risk of requiring a pacemaker postprocedure may
benefit from a concomitant approach. In conclusion, concomitant TAVI + PCI
approach is nonsuperior to the staged approach for the treatment of CAD
and AS. This review calls for robust trials in the field to further
strengthen the evidence. Copyright © 2024 Wolters Kluwer Health,
Inc. All rights reserved.

<40>
Accession Number
2028803162
Title
Effect of levosimendan on ventricular remodelling in patients with left
ventricular systolic dysfunction: a meta-analysis.
Source
ESC Heart Failure. 11(3) (pp 1352-1376), 2024. Date of Publication: June
2024.
Author
Wang X.; Zhao X.-Z.; Wang X.-W.; Cao L.-Y.; Lu B.; Wang Z.-H.; Zhang W.;
Ti Y.; Zhong M.
Institution
(Wang, Wang, Cao, Lu, Zhang, Ti, Zhong) National Key Laboratory for
Innovation and Transformation of Luobing Theory, The Key Laboratory of
Cardiovascular Remodeling and Function Research, Chinese Ministry of
Education, Chinese National Health Commission and Chinese Academy of
Medical Sciences, Department of Cardiology, Qilu Hospital of Shandong
University, China
(Zhao) Department of Cardiology, People's Hospital of Lixia District of
Jinan, Shandong, Jinan, China
(Wang) Department of Geriatric Medicine, Shandong Key Laboratory of
Cardiovascular Proteomics, Qilu Hospital, Cheeloo College of Medicine,
Shandong University, Jinan, China
Publisher
John Wiley and Sons Inc
Abstract
Heart failure is the final stage of several cardiovascular diseases, and
the key to effectively treating heart failure is to reverse or delay
ventricular remodelling. Levosimendan is a novel inotropic and vasodilator
agent used in heart failure, whereas the impact of levosimendan on
ventricular remodelling is still unclear. This study aims to investigate
the impact of levosimendan on ventricular remodelling in patients with
left ventricular systolic dysfunction. Electronic databases were searched
to identify eligible studies. A total of 66 randomized controlled trials
involving 7968 patients were included. Meta-analysis results showed that
levosimendan increased left ventricular ejection fraction [mean difference
(MD) = 3.62, 95% confidence interval (CI) (2.88, 4.35), P < 0.00001] and
stroke volume [MD = 6.59, 95% CI (3.22, 9.96), P = 0.0001] and
significantly reduced left ventricular end-systolic volume [standard mean
difference (SMD) = -0.52, 95% CI (-0.67, -0.37), P < 0.00001], left
ventricular end-diastolic volume index [SMD = -1.24, 95% CI (-1.61,
-0.86), P < 0.00001], and left ventricular end-systolic volume index [SMD
= -1.06, 95% CI (-1.43, -0.70), P < 0.00001]. In terms of biomarkers,
levosimendan significantly reduced the level of brain natriuretic peptide
[SMD = -1.08, 95% CI (-1.60, -0.56), P < 0.0001], N-terminal pro-brain
natriuretic peptide [SMD = -0.99, 95% CI (-1.41, -0.56), P < 0.00001], and
interleukin-6 [SMD = -0.61, 95% CI (-0.86, -0.35), P < 0.00001].
Meanwhile, levosimendan may increase the incidence of hypotension [risk
ratio (RR) = 1.24, 95% CI (1.12, 1.39), P < 0.0001], hypokalaemia [RR =
1.57, 95% CI (1.08, 2.28), P = 0.02], headache [RR = 1.89, 95% CI (1.50,
2.39), P < 0.00001], atrial fibrillation [RR = 1.31, 95% CI (1.12, 1.52),
P = 0.0005], and premature ventricular complexes [RR = 1.86, 95% CI (1.27,
2.72), P = 0.001]. In addition, levosimendan reduced all-cause mortality
[RR = 0.83, 95% CI (0.74, 0.94), P = 0.002]. In conclusion, our study
found that levosimendan might reverse ventricular remodelling when applied
in patients with left ventricular systolic dysfunction, especially in
patients undergoing cardiac surgery, decompensated heart failure, and
septic shock. Copyright © 2024 The Authors. ESC Heart Failure
published by John Wiley & Sons Ltd on behalf of European Society of
Cardiology.

<41>
Accession Number
2031984282
Title
Feasibility study of rehabilitation for cardiac patients aided by an
artificial intelligence web-based programme: a randomised controlled trial
(RECAP trial)-a study protocol.
Source
BMJ Open. 14(4) (no pagination), 2024. Article Number: e079404. Date of
Publication: 30 Apr 2024.
Author
Witharana P.; Chang L.; Maier R.; Ogundimu E.; Wilkinson C.; Athanasiou
T.; Akowuah E.
Institution
(Witharana, Chang, Maier, Wilkinson, Akowuah) Academic Cardiovascular
Unit, South Tees Hospitals NHS Foundation Trust, Middlesbrough, United
Kingdom
(Witharana, Athanasiou) Department of Surgery and Cancer, Imperial College
London, London, United Kingdom
(Ogundimu) Mathematical Sciences, University of Durham, Durham, United
Kingdom
(Wilkinson) Hull York Medical School, University of York, York, United
Kingdom
Publisher
BMJ Publishing Group
Abstract
Introduction Cardiac rehabilitation (CR) delivered by rehabilitation
specialists in a healthcare setting is effective in improving functional
capacity and reducing readmission rates after cardiac surgery. It is also
associated with a reduction in cardiac mortality and recurrent myocardial
infarction. This trial assesses the feasibility of a home-based CR
programme delivered using a mobile application (app). Methods The
Rehabilitation through Exercise prescription for Cardiac patients using an
Artificial intelligence web-based Programme (RECAP) randomised controlled
feasibility trial is a single-centre prospective study, in which patients
will be allocated on a 1:1 ratio to a home-based CR programme delivered
using a mobile app with accelerometers or standard hospital-based
rehabilitation classes. The home-based CR programme will employ artificial
intelligence to prescribe exercise goals to the participants on a weekly
basis. The trial will recruit 70 patients in total. The primary objectives
are to evaluate participant recruitment and dropout rates, assess the
feasibility of randomisation, determine acceptability to participants and
staff, assess the rates of potential outcome measures and determine
hospital resource allocation to inform the design of a larger randomised
controlled trial for clinical efficacy and health economic evaluation.
Secondary objectives include evaluation of health-related quality of life
and 6 minute walk distance. Ethics and dissemination RECAP trial received
a favourable outcome from the Berkshire research ethics committee in
September 2022 (IRAS 315483). Trial results will be made available through
publication in peer-reviewed journals and presented at relevant scientific
meetings. Copyright © Author(s) (or their employer(s)) 2024.

<42>
Accession Number
2032273898
Title
Partial CArdiac Denervation to Prevent Postoperative Atrial Fibrillation
After Coronary Artery Bypass Grafting (pCAD-POAF): Study Protocol for a
Randomized Controlled Trial.
Source
American Journal of Cardiology. 221 (pp 120-125), 2024. Date of
Publication: 15 Jun 2024.
Author
Yang Z.; Tiemuerniyazi X.; Huang S.; Song Y.; Xu F.; Feng W.
Institution
(Yang, Tiemuerniyazi, Huang, Song, Xu, Feng) Department of Cardiovascular
Surgery, Fuwai Hospital; National Center for Cardiovascular Diseases;
National Clinical Research Center for Cardiovascular Diseases; Chinese
Academy of Medical Sciences; and Peking Union Medical College, Beijing,
China
Publisher
Elsevier Inc.
Abstract
Postoperative atrial fibrillation (POAF) is commonly seen in patients who
underwent coronary artery bypass grafting (CABG), increasing the risk of
morbidity, mortality, and hospital expenses. This study aimed to evaluate
the effect of partial cardiac denervation, which is achieved by cutting
off the ligament of Marshall and resecting the fat pad along the Waterston
groove, on the prevention of POAF after CABG. Patients planned for CABG at
our center were screened for eligibility in this study. A total of 430
patients were randomized into the intervention (partial cardiac
denervation) group and control group. Intraoperative high-frequency
electrical stimulation and further histologic analysis were performed in a
certain number of patients to confirm the existence of ganglia. All
patients were continuously monitored for the incidence of POAF through an
electrophysiologic device until the sixth day postoperatively, and
required to complete a 30-day follow-up (12-lead electrocardiogram and
echocardiogram assessment) after discharge. The primary end point is the
incidence of POAF, whereas the secondary end points are the
cost-effectiveness and safety outcomes. In conclusion, this trial will
evaluate whether partial cardiac denervation through cutting off the
ligament of Marshall and resecting the fat pad along the Waterston groove
can reduce the incidence of POAF after CABG. If this procedure is revealed
to be effective and safe, it may provide a potential therapeutic approach
to prevent POAF in this group of patients. Copyright © 2024 The
Author(s)

<43>
Accession Number
2032273417
Title
Outcomes by sex in the International Study of Comparative Health
Effectiveness With Medical and Invasive Approaches (ISCHEMIA) trial.
Source
EuroIntervention. 20(9) (pp 551-560), 2024. Date of Publication: 2024.
Author
Gaudino M.; Alexander J.H.; Sandner S.; Harik L.; Kim J.; Stone G.W.;
Rahouma M.; O'Gara P.; Bhatt D.L.; Redfors B.
Institution
(Gaudino, Harik, Rahouma) Department of Cardiothoracic Surgery, Weill
Cornell Medicine, New York, NY, United States
(Alexander) Division of Cardiology, Duke Clinical Research Institute, Duke
University, Durham, NC, United States
(Sandner) Department of Cardiac Surgery, Medical University of Vienna,
Vienna, Austria
(Kim) Division of Biostatistics, Department of Population Health Sciences,
Weill Cornell Medicine, New York, NY, United States
(Stone) Zena and Michael A. Wiener Cardiovascular Institute, Icahn School
of Medicine at Mount Sinai, New York, NY, United States
(O'Gara) Department of Medicine, Brigham and Women's Hospital, Boston, MA,
United States
(Bhatt) Mount Sinai Heart, Icahn School of Medicine at Mount Sinai, New
York, NY, United States
(Redfors) Department of Cardiology, Sahlgrenska Academy, University of
Gothenburg, Gothenburg, Sweden
Publisher
Europa Group
Abstract
BACKGROUND: In the International Study of Comparative Health Effectiveness
With Medical and Invasive Approaches (ISCHEMIA) trial, among participants
with stable coronary artery disease, the risk of cardiac events was
similar between an invasive (INV) strategy of angiography and coronary
revascularisation and a conservative (CON) strategy of initial medical
therapy alone. Outcomes according to participant sex were not reported.
AIMS: We aimed to analyse the outcomes of ISCHEMIA by participant sex.
 METHOD(S): We evaluated 1) the association between participant sex
and the likelihood of undergoing revascularisation for participants
randomised to the INV arm; 2) the risk of the ISCHEMIA primary composite
outcome (cardiovascular death, any myocardial infarction [MI] or
rehospitalisation for unstable angina, heart failure or resuscitated
cardiac arrest) by participant sex; and 3) the contribution of the
individual primary outcome components to the composite outcome by
participant sex. RESULT(S): Of 5,179 randomised participants, 1,168
(22.6%) were women. Female sex was independently associated with a lower
likelihood of revascularisation when assigned to the INV arm (adjusted
odds ratio 0.75, 95% confidence interval [CI]: 0.57-0.99; p=0.04). The INV
versus CON effect on the primary composite outcome was similar between
sexes (women: hazard ratio [HR] 0.96, 95% CI: 0.70-1.33; men: HR 0.90, 95%
CI: 0.76-1.07; pinteraction=0.71). The contribution of the individual
components to the composite outcome was similar between sexes except for
procedural MI, which was significantly lower in women (9/151 [5.9%]) than
men (67/519 [12.9%]; p=0.01). CONCLUSION(S): In ISCHEMIA, women
assigned to the INV arm were less likely to undergo revascularisation than
men. The effect of an INV versus CON strategy was consistent by sex, but
women had a significantly lower contribution of procedural MI to the
primary outcome. Copyright © 2024 Europa Group. All rights
reserved.

<44>
Accession Number
2029813315
Title
Comparison between Imaging and Physiology in Guiding Coronary
Revascularization: A Meta-Analysis.
Source
Journal of Clinical Medicine. 13(9) (no pagination), 2024. Article Number:
2504. Date of Publication: May 2024.
Author
Improta R.; Di Pietro G.; Giansanti M.; Bruno F.; De Filippo O.; Tocci M.;
Colantonio R.; Sardella G.; D'Ascenzo F.; Mancone M.
Institution
(Improta, Di Pietro, Giansanti, Tocci, Colantonio, Sardella, Mancone)
Department of Clinical, Internal, Anesthesiology and Cardiovascular
Sciences, Umberto I Hospital, Sapienza University of Rome, Viale del
Policlinico 155 (Emodinamica A, Ottavo Padiglione, II Piano), Rome 00161,
Italy
(Bruno, De Filippo, D'Ascenzo) Department of Medical Science, Division of
Cardiology, Molinette Hospital, Turin University, Turin 10124, Italy
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Background: Percutaneous coronary intervention (PCI) is a widely used
revascularization strategy for coronary artery disease. The choice between
imaging-guided and physiology-guided PCI has been a subject of debate.
This meta-analysis aims to systematically compare outcomes between imaging
and physiology-guided PCI and management of intermediate coronary lesions
(ICLs). Method(s): A comprehensive literature search was conducted
across major databases for studies published up to December 2023 following
PRISMA guidelines. Seven eligible studies comparing imaging-guided and
physiology-guided PCI were selected for the final analysis. Relevant
outcome measures included major adverse cardiovascular events (MACE),
target vessel revascularization (TVR), target vessel failure (TVF), and
target lesion revascularization (TLR). Subgroup analysis was performed for
ICLs. Result(s): A total of 5701 patients were included in the
meta-analysis. After a mean follow-up of 2.1 years, imaging-guided PCI was
associated with lower rates of TVR compared to physiology-guided PCI (OR
0.70, 95% CI 0.52-0.95, p = 0.02); concerning MACE, TVF, and TLR, no
differences were found. When the analysis was restricted to studies
considering ICLs management, there were no differences between the two
techniques. Meta regression analysis did not show any impact of acute
coronary syndromes (ACS) presentation on MACE and TVR. Conclusion(s):
The findings suggest that imaging-guided PCI may reduce the need for
future revascularization of the target vessel compared to the
functional-guided approach, and this result was not influenced by ACS
presentation. These results may have important implications for clinical
practice, guiding interventional cardiologists in selecting the most
appropriate guidance strategy. Copyright © 2024 by the authors.

<45>
Accession Number
2029799687
Title
Urinary L-FABP as an Early Biomarker for Pediatric Acute Kidney Injury
Following Cardiac Surgery with Cardiopulmonary Bypass: A Systematic Review
and Meta-Analysis.
Source
International Journal of Molecular Sciences. 25(9) (no pagination), 2024.
Article Number: 4912. Date of Publication: May 2024.
Author
Wilnes B.; Castello-Branco B.; Branco B.C.; Sanglard A.; Vaz de Castro
P.A.S.; Simoes-e-Silva A.C.
Institution
(Wilnes, Castello-Branco, Branco, Sanglard, Vaz de Castro, Simoes-e-Silva)
Interdisciplinary Laboratory of Medical Investigation, Unit of Pediatric
Nephrology, Department of Pediatrics, Faculty of Medicine, Federal
University of Minas Gerais, MG, Belo Horizonte 30130-100, Brazil
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Acute kidney injury (AKI) following surgery with cardiopulmonary bypass
(CPB-AKI) is common in pediatrics. Urinary liver-type fatty acid binding
protein (uL-FABP) increases in some kidney diseases and may indicate
CPB-AKI earlier than current methods. The aim of this systematic review
with meta-analysis was to evaluate the potential role of uL-FABP in the
early diagnosis and prediction of CPB-AKI. Databases Pubmed/MEDLINE,
Scopus, and Web of Science were searched on 12 November 2023, using the
MeSH terms "Children", "CPB", "L-FABP", and "Acute Kidney Injury".
Included papers were revised. AUC values from similar studies were pooled
by meta-analysis, performed using random- and fixed-effect models, with p
< 0.05. Of 508 studies assessed, nine were included, comprising 1658
children, of whom 561 (33.8%) developed CPB-AKI. Significantly higher
uL-FABP levels in AKI versus non-AKI patients first manifested at baseline
to 6 h post-CPB. At 6 h, uL-FABP correlated with CPB duration (r = 0.498,
p = 0.036), postoperative serum creatinine (r = 0.567, p < 0.010), and
length of hospital stay (r = 0.722, p < 0.0001). Importantly, uL-FABP at
baseline (AUC = 0.77, 95% CI: 0.64-0.89, n = 365), 2 h (AUC = 0.71, 95%
CI: 0.52-0.90, n = 509), and 6 h (AUC = 0.76, 95% CI: 0.72-0.80, n = 509)
diagnosed CPB-AKI earlier. Hence, higher uL-FABP levels associate with
worse clinical parameters and may diagnose and predict CPB-AKI
earlier. Copyright © 2024 by the authors.

