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<1>
Accession Number
2030376781
Title
Current Prognostic Biomarkers for Abdominal Aortic Aneurysm: A
Comprehensive Scoping Review of the Literature.
Source
Biomolecules. 14(6) (no pagination), 2024. Article Number: 661. Date of
Publication: June 2024.
Author
Khan H.; Abu-Raisi M.; Feasson M.; Shaikh F.; Saposnik G.; Mamdani M.;
Qadura M.
Institution
(Khan, Abu-Raisi, Shaikh, Qadura) Division of Vascular Surgery, St.
Michael's Hospital, Toronto, ON M5B 1W8, Canada
(Khan, Abu-Raisi, Feasson, Shaikh, Saposnik, Mamdani, Qadura) Li Ka Shing
Knowledge Institute, St Michael's Hospital, Unity Health Toronto, Toronto,
ON M5B 1W8, Canada
(Saposnik) Division of Neurology, Department of Medicine, University of
Toronto, Toronto, ON M5S 1A1, Canada
(Qadura) Department of Surgery, University of Toronto, Toronto, ON M5T
1P5, Canada
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Abdominal aortic aneurysm (AAA) is a progressive dilatation of the aorta
that can lead to aortic rupture. The pathophysiology of the disease is not
well characterized but is known to be caused by the general breakdown of
the extracellular matrix within the aortic wall. In this comprehensive
literature review, all current research on proteins that have been
investigated for their potential prognostic capabilities in patients with
AAA was included. A total of 45 proteins were found to be potential
prognostic biomarkers for AAA, predicting incidence of AAA, AAA rupture,
AAA growth, endoleak, and post-surgical mortality. The 45 proteins fell
into the following seven general categories based on their primary
function: (1) cardiovascular health, (2) hemostasis, (3) transport
proteins, (4) inflammation and immunity, (5) kidney function, (6) cellular
structure, (7) and hormones and growth factors. This is the most
up-to-date literature review on current prognostic markers for AAA and
their functions. This review outlines the wide pathophysiological
processes that are implicated in AAA disease progression.<br/>Copyright
&#xa9; 2024 by the authors.

<2>
Accession Number
2033024288
Title
Systematic screening by a heart team and a machine learning approach
contribute to unraveling novel risk factors in revascularization
candidates with complex coronary artery disease.
Source
Polish Archives of Internal Medicine. 134(6) (no pagination), 2024.
Article Number: 16747. Date of Publication: 27 Jun 2024.
Author
Kageyama S.; Ninomiya K.; Jonik S.; Masuda S.; Revaiah P.C.; Tsai T.-Y.;
Garg S.; Onuma Y.; Serruys P.W.; Mazurek T.
Institution
(Kageyama) Department of Cardiology, Shizuoka City Shizuoka Hospital,
Shizuoka, Japan
(Kageyama, Ninomiya, Masuda, Revaiah, Tsai, Onuma, Serruys) Department of
Cardiology, University of Galway, Galway, Ireland
(Jonik, Mazurek) First Department of Cardiology, Medical University of
Warsaw, Warszawa, Poland
(Garg) Department of Cardiology, Royal Blackburn Hospital, Blackburn,
United Kingdom
Publisher
Medycyna Praktyczna Cholerzyn
Abstract
Introduction The baseline characteristics affecting mortality following
percutaneous or surgical revascularization in patients with left main and
/ or 3-vessel coronary artery disease (CAD) observed in real-world
practice differ from those established in randomized controlled trials
(RCTs) due to the constraints of inclusion / exclusion criteria.
Objectives This study aimed to assess whether systematic screening enables
identification of novel and registry-specific baseline patient
characteristics influencing long-term mortality. Patient and methods Least
absolute shrinkage and selection operator (LASSO) regression was used to
screen 42 baseline patient characteristics shared by the SYNTAX (Synergy
between Percutaneous Coronary Intervention with Taxus and Cardiac Surgery)
trial and a single-center Polish registry of 1035 consecutive patients
with complex CAD who received revascularization and were followed-up for 5
years. After screening, a classic Cox regression analysis was performed to
examine the suitability of a linear model for predicting 5-year mortality,
which was then compared with the mortality predicted in the same cohort
using the SYNTAX score II 2020 (SS2020). Result s The 5-year mortality
rate in the registry was 12.3%, and the strongest predictors were
pulmonary hypertension, chronic obstructive pulmonary disease, and
insulin-dependent diabetes. In an internal validation, the linear model
constructed after LASSO screening and combined with a classic Cox
regression analysis improved the prediction of 5-year mortality, as
compared with the SS2020 (concordance index of 0.92 and 0.75,
respectively). Conclusions A machine learning approach improved the
detection of registry-specific risk factors in all-comer patients amenable
to surgical or percutaneous revascularization who were evaluated by a
heart team. The risk factors identified in RCTs are not necessarily the
same as those detected in real clinical practice when systematic screening
is applied.<br/>Copyright &#xa9; Author(s), 2024.

<3>
Accession Number
2032972505
Title
Antiplatelet Resistance in Coronary Artery Bypass Grafting: A Systematic
Review.
Source
Surgery Research and Practice. 2024 (no pagination), 2024. Article Number:
1807241. Date of Publication: 2024.
Author
Thet M.S.; Khosravi A.; Egbulonu S.; Oo A.Y.
Institution
(Thet) Department of Surgery and Cancer, Imperial College London, London,
United Kingdom
(Khosravi) Department of Cardiothoracic Surgery, Liverpool Heart and Chest
Hospital, Liverpool, United Kingdom
(Egbulonu, Oo) Department of Cardiothoracic Surgery, St Bartholomew's
Hospital, London, United Kingdom
Publisher
Hindawi Limited
Abstract
Background. This systematic review examines the occurrence and
implications of resistance to primary antiplatelet agents, aspirin and
clopidogrel, often utilised in patients undergoing coronary artery bypass
grafting (CABG), alongside the methodologies for assessment of such
resistance. Methods. An extensive literature search across various
databases such as PubMed, MEDLINE via Ovid, Embase, and Cochrane CENTRAL
until May 2024 was conducted to identify studies evaluating antiplatelet
resistance in on-pump and off-pump CABG patients. Following quality
assessment, only high-quality studies were incorporated into this review.
Results. This review included 19 studies with 3,915 patients, four of
which were randomised controlled trials and 15 were observational studies.
Aspirin resistance incidence ranged from 11.0% to 51.5%, while clopidogrel
resistance was 22%. Antiplatelet resistance, assessed through a wide
variety of methods, was associated with a 13 times increase in the risk of
vein graft occlusion and increased rates of mortality, myocardial
infarction, and target vessel revascularisation in the case of clopidogrel
resistance. The effect of cardiopulmonary bypass on antiplatelet
resistance remains ambiguous. Conclusion. The academic literature lacks a
standardised definition for antiplatelet resistance. Assessment
methodologies greatly vary, leading to noninterchangeable outcomes. While
aspirin resistance has a conflicting overall significant impact on adverse
outcomes, clopidogrel resistance correlates with poorer clinical
outcomes.<br/>Copyright &#xa9; 2024 Myat Soe Thet et al.

<4>
Accession Number
2030370854
Title
Congenital Gerbode Defect: A Left Ventricular to Right Atrial
Shunt-State-of-the-Art Review of Its General Data, Diagnostic Modalities,
and Treatment Strategies.
Source
Journal of Cardiovascular Development and Disease. 11(6) (no pagination),
2024. Article Number: 166. Date of Publication: June 2024.
Author
Winter L.; Strizek B.; Recker F.
Institution
(Winter, Strizek, Recker) Department of Obstetrics and Prenatal Medicine,
University Hospital Bonn, Venusberg Campus 1, Bonn 53127, Germany
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
The congenital Gerbode defect is defined as an abnormal communication
between the left ventricle and the right atrium. This review aimed to
summarize existing evidence, shed light on the clinical implications, and
identify knowledge gaps. The systematic literature search was conducted in
the PubMed and Google Scholar medical databases using specifically
selected keywords. The inclusion of each publication was assessed
according to predefined eligibility criteria based on the PICOM
(Population, Phenomenon of Interest, Context, Methodology) schema. Titles
and abstracts were screened independently by two authors. Available
full-text versions of included publications were reviewed and relevant
information was extracted. A total of 78 reports were included. The
compilation of all congenital Gerbode defect cases described in the
literature revealed a variety of clinical presentations comprising
dyspnea, palpitations, growth retardation, and asymptomatology. A suitable
multimodal diagnostic approach for newborns consists of auscultation, TTE,
and optionally TEE and MRI. Because of its rarity, diversity of findings,
unknown pathophysiology, and similarity to more common cardiac diseases,
the diagnostic challenge remains significant. To prevent untreated
long-term sequelae, early individualized treatment is recommended.
Surgical defect closure is preferred to device closure for evidence
reasons, although major developments are currently taking place. In
conclusion, the congenital Gerbode defect provides a diagnostic challenge
for pediatricians to allow early diagnosis and intervention in order to
improve patients' quality of life.<br/>Copyright &#xa9; 2024 by the
authors.

<5>
Accession Number
2030026809
Title
Outcomes Following Surgical Repair of Sinus Venosus Atrial Septal Defects:
A Systematic Review and Meta-Analysis.
Source
Journal of the American Heart Association. 13(12) (no pagination), 2024.
Article Number: e033686. Date of Publication: 18 Jun 2024.
Author
El-Andari R.; Moolla M.; John K.; Slingerland A.; Campbell S.; Nagendran
J.; Hong Y.; Mathew A.
Institution
(El-Andari, Nagendran, Hong) Division of Cardiac Surgery, Department of
Surgery, Mazankowski Alberta Heart Institute, Canada
(Moolla, Mathew) Division of Cardiology, Department of Medicine,
Mazankowski Alberta Heart Institute, Canada
(John) University of Alberta, Edmonton, AB, Canada
(John) Division of Internal Medicine, Department of Medicine, Tufts
University, Medford, MA, United States
(Slingerland) Faculty of Medicine and Dentistry, University of Alberta,
Edmonton, AB, Canada
(Campbell) University of Alberta Library, Edmonton, AB, Canada
Publisher
American Heart Association Inc.
Abstract
BACKGROUND: Sinus venosus atrial septal defect (SVASD) is a rare
congenital cardiac anomaly comprising 5% to 10% of all atrial septal
defects. Although surgical closure is the standard treatment for SVASD,
data on outcomes have been confined to small cohorts. Thus, we conducted a
systematic review of the outcomes of SVASD repair. METHODS AND RESULTS:
The primary outcome was death. Secondary outcomes encompassed atrial
fibrillation, sinus node dysfunction, pacemaker insertion, cerebrovascular
accident, reoperation, residual septal defect, superior vena cava
obstruction, and reimplanted pulmonary vein obstruction. Pooled incidences
of outcomes were calculated using a randomeffects model. Forty studies
involving 1320 patients who underwent SVASD repair were included. The
majority were male patients (55.4%), with 88.0% presenting with associated
anomalous pulmonary venous connection. The weighted mean age was
18.6+/-12.5 years, and the overall weighted mean follow-up period was
8.6+/-10.4 years. The in-hospital mortality rate was 0.24%, with a 30-day
mortality rate of 0.5% reported in 780 patients. Incidences of atrial
fibrillation, sinus node dysfunction, pacemaker insertion, and
cerebrovascular accident over the long-term follow-up were 3.3%
(2.18%-4.93%), 6.5% (5.09%-8.2%), 2.23% (1.34%-3.57%), and 2.03%
(0.89%-2.46%) respectively. Reoperation occurred in 1.36% (0.68%-2.42%) of
surgeries, residual septal defect in 1.34% (0.69%-2.42%), superior vena
cava obstruction in 1.76% (1.02%-2.9%), and reimplanted pulmonary vein
obstruction in 1.4% (0.7%-2.49%). <br/>CONCLUSION(S): This is the first
comprehensive analysis of outcomes following surgical repair of SVASD. The
findings affirm the safety and effectiveness of surgery, establishing a
reference point for evaluating emerging transcatheter therapies. Safety
and efficacy profiles comparable to surgical repair are essential for
widespread adoption of transcatheter treatments.<br/>Copyright &#xa9; 2024
The Authors.

<6>
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. 20(3) (pp 137-150), 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. <br/>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. <br/>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.
<br/>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.<br/>Copyright
&#xa9; 2024 Expert Publishing Medicine Ltd trading as Taylor & Francis.

<7>
Accession Number
2029338872
Title
CT radiomic features reproducibility of virtual non-contrast series
derived from photon-counting CCTA datasets using a novel
calcium-preserving reconstruction algorithm compared with standard
non-contrast series: focusing on epicardial adipose tissue.
Source
International Journal of Cardiovascular Imaging. 40(6) (pp 1257-1267),
2024. Date of Publication: June 2024.
Author
Cui M.; Bao S.; Li J.; Dong H.; Xu Z.; Yan F.; Yang W.
Institution
(Cui, Bao, Li, Dong, Yan, Yang) Department of Radiology, Ruijin Hospital
affiliated to School of Medicine, Shanghai Jiao Tong University, Shanghai,
China
(Xu) Siemens Healthineers CT Collaboration, Erlangen, Germany
Publisher
Springer Science and Business Media B.V.
Abstract
Purpose: We aimed to evaluate the reproducibility of computed tomography
(CT) radiomic features (RFs) about Epicardial Adipose Tissue (EAT). The
features derived from coronary photon-counting computed tomography (PCCT)
angiography datasets using the PureCalcium (VNC<inf>PC</inf>) and
conventional virtual non-contrast (VNC<inf>Conv</inf>) algorithm were
compared with true non-contrast (TNC) series. <br/>Method(s): RFs of EAT
from 52 patients who underwent PCCT were quantified using
VNC<inf>PC</inf>, VNC<inf>Conv</inf>, and TNC series. The agreement of EAT
volume (EATV) and EAT density (EATD) was evaluated using Pearson's
correlation coefficient and Bland-Altman analysis. A total of 1530 RFs
were included. They are divided into 17 feature categories, each
containing 90 RFs. The intraclass correlation coefficients (ICCs) and
concordance correlation coefficients (CCCs) were calculated to assess the
reproducibility of RFs. The cutoff value considered indicative of
reproducible features was > 0.75. <br/>Result(s): the VNC<inf>PC</inf> and
VNC<inf>Conv</inf> tended to underestimate EATVs and overestimate EATDs.
Both EATV and EATD of VNC<inf>PC</inf> series showed higher correlation
and agreement with TNC than VNC<inf>Conv</inf> series. All types of RFs
from VNC<inf>PC</inf> series showed greater reproducibility than
VNC<inf>Conv</inf> series. Across all image filters, the Square filter
exhibited the highest level of reproducibility (ICC = 67/90, 74.4%; CCC =
67/90, 74.4%). GLDM_GrayLevelNonUniformity feature had the highest
reproducibility in the original image (ICC = 0.957, CCC = 0.958),
exhibiting a high degree of reproducibility across all image filters.
<br/>Conclusion(s): The accuracy evaluation of EATV and EATD and the
reproducibility of RFs from VNC<inf>PC</inf> series make it an excellent
substitute for TNC series exceeding VNC<inf>Conv</inf>
series.<br/>Copyright &#xa9; The Author(s), under exclusive licence to
Springer Nature B.V. 2024.

<8>
Accession Number
644630038
Title
Intravascular lithotripsy in peripheral lesions with severe calcification
and its use in TAVI procedure - A meta-analysis.
Source
Vasa - European Journal of Vascular Medicine. (no pagination), 2024. Date
of Publication: 2024.
Author
Sagris M.; Ktenopoulos N.; Soulaidopoulos S.; Dimitriadis K.; Papanikolaou
A.; Tzoumas A.; Terentes-Printzios D.; Lichtenberg M.; Korosoglou G.;
Toutouzas K.; Honton B.; Tousoulis D.; Tsioufis K.
Institution
(Sagris, Ktenopoulos, Soulaidopoulos, Dimitriadis, Papanikolaou,
Terentes-Printzios, Toutouzas, Tousoulis, Tsioufis) First Cardiology
Department, Hippokration General Hospital, National and Kapodistrian
University of Athens, School of Medicine, Athens, Greece
(Tzoumas) Department of Internal Medicine, University of Cincinnati,
Medical Center, Cincinnati, OH, United States
(Lichtenberg) Vascular Center Arnsberg, Germany
(Korosoglou) Department of Cardiology, Vascular Medicine and Pneumology,
GRN Hospital, Weinheim, Germany
(Honton) Department of Interventional Cardiology, Clinique Pasteur,
Toulouse, France
Publisher
Hogrefe Verlag GmbH & Co. KG
Abstract
Summary: Background: Heavily calcified peripheral artery lesions increase
the risk of vascular complications, constituting a severe challenge for
the operator during catheter-based cardiovascular interventions.
Intravascular Lithotripsy (IVL) technology disrupts subendothelial
calcification by using localized pulsative sonic pressure waves and
represents a promising technique for plaque modification in patients with
severe calcification in peripheral arteries. <br/>Purpose(s): Our aim was
to systematically review and summarize available data regarding the safety
and efficacy of IVL in preparing severely calcified peripheral arteries
and its use in Transcatheter Aortic Valve Implantation (TAVI).
<br/>Patients and Methods: This study was conducted according to the
PRISMA guidelines. We systematically searched PubMed, SCOPUS, and Cochrane
databases from their inception to February 23, 2023, for studies assessing
the characteristics and outcomes of patients undergoing IVL in the
peripheral vasculature. The diameter of the vessel lumen before and after
IVL was estimated. The occurrence of peri-procedural complications was
assessed using a random-effects model. <br/>Result(s): 20 studies with a
total of 1,223 patients with heavily calcified peripheral lesions were
analysed. The mean age of the cohort was 70.6 +/- 17.4 years. Successful
IVL delivery achieved in 100% (95% CI: 100%-100%, I2 = 0%), with an
increase in the luminal diameter (SMD: 4.66, 95% CI: 3.41-5.92, I2 =
90.8%) and reduction in diameter stenosis (SMD: -4.15, 95% CI: -4.75 to
-3.55, I2 = 92.8%), and a concomitant low rate of complications. The
procedure was free from dissection in 97% (95% CI: 91%-100%, I2 = 81.4%)
while dissections of any type (A, B, C, or D) were observed in 6% (95% CI:
2%-10%, I2 = 85.3%) of the patients. Several rare cases of abrupt closure,
no-reflow phenomenon, perforation, thrombus formation, and distal
embolization were recorded. Finally, the subgroup analysis of patients who
underwent a TAVI with IVL assistance presented successful implantation in
100% (95% CI: 100%-100%, I2 = 0%) of the cases, with only 4% (95% CI:
0%-12%, I2 = 68.96%) presenting dissections of any sort.
<br/>Conclusion(s): IVL seems to be an effective and safe technique for
modifying severely calcified lesions in peripheral arteries and it is a
promising modality in TAVI settings. Future prospective studies are needed
to validate our results.<br/>Copyright &#xa9; 2024 Hogrefe AG.

<9>
Accession Number
644635259
Title
Antithrombotic management after aortic valve replacement with biological
prosthesis: a meta-analysis.
Source
Journal of cardiothoracic surgery. 19(1) (pp 385), 2024. Date of
Publication: 26 Jun 2024.
Author
Uimonen M.; Kuitunen I.; Ponkilainen V.; Mennander A.; Mattila M.S.
Institution
(Uimonen, Mennander, Mattila) Heart Hospital, Tampere University Hospital,
Wellbeing Services County of Pirkanmaa, Tampere 33520, Finland
(Uimonen, Mennander, Mattila) Faculty of Medicine and Health Technology,
Tampere University, Tampere, Finland
(Kuitunen) Institute of Clinical Medicine, University of Eastern Finland,
Kuopio, Finland
(Kuitunen) Department of Pediatrics, Kuopio University Hospital, Kuopio,
Finland
(Ponkilainen) Department of Orthopedics, Tampere University Hospital,
Wellbeing Services County of Pirkanmaa, Tampere, Finland
Abstract
BACKGROUND: We aimed to summarise the existing knowledge regarding
antithrombotic medications following surgical aortic valve replacement
(SAVR) using a biological valve prosthesis. <br/>METHOD(S): We performed a
meta-analysis of studies that reported the results of using antithrombotic
medication to prevent thromboembolic events after SAVR using a biological
aortic valve prosthesis and recorded the outcomes 12 months after surgery.
Since no randomised controlled trials were identified, observational
studies were included. The analyses were conducted separately for periods
of 0-12 months and 3-12 months after surgery. A random effects model was
used to calculate pooled outcome event rates and 95% confidence intervals
(CIs). <br/>RESULT(S): The search yielded eight eligible observational
studies covering 6727 patients overall. The lowest 0- to 12-month
mortality was observed in patients with anticoagulation (2.0%, 95% CI
0.4-9.7%) and anticoagulation combined with antiplatelet therapy (2.2%,
95% CI 0.9-5.5%), and the highest was in patients without antithrombotic
medication (7.3%, 95% CI 3.6-14.2%). Three months after surgery, mortality
was lower in anticoagulant patients (0.5%, 95% CI 0.1-2.6%) than in
antiplatelet patients (3.0%, 95% CI 1.2-7.4%) and those without
antithrombotics (3.5%, 95% CI 1.3-9.3%). There was no eligible evidence of
differences in stroke rates observed among medication strategies. At 0- to
12-month follow-up, all antithrombotic treatment regimens resulted in an
increased bleeding rate (antiplatelet 4.2%, 95% CI 2.9-6.1%;
anticoagulation 7.5%, 95% CI 3.8-14.4%; anticoagulation combined with
antiplatelet therapy 8.3%, 95% CI 5.7-11.8%) compared to no antithrombotic
medication (1.1%, 95% CI 0.4-3.4%). At 3- to 12-month follow-up, there was
up to an eight-fold increase in the bleeding rate in patients with
anticoagulation combined with antiplatelet therapy when compared to those
with no antithrombotic medication. Overall, the evidence certainty was
ranked as very low. <br/>CONCLUSION(S): Although this meta-analysis
reveals that anticoagulation therapy has a beneficial tendency in terms of
mortality at 1 year after biological SAVR and suggests potential
advantages in continuing anticoagulation beyond 3 months, it is limited by
very low evidence certainty. The imperative for cautious interpretation
and the urgent need for more robust randomised research underscore the
complexity of determining optimal antithrombotic strategies in this
patient population.<br/>Copyright &#xa9; 2024. The Author(s).

<10>
Accession Number
2033013978
Title
The Perioperative Period of Heart Transplantation Is Affected by Thyroid
Hormone Status.
Source
Thyroid. 34(6) (pp 774-784), 2024. Date of Publication: 01 Jun 2024.
Author
Szecsi B.; Sinko R.; Vereb A.; Khochanskiy D.; Benke K.; Radovits T.;
Lakatos B.; Koszegi A.; Losoncz E.; Kugler S.; Szabo M.; Merkely B.;
Szekely A.; Gereben B.
Institution
(Szecsi, Vereb, Losoncz) Doctoral School of Theoretical and Translational
Medicine, Semmelweis University, Budapest, Hungary
(Sinko, Gereben) Laboratory of Molecular Cell Metabolism, HUN-REN
Institute of Experimental Medicine, Budapest, Hungary
(Khochanskiy, Szabo) Semmelweis University, Budapest, Hungary
(Benke, Radovits, Lakatos, Koszegi, Kugler, Merkely) Heart and Vascular
Centre, Semmelweis University, Budapest, Hungary
(Szekely) Department of Anesthesiology and Intensive Therapy, Semmelweis
University, Budapest, Hungary
(Szekely) Department of Oxiology and Emergency Care, Semmelweis
University, Budapest, Hungary
Publisher
Mary Ann Liebert Inc.
Abstract
Background: Orthotopic heart transplantation (HTx) is a long-term surgical
therapeutic approach for patients with end-stage heart failure. The
objective of the present study was to uncover associations between altered
thyroid hormone (TH) status and adverse outcomes after HTx.
<br/>Method(s): In this prospective, single-center cohort study, 283
patients underwent HTx between 2013 and 2020 at the Heart and Vascular
Center of Semmelweis University in Hungary. We measured serum free
triiodothyronine (fT3), free thyroxine (fT4), and thyrotropin (TSH) pre-
and postoperatively. TaqMan qPCR was used to measure type 2 deiodinase and
type 3 deiodinase mRNA (Dio2 and Dio3, respectively) levels from the
diseased heart bioptates. To assess the local TH action of the heart, mRNA
levels of Hcn2 and Myh7 were measured in a subgroup of patients receiving
extracorporeal membrane oxygenation (ECMO) postoperatively. Groups were
compared using nonparametric tests. Cox regression analysis and logistic
regression test were used to investigate the outcomes. The connection
between serum TH parameters and cardiac gene expressions was assessed
using linear regression. <br/>Result(s): Serum TSH (p = 0.009), fT3 (p <
0.001), and fT4 (p < 0.001) levels were lower after HTx than
preoperatively. Levothyroxine (LT4) administered to donors was associated
with better survival after 30 days (p = 0.049). LT4 replacement given to
recipients after HTx was associated with better survival after 30 days (p
= 0.018), 1 year (p = 0.002), and 2 years (p = 0.001). Dio3 mRNA level was
significantly increased in patients who were treated with ECMO (p =
0.026), left ventricular assist device (LVAD) (p = 0.008), and
biventricular assist device (BiVAD) (p = 0.013) preoperatively, and ECMO
(p = 0.042) postoperatively, compared with those who did not require any
type of mechanical circulatory support (MCS). We found no significant
difference in the expression of the Hcn2 and Myh7 marker genes between
patients on postoperative ECMO and those without MCS, and neither did they
correlate with serum hormone levels (p = 0.519 and p = 0.056,
respectively). <br/>Conclusion(s): We conclude that TH status plays an
important role in HTx patients, and monitoring of TH status in the
perioperative period may contribute to improved treatment outcomes. Our
findings require independent confirmation in a randomized controlled
clinical trial.<br/>Copyright 2024, Mary Ann Liebert, Inc., publishers.

<11>
Accession Number
2030449183
Title
Recurrence of anterior congenital diaphragmatic hernia after laparoscopic
repair in children.
Source
Pediatric Surgery International. 40(1) (no pagination), 2024. Article
Number: 166. Date of Publication: December 2024.
Author
Oumarou M.; Panait N.; El Khoury E.; Hamidou Z.; Pinol J.; Barila Lompe
P.; Merrot T.; Faure A.; Dariel A.
Institution
(Oumarou, Panait, El Khoury, Pinol, Barila Lompe, Merrot, Faure, Dariel)
Department of Pediatric Surgery, Hopital Timone Enfants, Assistance
Publique des Hopitaux de Marseille, 264, Rue Saint Pierre, Marseille
13385, France
(Hamidou) Department of Epidemiology and Health Economy, Assistance
Publique des Hopitaux de Marseille, Marseille, France
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Purpose: To report our experience with laparoscopic repair of anterior
congenital diaphragmatic hernia (CDH) using extracorporeal subcutaneous
knot tying and to define recurrence risk factors. <br/>Method(s): This
retrospective unicentric study included children who underwent
laparoscopic repair of anterior CDH without patch, using extracorporeal
knot tying of sutures passed through the full thickness of the abdominal
wall (2013-2020). A systematic review of the literature with meta-analysis
was performed using the MEDLINE database since 2000. <br/>Result(s): Eight
children were included (12 months [1-183]; 10.6 kg [3.6-65]). Among the
two patients with Down syndrome, one with previous cardiac surgery had a
recurrence at 17 months postoperatively. In our systematic review (26
articles), among the 156 patients included, 10 had a recurrence (none with
patch). Recurrence was statistically more frequent in patients with Down
syndrome (19.4%) than without (2.5%) (p < 0.0001), and when absorbable
sutures were used (50%) instead of non-absorbable sutures (5.3%) (p <
0.0001). <br/>Conclusion(s): Laparoscopic repair of anterior CDH without
patch was a safe and efficient surgical approach in our patients. The use
of a non-absorbable prosthetic patch should be specifically discussed in
anterior CDH associated with Down syndrome and/or in case of previous
cardiac surgery to perform a diaphragmatic tension-free
closure.<br/>Copyright &#xa9; The Author(s), under exclusive licence to
Springer-Verlag GmbH Germany, part of Springer Nature 2024.

<12>
Accession Number
2033062111
Title
Enterococcus faecalis as a cause of infective endocarditis - systematic
review of case reports.
Source
Medical Studies/Studia Medyczne. 40(2) (pp 216-224), 2024. Date of
Publication: 2024.
Author
Hajdys J.; Bielec F.; Brauncajs M.; Pastuszak-Lewandoska D.
Institution
(Hajdys, Bielec, Brauncajs, Pastuszak-Lewandoska) Department of
Microbiology and Laboratory Medical Immunology, Medical University of
Lodz, Lodz, Poland
Publisher
Termedia Publishing House Ltd.
Abstract
Introduction: Enterococcus bacteria account for nearly 10% of infective
endocarditis (IE), making it the fifth most common cause. Many cases of
enterococcal IE have been described. Aim of the research: To
systematically review these case reports and try to find common features
characterising IE caused by Enterococcus faecalis. <br/>Method(s): In
December 2022, the PubMed, EBSCO, and OVID databases were searched. The
final analysis included 28 publications yielding data on E. faecalis IE,
taken from 89 reported cases. <br/>Result(s) and Conclusion(s): The
systematic review revealed an enhanced mortality rate due to multiple
organ failure in patients with prosthetic valves and numerous
comorbidities. The presence of an artificial valve was associated with an
atypical course of E. faecalis IE. This was similar in patients who had a
history of cancer. Moreover, it was observed that E. faecalis IE in people
< 60 years old was mostly associated with either an atypical presentation
or another disease manifestation.<br/>Copyright &#xa9; 2024 Termedia
Publishing House Ltd.. All rights reserved.

<13>
Accession Number
2033068278
Title
Malignant Pericardial Effusion: A Systematic Review.
Source
CJC Open. (no pagination), 2024. Date of Publication: 2024.
Author
Mudra S.E.; Rayes D.; Kumar A.K.; Li J.Z.; Njus M.; McGowan K.;
Charalampous C.; Kalam K.A.; Syed A.; Majid M.; Schleicher M.; Agrawal A.;
Yesilyaprak A.; Klein A.L.
Institution
(Mudra, Rayes, Kumar, Li, Njus, McGowan, Charalampous, Kalam) Department
of Internal Medicine, MedStar Georgetown University Hospital, MedStar
Health, Washington, DC, United States
(Kumar, Syed, Majid, Agrawal, 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, Cleveland, OH, United States
(Schleicher) Floyd D. Loop Memorial Library, Cleveland Clinic, Cleveland,
OH, United States
(Yesilyaprak) Department of Internal Medicine, Wayne State University,
Detroit, MI, United States
Publisher
Elsevier Inc.
Abstract
Background: Malignant pericardial effusion (Eff) is often asymptomatic and
has an unknown prevalence, due to its occult presentation. The condition
often is identified postmortem on autopsy, and it is associated with a
poor prognosis. Given the late presentation of malignant pericardial Effs,
a minimal volume of literature has examined the epidemiology, clinical
characteristics, and outcomes of these complex patients. We conducted a
systematic review to advance present understanding of this condition.
<br/>Method(s): A search of 4 databases resulted in 41 case reports
meeting criteria. Inclusion criteria were being a patient aged > 18 years
who presented with pericardial Eff in the setting of malignancy.
Intervention was medical and/or surgical therapy, and the outcome was
mortality. <br/>Result(s): For the 41 patients included, the median age
was 54 years, and the majority were male patients (58%). Dyspnea was the
leading symptom (90%), and cardiac tamponade was present in 78% of cases.
Common cancers included lung, gastrointestinal, and renal neoplasms (59%).
Pericardiocentesis occurred in 98% of cases, with a median fluid
extraction volume of 1000 mL. Death occurred in 44%, primarily due to
disease progression and/or metastasis. <br/>Conclusion(s): This study
presents the largest systematic review on malignancy-induced pericardial
Effs to date. Notably, solid tumours, and specifically lung
adenocarcinomas, are common culprits. Malignant pericardial Effs are often
severe, with a majority of patients presenting with cardiac tamponade.
Overall, treatment options are limited, and the associated mortality rate
is high.<br/>Copyright &#xa9; 2024 The Authors

<14>
Accession Number
644638695
Title
Randomized Trial of Cholesterol Lowering With Evolocumab for Cardiac
Allograft Vasculopathy in Heart Transplant Recipients.
Source
JACC. Heart failure. (no pagination), 2024. Date of Publication: 10 Jun
2024.
Author
Broch K.; Lemstrom K.B.; Gustafsson F.; Eiskjaer H.; Karason K.; Gjesdal
G.; Fagerland M.W.; Pentikainen M.; Lommi J.; Gude E.; Andreassen A.K.;
Clemmensen T.S.; Christiansen E.H.; Bjorkelund E.; Berg E.S.; Arora S.;
Gullestad L.
Institution
(Broch, Gullestad) Oslo University Hospital Rikshospitalet, Oslo, Norway;
KG Jebsen Center for Cardiac Research, University of Oslo, Oslo, Norway
(Lemstrom, Pentikainen, Lommi) Helsinki University Hospital Heart and Lung
Center and University of Helsinki, Helsinki, Finland
(Gustafsson) Rigshospitalet-Copenhagen University Hospital, Copenhagen,
Denmark
(Eiskjaer, Clemmensen, Christiansen) Aarhus University Hospital, Aarhus,
Denmark
(Karason) Transplant Institute, Sahlgrenska University Hospital and
Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
(Gjesdal) Cardiology Unit, Department of Clinical Sciences, Lund
University and Department of Heart and Lung Medicine, Skane University
Hospital, Lund, Sweden
(Fagerland) Oslo Center for Biostatistics and Epidemiology, Research
Support Services, Oslo University Hospital, Oslo, Norway
(Gude, Andreassen, Bjorkelund, Berg) Oslo University Hospital
Rikshospitalet, Oslo, Norway
(Arora) Faculty of Medicine, University of Oslo, Oslo, Norway
Abstract
BACKGROUND: Cardiac allograft vasculopathy is characterized by increased
coronary intimal thickness and is a leading cause of death in heart
transplant (HTx) recipients despite the routine use of statins. The
experience with inhibitors of proprotein convertase subtilisin-kexin type
9 in HTx recipients is limited. Our hypothesis was that lowering
cholesterol with the proprotein convertase subtilisin-kexin type
9inhibitor evolocumab would reduce coronary intimal thickness in these
patients without compromising safety. <br/>OBJECTIVE(S): This double
blind, randomized trial was conducted to test whether evolocumab reduces
the burden of cardiac allograft vasculopathy. <br/>METHOD(S): Patients who
had received a cardiac allograft at one of the Nordic transplant centers
within the prior 4 to 8 weeks were randomized to monthly subcutaneous
injections of evolocumab 420 mg or matching placebo. The primary endpoint
was the baseline-adjusted maximal intimal thickness as measured by
intracoronary ultrasound after 12 months' treatment. <br/>RESULT(S): The
trial enrolled 128 patients between June 2019 and May 2022. Matched pairs
of coronary ultrasound images were available for 56 patients assigned to
evolocumab and 54 patients assigned to placebo. At 12 months, the adjusted
mean difference in the maximal intimal thickness between the 2 arms was
0.017 mm (95% CI: -0.006 to 0.040; P = 0.14). The mean reduction in
low-density lipoprotein cholesterol with evolocumab compared with placebo
was 1.11 mmol/L (95% CI: 0.86-1.37 mmol/L). The use of evolocumab was not
associated with an increase in adverse events. <br/>CONCLUSION(S): Twelve
months of treatment with evolocumab substantially reduced low-density
lipoprotein cholesterol but did not reduce maximal coronary intimal
thickness in HTx recipients. (Cholesterol Lowering With EVOLocumab to
Prevent Cardiac Allograft Vasculopathy in De-novo Heart Transplant
Recipients [EVOLVD]; NCT03734211).<br/>Copyright &#xa9; 2024 The Authors.
Published by Elsevier Inc. All rights reserved.

<15>
Accession Number
644638397
Title
A Randomized, Controlled Trial of Continuous Heparin Infusion to Prevent
Asymptomatic Catheter-Related Thrombosis at Discharge in Infants After
Cardiac Surgery: The CHIP-CRT Trial.
Source
Journal of pediatric hematology/oncology. (no pagination), 2024. Date of
Publication: 25 Jun 2024.
Author
Tan Y.; Sun X.; Zhong J.; Zou Y.; Ren Y.; Liu Y.; Zhao L.; Zhuang J.; Wang
S.; Sun Y.; Wang Y.
Institution
(Tan, Sun, Zhong, Zou, Ren, Liu, Zhao, Zhuang, Sun, Wang) Department of
Pediatrics, Guangdong Provincial People's Hospital (Guangdong Academy of
Medical Sciences), Southern Medical University
(Zhuang) Department of Cardiac Surgery, Guangdong Cardiovascular
Institute, Guangzhou, China
(Wang) Capital Medical University Affiliated Anzhen Hospital, Beijing,
China
(Sun) Department of Pediatrics, Shenzhen New Frontier United Family
Hospital, Shenzhen, China
Abstract
OBJECTIVES: There are conflicting results in preventing catheter-related
thrombosis (CRT). Continuing infusion of unfractionated heparin (UFH) was
a potential option for CRT. This study was to determine the effect of
continuous UFH infusion on asymptomatic CRT at discharge in infants after
cardiac surgery. STUDY DESIGN: This study was a randomized,
placebo-controlled, clinical trial at a single center. All infants with
central venous catheters after cardiac surgery, below 3 months of age,
were eligible. Stratified by CRT, infants were randomly assigned to the
UFH group or the normal saline group. UFH was initiated at a speed of 10
to 15 units/kg/h for infants with CRT and 2 to 3 units/kg/h without CRT.
The primary outcome was to determine the rate of CRT at discharge. The
secondary outcomes included thrombosis 6 months after surgery, adverse
events of UFH, and post-thrombotic symptoms. <br/>RESULT(S): Due to slow
recruitment during the COVID-19 pandemic, this trial was prematurely
stopped. Only 35 infants were randomly assigned to the UFH or control
groups. There was no statistically significant difference in CRT rate at
discharge (P=0.429) and 6 months after surgery (P=1.000) between groups.
All CRTs except one disappeared at discharge. No thrombosis or
post-thrombotic symptom was reported at follow-up evaluation. There was no
difference between groups in duration of thrombus (P=0.088), D dimer
(P=0.412), catheter in situ days (P=0.281), and post-thrombotic syndrome
(P=1.000), except for activated partial thromboplastin time (P=0.001).
<br/>CONCLUSION(S): With the early stop of this trial and limited data, it
is difficult to draw a definitive conclusion about the efficacy of UFH on
CRT. Meanwhile, considering the data from 6 months follow-up, in this
population, asymptomatic CRT might resolve with no
intervention.<br/>Copyright &#xa9; 2024 Wolters Kluwer Health, Inc. All
rights reserved.

<16>
Accession Number
644637437
Title
The Best Second Arterial Conduit for Coronary Artery Bypass Grafting: A
Meta-Analysis of Reconstructed Individual Patient Data.
Source
Cardiology in review. (no pagination), 2024. Date of Publication: 27 Jun
2024.
Author
Al-Tawil M.; Alqeeq B.F.; Jaffar-Karballai M.; Khalefa B.B.; Ayyad M.;
AlBandak M.; AboAbdo M.; Sabry H.; Harky A.; Haneya A.
Institution
(Al-Tawil, Ayyad, AlBandak) From the Faculty of Medicine, Al-Quds
University, Jerusalem, Palestine
(Alqeeq, AboAbdo) Faculty of Medicine, Islamic University of Gaza, Gaza,
Palestine
(Jaffar-Karballai) Department of Medicine, St George's University of
London, London, United Kingdom
(Khalefa) Faculty of medicine, Ain shams university, Cairo, Egypt
(Sabry, Harky) Department of Cardiothoracic Surgery, Liverpool Heart and
Chest Hospital, Liverpool, United Kingdom
(Haneya) Department of Cardiac and Thoracic Surgery, Heart Center Trier,
Trier, Germany
Abstract
Multiple arterial conduit revascularization in coronary bypass surgery is
being advocated over the use of venous conduits. However, there is a
critical gap regarding the optimal sequence of arterial conduit selection
following the left internal thoracic artery. This study is the first
individual patient data meta-analysis, which aimed to compare the right
internal thoracic artery (RITA) versus the radial artery (RA) as a
second-best arterial conduit. A comprehensive literature search was
conducted in MEDLINE, Embase, Scopus, and CENTRAL. A forward-backward
citation check was performed to identify other relevant studies. The study
protocol was registered in the PROSPERO (CRD42023455543). Eligible studies
included randomized controlled trials and propensity-score-matched cohort
studies reporting long-term outcomes (>3 years) after coronary bypass
surgery using the RITA versus RA as the second arterial conduit after left
internal thoracic artery. Overall, long-term survival between the RITA and
RA groups showed no significant difference. Landmark analyses demonstrated
the superiority of RITA as a second arterial conduit at 1 [hazard ratio
(HR): 0.86 (95% CI, 0.75-0.99), P = 0.036], 2 [0.83 (95% CI, 0.72-0.96), P
= 0.011], and 5 years [HR: 0.80 (95% CI, 0.68-0.95), P = 0.036]
post-surgery. Freedom from major cardiovascular events was significantly
higher using the RITA conduit [HR: 0.72 (95% CI, 0.59-0.89), P = 0.002].
This study supports the use of RITA, especially when used in a
skeletonized in situ fashion, as a second choice following the left
internal thoracic artery as it has the potential to enhance long-term
survival and outcomes. Further research with standardized surgical
techniques is warranted.<br/>Copyright &#xa9; 2024 Wolters Kluwer Health,
Inc. All rights reserved.

