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<1>
Accession Number
2030900002
Title
Analysis of composite time-to-event endpoints in cardiovascular outcome
trials.
Source
Clinical Trials. (no pagination), 2024. Date of Publication: 2024.
Author
Marceau West R.; Golm G.; Mehrotra D.V.
Institution
(Marceau West, Golm, Mehrotra) Clinical Biostatistics, Merck & Co., Inc.,
North Wales, PA, United States
Publisher
SAGE Publications Ltd
Abstract
Composite time-to-event endpoints are commonly used in cardiovascular
outcome trials. For example, the IMPROVE-IT trial comparing
ezetimibe+simvastatin to placebo+simvastatin in 18,144 patients with acute
coronary syndrome used a primary composite endpoint with five component
outcomes: (1) cardiovascular death, (2) non-fatal stroke, (3) non-fatal
myocardial infarction, (4) coronary revascularization >=30 days after
randomization, and (5) unstable angina requiring hospitalization. In such
settings, the traditional analysis compares treatments using the observed
time to the occurrence of the first (i.e. earliest) component outcome for
each patient. This approach ignores information for subsequent outcome(s),
possibly leading to reduced power to demonstrate the benefit of the test
versus the control treatment. We use real data examples and simulations to
contrast the traditional approach with several alternative approaches that
use data for all the intra-patient component outcomes, not just the
first. Copyright © The Author(s) 2024.

<2>
Accession Number
2033999539
Title
Non-Anon-B aortic dissection: just for cardiac surgeons? Asystematic
literature review on surgical and endovascular treatment.
Source
Italian Journal of Vascular and Endovascular Surgery. 31(2) (pp 121-134),
2024. Date of Publication: June 2024.
Author
Silvestri O.; Benenati A.; Rinaldi A.; Delguercio L.; Serra R.; Bossone
E.; Carbone A.; Accarino G.; Bracale U.M.; Turchino D.
Institution
(Silvestri, Benenati, Rinaldi, Delguercio, Accarino, Bracale, Turchino)
Department of Public Health, Vascular Surgery Unit, University of Naples
Federico II, Naples, Italy
(Serra) Department of Medical and Surgical Sciences, University of
Catanzaro, Catanzaro, Italy
(Bossone) Department of Public Health, Division of Cardiology, University
of Naples Federico II, Naples, Italy
(Carbone) Unit of Cardiology, Luigi Vanvitelli University of Campania,
Naples, Italy
Publisher
Edizioni Minerva Medica
Abstract
INTRODUCTION: Non-Anon-B dissections are fairly rare occurrences,
accounting for just a small percentage of total aortic dissections. For
years, treatment has been non-consensual being mostly confined to the
realm of cardiac surgery. In recent times, due to the development of
endovascular techniques, a procedural shift has occurred favoring less
invasive vascular surgery thus precepting the need for a multidisciplinary
approach and the concept of an aortic team in treating non-Anon-B
dissections. The aim of our study is to report on the state-of-the-art
treatment of non-Anon-B dissections and to determine, through a systematic
review, how often an aortic team is employed in clinical practice.
EVIDENCE ACQUISITION: Areview conducted of all available PubMed/MEDLINE
and Scopus databases in accordance with PRISMAstatement guidelines,
analyzing all studies published between 2000 and 2023. Combined keywords
referring to non-Anon-B dissections and their management, and
investigation of current employment of endovascular techniques in treating
these dissections. Our literature search initially covered a total of 260
articles concerning surgical, endovascular and hybrid treatment. Out of
these, 21 articles were selected for screening, excluding those with no
mention of non-Anon-B dissection and "aortic team." EVIDENCE SYNTHESIS:
Non-Anon-B aortic dissections remain a challenging pathology with several
treatment options, including endovascular, which is increasingly being
employed, and can therefore be considered a valid treatment choice in
aortic dissection management. CONCLUSION(S): While guidelines mention
the importance of an aortic team in treatment, no clear evidence of a
multidisciplinary approach for treating non-Anon-B dissection could be
found in current literature. Copyright © 2024 Edizioni Minerva
Medica. All rights reserved.

<3>
Accession Number
2033999538
Title
Management of congestive heart failure with heart transplantation using
stem cell-derived cardiac muscle: a systematic review.