<46>
Accession Number
2026080568
Title
Does dexmedetomidine reduce the risk of acute kidney injury after cardiac
surgery? A meta-analysis of randomized controlled trials.
Source
Brazilian Journal of Anesthesiology (English Edition). 74(3) (no
pagination), 2024. Article Number: 744446. Date of Publication: 01 May
2024.
Author
Zhao C.; Liu S.; Zhang H.; Gao M.
Institution
(Zhao, Zhang, Gao) Capital Medical University, Beijing Shijitan Hospital,
Department of Intensive Care Unit, Beijing, China
(Liu) Capital Medical University, Beijing Chest Hospital, Beijing
Tuberculosis and Thoracic Tumor Research Institute, Department of
Pharmacy, Beijing, China
Publisher
Elsevier Editora Ltda
Abstract
Background: Acute Kidney Injury (AKI) is a common complication after
cardiac surgery and has been associated with poor outcomes.
Dexmedetomidine (DEX) has been shown to confer direct renoprotection based
on some animal and clinical studies, but data from other trials came to
the opposite conclusion following cardiac surgery. This meta-analysis was
conducted to evaluate the effects of perioperative DEX administration on
the occurrence of AKI and the outcomes after cardiac surgery.
 Method(s): We searched databases including EMBASE, PubMed, and
Cochrane CENTRAL for Randomized Controlled Trials (RCTs) focused on DEX
for AKI in adult patients after cardiac surgery. The primary outcome was
incidence of AKI. Secondary outcomes were Mechanical Ventilation (MV)
duration, Intensive Care Unit (ICU) Length Of Stay (LOS), hospital LOS and
mortality. Result(s): Fifteen trials enrolling 2907 study patients
were collected in the meta-analyses. Compared with controls, DEX reduced
the incidence of postoperative AKI (Odds Ratio [OR = 0.66]; 95% Confidence
Interval [95% CI 0.48-0.91]; p = 0.01), and there was no significant
difference between groups in postoperative mortality (OR = 0.63; 95% CI
0.32-1.26; p = 0.19), MV duration (Weighted Mean Difference [WMD = -0.44];
95% CI -1.50-0.63; p = 0.42), ICU LOS (WMD = -1.19; 95% CI -2.89-0.51; p =
0.17), and hospital LOS (WMD = -0.31; 95% CI -0.76-0.15; p = 0.19).
 Conclusion(s): Perioperative DEX reduced the incidence of
postoperative AKI in adult patients undergoing cardiac surgery. No
significant decrease existed in mortality, MV duration, ICU LOS and
hospital LOS owing to DEX administration. Copyright © 2024

<47>
Accession Number
2023513903
Title
The association of hemoglobin with postoperative delirium and atrial
fibrillation after cardiac surgery: a retrospective sub-study.
Source
Brazilian Journal of Anesthesiology (English Edition). 74(3) (no
pagination), 2024. Article Number: 744424. Date of Publication: 01 May
2024.
Author
Sari S.; Brooker J.; Montalvo-Campana M.; Shehata P.; Pu X.; Insler S.;
Ruetzler K.; Troianos C.A.; Turan A.
Institution
(Sari, Brooker, Montalvo-Campana, Ruetzler, Turan) Cleveland Clinic,
Anesthesiology Institute, Department of Outcomes Research, Cleveland,
Ohio, United States
(Sari) Adnan Menderes University, Department of General Anesthesiology,
Aydin, Turkey
(Shehata, Ruetzler, Turan) Cleveland Clinic, Anesthesiology Institute,
Department of General Anesthesiology, Cleveland, Ohio, United States
(Pu) Cleveland Clinic, Department of Quantitative Health Sciences,
Cleveland, Ohio, United States
(Insler) Cleveland Clinic, Anesthesiology Institute, Department of
Intensive Care & Resuscitation, Cleveland, Ohio, United States
(Troianos) Cleveland Clinic, Anesthesiology Institute, Cleveland, Ohio,
United States
Publisher
Elsevier Editora Ltda
Abstract
Background: Most cardiac surgery patients experience postoperative anemia.
Delirium and Atrial Fibrillation (AF) are common and independent
predictors of morbidity and mortality. Few reports examine their
association with postoperative anemia. This study aims to quantify the
association between anemia and these outcomes in patients undergoing
cardiac surgery. Method(s): This post-hoc analysis of the DECADE
randomized controlled trial ran at six academic US hospitals. Patients
aged 18-85 years with heart rate > 50 bpm undergoing cardiac surgery who
had daily hemoglobin measurements in the first 5 Postoperative Days (POD)
were included. Delirium was assessed twice daily with the Confusion
Assessment Method for the ICU (CAM - ICU), preceded by the Richmond
Agitation and Sedation Scale, with patients excluded from assessment if
sedated. Patients had daily hemoglobin measurements, continuous cardiac
monitoring plus twice-daily 12-lead electrocardiograms, up to POD4. AF was
diagnosed by clinicians blinded to hemoglobin levels. Result(s): Five
hundred and eighty-five patients were included. Mean postoperative
hemoglobin Hazard Ratio (HR): 0.99 (95% CI 0.83, 1.19; p = 0.94) per 1
g.dL-1 hemoglobin decrease. 197 (34%) developed AF, mainly on
POD = 2.3. Estimated HR = 1.04 (95% CI 0.93, 1.17; p = 0.51) per 1
g.dL-1 hemoglobin decrease. Conclusion(s): Most patients
undergoing major cardiac surgery were anemic in the postoperative phase.
AF and delirium occurred in 34% and 12% of patients, respectively, but
neither were significantly correlated with postoperative
hemoglobin. Copyright © 2023

<48>
Accession Number
2031047913
Title
Effect of Adding Early Bedside Cycling to Inpatient Cardiac Rehabilitation
on Physical Function and Length of Stay After Heart Valve Surgery: A
Randomized Controlled Trial.
Source
Archives of Physical Medicine and Rehabilitation. 105(6) (pp 1050-1057),
2024. Date of Publication: June 2024.
Author
Ahmad A.M.; Abusarea S.A.; Fouad B.Z.; Guirguis S.A.; Shafie W.A.
Institution
(Ahmad, Abusarea, Guirguis) Department of Physical Therapy for
Cardiovascular and Respiratory Disorders, Faculty of Physical Therapy,
Cairo University, Giza, Egypt
(Fouad) Department of Cardiology, National Heart Institute, Giza, Egypt
(Shafie) Intensive Care Unit, National Heart Institute, Giza, Egypt
Publisher
W.B. Saunders
Abstract
Objective: To assess whether adding bedside cycling to inpatient cardiac
rehabilitation (CR) early after heart valve surgery could lead to better
physical function and shorter length of hospital stays. Design(s):
This is a single-centered, randomized, controlled, parallel-group
intervention study. Setting(s): This study was conducted at the
National Heart Institute from December 2022 to June 2023.
 Participant(s): Thirty-one patients following heart valve surgery
completed this study after being randomized into 2 groups: an intervention
group (n<inf>1</inf>=16) and an active control group (n<inf>2</inf>=15).
Eligibility criteria were heart valve surgery with median sternotomy,
clinical stability, and age from 20 to 40 years. Intervention(s): The
intervention group received early bedside cycling for the lower limbs,
using a mini bike, in addition to an inpatient CR program, and the control
group received the inpatient CR program alone. Main Outcome
Measure(s): The primary outcome was the physical functional capacity
assessed by the 6-minute walk distance (6MWD). The secondary outcomes were
the Barthel Index (BI), the forced vital capacity (FVC), the length of
intensive care unit (ICU) stay, the total length of hospital stay, and the
physical component summary (PCS) of the 12-item Short Form (SF-12) Health
Survey. Result(s): Compared with the control group, the intervention
group showed significantly greater 6MWD (P<.001), BI score (P<.001), and
FVC (P=.006) at hospital discharge, and shorter ICU stay (P=.002) and
total hospital stay (P=.015). At 1-month follow-up, the intervention group
showed a non-significantly higher PCS mean score than the control group
(P=.057). Conclusion(s): Adding early bedside cycling to a usual
inpatient CR program after heart valve surgery could induce significantly
greater short-term physical functional capacity as assessed by the 6MWD,
better activities of daily living as evaluated by the BI, higher pulmonary
function as measured by the FVC, and shorter lengths of ICU and total
hospital stays than the usual inpatient CR program alone. Copyright
© 2024 American Congress of Rehabilitation Medicine

<49>
Accession Number
2029840360
Title
Transcatheter aortic valve replacement for aortic regurgitation: a
systematic review and meta-analysis.
Source
ESC Heart Failure. (no pagination), 2024. Date of Publication: 2024.
Author
Liu R.; Fu Z.; Jiang Z.; Yan Y.; Yao J.; Liu X.; Yan X.; Song G.
Institution
(Liu, Fu, Jiang, Yan, Yao, Liu, Song) Department of Interventional Center
of Valvular Heart Disease, Beijing Anzhen Hospital Affiliated to Capital
Medical University, Beijing, China
(Yan) Center for Health Systems Research, Sutter Health, Sacramento, CA,
United States
Publisher
John Wiley and Sons Inc
Abstract
The efficacy and safety of new-generation devices (NGDs) for severe aortic
regurgitation (AR) have mostly been based on single-arm studies with
limited sample sizes. Our goal was to summarize the current evidence on
NGDs and compare the safety and efficacy of 'off-label' and 'on-label'
devices in NGDs. We searched MEDLINE, Embase, Cochrane Library, and Scopus
for articles on transcatheter aortic valve replacement in patients with
AR. A total of 31 studies that included 1851 patients were identified
through April 2023. Among these, 1067 (57.6%) patients received treatment
with 'on-label' devices (JenaValve and J-Valve). For NGDs, the total
device success rate at 30 days was 94.5% (on-label: 97.8%, off-label:
89.9%; P < 0.001), the all-cause mortality was 4.2% (on-label: 2.6%,
off-label: 5.1%; P = 0.006), permanent pacemaker implantation (PPI) was
8.8% (on-label: 6.9%, off-label: 18.4%; P < 0.001), and the rate of
greater-than-mild paravalvular leak (PVL) was 1.2% (on-label: 0.9%,
off-label: 3.8%; P = 0.003). On-label devices showed significantly better
safety and efficacy in terms of the success rate, PPI, greater-than-mild
PVL, and 30 day mortality than off-label devices. Copyright ©
2024 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on
behalf of European Society of Cardiology.

<50>
Accession Number
2029281348
Title
L-carnitine decreases myocardial injury in children undergoing open-heart
surgery: A randomized controlled trial.
Source
European Journal of Pediatrics. 183(6) (pp 2783-2789), 2024. Date of
Publication: June 2024.
Author
El Feky W.; El-Afify D.; Abdelhai D.; Elkashlan M.; Fakhreldin A.; El
Amrousy D.
Institution
(El Feky) Cardiothoracic Surgery Department, Faculty of Medicine, Kafr
Elsheikh University, Kafr Elsheikh, Egypt
(El-Afify) Clinical Pharmacy Department, Faculty of Pharmacy, Tanta
University, Tanta, Egypt
(Abdelhai) Clinical Pathology Department, Faculty of Medicine, Tanta
University, Tanta, Egypt
(Elkashlan) Anesthesia Department, Elmenshawy Hospital, Ministry of
Health, Tanta, Egypt
(Fakhreldin) Pediatric Department, Faculty of Medicine, Aswan University,
Aswan, Egypt
(El Amrousy) Pediatric Department, Faculty of Medicine, Tanta University,
Tanta, Egypt
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Abstract: Myocardial injury in open-heart surgery is related to several
factors including ischemia-reperfusion injury, generation of reactive
oxygen species, increased production of inflammatory mediators, and
enhancement of apoptosis of cardiomyocytes. The aim of this study was to
study the effect of L-carnitine on myocardial injury in children
undergoing open-heart surgery. This clinical trial was performed on 60
children with congenital heart disease (CHD) who underwent open-heart
surgery. They were randomized into two groups: L-carnitine group who
received L-carnitine 50 mg\kg\day once daily for 1 month before cardiac
surgery and control group who received placebo for 1 month before cardiac
surgery. Left ventricular cardiac function was assessed by conventional
echocardiography to measure left ventricular ejection fraction (LVEF) and
two-dimensional speckle tracking echocardiography (2D-STE) to determine
left ventricular global longitudinal strain (2D-LV GLS). Blood samples
were obtained pre-operatively at baseline before the administration of
L-carnitine or placebo and 12 h post-operatively to measure the level of
malondialdehyde (MDA), superoxide dismutase (SOD), fas, caspase-3,
creatinine kinase-MB (CK-MB), and troponin I. L-carnitine group had
significantly lower post-operative level of oxidative stress marker (MDA),
apoptosis markers (fas and caspase-3), and myocardial injury markers
(CK-MB and troponin I), but they had significantly higher SOD
post-operative level compared to the control group. In addition,
post-operative LVEF and 2D-LVGLS were significantly lower in the control
group compared to L-carnitine group. Conclusion(s): L-carnitine can
reduce myocardial injury, improve post-operative left ventricular cardiac
function, and may provide myocardium protection in children with CHD who
underwent open-heart surgery. Trial registration: The clinical trial was
registered at www.pactr.org with registration number PACTR202010570607420
at 29/10/2020 before recruiting the patients. (Table
presented.) Copyright © The Author(s) 2024.

<51>
Accession Number
2032183978
Title
A review of high-intensity interval training in heart transplant
recipients: Current knowledge and future perspectives.
Source
Journal of Cardiopulmonary Rehabilitation and Prevention. 44(3) (pp
150-156), 2024. Date of Publication: 01 May 2024.
Author
Nytroen K.; Rolid K.
Institution
(Nytroen) Oslo University Hospital Rikshospitalet, Norway
(Rolid) The Norwegian Health Archives, Tynset, Norway
(Rolid) The Research Council of Norway, Oslo, Norway
Publisher
Lippincott Williams and Wilkins
Abstract
Objective: This review reports how exercise-based rehabilitation
strategies have developed over the past decades, and it specifically
focuses on the effectiveness, safety, and implementation of high-intensity
interval training (HIIT). It provides an overview of the historical
progression, main research findings, and considerations surrounding HIIT
as the preferred exercise modality for recipients of heart transplant
(HTx). Review Methods: The review includes a timeline of studies spanning
from 1976-2023. The 2017 Cochrane systematic review on exercise-based
cardiac rehabilitation in recipients of HTx serves as the main knowledge
base (>=2015). Additionally, literature searches in PubMed/Medline and
ClinicalTrials.gov have been performed, and all reviews and studies
reporting the effects of moderate-to high-intensity exercise in recipients
of HTx, published in 2015 or later have been screened. Summary:
High-intensity interval training has gained prominence as an effective
exercise intervention for recipients of HTx, demonstrated by an
accumulation of performed studies in the past decade, although
implementation in clinical practice remains limited. Early restrictions on
HIIT in HTx recipients lacked evidence-based support, and recent research
challenges these previous restrictions. High-intensity interval training
results in greater improvements and benefits compared with
moderate-intensity continuous training in the majority of studies. While
HIIT is now regarded as generally suitable on a group level, individual
assessment is still advised. The impact of HIIT involves reinnervation and
central and peripheral adaptations to exercise, with variations in
recipent responses, especially between de novo and maintenance recipients,
and also between younger and older recipients. Long-Term effects and
mechanisms behind the HIIT effect warrant further investigation, as well
as a focus on optimized HIIT protocols and exercise
benefits. Copyright © 2024 Lippincott Williams and Wilkins. All
rights reserved.

<52>
Accession Number
644277455
Title
Hemadsorption to Contain Postoperative Cell-Free Hemoglobin and
Haptoglobin Preservation for Extended Cardiopulmonary Bypass Time in
Cardiac Surgery for Acute Kidney Injuries Prevention.
Source
Brazilian journal of cardiovascular surgery. 39(3) (pp e20230272), 2024.
Date of Publication: 15 May 2024.
Author
Condello I.; Morvillo J.B.; Fiore F.; Teora V.; Nasso G.; Speziale G.
Institution
(Condello, Fiore, Teora, Nasso, Speziale) Department of Cardiac Surgery,
Anthea Hospital, GVM Care & Research, Bari, Italy
(Morvillo) Department of Cardiac Surgery, Biomedic Research Institute of
Murcia (IMIB), Virgen de la Arrixaca University Hospital, Murcia, Spain
Abstract
INTRODUCTION: Prevention of acute kidney injury during cardiopulmonary
bypass (CPB) is still a challenge and has been the object of numerous
studies. The incidence of acute kidney injury in the context of CPB is
related to a multifactorial etiology. The role of hemadsorption in
relation to cell-free hemoglobin and haptoglobin preservation is not well
defined in the literature on CPB during cardiac surgery procedures.
 METHOD(S): This is a single-center pilot randomized report including
20 patients undergoing elective CPB procedures with an expected time > 120
minutes for each extracorporeal procedure. Patients were randomly
allocated to either standard of care (n=10) or Jafron HA380 (n=10) during
CPB. The primary outcome measured was the incidence of postoperative acute
kidney injuries. RESULT(S): The Jafron study group vs. control group
reported postoperative values for cell-free hemoglobin at 10 minutes after
CPB (mg/L) (11.6 +/- 0.6 vs. 29.9 +/- 0.3) (P-value 0.021), haptoglobin 10
minutes after CPB (mg/dl) (129.16 +/- 1.22 vs. 59.17 +/- 1.49) (P-value
0.017), creatinine peak after CPB (mg/dL) (0.92 +/- 0.17 vs. 1.32 +/- 0.9)
(P-value 0.030), and acute kidney injury after 48 hours (number of
patients) (one vs. four) (P-value 0.027). CONCLUSION(S): This pilot
study suggested that the use of Hemoperfusion Cartridge HA380 Jafron for
extended CPB time for complex cardiac surgery procedures was safe and
effective and is associated with a better postoperative preservation of
haptoglobin with a reduction of cell-free hemoglobin values and less
incidence of acute kidney injury, though larger studies are warranted to
confirm our result.

