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<1>
Accession Number
2030478659
Title
Construction and validation of a risk prediction model for postoperative
ICU admission in patients with colorectal cancer: clinical prediction
model study.
Source
BMC Anesthesiology. 24(1) (no pagination), 2024. Article Number: 222. Date
of Publication: December 2024.
Author
Wang L.; Wu Y.; Deng L.; Tian X.; Ma J.
Institution
(Wang, Wu, Deng, Tian, Ma) Department of Anesthesia and Perioperative
Medicine, General Hospital of Ningxia Medical University, 804 Shengli
South Street, Xingqing District, Ningxia, Yinchuan City, China
Publisher
BioMed Central Ltd
Abstract
Background: Transfer to the ICU is common following non-cardiac surgeries,
including radical colorectal cancer (CRC) resection. Understanding the
judicious utilization of costly ICU medical resources and supportive
postoperative care is crucial. This study aimed to construct and validate
a nomogram for predicting the need for mandatory ICU admission immediately
following radical CRC resection. Method(s): Retrospective analysis
was conducted on data from 1003 patients who underwent radical or
palliative surgery for CRC at Ningxia Medical University General Hospital
from August 2020 to April 2022. Patients were randomly assigned to
training and validation cohorts in a 7:3 ratio. Independent predictors
were identified using the least absolute shrinkage and selection operator
(LASSO) and multivariate logistic regression in the training cohort to
construct the nomogram. An online prediction tool was developed for
clinical use. The nomogram's calibration and discriminative performance
were assessed in both cohorts, and its clinical utility was evaluated
through decision curve analysis (DCA). Result(s): The final
predictive model comprised age (P = 0.003, odds ratio [OR] 3.623, 95%
confidence interval [CI] 1.535-8.551); nutritional risk screening 2002
(NRS2002) (P = 0.000, OR 6.129, 95% CI 2.920-12.863); serum albumin (ALB)
(P = 0.013, OR 0.921, 95% CI 0.863-0.982); atrial fibrillation (P = 0.000,
OR 20.017, 95% CI 4.191-95.609); chronic obstructive pulmonary disease
(COPD) (P = 0.009, OR 8.151, 95% CI 1.674-39.676); forced expiratory
volume in 1 s / Forced vital capacity (FEV1/FVC) (P = 0.040, OR 0.966, 95%
CI 0.935-0.998); and surgical method (P = 0.024, OR 0.425, 95% CI
0.202-0.891). The area under the curve was 0.865, and the consistency
index was 0.367. The Hosmer-Lemeshow test indicated excellent model fit (P
= 0.367). The calibration curve closely approximated the ideal diagonal
line. DCA showed a significant net benefit of the predictive model for
postoperative ICU admission. Conclusion(s): Predictors of ICU
admission following radical CRC resection include age, preoperative serum
albumin level, nutritional risk screening, atrial fibrillation, COPD,
FEV1/FVC, and surgical route. The predictive nomogram and online tool
support clinical decision-making for postoperative ICU admission in
patients undergoing radical CRC surgery. Trial registration: Despite the
retrospective nature of this study, we have proactively registered it with
the Chinese Clinical Trial Registry. The registration number is
ChiCTR2200062210, and the date of registration is
29/07/2022. Copyright © The Author(s) 2024.

<2>
Accession Number
2024551240
Title
The usefulness of [99mTc]MIBI scintigraphy in the diagnostic algorithm of
ultrasonographical suspected thyroid nodules by using EU-TIRADS criteria.
Source
Nuclear Medicine Review. 26 (pp 29-33), 2023. Date of Publication: 2023.
Author
Manevska N.; Makazlieva T.; Rizova B.S.; Stojanoski S.
Institution
(Manevska, Makazlieva, Rizova, Stojanoski) Institute of Pathophisiology
and Nuclear Medicine, Faculty of Medicine, Ss Cyril and Methodius
University, North Macedonia
Publisher
Via Medica
Abstract
Background: Although not yet involved in the algorithm of thyroid nodules,
99mTc-methoxy-isobutyl-isonitrile ([99mTc]MIBI) scintigraphy may help in
the individual diagnostic workup of a thyroid patient, especially where
indeterminate fine needle aspiration biopsy (FNAB) is present. The aim of
this study was to evaluate the usefulness of [99mTc]MIBI thyroid
scintigraphy in the diagnostic algorithm of thyroid nodules, particularly
in ultrasound EU-TIRADS 4 or 5 lesions, that cytologically were either
indeterminate or benign. Material(s) and Method(s): A retrospective
randomized study, including 42 thyroid patients, with mean age 47 +/- 17
years, was conducted. [99mTc]MIBI scan was compared with ultrasound (US)
EU-TIRADS criteria, pertechnetate scan, FNAB and histopathological
findings for the differentiation of malignant thyroid nodules from benign
lesions. Result(s): The US mainly detected hypoechoic inhomogeneous
presentation of the thyroid nodules (35/42, 83.33%), 4 cases with
isoechoic nodules and 2 cases presented with hyperechoic thyroid nodules.
Histopathology revealed malignancy in 15/42 (35.71%), while all other
patients 27/42 (64.29%) were benign. Visual analysis score showed that
patients scored with 1+ and 2+ were statistically significant to be
benign, while 13 vs. 10 pts that were visual score 3+ were malignant vs.
benign (p > 0.05). Sensitivity was 100%, while specificity was very low
22.22%, PPV was 41.67%. Conclusion(s): Even [99mTc]MIBI scan is not
routinely used as a daily practice diagnostic tool of thyroid nodules, we
will further apply it on a larger group of patients and try to quantify
the uptake of the radiotracer to see whether it will help in the
diagnostic algorithm of thyroid nodules. Copyright © 2022 Via
Medica.

<3>
Accession Number
2033108951
Title
Efficacy and safety of neoadjuvant immunotherapy combined with
chemotherapy for resectable esophageal cancer: a systematic review and
meta-analysis.
Source
Translational Cancer Research. 13(6) (pp 2735-2750), 2024. Date of
Publication: 30 Jun 2024.
Author
Wang M.; Dong W.; Liu A.; Lai T.; Zhang B.; Sun Q.
Institution
(Wang, Liu, Lai, Zhang) Department of Medical Oncology, Lu'an City
Hospital of Traditional Chinese Medicine Affiliated to Anhui University of
Chinese Medicine, Lu'an, China
(Dong, Sun) Department of Medical Oncology, Lu'an Hospital of Traditional
Chinese Medicine, Lu'an, China
Publisher
AME Publishing Company
Abstract
Background: Esophageal cancer is often overlooked in its early stages,
with approximately 70% of patients being diagnosed at a locally advanced
or late stage. Surgical treatment and chemotherapy are the mainstays of
esophageal cancer management. However, for locally advanced esophageal
cancer, both surgery alone and chemotherapy alone have high rates of
recurrence and metastasis. The objective of the research was to
investigate the security and therapeutic efficacy of neoadjuvant
immunochemotherapy (NICT) in the treatment of resectable, locally advanced
esophageal squamous cell carcinoma (ESCC). Method(s): We conducted a
literature search on PubMed, Embase, Cochrane, Web of Science, China
National Knowledge Infrastructure (CNKI), China Science and Technology
Journal Database (VIP), China Biomedical Literature Database, and Wanfang
for studies published before November 2023 that investigated on the
clinical effectiveness and safety of neoadjuvant immunotherapy in
resectable ESCC. The Newcastle-Ottawa Quality Assessment Scale (NOS) was
used for assessment, and Stata 17.0 was utilized for meta-analysis and
sensitivity analysis. Result(s): A total of 13 retrospective cohort
studies involving 1,276 patients were included in this analysis. The NICT
group showed a higher pathological complete response (pCR) rate [odds
ratio (OR) =5.72; 95% confidence interval (CI), 3.40-9.63]. The major
pathologic response (MPR) rate, objective response rate (ORR), R0
resection rate, and 1-year overall survival (OS) in the NICT group were
better than those in the neoadjuvant chemotherapy (NCT) group (OR =3.70,
95% CI: 2.32-5.91; OR =2.22, 95% CI: 1.44-3.40; OR =2.63, 95% CI:
1.58-4.38; OR =10.08, 95% CI: 4.32-23.56). However, the NICT group also
showed a drawback in terms of adverse reactions and postoperative
complications. The incidence of rash (OR =4.69, 95% CI: 1.42-15.49) and
pleural effusion (OR =3.99, 95% CI: 1.75-9.07) was significantly higher in
the NCT group compared to the NICT group. The subgroup analysis indicates
that the use of camrelizumab is associated with an increased incidence of
rash. Additionally, performing a left thoracic esophagectomy and
esophagogastric thoracic procedure significantly improved the R0 resection
rate. Conclusion(s): Neoadjuvant immunotherapy has shown promising
efficacy in patients with locally advanced ESCC; however, it is linked to
a higher occurrence of adverse events. Therefore, its use in clinical
practice should be carefully considered. Copyright ©
Translational Cancer Research. All rights reserved.

<4>
Accession Number
2030495621
Title
Comparative effectiveness of mesenchymal stem cell versus bone-marrow
mononuclear cell transplantation in heart failure: a meta-analysis of
randomized controlled trials.
Source
Stem Cell Research and Therapy. 15(1) (no pagination), 2024. Article
Number: 202. Date of Publication: December 2024.
Author
Hosseinpour A.; Kamalpour J.; Dehdari Ebrahimi N.; Mirhosseini S.A.;
Sadeghi A.; Kavousi S.; Attar A.
Institution
(Hosseinpour, Kamalpour, Attar) Department of Cardiovascular Medicine,
Shiraz University of Medical Sciences, Shiraz, Iran, Islamic Republic of
(Hosseinpour, Sadeghi, Kavousi) School of Medicine, Shiraz University of
Medical Sciences, Shiraz, Iran, Islamic Republic of
(Dehdari Ebrahimi) Transplant Research Center, Shiraz University of
Medical Sciences, Shiraz, Iran, Islamic Republic of
(Mirhosseini) MD-MPH Department, School of Medicine, Shiraz University of
Medical Sciences, Shiraz, Iran, Islamic Republic of
Publisher
BioMed Central Ltd
Abstract
Background: There is no clear evidence on the comparative effectiveness of
bone-marrow mononuclear cell (BMMNC) vs. mesenchymal stromal cell (MSC)
stem cell therapy in patients with chronic heart failure (HF).
 Method(s): Using a systematic approach, eligible randomized
controlled trials (RCTs) of stem cell therapy (BMMNCs or MSCs) in patients
with HF were retrieved to perform a meta-analysis on clinical outcomes
(major adverse cardiovascular events (MACE), hospitalization for HF, and
mortality) and echocardiographic indices (including left ventricular
ejection fraction (LVEF)) were performed using the random-effects model. A
risk ratio (RR) or mean difference (MD) with corresponding 95% confidence
interval (CI) were pooled based on the type of the outcome and subgroup
analysis was performed to evaluate the potential differences between the
types of cells. Result(s): The analysis included a total of 36 RCTs
(1549 HF patients receiving stem cells and 1252 patients in the control
group). Transplantation of both types of cells in patients with HF
resulted in a significant improvement in LVEF (BMMNCs: MD (95% CI) = 3.05
(1.11; 4.99) and MSCs: MD (95% CI) = 2.82 (1.19; 4.45), between-subgroup p
= 0.86). Stem cell therapy did not lead to a significant change in the
risk of MACE (MD (95% CI) = 0.83 (0.67; 1.06), BMMNCs: RR (95% CI) = 0.59
(0.31; 1.13) and MSCs: RR (95% CI) = 0.91 (0.70; 1.19), between-subgroup p
= 0.12). There was a marginally decreased risk of all-cause death (MD (95%
CI) = 0.82 (0.68; 0.99)) and rehospitalization (MD (95% CI) = 0.77 (0.61;
0.98)) with no difference among the cell types (p > 0.05).
 Conclusion(s): Both types of stem cells are effective in improving
LVEF in patients with heart failure without any noticeable difference
between the cells. Transplantation of the stem cells could not decrease
the risk of major adverse cardiovascular events compared with controls.
Future trials should primarily focus on the impact of stem cell
transplantation on clinical outcomes of HF patients to verify or refute
the findings of this study. Copyright © The Author(s) 2024.

<5>
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. 53(4) (pp 263-274), 2024.
Date of Publication: 01 Jul 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
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. 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). 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. 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.
 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. Copyright © 2024 Hogrefe.

<6>
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Accession Number
2033156296
Title
A meta-analysis supporting the superiority of staged carotid artery
stenting and coronary artery bypass grafting in patients with concurrent
severe coronary and carotid artery stenosis.
Source
Medicine (United States). 103(27) (pp e38665), 2024. Date of Publication:
05 Jul 2024.
Author
Hao D.; Jiang Y.; Wang P.; Mao L.
Institution
(Hao, Mao) Department of Geriatrics, Liaocheng People's Hospital,
Liaocheng, China
(Jiang) Department of Cardiology, Liaocheng People's Hospital, Liaocheng,
China
(Wang) Department of Neurosurgery, Liaocheng People's Hospital, Liaocheng,
China
Publisher
Lippincott Williams and Wilkins
Abstract
Background: This study sought to ascertain whether a staged approach
involving carotid artery stenting (CAS) and coronary artery bypass
grafting (CABG) holds superiority over the synchronous (Syn) strategy of
CAS or carotid endarterectomy (CEA) and CABG in patients necessitating
combined revascularization for concurrent carotid and coronary artery
disease. Method(s): Studies were identified through 3 databases:
PubMed, EMBASE, and the Cochrane Library. Statistical significance was
defined as a P value of less than .05 for all analyses, conducted using
STATA version 12.0. Result(s): In the comparison between staged
versus Syn CAS and CABG for patients with concomitant severe coronary and
carotid stenosis, 4 studies were analyzed. The staged procedure was
associated with a lower rate of 30-day stroke (OR = 8.329, 95% CI =
1.017-69.229, P = .048) compared to Syn CAS and CABG. In the comparison
between staged CAS and CABG versus Syn CEA and CABG for patients with
concomitant severe coronary and carotid stenosis, 5 studies were examined.
The staged CAS and CABG procedure was associated with a lower rate of
mortality (OR = 2.046, 95% CI = 1.304-3.210, P = .002) compared to Syn CEA
and CABG. Conclusion(s): The Syn CAS and CABG was linked to a higher
risk of peri-operative stroke compared to staged CAS and CABG.
Additionally, patients undergoing staged CAS and CABG exhibited a
significantly decreased risk of 30-day mortality compared to Syn CEA and
CABG. Future randomized trials or prospective cohorts are essential to
confirm and validate these findings. Copyright © 2024 the
Author(s).

<7>
Accession Number
2030486183
Title
Pulmonary Atresia with Intact Ventricular Septum, a National Comparison
Between Interventional and Surgical Approach, in Combination with a
Systemic Literature Review.
Source
Pediatric Cardiology. (no pagination), 2024. Date of Publication: 2024.
Author
Manhem S.; Odermarsky M.; Wahlander H.; Ekman-Joelsson B.-M.
Institution
(Manhem, Wahlander, Ekman-Joelsson) Department of Pediatrics, Institution
for Clinical Sciences, Sahlgrenska Academy, University of Gothenburg,
Gothenburg, Sweden
(Odermarsky) Department of Pediatric Cardiology, Skane University
Hospital, Lund, Sweden
(Odermarsky) Department of Clinical Sciences, Lund University, Lund,
Sweden
(Manhem, Wahlander, Ekman-Joelsson) Department of Cardiology, Queen Silvia
Children's Hospital, Behandlingsvagen 7, Gothenburg 416 50, Sweden
Publisher
Springer
Abstract
This study aimed to compare long-term morbidity in patients with pulmonary
atresia with intact ventricular septum (PA-IVS) treated with
catheter-based intervention (group A) versus those undergoing heart
surgery (group B) as initial intervention. Additionally, we conducted a
systematic literature review on PA-IVS treatment. All neonates born in
Sweden with PA-IVS between 2007 and 2019 were screened for inclusion. The
inclusion criterion was decompression of the right ventricle for initial
intervention. Medical records were reviewed, as well as the initial
preoperative angiogram, and the diagnostic echocardiogram. Comparisons
between groups were performed with Mann-Whitney U-test and Fisher's exact
test. A systematic literature review of original studies regarding
treatment of PA-IVS (2002 and onward) was conducted following the
Preferred Reporting Items for Systematic Reviews and Meta-Analyses
guidelines, to assess the outcomes of patients with PA-IVS. 34 (11
females) patients were included, 18 in group A and 16 in group B. There
was no mortality in either group. Follow-up time ranged from 2 to 15 years
(median 9). All attempted perforations in group A were successful, and 16
out of 18 patients reached biventricular circulation. In the surgical
group 15 out of 16 patients reached biventricular circulation. The
literature review presented heterogeneity in standards for treatment. This
retrospective population-based multicenter study demonstrates that both
catheter-based intervention and heart surgery are safe procedures. Our
results are comparable to, or exceed, those in the systematic literature
review. The systematic literature review displays a great heterogeneity in
study design, with no definitive golden standard treatment. Copyright
© The Author(s) 2024.

<8>
Accession Number
2030478458
Title
Perioperative hypotension and use of vasoactive agents in non-cardiac
surgery: A scoping review.
Source
Acta Anaesthesiologica Scandinavica. (no pagination), 2024. Date of
Publication: 2024.
Author
Baekgaard E.S.; Madsen B.K.; Crone V.; El-Hallak H.; Moller M.H.;
Vester-Andersen M.; Krag M.
Institution
(Baekgaard, Madsen, Crone, El-Hallak, Krag) Department of Anaesthesiology
and Intensive Care, Holbaek Hospital, Holbaek, Denmark
(Madsen) Department of Anaesthesiology and Intensive Care, Zealand
University Hospital, Koge, Denmark
(El-Hallak) Department of Anaesthesiology, Copenhagen University
Hospital-Gentofte, Hellerup, Denmark
(Moller) Department of Intensive Care, Copenhagen University
Hospital-Rigshospitalet, Copenhagen, Denmark
(Moller, Vester-Andersen, Krag) Department of Clinical Medicine, Faculty
of Health Sciences, University of Copenhagen, Copenhagen, Denmark
(Vester-Andersen) Department of Anaesthesiology and Intensive Care,
Copenhagen University Hospital-Herlev-Gentofte, Herlev, Denmark
Publisher
John Wiley and Sons Inc
Abstract
Background: Perioperative hypotension is common and associated with
adverse patient outcomes. Vasoactive agents are often used to manage
hypotension, but the ideal drug, dose and duration of treatment has not
been established. With this scoping review, we aim to provide an overview
of the current body of evidence regarding the vasoactive agents used to
treat perioperative hypotension in non-cardiac surgery. Method(s): We
included all studies describing the use of vasoactive agents for the
treatment of perioperative hypotension in non-cardiac surgery. We excluded
literature reviews, case studies, and studies on animals and healthy
subjects. We posed the following research questions: (1) in which surgical
populations have vasoactive agents been studied? (2) which agents have
been studied? (3) what doses have been assessed? (4) what is the duration
of treatment? and (5) which desirable and undesirable outcomes have been
assessed?. Result(s): We included 124 studies representing 10
surgical specialties. Eighteen different agents were evaluated,
predominantly phenylephrine, ephedrine, and noradrenaline. The agents were
administered through six different routes, and numerous comparisons
between agents, dosages and routes were included. Then, 88 distinct
outcome measures were assessed, of which 54 were judged to be
non-patient-centred. Conclusion(s): We found that studies concerning
vasoactive agents for the treatment of perioperative hypotension varied
considerably in all aspects. Populations were heterogeneous, interventions
and exposures included multiple agents compared against themselves, each
other, fluids or placebo, and studies reported primarily
non-patient-centred outcomes. Copyright © 2024 Acta
Anaesthesiologica Scandinavica Foundation.

<9>
Accession Number
2024766599
Title
Surgical vs transcatheter aortic valve replacement in bicuspid aortic
valve stenosis: A systematic review and meta-analysis.
Source
Trends in Cardiovascular Medicine. 34(5) (pp 304-313), 2024. Date of
Publication: July 2024.
Author
Kang J.J.; Fialka N.M.; EL-Andari R.; Watkins A.; Hong Y.; Mathew A.;
Bozso S.J.; Nagendran J.
Institution
(Kang, EL-Andari, Hong, Bozso, Nagendran) Division of Cardiac Surgery,
Department of Surgery, Minimally Invasive and Transcatheter Valve Surgery,
Mazankowski Alberta Heart Institute, University of Alberta, 4-108A Li Ka
Shing Health Research Center, 8602 - 112 Street, Edmonton, AB T6G 2E1,
Canada
(Fialka, Watkins) Faculty of Medicine and Dentistry, University of
Alberta, Edmonton, AB, Canada
(Mathew) Division of Cardiology, Department of Medicine, University of
Alberta, Edmonton, AB, Canada
Publisher
Elsevier Inc.
Abstract
This systematic review and meta-analysis aim to provide a comprehensive
analysis of the literature directly comparing the outcomes of surgical
aortic valve replacement (SAVR) and TAVR in patients with BAV stenosis.
Medline, PubMed, and Scopus were systematically searched for articles
published between 2000 and 2023, 1862 studies were screened, and 6
retrospective studies met the inclusion criteria. We included 6550
patients in the final analyses: 3,292 and 3,258 in the SAVR and TAVR
groups, respectively. Both groups have similar rates of in-hospital
mortality (odds ratio (OR) 1.11; 95% CI 0.59-2.10; p = 0.75) and stroke
(OR 1.25; 95% CI 0.85-1.86; p = 0.26. Patients who underwent SAVR
experienced lower rates of permanent pacemaker implantation (OR 0.54; 95%
CI 0.35-0.83; p = 0.005) and paravalvular leak (OR 0.47; 95% CI 0.26-0.86;
p = 0.02). On the other hand, patients who underwent TAVR displayed lower
rates of acute kidney injury (OR 1.81; 95% CI 1.15-2.84; p = 0.010), major
bleeding (OR 3.76; 95% CI 2.18-6.49; p < 0.00001), and pulmonary
complications (OR 7.68; 95% CI 1.21-48.84; p = 0.03). Despite the early
mortality data suggesting that TAVR may be a reasonable strategy for
patients with bicuspid AS with low to intermediate surgical risk, the
increased risk of PPI and PVL is concerning. A prospective, randomized,
controlled trial reporting long-term outcomes with pre-defined subgroup
analyses based on BAV morphology is paramount. In the interim, caution
should be exercised in the widespread adoption of TAVR in lower
surgical-risk patients. Copyright © 2023

<10>
Accession Number
2033144798
Title
Treat-to-target or high-intensity statin treatment in older adults with
coronary artery disease: A post hoc analysis of the LODESTAR trial.
Source
Age and Ageing. 53(7) (no pagination), 2024. Article Number: afae132. Date
of Publication: 01 Jul 2024.
Author
Lee S.-J.; Lee J.-B.; Yang T.-H.; Kang W.C.; Lee J.-Y.; Lee Y.-J.; Hong
S.-J.; Ahn C.-M.; Kim J.-S.; Kim B.-K.; Ko Y.-G.; Hong B.-K.; Choi D.;
Yoon J.; Jang Y.; Hong M.-K.; Kwon H.M.; Kim J.-Y.; Min P.K.; Yoon Y.W.;
Lee B.K.; Rim S.-J.; Choi E.-Y.; Oh P.C.; Kim K.S.; Choi J.Y.; Ryu J.K.;
Kim C.Y.; Cho H.-J.; Ahn M.-S.; Ahn S.G.; Lee J.-W.; Son J.-W.; Yoon
H.-J.; Lee C.H.; Hwang J.; Cho Y.-K.; Hur S.-H.; Han S.; Nam C.-W.; Kim
H.; Park H.-S.; Kim I.-C.; Cho Y.-H.; Jeong H.-J.; Kim J.-H.; Lim C.; Suh
Y.; Hwang E.S.; Lee J.H.; Lee S.Y.; Kwon S.U.; Kim S.-Y.; Park K.-H.; Kim
H.K.
Institution
(Lee, Lee, Hong, Ahn, Kim, Kim, Ko, Choi, Hong) Severance Hospital, Yonsei
University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722,
South Korea
(Lee) Daegu Catholic University Medical Center, Duryugongwon-ro 17-gil,
Nam-gu, Daegu 42472, South Korea
(Yang) Inje University Busan Paik Hospital, Bokji-ro 75, Busanjin-gu,
Busan 47392, South Korea
(Kang) Gachon University College of Medicine, Namdong-daero 774 beon-gil,
Namdong-gu, Incheon 21565, South Korea
(Lee) Kangbuk Samsung Hospital, Sungkyunkwan University School of
Medicine, Saemunan-ro, Jongno-gu, Seoul 03181, South Korea
(Hong) Gangnam Severance Hospital, Eonju-ro, Gangnam-gu, Seoul 06273,
South Korea
(Yoon) Wonju Severance Christian Hospital, Ilsan-ro, Wonju 26426, South
Korea
(Jang) CHA University College of Medicine, Yatap-ro, Bundang-gu, Seongnam
13497, South Korea
Publisher
Oxford University Press
Abstract
Background: The optimal statin treatment strategy that is balanced for
both efficacy and safety has not been clearly determined in older adults
with coronary artery disease (CAD). Method(s): In the post hoc
analysis of the LODESTAR (low-density lipoprotein cholesterol-targeting
statin therapy versus intensity-based statin therapy in patients with
coronary artery disease) trial, the impact between a treat-to-target
strategy versus a high-intensity statin therapy strategy was compared in
older adults (aged 75 years or older). The goal of treat-to-target
low-density lipoprotein cholesterol (LDL-C) level was 50-70 mg/dl. The
primary endpoint comprised the three-year composite of all-cause death,
myocardial infarction, stroke or coronary revascularisation.
 Result(s): Among 4, 400 patients with CAD enrolled in the LODESTAR
trial, 822 (18.7%) were aged 75 years or older. Poor clinical outcomes and
risk factors for atherosclerosis were more frequently observed in older
adults than in younger population (<75 years old). Among these older
adults with CAD, the prescription rate of high-intensity statin was
significantly lower in the treat-to-target strategy group throughout the
study period (P < 0.001). The mean LDL-C level for three years was 65 +/-
16 mg/dl in the treat-to-target strategy group and 64 +/- 18 mg/dl in the
high-intensity statin group (P = 0.34). The incidence of primary endpoint
occurrence was 10.9% in the treat-to-target strategy group and 12.0% in
the high-intensity statin group (hazard ratio 0.92, 95% confidence
interval 0.61-1.38, P = 0.69). Conclusion(s): High-intensity statin
therapy is theoretically more necessary in older adults because of worse
clinical outcomes and greater number of risk factors for atherosclerosis.
However, the primary endpoint occurrence with a treat-to-target strategy
with an LDL-C goal of 50-70 mg/dl was comparable to that of high-intensity
statin therapy and reduced utilisation of a high-intensity statin. Taking
efficacy as well as safety into account, adopting a tailored approach may
be considered for this high-risk population. Trial Registration:
ClinicalTrials.gov, NCT02579499. Copyright © 2024 The Author(s).
Published by Oxford University Press on behalf of the British Geriatrics
Society. All rights reserved.

<11>
Accession Number
2033132749
Title
Cerebrovascular events after transcatheter aortic valve implantation.
Source
EuroIntervention. 20(13) (pp e793-e805), 2024. Date of Publication: July
2024.
Author
Reddy P.; Merdler I.; Ben-Dor I.; Satler L.F.; Rogers T.; Waksman R.
Institution
(Reddy, Merdler, Ben-Dor, Satler, Rogers, Waksman) Section of
Interventional Cardiology, MedStar Washington Hospital Center, Washington,
DC, United States
(Rogers) Cardiovascular Branch, Division of Intramural Research, National
Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda,
MD, United States
Publisher
Europa Group
Abstract
Periprocedural stroke after transcatheter aortic valve implantation (TAVI)
remains a significant issue, which is associated with high morbidity, and
is increasingly important as intervention shifts to younger and lower-risk
populations. Over the last decade of clinical experience with TAVI, the
incidence of periprocedural stroke has stayed largely unchanged, although
it is prone to underreporting due to variation in ascertainment methods.
The aetiology of stroke in TAVI patients is multifactorial, and changing
risk profiles, differing study populations, and frequent device iterations
have made it difficult to discern consistent risk factors. The objective
of this review is to analyse and clarify the contemporary published
literature on the epidemiology and mechanisms of neurological events in
TAVI patients and evaluate potential preventive measures. This summary
aims to improve patient risk assessment and refine case selection for
cerebral embolic protection devices, while also providing a foundation for
designing future trials focused on stroke prevention. Copyright ©
Europa Digital & Publishing 2024. All rights reserved.

<12>
Accession Number
2033198972
Title
Transcatheter Aortic Valve Replacement in Low Surgical Risk Patients: An
Updated Metanalysis of Extended Follow-Up Randomized Controlled Trials.
Source
American Journal of Cardiology. 224 (pp 56-64), 2024. Date of Publication:
01 Aug 2024.
Author
Di Pietro G.; Improta R.; De Filippo O.; Bruno F.; Birtolo L.I.; Tocci M.;
Fabris T.; Saade W.; Colantonio R.; Celli P.; Sardella G.; Esposito G.;
Tarantini G.; Mancone M.; D'Ascenzo F.
Institution
(Di Pietro, Improta, Birtolo, Tocci, Saade, Colantonio, Sardella, Mancone)
Department of Clinical, Internal, Anesthesiology and Cardiovascular
Sciences, Umberto I Hospital, Sapienza University of Rome, Italy
(Di Pietro, Improta, De Filippo, Bruno, D'Ascenzo) Department of Medical
Science, Division of Cardiology, Molinette Hospital, Turin University,
Italy
(Fabris, Tarantini) Department of Cardiac, Thoracic and Vascular Sciences
and Public Health, University of Padova, Italy
(Celli) Department of General and Specialistic Surgery "Paride Stefanini",
"Sapienza" University of Rome, Rome, Italy
(Esposito) Division of Cardiology, Department of Advanced Biomedical
Sciences, Federico II University of Naples, Naples, Italy
Publisher
Elsevier Inc.
Abstract
The long-term safety and effectiveness of transcatheter aortic valve
replacement (TAVR) compared with surgical aortic valve replacement (SAVR)
in low surgical risk has not been evaluated in a pooled analysis. An
electronic database search was conducted for randomized controlled trials
with a maximal 5 years clinical and echocardiographic follow-up including
low surgical risk patients who underwent TAVR or SAVR. We calculated odds
ratio (OR) and 95% confidence intervals (CIs) using a random-effects
model. Subgroups analysis was performed for permanent pacemaker
implantation and paravalvular leaks. Three randomized controlled trials
were included with a total of 2,611 low surgical risk patients (Society of
Thoracic Surgeons score <4%). Compared with SAVR, the TAVR group had
similar rates of all-cause mortality (OR 0.94,95% CI 0.65 to 1.37, p =
0.75) and disabling stroke (OR 0.84, 95% CI 0.52 to 1.36, p = 0.48). No
significant differences were registered in the TAVR group in terms of
major cardiovascular events (OR 0.96, 95% CI 0.67 to 1.38, p = 0.83),
myocardial infarction (OR 0.69, 95% CI 0.34 to 1.40, p = 0.31), valve
thrombosis (OR 3.11, 95% CI 0.29 to 33.47, p = 0.35), endocarditis (OR
0.71,95% CI 0.35 to 1.48, p = 0.36), aortic valve reintervention (OR 0.93,
95% CI 0.52 to 1.66, p = 0.80), and rehospitalization (OR 0.80, 95% CI
0.52 to 1.02, p = 0.07) compared with SAVR. However, TAVR patients had a
higher risk of paravalvular leaks (OR 8.21, 95% CI 4.18 to 16.14, p
<0.00001), but lower rates of new-onset atrial fibrillation (OR 0.27,95%
CI 0.17 to 0.30, p <0.0001). The rates of permanent pacemaker implantation
were comparable from 1 year up to a maximum of 5 years (OR 1.32, 95% CI
0.88 to 1.97, p = 0.18). Lastly, TAVR had a greater effective orifice area
(0.10 cm2/m2, 95% CI 0.05 to 0.15, p = 0.0001), but
similar transvalvular mean gradients (0.60, 95% CI 3.94 to 2.73, p =
0.72). In conclusion, TAVR patients had similar long-term outcomes
compared with SAVR, except for an elevated risk of paravalvular leaks in
the TAVR group and increased rates of atrial fibrillation in the SAVR
cohort. Copyright © 2024 Elsevier Inc.