Source
Italian Journal of Vascular and Endovascular Surgery. 31(2) (pp 115-120),
2024. Date of Publication: June 2024.
Author
Sebayang A.N.; Sembiring Y.E.; Pribadi O.R.
Institution
(Sebayang, Sembiring, Pribadi) Department of Thoracic, Cardiac and
Vascular Surgery, Faculty of Medicine, Universitas Airlangga, Dr. Soetomo
General Hospital, Surabaya, Indonesia
Publisher
Edizioni Minerva Medica
Abstract
INTRODUCTION: Congestive heart failure is a collection of clinical
symptoms resulting from structural or functional abnormalities of the
heart which leads to impaired ventricular filling and ejection ability of
blood to the rest of the body. One of the treatments for this disease is
heart transplantation. Stem cell-derived hearts have been developed, so
there is no need to wait for a donor heart. Myocardium is essentially
impossible to regenerate as heart muscle cells do not return to the cell
cycle. Stem cell-derived myoblasts have been transplanted in experimental
settings to replace lost myocardial tissue. The purpose of this review is
to evaluate the effect of stem cell therapy in heart failure model.
EVIDENCE ACQUISITION: We used PRISMAprotocol to perform systematic review.
PubMed, ScienceDirect, and Cochrane were searched for articles from the
inception to October 2023. Studies reporting stem cell therapy, relevant
outcomes, and using subjects with heart failure models were included. The
main outcome was heart function, assessed by such parameters, including
LVEF, LVSD, LVDD, and LVSV. EVIDENCE SYNTHESIS: Heart transplantation
using stem cell-derived cardiac muscle is not impossible. Myoblasts and
cardiomyocytes derived from bone marrow stem cells will enable autologous
cell transfer into the myocardium. These cells can be easily obtained and
developed in culture. Cardiomyocytes derived from stem cells can be used
to replace all three types of heart muscle cells, and can be developed in
culture. Currently, ethical issues relating to the use of human embryonic
stem cells are a factor to consider. CONCLUSION(S): Cell transfer
therapy has been shown to improve heart function by initiating
cardiomyogenesis in experimental models. These findings suggest that
damaged myocardial function can be repaired with stem cell therapy. Stem
cell-derived cardiomyocytes, especially from embryonic cells or bone
marrow, will allow selective replacement of cardiac cells or atrial or
ventricular cardiomyocytes. Copyright © 2024 Edizioni Minerva
Medica. All rights reserved.

<4>
Accession Number
644981660
Title
Protective effects of fructose-1,6-bisphosphate postconditioning on
myocardial ischemia-reperfusion injury in patients undergoing valve
replacement:a randomized, double-blind, placebo-controlled clinical trial.
Source
European journal of cardio-thoracic surgery : official journal of the
European Association for Cardio-thoracic Surgery. (no pagination), 2024.
Date of Publication: 09 Aug 2024.
Author
Xu H.; Wang M.; Zhao T.; Yu X.; Wang F.
Institution
(Xu, Wang, Wang) Affiliated Hospital, North Sichuan Medical College
637000, China
(Zhao) North Sichuan Medical College 637000, China
(Yu) Second Affiliated Hospital of North Sichuan Medical College 637000,
China
Abstract
Legend of Graphical Abstract: The figure describes the serum CK-MB
concentrations in the FDP and NS groups at 4, 24, 48, and 72h
postoperatively. OBJECTIVE(S): Pharmacological postconditioning can
protect against myocardial ischaemia-reperfusion injury during cardiac
surgery with extracorporeal circulation. The aim of this study was to
observe the protective effects of fructose-1, 6-bisphosphate (FDP)
postconditioning on myocardial ischaemia-reperfusion injury in patients
undergoing cardiac valve replacement with extracorporeal circulation.