<53>
Accession Number
644277112
Title
Comparison of the Effects of Full Median Sternotomy vs. Mini-Incision on
Postoperative Pain in Cardiac Surgery: A Meta-Analysis.
Source
Brazilian journal of cardiovascular surgery. 39(4) (pp e20230154), 2024.
Date of Publication: 15 May 2024.
Author
Chaves A.J.; Avelino P.S.; Lopes J.B.
Institution
(Chaves) Faculdade de Medicina da Bahia, Universidade Federal da Bahia
(FMB/UFBA), Salvador, Bahia, Brazil
(Avelino) Faculdade de Medicina, Universidade Salvador (UNIFACS),
Salvador, Bahia, Brazil
(Lopes) Department of Anesthesiology and Surgery, Faculdade de Medicina da
Bahia, Universidade Federal da Bahia (FMB/UFBA), Salvador, Bahia, Brazil
Abstract
INTRODUCTION: It is not yet clear whether cardiac surgery by mini-incision
(minimally invasive cardiac surgery [MICS]) is overall less painful than
the conventional approach by full sternotomy (FS). A meta-analysis is
necessary to investigate polled results on this topic. METHOD(S):
PubMed/MEDLINE, Cochrane CENTRAL, Latin American and Caribbean Health
Sciences Literature (or LILACS), and Scientific Electronic Library Online
(or SciELO) were searched for all clinical trials, reported until 2022,
comparing FS with MICS in coronary artery bypass grafting (CABG), mitral
valve surgery (MVS), and aortic valve replacement (AVR), and postoperative
pain outcome was analyzed. Main summary measures were the method of
standardized mean differences (SMD) with a 95% confidence interval (CI)
and P-values (considered statistically significant when < 0.05).
 RESULT(S): In AVR, the general estimate of postoperative pain effect
favored MICS (SMD 0.87 [95% CI 0.04 to 1.71], P=0.04). However, in the
sensitivity analysis, there was no difference between the groups (SMD 0.70
[95% CI -0.69 to 2.09], P=0.32). For MVS, it was not possible to perform a
meta-analysis with the included studies, because they had different
methodologies. In CABG, the general estimate of the effect of
postoperative pain did not favor any of the approaches (SMD -0.40 [95% CI
-1.07 to 0.26], P=0.23), which was confirmed by sensitivity analysis (SMD
-0.02 [95% CI -0.71 to 0.67], P=0.95). CONCLUSION(S): MICS was not
globally less painful than the FS approach. It seems that postoperative
pain is more related to the degree of tissue retraction than to the size
of the incision.

<54>
Accession Number
2032259766
Title
User-defined outcomes of the Danish cardiovascular screening (DANCAVAS)
trial: A post hoc analyses of a population-based, randomised controlled
trial.
Source
PLoS Medicine. 21(5) (no pagination), 2024. Article Number: e1004403. Date
of Publication: May 2024.
Author
Diederichsen A.C.P.; Mejldal A.; Sogaard R.; Hallas J.; Lambrechtsen J.;
Steffensen F.H.; Frost L.; Egstrup K.; Busk M.; Urbonaviciene G.; Karon
M.; Rasmussen L.M.; Lindholt J.S.
Institution
(Diederichsen) Department of Cardiology, Odense University Hospital,
Odense, Denmark
(Mejldal) Open Patient Data Explorative Network, Department of Clinical
Research, Odense University Hospital, Odense, Denmark
(Sogaard) Elite Research Centre for Individualised Medicine, Odense
University Hospital, Odense, Denmark
(Hallas) Department of Clinical Pharmacology, University of Southern
Denmark, Odense, Denmark
(Lambrechtsen, Egstrup) Department of Cardiology, Svendborg Hospital,
Svendborg, Denmark
(Steffensen, Busk) Department of Cardiology, Lillebaelt Hospital, Vejle,
Denmark
(Frost, Urbonaviciene) Department of Cardiology, Regional Hospital Central
Jutland, Silkeborg, Denmark
(Karon) Department of Medicine, Nykobing Falster Hospital, Nykobing
Falster, Denmark
(Rasmussen) Department of Clinical Biochemistry and Pharmacology, Odense
University Hospital, Odense, Denmark
(Lindholt) Department of Cardiothoracic, Vascular Surgery Odense
University Hospital Odense, Denmark
Publisher
Public Library of Science
Abstract
Background The Danish cardiovascular screening (DANCAVAS) trial, a
nationwide trial designed to investigate the impact of cardiovascular
screening in men, did not decrease all-cause mortality, an outcome decided
by the investigators. However, the target group may have varied
preferences. In this study, we aimed to evaluate whether men aged 65 to 74
years requested a CT-based cardiovascular screening examination and to
assess its impact on outcomes determined by their preferences. Methods and
findings This is a post hoc study of the randomised DANCAVAS trial. All
men 65 to 74 years of age residing in specific areas of Denmark were
randomised (1:2) to invitation-to-screening (16,736 men, of which 10,471
underwent screening) or usual-care (29,790 men). The examination included
among others a non-contrast CT scan (to assess the coronary artery calcium
score and aortic aneurysms). Positive findings prompted preventive
treatment with atorvastatin, aspirin, and surveillance/surgical
evaluation. The usual-care group remained unaware of the trial and the
assignments. The user-defined outcome was based on patient preferences and
determined through a survey sent in January 2023 to a random sample of
9,095 men from the target group, with a 68.0% response rate (6,182
respondents). Safety outcomes included severe bleeding and mortality
within 30 days after cardiovascular surgery. Analyses were performed on an
intention-to-screen basis. Prevention of stroke and myocardial infarction
was the primary motivation for participating in the screening examination.
After a median follow-up of 6.4 years, 1,800 of 16,736 men (10.8%) in the
invited-to-screening group and 3,420 of 29,790 (11.5%) in the usual-care
group experienced an event (hazard ratio (HR), 0.93 (95% confidence
interval (CI), 0.88 to 0.98; p = 0.010); number needed to invite at 6
years, 148 (95% CI, 80 to 986)). A total of 324 men (1.9%) in the
invited-to-screening group and 491 (1.7%) in the usual-care group had an
intracranial bleeding (HR, 1.17; 95% CI, 1.02 to 1.35; p = 0.029).
Additionally, 994 (5.9%) in the invited-to-screening group and 1,722
(5.8%) in the usual-care group experienced severe gastrointestinal
bleeding (HR, 1.02; 95% CI, 0.95 to 1.11; p = 0.583). No differences were
found in mortality after cardiovascular surgery. The primary limitation of
the study is that exclusive enrolment of men aged 65 to 74 renders the
findings non-generalisable to women or men of other age groups. Conclusion
In this comprehensive population-based cardiovascular screening and
intervention program, we observed a reduction in the user-defined outcome,
stroke and myocardial infarction, but entail a small increased risk of
intracranial bleeding. Copyright © 2024 Diederichsen et al. This
is an open access article distributed under the terms of the Creative
Commons Attribution License, which permits unrestricted use, distribution,
and reproduction in any medium, provided the origina author and source are
credited.

<55>
Accession Number
2032253538
Title
Efficacy of human prothrombin complex concentrate in the treatment of
warfarin overdose in patients receiving warfarin for mechanical heart
valve replacement.
Source
Medicine (United States). 103(19) (pp E38022), 2024. Date of Publication:
10 May 2024.
Author
Uncu H.; Badak T.O.; Ucak H.A.; Cereb F.; Cakallioglu A.
Institution
(Uncu, Badak, Ucak, Cereb) Adana City Training and Research Hospital
Department of Cardiovascular Surgery, Adana, Turkey
(Cakallioglu) Adana Cukurova State Hospital Department of Cardiovascular
Surgery, Adana, Turkey
Publisher
Lippincott Williams and Wilkins
Abstract
Warfarin, a widely utilized anticoagulant, is paramount for preventing
thromboembolic events in patients with mechanical heart valve
replacements. However, its narrow therapeutic index can lead to
over-anticoagulation and overdose, resulting in serious health risks. This
study examines the efficacy of human prothrombin complex concentrate (PCC)
in managing warfarin overdose, in comparison with traditional treatments.
A retrospective analysis was conducted on 162 adults who presented with
warfarin overdose (INR > 5.0) at a tertiary care hospital between 2016 and
2020. Participants were divided into 2 groups - those treated with PCC (n
= 57) and those treated with conventional methods (n = 105), including
vitamin K and fresh frozen plasma. The primary outcome was the rate of
reaching the target (International Normalized Ratio) INR within 24 hours.
Secondary outcomes included transfusion requirements, thromboembolic
events, adverse reactions, 30-day mortality, and length of hospital stay.
PCC demonstrated significant efficacy, with 89.5% of patients achieving
the target INR within 24 hours, compared to 64.8% in the control group (P
< .05). The PCC group also had reduced transfusion requirements and a
shorter average hospital stay. There was no significant difference in
thromboembolic events or adverse reactions between the 2 groups, and the
reduced 30-day mortality in the PCC group was not statistically
significant. Human prothrombin complex concentrate is associated with
rapid reaching the target INR, decreased transfusion needs, and shortened
hospitalization, making it a promising option for warfarin overdose
management. While the results are encouraging, larger, multicenter,
randomized controlled trials are necessary to further validate these
findings and optimize PCC administration protocols. Copyright ©
2024 Lippincott Williams and Wilkins. All rights reserved.

<56>
Accession Number
2029857699
Title
Long-term clinical outcomes of intravascular imaging-guided percutaneous
coronary intervention versus angiography-guided percutaneous coronary
intervention in complex coronary lesions: a systematic review and
meta-analysis.
Source
Future Cardiology. (no pagination), 2024. Date of Publication: 2024.
Author
Ashraf D.A.; Ahmed U.; Khan Z.Z.; Mushtaq F.; Bano S.; Khan A.R.; Azam S.;
Haroon A.; Malik S.A.; Aslam R.; Kumar J.; Khan F.Z.; Faheem A.; Kumar S.;
Hassan S.
Institution
(Ashraf, Hassan) Department of Internal Medicine, Foundation University
Medical College, Islamabad 44000, Pakistan
(Ahmed) Department of Internal Medicine, Rawalpindi Medically University,
Rawalpindi 46000, Pakistan
(Khan) Department of Internal Medicine, CMH Lahore Medical & Dental
College, Lahore 54810, Pakistan
(Mushtaq) Department of Internal Medicine, Allama Iqbal Medical College,
Lahore 54700, Pakistan
(Bano) Department of Internal Medicine, Gujranwala Medical College,
Gujranwala 52250, Pakistan
(Khan, Malik, Aslam) Department of Internal Medicine, Nishtar Medical
University, Multan 66000, Pakistan
(Azam) Department of Internal Medicine, Shaikh Khalifa Bin Zayed Al Nahyan
Medical & Dental College, Lahore 64260, Pakistan
(Haroon) Department of Internal Medicine, Ziauddin Medical College,
Karachi 75600, Pakistan
(Kumar, Kumar) Department of Internal Medicine, Wayne State School of
Medicine, Detroit, MI 48201, United States
(Khan) Department of Internal Medicine, Al-Nafees Medical College,
Islamabad 44000, Pakistan
(Faheem) Department of Internal Medicine, Abbottabad Int. Medical College,
Abbottabad, Pakistan
Publisher
Taylor and Francis Ltd.
Abstract
Background: In this study, we aim to discuss the long-term clinical
outcomes of intravascular ultrasound imaging-guided percutaneous
intervention (IVUS-PCI) versus angiography-guided percutaneous coronary
intervention (PCI) in complex coronary lesions over a mean period of 2
years. Method(s): A systematic search and meta-analysis were
conducted to assess the efficacy of using intravascular ultrasound or
optical coherence tomography guidance in coronary artery stenting compared
to angiography. Result(s): A total of 11 randomized controlled trials
with 6740 patients were included. For the primary outcome, a pooled
analysis (3.2 vs 5.6%). For secondary outcomes, the risk was significantly
low in image-guided percutaneous intervention compared with angiography.
 Conclusion(s): Intravascular imaging-guided PCI is significantly more
effective than angiography-guided PCI in reducing the risk of target
lesion revascularization, target vessel revascularization, cardiac death,
major adverse cardiovascular events and stent thrombosis. Copyright
© 2024 Expert Publishing Medicine Ltd trading as Taylor & Francis.

<57>
Accession Number
644280384
Title
Trends in safety of catheter-based electrophysiology procedures in the
last 2 decades: A meta-analysis.
Source
Heart rhythm. (no pagination), 2024. Date of Publication: 16 Apr 2024.
Author
Oates C.P.; Basyal B.; Whang W.; Reddy V.Y.; Koruth J.S.
Institution
(Oates) MedStar Heart and Vascular Institute, Georgetown
University-Washington Hospital Center, Washington, DC; Helmsley Center for
Cardiac Electrophysiology, Icahn School of Medicine at Mount Sinai, New
York, New York
(Basyal) MedStar Heart and Vascular Institute, Georgetown
University-Washington Hospital Center, WA, United States
(Whang, Reddy, Koruth) Helmsley Center for Cardiac Electrophysiology,
Icahn School of Medicine at Mount Sinai, NY, United States
Abstract
BACKGROUND: Rapid technologic development and expansion of procedural
expertise have led to widespread proliferation of catheter-based
electrophysiology procedures. It is unclear whether these advances come at
cost to patient safety. OBJECTIVE(S): This meta-analysis aimed to
assess complication rates after modern electrophysiology procedures during
the lifetime of the procedures. METHOD(S): A comprehensive search was
performed to identify relevant data published before May 30, 2023. Studies
were included if they met the following inclusion criteria: prospective
trials or registries, including comprehensive complications data; and
patients undergoing atrial fibrillation ablation, ventricular
tachyarrhythmia ablation, leadless cardiac pacemaker implantation, and
percutaneous left atrial appendage occlusion. Pooled incidences of
procedure-related complications were individually assessed by random
effects models to account for heterogeneity. Temporal trends in
complications were investigated by clustering trials by publication year
(2000-2018 vs 2019-2023). RESULT(S): A total of 174 studies (43,914
patients) met criteria for analysis: 126 studies of atrial fibrillation
ablation (n = 24,057), 25 studies of ventricular tachyarrhythmia ablation
(n = 1781), 21 studies of leadless cardiac pacemaker (n = 8896), and 18
studies of left atrial appendage occlusion (n = 9180). The pooled
incidences of serious procedure-related complications (3.49% [2000-2018]
vs 3.05% [2019-2023]; P < .001), procedure-related stroke (0.46% vs 0.28%;
P = .002), pericardial effusion requiring intervention (1.02% vs 0.83%; P
= .037), and procedure-related death (0.15% vs 0.06%; P = .003)
significantly decreased over time. However, there was no significant
difference in the incidence of vascular complications over time (1.86% vs
1.88%; P = .888). CONCLUSION(S): Despite an increase in cardiac
electrophysiology procedures, procedural safety has improved over
time. Copyright © 2024 Heart Rhythm Society. Published by
Elsevier Inc. All rights reserved.

<58>
Accession Number
644280033
Title
Zero-Contrast Left Atrial Appendage Closure, a Feasible Alternative for
Patients with a High Risk of Contrast-Induced Nephropathy: Systematic
Literature Review and Meta-Analysis.
Source
Heart rhythm. (no pagination), 2024. Date of Publication: 13 May 2024.
Author
Rodriguez J.F.; Pachon M.J.; Areiza L.A.; Rodriguez W.G.
Institution
(Rodriguez, Pachon) Universidad del Rosario. Bogota, Colombia
(Areiza) Hospital Universitario Mayor, Colombia
(Rodriguez) Colsubsidio Calle 63. Bogota, Colombia
Abstract
BACKGROUND: Left atrial appendage closure (LAAC) is an alternative to
reduce thrombotic risk in patients with non-valvular atrial fibrillation.
Conventionally this procedure requires the use of a contrast agent. A
significant proportion of patients who underwent this procedure have
chronic kidney disease, presenting a high risk of contrast-induced
nephropathy. OBJECTIVE(S): We aimed to systematically review existing
literature regarding the feasibility and safety of a zero-contrast LAAC
technique. METHOD(S): We searched the MEDLINE/PubMed, EMBASE and the
Cochrane Central Register of Controlled Trials databases for studies
comparing a zero-contrast LAAC technique with conventional LAAC up to
April 2024. From each study, we extracted baseline characteristics,
feasibility, and safety outcomes. A random model meta-analysis was used to
compare outcomes between groups. RESULT(S): Five studies reporting
data from 367 patients were included. A 100% successful implantation rate
was reported in all the zero-contrast groups. The mean number of
recaptures reached no significant difference between the groups (MD= -0.15
CI: -0.67 to 0.37 I2 = 0% p=0.58). The zero-contrast group presented a
significantly shorter fluoroscopy time (MD = -4.03, CI: -7.72; -0.34, I2
=67%, P=0.03). Complications related to the procedure, peri-device leak,
and device-associated thrombus rates were not significantly different
among the groups. CONCLUSION(S): Zero-contrast LAAC is a feasible
alternative. The success and complication rates are consistent with those
of conventional LAAC. Aside from the inherent benefit of zero-contrast
exposure, this technique allows for a reduction in fluoroscopy
time. Copyright © 2024. Published by Elsevier Inc.