<13>
Accession Number
2033195085
Title
Rationale and design of the early valve replacement in severe asymptomatic
aortic stenosis trial.
Source
American Heart Journal. 275 (pp 119-127), 2024. Date of Publication:
September 2024.
Author
Richardson C.; Gilbert T.; Aslam S.; Brookes C.L.; Singh A.; Newby D.E.;
Dweck M.R.; Stewart R.A.H.; Myles P.S.; Briffa T.; Selvanayagam J.; Chow
C.K.; Murphy G.J.; Akowuah E.F.; Lord J.; Barber S.; Paola A.S.D.; McCann
G.P.; Hillis G.S.
Institution
(Richardson, Aslam, Brookes, Singh, Murphy, Barber, Paola, McCann) College
of Life Sciences, University of Leicester, Leicester, United Kingdom
(Gilbert, Hillis) Medical School, University of Western Australia, Perth,
Australia
(Newby, Dweck) British Heart Foundation Centre for Cardiovascular Science,
University of Edinburgh, Edinburgh, United Kingdom
(Stewart) Green Lane Cardiovascular Service, Auckland City Hospital,
University of Auckland, Auckland, New Zealand
(Myles) Department of Anaesthesiology and Perioperative Medicine, Alfred
Health and Monash University, Melbourne, Australia
(Briffa) School of Population and Global Health, University of Western
Australia, Perth, Australia
(Selvanayagam) Department of Cardiovascular Medicine, Flinders Medical
Centre, Adelaide, Australia
(Chow) Faculty of Medicine and Health, University of Sydney, Sydney,
Australia
(Akowuah) Department of Cardiac Surgery, the James Cook University
Hospital, South Tees Hospitals NHS Foundation Trust, Middlesbrough, United
Kingdom
(Lord) Southampton Health Technology Assessments Centre, University of
Southampton, Southampton, United Kingdom
(Hillis) Department of Cardiology, Royal Perth Hospital, Perth, Australia
(Richardson, Gilbert) These 2 authors contributed equally to this work.
(McCann, Hillis, Hillis) These 2 authors are joint senior authors and
co-CIs taking joint responsibility.
Publisher
Elsevier Inc.
Abstract
Background: Aortic valve replacement in asymptomatic severe aortic
stenosis is controversial. The Early valve replacement in severe
ASYmptomatic Aortic Stenosis (EASY-AS) trial aims to determine whether
early aortic valve replacement improves clinical outcomes, quality of life
and cost-effectiveness compared to a guideline recommended strategy of
'watchful waiting'. Method(s): In a pragmatic international, open
parallel group randomized controlled trial (NCT04204915), 2844 patients
with severe aortic stenosis will be randomized 1:1 to either a strategy of
early (surgical or transcatheter) aortic valve replacement or aortic valve
replacement only if symptoms or impaired left ventricular function
develop, or other cardiac surgery becomes nessessary. Exclusion criteria
include other severe valvular disease, planned cardiac surgery, ejection
fraction <50%, previous aortic valve replacement or life expectancy <2
years. The primary outcome is a composite of cardiovascular mortality or
heart failure hospitalization. The primary analysis will be undertaken
when 663 primary events have accrued, providing 90% power to detect a
reduction in the primary endpoint from 27.7% to 21.6% (hazard ratio 0.75).
Secondary endpoints include disability-free survival, days alive and out
of hospital, major adverse cardiovascular events and quality of life.
 Result(s): Recruitment commenced in March 2020 and is open in the UK,
Australia, New Zealand, and Serbia. Feasibility requirements were met in
July 2022, and the main phase opened in October 2022, with additional
international centers in set-up. Conclusion(s): The EASY-AS trial
will establish whether a strategy of early aortic valve replacement in
asymptomatic patients with severe aortic stenosis reduces cardiovascular
mortality or heart failure hospitalization and improves other important
outcomes. Copyright © 2024 The Authors

<14>
Accession Number
2033208430
Title
Comparison of Propofol-Based Total Intravenous Anesthesia versus Volatile
Anesthesia with Sevoflurane for Postoperative Delirium in Adult Coronary
Artery Bypass Grafting Surgery: A Prospective Randomized Single-Blinded
Study.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2024.
Date of Publication: 2024.
Author
Varsha A.V.; Unnikrishnan K.P.; Saravana Babu M.S.; Raman S.P.; Koshy T.
Institution
(Varsha, Unnikrishnan, Saravana Babu, Raman, Koshy) Cardiothoracic and
Vascular Anaesthesiology Division, Sree Chitra Tirunal Institute for
Medical Sciences and Technology, Thiruvananthapuram, India
Publisher
W.B. Saunders
Abstract
Objectives: To compare the incidence of delirium and early (at 1 week)
postoperative cognitive dysfunction (POCD) between propofol-based total
intravenous anesthesia (TIVA) and volatile anesthesia with sevoflurane in
adult patients undergoing elective coronary artery bypass graft surgery
(CABG) with cardiopulmonary bypass (CPB). Design(s): This was a
prospective randomized single-blinded study. Setting(s): The study
was conducted at a single institution, the Sree Chitra Tirunal Institute
for Medical Sciences and Technology, a tertiary care institution and
university-level teaching hospital. Participant(s): Seventy-two
patients undergoing elective CABG under CPB participated in this study.
 Intervention(s): This study was conducted on 72 adult patients (>18
years) undergoing elective CABG under CPB who were randomized to receive
propofol or sevoflurane. Anesthetic depth was monitored to maintain the
bispectral index between 40 and 60. Delirium was assessed using the
Confusion Assessment Method for the Intensive Care Unit. Early POCD was
diagnosed when there was a reduction of >2 points in the Montreal
Cognitive Assessment score compared to baseline. Cerebral oximetry changes
using near-infrared spectroscopy (NIRS), atheroma grades, and
intraoperative variables were compared between the 2 groups. Measurements
& Main Results: Seventy-two patients were randomized to receive propofol
(n = 36) or sevoflurane (n = 36). The mean patient age was 59.4 +/- 8.6
years. The baseline and intraoperative variables, including atheroma
grades, NIRS values, hemoglobin, glycemic control, and oxygenation, were
comparable in the 2 groups. Fifteen patients (21.7%) patients developed
delirium, and 31 patients (44.9%) had early POCD. The incidence of
delirium was higher with sevoflurane (n = 12; 34.2%) compared to propofol
(n = 3; 8.8%) (odds ratio [OR], 1.72; 95% confidence interval [CI],
1.13-2.62; p = 0.027)*. POCD was higher with sevoflurane (n = 20; 57.1%)
compared to propofol (n = 11; 32.3%) (OR, 1.63; 95% CI, 1.01-2.62; p =
0.038)*. In patients aged >65 years, delirium was higher with sevoflurane
(7/11; 63.6%) compared to propofol (1/7; 14.2%) (p = 0.03)*.
 Conclusion(s): Propofol-based TIVA was associated with a lower
incidence of delirium and POCD compared to sevoflurane in this cohort of
patients undergoing CABG under CPB. Large-scale, multicenter randomized
trials with longer follow-up are needed to substantiate the clinical
relevance of this observation. Copyright © 2024

<15>
Accession Number
2033208334
Title
Analgesic Effect and Sleep Quality of Low-Dose Dexmedetomidine in Cardiac
Surgical Patients After Ultrafast-Track Extubation: A Randomized Clinical
Trial.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2024.
Date of Publication: 2024.
Author
Lertkovit S.; Vacharaksa K.; Khamtuikrua C.; Tocharoenchok T.;
Chartrungsan A.; Sangarunakul N.; Suphathamwit A.
Institution
(Lertkovit, Vacharaksa, Khamtuikrua, Suphathamwit) Division of
Cardiothoracic Anesthesia, Department of Anesthesiology, Faculty of
Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
(Tocharoenchok, Chartrungsan) Division of Cardiothoracic Surgery,
Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol
University, Bangkok, Thailand
(Sangarunakul) Integrated Perioperative Geriatric Excellent Research
Center, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok,
Thailand
Publisher
W.B. Saunders
Abstract
Objective: To compare the analgesic and sleep quality effects of
dexmedetomidine infusion versus placebo in patients undergoing cardiac
surgery with ultra-fast track extubation. Design(s): The randomized,
double-blind clinical trial study. Setting(s): At a single academic
center hospital. Participant(s): We included patients aged 25 to 65
scheduled for elective cardiac surgery under general anesthesia with
cardiopulmonary bypass from October 2021 to December 2022.
 Intervention(s): After immediate extubation in the operating room,
the patients who were allocated at first after providing their consent to
either the dexmedetomidine group (Dex) or the placebo group (Placebo)
received continuous infusion of dexmedetomidine (0.2 mug/kg/h) or saline
for 12 hours postoperatively. Measurements and Main Results: The
groups' demographic and perioperative variables were not statistically
significant. Total morphine consumption in milligrams at 12 and 24 hours
after administered study drug, total sleep time in hours by BIS value
<=85, and sleep quality with the Richard-Campbell Sleep Questionnaire were
compared. The analysis included 22 Dex and 23 Placebo patients. The
consumption of morphine was not statistically different between the Dex
and Placebo groups at 12 and 24 hours (p = 0.707 and p = 0.502,
respectively). The Dex group had significantly longer sleep time (8.7 h
[7.8, 9.5]) than the Placebo group (5.8 h [2.9, 8.5]; p = 0.007). The Dex
group also exhibited better sleep quality (7.9 [6.7, 8.7] vs 6.6 [5.2,
8.0]; p = 0.038). Conclusion(s): Sedation with low-dose
dexmedetomidine infusion for ultra-fast track extubation following cardiac
surgery enhances sleep duration and quality. Copyright © 2024
Elsevier Inc.

<16>
Accession Number
644693105
Title
Nursing interventions to prevent pressure injury among open heart surgery
patients: A systematic review.
Source
Nursing in critical care. (no pagination), 2024. Date of Publication: 04
Jul 2024.
Author
Kurt Y.; Kasikci M.; Malaska R.
Institution
(Kurt) Faculty of Health Sciences, Fundamentals of Nursing Department,
Karadeniz Technical University, Trabzon, Turkey
(Kasikci) Fundamentals of Nursing Department, Head of the Nursing Faculty,
Ataturk University, Erzurum, Turkey
(Malaska) Nursing Professional Development Specialist, Gulf Coast Medical
Center Lee Memorial, Fort Myers, FL, United States
Abstract
BACKGROUND: Nurses are vital in identifying and preventive pressure
injuries (PIs) in hospitalized patients undergoing open heart surgery.
Interventions to prevent PIs are crucial for every critical patient, and
it's essential to recognize that preventing PIs involves a complex
intervention. AIM: To examine the nursing interventions for the prevention
of PI in patients with open heart surgery. METHOD(S): A systematic
review study. Web of Science, Science Direct, PubMed, Scopus, MEDLINE
Ultimate, CINAHL Ultimate, ULAKBIM, Cochrane Library, Google Scholar and
university library databases were scanned. The initial search performed in
the databases was updated on 4 February 2023, and on 7 April 2024, for
potential publications included in that period. Data between February 2013
and April 2024 were scanned. The databases were searched with the keywords
'pressure injury', 'nursing interventions' and 'open heart surgery'. The
systematic compilation process was carried out in accordance with the
guidelines in the Preferred Reporting Items for Systematic Reviews and
Meta-Analyses (PRISMA) guide. RESULT(S): Seventeen studies were
examined using nursing interventions that applied to the selected study
population. Care packages included an inflatable head pad, a pressure
sensor mattress cover, multi-layer silicone foam, pressure-reducing
coatings, endotracheal tube (ETT) repositioning and cuff pressure
regulation. Interventions to reduce PI in open heart surgery patients are
applied in the preadmission, perioperative and postoperative periods.
 CONCLUSION(S): It was concluded that care packages, inflatable head
pads, pressure sensor bedspreads, multi-layered silicone foam,
pressure-reducing covers, ETT repositioning and cuff pressure regulation
were effective in all nursing interventions. The strength of the available
evidence was rated from strong to weak. RELEVANCE TO CLINICAL PRACTICE:
These findings reveal an efficient combination of multi-component nursing
interventions for preventing PIs in planning patient care in the intensive
care. The interventions that are used throughout the patient's entire care
process are crucial for the prevention of PIs. Copyright © 2024
British Association of Critical Care Nurses.

<17>
Accession Number
644691865
Title
Concomitant Surgical Ablation in Paroxysmal vs Persistent Atrial
Fibrillation During Mitral Surgery.
Source
The Annals of thoracic surgery. (no pagination), 2024. Date of
Publication: 02 Jul 2024.
Author
Darehzereshki A.; Mehaffey J.H.; Hayanga J.W.A.; Chauhan D.; Mascio C.;
Rankin J.S.; Wei L.; Badhwar V.
Institution
(Darehzereshki, Mehaffey, Hayanga, Chauhan, Mascio, Rankin, Wei, Badhwar)
Department of Cardiovascular and Thoracic Surgery, West Virginia
University, Morgantown, WV, United States
Abstract
BACKGROUND: Despite prospective randomized evidence supporting concomitant
treatment of Atrial Fibrillation (AF) during mitral valve (MV) surgery,
variation in surgical management of AF remains. We sought to assess
longitudinal outcomes following surgical treatment of persistent or
paroxysmal AF during MV surgery in Medicare Beneficiaries. METHOD(S):
All Medicare beneficiaries with a diagnosis of AF undergoing MV surgery
(2018-2020) were evaluated. Patients were stratified by no AF treatment
versus Left Atrial Appendage Obliteration (LAAO) alone versus LAAO and
Surgical Ablation (SA+LAAO). Doubly robust risk-adjustment and subgroup
analysis by persistent or paroxysmal AF were performed. RESULT(S): A
total of 7,517 patients with preoperative AF underwent MV surgery (32.1%
no AF treatment, 23.1% LAAO alone, 44.7% SA+LAAO). After doubly robust
risk-adjustment, AF treatment with SA+LAAO or LAAO alone was associated
with lower 3-year readmission for stroke or bleeding. However, SA+LAAO was
associated with reduced 3-year mortality, and readmission for AF or heart
failure, compared to no AF treatment or LAAO alone. Compared to no AF
treatment or LAAO alone, SA+LAAO was associated with lower composite
endpoint of stroke or death at 3 years (HR 0.75 and HR 0.83,
respectively). Subgroup analysis identified similar longitudinal benefits
of SA+LAAO in patients with persistent or paroxysmal AF.
 CONCLUSION(S): In Medicare beneficiaries with AF undergoing MV
surgery, SA+LAAO was associated with improved longitudinal outcomes
compared to LAAO alone or no AF treatment in patients with paroxysmal or
persistent AF. These contemporary real-world data further clarify the
benefit of SA+LAAO during mitral valve surgery across all types of
AF. Copyright © 2024. Published by Elsevier Inc.

<18>
Accession Number
2033070349
Title
Associations of inflammatory biomarkers with morbidity and mortality after
noncardiac surgery: A systematic review and meta-analysis.
Source
Journal of Clinical Anesthesia. 97 (no pagination), 2024. Article Number:
111540. Date of Publication: October 2024.
Author
Baskaran G.; Heo R.H.; Wang M.K.; Meyre P.B.; Park L.; Blum S.; Devereaux
P.J.; Conen D.
Institution
(Baskaran) Faculty of Health Sciences, McMaster University, 1280 Main
Street West, Hamilton, ON L8S 4L8, Canada
(Baskaran, Wang, Devereaux, Conen) Population Health Research Institute,
20 Copeland Ave, Hamilton, ON L8L 2X2, Canada
(Baskaran, Heo, Park) Department of Medicine, University of Toronto, 27
King's College Circle, Toronto, ON M5S 1A1, Canada
(Wang, Devereaux, Conen) Department of Medicine, McMaster University, 1280
Main Street West, Hamilton, ON L8S 4L8, Canada
(Meyre, Blum) Division of Cardiology and Cardiovascular Research Institute
Basel, University Hospital Basel, Petersgraben 4, Basel 4031, Switzerland
(Devereaux, Conen) Department of Health Research Methods, Evidence &
Impact, McMaster University, 1280 Main Street West, Hamilton, ON L8S 4L8,
Canada
Publisher
Elsevier Inc.
Abstract
Background: Noncardiac surgery is associated with an inflammatory
response. Whether increased inflammation in the perioperative period is
associated with subsequent morbidity and mortality is unknown.
 Method(s): MEDLINE, EMBASE, and CENTRAL were systematically searched
from date of inception until May 2023. Longitudinal studies were included
if they reported multivariable adjusted associations of biomarkers
measured preoperatively and/or within 10 days after surgery with at least
one prespecified adverse outcome in noncardiac surgery patients. Data were
extracted independently and in duplicate. Risk estimates were pooled using
DerSimonian-Laird random-effects models and reported as summary odds
ratios (ORs) with 95% CIs. The outcomes were all-cause mortality and major
adverse cardiovascular events. Result(s): Fifty-two studies with a
total of 121,849 patients were included. The median follow-up was 56 [IQR,
28-63] months and the average age was 57 (+/-3) years. Elevated
preoperative C-reactive protein (CRP) levels were associated with a higher
risk of mortality (OR 1.57, 95% CI 1.29-1.90, I2 = 93%, 28
studies). This association was stronger in non-cancer surgery populations
(OR 2.10, 95% CI 1.92-2.31, I2 = 0%, 4 studies) when compared
to cancer surgery populations (OR 1.51, 95% CI 1.26-1.81, I2 =
83%, 24 studies) (p for subgroup difference = 0.001). Similarly, higher
postoperative CRP levels were associated with all-cause mortality (OR
1.61, 95% CI 1.17-2.20, I2 = 90%, 7 studies). Higher
preoperative CRP levels were associated with major cardiovascular events
(OR 2.11, 95% CI 1.51-2.94, I2 = 0%, 2 studies). Other
preoperatively measured biomarkers associated with all-cause mortality
were fibrinogen (OR 1.48, 95% CI 1.05-2.09, I2 = 52%, 5
studies), interleukin-6 (OR 1.17, 95% CI 1.07-1.28, I2 = 27%, 3
studies), and tumour necrosis factor-alpha (OR 1.37, 95% CI 1.16-1.61,
I2 = 0%, 2 studies). Conclusion and relevance: Inflammatory
biomarker levels in the perioperative period were associated with
all-cause mortality and adverse cardiovascular events in patients
undergoing noncardiac surgery. Copyright © 2024 The Author(s)

<19>
Accession Number
2032953326
Title
Coronary Artery Bypass Graft Failure in Women: Incidence and Clinical
Implications.
Source
Journal of the American College of Cardiology. 84(2) (pp 182-191), 2024.
Date of Publication: 09 Jul 2024.
Author
Sandner S.; Redfors B.; An K.R.; Harik L.; Heise R.; Di Franco A.; Fremes
S.E.; Hare D.L.; Kulik A.; Lamy A.; Peper J.; Ruel M.; ten Berg J.M.;
Willemsen L.M.; Zhao Q.; Zhu Y.; Wojdyla D.M.; Bhatt D.L.; Alexander J.H.;
Gaudino M.
Institution
(Sandner, An, Harik, Heise, Di Franco, Gaudino) Department of
Cardiothoracic Surgery, Weill Cornell Medicine, New York, NY, United
States
(Sandner) Department of Cardiac Surgery, Medical University of Vienna,
Vienna, Austria
(Redfors) 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, Gothenburg
University, Gothenburg, Sweden
(An) Division of Cardiac Surgery, University of Toronto, Toronto, ON,
Canada
(Fremes) Schulich Heart Centre Sunnybrook Health Sciences Centre,
University of Toronto, Toronto, ON, Canada
(Hare) Department of Cardiology, Austin Health, University of Melbourne,
Melbourne, VIC, Australia
(Kulik) Division of Cardiac Surgery, Boca Raton Regional Hospital and
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
(Zhao, Zhu) Ruijin Hospital, Shanghai Jiao Tong University School of
Medicine, Shanghai, China
(Wojdyla) Duke Clinical Research Institute, Duke University, Durham, NC,
United States
(Bhatt) Mount Sinai Heart, Icahn School of Medicine, Mount Sinai, New
York, NY, United States
(Alexander) Department of Medicine and Duke Clinical Research Institute,
Duke University, Durham, NC, United States
Publisher
Elsevier Inc.
Abstract
Background: Women have worse outcomes after coronary artery bypass surgery
(CABG) than men. Objective(s): This study aimed to determine the
incidence of CABG graft failure in women, its association with cardiac
events, and whether it contributes to sex-related differences in outcomes.
 Method(s): A pooled analysis of individual patient data from
randomized clinical trials with systematic imaging follow-up was
performed. Multivariable logistic regression models were used to assess
the association of graft failure with myocardial infarction and repeat
revascularization between CABG and imaging (primary outcome) and death
after imaging (secondary outcome). Mediation analysis was performed to
evaluate the effect of graft failure on the association between female sex
and risk of death. Result(s): Seven randomized clinical trials (N =
4,413, 777 women) were included. At a median imaging follow-up of 1.03
years, graft failure was significantly more frequent among women than men
(37.3% vs 32.9% at the patient-level and 20.5% vs 15.8% at the graft
level; P = 0.02 and P < 0.001, respectively). In women, graft failure was
associated with an increased risk of myocardial infarction and repeat
revascularization (OR: 3.94; 95% CI: 1.79-8.67) and death (OR: 3.18; 95%
CI: 1.73-5.85). Female sex was independently associated with the risk of
death (direct effect, HR: 1.84; 95% CI: 1.35-2.50) but the association was
not mediated by graft failure (indirect effect, HR: 1.04; 95% CI:
0.86-1.26). Conclusion(s): Graft failure is more frequent in women
and is associated with adverse cardiac events. The excess mortality risk
associated with female sex among CABG patients is not mediated by graft
failure. Copyright © 2024 American College of Cardiology
Foundation

<20>
Accession Number
2030474562
Title
An updated meta-analysis of optimal medical therapy with or without
invasive therapy in patients with stable coronary artery disease.
Source
BMC Cardiovascular Disorders. 24(1) (no pagination), 2024. Article Number:
335. Date of Publication: December 2024.
Author
Bi L.; Geng Y.; Wang Y.; Li S.; Sun K.; Guo Y.; Zhang O.; Zhang P.
Institution
(Bi, Geng, Wang, Li, Zhang, Zhang) Department of Cardiology, Beijing
Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua
University, NO. 168 Litang Road, Changping District, Beijing 102218, China
(Sun) Beijing Changping District Tiantongyuan North Community Healthcare
Center, Beijing, China
(Guo) Department of Emergency, Tsinghua University Hospital, Beijing,
China
Publisher
BioMed Central Ltd
Abstract
Background: The efficacy of optimal medical therapy (OMT) with or without
revascularization therapy in patients with stable coronary artery disease
(SCAD) remains controversial. We performed a meta-analysis of randomized
controlled trials (RCTs) that compared OMT with or without
revascularization therapy for SCAD patients. Method(s): Studies were
searched in PubMed, EMBASE, and the Cochrane Central Register of Clinical
Trials from January 1, 2005, to December 30, 2023. The main efficacy
outcome was a composite of all-cause death, myocadiac infarction,
revascularization, and cerebrovascular accident. Results were pooled using
random effects model and fixed effects model and are presented as odd
ratios (ORs) with 95% confidence intervals (CI). Result(s): Ten
studies involving 12,790 participants were included. The arm of OMT with
revascularization compared with OMT alone was associated with decreased
risks for MACCE (OR 0.55 [95% CI 0.38-0.80], I2=93%, P = 0.002), CV death
(OR 0.84 [95% CI 0.73-0.97], I2=36%, P = 0.02), revascularization (OR 0.32
[95% CI 0.20-0.50], I2=92%, P < 0.001), and MI (OR 0.85 [95% CI
0.76-0.96], I2=45%, P = 0.007). While there was no significant difference
between OMT with revascularization and OMT alone in the odds of all-cause
death (OR 0.94 [95% CI 0.84-1.05], I2=0%, P = 0.30). Conclusion(s):
The current updated meta-analysis of 10 RCTs shows that in patients with
SCAD, OMT with revascularization would reduce the risk for MACCE,
cardiovascular death, and MI. However, the invasive strategy does not
decrease the risks for all-cause mortality when comparing with OMT
alone. Copyright © The Author(s) 2024.

<21>
Accession Number
2030470370
Title
European Society for Organ Transplantation (ESOT) Consensus Statement on
the Use of Non-invasive Biomarkers for Cardiothoracic Transplant Rejection
Surveillance.
Source
Transplant International. 37 (no pagination), 2024. Article Number: 12445.
Date of Publication: 2024.
Author
Nikolova A.; Agbor-Enoh S.; Bos S.; Crespo-Leiro M.; Ensminger S.;
Jimenez-Blanco M.; Minervini A.; Perch M.; Segovia J.; Vos R.; Khush K.;
Potena L.
Institution
(Nikolova) Smidt Heart Institute, Cedars-Sinai Medical Center, Los
Angeles, CA, United States
(Agbor-Enoh) Genomic Research Alliance for Transplantation (GRAfT) and
Laboratory of Applied Precision Omics, National Heart, Lung, and Blood
Institute (NHLBI), NIH, Bethesda, MD, United States
(Agbor-Enoh) Lung Transplantation, Department of Medicine, Johns Hopkins
Hospital, Baltimore, MD, United States
(Bos) Newcastle University Translational and Clinical Research Institute,
Newcastle uponTyne, United Kingdom
(Bos) Institute of Transplantation, Newcastle Upon Tyne Hospitals NHS
Trust, Newcastle uponTyne, United Kingdom
(Crespo-Leiro) Cardiology Department, Complexo Hospitalario Universitario
A Coruna (CHUAC), Instituto de Investigacion Biomedica A Coruna (INIBIC),
Universitade de Coruna (UDC), Centro de Investigacion Biomedica en
Red-Enfermedades Cardiovasculares/Network Biomedical Research
Center-Cardiovascular Diseases (CIBERCV), La Coruna, Spain
(Ensminger) Klinik fur Herz- und Thorakale Gefaschirurgie, Universitares
Herzzentrum Lubeck, Lubeck, Germany
(Jimenez-Blanco) Cardiology Department, University Hospital Ramon y Cajal
(Madrid), Centro de Investigacion Biomedica en Red-Enfermedades
Cardiovasculares (CIBERCV), Madrid, Spain
(Minervini, Potena) Heart Failure and Transplant Unit, IRCCS Azienda
Ospedaliero-Universitaria di Bologna, Bologna, Italy
(Perch) Department of Cardiology, Section for Lung Transplantation,
Righospitalet, Copenhagen, Denmark
(Perch) Department of Clinical Medicine, University of Copenhagen,
Copenhagen, Denmark
(Segovia) Cardiology Department, Puerta de Hierro Majadahonda University
Hospital, Universidad Autonoma de Madrid, Instituto de Investigacion
Sanitaria Puerta de Hierro-Segovia de Arana/Puerta de Hierro Health
Research Institute-Segovia de Arana (IDIPHISA), Centro de Investigacion
Biomedica en Red-Enfermedades Cardiovasculares, Network Biomedical
Research Center, Cardiovascular Diseases (CIBERCV), Madrid, Spain
(Vos) Department of Respiratory Diseases, UZ Leuven, Lung Transplant Unit,
Department of Chronic Diseases and Metabolism, Laboratory of Respiratory
Diseases and Thoracic Surgery (BREATHE), KU Leuven, Leuven, Belgium
(Khush) Division of Cardiovascular Medicine, Stanford University School of
Medicine, Palo Alto, CA, United States
Publisher
Frontiers Media SA
Abstract
While allograft rejection (AR) continues to threaten the success of
cardiothoracic transplantation, lack of accurate and repeatable
surveillance tools to diagnose AR is a major unmet need in the clinical
management of cardiothoracic transplant recipients. Endomyocardial biopsy
(EMB) and transbronchial biopsy (TBBx) have been the cornerstone of
rejection monitoring since the field's incipience, but both suffer from
significant limitations, including poor concordance of biopsy
interpretation among pathologists. In recent years, novel molecular tools
for AR monitoring have emerged and their performance characteristics have
been evaluated in multiple studies. An international working group
convened by ESOT has reviewed the existing literature and provides a
series of recommendations to guide the use of these biomarkers in clinical
practice. While acknowledging some caveats, the group recognized that
Gene-expression profiling and donor-derived cell-free DNA (dd-cfDNA) may
be used to rule out rejection in heart transplant recipients, but they are
not recommended for cardiac allograft vasculopathy screening. Other
traditional biomarkers (NT-proBNP, BNP or troponin) do not have sufficient
evidence to support their use to diagnose AR. Regarding lung transplant,
dd-cfDNA could be used to rule out clinical rejection and infection, but
its use to monitor treatment response is not recommended. Copyright
© 2024 Nikolova, Agbor-Enoh, Bos, Crespo-Leiro, Ensminger,
Jimenez-Blanco, Minervini, Perch, Segovia, Vos, Khush and Potena.