<17>
Accession Number
2030344868
Title
Efficacy and safety of drug-coated balloons in chronic total coronary
occlusion recanalization: a systematic review and meta-analysis.
Source
BMC Cardiovascular Disorders. 24(1) (no pagination), 2024. Article Number:
324. Date of Publication: December 2024.
Author
Zhao Y.; Wang P.; Zheng Z.; Ma Q.; Shi Y.; Liu J.
Institution
(Zhao, Wang, Zheng, Ma, Shi, Liu) Center for Coronary Artery
Disease(CCAD), Beijing Anzhen Hospital, Capital Medical University,
Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing, China
Publisher
BioMed Central Ltd
Abstract
Background: With advancements in chronic total coronary occlusion (CTO)
recanalization techniques and concepts, the success rate of recanalization
has been steadily increasing. However, the current data are too limited to
draw any reliable conclusions about the efficacy and safety of drug-coated
balloons (DCBs) in CTO percutaneous coronary intervention (PCI). Herein,
we conducted a meta-analysis to confirm the efficacy of DCB in CTO PCI.
<br/>Method(s): We systematically searched PubMed, Web of Science and
Embase from inception to July 25, 2023. The primary outcome was major
advent cardiovascular events (MACE), including cardiac death, nonfatal
myocardial infarction (MI), target lesion revascularization (TLR), and
target vessel revascularization (TVR). The follow-up angiographic
endpoints were late lumen enlargement (LLE), reocclusion and restenosis.
<br/>Result(s): Five studies with a total of 511 patients were included in
the meta-analysis. Across studies, patients were predominantly male
(72.9-85.7%) and over fifty years old. The summary estimate rate of MACE
was 13.0% (95% CI 10.1%-15.9%, I² = 0%, p = 0.428). The summary
estimate rates of cardiac death and MI were 2.2% (95% CI 0.7%-3.7%,
I² = 0%, p = 0.873) and 1.2% (95% CI -0.2-2.6%, I² =
13.7%, p = 0.314), respectively. Finally, the pooled incidences of TLR and
TVR were 10.1% (95% CI 5.7%-14.5%, I² = 51.7%, p = 0.082) and
7.1% (95% CI 3.0%-11.2%, I² = 57.6%, p = 0.070), respectively.
Finally, the summary estimate rates of LLE, reocclusion and restenosis
were 59.4% (95% CI 53.5-65.3%, I² = 0%, p = 0.742), 3.3% (95%
CI 1.1-5.4%, I² = 0%, p = 0.865) and 17.5% (95% CI 12.9-22.0%,
I² = 0%, p = 0.623), respectively. <br/>Conclusion(s):
Accordingly, DCB has the potential to be used as a treatment for CTO in
suitable patients.<br/>Copyright &#xa9; The Author(s) 2024.

<18>
[Use Link to view the full text]
Accession Number
2032993297
Title
Immediate vs. multistage revascularization of non-infarct coronary
artery(-ies) in patients with hemodynamically stable multivessel disease
acute myocardial infarction: a systematic review and meta-analysis.
Source
Coronary Artery Disease. 35(5) (pp 422-437), 2024. Date of Publication: 01
Aug 2024.
Author
Oli P.R.; Shrestha D.B.; Dawadi S.; Shtembari J.; Regmi L.; Pant K.;
Shrestha B.; Mattumpuram J.; Katz D.H.
Institution
(Oli, Regmi) Department of Internal Medicine, Province Hospital, Surkhet,
Karnali province, Birendranagar, Nepal
(Shrestha, Shtembari) Department of Internal Medicine, Mount Sinai
Hospital, Chicago, IL, United States
(Dawadi) Department of Internal Medicine, Nepalese Army Institute of
Health Sciences, Kathmandu, Nepal
(Pant) Department of Internal Medicine, Division of Cardiovascular
Medicine, University of Illinois, College of Medicine, OSF Healthcare,
Peoria, IL, United States
(Shrestha, Katz) Division of Cardiology, Department of Internal Medicine,
Bassett Medical Center, Cooperstown, NY, United States
(Mattumpuram) Division of Cardiology, Department of Internal Medicine,
University of Louisville, School of Medicine, Louisville, KY, United
States
Publisher
Lippincott Williams and Wilkins
Abstract
Background Untreated multivessel disease (MVD) in acute myocardial
infarction (AMI) has been linked to a higher risk of recurrent ischemia
and death within one year . Current guidelines recommend percutaneous
coronary intervention (PCI) for significant non-infarct artery (-ies)
(non-IRA) stenosis in hemodynamically stable AMI patients with MVD, either
during or after successful primary PCI, within 45-days. However, deciding
the timing of revascularization for non-IRA in cases of MVD is uncertain.
Methods This meta-analysis was performed based on PRISMA guidelines after
registering in PROSPERO (CRD42023472652). Databases were searched for
relevant articles published before 10 November 2023. Pertinent data from
the included studies were extracted and analyzed using RevMan v5.4.
Results Out of 640 studies evaluated, there were 13 RCTs with 5144
patients with AMI with MVD. The immediate non-IRA PCI is associated with a
significantly lower occurrence of unplanned ischemia-driven PCI (OR 0.60;
confidence interval [CI] 0.44-0.83) and target-vessel revascularization
(OR 0.72; CI 0.53-0.97) . Although there is a favorable trend for major
adverse cardiovascular and cerebrovascular events (MACCE), nonfatal AMI,
cerebrovascular events, and major bleeding in the immediate non-culprit
artery (-ies) PCI, those were statistically non-significant. Similarly,
all-cause mortality, cardiovascular mortality, stent thrombosis, and acute
renal insufficiency did not show significant differences between two
groups. Conclusion Among hemodynamically stable patients with multivessel
AMI, the immediate PCI strategy was superior to the multistage PCI
strategy for the unplanned ischemia-driven PCI and target-vessel
revascularization while odds are favorable in terms of MACCE, nonfatal
AMI, cerebrovascular events, and major bleeding at longest
follow-up.<br/>Copyright &#xa9; 2024 Wolters Kluwer Health, Inc. All
rights reserved.

<19>
Accession Number
2032956631
Title
Noninvasive imaging modalities in coronary artery disease: a meta analysis
comparing coronary computed tomography angiography and standard of care.
Source
Future Cardiology. 20(2) (pp 81-88), 2024. Date of Publication: 2024.
Author
Dani A.; Shah P.; Desai D.
Institution
(Dani, Shah, Desai) Shri Nathiba Hargovandas Lakhmichand Municipal Medical
College, Ahmedabad 380006, India
Publisher
Taylor and Francis Ltd.
Abstract
Introduction: Coronary artery disease has become a global pandemic and a
major cause of death. The risk-factor calculation for coronary artery
damage is an invasive procedure. <br/>Aim(s): To compare coronary computed
tomography angiography (CCTA) with standard of care (SOC) to calculate
need for revascularization, invasive coronary angiography as well as for
myocardial infarction (MI) incidence and all-cause mortality. Methodology,
results & conclusion: CCTA is significantly correlated with a reduction in
MI episodes (RR = 0.752, 95% CI = 0.578-1.409; p < 0.033) and an increase
in revascularizations (RR = 1.401, 95% CI = 1.315-1.492; p < 0.001) and
invasive coronary angiography procedures (RR = 1.304, 95% CI =
1.208-1.409; p < 0.001). However, it was found that it did not affect
all-cause mortality. On the contrary, standard care approaches were
associated with greater rates of MI but lesser referrals for invasive
coronary angiography and revascularization.<br/>Copyright &#xa9; 2024
Expert Publishing Medicine Ltd trading as Taylor & Francis.

<20>
Accession Number
2030026819
Title
Skeletonized Versus Pedicled Harvesting of the Internal Thoracic Artery
and Long-Term Clinical Outcomes in Coronary Artery Bypass Surgery.
Source
Journal of the American Heart Association. 13(12) (no pagination), 2024.
Article Number: e034354. Date of Publication: 18 Jun 2024.
Author
Dalen M.; Dismorr M.; Glaser N.; Sartipy U.
Institution
(Dalen, Sartipy) Department of Cardiothoracic Surgery, Karolinska
University Hospital, Stockholm, Sweden
(Dalen, Dismorr, Glaser, Sartipy) Department of Molecular Medicine and
Surgery, Karolinska Institutet, Stockholm, Sweden
(Glaser) Department of Cardiology, Stockholm South General Hospital,
Stockholm, Sweden
Publisher
American Heart Association Inc.
Abstract
BACKGROUND: The internal thoracic artery (ITA) is the most important
conduit for coronary artery bypass grafting. Recent evidence suggests that
skeletonized ITA harvesting yields long-term outcomes inferior to those of
pedicled harvesting. The aim was to investigate the impact of the ITA
harvesting method on 10-year mortality and major adverse cardiovascular
events. METHODS AND RESULTS: In this observational cohort study, we
identified all patients from the SWEDEHEART (Swedish WebSystem for
Enhancement and Development of Evidence-Based Care in Heart Disease
Evaluated According to Recommended Therapies) register who underwent
isolated coronary artery bypass grafting using at least 1 ITA at
Karolinska University Hospital from 2012 to 2021. The main outcome was
all-cause mortality, and the secondary outcomes were a combination of
myocardial infarction, repeat revascularization, heart failure, and
stroke. Outcomes were ascertained using national health data registers and
compared between the skeletonized and pedicled groups using weighted
flexible parametric survival models. Among 3267 patients, 1657 (51%)
underwent pedicled ITA harvesting and 1610 (49%) underwent skeletonized
ITA harvesting. The patients' mean age was 66 years, and 15% were women.
The weighted all-cause mortality incidence rate in the pedicled versus
skeletonized ITA group was 2.6% (95CI, 2.2%-3.0%) versus 2.6% (95% CI,
2.2%-3.1%), respectively (hazard ratio (HR), 1.01 [95% CI, 0.81-1.27]).
The weighted major adverse cardiovascular events incidence rate was 7.8%
(95% CI, 7.1%-8.6%) versus 7.5% (95% CI, 6.7%-8.4%), respectively (HR,
0.94 [95% CI, 0.82-1.08]). <br/>CONCLUSION(S): We found no significant
differences in all-cause mortality or major adverse cardiovascular events
rates between the 2 ITA harvesting methods.<br/>Copyright &#xa9; 2024 The
Authors.

<21>
Accession Number
2029413021
Title
Rationale and Design of the IMPROVE Trial: A Multicenter, Randomized,
Controlled, Open-label, Blinded-endpoint Trial Assessing the Efficacy of
Remote Ischemic Conditioning in Patients Undergoing Off-Pump Coronary
Artery Bypass Grafting.
Source
Advances in Therapy. 41(7) (pp 3003-3012), 2024. Date of Publication: July
2024.
Author
Yan Y.; Zhao C.; Niu J.; Yan P.; Li J.; Wang D.; Li G.
Institution
(Yan, Zhao, Niu, Yan, Li, Wang) Department of Cardiovascular Surgery, The
First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
(Li) Department of Cardiovascular Surgery, People's Hospital of Qinghai
Province, Xining, China
(Wang) Department of Clinical Sciences, Liverpool School of Tropical
Medicine, Pembroke Place, Liverpool, United Kingdom
(Wang) Department of Neurology, Guangdong Key Laboratory of Age-Related
Cardiac and Cerebral Diseases, Affiliated Hospital of Guangdong Medical
University, Zhanjiang, China
(Li) Department of Cardiovascular Medicine, The First Affiliated Hospital
of Xi'an Jiaotong University, Xi'an, China
Publisher
Adis
Abstract
Introduction: Despite the appearance of off-pump coronary artery bypass
grafting (CABG), ischemia-reperfusion injury (IRI) in the perioperative
period still arouses concerns of clinicians. Remote ischemic conditioning
(RIC) is the process of repeated ischemia and reperfusion in the
peripheral vessels, which is proven to reduce IRI in vital organs.
However, the effect of RIC in patients undergoing off-pump CABG is still
unclear. <br/>Method(s): This IMPROVE trial is a national, multicenter,
randomized, controlled, open-label, blinded-endpoint clinical trial
designed to assess whether RIC intervention can improve short-term
prognosis of patients undergoing off-pump CABG. It plans to enroll 648
patients who will be randomly assigned into a RIC group or control group.
Patients in the RIC group will receive four cycles of 5 min of
pressurization (about 200 mmHg) and 5 min of rest in the 3 days before and
7 days after the surgery. Planned Outcomes: The primary outcome is the
occurrence of major adverse cardiovascular and cerebrovascular events
(MACCE) within the 3-month follow-up. MACCE is defined as all-cause death,
myocardial infarction, stroke, and coronary revascularization surgery.
Clinical Trial Registration: NCT06141525
(ClinicalTrials.gov).<br/>Copyright &#xa9; The Author(s), under exclusive
licence to Springer Healthcare Ltd., part of Springer Nature 2024.

<22>
Accession Number
2033023387
Title
Evidence-based interventions to improve sleep quality after thoracic
surgery:A retrospective analysis of clinical studies.
Source
Sleep Medicine. 121 (pp 85-93), 2024. Date of Publication: September 2024.
Author
Lin J.; Wang B.; Zeng W.; Zhuang S.; Liu M.; Yang J.
Institution
(Lin, Wang, Zeng, Zhuang, Liu, Yang) Department of Pharmacy, Fujian
Medical University Union Hospital, Fuzhou, China
(Lin, Wang, Zeng, Zhuang, Liu, Yang) College of Pharmacy, Fujian Medical
University, Fuzhou, China
Publisher
Elsevier B.V.
Abstract
Objective: To investigate and rank the evidence for the efficacy of
interventions in improving sleep quality after cardiac surgery using
comprehensive comparisons. <br/>Background(s): Clinical evidence suggests
that over 80 % of adult cardiac surgery patients experience sleep
disturbances during the first week postoperatively. While certain
interventions have been shown to improve post-thoracic surgery sleep
quality, a systematic description of the effects of these varied
interventions is lacking. <br/>Method(s): This systematic search was
conducted across PubMed, Web of Science, Cochrane, Embase, and CINAHL
databases to collate all published randomized clinical trials as evidence.
Two researchers independently extracted pertinent information from
eligible trials and assessed the quality of included studies. Based on
statistical heterogeneity, traditional meta-analysis using fixed or
random-effects models was employed to assess the efficacy of
interventions, and a Frequentist network meta-analysis using a consistency
model was conducted to rank the effectiveness of intervention protocols.
<br/>Result(s): Our review incorporated 37 articles (n = 3569),
encompassing 46 interventions, including 9 reports on pharmacological
interventions (24.3 %), 28 on non-pharmacological interventions (75.7 %),
and 5 on anesthetic management interventions (13.5 %). The analysis
indicated the efficacy of Benson's relaxation technique, Progressive
muscle relaxation, Education, Aromatherapy, Acupressure, Massage, and Eye
masks in enhancing postoperative sleep quality. Specifically, Benson's
relaxation technique (cumulative ranking curve area: 0.80; probability:
98.3 %) and Acupressure (cumulative ranking curve area: 0.96; probability:
58.3 %) were associated with the highest probability of successfully
improving postoperative sleep quality, while Progressive muscle relaxation
(cumulative ranking curve area: 0.70; probability: 35.2 %) and Eye masks
(cumulative ranking curve area: 0.81; probability: 78.8 %) were considered
secondary options. Eye masks and Massage significantly reduced
postoperative sleep latency, with Eye masks (cumulative ranking curve
area: 0.82; probability: 51.0 %) being most likely to enhance sleep
quality postoperatively, followed by Massage (cumulative ranking curve
area: 0.60; probability: 27.2 %). Education, Music, Massage, Eye masks,
and Handholding were effective in alleviating pain intensity, with
Education being most likely to successfully reduce postoperative pain
(cumulative ranking curve area: 0.92; probability: 54.3 %), followed by
Music (cumulative ranking curve area: 0.91; probability: 54 %).
<br/>Conclusion(s): Our findings can be utilized to optimize strategies
for managing post-thoracic surgery sleep disturbances and to develop
evidence-based approaches for this purpose. Benson's relaxation technique,
Progressive muscle relaxation, Education, Aromatherapy, Acupressure,
Massage, and Eye masks significantly improve sleep quality in
postoperative patients. Key: disorders of initiating and maintaining
sleep, sleep wake disorders, thoracic surgical procedures, cardiac
surgical procedures, sleep quality, pain, network
meta-analysis.<br/>Copyright &#xa9; 2024 Elsevier B.V.

<23>
Accession Number
2033050472
Title
The 2023 American Association for Thoracic Surgery (AATS) Expert Consensus
Document: Management of subsolid lung nodules.
Source
Journal of Thoracic and Cardiovascular Surgery. (no pagination), 2024.
Date of Publication: 2024.
Author
Chen H.; Kim A.W.; Hsin M.; Shrager J.B.; Prosper A.E.; Wahidi M.M.; Wigle
D.A.; Wu C.C.; Huang J.; Yasufuku K.; Henschke C.I.; Suzuki K.; Tailor
T.D.; Jones D.R.; Yanagawa J.
Institution
(Chen) Division of Thoracic Surgery, Department of Surgery, Fudan
University Shanghai Cancer Center, Shanghai, China
(Kim) Division of Thoracic Surgery, Department of Surgery, University of
Southern California, Los Angeles, Calif, United States
(Hsin) Department of Cardiothoracic Surgery, Queen Mary Hospital, Hong
Kong Special Administrative Region, Hong Kong
(Shrager) Division of Thoracic Surgery, Department of Cardiothoracic
Surgery, Stanford University School of Medicine, Stanford, Calif, United
States
(Prosper) Division of Cardiothoracic Imaging, Department of Radiological
Sciences, University of California at Los Angeles, Los Angeles, Calif,
United States
(Wahidi) Section of Interventional Pulmnology, Division of Pulmonology and
Critical Care, Department of Medicine, Northwestern University Feinberg
School of Medicine, Chicago, Ill, United States
(Wigle) Division of Thoracic Surgery, Department of Surgery, Mayo Clinic,
Rochester, Minn, United States
(Wu) Division of Diagnostic Imaging, Department of Thoracic Imaging, MD
Anderson Cancer Center, Houston, Tex, United States
(Huang, Jones) Division of Thoracic Surgery, Department of Surgery,
Memorial Sloan Kettering Cancer Center, New York, NY, United States
(Yasufuku) Division of Thoracic Surgery, Department of Surgery, Toronto
General Hospital, University Health Network, Toronto, ON, Canada
(Henschke) Department of Radiology, Icahn School of Medicine at Mount
Sinai, New York, NY, United States
(Suzuki) Department of General Thoracic Surgery, Juntendo University
Hospital, Tokyo, Japan
(Tailor) Division of Cardiothoracic Imaging, Department of Radiology, Duke
Health, Durham, NC, United States
(Yanagawa) Division of Thoracic Surgery, Department of Surgery, David
Geffen School of Medicine at the University of California at Los Angeles,
Los Angeles, Calif, United States
Publisher
Elsevier Inc.
Abstract
Objective: Lung cancers that present as radiographic subsolid nodules
represent a subtype with distinct biological behavior and outcomes. The
objective of this document is to review the existing literature and report
consensus among a group of multidisciplinary experts, providing specific
recommendations for the clinical management of subsolid nodules.
<br/>Method(s): The American Association for Thoracic Surgery Clinical
Practice Standards Committee assembled an international, multidisciplinary
expert panel composed of radiologists, pulmonologists, and thoracic
surgeons with established expertise in the management of subsolid nodules.
A focused literature review was performed with the assistance of a medical
librarian. Expert consensus statements were developed with class of
recommendation and level of evidence for each of 4 main topics: (1)
definitions of subsolid nodules (radiology and pathology), (2)
surveillance and diagnosis, (3) surgical interventions, and (4) management
of multiple subsolid nodules. Using a modified Delphi method, the
statements were evaluated and refined by the entire panel. <br/>Result(s):
Consensus was reached on 17 recommendations. These consensus statements
reflect updated insights on subsolid nodule management based on the latest
literature and current clinical experience, focusing on the correlation
between radiologic findings and pathological classifications,
individualized subsolid nodule surveillance and surgical strategies, and
multimodality therapies for multiple subsolid lung nodules.
<br/>Conclusion(s): Despite the complex nature of the decision-making
process in the management of subsolid nodules, consensus on several key
recommendations was achieved by this American Association for Thoracic
Surgery expert panel. These recommendations, based on evidence and a
modified Delphi method, provide guidance for thoracic surgeons and other
medical professionals who care for patients with subsolid
nodules.<br/>Copyright &#xa9; 2024 The Authors

<24>
Accession Number
2033050267
Title
Hypothermia for expanded criteria organ donors in kidney transplantation
in France (HYPOREME): a multicentre, randomised controlled trial.
Source
The Lancet Respiratory Medicine. (no pagination), 2024. Date of
Publication: 2024.
Author
Canet E.; Brule N.; Pere M.; Feuillet F.; Blancho G.; Martin-Lefevre L.;
Garandeau C.; Asehnoune K.; Rozec B.; Duveau A.; Dube L.; Pierrot M.;
Humbert S.; Tirot P.; Boyer J.-M.; Labadie F.; Robert R.; Benard T.;
Kerforne T.; Thierry A.; Lesieur O.; Vincent J.-F.; Lesouhaitier M.;
Larmet R.; Vigneau C.; Goepp A.; Bouju P.; Quentin C.; Egreteau P.-Y.;
Huet O.; Renault A.; Le Meur Y.; Venhard J.-C.; Buchler M.; Voellmy M.-H.;
Herve F.; Schnell D.; Courte A.; Glotz D.; Amrouche L.; Hazzan M.; Kamar
N.; Moal V.; Bourenne J.; Le Quintrec M.; Morelon E.; Kamel T.; Grimbert
P.; Heng A.-E.; Merville P.; Garin A.; Hiesse C.; Fermier B.; Mousson C.;
Guyot-Colosio C.; Bouvier N.; Rerolle J.-P.; Durrbach A.; Drouin S.;
Caillard S.; Frimat L.; Girerd S.; Albano L.; Rostaing L.; Bertrand D.;
Hertig A.; Westeel P.-F.; Montini F.; Delpierre E.; Dorez D.; Alamartine
E.; Ouisse C.; Sebille V.; Reignier J.
Publisher
Elsevier Ltd
Abstract
Background: Expanded criteria donors help to increase graft availability,
but provide organs with an increased risk of delayed graft function. We
aimed to investigate whether donor hypothermia decreases the risk of
delayed graft function compared with normothermia. <br/>Method(s): We did
this multicentre, randomised, controlled, parallel-arm trial at 53
intensive care units and transplant centres in France. We included
expanded criteria donors in whom death was diagnosed based on neurological
criteria, in compliance with French law, and the recipients of their
kidney grafts. Eligible expanded criteria donors were older than 60 years
or were aged 50-59 years and had at least two other risk factors (history
of hypertension, creatinine >132 mumol/L, or cerebrovascular cause of
death). Donors were randomly assigned to hypothermia (34-35degreeC) or
normothermia (36.5-37.5degreeC). Machine perfusion was used routinely.
Randomisation was done using a computer-generated, interactive,
web-response system, in permuted blocks (block size six), stratified by
centre. Outcome assessors were masked; investigator masking was not
feasible. The primary outcome was the proportion of kidney recipients with
delayed graft function, defined as renal replacement therapy within 7 days
after transplantation, assessed in the modified intention-to-treat (mITT)
population, which included all recipients who received at least one kidney
from an expanded criteria donor, with the exception of those under
guardianship. Secondary outcomes in expanded criteria donors were the
number of organs recovered and transplanted, kidney function, body
temperature, total volume of fluids administered, blood pressure and need
for vasopressors and inotropes, and adverse events (cardiovascular events,
metabolic disturbances, and coagulation disorders). Secondary outcomes in
kidney recipients were duration of hospital stay, kidney graft function
and vital status at day 7, day 28, 3 months, and 1 year after
transplantation, and adverse events (infections, cardiovascular events,
and surgical complications). Secondary outcomes were assessed in the mITT
population. The trial was registered at ClinicalTrials.gov, NCT03098706.
<br/>Finding(s): Between Nov 9, 2017, and March 3, 2021, 365 donors were
randomly assigned, of whom 298 (151 [51%] male, 147 [49%] female) provided
kidneys to 526 recipients (323 [61%] male, 203 [39%] female). 251
recipients in the hypothermia group and 275 recipients in the normothermia
group were included in the analysis. Graft function was delayed in 40
(16%) of 251 recipients in the hypothermia group and 58 (21%) of 275
recipients in the normothermia group (odds ratio 0.71 [95% CI 0.44-1.13];
p=0.14; absolute difference -5.2% [95% CI 11.8-1.5]). Compared with donors
in the normothermia group, donors in the hypothermia group had higher
highest mean arterial pressure (115 mm Hg [SD 22] vs 108 mm Hg [20];
p=0.001). 1 year after transplantation, recipients in the hypothermia
group had a lower mean creatinine concentration (152.4 mumol/L [SD 59.1]
vs 169.7 mumol/L [51.4]; p=0.0351) and a higher mean creatinine clearance
(42.3 mL/min/1.73 m² [15.8] vs 40.5 mL/min/1.73 m²
[17.9]; p=0.0414) than those in the normothermia group. No significant
differences between groups were identified for any other secondary
outcomes. <br/>Interpretation(s): Hypothermia in expanded criteria donors
whose organs were routinely stored using machine perfusion did not
decrease the frequency of delayed kidney graft function. However,
hypothermia was associated with a lower serum creatinine concentration and
a higher creatinine clearance 1 year after transplantation.
<br/>Funding(s): French Ministry of Health and French Intensive Care
Society.<br/>Copyright &#xa9; 2024 Elsevier Ltd

<25>
Accession Number
2030436268
Title
Empagliflozin to prevent post-operative atrial fibrillation in patients
undergoing coronary artery bypass graft surgery: Rationale and design of
the EMPOAF trial.
Source
PACE - Pacing and Clinical Electrophysiology. (no pagination), 2024. Date
of Publication: 2024.
Author
Aghakouchakzadeh M.; Hosseini K.; Haghjoo M.; Mirzabeigi P.; Tajdini M.;
Talasaz A.H.; Jalali A.; Askarinejad A.; Kohansal E.; Hedayat B.; Parvas
E.; Bozorgi A.; Bagheri J.; Givtaj N.; Hadavand N.; Hajighasemi A.; Tafti
S.H.A.; Hosseini S.; Sadeghipour P.; Kakavand H.
Institution
(Aghakouchakzadeh, Hosseini, Tajdini, Talasaz, Hedayat, Parvas, Bozorgi,
Bagheri, Hajighasemi, Tafti) Tehran Heart Center, Tehran University of
Medical Sciences, Tehran, Iran, Islamic Republic of
(Hosseini, Tajdini, Jalali) Cardiovascular Diseases Research Institute,
Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran,
Islamic Republic of
(Haghjoo) Cardiac Electrophysiology Research Center, Rajaie Cardiovascular
Medical and Research Center, Iran University of Medical Sciences, Tehran,
Iran, Islamic Republic of
(Mirzabeigi, Kakavand) Department of Clinical Pharmacy and
Pharmacoeconomics, Faculty of Pharmacy, Iran University of Medical
Sciences, Tehran, Iran, Islamic Republic of
(Talasaz) Department of Clinical Pharmacy, School of Pharmacy, Tehran
University of Medical Sciences, Tehran, Iran, Islamic Republic of
(Askarinejad, Kohansal, Hadavand, Kakavand) Rajaie Cardiovascular Medical
and Research Center, Iran University of Medical Sciences, Tehran, Iran,
Islamic Republic of
(Givtaj, Hosseini) Heart Valve Disease Research Center, Rajaie
Cardiovascular Medical and Research Center, Iran University of Medical
Sciences, Tehran, Iran, Islamic Republic of
(Sadeghipour) Vascular Disease and Thrombosis Research Center, Rajaie
Cardiovascular Medical and Research Institute, Tehran, Iran, Islamic
Republic of
Publisher
John Wiley and Sons Inc
Abstract
Background: Postoperative atrial fibrillation (POAF) is one of the most
common types of acute AF and can complicate the treatment course of
approximately one third of patients undergoing cardiac surgery.
Sodium-glucose cotransporter-2 (SGLT2) inhibitors are among the newest
antidiabetic drugs which can be therapeutic options for preventing POAF by
different mechanisms. <br/>Method(s): Empagliflozin to Prevent POAF
(EMPOAF) is an interventional, investigator-initiated, double-blind,
placebo-controlled, multicenter, randomized controlled trial which will be
conducted in two referral teaching cardiology hospitals in Tehran.
Four-hundred ninety-two adult patients who are scheduled for elective
isolated coronary artery bypass graft (CABG) surgery will be randomly
assigned to one of the groups of intervention (empagliflozin 10 mg daily)
or placebo starting at least 3 days before surgery until discharge. Key
exclusion criteria are a history of diabetes mellitus, AF, ketoacidosis,
or recurrent urinary tract infections along with severe renal or hepatic
impairment, unstable hemodynamics, and patients receiving SGLT2 inhibitors
for another indication. The primary outcome will be the incidence of POAF.
Key secondary endpoints will be the composite rate of life-threatening
arrhythmias, postoperative acute kidney injury, hospitalization length,
in-hospital mortality, stroke, and systemic embolization. Key safety
endpoints will be the rate of life-threatening and/or genitourinary tract
infections, hypoglycemia, and ketoacidosis. <br/>Conclusion(s): EMPOAF
will prospectively evaluate whether empagliflozin 10 mg daily can reduce
the rate of POAF in patients undergoing elective CABG. Enrolment into this
study has started by November 2023 and is expected to be ended before the
end of 2025.<br/>Copyright &#xa9; 2024 Wiley Periodicals LLC.

<26>
Accession Number
2030436227
Title
Left versus right ventricular pacing during TAVR and balloon aortic
valvuloplasty: A systematic review and meta-analysis.
Source
PACE - Pacing and Clinical Electrophysiology. (no pagination), 2024. Date
of Publication: 2024.
Author
Khalefa B.B.; Ayyad M.; Albandak M.; Ayyad A.; Yassin M.N.A.; Awad A.K.
Institution
(Khalefa, Awad) Faculty of Medicine, Ain Shams University, Cairo, Egypt
(Ayyad, Albandak, Ayyad) Faculty of Medicine, Al-Quds University,
Jerusalem, Palestine
(Yassin) Faculty of Medicine, Cairo University, Cairo, Egypt
Publisher
John Wiley and Sons Inc
Abstract
Introduction: While right ventricular pacing (RVP) is the conventional
temporary pacing modality used for transcatheter aortic valve replacement
(TAVR), this approach possesses inherent risks and procedural challenges.
We aim to assess and compare the safety and efficacy of left ventricular
pacing (LVP) and RVP during TAVR and balloon aortic valvuloplasty (BAV).
<br/>Method(s): Following PRISMA guidelines, a comprehensive literature
search was conducted in four databases from inception to December 15th,
2023. We included observational studies and clinical trials comparing LVP
with RVP during TAVR and BAV procedures. Primary outcomes included
short-term mortality, mortality due to cardiac tamponade, and procedural
complications including bleeding, vascular complications, and cardiac
tamponade. Secondary outcomes comprised procedure duration and length of
hospital stay. <br/>Result(s): Five studies involving 830 patients with
RVP and 1577 with LVP were included. Short-term mortality was
significantly higher in the RVP group (RR 2.32, 95% CI: [1.37-3.93], P
=.002), as was the incidence of cardiac tamponade (RR 2.19, 95% CI:
[1.11-4.32], P =.02). LVP demonstrated shorter hospital stays (MD = 1.34
d, 95% CI: [0.90, 1.78], P <.001) and reduced procedure duration (MD =
7.75 min, 95% CI: [5.08, 10.41], P <.00001) compared to RVP. New pacemaker
implantation was higher in the RVP group (RR 2.23, 95% CI: [1.14, 4.39], P
=.02). <br/>Conclusion(s): LVP during TAVR and BAV emerges a safer
alternative to RVP, offering reduced mortality, hospital stays, and
procedure durations.<br/>Copyright &#xa9; 2024 Wiley Periodicals LLC.

<27>
Accession Number
644625230
Title
Heart failure with preserved ejection fraction management: a systematic
review of clinical practice guidelines and recommendations.
Source
European heart journal. Quality of care & clinical outcomes. (no
pagination), 2024. Date of Publication: 25 Jun 2024.
Author
Mahmood A.; Dhall E.; Primus C.P.; Gallagher A.; Zakeri R.; Mohammed S.F.;
Chahal A.A.; Ricci F.; Aung N.; Khanji M.Y.
Institution
(Mahmood, Chahal, Aung, Khanji) William Harvey Research Institute, NIHR
Barts Biomedical Research Centre, Queen Mary University of London,
Charterhouse Square, London EC1M 6BQ, United Kingdom
(Mahmood, Dhall, Gallagher, Khanji) Newham University Hospital, Barts
Health NHS Trust, Glen Road, London E13 8SL, United Kingdom
(Primus, Gallagher, Chahal, Aung, Khanji) Barts Heart Centre, St
Bartholomew's Hospital, Barts Health NHS Trust, West Smithfield, London
EC1A 7BE, UK
(Zakeri) School of Cardiovascular Medicine & Sciences, James Black Centre,
King's College London, 125 Coldharbour Lane, London SE5 9NU, United
Kingdom
(Mohammed) Department of Cardiology, Creighton University School of
Medicine, Omaha, NE 68124, USA
(Chahal) Department of Cardiovascular Medicine, Mayo Clinic, SW Rochester,
200 First Str, United States
(Chahal) Center for Inherited Cardiovascular Diseases, Department of
Cardiology, WellSpan Health, 30 Monument Rd, PA 17403, York, United States
(Ricci) Department of Neuroscience, Imaging and Clinical Sciences, "G.
d'Annunzio" University of Chieti-Pescara, Via dei Vestini 33 - 66100
Chieti, Italy
(Ricci) University Cardiology Division, SS Annunziata Polyclinic
University Hospital, Via dei Vestini 5 - 66100 Chieti, Italy
(Ricci) Department of Clinical Sciences, Lund University, Sweden
Abstract
Multiple guidelines exist for the diagnosis and management of heart
failure with preserved ejection fraction (HFpEF). We systematically
reviewed current guidelines and recommendations, developed by national and
international medical organizations, on the management of HFpEF in adults
to aid clinical decision-making. We searched MEDLINE and EMBASE on 28
February 2024 for publications over the last 10 years as well as websites
of organizations relevant to guideline development. Of the ten guidelines
and recommendations retrieved, seven showed considerable rigour of
development and were subsequently retained for analysis. There was
consensus on the definition of HFpEF and the diagnostic role of serum
natriuretic peptides and resting transthoracic echocardiography.
Discrepancies were identified in the thresholds of serum natriuretic
peptides and transthoracic echocardiography parameters used to diagnose
HFpEF. There was agreement on the general pharmacological and supportive
management of acute and chronic HFpEF. However, differences exist in
strategies to identify and address specific phenotypes. Contemporary
guidelines for HFpEF management agree on measures to avoid its development
and the consideration of cardiac transplantation in advanced disease.
There were discrepancies in recommended frequency of surveillance for
patients with HFpEF and sparse recommendations on screening for HFpEF in
the general population, use of diagnostic scoring systems, and the role of
newly emerging therapies.<br/>Copyright &#xa9; The Author(s) 2024.
Published by Oxford University Press on behalf of the European Society of
Cardiology.

<28>
Accession Number
2031327781
Title
Late Outcomes After Transcatheter Aortic Valve Implantation with
Balloon-Versus Self-Expandable Valves: Meta-Analysis of Reconstructed
Time-To-Event Data.
Source
Cardiology Clinics. 42(3) (pp 373-387), 2024. Date of Publication: August
2024.
Author
Jacquemyn X.; Van den Eynde J.; Caldonazo T.; Brown J.A.; Dokollari A.;
Serna-Gallegos D.; Clavel M.-A.; Pibarot P.; Sultan I.; Sa M.P.
Institution
(Jacquemyn, Van den Eynde) Department of Cardiovascular Sciences, KU
Leuven, Leuven, Belgium
(Caldonazo) Department of Cardiothoracic Surgery, Friedrich Schiller
University, Jena, Germany
(Brown, Serna-Gallegos, Sultan, Sa) Department of Cardiothoracic Surgery,
University of Pittsburgh, Pittsburgh, PA, United States
(Brown, Serna-Gallegos, Sultan, Sa) UPMC Heart and Vascular Institute,
University of Pittsburgh Medical Center, Pittsburgh, PA, United States
(Dokollari) Department of Cardiac Surgery, St. Boniface Hospital,
University of Manitoba, Winnepeg, Canada
(Clavel, Pibarot) Centre de Recherche de l'Institut Universitaire de
Cardiologie et de Pneumologie de Quebec, Quebec City, Quebec, Canada
(Clavel, Pibarot) Department of Medicine, Universite Laval, Quebec City,
Quebec, Canada
Publisher
W.B. Saunders

<29>
Accession Number
2032986530
Title
Association between Human Blood Proteome and the Risk of Myocardial
Infarction.
Source
Reviews in Cardiovascular Medicine. 25(6) (no pagination), 2024. Date of
Publication: June 2024.
Author
Wang L.; Zhang W.; Fang Z.; Lu T.; Gu Z.; Sun T.; Han D.; Wang Y.; Cao F.
Institution
(Wang, Zhang, Fang, Lu, Cao) Department of Medicine School, Nankai
University, Tianjin 300071, China
(Wang, Zhang, Fang, Lu, Sun, Han, Wang, Cao) Department of Cardiology,
National Research Centre for Geriatric Diseases, National Key Lab for
Chronic Kidney Disease, Second Medical Centre of Chinese PLA General
Hospital, Beijing 100853, China
(Gu) Chinese PLA Medical College, Department of Cardiology, National
Clinic Research Center Geriatric Disease, 2nd Medical Center of Chinese
PLA General Hospital, Beijing 100853, China
Publisher
IMR Press Limited
Abstract
Background: The objective of this study is to estimate the causal
relationship between plasma proteins and myocardial infarction (MI)
through Mendelian randomization (MR), predict potential target-mediated
side effects associated with protein interventions, and ensure a
comprehensive assessment of clinical safety. <br/>Method(s): From 3
proteome genome-wide association studies (GWASs) involving 9775 European
participants, 331 unique blood proteins were screened and chosed. The
summary data related to MI were derived from a GWAS meta-analysis,
incorporating approximately 61,000 cases and 577,000 controls. The
assessment of associations between blood proteins and MI was conducted
through MR analyses. A phenome-wide MR (Phe-MR) analysis was subsequently
employed to determine the potential on-target side effects of protein
interventions. <br/>Result(s): Causal mediators for MI were identified,
encompassing cardiotrophin-1 (CT-1) (odds ratio [OR] per SD increase: 1.16
95% confidence interval [CI]: 1.13-1.18 p = 1.29 x 10^-
³¹), Selenoprotein S (SELENOS) (OR: 1.16 95% CI: 1.13-1.20 p =
4.73 x 10^- ²⁴), killer cell immunoglobulin-like
receptor 2DS2 (KIR2DS2) (OR: 0.93 95% CI: 0.90-0.96 p = 1.08 x
10^- ⁵), vacuolar protein sorting-associated protein
29 (VPS29) (OR: 0.92 95% CI: 0.90-0.94 p = 8.05 x 10^-
¹³), and histo-blood group ABO system transferase (NAGAT) (OR:
1.05 95% CI: 1.03-1.07 p = 1.41 x 10^- ⁵). In the
Phe-MR analysis, memory loss risk was mediated by CT-1, VPS29 exhibited
favorable effects on the risk of 5 diseases, and KIR2DS2 showed no
predicted detrimental side effects. <br/>Conclusion(s): Elevated genetic
predictions of KIR2DS2 and VPS29 appear to be linked to a reduced risk of
MI, whereas an increased risk is associated with CT-1, SELENOS, and NAGAT.
The characterization of side effect profiles aids in the prioritization of
drug targets. Notably, KIR2DS2 emerges as a potentially promising target
for preventing and treating MI, devoid of predicted detrimental side
effects.<br/>Copyright &#xa9; 2024 The Author(s). Published by IMR Press.

<30>
Accession Number
2032986501
Title
Studying the Outcomes in Patients with Tricuspid Regurgitation Treated
with Valve Repair or Valve Replacement: Interpreting the Survival Pattern
on The Long Term by Application of Artificial Intelligence Methods.
Source
Reviews in Cardiovascular Medicine. 25(6) (no pagination), 2024. Date of
Publication: June 2024.
Author
Messori A.; Trippoli S.; Romeo M.R.; Fadda V.; Rivano M.; Spazio L.D.
Institution
(Messori, Trippoli) HTA Unit, Regione Toscana, Regional Health Service,
Firenze 50139, Italy
(Romeo) Ospedale del Cuore, Fondazione Monasterio, Regional Health
Service, Massa 54100, Italy
(Fadda) ESTAR Toscana, Regional Health Service, Firenze 50135, Italy
(Rivano) Hospital Pharmacy Department, R. Binaghi, Cagliari 09126, Italy
(Rivano) Scientific Direction of Italian Society of Clinical Pharmacy and
Therapeutics (SIFACT), Torino 10123, Italy
(Spazio) Hospital Pharmacy Department, S. Chiara Trento Hospital, Azienda
Provinciale per i Servizi Sanitari (APSS), Trento 38122, Italy
Publisher
IMR Press Limited
Abstract
Background: The reconstruction of individual patient data from published
Kaplan-Meier survival curves is a new technique (often denoted as the
IPDfromKM method) for studying efficacy in cases where multiple trials are
available, and the endpoint is long-term mortality. In patients with
tricuspid regurgitation, both valve repair and valve replacement have been
proposed to improve prognosis 6 controlled clinical trials (CTs) have been
conducted to compare the two therapeutic options mentioned above. The
objective of our analysis was to study these six trials through the
application of the IPDfromKM method. <br/>Method(s): In the present
report, we applied the IPDfromKM method to carry out a pooled analysis of
these 6 CTs to investigate the effectiveness of valve repair vs valve
replacement and to assess the between-study heterogeneity from this
clinical material. After reconstructing individual patient data from these
6 trials, patients treated with valve repair were pooled together and
their Kaplan-Meier curve was generated. Likewise, patients treated with
valve replacement were pooled together and their Kaplan-Meier curve was
generated. Finally, these two curves were compared by standard survival
statistics. The hazard ratio (HR) was determined death from any cause was
the endpoint. <br/>Result(s): These 6 CTs included a total of 552 patients
in each of these CTs, the patient group treated with valve repair was
compared with another group treated with valve replacement. Our
statistical results showed a significantly better survival for valve
repair compared with valve replacement (HR, 0.6098 95% confidence
intervals (CI), 0.445 to 0.835 p = 0.002). Heterogeneity was found to be
significant in the 6 patient arms undergoing replacement, but not in those
undergoing valve repair. In valve replacement, the classification of
patients in class III or IV of New York Heart Association (NYHA) was the
main negative prognostic factor. <br/>Conclusion(s): Our analysis
confirmed the methodological advantages of the IPDfromKM method in the
indirect comparative analysis of multiple trials. These advantages include
appropriate analysis of censored patients, original assessment of
heterogeneity, and graphical presentation of the results, wherein
individual patients retain an important role.<br/>Copyright &#xa9; 2024
The Author(s). Published by IMR Press.