<59>
Accession Number
2027607360
Title
Posterior Annulus Elevation Technique in Reducing Residual Regurgitation
During Mitral Valve Repair in Children: A Randomized Controlled Trial.
Source
World Journal for Pediatric and Congenital Heart Surgery. 15(3) (pp
353-362), 2024. Date of Publication: May 2024.
Author
Rahmat B.; Siswanto B.B.; Fakhri D.; Sakidjan I.; Murni T.W.; Timan I.S.;
Kekalih A.; Kurniawati Y.; Fardhani D.G.; Arya Wardana P.W.
Institution
(Rahmat) Doctoral Program in Medical Sciences, Faculty of Medicine,
Universitas Indonesia, Jakarta, Indonesia
(Rahmat, Fakhri, Fardhani) Pediatric and Congenital Heart Surgery Unit,
National Cardiovascular Center Harapan Kita, Jakarta, Indonesia
(Siswanto, Sakidjan, Kurniawati) Department of Cardiology and Vascular
Medicine, Faculty of Medicine, Universitas Indonesia, National
Cardiovascular Centre Harapan Kita, Jakarta, Indonesia
(Murni) Cardiothoracic Surgery Division, Department of Surgery, Hasan
Sadikin Hospital, Jawa Barat, Indonesia
(Timan) Human Genetic Research Center IMERI-FKUI, Universitas Kristen
Krida Wacana, Jakarta, Indonesia
(Kekalih) Community Medicine Department, Faculty of Medicine, Universitas
Indonesia, Jakarta, Indonesia
(Arya Wardana) Department of Thoracic, Cardiac and Vascular Surgery,
Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
Publisher
SAGE Publications Inc.
Abstract
Background: The current technique used in severe mitral regurgitation in
children can occasionally lead to residual regurgitation. To address this
issue, the posterior annulus elevation technique was developed to enhance
coaptation and reduce residual lesions. This study aims to evaluate the
effectiveness of this technique in reducing residual regurgitation during
mitral valve repair in children. Method(s): A total of 64 patients
aged <18 years old undergoing mitral valve repair were randomized into two
groups: the intervention (with posterior annulus elevation) group and the
control group, which underwent conventional repair techniques. Various
parameters, including coaptation area, residual mitral regurgitation,
clinical outcomes, metabolic, and hemolytic markers, were measured on days
0, 5, 2 weeks, and 3 months after surgery. Result(s): The
intervention group (n = 32) showed a significant reduction in residual
mitral regurgitation compared with the control group (n = 32) on each
evaluation. At three months after surgery, we found that the posterior
annulus elevation technique could be a protective factor that reduces the
chance of residual regurgitation compared with the control group (RR =
0.31; confidence interval: 0.18-0.54; P <=.001). Coaptation length and
index were also found to be significantly higher in the intervention group
(P <=.001). Clinical outcomes, metabolic markers, and hemolysis marker did
not show any significant differences between the two groups.
 Conclusion(s): The posterior annulus elevation technique demonstrated
effectiveness in reducing residual mitral regurgitation and improving
coaptation area in pediatric mitral valve repair. This technique showed
better short-term surgical outcomes in children with mitral regurgitation
compared with the conventional technique. Copyright © The
Author(s) 2023.

<60>
Accession Number
2031980805
Title
Regurgitant volume to LA volume ratio in patients with secondary MR: the
COAPT trial.
Source
European Heart Journal Cardiovascular Imaging. 25(5) (pp 616-625), 2024.
Date of Publication: 01 May 2024.
Author
Coisne A.; Scotti A.; Granada J.F.; Grayburn P.A.; Mack M.J.; Cohen D.J.;
Kar S.; Lim D.S.; Lindenfeld J.; Bax J.; Kotinkaduwa L.N.; Redfors B.;
Weissman N.J.; Asch F.M.; Stone G.W.
Institution
(Coisne, Scotti, Granada, Cohen, Kotinkaduwa, Redfors) Clinical Trials
Center, Cardiovascular Research Foundation, New York, NY, United States
(Coisne, Scotti) Montefiore-Einstein Center for Heart and Vascular Care,
Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY,
United States
(Coisne) University Lille, Inserm, CHU Lille, Institut Pasteur de Lille,
U1011-EGID, Lille F-59000, France
(Grayburn) Department of Internal Medicine, Division of Cardiology, Baylor
Scott and White Heart and Vascular Hospitals, Plano, TX, United States
(Mack) Baylor Scott and White Health, Plano, TX, United States
(Cohen) Saint Francis Hospital, Roslyn, NY, United States
(Kar) Los Robles Regional, Thousand Oaks, CA, United States
(Kar) Bakersfield Heart Hospital, Bakersfield, CA, United States
(Lim) Division of Cardiology, Department of Medicine, University of
Virginia Health System, Charlottesville, VA, United States
(Lindenfeld) Advanced Heart Failure and Cardiac Transplantation Section,
Vanderbilt Heart and Vascular Institute, Nashville, TN, United States
(Bax) Department of Cardiology, Leiden University Medical Center, Leiden,
Netherlands
(Redfors) Department of Cardiology, Sahlgrenska University Hospital,
Gothenburg, Sweden
(Weissman, Asch) MedStar Health Research Institute, Georgetown University,
Washington, DC, United States
(Stone) Zena and Michael A. Wiener Cardiovascular Institute, Icahn School
of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY 10029,
United States
Publisher
Oxford University Press
Abstract
Aims The conceptual framework of proportionate vs. disproportionate mitral
regurgitation (MR) translates poorly to individual patients with heart
failure (HF) and secondary MR. A novel index, the ratio of MR severity to
left atrial volume (LAV), may identify patients with 'disproportionate' MR
and a higher risk of events. The objectives, therefore, were to
investigate the prognostic impact of MR severity to LAV ratio on outcomes
among HF patients with severe secondary MR randomized to transcatheter
edge-to-edge repair (TEER) with the MitraClipTM device plus
guideline-directed medical therapy (GDMT) vs. GDMT alone in the COAPT
trial Methods The ratio of pre-procedural regurgitant volume (RVol) to LAV
was calculated from baseline transthoracic echocardiograms. and results
The primary endpoint was 2-year covariate-adjusted rate of HF
hospitalization (HFH). Among 567 patients, the median RVol/LAV was 0.67
(interquartile range 0.48-0.91). In patients randomized to GDMT alone,
lower RVol/LAV was independently associated with an increased 2-year risk
of HFH (adjHR: 1.77; 95% CI: 1.20-2.63). RVol/LAV was a stronger predictor
of adverse outcomes than RVol or LAV alone. Treatment with TEER plus GDMT
compared with GDMT alone was associated with lower 2-year rates of HFH
both in patients with low and high RVol/LAV (P<inf>interaction</inf> =
0.28). Baseline RVol/LAV ratio was unrelated to 2-year mortality, health
status, or functional capacity in either treatment group Conclusion Low
RVol/LAV ratio was an independent predictor of 2-year HFH in HF patients
with severe MR treated with GDMT alone in the COAPT trial. TEER improved
outcomes regardless of baseline RVol/LAV ratio. Clinical Trial Trial Name:
Cardiovascular Outcomes Assessment of the MitraClip Percutaneous Therapy
for Heart Failure Patients With Registration Functional Mitral
Regurgitation (The COAPT Trial) (COAPT) ClinicalTrial.gov Identifier
NCT01626079 URL
https://clinicaltrials.gov/ct2/show/NCT01626079 Copyright © The
Author(s) 2023. Published by Oxford University Press.

<61>
Accession Number
2024055398
Title
Coronary surgery provides better survival than drug-eluting stent: A
pooled meta-analysis of Kaplan-Meier-derived individual patient data.
Source
Journal of Thoracic and Cardiovascular Surgery. 167(6) (pp 2138-2146.e3),
2024. Date of Publication: June 2024.
Author
Urso S.; Sadaba R.; Gonzalez-Martin J.M.; Dayan V.; Nogales E.; Tena M.A.;
Abad C.; Portela F.
Institution
(Urso, Tena, Abad, Portela) Cardiac Surgery Department, Hospital
Universitario Dr Negrin, Las Palmas de Gran Canaria, Spain
(Sadaba) Cardiac Surgery Department, Hospital Universitario de Navarra,
Pamplona, Spain
(Gonzalez-Martin) Research Unit, Hospital Universitario Dr Negrin, Las
Palmas de Gran Canaria, Spain
(Dayan) Cardiac Surgery Department, Centro Cardiovascular Universitario,
Universidad de la Republica, Montevideo, Uruguay
(Nogales) Cardiology Department, Complejo Hospitalario Universitario
Insular-Materno Infantil, Las Palmas de Gran Canaria, Spain
Publisher
Elsevier Inc.
Abstract
Objectives: We explored the current evidence on coronary disease treatment
comparing the survival of 2 therapeutic strategies: coronary artery bypass
grafting (CABG) and percutaneous coronary intervention (PCI) with
drug-eluting stent (DES). Method(s): PubMed, Embase, and Google
Scholar were searched for randomized clinical trials comparing CABG versus
PCI with DES. The end point was overall mortality. Two statistical
approaches were used: the generic inverse variance method, which was used
to pool the incident rate ratios, and the pooled meta-analysis of
Kaplan-Meier-derived individual patient data. Result(s): Eight
randomized clinical trials comparing 4975 patients undergoing CABG and
4992 patients undergoing PCI were included in our meta-analysis. Generic
inverse variance method showed a statistically significant survival
benefit of the CABG group (incident rate ratio, 1.21; 95% confidence
interval, 1.09-1.35; P < .01). The Kaplan-Meier estimates of survival at
1, 5, and 10 years of the CABG group were 97.1%, 90.3%, and 80.3%,
respectively. The Kaplan-Meier estimates of survival at 1, 5, and 10 years
of the PCI group were 97.0%, 87.7%, and 76.4%, respectively. The log-rank
analysis confirmed a statistically significant benefit in term of overall
mortality of the CABG group (hazard ratio, 1.24; 95% confidence interval,
1.11-1.38; P = .0001). Conclusion(s): The present meta-analysis
suggests that CABG provides a consistent survival benefit over PCI with
DES. Copyright © 2023 The American Association for Thoracic
Surgery

<62>
Accession Number
2031887941
Title
Clinical Outcomes With Electronic Nudges to Increase Influenza
Vaccination.
Source
Annals of Internal Medicine. 177(4) (pp 476-483), 2024. Date of
Publication: 01 Apr 2024.
Author
Johansen N.D.; Vaduganathan M.; Bhatt A.S.; Lee S.G.; Modin D.; Claggett
B.L.; Dueger E.L.; Samson S.; Loiacono M.M.; Harris R.C.; Kober L.;
Solomon S.D.; Sivapalan P.; Jensen J.U.S.; Martel C.J.-M.; Krause T.G.;
Biering-Sorensen T.
Institution
(Johansen, Modin, Biering-Sorensen) Department of Cardiology, Copenhagen
University Hospital - Herlev and Gentofte, Center for Translational
Cardiology and Pragmatic Randomized Trials, Department of Biomedical
Sciences, Faculty of Health and Medical Sciences, University of
Copenhagen, Copenhagen, Denmark
(Vaduganathan, Lee) Cardiovascular Division, Brigham and Women's Hospital,
Harvard Medical School, Center for Cardiometabolic Implementation Science,
Brigham and Women's Hospital, Boston, MA, United States
(Bhatt) Cardiovascular Division, Brigham and Women's Hospital, Harvard
Medical School, Center for Cardiometabolic Implementation Science, Brigham
and Women's Hospital, Boston, Massachusetts, Kaiser Permanente San
Francisco Medical Center, Division of Research, San Francisco, CA, United
States
(Claggett, Solomon) Cardiovascular Division, Brigham and Women's Hospital,
Harvard Medical School, Boston, MA, United States
(Dueger, Samson) Sanofi, Lyon, France
(Loiacono) Sanofi, Swiftwater, PA, United States
(Harris) Sanofi, Singapore
(Kober) Department of Clinical Medicine, Faculty of Health and Medical
Sciences, University of Copenhagen, Department of Cardiology, Copenhagen
University Hospital, Rigshospitalet, Copenhagen, Denmark
(Sivapalan, Jensen) Department of Clinical Medicine, Faculty of Health and
Medical Sciences, University of Copenhagen, Respiratory Medicine Section,
Department of Medicine, Copenhagen University Hospital - Herlev and
Gentofte, Copenhagen, Denmark
(Martel, Krause) Epidemiological Infectious Disease Preparedness, Statens
Serum Institut, Copenhagen, Denmark
Publisher
American College of Physicians
Abstract
Background: In the NUDGE-FLU (Nationwide Utilization of Danish Government
Electronic letter system for increasing inFLUenza vaccine uptake) trial,
electronic letters incorporating cardiovascular (CV) gain-framing and
repeated messaging increased influenza vaccination by approximately 1
percentage point. Objective(s): To evaluate the effects of the
successful nudging interventions on downstream clinical outcomes.
 Design(s): Prespecified exploratory analysis of a nationwide
randomized implementation trial. (ClinicalTrials. gov: NCT05542004)
Setting: The 2022 to 2023 influenza season. Participant(s): 964 870
Danish citizens aged 65 years or older. Intervention(s): Usual care
or 9 different electronically delivered behavioral nudging letters.
Measurements: Cardiovascular, respiratory, and other clinical end points
during follow-up from intervention delivery (16 September 2022) through 31
May 2023. Result(s): The analysis set included 691 820 participants.
Hospitalization for pneumonia or influenza occurred in 3354 of 346 327
(1.0%) participants in the usual care group, 396 of 38 586 (1.0%) in the
CV gain-framing group (hazard ratio [HR], 1.06 [95% CI, 0.95 to 1.18];
versus usual care), and 403 of 38 231 (1.1%) in the repeated letter group
(HR, 1.09 [CI, 0.98 to 1.21]; versus usual care). In the usual care group,
44 682 (12.9%) participants were hospitalized for any cause, compared with
5002 (13.0%) in the CV gain-framing group (HR, 1.00 [CI, 0.97 to 1.03];
versus usual care) and 4965 (13.0%) in the repeated letter group (HR, 1.01
[CI, 0.98 to 1.04]; versus usual care). A total of 6341 (1.8%)
participants died in the usual care group, compared with 721 (1.9%) in the
CV gain-framing group (HR, 1.02 [CI, 0.94 to 1.10]; versus usual care) and
646 (1.7%) in the repeated letter group (HR, 0.92 [CI, 0.85 to 1.00];
versus usual care). Limitation(s): Prespecified but exploratory
analysis, potential misclassification of events in routinely collected
registry data, and results may not be generalizable to other health
systems or countries with other racial compositions and/or cultural or
societal norms. Conclusion(s): In a prespecified exploratory
analysis, modest increases in influenza vaccination rates seen with
electronic nudges did not translate into observable improvements in
clinical outcomes. Seasonal influenza vaccination should remain strongly
recommended. Copyright © 2024 American College of Physicians. All
rights reserved.

<63>
Accession Number
2031347062
Title
The Influence of Audiovisual Distraction on Pain Reduction During
Transcatheter Aortic Valve Implantation Under Monitored Anesthesia Care: A
Prospective Randomized Trial.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 38(6) (pp 1353-1360),
2024. Date of Publication: June 2024.
Author
Pitts L.; Hellner N.; Kofler M.; Ryschka M.; Unbehaun A.; O'Brien B.;
Kempfert J.; Hommel M.
Institution
(Pitts, Kofler, Unbehaun, Kempfert) Department of Cardiothoracic and
Vascular Surgery, Deutsches Herzzentrum der Charite, Berlin, Germany
(Pitts, Hellner, Kofler, Ryschka, Unbehaun, O'Brien, Kempfert, Hommel)
Charite-Universitatsmedizin Berlin, corporate member of Freie Universitat
Berlin and Humboldt-Universitat zu Berlin, Berlin, Germany
(Hellner, Ryschka, O'Brien, Hommel) Department of Cardiac Anesthesiology
and Intensive Care Medicine, Deutsches Herzzentrum der Charite, Berlin,
Germany
(Kofler, O'Brien, Kempfert) German Center for Cardiovascular Research,
Berlin, Germany
Publisher
W.B. Saunders
Abstract
Objectives: To investigate the effect of an audiovisual distraction system
on the dose of remifentanil for perioperative sedation during
transcatheter aortic valve implantation under monitored anesthesia care.
 Design(s): Single-center prospective randomized nonblinded study.
 Setting(s): Tertiary referral academic hospital. Participant(s):
Ninety patients who underwent transfemoral transcatheter aortic valve
implantation between July 2019 and July 2021. Intervention(s):
Patients were randomized to use either a novel audiovisual distraction
system during the intervention (n = 45) or standard care without an
audiovisual distraction system (n = 45). Measurements and Main
Results: Standardized questionnaires were given to each patient at
admission and before and after the intervention to assess their levels of
anxiety. Primary endpoints were the average and peak infusion rates of
remifentanil. All patients were considered for the final analysis
according to an intention-to-treat design. No relevant differences in pre-
and postinterventional anxiety status were observed between the groups.
Similarly, there were no significant differences in reported pain scores
(p = 0.364). The average infusion rate (p = 0.028) and peak infusion rate
(p = 0.025) of remifentanil were lower in the group with an audiovisual
distraction system. Conclusion(s): Audiovisual distraction is a
useful adjunct to reduce the dose of remifentanil under monitored
anesthesia care during transcatheter aortic valve implantation. Larger
studies are needed to evaluate potential positive effects on patient
satisfaction, incidence of delirium, and possible economic
benefits. Copyright © 2023 Elsevier Inc.