<22>
Accession Number
2030466292
Title
Effects of ultrasound-guided serratus plane block combined with general
anesthesia on postoperative early quality of recovery and analgesia in
patients undergoing transapical transcatheter aortic valve implantation
surgery: study protocol for a randomized controlled trial.
Source
Trials. 25(1) (no pagination), 2024. Article Number: 436. Date of
Publication: December 2024.
Author
Xiao C.; Chen F.; Cao L.; Yang M.; Tan Y.; Lin G.; Yang G.; Jing S.; Li H.
Institution
(Xiao, Chen, Cao, Yang, Tan, Lin, Yang, Jing, Li) Department of
Anesthesiology, Xinqiao Hospital of Chongqing, Second Affiliated Hospital
of Army Medical University, PLA, Chongqing 400037, China
Publisher
BioMed Central Ltd
Abstract
Background: Compared to traditional thoracotomy, transapical transcatheter
aortic valve implantation (TAVI) surgery offers reduced trauma and faster
recovery, fostering the adoption of enhanced recovery after surgery (ERAS)
protocols in cardiac surgery. Despite these advancements, postoperative
pain management has received insufficient attention. The potential effects
of multi-mode analgesia, including ultrasound-guided serratus anterior
plane block (SAPB), on postoperative pain and early quality of recovery
have not been widely studied, lacking comprehensive prospective evidence.
Therefore, this study aims to investigate the impact of SAPB combined with
general anesthesia on early recovery quality and analgesic efficacy in
transapical TAVI patients. Method(s): This prospective, randomized
controlled study will enroll 70 patients undergoing transapical TAVI,
randomly allocated to either the SAPB group or the control group. The
primary outcome, assessed using Quality of Recovery-40 (QOR-40) scale,
focuses on the quality of recovery at 24 h and 48 h postoperatively.
Secondary outcomes include the visual analog scale (VAS) pain scores at
rest and during coughing at 6 h, 12 h, 24 h, and 48 h after surgery,
frequency of patient-controlled analgesia (PCA) utilization at 24 h and 48
h, opioid consumption at 24 h and 48 h, time and frequency of rescue
analgesia and severe pain at 24 h and 48 h, incidence of nausea and
vomiting at 48 h after surgery, and dosage of antiemetic drugs.
 Discussion(s): The purpose of our study is to evaluate the effects of
ultrasound-guided SAPB combined with general anesthesia on postoperative
early quality of recovery and analgesia in transapical TAVI patients. The
results obtained may provide valuable insight for the implementation of
multi-mode analgesia and enhanced ERAS in this specific patient
population. Trial registration: China Clinical Trial Register
ChiCTR2300068584. Registered on 24 February 2023. Copyright © The
Author(s) 2024.

<23>
Accession Number
2030453892
Title
Assessment of Myocardial Viability in Ischemic Cardiomyopathy With Reduced
Left Ventricular Function Undergoing Coronary Artery Bypass Grafting.
Source
Clinical Cardiology. 47(7) (no pagination), 2024. Article Number: e24307.
Date of Publication: July 2024.
Author
Arjomandi Rad A.; Tserioti E.; Magouliotis D.E.; Vardanyan R.; Samiotis
I.V.; Skoularigis J.; Ariff B.; Xanthopoulos A.; Triposkiadis F.; Casula
R.; Athanasiou T.
Institution
(Arjomandi Rad) Division of Medical Sciences, University of Oxford,
Oxford, United Kingdom
(Arjomandi Rad, Tserioti, Vardanyan, Casula, Athanasiou) Department of
Surgery and Cancer, Imperial College London, London, United Kingdom
(Magouliotis, Samiotis, Athanasiou) Department of Cardiothoracic Surgery,
University Hospital of Larissa, Larissa, Greece
(Skoularigis, Xanthopoulos, Triposkiadis) Department of Cardiology,
University Hospital of Larissa, Larissa, Greece
(Ariff) Department of Radiology, Hammersmith Hospital, Imperial College
Healthcare NHS Trust, London, United Kingdom
(Casula, Athanasiou) Department of Cardiothoracic Surgery, Hammersmith
Hospital, Imperial College Healthcare NHS Trust, London, United Kingdom
Publisher
John Wiley and Sons Inc
Abstract
Background: We aim to provide a comprehensive review of the current state
of knowledge of myocardial viability assessment in patients undergoing
coronary artery bypass grafting (CABG), with a focus on the clinical
markers of viability for each imaging modality. We also compare mortality
between patients with viable myocardium and those without viability who
undergo CABG. Method(s): A systematic database search with
meta-analysis was conducted of comparative original articles (both
observations and randomized controlled studies) of patients undergoing
CABG with either viable or nonviable myocardium, in EMBASE, MEDLINE,
Cochrane database, and Google Scholar, from inception to 2022. Imaging
modalities included were dobutamine stress echocardiography (DSE), cardiac
magnetic resonance (CMR), single-photon emission computed tomography
(SPECT), and positron emission tomography (PET). Result(s): A total
of 17 studies incorporating a total of 2317 patients were included. Across
all imaging modalities, the relative risk of death post-CABG was reduced
in patients with versus without viability (random-effects model: odds
ratio: 0.42; 95% confidence interval: 0.29-0.61; p < 0.001). Imaging for
myocardial viability has significant clinical implications as it can
affect the accuracy of the diagnosis, guide treatment decisions, and
predict patient outcomes. Generally, based on local availability and
expertise, either SPECT or DSE should be considered as the first step in
evaluating viability, while PET or CMR would provide further evaluation of
transmurality, perfusion metabolism, and extent of scar tissue.
 Conclusion(s): The assessment of myocardial viability is an essential
component of preoperative evaluation in patients with ischemic heart
disease undergoing surgical revascularization. Careful patient selection
and individualized assessment of viability remain paramount. Copyright
© 2024 The Author(s). Clinical Cardiology published by Wiley
Periodicals LLC.

<24>
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. 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. 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). 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. Copyright © The Author(s), under exclusive licence to
Springer-Verlag GmbH Germany, part of Springer Nature 2024.

<25>
Accession Number
2033169165
Title
The Effect of Eicosapentaenoic and Docosahexaenoic Acid Supplementation on
Coronary Artery Calcium Progression in Subjects With Diabetes and Coronary
Artery Disease: A Secondary Analysis of a Randomized Trial.
Source
American Journal of Cardiology. 225 (pp 98-104), 2024. Date of
Publication: 15 Aug 2024.
Author
Asbeutah A.A.; Daher R.; Malik A.; Hariri E.; Alfaddagh A.; Elajami T.K.;
Welty F.K.
Institution
(Asbeutah, Malik, Elajami, Welty) Division of Cardiology, Beth Israel
Deaconess Medical Center, Boston, Massachusetts, United States
(Daher) Department of Internal Medicine, Cooper University Healthcare,
Camden, New Jersey, United States
(Hariri) Division of Cardiology, Johns Hopkins Medicine, Baltimore,
Maryland, United States
(Alfaddagh) Ciccarone Center for the Prevention of Cardiovascular Disease,
Johns Hopkins School of Medicine, Baltimore, Maryland, United States
Publisher
Elsevier Inc.
Abstract
Higher coronary artery calcium (CAC) scores and progression of CAC are
associated with higher mortality. We previously reported that subjects
with coronary artery disease randomly allocated to eicosapentaenoic acid
(EPA) and docosahexaenoic acid (DHA) supplementation or none had similar
significant increases in CAC score over 30 months. Whether these findings
are influenced by diabetes status is unknown. A total of 242 subjects with
coronary artery disease who were on statin therapy were randomly allocated
to to 1.86 g EPA and 1.5 g DHA daily or none (control). The CAC score was
measured at baseline and 30-month follow-up using noncontrast, cardiac
computed tomography. A significant interaction term between diabetes
status and treatment arm was noted in the prediction of the CAC score (p
<0.001). A total of 176 subjects (85.8% men) had no diabetes and 66
subjects (80.3% men) had diabetes. The mean age was 62.9 +/- 7.9 versus
63.2 +/- 7.1 years, respectively. The mean low-density lipoprotein
cholesterol and median triglyceride levels were not significantly
different between those without and with diabetes: 77.7 +/- 25.9 versus
77.1 +/- 30.2 mg/100 ml, respectively, and 117.0 (78.0 to 158.0) versus
119.0 (84.5 to 201.5) mg/100 ml, respectively. Subjects with diabetes on
EPA+DHA had a greater increase in CAC score than subjects with diabetes in
the control group (median 380.7 vs 183.5, respectively, p = 0.021). In
contrast, no difference occurred between the EPA+DHA and control groups in
subjects without diabetes (175.7 vs 201.1, respectively, p = 0.41). In
conclusion, EPA+DHA supplementation was associated with greater CAC
progression in subjects with diabetes than subjects with diabetes in the
control group over a 30-month period; whether this indicates progression
of the disease burden or plaque stabilization requires further
study. Copyright © 2024 Elsevier Inc.

<26>
Accession Number
2033129306
Title
Long-Term Outcomes of Tricuspid Valve Replacement With Mechanical Versus
Tissue Valves: Meta-Analysis of Reconstructed Time-to-Event Data.
Source
American Journal of Cardiology. 225 (pp 89-97), 2024. Date of Publication:
15 Aug 2024.
Author
Sa M.P.; Iyanna N.; Tabrizi N.S.; Jacquemyn X.; Ahmad D.; Brown J.A.;
Yousef S.; Serna-Gallegos D.; Yoon P.D.; Sultan I.
Institution
(Sa, Iyanna, Ahmad, Brown, Yousef, Serna-Gallegos, Yoon, Sultan) UPMC
Heart and Vascular Institute, University of Pittsburgh Medical Center,
Pittsburgh, PA, United States
(Sa, Iyanna, Ahmad, Brown, Yousef, Serna-Gallegos, Yoon, Sultan)
Department of Cardiothoracic Surgery, University of Pittsburgh,
Pittsburgh, PA, United States
(Tabrizi) Albany Medical College, Albany, New York, United States
(Jacquemyn) Department of Cardiovascular Sciences, KU Leuven, Leuven,
Belgium
Publisher
Elsevier Inc.
Abstract
Tricuspid valve replacement (TVR) with mechanical versus tissue valves
remains a controversial subject. To evaluate the long-term effects of
types of valves on patient-relevant outcomes, we performed a systematic
review with meta-analysis of reconstructed time-to-event data of studies
published by March 15, 2024 (according to referred the Reporting Items for
Systematic Reviews and Meta-analyses guidelines). A total of 21 studies
met our eligibility criteria and included 7,166 patients (mechanical:
2,495 patients, 34.8%). Patients who underwent mechanical TVR had a lower
risk of death than those who received a tissue valve (hazard ratio [HR]
0.77, 95% confidence interval [CI] 0.70 to 0.84, p <0.001). Mechanical TVR
was associated with lifetime gain, as evidenced by the restricted mean
survival time, which was 2.2 years longer in patients who underwent TVR
with mechanical valves (12.4 vs 10.2 years, p <0.001). Our landmark
analysis for reoperations revealed the following: from the time point 0 to
7 years, we found no difference in the risk of reoperation between
mechanical and tissues valves (HR 0.98, 95% CI 0.60 to 1.61, p = 0.946);
however, from the time point 7 years onward, we found that mechanical TVR
had a lower risk of reoperation in the follow-up (HR 0.24, 95% CI 0.08 to
0.72, p = 0.001). The meta-regression analysis demonstrated a modulating
effect of atrial fibrillation on the association between mechanical valves
and mortality; the HRs for all-cause death tended to decrease in the
presence of populations with a larger proportion of atrial fibrillation (p
= 0.018). In conclusion, our results suggest that TVR with mechanical
valves, whenever considered clinically reasonable and accepted by patients
as an option, can offer a better long-term survival and lower risk of
reoperation in the long run. Copyright © 2024 Elsevier Inc.

<27>
Accession Number
2033126413
Title
Selection for transcatheter versus surgical aortic valve replacement and
mid-term survival: results of the AUTHEARTVISIT study.
Source
European Journal of Cardio-thoracic Surgery. 66(1) (no pagination), 2024.
Article Number: ezae214. Date of Publication: 01 Jul 2024.
Author
Auer J.; Krotka P.; Reichardt B.; Traxler D.; Wendt R.; Mildner M.;
Ankersmit H.J.; Graf A.
Institution
(Auer) Department of Internal Medicine I with Cardiology and Intensive
Care, St Josef Hospital Braunau, Braunau am Inn, Austria
(Krotka, Graf) Center for Medical Data Science, Medical University of
Vienna, Vienna, Austria
(Reichardt) Austrian Social Health Insurance Fund, Eisenstadt, Austria
(Traxler, Ankersmit) Clinic of Thoracic Surgery, Medical University of
Vienna, Vienna, Austria
(Traxler, Ankersmit) Laboratory for Cardiac and Thoracic Diagnosis,
Regeneration and Applied Immunology, Vienna, Austria
(Traxler) Department of Oral and Maxillofacial Surgery, Medical University
of Vienna, Vienna, Austria
(Wendt) Department of Nephrology, Hospital St Georg Leipzig, Leipzig,
Germany
(Mildner) Department of Dermatology, Medical University of Vienna, Vienna,
Austria
Publisher
European Association for Cardio-Thoracic Surgery
Abstract
OBJECTIVES: Limited data are available from randomized trials comparing
outcomes between transcatheter aortic valve replacement (TAVR) and surgery
in patients with different risks and with follow-up of at least 4 years or
longer. In this large, population-based cohort study, long-term mortality
and morbidity were investigated in patients undergoing aortic valve
replacement (AVR) for severe aortic stenosis using a surgically implanted
bioprosthesis (surgical/biological aortic valve replacement; sB-AVR) or
TAVR. METHOD(S): Individual data from the Austrian Insurance Funds
from 2010 through 2020 were analysed. The primary outcome was all-cause
mortality, assessed in the overall and propensity score-matched
populations. Secondary outcomes included reoperation and cardiovascular
events. RESULT(S): From January 2010 through December 2020, a total
of 18 882 patients underwent sB-AVR (n 1/4 11 749; 62.2%) or TAVR (n 1/4
7133; 37.8%); median follow-up was 5.8 (95% CI 5.7-5.9) years (maximum
12.3 years). The risk of all-cause mortality was higher with TAVR compared
with sB-AVR: hazard ratio 1.552, 95% confidence interval (CI) 1.469-1.640,
P < 0.001; propensity score-matched hazard ratio 1.510, 1.403-1.625, P <
0.001. Estimated median survival was 8.8 years (95% CI 8.6-9.1) with
sB-AVR versus 5 years (4.9-5.2) with TAVR. Estimated 5-year survival
probability was 0.664 (0.664-0.686) with sB-AVR versus 0.409 (0.378-0.444)
with TAVR overall, and 0.690 (0.674-0.707) and 0.560 (0.540-0.582),
respectively, with propensity score matching. Separate subgroup analyses
for patients aged 65-75 years and >75 years indicated a significant
survival benefit in patients selected for sB-AVR in both groups. Other
predictors of mortality were age, sex, previous heart failure, diabetes
and chronic kidney disease. CONCLUSION(S): In this retrospective
national population-based study, selection for TAVR was significantly
associated with higher all-cause mortality compared with sB-AVR in
patients >=65 years with severe, symptomatic aortic stenosis in the
>2-year follow-up. Copyright ©The Author(s) 2024.

<28>
Accession Number
2033122594
Title
Short- and intermediate-term outcomes of transcatheter aortic valve
replacement in low-risk patients: A meta-analysis and systematic review.
Source
IJC Heart and Vasculature. 53 (no pagination), 2024. Article Number:
101458. Date of Publication: August 2024.
Author
Rahman H.; Ghosh P.; Nasir F.; Khan M.A.; Rehman N.; Sharma S.; Sporn D.;
Kaluski E.
Institution
(Rahman, Ghosh) Division of Cardiology, Guthrie Robert Packer Hospital,
Sayre, PA, United States
(Nasir) Department of Medicine, Miami Valley Hospital, Dayton, OH, United
States
(Khan) Department of Medicine, Guthrie Robert Packer Hospital, Sayre, PA,
United States
(Rehman, Sharma, Sporn, Kaluski) Division of Cardiology, Guthrie Health
System/ Robert Packer Hospital, Sayre, PA, United States
(Kaluski) Division of Cardiology, Rutgers New Jersey Medical School,
Newark, NJ, United States
(Kaluski) Division of Cardiology, The Geisinger Commonwealth Medical
College, Scranton, PA, United States
Publisher
Elsevier Ireland Ltd
Abstract
Background: Transcatheter aortic valve replacement (TAVR) being currently
employed in low surgical risk patients with severe symptomatic aortic
stenosis (AS). The durability and extended outcomes of TAVR as compared to
surgical aortic valve replacement (SAVR) in low-risk patients remains
uncertain. Method(s): We selected randomized controlled trials (RCT)
comparing outcomes of TAVR vs. SAVR in low surgical risk patients having
severe AS using online databases. The primary outcome was all-cause death.
The secondary outcomes were composite of all-cause death & disabling
stroke, cardiovascular (CV) death, stroke, myocardial infarction (MI),
permanent pacemaker (PPM) placement, new onset atrial fibrillation (AF),
valve re-intervention and valve thrombosis. The outcomes were stratified
at short- (1-year) and intermediate-term (<=5 years) follow-up. We used a
random effect model to report outcomes as relative risk (RR) with a 95 %
confidence interval (CI). Result(s): The analysis consisted of six
RCTs comprising 5,122 subjects with a mean age of 75.4 years. At
short-term follow up, there was a significant reduction in all-cause death
(RR: 0.62, 0.46-0.82, p = 0.001) and composite of all-cause death and
disabling stroke (RR: 0.62, 0.45-0.83, p = 0.002) in patients undergoing
TAVR. At intermediate-term follow-up, there was no significant difference
in survival (RR:0.95, 0.73-1.24, p = 0.71) and composite outcome (RR:
0.95, 0.74-1.22, p = 0.71). TAVR patients had lower incidence of new onset
AF, however, higher PPM placement. Conclusion(s): In patients with
severe AS having low-surgical risk, patients undergoing TAVR had improved
short-term survival as compared to SAVR. This survival advantage was
absent at intermediate-term follow-up. The long-term outcomes remain
uncertain. Copyright © 2024 The Author(s)

<29>
Accession Number
2030484717
Title
The use of transcutaneous electrical acupoint stimulation to reduce opioid
consumption in patients undergoing off-pump CABG: a randomized controlled
trial.
Source
Perioperative Medicine. 13(1) (no pagination), 2024. Article Number: 68.
Date of Publication: December 2024.
Author
Zhang H.; Wang L.; Zheng Z.; Han J.; Li L.; Yao W.; Li Z.; Luo G.; Gao B.;
Shen J.; Dong H.; Lei C.
Institution
(Zhang, Wang, Zheng, Luo, Gao, Shen, Dong, Lei) Department of
Anesthesiology and Perioperative Medicine, Xijing Hospital, Fourth
Military Medical University, Xi'an 710032, China
(Han) Department of Anesthesiology, Tianjin Chest Hospital, Tianjin, China
(Li) Department of Anesthesiology, General Hospital of Northern Theater
Command, Shenyang, China
(Yao) Department of Anesthesiology, Tongji Hospital, Tongji Medical
College, Huazhong University of Science and Technology, Wuhan, China
(Li) Department of Anesthesiology, The Second Xiangya Hospital, Central
South University, Changsha, China
Publisher
BioMed Central Ltd
Abstract
Background: High doses of long-acting opioids were used to facilitate
off-pump coronary artery bypass grafting procedure, which may result in
opioid-related adverse events after surgery. Transcutaneous electrical
acupoint stimulation (TEAS) had been reported to be effective in reducing
intraoperative opioids consumption during surgery. The aim of this study
is to assess whether TEAS with difference acupoints can reduce the doses
of opioid analgesics. Method(s): This was a multicenter, randomized,
controlled, double-blind trial. Patients underwent off-pump coronary
artery bypass grafting under general anesthesia were enrolled. Eligible
patients were randomly and equally grouped into sham acupuncture group (n
= 105), regional acupoints combination group (n = 105), or distal-proximal
acupoints combination group (n = 105) using a centralized
computer-generated randomization system. Transcutaneous electrical
acupoint stimulation was applied for 30 min before anesthesia induction.
The primary outcome was the doses of sufentanil during anesthesia.
Secondary outcomes included the highest postoperative vasoactive-inotropic
scores within 24 h, intraoperative propofol consumption, length of
mechanical ventilation, duration of cardiac care unit and postoperative
hospital stay, incidence of postoperative complications, and mortality
within 30 days after surgery. Result(s): Of the 315 randomized
patients, 313 completed the trial. In the modified intention-to-treat
analysis, the doses of sufentanil were 303.9 (10.8) mug in the
distal-proximal acupoints group, significantly lower than the sham group,
and the mean difference was - 34.9 (- 64.9 to - 4.9) mug, p = 0.023. The
consumption of sufentanil was lower in distal-proximal group than regional
group (303.9 vs. 339.5), and mean difference was - 35.5 (- 65.6 to - 5.5)
mug, p = 0.020. The distal-proximal group showed 10% reduction in opioids
consumption comparing to both regional and sham groups. Secondary outcomes
were comparable among three groups. Conclusion(s): Transcutaneous
electrical acupoint stimulation with distal-proximal acupoints
combination, compared to regional acupoints combination and sham
acupuncture, significantly reduced sufentanil consumption in patients who
underwent off-pump coronary artery bypass grafting surgery. Copyright
© The Author(s) 2024.

<30>
Accession Number
2029824963
Title
A systematic review of the prevalence of chronic postsurgical pain in
children.
Source
Paediatric Anaesthesia. 34(8) (pp 701-719), 2024. Date of Publication:
August 2024.
Author
Sim N.Y.W.; Chalkiadis G.A.; Davidson A.J.; Palmer G.M.
Institution
(Sim) Department of Anaesthesia and Perioperative Medicine, Monash Health,
Clayton, VIC, Australia
(Chalkiadis, Davidson, Palmer) Department of Anaesthesia and Pain
Management, Royal Children's Hospital, Parkville, VIC, Australia
(Chalkiadis, Davidson, Palmer) Murdoch Children's Research Institute,
Parkville, VIC, Australia
(Chalkiadis, Davidson, Palmer) Department of Paediatrics, University of
Melbourne, Parkville, VIC, Australia
(Davidson) Department of Critical Care, University of Melbourne,
Parkville, VIC, Australia
Publisher
John Wiley and Sons Inc
Abstract
Two prior reviews highlight the scarcity and conflicting nature of
available data on chronic postsurgical pain in children, reporting a wide
prevalence range of 3.2% to 64% (at >=3 months). This updated systematic
review aimed to consolidate information on the prevalence of pediatric
chronic postsurgical pain. A thorough literature search of full
English-text publications from April 2014 to August 2021 was conducted
using Ovid MEDLINE, PubMed, and Cochrane Database of Systematic Reviews,
with search terms: postoperative pain, child, preschool, pediatrics,
adolescent, chronic pain. Seventeen relevant studies were identified. Most
assessed chronicity once greater than 3 months duration postoperatively
(82%), were predominantly prospective (71%) and conducted in inpatient
settings (88%). The surgeries examined included orthopedic (scoliosis and
limb), urological, laparotomy, inguinal, and cardiothoracic procedures,
involving numbers ranging from 36 to 750, totaling 3137 participants/2792
completers. The studies had wide variations in median age at surgery (6
days to 16 years), the percentage of female participants (unspecified or
12.5% to 90%), and follow-up duration (2.5 months to 9 years). Various
pain, functional, psychosocial, and health-related quality of life
outcomes were documented. Chronic postsurgical pain prevalence varied
widely from 2% to 100%. Despite increased data, challenges persist due to
heterogeneity in definitions, patient demographics, mixed versus single
surgical populations, diverse perioperative analgesic interventions,
follow-up durations and reported outcomes. Interpretation is further
complicated by limited information on impact, long-term analgesia and
healthcare utilization, and relatively small sample sizes, hindering the
assessment of reported associations. In some cases, preoperative pain and
deformity may not have been addressed by surgery and persisting pain
postoperatively may then be inappropriately termed chronic postsurgical
pain. Larger-scale, procedure-specific data to better assess current
prevalence, impact, and whether modifiable factors link to negative
long-term outcomes, would be more useful and allow targeted perioperative
interventions for at-risk pediatric surgical patients. Copyright
© 2024 The Authors. Pediatric Anesthesia published by John Wiley &
Sons Ltd.

<31>
Accession Number
2029657734
Title
Outcomes of Patients with a Mechanical Heart Valve and Poor
Anticoagulation Control on Warfarin.
Source
Thrombosis and Haemostasis. 124(7) (pp 613-624), 2024. Date of
Publication: 25 Jun 2024.
Author
Johansson I.; Benz A.P.; Kovalova T.; Balasubramanian K.; Fukakusa B.;
Lynn M.J.; Nair N.; Sikder O.; Patel K.; Gayathri S.; Robinson M.; Hardy
C.; Tyrwhitt J.; Schulman S.; Eikelboom J.W.; Connolly S.J.
Institution
(Johansson, Benz, Kovalova, Balasubramanian, Hardy, Tyrwhitt, Eikelboom,
Connolly) Population Health Research Institute, Hamilton Health Sciences,
McMaster University, ON, Canada
(Johansson) Division of Cardiology, Department of Medicine K2, Karolinska
University Hospital Solna, Karolinska Institutet, Stockholm, Sweden
(Benz) Department of Cardiology, University Medical Center Mainz, Johannes
Gutenberg-University, Mainz, Germany
(Fukakusa) Division of Cardiology, Department of Pediatrics, The
University of British Columbia, Vancouver, Canada
(Lynn) Department of Medicine, University of British Columbia, Vancouver,
Canada
(Nair) Division of Medicine, Michael G. DeGroote School of Medicine,
McMaster University, Hamilton, Canada
(Sikder) Division of Medicine, School of Nursing, McMaster University,
Hamilton, Canada
(Patel) Department of Medicine, University of Ottawa, Ottawa, ON, Canada
(Gayathri) Department of Medicine, Faculty of Health Sciences, McMaster
University, Hamilton, Canada
(Robinson, Schulman) Department of Medicine and Thrombosis,
Atherosclerosis Research Institute, McMaster University, Hamilton, Canada
Publisher
Georg Thieme Verlag
Abstract
Background Patients with a mechanical heart valve (MHV) require oral
anticoagulation. Poor anticoagulation control is thought to be associated
with adverse outcomes, but data are limited. Objective To assess the risks
of clinical outcomes in patients with a MHV and poor anticoagulation
control on warfarin. Methods We conducted a retrospective study of
consecutive patients undergoing MHV implantation at a tertiary care center
(2010-2019). Primary outcome was a composite of ischemic stroke, systemic
embolism, or prosthetic valve thrombosis. Major bleeding and death were
key secondary outcomes.We constructedmultivariable regression models to
assess the association between time in therapeutic range (TTR) on warfarin
beyond 90 days after surgery with outcomes. Results We included 671
patients with a MHV (80.6% in aortic, 14.6% in mitral position; mean age
61 years, 30.3% female). Median follow-up was 4.9 years, meanTTR was 62.5%
(14.5% TTR<40%, 24.6% TTR 40-60%, and 61.0% TTR>60%). Overall rates of the
primary outcome, major bleeding, and death were 0.73, 1.41, and 1.44 per
100 patient-years. Corresponding rates for patients with TTR <40% were
1.31, 2.77, and 3.22 per 100 patient-years. In adjusted analyses, every
10% decrement in TTR was associated with a 31% increase in hazard for the
primary outcome (hazard ratio [HR]: 1.31, 95% confidence interval [CI]:
1.13-1.52), 34% increase in major bleeding (HR: 1.34, 95% CI: 1.17-1.52),
and 32% increase in death (HR: 1.32, 95% CI: 1.11-1.57). Conclusion In
contemporary patients with a MHV, poor anticoagulation control on warfarin
was associated with increased risks of thrombotic events, bleeding, and
death. Copyright © 2023. The Author(s).

<32>
Accession Number
2028905038
Title
Goal setting among older adults starting mobile health cardiac
rehabilitation in the RESILIENT trial.
Source
Journal of the American Geriatrics Society. 72(7) (pp 2157-2166), 2024.
Date of Publication: July 2024.
Author
Shwayder E.; Dodson J.A.; Tellez K.; Johanek C.; Adhikari S.; Meng Y.;
Schoenthaler A.; Jennings L.A.
Institution
(Shwayder, Dodson) Leon H. Charney Division of Cardiology, Department of
Medicine, New York University Grossman School of Medicine, New York, NY,
United States
(Dodson, Tellez, Johanek) Division of Healthcare Delivery Science,
Department of Population Health, New York University Grossman School of
Medicine, New York, NY, United States
(Adhikari, Meng) Division of Biostatistics, New York University Grossman
School of Medicine, New York, NY, United States
(Schoenthaler) Institute for Excellence in Health Equity, New York
University Grossman School of Medicine, New York, NY, United States
(Jennings) Reynolds Section of Geriatrics and Palliative Medicine,
University of Oklahoma Health Sciences Center, Oklahoma City, OK, United
States
Publisher
John Wiley and Sons Inc
Abstract
Background: There is growing recognition that healthcare should align with
individuals' health priorities; however, these priorities remain
undefined, especially among older adults. The Rehabilitation Using Mobile
Health for Older Adults with Ischemic Heart Disease in the Home Setting
(RESILIENT) trial, designed to test the efficacy of mobile health cardiac
rehabilitation (mHealth-CR) in an older cohort, also measures the
attainment of participant-defined health outcome goals as a prespecified
secondary endpoint. This study aimed to characterize the health priorities
of older adults with ischemic heart disease (IHD) using goal attainment
scaling-a technique for measuring individualized goal achievement-in a
sample of 100 RESILIENT participants. Method(s): The ongoing
RESILIENT trial randomizes patients aged >=65 years with IHD (defined as
hospitalization for acute coronary syndrome and/or coronary
revascularization), to receive mHealth-CR or usual care. For the current
study, we qualitatively coded baseline goal attainment scales from
randomly selected batches of 20 participants to identify participants'
cardiac rehabilitation outcome goals and their perceptions of barriers and
action plans for goal attainment. We used a deductive framework (i.e., 4
value categories from Patient Priorities Care) and inductive approaches to
code and analyze interviews until thematic saturation. Result(s):
This sample of 100 older adults set diverse health outcome goals. Most
(54.6%) prioritized physical activity, fewer (17.1%) identified symptom
management, fewer still (13.7%) prioritized health metrics, mostly
comprised of weight loss goals (10.3%), and the fewest (<4%) were related
to clinical metrics such as reducing cholesterol or preventing hospital
readmission. Participants anticipated extrinsic (access to places to
exercise, time) and intrinsic (non-cardiac pain, motivation) barriers.
Action plans detailed strategies for exercise, motivation, accountability,
and overcoming time constraints. Conclusion(s): Using goal attainment
scaling, we elicited specific and measurable goals among older adults with
IHD beginning cardiac rehabilitation. Priorities were predominantly
functional, diverging from clinical metrics emphasized by clinicians and
healthcare systems. Copyright © 2024 The American Geriatrics
Society.