<31>
Accession Number
2032981840
Title
Prevalence of preoperative depression and adverse outcomes in older
patients undergoing elective surgery: A systematic review and
meta-analysis.
Source
Journal of Clinical Anesthesia. 97 (no pagination), 2024. Article Number:
111532. Date of Publication: October 2024.
Author
Chen A.; An E.; Yan E.; Saripella A.; Khullar A.; Misati G.; Alhamdah Y.;
Englesakis M.; Mah L.; Tartaglia C.; Chung F.
Institution
(Chen, Chung) Temerty Faculty of Medicine, University of Toronto, Toronto,
ON, Canada
(An) Michael G. DeGroote School of Medicine, McMaster University,
Hamilton, ON, Canada
(Yan, Alhamdah, Chung) Institute of Medical Science, Temerty Faculty of
Medicine, University of Toronto, ON, Canada
(Saripella, Chung) Department of Anesthesia and Pain Management, Toronto
Western Hospital, University Health Network, University of Toronto,
Toronto, ON, Canada
(Khullar) Universeity of Alberta Medicine, University of Alberta,
Edmonton, AB, Canada
(Misati) Cummings School of Medicine, University of Calgary, Calgary, AB,
Canada
(Englesakis) Library & Information Services, University Health Network,
Toronto, ON, Canada
(Mah) Division of Geriatric Psychiatry, Department of Psychiatry, Temerty
Faculty of Medicine, University of Toronto, Toronto, ON, Canada
(Tartaglia) Division of Neurology, Department of Medicine, University of
Toronto, Toronto, ON, Canada
Publisher
Elsevier Inc.
Abstract
Study objective: Depression is a common cause of long-lasting disability
and preoperative mental health state that has important implications for
optimizing recovery in the perioperative period. In older elective
surgical patients, the prevalence of preoperative depression and
associated adverse pre- and postoperative outcomes are unknown. This
systematic review and meta-analysis aimed to determine the prevalence of
preoperative depression and the associated adverse outcomes in the older
surgical population. <br/>Design(s): Systematic review and meta-analysis.
<br/>Setting(s): MEDLINE, MEDLINE Epub Ahead of Print and In-Process,
In-Data-Review & Other Non-Indexed Citations, Embase/Embase Classic,
Cochrane CENTRAL, and Cochrane Database of Systematic Reviews,
ClinicalTrials.Gov, the WHO ICTRP (International Clinical Trials Registry
Platform) for relevant articles from 2000 to present. <br/>Patient(s):
Patients aged >=65 years old undergoing non-cardiac elective surgery with
preoperative depression assessed by tools validated in older adults. These
validated tools include the Geriatric Depression Scale (GDS), Hospital
Depression and Anxiety Scale (HADS), Beck Depression Inventory-II (BDI),
Patient Health Questionnaire-9 (PHQ-9), and the Centre for Epidemiological
Studies Depression Scale (CES[sbnd]D). <br/>Intervention(s): Preoperative
assessment. Measurement: The primary outcome was the prevalence of
preoperative depression. Additional outcomes included preoperative
cognitive impairment, and postoperative outcomes such as delirium,
functional decline, discharge disposition, readmission, length of stay,
and postoperative complications. <br/>Main Result(s): Thirteen studies (n
= 2824) were included. Preoperative depression was most assessed using the
Geriatric Depression Scale-15 (GDS-15) (n = 12). The overall prevalence of
preoperative depression was 23% (95% CI: 15%, 30%). Within non-cancer
non-cardiac mixed surgery, the pooled prevalence was 19% (95% CI: 11%,
27%). The prevalence in orthopedic surgery was 17% (95% CI: 9%, 24%). In
spine surgery, the prevalence was higher at 46% (95% CI: 28%, 64%).
Meta-analysis showed that preoperative depression was associated with a
two-fold increased risk of postoperative delirium than those without
depression (32% vs 23%, OR: 2.25; 95% CI: 1.67, 3.03; I²: 0%; P
<=0.00001). <br/>Conclusion(s): The overall prevalence of older surgical
patients who suffered from depression was 23%. Preoperative depression was
associated with a two-fold higher risk of postoperative delirium. Further
work is needed to determine the need for depression screening and
treatment preoperatively.<br/>Copyright &#xa9; 2024 The Authors

<32>
Accession Number
2032958588
Title
Safety and Effectiveness of Transthoracic Echocardiography and
Transesophageal Echocardiography in the Interventional Closure of Atrial
Septal Defects in Children: A Systematic Review and Meta-Analysis.
Source
Heart Surgery Forum. 27(6) (pp E668-E679), 2024. Date of Publication: June
2024.
Author
Lu H.; Wang J.; Zhou L.; Liu L.
Institution
(Lu, Zhou) Department of Ultrasound, Taizhou Hospital of Zhejiang Province
Affiliated, Wenzhou Medical University, Zhejiang, Taizhou 318050, China
(Wang) Quality Improvement Office, Taizhou Hospital of Zhejiang Province
Affiliated, Wenzhou Medical University, Zhejiang, Taizhou 318050, China
(Liu) Department of Pediatrics, Taizhou Hospital of Zhejiang Province
Affiliated, Wenzhou Medical University, Zhejiang, Taizhou 318050, China
Publisher
Forum Multimedia Publishing LLC
Abstract
Objective: Through this meta-analysis, a systematic review was conducted
on the effects of transthoracic echocardiography (TTE) and transesophageal
echocardiography (TEE) in the interventional closure of atrial septal
defects (ASDs) in children. <br/>Method(s): We searched papers in the
PubMed, Web of Science, Cochrane Library, Google Scholar, CNKI, Wanfang,
Embase, and VIP databases. The search time limit was from the
establishment of the database to May 2023. Randomized controlled trials on
the effect of TTE and TEE in the interventional closure of ASD in children
were screened. The included results were integrated and analyzed, and
ReviewManager 5.4 was used for the meta-analysis. <br/>Result(s): Six
studies with a total of 253 patients with ASD were included in this
meta-analysis. Results showed that the surgical success rate in each study
was more than 90%, with no difference between TEE and TTE (p = 0.11;risk
ratio (RR) = 0.96, 95% confidence interval (CI): 0.89 to 1.04). The
surgery time of TTE was significantly shorter than that of TEE (standard
mean difference (SMD) = -1.52, 95% CI: -2.30 to -0.74). The fluoroscopy
time of TTE was shorter than that of TEE (SMD = -0.69, 95% CI: -1.08 to
-0.30). We found no significant difference in complication rates (RR =
0.36, 95% CI: 0.09 to 1.39). <br/>Conclusion(s): The combination of TTE
and TEE is important during surgery, and postoperative complications are
relatively small. The surgery time and fluoroscopy time of TTE are shorter
than those of TEE.<br/>Copyright &#xa9; 2024 Forum Multimedia Publishing,
LLC.

<33>
Accession Number
2032957965
Title
Association between overweight and obesity with coronary artery bypass
graft failure: an individual patient data analysis of clinical trials.
Source
European Journal of Cardio-thoracic Surgery. 65(6) (no pagination), 2024.
Article Number: ezae221. Date of Publication: 01 Jun 2024.
Author
An K.R.; Sandner S.; Redfors B.; Alexander J.H.; Alzghari T.; Caldonazo
T.; Cancelli G.; Dell'Aquila M.; Dimagli A.; Gibson C.M.; Harik L.; Heise
R.; Kulik A.; Lamy A.; Leith J.; Peper J.; Perezgrovas-Olaria R.; Rossi
C.S.; Ruel M.; Soletti G.J.; Ten Berg J.M.; Willemsen L.M.; Wojdyla D.M.;
Zhao Q.; Zhu Y.; Verma S.; Gaudino M.F.L.
Institution
(An, Alzghari, Caldonazo, Cancelli, Dell'Aquila, Dimagli, Harik, Leith,
Perezgrovas-Olaria, Rossi, Soletti, Gaudino) Department of Cardiothoracic
Surgery, Weill Cornell Medicine, New York, NY, United States
(An, Verma) Division of Cardiac Surgery, St Michael's Hospital, University
of Toronto, Toronto, ON, Canada
(Sandner) Department of Cardiac Surgery, Medical University of Vienna,
Vienna, Austria
(Redfors, Heise) Department of Population Health Sciences, Weill Cornell
Medicine, New York, NY, United States
(Redfors) Department of Cardiology, Sahlgrenska University Hospital,
Gothenburg, Sweden
(Redfors) Department of Molecular and Clinical Medicine, Institute of
Medicine, Gothenburg University, Gothenburg, Sweden
(Alexander) Department of Medicine, Duke Clinical Research Institute, Duke
University, Durham, NC, United States
(Gibson) Division of Cardiovascular Medicine, Department of Medicine, Beth
Israel Deaconess Medical Center, Harvard Medical School, Boston, MA,
United States
(Kulik) Division of Cardiac Surgery, Boca Raton Regional Hospital, Florida
Atlantic Hospital, Boca Raton, FL, United States
(Lamy) Department of Surgery, McMaster University, Hamilton, ON, Canada
(Peper, Ten Berg, Willemsen) Department of Cardiology, St Antonius
Hospital, Nieuwegein, Netherlands
(Ruel) Division of Cardiac Surgery, University of Ottawa Heart Institute,
Ottawa, ON, Canada
(Wojdyla) Duke Clinical Research Institute, Duke University, Durham, NC,
United States
(Zhao, Zhu) Department of Cardiovascular Surgery, Ruijin Hospital,
Shanghai Jiao Tong University School of Medicine, Shanghai, China
Publisher
European Association for Cardio-Thoracic Surgery
Abstract
OBJECTIVES: The association between obesity and graft failure after
coronary artery bypass grafting has not been previously investigated.
<br/>METHOD(S): We pooled individual patient data from randomized clinical
trials with systematic postoperative coronary imaging to evaluate the
association between obesity and graft failure at the individual graft and
patient levels. Penalized cubic regression splines and mixed-effects
multivariable logistic regression models were performed. <br/>RESULT(S):
Six trials comprising 3928 patients and 12 048 grafts were included. The
median time to imaging was 1.03 (interquartile range 1.00-1.09) years. By
body mass index (BMI) category, 800 (20.4%) patients were normal weight
(BMI 18.5-24.9), 1668 (42.5%) were overweight (BMI 25-29.9), 983 (25.0%)
were obesity class 1 (BMI 30-34.9), 344 (8.8%) were obesity class 2 (BMI
35-39.9) and 116 (2.9%) were obesity class 3 (BMI 40). As a continuous
variable, BMI was associated with reduced graft failure [adjusted odds
ratio (aOR) 0.98 (95% confidence interval (CI) 0.97-0.99)] at the
individual graft level. Compared to normal weight patients, graft failure
at the individual graft level was reduced in overweight [aOR 0.79 (95% CI
0.64-0.96)], obesity class 1 [aOR 0.81 (95% CI 0.64-1.01)] and obesity
class 2 [aOR 0.61 (95% CI 0.45-0.83)] patients, but not different compared
to obesity class 3 [aOR 0.94 (95% CI 0.62-1.42)] patients. Findings were
similar, but did not reach significance, at the patient level.
<br/>CONCLUSION(S): In a pooled individual patient data analysis of
randomized clinical trials, BMI and obesity appear to be associated with
reduced graft failure at 1 year after coronary artery bypass
grafting.<br/>Copyright # The Author(s) 2024. Published by Oxford
University Press on behalf of the European Association for Cardio-Thoracic
Surgery. All rights reserved.

<34>
Accession Number
2032950399
Title
Tranexamic acid may benefit patients with preexisting thromboembolic risk
undergoing total joint arthroplasty: a systematic review and
meta-analysis.
Source
EFORT Open Reviews. 9(6) (pp 467-478), 2024. Date of Publication: 2024.
Author
Dang X.; Liu M.; Yang Q.; Jiang J.; Liu Y.; Sun H.; Tian J.
Institution
(Dang, Tian) Evidence-based Medicine Center, School of Basic Medical
Sciences, Lanzhou University, P.R., Lanzhou, China
(Dang) Department of Pharmaceutical, Lanzhou University Second Hospital,
Gansu province, Lanzhou, China
(Liu) The First Clinical Medical School, Gansu University of Chinese
Medicine, Gansu, China
(Yang) Department of Neurosurgery, Lanzhou University Second Hospital,
Gansu province, Lanzhou, China
(Jiang) Department of Orthopedics, Lanzhou University Second Hospital,
Gansu province, Lanzhou, China
(Liu) Gansu High Throughput Screening and Creation Center for Health
Products, School of Pharmacy, Lanzhou University, Lanzhou, China
(Sun) Cuiying Biomedical Research Center, Lanzhou University Second
Hospital, Gansu province, Lanzhou, China
Publisher
British Editorial Society of Bone and Joint Surgery
Abstract
* Purpose: This study sought to determine if the use of tranexamic acid
(TXA) in preexisting thromboembolic risk patients undergoing total joint
arthroplasty (TJA) was linked to an increased risk of death or
postoperative complications. * Methods: We conducted a comprehensive
search for studies up to May 2023 in PubMed, Web of Science, EMBASE, and
the Cochrane Library. We included randomized clinical trials, cohort
studies, and case-control studies examining the use of TXA during TJA
surgeries on high-risk patients. The Cochrane Risk of Bias instrument was
used to gauge the excellence of RCTs, while the MINORS index was
implemented to evaluate cohort studies. We used mean difference (MD) and
relative risk (RR) as effect size indices for continuous and binary data,
respectively, along with 95% CIs. * Results: Our comprehensive study,
incorporating data from 11 diverse studies involving 812 993 patients,
conducted a meta-analysis demonstrating significant positive outcomes
associated with TXA administration. The findings revealed substantial
reductions in critical parameters, including overall blood loss (MD =
-237.33; 95% CI (-425.44, -49.23)), transfusion rates (RR = 0.45; 95% CI
(0.34, 0.60)), and 90-day unplanned readmission rates (RR = 0.86; 95% CI
(0.76, 0.97)). Moreover, TXA administration exhibited a protective effect
against adverse events, showing decreased risks of pulmonary embolism (RR
= 0.73; 95% CI (0.61, 0.87)), myocardial infarction (RR = 0.47; 95% CI
(0.40-0.56)), and stroke (RR = 0.73; 95% CI (0.59-0.90)). Importantly, no
increased risk was observed for mortality (RR = 0.53; 95% CI (0.24,
1.13)), deep vein thrombosis (RR = 0.69; 95% CI (0.44, 1.09)), or any of
the evaluated complications associated with TXA use. * <br/>Conclusion(s):
The results of this study indicate that the use of TXA in TJA patients
with preexisting thromboembolic risk does not exacerbate complications,
including reducing mortality, deep vein thrombosis, and pulmonary
embolism. Existing evidence strongly supports the potential benefits of
TXA in TJA patients with thromboembolic risk, including lowering blood
loss, transfusion, and readmission rates.<br/>Copyright &#xa9; (2024), the
author(s)

<35>
Accession Number
2032895351
Title
Mitral Regurgitation Quantification, Management, and Guidelines: A 2024
Update.
Source
Annals of Clinical Cardiology. 6(1) (pp 4-16), 2024. Date of Publication:
2024.
Author
Alqouba M.; Alhumaidi M.; Al Jarallah M.; Dashti R.; Khalil M.; Al Mulla
K.; Sharma R.M.; Tse G.; Rajan R.
Institution
(Alqouba, Alhumaidi) Department of Medicine, Faculty of Medicine, Kuwait
University, Kuwait
(Al Jarallah, Dashti, Khalil, Al Mulla, Rajan) Department of Cardiology,
Sabah Al Ahmad Cardiac Center, Al-Amiri Hospital, Kuwait City, Kuwait
(Sharma) Department of Medicine, Faculty of Medicine and Health Sciences,
Royal College of Surgeons in Ireland, Dublin, Ireland
(Tse, Rajan) Cardiovascular Analytics Group, Hong Kong, Hong Kong
Publisher
Wolters Kluwer Medknow Publications
Abstract
A comparison of the recommendations for the diagnosis and treatment of
mitral regurgitation (MR), the second-most common valvular heart ailment
in high-income countries, from the European Society of Cardiology/European
Association for Cardio-Thoracic Surgery 2021 and American College of
Cardiology/American Heart Association 2020 guidelines. We systematically
reviewed and contrasted the guidelines on the diagnosis and treatment of
MR to inform clinical judgment. A multimodal approach comprising a
comprehensive history and physical examination, echocardiography, and, in
some cases, cardiac magnetic resonance imaging, is the preferred method
for diagnosis, treatment guidance, and follow-up in patients with valvular
heart disease. Both guidelines agreed on the multidisciplinary approach of
the heart team and the definition and grading of severe primary MR. There
was substantial agreement on the thresholds for intervention, such as the
onset of symptoms, left ventricular failure, and hypertrophy; however,
there were differences among asymptomatic individuals with preserved
ventricular function. While there was a consensus on the need for
intervention in patients with severe secondary MR and those who continued
to experience symptoms despite optimization of medical therapy, there was
a disagreement regarding whether a transcatheter or surgical
repair/replacement should be performed.<br/>&#xa9; 2024 Copyright: Annals
of Clinical Cardiology.

<36>
Accession Number
2032488723
Title
Ear-Marking Relief: A Meta-Analysis on the Efficacy of Auricular
Acupressure in Alleviating Anxiety Disorders.
Source
Complementary Medicine Research. 31(3) (pp 266-277), 2024. Date of
Publication: 01 Jun 2024.
Author
Hu N.; Soh K.L.; Japar S.; Li T.
Institution
(Hu, Soh, Li) Department of Nursing, Universiti Putra Malaysia, Selangor,
Malaysia
(Hu) Jiangxi Open University, Jiangxi, China
(Japar) Department of Medicine, Universiti Putra Malaysia, Selangor,
Malaysia
Publisher
S. Karger AG
Abstract
Background: The increasing worldwide mental health crisis, notably
anxiety, emphasizes the urgency for available and effective interventions.
Traditional therapies, although beneficial, pose limitations due to their
considerable costs and possible adverse effects, thereby inviting
alternative treatments such as auricular acupressure (AA). This
non-pharmacological, integrative method, underpinned by Eastern and
Western medical principles, presents a significant prospect for managing
anxiety. <br/>Objective(s): This study aims to evaluate the existing
evidence on the efficacy of AA in reducing anxiety, as elucidated through
a systematic review. <br/>Method(s): A comprehensive search of randomized
controlled trials was conducted across various databases: the Cochrane
Central Register of Controlled Trials (CENTRAL), PubMed, EMBASE, Web of
Science, Chinese National Knowledge Infrastructure (CNKI), China Biology
Medicine (CBM), Wan Fang, and Database for Chinese Technical Periodicals
(VIP). Two reviewers retrieved the pertinent studies and assessed their
methodological quality. A meta-analysis was then conducted, incorporating
data from all relevant time points. <br/>Result(s): Upon examining 25
studies encompassing 1,909 participants, it was discerned that AA
significantly diminished anxiety (SMD = -1.1074; 95% confidence interval,
-1.348 to -0.801; z = 7.70, p < 0.01). Subgroup analyses indicated that
neither an increased number of auricular points nor extended intervention
augmented effects. Larger effect sizes were associated with probing and
avoidance of sham acupressure. Notably, 23 of the 25 studies exhibited
some bias, suggesting further research is necessary. <br/>Conclusion(s):
The extant evidence advocates for AA as an effective supplementary
intervention that reduces patient anxiety. The results hint at a potential
placebo effect elicited by sham acupressure, necessitating rigorous
control group definitions in future inquiries. The study findings suggest
that fewer acupressure points and shorter intervention durations could
effectively alleviate anxiety symptoms. Nonetheless, the significant
heterogeneity across the studies underscores the requirement for more
stringent research methodologies to substantiate these
conclusions.<br/>Copyright &#xa9; 2024 S. Karger AG, Basel.

<37>
Accession Number
2030355176
Title
Comprehensive Summary of Safety Data on Nirsevimab in Infants and Children
from All Pivotal Randomized Clinical Trials.
Source
Pathogens. 13(6) (no pagination), 2024. Article Number: 503. Date of
Publication: June 2024.
Author
Mankad V.S.; Leach A.; Chang Y.; Wahlby Hamren U.; Kiazand A.; Kubiak
R.J.; Takas T.; Villafana T.; Shroff M.
Institution
(Mankad) AstraZeneca, Durham, NC 27703, United States
(Leach, Chang, Takas, Villafana) Vaccines & Immune Therapies,
BioPharmaceuticals RD, AstraZeneca, Gaithersburg, MD 20878, United States
(Wahlby Hamren) Clinical Pharmacology and Quantitative Pharmacology, R&D,
AstraZeneca, Gothenburg SE-43183, Sweden
(Kiazand) Patient Safety, Chief Medical Office, Oncology R&D, AstraZeneca,
Gaithersburg, MD 20878, United States
(Kubiak) Clinical Pharmacology and Quantitative Pharmacology,
BioPharmaceuticals R&D, AstraZeneca, Gaithersburg, MD 20878, United States
(Shroff) Patient Safety, Chief Medical Office, Oncology R&D, AstraZeneca,
Waltham, MA 02451, United States
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Background: Nirsevimab is approved in the US for the prevention of
respiratory syncytial virus (RSV) lower respiratory tract disease in
neonates and infants during their first RSV season and in children aged
<=24 months who remain vulnerable to severe RSV disease through their
second RSV season. We summarize a pre-specified analysis of nirsevimab
safety data from three randomized controlled trials: Phase 2b
(NCT02878330; healthy infants born >=29 to <35 weeks' gestational age
[wGA]); Phase 3 MELODY (NCT03979313; healthy infants born >=35 wGA); and
Phase 2/3 MEDLEY (NCT03959488; infants with congenital heart disease [CHD]
and/or chronic lung disease of prematurity [CLD] or born <=35 wGA).
<br/>Method(s): Participants (randomized 2:1) received a single
intramuscular dose of nirsevimab or comparator (placebo, Phase 2b/MELODY;
5x once-monthly palivizumab, MEDLEY) before their first RSV season
(recipients < 5 kg, nirsevimab 50 mg; >=5 kg, nirsevimab 100 mg). In
MEDLEY, children with CHD/CLD continued to a second RSV season:
first-season nirsevimab recipients received nirsevimab 200 mg;
first-season palivizumab recipients were re-randomized 1:1 to receive
nirsevimab 200 mg or 5x once-monthly palivizumab. <br/>Result(s): The
incidence, severity, and nature of AEs were similar across treatments
(nirsevimab, n = 3184; placebo, n = 1284; palivizumab, n = 304). Most AEs
were mild to moderate in severity, with >=98% unrelated to treatment. AEs
of special interest occurred infrequently (<1%): no anaphylaxis or
thrombocytopenia were treatment-related, and no immune complex disease was
reported. Deaths (incidence < 1.0%) were all unrelated to treatment.
<br/>Conclusion(s): A single dose per season of nirsevimab for the
prevention of RSV disease had a favorable safety profile, irrespective of
wGA or comorbidities.<br/>Copyright &#xa9; 2024 by the authors.

<38>
Accession Number
2030338356
Title
Efficacy and Safety of Edoxaban in Anticoagulant Therapy Early After
Surgical Bioprosthetic Valve Replacement: Rationale and Design of the
ENBALV Trial.
Source
Cardiovascular Drugs and Therapy. (no pagination), 2024. Date of
Publication: 2024.
Author
Izumi C.; Amano M.; Fukushima S.; Yaku H.; Eishi K.; Sakaguchi T.; Minami
M.; Yamamoto H.; Onda K.; Omae K.
Institution
(Izumi, Amano) Department of Heart Failure and Transplant, National
Cerebral and Cardiovascular Center, 6-1 Kishibe Shimmachi, Suita-City,
Osaka 564-8565, Japan
(Fukushima) Department of Cardiovascular Surgery, National Cerebral and
Cardiovascular Center, Suita, Japan
(Yaku) Department of Cardiovascular Surgery, Kyoto Prefectural University
of Medicine, Kyoto, Japan
(Eishi) Department of Cardiovascular Surgery, Hakujyuji Hospital, Fukuoka,
Japan
(Sakaguchi) Department of Cardiovascular Surgery, Hyogo Medical
University, Nishinomiya, Japan
(Minami, Yamamoto, Onda, Omae) Department of Data Science, National
Cerebral and Cardiovascular Center, Suita, Japan
Publisher
Springer
Abstract
Background and Purpose: Anticoagulant therapy with vitamin K antagonists
is recommended within 3 to 6 months after bioprosthetic valve replacement
to prevent thromboembolic events. However, data regarding whether direct
oral anticoagulants can be an alternative to warfarin in such patients are
limited. The purpose of this study is to compare the efficacy and safety
of edoxaban versus warfarin within 3 months after bioprosthetic valve
replacement. <br/>Method(s): The ENBALV trial is an
investigator-initiated, phase 3, randomized, open-label, multicenter
study. It involves patients aged 18 to 85 years undergoing bioprosthetic
valve replacement at the aortic and/or mitral position. They are
randomized 1:1 to receive either edoxaban or warfarin. Administration of
edoxaban or warfarin is to be continued for 12 weeks after surgery. The
primary outcome is the occurrence rate of stroke or systemic embolism at
12 weeks after surgery. The net clinical outcome is a composite of stroke,
systemic embolism, or major bleeding, which is included in the secondary
outcomes. <br/>Conclusion(s): The ENBALV trial demonstrates the efficacy
and safety of edoxaban compared with warfarin in patients early after
bioprosthetic valve replacement, including patients with sinus rhythm,
which will bring a significant benefit to patients in clinical practice.
Trial Registration: Japan Registry of Clinical Trials (jRCT) 2051210209.
30 Mar 2022
https://jrct.niph.go.jp/latest-detail/jRCT2051210209.<br/>Copyright &#xa9;
The Author(s), under exclusive licence to Springer Science+Business Media,
LLC, part of Springer Nature 2024.

<39>
[Use Link to view the full text]
Accession Number
631535683
Title
Balloon-Expandable Versus Self-Expanding Transcatheter Aortic Valve
Replacement A Propensity-Matched Comparison From the FRANCE-TAVI Registry.
Source
Circulation. 141(4) (pp 243-259), 2020. Date of Publication: 28 Jan 2020.
Author
Van Belle E.; Vincent F.; Labreuche J.; Auffret V.; Debry N.; Lefevre T.;
Eltchaninoff H.; Manigold T.; Gilard M.; Verhoye J.-P.; Himbert D.; Koning
R.; Collet J.-P.; Leprince P.; Teiger E.; Duhamel A.; Cosenza A.; Schurtz
G.; Porouchani S.; Lattuca B.; Robin E.; Coisne A.; Modine T.; Richardson
M.; Joly P.; Rioufol G.; Ghostine S.; Bar O.; Amabile N.; Champagnac D.;
Ohlmann P.; Meneveau N.; Lhermusier T.; Leroux L.; Leclercq F.; Gandet T.;
Pinaud F.; Cuisset T.; Motreff P.; Souteyrand G.; Iung B.; Folliguet T.;
Commeau P.; Cayla G.; Bayet G.; Darremont O.; Spaulding C.; Le Breton H.;
Delhaye C.
Institution
(Van Belle, Vincent, Debry, Cosenza, Schurtz, Porouchani, Robin, Coisne,
Modine, Richardson, Delhaye) Departement de Cardiologie, Institut Coeur
Poumon, Inserm U1011, Institut Pasteur de Lille, EGID, France
(Labreuche, Duhamel) Department of Biostatistics, EA 2694-Sante Publique:
Epidemiologie et Qualite des Soins, France
(Auffret, Verhoye, Le Breton) CHU de Lille, Universite de Lille, France
(Auffret, Collet, Le Breton) CHU Pontchaillou, Service de Cardiologie et
Maladies Vasculaires, CIC-IT 804, Universite de Rennes 1, Laboratoire de
Traitement du Signal et de l'Image, Inserm U1099, Rennes, France
(Lefevre) Institut Cardiovasculaire Paris-Sud, Hopital Prive
Jacques-Cartier, Massy, France
(Eltchaninoff) CHU Rouen-Charles-Nicolle, Service de Cardiologie, Inserm
U644, Rouen, France
(Manigold) CHU Guillaume et Rene Laennec, Institut du Thorax, Service de
Cardiologie, Nantes, France
(Gilard) CHU La Cavale Blanche, Departement de Cardiologie, Optimisation
des Regulations Physiologiques, UFR Sciences et Techniques, Brest, France
(Himbert, Iung) AP-HP, Hopital Bichat, Departement de Cardiologie,
Universite Paris-Diderot, France
(Koning) Clinique Saint-Hilaire, Service de Cardiologie, Rouen, France
(Collet, Leprince) AP-HP, CHU La Pitie-Salpetriere, Service de
Cardiologie, Paris, France
(Teiger) Hopital Henri-Mondor Assistance Publique Hopitaux de Paris,
Departement de Cardiologie, Creteil, France
(Lattuca, Cayla) CHU Nimes, Universite Montpellier, Nimes, France
(Joly) Hopital Saint-Joseph, Federation de Cardiologie, Marseille, France
(Rioufol) CHU Louis Pradel, Division de Cardiologie, Centre
d'Investigation Clinique de Lyon (CIC), Bron, France
(Ghostine) Centre Marie Lannelongue, Departement de Cardiologie, Le
Plessis Robinson, France
(Bar) Clinique Saint Gatien, Service de Cardiologie, Tours, France
(Amabile) Institut Mutualiste Montsouris, Departement de Cardiologie,
Paris, France
(Champagnac) Clinique du Tonkin, Service de Cardiologie, Villeurbanne,
France
(Ohlmann) CHU de Strasbourg, Nouvel Hopital Civil, Departement de
Cardiologie, Universite de Strasbourg, France
(Meneveau) CHU Besancon, Hopital Jean Minjoz, Besancon, France
(Lhermusier) CHU de Toulouse, Departement de Cardiologie, Inserm U1048,
Universite de Toulouse 3, France
(Leroux) Hopital Cardiologique du Haut-Leveque, Departement de Cardiologie
Interventionnelle, Universite de Bordeaux, Pessac, France
(Leclercq, Gandet) CHU Arnaud de Villeneuve, Service de Cardiologie,
Montpellier, France
(Pinaud) CHU d'Angers, Service de Chirurgie Cardiaque, CNRS UMR 6214,
INSERM 1083, Universite d'Angers, France
(Cuisset) CHU La Timone Assistance Publique Hopitaux de Marseille,
Departement de Cardiologie, Inserm UMR1062, INRA UMR 1260, Universite
d'Aix-Marseille, France
(Motreff, Souteyrand) CHU Gabriel Montpied, Departement de Cardiologie,
ISIT, CaVITI, CNRS (UMR-6284), Universite d'Auvergne, Clermont-Ferrand,
France
(Folliguet) CHU de Nancy, Service de Chirurgie Cardiovasculaire,
Vandoeuvre-les-Nancy, France
(Commeau) Polyclinique les Fleurs, Ollioules, France
(Bayet) Hopital Prive Clairval, Service de Cardiologie, Marseille, France
(Darremont) Clinique Saint Augustin, Service de Cardiologie, Bordeaux,
France
(Spaulding) Hopital Europeen Georges Pompidou, Paris, France
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND: No randomized study powered to compare balloonexpandable (BE)
with selfexpanding (SE) transcatheter heart valves (THVs) on individual
end points after transcatheter aortic valve replacement has been conducted
to date. <br/>METHOD(S): From January 2013 to December 2015, the
FRANCE-TAVI nationwide registry (Registry of Aortic Valve Bioprostheses
Established by Catheter) included 12 141 patients undergoing BE-THV
(Edwards, n=8038) or SE-THV (Medtronic, n=4103) for treatment of native
aortic stenosis. Longterm mortality status was available in all patients
(median 20 months; interquartile range, 14 to 30). Patients treated with
BE-THV (n=3910) were successfully matched 1:1 with 3910 patients treated
with SE-THV by using propensity score (25 clinical, anatomical, and
procedural variables) and by date of the procedure (within 3 months). The
first coprimary outcome was >= moderate occurrence of paravalvular
regurgitation or in-hospital mortality, or both. The second coprimary
outcome was 2-year all-cause mortality. <br/>RESULT(S): In
propensity-matched analyses, the incidence of the first coprimary outcome
was higher with SE-THV (19.8%) compared with BE-THV (11.9%; relative risk,
1.68 [95% CI, 1.46-1.91]; P<0.0001). Each component of the outcome was
also higher in patients receiving SE-THV: >= moderate paravalvular
regurgitation (15.5% versus 8.3%; relative risk, 1.90 [95% CI, 1.63-2.22];
P<0.0001) and inhospital mortality (5.6% versus 4.2%; relative risk, 1.34
[95% CI, 1.07-1.66]; P=0.01). During followup, allcause mortality occurred
in 899 patients treated with SE-THV (2-year mortality, 29.8%) and in 801
patients treated with BE-THV (2-year mortality, 26.6%; hazard ratio, 1.17
[95% CI, 1.06-1.29]; P=0.003). Similar results were found using inverse
probability of treatment weighting using propensity score analysis.
<br/>CONCLUSION(S): The present study suggests that use of SE-THV was
associated with a higher risk of paravalvular regurgitation and higher
inhospital and 2-year mortality compared with use of BE-THV. These data
strongly support the need for a randomized trial sufficiently powered to
compare the latest generation of SE-THV and BE-THV.<br/>Copyright &#xa9;
2019 American Heart Association, Inc.

<40>
Accession Number
644607448
Title
Effect of home-based prehabilitation on objectively measured physical
activity in patients undergoing elective major cardiac and non-cardiac
surgery. Data from a randomized controlled trial.
Source
European Journal of Preventive Cardiology. Conference: ESC Preventive
Cardiology 2024. Athens Greece. 31(Supplement 1) (pp I279-I280), 2024.
Date of Publication: June 2024.
Author
Vetsch T.; Engel D.; Beilstein C.M.; Wuethrich P.Y.; Eser P.; Wilhlem M.
Institution
(Vetsch, Eser, Wilhlem) Inselspital - University of Bern, Centre for
Rehabilitation and Sports Medicine, Bern, Switzerland
(Engel, Beilstein, Wuethrich) Inselspital - University of Bern,
Anaesthesiology and Pain Medicine, Bern, Switzerland
Publisher
Oxford University Press
Abstract
Background: Low functional capacity in patients undergoing major elective
surgery is associated with postoperative complications. Prehabilitation
aims to increase functional capacity by increasing preoperative physical
activity. Low functional capacity in patients eligible for major surgery
is associated with high age and comorbid burden. In this population,
center-based prehabilitation is a barrier for participation. Therefore, we
developed a multimodal home-based prehabilitation intervention. Data
regarding the effectiveness of a home-based prehabilitation intervention
to increase physical activity before surgery is limited. We hypothesize
that home-based prehabilitation leads to an increase in physical activity
in patients undergoing major cardiac and non-cardiac surgery.
<br/>Method(s): We included patients aged over 65 with a proven low
functional capacity and/or ventilatory efficiency measured by preoperative
cardiopulmonary exercise testing. Patients were randomized to either
standard of care or intervention. The intervention group received a
home-based prehabilitation intervention 2-4 weeks before surgery. As part
of the multimodal intervention, patients were prescribed a walking regimen
according to the physical activity guidelines published by the World
Health Organization (WHO). Patients were followed-up with weekly telephone
calls by a physiotherapist to increase adherence and motivation. All
patients were provided a wrist-worn tri-axial accelerometer at the
baseline visit. The accelerometer was collected at the ward once the
patient entered the hospital for surgery. Physical activity was estimated
by calculating the average Euclidean norm minus one (ENMO, milligravity
[mg]) per day. Baseline characteristics were tested by Wilcoxon rank-sum
test and a linear model for the primary outcome was performed to adjust
for confounders. Data analysis was performed using R Studio.
<br/>Result(s): 37 patients scheduled for cardiac and 62 for non-cardiac
surgery were included (Table 1). Mean group difference of daily physical
activity levels in non-cardiac surgery patients was 3.01 mg (p = 0.03, 95%
CI [0.3, 5.6]). Mean group difference of daily physical activity levels in
cardiac surgery patients was 0.27 mg (p = 0.95, 95% CI [-4.1, 5.0])
(Figure 1). Patients undergoing cardiac surgery had higher overall
activity levels compared to non-cardiac also when adjusted for age.
<br/>Conclusion(s): Home-based prehabilitation increases preoperative
physical activity levels in patients undergoing major non-cardiac surgery,
but not in patients undergoing major cardiac surgery. Higher activity
levels in cardiac surgery patients was unexpected, but may be explained by
previous inclusion of patients with cardiac diseases in exercise-based
rehabilitation and physical activity recommendations at routine cardiac
follow-up visits. (Table Presented).

<41>
[Use Link to view the full text]
Accession Number
642976686
Title
Mitral Valve Repair vs. Mitral Valve Replacement in Rheumatic Heart
Disease Patients: A Systematic Review and Meta-Analysis.
Source
Circulation. Conference: American Heart Association's 2023 Scientific
Sessions and the American Heart Association's 2023 Resuscitation Science
Symposium. Philadelphia, PA United States. 148(Supplement 1) (no
pagination), 2023. Date of Publication: November 2023.
Author
Ul Hassan O.; Yasmin F.; Moeed A.; Rahman S.U.U.; Jawed S.
Publisher
Lippincott Williams and Wilkins
Abstract
Background Mitral valve repair (MVP) is recommended over mitral valve
replacement (MVR) for mitral valve disease. However, its benefits in
rheumatic heart disease (RHD) patients are unclear. We conducted this
meta-analysis to compare perioperative and long-term clinical and safety
outcomes of MVP vs. MVR. <br/>Method(s): MEDLINE, Google Scholar, and
Scopus were searched from inception till June 2023 comparing clinical
outcomes with MVP vs. MVR in RHD patients. Primary outcomes were early
mortality and long-term survival. Secondary outcomes were freedom from
reoperation, freedom from valve related adverse events, postoperative
infective endocarditis (IE), thromboembolic events (TEE), and hemorrhagic
events. The outcome measures were summary random effects risk ratio (RR)
and hazard ratios (HR) with 95% confidence intervals. <br/>Result(s): A
total of 19 studies with 10,724 RHD patients (3,495 MVP vs. 7,229 MVR;
mean age: 38.3 years for MVP vs. 43.5 years for MVR) were included. MVP
was associated with significantly lower early mortality (RR 0.62 [0.45,
0.85]; p=0.003), and long-term mortality (HR 0.53 [0.37, 0.76]; p=0.0006).
Upon meta-regression analysis, only increasing age was associated with
early mortality (Coeff: 0.0194, p=0.037). However, MVP was associated with
significantly lower freedom from reoperation at both 5- (RR 0.88 [0.83,
0.93]; p<0.0001) and 10-year (RR 0.90 [0.83, 0.98]; p=0.01) follow-ups.
Freedom from valve related adverse events was higher in the MVP group at
10-year follow-up (RR 1.15 [1.06, 1.24]; p=0.0006) with no significant
difference at 5-year follow-up (RR 1.03 [0.94, 1.14]; p=0.50). No
significant difference was seen for IE (RR 1.03, p=0.91) and hemorrhagic
events (RR 0.70, p=0.05). TEE were significantly lower in the MVP group
(RR 0.59 [0.44, 0.78]; p=0.0003). <br/>Conclusion(s): In RHD, MVP reduced
early- and long-term mortality and achieved greater freedom from valve
related adverse events. However, there was a higher risk of reoperation in
MVP. (Figure Presented).

<42>
Accession Number
642976387
Title
Mineralocorticoid Antagonist Use for Transthyretin Amyloid Cardiomyopathy
and Associated Outcomes.
Source
Circulation. Conference: American Heart Association's 2023 Scientific
Sessions and the American Heart Association's 2023 Resuscitation Science
Symposium. Philadelphia, PA United States. 148(Supplement 1) (no
pagination), 2023. Date of Publication: November 2023.
Author
Stern L.K.; Kim S.K.; Singer-Englar T.; Kobashigawa J.A.; Kittleson M.M.;
Patel J.K.
Publisher
Lippincott Williams and Wilkins
Abstract
Background: Diuretics have been the mainstay of symptomatic treatment for
patients with amyloid cardiomyopathy however, there remains no established
guideline directed medical therapy for this population. The anti-fibrotic
properties of mineralocorticoid antagonists (MRA) are intriguing for
potential use in transthyretin amyloid cardiomyopathy (ATTR CM); while
they have shown promise for treatment of patients with heart failure with
preserved ejection fraction, their use has never been studied specifically
in the ATTR CM population. The purpose of our study is to evaluate the
real-world use of MRA and associated outcomes in patients with ATTR CM at
a large cardiac amyloid treatment center. <br/>Method(s): Between 2009 and
2023, 168 patients with ATTR CM at our center were assessed for history of
MRA use. Biomarkers, including baseline levels of troponin and natriuretic
peptides, as well as kidney function were assessed. We also assessed the
outcomes of 5-year survival, need for heart transplant, hospitalization,
and mechanical circulatory support (MCS) use. <br/>Result(s): Of the 168
patients, 49 (29%) had a history of MRA use and 119 (71%) had no prior
use. Between the two groups, there was no significant difference in age,
frequency of ATTR CM subtype, kidney disease, or biomarker level at the
time of diagnosis. While 5-year survival and need for MCS were similar
between the two groups, there was a higher rate of transplant and
hospitalization in the MRA use group. <br/>Conclusion(s): In a cohort of
patients with ATTR CM, MRA use is uncommon and was not associated with
improved outcomes. It was associated with higher rates of hospitalizations
and heart transplantation; however, this may represent confounding by
indication. Future investigations with larger registry cohorts and
randomized control trials are warranted for further evaluation of
biological and clinical effect of MRA use. .

<43>
[Use Link to view the full text]
Accession Number
642976267
Title
Outcomes From Left Atrial Appendage Occlusion Utilizing the Watchman FLX
versus Watchman 2.5: A Systematic Review and Meta-Analysis.
Source
Circulation. Conference: American Heart Association's 2023 Scientific
Sessions and the American Heart Association's 2023 Resuscitation Science
Symposium. Philadelphia, PA United States. 148(Supplement 1) (no
pagination), 2023. Date of Publication: November 2023.
Author
Aldaas O.M.; Barat M.; Aldaas A.M.; Han F.; Hoffmayer K.S.; Krummen D.E.;
Ho G.; Raissi F.; Birgersdotter-Green U.; Reeves R.; Feld G.K.; Hsu J.C.
Publisher
Lippincott Williams and Wilkins
Abstract
Introduction: Left atrial appendage occlusion with the Watchman device has
been shown to be noninferior to oral anticoagulation in preventing strokes
in patients with atrial fibrillation. The Watchman FLX device was designed
to overcome many of the limitations of the Watchman 2.5. Hypothesis: The
Watchman FLX will have better short- and long-term safety and efficacy
relative to the Watchman 2.5. <br/>Method(s): We performed an extensive
literature search and systematic review of studies that compared the
short- and/or long-term safety and efficacy of the Watchman FLX versus
Watchman 2.5. Risk ratio 95% confidence intervals (CI) were measured using
the Mantel-Haenszel method for dichotomous variables, where a RR<1.0
favors the FLX group. <br/>Result(s): Seven studies with a total of 2315
patients were included, of which 24.0% (n=555) had the FLX and 76.0%
(n=1760) had the 2.5 implanted. There were no statistically significant
differences in procedural complications or device-related thrombosis, but
significantly less peri-device leak at follow-up, as shown in Figure 1.
There were no statistically significant differences in pericardial
effusion/tamponade (MD 0.54; 95% CI 0.09-3.25) or device embolization (MD
0.44; 95% CI 0.05-4.14). No statistically significant differences were
seen in major bleeding (MD 1.06; 95% CI 0.55-2.05), transient ischemic
attack, stroke or systemic embolism (MD 0.31; 95% CI 0.08-1.20) or
all-cause mortality (MD 1.65; 95% CI 0.76-3.57) at follow-up.
<br/>Conclusion(s): Based on the results of this meta-analysis, the
Watchman FLX appears to be as safe as the Watchman 2.5, but with lower
rates of peri-device leak.