 METHOD(S): Patients undergoing elective mitral valve replacement
and/or aortic valve replacement were divided into normal saline
postconditioning group (NS group) and FDP postconditioning group (FDP
group). The primary outcome was the plasma concentration of creatine
kinase-MB (CK-MB). The secondary outcomes were the plasma concentrations
of lactate dehydrogenase (LDH), creatine kinase (CK), high-sensitivity
C-reactive protein (hs-CRP), alpha-hydroxybutyrate dehydrogenase
(alpha-HBDH) and cardiac troponin I (cTnI), the spontaneous cardiac rhythm
recovery profile, the extracorporeal circulation time and duration of
surgery, ICU and postoperative hospitalization. RESULT(S): Forty
patients were randomly assigned to receive intervention and included in
the analysis. The serum concentrations of CK-MB, LDH, CK, cTnI, alpha-HBDH
and hs-CRP at T1~4 were lower in the FDP group than in the NS group
(P<0.001). Compared with the NS group, the dosage of dopamine administered
1~90min after cardiac resuscitation, the spontaneous cardiac rhythm
recovery time and the incidence of ventricular fibrillation were lower in
the FDP group (P<0.001, P<0.001 and P=0.040, respectively). The values of
ST- changes were increased more significantly in the NS group than in the
FDP group (median [standard deviation] 1.3 [0.3] mm vs 0.7 [0.2]
mm)(P<0.001). Compared with the NS group, the time of recovery of
ST-segment deviations was shorter in the FDP group(50.3 [12.3] min vs 34.6
[6.9] min) (P<0.001). CONCLUSION(S): The fructose-1, 6-bisphosphate
postconditioning could improve both myocardial ischaemia-reperfusion
injury and the spontaneous cardiac rhythm recovery during cardiac valve
surgery with extracorporeal circulation. Copyright © The
Author(s) 2024. Published by Oxford University Press on behalf of the
European Association for Cardio-Thoracic Surgery. All rights reserved.

<5>
Accession Number
644981481
Title
Left Atrial Appendage Closure Compared With Oral Anticoagulants for
Patients With Atrial Fibrillation: A Systematic Review and Network
Meta-Analysis.
Source
Journal of the American Heart Association. (pp e034815), 2024. Date of
Publication: 09 Aug 2024.
Author
Oliva A.; Ioppolo A.M.; Chiarito M.; Cremonesi A.; Azzano A.; Micciche E.;
Mangiameli A.; Ariano F.; Ferrante G.; Reimers B.; Garot P.; Amabile N.;
Mehran R.; Condorelli G.; Stefanini G.; Cao D.
Institution
(Oliva, Ioppolo, Cremonesi, Azzano, Micciche, Mangiameli, Ariano, Cao)
Cardiovascular Department Humanitas Gavazzeni Hospital Bergamo Italy,
Italy
(Oliva, Chiarito, Cremonesi, Ferrante, Reimers, Condorelli, Stefanini,
Cao) Department of Biomedical Sciences Humanitas University Pieve Emanuele
MI Italy, Italy
(Oliva, Chiarito, Ferrante, Reimers, Condorelli, Stefanini) Cardio Center
Humanitas Clinical and Research Hospital IRCCS Rozzano Italy, Italy
(Garot, Amabile, Cao) Institut Cardiovasculaire Paris Sud (ICPS), France
(Mehran) Zena and Michael A. Wiener Cardiovascular Institute Icahn School
of Medicine at Mount Sinai New York NY USA
Abstract
BACKGROUND: Percutaneous left atrial appendage closure (LAAC) has been
suggested as an alternative to long-term oral anticoagulation for
nonvalvular atrial fibrillation, but comparative data remain scarce. We
aimed to assess ischemic and bleeding outcomes of LAAC compared with
vitamin K antagonists (VKAs) or direct oral anticoagulants (DOACs) for the
prevention of cardioembolic events in patients with atrial fibrillation.
METHODS AND RESULTS: Embase and MEDLINE were searched for randomized
trials comparing LAAC, VKAs, and DOACs. The primary efficacy end point was
any stroke or systemic embolism. Treatment effects were calculated from a
network meta-analysis and ranked according to the surface under the
cumulative ranking curve. Seven trials and 73199 patients were included.