<33>
Accession Number
2026381307
Title
Inverse Association of Lipoprotein(a) on Long-Term Bleeding Risk in
Patients with Coronary Heart Disease: Insight from a Multicenter Cohort in
Asia.
Source
Thrombosis and Haemostasis. 124(7) (pp 684-694), 2024. Date of
Publication: 25 Jun 2024.
Author
Wang P.; Yuan D.; Zhao X.; Zhu P.; Guo X.; Jiang L.; Xu N.; Wang Z.; Liu
R.; Wang Q.; Chen Y.; Zhang Y.; Xu J.; Liu Z.; Song Y.; Zhang Z.; Yao Y.;
Feng Y.; Tang X.; Wang X.; Gao R.; Han Y.; Yuan J.
Institution
(Wang, Yuan, Zhu, Jiang, Xu, Liu, Chen, Xu, Song, Yao, Tang, Gao, Yuan)
Department of Cardiology, Center for Coronary Heart Disease, Fuwai
Hospital, National Center for Cardiovascular Diseases, Chinese Academy of
Medical Sciences and Peking Union Medical College, Beijing, China
(Zhao) Special Demand Medical Care Center, Chinese Academy of Medical
Sciences and Peking Union Medical College, Fuwai Hospital, Beijing, China
(Guo) Department of Cardiology, Zhejiang University School of Medicine,
The First Affiliated Hospital, Zhejiang Province, Hangzhou, China
(Wang) Department of Cardiology, Xinxiang Central Hospital, Henan
Province, Xinxiang, China
(Wang) Department of Cardiology, The First Hospital of Qinhuangdao, Hebei
Province, Qinhuangdao, China
(Zhang) Department of Cardiology, Peking University Third Hospital,
Beijing, China
(Liu) Department of Cardiology, Peking Union Medical College Hospital,
Beijing, China
(Zhang) Department of Cardiology, The First Hospital of Lanzhou
University, Gansu Province, Lanzhou, China
(Feng) Department of Cardiology, Guangdong Cardiovascular Institute,
Guangdong Provincial People's Hospital, Guangdong Province, Guangzhou,
China
(Wang, Han) Department of Cardiology, General Hospital of Northern Theater
Command, Liaoning Province, Shenyang, China
(Yuan) National Clinical Research Center for Cardiovascular Diseases,
Chinese Academy of Medical Sciences, Peking Union Medical College, Fuwai
Hospital, National Center for Cardiovascular Diseases, Beijing, China
Publisher
Georg Thieme Verlag
Abstract
Background Lipoprotein(a), or Lp(a), has been recognized as a strong risk
factor for atherosclerotic cardiovascular disease. However, the
relationship between Lp(a) and bleeding remains indistinct, especially in
the secondary prevention population of coronary artery disease (CAD). This
investigation aimed to evaluate the association of Lp(a) with long-term
bleeding among patients with CAD. Methods Based on a prospective
multicenter cohort of patients with CAD consecutively enrolled from
January 2015 to May 2019 in China, the current analysis included 16,150
participants. Thus, according to Lp(a) quintiles, all subjects were
divided into five groups. The primary endpoint was bleeding at 2-year
follow-up, and the secondary endpoint was major bleeding at 2-year
follow-up. Copyright © 2023. The Author(s).

<34>
Accession Number
2025910294
Title
Right heart catheterization in clinical practice: a review of basic
physiology and important issues relevant to interpretation.
Source
American Journal of Cardiovascular Disease. 13(3) (pp 122-137), 2023. Date
of Publication: 2023.
Author
Rio-Pertuz G.D.; Nugent K.; Argueta-Sosa E.
Institution
(Rio-Pertuz) Department of Internal Medicine, Texas Tech University Health
Sciences Center, Lubbock, TX 79430, United States
(Nugent) Division of Pulmonary and Critical Care Medicine, Texas Tech
University Health Sciences Center, Lubbock, TX 79430, United States
(Argueta-Sosa) Division of Cardiology, Department of Internal Medicine,
Texas Tech University Health Sciences Center, Lubbock, TX 79430, United
States
Publisher
E-Century Publishing Corporation
Abstract
Pulmonary artery catheterization is a diagnostic procedure in which a
catheter is inserted through a central vein and advanced toward the
pulmonary artery to measure right atrial, right ventricular, and pulmonary
artery pressures, estimate cardiac output, identify intracardiac shunts,
and measure pulmonary vascular resistance. Hemodynamic measurements can
provide a better understanding of the pathophysiology of heart failure and
pulmonary hypertension, but their proper assessment and optimal use can be
challenging due to differences in techniques that can lead to differences
in conclusions and therapeutic management strategies. In this review, we
will discuss right heart catheterization and its role in clinical practice
(e.g., shunt evaluation, management of cardiogenic shock) and summarize
important concerns related to measurement and
interpretation. Copyright © 2023, E-Century Publishing
Corporation. All rights reserved.

<35>
Accession Number
2030473406
Title
Infective endocarditis associated with left atrial appendage occlusion
device: a contemporary systematic review.
Source
Journal of Interventional Cardiac Electrophysiology. (no pagination),
2024. Date of Publication: 2024.
Author
Sanchez-Nadales A.; Iddrisu M.; Wardak R.; Arriola G.M.; Baez-Escudero J.;
Xu B.
Institution
(Sanchez-Nadales, Arriola) Department of Cardiology, Department of
Cardiovascular Disease, Cleveland Clinic Florida, Weston Campus, Weston,
FL 33324, United States
(Iddrisu) Department of Internal Medicine, Advocate Illinois Masonic
Medical Center, Chicago, IL 60657, United States
(Wardak) Department of Internal Medicine, Cleveland Clinic Florida,
Weston, FL 33321, United States
(Baez-Escudero) Department of Cardiac Pacing and Electrophysiology,
Department of Cardiovascular Disease, Cleveland Clinic Florida, Weston
Campus, Weston, FL 33324, United States
(Xu) Section of Cardiovascular Imaging, Robert and Suzanne Tomsich
Department of Cardiovascular Medicine, Sydell and Arnold Miller Family
Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, OH
44195, United States
Publisher
Springer
Abstract
Background: Data are limited regarding infective endocarditis (IE)
complicating left atrial appendage occlusion (LAAO) device procedures.
This systematic review examines the etiology, diagnosis, and management of
infective endocarditis (IE) following LAAO. Method(s): A
comprehensive search of six databases was performed between 2007 and 2022.
In selecting studies, articles were included if they provided information
about IE complicating LAAO, with relevant clinical and imaging details.
Articles were excluded if they were editorials, study protocols, letters,
or abstracts. Result(s): We identified seven cases of IE complicating
LAAO published between 2007 and 2022, from the United States and Europe,
highlighting the exceedingly rare reported incidence of the condition.
Staphylococcus aureus is the predominant organism implicated in LAAO
infections. Echocardiography is a key imaging modality for diagnosing LAAO
IE. Both antibiotic therapy and surgical intervention in appropriate
patients are important for managing LAAO device-related IE.
 Conclusion(s): The limited data in the current literature regarding
LAAO IE underscores the need for prospective clinical trials to establish
evidence-based guidelines for infection prophylaxis, diagnosis, and
management. Our findings emphasize the importance of vigilance for
device-related infections, especially as the use of LAAO devices continues
to grow worldwide. Copyright © The Author(s), under exclusive
licence to Springer Science+Business Media, LLC, part of Springer Nature
2024.

<36>
Accession Number
2030463495
Title
Evaluation of the effect of empagliflozin on prevention of atrial
fibrillation after coronary artery bypass grafting: a double-blind,
randomized, placebo-controlled trial.
Source
Naunyn-Schmiedeberg's Archives of Pharmacology. (no pagination), 2024.
Date of Publication: 2024.
Author
Zarei B.; Fazli B.; Tayyebi M.; Abbasi Teshnizi M.; Moeinipour A.;
Javedanfar O.; Javidi Dasht Bayaz R.; Rahmati M.; Ghavami V.; Amini S.;
Mohammadpour A.H.
Institution
(Zarei, Mohammadpour) Department of Clinical Pharmacy, School of Pharmacy,
Mashhad University of Medical Sciences, Mashhad, Iran, Islamic Republic of
(Fazli) Department of Anesthesiology, Mashhad University of Medical
Sciences, Mashhad, Iran, Islamic Republic of
(Tayyebi) Interventional Cardiac Electrophysiologist, Department of
Cardiovascular Diseases, Faculty of Medicine, Mashhad University of
Medical Sciences, Mashhad, Iran, Islamic Republic of
(Abbasi Teshnizi, Moeinipour, Javedanfar) Department of Cardiac Surgery,
Mashhad University of Medical Sciences, Mashhad, Iran, Islamic Republic of
(Javidi Dasht Bayaz, Rahmati) Vascular and Endovascular Surgery Research
Center, Faculty of Medicine, Mashhad University of Medical Sciences,
Mashhad, Iran, Islamic Republic of
(Ghavami) Department of Biostatistics, Social Determinants of Health
Research Center, Mashhad University of Medical Sciences, Mashhad, Iran,
Islamic Republic of
(Amini) Department of Anesthesia, School of Medicine, Mashhad University
of Medical Sciences, Mashhad, Iran, Islamic Republic of
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
This study is aimed at evaluating the effect of empagliflozin in
preventing atrial fibrillation after coronary artery bypass grafting
(CABG). Eighty-two patients who fulfilled the inclusion criteria were
allocated to the empagliflozin group (n = 43) or placebo group (n = 39).
In two groups, patients received empagliflozin or placebo tablets 3 days
before surgery and on the first three postoperative days (for 6 days) in
addition to the standard regimen during hospitalization. During the first
3 days after surgery, types of arrhythmias after cardiac surgery,
including supraventricular arrhythmias, especially postoperative atrial
fibrillation (POAF), ventricular arrhythmias, and heart blocks, were
assessed by electrocardiogram monitoring. C-reactive protein (CRP) levels
were evaluated pre-operatively and postoperative on the third day. The
incidence of POAF in the treatment group was lower compared to the control
group; however, this reduction was statistically non-significant (p =
0.09). The frequency of ventricular tachycardia was reduced significantly
in the treatment group versus patients in the control (p = 0.02). Also, a
significant reduction in the frequency of premature ventricular
contractions (PVCs) was seen in the treatment group in comparison with the
control group (p = 0.001). After the intervention, CRP levels were
significantly less in the empagliflozin group compared to the control
group in the third postoperative day (p = 0.04). The prophylactic use of
empagliflozin effectively reduced the incidence of ventricular arrhythmia
in patients undergoing CABG surgery. Copyright © The Author(s),
under exclusive licence to Springer-Verlag GmbH Germany, part of Springer
Nature 2024.

<37>
Accession Number
2028818515
Title
The role of beta-adrenergic receptors in the regulation of cardiac
tolerance to ischemia/reperfusion. Why do beta-adrenergic receptor
agonists and antagonists protect the heart?.
Source
Fundamental and Clinical Pharmacology. 38(4) (pp 658-673), 2024. Date of
Publication: August 2024.
Author
Maslov L.N.; Naryzhnaya N.V.; Voronkov N.S.; Kurbatov B.K.; Derkachev
I.A.; Ryabov V.V.; Vyshlov E.V.; Kolpakov V.V.; Tomilova E.A.;
Sapozhenkova E.V.; Singh N.; Fu F.; Pei J.
Institution
(Maslov, Naryzhnaya, Voronkov, Kurbatov, Derkachev, Ryabov, Vyshlov)
Cardiology Research Institute, Tomsk National Research Medical Centre,
Russian Academy of Sciences, Tomsk, Russian Federation
(Kolpakov, Tomilova, Sapozhenkova) Tyumen State Medical University,
Tyumen, Russian Federation
(Singh) Department of Pharmaceutical Sciences and Drug Research, Punjabi
University, Patiala, India
(Fu, Pei) Department of Physiology and Pathophysiology, National Key
Discipline of Cell Biology, School of Basic Medicine, Fourth Military
Medical University, Xi'an, China
Publisher
John Wiley and Sons Inc
Abstract
Background: Catecholamines and beta-adrenergic receptors (beta-ARs) play
an important role in the regulation of cardiac tolerance to the impact of
ischemia and reperfusion. This systematic review analyzed the molecular
mechanisms of the cardioprotective activity of beta-AR ligands.
 Method(s): We performed an electronic search of topical articles
using PubMed databases from 1966 to 2023. We cited original in vitro and
in vivo studies and review articles that documented the cardioprotective
properties of beta-AR agonists and antagonists. Result(s): The
infarct-reducing effect of beta-AR antagonists did not depend on a
decrease in the heart rate. The target for beta-blockers is not only
cardiomyocytes but also neutrophils. beta1-blockers (metoprolol,
propranolol, timolol) and the selective beta2-AR agonist arformoterol have
an infarct-reducing effect in coronary artery occlusion (CAO) in animals.
Antagonists of beta1- and beta2-AR (metoprolol, propranolol, nadolol,
carvedilol, bisoprolol, esmolol) are able to prevent reperfusion cardiac
injury. All beta-AR ligands that reduced infarct size are the selective or
nonselective beta1-blockers. It was hypothesized that beta1-AR blocking
promotes an increase in cardiac tolerance to I/R. The activation of
beta1-AR, beta2-AR, and beta3-AR can increase cardiac tolerance to I/R.
The cardioprotective effect of beta-AR agonists is mediated via the
activation of kinases and reactive oxygen species production.
 Conclusion(s): It is unclear why beta-blockers with the similar
receptor selectivity have the infarct-sparing effect while other
beta-blockers with the same selectivity do not affect infarct size. What
is the molecular mechanism of the infarct-reducing effect of beta-blockers
in reperfusion? Why did in early studies beta-blockers decrease the
mortality rate in patients with acute myocardial infarction (AMI) and
without reperfusion and in more recent studies beta-blockers had no effect
on the mortality rate in patients with AMI and reperfusion? The creation
of more effective beta-AR ligands depends on the answers to these
questions. Copyright © 2024 Societe Francaise de Pharmacologie et
de Therapeutique. Published by John Wiley & Sons Ltd.

<38>
Accession Number
2033144842
Title
Effects of Dexmedetomidine on Perioperative Glycemic Control in Adult
Diabetic Patients Undergoing Cardiac Surgery.
Source
Annals of Cardiac Anaesthesia. 27(3) (pp 228-234), 2024. Date of
Publication: 2024.
Author
Panidapu N.; Babu S.; Gadhinglajkar S.V.; Thomas D.; Aspari A.M.; Sen B.
Institution
(Panidapu, Sen) Department of Cardiac Anesthesia, Amrita Institute of
Medical Sciences, Kerala, Kochi, India
(Babu, Gadhinglajkar, Thomas, Aspari) Division of Cardiothoracic and
Vascular Anesthesia, Sree Chitra Tirunal Institute for Medical Sciences
and Technology, Kerala, Trivandrum, India
Publisher
Wolters Kluwer Medknow Publications
Abstract
Background and Objective: To study the effects of dexmedetomidine (DEX) on
perioperative blood glucose levels in adult diabetes mellitus (DM)
patients undergoing cardiac surgery. Methods and Material: A prospective,
observational study was conducted on 100 adult diabetic patients aged
between 18 and 75 years undergoing cardiac surgery with cardiopulmonary
bypass (CPB). The patients were divided into two groups (group D and group
C) of 50 each. Group D patients received DEX infusion, whereas the group C
patients received 0.9% normal saline infusion. Result(s): The blood
glucose levels, heart rate, mean arterial pressure, and serum potassium
levels at different time points were comparable between the two groups (P
> 0.05). The mean dose of insulin required in the combined population as
well as in both controlled and uncontrolled DM patients was significantly
less in group D than in group C (combined population - 36.03 +/- 22.71 vs
47.82 +/- 30.19 IU, P = 0.0297; uncontrolled DM - 37.36 +/- 23.9 IU vs
48.16 +/- 25.15 IU, P = 0.0301; controlled DM - 34.7 +/- 21.5 IU vs 47.63
+/- 35.25 IU, P = 0.0291). Duration of mechanical ventilation and VIS were
comparable between the two groups. The incidence of arrhythmias (20% vs
46%, P = 0.0059) and delirium (6% vs 20%, P = 0.0384) was significantly
less in group D than in group C. None of the patients in either group had
stroke, myocardial ischemia, and mortality. Conclusion(s): The
results suggested that DEX infusion during the intraoperative period was
very effective for perioperative glycemic control and reduction of insulin
requirement in DM patients undergoing cardiac surgery. Copyright
© 2024 Annals of Cardiac Anaesthesia.

<39>
Accession Number
2033144838
Title
Effectiveness of Erector Spinae Plane Block as Perioperative Analgesia in
Midline Sternotomies: A Systematic Review and Meta-Analysis of Randomized
Controlled Trials.
Source
Annals of Cardiac Anaesthesia. 27(3) (pp 193-201), 2024. Date of
Publication: 2024.
Author
Patel N.; Fayed M.; Maroun W.; Milad H.; Adlaka K.; Schultz L.; Aiyer R.;
Forrest P.; Mitchell J.D.
Institution
(Patel) Department of Anesthesiology and Pain Medicine, Massachusetts
General Hospital, Boston, MA, United States
(Fayed) Department of Anesthesiology and Pain Medicine, Montefiore Medical
Center, Bronx, NY, United States
(Maroun, Schultz, Forrest, Mitchell) Department of Anesthesiology and Pain
Medicine, Henry Ford Health, Fullerton, Detroit, MI, United States
(Milad, Adlaka) Wayne State University, School of Medicine, Fullerton,
Detroit, MI, United States
(Aiyer) Westside Pain Management, Long Beach, CA, United States
Publisher
Wolters Kluwer Medknow Publications
Abstract
With the advancements in regional anesthesia and ultrasound techniques,
the use of non-neuraxial blocks like the erector spinae plane block (ESPB)
has been increasing in cardiac surgeries with promising outcomes. A total
of 3,264 articles were identified through a literature search.
Intervention was defined as ESPB. Comparators were no regional technique
performed or sham blocks. Four studies with a total of 226 patients were
included. Postoperative opioid consumption was lower in the group that
received ESPB than the group that did not (weighted mean difference [WMD]:
-204.08; 95% CI: -239.98 to -168.19; P < 0.00001). Intraoperative opioid
consumption did not differ between the two groups (WMD: -398.14; 95% CI:
-812.17 to 15.98; P = 0.06). Pain scores at 0 hours were lower in the
group that received ESPB than the group that did not (WMD: -1.27; 95% CI:
-1.99 to -0.56; P = 0.0005). Pain scores did not differ between the two
groups at 4-6 hours (WMD: -0.79; 95% CI: -1.70 to 0.13; P = 0.09) and 12
hours (WMD: -0.83; 95% CI: -1.82 to 0.16; P = 0.10). Duration of
mechanical ventilation in minutes was lower in the group that received
ESPB than the group that did not (WMD: -45.12; 95% CI: -68.82 to -21.43; P
= 0.0002). Given the limited number of studies and the substantial
heterogeneity of measured outcomes and interventions, further studies are
required to assess the benefit of ESPB in midline
sternotomies. Copyright © 2024 Annals of Cardiac Anaesthesia.

<40>
Accession Number
2033099780
Title
Effects of Balanced Versus Saline-based Solutions on Acute Kidney Injury
in Off-pump Coronary Artery Bypass Surgery: A Randomized Controlled Trial.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2024.
Date of Publication: 2024.
Author
Nam J.-S.; Kim W.-J.; Seo W.-W.; Lee S.-W.; Joung K.-W.; Chin J.-H.; Choi
D.-K.; Choi I.-C.
Institution
(Nam, Kim, Seo, Lee, Joung, Chin, Choi, Choi) Department of Anesthesiology
and Pain Medicine, Asan Medical Center, University of Ulsan College of
Medicine, Seoul, South Korea
Publisher
W.B. Saunders
Abstract
Objectives: To determine whether balanced solutions can reduce the
incidence of acute kidney injury after off-pump coronary artery bypass
surgery compared with saline. Design(s): Randomized controlled trial.
 Setting(s): Single tertiary care center. Participant(s):
Patients who underwent off-pump coronary artery bypass surgery between
June 2014 and July 2020. Intervention(s): Balanced solution-based
chloride-restrictive intravenous fluid strategy. Measurements and
Main Results: The primary outcome was acute kidney injury within 7
postoperative days, as defined by the 2012 Kidney Disease: Improving
Global Outcomes Clinical Practice Guideline. The incidence of acute kidney
injury was 4.4% (8/180) in the balanced group and 7.3% (13/178) in the
saline group. The difference was not statistically significant (risk
difference, -2.86%; 95% confidence interval [CI], -7.72% to 2.01%; risk
ratio, 0.61, 95% CI, 0.26 to 1.43; p = 0.35). Compared with the balanced
group, the saline group had higher levels of intraoperative serum chloride
and lower base excess, which resulted in a lower pH. Conclusion(s):
In patients undergoing off-pump bypass surgery with a normal estimated
glomerular filtration rate, the intraoperative balanced solution-based
chloride-restrictive intravenous fluid administration strategy did not
decrease the rate of postoperative acute kidney injury compared with the
saline-based chloride-liberal intravenous fluid administration
strategy. Copyright © 2024 Elsevier Inc.

<41>
Accession Number
2033166242
Title
Comparison of the effect of telephone follow-up with social network
follow-up program on self-efficacy and depression in patients undergoing
coronary artery bypass graft surgery: A randomized controlled trial.
Source
Internet Interventions. 37 (no pagination), 2024. Article Number: 100757.
Date of Publication: September 2024.
Author
Hassanzadeh A.; Baharestani B.; Dizaji N.N.; Shabani F.; Fathollahi M.S.;
Goli R.; Kouhpayeh M.S.
Institution
(Hassanzadeh, Shabani) Department of Nursing, School of Nursing and
Midwifery, Tehran University of Medical Sciences, Tehran, Iran, Islamic
Republic of
(Dizaji, Goli) Department of nursing, School of Nursing and Midwifery,
Urmia University of Medical Sciences, Urmia, Iran, Islamic Republic of
(Kouhpayeh) Department of Nursing, School of Nursing and Midwifery, Jiroft
University of Medical Sciences, Kerman, Iran, Islamic Republic of
(Hassanzadeh, Baharestani, Shabani) Cardiovascular Research Center, Rajaie
Cardiovascular Medical and Research Center, Iran University of Medical
Sciences, Tehran, Iran, Islamic Republic of
(Fathollahi) Department of Epidemiology and Biostatistics, Faculty of
Medicine, Rajaie Cardiovascular, Medical and Research Center, Iran
University of Medical Sciences, Tehran, Iran, Islamic Republic of
Publisher
Elsevier B.V.
Abstract
Introduction: Coronary artery bypass graft (CABG) surgery is a common
procedure to improve blood flow to the heart muscles, but patients often
face challenges during the recovery period. Self-efficacy and depression
play crucial roles in patient outcomes. Telephone follow-up and social
network follow-up have been introduced as interventions to enhance
self-efficacy. This study aims to compare the effectiveness of telephone
follow-up and social network follow-up on self-efficacy and depression in
CABG patients. Method(s): The study is a single-blinded, randomized
controlled trial conducted at Shahid Rajaee Heart Hospital in Tehran,
Iran. The sample size was determined to be 99 patients who met the
inclusion criteria. Data were collected using a demographic questionnaire,
Sullivan's cardiac self-efficacy questionnaire, and the Beck Depression
Inventory (BDI). Participants were assigned to three groups: control,
telephone follow-up, and WhatsApp follow-up using randomization. Data were
analyzed using IBM SPSS Statistics for Windows, version 25 (IBM Corp.,
Armonk, N.Y., USA). Result(s): The results revealed significant
improvements in self-efficacy and reductions in depression scores for both
the telephone and WhatsApp follow-up groups compared to the control group
following the intervention (p < 0.001). Additionally, the mean
self-efficacy score was higher and the mean depression score was lower in
the WhatsApp follow-up group than in the telephone follow-up group after
the intervention (p < 0.001). Discussion(s): The findings provide
valuable insights for healthcare professionals in choosing appropriate
interventions to enhance patients' self-efficacy levels and improve mental
health outcomes. Both telephone follow-up and social network follow-up
interventions have their own advantages and can be effective in supporting
patients' recovery after CABG surgery. Copyright © 2024 The
Author(s)

<42>
Accession Number
2033192240
Title
Preoperative Nonselective Chest Computed Tomography Prior to Primary
Cardiac Surgery Results in Meaningful Change to Surgical Management:
Systematic Review and Pooled Prevalence Meta-Analysis.
Source
Heart Lung and Circulation. (no pagination), 2024. Date of Publication:
2024.
Author
Indja B.; Chang J.; Flynn C.D.; Vallely M.
Institution
(Indja, Chang, Flynn, Vallely) Department of Cardiothoracic Surgery, St
George Hospital, Kogarah, NSW, Australia
(Vallely) Department of Cardiothoracic Surgery, Macquarie University
Hospital, Macquarie University, NSW, Australia
Publisher
Elsevier Ltd
Abstract
Background: Routine screening chest computed tomography (CT) prior to
primary cardiac surgery is advocated by some surgeons due to the purported
benefits of identifying significant aortic calcification that impacts
ongoing management, such as performing anaortic off-pump surgery or
adjusting cannulation strategy. Additionally, axial imaging can identify
incidental findings that may require concomitant or staged procedures such
as ascending aortic dilatation or pulmonary lesions. The objective of this
study was to quantify the impact that nonselective chest CT prior to
primary cardiac surgery had on subsequent management. Method(s): A
systematic review and pooled prevalence meta-analyses were performed in
accordance with Preferred Reporting Items for Systematic Reviews and
Meta-analyses guidelines. Included studies performed non-selective chest
CT prior to primary cardiac surgery. Result(s): A total of eight
studies, including 2,250 patients were included. The rate of mortality and
stroke was low (1% and 2%, respectively). Calcification of the ascending
aorta was identified in 15% of patients (95% confidence interval [CI]
5.0-26.0). A significant change to the surgical plan such as cannulation
strategy, off-pump surgery, cancellation, or an additional procedure was
required in 7% (95% CI 2.0-12.0). Clinically relevant incidental findings
requiring in-patient management or follow-up were identified in 10% (95%
CI 6.0-14.0). Conclusion(s): Nonselective CT chest prior to primary
cardiac surgery identifies clinically relevant findings that result in a
modification of the surgical plan in a significant population of patients
to address the risk of stroke associated with aortic calcification as well
as the identification of important incidental findings such as pulmonary
lesions. Copyright © 2024 Australian and New Zealand Society of
Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of
Australia and New Zealand (CSANZ)

<43>
Accession Number
2033192060
Title
Concomitant Tricuspid Valve Ring Annuloplasty During Mitral Valve Surgery
Versus Mitral Valve Surgery Alone: A Systematic Review and Meta-Analysis.
Source
Heart Lung and Circulation. (no pagination), 2024. Date of Publication:
2024.
Author
Poon S.S.; Chan J.; Ahmed Y.; Aslam U.; Cianci V.; Sharma S.; Kumar P.
Institution
(Poon, Ahmed, Aslam, Cianci, Sharma, Kumar) Department of Cardiothoracic
Surgery, Morriston Hospital, Wales, Swansea, United Kingdom
(Chan) Department of Cardiothoracic Surgery, Bristol Royal Infirmary,
Bristol, United Kingdom
Publisher
Elsevier Ltd
Abstract
Aim: Although current guidelines recommend concomitant tricuspid
annuloplasty for moderate or greater tricuspid regurgitation (TR) and/or
dilated annulus, there remains significant variation in undertaking
concomitant tricuspid valve surgery (TVA) across different centres. This
meta-analysis aimed to compare the clinical outcomes of concomitant
tricuspid valve surgery for patients with moderate or greater TR and/or
dilated annulus at the time of mitral valve (MV) surgery. Method(s):
A systematic review of the literature using six databases. Eligible
studies include comparative studies on TVA concomitant with MV surgery
versus MV surgery alone. A meta-analysis was performed on studies
reporting outcomes of interest to quantify the effects of concomitant
tricuspid ring annuloplasty. Result(s): Two randomised controlled
trials and six cohort studies were included in the analysis. 1,941
patients were included in the analysis, of whom, 1,090 underwent
concomitant TVA and 851 underwent MV surgery alone. Pooled analysis
demonstrated that there was less progression of moderate/severe TR in the
concomitant group (3.0% vs 9.6%; odds ratio [OR] 0.29; 95% confidence
interval [CI] 0.13-0.55; p=0.0001). There was no significant difference in
in-hospital mortality (3.0% vs 3.8%; OR 0.79; 95% CI 0.47-1.34; p=0.38).
The rate of permanent pacemaker implantation was higher in the concomitant
group although this did not reach statistical significance (7.6% vs 5.3%;
OR 1.30; 95% CI 0.85-1.98; p=0.23). Cardiopulmonary bypass was longer in
the concomitant TVA group by 20 minutes (mean difference 13.9-26.0;
p<0.00001). Conclusion(s): Our study demonstrated that concomitant
tricuspid ring annuloplasty at the time of MV surgery is associated with a
significantly lower rate of TR progression without increasing the
operative mortality. There is a trend towards a higher permanent pacemaker
implantation rate although this did not reach statistical
significance. Copyright © 2024

<44>
Accession Number
2033175162
Title
Continuous Glucose Monitoring and the Effect of Liraglutide in Cardiac
Surgery Patients: A Substudy of the Randomized Controlled GLOBE Trial.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2024.
Date of Publication: 2024.
Author
Oosterom-Eijmael M.J.P.; Hermanides J.; van Raalte D.H.; Kouw I.W.K.;
DeVries J.H.; Hulst A.H.
Institution
(Oosterom-Eijmael, Hermanides, Hulst) Department of Anesthesiology,
Amsterdam University Medical Center, Amsterdam, Netherlands
(Oosterom-Eijmael, van Raalte, DeVries) Department of Endocrinology,
Amsterdam University Medical Center, Amsterdam, Netherlands
(Oosterom-Eijmael, van Raalte, Hulst) Amsterdam Cardiovascular Sciences
Research Institute, Amsterdam, Netherlands
(Hermanides) Amsterdam Public Health Research Institute, Amsterdam,
Netherlands
(Kouw) Department of Intensive Care Medicine, Intensive Care Research,
Gelderse Vallei Hospital, Ede, Netherlands
(Kouw) Wageningen University & Research, Division of Human Nutrition and
Health, Wageningen, Netherlands
(DeVries, Hulst) Amsterdam Gastroenterology Endocrinology Metabolism,
Amsterdam, Netherlands
Publisher
W.B. Saunders
Abstract
Objectives: The objectives of the current research were to evaluate the
accuracy and reliability of continuous glucose monitoring (CGM) in
patients undergoing cardiac surgery and assess the impact of preoperative
liraglutide administration on perioperative glucose control as captured by
CGM. Design(s): This was a prospective, single-center, prespecified
analysis of the GLOBE trial, a randomized controlled trial comparing
preoperative liraglutide treatment to placebo in patients undergoing
cardiac surgery. Setting(s): The work took place at a single-center
academic hospital in the Netherlands. Participant(s): Twenty-five
patients undergoing cardiac surgery were recruited from the hospital's
cardiac surgery department. Intervention(s): Participants received
the Dexcom G5 CGM system from the day before surgery until discharge from
the intensive care unit after surgery. Additionally, participants were
randomized to receive either preoperative liraglutide or placebo.
 Measurements and Main Results: Arterial blood gas (ABG) glucose
measurements were collected as a reference and matched to CGM readings to
assess accuracy and reliability. In 240 paired CGM-ABG glucose
measurements, the mean absolute relative difference was 14.4 +/- 12.5%.
Temporary sensor interruption occurred mainly intraoperatively (92% of
patients). The median duration of intraoperative sensor interruption was
65 (48-95) minutes. Liraglutide increased glycemic time in range 72%
versus 47% in the control group (absolute difference 25%, 95% confidence
interval -41.4 to -8.9, p =.004). Conclusion(s): Despite
intraoperative sensor interruption, CGM seems an accurate method for
semi-invasive, real-time assessment of blood glucose levels. CGM can
provide a detailed observation of the pre- and postoperative glycemic
trajectory, demonstrating increased time in range following perioperative
liraglutide treatment compared with placebo. Copyright © 2024 The
Author(s)

<45>
Accession Number
644683368
Title
Impact of minimal invasive extracorporeal circulation on systemic
inflammatory response - a randomized trial.
Source
Journal of cardiothoracic surgery. 19(1) (pp 418), 2024. Date of
Publication: 03 Jul 2024.
Author
Halle D.R.; Benhassen L.L.; Soberg K.L.; Nielsen P.F.; Kimose H.-H.; Bauer
A.; Hasenkam J.M.; Modrau I.S.
Institution
(Halle, Benhassen, Soberg, Nielsen, Kimose, Hasenkam, Modrau) Department
of Cardiothoracic and Vascular Surgery, Aarhus University Hospital, Aarhus
N, Palle Juul-Jensens Boulevard 99 8200, Denmark
(Benhassen, Kimose, Hasenkam, Modrau) Department of Clinical Medicine,
Aarhus University, Aarhus, Denmark
(Bauer) Dept. of Cardiovascular Perfusion, MediClin Heart Centre Coswig,
Coswig, Germany
Abstract
BACKGROUND: Extracorporeal circulation causes a systemic inflammatory
response, that may cause postoperative haemodynamic instability and
end-organ dysfunction. This study aimed to investigate the impact of
minimal invasive extracorporeal circulation (MiECC) on the systemic
inflammatory response compared with conventional extracorporeal
circulation (CECC). METHOD(S): Patients undergoing coronary artery
bypass grafting were randomized to MiECC (n=30) and CECC (n=30). Primary
endpoint was tumor necrosis factor-alpha. Secondary endpoints were other
biochemical markers of inflammation (IL1beta, IL6 and IL8, C-reactive
protein, leukocytes), and markers of inadequate tissue perfusion and
tissue damage (lactate dehydrogenase, lactate and creatine kinase-MB). In
addition, we registered signs of systemic inflammatory response syndrome,
haemodynamic instability, atrial fibrillation, respiratory dysfunction,
and infection. RESULT(S): Patients treated with MiECC showed
significantly lower levels of tumor necrosis factor-alpha than CECC during
and early after extracorporeal circulation (median: MiECC 3.4 pg/mL; CI
2.2-4.5 vs. CECC 4.6 pg/mL; CI 3.4-5.6; p=0.01). Lower levels of creatine
kinase-MB and lactate dehydrogenase suggested less tissue damage. However,
we detected no other significant differences in any other markers of
inflammation, tissue damage or in any of the clinical outcomes.
 CONCLUSION(S): Lower levels of TNF-alpha after MiECC compared with
CECC may reflect reduced inflammatory response, although other biochemical
markers of inflammation were comparable. Our results suggest better
end-organ protection with MiECC compared with CECC. Clinical parameters
related to systemic inflammatory response were comparable in this study.
CLINICAL REGISTRATION NUMBER: NCT03216720. Copyright © 2024. The
Author(s).