<44>
Accession Number
642976243
Title
Robotic-Assisted versus Conventional Mitral Valve Repair: An Updated
Meta-Analysis of Operative and Post- Operative Outcomes.
Source
Circulation. Conference: American Heart Association's 2023 Scientific
Sessions and the American Heart Association's 2023 Resuscitation Science
Symposium. Philadelphia, PA United States. 148(Supplement 1) (no
pagination), 2023. Date of Publication: November 2023.
Author
Elfaituri M.K.; Khaled A.; Ben Ghatnsh A.; Khaled T.; Faraj H.A.A.;
Msherghi A.
Publisher
Lippincott Williams and Wilkins
Abstract
Introduction: Cardiac surgery has seen notable advancements, especially in
mitral valve repair, with the emergence of robotic-assisted mitral valve
repair (RAMVR). Amid ongoing debates about RAMVR's efficacy and safety
versus conventional mitral valve repair (CMVR), this updated meta-analysis
offers a comprehensive comparison based on recently published data.
<br/>Aim(s): The study aims to provide a comparison of RAMVR and CMVR,
focusing on key operative and postoperative outcomes. <br/>Method(s): A
systematic search was conducted utilizing databases such as PubMed,
EMBASE, and the Cochrane Library, until January 2023. The inclusion
criteria included studies that compared RAMVR with CMVR. The meta-analysis
incorporated a random-effects model to calculate pooled mean differences
(MD) and relative risks (RR). All statistical analyses were carried out
using R software (version 4.0.3), by metafor and meta packages.
<br/>Result(s): Ten studies with a total of 54,235 patients (5,092 in the
RAMVR group and 49,143 in the CMVR group) were included. The meta-analysis
showed that RAMVR was associated with a significantly shorter hospital
stay (MD -1.79 days; 95% CI -2.77 to -0.83, P=<0.01, I2=100%) and ICU
length of stay (MD -16.76 days; 95% CI -29.34 to -4.19, P=<0.01, I2=98%).
However, RAMVR was associated with significantly longer cardiopulmonary
bypass time (MD 42.90 minutes; 95% CI 29.58 to 56.22, P<0.01, I2=98%) and
cross-clamp time (MD 29.67 minutes; 95% CI 19.84 to 39.51, P<0.01,
I2=98%). In terms of relative risks, RAMVR had a lower rate of overall
mortality (RR 0.55; 95% CI 0.42 to 0.74, P<0.01, I2=0%) and rate of
infection (RR 0.62; 95% CI 0.52 to 0.74, P<0.01, I2=0%). However, there
was no statistically significant difference in the rate of blood
transfusion, stroke rate, atrial fibrillation, and transient ischemic
attack. <br/>Conclusion(s): This study suggests that RAMVR may offer
benefits such as shorter hospital and ICU stays and lower overall
mortality and infection rates, but it also involves longer cardiopulmonary
bypass and cross-clamp times. Given the high heterogeneity across the
included studies, this underlines the importance of further highquality
randomized controlled trials to optimize RAMVR techniques for improving
patient outcomes in mitral valve repair.

<45>
Accession Number
642976069
Title
Takotsubo Syndrome and Surgery: A Systematic Review.
Source
Circulation. Conference: American Heart Association's 2023 Scientific
Sessions and the American Heart Association's 2023 Resuscitation Science
Symposium. Philadelphia, PA United States. 148(Supplement 1) (no
pagination), 2023. Date of Publication: November 2023.
Author
Li P.; Dobbin T.; Cai P.; Shi A.; Liu Q.
Publisher
Lippincott Williams and Wilkins
Abstract
Background: Takotsubo syndrome (TTS) is a rare cardiovascular condition
characterized by reversible ventricular dysfunction. An increasing number
of studies have shown surgery as a trigger for TTS. <br/>Method(s): We
performed a systematic review of all case reports and case series
reporting an association between surgery and TTS by searching PubMed,
EMBASE, and Cochrane Library databases in June 2022. A total of 172 cases
(Surgery-TTS) were selected and compared with previously reported 1,750
TTS patients of any type (All-TTS). <br/>Result(s): In TTS patients
triggered by surgery, the most common symptom was dyspnea (48.6%),
followed by chest pain (31.8%) and dizziness (4.7%). The most common type
of TTS was apical, accounting for 80.4% of cases, followed by the basal
(8.2%), biventricular (5.1%), and midventricular (3.8%) types. Among these
cases, 46.5% were associated with intraabdominal procedures, 25% with
cardiothoracic surgery, followed by 12.3% with ENT/Ophthalmology and 8.7%
with neurosurgery. Compared with the All-TTS cohort, the Surgery-TTS
cohort was younger (55.9 vs 66.4, P < 0.001) and had a lower incidence of
chest pain (75.9% vs. 31.8%; P < 0.001) and QT prolongation (18.0% vs.
47.7%, P < 0.001) but a significantly increased in-hospital mortality
(10.4% vs 4.1%, P = 0.001). Furthermore, basal-type TTS was significantly
more common in the Surgery-TTS cohort than in the All-TTS cohort (8.2% vs.
2.2%, P < 0.001). <br/>Conclusion(s): Surgical triggers are associated
with increased mortality and atypical presentation in TTS patients when
compared with patients who have TTS of all types. A high degree of
clinical suspicion is required to concurrently diagnose TTS in surgical
patients.

<46>
[Use Link to view the full text]
Accession Number
642976011
Title
Revascularization Shows Beneficial Cardiovascular Outcomes in Severe
Ischemic Cardiomyopathy: A Systematic Review and Meta-Analysis.
Source
Circulation. Conference: American Heart Association's 2023 Scientific
Sessions and the American Heart Association's 2023 Resuscitation Science
Symposium. Philadelphia, PA United States. 148(Supplement 1) (no
pagination), 2023. Date of Publication: November 2023.
Author
Fatima S.; Hurera A.; Rivera M.T.; Sezer A.; Hickey G.W.
Publisher
Lippincott Williams and Wilkins
Abstract
Introduction: Revascularization approach is historically prioritized over
optimal medical therapy (OMT) for patients with severe stable ischemic
cardiomyopathy (ICM) with ejection fraction < 35%. However, with
advancement in OMT, recent studies have shown similar cardiovascular
outcomes between the two strategies. Herein, we present a systematic
review and meta-analysis examining the cardiovascular outcomes of
revascularization strategies compared to OMT. Research Question: Is
revascularization associated with improved cardiovascular outcomes in
patients with severe stable ICM compared to OMT alone? Methods: PubMed,
Embase, Cochrane, CT.gov, ICTRP were searched using the search terms
coronary artery bypass grafting (CABG) or percutaneous coronary
intervention (PCI) versus OMT and ICM or heart failure (HF) from inception
till May 2023. Included studies compared all-cause mortality,
cardiovascular mortality, HF-related deaths, acute myocardial infarction
(AMI), stroke and HF hospitalization. Data were pooled into risk ratios
(RR) using fixed-effects model. <br/>Result(s): 3 studies (n= 2050,
Revascularization = 1026 and OMT= 1024) met our inclusion criteria. The
follow-up period ranged from 3.4-9.8 years. Revascularization strategies
primarily through CABG had protective effects for all-cause mortality (RR
0.91, 95% CI 0.84-0.98, p= 0.01, I2 0%, N= 3 studies), cardiovascular
death (RR 0.83, 95% CI 0.74-0.93, p=0.00, I2 0%, N= 2 studies) and HF
hospitalizations (RR 0.80, 95% CI 0.69-0.93, p= 0.00, I2 19.20%, N= 2
studies). No significant differences were observed in risks of HF related
deaths, AMI and stroke between the two strategies. <br/>Conclusion(s):
Revascularization primarily through CABG reduces all-cause and
cardiovascular mortality as well as HF hospitalizations in severe stable
ICM. Further studies are warranted to determine which patients can derive
the greatest advantages from revascularization.

<47>
Accession Number
642975783
Title
Lessons From Launching a Digital Health Trial for Hybrid Cardiac
Rehabilitation.
Source
Circulation. Conference: American Heart Association's 2023 Scientific
Sessions and the American Heart Association's 2023 Resuscitation Science
Symposium. Philadelphia, PA United States. 148(Supplement 1) (no
pagination), 2023. Date of Publication: November 2023.
Author
Kim C.H.; Nimbalkar M.; Isakadze N.; Gao Y.; MacFarlane Z.; Ding J.;
Broderick A.; Bush A.; Gallagher J.; Wiley B.; Lobien J.; Reddy T.; Aguado
C.; Benjamin P.; Neigh B.; Stewart K.J.; Mathews L.M.; Spaulding E.;
Martin S.S.; Marvel F.A.
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND: Despite the well-established benefits of cardiac
rehabilitation (CR) for secondary prevention of cardiovascular disease,
participation remains low due to limited supply and access barriers. We
built a hybrid CR program that combines in-person and home-based CR (with
smartphone app (Corrie Health), smartwatch, Bluetooth blood pressure
monitor, and health coaching delivered over 12 weeks). We assessed this
novel CR program in a pilot study at Johns Hopkins Hospital and applied
the lessons learned to launch a randomized controlled trial (mTECH REHAB;
NCT05238103) of hybrid versus traditional CR. <br/>METHOD(S): We examined
pilot data from Nov 2022 to Feb 2023 for electronic health record (EHR)
screening, bedside enrollment, technology onboarding, access to CR, and
weekly health coaching. We identified barriers in the enrollment process
which we then used to guide trial design and team organization.
<br/>RESULT(S): EHR screening yielded 1,270 candidates, among which 209
(16.5%) were eligible following chart review. Our team approached 106
(50.7%) at bedside and 20 (9.6%) were enrolled into the pilot study. Ten
(50.0%) were lost to follow up, with reasons of: loss of interest (3),
post-procedural complication (3), frailty requiring acute CR (1), no
insurance coverage (1), follow up in external CR (1), and technology
challenges (1). These findings informed trial design as follows: 1)
pre-specified filters for cardiovascular procedures/surgeries were added
to EHR screening; 2) remote enrollment pathway was added; 3) a 2-week
run-in period was added to verify insurance and continued interest
following hospital discharge; and 4) standardized workflows and
specialized teams were developed for patient recruitment, technology
onboarding, and health coaching. The mTECH REHAB trial was launched in Apr
2023. In the first 9 weeks, 851 patients were screened, 157 (18.4%) were
eligible, 148 (94.2%) were able to be reached at bedside or via telephone,
41 (27.7%; 16 bedside, 25 remote) were enrolled, and 5 (12.2%) were lost
to early follow up because of: loss of interest (3), post-procedural
complication (1), and patient relocation (1). <br/>CONCLUSION(S): A pilot
study can inform and improve the enrollment process in a multi-component
digital health trial.

<48>
[Use Link to view the full text]
Accession Number
642975597
Title
Prothrombin Complex Concentrate is Superior to Fresh Frozen Plasma for the
Management of Bleeding in Patients Undergoing Cardiac Surgery: A
Systematic Review and Meta-Analysis.
Source
Circulation. Conference: American Heart Association's 2023 Scientific
Sessions and the American Heart Association's 2023 Resuscitation Science
Symposium. Philadelphia, PA United States. 148(Supplement 1) (no
pagination), 2023. Date of Publication: November 2023.
Author
Viana P.; Relvas J.H.; Persson M.Z.; Dias Delfino Cabral T.; De Oliveira
J.S.; Persson J.E.Z.; Bonow P.A.; Freire C.V.S.; Velasquez C.; Amaral S.
Publisher
Lippincott Williams and Wilkins
Abstract
Introduction: Prothrombin Complex Concentrate (PCC) and Fresh Frozen
Plasma (FFP) are commonly used for management of bleeding in cardiac
surgery patients. However, the relative efficacy and safety of these two
strategies remain uncertain. Hypothesis: We conducted a meta-analysis to
compare outcomes of PCC vs. FFP in patients who undergo cardiac surgery
complicated by bleeding. <br/>Method(s): PubMed, Embase, and Cochrane were
searched for studies comparing PCC vs. FFP in patients who have cardiac
surgery complicated by bleeding. Review Manager 5.4 was used for
statistical analysis. Binary and continuous outcomes were compared with
pooled odds-ratio and mean differences, respectively. The metaanalysis
protocol was registered prospectively in PROSPERO. <br/>Result(s): We
included 8 studies with 1,500 patients, of whom 613 (40.9%) received PCC.
The mean follow-up period ranged from 28-90 days. The PCC group had
significantly lower chest tube drainage at 24 hours (MD -148.50 mL; 95% CI
-253.02 to -43.99 mL; p = 0.005; I²= 42%; Figure 1A). Also,
there were fewer units of RBC transfusion within the first 24 hours (MD
-1.02 units; 95% CI -1.81 to -0.24 units; p = 0.01; I²= 56%;
Figure 1B) and fewer patients requiring RBC transfusion within the first
24 hours (OR 0.38; 95% CI 0.28-0.52; p < 0.001; I²= 3%) in the
PCC group. There was no significant difference between groups in all-cause
mortality, thromboembolic events, stroke, or length of hospital stay. A
subgroup analysis restricted to RCTs showed a significant reduction in the
number of patients requiring RBC transfusion within 24 hours with PCC
relative to FFP (OR 0.51; 95% CI 0.27-0.95; p = 0.04; I²= 0%).
<br/>Conclusion(s): These findings suggest that PCC is an effective
strategy compared with FFP in reducing chest tube drainage and the need
for RBC transfusion within the first 24 hours in patients who undergo
cardiac surgery complicated by bleeding, without a significant difference
in mortality or thromboembolic events between groups. (Figure Presented).

<49>
[Use Link to view the full text]
Accession Number
642975576
Title
Does Mineralocorticoid Receptor Blockade Affect the Occurrence of
Perioperative Atrial Fibrillation in Cardiac Surgery Patients? - A
Systematic Review and Meta-Analysis.
Source
Circulation. Conference: American Heart Association's 2023 Scientific
Sessions and the American Heart Association's 2023 Resuscitation Science
Symposium. Philadelphia, PA United States. 148(Supplement 1) (no
pagination), 2023. Date of Publication: November 2023.
Author
Rajak K.; Halder A.; Ghimire M.; Gautam S.S.; Khanal R.; Jaiswal V.;
Atrash A.; Goswami R.
Publisher
Lippincott Williams and Wilkins
Abstract
Background: Mineralocorticoid receptor antagonists (MRAs) have emerged as
potential therapy to prevent atrial fibrillation (AF). However,
inconsistent results of MRAs effect on perioperative AF have been reported
in the literature in patients undergoing cardiac surgery. To our
knowledge, this is the first metanalysis to assess the effect of MRAs on
occurrence of perioperative AF in patients undergoing cardiac surgery.
<br/>Method(s): We searched different electronic databases from inception
to April 30th, 2023, for randomized controlled trials (RCTs) and
observational studies that evaluated the use of MRAs in patients with
heart failure and left ventricular ejection fraction (LVEF) 30-50% who
were referred for Coronary Artery Bypass Grafting (CABG) and/or valve
surgery without any AF history. Primary outcome was occurrence of
perioperative AF. Three independent reviewers selected and appraised the
data. A random-effects metaanalysis was performed to estimate pooled odds
ratios (OR) and 95% confidence intervals (CI). <br/>Result(s): We included
4 studies, 1 RCT and 3 observational cohorts, with a cumulative number of
1,128 patients with mean age 65.15 years. 412(36.5%) received an MRA
(spironolactone or eplerenone). The follow up duration was 5 days to 1
month. During follow-up, 118 (28.64%) patients treated with MRAs,
developed AF, compared to 224 (31.28%) patients, without MRA treatment.
However, metanalysis showed that there is no significant reduction in
occurrence of perioperative AF in MRA treated patients (OR: 0.88 CI:
0.58-1.33 p=0.55), I2 53%; Figure] <br/>Conclusion(s): Experimental data
have shown that MRA blockade prevents perioperative AF in animal models
but our metanalysis demonstrated that MRAs were not protective for
perioperative AF in patients undergoing cardiac surgery. Larger trials in
humans are warranted to evaluate its efficacy, particularly in patients
undergoing cardiac surgery.

<50>
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Accession Number
642975555
Title
Patient Reported Outcomes Measures Are Infrequently Used in Clinical
Studies of Heart Transplant Recipients.
Source
Circulation. Conference: American Heart Association's 2023 Scientific
Sessions and the American Heart Association's 2023 Resuscitation Science
Symposium. Philadelphia, PA United States. 148(Supplement 1) (no
pagination), 2023. Date of Publication: November 2023.
Author
Austin M.A.; Reza N.
Publisher
Lippincott Williams and Wilkins
Abstract
Introduction / Background: The goals of heart transplantation (HT) are to
improve symptoms, restore quality of life, and extend survival. Clinical
trials in HT recipients have largely focused on objective outcomes such as
measures of cardiac function and survival; however, a paucity of data
exists regarding the use of patient reported outcome measures (PROMs) as
outcomes in these studies. <br/>Aim(s): We aimed to characterize the use
of PROMs in registered clinical trials of HT recipients. <br/>Method(s):
All clinical studies of adult HT recipients were queried from
ClinicalTrials.gov, and studies were stratified by inclusion of PROMs.
Studies reporting PROMs were identified via specific search terms using
the "outcomes measures" field. Summary statistics compared characteristics
of studies that did versus did not report PROMs. Results/Data: Between
November 1999 and August 2022, 227 studies of HT recipients were
registered on ClinicalTrials.gov. At least one PROM was reported in 11%
(n=24/227) of registered studies. Studies reporting PROMs were more likely
to be conducted outside of the United States (91.7% vs 54.2%, p<0.001) and
report a greater number of total primary/secondary outcomes (PROMs: median
7 [IQR: 4, 9] vs. No PROMs: median 3 [IQR: 2, 6]; p<0.001). The majority
of studies reporting PROMs (58.3%) were initiated after 2020. Twenty-one
distinct PROM tools/domains were reported as outcome measures, with the
Short Form Health Survey 36 being most frequently used (n=10/24). Thirteen
of the 21 PROMs included questions assessing mental health, whereas only
three PROM tools were cardiac-specific (Figure). <br/>Conclusion(s): Only
about one in ten registered clinical trials of HT recipients include
PROMs, and mental health was the most commonly assessed domain when a PROM
was included. Development and validation of PROM tools is needed to assess
the multifaceted nature of health-related quality of life in HT
recipients. (Figure Presented).

<51>
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Accession Number
642975512
Title
Role of Elevated High-Sensitivity Cardiac Troponin T in Determining the
Clinical and Angiographic Outcomes in Patients With Chronic Total
Occlusion Undergoing Percutaneous Intervention: A Meta-Analysis.
Source
Circulation. Conference: American Heart Association's 2023 Scientific
Sessions and the American Heart Association's 2023 Resuscitation Science
Symposium. Philadelphia, PA United States. 148(Supplement 1) (no
pagination), 2023. Date of Publication: November 2023.
Author
Damarlapally N.; Sawhney A.; Verma J.; Klair H.S.S.; Kolli D.; Sibia B.S.;
Chalasani V.; Reddy R.; Teja Kolli J.; Desai R.; Sachdeva R.; Kumar G.;
Paul T.K.
Publisher
Lippincott Williams and Wilkins
Abstract
Background: Percutaneous Coronary Intervention of Chronic Total Occlusion
(CTO-PCI) leads to higher periprocedural myocardial injury (PMI); however,
the prognostic value of high-sensitive-Cardiac Troponin T (Hs-cTnT) in
CTO-PCI outcomes is not well studied. This review evaluated the
association of Hs-cTnT with major adverse cardiovascular events (MACE)
following CTO-PCI. <br/>Method(s): We conducted a thorough literature
search in PubMed, Scopus, Embase, and Google Scholar, using relevant
keywords, to identify studies up to 2022. The primary outcome of interest
was MACE, which included all-cause mortality, PMI, target vessel
revascularization (TVR), and target vessel reocclusion (TVRO). Pooled odds
ratios (OR) and 95% confidence intervals (CI) were estimated using binary
random-effects models. Heterogeneity was assessed using I statistics.
<br/>Result(s): Our analysis included four studies investigating 1499
post-CTO-PCI patients (mean age 66.77+/-10.09 years, 81.5% male). Patients
with multivessel disease, retrograde approach, and previous PCI or
coronary artery bypass graft procedures were more likely to present with
elevated Hs-cTnT levels due to the complexity of the procedure. No
difference in baseline comorbidities was noted in patients with and
without elevated Hs-cTnT, including diabetes and hypertension. There was
no significant association between Hs-cTnT levels and MACE (OR:1.56
p=0.25), TVR (OR:2.03, p=0.22), PMI (OR:3.45, p=0.07), and mortality
(OR:2.35, p=0.14) (Figure 1). However, a significant association was found
between HscTnT levels and TVRO [OR:8.78 (95% C.I. 3.64-21.17) p<0.01, I2
0%]. <br/>Conclusion(s): Patients with elevated Hs-cTnT levels have a
nine-fold higher risk of TVRO than those with normal levels in CTO-PCI.
Periprocedural Hs-cTnT measurement can be utilized for risk stratification
of TVRO after CTO-PCI with no association with MACE. Overall smaller
sample size warrants more randomized studies to substantiate the results.

<52>
Accession Number
642975415
Title
Inflammation and Cholesterol as Predictors of Cardiovascular Events and
Risk Reduction With Bempedoic Acid Among Statin Intolerant Patients: An
Analysis of the CLEAR Outcomes Trial.
Source
Circulation. Conference: American Heart Association's 2023 Scientific
Sessions and the American Heart Association's 2023 Resuscitation Science
Symposium. Philadelphia, PA United States. 148(Supplement 1) (no
pagination), 2023. Date of Publication: November 2023.
Author
Ridker P.M.; Lei L.; Louie M.J.; Haddad T.M.; Nicholls S.J.; Lincoff A.M.;
Libby P.; Nissen S.E.
Publisher
Lippincott Williams and Wilkins
Abstract
Introduction: Among contemporary statin-treated patients, residual
inflammatory risk assessed by high-sensitivity C-reactive protein (hsCRP)
is a stronger predictor of future cardiovascular (CV) events and all-cause
mortality than residual cholesterol risk assessed by low density
lipoprotein cholesterol (LDLC). Whether these relationships are present
among statin-intolerant patients is unknown but has implications for the
choice of preventive therapies including bempedoic acid, an agent that
reduces both LDLC and hsCRP. <br/>Method(s): In the multi-national
CLEAR-Outcomes trial, 13,970 statin-intolerant patients were randomly
allocated 1:1 to 180 mg oral bempedoic acid daily or matching placebo and
followed for incident myocardial infarction (MI), stroke, coronary
revascularization, CV death, and all-cause mortality. Quartiles of
increasing baseline hsCRP and LDLC were assessed as predictors of future
adverse CV events after adjustment for traditional risk factors and
treatment (bempedoic acid vs. placebo). <br/>Result(s): Baseline hsCRP was
significantly associated with incident composite endpoint of MI, stroke,
coronary revascularization, and CV death (highest vs lowest hsCRP
quartile, HR=1.43, 95% CI 1.24- 1.65), CV mortality (HR=2.00, 95% CI
1.53-2.61), and all-cause mortality (HR=2.21, 95% CI 1.79- 2.73). By
contrast, the relationship of baseline LDLC quartile (highest vs. lowest)
to future CV events was smaller for the composite endpoint (HR=1.19, 95%
CI 1.04-1.37) and neutral for CV mortality (HR 0.90, 95% CI 0.70-1.17) and
all-cause mortality (HR 0.95, 95% CI 0.78-1.16) such that risks were high
for those with elevated hsCRP irrespective of LDLC level. Compared to
placebo, bempedoic acid reduced median hsCRP by 21.6% and mean LDLC levels
by 21.1% at 6 months and demonstrated similar efficacy in reducing major
adverse CV events across all levels of hsCRP and LDLC.
<br/>Interpretation(s): Among contemporary statin-intolerant patients,
inflammation assessed by hsCRP was a stronger predictor of risk for future
CV events and death than was hyperlipidemia assessed by LDLC. Compared to
placebo, bempedoic acid had similar efficacy for reducing CV risk across
hsCRP and LDLC strata.

<53>
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Accession Number
642975368
Title
Efficacy and Safety of Bempedoic Acid for Prevention of Cardiovascular
Events and Diabetes Mellitus: A Systematic Review and Meta-Analysis of
Randomized Control Trials.
Source
Circulation. Conference: American Heart Association's 2023 Scientific
Sessions and the American Heart Association's 2023 Resuscitation Science
Symposium. Philadelphia, PA United States. 148(Supplement 1) (no
pagination), 2023. Date of Publication: November 2023.
Author
Yasmin F.; Najeeb H.; Moeed A.; Ali E.; Ur U Rahman S.; Khan M.S.; Shah
N.; Michos E.D.
Publisher
Lippincott Williams and Wilkins
Abstract
Background: Bempedoic acid (BA) is considered an alternative therapy for
hyperlipidemia (HLD) in statin-intolerant patients. Given the positive
results from the CLEAR-OUTCOMES trial, we performed a meta-analysis
pooling recently conducted randomized control trials (RCTs) to provide a
comprehensive clinical evaluation of the safety and efficacy of BA.
Hypothesis: Bempedoic acid therapy in HLD patients with statin intolerance
may be associated with a significant reduction in LDL-C levels, and CV
events. <br/>Method(s): All RCTs reporting CV outcomes and/or % change in
LDL-C from baseline till completion of follow-up duration in HLD patients
with statin-intolerance were included in MEDLINE, Google Scholar, and
Scopus databases (Inception to April 2023). The outcome measures were
summary random effects risk ratio (RR) and mean differences (MD) with 95%
confidence intervals. <br/>Result(s): Twelve RCTs were included with 18
510 patients (10,033 BA vs. 8,477 placebo). BA therapy resulted in greater
significant % reduction in LDL-C levels post-treatment (mean difference
from baseline: 21.73% [-26.94, -16.51], p<0.00001) with no significant
impact of the male sex, age, and follow-up duration on LDL-C upon
meta-regression analysis. The risk of MACE (RR, 0.86 [0.79, 0.93], p <
0.0004), coronary artery revascularization (RR, 0.81 [0.72, 0.91], p =
0.0005), and myocardial infarction (RR, 0.71 [0.51, 0.99], p= 0.04) were
significantly reduced with BA (Figure 1). However, no significant
reduction in cardiac death (RR, 1.05 [0.89, 1.24], p = 0.56) was observed.
A total of 1,019 new-onset DM events (521/6027 with BA; 498/4946 with
placebo) were reported, and demonstrated a non-significant lower risk of
new-onset or worsening DM (RR 0.83; 95% CI [0.62, 1.13]; P = 0.24) with BA
vs. placebo. <br/>Conclusion(s): BA was observed to be safe, efficacious,
associated with improved cardiovascular outcomes, and with no effect on
new-onset or worsening DM among HLD patients with statin intolerance.
(Figure Presented).

<54>
Accession Number
642975199
Title
Long-Term Outcomes of Prosthesis-Patient Mismatch After Surgical Aortic
Valve Replacement: Meta- Analysis of Kaplan-Meier-Derived Individual
Patient Data.
Source
Circulation. Conference: American Heart Association's 2023 Scientific
Sessions and the American Heart Association's 2023 Resuscitation Science
Symposium. Philadelphia, PA United States. 148(Supplement 1) (no
pagination), 2023. Date of Publication: November 2023.
Author
Sa M.P.; Jacquemyn X.; Van Den Eynde J.; Chu D.; Serna-Gallegos D.; Ebels
T.; Clavel M.-A.; Pibarot P.; Sultan I.
Publisher
Lippincott Williams and Wilkins
Abstract
Introduction - It remains controversial whether prosthesis-patient
mismatch (PPM) impacts long-term outcomes after surgical aortic valve
replacement (SAVR). Hypothesis - PPM is associated with poor outcomes
after SAVR. Methods - Study-level meta-analysis of reconstructed
time-to-event data from Kaplan-Meier curves of studies published by March
2023. Results - Sixty-five studies met our eligibility criteria and
included 122,989 patients (any PPM: 68,332 patients, 55.6%). At 25 years
of follow-up, the survival rates were 11.8% and 20.6% in patients with and
without any PPM, respectively (HR 1.16; 95%CI 1.13-1.18, p<0.001). At 20
years of follow-up, the survival rates were 19.5%, 12.1 and 8.8% in
patients with no, moderate and severe, respectively (moderate vs no PPM:
HR 1.09; 95%CI 1.06-1.11; p<0.001; severe vs no PPM: HR 1.29; 95%CI 1.24-
1.35; p<0.001). RMST was 0.8 years shorter in patients with moderate PPM,
and 2.1 years shorter in patients with severe PPM in comparison with
patients without PPM (10.2 years and 8.9 years vs. 11.0 years
respectively, p<0.001). PPM was associated with higher risk of cardiac
death, HF-related hospitalizations and aortic valves reinterventions over
time (p<0.001). Statistically significant associations between PPM and
worse survival were observed regardless of type of valves (bioprosthetic
vs mechanical valves), contemporary PPM definitions unadjusted and
adjusted to body mass index and PPM quantification method (in vitro, in
vivo, Doppler echocardiography). Our metaregression analysis revealed that
populations with more women tend to have higher HRs for all-cause death
associated with PPM. Conclusions - The results of the present study
suggest that any degree of PPM is associated with poorer long-term
outcomes following SAVR and provide support for implementation of
preventive strategies to avoid PPM after SAVR. (Figure Presented).

<55>
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Accession Number
642974973
Title
Outcomes of Leadless Pacemaker Implantation Following Transvenous Lead
Removal of Infected Cardiac Implantable Electronic Device: A Systematic
Review.
Source
Circulation. Conference: American Heart Association's 2023 Scientific
Sessions and the American Heart Association's 2023 Resuscitation Science
Symposium. Philadelphia, PA United States. 148(Supplement 1) (no
pagination), 2023. Date of Publication: November 2023.
Author
Tan M.C.; Tan J.L.; Tay S.T.; Sorajja D.; Scott L.; Cha Y.-M.; Russo A.M.;
Hussein A.; Lee J.
Publisher
Lippincott Williams and Wilkins
Abstract
Background: The outcomes of leadless pacemaker (LP) implantation after
transvenous lead removal (TLR) of infected cardiac implantable electronic
devices (CIED) are not well-established. <br/>Objective(s): This study
sought to describe the outcomes of LP implantation following TLR of
infected CIED. <br/>Method(s): We conducted a literature search using
PubMed and Embase for a combination of term including leadless pacemaker
implantation, transvenous lead extraction, transvenous lead removal,
transvenous lead explant, infected cardiac implantable electronic device.
The inclusion criterion was LP implantation after TLR of infected CIED.
The exclusion criterion was TLR for non-infectious reason. Study
end-points were procedural complications and LP infection. <br/>Result(s):
Of 132 publications reviewed, 13 studies with a total of 253 patients (74
+/- 14 years of age, 69% males) were included. Amongst, 56.8% had systemic
CIED infection and 43.2% had isolated pocket infection. Staphylococcus
Aureus was the most common causative organism in 33% of the reported
patients. Of 253 patients included, 105 patients (41.5%) underwent
concomitant LP implantation during TLR procedure, and 36 patients (14.2%)
had transvenous pacing as a bridge from TLR to LP implantation. During the
LP implantation, 1 patient (0.4%) had an intra-procedural complication
requiring sternotomy. Post-LP implantation, 2 patients (0.8%) developed
groin hematoma, 2 patients (0.8%) developed femoral arteriovenous fistula,
and 1 patient (0.4%) developed pericardial effusion requiring
pericardiocentesis. During a mean follow-up of 11.3 +/-10.6 months, 3
patients (1.2%) developed pacemaker syndrome, 1 patient (0.4%) developed
acute on chronic heart failure exacerbation, and only 1 patient (0.4%)
developed LP-related infection requiring LP retrieval. <br/>Conclusion(s):
This study suggests that LP implant is feasible and safe post-removal of
infected CIED with cumulative adverse events at 4% and a reinfection rate
of 0.4%.

<56>
Accession Number
642974967
Title
Mid-Term Survival of Low-Risk Patients Treated With Transcatheter versus
Surgical Aortic Valve Replacement: Meta-Analysis of Reconstructed
Time-to-Event Data.
Source
Circulation. Conference: American Heart Association's 2023 Scientific
Sessions and the American Heart Association's 2023 Resuscitation Science
Symposium. Philadelphia, PA United States. 148(Supplement 1) (no
pagination), 2023. Date of Publication: November 2023.
Author
Sa M.P.; Jacquemyn X.; Van Den Eynde J.; Serna-Gallegos D.; Chu D.; Clavel
M.-A.; Pibarot P.; Sultan I.
Publisher
Lippincott Williams and Wilkins
Abstract
Background: We performed a meta-analysis of reconstructed time-to-event
data from randomized controlled trials (RCTs) and propensity-score matched
(PSM) studies comparing transcatheter versus surgical aortic valve
replacement (TAVR versus SAVR) to evaluate mid-term outcomes in patients
considered low risk for SAVR. <br/>Methods and Results: Study-level
meta-analysis of Kaplan-Meier-derived time-to-event of RCTs and PSM
studies published by December 31, 2022. Eight studies (3 RCTs; 5 PSM
studies) met our eligibility criteria and included 5,444 patients (2,639
patients underwent TAVR and 2,805 patients underwent SAVR). TAVR showed a
higher risk of all-cause mortality at 8 years of follow-up [hazard ratio
(HR) 1.22, 95% confidence interval (CI) 1.03-1.43, P=0.018]. Up to 2 years
of follow-up, TAVR was not inferior to SAVR (HR 1.08, 95%CI 0.89-1.31,
P=0.448); however, we observed a statistically significant difference
after 2 years with higher mortality with TAVR (HR 1.51; 95% CI 1.14-2.00;
P=0.004). This difference was driven by PSM studies; our sensitivity
analysis showed a statistically significant difference between TAVR and
SAVR when we included only PSM studies (HR 1.41, 95%CI 1.16-1.72,
P=0.001), but no statistically significant difference when we included
only RCTs (HR 0.89, 95%CI 0.69-1.16, P=0.398). At 8 years of follow-up
after the primary intervention, the treatment difference in restricted
mean survival time (RMST) is statistically significant, resulting in a
benefit of 187.2 days (95% CI, 85.1-289.2, P<0.001) in the SAVR arm.
<br/>Conclusion(s): In comparison with TAVR, SAVR appeared to be
associated with improved survival beyond 2 years in low-risk patients.
However, the survival benefit of SAVR was only observed in PSM studies and
not in RCTs. The addition of data from ongoing RCTs as well as longer
follow-up in previous RCTs will help to confirm if there is a difference
in mid- and long-term survival between TAVR vs. SAVR in low-risk
population. (Figure Presented).

<57>
Accession Number
642974927
Title
Safety and Efficacy of Left Atrial Appendage Occlusion in Patients With
Chronic Kidney Disease: A MetaAnalysis.
Source
Circulation. Conference: American Heart Association's 2023 Scientific
Sessions and the American Heart Association's 2023 Resuscitation Science
Symposium. Philadelphia, PA United States. 148(Supplement 1) (no
pagination), 2023. Date of Publication: November 2023.
Author
Ang S.P.; Chia J.E.; Jaiswal V.; Chia T.H.; Iglesias J.
Publisher
Lippincott Williams and Wilkins
Abstract
Introduction: Left atrial appendage occlusion (LAAO) has been recognized
as an alternative to preventing thromboembolic stroke in selected patients
with non-valvular atrial fibrillation (AF). However, limited evidence
exists regarding the safety of LAAO in patients with chronic kidney
disease (CKD). This meta-analysis aims to evaluate the safety and efficacy
of LAAO in CKD patients. <br/>Method(s): We conducted a comprehensive
search across various electronic databases, including PubMed, Embase, and
the Cochrane Library, to identify relevant studies comparing the outcomes
of CKD and non-CKD patients undergoing LAAO. The outcomes of interest
included procedural success, inhospital mortality, major bleeding, stroke,
transient ischemic attack (TIA), and pericardial effusion/tamponade. The
outcomes were pooled using the Hartung-Knapp-Sidik-Jonkman random-effects
model, and the results were expressed as odds ratios (OR) with their
corresponding 95% confidence intervals (CI). <br/>Result(s): Seven studies
involving 38,184 patients (5,742 CKD, 32,442 non-CKD) were included in the
final analysis. The rate of procedural success (98.4% vs. 97.2%, OR 1.64,
95% CI: 0.78-3.45, p=0.19) was similar between both groups. Regarding
procedural complications, there were no significant differences in terms
of the risk of in-hospital mortality (OR 1.87, 95% CI: 0.60-5.82, p=0.28),
stroke (OR 2.19, 95% CI: 0.76-6.29, p=0.15), TIA (OR 1.64, 95% CI:
0.78-3.45, p=0.19), major bleeding (OR 1.85, 95% CI: 0.78-4.42, p=0.16),
or pericardial effusion/tamponade (OR 1.23, 95% CI: 0.76-2.00, p=0.39)
between the two patient groups. <br/>Conclusion(s): Our study demonstrates
comparable safety and efficacy of LAAO in patients with CKD compared to
those without CKD. Further large prospective studies are warranted to
confirm these findings.

<58>
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Accession Number
642974910
Title
Changes in Triglyceride Levels During Omega-3 Fatty Acid Supplementation,
and Incident Cardiovascular Events: Secondary Analysis From the OMEMI
Trial.
Source
Circulation. Conference: American Heart Association's 2023 Scientific
Sessions and the American Heart Association's 2023 Resuscitation Science
Symposium. Philadelphia, PA United States. 148(Supplement 1) (no
pagination), 2023. Date of Publication: November 2023.
Author
Myhre P.L.; Kalstad A.; Tveit S.H.; Laake K.; Nilsen D.; Tveit A.; Solheim
S.; Seljeflot I.
Publisher
Lippincott Williams and Wilkins
Abstract
Background: Elevated triglyceride levels are associated with increased
cardiovascular risk. Omega-3 polyunsaturated fatty acids (n-3PUFA) are
known to reduce triglyceride levels, but whether changes in triglycerides
mediate any cardiovascular effects of n-3PUFA, remains unclear.
<br/>Method(s): In the randomized controlled OMEMI trial, 1014 elderly
(70-82 years) patients with a recent acute myocardial infarction (AMI)
were treated with 1.8 g/day of eicosapentaenoic acid (EPA) and
docosahexaenoic acid (DHA) or placebo (corn oil) for two years, and
followed for the primary outcome of MACE (AMI, coronary revascularization,
stroke, heart failure hospitalization or all-cause death). Relative
changes in triglycerides from baseline to 3 months (n=920, 91%), were
associated with incident MACE (N=175) using landmark Cox regression
models. <br/>Result(s): The median (Q1-Q3) baseline triglyceride
concentration was 97 (74-135) mg/dL, and higher levels were associated
with higher BMI, diabetes and heart failure, in multivariable models.
After 3 months of treatment, triglycerides decreased by median -10% and 0%
in the n-3PUFA and placebo groups, respectively, followed by relatively
stable levels at 12 and 24 months (Figure). Greater triglyceride
reductions at 3-months were associated with a lower risk of MACE in the
n-3PUFA group (HR 1.98 [95%CI 1.23-3.17] per doubling, p=0.004; Figure),
and this persisted after adjusting for baseline triglycerides, age, sex,
BMI and comorbidities (HR 2.34 [1.37-3.98], p=0.002). Changes in
triglycerides did not associate with MACE in the placebo group (HR 1.13
[0.63-2.02], p=0.68). <br/>Conclusion(s): Treatment with 1.8 g/day of
EPA/DHA modestly reduced triglyceride levels and greater ontreatment
triglyceride-reductions were associated with a lower risk of MACE.
Although the overall OMEMItrial was neutral, these findings suggest that
n-3PUFA-related triglyceride changes may play a role with respect to
cardiovascular outcomes. .

<59>
Accession Number
642974811
Title
Associations Among Self-Reported and Physiologic Sleep Measurements and
Fatigue in Adults Following Major Cardiac Events.
Source
Circulation. Conference: American Heart Association's 2023 Scientific
Sessions and the American Heart Association's 2023 Resuscitation Science
Symposium. Philadelphia, PA United States. 148(Supplement 1) (no
pagination), 2023. Date of Publication: November 2023.
Author
Forster A.; Alwine J.; Wierenga K.L.
Publisher
Lippincott Williams and Wilkins
Abstract
Background: Insufficient sleep contributes to fatigue and cardiometabolic
disorders. Current sleep measures vary in accuracy, with weak correlations
between self-report and physiologic measures. Developing reliably
associated self-report and physiologic sleep measures can optimize data
collection methods. <br/>Purpose(s): Investigate correlations between
self-reported and physiologic sleep measures in cardiac rehabilitation
patients and determine associations with fatigue. <br/>Method(s):
Participants (N = 25, 58% male, 89% non-Hispanic white, mean age = 61
years) recruited from cardiac rehabilitation centers participated in a
three-arm RCT. Inclusion criteria were experiencing a myocardial
infarction or revascularization procedure, enrollment in cardiac
rehabilitation, and experiencing depression or anxiety. Participants
without complete sleep measures were excluded. Data was collected at
baseline, 3-, and 6-months. Sleep was measured over 8 days with an
investigator-developed self-report diary and an ActiGraph GT9X Link
accelerometer. ActiGraphs collected data with a 30Hz sampling rate and
were scored using the autodetected sleep periods to determine total sleep
time. Mean daily minutes of sleep were calculated from self-report and
ActiGraph data. Participants also completed a demographics survey and
Fatigue Severity Scale. Statistical methods included Pearson correlation
coefficients with 95% confidence intervals (CI) estimated with Fisher's
r-to-z transformation. <br/>Result(s): Results showed self-reported and
ActiGraph measured sleep were highly correlated (r = 0.889, [95% CI 0.812,
0.935], p < 0.001). Fatigue was not correlated with self-reported (r =
0.074, [95% CI -0.206, 0.342] p = 0.607) or ActiGraph measured sleep (r =
0.150, [95% CI -0.131, 0.408] p = 0.295). Even though the finding was
non-significant, the correlation between fatigue and ActiGraph measured
sleep was larger than self-reported sleep. <br/>Conclusion(s): Accurate
sleep measures are essential to inform future research and interventions.
Unlike past work, this investigator-developed, self-report measure was
strongly correlated with the physiologic measure. Researchers should
consider reliability when selecting sleep measures.