The risk of the primary end point was not statistically different between
LAAC versus VKAs (odds ratio [OR], 0.92 [95% CI, 0.62-1.50]) and LAAC
versus DOACs (OR, 1.11 [95% CI, 0.71-1.73]). LAAC and DOACs resulted in
similar risk of major or minor (OR, 0.93 [95% CI, 0.61-1.42]) and major
bleeding (OR, 0.92 [95% CI, 0.58-1.46]); however, after exclusion of
procedural bleeding, bleeding risk was significantly lower in those
undergoing LAAC. Both LAAC and DOACs reduced the risk of all-cause death
compared with VKAs (LAAC versus VKAs: OR, 0.70 [95% CI, 0.53-0.91]; DOACs
versus VKAs: OR, 0.90 [95% CI, 0.85-0.95], respectively). DOACs ranked as
the best treatment for stroke or systemic embolism prevention (66.9%) and
LAAC for reducing major bleeding (63.9%) and death (96.4%).
 CONCLUSION(S): As a nonpharmacological alternative to oral
anticoagulation for atrial fibrillation, LAAC showed similar efficacy and
safety compared with VKAs or DOACs. Prospective confirmation from larger
studies is warranted.

<6>
Accession Number
2033509928
Title
A Bright Future for Tricuspid Repair Success.
Source
Journal of the American College of Cardiology. 84(7) (pp 617-619), 2024.
Date of Publication: 13 Aug 2024.
Author
Sorajja P.; Hamid N.
Institution
(Sorajja, Hamid) Valve Science Center, Minneapolis Heart Institute
Foundation, and the Allina Health Minneapolis Heart Institute at Abbott
Northwestern Hospital, Minneapolis, MN, United States
Publisher
Elsevier Inc.

<7>
Accession Number
2001652231
Title
LONG TERM OUTCOMES OF TRANSCATHETER AORTIC VALVE REPLACEMENT VERSUS
SURGICAL AORTIC VALVE REPLACEMENT FOR INTERMEDIATE SURGICAL RISK PATIENTS:
A SYSTEMATIC REVIEW AND META-ANALYSIS.
Source
Journal of the American College of Cardiology. Conference: The American
College of Cardiology 68th Annual Scientific Sessions. New Orleans United
States. 73(9 Supplement 1) (pp 1103), 2019. Date of Publication: 12 Mar
2019.
Author
Croix G.R.S.; Jean S.; Ibrahim M.; Ashinne B.; Toirac A.; Maning J.; de
Marchena E.
Institution
(Croix, Jean, Ibrahim, Ashinne, Toirac, Maning, de Marchena) Jackson
Memorial Hospital/University of Miami, Miami, FL, United States
(Croix, Jean, Ibrahim, Ashinne, Toirac, Maning, de Marchena) Boston
Medical Center, Boston, MA, United States
Publisher
Elsevier Inc.
Abstract
Background The comparative benefits and harms of TAVR and SAVR for
intermediate surgical risk patients with aortic stenosis haven't shown any
significant statistical and clinical difference at 30 days and at 1 year.
However, the comparison has not been properly characterized at 2 years.
This meta-analysis aims to assess the differential outcomes of TAVR and
SAVR in intermediate surgical risk patients only enrolled in randomized
controlled trials with at least 2 years of follow up. Methods We performed
a systematic literature review to identify only randomized clinical
studies that reported 2 years outcomes. 9 databases including Pubmed,
Embase, Cochrane, Scopus containing articles from January 2000 to
September 2018 were analyzed. Results We found 546 publications through
the databases including 3 relevant RCT for a total of 4075 participants.
Analysis of the TAVR and SAVR cohorts revealed no significant differences
in term of 2 year all-cause mortality [OR (95% CI): 0.84 (0.70, 1.01), P
value = 0.06]. The incidence of stroke was not statistically significant
in both groups either [OR (95% CI): 0.96. Nevertheless, there was a higher
rate of pacemaker implantations for the TAVR group [OR (95% CI): 2.36.
Conclusion This study confirms that all-cause mortality at 2 years is not
statistically significant. There is no difference in incidence of stroke
either. However, there appears to have an increased risk of pacemaker
placement in intermediate risk patients undergoing TAVR compared to SAVR.
[Formula presented] Copyright © 2019 American College of
Cardiology Foundation

<8>
Accession Number
2001652209
Title
PERCUTANEOUS MITRAL VALVE REPAIR WITH MITRACLIP FOR THE MANAGEMENT OF
FUNCTIONAL MITRAL REGURGITATION.