<46>
Accession Number
644681022
Title
Preoperative coronary interventions for preventing acute myocardial
infarction in the perioperative period of major open vascular or
endovascular surgery.
Source
The Cochrane database of systematic reviews. 7 (pp CD014920), 2024. Date
of Publication: 03 Jul 2024.
Author
Botelho F.E.; Flumignan R.L.; Shiomatsu G.Y.; de Castro-Santos G.; Cacione
D.G.; Leite J.O.; Baptista-Silva J.C.
Institution
(Botelho, Shiomatsu, de Castro-Santos) Department of Surgery, Universidade
Federal de Minas Gerais (UFMG), Belo Horizonte, Minas Gerais, Brazil
(Flumignan, Cacione, Baptista-Silva) Department of Surgery, Division of
Vascular and Endovascular Surgery, Universidade Federal de Sao Paulo, Sao
Paulo, Brazil
(Flumignan, Baptista-Silva) Universidade Federal de Sao Paulo, Sao Paulo,
Brazil
(Leite) Department of Surgery, University of Cincinnati, Cincinnati, OH,
United States
Abstract
BACKGROUND: Postoperative myocardial infarction (POMI) is associated with
major surgeries and remains the leading cause of mortality and morbidity
in people undergoing vascular surgery, with an incidence rate ranging from
5% to 20%. Preoperative coronary interventions, such as coronary artery
bypass grafting (CABG) or percutaneous coronary interventions (PCI), may
help prevent acute myocardial infarction in the perioperative period of
major vascular surgery when used in addition to routine perioperative
drugs (e.g. statins, angiotensin-converting enzyme inhibitors, and
antiplatelet agents), CABG by creating new blood circulation routes that
bypass the blockages in the coronary vessels, and PCI by opening up
blocked blood vessels. There is currently uncertainty around the benefits
and harms of preoperative coronary interventions. OBJECTIVE(S): To
assess the effects of preoperative coronary interventions for preventing
acute myocardial infarction in the perioperative period of major open
vascular or endovascular surgery. SEARCH METHOD(S): We searched the
Cochrane Vascular Specialised Register, CENTRAL, MEDLINE Ovid, Embase
Ovid, LILACS, and CINAHL EBSCO on 13 March 2023. We also searched the
World Health Organization International Clinical Trials Registry Platform
and ClinicalTrials.gov. SELECTION CRITERIA: We included all randomised
controlled trials (RCTs) or quasi-RCTs that compared the use of
preoperative coronary interventions plus usual care versus usual care for
preventing acute myocardial infarction during major open vascular or
endovascular surgery. We included participants of any sex or any age
undergoing major open vascular surgery, major endovascular surgery, or
hybrid vascular surgery. DATA COLLECTION AND ANALYSIS: We used standard
Cochrane methods. Our primary outcomes of interest were acute myocardial
infarction, all-cause mortality, and adverse events resulting from
preoperative coronary interventions. Our secondary outcomes were
cardiovascular mortality, quality of life, vessel or graft secondary
patency, and length of hospital stay. We reported perioperative and
long-term outcomes (more than 30 days after intervention). We assessed the
certainty of the evidence using the GRADE approach. MAIN RESULTS: We
included three RCTs (1144 participants). Participants were randomised to
receive either preoperative coronary revascularisation with PCI or CABG
plus usual care or only usual care before major vascular surgery. One
trial enrolled participants if they had no apparent evidence of coronary
artery disease. Another trial selected participants classified as high
risk for coronary disease through preoperative clinical and laboratorial
testing. We excluded one trial from the meta-analysis because participants
from both the control and the intervention groups were eligible to undergo
preoperative coronary revascularisation. We identified a high risk of
performance bias in all included trials, with one trial displaying a high
risk of other bias. However, the risk of bias was either low or unclear in
other domains. We observed no difference between groups for perioperative
acute myocardial infarction, but the evidence is very uncertain (risk
ratio (RR) 0.28, 95% confidence interval (CI) 0.02 to 4.57; 2 trials, 888
participants; very low-certainty evidence). One trial showed a reduction
in incidence of long-term (> 30 days) acute myocardial infarction in
participants allocated to the preoperative coronary interventions plus
usual care group, but the evidence was very uncertain (RR 0.09, 95% CI
0.03 to 0.28; 1 trial, 426 participants; very low-certainty evidence).
There was little to no effect on all-cause mortality in the perioperative
period when comparing the preoperative coronary intervention plus usual
care group to usual care alone, but the evidence is very uncertain (RR
0.79, 95% CI 0.31 to 2.04; 2 trials, 888 participants; very low-certainty
evidence). The evidence is very uncertain about the effect of preoperative
coronary interventions on long-term (follow up: 2.7 to 6.2 years)
all-cause mortality (RR 0.74, 95% CI 0.30 to 1.80; 2 trials, 888
participants; very low-certainty evidence). One study reported no adverse
effects related to coronary angiography, whereas the other two studies
reported five deaths due to revascularisations. There may be no effect on
cardiovascular mortality when comparing preoperative coronary
revascularisation plus usual care to usual care in the short term (RR
0.07, 95% CI 0.00 to 1.32; 1 trial, 426 participants; low-certainty
evidence). Preoperative coronary interventions plus usual care in the
short term may reduce length of hospital stay slightly when compared to
usual care alone (mean difference -1.17 days, 95% CI -2.05 to -0.28; 1
trial, 462 participants; low-certainty evidence). We downgraded the
certainty of the evidence due to concerns about risk of bias, imprecision,
and inconsistency. None of the included trials reported on quality of life
or vessel graft patency at either time point, and no study reported on
adverse effects, cardiovascular mortality, or length of hospital stay at
long-term follow-up. AUTHORS' CONCLUSION(S): Preoperative coronary
interventions plus usual care may have little or no effect on preventing
perioperative acute myocardial infarction and reducing perioperative
all-cause mortality compared to usual care, but the evidence is very
uncertain. Similarly, limited, very low-certainty evidence shows that
preoperative coronary interventions may have little or no effect on
reducing long-term all-cause mortality. There is very low-certainty
evidence that preoperative coronary interventions plus usual care may
prevent long-term myocardial infarction, and low-certainty evidence that
they may reduce length of hospital stay slightly, but not cardiovascular
mortality in the short term, when compared to usual care alone. Adverse
effects of preoperative coronary interventions were poorly reported in
trials. Quality of life and vessel or graft patency were not reported. We
downgraded the certainty of the evidence most frequently for high risk of
bias, inconsistency, or imprecision. None of the analysed trials provided
significant data on subgroups of patients who could potentially experience
more substantial benefits from preoperative coronary intervention (e.g.
altered ventricular ejection fraction). There is a need for evidence from
larger and homogeneous RCTs to provide adequate statistical power to
assess the role of preoperative coronary interventions for preventing
acute myocardial infarction in the perioperative period of major open
vascular or endovascular surgery. Copyright © 2024 The Cochrane
Collaboration. Published by John Wiley & Sons, Ltd.

<47>
Accession Number
644678104
Title
Effects of perioperative magnesium on postoperative analgesia following
thoracic surgery: a meta-analysis of randomised controlled trials.
Source
Magnesium research. 36(4) (pp 54-68), 2024. Date of Publication: 01 Jun
2024.
Author
Hung K.-C.; Yang S.-H.; Liao S.-W.; Yu C.-H.; Liu M.-Y.; Chen J.-Y.
Institution
(Hung, Chen) School of Medicine, National Sun Yat-Sen University. No. 70
Lienhai Road, Kaohsiung 80424, Taiwan, Department of Anesthesiology, Chi
Mei Medical Center, Tainan 71004, Taiwan
(Yang) Department of Neurology, Chi Mei Medical Center, Tainan 71004,
Taiwan (Republic of China)
(Liao) Department of Anesthesiology, Chi Mei Medical Center, Tainan 71004,
Taiwan, Chia Nan University of Pharmacy and Science, Tainan 71710, Taiwan,
The center for General Education, Southern Taiwan University of Science
and Technology, Tainan 71004, Taiwan
(Yu) Department of Anesthesiology, Chi Mei Medical Center, Tainan 71004,
Taiwan (Republic of China)
(Liu) Department of Nutrition, Chi Mei Medical Center, Tainan 71004,
Taiwan, Department of Food Nutrition, Chung Hwa University of Medical
Technology, Tainan 71703, Taiwan
Abstract
To evaluate the analgesic effects of intravenous magnesium in patients
undergoing thoracic surgery. Randomised clinical trials (RCTs) were
systematically identified from MEDLINE, EMBASE, Google Scholar and the
Cochrane Library from inception to May 1st, 2023. The primary outcome was
the effect of intravenous magnesium on the severity of postoperative pain
at 24 hours following surgery, while the secondary outcomes included
association between intravenous magnesium and pain severity at other time
points, morphine consumption, and haemodynamic changes. Meta-analysis of
seven RCTs published between 2007 and 2019, involving 549 adults, showed
no correlation between magnesium and pain scores at 1-4 (standardized mean
difference [SMD]=-0.06; p=0.58), 8-12 (SMD=-0.09; p=0.58), 24 (SMD=-0.16;
p=0.42), and 48 (SMD=-0.27; p=0.09) hours post-surgery. Perioperative
magnesium resulted in lower equivalent morphine consumption at 24 hours
post-surgery (mean difference [MD]=-25.22 mg; p=0.04) and no effect at 48
hours (MD=-4.46 mg; p=0.19). Magnesium decreased heart rate (MD = -5.31
beats/min; p=0.0002) after tracheal intubation or after surgery, but had
no effect on postoperative blood pressure (MD=-6.25 mmHg; p=0.11). There
was a significantly higher concentration of magnesium in the magnesium
group compared with that in the placebo group (MD = 0.91 mg/dL;
p<0.00001). This meta-analysis provides evidence supporting perioperative
magnesium as an analgesic adjuvant at 24 hours following thoracic surgery,
but no opioid-sparing effect at 48 hours post-surgery. The severity of
postoperative pain did not significantly differ between any of the
postoperative time points, irrespective of magnesium. Further research on
perioperative magnesium in various surgical settings is needed.

<48>
Accession Number
644672042
Title
Erratum: Correction: Epicardial placement of human placental membrane
allografts in coronary artery bypass graft surgery is associated with
reduced postoperative atrial fibrillation: a pilot study for a future
multi-center randomized controlled trial (Journal of cardiothoracic
surgery (2024) 19 1 DOI: 10.1186/s13019-024-02822-8).
Source
Journal of cardiothoracic surgery. 19(1) (pp 410), 2024. Date of
Publication: 01 Jul 2024.
Author
Khalpey Z.; Kumar U.; Hitscherich P.; Aslam U.; Chnari E.; Long M.
Institution
(Khalpey, Kumar) Department of Cardiothoracic Surgery, Heart and Vascular
Institute, 10210 N 92nd St Suite 300, HonorHealth, Scottsdale, AZ 85258,
United States
(Kumar) Gonville & Caius College, University of Cambridge, Trinity Street,
Cambridge CB2 1TA, United Kingdom
(Hitscherich, Chnari, Long) MTF Biologics, 125 May Street, Edison, NJ
08837, United States
(Aslam) General Surgery Residency Program, HonorHealth, Phoenix, AZ 85250,
United States

<49>
Accession Number
2033144619
Title
Modelling years of life lost due to acute type A aortic dissection in the
German healthcare setting: A predictive study.
Source
BMJ Open. 14(6) (no pagination), 2024. Article Number: e078398. Date of
Publication: 25 Jun 2024.
Author
Schiele P.; Konig A.N.; Meyer A.; Falk V.; Nienaber C.A.; Kurz S.D.
Institution
(Schiele) Department of Statistics, Ludwig-Maximilians-Universitat
Munchen, Munchen, Germany
(Konig) Munich School of Management and Munich Center of Health Sciences,
Ludwig-Maximilians-Universitat Munchen, Munchen, Germany
(Meyer, Falk, Kurz) Department of Cardiothoracic and Vascular Surgery,
Deutsches Herzzentrum der Charite (DHZC), Berlin, Germany
(Meyer, Falk, Kurz) Charite-Universitatsmedizin Berlin, Corporate Member
of Freie Universitat Berlin, Humboldt-Universitat zu Berlin, Berlin
Institute of Health, Berlin, Germany
(Meyer, Falk) DZHK (German Centre for Cardiovascular Research), Partner
Site Berlin, Berlin, Germany
(Falk) Department of Health Sciences and Technology, ETH Zurich, Zurich,
Switzerland
(Nienaber) National Heart and Lung Institute, Imperial College London,
London, United Kingdom
(Nienaber) Cardiology and Aortic Centre, The Royal Brompton & Harefield
Hospitals As Part of Guys', St. Thomas' NHS Foundation Trust, London,
United Kingdom
Publisher
BMJ Publishing Group
Abstract
Objectives This study aimed to develop a patient-centred approach to the
burden of acute type A aortic dissection (ATAAD) through modelling. The
main objective was to identify potential improvements in managing this
life-threatening cardiovascular condition and to provide evidence-based
recommendations to optimise outcomes. Design We developed a predictive
model along patient pathways to estimate the burden of ATAAD through the
years of life lost (YLLs) metric. The model was created based on a
systematic review of the literature and was parameterised using
demographic data from the German healthcare environment. The model was
designed to allow interactive simulation of different scenarios resulting
from changes in key impact factors. Setting The study was conducted using
data from the German healthcare environment and results from the
literature review. Participants The study included a comprehensive
modelling of ATAAD cases in Germany but did not directly involve
participants. Interventions There were no specific interventions applied
in this study based on the modelling design. Primary and secondary outcome
measures The single outcome measure was the estimation of YLL due to ATAAD
in Germany. Results Our model estimated 102 791 YLL per year for ATAAD in
Germany, with 62 432 and 40 359 YLL for men and women, respectively.
Modelling an improved care setting yielded 93 191 YLL or 9.3% less YLL
compared with the current standard while a worst-case scenario resulted in
113 023 or 10.0% more YLL. The model is accessible at
https://acuteaorticdissection.com/ to estimate custom scenarios.
Conclusions Our study provides an evidence-based approach to estimating
the burden of ATAAD and identifying potential improvements in the
management of pathways. This approach can be used by healthcare
decision-makers to inform policy changes aimed at optimising patient
outcomes. By considering patient-centred approaches in any healthcare
environment, the model has the potential to improve efficient care for
patients suffering from ATAAD. Copyright © 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.

<50>
Accession Number
2033142624
Title
Comparative Profiles of the WATCHMANTM and AmplatzerTM Cardiac
Plug/AmplatzerTM AmuletTM Devices for Left Atrial Appendage Closure in
Non-valvular Atrial Fibrillation: A Comprehensive Systematic Review and
Meta-analysis.
Source
Journal of Innovations in Cardiac Rhythm Management. 15(6) (pp 5917-5929),
2024. Date of Publication: June 2024.
Author
Raja F.; Rani K.; Kumar S.; Someshwar F.; Khan M.A.N.; Abubakar F.; Bhatt
D.; Subedi D.J.; Shadmani S.; Abdullah F.T.Z.
Institution
(Raja) Department of Internal Medicine, Federal Medical and Dental
College, Islamabad, Pakistan
(Rani) Department of Internal Medicine, Chandka Medical College SMBBMU,
Larkana, Pakistan
(Kumar, Someshwar) Department of Internal Medicine, Liaquat National
Hospital and Medical College, Karachi, Pakistan
(Khan, Abubakar) Department of Internal Medicine, King Edward Medical
University, Lahore, Pakistan
(Bhatt) Department of Internal Medicine, American University of Barbados,
Bridgetown, Barbados
(Subedi) Department of Internal Medicine, College of Medical Sciences,
Bharatpur, Nepal
(Shadmani) Department of Internal Medicine, Shaheed Mohtarma Benazir
Bhutto Medical College, Karachi, Pakistan
(Abdullah) Department of Internal Medicine, Allama Iqbal Medical College,
Lahore, Pakistan
Publisher
MediaSphere Medical LLC
Abstract
Atrial fibrillation (AF) is a prevalent cardiac arrhythmia marked by
irregular and frequent tachycardic rhythms in the atria, affecting 1%-2%
of the general population. The WATCHMANTM device from Boston Scientific
(Marlborough, MA, USA) and the AmplatzerTM AmuletTM device from Abbott
(Chicago, IL, USA) are two devices used globally for left atrial appendage
closure (LAAC) in non-valvular AF. A systematic search was conducted in
PubMed, the Cochrane Library, and Elsevier's ScienceDirect literature
databases to identify studies comparing the WATCHMANTM procedure with
AmuletTM device implantation for LAAC in patients with AF. The analyses
were conducted using the random-effects model. A total of 20 studies were
identified, with 18 falling into the category of observational studies and
2 being randomized controlled trials. A total of 6310 participants were
included in this meta-analysis, with 3198 individuals (50.68%) assigned to
the WATCHMANTM procedure group and 3112 individuals (49.32%) allocated to
the AmplatzerTM Cardiac Plug (ACP) group. The analysis revealed a higher
risk of stroke associated with the WATCHMANTM technique (relative risk
[RR], 1.14), albeit without statistical significance. Conversely, the
WATCHMANTM approach led to a significantly lower risk of cardiac death
(RR, 0.44; P = .04). Notably, the risks of all-cause mortality (RR, 0.89;
95% confidence interval [CI], 0.73-1.08; I2 = 0%; P = .25) and
major bleeding (RR, 0.93; 95% CI, 0.65-1.33; I2 = 31%; P = .70)
were clinically reduced with the WATCHMANTM procedure, although
statistical significance was not achieved. Compared to AmuletTM device
implantation, WATCHMANTM device implantation decreased the risk of cardiac
mortality, while the risks of stroke, systemic embolism, all-cause
mortality, and major bleeding were not statistically
significant. Copyright © 2024 Innovations in Cardiac Rhythm
Management.

<51>
Accession Number
644683956
Title
Impact of SGLT2 Inhibitors on Renal Function in Type 2 Diabetic Patients
with Coronary Artery Disease Undergoing Percutaneous Intervention: A
Systematic Review and Meta-Analysis.
Source
Current diabetes reviews. (no pagination), 2024. Date of Publication: 03
Jul 2024.
Author
Basutkar R.S.; Cutinha R.M.; Sathish V.; Shahil A.; Saneen Ck N.
Institution
(Basutkar, Cutinha, Sathish, Shahil, Saneen Ck) NGSM Institute of
Pharmaceutical Sciences, Pharmacy Practice, India
Abstract
BACKGROUND AND OBJECTIVES: Contrast agents directly cause kidney toxicity
in patients undergoing Percutaneous Intervention for cardiovascular
disease with Type 2 diabetes. This meta-analysis aims to evaluate the
effects of SGLT2-i on renal function in individuals undergoing
Percutaneous Intervention. METHOD(S): The databases used for the
search included PubMed, Scopus, Cochrane Central Registry of Controlled
Trials, and Google Scholar. We considered Randomized controlled trials and
observational studies published from January 2013 to August 2023. The
eligibility to include the studies was assessed independently. The
Cochrane modified data extraction form, and Joanna Briggs Institute was
used. The Cochrane risk of bias tool and Newcastle-Ottawa quality
assessment scale were used to assess the quality of the studies. The
certainty of the evidence was assessed using GradePro software.
 RESULT(S): The pooled estimate showed a substantial reduction in
serum creatinine levels at 48- and 72-hours post-PCI who received SGLT2i
(MD -9.57; 95% CI -18.36, -0.78; p-value 0.03) and (MD -14.40; 95% CI
-28.57, -0.22; p-value 0.05). There was a decrease in the incidence of the
CI-AKI among SGT2i users (RR: 0.46; 95% CI: 0.32, 0.67; p value< 0.0001).
There was no significant difference in the number of patients requiring
hemodialysis, but a smaller number of patients required hemodialysis among
the SGLT2i users (RR: 0.88; 95% CI: 0.19, 4.07; p-value = 0.87).
 CONCLUSION(S): The use of SGLT2i confers substantial beneficial
effects on kidney function and reduction of incidence of Contrast-induced
acute kidney injury among patients undergoing PCI procedures for
cardiovascular disease with diabetes. Copyright© Bentham Science
Publishers; For any queries, please email at epub@benthamscience.net.

<52>
Accession Number
644678155
Title
Twenty percent human albumin solution fluid bolus administration therapy
in patients after cardiac surgery-II: a multicentre randomised controlled
trial.
Source
Intensive care medicine. (no pagination), 2024. Date of Publication: 02
Jul 2024.
Author
Wigmore G.J.; Deane A.M.; Presneill J.J.; Eastwood G.; Serpa Neto A.;
Maiden M.J.; Bihari S.; Baker R.A.; Bennetts J.S.; Ghanpur R.; Anstey
J.R.; Raman J.; Bellomo R.
Institution
(Wigmore, Deane, Presneill, Serpa Neto, Maiden, Bellomo) Department of
Critical Care, Melbourne Medical School, Faculty of Medicine, Dentistry
and Health Sciences, University of Melbourne, Melbourne, VIC, Australia
(Wigmore) Department of Anaesthesia and Pain Medicine, Western Health,
Melbourne, VIC, Australia
(Deane, Presneill, Maiden, Anstey, Bellomo) Department of Intensive Care,
Royal Melbourne Hospital, Melbourne, VIC, Australia
(Presneill, Serpa Neto, Bellomo) Australian and New Zealand Intensive Care
Research Centre (ANZIC-RC), School of Public Health and Preventive
Medicine, Monash University, Melbourne, VIC, Australia
(Eastwood, Serpa Neto, Raman, Bellomo) Department of Intensive Care,
Austin Hospital, Melbourne, VIC, Australia
(Serpa Neto) Department of Critical Care Medicine, Hospital Israelita
Albert Einstein, Sao Paulo, Brazil
(Maiden) Intensive Care Unit, Barwon Health, Geelong, VIC, Australia
(Bihari) College of Medicine and Public Health, Flinders University,
Adelaide, SA, Australia
(Bihari) Department of ICCU, Flinders Medical Centre, Adelaide, SA,
Australia
(Baker, Bennetts) Flinders Medical Centre and College of Medicine and
Public Health Flinders University, Cardiothoracic Quality and Outcomes,
Adelaide, SA, Australia
(Ghanpur) Department of Intensive Care, Warringal Private Hospital,
Melbourne, VIC, Australia
(Raman) University of Melbourne, Melbourne, VIC, Australia
(Raman) St. Vincent's Hospital, Melbourne, VIC, Australia
(Bellomo) Data Analytics Research and Evaluation Centre, Austin Hospital,
Melbourne, VIC, Australia
Abstract
PURPOSE: After cardiac surgery, fluid bolus therapy (FBT) with 20% human
albumin may facilitate less fluid and vasopressor administration than FBT
with crystalloids. We aimed to determine whether, after cardiac surgery,
FBT with 20% albumin reduces the duration of vasopressor therapy compared
with crystalloid FBT. METHOD(S): We conducted a multicentre,
parallel-group, open-label, randomised clinical trial in six intensive
care units (ICUs) involving cardiac surgery patients deemed to require
FBT. We randomised 240 patients to receive up to 400 mL of 20% albumin/day
as FBT, followed by 4% albumin for any subsequent FBT on that day, or to
crystalloid FBT for at least the first 1000 mL, with use of crystalloid or
4% albumin FBT thereafter. The primary outcome was the cumulative duration
of vasopressor therapy. Secondary outcomes included fluid balance.
 RESULT(S): Of 480 randomised patients, 466 provided consent and
contributed to the primary outcome (mean age 65 years; median EuroSCORE II
1.4). The cumulative median duration of vasopressor therapy was 7
(interquartile range [IQR] 0-19.6) hours with 20% albumin and 10.8 (IQR
0-22.8) hours with crystalloids (difference -3.8 h, 95% confidence
interval [CI] -8 to 0.4; P=0.08). Day one fluid balance was less with 20%
albumin FBT (mean difference -701 mL, 95% CI -872 to -530).
 CONCLUSION(S): In patients after cardiac surgery, when compared to a
crystalloid-based FBT, 20% albumin FBT was associated with a reduced
positive fluid balance but did not significantly reduce the duration of
vasopressor therapy. Copyright © 2024. The Author(s).

<53>
Accession Number
644670426
Title
Trial Designs A44002PZS Electronic Physician Notification to Facilitate
the Recognition and Management of Severe Aortic Stenosis: Rationale,
design, and methods of the randomized controlled DETECT AS Trial.
Source
American heart journal. (no pagination), 2024. Date of Publication: 29
Jun 2024.
Author
Abou-Karam R.; Tanguturi V.; Cheng F.; Elmariah S.
Institution
(Abou-Karam, Cheng) Cardiovascular Research Center, Department of
Medicine, Massachusetts General Hospital, Harvard Medical School, Boston,
MA; Cardiovascular Disease Initiative, Broad Institute of MIT and Harvard,
Cambridge, MA
(Tanguturi) Cardiology Division, Department of Medicine, Massachusetts
General Hospital, Boston, MA, United States
(Elmariah) Cardiovascular Division, Department of Medicine, University of
California-San Francisco, San Francisco, CA, United States
Abstract
BACKGROUND: Symptomatic severe aortic stenosis causes substantial
morbidity and mortality when left untreated, yet recent data suggest its
undertreatment. OBJECTIVE(S): To evaluate the efficacy of electronic
physician notification to facilitate the guideline-directed management of
patients with severe aortic stenosis. HYPOTHESIS: We hypothesize that
patients with severe aortic stenosis who are in the care of physicians who
receive the notification are more likely to undergo aortic valve
replacement within 1-year. METHODS/DESIGN: The Electronic Physician
Notification to Facilitate the Recognition and Management of Severe Aortic
Stenosis (DETECT AS) trial is a randomized controlled trial and quality
improvement initiative designed to evaluate the efficacy of electronic
provider notification versus usual clinical care in the management of
patients with severe aortic stenosis. Providers ordering an echocardiogram
with findings potentially indicative of severe aortic stenosis, defined by
an aortic valve area <=1.0 cm2, are randomized in a 1:1 fashion to receive
electronic notification (intervention) or usual care. Providers in the
notification arm are sent a notification within the electronic health
record inbox outlining customized guideline recommendations for the
management of patients with severe aortic stenosis based on the 2020
ACC/AHA Clinical Practice Guidelines for Valvular Heart Diseases for the
index and all subsequent echocardiograms. Providers in the control arm
receive no notification. Randomization continues until 940 patients have
been enrolled. SETTING: Multi-centered, academic health system OUTCOMES:
The primary endpoint is the proportion of patients with severe AS
receiving an aortic valve replacement within 1-year of the index
echocardiogram. Secondary endpoints include mortality, heart failure
hospitalization, transthoracic echocardiogram utilization/surveillance,
aortic stenosis billing code diagnosis, and cardiology/Heart Valve Team
referral. CONCLUSION(S): The DETECT AS trial will provide insight
into whether electronic notification of providers on the presence of
severe aortic stenosis and associated clinical guideline recommendations
will facilitate recognition and guideline-directed management of severe
aortic stenosis. TRIAL REGISTRATION: ClinicalTrials.gov, NCT05230225,
https://clinicaltrials.gov/ct2/show/NCT05230225. Copyright ©
2024. Published by Elsevier Inc.