<60>
Accession Number
642974744
Title
The Effect of Sacubitril/Valsartan Therapy on Hospitalization and
Mortality in Patients Non-Respondent to Cardiac Resynchronization Therapy.
Source
Circulation. Conference: American Heart Association's 2023 Scientific
Sessions and the American Heart Association's 2023 Resuscitation Science
Symposium. Philadelphia, PA United States. 148(Supplement 1) (no
pagination), 2023. Date of Publication: November 2023.
Author
Szabo K.M.; Toth A.Z.; Racz V.; Nagy A.C.; Barta J.; Borbely A.; Csanadi
Z.
Publisher
Lippincott Williams and Wilkins
Abstract
Background: Non-responders to Cardiac Resynchronization Therapy (CRT-NR)
have poor prognosis. Sacubitril/valsartan (SV) treatment improved the
outcomes of heart failure patients with reduced left ventricular (LV)
ejection fraction (HFrEF) in randomized trials; however, limited data are
available on the specific cohort of CRT-NRs. Aim of the study: We have
compared heart failure hospitalization (HFH) and mortality rates in three
patient cohorts: CRT-NR patients on S/V versus on ACEi/ARB and general
HFrEF patients on S/V. <br/>Method(s): 275 HF patients, including 70
CRT-NRs receiving S/V at least for 6 months (Group I); 70 CRT-NRs on
ACEi/ARB treatment (Group II); and 135 HFrEF patients without CRT
indication on S/V therapy at least for 6 months (Group III) were included.
CRT-NR was defined as a less than 10% improvement in left ventricular
ejection fraction (LVEF) 6 months after device implantation. Rates of HFH
and the composite of all-cause mortality/heart transplantation/LVAD
therapy were compared with a mean follow-up of 21.5 months. A subgroup
analysis was also performed in patients on S/V (Groups I and III) who
demonstrated a more versus less than 10% increase in LVEF after 6 months
of S/V treatment (S/V super-responders versus S/V moderate responders,
respectively). <br/>Result(s): HFH rates were similar in Groups I and III
(28.5% vs. 28.1%, respectively; p>0.05), while significantly higher
(54.2%) in Group II (p=0.02). No significant difference in the composite
mortality endpoint was demonstrated between the three groups (22.8% vs.
24.2% vs. 22.2%, p=0.08). On S/V treatment, 13 out of the 70 (18.5%)
CRT-NR patients (Group I) and 24 out of the 135 (17.8%) HFrEF patients
(Group III) were found to be SV super-responders. Comparing these 37
patients with the 168 S/V moderate responders, neither the HFH (24.3% vs
30.9%, p=0.07), nor the composite mortality rates (24.3% vs 23.2%, p=0.53)
demonstrated significant differences. <br/>Conclusion(s): S/V treatment in
CRT-NRs improved hospitalization rates similarly to what was observed in a
general HFrEF population. No benefit in mortality rates was demonstrated
in this cohort. The extent of change in LVEF on S/V was not predictive of
a better response on HFH or mortality.

<61>
Accession Number
642974724
Title
Long-Term Risk of Stroke After Coronary Artery Bypass Surgery With Carotid
Revascularization: A Randomized Controlled Trial.
Source
Circulation. Conference: American Heart Association's 2023 Scientific
Sessions and the American Heart Association's 2023 Resuscitation Science
Symposium. Philadelphia, PA United States. 148(Supplement 1) (no
pagination), 2023. Date of Publication: November 2023.
Author
Knipp S.C.; Holst H.T.T.; Bilbilis K.; Kamler M.; Weimar C.
Publisher
Lippincott Williams and Wilkins
Abstract
Introduction: In patients with carotid artery stenosis, combined coronary
and carotid surgery has been widely used despite lack of evidence from
randomized trials. Moreover, there are no data on long-term outcome
following carotid revascularization versus best medical treatment.
Hypothesis: May simultaneous coronary artery bypass grafting (CABG) and
carotid endarterectomy (CEA) prevent the long-term risk of stroke?
Methods: In the Coronary Artery Bypass graft surgery in patients with
Asymptomatic Carotid Stenosis (CABACS) trial, patients with coronary
disease and high-grade carotid stenosis (NASCET >=70%) were randomized to
receive combined simultaneous CABG+CEA or CABG alone. Primary endpoint was
the composite rate of non-fatal stroke or death within 30 days after
surgery, with both treatments assumed to be equally safe and efficacious.
Secondary endpoints included any stroke, stroke or vascular death and
death of any cause, and follow-up was five years. While our previous
report focused on primary outcome, here we evaluate the long-term results
of the trial. <br/>Result(s): The trial was terminated prematurely after
recruitment of 129 patients in 17 centers in Germany and the Czech
Republic. The rate of stroke or death at 30 days was not significantly
different following combined CABG+CEA and CABG alone (18.5% (95%
confidence interval [95% CI]: 0.099-0.300) versus 9.7% (95% CI:
0.036-0.199), p=0.203). By 5 years, stroke or death rate was 40.6% (95%
CI: 0.285-0.536) following CABG+CEA and 35.0% (95% CI: 0.231-0.484)
following CABG alone (p=0.581). Strokes of any kind tended to occur more
frequently after CABG+CEA (5 years: 29.4% vs. 18.8%, p=0.245), while death
rate was similar in both treatment arms (25.4% vs 23.3% (p=0.837).
Subgroup analysis revealed no significant effect of center on outcomes.
<br/>Conclusion(s): Long-term risk of stroke or death was higher after
combined CABG+CEA, mainly due to increased perioperative event rates.
Because of minor power, further trials are warranted to confirm our
results.

<62>
Accession Number
642974707
Title
Lipoprotein (a) as a Predictor of Recurrent Myocardial Infarction/Coronary
Revascularization in Patients With Acute Coronary Syndrome Who Underwent
PCI: A Meta- Analysis of Observational Studies.
Source
Circulation. Conference: American Heart Association's 2023 Scientific
Sessions and the American Heart Association's 2023 Resuscitation Science
Symposium. Philadelphia, PA United States. 148(Supplement 1) (no
pagination), 2023. Date of Publication: November 2023.
Author
Singh S.; Singh D.; Srikanth S.; Subramanian L.; Bhanushali A.K.; Suchday
P.; Guddeti A.V.; Naseem H.; Shenoy A.; Puli S.; Desai R.
Publisher
Lippincott Williams and Wilkins
Abstract
Introduction: Lipoprotein (a) [Lp(a)] has been recognized as an
independent predictor of atherosclerotic cardiovascular disease (ASCVD).
However, there is limited data on the association between Lp(a) levels and
risk of recurrent myocardial infarction (MI)/coronary revascularization in
patients with acute coronary syndrome (ACS) who underwent percutaneous
coronary intervention (PCI). <br/>Method(s): PubMed/Medline, EMBASE, and
Scopus were searched for studies evaluating the association of Lp(a) with
recurrent ischemic events from the year 2000-2023. Patients with coronary
artery disease or ACS with baseline Lp(a) who underwent PCI or coronary
stenting and had outcomes as recurrent MI/ coronary revascularization were
included. Random effects models and I statistics were used for pooled
hazard ratios (HR), odds ratio (OR), and heterogeneity assessment. A
leaveone- out sensitivity analysis was also performed. <br/>Result(s): The
initial search resulted in 651 articles, of which nine studies with 27964
patients (mean age 58-66 years, 74.79% male) were included. Of the nine
studies, six were retrospective and three prospective. Mean+/-SD/Median
(IQ) follow-up duration was four years [range 2-7 years]. There was an
increased risk of recurrent MI/coronary revascularization associated with
Lp(a) >=30 mg/dL (OR, 1.44, 95% CI: 1.09-1.89, I²= 79.24%,
p=0.009) (Fig 1a) and Lp(a) >=10-30 mg/dL (OR, 1.19, 95% CI: 1.009- 1.416,
I²= 0%, p=0.039) (Fig 1b), but failed to reach significance
with Lp(a) as a continuous variable (OR, 1.004, 95% CI: 0.998-1.009,
I²= 85.02%, p=0.221) (Fig 1c). Leave-one-out sensitivity
analysis showed an equivalent result for various Lp(a) cutoffs (Fig 1a,
1b, and 1c). <br/>Conclusion(s): Our meta-analysis suggests an association
of raised Lp(a) with increased risk of recurrent MI/coronary
revascularization in ACS patients who underwent PCI. (Figure Presented).

<63>
[Use Link to view the full text]
Accession Number
642974555
Title
Analysis of the Composite of Death and Stroke at Follow-Up Among Risk
Profiles in Trials Comparing Transcatheter and Surgical Aortic Valve
Implantation. A Systematic Review and Meta-Analysis.
Source
Circulation. Conference: American Heart Association's 2023 Scientific
Sessions and the American Heart Association's 2023 Resuscitation Science
Symposium. Philadelphia, PA United States. 148(Supplement 1) (no
pagination), 2023. Date of Publication: November 2023.
Author
Barili F.; Anselmi A.; Brophy J.; Boden W.E.; De Caterina R.S.; Dayan V.;
Roda J.R.; Sousa-Uva M.; Almeida R.M.; Tomasi J.; Verhoye J.-P.; Musumeci
F.; Mandrola J.M.; Kaul S.; Parolari A.
Publisher
Lippincott Williams and Wilkins
Abstract
Introduction: To compare the effectiveness of transcatheter vs surgical
aortic valve implantation on mid-term composite of death for any cause or
stroke within high, intermediate and low-risk profiles. <br/>Method(s): We
performed a systematic review of the literature between 2007 and 2023
including randomized controlled trials comparing a composite of all-cause
mortality or stroke of transcatheter vs surgical aortic valve replacement.
Hazard ratios (HRs) and restricted mean survival time (RMST) differences
within high, intermediate and low-risk profiles were estimated by
reconstructing time-toevent data from Kaplan-Meier curves. <br/>Result(s):
Seven trials were included (8418 participants). The incidence of composite
endpoint increases concordantly with higher risk profiles for both
treatments. A time variant effect unites all the risk profiles with
transcathteter superior to surgery early and a trend toward HR reversal
after 24 months, also supported by an cumulative additional time-to-event
of 0.57 months at 3 years driven by high risk (95%CI 0.19 - 0.9) that is
reabsorbed at 60 months, The benefit of transcatheter approach increased
over time till 5 years in high risk, while intermediate and low risk
showed a similar quadratic association (a parameter -0.0004, 95%CI -0.0008
- 0, p-value 0.05; b parameter 0.029, 95%CI 0.012 - 0.046, p-value 0.001),
with a smaller increase of the transcatheter that is reabsorbed after a
nadir at 36 months. <br/>Conclusion(s): There is a different trend of
benefit of transcatheter approach within risks. TAVI maintains a benefit
over surgery at 5-years in high risk, while its advantage is smaller and
runs out at 5 years in the low-mid risk groups. (Figure Presented).

<64>
[Use Link to view the full text]
Accession Number
642974497
Title
Performance of a Polygenic Risk Score for Coronary Artery Disease Across
the Spectrum of ASCVD: An Analysis of 60k Patients From 6 TIMI Randomized
Trials.
Source
Circulation. Conference: American Heart Association's 2023 Scientific
Sessions and the American Heart Association's 2023 Resuscitation Science
Symposium. Philadelphia, PA United States. 148(Supplement 1) (no
pagination), 2023. Date of Publication: November 2023.
Author
Zimerman A.; Kamanu F.; Melloni G.; Roselli C.; Antman E.M.; Bhatt D.;
Bonaca M.P.; Cannon C.P.; Giugliano R.; O'Donoghue M.; Scirica B.; Wiviott
S.D.; Braunwald E.; Ellinor P.T.; Sabatine M.S.; Ruff C.; Marston N.A.
Publisher
Lippincott Williams and Wilkins
Abstract
Background: Coronary artery disease (CAD) polygenic risk scores (PRS) may
improve risk stratification, but whether performance differs by ASCVD
status remains unclear. <br/>Purpose(s): To compare the predictive ability
of a CAD PRS for coronary events in pts with ASCVD and prior event, ASCVD
without event, and without overt ASCVD. <br/>Method(s): We studied
genotyped pts from 6 multinational TIMI RCTs. Using a 2.3 million SNP CAD
PRS, we first assigned pts to low (Q1), intermediate (Q2-4), or high (Q5)
genetic risk, after which pts were grouped by ASCVD status at baseline.
The primary endpoint was any coronary event, a composite of death from
coronary disease, myocardial infarction, or coronary revascularization.
Cox proportional hazards models were used to estimate risk of events,
adjusted for ancestry (principal components 1-5), age, sex, SBP, eGFR,
diabetes, smoking, and trial. <br/>Result(s): We included 59,905 pts (mean
age 66 yrs; 71% male; 79% with prior ASCVD; 49% with diabetes), of whom
10.6% had coronary events during follow-up. Compared with low genetic risk
pts, event rates were greater in intermediate (HR 1.59 [95% CI 1.47-1.71];
p<0.001) and high (HR 2.08 [1.91-2.27]; p<0.001) genetic risk pts. There
was a significant interaction between the CAD PRS and clinical ASCVD
(P<inf>interaction</inf><0.001), such that genetic risk discriminated
relative risk of future coronary events more strongly in pts without overt
ASCVD (Fig 1A). In this subgroup, high genetic risk pts had a nearly
5-fold higher hazard of events than low genetic risk pts (8.5% vs 1.6% at
3 yrs; HR 4.63 [3.46-6.21]; p<0.001). Pts without clinical ASCVD and high
genetic risk had event rates comparable to pts with established ASCVD and
low genetic risk (Fig 1B). <br/>Conclusion(s): The gradient of relative
risk prediction of coronary events from a CAD PRS depends on the presence
of known ASCVD and is strongest in patients without clinical disease.
Genetic risk stratification may be more useful in pts without overt ASCVD
to help focus preventive measures. (Figure Presented).

<65>
Accession Number
642974455
Title
Outcomes of High-Intensity Interval Training Are Superior to Moderate
Exercise Training Among Post-Heart Transplant Patients.
Source
Circulation. Conference: American Heart Association's 2023 Scientific
Sessions and the American Heart Association's 2023 Resuscitation Science
Symposium. Philadelphia, PA United States. 148(Supplement 1) (no
pagination), 2023. Date of Publication: November 2023.
Author
Sulague R.M.; Coronel M.-K.; Alfonso P.G.; Cartojano T.D.; Cruz N.;
Mortalla E.D.; Lavie C.J.
Publisher
Lippincott Williams and Wilkins
Abstract
INTRODUCTION: Heart failure patients who underwent heart transplantation
(Htx) need to undergo cardiac rehabilitation (CR) to regain and improve
their physical ability and functional capacity. To date, there is no
established exercise regimen that optimizes this recovery. This study aims
to compare the outcomes of HighIntensity Interval Training (HIIT) versus
Moderate Exercise Training (MT) among Htx patients. Hypothesis: The
outcomes of HIIT are superior to MT among Htx patients. <br/>Method(s): A
systematic review was conducted in multiple databases including PubMed,
Embase, and Google Scholar from inception to 2022 following the PRISMA
guidelines to look for randomized controlled trials that directly compare
clinical outcomes of HIIT versus MT. Joanna Briggs Institute (JBI)
critical assessment tool was used to assess the risk of bias. A
meta-analysis was performed using a random effect model to calculate mean
differences with 95% confidence intervals (CI). This study is registered
on Prospero (CRD42023403954). <br/>Result(s): This study included four
clinical trials (n=177 patients). The average age was 51 years +/- 10.57,
with a majority male (73%). On average, patients were overweight (BMI =
25.78 +/- 4.08) with comorbidities including hypertension (81%) and
diabetes (12%). Compared to baseline levels, the peak oxygen consumption
(VO2 peak), maximal muscle strength extensors, maximal muscle endurance,
body mass index, and FEV1 were statistically significantly increased after
the intervention of either HIIT or MT. Of these, HIIT had higher percent
changes in VO2 peak at 0.205 (95% CI: 0.007 to 0.417, p=0.0578), maximal
muscle strength extensors at 0.100 (95% CI: 0.059 to 0.141, p<0.001), and
maximal muscle endurance at 0.263 (95% CI: 0.185 to 0.341, p<0.001)
compared to MT. <br/>CONCLUSION(S): Both exercise CR regimens
significantly improved the physical ability and functional performance of
Htx patients. However, HIIT was superior to MT in terms of VO2 peak,
maximal muscle strength extensors, and maximal muscle endurance, which may
be associated with higher survival.

<66>
[Use Link to view the full text]
Accession Number
642974363
Title
Utility of Intracardiac Echocardiography for Prosthetic Valve Infective
Endocarditis and Cardiovascular Device-Related Infection: A Contemporary
Systematic Review.
Source
Circulation. Conference: American Heart Association's 2023 Scientific
Sessions and the American Heart Association's 2023 Resuscitation Science
Symposium. Philadelphia, PA United States. 148(Supplement 1) (no
pagination), 2023. Date of Publication: November 2023.
Author
Sanchez-Nadales A.; Cedeno J.; Sonnino A.; Sarkar A.; Asher C.R.; Xu B.
Publisher
Lippincott Williams and Wilkins
Abstract
Introduction: Infective endocarditis (IE), particularly prosthetic valve
endocarditis (PVE) and cardiac devicerelated endocarditis (CDIE), presents
significant diagnostic challenges. The efficacy of intra-cardiac
echocardiography (ICE) for diagnosing IE and assessing intra-cardiac
infections when transesophageal echocardiography (TEE) is contraindicated,
is not extensively studied. <br/>Method(s): We searched six databases,
including PubMed, Embase, Scopus, Ovid, Science Direct, and Web of
Science, for articles published between September 2002 and November 2022,
related to the utility of ICE in IE. Eligibility screening followed the
search. <br/>Result(s): From the 12 identified studies discussing ICE for
IE diagnosis, ten cases of IE were highlighted in nine reports, and three
cohort studies included 236 patients without individual patient details.
ICE was not used in any native valve IE case. Predominantly male patients
(90%) had a median age of 42 years, developing endocarditis 2.5 years post
initial cardiac procedure. The most common microorganisms identified were
Staphylococcus species. ICE proved beneficial in various scenarios,
particularly PVE and CDIE, especially when echocardiography studies were
inconclusive or contraindicated. As an alternative to TEE, ICE offers
clear visualization of right heart structure, guiding interventions such
as pacemaker lead extractions. It excels in detecting device lead
abnormalities and small vegetations in CDIE cases, supporting risk
stratification and preparation for infected device extraction. Notably,
all PVE cases involved bioprosthetic valves, affecting various heart
structures and valves. <br/>Conclusion(s): This systematic review
highlights ICE as an adjunct imaging modality in IE, especially in PVE and
CDIE when TEE is contraindicated. Preliminary data suggest its valuable
role during intracardiac lead extractions.

<67>
Accession Number
642974159
Title
Use of Computed Tomography Coronary Angiography in Pre-Operative Risk
Assessment in Non-Cardiac Surgeries.
Source
Circulation. Conference: American Heart Association's 2023 Scientific
Sessions and the American Heart Association's 2023 Resuscitation Science
Symposium. Philadelphia, PA United States. 148(Supplement 1) (no
pagination), 2023. Date of Publication: November 2023.
Author
Shah R.P.; Yadav R.; Duhan S.; Patel N.N.; Raheela F.; AlJaroudi W.; Paul
T.K.; Alraies M.C.C.
Publisher
Lippincott Williams and Wilkins
Abstract
Introduction: Computed Tomography Coronary Angiography (CTCA) has emerged
as a promising tool for detecting and evaluating coronary artery diseases
(CAD). However, the role of CTCA for risk assessment tool for patients
undergoing noncardiac surgeries is unknown. <br/>Method(s): We searched
databases like PubMed and Google Scholar to compile the literature
including reviews, meta-analyses, scientific articles, and guidelines,
describing the use of CTCA in the diagnosis and evaluation of cardiac risk
assessment in noncardiac surgeries. <br/>Result(s): Based on our
literature review we found that CTCA is a promising adjunctive tool for
preoperative assessment in noncardiac surgeries to evaluate cardiac risk
with high sensitivity and negative predictive value. VISION-CTA sub study
showed that CTCA combined with Myocardial Perfusion Imaging (MPI) predicts
major adverse cardiac events within 30 days of surgery with higher
accuracy than either test alone. McCarthy KJ et al found an increase in
the proportion of CTCAs performed from before 2018, 2018 to post 2018,
(3%, 6.3%, and 26.3% respectively; p <0.001) and obstructive CAD diagnosis
using CTCA (0%, 30%, and 51.4% respectively; p = 0.04). Hence supporting a
shift to non-invasive CTCA for pre-operative assessment of liver
transplant candidates. According to Ahn J et al, CTCA shows 100%
sensitivity and 99.3% negative predictive value in predicting major
adverse cardiac events and can be used to stratify intermediate risk
noncardiac surgery patients. <br/>Conclusion(s): CTCA is a valuable risk
assessment tool in patients undergoing noncardiac surgery because of its
high sensitivity and negative predictive value. There is a need for
further research and guidelines for using CTCA as a risk assessment tool
in noncardiac surgeries.

<68>
Accession Number
642974055
Title
Evaluating the Predictive Accuracy of Viscoelastic Blood Coagulation
Measurements for Postoperative Bleeding in Cardiac Surgery: A Diagnostic
Accuracy Meta-Analysis.
Source
Circulation. Conference: American Heart Association's 2023 Scientific
Sessions and the American Heart Association's 2023 Resuscitation Science
Symposium. Philadelphia, PA United States. 148(Supplement 1) (no
pagination), 2023. Date of Publication: November 2023.
Author
Elfaituri M.K.; Khaled A.; Faraj H.A.A.; Ben Ghatnsh A.; Msherghi A.
Publisher
Lippincott Williams and Wilkins
Abstract
Introduction: Postoperative bleeding in cardiac surgery significantly
impacts patient morbidity and mortality. Viscoelastic blood coagulation
measurements, such as point-of-care (POC) viscoelastic hemostatic assays
(VHAs), are proposed tools for predicting this complication and enabling
proactive management. However, thoroughly evaluating existing evidence is
essential to confirm their effectiveness. Hypothesis: This study aims to
evaluate the diagnostic accuracy of viscoelastic blood coagulation
measurements in predicting postoperative bleeding following cardiac
surgery. <br/>Method(s): A systematic search of studies published up to
May 2022 was conducted, employing databases such as PubMed, EMBASE, and
the Cochrane Library. Included studies implemented viscoelastic blood
coagulation measurements in cardiac surgery settings, providing data on
diagnostic accuracy for predicting postoperative bleeding. Major
postoperative blood loss, as defined within each study setting, was used
as the reference standard. Statistical analysis was performed using R
software (version 4.0.3) with mada package. This analysis enabled various
diagnostic accuracy metrics pooling, all presented with a 95% Confidence
Interval (CI). <br/>Result(s): This analysis incorporated 10 studies
comprising 2048 patients, 374 of them experienced confirmed postoperative
bleeding after cardiac surgery. The pooled sensitivity and specificity of
viscoelastic blood coagulation measurements for predicting postoperative
bleeding were found to be 65% (95% CI: 42.9-82%, I2=89.4%) and 85% (95%
CI: 69.7-93.3%, I2=95.1%) respectively. The falsepositive rate was
identified as 15% (95% CI: 6.7-30.3%). The diagnostic odds ratio was 10.50
(95% CI: 2.93-37.57). The positive and negative Likelihood Ratios were
4.34 (95% CI: 1.89-9.95) and 0.42 (95% CI: 0.23-0.75), respectively.
<br/>Conclusion(s): Despite moderate sensitivity, viscoelastic blood
coagulation measurements exhibit high specificity in predicting
postoperative bleeding in cardiac surgery, potentially enhancing patient
management through early intervention. However, due to the observed
heterogeneity, further largescale studies are required to confirm these
results and assess their impact on patient outcomes.

<69>
Accession Number
642974014
Title
Acute Type A Aortic Dissection Surgical Repair in Octogenarians, Meta
Analysis.
Source
Circulation. Conference: American Heart Association's 2023 Scientific
Sessions and the American Heart Association's 2023 Resuscitation Science
Symposium. Philadelphia, PA United States. 148(Supplement 1) (no
pagination), 2023. Date of Publication: November 2023.
Author
Hasan M.T.; Rezq H.S.; Aboeldahab H.; Elkhashab M.K.; Hamouda S.M.;
Elkersh H.; Awad A.K.; Nabeel A.; Gardezi S.K.; Awan R.U.
Publisher
Lippincott Williams and Wilkins
Abstract
Aortic dissection is a serious medical condition that can lead to
life-threatening complications. Type A aortic dissection (TAAD) is a
subtype that occurs in the ascending aorta and is associated with
increased morbidity and mortality rates. Surgical intervention is the
standard of care for TAAD, but the optimal surgical approach for
octogenarians remains a topic of debate. This meta-analysis aimed to
investigate the long-term surgical outcomes of TAAD in octogenarians.
Electronic databases were searched from inception to September 20, 2022,
to include any randomized clinical trials (RCT) and observational studies
that compare TAAD in octogenarians versus TAAD in septuagenarians. The
Mantel-Haenszel method was used to pool study estimates and calculate odds
ratios (OR) with 95% confidence intervals (CI). Twenty-seven observational
studies comprising 18,057 participants were included in the metaanalysis.
Surgical repair for TAAD in octogenarians had a lower risk of
re-exploration (RR = 0.08), stroke (RR = 0.09), renal failure (RR = 0.09),
respiratory failure (RR = 0.18), neurological complications (RR = 0.09),
and bleeding (RR = 0.08), compared to septuagenarians. On the other hand,
antegrade cerebral perfusion (RR = 0.39) and tracheostomy (RR = 0.11) were
less likely to be used in octogenarians than in septuagenarians. In terms
of surgical parameters, octogenarians had a significantly shorter
cardiopulmonary bypass surgery time and systemic cardiac arrest time than
septuagenarians (MD = -13.84 and -2.46), respectively. Even though
postoperative mortality rose dramatically with age, surgical care was
associated with a significantly reduced inpatient mortality rate when
compared to medical management. Octogenarians undergoing surgical repair
for type A aortic dissection have a statistically significant difference
in cardiopulmonary bypass surgery time, systemic cardiac arrest time, and
5-year survival rate when compared to septuagenarians. (Figure Presented).

<70>
Accession Number
642973917
Title
Annual Vascular and Bleeding Outcomes in East Asian Poststenting Patients
With Acute Coronary Syndrome: The BRIC-ACS II Trial.
Source
Circulation. Conference: American Heart Association's 2023 Scientific
Sessions and the American Heart Association's 2023 Resuscitation Science
Symposium. Philadelphia, PA United States. 148(Supplement 1) (no
pagination), 2023. Date of Publication: November 2023.
Author
Li D.; Chen Y.; Yu Y.; Tuo X.
Publisher
Lippincott Williams and Wilkins
Abstract
Objective: To determine the incidence of bleeding and thrombotic vascular
events in the 'realworld'acute coronary syndromes (ACS) Chinese patients
over 1-year following stent implantation. <br/>Background(s): The balance
between vascular and bleeding outcomes during dual antiplatelet therapy
(DAPT) is a matter of considerable controversy, especially in Asian
populations. In contrast to Europeans, Chinese patients experience more
bleeding but less thrombotic events over aggressive DAPT with ticagrelor
than after conventional clopidogrel. <br/>Methods and Results: From
November 2017 till April 2020 we enrolled post-stenting ACS patients
(n=5,515) from 30 tertiary hospitals with the strict 1-year follow-up
(n=5.150). Only few 153(3.0%) patients developed MACE (a composite of
all-cause death, myocardial infarction, ischemic stroke, or urgent
coronary revascularization). The cumulative incidence of annual bleeding
(BARC >=2) was 5.8% (298/5150) among patients who completed 1year
follow-up.The BARC >=2 bleeding was almost twice higher 298 (5.8%) and was
not associated with worsened MACE [CI:0.37 -1.67; P =0.52). Patients
treated with ticagrelor (n=1620, 6.0%) had a significantly increased risk
of bleeding than those treated with clopidogrel (n=2331; 4.1%) (HR=1.486;
95% CI:1.12-1.97; P=0.006), but similar risk of vascular MACE (2.7% vs
2.8%; HR= 0.94; 95% CI:0.64-1.38; P = 0.747).The factors independently
associated with the comprehensive risk of BARC >=2 bleeding and MACE ,
including female gender, renal insufficiency, peptic ulcer, atrial
fibrillation, continuous use of ticagrelor and non-continuous DAPT. The
discrimination of the nomogram model was further tested by the ROC curve
(AUC value:0.610 (95% CI, 0.577-0.642 )). <br/>Conclusion(s): The annual
incidence of BARC>=2 bleeding in ACS patients treated with PCI in China
was almost twice higher (5.8%) than MACE (3.0%). DAPT with ticagrelor
increased the bleeding rates with no trend towards MACE reduction. The
trial was registered at the clinnicaltrials.org as NCT03402711.This study
was sponsored by Sanofi.

<71>
[Use Link to view the full text]
Accession Number
642973810
Title
Sex-Specific Differences in Outcomes Following Alcohol Septal Ablation or
Septal Myectomy for Hypertrophic Obstructive Cardiomyopathy: A Systematic
Review and Meta-Analysis.
Source
Circulation. Conference: American Heart Association's 2023 Scientific
Sessions and the American Heart Association's 2023 Resuscitation Science
Symposium. Philadelphia, PA United States. 148(Supplement 1) (no
pagination), 2023. Date of Publication: November 2023.
Author
Saravanabavanandan R.; Jaimalani A.; Khan M.A.N.; Riaz S.; Mangas G.;
Ahsan S.M.; Posani S.; Patel T.; Fawad M.; Al-Tawil M.
Publisher
Lippincott Williams and Wilkins
Abstract
Introduction: Clinical evidence and emerging studies suggest that the
clinical heterogeneity observed in hypertrophic obstructive cardiomyopathy
(HOCM) could be due to sex-based differences. However, definite evidence
to guide sex-specific treatment is not yet available. We aim to explore
the sexrelated differences in treatment outcomes following alcohol septal
ablation (ASA) and septal myectomy (SM). <br/>Method(s): We searched
PUBMED/MEDLINE, EMBASE, and SCOPUS to identify studies that report
sex-stratified comparison of outcomes in adults undergoing ASA or SM. The
primary outcomes were the short-term/ 30-day mortality, post-operative
permanent pacemaker (PPM) requirement, and the length of in-hospital stay.
<br/>Result(s): Fifteen studies totaling 31,907 patients (47% men and 53%
women) met our eligibility criteria. Among patients undergoing ASA
(n=13357) or SM (n=18550), females were found to be significantly older at
the time of intervention (ASA - mean difference (MD): 7.55 years; 95% CI
[4.83, 10.28]; p < 0.00001; SM - MD: 4.41; 95% CI [2.79, 6.03]; p <
0.00001).In both the ASA and SM treatment arms, females had a
significantly higher risk of short-term all-cause mortality (ASA - RR:
0.48, 95% CI [0.32, 0.71]; p = 0.0003; SM - RR: 0.63; 95% CI [0.44, 0.90];
p = 0.01), greater PPM implantation rate (ASA - p = 0.002; SM - p = 0.05),
and longer in-hospital stay (ASA - MD: 1.00 days; p < 0.00001; SM - MD:
0.69; p < 0.00001). Among those undergoing ASA, females had a
significantly higher rate of atrioventricular (AV) block (p < 0.00001).
However, the 30-day re-admission rate following SM was similar in both
sexes. <br/>Conclusion(s): This is the first meta-analysis to compare sex
differences in HOCM treatment outcomes. Female patients were older, had
higher short-term mortality, and required more PPM implants compared to
males, regardless of whether they received ASA or SM. This emphasizes the
critical need for a sex-specific treatment approach in managing HOCM. .

<72>
[Use Link to view the full text]
Accession Number
642973740
Title
Safety and Efficacy of Botulinum Toxin Type A for Prevention of
Postoperative Atrial Fibrillation in Cardiac Surgery Patients: Pulmonary
Function Test Results From the Phase 2 NOVA Study.
Source
Circulation. Conference: American Heart Association's 2023 Scientific
Sessions and the American Heart Association's 2023 Resuscitation Science
Symposium. Philadelphia, PA United States. 148(Supplement 1) (no
pagination), 2023. Date of Publication: November 2023.
Author
Lang J.E.; Leaback R.; Ailawadi G.; Iribarne A.; Gleason K.J.; Sullivan
A.O.; Huang N.-Y.; Ferguson W.G.; Miller J.
Publisher
Lippincott Williams and Wilkins
Abstract
Background: Postoperative atrial fibrillation (POAF) is the most common
complication after cardiac surgery. Autonomic neuromodulation, including
injection of botulinum toxin into epicardial fat pads, may suppress and/or
attenuate atrial fibrillation. The respiratory safety of a potential
preventative treatment for AF is critical. <br/>Aim(s): To assess efficacy
and pulmonary safety of botulinum toxin type A (BoNT/A; AGN-151607) 125U
and 250U vs placebo for prevention of POAF after coronary artery bypass
graft and/or valve surgery. <br/>Method(s): NeurOtoxin for the PreVention
of post-operative Atrial fibrillation (NOVA; NCT03779841) was a phase 2,
international, multicenter, randomized, placebo-controlled trial. The
primary endpoint was proportion of patients with continuous AF >=30
seconds within the first 30 days. Respiratory function was assessed via
pulmonary function tests (PFTs) performed at baseline and day 30 after
treatment. Adverse events (AEs), serious adverse events (SAEs), and time
to extubation were recorded. <br/>Result(s): A total of 323 patients were
randomized: BoNT/A 125U (n=106), 250U (n=109), placebo (n=108). The
primary endpoint occurred in 46.1% of the placebo group, 36.5% of the 125U
group (relative risk [RR] vs placebo, 0.80 [95% CI: 0.58, 1.10]; P=0.16),
and 47.2% of the 250U group (RR vs placebo, 1.04 [95% CI: 0.79, 1.37];
P=0.78). Baseline, day 30, and change from baseline PFT results were
similar for active treatment vs placebo (Table). Median time to extubation
was 9.7, 9.6, and 9.6 h in the placebo, 125U, and 250U groups,
respectively. Respiratory AEs were reported in 42.9%, 38.1%, and 50.5% of
patients, and respiratory SAEs in 11.4%, 6.7%, and 5.5% of patients in the
placebo, 125U, and 250U groups, respectively. <br/>Conclusion(s): In this
analysis of respiratory function, there appeared to be no detrimental
effect of AGN151607 compared with placebo, as evidenced by similar
outcomes in PFT parameters and respiratory AE/SAE incidences among
treatment arms.

<73>
Accession Number
642973720
Title
A Randomised Open-Label Controlled Trial of a Remote Cardiac
Rehabilitation System With Wearable Medical Devices - An Interim Report of
the TELE-REHA Trial.
Source
Circulation. Conference: American Heart Association's 2023 Scientific
Sessions and the American Heart Association's 2023 Resuscitation Science
Symposium. Philadelphia, PA United States. 148(Supplement 1) (no
pagination), 2023. Date of Publication: November 2023.
Author
Nakayama A.; Ishii N.; Hori K.; Yoshida A.; Isobe M.
Publisher
Lippincott Williams and Wilkins
Abstract
Introduction: Outpatient cardiac rehabilitation (CR) prevents recurrence
after cardiac surgery or cardiac catheterisation, but participation rate
of outpatient CR is low. Although attempts at remote CR have been
investigated with advances in equipment, they have not yet reached the
stage of social implementation, and it is not clear whether remote CR can
be an alternative to outpatient CR. <br/>Objective(s): The aim of this
study was to confirm the safety and efficacy of remote CR management using
wearable devices feasible in Japan, and to implement the device early in
society. <br/>Primary Outcome: All-cause death, cardiovascular events,
EFs, e/e', BNPs, CRPs, PeakVO2, VEVCO2 slop, muscle mass; secondary
outcome: EQ5D. Subjects: Patients discharged home after hospitalization
for cardiovascular diseases. Study design: A single-centre, randomised,
open-label, parallel-group study was conducted to evaluate the efficacy
and safety of wearable device (Apple Watch)-based Remote-CR versus
Outpatient-CR. In Remote-CR group, ECG and SpO2 are measured by Apple
Watch before and after exercise. Biweekly health information, weight,
blood pressure, heart rate, electrocardiogram (ECG) and EQ5D are
automatically transmitted by the app. Tele-nursing was provided by trained
nurses on a bi-weekly basis, based on the health information provided by
the app. For both groups, the intervention period was 90 days, and blood
sampling, ECG, cardiopulmonary exercise testing (CPX), and body
composition testing were performed at the end of the study.
<br/>Result(s): A total of 110 cardiovascular patients were randomly
divided into Remote-CR group and Outpatient-CR group. The background of
the two groups was similar. Though the PeakVO2 and EQ5D scores after the
CR program were not significantly improved in Outpatient-CR group, those
were significantly improved in Remote-CR group (P=0.02). The dropout rate
from CR program was lower in Remote-CR group than Outpatient-CR group. No
significant incident occurred in both group. <br/>Conclusion(s): Remote-CR
is expected to be as effective as Outpatient-CR and safe for patients
after cardiac treatment, and can provide a relapse prevention programme
for those who are difficult to attend.

<74>
[Use Link to view the full text]
Accession Number
642973304
Title
Lipoprotein(a) and Oxidized Phospholipids on Lipoproteins and
Cardiovascular Outcomes in Patients With Chronic Coronary Syndrome Treated
With Colchicine.
Source
Circulation. Conference: American Heart Association's 2023 Scientific
Sessions and the American Heart Association's 2023 Resuscitation Science
Symposium. Philadelphia, PA United States. 148(Supplement 1) (no
pagination), 2023. Date of Publication: November 2023.
Author
Mohammadnia N.; Van Broekhoven A.; Bax W.A.; Eikelboom J.W.; Mosterd A.;
Yang X.; Tijssen J.G.; Thompson P.L.; De Kleijn D.; El Messaoudi S.;
Tsimikas S.; Yeang C.; Cornel J.H.
Publisher
Lippincott Williams and Wilkins
Abstract
Introduction: Lipoproteins carrying pro-inflammatory oxidized
phospholipids (OxPL), exemplified by lipoprotein(a) [Lp(a)], contribute to
residual risk for major adverse cardiovascular events (MACE) in patients
with chronic coronary syndrome (CCS) despite optimal medical treatment.
Hypothesis: Anti-inflammatory colchicine therapy modifies MACE in patients
with elevated Lp(a), OxPL on apo(a) [OxPL-apo(a)], and OxPL on apoB
containing lipoproteins (OxPL-apoB). Aims To study the relationship of
Lp(a), OxPL-apo(a) and OxPL-apoB with MACE in 1777 LoDoCo2 trial
participants with CCS randomized to colchicine or placebo. <br/>Method(s):
End of study but not baseline samples were available. Because Lp(a),
OxPL-apo(a) and OxPL-apoB levels are strongly genetically determined, we
assumed that end of study values would reflect baseline values. The
primary endpoint was a composite of MI, ischemic CVA or ischemia driven
coronary revascularization. Cox regression was used to compare the
incidence of the primary endpoint by Lp(a) dichotomized at 125 nmol/L and
OxPL-apo(a) and OxPL-apoB in tertiles. <br/>Result(s): At study end,
median (IQR) on-colchicine Lp(a), OxPL-apo(a), and OxPL-apoB levels in
nmol/L were 22.4 (7.2-102.7), 7.8 (2.0-34.5) and 3.1 (1.3-6.3), similar to
on-placebo levels of 23.9 (9.9-95.7), 8.8 (2.7-34.0), and 3.1 (1.4-5.9),
respectively (p = 0.20, 0.98 and 0.18). MACE reduction with colchicine was
independent of Lp(a) and OxPL-apo(a) (P<inf>interaction</inf>= 0.92 and
0.66 respectively). However, the largest MACE reduction was present in the
highest vs lowest OxPL-apoB tertile (Figure, P<inf>interaction</inf> <
0.05). <br/>Conclusion(s): The benefit of colchicine in reducing MACE was
highest in subjects with elevated OxPL-apoB, suggesting colchicine may be
most effective in subjects with heightened oxidation-driven inflammation.
These findings may be hypothesis-generating and require validation in
larger trials with baseline biomarker assessment including CRP and IL-6.
(Figure Presented).

<75>
Accession Number
642973188
Title
Identifying the Genetic Determinants of Early Heart Failure in Patients
With Congenital Heart Disease.
Source
Circulation. Conference: American Heart Association's 2023 Scientific
Sessions and the American Heart Association's 2023 Resuscitation Science
Symposium. Philadelphia, PA United States. 148(Supplement 1) (no
pagination), 2023. Date of Publication: November 2023.
Author
Bair C.A.; Kurzlechner L.; George I.; Monaco G.; Berkman A.; Kreinbrook
J.; Moya-Mendez M.E.; Gonzalez C.D.; Gurumoorthi M.; Bidzimou M.; Pace L.;
Allen A.; Beckerman Z.; Andersen N.D.; Turek J.W.; Leong M.E.; Hoffman T.;
Li J.S.; Landstrom A.P.
Publisher
Lippincott Williams and Wilkins
Abstract
Introduction: Heart failure (HF) is the most common cause of death in
patients with congenital heart disease (CHD). Evidence suggests genetics
play a role in HF predisposition. In particular, variants in
cardiomyopathy-associated genes may be associated with HF and early
mortality in CHD populations. Goal: Our goal is to leverage a large,
well-curated, population-based cohort of individuals with CHD in North
Carolina (NC) to determine the genetic underpinnings of HF in CHD.
Hypothesis: We hypothesize that rare variants in cardiomyopathy-associated
genes will be overrepresented in CHD patients with HF compared to patients
without HF. <br/>Method(s): Patients were enrolled with inclusion criteria
of 1) presence of CHD, 2) 2+ cardiac evaluations. Whole blood was
collected for exome sequencing (ES). The presence of HF was defined as
death, cardiac transplantation or listed for cardiac transplantation, VAD
placement, ECMO cannulation, EF <= 40% on 2 images, or diagnosis of HF by
a cardiologist and taking at least 1 HF medication. ES data was filtered
for variants in cardiomyopathy-associated genes. <br/>Result(s): We have
established NC-DEFINE: Determining the Genetic Basis of Heart Failure in
Patients with CHD in NC, a prospectively enrolled cohort of patients with
CHD for which ES data are available. We enrolled 138 CHD patients (mean
age at enrollment [std dev]: 7.44+/-11.89 years; 40.6% female, 1.4% Asian,
23.9% Black, 6.5% Hispanic). About half (52.9%) have single ventricle
physiology and 26% have HF. In a pilot ES cohort of 48 patients, there was
an average of 524.2 variants/patient in cardiomyopathy genes of interest.
After filtering out common and tolerated variants, 8 loss-of-function and
28 missense variants were identified and interpreted using ACMG criteria.
Likely pathogenic or pathogenic (LPP) variants were found in 26.9% (7/26)
of HF patients and 9.1% (2/22) of non-HF patients (p=0.15). The RR for
having a cardiomyopathy-associated LPP variant and developing HF in the
setting of CHD was 1.60 (95% CI 1.0-2.57). <br/>Conclusion(s): We have
established NC-DEFINE, a novel prospectively enrolled CHD cohort, to
define the genetic architecture of HF in CHD. In a pilot ES cohort, we
found enrichment of rare, LPP variants in cardiomyopathy-associated genes
in patients with HF. .