<64>
Accession Number
2031325058
Title
Heel skin microclimate control: Secondary analysis of a self-controlled
randomized clinical trial.
Source
Journal of Tissue Viability. 33(2) (pp 305-311), 2024. Date of
Publication: May 2024.
Author
Eberhardt T.D.; Lima S.B.D.; Pozzebon B.R.; Santos K.P.D.; Silveira
L.B.D.; Soares R.S.D.A.; Alves P.J.
Institution
(Eberhardt) University of Passo Fundo, RS, Brazil
(Lima, Santos, Silveira) University Federal of Santa Maria, RS, Brazil
(Pozzebon) Hospital Santa Cruz, RS, Santa Cruz do Sul, Brazil
(Soares) Polytechnic College of University Federal of Santa Maria, RS,
Brazil
(Alves) Portuguese Catholic University, Porto, Portugal
Publisher
Tissue Viability Society
Abstract
Objective: this study was undertaken to evaluate the efficacy of
multilayer polyurethane foam with silicone (MPF) compared to transparent
polyurethane film (TPF) dressings in the control of heel skin microclimate
(temperature and moisture) of hospitalized patients undergoing elective
surgeries. Method(s): the study took of a secondary analysis of a
randomized self-controlled trial, involving patients undergoing elective
surgical procedure of cardiac and gastrointestinal specialties in a
university hospital in southern Brazil, from March 2019 to February 2020.
Patients served as their own control, with their heels randomly allocated
to either TPF (control) or MPF (intervention). Skin temperature was
measured using a digital infrared thermometer; and moisture determined
through capacitance, at the beginning and end of surgery. The study was
registered in the Brazilian Registry of Clinical Trials: RBR-5GKNG5.
 Result(s): significant difference in the microclimate variables were
observed when the groups (intervention and control) and the timepoint of
measurement (beginning and end of surgery) were compared. When assessing
temperature, an increase (+3.3 degreeC) was observed with TPF and a
decrease (-7.4 degreeC) was recorded with MPF. Regarding skin moisture, an
increase in moisture (+14.6 AU) was recorded with TPF and a slight
decrease (-0.3 AU) with MPF. Conclusion(s): The findings of this
study suggest that MPF is more effective than TPF in controlling skin
microclimate (temperature and moisture) in heels skin of hospitalized
patients undergoing elective surgeries. However, this control should be
better investigated in other studies. Copyright © 2024 Tissue
Viability Society / Society of Tissue Viability

<65>
Accession Number
2032075386
Title
Recurrent cardiovascular events in patients with type 2 diabetes and
haemodialysis: analysis from the 4D Study.
Source
Clinical Kidney Journal. 16(10) (pp 1612-1621), 2023. Date of Publication:
01 Oct 2023.
Author
Marx N.; Wanner C.; Jankowski J.; Marz W.; Krane V.; Genser B.
Institution
(Marx, Krane) Department of Internal Medicine I, Cardiology, University
Hospital Aachen, RWTH Aachen University, Aachen, Germany
(Wanner) Department of Medicine I, Division of Nephrology, University
Hospital Wurzburg, Wurzburg, Germany
(Jankowski) Institute for Molecular Cardiovascular Research, RWTH Aachen
University, University Hospital, Aachen, Germany
(Marz) SYNLAB Academy, SYNLAB Holding Deutschland GmbH, Germany
(Marz) Clinical Institute of Medical and Chemical Laboratory Diagnostics,
Medical University of Graz, Austria
(Genser) Medical Clinic V Medical Faculty of Mannheim, University of
Heidelberg, Germany High5Data GmbH, Germany
Publisher
Oxford University Press
Abstract
Background. In the 'Die Deutsche Diabetes Dialyse Studie' (4D Study),
treatment of patients with type 2 diabetes mellitus (T2DM) on
haemodialysis (HD) with atorvastatin compared with placebo had no
significant effect on the first composite primary major adverse
cardiovascular event (MACE) endpoint of death from cardiac causes, fatal
stroke, non-fatal myocardial infarction or non-fatal stroke. In this study
we analysed first and recurrent events in 1255 patients from the 4D Study.
Methods. We conducted an event history analysis to investigate the effects
of previous clinical events on the risk of different endpoints in the
total patient group and after stratification by randomization group.
Results. During a median follow-up of 4 years, a total of 548 MACEs
occurred, with 469 first and 79 recurrent events. The most frequent event
was sudden cardiac death, followed by death due to infection/sepsis. Of
the 548 total MACEs, 260 occurred in the atorvastatin group and 288 in the
placebo group [hazard ratio 0.91 (95% confidence interval 0.76-1.07), P =
.266]. Interestingly, analyses of the baseline hazard functions for first
and recurrent events as a function of time after randomization
demonstrated that the risks of the composite primary endpoint continually
increased in the placebo group with increasing time in the study, whereas
the risk in the atorvastatin group remained constant after =1.5 years.
Conclusion. This recurrent and total event analysis from the 4D Study
underscores the high risk of sudden cardiac death and death due to
infection/sepsis in patients with T2DM receiving HD and raises the
hypothesis that atorvastatin may stabilize cardiovascular risk only after
1-2 years in this high-risk population. Copyright © The Author(s)
2023. Published by Oxford University Press on behalf of the ERA.

<66>
Accession Number
643493472
Title
Concomitant tricuspid valve surgery in patients undergoing left
ventricular assist device: a systematic review and meta-analysis.
Source
International journal of surgery (London, England). 110(5) (pp 3039-3049),
2024. Date of Publication: 01 May 2024.
Author
Luo Y.; Leng J.; Shi R.; Jiang Y.; Chen D.; Wu Q.; Tie H.
Institution
(Luo, Leng, Jiang, Chen, Wu, Tie) Department of Cardiothoracic Surgery,
First Affiliated Hospital of Chongqing Medical University, Chongqing,
China
(Shi) Department of Critical Care Medicine, First Affiliated Hospital of
Sun Yat-sen University, Guangzhou, Guangdong, China
Abstract
INTRODUCTION: This study aims to investigate the effect of concomitant
tricuspid valve surgery (TVS) during left ventricular assist device (LVAD)
implantation due to the controversy over the clinical outcomes of
concomitant TVS in patients undergoing LVAD. METHOD(S): A systematic
literature search was performed in PubMed and EMbase from the inception to
1 August 2023. Studies comparing outcomes in adult patients undergoing
concomitant TVS during LVAD implantation (TVS group) and those who did not
(no-TVS group) were included. The primary outcomes were right heart
failure (RHF), right ventricular assist device (RVAD) implantation, and
early mortality. All meta-analyses were performed using random-effects
models, and a two-tailed P <0.05 was considered significant.
 RESULT(S): Twenty-one studies were included, and 16 of them were
involved in the meta-analysis, with 660 patients in the TVS group and 1291
in the no-TVS group. Patients in the TVS group suffered from increased
risks of RHF [risk ratios (RR)=1.31, 95% CI: 1.01-1.70, P =0.04; I2 =38%,
pH =0.13), RVAD implantation (RR=1.56, 95% CI: 1.16-2.11, P =0.003; I2
=0%, pH =0.74), and early mortality (RR=1.61, 95% CI: 1.07-2.42, P =0.02;
I2 =0%, pH =0.75). Besides, the increased risk of RHF holds true in
patients with moderate to severe tricuspid regurgitation (RR=1.36, 95% CI:
1.04-1.78, P =0.02). TVS was associated with a prolonged cardiopulmonary
bypass time. No significant differences in acute kidney injury,
reoperation requirement, hospital length of stay, or ICU stay were
observed. CONCLUSION(S): Concomitant TVS failed to show benefits in
patients undergoing LVAD, and it was associated with increased risks of
RHF, RVAD implantation, and early mortality. Copyright © 2024 The
Author(s). Published by Wolters Kluwer Health, Inc.

<67>
Accession Number
643493363
Title
A commentary on 'Transversus thoracic muscle plane block for pain during
cardiac surgery: a systematic review and meta-analysis'.
Source
International journal of surgery (London, England). 110(5) (pp 3103-3104),
2024. Date of Publication: 01 May 2024.
Author
Zhong W.; Zhao B.; Liu L.; Xi G.; Zhou J.
Institution
(Zhong) Department of Anesthesia, Henan Provincial Chest Hospital (Chest
Hospital of Zhengzhou University), Zhengzhou, Henan, China

<68>
Accession Number
2032248075
Title
Influence of intravenous fentanyl or dexmedetomidine infusions, combined
with lidocaine and ketamine, on cardiovascular response, sevoflurane
requirement and postoperative pain in dogs anesthetized for unilateral
mastectomy.
Source
Veterinary Anaesthesia and Analgesia. (no pagination), 2024. Date of
Publication: 2024.
Author
Cardozo H.G.; Monteiro E.R.; Correia B.S.; Victor B Ferronatto J.;
Almeida-Filho F.T.; Alievi M.M.; Valle S.F.
Institution
(Cardozo, Monteiro, Correia, Victor B Ferronatto, Almeida-Filho, Alievi,
Valle) Faculty of Veterinary Medicine, Federal University of Rio Grande do
Sul, RS, Porto Alegre, Brazil
Publisher
Association of Veterinary Anaesthetists and American College of Veterinary
Anesthesia and Analgesia
Abstract
Objective: To compare the effects of constant rate infusions (CRI) of
fentanyl or dexmedetomidine, combined with lidocaine and ketamine, on
cardiovascular response during surgery, sevoflurane requirement and
postoperative pain in dogs undergoing mastectomy. Study design:
Prospective, randomized, blinded, clinical trial. Animals: A total of 29
female dogs with mammary tumors. Method(s): Premedication consisted
of intramuscular acepromazine and morphine. General anesthesia was induced
with intravenous propofol and maintained with sevoflurane. Dogs were
randomized to be administered intravenous DLK [dexmedetomidine 1 mug
kg-1 loading dose (LD) and 1 mug kg-1
hour-1; lidocaine 2 mg kg-1 LD and 3 mg
kg-1 hour-1; ketamine 1 mg kg-1 LD and
0.6 mg kg-1 hour-1; n = 14] or FLK (fentanyl 5 mug
kg-1 LD and 9 mug kg-1 hour-1; same doses
of lidocaine and ketamine; n = 15) during anesthesia. Cardiorespiratory
variables and end-tidal sevoflurane (FE'Sevo) were recorded during
surgery. The number of dogs administered ephedrine to treat arterial
hypotension [mean arterial pressure (MAP) < 60 mmHg] was recorded.
Meloxicam was administered to both groups. Postoperative pain and rescue
analgesia requirement were assessed for 24 hours using the short form of
the Glasgow Composite Measure Pain Scale. Data were compared using a mixed
effects model or a Mann-Whitney test. Result(s): More dogs required
ephedrine in FLK than in DLK (67% versus 7%). Heart rate was not
significantly different between groups, whereas lower values of MAP (p <=
0.01) and FE'Sevo (p = 0.018) were observed in FLK than in DLK. Rescue
analgesia was administered to 2/15 dogs in FLK and 0/14 dogs in DLK.
Conclusions and clinical relevance: Based on the cardiovascular response
during surgery, intraoperative infusions of FLK and DLK provided adequate
antinociception. Infusion of DLK provided greater stability of blood
pressure. Both protocols resulted in minimal need for additional analgesia
within 24 hours postoperatively. Copyright © 2024 Association of
Veterinary Anaesthetists and American College of Veterinary Anesthesia and
Analgesia

<69>
Accession Number
2032206244
Title
Chlorthalidone vs Hydrochlorothiazide for Hypertension Treatment after
Myocardial Infarction or Stroke: A Secondary Analysis of a Randomized
Clinical Trial.
Source
JAMA Network Open. (pp E2411081), 2024. Date of Publication: 2024.
Author
Ishani A.; Hau C.; Cushman W.C.; Leatherman S.M.; Lew R.A.; Glassman P.A.;
Taylor A.A.; Ferguson R.E.
Institution
(Ishani) Minneapolis VA Healthcare System, Minneapolis, MN, United States
(Ishani) Department of Medicine, University of Minnesota, Minneapolis,
United States
(Hau, Leatherman, Lew, Ferguson) Cooperative Studies Program Coordinating
Center, VA Boston Healthcare System, Boston, MA, United States
(Cushman) Medical Service, Memphis VA Medical Center, Memphis, TN, United
States
(Cushman) Department of Preventive Medicine, University of Tennessee
Health Science Center, Memphis, United States
(Leatherman, Lew) Department of Biostatistics, Boston University, School
of Public Health, Boston, MA, United States
(Glassman) Pharmacy Benefits Management Services, Department of Veterans
Affairs, Washington, DC, United States
(Glassman) VA Greater Los Angeles Healthcare System, Los Angeles, CA,
United States
(Glassman) David Geffen School of Medicine at UCLA, Los Angeles, CA,
United States
(Taylor) Michael E. DeBakey VA Medical Center, Houston, TX, United States
(Taylor) Department of Medicine, Baylor College of Medicine, Houston, TX,
United States
(Ferguson) Department of Medicine, Boston University Chobanian &
Avedisian, School of Medicine, Boston, MA, United States
Publisher
American Medical Association
Abstract
Importance: Patients with prior myocardial infarction (MI) or stroke have
a greater risk of recurrent cardiovascular (CV) events. Objective(s):
To evaluate the association of chlorthalidone (CTD) vs hydrochlorothiazide
(HCTZ) with CV outcomes and noncancer deaths in participants with and
without prior MI or stroke. Design, Setting, and Participant(s): This
was a prespecified secondary analysis of the Diuretic Comparison Project
(DCP), a pragmatic randomized clinical trial conducted within 72
participating Veterans Affairs health care systems from June 2016 to June
2021, in which patients aged 65 years or older with hypertension taking
HCTZ at baseline were randomized to continue HCTZ or switch to CTD at
pharmacologically comparable doses. This secondary analysis was performed
from January 3, 2023, to February 29, 2024. Exposures: Pharmacologically
comparable daily dose of HCTZ or CTD and history of MI or stroke.
 Main Outcomes and Measures: Outcome ascertainment was performed from
randomization to the end of the study. The primary outcome consisted of a
composite of stroke, MI, urgent coronary revascularization because of
unstable angina, acute heart failure hospitalization, or noncancer death.
Additional outcomes included achieved blood pressure and hypokalemia
(potassium level <3.1 mEq/L; to convert to mmol/L, multiply by 1.0).
 Result(s): The DCP randomized 13523 participants to CTD or HCTZ, with
a mean (SD) study duration of 2.4 (1.4) years. At baseline, median age was
72 years (IQR, 69-75 years), and 96.8% were male. Treatment effect was
evaluated in subgroups of participants with (n = 1455) and without (n =
12068) prior MI or stroke at baseline. There was a significant adjusted
interaction between treatment group and history of MI or stroke.
Participants with prior MI or stroke randomized to CTD had a lower risk of
the primary outcome than those receiving HCTZ (105 of 733 [14.3%] vs 140
of 722 [19.4%]; hazard ratio [HR], 0.73; 95% CI, 0.57-0.94; P =.01)
compared with participants without prior MI or stroke, among whom
incidence of the primary outcome was slightly higher in the CTD arm
compared with the HCTZ arm (597 of 6023 [9.9%] vs 535 of 6045 [8.9%]; HR,
1.12; 95% CI, 1.00-1.26; P =.054) (P =.01 for interaction). The incidence
of a nadir potassium level less than 3.1 mEq/L and hospitalization for
hypokalemia differed among those with and without prior MI or stroke when
comparing those randomized to CTD vs HCTZ, with a difference only among
those without prior MI or stroke (potassium level <3.1 mEq/L: prior MI or
stroke, 43 of 733 [5.9%] vs 37 of 722 [5.1%] [P =.57]; no prior MI or
stroke, 292 of 6023 [4.9%] vs 206 of 6045 [3.4%] [P <.001];
hospitalization for hypokalemia: prior MI or stroke, 14 of 733 [1.9%] vs
16 of 722 [2.2%] [P =.72]; no prior MI or stroke: 84 of 6023 [1.4%] vs 57
of 6045 [0.9%] [P =.02]). Conclusions and Relevance: Results of this
secondary analysis of the DCP trial suggest that CTD may be associated
with reduced major adverse CV events and noncancer deaths in patients with
prior MI or stroke compared with HCTZ. Trial Registration:
ClinicalTrials.gov Identifier: NCT02185417. Copyright © 2024
American Medical Association. All rights reserved.