<54>
Accession Number
2033121932
Title
Effects of Rapid Uptitration of Neurohormonal Blockade on Effective,
Sustainable Decongestion and Outcomes in STRONG-HF.
Source
Journal of the American College of Cardiology. 84(4) (pp 323-336), 2024.
Date of Publication: 23 Jul 2024.
Author
Biegus J.; Mebazaa A.; Davison B.; Cotter G.; Edwards C.; Celutkiene J.;
Chioncel O.; Cohen-Solal A.; Filippatos G.; Novosadova M.; Sliwa K.; Adamo
M.; Arrigo M.; Lam C.S.P.; Ter Maaten J.M.; Deniau B.; Barros M.;
Cerlinskaite-Bajore K.; Damasceno A.; Diaz R.; Gayat E.; Kimmoun A.; Pang
P.S.; Pagnesi M.; Saidu H.; Takagi K.; Tomasoni D.; Voors A.A.; Metra M.;
Ponikowski P.
Institution
(Biegus, Ponikowski) Institute of Heart Diseases, Wroclaw Medical
University, Wroclaw, Poland
(Mebazaa, Davison, Cotter, Cohen-Solal, Deniau, Gayat) Universite Paris
Cite, INSERM UMR-S 942(MASCOT), Paris, France
(Mebazaa, Deniau, Gayat) Department of Anesthesiology and Critical Care
and Burn Unit, Saint-Louis and Lariboisiere Hospitals, FHU PROMICE, DMU
Parabol, APHP Nord, Paris, France
(Davison, Cotter, Edwards, Novosadova, Barros, Takagi) Momentum Research
Inc, Durham, NC, United States
(Davison, Cotter) Heart Initiative, Durham, NC, United States
(Celutkiene, Cerlinskaite-Bajore) Clinic of Cardiac and Vascular Diseases,
Institute of Clinical Medicine, Faculty of Medicine, Vilnius University,
Vilnius, Lithuania
(Chioncel) Emergency Institute for Cardiovascular Diseases "Prof.
C.C.Iliescu,", University of Medicine "Carol Davila,", Bucharest, Romania
(Cohen-Solal) Department of Cardiology, APHP Nord, Lariboisiere University
Hospital, Paris, France
(Filippatos) National and Kapodistrian University of Athens, School of
Medicine, Attikon University Hospital, Athens, Greece
(Sliwa) Cape Heart Institute, Division of Cardiology, Department of
Medicine, Groote Schuur Hospital and University of Cape Town, Cape Town,
South Africa
(Adamo, Pagnesi, Tomasoni, Metra) Cardiology, ASST Spedali Civili and
Department of Medical and Surgical Specialties, Radiological Sciences, and
Public Health, University of Brescia, Brescia, Italy
(Arrigo) Department of Internal Medicine, Stadtspital Zurich, Zurich,
Switzerland
(Lam) National Heart Centre Singapore and Duke-National University of
Singapore, Singapore
(Ter Maaten, Voors) University of Groningen, Department of Cardiology,
University Medical Centre Groningen, Groningen, Netherlands
(Damasceno) Faculty of Medicine, Eduardo Mondlane University, Maputo,
Mozambique
(Diaz) Estudios Clinicos Latinoamerica, Instituto Cardiovascular de
Rosario, Rosario, Argentina
(Kimmoun) Universite de Lorraine, Nancy, France, INSERM, Defaillance
Circulatoire Aigue et Chronique, Service de Medecine Intensive et
Reanimation Brabois, CHRU de Nancy, Vandoeuvre-les-Nancy, France
(Pang) Department of Emergency Medicine, Department of Medicine, Indiana
University School of Medicine, Indianapolis, IN, United States
(Saidu) Department of Medicine, Murtala Muhammed Specialist
Hospital/Bayero University Kano, Kano, Nigeria
Publisher
Elsevier Inc.
Abstract
Background: Comprehensive uptitration of neurohormonal blockade targets
fundamental mechanisms underlying development of congestion and may be an
additional approach for decongestion after acute heart failure (AHF).
 Objective(s): This hypothesis was tested in the STRONG-HF (Safety,
Tolerability, and Efficacy of Rapid Optimization, Helped by N-Terminal
Pro-Brain Natriuretic Peptide Testing of Heart Failure Therapies) trial.
 Method(s): In STRONG-HF, patients with AHF were randomized to the
high-intensity care (HIC) arm with fast up-titration of neurohormonal
blockade or to usual care (UC). Successful decongestion was defined as an
absence of peripheral edema, pulmonary rales, and jugular venous pressure
<6 cm. Result(s): At baseline, the same proportion of patients in
both arms had successful decongestion (HIC 48% vs UC 46%; P = 0.52). At
day 90, higher proportion of patients in the HIC arm (75%) experienced
successful decongestion vs the UC arm (68%) (P = 0.0001). Each separate
component of the congestion score was significantly better in the HIC arm
(all, P < 0.05). Additional markers of decongestion also favored the HIC:
weight reduction (adjusted mean difference: -1.36 kg; 95% CI: -1.92 to
-0.79 kg), N-terminal pro-B-type natriuretic peptide level, and lower
orthopnea severity (all, P < 0.001). More effective decongestion was
achieved despite a lower mean daily dose of loop diuretics at day 90 in
the HIC arm. Among patients with successful decongestion at baseline,
those in the HIC arm had a significantly better chance of sustaining
decongestion at day 90. Successful decongestion in all subjects was
associated with a lower risk of 180-day HF readmission or all-cause death
(HR: 0.40; 95% CI: 0.27-0.59; P < 0.0001). Conclusion(s): In
STRONG-HF, intensive uptitration of neurohormonal blockade was associated
with more efficient and sustained decongestion at day 90 and a lower risk
of the primary endpoint. Copyright © 2024 American College of
Cardiology Foundation

<55>
Accession Number
2033107576
Title
Effects of systematic cardiac rehabilitation training in elderly patients
with unstable angina following cardiac stent implantation.
Source
World Journal of Clinical Cases. 12(20) (pp 4137-4145), 2024. Date of
Publication: 16 Jul 2024.
Author
Yan L.-L.; Yang X.; Chen L.; Lu X.
Institution
(Yan, Yang, Chen) Department of Rehabilitation Medicine, Liyang City
People's Hospital, Jiangsu Province, Liyang 213300, China
(Lu) Rehabilitation Medicine Center, Jiangsu Provincial People's Hospital,
Jiangsu Province, Nanjing 210029, China
Publisher
Baishideng Publishing Group Inc
Abstract
BACKGROUND Coronary stent implantation is usually used to treat unstable
angina to alleviate stenosis or occlusion, promoting blood flow
restoration and alleviating symptoms such as myocardial ischemia. And
postoperative cardiac rehabilitation is essential for enhancing recovery
and prognosis. Nevertheless, conventional rehabilitation lacks
specificity, particularly for elderly patients with multiple comorbidities
and poor compliance, rendering it less effective. AIM To investigate the
effects of systematic cardiac rehabilitation training in elderly patients
with unstable angina following coronary stenting intervention. METHODS A
retrospective enrollment was conducted comprising fifty-four elderly
patients with unstable angina pectoris who underwent systematic cardiac
rehabilitation training after receiving coronary intervention as the
rehabilitation group, while fifty-three elderly patients who received
basic nursing and rehabilitation guidance measures after coronary
intervention were assigned to the control group. Differences in Seattle
Angina Questionnaire scores, survival quality (SF-36) scores,
cardiopulmonary exercise function assessment index, echocardiographic
cardiac function index, and adverse cardiovascular events were compared
between the two groups. RESULTS After intervention, the rehabilitation
group observed greater VO2 Max, maximum metabolic equivalent, eft
ventricular ejection fraction, left ventricular end-diastolic diameter and
smaller left ventricular end-systolic diameter. And the rehabilitation
group observed greater scores of physical activity limitation, stable
angina pectoris, treatment satisfaction, and SF- 36 score. The incidence
of adverse cardiovascular events in the two groups, showed no significant
difference. CONCLUSION Systematic cardiac rehabilitation following
coronary stenting in elderly patients with unstable angina pectoris can
enhance cardiac function recovery, consequently enhancing both quality of
life and cardiopulmonary exercise tolerance. Copyright © (2024),
Published by Baishideng Publishing Group Inc. All rights reserved.

<56>
Accession Number
2031105425
Title
Efficacy and safety of Tongxin formula after stent implantation for acute
coronary syndrome: A multicenter, double-blind, placebo-controlled
randomized trial.
Source
Explore. 20(5) (no pagination), 2024. Article Number: 102992. Date of
Publication: 01 Sep 2024.
Author
Zhu W.; Wang S.; Zhang L.; Xie F.-Q.; Cheng J.; Li X.-K.; Chen W.; Yan
S.-Y.; Feng Q.-M.
Institution
(Zhu, Wang, Zhang, Xie, Cheng, Feng) Department of Cardiology, Shanghai
Municipal Hospital of Traditional Chinese Medicine, Shanghai University of
Traditional Chinese Medicine, 274 Zhijiang Middle Road Jing 'an District,
Shanghai 200071, China
(Li) Department of Cardiology, Tenth People's Hospital, Tongji University,
Shanghai 200072, China
(Chen) Department of Cardiology, Changzheng Hospital, Second Military
Medical University, Shanghai 200003, China
(Yan) Institute of Science, Technology and Humanities, Shanghai University
of Traditional Chinese Medicine, Shanghai 201203, China
Publisher
Elsevier Inc.
Abstract
Objective: The aim of this study is to comprehensively evaluate both the
efficacy and safety profile of integrating the Tongxin formula with
optimal medical therapy (OMT) for patients experiencing acute coronary
syndromes subsequent to coronary stenting, over the course of one year.
 Method(s): We enrolled 150 patients diagnosed with acute coronary
syndromes who had received stent placement within one month and exhibited
a TCM syndrome characterized by Qi deficiency and blood stasis. This group
comprised patients with unstable angina, non-ST-segment elevation
myocardial infarction, and ST-segment elevation myocardial infarction. The
participants were divided equally, allocating 75 to the Tongxin formula
group and 75 to a placebo-controlled group. After undergoing percutaneous
coronary intervention (PCI) surgery, both groups received conventional
Western medical care, including dual antiplatelet therapy and
lipid-lowering medications. The placebo-controlled group received a
placebo, while the Tongxin formula group were administered Tongxin formula
granules orally. Both study cohorts were monitored for a duration of 6
months. The primary endpoints included the occurrence of major adverse
cardiovascular events and the rate of lumen diameter reduction
post-treatment in both groups, with the Seattle Angina Scale serving as a
secondary assessment tool. Safety evaluations encompassed the measurement
of liver and kidney function, coagulation parameters, and other relevant
indicators. Result(s): The rate of adverse cardiovascular events in
the placebo-controlled group was 42.46 % within a year of surgery, whereas
it was 16.90 % in the Tongxin formula group (P < 0.05). Comparing the
Tongxin formula group to the placebo-controlled group, there was a
decrease in the frequency of unstable angina and readmission due to
cardiovascular events (P < 0.05). Coronary angiography performed 6 months
after surgery revealed that the Tongxin formula group had considerably
less lumen loss than the placebo-controlled group in a number of segments,
including the entire segment, within the stent, at the proximal end, and
at the distal end (P < 0.05). Six months after surgery, the Seattle angina
score was higher in the Tongxin formula group than in the
placebo-controlled group (P < 0.05). There were no significant changes in
indicators such as liver and renal function as well as coagulation indexes
in both groups within the first 12 months after surgery (P > 0.05).
 Conclusion(s): Tongxin formula has been shown to lower the occurrence
of major adverse cardiovascular events, minimize narrowing of blood vessel
lumen, enhance clinical symptoms, and enhance the quality of life of
patients following PCI surgery, all while maintaining a good safety
profile. Copyright © 2024

<57>
Accession Number
644668384
Title
Evaluating Vascular and Bleeding Risks of Vascular Closure Devices in
Transfemoral Transcatheter Aortic Valve Replacement: A Network
Meta-Analysis.
Source
ASAIO Journal. Conference: 70th Annual Conference of the American Society
for Artificial Internal Organs, ASAIO 2024. Baltimore, MA United States.
70(Supplement 3) (pp 143), 2024. Date of Publication: May 2024.
Author
Elhadi M.; Khaled A.; Faraj H.
Institution
(Elhadi, Khaled, Faraj) Faculty of Medicine, University of Tripoli,
Tripoli, Libyan Arab Jamahiriya
Publisher
Lippincott Williams and Wilkins
Abstract
Background: Transfemoral transcatheter aortic valve replacement (TAVR) has
become a feasible option for high-risk patients with severe aortic
stenosis, despite potential vascular and bleeding complications that can
impact patient outcomes. Vascular closure devices (VCDs) have been
proposed to mitigate these complications, but the comparative efficacy and
safety of these different VCDs remain to be established. This study aims
to evaluate and compare the rate of vascular and bleeding complications
associated with VCDs. Method(s): A systematic literature search was
conducted in PubMed, Embase, and Web of Science until December 2022,
focusing on studies comparing MANTA, ProGlide, and Prostar VCDs in
transfemoral TAVR. Using netmeta package in R software, we conducted a
network metaanalysis applying random-effects models and using Odds Ratio
(OR) as an effect estimate for the specified outcomes. Result(s): The
meta-analysis included 15 studies with 1,038 patients in the MANTA, 4,688
in the ProGlide, and 3,425 in the Prostar studies. The treatment ranking
was as follows: MANTA, ProGlide, and Prstar. When compared to MANTA as a
reference, there was no significant difference in major vascular
complications in ProGlide (OR=0.85, 95% CI: 0.41; 1.75) and Prostar
(OR=0.39, 95% CI: 0.03; 4.75). In terms of minor vascular complications,
no significant difference was observed among the three devices compared to
MANTA, with ProGlide yielding an OR of 0.87 (95% CI: 0.52; 1.46) and
Prostar an OR of 0.54 (95% CI: 0.20; 1.45). No significant differences
were found in the device failure rate compared to MANTA, where ProGlide
yielded an OR of 0.82 (95% CI: 0.32; 2.15) and Prostar an OR of 1.49 (95%
CI: 0.15; 14.67). Prostar showed a desirable and lower rate for the severe
bleeding rate, albeit not significantly different from MANTA (OR=0.68, 95%
CI: 0.49; 0.95) and Prostar 0.68 [95% CI: 0.49; 0.95]. Conclusion(s):
Our study sheds new light on the comparable effects of various VCDs on
vascular and bleeding complications post-TAVR, with no significant
differences noted across the three devices. Due to the limited comparative
studies, further large-scale, randomized controlled trials are essential
to reinforce these findings and inform VCD usage guidelines in TAVR.

<58>
Accession Number
644668359
Title
Unraveling the Beat: Insights into Mitral Annular Disjunction.
Source
Journal of Thoracic Imaging. Conference: 2024 Annual Meeting of the
Society of Thoracic Radiology. Tucson, AZ United States. 39(4) (pp W59),
2024. Date of Publication: July 2024.
Author
Gulati V.; Gulati A.; Hu R.; Rajiah P.; Sundaram B.
Institution
(Gulati) Mercy Catholic Medical Center, Darby, PA, United States
(Gulati, Sundaram) Thomas Jefferson University Hospitals, Philadelphia,
PA, United States
(Hu) University of Pennsylvania, Perelman School of Medicine,
Philadelphia, PA, United States
(Rajiah) Mayo Clinic, Rochester, MN, United States
Publisher
Lippincott Williams and Wilkins
Abstract
Background: Mitral annular disjunction (MAD) refers to the atrial
displacement of the hinge point of the mitral valve annulus from the
ventricular myocardium, an entity that is closely associated with mitral
valve prolapse (MVP) and, potentially, malignant cardiac arrhythmias.
Evaluation for MAD is an important component of cardiac imaging,
especially in patients with MVP and unexplained cardiac arrhythmias. MAD
could potentially be the missing link in explaining the poor outcomes in a
portion of patients with MVP. MAD is increasingly encountered on imaging,
however, awareness and knowledge of MAD is suboptimal as there are no
consensus or guidelines for this entity. Educational Goals/Teaching
Points: Mitral annular disjunction is an arrhythmogenic entity that can
cause sudden cardiac death, particularly in young adults. This exhibit
will review the role of cardiac MRI as an important diagnostic tool that
aids in recognizing and quantifying MAD, MVP, fibrosis in the papillary
muscle, and myocardium, which may predict and help improve outcomes
following electrophysiology procedures and mitral valve surgery. This
exhibit will also review the anatomy of the mitral valve followed by MAD's
pathophysiology, controversy, prevalence, clinical implications, and
imaging considerations, focusing on cardiac MRI with an overview of
imaging protocols, common pitfalls, and exam reporting elements.
 Conclusion(s): Mitral annular disjunction is an increasingly
recognized entity associated with mitral valve prolapse and may
significantly impact patient management given its arrhythmogenic
potential. Awareness of this diagnosis with its relevant details and
implications is vital since it may be an incidental imaging finding either
in isolation, or combined with other mitral valve disorders, particularly
in young patients or other systemic diseases. (Table Presented).

<59>
Accession Number
644668332
Title
Systematic review of sex differences in LVAD recovery and outcomes.
Source
ASAIO Journal. Conference: 70th Annual Conference of the American Society
for Artificial Internal Organs, ASAIO 2024. Baltimore, MA United States.
70(Supplement 3) (pp 140), 2024. Date of Publication: May 2024.
Author
Lobo A.D.; Ahmed M.M.; Dungan J.R.
Institution
(Lobo) Medicine, Pontificia Universidade Catolica do Parana, Curitiba, PR,
Brazil
(Ahmed) Cardiovascular Medicine, University of Florida, Gainesville, FL,
United States
(Dungan) College of Nursing, University of Florida, Gainesville, FL,
United States
Publisher
Lippincott Williams and Wilkins
Abstract
Introduction: Left Ventricular Assist Devices (LVADs) are a pivotal
therapeutic option for end-stage heart failure patients awaiting heart
transplantation or for destination therapy. Despite the increasing
utilization of LVADs, women account for less than 25% of LVAD recipients,
who tend to be older at time of placement. There remains a shortage of
research on potential gender-specific differences in outcomes,
particularly in achieving recovery after LVAD implantation. The purpose of
this systematic review was to synthesize evidence in the literature of sex
differences in post-LVAD outcomes, specifically recovery, adverse events
and survival as well as identify sex-associated predictors.
 Method(s): A comprehensive electronic search of PubMed, Embase, and
Web of Science databases was performed. To account for varying definitions
and assessments of LVADs, outcomes and sexes, a broad set of search terms
and MESH headings were utilized. The search included all articles
published within 10 years of January 2024. Covidence © software was
used for article extraction, screening, and selection in accordance with
PRISMA guidelines. Studies were included if they reported differences in
LVAD outcomes comparing men and women. Exclusion criteria are shown in
Figure 1. PRISMA Diagram. Result(s): From the 58 initially obtained,
24 studies met inclusion criteria. A total of 189,511 patients were
included, with women comprising 26.2% (n = 49,641) of the combined cohort.
16.6% (n =4) of studies reported sexbased recovery outcomes, with a trend
toward increased recovery rates among women. 66.6% of studies (n=16)
reported post-LVAD outcomes by sex, with 11 reporting significant survival
differences. Three articles reported completely null findings for sex
differences in outcomes. Data analysis from full-text review is still in
progress. Conclusion(s): Women remain underrepresented in LVAD
literature, particularly when examining post LVAD recovery. There is
emerging evidence suggestive of significant sex differences in
non-survival outcomes, with a trend towards women having a higher
frequency recovery compared to men. However, there is a paucity of data on
sex differences in recovery metrics. Identifying these disparities and
sexassociated predictors could inform future research to optimize
postimplantation recovery and outcomes equitably among men and women.

<60>
Accession Number
644668269
Title
Exploring the Diagnostic Potential of Echocardiography in Detecting Occult
Cardiac Injuries After Penetrating Thoracic Trauma: A Diagnostic Accuracy
Meta-analysis.
Source
ASAIO Journal. Conference: 70th Annual Conference of the American Society
for Artificial Internal Organs, ASAIO 2024. Baltimore, MA United States.
70(Supplement 3) (pp 135), 2024. Date of Publication: May 2024.
Author
Elhadi M.; Khaled A.; Faraj H.
Institution
(Elhadi, Khaled, Faraj) Faculty of Medicine, University of Tripoli,
Tripoli, Libyan Arab Jamahiriya
Publisher
Lippincott Williams and Wilkins
Abstract
Background: Penetrating thoracic trauma can lead to occult cardiac
injuries, a potentially life-threatening condition that often poses
diagnostic challenges in stable patients. Despite its invasive nature,
subxiphoid pericardiotomy is traditionally recognized as the diagnostic
standard. While echocardiography is proposed as a non-invasive
alternative, its comparative accuracy against the standard method is yet
to be definitively determined. This study aims to evaluate the diagnostic
accuracy of echocardiography in detecting occult cardiac injuries
following penetrating thoracic trauma in stable patients. Method(s):
A comprehensive literature search was performed across multiple databases,
including PubMed, EMBASE, and Web of Science, to identify studies that
compared echocardiography to subxiphoid pericardiotomy for detecting
occult cardiac injuries in stable patients after penetrating thoracic
trauma. Statistical analyses were conducted using the mada package in R
software (version 4.0.3), facilitating the pooling of sensitivity,
specificity, false-positive rate, diagnostic odds ratio, and positive and
negative likelihood ratios, all with corresponding 95% Confidence
Intervals (CI). Result(s): The meta-analysis included four studies
encompassing 492 patients, of whom 183 had confirmed cardiac injuries, and
309 were identified as non-injured. The pooled sensitivity of
echocardiography, compared to subxiphoid pericardiotomy, was 84.2% (95%
CI: 78.1-88.8%, I2=49.9%), and the specificity was 81.5% (95% CI:
26.4-98.2%, I2=94.3%). The false-positive rate was 18.5% (95% CI:
1.8-73.6%). The diagnostic odds ratio was 23.41 (95% CI: 1.84-296.98),
with the positive likelihood ratio at 4.55 (95% CI: 0.58-35.23) and the
negative likelihood ratio at 0.19 (95% CI: 0.11-0.34). Conclusion(s):
Echocardiography shows promise as a non-invasive method for identifying
occult cardiac injuries after penetrating thoracic trauma, though its
performance compared to subxiphoid pericardiotomy warrants cautious
interpretation due to high heterogeneity in specificity and wide
confidence intervals. Further high-quality studies are required to affirm
these findings and assess echocardiography's potential as a standard
diagnostic tool.

<61>
Accession Number
644668211
Title
Del Nido vs Conventional Cardioplegia: A Comparative Meta-Analysis of
Operative and Postoperative Outcomes in Adult Cardiac Surgery.
Source
ASAIO Journal. Conference: 70th Annual Conference of the American Society
for Artificial Internal Organs, ASAIO 2024. Baltimore, MA United States.
70(Supplement 3) (pp 20), 2024. Date of Publication: May 2024.
Author
Elhadi M.; Khaled A.; Ghatnsh A.B.; Faraj H.
Institution
(Elhadi, Khaled, Ghatnsh, Faraj) Faculty of Medicine, University of
Tripoli, Tripoli, Libyan Arab Jamahiriya
Publisher
Lippincott Williams and Wilkins
Abstract
Background: Cardioplegia, a key element of cardiac surgery, has evolved
with the introduction of Del Nido cardioplegia, which provides extended
myocardial protection. However, the comparative efficacy of Del Nido and
conventional cardioplegia remains a topic of debate. This study aims to
compare the operative and postoperative effects of Del Nido and
conventional cardioplegia in cardiac surgery. Method(s): We performed
a literature search of PubMed, Embase, and Scopus until April 2023 for
studies comparing Del Nido and conventional cardioplegia, focusing on key
operative and postoperative outcomes. These outcomes, both continuous and
dichotomous, were assessed using Mean Difference (MD) and Odds Ratio (OR),
respectively. Analysis was done using R (version 4.0.3) using metafor and
meta packages. Result(s): Our analysis incorporated 36 studies with
21429 patients (8350 in the Del Nido group and 13079 in the conventional
group). For operative outcomes, Del Nido cardioplegia showed a significant
reduction in aortic cross-clamp time (MD -6.68 min; 95% CI -10.28 to
-3.09, P<0.01, I2=96%) and cardioplegia volume (MD -1223.44 mL; 95% CI
-1472.21 to -974.66, P<0.01, I2=99%). For perioperative outcomes, there
were no significant differences between the two groups in troponin T
levels (MD -0.11 ng/ mL; 95% CI -0.26 to 0.05, P=0.18, I2=98%), CK-MB (MD
-1.60 ng/mL; 95% CI -4.49 to 1.29, P=0.28, I2=79%), mechanical ventilation
time (MD -0.54 hours; 95% CI -1.22 to 0.12, P=0.11, I2=69%), length of ICU
stay (MD -0.14 days; 95% CI -0.34 to 0.06, P=0.17, I2=73%), and length of
hospital stay (MD 0.01 days; 95% CI -0.25 to 0.26, P=0.96, I2=36%). In
terms of major events, there were no significant differences in
perioperative mortality (OR 0.97; 95% CI 0.70 to 1.34, P=0.86, I2=0%),
atrial fibrillation rate (OR 0.99; 95% CI 0.77 to 1.27, P=0.96, I2=67%),
and myocardial infarction (OR 1.23; 95% CI 0.74 to 2.04, P=0.42, I2=0%)
between the Del Nido and conventional cardioplegia groups.
 Conclusion(s): Del Nido cardioplegia may offer operative benefits
over conventional cardioplegia, while postoperative outcomes remain
similar. Further high-quality studies are necessary to confirm these
findings, underlining the importance of continued exploration in this area
of cardiac surgery.

<62>
Accession Number
644668058
Title
Coronary Computed Tomography Angiography versus Invasive Coronary
Angiography in Stable Angina: A Meta-Analysis of Randomized Controlled
Trials.
Source
Journal of Thoracic Imaging. Conference: 2024 Annual Meeting of the
Society of Thoracic Radiology. Tucson, AZ United States. 39(4) (pp W51),
2024. Date of Publication: July 2024.
Author
Altmayer S.; Machado M.; Felix N.; Melo P.; Cardoso R.
Institution
(Altmayer) Stanford University, Palo Alto, CA, United States
(Machado) Faculdades Integradas Pitagoras de Montes Claros, Montes Claros,
Brazil
(Felix) Universidade Federal de Campina Grande, Campina Grande, Brazil
(Melo) Cardiovascular Research Foundation, New York, NY, United States
(Cardoso) Brigham and Women's Hospital, Boston, MA, United States
Publisher
Lippincott Williams and Wilkins
Abstract
Objectives: To perform a meta-analysis of the effectiveness of coronary
computed tomography angiography (CCTA) compared to invasive coronary
angiography (ICA) as a first test strategy in patients with stable angina.
 Material(s) and Method(s): MEDLINE, EMBASE, and Cochrane databases
were searched for randomized controlled trials (RCTs) comparing CCTA first
versus ICA first for stable angina who were initially referred to ICA.
Relative risks (RR) and mean differences with 95% confidence intervals
were computed for binary and continuous outcomes. Result(s): Five
RCTs with a total of 5,727 patients were included, of whom 51.1% were
referred to CCTA; 22.5% of patients had evidence of ischemia on a prior
functional test. In follow-up ranging from 1 to 3.5 years, 660 of the
2,928 patients randomized to CCTAfirst underwent ICA (23%). Patients who
underwent CCTA had lower rates of coronary revascularization (RR 0.74; 95%
CI 0.66-0.84; P<0.001) and stroke (RR 0.50; 95% CI 0.26-0.98; P=0.043).
Cardiovascular mortality (RR 0.55; 95% CI 0.24-1.23; P=0.146); major
adverse cardiovascular events (RR 0.84; 95% CI 0.64-1.10; P= 0.198);
non-fatal myocardial infarction (RR 1.09; 95% CI 0.63-1.88; P= 0.768); and
cardiovascular hospitalizations (RR 0.91; 95% CI 0.59-1.39; P= 0.669) did
not differ significantly between groups. Conclusion(s): In patients
with stable angina referred for ICA, the CCTA first strategy avoided the
need for ICA in 77% of patients. CCTA first was associated with a
significant reduction in the rates of coronary revascularization and
stroke compared to a direct ICA strategy without impact on mortality or
major cardiovascular events. Clinical Relevance Application: Most patients
with suspected chronic coronary syndromes referred to diagnostic ICA do
not have obstructive epicardial coronary artery disease. CCTA is an ideal
noninvasive imaging modality to rule out obstructive coronary artery
disease. Our meta-analysis demonstrates that a CCTA-first approach is safe
and is associated with significantly lower rates of revascularization and
stroke in patients with stable angina referred for ICA. (Table Presented).

<63>
[Use Link to view the full text]
Accession Number
2033126319
Title
Vitamin C for all?.
Source
Current Opinion in Critical Care. 30(4) (pp 298-304), 2024. Date of
Publication: 01 Aug 2024.
Author
de Man A.; Long M.T.; Stoppe C.
Institution
(de Man) Amsterdam UMC, Location Vrije Universiteit, Department of
Intensive Care, Amsterdam, Netherlands
(de Man) Amsterdam Cardiovascular Sciences, Amsterdam, Netherlands
(Long) Departments of Anesthesiology, Internal Medicine & Emergency
Medicine, University of Wisconsin Hospitals & Clinics, Madison, WI, United
States
(Stoppe) University Hospital Wuerzburg, Department of Anaesthesiology,
Intensive Care, Emergency, and Pain Medicine, Wuerzburg, Germany
(Stoppe) German Heart Center Charite Berlin, Department of Cardiac
Anesthesiology and Intensive Care Medicine, Berlin, Germany
Publisher
Lippincott Williams and Wilkins
Abstract
Purpose of review Vitamin C can be a potential adjunctive treatment option
for critically ill individuals due to its pleiotropic effects as electron
donor in many enzymatic reactions throughout the body. Recently, several
important randomized controlled trials (RCTs) investigating vitamin C in
critically ill patients have been published. Recent findings Two recent
large RCTs administering high-dose vitamin C to patients with sepsis and
COVID-19 showed signs of harm. Though performed at high standard, these
trials had several limitations. Recent studies in cardiac surgery and
burns showed decreased cardiac enzymes and improved clinical outcomes
after cardiac surgery, and decreased fluid requirements, reduced wound
healing time and in-hospital mortality after burns. Vitamin C may hold
benefit in the management of other ischemia/reperfusion injury
populations, including postcardiac arrest patients and after solid organ
transplantation. Currently, covering basal vitamin C requirements during
critical illness is recommended, though the exact dose remains to be
determined. Summary Future work should address optimal vitamin C timing,
since early versus late drug administration are likely distinct, and
duration of therapy, where withdrawal-induced injury is possible.
Additionally accurate assessment of body stores with determination of
individual vitamin requirements is crucial to ascertain patient and
subgroups most likely to benefit from vitamin C. Copyright © 2024
Wolters Kluwer Health, Inc. All rights reserved.