<76>
Accession Number
642973124
Title
Oral Anticoagulation for New Onset PostOperative Atrial Fibrillation After
Combined Coronary Artery Bypass Grafting and Valve Surgery is Not
Associated With Improved Outcomes.
Source
Circulation. Conference: American Heart Association's 2023 Scientific
Sessions and the American Heart Association's 2023 Resuscitation Science
Symposium. Philadelphia, PA United States. 148(Supplement 1) (no
pagination), 2023. Date of Publication: November 2023.
Author
Tejpal A.; Lee J.G.; Fang J.; Jeong I.; Ouzounian M.; Atzema C.; Austin
P.; Ha A.C.
Publisher
Lippincott Williams and Wilkins
Abstract
Introduction: Post-operative atrial fibrillation (POAF) after cardiac
surgery is common and is associated with increased risk of stroke and
death. The incidence of POAF is highest among patients who undergo
combined CABG and valve surgery, at 40-60%. The risks and benefits of oral
anticoagulation (OAC) in this high-risk population are not well
established. Research Question: Among patients with POAF after combined
CABG and valve surgery, what is the association between OAC use and
clinical outcomes? Methods: From a population-based registry in Ontario,
Canada, we identified consecutive patients >65 years of age who developed
POAF after combined CABG and left-sided, non-mechanical valve surgery from
Oct/08-Mar/18. The exposure of interest was OAC prescription within 90
days after hospital discharge. Outcomes included death, cardiovascular
death, stroke, MI, thromboembolism, and bleeding. Follow-up began at 90
days after discharge and continued for 24 months. Outcomes were analyzed
using inverse probability of treatment weighting using the propensity
score. Statistical measures of association were reported as hazard ratios
with 95% confidence intervals. <br/>Result(s): Among 4,836 patients who
had combined CABG/valve surgery, 1,939 (40.1%) developed POAF and these
patients had a higher rate of death (HR 1.31, 95% CI 1.01-1.68 P=0.04).
OAC was prescribed in 1,153 (59.5%) patients (86% warfarin and 14% DOAC).
The use of OAC was not associated with a lower rate of death,
stroke/MI/thromboembolism, or cardiovascular death but was associated with
an increased rate of bleeding (HR 1.62, 95% CI 1.00-2.61, P=0.048).
<br/>Conclusion(s): Among patients with POAF after combined CABG/valve
surgery, use of warfarin or DOAC did not improve ischemic cardiovascular
outcomes or survival and was associated with higher rates of bleeding.
Randomized control trials are needed to define the risk and benefit of OAC
use in this high-risk population. Until then, routine use of OAC is not
recommended.

<77>
Accession Number
642973101
Title
Impact of the Type of Tricuspid Annuloplasty Ring Concomitant With Mitral
Annuloplasty on Atrial Arrhythmia Behaviour and Pacemaker Implantation
Rate, Fact or Fancy.
Source
Circulation. Conference: American Heart Association's 2023 Scientific
Sessions and the American Heart Association's 2023 Resuscitation Science
Symposium. Philadelphia, PA United States. 148(Supplement 1) (no
pagination), 2023. Date of Publication: November 2023.
Author
Hassan M.; Keller D.; Makhmetov B.; Omerbasic Z.; Radakovic D.; Madrahimov
N.; Leyh R.; Bening C.
Publisher
Lippincott Williams and Wilkins
Abstract
Background: Tricuspid valve repair has been advocated in patients
undergoing mitral valve surgery who have not only preoperative severe TR
but also for tricuspid annular dilatation (TAD) of >40 mm. We sought to
analyze the impact of the type of tricuspid annuloplasty ring on the
atrial arrhythmia behavior and the incidence of permanent pacemaker
implantations in patients undergoing mitral valve annuloplasty.
<br/>Method(s): We performed a retrospective review of 408 patients
underwent combined tricuspid and mitral valve annuloplasty in our
institution between the years 2007 and 2014.Patients were 68,8 +/- 10,7
years old, 67% male, 33% female. A total of 325 patients met the inclusion
criteria; 201 received threedimensional (3D) rigid ring (group 1) and 124
received ring annuloplasty with flexible bands (group2). The distribution
of the preoperative and perioperative variables was similar.
<br/>Result(s): There was no statistical difference in the incidence of
high-grade heart conduction disorders lasting more than 3 days
postoperatively (13.4% in group 1 and 12.9% in group 2; P = 0.89).
Likewise, there was no difference in the incidence of postoperative atrial
fibrillation between the two groups (41.2% in group 1 and 37.1% in group
2; P = 0.45). On the other hand, there was statistical difference in the
incidence of permanent pacemaker implantation between the two groups
(12.9% in group 1 and 25.8% in group 2; P = 0.003). Likewise, there was
difference in the incidence of sick sinus syndrome between the two groups
(0.01% in group 1 and 16.1% in group 2; P < 0.00001). <br/>Conclusion(s):
The need for permanent pacemaker implantation and the incidence of sick
sinus syndrom may be increased after the use of flexible tricuspid
annuloplasty ring in the setting of mitral valve surgery.Moreover, the
present study found no association between the use of Flexible tricuspid
annuloplasty ring and a higher incidence of postoperative atrial
fibrillation or high-grade heart conduction disorders.Further large-scale
randomized controlled studies are needed to elucidate the Impact of the
type of tricuspid annuloplasty ring.

<78>
[Use Link to view the full text]
Accession Number
642972772
Title
The Efficacy and Safety of Botulinum Toxin Type A to Prevent Postoperative
Atrial Fibrillation in Patients Undergoing Cardiac Surgery: A
Meta-Analysis of Randomized Controlled Trials.
Source
Circulation. Conference: American Heart Association's 2023 Scientific
Sessions and the American Heart Association's 2023 Resuscitation Science
Symposium. Philadelphia, PA United States. 148(Supplement 1) (no
pagination), 2023. Date of Publication: November 2023.
Author
Abdelazeem B.; Kambalapalli S.; Saleh O.; AlBarakat M.M.; Gowaily I.;
Mahmoud A.; Ali S.; Abuelazm M.T.
Publisher
Lippincott Williams and Wilkins
Abstract
Background: Postoperative atrial fibrillation (POAF) is prevalent in about
30 to 60 percent of patients undergoing cardiac surgery leading to worse
outcomes. However, effective POAF therapies are lacking. Botulinum toxin
type A (BTX) epicardial injection can prevent POAF by impairing
cholinergic signaling. <br/>Method(s): We conducted a systematic review
and meta-analysis synthesizing randomized controlled trials (RCTs), which
were retrieved by systematically searching: PubMed, EMBASE, Web of
Science, SCOPUS, and Cochrane through November 23 , 2022. RevMan version
5.4 software was used to pool dichotomous outcomes using risk ratio (RR)
and continuous outcomes using mean difference (MD) presented with the
corresponding confidence interval (CI). <br/>Result(s): Three RCTs with a
total of 509 patients (308 in the BTX group and 205 in the placebo group)
were included in our analysis. Two RCTs included patients undergoing
open-chest cardiac surgery, including coronary artery bypass graft (CABG)
and/ or valve surgery, while one RCT included patients undergoing CABG
only. There was no difference between BTX and placebo regarding POAF
incidence (RR: 0.81 with 95% CI [0.65, 1.00], P= 0.05), postoperative
hospital length of stay in days (MD: -0.03 with 95% CI [-0.54, 0.49], P=
0.91), all-cause mortality, (RR: 1.64 with 95% CI [0.22, 12.17], P= 0.63),
any adverse event (RR: 1.03 with 95% CI [0.94, 1.12], P= 0.51), and any
serious adverse event (RR: 0.89 with 95% CI [0.68, 1.15], P= 0.36).
<br/>Conclusion(s): There was no difference between epicardial fat
injection of BTX versus placebo for preventing POAF; however, BTX showed a
similar safety profile compared to placebo and our analysis can be
underpowered to detect a significant effect. Hence, further large-scale
RCTs are warranted to investigate BTX for POAF, especially in high-risk
cohorts.

<79>
[Use Link to view the full text]
Accession Number
642972265
Title
Carvedilol Outperforms Metoprolol in Preventing Postoperative Atrial
Fibrillation: A Systematic Review and MetaAnalysis.
Source
Circulation. Conference: American Heart Association's 2023 Scientific
Sessions and the American Heart Association's 2023 Resuscitation Science
Symposium. Philadelphia, PA United States. 148(Supplement 1) (no
pagination), 2023. Date of Publication: November 2023.
Author
Abouzid M.R.; Eldahtoury S.; Naccour S.; Anwar J.; Elshafei S.; Vyas A.;
Nwaukwa C.
Publisher
Lippincott Williams and Wilkins
Abstract
Introduction: Postoperative atrial fibrillation (POAF) is a common
complication following cardiac surgery. Current guidelines suggest
beta-blockers for the prevention of POAF. Carvedilol is a nonselective
betablocker with anti-inflammatory, antioxidant, and various cationic
channel-blocking effects. This metaanalysis aims to compare the efficacy
of carvedilol versus metoprolol in the prevention of POAF. <br/>Method(s):
We considered randomized controlled studies (RCTs) and retrospective
studies that demonstrated the efficacy of carvedilol versus metoprolol in
the prevention of POAF. Pooled data were analyzed using either the
fixed-effect or random-effect model in Review Manager 5.3. The incidence
of POAF was the primary endpoint, while mortality rate and bradycardia
were secondary outcomes. <br/>Result(s): A total of five RCTs and two
retrospective studies (1000 patients) were included in this metaanalysis.
The overall effect did not favor either of the two groups in terms of
mortality rate [Risk ratio 0.45, 95 % CI (0.1-1.97), P=0.29] as well as
incidence of bradycardia [Risk ratio 0.63, 95 % CI (0.32-1.23), P=0.17].
However, the incidence of POAF was lower in patients who received
carvedilol compared to metoprolol [Risk ratio 0.54, 95 % CI (0.42-0.71), P
< 0.00001]. <br/>Conclusion(s): In patients undergoing cardiac surgery,
carvedilol has been shown to successfully minimize the occurrence of POAF.
It appeared to be more effective than metoprolol. To definitively
establish the efficacy of carvedilol compared to metoprolol and other
beta-blockers in the prevention of POAF, largescale, well-designed
randomized controlled trials are required.

<80>
Accession Number
642971725
Title
Long-Term Efficacy of Evolocumab in Patients With and Without Multivessel
Coronary Artery Disease.
Source
Circulation. Conference: American Heart Association's 2023 Scientific
Sessions and the American Heart Association's 2023 Resuscitation Science
Symposium. Philadelphia, PA United States. 148(Supplement 1) (no
pagination), 2023. Date of Publication: November 2023.
Author
McClintick D.J.; O'Donoghue M.L.; De Ferrari G.M.; Ferreira J.M.; Ran X.;
Im K.A.; Lopez J.A.; Elliott-Davey M.; Wang B.; Monsalvo M.L.; Atar D.;
Keech A.; Giugliano R.P.; Sabatine M.S.
Publisher
Lippincott Williams and Wilkins
Abstract
Background: In FOURIER, the magnitude of reduction in risk of major
adverse cardiovascular events (MACE) was larger in patients with
multivessel disease (MVD) than in those without. However, the median
follow-up was only 2.2 yrs. The open-label extension (FOURIER-OLE) allows
for a better assessment of the long-term benefit of intensive
lipid-lowering in these two subgroups. <br/>Method(s): Patients with CAD
at time of enrollment in the parent FOURIER trial were categorized based
on the presence or absence of MVD (>=40% stenosis in >=2 large vessels).
Primary endpoint (PEP; CV death, MI, stroke, hospitalization for UA, or
coronary revascularization) and key secondary endpoint (SEP; CV death, MI,
or stroke) were assessed through FOURIER and FOURIER-OLE, during which all
patients received evolocumab. <br/>Result(s): At enrollment in FOURIER,
23,674 patients had CAD, of whom 25% had MVD (N=6007). In the placebo arm,
those with MVD had a higher risk of the PEP (HR 1.45 [95%CI 1.32-1.60],
P<0.0001) & SEP (HR 1.37 [1.22-1.56], P<0.0001) than those without MVD.
The magnitude of the overall relative risk reduction in those initially
randomized to evolocumab tended to be greater in patients with MVD than in
those without (RRR 23% vs. 12% for PEP; 30% vs. 15% for SEP;
P<inf>int</inf> 0.07 & 0.04, respectively). The magnitude of benefit
tended to grow over the first several years (Fig). This was especially
true for CV death, in which for patients with MVD, initial randomization
to evolocumab reduced the risk of CV death in the later years (HR 0.70
[0.51-0.97]; Fig bottom). <br/>Conclusion(s): Evolocumab reduced the rate
of MACE in patients with and without MVD, with earlier and larger benefit
seen in patients with MVD. The magnitude of benefit grew over time,
supporting early initiation of intensive LDL-C lowering both in patients
with and without MVD.

<81>
Accession Number
2033032142
Title
Acute normovolemic hemodilution in cardiac surgery: rationale and design
of a multicenter randomized trial.
Source
Contemporary Clinical Trials. 143 (no pagination), 2024. Article Number:
107605. Date of Publication: August 2024.
Author
Monaco F.; Guarracino F.; Vendramin I.; Lei C.; Zhang H.; Lomivorotov V.;
Osinsky R.; Efremov S.; Gurcu M.E.; Mazzeffi M.; Pasyuga V.; Kotani Y.;
Biondi-Zoccai G.; D'Ascenzo F.; Romagnoli E.; Nigro Neto C.; Do Nascimento
V.T.N.D.S.; Ti L.K.; Lorsomradee S.; Farag A.; Bukamal N.; Brizzi G.;
Lobreglio R.; Belletti A.; Arangino C.; Paternoster G.; Bonizzoni M.A.;
Tucciariello M.T.; Kroeller D.; Di Prima A.L.; Mantovani L.F.; Ajello V.;
Gerli C.; Porta S.; Ferrod F.; Giardina G.; Santonocito C.; Ranucci M.;
Lembo R.; Pisano A.; Morselli F.; Nakhnoukh C.; Oriani A.; Pieri M.;
Scandroglio A.M.; Kirali K.; Likhvantsev V.; Longhini F.; Yavorovskiy A.;
Bellomo R.; Landoni G.; Zangrillo A.
Institution
(Monaco, Kotani, Belletti, Bonizzoni, Di Prima, Gerli, Giardina, Lembo,
Morselli, Nakhnoukh, Oriani, Pieri, Scandroglio, Landoni, Zangrillo)
Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific
Institute, Milan, Italy
(Guarracino, Brizzi) Department of Cardiothoracic Anesthesia and ICU,
Azienda Ospedaliero Universitaria Pisana, Pisa, Italy
(Vendramin) Division of Cardiac Surgery, Azienda Sanitaria Universitaria
Friuli Centrale, Udine, Italy
(Vendramin) Department of Medicine, University of Udine, Udine, Italy
(Lei, Zhang) Department of Anesthesiology and Perioperative Medicine,
Xijing Hospital, Xi'an, China
(Lomivorotov, Osinsky) E. Meshalkin National Medical Research Center,
Department of Anesthesiology and Intensive Care, Novosibirsk, Russian
Federation
(Lomivorotov) Penn State Milton S. Hershey Medical Center, Department of
Anesthesiology and Perioperative Medicine, Hershey, PA, United States
(Efremov) Saint Petersburg State University Hospital, Saint-Petersburg,
Russian Federation
(Gurcu) Kosuyolu High Specialization Education and Research Hospital,
Istanbul, Turkey
(Mazzeffi) Department of Anesthesiology, University of Virginia School of
Medicine, Charlottesville, VA, United States
(Pasyuga) Department of Anesthesiology and Intensive Care, Federal Center
for Cardiovascular Surgery Astrakhan, Astrakhan, Russian Federation
(Kotani) Department of Intensive Care Medicine, Kameda Medical Center,
Kamogawa, Japan
(Biondi-Zoccai) Sapienza University of Rome, Latina, Italy
(Biondi-Zoccai) Mediterranea Cardiocentro, Napoli, Italy
(D'Ascenzo) Cardiovascular and Thoracic Department, A.O.U. Citta della
Salute e della Scienza, Turin, Italy
(D'Ascenzo, Kirali) Department of Medical Sciences, University of Turin,
Turin, Italy
(Romagnoli) Fondazione Policlinico Universitario Agostino Gemelli IRCCS,
Via Pineta Sacchetti, 217, Rome 00168, Italy
(Romagnoli) Universita Cattolica del Sacro Cuore, Campus di Roma, Largo
Francesco Vito, 1, Rome 00168, Italy
(Nigro Neto, Do Nascimento) Dante Pazzanese Institute of Cardiology, Sao
Paulo, Brazil
(Ti) National University Hospital, Singapore
(Lorsomradee) Chiang Mai University Hospital, Chiang Mai, Thailand
(Farag) King Abdullah Medical City - Holy Capital (KAMC-HC), Makkah, Saudi
Arabia
(Bukamal) Cardiothoracic ICU and Anesthesia Department, Mohammed Bin
Khalifa Specialist Cardiac Center, Awali 183261, Bahrain
(Lobreglio) Department of Anesthesia, Intensive Care and Emergency, Citta
della Salute e della Scienza University Hospital, Turin, Italy
(Arangino) Department of Cardiothoracic Anesthesia and Intensive Care,
IRCCS Centro Cardiologico Monzino, Milan, Italy
(Paternoster, Tucciariello) Cardiovascular Anesthesia and Intensive Care,
San Carlo Hospital, Potenza, Italy
(Kroeller) Department of Anesthesia and Intensive Care Units, IRCCS
Humanitas Research Hospital, MI, Rozzano, Italy
(Mantovani) Maria Cecilia Hospital GVM Care and research, RA, Cotignola,
Italy
(Ajello) Department of Cardio Thoracic anesthesia and Intensive Care,
Hospital Tor Vergata Roma, Italy
(Porta, Ferrod) Department of Cardiovascular Anestesia, Azienda
Ospedaliera Umberto I Mauriziano, Turin, Italy
(Santonocito) Anaesthesia and Intensive Care Medicine III, Policlinico
University Hospital, Catania, Italy
(Ranucci) Department of Cardiovascular Anesthesia and Intensive Care,
IRCCS Policlinico San Donato, Italy
(Pisano) Cardiac Anesthesia and Intensive Care Unit, Azienda Ospedaliera
Dei Colli, Monaldi Hospital, Naples, Italy
(Likhvantsev) Department of Clinical Trials, V. Negovsky Reanimatology
Research Institute, Moscow, Russian Federation
(Likhvantsev) Department of Anesthesiology and Resuscitation, First Moscow
State Medical University, Moscow, Russian Federation
(Longhini) Anesthesia and Intensive Care, Department of Medical and
Surgical Sciences, Magna Graecia University of Catanzaro, Italy
(Yavorovskiy) I.M. Sechenov First Moscow State Medical University,
Ministry of Public Health of Russia, Moscow, Russian Federation
(Bellomo) Department of Critical Care, The University of Melbourne,
Melbourne, Australia
(Bellomo) Australian and New Zealand Intensive Care Research Centre,
Monash University, Melbourne, Australia
(Pieri, Landoni, Zangrillo) Vita-Salute San Raffaele University, Milan,
Italy
Publisher
Elsevier Inc.
Abstract
Background: Minimizing the use of blood component can reduce known and
unknown blood transfusion risks, preserve blood bank resources, and
decrease healthcare costs. Red Blood Cell (RBC) transfusion is common
after cardiac surgery and associated with adverse perioperative outcomes,
including mortality. Acute normovolemic hemodilution (ANH) may reduce
bleeding and the need for blood product transfusion after cardiac surgery.
However, its blood-saving effect and impact on major outcomes remain
uncertain. <br/>Method(s): This is a single-blinded, multinational,
pragmatic, randomized controlled trial with a 1:1 allocation ratio
conducted in Tertiary and University hospitals. The study is designed to
enroll patients scheduled for elective cardiac surgery with planned
cardiopulmonary bypass (CPB). Patients are randomized to receive ANH
before CPB or the best available treatment without ANH. We identified an
ANH volume of at least 650 ml as the critical threshold for clinically
relevant benefits. Larger ANH volumes, however, are allowed and tailored
to the patient's characteristics and clinical conditions. <br/>Result(s):
The primary outcome is the percentage of patients receiving RBCs
transfusion from randomization until hospital discharge, which we
hypothesize will be reduced from 35% to 28% with ANH. Secondary outcomes
are all-cause 30-day mortality, acute kidney injury, bleeding
complications, and ischemic complications. <br/>Conclusion(s): The trial
is designed to determine whether ANH can safely reduce RBC transfusion
after elective cardiac surgery with CPB. Study registration: This trial
was registered on ClinicalTrials.gov in April 2019 with the trial
identification number NCT03913481.<br/>Copyright &#xa9; 2024

<82>
Accession Number
2033009462
Title
Effectiveness of Adaptive Support Ventilation in Facilitating Weaning from
Mechanical Ventilation in Postoperative Patients.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2024.
Date of Publication: 2024.
Author
Tsai Y.-C.; Jhou H.-J.; Huang C.-W.; Lee C.-H.; Chen P.-H.; Hsu S.-D.
Institution
(Tsai, Hsu) Division of Traumatology, Department of Surgery, Tri-Service
General Hospital, National Defense Medical Center, Taipei, Taiwan
(Republic of China)
(Tsai) Division of Plastic Surgery, Department of Surgery, Tri-Service
General Hospital, National Defense Medical Center, Taipei, Taiwan
(Republic of China)
(Jhou) Department of Neurology, Changhua Christian Hospital, Changhua,
Taiwan (Republic of China)
(Huang) Division of Plastic Surgery, Department of Surgery, Cathay General
Hospital, Taipei, Taiwan (Republic of China)
(Lee, Chen) Division of Hematology and Oncology, Department of Internal
Medicine, Tri-Service General Hospital, National Defense Medical Center,
Taipei, Taiwan (Republic of China)
Publisher
W.B. Saunders
Abstract
Objective: This meta-analysis aims to evaluate the effectiveness of
adaptive support ventilation (ASV) in facilitating postoperative weaning
from mechanical ventilation in cardiac surgery patients. <br/>Design(s): A
systematic review and meta-analysis to assess ASV in weaning postoperative
cardiac surgery patients. Outcomes included early extubation, reintubation
rates, time to extubation, and lengths of intensive care units and
hospital stays. <br/>Setting(s): We searched electronic databases from
inception to March 2023 and included randomized controlled trials that
compared ASV with conventional ventilation methods in this population.
<br/>Participant(s): Postoperative cardiac surgery patients.
<br/>Measurements and Main Results: A random effects model was used for
meta-analysis, and trial sequential analysis (TSA) was conducted to assess
result robustness. The meta-analysis included 11 randomized controlled
trials with a total of 1027 randomized patients. ASV was associated with a
shorter time to extubation compared to conventional ventilation (random
effects, mean difference -68.30 hours; 95% confidence interval, -115.50 to
-21.09) with TSA providing a conclusive finding. While ASV indicated
improved early extubation rates, no significant differences were found in
reintubation rates or lengths of intensive care unit and hospital stays,
with these TSA results being inclusive. <br/>Conclusion(s): ASV appears to
facilitate a shorter time to extubation in postoperative cardiac surgery
patients compared to conventional ventilation, suggesting benefits in
accelerating the weaning process and reducing mechanical ventilation
duration.<br/>Copyright &#xa9; 2024 Elsevier Inc.

<83>
Accession Number
2033009404
Title
Association between driving pressure-guided ventilation and postoperative
pulmonary complications in surgical patients: a meta-analysis with trial
sequential analysis.
Source
British Journal of Anaesthesia. (no pagination), 2024. Date of
Publication: 2024.
Author
Gu W.-J.; Cen Y.; Zhao F.-Z.; Wang H.-J.; Yin H.-Y.; Zheng X.-F.
Institution
(Gu, Cen, Zhao, Yin) Department of Intensive Care Unit, The First
Affiliated Hospital of Jinan University, Guangzhou, China
(Wang, Zheng) Department of Bone and Joint Surgery and Sports Medicine
Center, The First Affiliated Hospital of Jinan University, Guangzhou,
China
Publisher
Elsevier Ltd
Abstract
Background: Prior studies have reported inconsistent results regarding the
association between driving pressure-guided ventilation and postoperative
pulmonary complications (PPCs). We aimed to investigate whether driving
pressure-guided ventilation is associated with a lower risk of PPCs.
<br/>Method(s): We systematically searched electronic databases for RCTs
comparing driving pressure-guided ventilation with conventional protective
ventilation in adult surgical patients. The primary outcome was a
composite of PPCs. Secondary outcomes were pneumonia, atelectasis, and
acute respiratory distress syndrome (ARDS). Meta-analysis and subgroup
analysis were conducted to calculate risk ratios (RRs) with 95% confidence
intervals (CI). Trial sequential analysis (TSA) was used to assess the
conclusiveness of evidence. <br/>Result(s): Thirteen RCTs with 3401
subjects were included. Driving pressure-guided ventilation was associated
with a lower risk of PPCs (RR 0.70, 95% CI 0.56-0.87, P=0.001), as
indicated by TSA. Subgroup analysis (P for interaction=0.04) found that
the association was observed in non-cardiothoracic surgery (nine RCTs,
1038 subjects, RR 0.61, 95% CI 0.48-0.77, P< 0.0001), with TSA suggesting
sufficient evidence and conclusive result; however, it did not reach
significance in cardiothoracic surgery (four RCTs, 2363 subjects, RR 0.86,
95% CI 0.67-1.10, P=0.23), with TSA indicating insufficient evidence and
inconclusive result. Similarly, a lower risk of pneumonia was found in
non-cardiothoracic surgery but not in cardiothoracic surgery (P for
interaction=0.046). No significant differences were found in atelectasis
and ARDS between the two ventilation strategies. <br/>Conclusion(s):
Driving pressure-guided ventilation was associated with a lower risk of
postoperative pulmonary complications in non-cardiothoracic surgery but
not in cardiothoracic surgery. Systematic Review Protocol: INPLASY
202410068.<br/>Copyright &#xa9; 2024 British Journal of Anaesthesia

<84>
Accession Number
644615990
Title
Clinical evaluation of laryngeal mask airways in video-assisted thoracic
surgery: a meta-analysis of randomized controlled trials.
Source
Journal of cardiothoracic surgery. 19(1) (pp 361), 2024. Date of
Publication: 24 Jun 2024.
Author
Luo K.; Chen K.; Li Y.; Ji Y.
Institution
(Luo, Chen, Ji) Department of Anesthesiology, West China Hospital of
Stomatology, Sichuan University, Chengdu, China
(Li) Department of Anesthesiology, West China Hospital, Sichuan
University, Chengdu, China
Abstract
BACKGROUND: Endotracheal intubation is often associated with postoperative
complications such as sore throat discomfort and hoarseness, reducing
patient satisfaction and prolonging hospital stays. Laryngeal mask airway
(LMA) plays a critical role in reducing airway complications related to
endotracheal intubation. This meta-analysis was performed to determine the
efficacy and safety of LMA in video-assisted thoracic surgery (VATS).
<br/>METHOD(S): The PubMed, Embase, Cochrane Library, Medline and Web of
Science databases were searched for eligible studies from inception until
October 5, 2023. Cochrane's tool (RoB 2) was used to evaluate the
possibility biases of RCTs. We performed sensitivity analysis and subgroup
analysis to assess the robustness of the results. <br/>RESULT(S): Seven
articles were included in this meta-analysis. Compared with endotracheal
intubation, there was no significant difference in the postoperative
hospital stay (SMD = -0.47, 95% CI = -0.98-0.03, P=0.06), intraoperative
minimum SpO2 (SMD=0.00, 95% CI = -0.49-0.49, P=1.00), hypoxemia (RR=1.00,
95% CI=0.26-3.89, P=1.00), intraoperative highest PetCO2 (SMD=0.51, 95% CI
= -0.12-1.15, P=0.11), surgical field satisfaction (RR=1.01, 95%
CI=0.98-1.03, P=0.61), anesthesia time (SMD = -0.10, 95% CI = -0.30-0.10,
P=0.31), operation time (SMD=0.06, 95% CI = -0.13-0.24, P=0.55) and blood
loss (SMD =- 0.13, 95% CI = -0.33-0.07, P=0.21) in LMA group. However, LMA
was associated with a lower incidence of throat discomfort (RR=0.28, 95%
CI=0.17-0.48, P<0.00001) and postoperative hoarseness (RR=0.36, 95%
CI=0.16-0.81, P=0.01), endotracheal intubation was found in connection
with a longer postoperative awake time (SMD = -2.19, 95% CI = -3.49 -
-0.89, P=0.001). <br/>CONCLUSION(S): Compared with endotracheal
intubation, LMA can effectively reduce the incidence of throat discomfort
and hoarseness post-VATS, and can accelerate the recovery from anesthesia.
LMA appears to be an alternative to endotracheal intubation for some
specific thoracic surgical procedures, and the efficacy and safety of LMA
in VATS need to be further explored in the future.<br/>Copyright &#xa9;
2024. The Author(s).

<85>
Accession Number
2032844644
Title
Preoperative computed tomography-guided localization for pulmonary
nodules: a randomized controlled trial of coil and anchored needle
localization.
Source
Wideochirurgia I Inne Techniki Maloinwazyjne. 19(2) (pp 178-186), 2024.
Date of Publication: 2024.
Author
Lv Y.-N.; Zhang W.-T.; Wang Y.; Wang G.
Institution
(Lv) Department of Radiology, Xuzhou Universal Medical Imaging Diagnostic
Center, Xuzhou, China
(Zhang) Department of Radiology, The First Hospital, Zhangjiakou, China
(Wang, Wang) Department of Radiology, Xuzhou Central Hospital, Xuzhou,
China
Publisher
Termedia Publishing House Ltd.
Abstract
Introduction: In patients with pulmonary nodules (PNs), computed
tomography (CT)-guided localization is commonly performed prior to the
resection of these nodules through video-assisted thoracic surgery (VATS).
<br/>Aim(s): To evaluate the relative clinical efficacy of coil and
anchored needle (AN) insertion as approaches to preoperative CT-guided PN
localization. <br/>Material(s) and Method(s): This single-center,
prospective, open-label, randomized controlled trial (registration number:
NCT05183945) enrolled consecutive patients from January 2022 to July 2022,
assigning these patients at random to undergo either coil or AN
localization prior to VATS. Efficacy and safety outcomes in these two
groups were then compared. <br/>Result(s): This study enrolled in total
100 patients with 120 PNs who were assigned at random to the coil
(patients = 50; PNs = 60) and AN (patients = 50; PNs = 60) localization
groups. The respective technical success rates for coil and AN
localization were 98.3% (59/60) and 100% (60/60), with no significant
difference between the groups (p = 1.000). The coil group had a
significantly longer median duration of localization relative to the AN
group (16.0 min vs. 8.0 min, p < 0.001). Similar rates of
localization-related pneumothorax (8.3% vs. 5.0%, p = 0.715) and pulmonary
hemorrhage (5.0% vs. 13.3%, p = 0.110) were observed in both groups. In
addition, the VATS resection procedures achieved 100% technical success
rates in both of these localization groups. <br/>Conclusion(s): Both coil-
and AN-based localization approaches can be successfully employed to
localize PNs prior to VATS resection, with the AN localization procedure
requiring less time to complete on average as compared to the coil-based
approach.<br/>Copyright &#xa9; 2024 Termedia Publishing House Ltd.. All
rights reserved.

<86>
Accession Number
2030375860
Title
Percutaneous Coronary Intervention before or after Transcatheter Aortic
Valve Replacement: A Systematic Review and Meta-Analysis Involving 1531
Patients.
Source
Journal of Clinical Medicine. 13(12) (no pagination), 2024. Article
Number: 3521. Date of Publication: June 2024.
Author
Caminiti R.; Ielasi A.; Vetta G.; Parlavecchio A.; Della Rocca D.G.;
Pellegrini D.; Pellicano M.; Montonati C.; Mancini N.; Carciotto G.;
Ajello M.; Iuvara G.; Costa F.; Laterra G.; Barbanti M.; Ceresa F.; Patane
F.; Micari A.; Vizzari G.
Institution
(Caminiti, Ielasi, Pellegrini, Pellicano, Montonati) U.O. Cardiologia
Ospedaliera, IRCCS Ospedale Galeazzi-Sant'Ambrogio, Milan 20157, Italy
(Caminiti) Divisione di Cardiologia-Emodinamica, Policlinico Madonna della
Consolazione, Reggio Calabria 89124, Italy
(Vetta, Della Rocca) Heart Rhythm Management Centre, Universitair
Ziekenhuis Brussel-Vrije Universiteit Brussel, European Reference Networks
Guard-Heart, Brussels 1050, Belgium
(Parlavecchio, Carciotto, Ajello, Iuvara, Costa, Micari, Vizzari)
Interventional Cardiology Unit, Department of Clinical and Experimental
Medicine, University of Messina, Messina 98122, Italy
(Mancini) Department of Clinical, Special and Dental Sciences, Marche
Polytechnic University, Ancona 60131, Italy
(Laterra, Barbanti) Faculty of Medicine and Surgery, Universita degli
Studi di Enna "Kore", Enna 94100, Italy
(Ceresa, Patane) Department of Cardiothoracic Surgery, Papardo Hospital,
Messina 98158, Italy
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Background: The optimal timing to perform percutaneous coronary
interventions (PCIs) in patients undergoing transcatheter aortic valve
replacement (TAVR) is not well established. In this meta-analysis, we
aimed to compare the outcomes of patients undergoing PCI before versus
after TAVR. <br/>Method(s): A comprehensive literature search was
performed including Medline, Embase, and Cochrane electronic databases up
to 5 April 2024 for studies that compared PCI before and after TAVR
reporting at least one clinical outcome of interest (PROSPERO ID:
CRD42023470417). The analyzed outcomes were mortality, stroke, and
myocardial infarction (MI) at follow-up. <br/>Result(s): A total of 3
studies involving 1531 patients (pre-TAVR PCI n = 1240; post-TAVR PCI n =
291) were included in this meta-analysis following our inclusion criteria.
Mortality was higher in the pre-TAVR PCI group (OR: 2.48; 95% CI:
1.19-5.20; p = 0.02). No differences were found between PCI before and
after TAVR for the risk of stroke (OR: 3.58; 95% CI: 0.70-18.15; p = 0.12)
and MI (OR: 0.66; 95% CI: 0.30-1.42; p = 0.29). <br/>Conclusion(s): This
meta-analysis showed in patients with stable CAD undergoing TAVR that PCI
after TAVR is associated with lower mortality compared with PCI before
TAVR.<br/>Copyright &#xa9; 2024 by the authors.

<87>
Accession Number
2030375746
Title
Safety of Fibrinogen Concentrate in Non-Trauma and Non-Obstetric Adult
Patients during Perioperative Care: Systematic Review and Meta-Analysis.
Source
Journal of Clinical Medicine. 13(12) (no pagination), 2024. Article
Number: 3482. Date of Publication: June 2024.
Author
Gomes M.; Angelo-Dias M.; Duarte G.S.; Dias S.S.; Serra S.S.; Lima J.
Institution
(Gomes) Transfusion Medicine Department, Hemovida, Hospital da Luz Lisboa,
Luz Saude, Lisboa 1500-650, Portugal
(Angelo-Dias, Lima) NOVA Medical School (NMS), Faculdade de Ciencias
Medicas (FCM), Universidade Nova de Lisboa, Lisboa 1099-085, Portugal
(Angelo-Dias, Dias, Lima) Comprehensive Health Research Centre (CHRC),
NOVA Medical School (NMS), Faculdade de Ciencias Medicas (FCM),
Universidade Nova de Lisboa, Lisboa 1099-085, Portugal
(Duarte) Clinical Pharmacology, Hospital da Luz Lisboa, Luz Saude, Lisboa
1500-650, Portugal
(Duarte) Laboratory of Clinical Pharmacology and Therapeutics, Faculty of
Medicine, University of Lisbon, Lisboa 1649-004, Portugal
(Dias) ciTechCare-Centre for Innovative Care and Health Technology,
Polytechnic of Leiria, Leiria 2411-901, Portugal
(Serra) Library, NOVA Medical School (NMS), Faculdade de Ciencias Medicas
(FCM), Universidade Nova de Lisboa, Lisboa 1099-085, Portugal
(Lima) Department of Obstetrics and Gynecology, Hospital da Luz Lisboa,
Luz Saude, Lisboa 1500-650, Portugal
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Background: Low fibrinogen levels are associated with an increased risk of
perioperative bleeding. However, there is an ongoing debate over the ideal
treatment threshold, the benefits of prophylactic supplementation with
fibrinogen concentrate, and the best source of fibrinogen. While
fibrinogen concentrate supplementation is being widely used to treat
bleeding related to acquired haemostatic deficiencies, there is a lack of
evidence regarding its dosage, effectiveness, and safety. This systematic
review provides an up-to-date summary of the relationship between
fibrinogen concentrate supplementation and safety measures in the
perioperative care of non-trauma, non-obstetric adult patients.
<br/>Method(s): A comprehensive online search was conducted on
PubMed/Medline, EMBASE, Scopus, Web of Science, the Cochrane Database of
Systematic Reviews, and the Cochrane Central Register of Controlled
Trials. <br/>Result(s): This systematic review and meta-analysis
encompasses ten studies involving 1391 patients. There was a decreased
risk of total thromboembolic events in patients treated with fibrinogen
compared to the control (OR 0.65, 95% CI 0.43 to 0.98, I² =
0%). In addition, when fibrinogen was used prophylactically, it resulted
in shorter ICU stays (MD -1.50, 95% CI -2.64 to -0.36), when set against
its therapeutic use. A sensitivity analysis on cardiovascular surgery
studies did not reveal any statistically significant difference.
<br/>Conclusion(s): The use of fibrinogen concentrate in the perioperative
care of non-trauma and non-obstetric adult patients may lead to potential
benefits.<br/>Copyright &#xa9; 2024 by the authors.

<88>
Accession Number
644614060
Title
Stellate ganglion block for visceral pain in elderly patients undergoing
video-assisted thoracoscopic lung cancer surgery: a randomized, controlled
trial.
Source
International journal of surgery (London, England). (no pagination),
2024. Date of Publication: 24 Jun 2024.
Author
Xiang X.-B.; Wu Y.-Y.; Fang Z.; Tang X.; Wu Y.-L.; Zhou J.; Cheng X.-Q.
Institution
(Xiang, Tang, Wu, Zhou) Department of Anesthesiology, Zhejiang Cancer
Hospital and Institute of Medicine (HIM), Chinese Academy of Sciences,
Hangzhou, Zhejiang, China
(Wu, Fang, Cheng) Department of Anesthesiology, First Affiliated Hospital
of Anhui Medical University and Key Laboratory of Anesthesiology and
Perioperative Medicine of Anhui Higher Education Institutes, Anhui Medical
University, Hefei, China
Abstract
BACKGROUND: Visceral pain occurs commonly following thoracic surgery, but
an effective method to relieve visceral pain in thoracic surgery remains
controversial. We test the effect of stellate ganglion blocks (SGB) on
perioperative visceral pain following video-assisted thoracoscopic surgery
(VATS). <br/>METHOD(S): A prospective, randomized, controlled trial
enrolled 77 elderly patients undergoing VATS. Patients were randomized to
SGB followed by modified intercostal nerve block (Group S, n=37); or
modified intercostal nerve block only (Group C, n=40). Remifentanil
0.02-0.2 mug.kg-1.min-1 was titrated to keep pain threshold index values
between 40-65 and maintain mean arterial pressure or heart rate values
around 20% of baseline values. Patient-controlled intravenous analgesia
with sufentanil was used in the postoperative period. The co-primary
outcomes were the perioperative cumulative opioid consumption and pain
scores on movement at 24 h after surgery. <br/>RESULT(S): Compared with
control group, SGB greatly reduced the intraoperative remifentanil
consumption[300.00(235.00-450.00)mug versus 710.00(500.00-915.00)mug;
P<0.01], with no difference in cumulative sufentanil consumption to 48h
post-surgery. There was a statistically significant difference in pain
scores on movement at 24h between groups [4.00(3.00-4.00) versus
4.00(3.25-5.00); P=0.01]. Further exploratory analyses showed significant
difference for intra-chest pain on movement at 24h [3.00(2.00-3.00) versus
3.00(2.25-4.00); P=0.01]. No significant difference was observed in
nausea/vomiting, time to pass flatus and postoperative length of stay.
<br/>CONCLUSION(S): Preoperative stellate ganglion blocks for elderly
patients could effectively blunt intraoperative visceral stress and reduce
postoperative visceral pain extending 24 h after VATS. This initial
finding deserve further investigation.<br/>Copyright &#xa9; 2024 The
Author(s). Published by Wolters Kluwer Health, Inc.

<89>
Accession Number
644594826
Title
Semaglutide and Cardiovascular Outcomes by Baseline HbA1c and Change in
HbA1c in People With Overweight or Obesity but Without Diabetes in SELECT.
Source
Diabetes care. (no pagination), 2024. Date of Publication: 22 Jun 2024.
Author
Lingvay I.; Deanfield J.; Kahn S.E.; Weeke P.E.; Toplak H.; Scirica B.M.;
Ryden L.; Rathor N.; Plutzky J.; Morales C.; Lincoff A.M.; Lehrke M.;
Jeppesen O.K.; Gajos G.; Colhoun H.M.; Cariou B.; Ryan D.
Institution
(Lingvay) Department of Internal Medicine/Endocrinology and Peter
O'Donnell Jr. School of Public Health, University of Texas Southwestern
Medical Center, Dallas, TX, United States
(Deanfield) Institute of Cardiovascular Science, University College
London, London, United Kingdom
(Kahn) VA Puget Sound Health Care System and University of Washington,
Seattle, WA, United States
(Weeke, Rathor, Jeppesen) Novo Nordisk A/S, Denmark
(Toplak) Division of Endocrinology and Diabetology, Department of
Medicine, Medical University of Graz, Graz, Austria
(Scirica) TIMI Study Group, Division of Cardiovascular Medicine, Brigham
and Women's Hospital, Harvard Medical School, Boston, MA, United States
(Ryden) Department of Medicine K2, Karolinska Institute, Stockholm, Sweden
(Plutzky) Cardiovascular Division, Brigham and Women's Hospital, Harvard
Medical School, Boston, MA, United States
(Morales) Vithas Hospital, Sevilla, Spain
(Lincoff) Department of Cardiovascular Medicine, Cleveland Clinic,
Cleveland Clinic Lerner College of Medicine, Case Western Reserve
University, Cleveland, OH, United States
(Lehrke) University of Aachen, Aachen, Germany
(Gajos) Department of Coronary Artery Disease and Heart Failure,
Jagiellonian University Medical College, Krakow, Poland
(Colhoun) Institute of Genetics and Cancer, University of Edinburgh,
Edinburgh, United Kingdom
(Cariou) L'institut du thorax, INSERM, CNRS, CHU Nantes, Nantes, France
(Ryan) Pennington Biomedical Research Center, Baton Rouge, LA, United
States
Abstract
OBJECTIVE: To evaluate the cardiovascular effects of semaglutide by
baseline glycated hemoglobin (HbA1c) and change in HbA1c in a prespecified
analysis of Semaglutide Effects on Cardiovascular Outcomes in People With
Overweight or Obesity (SELECT). RESEARCH DESIGN AND METHODS: In SELECT,
people with overweight or obesity and atherosclerotic cardiovascular
disease without diabetes were randomized to weekly semaglutide 2.4 mg or
placebo. The primary end point of first major adverse cardiovascular event
(MACE) (cardiovascular mortality, nonfatal myocardial infarction, or
stroke) was reduced by 20% with semaglutide versus placebo. Analysis of
outcomes included first MACE, its individual components, expanded MACE
(cardiovascular mortality, nonfatal myocardial infarction, or stroke;
coronary revascularization; or hospitalization for unstable angina), a
heart failure composite (heart failure hospitalization or urgent medical
visit or cardiovascular mortality), coronary revascularization, and
all-cause mortality by baseline HbA1c subgroup and categories of HbA1c
change (<-0.3, -0.3 to 0.3, and >0.3 percentage points) from baseline to
20 weeks using the intention-to-treat principle with Cox proportional
hazards. <br/>RESULT(S): Among 17,604 participants (mean age 61.6 years,
72.3% male), baseline HbA1c was <5.7% for 33.5%, 5.7% to <6.0% for 34.6%,
and 6.0% to <6.5% for 31.9%. Cardiovascular risk reduction with
semaglutide versus placebo was not shown to be different across baseline
HbA1c groups and was consistent with that of the overall study for all end
points, except all-cause mortality. Cardiovascular outcomes were also
consistent across subgroups of HbA1c change. <br/>CONCLUSION(S): In people
with overweight or obesity and established atherosclerotic cardiovascular
disease but not diabetes, semaglutide reduced cardiovascular events
irrespective of baseline HbA1c or change in HbA1c. Thus, semaglutide is
expected to confer cardiovascular benefits in people with established
atherosclerotic cardiovascular disease who are normoglycemic at baseline
and/or in those without HbA1c improvements.<br/>Copyright &#xa9; 2024 by
the American Diabetes Association.