<70>
Accession Number
2032147337
Title
Efficacy and Safety of Botulinum Toxin Type A for the Prevention of
Postoperative Atrial Fibrillation.
Source
JACC: Clinical Electrophysiology. 10(5) (pp 930-940), 2024. Date of
Publication: May 2024.
Author
Piccini J.P.; Ahlsson A.; Dorian P.; Gillinov A.M.; Kowey P.R.; Mack M.J.;
Milano C.A.; Noiseux N.; Perrault L.P.; Ryan W.; Steinberg J.S.; Voisine
P.; Waldron N.H.; Gleason K.J.; Titanji W.; Leaback R.D.; O'Sullivan A.;
Ferguson W.G.; Benussi S.; Akhter S.A.; Andreas M.; Castella M.;
Dalrymple-Hay M.; El-Eshmawi A.; Groh M.; Hanke T.; Jeanmart H.; Katz M.;
McCullough J.N.; Melby S.; Miller J.; Romano M.A.; Podgoreanu M.V.; Sharma
V.; Shults C.; Teman N.; Whitson B.A.; Wickbom A.; Vallabhajosyula P.; Yau
T.
Institution
(Piccini) Department of Electrophysiology, Duke Clinical Research
Institute/Duke University Medical Center, Durham, NC, United States
(Ahlsson) Cardiovascular Division, Karolinska Institute, Stockholm, Sweden
(Dorian) Division of Cardiology, St Michael's Hospital, Toronto, ON,
Canada
(Gillinov) Department of Thoracic and Cardiovascular Surgery, Cleveland
Clinic, Cleveland, OH, United States
(Kowey) Division of Cardiovascular Research, Lankenau Heart Institute,
Wynnewood, PA, United States
(Mack, Ryan) Department of Thoracic Surgery, Baylor Scott and White
Health, Dallas, TX, United States
(Milano) Division of Cardiothoracic Surgery, Duke Clinical Research
Institute/Duke University Medical Center, Durham, NC, United States
(Noiseux) Division of Cardiac Surgery, Centre Hospitalier de l'Universite
de Montreal, Centre de Recherche du Centre Hospitalier de l'Universite de
Montreal, QC, Canada
(Perrault) Department of Surgery, Montreal Heart Institute, Universite de
Montreal, Montreal, Quebec City, QC, Canada
(Steinberg) Clinical Cardiovascular Research Center, University of
Rochester School of Medicine and Dentistry, Rochester, NY, United States
(Voisine) Division of Cardiac Surgery, Institut Universitaire de
Cardiologie et de Pneumologie de Quebec, QC, Canada
(Waldron) Department of Anesthesiology and Critical Care, Mayo Clinic,
Jacksonville, FL, United States
(Gleason, Titanji, Leaback, O'Sullivan, Ferguson) AbbVie Inc, North
Chicago, IL, United States
(Benussi) Department of Cardiothoracic Surgery, University of Brescia,
Brescia, Italy
(Akhter) East Carolina University Brody School of Medicine, Greenville,
NC, United States
(Andreas) Medical University of Vienna, Vienna, Austria
(Benussi) University of Brescia, Brescia, Italy
(Castella) Hospital Clinic de Barcelona, Barcelona, Spain
(Dalrymple-Hay) University Hospital Plymouth NHS Trust, Plymouth, United
Kingdom
(El-Eshmawi) Icahn School of Medicine at Mount Sinai - The Mount Sinai
Medical Center, New York, NY, United States
(Groh) Mission Hospital, Asheville, NC, United States
(Hanke) Asklepios Klinik Harburg-Hamburg, Hamburg, Germany
(Jeanmart) CIUSS du NIM site Hopital du Sacre-Coeur de Montreal, Montreal,
Canada
(Katz) Medical University of South Carolina, Charleston, SC, United States
(McCullough) Dartmouth Hitchcock Medical Center, Lebanon, NH, United
States
(Melby) Washington University School of Medicine, St. Louis, MO, United
States
(Miller) Emory St Joseph's Hospital, Atlanta, GA, United States
(Noiseux) Centre Hospitalier de l'Universite de Montreal, Centre de
Recherche du CHUM, QC, Canada
(Romano) University of Michigan Health System, Ann Arbor, MI, United
States
(Perrault) Montreal Heart Institute/ Universite de Montreal, Montreal,
Canada
(Piccini) Duke Clinical Research Institute/Duke University Medical Center,
Durham, NC, United States
(Podgoreanu) Duke University Medical Center, Durham, NC, United States
(Ryan) Baylor Scott & White Health, Dallas, TX, United States
(Sharma) University of Utah Health, Salt Lake City, UT, United States
(Shults) Medstar Heart and Vascular Institute, Washington, DC, United
States
(Teman) University of Virginia, Charlottesville, VA, United States
(Voisine) IUCPQ, QC, Canada
(Whitson) Ohio State University - Davis Heart and Lung Institute,
Columbus, OH, United States
(Wickbom) Orebro University Hospital Sweden, Orebro, Sweden
(Vallabhajosyula) Yale New Haven Hospital, New Haven, CT, United States
(Yau) Toronto General Hospital, Toronto, Canada
Publisher
Elsevier Inc.
Abstract
Background: Postoperative atrial fibrillation (POAF) is associated with
increased morbidity and mortality. Epicardial injection of botulinum toxin
may suppress POAF. Objective(s): This study sought to assess the
safety and efficacy of AGN-151607 for the prevention of POAF after cardiac
surgery. Method(s): This phase 2, randomized, placebo-controlled
trial assessed the safety and efficacy of AGN-151607, 125 U and 250 U vs
placebo (1:1:1), for the prevention of POAF after cardiac surgery.
Randomization was stratified by age (<65, >=65 years) and type of surgery
(nonvalvular/valve surgery). The primary endpoint was the occurrence of
continuous AF >=30 seconds. Result(s): Among 312 modified
intention-to-treat participants (placebo, n = 102; 125 U, n = 104; and 250
U, n = 106), the mean age was 66.9 +/- 6.8 years; 17% were female; and 64%
had coronary artery bypass graft (CABG) only, 12% had CABG + valve, and
24% had valve surgery. The primary endpoint occurred in 46.1% of the
placebo group, 36.5% of the 125-U group (relative risk [RR] vs placebo:
0.80; 95% CI: 0.58-1.10; P = 0.16), and 47.2% of the 250-U group (RR vs
placebo: 1.04; 95% CI: 0.79-1.37; P = 0.78). The primary endpoint was
reduced in the 125-U group in those >=65 years of age (RR: 0.64; 95% CI:
0.43-0.94; P = 0.02) with a greater reduction in CABG-only participants
>=65 years of age (RR: 0.49; 95% CI: 0.27-0.87; P = 0.01).
Rehospitalization and rates of adverse events were similar across the 3
groups. Conclusion(s): There were no significant differences in the
rate of POAF with either dose compared with placebo; however, there was a
lower rate of POAF in participants >=65 years undergoing CABG only and
receiving 125 U of AGN-151607. These hypothesis-generating findings
require investigation in a larger, adequately powered randomized clinical
trial. (Botulinum Toxin Type A [AGN-151607] for the Prevention of
Post-operative Atrial Fibrillation in Adult Participants Undergoing
Open-chest Cardiac Surgery [NOVA]; NCT03779841); A Phase 2, Multi-Center,
Randomized, Double-Blind, Placebo-Controlled, Dose Ranging Study to
Evaluate the Efficacy and Safety of Botulinum Toxin Type A [AGN 151607]
Injections into the Epicardial Fat Pads to Prevent Post-Operative Atrial
Fibrillation in Patients Undergoing Open-Chest Cardiac Surgery;
2017-004399-68) Copyright © 2024 American College of Cardiology
Foundation

<71>
Accession Number
2028717994
Title
Stroke reduction by cerebral embolic protection devices in transcatheter
aortic valve implantation: A systematic review and Bayesian meta-analysis.
Source
Heart. 110(11) (pp 757-765), 2024. Date of Publication: 01 Jun 2024.
Author
Heuts S.; Gabrio A.; Veenstra L.; Maesen B.; Kats S.; Maessen J.G.; Walton
A.S.; Nanayakkara S.; Lansky A.J.; Van 'T Hof A.W.J.; Vriesendorp P.A.
Institution
(Heuts, Maesen, Kats, Maessen) Cardiothoracic Surgery, Maastricht
University Medical Center+, Maastricht, Netherlands
(Heuts, Maesen, Maessen, Van 'T Hof, Vriesendorp) Cardiovascular Research
Institute Maastricht (CARIM), Maastricht University, Maastricht,
Netherlands
(Gabrio) Methodology and Statistics, Maastricht University, Maastricht,
Netherlands
(Gabrio) Care and Public Health Research Institute (CAPHRI), Maastricht
University, Maastricht, Netherlands
(Veenstra, Van 'T Hof, Vriesendorp) Cardiology, Maastricht University
Medical Center+, Maastricht, Netherlands
(Veenstra, Van 'T Hof) Cardiology, Zuyderland Medical Center, Heerlen,
Netherlands
(Walton, Nanayakkara) Cardiovascular Medicine, Alfred Hospital, Melbourne,
VIC, Australia
(Walton, Nanayakkara) Heart Failure Research Group, Baker Heart and
Diabetes Institute, Melbourne, VIC, Australia
(Nanayakkara) Faculty of Medicine, Nursing and Health Sciences, Monash
University, Melbourne, VIC, Australia
(Lansky) Yale Cardiovascular Research Group, Yale Medical School, New
Haven, CT, United States
Publisher
BMJ Publishing Group
Abstract
Objectives The use of cerebral embolic protection (CEP) during
transcatheter aortic valve implantation (TAVI) has been studied in several
randomised trials. We aimed to perform a systematic review and Bayesian
meta-analysis of randomised CEP trials, focusing on a clinically relevant
reduction in disabling stroke. Methods A systematic search was applied to
three electronic databases, including trials that randomised TAVI patients
to CEP versus standard treatment. The primary outcome was the risk of
disabling stroke. Outcomes were presented as relative risk (RR), absolute
risk differences (ARDs), numbers needed to treat (NNTs) and the 95%
credible intervals (CrIs). The minimal clinically important difference was
determined at 1.1% ARD, per expert consensus (NNT 91). The principal
Bayesian meta-analysis was performed under a vague prior, and secondary
analyses were performed under two informed literature-based priors.
Results Seven randomised studies were included for meta-analysis (n=3996:
CEP n=2126, control n=1870). Under a vague prior, the estimated median RR
of CEP use for disabling stroke was 0.56 (95% CrI 0.28 to 1.19, derived
ARD 0.56% and NNT 179, I 2 =0%). Although the estimated posterior
probability of any benefit was 94.4%, the probability of a clinically
relevant effect was 0-0.1% under the vague and informed literature-based
priors. Results were robust across multiple sensitivity analyses.
Conclusion There is a high probability of a beneficial CEP treatment
effect, but this is unlikely to be clinically relevant. These findings
suggest that future trials should focus on identifying TAVI patients with
an increased baseline risk of stroke, and on the development of new
generation devices. PROSPERO registration number
CRD42023407006. Copyright © Author(s) (or their employer(s))
2024. No commercial re-use. See rights and permissions. Published by BMJ.

<72>
Accession Number
2028594005
Title
Comparison of remimazolam-based and propofol-based total intravenous
anesthesia on hemodynamics during anesthesia induction in patients
undergoing transcatheter aortic valve replacement: a randomized controlled
trial.
Source
Journal of Anesthesia. 38(3) (pp 330-338), 2024. Date of Publication: June
2024.
Author
Kotani T.; Ida M.; Naito Y.; Kawaguchi M.
Institution
(Kotani, Ida, Naito, Kawaguchi) Department of Anesthesiology, Nara Medical
University Kashihara, Shijo 840, Nara 634-8522, Japan
Publisher
Springer
Abstract
Purpose: This study aimed to compare the hemodynamic effects of
remimazolam- and propofol-based total intravenous anesthesia in patients
who underwent transcatheter aortic valve replacement. Method(s): This
was a single-center, single-blind, randomized controlled trial set at Nara
Medical University, Kashihara, Japan. We included 36 patients aged >= 20
years scheduled to undergo elective transfemoral transcatheter aortic
valve replacement (TAVR) under general anesthesia. The participants were
randomly assigned to the remimazolam and propofol groups (n = 18 each).
Remimazolam- or propofol-based total intravenous anesthesia was initiated
at 12 mg/kg/min or 2.5 mcg/mL via target-controlled infusion,
respectively, along with remifentanil. After confirming the loss of
consciousness, the administration rate was adjusted using
electroencephalographic monitoring. The primary outcome was the rate of
arterial hypotension, defined as a mean arterial pressure < 60 mmHg, from
anesthesia induction until the beginning of the surgical incision. The
total doses of ephedrine and phenylephrine were also assessed.
 Result(s): During anesthesia induction, the arterial hypotension
rates were 11.9% and 21.6% in the remimazolam and propofol groups,
respectively (P = 0.01). The total dose of ephedrine was higher in the
propofol group (14.4 mg) than in the remimazolam group (1.6 mg) (P <
0.001); however, the total dose of phenylephrine was not significantly
different between the two groups (propofol 0.31 mg vs. remimazolam: 0.17
mg, P = 0.10). Conclusion(s): Remimazolam-based total intravenous
anesthesia resulted in a lower hypotension rate than propofol-based total
intravenous anesthesia during induction in patients undergoing TAVR.
Remimazolam-based total intravenous anesthesia can be used safely during
anesthetic induction in patients with severe aortic
stenosis. Copyright © The Author(s) under exclusive licence to
Japanese Society of Anesthesiologists 2024.

<73>
Accession Number
2026943059
Title
Optimal antiplatelet strategy following coronary artery bypass grafting: A
meta-analysis.
Source
Heart. 110(5) (pp 323-330), 2024. Date of Publication: 01 Mar 2024.
Author
Agrawal A.; Kumar A.; Majid M.; Badwan O.; Arockiam A.D.; El Dahdah J.;
Syed A.B.; Schleicher M.; Reed G.W.; Cremer P.C.; Griffin B.P.; Menon V.;
Wang T.K.M.
Institution
(Agrawal, Kumar, Majid, Badwan, Arockiam, El Dahdah, Syed, Reed, Cremer,
Griffin, Menon, Wang) Department of Cardiovascular Medicine, Cleveland
Clinic, Cleveland, OH, United States
(Schleicher) Floyd D. Loop Alumni Library, Cleveland Clinic, Cleveland,
OH, United States
Publisher
BMJ Publishing Group
Abstract
Objective Coronary artery bypass grafting (CABG) is an established
revascularisation strategy for multivessel and left main coronary artery
disease. Although aspirin is routinely recommended for patients with CABG,
the optimal antiplatelet regimen after CABG remains unclear. We evaluated
the efficacies and risks of different antiplatelet regimens (dual (DAPT)
versus single (SAPT), and dual with clopidogrel (DAPT-C) versus dual with
ticagrelor or prasugrel (DAPT-T/P)) after CABG. Methods We followed
Preferred Reporting Items for Systematic Reviews and Meta-Analyses
guidelines and performed a comprehensive literature search using PubMed,
Ovid Medline, Ovid Embase and Cochrane Central Register of Controlled
Trials. Data were extracted and pooled using random-effects models and
Review Manager (V.5.4). Results Among the 2970 article abstracts screened,
215 full-text articles were reviewed and 38 studies totaling 77 447 CABG
patients were included for analyses. DAPT compared with SAPT was
associated with significantly lower all-cause mortality (OR 0.65 with 95%
CI 0.50 to 0.86; p=0.002), cardiovascular mortality (OR 0.53, 95% CI 0.33
to 0.84; p=0.008), and major adverse cardiac and cerebrovascular events
(MACCE) (OR 0.68, 95% CI 0.51 to 0.91; p=0.01), but higher rates of major
(OR 1.30, 95% CI 1.08 to 1.56; p=0.007) and minor bleeding (OR 1.87, 95%
CI 1.28 to 2.74; p=0.001) after CABG. DAPT-T/P compared with DAPT-C was
associated with significantly lower all-cause (OR 0.43, 95% CI 0.29 to
0.65; p<=0.0001) and cardiovascular mortality (OR 0.44, 95% CI 0.24 to
0.80; p=0.008), and no differences on other cardiovascular or bleeding
outcomes after CABG. Conclusion In patients with CABG, DAPT compared with
SAPT and DAPT-T/P compared with DAPT-C were associated with reduction in
all-cause and cardiovascular mortality, especially in patients with acute
coronary syndrome. Additionally, DAPT was associated with reduction in
MACCE, but higher rates of major and minor bleeding. An individualised
approach to choosing antiplatelet regimen is necessary for patients with
CABG based on ischaemic and bleeding risks. Copyright © Author(s)
(or their employer(s)) 2024. No commercial re-use. See rights and
permissions. Published by BMJ.