<64>
[Use Link to view the full text]
Accession Number
2033126327
Title
Building a cardiogenic shock response team: key considerations necessary
to improve outcomes.
Source
Current Opinion in Critical Care. 30(4) (pp 354-361), 2024. Date of
Publication: 01 Aug 2024.
Author
Varma B.; Katz J.N.; Alviar C.L.
Institution
(Varma, Katz, Alviar) The Leon H. Charney Division of Cardiovascular
Medicine, New York University Grossman School of Medicine, NYU Langone
Medical Center, United States
(Katz, Alviar) Bellevue Hospital Center, New York, NY, United States
Publisher
Lippincott Williams and Wilkins
Abstract
Purpose of review This review provides key information about cardiogenic
shock (CS) teams, including published evidence and practical
recommendations to create a CS team and program. Recent findings CS is a
complex disease process with a high in-hospital mortality rate ranging
from 30% to 70% according to recent registries and randomized studies. The
explanation for the elevated rates is likely multifactorial, including the
various etiologies of cardiogenic shock as well as delays in recognition
and deployment of appropriate therapies. Accordingly, the use of
cardiogenic shock team has been implemented with the aim of improving
outcomes in these patients. The CS team typically consists of members with
critical care or cardiac critical care expertise, heart failure,
cardiothoracic surgery, and interventional cardiology. A number of
retrospective studies have now supported the benefits of a CS team,
particularly in selecting the appropriate candidates for tailored
mechanical circulatory support therapies and providing interventions in a
timely manner, which have translated into improved outcomes. Summary CS
teams provides a platform for expedited recognition of CS and timely,
standardized, and multidisciplinary discussions regarding appropriate
management and care. Copyright © 2024 Wolters Kluwer Health, Inc.
All rights reserved.

<65>
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. 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. 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.
 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 %).
 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. Copyright © 2024 Elsevier B.V.

<66>
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. 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. 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. Copyright © 2024 Termedia
Publishing House Ltd.. All rights reserved.

<67>
Accession Number
2033045978
Title
A Novel USG-Guided PEC Block with Ropivacaine and Fentanyl for
Postoperative Analgesia in Chest Wall Surgeries: A Randomized Controlled
Trial.
Source
Journal of Cellular and Molecular Anesthesia. 9(2) (no pagination), 2024.
Article Number: e146530. Date of Publication: 2024.
Author
Kheskani D.; Chhanwal H.; Parmar S.; Singh A.; Patel Y.
Institution
(Kheskani, Chhanwal, Parmar, Singh, Patel) Hospital and Research Centre,
GCS Medical College, Gujarat, India
Publisher
Shahid Beheshti University of Medical Sciences, Anesthesiology Research
Center
Abstract
Background: Perioperative analgesia can be administered through various
routes to patients undergoing chest wall surgeries. A recently introduced
technique is the ultrasound-guided pectoral nerve block, which aims to
alleviate pain effectively. Objective(s): The purpose of this study
is to investigate and compare the total duration of analgesia and the
timing of the first rescue analgesia. Method(s): In this prospective,
randomized, triple-blind study, 60 adult patients scheduled for elective
chest wall surgeries were enrolled. They were randomly divided into two
equal groups: Group R received 38 mL of 0.2% ropivacaine and 2 ml of
normal saline, and group F received 38 mL of 0.2% ropivacaine and 2 mL of
fentanyl (100 mcg). All patients were administered general anesthesia and
the PEC1 and PEC2 blocks postoperatively prior to extubation. The primary
objective was to assess the total duration of postoperative analgesia, the
Numeric Rating Scale (NRS) pain score, and the time to first rescue
analgesia in both groups. The secondary outcome was the total consumption
of postoperative analgesics. Result(s): The total duration of
analgesia, as well as the consumption of paracetamol and fentanyl
postoperatively in group F, were 11.02 +/- 2.01 hours, 1.5 +/- 0.5 g, and
0 mcg, respectively. In contrast, in group R, these were 8.28 +/- 0.51
hours, 2.2 +/- 0.8 grams, and 35.1 +/- 13.4 mcg, respectively. The NRS
scores at rest and during movement in group F were lower compared to group
R. Conclusion(s): Ultrasound-guided PEC1 and PEC2 blocks with
fentanyl as an adjuvant to ropivacaine have significantly reduced the
requirements for analgesia and pain scores. Copyright © 2024,
Kheskani et al.

<68>
Accession Number
2033032344
Title
Assessment of paravalvular regurgitation after transcatheter aortic valve
replacement using 2D multi-velocity encoding and 4D flow cardiac magnetic
resonance.
Source
European Heart Journal Cardiovascular Imaging. 25(7) (pp 929-936), 2024.
Date of Publication: 01 Jul 2024.
Author
Rooijakkers M.J.P.; El Messaoudi S.; Stens N.A.; Van Wely M.H.; Habets J.;
Brink M.; Rodwell L.; Giese D.; Van Der Geest R.J.; Van Royen N.; Nijveldt
R.
Institution
(Rooijakkers, El Messaoudi, Stens, Van Wely, Van Royen, Nijveldt)
Department of Cardiology, Radboud University Medical Centre, Geert
Grooteplein Zuid 10, GA, Nijmegen 6525, Netherlands
(Stens) Department of Medical BioSciences, Radboud University Medical
Centre, Nijmegen, Netherlands
(Habets, Brink) Department of Radiology and Nuclear Medicine, Radboud
University Medical Centre, Nijmegen, Netherlands
(Habets) Department of Radiology and Nuclear Medicine, Haaglanden Medical
Centre, The Hague, Netherlands
(Rodwell) Department of Health Sciences, Section Biostatistics, Radboud
Institute for Health Sciences, Nijmegen, Netherlands
(Giese) Magnetic Resonance, Siemens Healthcare GmbH, Erlangen, Germany
(Giese) Institute of Radiology, Friedrich-Alexander-Universitat
Erlangen-Nurnberg (FAU), University Hospital Erlangen, Erlangen, Germany
(Van Der Geest) Department of Medical Imaging, Leiden University Medical
Centre, Leiden, Netherlands
Publisher
Oxford University Press
Abstract
Aims: To compare the novel 2D multi-velocity encoding (venc) and 4D flow
acquisitions with the standard 2D flow acquisition for the assessment of
paravalvular regurgitation (PVR) after transcatheter aortic valve
replacement (TAVR) using cardiac magnetic resonance (CMR)-derived
regurgitant fraction (RF). Methods and Results: In this prospective
study, patients underwent CMR 1 month after TAVR for the assessment of
PVR, for which 2D multi-venc and 4D flow were used, in addition to
standard 2D flow. Scatterplots and Bland-Altman plots were used to assess
correlation and visualize agreement between techniques. Reproducibility of
measurements was assessed with intraclass correlation coefficients. The
study included 21 patients (mean age +/- SD 80 +/- 5 years, 9 men). The
mean RF was 11.7 +/- 10.0% when standard 2D flow was used, 10.6 +/- 7.0%
when 2D multi-venc flow was used, and 9.6 +/- 7.3% when 4D flow was used.
There was a very strong correlation between the RFs assessed with 2D
multi-venc and standard 2D flow (r = 0.88, P < 0.001), and a strong
correlation between the RFs assessed with 4D flow and standard 2D flow (r
= 0.74, P < 0.001). Bland-Altman plots revealed no substantial bias
between the RFs (2D multi-venc: 1.3%; 4D flow: 0.3%). Intra-observer and
inter-observer reproducibility for 2D multi-venc flow were 0.98 and 0.97,
respectively, and 0.92 and 0.90 for 4D flow, respectively.
 Conclusion(s): Two-dimensional multi-venc and 4D flow produce an
accurate quantification of PVR after TAVR. The fast acquisition of the 2D
multi-venc sequence and the free-breathing acquisition with retrospective
plane selection of the 4D flow sequence provide useful advantages in
clinical practice, especially in the frail TAVR population. Copyright
© 2024 The Author(s). Published by Oxford University Press on behalf
of the European Society of Cardiology.

<69>
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. 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. 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. 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. Copyright © 2024

<70>
Accession Number
2029828207
Title
Incidence and pattern of urgent revascularization in acute coronary
syndromes treated with ticagrelor or prasugrel.
Source
Clinical Research in Cardiology. 113(7) (pp 1060-1069), 2024. Date of
Publication: July 2024.
Author
Aytekin A.; Scalamogna M.; Coughlan J.J.; Lahu S.; Ndrepepa G.; Menichelli
M.; Mayer K.; Wohrle J.; Bernlochner I.; Witzenbichler B.; Hochholzer W.;
Sibbing D.; Angiolillo D.J.; Hemetsberger R.; Tolg R.; Valina C.; Muller
A.; Kufner S.; Liebetrau C.; Xhepa E.; Hapfelmeier A.; Sager H.B.; Joner
M.; Richardt G.; Laugwitz K.-L.; Neumann F.J.; Schunkert H.; Schupke S.;
Kastrati A.; Cassese S.
Institution
(Aytekin, Scalamogna, Lahu, Ndrepepa, Mayer, Kufner, Xhepa, Sager, Joner,
Schunkert, Schupke, Kastrati, Cassese) Department of Cardiology, Deutsches
Herzzentrum Munchen, Technische Universitat Munchen, Lazarettstrasse, 36,
Munich, Germany
(Coughlan) Cardiovascular Research Institute, Mater Private Network,
Dublin, Ireland
(Menichelli) Department of Cardiology, Ospedale Fabrizio Spaziani,
Frosinone, Italy
(Wohrle) Department of Cardiology, Medical Campus Lake Constance,
Friedrichshafen, Germany
(Bernlochner, Muller, Laugwitz) Klinik Und Poliklinik Fur Innere Medizin
I, Klinikum Rechts Der Isar, Technische Universitat Munchen, Munich,
Germany
(Bernlochner, Sibbing, Sager, Joner, Laugwitz, Schunkert, Schupke,
Kastrati) German Center for Cardiovascular Research, Partner Site Munich
Heart Alliance, Munich, Germany
(Witzenbichler) Department of Cardiology and Pneumology, Helios
Amper-Klinikum Dachau, Dachau, Germany
(Hochholzer) Department of Cardiology and Intensive Care Medicine,
Klinikum Wurzburg Mitte, Wurzburg, Germany
(Sibbing) Department of Cardiology, Klinik der Universitat Munchen,
Ludwig-Maximilians-University, Munich, Germany
(Angiolillo) Division of Cardiology, University of Florida College of
Medicine, Jacksonville, FL, United States
(Hemetsberger) Department of Cardiology, Internal Medicine II, Medical
University of Vienna, Vienna, Austria
(Tolg, Richardt) Department of Cardiology, Heart Center Bad Segeberg, Bad
Segeberg, Germany
(Valina, Neumann) Department of Cardiology and Angiology, Medical Center -
University of Freiburg, Freiburg, Germany
(Valina, Neumann) Faculty of Medicine, University of Freiburg, Freiburg,
Germany
(Liebetrau) Heart Center, Campus Kerckhoff of Justus-Liebig-University,
Giessen, Germany
(Hapfelmeier) Institute of AI and Informatics in Medicine, School of
Medicine, Technical University of Munich, Munich, Germany
(Hapfelmeier) School of Medicine, Institute of General Practice and Health
Services Research, Munich, Germany
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Background: The ISAR-REACT 5 trial compared the efficacy and safety of
ticagrelor and prasugrel in patients with ACS managed invasively. The
present study sought to investigate the impact of ticagrelor and prasugrel
on the incidence and pattern of urgent revascularization in acute coronary
syndromes (ACS) patients undergoing percutaneous coronary intervention
(PCI). Methods and Results: This post-hoc analysis of the ISAR-REACT
5 trial included all ACS patients who underwent PCI. The primary endpoint
for this analysis was the incidence of urgent revascularization at
12-month follow-up. Secondary outcome was the pattern of urgent
revascularization procedures (namely, urgent target vessel/non-target
vessel revascularization - TVR/NTVR). Among 3,377 ACS patients who
underwent PCI, 1,676 were assigned to ticagrelor and 1,701 to prasugrel
before PCI. After 12 months, the incidence of urgent revascularization was
higher among patients assigned to ticagrelor as compared to prasugrel
(6.8% vs. 5.2%; hazard ratio [HR] = 1.32, 95% confidence interval [CI]
1.00-1.75; p = 0.051), mostly attributable to significantly more urgent
NTVR in the ticagrelor group (3.8% vs. 2.4%; HR = 1.62 [1.09-2.41]; p =
0.017). The risk of urgent TVR did not differ between treatment groups
(3.3% vs. 3.0%; HR = 1.13 [0.77-1.65]; p = 0.546). Conclusion(s): In
ACS patients treated with PCI, the cumulative rate of urgent
revascularizations after 12 months is higher with ticagrelor compared to
prasugrel, due to a significant increase in urgent revascularizations
involving remote coronary vessels. Graphic abstract: (Figure
presented.) Copyright © The Author(s) 2024.

<71>
Accession Number
2029655177
Title
Trends in preoperative carbohydrate load practice: A systematic review.
Source
Journal of Parenteral and Enteral Nutrition. 48(5) (pp 527-537), 2024.
Date of Publication: July 2024.
Author
Canelli R.J.; Louca J.; Gonzalez R.M.; Rendon L.F.; Hartman C.R.; Bilotta
F.
Institution
(Canelli, Louca, Gonzalez) Department of Anesthesiology, Boston University
School of Medicine, Boston Medical Center, Boston, MA, United States
(Rendon, Hartman) Boston Medical Center, Boston, MA, United States
(Bilotta) Sapienza University of Rome, Rome, Italy
Publisher
John Wiley and Sons Inc
Abstract
Background: The preoperative carbohydrate load (PCL) is intended to
improve surgical outcomes by reducing the catabolic state induced by
overnight fasting. However, there is disagreement on the optimal PCL
prescription, leaving local institutions without a standardized PCL
recommendation. Results from studies that do not prescribe PCL in
identical ways cannot be pooled to draw larger conclusions on outcomes
affected by the PCL. The aim of this systematic review is to catalog
prescribed PCL characteristics, including timing of ingestion, percentage
of carbohydrate contribution, and volume, to ultimately standardize PCL
practice. Method(s): A comprehensive search was conducted in
accordance with the Preferred Reporting Items for Systematic Reviews and
Meta-Analyses guidelines. Randomized controlled trials were included if
they studied at least one group of patients who were prescribed a PCL and
the PCL was described with respect to timing of ingestion, carbohydrate
contribution, and total volume. Result(s): A total of 67 studies with
6551 patients were included in this systematic review. Of the studies,
49.3% were prescribed PCL on the night before surgery and morning of
surgery, whereas 47.8% were prescribed PCL on the morning of surgery
alone. The mean prescribed carbohydrate concentration was 13.5% (+/-3.4).
The total volume prescribed was 648.2 ml (+/-377). Conclusion(s):
Variation in PCL practices prevent meaningful data pooling and outcome
analysis, highlighting the need for standardized PCL prescription. Efforts
dedicated to the establishment of a gold standard PCL prescription are
necessary so that studies can be pooled and analyzed with respect to
meaningful clinical end points that impact surgical outcomes and patient
satisfaction. Copyright © 2024 American Society for Parenteral
and Enteral Nutrition.

<72>
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. 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. 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. Copyright © 2024 Wiley Periodicals LLC.

<73>
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).
 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. 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). Conclusion(s): LVP during TAVR and BAV emerges a safer
alternative to RVP, offering reduced mortality, hospital stays, and
procedure durations. Copyright © 2024 Wiley Periodicals LLC.

<74>
Accession Number
2033117669
Title
Antifungal prophylaxis against invasive Candida and Aspergillus infection
in adult heart transplant recipients: protocol for a systematic review and
meta-analysis.
Source
European Journal of Hospital Pharmacy. (no pagination), 2024. Date of
Publication: 2024.
Author
Irshad Z.; Jenkins A.; Lim H.S.; Maidment I.D.
Institution
(Irshad, Jenkins, Lim) University Hospitals Birmingham NHS Foundation
Trust, Birmingham, United Kingdom
(Maidment) Aston University, Birmingham, United Kingdom
Publisher
BMJ Publishing Group
Abstract
Introduction: Invasive fungal infections (IFI) can contribute to increased
mortality and morbidity rates after heart transplant in adults. The most
common causes are Aspergillus and Candida species. There is uncertainty on
how effective antifungal prophylaxis is against Candida spp infections and
limited guidance on the prevention of Aspergillus spp infections. This
systematic review and meta-analysis will assess the literature to see if
antifungal prophylaxis reduces the incidence of IFI after heart transplant
in adults. Methods and analysis: This systematic review protocol follows
the Preferred Reporting Items for Systematic reviews and Meta Analysis
guidelines. A systematic search of the Cochrane Library, Web of Science,
Scopus, Embase, MEDLINE, and Proquest databases will be undertaken.
Reference lists of retrieved publications and conference abstracts will
also be searched. Title, abstract and full-text screening will be
undertaken by two reviewers. Discrepancies will be resolved by a third
reviewer. Studies with paediatric patients, multi-organ transplants, or
patients with a second heart transplant will be excluded, along with those
who do not have clear definitions and diagnostic criteria for IFI. Risk of
bias will be assessed using the Cochrane Risk of Bias 2 tool and the Risk
of Bias in Non-randomised Studies of Interventions tool. A meta-analysis
will be carried out, but if studies are not deemed to be sufficiently
similar, only a narrative synthesis will be undertaken. Ethics and
dissemination: Ethical approval is not required for this systematic review
as primary data will not be collected. The results of the review will be
disseminated through publication in an academic journal and scientific
conferences. Copyright © European Association of Hospital
Pharmacists 2024.

<75>
Accession Number
2030432388
Title
Effect of empagliflozin on ventricular arrhythmias in patients with type 2
diabetes treated with an implantable cardioverter-defibrillator: the
EMPA-ICD trial.
Source
Cardiovascular Diabetology. 23(1) (no pagination), 2024. Article Number:
224. Date of Publication: December 2024.
Author
Fujiki S.; Iijima K.; Nakagawa Y.; Takahashi K.; Okabe M.; Kusano K.;
Owada S.; Kondo Y.; Tsujita K.; Shimizu W.; Tomita H.; Shoda M.; Watanabe
M.; Tokano T.; Murohara T.; Kaneshiro T.; Kato T.; Hayashi H.; Maemura K.;
Niwano S.; Umemoto T.; Yoshida H.; Ota K.; Tanaka T.; Kitamura N.; Node
K.; Minamino T.
Institution
(Fujiki, Minamino) Department of Cardiovascular Medicine, Niigata
University Graduate School of Medical and Dental Sciences, Niigata, Japan
(Iijima, Hayashi, Minamino) Department of Cardiovascular Biology and
Medicine, Juntendo University Graduate School of Medicine, 2-1-1 Hongo,
Bunkyo-ku, Tokyo 113-8421, Japan
(Nakagawa) Department of Cardiovascular Medicine, Shiga University of
Medical Science, Shiga, Otsu, Japan
(Takahashi) Department of Cardiology, Niigata City General Hospital,
Niigata, Japan
(Okabe) Department of Cardiology, Tachikawa General Hospital, Niigata,
Japan
(Kusano) Department of Cardiovascular Medicine, National Cerebral and
Cardiovascular Center, Osaka, Japan
(Owada) Department of Internal Medicine, Division of Cardiology, Iwate
Medical University, Iwate, Japan
(Kondo) Department of Cardiovascular Medicine, Chiba University Graduate
School of Medicine, Chiba, Japan
(Tsujita) Department of Cardiovascular Medicine, Graduate School of
Medical Sciences, Kumamoto University, Kumamoto, Japan
(Shimizu) Department of Cardiovascular Medicine, Nippon Medical School,
Tokyo, Japan
(Tomita) Department of Cardiology and Nephrology, Hirosaki University
Graduate School of Medicine, Aomori, Japan
(Watanabe) Department of Cardiovascular Medicine, Hokkaido University
Graduate School of Medicine, Hokkaido, Sapporo, Japan
(Shoda) Department of Cardiology, Tokyo Women's Medical University
Hospital, Tokyo, Japan
(Watanabe) Department of Cardiology, Pulmonology, and Nephrology, Yamagata
University Faculty of Medicine, Yamagata, Japan
(Tokano) Department of Cardiology, Juntendo University Urayasu Hospital,
Chiba, Japan
(Murohara) Department of Cardiology, Nagoya University Graduate School of
Medicine, Aichi, Nagoya, Japan
(Kaneshiro) Department of Cardiovascular Medicine, Fukushima Medical
University, Fukushima, Japan
(Kato) Department of Cardiology, Graduate School of Medical Science,
Kanazawa University, Kanazawa, Japan
(Maemura) Department of Cardiovascular Medicine, Nagasaki University
Graduate School of Biomedical Sciences, Nagasaki, Japan
(Niwano) Department of Cardiovascular Medicine, Kitasato University,
Kanagawa, Japan
(Umemoto) Department of Cardiology, Jichi Medical University Saitama
Medical Center, Saitama, Japan
(Yoshida) Department of Medial Statistics, Osaka Metropolitan University
Graduate School of Medicine, Osaka, Japan
(Ota) Data Management Group, Department of Clinical Research Support,
Center for Clinical Research and Innovation, Osaka Metropolitan University
Hospital, Osaka, Japan
(Tanaka, Kitamura) Clinical and Translational Research Center, Niigata
University Medical and Dental Hospital, Niigata, Japan
(Node) Department of Cardiovascular Medicine, Saga University, Saga, Japan
(Minamino) Japan Agency for Medical Research and Development-Core Research
for Evolutionary Medical Science and Technology (AMED-CREST), Japan Agency
for Medical Research and Development, Tokyo, Japan
Publisher
BioMed Central Ltd
Abstract
Background: Sodium-glucose cotransporter 2 (SGLT2) inhibitors reduce the
risk of hospitalization for heart failure and cardiovascular death with
type 2 diabetes; however, their effect on arrhythmias is unclear. The
purpose of this study was to investigate the effects of empagliflozin on
ventricular arrhythmias in patients with type 2 diabetes. Method(s):
A total of 150 patients with type 2 diabetes who were treated with an
implantable cardioverter-defibrillator or cardiac resynchronization
therapy defibrillator (ICD/CRT-D) were randomized to once-daily
empagliflozin or placebo for 24 weeks. The primary endpoint was the change
in the number of ventricular arrhythmias from the 24 weeks before to the
24 weeks during treatment. Secondary endpoints included the change in the
number of appropriate device discharges and other values. Result(s):
In the empagliflozin group, the number of ventricular arrhythmias recorded
by ICD/CRT-D decreased by 1.69 during treatment compared to before
treatment, while in the placebo group, the number increased by 1.79. The
coefficient for the between-group difference was - 1.07 (95% confidence
interval [CI] - 1.29 to - 0.86; P < 0.001). The change in the number of
appropriate device discharges during and before treatment was 0.06 in the
empagliflozin group and 0.27 in the placebo group, with no significant
difference between the groups (P = 0.204). Empagliflozin was associated
with an increase in blood ketones and hematocrit and a decrease in blood
brain natriuretic peptide and body weight. Conclusion(s): In patients
with type 2 diabetes treated with ICD/CRT-D, empagliflozin reduces the
number of ventricular arrhythmias compared with placebo. Trial
registration jRCTs031180120. Copyright © The Author(s) 2024.

<76>
Accession Number
2033090598
Title
Fluid accumulation in critically ill children: a systematic review and
meta-analysis.
Source
eClinicalMedicine. 74 (no pagination), 2024. Article Number: 102714. Date
of Publication: August 2024.
Author
Lintz V.C.; Vieira R.A.; Carioca F.D.L.; Ferraz I.D.S.; Silva H.M.;
Ventura A.M.C.; de Souza D.C.; Brandao M.B.; Nogueira R.J.N.; de Souza
T.H.
Institution
(Lintz, Vieira, Carioca, Ferraz, Silva, Brandao, Nogueira, de Souza)
Paediatric Intensive Care Unit, Department of Paediatrics, Clinics
Hospital of the State University of Campinas (UNICAMP), SP, Campinas,
Brazil
(Ventura, de Souza) Paediatric Intensive Care Unit, Department of
Paediatrics, University Hospital of the University of Sao Paulo (USP), SP,
Sao Paulo, Brazil
(de Souza) Sirio-Libanes Hospital, Sao Paulo, Brazil
Publisher
Elsevier Ltd
Abstract
Background: Fluids are often administered for various purposes, such as
resuscitation, replacement, maintenance, nutrition, or drug infusion.
However, its use is not without risks. Critically ill patients are highly
susceptible to fluid accumulation (FA), which is associated with poor
outcomes, including organ dysfunction, prolonged mechanical ventilation,
extended hospital stays, and increased mortality. This study aimed to
assess the association between FA and poor outcomes in critically ill
children. Method(s): In this systematic review and meta-analysis, we
searched PubMed, Embase, ClinicalTrials.gov, and Cochrane Library
databases from inception to May 2024. Relevant publications were searched
using the following terms: child, children, infant, infants, pediatric,
pediatrics, critically ill children, critical illness, critical care,
intensive care, pediatric intensive care, pediatric intensive care unit,
fluid balance, fluid overload, fluid accumulation, fluid therapy, edema,
respiratory failure, respiratory insufficiency, pulmonary edema,
mechanical ventilation, hemodynamic instability, shock, sepsis, acute
renal failure, acute kidney failure, acute kidney injury, renal
replacement therapy, dialysis, mortality. Paediatric studies were
considered eligible if they assessed the effect of FA on the outcomes of
interest. The main outcome was all-cause mortality. Pooled analyses were
performed by using random-effects models. This review was registered on
PROSPERO (CRD42023432879). Finding(s): A total of 120 studies (44,682
children) were included. Thirty-five FA definitions were identified. In
general, FA was significantly associated with increased mortality (odds
ratio [OR] 4.36; 95% confidence interval [CI] 3.53-5.38), acute kidney
injury (OR 1.98; 95% CI 1.60-2.44), prolonged mechanical ventilation
(weighted mean difference [WMD] 38.1 h, 95% CI 19.35-56.84), and longer
stay in the intensive care unit (WMD 2.29 days; 95% CI 1.19-3.38). The
percentage of FA was lower in survivors when compared to non-survivors
(WMD -4.95 [95% CI, -6.03 to -3.87]). When considering only studies that
controlled for potential confounding variables, the pooled analysis
revealed 6% increased odds of mortality associated with each 1% increase
in the percentage of FA (adjusted OR = 1.06 [95% CI, 1.04-1.09).
 Interpretation(s): FA is significantly associated with poorer
outcomes in critically ill children. Thus, clinicians should closely
monitor fluid balance, especially when new-onset or worsening organ
dysfunction occurs in oedematous patients, indicating potential FA
syndrome. Future research should explore interventions like restrictive
fluid therapy or de-resuscitation methods. Meanwhile, preventive measures
should be prioritized to mitigate FA until further evidence is available.
 Funding(s): None. Copyright © 2024 The Author(s)

<77>
Accession Number
2033067713
Title
Cost-effectiveness of extracorporeal cardiopulmonary resuscitation vs.
conventional cardiopulmonary resuscitation in out-of-hospital cardiac
arrest: A pre-planned, trial-based economic evaluation.
Source
European Heart Journal: Acute Cardiovascular Care. 13(6) (pp 484-492),
2024. Date of Publication: 01 Jun 2024.
Author
Delnoij T.S.R.; Suverein M.M.; Essers B.A.B.; Hermanides R.C.; Otterspoor
L.; Elzo Kraemer C.V.; Vlaar A.P.J.; Van Der Heijden J.J.; Scholten E.;
Den Uil C.; Akin S.; De Metz J.; Van Der Horst I.C.C.; Maessen J.G.;
Lorusso R.; Van De Poll M.C.G.
Institution
(Delnoij, Suverein, Van Der Horst, Van De Poll) Department of Intensive
Care Medicine, Maastricht University, Medical Center, P. Debyelaan 25,
Maastricht 6229 HX, Netherlands
(Delnoij) Department of Cardiology, Maastricht University, Medical Center,
P. Debyelaan 25, Maastricht 6229 HX, Netherlands
(Essers) Department of Clinical Epidemiology and Medical Technical
Assessment, Maastricht University Medical Center, Maastricht, Netherlands
(Hermanides) Department of Cardiology, Isala Hospital, Zwolle, Netherlands
(Otterspoor) Department of Intensive Care Medicine, Catharina Hospital,
Eindhoven, Netherlands
(Elzo Kraemer) Department of Intensive Care Medicine, Leiden University,
Medical Center, Leiden, Netherlands
(Vlaar) Department of Intensive Care Medicine, Amsterdam University
Medical Center Location AMC, Amsterdam, Netherlands
(Vlaar) Department of Intensive Care Medicine, Maasstad Hospital,
Rotterdam, Netherlands
(Van Der Heijden) Department of Intensive Care Medicine, University
Medical Center Utrecht, Utrecht, Netherlands
(Scholten) Department of Intensive Care Medicine, St. Antonius Hospital,
Nieuwegein, Netherlands
(Den Uil) Department of Intensive Care Medicine, Department of Cardiology,
Erasmus Medical Center, Rotterdam, Netherlands
(Akin) Department of Intensive Care Medicine, HagaZiekenhuis, The Hague,
Netherlands
(De Metz) Department of Intensive Care Medicine, OLVG, Amsterdam,
Netherlands
(Van Der Horst, Maessen, Lorusso) Cardiovascular Research Institute
Maastricht, Maastricht University, Medical Center, Maastricht, Netherlands
(Maessen, Lorusso) Department of Cardiothoracic Surgery, Maastricht
University, Medical Center, Maastricht, Netherlands
Publisher
Oxford University Press
Abstract
Aims: When out-of-hospital cardiac arrest (OHCA) becomes refractory,
extracorporeal cardiopulmonary resuscitation (ECPR) is a potential option
to restore circulation and improve the patient's outcome. However, ECPR
requires specific materials and highly skilled personnel, and it is
unclear whether increased survival and health-related quality of life
(HRQOL) justify these costs. Methods and Results: This
cost-effectiveness study was part of the INCEPTION study, a multi-centre,
pragmatic randomized trial comparing hospital-based ECPR to conventional
CPR (CCPR) in patients with refractory OHCA in 10 cardiosurgical centres
in the Netherlands. We analysed healthcare costs in the first year and
measured HRQOL using the EQ-5D-5L at 1, 3, 6, and 12 months. Incremental
cost-effectiveness ratios (ICERs), cost-effectiveness planes, and
acceptability curves were calculated. Sensitivity analyses were performed
for per-protocol and as-Treated subgroups as well as imputed productivity
loss in deceased patients. In total, 132 patients were enrolled: 62 in the
CCPR and 70 in the ECPR group. The difference in mean costs after 1 year
was 5109 (95% confidence interval-7264 to 15 764). Mean quality-Adjusted
life year (QALY) after 1 year was 0.15 in the ECPR group and 0.11 in the
CCPR group, resulting in an ICER of 121 643 per additional QALY gained.
The acceptability curve shows that at a willingness-To-pay threshold of
80.000, the probability of ECPR being cost-effective compared with CCPR is
36%. Sensitivity analysis showed increasing ICER in the per-protocol and
as-Treated groups and lower probabilities of acceptance.
 Conclusion(s): Hospital-based ECPR in refractory OHCA has a low
probability of being cost-effective in a trial-based economic
evaluation. Copyright © 2024 The Author(s). Published by Oxford
University Press on behalf of the European Society of Cardiology. All
rights reserved.