<90>
Accession Number
2032962557
Title
A review regarding the article 'impact of simulation-based training on
transesophageal echocardiography learning: A systemic review and
meta-analysis of randomized controlled trials'.
Source
Current Problems in Cardiology. 49(9) (no pagination), 2024. Article
Number: 102717. Date of Publication: September 2024.
Author
Su Y.; Yuan D.
Institution
(Su) Department of Anesthesiology, West China Hospital, Sichuan
University/West China School of Nursing, Sichuan, Chengdu 610041, China
(Yuan) Department of Cardiovascular Surgery, Chengdu Shang Jin Nan Fu
Hospital, West China Hospital of Sichuan University, Sichuan Province,
Chengdu 610041, China
Publisher
Elsevier Inc.
Abstract
Transesophageal echocardiography (TEE) has emerged as a critical imaging
technique for anesthesiologists, enabling them to monitor and detect
significant cardiothoracic conditions in both cardiac and noncardiac
surgical patients throughout the perioperative period. Given the expanding
applications of TEE, its integration into the anesthesiology residency
curriculum at an early stage is crucial. This ensures that residents have
ample time to develop their TEE skills, thereby facilitating meaningful
clinical application post-residency. While studies have demonstrated the
successful use of simulators and web-based modules in TEE education, there
is currently a lack of educational materials that provide a structured
curriculum specifically designed to teach the fundamentals of TEE to
residents. Furthermore, simulation training in TEE prior to patient
exposure may contribute to enhanced patient safety and comfort. By
providing residents with the opportunity to practice their TEE skills in a
controlled, risk-free environment, simulation training can help to
mitigate the potential risks associated with real-world patient care. TEE
has become an indispensable tool for anesthesiologists, and its
integration into the residency curriculum is essential. The use of
simulation-based training, particularly in a virtual reality setting,
offers a promising avenue for enhancing TEE education and fostering the
development of competent practitioners.<br/>Copyright &#xa9; 2024

<91>
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. <br/>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. <br/>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. <br/>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.<br/>Copyright &#xa9; 2024 European Society
for Clinical Nutrition and Metabolism

<92>
Accession Number
2030303182
Title
The evolution of TAVI performance overtime: an overview of systematic
reviews.
Source
BMC Cardiovascular Disorders. 24(1) (no pagination), 2024. Article Number:
314. Date of Publication: December 2024.
Author
Angioletti C.; Moretti G.; Manetti S.; Pastormerlo L.; Vainieri M.;
Passino C.
Institution
(Angioletti, Moretti, Vainieri) Management and Healthcare Laboratory,
Institute of Management, Sant'Anna School of Advanced Studies, Pisa, Italy
(Manetti) Department of Management Engineering, Politecnico di Milano,
Milano, Italy
(Pastormerlo, Passino) Fondazione Toscana G. Monasterio, Pisa, Italy
(Passino) Health Science Interdisciplinary Center, Sant'Anna School of
Advanced Studies, Pisa, Italy
Publisher
BioMed Central Ltd
Abstract
Background: Transcatheter aortic valve implantation (TAVI) is a
well-established treatment for high and intermediate-risk patients with
severe aortic stenosis (AS). Recent studies have demonstrated
non-inferiority of TAVI compared to surgery in low-risk patients. In the
past decade, numerous literature reviews (SLRs) have assessed the use of
TAVI in different risk groups. This is the first attempt to provide an
overview of SRs (OoSRs) focusing on secondary studies reporting clinical
outcomes/process indicators. This research aims to summarize the findings
of extant literature on the performance of TAVI over time. <br/>Method(s):
A literature search took place from inception to April 2024. We searched
MEDLINE and the Cochrane Library for SLRs. SLRs reporting at least one
review of clinical indicators were included. Subsequently, a two-step
inclusion process was conducted: [1] screening based on title and
abstracts and [2] screening based on full-text papers. Relevant data were
extracted and the quality of the reviews was assessed. <br/>Result(s): We
included 33 SLRs with different risks assessed via the Society of Thoracic
Surgeons (STS) score. Mortality rates were comparable between TAVI and
Surgical Aortic Valve Replacement (SAVR) groups. TAVI is associated with
lower rates of major bleeding, acute kidney injury (AKI) incidence, and
new-onset atrial fibrillation. Vascular complications, pacemaker
implantation, and residual aortic regurgitation were more frequent in TAVI
patients. <br/>Conclusion(s): This study summarizes TAVI performance
findings over a decade, revealing a shift to include both high and
low-risk patients since 2020. Overall, TAVI continues to evolve,
emphasizing improved outcomes, broader indications, and addressing
challenges.<br/>Copyright &#xa9; The Author(s) 2024.

<93>
Accession Number
2029699937
Title
Transdermal bisoprolol for prevention of postoperative atrial
fibrillation: A systematic review and meta-analysis.
Source
Journal of Arrhythmia. 40(3) (pp 434-439), 2024. Date of Publication: June
2024.
Author
Kim A.G.; Banga S.; Ang Q.X.; Atti L.; Ghnaima H.; AlAttal S.; Banga P.;
Wilcox M.D.
Institution
(Kim, Ang, Atti, Ghnaima, AlAttal) Internal Medicine, Michigan State
University, East Lansing, MI, United States
(Banga, Wilcox) Cardiology, Michigan State University, East Lansing, MI,
United States
(Banga) Radiology, University of Michigan, Ann Arbor, MI, United States
Publisher
John Wiley and Sons Inc
Abstract
Background: The transdermal patch of bisoprolol available in Japan has
been reported to demonstrate superior efficacy in preventing postoperative
atrial fibrillation, possibly surpassing its oral counterpart. However,
there has been no systematic review and meta-analysis assessing the
efficacy of transdermal bisoprolol. <br/>Method(s): A comprehensive
systematic literature search was conducted on PubMed, Embase, and Cochrane
to identify all relevant studies assessing the efficacy of transdermal
bisoprolol in preventing postoperative atrial fibrillation. The search
covered studies from inception up to December 4, 2023. For data analysis,
Review Manager (RevMan) 5.4 software was employed, using a random-effects
model to calculate risk ratios (RR) and 95% confidence intervals (CI).
<br/>Result(s): Three studies, comprising a total of 551 patients
(transdermal bisoprolol 228 and control 323), were included. There was a
decreased risk of postoperative atrial fibrillation or atrial
tachyarrhythmias in patients treated with transdermal bisoprolol (RR 0.43,
95% CI 0.27-0.67, p =.0002, I² = 0%). <br/>Conclusion(s):
Transdermal administration of bisoprolol has consistently shown efficacy,
and this pooled analysis supports its effectiveness. The heterogeneity of
the included studies limits certain interpretations. Future randomized
clinical trials may elucidate the superiority of transdermal
administration over oral administration.<br/>Copyright &#xa9; 2024 The
Authors. Journal of Arrhythmia published by John Wiley & Sons Australia,
Ltd on behalf of Japanese Heart Rhythm Society.

<94>
Accession Number
2028055508
Title
Blood pressure levels and adverse cardiovascular outcomes in heart
failure: A systematic review and meta-analysis.
Source
European Journal of Heart Failure. 26(5) (pp 1111-1124), 2024. Date of
Publication: May 2024.
Author
Seidu S.; Lawson C.A.; Kunutsor S.K.; Khunti K.; Rosano G.M.C.
Institution
(Seidu, Kunutsor, Khunti) Diabetes Research Centre, University of
Leicester, Leicester General Hospital, Leicester, United Kingdom
(Lawson) Department of Cardiovascular Sciences, University of Leicester,
Leicester, United Kingdom
(Lawson) National Institute for Health Research Biomedical Research
Centre, Glenfield Hospital, Leicester, United Kingdom
(Rosano) IRCCS San Raffaele, Rome, Italy
Publisher
John Wiley and Sons Ltd
Abstract
Aim: Existing data on the association between blood pressure levels and
adverse cardiovascular outcomes in patients with heart failure (HF) are
inconsistent. The optimal blood pressure targets for patients with HF
remain uncertain. This study sought to assess the associations between
blood pressure (systolic [SBP] and diastolic blood pressure [DBP]) levels
and adverse cardiovascular disease (CVD) outcomes in patients with HF.
<br/>Methods and Results: A systematic review and meta-analysis were
conducted using MEDLINE, Embase, the Cochrane Library, and Web of Science
databases up to 5 May 2023. The outcomes of interest included adverse
cardiovascular events and all-cause mortality. Pooled relative risks (RRs)
with corresponding 95% confidence intervals (CIs) were calculated.
Forty-three unique observational cohort studies, comprising 120 643
participants with HF, were included. The pooled RRs (95% CIs) for SBP
thresholds of >=140 mmHg versus <140 mmHg were 0.92 (0.83-1.01) for
all-cause mortality, 0.83 (0.67-1.04) for CVD death, and 0.98 (0.80-1.21)
for HF hospitalization. The pooled RR (95% CI) for SBP thresholds of >=160
mmHg versus <160 mmHg and all-cause mortality was 0.67 (0.62-0.74). SBP
levels below <130, <120, and <110 mmHg were each associated with an
increased risk of various cardiovascular endpoints and all-cause
mortality. The pooled RR (95% CI) for DBP thresholds of >=80 mmHg versus
<80 mmHg and all-cause mortality was 0.86 (0.67-1.10). A 10 mmHg increase
in SBP or DBP was associated with a reduction in all-cause mortality and
other cardiovascular endpoints. <br/>Conclusion(s): The findings suggest
that lower and normal baseline SBP levels (<130, <120, and <110 mmHg) may
be associated with future risk of worse outcomes in patients with HF.
Optimal baseline blood pressure levels for these patients may lie within
the range of >=140 mmHg for SBP. In the absence of observational studies
with repeated blood pressure measurements or definitive trials evaluating
optimal blood pressure targets, individualized blood pressure targets
based on patients' unique circumstances are warranted in HF
management.<br/>Copyright &#xa9; 2024 The Authors. European Journal of
Heart Failure published by John Wiley & Sons Ltd on behalf of European
Society of Cardiology.

<95>
[Use Link to view the full text]
Accession Number
629783613
Title
Five-year outcomes after PCI or CABG for left main coronary disease.
Source
New England Journal of Medicine. 381(19) (pp 1820-1830), 2019. Date of
Publication: 07 Nov 2019.
Author
Stone G.W.; Pieter Kappetein A.; Sabik J.F.; Pocock S.J.; Morice M.-C.;
Puskas J.; Kandzari D.E.; Karmpaliotis D.; Morris Brown W.; Lembo N.J.;
Banning A.; Merkely B.; Horkay F.; Boonstra P.W.; Van Boven A.J.; Ungi I.;
Bogats G.; Mansour S.; Noiseux N.; Sabate M.; Pomar J.; Hickey M.;
Gershlick A.; Buszman P.E.; Bochenek A.; Schampaert E.; Page P.; Modolo
R.; Gregson J.; Simonton C.A.; Mehran R.; Kosmidou I.; Genereux P.;
Crowley A.; Dressler O.; Serruys P.W.
Institution
(Stone, Karmpaliotis, Morris Brown, Lembo, Modolo, Kosmidou, Genereux,
Crowley, Dressler) Cardiovascular Research Foundation, 1700 Broadway, 8th
Fl., New York, NY 10019, United States
(Stone, Mehran) Zena and Michael A. Wiener Cardiovascular Institute, Icahn
School of Medicine at Mount Sinai, New York, United States
(Puskas) Mount Sinai Heart at Mount Sinai Saint Luke's, New York, United
States
(Karmpaliotis, Lembo, Kosmidou) New York-Presbyterian Hospital, Columbia
University Medical Center, New York, United States
(Pieter Kappetein) Erasmus Medical Center, Rotterdam, Netherlands
(Van Boven, Buszman) Medisch Centrum Leeuwarden, Leeuwarden, Netherlands
(Modolo) Academic Medical Center, University of Amsterdam, Amsterdam,
Netherlands
(Sabik) University Hospitals Cleveland Medical Center, Cleveland, United
Kingdom
(Pocock, Gregson) London School of Hygiene and Tropical Medicine, United
Kingdom
(Serruys) InternationalCentre for Circulatory Health, National Heart and
Lung Institute, Imperial College London, London, United Kingdom
(Banning) John Radcliffe Hospital, Oxford, United Kingdom
(Hickey, Gershlick) University Hospitals of Leicester, NHS Trust,
Leicester, United Kingdom
(Morice) Hopital Prive Jacques Cartier, Ramsay Generale de Sante, Massy,
France
(Kandzari, Morris Brown) Piedmont Heart Institute, Atlanta, United States
(Merkely, Horkay) Semmelweis University, Budapest, Hungary
(Ungi, Bogats) University of Szeged, Szeged, Hungary
(Mansour, Noiseux) Centre Hospitalier, L'Universite de Montreal, Canada
(Schampaert, Page, Genereux) Hopital du Sacre-Coeur de Montreal, Canada
(Sabate, Pomar) Hospital Clinic, Barcelona, Spain
(Buszman, Bochenek) Medical University of Silesia, Katowice, Poland
(Buszman, Bochenek) American Heart of Poland, Ustron, Poland
(Modolo) University of Campinas, Campinas, Brazil
(Simonton) Abbott Vascular, Santa Clara, CA, United States
(Genereux) Gagnon Cardiovascular Institute, Morristown Medical Center,
Morristown, NJ, United States
Publisher
Massachussetts Medical Society
Abstract
BACKGROUND Long-term outcomes after percutaneous coronary intervention
(PCI) with contemporary drug-eluting stents, as compared with
coronary-artery bypass grafting (CABG), in patients with left main
coronary artery disease are not clearly established. METHODS We randomly
assigned 1905 patients with left main coronary artery disease of low or
intermediate anatomical complexity (according to assessment at the
participating centers) to undergo either PCI with fluoropolymer-based
cobalt-chromium everolimus-eluting stents (PCI group, 948 patients) or
CABG (CABG group, 957 patients). The primary outcome was a composite of
death, stroke, or myocardial infarction. RESULTS At 5 years, a primary
outcome event had occurred in 22.0% of the patients in the PCI group and
in 19.2% of the patients in the CABG group (difference, 2.8 percentage
points; 95% confidence interval [CI], -0.9 to 6.5; P=0.13). Death from any
cause occurred more frequently in the PCI group than in the CABG group (in
13.0% vs. 9.9%; difference, 3.1 percentage points; 95% CI, 0.2 to 6.1). In
the PCI and CABG groups, the incidences of definite cardiovascular death
(5.0% and 4.5%, respectively; difference, 0.5 percentage points; 95% CI,
-1.4 to 2.5) and myocardial infarction (10.6% and 9.1%; difference, 1.4
percentage points; 95% CI, -1.3 to 4.2) were not significantly different.
All cerebrovascular events were less frequent after PCI than after CABG
(3.3% vs. 5.2%; difference, -1.9 percentage points; 95% CI, -3.8 to 0),
although the incidence of stroke was not significantly different between
the two groups (2.9% and 3.7%; difference, -0.8 percentage points; 95% CI,
-2.4 to 0.9). Ischemia-driven revascularization was more frequent after
PCI than after CABG (16.9% vs. 10.0%; difference, 6.9 percentage points;
95% CI, 3.7 to 10.0). CONCLUSIONS In patients with left main coronary
artery disease of low or intermediate anatomical complexity, there was no
significant difference between PCI and CABG with respect to the rate of
the composite outcome of death, stroke, or myocardial infarction at
5years.(FundedbyAbbottVascular;EXCELClinicalTrials.govnumber,NCT01205776).
<br/>Copyright &#xa9; 2019 Massachusetts Medical Society.

<96>
[Use Link to view the full text]
Accession Number
629366089
Title
Antithrombotic therapy for atrial fibrillation with stable coronary
disease.
Source
New England Journal of Medicine. 381(12) (pp 1103-1113), 2019. Date of
Publication: 19 Sep 2019.
Author
Yasuda S.; Kaikita K.; Akao M.; Ako J.; Matoba T.; Nakamura M.; Miyauchi
K.; Hagiwara N.; Kimura K.; Hirayama A.; Matsui K.; Ogawa H.
Institution
(Yasuda, Ogawa) National Cerebral and Cardiovascular Center, Suita, Japan
(Hirayama) Department of Cardiology, Osaka Police Hospital, Osaka, Japan
(Kaikita) Department of Cardiovascular Medicine, Graduate School of
Medical Sciences, Kumamoto University, Kumamoto, Japan
(Matsui) Department of General Medicine, Kumamoto University Hospital,
Kumamoto, Japan
(Akao) Department of Cardiology, National Hospital Organization, Kyoto
Medical Center, Kyoto, Japan
(Ako) Department of Cardiovascular Medicine, Kitasato University, School
of Medicine, Sagamihara, Japan
(Matoba) Department of Cardiovascular Medicine, Kyushu University
Hospital, Fukuoka, Japan
(Nakamura) Division of Cardiovascular Medicine, Toho University, Ohashi
Medical Center, Tokyo, Japan
(Miyauchi) Department of Cardiology, Juntendo University, School of
Medicine, Tokyo, Japan
(Hagiwara) Department of Cardiology, Tokyo Women's Medical University,
Tokyo, Japan
(Kimura) Cardiovascular Center, Yokohama City University Medical Center,
Yokohama, Japan
Publisher
Massachussetts Medical Society
Abstract
BACKGROUND There are limited data from randomized trials evaluating the
use of antithrombotic therapy in patients with atrial fibrillation and
stable coronary artery disease. METHODS In a multicenter, open-label trial
conducted in Japan, we randomly assigned 2236 patients with atrial
fibrillation who had undergone percutaneous coronary intervention (PCI) or
coronary-artery bypass grafting (CABG) more than 1 year earlier or who had
angiographically confirmed coronary artery disease not requiring
revascularization to receive monotherapy with rivaroxaban (a non-vitamin K
antagonist oral anticoagulant) or combination therapy with rivaroxaban
plus a single antiplatelet agent. The primary efficacy end point was a
composite of stroke, systemic embolism, myocardial infarction, unstable
angina requiring revascularization, or death from any cause; this end
point was analyzed for noninferiority with a noninferiority margin of
1.46. The primary safety end point was major bleeding, according to the
criteria of the International Society on Thrombosis and Hemostasis; this
end point was analyzed for superiority. RESULTS The trial was stopped
early because of increased mortality in the combination-therapy group.
Rivaroxaban monotherapy was noninferior to combination therapy for the
primary efficacy end point, with event rates of 4.14% and 5.75% per
patient-year, respectively (hazard ratio, 0.72; 95% confidence interval
[CI], 0.55 to 0.95; P<0.001 for noninferiority). Rivaroxaban monotherapy
was superior to combination therapy for the primary safety end point, with
event rates of 1.62% and 2.76% per patient-year, respectively (hazard
ratio, 0.59; 95% CI, 0.39 to 0.89; P=0.01 for superiority). CONCLUSIONS As
antithrombotic therapy, rivaroxaban monotherapy was noninferior to
combination therapy for efficacy and superior for safety in patients with
atrial fibrillation and stable coronary artery disease.<br/>Copyright
&#xa9; 2019 Massachusetts Medical Society.

<97>
Accession Number
2029868764
Title
Peripheral Microvascular Dysfunction in Children and Adults with
Congenital Heart Disease: A Literature Review.
Source
Current Cardiology Reviews. 20(4) (pp 1-14), 2024. Article Number:
e210224227260. Date of Publication: 2024.
Author
Vanreusel I.; Hens W.; Van Craenenbroeck E.; Van Berendoncks A.; Segers
V.F.M.
Institution
(Vanreusel, Hens, Van Craenenbroeck, Van Berendoncks, Segers) Department
of Cardiology, Antwerp University Hospital, Edegem 2650, Belgium
(Vanreusel, Van Craenenbroeck, Van Berendoncks, Segers) Research Group
Cardiovascular Diseases, GENCOR, University of Antwerp, Antwerp 2610,
Belgium
(Hens) Cardiac Rehabilitation Centre, Antwerp University Hospital, Edegem
2650, Belgium
(Hens) Department of Rehabilitation Sciences and Physiotherapy, Faculty of
Medicine and Health Sciences, MOVANT Research Group, University of
Antwerp, Antwerp 2000, Belgium
Publisher
Bentham Science Publishers
Abstract
Although there is a continually growing number of patients with congenital
heart disease (CHD) due to medical and surgical advances, these patients
still have a poorer prognosis compared to healthy individuals of similar
age. In patients with heart failure, microvascular dysfunction (MVD) has
recently emerged as a crucial modulator of disease initiation and
progres-sion. Because of the substantial pathophysiological overlap
between CHD and heart failure induced by other etiologies, MVD could be
important in the pathophysiology of CHD as well. MVD is believed to be a
systemic disease and may be manifested in several vascular beds. This
review will focus on what is currently known about MVD in the peripheral
vasculature in CHD. Therefore, a search on the direct assessment of the
vasodilatory capacity of the peripheral micro-circulation in patients with
CHD was conducted in the PubMed database. Since there is little data
available and the reported studies are also very heterogeneous, peripheral
MVD in CHD is not sufficiently understood to date. Its exact extent and
pathophysiological relevance remain to be elucidated in further
research.<br/>Copyright &#xa9; 2024 Bentham Science Publishers.

<98>
Accession Number
2029337546
Title
gamma-Glutamyl Transferase and Long-Term Survival in the SYNTAXES Trial:
Is It Just the Liver?.
Source
Journal of the American Heart Association. 13(8) (no pagination), 2024.
Article Number: e032276. Date of Publication: 16 Apr 2024.
Author
Ninomiya K.; Serruys P.W.; Garg S.; Kageyama S.; Kotoku N.; Masuda S.;
Revaiah P.C.; O'leary N.; Kappetein A.P.; Mack M.J.; Holmes D.R.;
Davierwala P.M.; Mohr F.W.; Thuijs D.J.F.M.; Onuma Y.
Institution
(Ninomiya, Serruys, Kageyama, Kotoku, Masuda, Revaiah, O'leary, Onuma)
Department of Cardiology, University of Galway, Ireland
(Serruys) National Heart and Lung Institute, Imperial College London,
London, United Kingdom
(Garg) Department of Cardiology, Royal Blackburn Hospital, Blackburn,
United Kingdom
(Kappetein, Thuijs) Department of Cardiothoracic Surgery, Erasmus
University Medical Centre, Rotterdam, Netherlands
(Mack) Department of Cardiothoracic Surgery, Baylor University Medical
Center, Dallas, TX, United States
(Holmes) Department of Cardiovascular Diseases and Internal Medicine, Mayo
Clinic, Rochester, MN, United States
(Davierwala, Mohr) University Department of Cardiac Surgery, Heart Centre
Leipzig, Leipzig, Germany
(Davierwala) Division of Cardiovascular Surgery, Peter Munk Cardiac
Centre, Toronto General Hospital, University Health Network, Toronto, ON,
Canada
(Davierwala) Department of Surgery, University of Toronto, Canada
(Onuma) Galway University Hospital, Galway, Ireland
Publisher
American Heart Association Inc.
Abstract
BACKGROUND: Recently, machine learning algorithms have identified
preprocedural gamma-glutamyl transferase (GGT) as a significant predictor
of long-term mortality after coronary revascularization in the SYNTAX
(Synergy Between PCI [Percutaneous Coronary Intervention] With Taxus and
Cardiac Surgery) trial. The aim of the present study is to investigate the
impact of preprocedural GGT on 10-year all-cause mortality in patients
with complex coronary artery disease after revascularization. METHODS AND
RESULTS: The SYNTAX trial was a randomized trial comparing PCI with
coronary artery bypass grafting in 1800 patients with complex coronary
artery disease. The present report is a post hoc subanalysis of the
SYNTAXES (Synergy Between PCI With Taxus and Cardiac Surgery Extended
Survival) trial, an investigator-driven extended 10-year follow-up of the
SYNTAX trial. The association between preprocedural GGT and 10-year
all-cause mortality was investigated. The mean values of GGT for men and
women were 43.5 (SD, 48.5) and 36.4 (SD, 46.1) U/L, respectively. In
multivariable Cox regression models adjusted by traditional risk factors,
GGT was an independent predictor for all-cause death at 10-year follow-up,
and each SD increase in log-GGT was associated with a 1.24-fold risk of
all cause death at 10-year follow-up (95% CI, 1.10-1.40). According to
previously reported sex-related GGT thresholds, patients with higher GGT
level had a 1.74-fold risk of all-cause death at 10-year follow-up (95%
CI, 1.32-2.29) compared with patients with lower GGT level.
<br/>CONCLUSION(S): Preprocedural GGT is an independent predictor of
10-year mortality after coronary revascularization in patients with
complex coronary artery disease. In patients with elevated GGT, strong
secondary prevention may be required after revascularization and must be
studied prospectively.<br/>Copyright &#xa9; 2024 The Authors.

<99>
Accession Number
2029133455
Title
High-sensitive troponinT, interleukin-8, and interleukin-6 link with
post-surgery risk in infant heart surgery.
Source
Acta Anaesthesiologica Scandinavica. 68(6) (pp 745-752), 2024. Date of
Publication: July 2024.
Author
Thorlacius E.M.; Keski-Nisula J.; Vistnes M.; Ojala T.; Molin M.;
Synnergren M.; Romlin B.S.; Ricksten S.-E.; Wahlander H.; Castellheim A.G.
Institution
(Thorlacius, Romlin, Ricksten, Castellheim) Department of Anesthesiology
and Intensive Care medicine, Sahlgrenska Academy, University of
Gothenburg, Gothenburg, Sweden
(Thorlacius, Romlin, Ricksten, Wahlander, Castellheim) Region Vastra
Gotaland, Sahlgrenska University Hospital, Gothenburg, Sweden
(Keski-Nisula) Department of Anesthesia and Intensive Care, Children's
Hospital, Helsinki University Hospital, Helsinki University, Helsinki,
Finland
(Vistnes) Department of Internal Medicine, Diakonhjemmet Hospital and
Institute for Experimental Medical Research, Oslo University Hospital and
University of Oslo, Oslo, Norway
(Ojala) Department of Pediatric Cardiology, Children's Hospital, Helsinki
University Hospital, Helsinki University, Helsinki, Finland
(Molin) Statistical Consultation Group, Gothenburg, Sweden
(Synnergren) Department of Pediatric Thoracic Surgery, Sahlgrenska
University Hospital, Gothenburg, Sweden
(Wahlander) Department of Pediatric Cardiology, Sahlgrenska Academy,
University of Gothenburg, Gothenburg, Sweden
Publisher
John Wiley and Sons Inc
Abstract
Background: This study focuses on biomarkers in infants after open heart
surgery, and examines the association of high-sensitive troponin T
(hs-cTnT), interleukin-6 (IL-6), and interleukin-8 (IL-8) with
postoperative acute kidney injury (AKI), ventilatory support time and need
of vasoactive drugs. <br/>Method(s): Secondary exploratory study from a
double-blinded clinical randomized trial (Mile-1) on 70 infants undergoing
open heart surgery with cardiopulmonary bypass (CPB). In this sub-study,
the entire study population was examined without considering the study
drugs. The biomarkers' peak concentration (highest concentration at 2 or 6
h post-CPB) were used for statistical analyses. <br/>Result(s): Peak IL-8,
hs-cTnT, and IL-6 occurred at 2 h post-CPB for 96%, 79%, and 63% of the
patients, respectively. The odds ratio of developing AKI2-3 for IL-6 > 293
pg/mL was 23.4 (95% CI 5.3;104.0), for IL-8 > 100 pg/mL it was 11.5
(3.0;44.2), and for hs-cTnT >5597 pg/mL it was 6.1 (1.5; 24.5). In more
than two third of the patients with the highest peak concentrations of
IL-8, IL-6, and hs-cTnT, there was a need for ventilatory support for >24
h and use of vasoactive drugs at 24 h post-CPB, while in less than one
third of the patients with the lowest peak concentrations of IL-8 and
hs-cTnT such requirements were observed. <br/>Conclusion(s): The peak
biomarker concentrations and CPB-time strongly predicted AKI2-3, with IL-6
and IL-8 emerging as strongest predictors. Furthermore, our findings
suggest that measuring hs-cTnT and IL-8 just 2 h post-CPB-weaning may
assist in identifying infants suitable for early extubation and highlight
those at risk of prolonged ventilation.<br/>Copyright &#xa9; 2024 The
Authors. Acta Anaesthesiologica Scandinavica published by John Wiley &
Sons Ltd on behalf of Acta Anaesthesiologica Scandinavica Foundation.

<100>
Accession Number
2032981823
Title
Efficacy and safety of TAVR versus SAVR in patients with small aortic
annuli: A systematic review and meta-analysis.
Source
International Journal of Cardiology. 411 (no pagination), 2024. Article
Number: 132243. Date of Publication: 15 Sep 2024.
Author
Ayyad M.; Jabri A.; Khalefa B.B.; Al-Abdouh A.; Madanat L.; Albandak M.;
Alhuneafat L.; Sukhon F.; Shahrori Z.; Mourid M.R.; Mhanna M.; Giustino
G.; Wang D.D.; Hanson I.D.; Abbas A.E.; AlQarqaz M.; Villablanca P.
Institution
(Ayyad) Department of Internal Medicine, Rutgers New Jersey Medical
School, Newark, NJ, United States
(Jabri, Giustino, Wang, AlQarqaz, Villablanca) Division of Cardiovascular
Medicine, Henry Ford Hospital, Detroit, MI, United States
(Khalefa) Faculty of Medicine, Ain Shams University, Cairo, Egypt
(Al-Abdouh, Albandak) Division of hospital medicine, University of
Kentucky, Lexington, KY, United States
(Albandak) Department of Internal Medicine, University of Toledo, Toledo,
OH, United States
(Madanat, Hanson, Abbas) Department of Cardiovascular Medicine, William
Beaumont University Hospital, Royal Oak, MI, United States
(Alhuneafat) Cardiovascular Division, University of Minnesota,
Minneapolis, MN, United States
(Sukhon) Heart and Vascular Center, Metrohealth Medical Center, Cleveland,
OH, United States
(Shahrori) Case Western Reserve University/Metrohealth Medical Center
Cleveland, OH, United States
(Mourid) Faculty of Medicine, Alexandria Universty, Alexandria, Egypt
(Mhanna) Division of Cardiovascular Medicine, University of Iowa, IA,
United States
(Jabri, Giustino, Wang, AlQarqaz, Villablanca) Michigan State University,
College of Human Medicine, United States
(Madanat, Hanson, Abbas) Oakland University William Beaumont School of
Medicine, United States
Publisher
Elsevier Ireland Ltd
Abstract
Introduction: Patients with a small aortic annulus (SAA) undergoing aortic
valve replacement are at increased risk of patient-prosthesis mismatch
(PPM), which adversely affects outcomes. Transcatheter aortic valve
replacement (TAVR) has shown promise in mitigating PPM compared to
surgical aortic valve replacement (SAVR). <br/>Method(s): We conducted a
systematic review and meta-analysis following PRISMA guidelines to compare
clinical outcomes, mortality, and PPM between SAA patients undergoing TAVR
and SAVR. Eligible studies were identified through comprehensive
literature searches and assessed for quality and relevance.
<br/>Result(s): Nine studies with a total of 2476 patients were included.
There was no significant difference in 30-day Mortality between TAVR vs
SAVR groups (OR = 0.65, 95% CI [ 0.09-4.61], P = 0.22). There was no
difference between both groups regarding myocardial infarction at 30 days
(OR = 0.63, 95% CI [0.1-3.89], P = 0.62). TAVR was associated with a
significantly lower 30-day major bleeding and 2-year major bleeding,
Pooled studies were homogeneous (OR = 0.44, 95% CI [0.31-0.64], P < 0.01,
I2 = 0, P = 0.89), (OR = 0.4 ,95% CI [0.21-0.77], P = 0.03, I2 = 0%, P =
0.62) respectively. TAVR was associated with a lower rate of moderate PPM
(OR = 0.6, 95% CI [ 0.44-0.84], p value = 0.01, i2 = 0%, p value = 0.44).
The overall effect estimate did not favor any of the two groups regarding
short-term Mild AR (OR = 5.44, 95% CI [1.02-28.91], P = 0.05) and
Moderate/severe AR (OR = 4.08, 95% CI [ 0.79-21.02], P = 0.08, I2 = 0%, P
= 0.59). <br/>Conclusion(s): Our findings suggest that both TAVR and SAVR
are viable options for treating AS in patients with a small aortic
annulus. TAVR offers advantages in reducing PPM and major bleeding, while
SAVR performs better in terms of pacemaker implantation. Future studies
should focus on comparing newer generation TAVR techniques and devices
with SAVR. Consideration of patient characteristics is crucial in
selecting the optimal treatment approach for AS.<br/>Copyright &#xa9; 2024

<101>
Accession Number
2032958207
Title
Rigid ring vs. flexible band for tricuspid valve repair in patients with
tricuspid valve regurgitation: A systematic review and meta-analysis.
Source
International Journal of Cardiology: Cardiovascular Risk and Prevention.
22 (no pagination), 2024. Article Number: 200296. Date of Publication:
September 2024.
Author
Abdelaal S.A.; Hefnawy M.T.; Ewais E.; Mostafa N.; Abozaid A.M.; Mouffokes
A.; Moustapha A.; Mohamed M.; Ghaith H.S.; Ramadan A.; Kengo N.E.; Negida
A.
Institution
(Abdelaal) Kharkiv National Medical University, Kharkiv, Ukraine
(Hefnawy, Ewais, Moustapha, Mohamed, Negida) Faculty of Medicine, Zagazig
University, Zagazig, Egypt
(Abozaid) Faculty of Medicine, Tanta University, Tanta, Egypt
(Mouffokes) Faculty of Medicine, University of Oran 1 Ahmed Ben Bella,
Oran, Algeria
(Ghaith) Faculty of Medicine, Al-Azhar University, Cairo, Egypt
(Ramadan) Faculty of Medicine, South Valley University, Qena, Egypt
(Kengo) Faculty of Medicine and Biomedical Sciences, University of Garoua,
Garoua, Cameroon
(Hefnawy) Medical Affairs Department, Volaris LLC, Dubai, United Arab
Emirates
(Ewais) Faculty of Nursing, Ain Shams University, Cairo, Egypt
(Mostafa) Faculty of Medicine, Ain Shams University, Cairo, Egypt
Publisher
Elsevier B.V.
Abstract
Background & objectives: Rigid ring and Flexible band are techniques used
to repair tricuspid valve regurgitation. The comparison between both
techniques' effectiveness is controversial in the literature. We conducted
this systematic review and meta-analysis to compare the safety and
efficacy of rigid ring versus flexible band for tricuspid valve repair in
patients with tricuspid valve regurgitation. <br/>Method(s): We conducted
a PRISMA-compliant systematic review and meta-analysis. A systematic
search was performed in major databases, including PubMed, Scopus, Web of
Science, and Cochrane CENTRAL to identify relevant published studies. Data
were extracted and analyzed using Stata (version 17 for Mac) and Revman
(version 5.4 for Windows). <br/>Result(s): Twelve studies were included in
this meta-analysis. Total number of patients was 4259. The rigid ring
wasn't superior to the flexible band in terms of postoperative tricuspid
regurgitation RR 0.74, 95 % CI (0.43-1.27) (P = 0.29). However, the
results were not homogeneous. After employing sensitivity analysis, the
significance of the pooled effect estimate didn't change, showing no
significant difference between the two annuloplasty RR 0.72, 95%CI
(0.45-1.15). On the other hand, the rigid ring was associated with a
higher bypass time than the flexible band (RR 4.85, P = 0.00). There were
no differences between the two groups in terms of hospital stay, ICU
stays, prolonged ventilation, mechanical ventilation time, annuloplasty
size, stroke, concomitant mitral valve surgery, concomitant aortic valve
surgery, atrial fibrillation, pacemaker implantation, low cardiac output,
in-hospital death, or late death (all P > 0.05). <br/>Conclusion(s): Our
study findings suggested no difference between rigid ring compared to
flexible band regarding the rates of postoperative tricuspid
regurgitation; however, rigid ring may encompass a higher bypass time.
Therefore, further research is required to ensure our
findings.<br/>Copyright &#xa9; 2024 The Authors

<102>
Accession Number
2032879924
Title
After stent implantation for ACS, ticagrelor monotherapy after <1 mo of
DAPT vs. 12 mo of DAPT improved 1-y net clinical benefit: Commentary.
Source
Annals of Internal Medicine. 177(6) (pp JC64), 2024. Date of Publication:
01 Jun 2024.
Author
Chia J.E.; Mukherjee D.
Institution
(Chia, Mukherjee) Texas Tech University Health Sciences Center at El Paso,
El Paso, TX, United States
Publisher
American College of Physicians

<103>
[Use Link to view the full text]
Accession Number
2032859131
Title
Loss-of-Resistance Versus Dynamic Pressure-Sensing Technology for
Successful Placement of Thoracic Epidural Catheters: A Randomized Clinical
Trial.
Source
Anesthesia and Analgesia. 139(1) (pp 201-210), 2024. Date of Publication:
01 Jul 2024.
Author
Ranganath Y.S.; Ramanujam V.; Al-Hassan Q.; Sibenaller Z.; Seering M.S.;
Singh T.S.S.; Punia S.; Parra M.C.; Wong C.A.; Sondekoppam R.V.
Institution
(Ranganath) Department of Anesthesia, Indiana University School of
Medicine, Indianapolis, IN, United States
(Ramanujam) Department of Anesthesiology, Warren Alpert Medical School of
Brown University, Providence, RI, United States
(Al-Hassan) Almoosa Specialist Hospital Al-Mubarraz, Saudi Arabia
(Sibenaller, Seering, Singh, Punia, Parra, Wong, Sondekoppam) Department
of Anesthesia, University of Iowa Carver College of Medicine, Iowa City,
IA, United States
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND: The traditional loss-of-resistance (LOR) technique for
thoracic epidural catheter placement can be associated with a high primary
failure rate. In this study, we compared the traditional LOR technique and
dynamic pressure-sensing (DPS) technology for primary success rate and
secondary outcomes pertinent to identifying the thoracic epidural space.
<br/>METHOD(S): This pragmatic, randomized, patient- and assessor-blinded
superiority trial enrolled patients ages 18 to 75 years, scheduled for
major thoracic or abdominal surgeries at a tertiary care teaching
hospital. Anesthesiology trainees (residents and fellows) placed thoracic
epidural catheters under faculty supervision and rescue. The primary
outcome was the success rate of thoracic epidural catheter placement,
evaluated by the loss of cold sensation in the thoracic dermatomes 20
minutes after injecting the epidural test dose. Secondary outcomes
included procedural time, ease of catheter placement, the presence of a
positive falling meniscus sign, early hemodynamic changes, and unintended
dural punctures. Additionally, we explored outcomes that included number
of attempts, needle depth to epidural space, need for faculty to rescue
the procedure from the trainee, patient-rated procedural discomfort, pain
at the epidural insertion site, postoperative pain scores, and opioid
consumption over 48 hours. <br/>RESULT(S): Between March 2019 and June
2020, 133 patients were enrolled; 117 were included in the final analysis
(n = 57 for the LOR group; n = 60 for the DPS group). The primary success
rate of epidural catheter placement was 91.2% (52 of 57) in the LOR group
and 96.7% (58 of 60) in the DPS group (95% confidence interval [CI] of
difference in proportions: -0.054 [-0.14 to 0.03]; P =.264). No difference
was observed in procedural time between the 2 groups (median interquartile
range [IQR] in minutes: LOR 5.0 [7.0], DPS 5.5 [7.0]; P =.982). The number
of patients with epidural analgesia onset at 10 minutes was 49.1% (28 of
57) in the LOR group compared to 31.7% (19 of 60) in the DPS group (P
=.062). There were 2 cases of unintended dural punctures in each group.
Other secondary or exploratory outcomes were not significantly different
between the groups. <br/>CONCLUSION(S): Our trial did not establish the
superiority of the DPS technique over the traditional LOR method for
identifying the thoracic epidural space (Clinicaltrials.gov identifier:
NCT03826186).<br/>Copyright &#xa9; 2024 Lippincott Williams and Wilkins.
All rights reserved.