<74>
Accession Number
2032019195
Title
PEUTZ-JEGHERS SYNDROME AND LUNG CANCER RISK: DOES THE RISK MEET THE
THRESHOLD FOR LUNG CANCER SCREENING?.
Source
Gastroenterology. Conference: DDW 2024. Washington, DC United States.
166(5 Supplement) (pp S-375), 2024. Date of Publication: 18 May 2024.
Author
Konjeti M.; Shareef F.; Gupta S.; Weiss J.
Publisher
W.B. Saunders
Abstract
Background: Peutz-Jeghers Syndrome (PJS) is an autosomal dominant
hamartomatous polyposis syndrome caused by pathogenic variants in the
STK11 gene that predisposes individuals to both intestinal and
extraintestinal cancers, including lung cancer. Screening recommendations
exist from multiple societies for breast, stomach, colon, pancreas,
gynecologic, and testicular cancer screening in patients with PJS.
However, no formal recommendations exist for lung cancer screening beyond
smoking cessation. Our aim was to conduct a systematic review of lung
cancer risk in PJS and compare observed risks to risks for individuals in
the general population currently eligible for lung cancer screening based
on age and smoking history. Method(s): PubMed and Web of Science were
searched from 1/1/80 through 9/11/23 utilizing the terms "Peutz Jeghers
Syndrome" AND "cancer" in all fields. We included cohort studies,
case-control studies, case series, case reports, systematic reviews, and
meta-analyses that reported on lung cancer risk among individuals with
PJS. Lung cancer risks in PJS were then compared to the 5-year, 10-year,
and lifetime risks for lung cancer in the general population based on
pack-years of smoking and age. Result(s): Of 3500 articles screened,
11 articles specifically addressed lung cancer risk and were included for
full text review. Type of lung cancer most commonly identified in patients
with PJS was adenocarcinoma with only 3 cases in the literature of
bronchioalveolar carcinoma. Across the studies, the lifetime risk of lung
cancer in patients with PJS was 7%-17%, with a cumulative lung cancer risk
surpassing 5% by age 55. Lung cancer screening guidelines from the USPSTF
recommend that individuals between 50 and 80 years old with a 20 pack-year
smoking history and currently smoke or have quit within the past 15 years
should receive a low dose computed tomography scan (LDCT) annually. The
American Association for Thoracic Surgery and the National Comprehensive
Cancer Network recommend that those aged >=50 years, with >=20 pack-year
smoking history and an additional 5-year cumulative risk?>5% should also
undergo annual LDCT. For USPSTF eligible smokers the 5-year risk of
developing lung cancer is 3.9%, and thus lower than the observed lung
cancer risk among individuals with PJS. Conclusion(s): Individuals
with PJS have an estimated lifetime lung cancer risk that exceeds current
guideline thresholds for recommending lung cancer screening based on age
and smoking status in the general population. Based on their lifetime risk
for lung cancer, individuals with PJS may benefit from lung cancer
screening with LDCT. Copyright © 2024 AGA Institute

<75>
Accession Number
2032013567
Title
PREVALENCE OF GASTROPARESIS IN POST-LUNG AND LUNG/HEART TRANSPLANTATION: A
SYSTEMATIC REVIEW AND META-ANALYSIS.
Source
Gastroenterology. Conference: DDW 2024. Washington, DC United States.
166(5 Supplement) (pp S-776), 2024. Date of Publication: 18 May 2024.
Author
Ali M.J.; Aiman W.; Ali M.A.; Mehari A.; Kibreab A.
Publisher
W.B. Saunders
Abstract
Background and Aim: Gastroparesis has been reported in patients post-lung
and lung/heart transplant, potentially affecting long-term outcomes. The
prevalence of gastroparesis is not well defined, exhibiting variations in
reported rates across different studies. Therefore, the aim of this study
was to determine the prevalence of gastroparesis in individuals who have
undergone lung and heart/lung transplants. Method(s): A literature
search was performed on Embase with keywords "gastroparesis" AND "lung
transplant" from the inception of data till 11/30/23. We included all
retrospective studies providing data about the prevalence of gastroparesis
in lung transplant patients. All case reports case series, and review
articles were excluded. PRISMA guidelines were followed while conducting
this systematic review and meta-analysis. R programming language software
was used to conduct this meta-analysis. Analysis was conducted using a
random effects model. Result(s): A total of 175 articles were
identified with a literature search. A total of 17 retrospective studies
(N=3914) were included based on inclusion criteria that provided data on
the prevalence of gastroparesis in lung transplant patients. A total of
1,875 patients were males while 1,560 patients were females. The pooled
prevalence of gastroparesis was 24% (95% CI = 14%-38%, I<inf>2</inf>=98%)
(Figure 1). Conclusion(s): There is a high prevalence of
gastroparesis following lung and lung/heart transplants. The findings
emphasize the need for population-based prevalence studies to ascertain
the clinical significance and potential impact on long-term outcomes in
these transplant recipients. [figure presented] Copyright © 2024
AGA Institute

<76>
Accession Number
644260844
Title
When nudge comes to shove - design and implementation of an ASA Physical
Status decision support tool for pediatric patients.
Source
Anesthesia and Analgesia. Conference: Annual Meeting of the Society for
Technology in Anesthesia, STA 2024. Houston, TX United States. 138(4
Supplement) (pp 50), 2024. Date of Publication: April 2024.
Author
Johnson G.; Simpao A.F.; Gidaro U.; Sloberman L.; Feng B.; Weintraub A.
Institution
(Johnson, Simpao, Gidaro, Sloberman, Weintraub) Children's Hospital of
Philadelphia (CHOP), Philadelphia, PA, United States
(Johnson, Simpao, Weintraub) Perelman School of Medicine, University of
Pennsylvania, Philadelphia, PA, United States
(Feng) Epic Systems Corporation, Verona, WI, United States
Publisher
Lippincott Williams and Wilkins
Abstract
Introduction: The American Society of Anesthesiologists Physical Status
(ASA PS) classification was created as a means of communicating a
patient's pre-anesthesia comorbidities. ASA PS is also used as a component
of anesthesia billing. In 2020, the ASA released updated, pediatric
specific guidelines for ASA PS, including that fullterm infants less than
six weeks of age should be considered ASA PS III. We hypothesized that our
department was not only under classifying ASA III PS in patients < 6 weeks
of age, but that we were also grossly underutilizing the emergency, "E",
designation. We set out to improve our ASA PS and "E" classification via
our EHR (Epic, Verona, WI). Method(s): Our initial attempt to improve
"E" designation was embedding an alert in our pre-anesthesia evaluation
form to have the user select "E" if emergency exception to consent was
required. We created a Best Practice Advisory to prompt the user to select
"E" for appendectomies, control of post-tonsillectomy hemorrhage,
testicular torsion, ruptured globe, or ASA PS V. We added a hard stop to
select "E" for any general case (non-cardiac) marked as an ASA V. We
implemented an additional soft-stop notification if an add on surgical
case was booked as "now," "immediate," or "emergent." Finally, we removed
the ASA I &II PS options from the pre-anesthesia navigator for children <
42 days old. Result(s): The ASA V hard stop to mark "E" was
implemented in December 2022 and resulted in substantial improvement in
"E" designation for patients in the general operating room (non-cardiac).
The ASA "E" soft stop notification based on add-on case classification was
then implemented in May of 2023. Unfortunately, after implementation, we
showed almost no improvement in our ASA "E" designation based on case
classification. Our final intervention, removing the option to mark ASA I
or II for patient < 42 days old resulted in no cases being marked ASA I or
II thereafter. Conclusion(s): An EHR based ASA PS decision support
tool is feasible and effective in improving both "E" designation in ASA V
patients, and ASA III classification for healthy children < 42 days.
Future plans include continued staff education on appropriate ASA
classification as well as problem list integration into a best practice
advisory for ASA classification. (Figure Presented).

<77>
Accession Number
2032151411
Title
In-hospital initiation of a PCSK9 inhibitor in patients with acute
coronary syndrome: A systematic review and meta-analysis of randomized
controlled trials.
Source
Medicine (United States). 103(10) (pp E37416), 2024. Date of Publication:
08 Mar 2024.
Author
Shi W.; Xu Y.; Zhou L.; Wang W.; Huang W.; Zhou B.
Institution
(Shi, Xu, Zhou) Department of Cardiology, The Sixth People's Hospital of
Chengdu, Chengdu 610000, China
(Wang) Department of Cardiac Ultrasound, Peking Union Medical College
Hospital, Beijing 100005, China
(Huang, Zhou) Department of Cardiology, The First Affiliated Hospital of
Chongqing Medical University, Chongqing 400016, China
Publisher
Lippincott Williams and Wilkins
Abstract
Background: Proprotein convertase subtilisin/kexin type 9 (PCSK9)
inhibitors have been shown to be effective and safe in patients with
stable angina and previous myocardial infarction. However, evidence for
initiating their use in patients hospitalized with acute coronary syndrome
(ACS) is limited. This systematic review and meta-analysis was performed
to provide more clinical evidence. Method(s): PubMed, Embase, OVID,
Cochrane Library and ClinicalTrials.gov were systematically searched for
eligible randomized controlled trials up to March 20, 2023. The risk
ratios, standardized mean differences and 95% confidence intervals were
calculated for primary and secondary outcomes. The bias risk of the
included studies was assessed using the Cochrane RoB 2 criteria.
 Result(s): About 8 randomized controlled trials involving 1255
inpatients with ACS were included. PCSK9 inhibitor treatment significantly
reduced low-density lipoprotein cholesterol (LDL-C) (SMD -1.28, 95% CI
-1.76 to -0.8, P = .001), triglycerides (TG) (SMD -0.93, 95% CI -1.82 to
-0.05, P = .03), total cholesterol (SMD -1.36, 95% CI -2.01 to -0.71, P =
.001), and apolipoprotein B (Apo B) (SMD -0.81, 95% CI -1.09 to -0.52, P =
.001) within approximately 1 month. PCSK9 inhibitor treatment
significantly reduced the total atheroma volume (TAV) (SMD -0.33, 95% CI
-0.59 to -0.07, P = .012). It also significantly increased minimum fibrous
cap thickness (FCT) (SMD 0.41, 95% CI 0.22-0.59, P = .001) in long-term
follow-up (>6 months). PCSK9 inhibitor treatment significantly reduced the
risk of readmission for unstable angina (RR 0.32, 95% CI 0.12-0.91, P =
.032) in short-term follow-up (<6 months). There were no significant
differences in all-cause mortality, cardiovascular death, myocardial
infarction, ischemic stroke, coronary revascularization or heart failure.
Only nasopharyngitis (RR 1.71, 95% CI 1.01-2.91, P = .047) adverse events
were significantly observed in the PCSK9 inhibitor group.
 Conclusion(s): Application of a PCSK9 inhibitor in hospitalized
patients with ACS reduced lipid profiles and plaque burdens and was well
tolerated with few adverse events. Copyright © 2024 Lippincott
Williams and Wilkins. All rights reserved.

<78>
Accession Number
2032182550
Title
Comparison between propofol and total inhalational anaesthesia on
cardiovascular outcomes following on-pump cardiac surgery in higher-risk
patients: a randomised controlled pilot and feasibility study.
Source
Open Heart. 11(1) (no pagination), 2024. Article Number: e002630. Date of
Publication: 09 May 2024.
Author
Milne B.; John M.; Evans R.; Robertson S.; Scanaill P.O.; Murphy G.J.;
Landoni G.; Marber M.; Clayton T.; Kunst G.
Institution
(Milne, Scanaill, Kunst) Department of Anaesthetics and Pain Therapy,
King's College Hospital NHS Foundation Trust, London, United Kingdom
(John) Department of Anaesthesia, Guy's and St Thomas' Hospitals NHS
Trust, London, United Kingdom
(Evans, Robertson, Clayton) London School of Hygiene and Tropical
Medicine, Medical Statistics, 1 Keppel Street, London WC1E 7HT, United
Kingdom
(Murphy) Department of Cardiovascular Sciences, College of Life Sciences,
University of Leicester, Leicester, United Kingdom
(Landoni) Department of Anesthesia and Intensive Care, IRCCS San Raffaele
Scientific Institute, Milan, Italy
(Marber, Kunst) School of Cardiovascular and Metabolic Medicine &
Sciences, King's College London, London, United Kingdom
Publisher
BMJ Publishing Group
Abstract
Objectives Myocardial revascularisation and cardiopulmonary bypass (CPB)
can cause ischaemia-reperfusion injury, leading to myocardial and other
end-organ damage. Volatile anaesthetics protect the myocardium in
experimental studies. However, there is uncertainty about whether this
translates into clinical benefits because of the coadministration of
propofol and its detrimental effects, restricting myocardial protective
processes. Methods In this single-blinded, parallel-group randomised
controlled feasibility trial, higher-risk patients undergoing elective
coronary artery bypass graft (CABG) surgery with an additive European
System for Cardiac Operative Risk Evaluation >=5 were randomised to
receive either propofol or total inhalational anaesthesia as single agents
for maintenance of anaesthesia. The primary outcome was the feasibility of
recruiting and randomising 50 patients across two cardiac surgical
centres, and secondary outcomes included the feasibility of collecting the
planned perioperative data, clinically relevant outcomes and assessments
of effective patient identification, screening and recruitment. Results
All 50 patients were recruited within 11 months in two centres, allowing
for a 13-month hiatus in recruitment due to the COVID-19 pandemic.
Overall, 50/108 (46%) of eligible patients were recruited. One patient
withdrew before surgery and one patient did not undergo surgery. All but
one completed in-hospital and 30-day follow-up. Conclusions It is feasible
to recruit and randomise higher-risk patients undergoing CABG surgery to a
study comparing total inhalational and propofol anaesthesia in a timely
manner and with high acceptance and completion rates. Trial registration
number NCT04039854. Copyright © Author(s) (or their employer(s))
2024.

<79>
Accession Number
2016754854
Title
Comparative Evaluation of the Incidence of Postoperative Pulmonary
Complications After Minimally Invasive Valve Surgery vs. Full Sternotomy:
A Systematic Review and Meta-Analysis of Randomized Controlled Trials and
Propensity Score-Matched Studies.
Source
Frontiers in Cardiovascular Medicine. 8 (no pagination), 2021. Article
Number: 724178. Date of Publication: 2021.
Author
Mohamed M.A.; Ding S.; Ali Shah S.Z.; Li R.; Dirie N.I.; Cheng C.; Wei X.
Institution
(Mohamed, Ding, Cheng, Wei) Division of Cardiothoracic and Vascular
Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of
Science and Technology, Wuhan, China
(Ali Shah, Li) Department of Rehabilitation Medicine, Tongji Hospital,
Tongji Medical College, Huazhong University of Science and Technology,
Wuhan, China
(Dirie) Division of Urology, Tongji Hospital, Tongji Medical College,
Huazhong University of Science and Technology, Wuhan, China
Publisher
Frontiers Media SA
Abstract
Background: Postoperative pulmonary complications remain a leading cause
of increased morbidity, mortality, longer hospital stays, and increased
costs after cardiac surgery; therefore, our study aims to analyze whether
minimally invasive valve surgery (MIVS) for both aortic and mitral valves
can improve pulmonary function and reduce the incidence of postoperative
pulmonary complications when compared with the full median sternotomy (FS)
approach. Method(s): A comprehensive systematic literature research
was performed for studies comparing MIVS and FS up to February 2021.
Randomized controlled trials (RCTs) and propensity score-matching (PSM)
studies comparing early respiratory function and pulmonary complications
after MIVS and FS were extracted and analyzed. Secondary outcomes included
intra-and postoperative outcomes. Result(s): A total of 10,194
patients from 30 studies (6 RCTs and 24 PSM studies) were analyzed. Early
mortality differed significantly between the groups (MIVS 1.2 vs. FS 1.9%;
p = 0.005). Compared with FS, MIVS significantly lowered the incidence of
postoperative pulmonary complications (odds ratio 0.79, 95% confidence
interval [0.67, 0.93]; p = 0.004) and improved early postoperative
respiratory function status (mean difference -24.83 [-29.90, -19.76]; p <
0.00001). Blood transfusion amount was significantly lower after MIVS (p <
0.02), whereas cardiopulmonary bypass time and aortic cross-clamp time
were significantly longer after MIVS (p < 0.00001). Conclusion(s):
Our study showed that minimally invasive valve surgery decreases the
incidence of postoperative pulmonary complications and improves
postoperative respiratory function status. Copyright © 2021
Mohamed, Ding, Ali Shah, Li, Dirie, Cheng and Wei.

<80>
Accession Number
2032162620
Title
Early unfractionated heparin treatment in patients with STEMI - trial
design and rationale.
Source
PLoS ONE. 19(5 May) (no pagination), 2024. Article Number: e0303376. Date
of Publication: May 2024.
Author
Fister M.; Mikuz U.; Ziberna K.; Franco D.; Radsel P.; Bunc M.; Noc M.;
Goslar T.
Institution
(Fister, Mikuz, Radsel, Bunc, Noc, Goslar) Department of Intensive
Internal Medicine, University Medical Center Ljubljana, Ljubljana,
Slovenia
(Fister, Ziberna, Radsel, Bunc, Noc, Goslar) Medical Faculty, University
of Ljubljana, Ljubljana, Slovenia
(Franco) Department of Advanced Biomedical Science, University of Naples
"Federico II", Naples, Italy
Publisher
Public Library of Science
Abstract
The early unfractionated heparin (UFH) treatment in patients with
ST-elevation myocardial infarction (STEMI) is a single-center, open-label,
randomized controlled trial. The study population are patients with STEMI
that undergo primary percutaneous coronary intervention (PPCI). The trial
was designed to investigate whether early administration of unfractionated
heparin immediately after diagnosis of STEMI is beneficial in terms of
patency of infarct-related coronary artery (IRA) when compared to
established UFH administration at the time of coronary intervention. The
patients will be randomized in 1:1 fashion in one of the two groups. The
primary efficacy endpoint of the study is Thrombolysis in myocardial
infarction (TIMI) flow grades 2 and 3 on diagnostic coronary angiography.
Secondary outcome measures are: TIMI flow after PPCI, progression to
cardiogenic shock, 30-day mortality, ST-segment resolution, highest
Troponin I and Troponin I values at 24 hours. The safety outcome is
bleeding complications. The study of early heparin administration in
patients with STEMI will address whether pretreatment with UFH can
increase the rate of spontaneous reperfusion of infarct-related coronary
artery. Copyright © 2024 Fister et al. This is an open access
article distributed under the terms of the Creative Commons Attribution
License, which permits unrestricted use, distribution, and reproduction in
any medium, provided the original author and source are credited.