<78>
Accession Number
2030439997
Title
Effect of near-infrared spectroscopy on postoperative delirium in cardiac
surgery with cardiopulmonary bypass: a systematic review and
meta-analysis.
Source
Frontiers in Cardiovascular Medicine. 11 (no pagination), 2024. Article
Number: 1404210. Date of Publication: 2024.
Author
Sun Q.; Wu W.
Institution
(Sun, Wu) Department of Anesthesiology, Qilu Hospital (Qingdao), Cheeloo
College of Medicine, Shandong University, Qingdao, China
Publisher
Frontiers Media SA
Abstract
Background: Postoperative delirium (POD) is a common anesthetic side
effect in cardiac surgery. However, the role of oxygen saturation
monitoring in reducing postoperative delirium has been controversial.
Therefore, this meta-analysis aimed to analyze whether NIRS monitoring
during cardiac surgery under cardiopulmonary bypass could reduce the
incidence of postoperative delirium. Method(s): PubMed, Web of
Science, Cochrane Library, Embase and China National Knowledge
Infrastructure (CNKI) databases were systematically searched using the
related keywords for randomized-controlled trials (RCTs) published from
their inception to March 16, 2024. This review was conducted by the
Preferred Reporting Project and Meta-Analysis Statement (PRISMA)
guidelines for systematic review. The primary outcome was postoperative
delirium, and the second outcomes included the length of ICU stay, the
incidence of kidney-related adverse outcomes, and the incidence of
cardiac-related adverse outcomes. Result(s): The incidence of
postoperative delirium could be reduced under the guidance of
near-infrared spectroscopy monitoring (OR, 0.657; 95% CI, 0.447-0.965; P =
0.032; I2 = 0%). However, there were no significant differences
in the length of ICU stay (SMD, 0.005 days; 95% CI, -0.135-0.146; P =
0.940; I2 = 39.3%), the incidence of kidney-related adverse
outcomes (OR, 0.761; 95% CI, 0.386-1.500; P = 0.430; I2 = 0%),
and the incidence of the cardiac-related adverse outcomes (OR, 1.165; 95%
CI, 0.556-2.442; P = 0.686; I2 = 0%) between the two groups.
 Conclusion(s): Near-infrared spectroscopy monitoring in cardiac
surgery with cardiopulmonary bypass helps reduce postoperative delirium in
patients. Systematic Review Registration: PROSPERO, identifier,
CRD42023482675 Copyright 2024 Sun and Wu.

<79>
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. 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. 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). 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. Copyright © 2024 by the authors.

<80>
Accession Number
641884589
Title
Comparing the effect of the Model of Therapeutic Engagement in cardiac
rehabilitation on the sense of coherence and adherence to treatment: a
randomized clinical trial.
Source
Disability and rehabilitation. 46(14) (pp 3007-3016), 2024. Date of
Publication: 01 Jul 2024.
Author
Pakrad F.; Jahandideh S.; Oshvandi K.; Majidi L.; Khazaei S.; Pakrad B.
Institution
(Pakrad) Chronic Diseases (Home Care) Research Center, Hamadan University
of Medical Sciences, Hamadan, Iran, Islamic Republic of
(Pakrad, Oshvandi) Department of Nursing, Faculty of Nursing and
Midwifery, Hamadan University of Medical Sciences, Hamadan, Iran, Islamic
Republic of
(Jahandideh) School of Nursing and Midwifery, Deakin University, Geelong,
VIC, Australia
(Majidi) Department of Physical Medicine and Rehabilitation, Faculty of
Medicine, Hamadan University of Medical Sciences, Hamadan, Iran, Islamic
Republic of
(Khazaei) Research Centre for Health Sciences, Hamadan University of
Medical Sciences, Hamadan, Iran, Islamic Republic of
(Pakrad) Department of exercise physiology, Farhangian University,
Hamadan, Iran, Islamic Republic of
Abstract
PURPOSE: The study aimed to compare the effectiveness of a traditional
cardiac rehabilitation (CR) program with an enhanced program incorporating
the model of therapeutic engagement (MTE) and extended remote support for
patients undergoing coronary artery bypass graft (CABG) patients.
MATERIALS AND METHODS: In a randomized controlled trial, 88 CABG patients
were assigned to experimental and control groups. The experimental group
received integrated MTE cardiac rehabilitation, and assessments were
conducted at three time points: pre-CR, one month later, and three months
post-CR. The study measured medication adherence (MARS-5) and sense of
coherence (SoC-13) scales. RESULT(S): The study found no significant
differences in demographic factors between the experimental and control
groups. However, significant differences were observed in MARS and
individuals' SoC scores over time in the experimental group, with notable
improvements (p<0.001). The control group showed significant changes only
up to one month. Group effects were evident, with consistent increases in
the experimental group's outcomes at each assessment point.
 CONCLUSION(S): Integrating the MTE into CR programs offers benefits
in terms of medication adherence and individuals' sense of coherence,
which warrants further investigation and clinical implementation.

<81>
Accession Number
644653724
Title
The Effect of Informing Patient Relatives with a Short Message on Anxiety
Levels during Cardiovascular Surgery in Turkiye: A Randomized Controlled
Trial.
Source
Nigerian journal of clinical practice. 27(6) (pp 708-715), 2024. Date of
Publication: 01 Jun 2024.
Author
Sisman C.; Digin F.
Institution
(Sisman) Department of Operating Room, Uludag University Health
Application and Research Center, Bursa, Turkey
(Digin) Department of Surgical Nursing, Kirklareli University Faculty of
Health Sciences, Turkey
Abstract
BACKGROUND: Surgical procedures cause a certain level of anxiety in the
relatives of the patients, it has been observed that heart surgeries cause
more anxiety. AIM: To determine the effects of informing patients'
relatives with short messages on anxiety levels during cardiovascular
surgery. METHOD(S): The study was conducted as a randomized
controlled research investigation from October 1, 2015, to December 31,
2022, at the cardiovascular surgery operating room of a university
hospital and included 84 patient relatives (42 experimental and 42 control
group). The Patient Relatives Information Form and the State and Trait
Anxiety Inventory were used to collect the study data. The patients'
relatives in the experimental group were informed by short messages
(preparations for surgery have begun, your relative's surgery has started,
your relative's surgery is still ongoing, and your relative's surgery is
completed) during the surgery. State Anxiety Inventory was re-administered
to all patients' relatives after cardiovascular surgery. The study was
registered with ClinicalTrials.gov (NCT05157789). RESULT(S): It was
found that the postoperative State Anxiety Inventory score of the
experimental group was significantly lower than that of the control group
(P < 0.001). The difference between preoperative and postoperative state
anxiety scores was significantly higher in the experimental group (P <
0.001). CONCLUSION(S): Informing the patients' relatives with a short
message during cardiovascular surgery significantly reduced the level of
anxiety. Copyright © 2024 Copyright: © 2024 Nigerian Journal
of Clinical Practice.

<82>
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. Design(s): Systematic review and meta-analysis.
 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. 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). 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. 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). 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. Copyright © 2024 The Authors

<83>
Accession Number
2033007081
Title
Outcomes of Video-assisted Thoracic Surgery-guided Early Evacuation of
Traumatic Hemothorax: A Randomized Pilot Study at Level I Trauma Center.
Source
Journal of Emergencies, Trauma and Shock. 17(2) (pp 73-79), 2024. Date of
Publication: 2024.
Author
Kumar A.; Gora D.; Bagaria D.; Priyadarshini P.; Choudhary N.; Priyadarshi
A.; Gupta S.; Alam J.; Gupta A.; Mishra B.; Kumar S.; Sagar S.
Institution
(Kumar, Bagaria, Priyadarshini, Choudhary, Priyadarshi, Gupta, Alam,
Gupta, Mishra, Kumar, Sagar) Division of Trauma Surgery and Critical Care,
JPN Apex Trauma Centre, AIIMS, New Delhi, India
(Gora) Department of Trauma Surgery, SMS Medical College, Rajasthan,
Jaipur, India
Publisher
Wolters Kluwer Medknow Publications
Abstract
Introduction: Traumatic hemothorax is accounted for about 20% of traumatic
chest injuries. Although majority can be managed with the timely placement
of intercostal tube (ICT) drainage, the remaining pose a challenge owing
to high complication rates associated with retained hemothorax. Although
various treatment modalities including intrapleural instillation of
fibrinolytics, radioimage guided drainage, VATS guided evacuation and
thoractomy do exist to address the retained hemothorax, but indications
along with timing to employ a specific treatment option is still unclear
and ambiguous. Method(s): Patient with residual hemothorax (>200 mL)
on ultrasonography after 48 h of indwelling ICT was randomized into either
early video-assisted thoracic surgery (VATS) or conventional approach
cohort. Early VATS cohort was subjected to video-assisted thoracoscopic
evacuation of undrained blood along with normal saline irrigation and ICT
placement. The conventional cohort underwent intrapleural thrombolytic
instillation for 3 consecutive days. The outcome measures were the
duration of indwelling ICT, removal rate of tube thoracostomy, length of
hospital stay, duration of intensive care unit (ICU) monitoring, need for
mechanical ventilation, incidence of pulmonary and pleural complications,
and requirement of additional intervention to address undrained hemothorax
and mortality rate. Result(s): The early VATS cohort had shorter
length of hospital stay (7.50 +/- 0.85 vs. 9.50 +/- 3.03, P = 0.060),
reduced duration of indwelling ICT (6.70 +/- 1.25 vs. 8.30 +/- 2.91, P =
0.127) with higher rate of tube thoracostomy removal (70% vs. 30%, P =
0.003) and lesser need of additional interventions (0% vs. 30%, P =
0.105). Thoracotomy (3 patients) and image-guided drainage (4 patients)
were additional interventions to address retained hemothorax in the
conventional cohort. However, similar length of ventilator assistance (0.7
+/- 0.48 vs. 0.60 +/- 1.08, P = 0.791) and prolonged ICU monitoring (1.30
+/- 1.06 vs. 0.90 +/- 1.45, P = 0.490) was observed in early VATS cohort.
Both the cohorts had no mortality. Conclusion(s): VATS-guided early
evacuation of traumatic hemothorax is associated with shorter length of
hospital stay along with abbreviated indwelling ICT duration, reduced
incidence of complications, lesser readmissions, and improved rate of tube
thoracostomy removal. However, the duration of ventilator requirement, ICU
stay, and mortality remain unchanged. Copyright © 2024 Journal of
Emergencies, Trauma, and Shock.

<84>
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).
 Aim(s): To evaluate the relative clinical efficacy of coil and
anchored needle (AN) insertion as approaches to preoperative CT-guided PN
localization. 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. 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. 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. Copyright © 2024 Termedia Publishing House Ltd.. All
rights reserved.

<85>
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.
 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. 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.
 Conclusion(s): The use of fibrinogen concentrate in the perioperative
care of non-trauma and non-obstetric adult patients may lead to potential
benefits. Copyright © 2024 by the authors.

<86>
Accession Number
2030050379
Title
Bibliometric Analysis of the Top-100 Cited Articles on Postoperative
Delirium.
Source
Journal of Multidisciplinary Healthcare. 17 (pp 2961-2972), 2024. Date of
Publication: 2024.
Author
Miao Q.; Zhou R.; Li X.; Xiong L.
Institution
(Miao, Zhou, Li, Xiong) Shanghai Key Laboratory of Anesthesiology and
Brain Functional Modulation, Clinical Research Center for Anesthesiology
and Perioperative Medicine, Translational Research Institute of Brain and
Brain-Like Intelligence, Department of Anesthesiology and Perioperative
Medicine, Shanghai Fourth People's Hospital, School of Medicine, Tongji
University, Shanghai City, China
Publisher
Dove Medical Press Ltd
Abstract
Objective: Postoperative delirium (POD), a common complication affecting
short-and long-term prognosis in elderly patients, leads to a heavy burden
on social economy and health care. The main purpose of this study is to
conduct a bibliometric analysis of the 100 most frequently cited articles
on POD. Method(s): "Postoperative delirium" and its synonyms were
searched in the Web of Science (WoS) core database. The top-100 cited
articles were automatically selected by sorting the records in descending
order. Key information such as author, journal, article type, publication
year, citations, since 2013 usage count, institution, country, and
keywords were extracted and analyzed. VOSviewer software was applied to do
the visualization analyses of institution co-operation, author
interaction, author co-citation, and keywords co-occurrence. The CiteSpace
software was used to analyze keywords burst. Result(s): Most articles
were published by authors and institutions in the United States of America
(USA). Inouye was the most influential author of this field. The journals
that recorded these articles had a high impact factor (IF), with a highest
IF of 168.9 and an average IF of 18.04. Cohort studies were the main
document type in this field (42 publications), followed by randomized
controlled trial (RCT) and systematic reviews or meta-analysis (18 and 14,
respectively). The 10 keywords with the highest appearance were
"delirium", "risk-factors", "surgery", "confusion assessment method",
"elderly patients", "hip fracture", "intensive care unit", "cardiac
surgery", "general anesthesia", and "risk". Moreover, "double blind" and
"cardiac surgery" were the most recent booming keywords.
 Conclusion(s): We indicated the current research status and tendency
of POD by analyzing the 100 most influential articles on POD. The USA is
the leader in this field. Prospective study is the preference for authors
to cite. Cardiac surgery remains the primary research carrier and the
hotspots in the near future may be double-blind studies. Copyright
© 2024 Miao et al.

<87>
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. 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). Copyright © The Author(s), under exclusive
licence to Springer Healthcare Ltd., part of Springer Nature 2024.

<88>
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. 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. 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.
 Participant(s): Postoperative cardiac surgery patients.
 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. 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. Copyright © 2024 Elsevier Inc.

<89>
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.
 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. 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. 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. Copyright © 2024 British Journal of Anaesthesia

<90>
Accession Number
643814644
Title
Efficacy of mitral valve repair in combination with coronary
revascularization for moderate ischaemic mitral regurgitation: a
systematic review and meta-analysis of randomized controlled trials.
Source
International journal of surgery (London, England). 110(6) (pp 3879-3887),
2024. Date of Publication: 01 Jun 2024.
Author
Li X.; Hou B.; Hou S.; Jiang W.; Liu Y.; Zhang H.
Institution
(Li, Hou, Jiang, Zhang) Department of Cardiac Surgery Center, Beijing
Anzhen Hospital, Beijing Institute of Heart, Lung, Blood Vascular
Diseases, Capital Medical University, Chaoyang district, Beijing, China
(Hou, Liu) Department of Cardiovascular Surgery, First Affiliated Hospital
of Anhui Medical University, Hefei, China
Abstract
BACKGROUND: The efficacy of mitral valve repair (MVR) in combination with
coronary artery bypass grafting (CABG) for moderate ischaemic mitral
regurgitation (IMR) remains unclear. To evaluate whether MVR + CABG is
superior to CABG alone, the authors conducted a systematic review and
meta-analysis of existing randomized controlled trials (RCTs).
 METHOD(S): The authors searched PubMed, Web of Science, and the
Cochrane Central Register of Controlled Trials for eligible RCTs from the
date of their inception to October 2023. The primary outcomes were
operative (in-hospital or within 30 days) and long-term (>= 1 year)
mortality. The secondary outcomes were postoperative stroke, worsening
renal function (WRF), and reoperation for bleeding or tamponade. The
authors performed random-effects meta-analyses and reported the results as
risk ratios (RRs) with 95% CIs. RESULT(S): Six RCTs were eligible for
inclusion. Compared with CABG alone, MVR + CABG did not increase the risk
of operative mortality (RR, 1.244; 95% CI, 0.514-3.014); however, it was
also not associated with a lower risk of long-term mortality (RR, 0.676;
95% CI, 0.417-1.097). Meanwhile, there was no difference between the two
groups in terms of postoperative stroke (RR, 2.425; 95% CI, 0.743-7.915),
WRF (RR, 1.257; 95% CI, 0.533-2.964), and reoperation for bleeding or
tamponade (RR, 1.667; 95% CI, 0.527-5.270). CONCLUSION(S): The
findings of this meta-analysis suggest that MVR + CABG fails to improve
the clinical outcomes of patients with moderate IMR compared to CABG
alone. Copyright © 2024 The Author(s). Published by Wolters
Kluwer Health, Inc.

<91>
Accession Number
643685860
Title
The effect of omentoplasty in various surgical operations: systematic
review and meta-analysis.
Source
International journal of surgery (London, England). 110(6) (pp 3778-3794),
2024. Date of Publication: 01 Jun 2024.
Author
Peng Y.; Xiong S.; Ding Y.; Xie L.; Wang Y.; Mei Y.; Liu W.; Deng T.
Institution
(Peng, Xiong, Ding, Xie, Wang, Mei, Deng) National Clinical Research
Center for Metabolic Diseases, Department of Metabolism and Endocrinology
(Peng, Xiong, Ding, Xie, Wang, Mei, Deng) Key Laboratory of Diabetes
Immunology, Ministry of Education, Metabolic Syndrome Research Center
(Liu) Department of Biliopancreatic Surgery and Bariatric Surgery
(Deng) Clinical Immunology Center, Second Xiangya Hospital of Central
South University, Changsha, Hunan, China
Abstract
BACKGROUND: Omentoplasty is commonly used in various surgeries. However,
its effectiveness is unsure due to lack of convincing data and research.
To clarify the impact of omentoplasty on postoperative complications of
various procedures, this systematic review and meta-analysis was
performed. METHOD(S): A systematic review of published literatures
from four databases: PubMed, Web of Science, Cochrane Library, and Embase
before 14 July 2022. The authors primarily included publications on five
major surgical operations performed in conjunction with omentoplasty:
thoracic surgery, esophageal surgery, gastrointestinal surgery,
pelvi-perineal surgery, and liver surgery. The protocol was registered in
PROSPERO. RESULT(S): This review included 25 273 patients from 91
studies ( n =9670 underwent omentoplasty). Omentoplasty was associated
with a lower risk of overall complications particularly in
gastrointestinal [relative risk (RR) 0.53; 95% CI: 0.39-0.72] and liver
surgery (RR 0.54; 95% CI: 0.39-0.74). Omentoplasty reduced the risk of
postoperative infection in thoracic (RR 0.38; 95% CI: 0.18-0.78) and liver
surgery (RR 0.39; 95% CI: 0.29-0.52). In patients undergoing esophageal
(RR 0.89; 95% CI: 0.80-0.99) and gastrointestinal (RR 0.28; 95% CI:
0.23-0.34) surgery with a BMI greater than 25, omentoplasty is
significantly associated with a reduced risk of overall complications
compared to patients with normal BMI. No significant differences were
found in pelvi-perineal surgery, except infection in patients whose BMI
ranged from 25 kg/m 2 to 29.9 kg/m 2 (RR 1.25; 95% CI: 1.04-1.50) and
anastomotic leakage in patients aged over 60 (RR 0.59; 95% CI: 0.39-0.91).
 CONCLUSION(S): Omentoplasty can effectively prevent postoperative
infection. It is associated with a lower incidence of multiple
postoperative complications in gastrointestinal and liver
surgery. Copyright © 2024 The Author(s). Published by Wolters
Kluwer Health, Inc.

<92>
Accession Number
644649397
Title
Effects of different anesthetic regimens on postoperative cognitive
function of elderly patients undergoing thoracic surgery: a double-blinded
randomized controlled trial.
Source
Journal of cardiothoracic surgery. 19(1) (pp 394), 2024. Date of
Publication: 27 Jun 2024.
Author
Xie L.; Wei X.; He K.; Wang S.; Xu M.
Institution
(Xie, He, Wang, Xu) Department of Anesthesiology, Division of Life
Sciences and Medicine, First Affiliated Hospital of USTC, University of
Science and Technology of China, Hefei, Anhui 230001, China
(Wei) Department of Anesthesiology, Division of Life Sciences and
Medicine, First Affiliated Hospital of USTC, University of Science and
Technology of China, Hefei, Anhui 230001, China
Abstract
OBJECTIVE: Postoperative cognitive dysfunction (POCD) is a serious
surgical complication. We assessed the different POCD incidences between
anesthesia using sevoflurane and sevoflurane combined with
dexmedetomidine, with propofol-based sedation in elderly patients who
underwent a thoracic surgical procedure. METHOD(S): A total of 90
patients aged 65 to 80 years old who underwent a thoracic surgical
procedure at our hospital and 15 nonsurgical participants as controls,
were enrolled in this study. Patients were divided in a randomized 1:1:1
ratio into 3 groups. All participants were randomized into a trial with
three anesthesia groups (P, PS, PSD) or a control group (C) of healthy
matches. All trial groups received distinct anesthetic combinations during
surgery, while controls mirrored patient criteria.Group P (propofol and
remifentanil were maintained during the surgery), Group PS (propofol,
remifentanil, and sevoflurane were maintained during the surgery), and
Group PSD (propofol, remifentanil, sevoflurane, and dexmedetomidine were
maintained during the surgery).All participants were rated using a series
of cognitive assessment scales before and three days after surgery. All
participants were interviewed over the telephone, 7 days, 30 days, and 90
days postoperatively. RESULT(S): POCD incidences in the PSD (combined
anesthetization with propofol, sevoflurane, and dexmedetomidine) group was
significantly lower than that in the PS (combined anesthetization with
propofol and sevoflurane) group, 1 day post-surgery (10.0% vs. 40.0%,
P=0.008), and the results were consistent at 3 days post-surgery. When the
patients were assessed 7 days, 30 days, and 90 days postoperatively, there
was no significant difference in POCD incidence among the three groups.
Multivariate logistic regression analysis of POCD one day after surgery
showed that education level was negatively correlated with incidence of
POCD (P=0.018) and single lung ventilation time was positively correlated
with incidence of POCD (P=0.001). CONCLUSION(S): For elderly patients
who underwent a thoracic surgical procedure, dexmedetomidine sedation
shows an obvious advantage on improving short-term POCD incidence, which
is caused by sevoflurane. Copyright © 2024. The Author(s).

<93>
Accession Number
644646571
Title
PCSK9 Inhibitor Added to High-Intensity Statin Therapy to Prevent
Cardiovascular Events in Patients with Acute Coronary Syndrome after
Percutaneous Coronary Intervention: A Randomized, Double- Blind,
Placebo-Controlled, Multicenter SHAWN Study.
Source
American heart journal. (no pagination), 2024. Date of Publication: 26
Jun 2024.
Author
Wu Z.-M.; Kan J.; Ye F.; You W.; Wu X.-Q.; Tian N.-L.; Lin S.; Ge Z.; Liu
Z.-Z.; Bo Li X.; Gao X.-F.; Chen J.; Wang Y.; Wen S.-Y.; Xie P.; Cong
H.-L.; Liu L.-J.; Zeng H.-S.; Zhou L.; Liu F.; Zheng Y.-H.; Li R.; Ji
H.-L.; Zhou S.-H.; Zhao S.-M.; Qian X.-S.; Luo J.; Wang X.; Zhang J.-J.;
Chen S.-L.
Institution
(Wu, Kan, Ye, You, Wu, Tian, Lin, Ge, Liu, Bo Li, Gao) Division of
Cardiology, Nanjing First Hospital, Nanjing Medical University, Nanjing,
China
(Chen) Division of Cardiology, Renmin Hospital of Wuhan University, Wuhan,
China
(Wang) Division of Cardiology, Xiamen Cardiovascular Hospital, Xiamen
University, Xiamen, China
(Wen) Division of Cardiology, Tianjin 4th Central Hospital, Tianjin, China
(Xie) Division of Cardiology, Gansu Province People's Hospital, Lanzhou,
China
(Cong) Division of Cardiology, Tianjin Chest Hospital, Tianjin, China
(Liu) Division of Cardiology, First Affiliated Hospital of Anhui
University of Science and Technology, Huainan, China
(Zeng) Division of Cardiology, Huazhong University of Science and
Technology Tongji Medical College Tongji Hospital, Wuhan, China
(Zhou) Division of Cardiology, Changzhou Jintan First People's Hospital,
Changzhou, China
(Liu) Division of Cardiology, Second Hospital of Hebei Medical University,
Shijiazhuang, China
(Zheng) Division of Cardiology, Liyang Hospital of Chinese Medicine, China
(Li) Division of Cardiology, First Affiliated Hospital of Harbin Medical
University, Harbin, China
(Ji) Division of Cardiology, First Hospital of Jilin University, Jilin,
China
(Zhou) Division of Cardiology, Second Xiangya Hospital of Central South
University, Changsha, China
(Zhao) Division of Cardiology, First Peoples of Hospital of Taicang,
Suzhou, China
(Qian) Division of Cardiology, Zhangjiagang First People's Hospital,
Zhangjiagang, China
(Luo) Division of Cardiology, People's Hospital of Ganzhou, China
(Wang) Division of Cardiology, Lianyungang Hospital of Chinese Medicine,
Lianyungang, China
(Zhang) Division of Cardiology, Nanjing First Hospital, Nanjing Medical
University, Nanjing, China
(Chen) Division of Cardiology, Nanjing First Hospital, Nanjing Medical
University, Nanjing, China
Abstract
BACKGROUND: It is currently uncertain whether the combination of a
proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitor and
high-intensity statin treatment can effectively reduce cardiovascular
events in patients with acute coronary syndrome (ACS) who have undergone
percutaneous coronary intervention (PCI) for culprit lesions.
 METHOD(S): This study protocol describes a double-blind, randomized,
placebo-controlled, multicenter study aiming to investigate the efficacy
and safety of combining a PCSK9 inhibitor with high-intensity statin
therapy in patients with ACS following PCI. A total of 1212 patients with
ACS and multiple lesions will be enrolled and randomly assigned to receive
either PCSK9 inhibitor plus high-intensity statin therapy or
high-intensity statin monotherapy. The randomization process will be
stratified by sites, diabetes, initial presentation and use of stable (>=4
weeks) statin treatment at presentation. PCSK 9 inhibitor or its placebo
is injected within 4 hours after PCI for the culprit lesion. The primary
endpoint is the composite of cardiovascular death, myocardial infarction,
stroke, re-hospitalization due to ACS or heart failure, or any
ischemia-driven coronary revascularization at one-year follow-up between
two groups. Safety endpoints mean PCSK 9 inhibitor and statin intolerance.
 CONCLUSION(S): The SHAWN study has been specifically designed to
evaluate the effectiveness and safety of adding a PCSK9 inhibitor to
high-intensity statin therapy in patients who have experienced ACS
following PCI. The primary objective of this study is to generate new
evidence regarding the potential benefits of combining a PCSK9 inhibitor
with high-intensity statin treatment in reducing cardiovascular events
among these patients. Copyright © 2024. Published by Elsevier
Inc.

<94>
Accession Number
644646276
Title
Transfusion strategy trials excluding patients transfused outside the
trial study period are more likely to report a trend favouring restrictive
strategies: a meta-analysis.
Source
Journal of clinical epidemiology. (pp 111441), 2024. Date of Publication:
25 Jun 2024.
Author
Trentino K.M.; Shander A.; Gross I.; Farmer S.L.
Institution
(Trentino) Medical School, University of Western Australia, Community and
Virtual Care, East Metropolitan Health Service, Perth, Australia
(Shander) TeamHealth Department of Anesthesiology and Critical Care,
Englewood Health, NJ, United States
(Gross) Discipline of Surgery, Medical School, The University of Western
Australia, Perth, Western Australia, Australia. Department of Medicine,
Emeritus, Northern Light Eastern Maine Medical Center, Bangor, Maine
(Farmer) Department of Haematology, Royal Perth Hospital, Perth Western
Australia, Australia; Discipline of Surgery, Medical School, The
University of Western Australia, Perth, Western Australia, Australia
Abstract
OBJECTIVE: Some large, randomized trials investigating red cell
transfusion strategies have significant numbers of transfusions
administered outside the trial study period. We sought to investigate the
potential impact of this methodological issue. STUDY DESIGN AND SETTING:
Meta-analysis of randomized controlled trials comparing liberal versus
restrictive transfusion strategies in cardiac surgery and acute myocardial
infarction patients. The outcome of interest was 30-day or in-hospital
mortality. RESULT(S): In cardiac surgery, the pooled risk ratio for
mortality was 0.83 (95% CI 0.62-1.12, P=0.22) times lower in the
restrictive group when compared to the liberal group in trials applying a
transfusion strategy throughout the patient's entire perioperative period,
and 1.33 (95% CI 0.84-2.11, P=0.22) times higher in the restrictive group
in trials not applying transfusion strategies throughout the entire
perioperative period. When combined, the risk ratio for mortality was 0.98
(95% CI 0.73-1.32, P=0.89). In patients with acute myocardial infarction,
the risk ratio for mortality was 0.72 (95%CI 0.40-1.28, P=0.26) times
lower in the restrictive group when compared to the liberal group in one
trial excluding patients administered the intervention pre-randomization
and 1.19 (95% CI 0.96-1.47, P=0.11) times higher in the restrictive group
in one trial including patients receiving the intervention
pre-randomization. When combined the risk ratio for mortality was 1.00
(0.62-1.59, P=0.99). CONCLUSION(S): Though not statistically
significant, there was a consistent difference in trends between
randomized controlled trials administering significant numbers of
transfusion outside the trial study period compared to those that did not.
The implications of our results may extend to randomized controlled trials
in other settings that ignore if and how frequently an investigated
therapy is administered outside the trial window. Copyright ©
2024 The Author(s). Published by Elsevier Inc. All rights reserved.

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