<104>
[Use Link to view the full text]
Accession Number
2032859127
Title
A Pilot Study of Renin-Guided Angiotensin-II Infusion to Reduce Kidney
Stress After Cardiac Surgery.
Source
Anesthesia and Analgesia. 139(1) (pp 165-173), 2024. Date of Publication:
01 Jul 2024.
Author
Sadjadi M.; Von Groote T.; Weiss R.; Strauss C.; Wempe C.; Albert F.;
Langenkamper M.; Landoni G.; Bellomo R.; Khanna A.K.; Coulson T.; Meersch
M.; Zarbock A.
Institution
(Sadjadi, Von Groote, Weiss, Straus, Wempe, Langenkamper, Meersch,
Zarbock) Department of Anesthesiology, Intensive Care and Pain Medicine,
University Hospital Munster, Munster, Germany
(Albert) Institute of Biostatistics and Clinical Research, University of
Munster, Munster, Germany
(Landoni) Department of Intensive Care and Anesthesia, Irccs San Raffaele
Scientific Institute, Milan, Italy
(Sadjadi) Department of Anesthesia and Intensive Care, School of Medicine,
Vita-Salute San Raffaele University, Milan, Italy
(Bellomo, Coulson) Department of Critical Care, The University of
Melbourne, Melbourne, Australia
(Von Groote) Department of Intensive Care, Royal Melbourne Hospital,
Parkville, VIC, Australia
(Bellomo) Department of Intensive Care, Austin Health, Heidelberg,
Australia
(Bellomo) Australian and New Zealand Intensive Care Research Centre,
School of Public Health and Preventive Medicine, Monash University,
Melbourne, VIC, Australia
(Khanna) Department of Anesthesiology, Section on Critical Care Medicine,
School of Medicine, Wake Forest University, Atrium Health Wake Forest
Baptist Medical Center, Winston-Salem, NC, United States
(Khanna) Outcomes Research Consortium, Cleveland, OH, United States
(Khanna) Perioperative Outcomes and Informatics Collaborative (POIC),
Winston-Salem, NC, United States
(Meersch) Department of Anesthesiology and Perioperative Medicine, The
Alfred Hospital, Melbourne, VIC, Australia
(Meersch) Department of Critical Care, University of Melbourne, Melbourne,
VIC, Australia
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND: Vasoplegia is common after cardiac surgery, is associated with
hyperreninemia, and can lead to acute kidney stress. We aimed to conduct a
pilot study to test the hypothesis that, in vasoplegic cardiac surgery
patients, angiotensin-II (AT-II) may not increase kidney stress (measured
by [TIMP-2][IGFBP7]). <br/>METHOD(S): We randomly assigned patients with
vasoplegia (cardiac index [CI] > 2.1l/min, postoperative hypotension
requiring vasopressors) and DELTA-renin (4-hour postoperative-preoperative
value) >=3.7 microU/mL, to AT-II or placebo targeting a mean arterial
pressure >=65 mm Hg for 12 hours. The primary end point was the incidence
of kidney stress defined as the difference between baseline and 12 hours
[TIMP-2][IGFBP7] levels. Secondary end points included serious adverse
events (SAEs). <br/>RESULT(S): We randomized 64 patients. With 1 being
excluded, 31 patients received AT-II, and 32 received placebo. No
significant difference was observed between AT-II and placebo groups for
kidney stress (DELTA-[TIMP-2][IGFBP7] 0.06 [ng/mL]²/1000
[Q1-Q3, -0.24 to 0.28] vs -0.08 [ng/mL]²/1000 [Q1-Q3, -0.35 to
0.14]; P =.19; Hodges-Lehmann estimation of the location shift of 0.12
[ng/mL]²/1000 [95% confidence interval, CI, -0.1 to 0.36]).
AT-II patients received less fluid during treatment than placebo patients
(2946 vs 3341 mL, P =.03), and required lower doses of norepinephrine
equivalent (0.19 mg vs 4.18mg, P <.001). SAEs were reported in 38.7% of
patients in the AT-II group and in 46.9% of patients in the placebo group.
<br/>CONCLUSION(S): The infusion of AT-II for 12 hours appears feasible
and did not lead to an increase in kidney stress in a high-risk cohort of
cardiac surgery patients. These findings support the cautious continued
investigation of AT-II as a vasopressor in hyperreninemic cardiac surgery
patients.<br/>Copyright &#xa9; 2024 Lippincott Williams and Wilkins. All
rights reserved.

<105>
[Use Link to view the full text]
Accession Number
2032859118
Title
Associations Between Nonanemic Iron Deficiency and Postoperative Outcomes
in Cardiac Surgery: A Systematic Review and Meta-Analysis.
Source
Anesthesia and Analgesia. 139(1) (pp 47-57), 2024. Date of Publication: 01
Jul 2024.
Author
Peri V.; Devlin P.; Perry L.; Richards T.; Miles L.F.
Institution
(Peri, Devlin, Miles) Department of Anaesthesia, Austin Health, Melbourne,
Australia
(Perry, Miles) Department of Critical Care, Melbourne Medical School, The
University of Melbourne, Melbourne, Australia
(Richards) Department of Anaesthesiology and Perioperative Medicine,
Central Clinical School, Monash University, Melbourne, Australia
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND: Preoperative screening for iron deficiency is a part of
patient blood management protocols. This systematic review, meta-analysis,
and meta-regression reviews the association between nonanemic iron
deficiency and postoperative outcomes in patients undergoing cardiac
surgery. We aimed to determine whether preoperative screening for
nonanemic iron deficiency should be recommended in patients undergoing
cardiac surgery. <br/>METHOD(S): Electronic databases MEDLINE (Ovid),
Embase (Ovid), and Scopus were searched from inception until December 9,
2022. Studies were considered for inclusion if they (1) used an
observational study design; (2) enrolled adult patients undergoing cardiac
surgery; and (3) included an iron-deficient and iron-replete group,
defined using serum ferritin and/or transferrin saturation. The primary
outcome was the length of acute hospital stay. Secondary outcomes included
length of intensive care unit stay, requirement for allogeneic red blood
cell transfusion, number of red blood cell units transfused, days alive
and at home at postoperative days 30 and 90, all-cause postoperative
complications, postoperative infection, mortality, and hospital
readmission. Meta-regression was performed to assess the effects of study
and patient-level factors on the associations between nonanemic iron
deficiency and specific outcomes. Individual study quality was assessed
using the Risk of Bias in Non-Randomized Studies of Exposures (ROBINS-E)
tool. The Grading of Recommendations, Assessment, Development, and
Evaluations (GRADE) framework was used to determine the quality of
evidence for each outcome. <br/>RESULT(S): Eight studies (2683 patients)
were included. No significant association was observed between nonanemic
iron deficiency and any of the primary or secondary outcomes except for an
increased requirement for allogeneic red blood cell transfusion (odds
ratio [OR], 1.39 [95% confidence interval, CI, 1.16-1.68; P <.001;
I² 2.8%]). Meta-regression did not identify any potential
sources of heterogeneity to explain variation in individual study results.
The quality of evidence was rated as "low" or "very low" for all outcomes.
<br/>CONCLUSION(S): Few high-quality studies are available to assess
associations between nonanemic iron deficiency and outcomes after cardiac
surgery. Acknowledging these limitations, the presence of preoperative
nonanemic iron deficiency was not associated with a change in the primary
outcome of length of hospital stay, or any patient-centered secondary
outcome compared to those without iron deficiency. There was an
association with increased requirement for allogeneic red blood cell
transfusion, but this did not impact the reported patient-centered
outcomes.<br/>Copyright &#xa9; 2024 Lippincott Williams and Wilkins. All
rights reserved.

<106>
Accession Number
2032843253
Title
Pilot study to evaluate the use of remote patient monitoring to guide the
timing of valve intervention in patients with severe asymptomatic aortic
stenosis (APRAISE-AS): study protocol for a randomised controlled trial
delivered in two tertiary cardiac centres in the UK.
Source
BMJ Open. 14(6) (no pagination), 2024. Article Number: e086587. Date of
Publication: 10 Jun 2024.
Author
Khan N.; Steeds R.P.; Kyte D.; Fabritz L.; Collis P.; Chua W.; Stubbs C.;
Mehta S.; Sun Y.; Nulty M.; Kirkham K.; Cotton J.M.
Institution
(Khan, Steeds, Fabritz, Chua) Department of Cardiology (QEHB), University
Hospitals Birmingham Nhs Foundation Trust, Birmingham, United Kingdom
(Khan, Steeds, Collis) Institute of Cardiovascular Sciences, University of
Birmingham, Birmingham, United Kingdom
(Kyte) School of Allied Health and Community, University of Worcester,
Worcester, United Kingdom
(Kyte) Centre for Patient Reported Outcomes Research, Institute for
Applied Health Research, University of Birmingham, Birmingham, United
Kingdom
(Fabritz) University Center of Cardiovascular Sciences, Department of
Cardiology, University Heart and Vascular Center, University Hospital
Hamburg Eppendorf, Hamburg, Germany
(Stubbs, Mehta, Sun, Nulty, Kirkham) Birmingham Clinical Trials Unit,
Institute for Applied Health Research, University of Birmingham,
Birmingham, United Kingdom
(Cotton) Department of Cardiology, The Royal Wolverhampton Hospitals Nhs
Trust, Wolverhampton, United Kingdom
Publisher
BMJ Publishing Group
Abstract
Introduction Aortic stenosis (AS) is common affecting >13% of adults over
the age of 75 years. In people who develop symptoms, without valve
replacement, prognosis is dismal with mortality as high as 50% at 1 year.
In asymptomatic patients, the timing of valve intervention is less well
defined and a strategy of watchful waiting is recommended. Many, however,
may develop symptoms and attribute this to age related decline, rather
than worsening AS. Timely intervention in asymptomatic severe AS is
critical, since delayed intervention often results in poor outcomes.
Proactive surveillance of symptoms, quality of life and functional
capacity should enable timely identification of people who will benefit
from aortic valve replacement. There are no data however, to support the
clinical and cost effectiveness of such an approach in a healthcare
setting in the UK. The aim of this pilot trial is to test the feasibility
of a full-scale randomised controlled trial (RCT) to determine the utility
of proactive surveillance in people with asymptomatic severe AS to guide
the timing of intervention. Methods and analysis APRAISE-AS is a
multi-centre, non-blinded, two-arm, parallel group randomised controlled
trial of up to 66 participants aged >18 years with asymptomatic severe AS.
Participants will be randomised to either standard care or standard care
supplemented with the APRAISE-AS intervention. Primary outcomes will
capture; adherence to and participant acceptability of the intervention,
recruitment and retention rates, and completeness of data collection. The
findings will be used to inform the sample size and most appropriate
outcome measure(s) for a full-scale RCT and health economic evaluation.
Ethics and dissemination Ethical approval was granted by the Black Country
REC, reference: 22/WM/0214. Results will be submitted for publication in
peer-reviewed journals and disseminated at local, regional and national
meetings where appropriate. Trial registration number ISRCTN19413194
registered on 14.07.2023.<br/>Copyright &#xa9; 2024 BMJ Publishing Group.
All rights reserved.

<107>
Accession Number
2032843209
Title
Association of perioperative glucose profiles assessed by continuous
glucose monitoring (CGM) with prognosis in Chinese patients with
non-ST-elevation acute coronary syndrome: A cohort study protocol.
Source
BMJ Open. 14(6) (no pagination), 2024. Article Number: e079666. Date of
Publication: 12 Jun 2024.
Author
Shi J.; Zhang H.; Wang X.; Weng J.; Ding Y.; Wu J.; Zheng X.; Luo S.; Hu
H.
Institution
(Shi, Zhang, Wang, Weng, Ding, Zheng, Luo) Department of Endocrinology,
Centre for Leading Medicine and Advanced Technologies of IHM, The First
Affiliated Hospital of USTC, Division of Life Sciences and Medicine,
University of Science and Technology of China, Anhui, Hefei 230001, China
(Shi, Zhang, Wang, Weng, Ding, Zheng, Luo) University of Science and
Technology of China, Anhui, Hefei, China
(Wu, Hu) Department of Cardiology, The First Affiliated Hospital of USTC,
Division of Life Science and Medicine, University of Science and
Technology of China, Anhui, Hefei, China
Publisher
BMJ Publishing Group
Abstract
Introduction Non-ST-elevation acute coronary syndrome (NSTE-ACS) remains a
significant clinical concern, accounting for over 70% of acute coronary
syndrome cases. One well-established risk factor for NSTE-ACS is abnormal
glucose metabolism, which is associated with a poor prognosis
postpercutaneous coronary intervention. Effective monitoring of blood
glucose is crucial in diabetes care, as it helps identify glucose
metabolic imbalances, thereby guiding therapeutic strategies and assessing
treatment efficacy. Continuous glucose monitoring (CGM) provides
comprehensive glucose profiles. Therefore, the study aims to use CGM to
track perioperative glucose variations in NSTE-ACS patients and to
determine its prognostic implications. Methods and analysis This is a
multicentre, prospective observational study in a sample of patients (aged
>18 years) with NSTE-ACS. A total of 1200 eligible patients will be
recruited within 1 year at 6 sites in China. The primary composite
endpoint will be determined as major adverse cardiovascular events (MACE)
at 3 years. MACE includes all-cause mortality, non-fatal myocardial
infarction, non-fatal stroke and target vessel revascularisation.
Employing the CGM system, glucose levels will be continuously monitored
throughout the perioperative phase. Prespecified cardiovascular analyses
included analyses of the components of this composite and outcomes
according to CGM-derived glucometrics at baseline. Ethics and
dissemination This study has received approval from the Medical Research
Ethics Committee of The First Affiliated Hospital of the University of
Science and Technology of China (No. 2022KY357) and will adhere to the
moral, ethical and scientific principles outlined in the Declaration of
Helsinki. All participants will provide written informed consent prior to
any study-related procedures. Findings from the study will be shared at
conferences and published in peer-reviewed scientific journals. Trial
registration number ChiCT2300069663.<br/>Copyright &#xa9; Author(s) (or
their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial
re-use. See rights and permissions. Published by BMJ.

<108>
Accession Number
2030340345
Title
Subclinical leaflet thrombosis and anticoagulation strategy following
trans-catheter aortic valve replacement: A systematic review.
Source
Health Science Reports. 7(6) (no pagination), 2024. Article Number: e2200.
Date of Publication: June 2024.
Author
Shashank S.; Balireddi L.D.; Inban P.; Al-ezzi S.M.S.; Reddy N.J.;
Alalousi Y.; Prajjwal P.; John J.; Shajeri M.A.A.; Almadhoun M.K.I.K.H.;
Sulaimanov M.; Amiri B.; Marsool M.D.M.; Amir Hussin O.
Institution
(Shashank) Shadan Institute of Medical Sciences, Hyderabad, India
(Balireddi) Mamata Medical College, Khammam, India
(Inban) Government Medical College, Omandurar, Chennai, India
(Al-ezzi) Internal Medicine, Lugansk State Medical University, Lugansk,
Ukraine
(Reddy) Internal Medicine, VN Karazina Kharkiv National University,
Kharkiv, Ukraine
(Alalousi) St Joseph University Medical Center, Paterson, Brooklyn, NY,
United States
(Prajjwal) Bharati Vidyapeeth University Medical College, Pune, India
(John) Dr. Somervell Memorial CSI Medical College and Hospital,
Neyyattinkara, Thiruvananthapuram, India
(Shajeri) Internal Medicine, Jazan University, Jazan, Saudi Arabia
(Almadhoun) Internal Medicine, Mutah University, Karak, Jordan
(Sulaimanov) Northeast Georgia Medical Center, Gainesville, FL, United
States
(Amiri) Cardiovascular Research Center, Tabriz University of Medical
Sciences, Tabriz, Iran, Islamic Republic of
(Marsool) Al-kindy College of Medicine, University of Baghdad, Baghdad,
Iraq
(Amir Hussin) Internal Medicine, Al Manhal University Academy of Science,
Khartoum North, Sudan
Publisher
John Wiley and Sons Inc
Abstract
Objective: Subclinical leaflet thrombosis (SLT) develops in 15% of
patients undergoing trans-catheter aortic valve replacement (TAVR). TAVR
is a procedure in which a faulty aortic valve is replaced with a
mechanical one. An aortic valve replacement can be done with open-heart
surgery; this is called surgical aortic valve replacement (SAVR). A
significant problem is defining the best course of treatment for
asymptomatic individuals with SLT post-TAVR, including the use of oral
anticoagulation (OAC) in it. Study design: Systematic review.
<br/>Method(s): The most pertinent published research (original papers and
reviews) in the scientific literature were searched for and critically
assessed using the online, internationally indexed databases PubMed,
Medline, and Cochrane Reviews. Keywords like "Transcatheter valve
replacement" and "Subclinical leaflet thrombosis" were used to search the
papers. Selected studies were critically assessed for inclusion based on
predefined criteria. <br/>Result(s): The review examined the prevalence
and characteristics of SLT after TAVR. To note, the incidence of SLT is
seen to be higher in TAVR compared SAVR. Dual antiplatelet therapy, which
is utilized in antithrombotic regimens post-TAVR, can possibly hasten SLT
progression which could result in the impaired mobility of leaflets and
the worsening of pressure gradients. <br/>Conclusion(s): The use of dual
antiplatelet drugs in routine antithrombotic therapy tends to accelerate
initial subclinical leaflet thrombosis after TAVI, which results in a
developing restriction of leaflet mobility and an increase in pressure
differences.<br/>Copyright &#xa9; 2024 The Author(s). Health Science
Reports published by Wiley Periodicals LLC.

<109>
Accession Number
2032939140
Title
Prognostic Value of CT-Derived Myocardial Biomarkers: Extracellular Volume
Fraction and Strain in Patients with Severe Aortic Stenosis Undergoing
Transcatheter Aortic Valve Replacement: A Systematic Review and
Meta-analysis.
Source
Academic Radiology. (no pagination), 2024. Date of Publication: 2024.
Author
He X.; Li Y.; Wang Y.; Tian W.; Li Z.; Ge L.; Wang G.; Chen Z.
Institution
(He, Li, Wang, Tian, Li, Wang, Chen) Department of Radiology, The First
Hospital of Lanzhou University, The First Clinical Medical College of
Lanzhou University, Intelligent Imaging Medical Engineering Research
Center of Gansu Province, Accurate Image Collaborative Innovation
International Science and Technology Cooperation Base of Gansu Province,
Gansu Province Clinical Research Center for Radiology Imaging, Lanzhou
73000, China
(Ge) Evidence-Based Social Sciences Research Centre, School of Public
Health, Lanzhou University, Lanzhou 730030, China
Publisher
Elsevier Inc.
Abstract
Rationale and Objectives: This study aimed to investigate the prognostic
value of preoperative CT scan-derived myocardial biomarkers in patients
with severe aortic stenosis (AS) undergoing transcatheter aortic valve
replacement (TAVR). <br/>Material(s) and Method(s): In April 2024, three
databases (PubMed, Web of Science and Embase) were searched to identify
studies. A random-effects model for meta-analysis was conducted to
calculate pooled hazard ratios (HR) and 95% confidence intervals (CI) to
assess the prognostic value. The I² statistic was used to
assess heterogeneity. Meta-regression analysis was conducted to appraise
which variables yielded a significant impact on the HR of included
biomarkers. <br/>Result(s): 11 studies were identified, of which six
studies involved 678 patients reporting extracellular volume fraction
(ECV), one study involved 300 patients reporting ECV and left ventricular
global longitudinal strain (LVGLS), three studies involved 868 patients
reporting LVGLS and one study involved 376 patients reporting LVGLS and
peak left atrial longitudinal strain (PALS). The endpoints included
all-cause mortality, major adverse cardiovascular events (MACE) and a
composite outcome of the previous two. The meta-analysis revealed that
ECV, whether considered as a dichotomous variable (pooled HR: 3.87, 95%
CI: 2.63-5.70, I² = 0%), or as a continuous variable (pooled
HR: 1.12, 95% CI: 1.05-1.19, I² = 66%), and LVGLS, whether
considered as a dichotomous variable (pooled HR: 1.70, 95% CI: 1.30-2.22,
I² = 0%) or a continuous variable (pooled HR: 1.07, 95% CI:
1.04-1.10, I² = 0%) were all significant predictors for
outcomes in patients with severe AS after TAVR. Age, sex, follow-up time
and mean pressure gradient had a significant impact on the model of ECV
(continuous). <br/>Conclusion(s): The higher CT-derived ECV and impaired
LVGLS are able to predict worse outcomes in patients with severe AS who
have undergone TAVR.<br/>Copyright &#xa9; 2024 The Association of
University Radiologists

<110>
Accession Number
2032938098
Title
Effect of Ciprofol on Left Ventricular Myocardial Strain and Myocardial
Work in Children Undergoing Cardiac Surgery: A Single-center Double-blind
Randomized Noninferiority Study.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2024.
Date of Publication: 2024.
Author
Qin X.; Dan Y.; Wang H.; Sun L.; Ji W.; Bai J.; Mamtili I.; Zhang K.;
Zheng J.
Institution
(Qin, Dan, Sun, Ji, Bai, Zhang, Zheng) Department of Anesthesiology,
Shanghai Children's Medical Center, Shanghai Jiao Tong University School
of Medicine, Shanghai, China
(Qin, Dan, Sun, Ji, Bai, Zhang, Zheng) Department of Anesthesiology,
National Children's Medical Center, Shanghai, China
(Qin, Mamtili) Department of Anesthesiology, Shanghai Xuhui Central
Hospital, Shanghai, China
(Bai, Zhang) Department of Anesthesiology, Shanghai Children's Medical
Center Hainan Branch, Shanghai Jiao Tong University School of Medicine,
Shanghai, China
(Wang) GE Healthcare, Shanghai, China
Publisher
W.B. Saunders
Abstract
Objective: The current work was designed to compare the effects of
ciprofol and propofol on left ventricular systolic function and myocardial
work by noninvasive speckle-tracking echocardiography in children
undergoing surgical repair of atrial septal or ventricular septal defects.
<br/>Design(s): A single-center double-blind randomized noninferiority
study was conducted. <br/>Setting(s): The research occurred at a tertiary
care center affiliated with Shanghai Jiao Tong University, China.
<br/>Participant(s): One hundred and twelve children aged 1 month to 16
years undergoing atrial septal or ventricular septal defect surgery with
cardiopulmonary bypass were included. <br/>Intervention(s): One hundred
and twelve children were allocated randomly to receive ciprofol (n = 67)
or propofol (n = 45) in a 1.5:1 ratio. Ciprofol or propofol were
intravenously infused at loading doses of 0.4 mg/kg or 2.0 mg/kg,
respectively, over 30 seconds, depending on the physical condition of each
patient. When the bispectral index was maintained between 45 and 55 after
induction, transthoracic echocardiography, including apical two-chamber,
three-chamber, and four-chamber views, were collected bedside.
<br/>Measurements and Main Results: Of the 112 patients enrolled, 104
completed the study. Global longitudinal strain in the ciprofol and
propofol groups after anesthesia was -17.3% (95% confidence interval [CI]
-18.0% to -16.6%) and -17.8% (95% CI -18.7 to -17.0%) in the full analysis
set and -17.5% (95% CI -18.2% to -16.9%) and -17.8% (95% CI -18.7% to
-17.0%) in the per-protocol set, respectively. The noninferiority margin
was set at 2% and confirmed with a lower limit of two-sided 95% CI for the
intergroup difference of 1.58% in the full analysis set and 1.34% in the
per-protocol set. There were no significant differences between the groups
in left ventricular systolic and diastolic function and myocardial work
indices. Postoperative vasoactive-inotropic score, NT-proBNP, duration of
mechanical ventilation, and the length of stay in the cardiac intensive
care unit and hospital were also comparable between the two groups (all p
> 0.05). <br/>Conclusion(s): Ciprofol did not show different effects on
myocardial function and postoperative outcomes from propofol. Further, on
the sensitive cardiac systole marker global longitudinal strain, ciprofol
demonstrated noninferiority to propofol. Ciprofol might be an alternative
solution for cardiac anesthesia in children with congestive heart disease
with mild lesion.<br/>Copyright &#xa9; 2024 Elsevier Inc.

<111>
Accession Number
2032937760
Title
Effect of Low-dose Ketamine Infusion on Opioid Consumption in Children
Undergoing Open Cardiac Surgery: A Randomized Controlled Double-Blind
Study.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2024.
Date of Publication: 2024.
Author
Abdelfattah M.; Abdelbaser I.; Awad K.A.; Atallah A.M.; Sanad M.;
Sayedalahl M.
Institution
(Abdelfattah, Abdelbaser, Awad, Sayedalahl) Department of Anesthesia and
Surgical Intensive Care, Faculty of Medicine, Mansoura University,
Mansoura, Egypt
(Atallah) Faculty of Medicine, 6th October University, 6th of October
City, Egypt
(Sanad) Department of Cardiothoracic Surgery, Faculty of Medicine,
Mansoura University, Mansoura, Egypt
Publisher
W.B. Saunders
Abstract
Objective: This study was designed to evaluate the effect of low-dose
ketamine infusion on the perioperative consumption of opioids in pediatric
open cardiac surgery. <br/>Design(s): A randomized, controlled,
double-blinded single-center study was conducted. <br/>Setting(s): The
study took place in a tertiary care children's hospital.
<br/>Participant(s): Patients of both sexes aged 2-12 years who underwent
cardiac surgery were included. <br/>Intervention(s): Patients in the
ketamine group received a bolus of 0.3 mg/kg of ketamine before skin
incision followed by continuous intraoperative infusion of 0.25 mg/kg/h
and postoperative infusion of 0.1 mg/kg/h for 24 h. Patients in the
control groups received volumes of normal saline either bolus or
continuous infusion like that of the ketamine group. <br/>Measurements and
Main Results: The primary outcome was the total dose of fentanyl consumed
over the first 24 hours postoperatively. Secondary outcomes were
intraoperative fentanyl consumption, time to extubation, modified
objective pain score, and incidence of vomiting, pruritus, diplopia, or
hallucinations. A total of 80 patients were recruited but the final
analysis was done on 35 patients in the ketamine group and 34 in the
control group. Fentanyl consumption during surgery and in the first 24
hours postoperatively was significantly lower in the ketamine than the
control group. Patients in both the ketamine and control groups had
similar times to extubation. Modified objective pain scores were
significantly lower in the ketamine group than the control group. None of
the patients in either group had diplopia or hallucinations.
<br/>Conclusion(s): Low-dose ketamine infusion in children undergoing open
cardiac surgery reduced intra- and postoperative opioid consumption and
postoperative pain scores. Moreover, ketamine did not cause diplopia or
hallucinations.<br/>Copyright &#xa9; 2024 Elsevier Inc.

<112>
Accession Number
644595266
Title
Del Nido cardioplegia versus cold blood cardioplegia in adult cardiac
surgery: a meta-analysis of randomized clinical trials.
Source
Journal of cardiothoracic surgery. 19(1) (pp 356), 2024. Date of
Publication: 22 Jun 2024.
Author
Li C.; Xiang H.; Yang H.; Liu W.; Lan W.; Luo C.; Han S.; Li Y.; Tang Y.
Institution
(Li, Xiang, Yang, Liu, Lan, Luo, Han, Li) Department of Cardiovascular
Surgery, Second Affiliated Hospital, Jiangxi Medical College, Nanchang
University, Jiangxi Province, Nanchang 330006, China
(Tang) Department of Cardiovascular Surgery, Second Affiliated Hospital,
Jiangxi Medical College, Nanchang University, Jiangxi Province, Nanchang
330006, China
Abstract
OBJECTIVE: Systematic evaluation of the safety of del Nido cardioplegia
compared to cold blood cardioplegia in adult cardiac surgery.
<br/>METHOD(S): We systematically searched PubMed, EMbase, The Cochrane
Library and ClinicalTrials.gov for randomized clinical trials (published
by 14 January 2024) comparing del Nido cardioplegia to cold blood
cardioplegia in adult. Our main endpoints were myocardial injury markers
and clinical outcomes. We assessed pooled data by use of a random-effects
model or a fixed-effects model. <br/>RESULT(S): A total of 10 studies were
identified, incorporating 889 patients who received del Nido cardioplegia
and 907 patients who received cold blood cardioplegia. The meta-analysis
results showed that compared with the cold blood cardioplegia, the del
Nido cardioplegia had less volume of cardioplegia, higher rate of
spontaneous rhythm recovery after cross clamp release, lower levels of
postoperative cardiac troponin T and creatinine kinase-myocardial band,
all of which were statistically significant. However, there was no
statistically significant difference in postoperative troponin I and
postoperative left ventricular ejection fraction. The clinical outcomes
including mechanical ventilation time, intensive care unit stay time,
hospital stay time, postoperative stroke, postoperative new-onset atrial
fibrillation, postoperative heart failure requiring intra-aortic balloon
pump mechanical circulation support, and in-hospital mortality of both are
comparable. <br/>CONCLUSION(S): Existing evidence suggests that del Nido
cardioplegia reduced volume of cardioplegia administration and attempts of
defibrillation. The superior postoperative results in CTnT and CK-MB may
provide a direction for further research on improvement of the composition
of cardioplegia.<br/>Copyright &#xa9; 2024. The Author(s).

<113>
Accession Number
644585579
Title
Bleeding in minimally invasive versus conventional aortic valve
replacement.
Source
Journal of cardiothoracic surgery. 19(1) (pp 349), 2024. Date of
Publication: 21 Jun 2024.
Author
Bratt S.; Dimberg A.; Kastengren M.; Lilford R.D.; Svenarud P.; Sartipy
U.; Franco-Cereceda A.; Dalen M.
Institution
(Bratt, Dimberg, Lilford, Svenarud, Sartipy, Franco-Cereceda, Dalen)
Department of Cardiothoracic Surgery, Karolinska University Hospital,
Stockholm, SE-17176, Sweden
(Bratt, Dimberg, Kastengren, Svenarud, Sartipy, Franco-Cereceda, Dalen)
Department of Molecular Medicine and Surgery, Karolinska Institutet,
Stockholm, Sweden
(Kastengren) Department of Cardiology, Karolinska University Hospital,
Stockholm, Sweden
Abstract
BACKGROUND: Observational studies have shown reduced perioperative
bleeding in patients undergoing minimally invasive, compared with full
sternotomy, aortic valve replacement. Data from randomized trials are
conflicting. <br/>METHOD(S): This was a Swedish single center study where
adult patients with aortic stenosis, 100 patients were randomly assigned
in a 1:1 ratio to undergo either minimally invasive (ministernotomy) or
full sternotomy aortic valve replacement. The primary outcome was severe
or massive bleeding defined by the Universal Definition of Perioperative
Bleeding in adult cardiac surgery (UDPB). Secondary outcomes included
blood product transfusions, chest tube output, re-exploration for
bleeding, and several other clinically relevant events. <br/>RESULT(S):
Out of 100 patients, three patients randomized to ministernotomy were
intraoperatively converted to full sternotomy (none was bleeding-related).
Three patients (6%) in the full sternotomy group and 3 patients (6%) in
the ministernotomy group suffered severe or massive postoperative bleeding
according to the UDPB definition (p=1.00). Mean chest tube output during
the first 12 postoperative hours was 350 (standard deviation (SD) 220) ml
in the full sternotomy group and 270 (SD 190) ml in the ministernotomy
group (p=0.08). 28% of patients in the full sternotomy group and 36% of
patients in the ministernotomy group received at least one packed red
blood cells transfusion (p=0.39). Two patients in each group (4%)
underwent re-exploration for bleeding. <br/>CONCLUSION(S): Minimally
invasive aortic valve replacement did not result in less bleeding-related
outcomes compared to full sternotomy. CLINICAL TRIAL REGISTRATION:
http://www. CLINICALTRIALS: gov . Unique identifier:
NCT02272621.<br/>Copyright &#xa9; 2024. The Author(s).

<114>
Accession Number
644588009
Title
Ultra-short-period perioperative pulmonary rehabilitation on short-term
outcomes after surgery in smoking patients with lung cancer: A randomized
clinical trial.
Source
International journal of surgery (London, England). (no pagination),
2024. Date of Publication: 21 Jun 2024.
Author
Han D.; Wang X.; Sun X.; Cao Y.; Li C.; Guo W.; Hu Y.; Hang J.; Li J.; Xie
Q.; Li H.
Institution
(Han, Wang, Cao, Li, Guo, Hu, Hang, Li) Department of Thoracic Surgery,
Ruijin Hospital, Shanghai Jiao Tong University School of Medicine
(Sun, Xie) Department of Rehabilitation, Ruijin Hospital, Shanghai Jiao
Tong University School of Medicine
(Li) Clinical Research Center, Ruijin Hospital, Shanghai Jiao Tong
University School of Medicine
Abstract
BACKGROUND: Pulmonary rehabilitation is essential for airway management
after thoracic surgery. Most current pulmonary rehabilitations are
composed of 2-4-week exercises, which require significant consumption of
medical resources and concerns about disease progression. MATERIALS AND
METHODS: This single-center, prospective, randomized controlled trial
enrolled smoking patients with pulmonary masses or nodules suitable for
lobectomy, aged 18-80, with smoking history (>=20 pack-years). Eligible
patients were randomized in a 1:1 ratio into two groups. Patients in the
intervention group underwent perioperative breathing exercises based on
positive pressure vibration expectoration and three-day preoperative lower
limb endurance training. Patients in the control group received routine
perioperative care. The primary outcome was in-hospital incidence of
postoperative pulmonary complications. Secondary outcomes included
postoperative hospital stay, total hospitalization cost, postoperative
drainage time, drainage volume, semiquantitative cough strength score,
pain score, Borg scale-assessed fatigue, and walking distance on
postoperative days 1 and 2. <br/>RESULT(S): A total of 194 patients were
included in the study with 94 in the intervention group and 100 in the
control group. Our ultrashort pulmonary rehabilitation program potentially
reduced pulmonary complications incidence (24.5% vs. 33.0%), but without
statistical significance (P=0.190). No significant differences were found
in other perioperative outcomes, except for postoperative semiquantitative
cough strength score (3 [interquartile range, 3-3.75] vs. 3 [interquartile
range, 2-3], P<0.001) and change in walking distance from postoperative
days 1 to 2 (60 [interquartile range, 40-82.5] vs. 30 [interquartile
range, 10-60], P=0.003). <br/>CONCLUSION(S): There were no significant
differences in postoperative complications and other hospitalizations, but
our ultrashort rehabilitation program improved patients' semiquantitative
cough strength score and walking distance, indicating potential for better
outcomes. This treatment is a safe and effective means of airway
management for thoracic surgery in the era of enhanced recovery.
(ClinicalTrials.gov Identifier: XXX).<br/>Copyright &#xa9; 2024 The
Author(s). Published by Wolters Kluwer Health, Inc.

<115>
Accession Number
644587898
Title
Left main revascularization guidelines: navigating the data.
Source
Current opinion in cardiology. (no pagination), 2024. Date of
Publication: 21 Jun 2024.
Author
Vallee A.; Rahmouni K.; Ponnambalam M.; Issa H.; Ruel M.
Institution
(Vallee, Rahmouni, Ponnambalam, Issa, Ruel) University of Ottawa Heart
Institute, University of Ottawa, Ottawa, ON, Canada
(Vallee) Cardiac and Vascular Surgery Department, Marie Lannelongue
Hospital, Le Plessis Robinson, France
Abstract
PURPOSE OF REVIEW: This article explores recent developments in left main
revascularization, with a focus on appraising the latest American and
European guidelines. RECENT FINDINGS: Recent pooled data analysis from
four major randomized controlled trials (RCTs) for left main coronary
artery stenosis indicate an advantage for CABG over PCI in regard to
freedom from major adverse cardiovascular events, despite no significant
difference in mortality observed at 5 years. Additional data support the
use of CABG for patients with left ventricular dysfunction, complex left
main lesions, diffuse coronary disease, and diabetes. SUMMARY: The data
underpinning the guidelines on each revascularization modality (PCI versus
CABG) must consider factors such as lesion complexity, diabetes, and left
ventricular dysfunction. Additionally, the findings of the four major RCTs
upon which the guidelines are based must be ascertained in light of the
latest advancements in these revascularization techniques.<br/>Copyright
&#xa9; 2024 Wolters Kluwer Health, Inc. All rights reserved.

<116>
Accession Number
644586564
Title
Dexamethasone for Cardiac Surgery: A Practice Preference-Randomized
Consent Comparative Effectiveness Trial.
Source
Anesthesiology. (no pagination), 2024. Date of Publication: 21 Jun 2024.
Author
Myles P.S.; Dieleman J.M.; Munting K.E.; Forbes A.; Martin C.A.; Smith
J.A.; McGiffin D.; Verheijen L.P.J.; Wallace S.
Institution
(Myles, Wallace) Department of Anaesthesiology and Perioperative Medicine,
Alfred Hospital and Monash University, Melbourne, VIC, Australia
(Dieleman) Department of Anaesthesia, Westmead Hospital; Western Sydney
University, Penrith, New South Wales, Australia
(Munting, Verheijen) Department of Anaesthesia, University Medical Center,
Utrecht, Netherlands
(Forbes, Martin) Biostatistics Unit, School of Public Health and
Preventive Medicine, Monash University, Melbourne, VIC, Australia
(Smith) Department of Cardiothoracic Surgery, Monash Health; Department of
Surgery, School of Clinical Sciences at Monash Health, Monash University,
Clayton, Victoria, Australia
(McGiffin) Department of Cardiothoracic Surgery, Alfred Hospital,
Melbourne, VIC, Australia
Abstract
BACKGROUND: High-dose corticosteroids have been used to attenuate the
inflammatory response to cardiac surgery and cardiopulmonary bypass, but
patient outcome benefits remain unclear. Our primary aim was to determine
whether using dexamethasone was superior to not using dexamethasone to
increase the number of home days in the first 30 days after cardiac
surgery. Our secondary aim was to evaluate efficiency, value and impact of
the novel trial design. <br/>METHOD(S): This pragmatic, international
trial incorporating a prerandomized consent design favoring local practice
enrolled patients undergoing cardiac surgery across 7 hospitals in
Australia and The Netherlands. Patients were randomly assigned to
dexamethasone, 1 mg/kg, or not (control). The primary outcome was the
number of days alive and at home up to 30 days after surgery ("home
days"). Secondary outcomes included prolonged mechanical ventilation (>48
h), sepsis, renal failure, myocardial infarction, stroke and death.
<br/>RESULT(S): Of 2093 patients assessed for eligibility, 1951 were
randomized (median age 63 years, 80% male). The median number of home days
was 23.0 (IQR, 20.1 to 24.1) in the dexamethasone group and 23.1 (IQR,
20.1 to 24.6) in the no dexamethasone group; median difference 0.1 (95%
CI, -0.3 to 0.5), P=0.66. The rates of prolonged mechanical ventilation,
RR 0.72 (95% CI, 0.48 to 1.08), sepsis, RR 1.02 (95% CI, 0.57 to 1.82),
renal failure, RR 0.94 (95% CI, 0.80 to 1.12), myocardial infarction, RR
1.20 (95% CI, 0.30 to 4.82), stroke, RR 1.06 (95% CI, 0.54 to 2.08), and
death, RR 0.72 (95% CI, 0.22 to 2.35), were comparable between groups (all
P>0.10). Dexamethasone reduced intensive care unit stay, median 29 (IQR,
22 to 50) h vs. 43 (24 to 72) h, P=0.004. Our novel trial design was
highly efficient (89.3% enrolment). <br/>CONCLUSION(S): Among patients
undergoing cardiac surgery, high-dose dexamethasone decreased intensive
care unit stay but did not increase the number of home days after
surgery.<br/>Copyright &#xa9; 2024 American Society of Anesthesiologists.
All Rights Reserved.

<117>
Accession Number
643763307
Title
Cost-effectiveness of low-dose colchicine in patients with chronic
coronary disease in the netherlands.
Source
European heart journal. Quality of care & clinical outcomes. (no
pagination), 2024. Date of Publication: 14 Mar 2024.
Author
Fiolet A.T.L.; Keusters W.; Blokzijl J.; Nidorf S.M.; Eikelboom J.E.;
Budgeon C.A.; Tijssen J.G.P.; Romer T.; Westendorp I.; Cornel J.H.;
Thompson P.L.; Frederix G.W.J.; Mosterd A.; de Wit G.A.
Institution
(Fiolet) Department of Cardiology, University Medical Centre Utrecht,
Utrecht, Netherlands
(Fiolet, Cornel, Mosterd) Dutch Network for Cardiovascular Research (WCN),
Utrecht, Netherlands
(Keusters) Department of Data Science, Dutch Healthcare Authority,
Utrecht, Netherlands
(Blokzijl) Physical Therapy Sciences, University Medical Center Utrecht,
Utrecht University, Utrecht, Netherlands
(Nidorf, Thompson) Heart and Vascular Research Institute of Western
Australia, Perth, Australia
(Nidorf, Thompson) GenesisCare Western Australia, Perth, Australia
(Eikelboom) Department of Medicine, McMaster University, Hamilton,
Ontario, Canada
(Budgeon) University of Western Australia, Perth, Australia
(Tijssen) Department of Cardiology, Amsterdam University Medical Centres,
Amsterdam, Netherlands
(Tijssen) Cardialysis BV, Rotterdam, Netherlands
(Romer) Department of Cardiology, Alrijne Hospital, Leiden, Netherlands
(Westendorp) Cardiology Center Netherlands, Netherlands
(Westendorp) Department of Cardiology, Redd Cross Hospital, Beverwijk,
Netherlands
(Cornel) Department of Cardiology, Northwest Clinics, Alkmaar, Netherlands
(Cornel) Department of Cardiology, Radboudumc, Nijmegen, Netherlands
(Thompson) Sir Charles Gairdner Hospital, Perth, Australia
(Frederix, de Wit) Juliuscenter for Health Sciences and Primary Care,
University Medical Center Utrecht, Utrecht, Netherlands
(Mosterd) Department of Cardiology, Meander Medical Centre, Amersfoort,
Netherlands
(de Wit) National Institute for Public Health and the Environment,
Bilthoven, Netherlands
(de Wit) Department of Health Sciences, Faculty of Science, Vrije
Universiteit, Amsterdam, Netherlands
Abstract
AIMS: Recent trials have shown that low-dose colchicine (0.5 mg once
daily) reduces major cardiovascular events in patients with acute and
chronic coronary syndromes. We aimed to estimate the cost-effectiveness of
low-dose colchicine therapy in patients with chronic coronary disease when
added to standard background therapy. METHODS AND RESULTS: This Markov
cohort cost-effectiveness model used estimates of therapy effectiveness,
transition probabilities, costs and quality of life obtained from the
Low-dose Colchicine 2 (LoDoCo2) trial, as well as meta-analyses and public
sources. In this trial, Low-dose colchicine was added to standard of care
and compared to placebo. The main outcomes were cardiovascular events
including myocardial infarction, stroke and coronary revascularisation,
quality-adjusted life-year (QALY), the cost per QALY gained (incremental
cost-effectiveness ratio), and net monetary benefit. In the model,
low-dose colchicine therapy yielded 0.04 additional QALYs compared with
standard of care at an incremental cost of 455 from a societal perspective
and 729 from a healthcare perspective, resulting in a cost per QALY gained
of 12,176/QALY from a societal perspective and 19,499/QALY from a
healthcare perspective. Net monetary benefit was 1,414 from a societal
perspective and 1,140 from a healthcare perspective. Low-dose colchicine
has a 96% and 94% chance of being cost effective, from respectively a
societal and healthcare perspective when using a willingness to pay of
50,000/QALY. Net monetary benefit would decrease below zero when annual
low-dose colchicine costs would exceed an annual cost of 221 per patient.
<br/>CONCLUSION(S): Adding low-dose colchicine to standard of care in
patients with chronic coronary disease is cost-effective according to
commonly accepted thresholds in Europe and Australia and compares
favourably in cost-effectiveness to other drugs used in chronic coronary
disease.<br/>Copyright &#xa9; The Author(s) 2024. Published by Oxford
University Press on behalf of the European Society of Cardiology.