<81>
Accession Number
2029824458
Title
Preoperative fasting glucose value can predict acute kidney injury in
non-cardiac surgical patients without diabetes but not in patients with
diabetes.
Source
Perioperative Medicine. 13(1) (no pagination), 2024. Article Number: 39.
Date of Publication: December 2024.
Author
Pang Q.; Feng Y.; Yang Y.; Liu H.
Institution
(Pang, Feng, Yang, Liu) Department of Anesthesiology, Chongqing University
Cancer Hospital, Hanyu Road 181, Shapingba District, Chongqing 400030,
China
Publisher
BioMed Central Ltd
Abstract
Background: Postoperative acute kidney injury (AKI) is a common and costly
complication after non-cardiac surgery. Patients with or without diabetes
could develop hyperglycemia before surgery, and preoperative hyperglycemia
was closely associated with postoperative poor outcomes, but the
association between preoperative fasting blood glucose level and
postoperative AKI is still unclear. Method(s): Data from patients
undergoing non-cardiac surgery in Chongqing University Cancer Hospital
from January 1, 2017, to May 31, 2023, were collected, preoperative
glucose value and perioperative variables were extracted, the primary
exposure of interest was preoperative glucose value, and the outcome was
postoperative AKI. Result(s): Data from 39,986 patients were included
in the final analysis, 741(1.9%) patients developed AKI, 134(5.6%) in the
cohort with DM, and 607(1.6%) in the cohort without DM(OR 1.312, 95% CI
1.028-1.675, P = 0.029). A significant non-linear association between
preoperative glucose and AKI exists in the cohort without DM after
covariable adjustment (P = 0.000), and every 1 mmol/L increment of
preoperative glucose level increased OR by 15% (adjusted OR 1.150, 95% CI
1.078-1.227, P = 0.000), the optimal cut-point of preoperative fasting
glucose level to predict AKI was 5.39 mmol/L (adjusted OR 1.802, 95%CI
1.513-2.146, P = 0.000). However, in the cohort with DM, the relation
between preoperative glucose and postoperative AKI was not significant
after adjusting by covariables (P = 0.437). No significance exists between
both cohorts in the risk of AKI over the range of preoperative glucose
values. Conclusion(s): A preoperative fasting glucose value of 5.39
mmol/L can predict postoperative acute kidney injury after non-cardiac
surgery in patients without diagnosed diabetes, but it is not related to
AKI in patients with the diagnosis. Copyright © The Author(s)
2024.

<82>
Accession Number
2032076128
Title
Safety and efficacy of colchicine for the prevention of post-operative
atrial fibrillation in patients undergoing cardiac surgery: a
meta-analysis of randomized controlled trials.
Source
Europace. 25(7) (no pagination), 2023. Article Number: euad169. Date of
Publication: 01 Jul 2023.
Author
Agarwal S.; Beard C.W.; Khosla J.; Clifton S.; Anwaar M.F.; Ghani A.;
Farhat K.; Pyrpyris N.; Momani J.; Munir M.B.; DeSimone C.V.; Deshmukh A.;
Stavrakis S.; Jackman W.M.; Po S.; Asad Z.U.A.
Institution
(Agarwal, Beard, Khosla, Anwaar, Ghani, Farhat, Stavrakis, Jackman, Po,
Asad) Department of Medicine, University of Oklahoma Health Sciences
Center, 800 Stanton L Young Blvd, Oklahoma City, OK 73104, United States
(Clifton) Robert M Bird Health Sciences Library, University of Oklahoma
Health Sciences Center, Oklahoma City, OK, United States
(Pyrpyris) First Department of Cardiology, School of Medicine, National
and Kapodistrian University of Athens, Hippokration Hospital, Athens,
Greece
(Momani) Department of Internal Medicine, Alfaisal University, Riyadh,
Saudi Arabia
(Munir) Division of Cardiovascular Medicine, University of California
Davis, Sacramento, CA, United States
(DeSimone, Deshmukh) Department of Cardiovascular Medicine, Mayo Clinic,
Rochester, MN, United States
Publisher
Oxford University Press
Abstract
Background and Colchicine is an anti-inflammatory drug that may
prevent post-operative atrial fibrillation (POAF). The effect of this drug
has Aims been inconsistently shown in previous clinical trials. We aimed
to compare the efficacy and safety of colchicine vs. placebo to prevent
POAF in patients undergoing cardiac surgery. Methods A systematic search
of EMBASE, MEDLINE, SCOPUS, ClinicalTrials.gov, and the Cochrane Library
for randomized con- and results trolled trials (RCTs) was conducted from
inception till April 2023. The primary outcome was the incidence of POAF
after any cardiac surgery. The secondary outcome was the rate of drug
discontinuation due to adverse events and adverse gastrointestinal events.
Risk ratios (RR) were reported using the Mantel Haenszel method. A total
of eight RCTs comprising 1885 patients were included. There was a
statistically significant lower risk of developing POAF with colchicine
vs. placebo (RR: 0.70; 95% CI: 0.59-0.82; P < 0.01, I2 = 0%),
and this effect persisted across different subgroups. There was a
significantly higher risk of adverse gastrointestinal events (RR: 2.20;
95% CI: 1.38-3.51; P < 0.01, I2 = 55%) with no difference in
the risk of drug discontinuation in patients receiving colchicine vs.
placebo (RR: 1.33; 95% CI: 0.93-1.89; P = 0.11, I2 = 0%).
Conclusion This meta-analysis of eight RCTs shows that colchicine is
effective at preventing POAF, with a significantly higher risk of adverse
gastrointestinal events but no difference in the rate of drug
discontinuation. Future studies are required to define the optimal
duration and dose of colchicine for the prevention of POAF. Copyright
© 2023 Oxford University Press. All rights reserved.

<83>
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. 79(6) (pp 1510-1524), 2024. Date of
Publication: June 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. 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). 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. 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. Copyright © 2023 Society for Vascular Surgery

<84>
Accession Number
2029824963
Title
A systematic review of the prevalence of chronic postsurgical pain in
children.
Source
Paediatric Anaesthesia. (no pagination), 2024. Date of Publication: 2024.
Author
Sim N.Y.W.; Chalkiadis G.A.; Davidson A.J.; Palmer G.M.
Institution
(Sim) Department of Anaesthesia and Perioperative Medicine, Monash Health,
Clayton, VIC, Australia
(Chalkiadis, Davidson, Palmer) Department of Anaesthesia and Pain
Management, Royal Children's Hospital, Parkville, VIC, Australia
(Chalkiadis, Davidson, Palmer) Murdoch Children's Research Institute,
Parkville, VIC, Australia
(Chalkiadis, Davidson, Palmer) Department of Paediatrics, University of
Melbourne, Parkville, VIC, Australia
(Davidson) Department of Critical Care, University of Melbourne,
Parkville, VIC, Australia
Publisher
John Wiley and Sons Inc
Abstract
Two prior reviews highlight the scarcity and conflicting nature of
available data on chronic postsurgical pain in children, reporting a wide
prevalence range of 3.2% to 64% (at >=3 months). This updated systematic
review aimed to consolidate information on the prevalence of pediatric
chronic postsurgical pain. A thorough literature search of full
English-text publications from April 2014 to August 2021 was conducted
using Ovid MEDLINE, PubMed, and Cochrane Database of Systematic Reviews,
with search terms: postoperative pain, child, preschool, pediatrics,
adolescent, chronic pain. Seventeen relevant studies were identified. Most
assessed chronicity once greater than 3 months duration postoperatively
(82%), were predominantly prospective (71%) and conducted in inpatient
settings (88%). The surgeries examined included orthopedic (scoliosis and
limb), urological, laparotomy, inguinal, and cardiothoracic procedures,
involving numbers ranging from 36 to 750, totaling 3137 participants/2792
completers. The studies had wide variations in median age at surgery (6
days to 16 years), the percentage of female participants (unspecified or
12.5% to 90%), and follow-up duration (2.5 months to 9 years). Various
pain, functional, psychosocial, and health-related quality of life
outcomes were documented. Chronic postsurgical pain prevalence varied
widely from 2% to 100%. Despite increased data, challenges persist due to
heterogeneity in definitions, patient demographics, mixed versus single
surgical populations, diverse perioperative analgesic interventions,
follow-up durations and reported outcomes. Interpretation is further
complicated by limited information on impact, long-term analgesia and
healthcare utilization, and relatively small sample sizes, hindering the
assessment of reported associations. In some cases, preoperative pain and
deformity may not have been addressed by surgery and persisting pain
postoperatively may then be inappropriately termed chronic postsurgical
pain. Larger-scale, procedure-specific data to better assess current
prevalence, impact, and whether modifiable factors link to negative
long-term outcomes, would be more useful and allow targeted perioperative
interventions for at-risk pediatric surgical patients. Copyright
© 2024 The Authors. Pediatric Anesthesia published by John Wiley &
Sons Ltd.

<85>
Accession Number
2028863805
Title
A Randomized Trial Comparing Standard of Care to Bayesian Warfarin Dose
Individualization.
Source
Clinical Pharmacology and Therapeutics. 115(6) (pp 1316-1325), 2024. Date
of Publication: June 2024.
Author
Xue L.; Ma G.; Holford N.; Qin Q.; Ding Y.; Hannam J.A.; Ding X.; Fan H.;
Ji Z.; Yang B.; Shen H.; Shen Z.; Miao L.
Institution
(Xue, Qin, Ding, Miao) Department of Pharmacy, The First Affiliated
Hospital of Soochow University, Suzhou, China
(Xue) Department of Pharmacology, Faculty of Medicine, University of the
Basque Country (UPV/EHU), Leioa, Spain
(Ma, Holford, Hannam) Department of Pharmacology and Clinical
Pharmacology, University of Auckland, Auckland, New Zealand
(Ding, Fan, Ji, Yang, Shen, Shen) Department of Cardiovascular Surgery,
The First Affiliated Hospital of Soochow University, Suzhou, China
(Ding, Fan, Ji, Yang, Shen, Shen) Institute for Cardiovascular Science,
Soochow University, Suzhou, China
(Miao) National Clinical Research Center for Hematologic Diseases, The
First Affiliated Hospital of Soochow University, Suzhou, China
(Miao) Institute for Interdisciplinary Drug Research and Translational
Sciences, Soochow University, Suzhou, China
Publisher
John Wiley and Sons Inc
Abstract
The quality of warfarin treatment may be improved if management is guided
by the use of models based upon pharmacokinetic-pharmacodynamic theory. A
prospective, two-armed, single-blind, randomized controlled trial compared
management aided by a web-based dose calculator (NextDose) with standard
clinical care. Participants were 240 adults receiving warfarin therapy
following cardiac surgery, followed up until the first outpatient
appointment at least 3 months after warfarin initiation. We compared the
percentage of time spent in the international normalized ratio acceptable
range (%TIR) during the first 28 days following warfarin initiation, and
%TIR and count of bleeding events over the entire follow-up period. Two
hundred thirty-four participants were followed up to day 28 (NextDose: 116
and standard of care: 118), and 228 participants (114 per arm) were
followed up to the final study visit. Median %TIR tended to be higher for
participants receiving NextDose guided warfarin management during the
first 28 days (63 vs. 56%, P = 0.13) and over the entire follow-up period
(74 vs. 71%, P = 0.04). The hazard of clinically relevant minor bleeding
events was lower for participants in the NextDose arm (hazard ratio: 0.21,
P = 0.041). In NextDose, there were 89.3% of proposed doses accepted by
prescribers. NextDose guided dose management in cardiac surgery patients
requiring warfarin was associated with an increase in %TIR across the full
follow-up period and fewer hemorrhagic events. A theory-based,
pharmacologically guided approach facilitates higher quality warfarin
anticoagulation. An important practical benefit is a reduced requirement
for clinical experience of warfarin management. Copyright © 2024
The Authors. Clinical Pharmacology & Therapeutics published by Wiley
Periodicals LLC on behalf of American Society for Clinical Pharmacology
and Therapeutics.

<86>
Accession Number
2029837289
Title
Retraction: Comparative evaluation of the incidence of postoperative
pulmonary complications after minimally invasive valve surgery vs. full
sternotomy: a systematic review and meta-analysis of randomized controlled
trials and propensity score-matched studies (Frontiers in Cardiovascular
Medicine, (2021), 8, (724178), 10.3389/fcvm.2021.724178).
Source
Frontiers in Cardiovascular Medicine. 11 (no pagination), 2024. Article
Number: 1422760. Date of Publication: 2024.
Publisher
Frontiers Media SA
Abstract
Following publication, concerns were raised regarding the scientific
validity of the article. An investigation was conducted in accordance with
Frontiers' policies. The authors failed to provide a satisfactory
explanation and as a result, the conclusions of the article have been
deemed unreliable and the article is retracted. This retraction was
approved by the Chief Editors of Cardiovascular Medicine and the Chief
Executive Editor of Frontiers. The authors agree to this
retraction. Copyright 2024 Frontiers Editorial Office.

<87>
Accession Number
644254639
Title
Erratum: Correction to: An Aspirin-Free Versus Dual Antiplatelet Strategy
for Coronary Stenting: STOPDAPT-3 Randomized Trial (Circulation (2024) 149
8 (585-600)).
Source
Circulation. 149(20) (pp e1189-e1190), 2024. Date of Publication: 14 May
2024.
Author
Anonymous

<88>
Accession Number
2032248538
Title
Case report: acute myocarditis in two patients with coronary artery
disease presenting with chest pain-thinking outside the box.
Source
European Heart Journal - Case Reports. 8(5) (no pagination), 2024. Article
Number: ytae220. Date of Publication: 01 May 2024.
Author
Amelotti N.; Brusamolino M.; Mapelli M.; Contini M.; Baggiano A.; Fazzari
F.; Pontone G.; Agostoni P.
Institution
(Amelotti, Brusamolino, Mapelli, Contini, Baggiano, Fazzari, Pontone,
Agostoni) Centro Cardiologico Monzino, IRCCS, Via Carlo Parea, 4, Milan
20138, Italy
(Amelotti, Brusamolino, Mapelli, Baggiano, Agostoni) Department of
Clinical Sciences and Community Health, Cardiovascular Section, University
of Milan, Milan, Italy
(Pontone) Department of Biomedical, Surgical and Dental Sciences,
University of Milan, Milan, Italy
Publisher
Oxford University Press
Abstract
Background In a subset of patients, acute myocarditis (AM) may mimic acute
myocardial infarction, with a similar clinical presentation characterized
by chest pain, electrocardiogram (ECG) changes consistent with acute
coronary syndromes (ACS), and serum markers increment. . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Case summary
We present two cases of infarct-like myocarditis in patients with known
coronary artery disease (CAD), in which the discrepancy between
transthoracic echocardiogram findings, ECG, and angiography prompted us to
look beyond the simplest diagnosis. In these cases, making a prompt and
correct diagnosis is pivotal to address adequate therapy and establish a
correct prognosis. . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . Discussion The right diagnosis can avoid
unnecessary coronary revascularizations and subsequent antiplatelet
therapy that may be associated with an increased haemorrhagic risk.
Moreover, it allows setting up guideline-directed therapy for myocarditis,
proper follow-up, as well as recommending abstention from physical
activity. Copyright © The Author(s) 2024.

<89>
Accession Number
644250607
Title
Long-term outcomes comparison of mitral valve repair or replacement for
secondary mitral valve regurgitation. An updated systematic review and
reconstructed time-to-event study-level meta-analysis.
Source
Current problems in cardiology. (pp 102636), 2024. Date of Publication:
10 May 2024.
Author
Formica F.; Gallingani A.; Tuttolomondo D.; Hernandez-Vaquero D.;
D'Alessandro S.; Singh G.; Benassi F.; Grassa G.; Pattuzzi C.; Maestri F.;
Nicolini F.
Institution
(Formica, Grassa, Pattuzzi, Nicolini) University of Parma, Department of
Medicine and Surgery, Parma, Italy; Cardiac Surgery Unit, University
Hospital of Parma, Parma, Italy
(Gallingani, Benassi, Maestri) Cardiac Surgery Unit, University Hospital
of Parma, Parma, Italy
(Tuttolomondo) Cardiology Unit, University Hospital of Parma, Parma, Italy
(Hernandez-Vaquero) Cardiac Surgery Department, Hospital Universitario
Central de Asturias, Oviedo, Spain
(D'Alessandro) Cardiac Surgery Unit, San Giovanni Bosco Hospital, Turin,
Italy
(Singh) Department of Critical Care Medicine and Division of Cardiac
Surgery, Mazankowski Alberta Heart Institute, University of Alberta,
Edmonton, Canada
Abstract
BACKGROUND AND AIM: The ideal surgical intervention for secondary mitral
regurgitation (SMR), a disease of the left ventricle not the mitral valve
itself, is still debated. We performed an updated systematic review and
study-level meta-analysis investigating mitral valve repair (MVr) versus
mitral valve replacement (MVR) for adult patients with SMR, with or
without coronary artery disease (CAD). METHOD(S): PubMed, CENTRAL and
EMBASE were searched for studies comparing MVr versus MVR. Randomized
trial or observational studies were considered eligible. Primary endpoint
was long-term mortality for any cause. Kaplan-Meier survival curves were
reconstructed and compared with Cox linear regression. Landmark analysis
and time-varying hazard ratio (HR) were analyzed. Sensitivity analyses
included meta-regression and separate sub-analysis. A random effects model
was used. RESULT(S): Twenty-three studies (MVr=3,727 and MVR=2,839)
were included. One study was a randomized trial, and 19 studies were
adjusted. The mean weighted follow-up was 3.7+/-2.8 years. MVR was
associated with significative greater late mortality (HR=1.26; 95% CI,
1.14-1.39; P<0.0001) at 10-year follow-up. There was a time-varying trend
showing an increased risk of mortality in the first 2 years after MVR
(HR=1.38; 95% CI, 1.21-1.56; P<0.0001), after which this difference
dissipated (HR=0.94; 95% CI, 0.81-1.09; P=0.41). Separate sub-analyses
showed comparable long-term mortality in patients with concomitant
coronary surgery >=90%, left ventricle ejection fraction <=40%, and
sub-valvular apparatus preservation rate of 100%. CONCLUSION(S):
Compared to repair, MVR is associated with higher probability of mortality
in the first 2 years following surgery, after which the two procedures
showed comparable late mortality rate. Copyright © 2024.
Published by Elsevier Inc.

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