Source
Journal of the American College of Cardiology. Conference: The American
College of Cardiology 68th Annual Scientific Sessions. New Orleans United
States. 73(9 Supplement 1) (pp 1184), 2019. Date of Publication: 12 Mar
2019.
Author
Marmagkiolis K.; Iliescu C.; Hakeem A.; Cilingiroglu M.
Institution
(Marmagkiolis, Iliescu, Hakeem, Cilingiroglu) Pepin Heart Institute,
Florida Hospital, Tampa, FL, United States
(Marmagkiolis, Iliescu, Hakeem, Cilingiroglu) University of Arkansas,
Little Rock, AR, United States
Publisher
Elsevier Inc.
Abstract
Background Mitral regurgitation (MR) is the most frequent valve
abnormality in the United States. The optimal management of functional MR
remains unclear. MitraClip is a novel device for the percutaneous
management of mitral insufficiency via implantation of a metallic clip to
the mitral valve leaflets. Methods We performed a literature search using
PubMed, EMBASE, and Cochrane Central Register of Controlled Trials from
September 2008 to September 2018. Studies comparing percutaneous mitral
valve repair using the MitraClip device against conservative therapy for
the management of functional mitral regurgitation were included. Results
Seven studies (Swaans et al, Velazquez et al, Armeni et al, Giannini et
al, Asgar et al, COAPT and MITRA-FR) with 1174 patients in MitraClip group
and 1015 patients in medical therapy group met inclusion criteria. The
12-month mortality in the MitraClip group was 16.9 % compared with 23.4%
in the medical therapy group (OR 0.71 (0.55, 0.91); P<0.006). The rate of
readmission at 12 months was 29.9% in the MitraClip group compared with
54.1% in the medical therapy group (OR: 040 (0.32-0.49); p< 0.0001. There
was no evidence of significant heterogeneity or publication bias for any
of the endpoints. Conclusion Based on the results of this meta-analysis,
percutaneous mitral valve repair with MitraClip appears to be superior to
medical therapy for symptomatic moderate-to-severe functional mitral
insufficiency. Copyright © 2019 American College of Cardiology
Foundation

<9>
Accession Number
2001652189
Title
EFFICACY AND SAFETY OF LONG-TERM EVOLOCUMAB USE IN ASIAN VERSUS OTHER
SUBJECTS: THE FOURIER TRIAL.
Source
Journal of the American College of Cardiology. Conference: The American
College of Cardiology 68th Annual Scientific Sessions. New Orleans United
States. 73(9 Supplement 1) (pp 189), 2019. Date of Publication: 12 Mar
2019.
Author
Keech A.C.; Sever P.; Jiang L.; Hirayama A.; Lu C.; Tay L.; Deedwania P.;
Siu C.-W.; Pineda A.L.; Choi D.; Charng M.-J.; Amerena J.; Ahmad W.A.W.;
Chopra V.K.; Pedersen T.; Giugliano R.; Sabatine M.
Institution
(Keech, Sever, Jiang, Hirayama, Lu, Tay, Deedwania, Siu, Pineda, Choi,
Charng, Amerena, Ahmad, Chopra, Pedersen, Giugliano, Sabatine) NHMRC
Clinical Trials Centre, Sydney, Australia
Publisher
Elsevier Inc.
Abstract
Background There are concerns that Asian people respond differently to
some medications. We evaluated the efficacy and safety of evolocumab use
in the FOURIER trial among participants of Asian versus other backgrounds.
Methods The effects of adding evolocumab (either 140 mg subcutaneously
every 2 weeks or 420 mg subcutaneously monthly) versus matching placebo to
background optimized statin therapy over a median 2.2 years follow-up, on
LDL-C reductions, cardiovascular events and adverse safety events were
compared among all 27,564 FOURIER participants with prior MI, stroke or
PAD, according to Asian (n=2,723) versus other (n=24,841) declared race.
Results High-intensity statin use, compared with moderate dosing, was less
frequent in Asian subjects compared with others (33% v. 73%). Stroke was
the qualifying atherosclerotic event in Asians more than in others (29%
vs. 18%). Baseline LDL-C levels were similar among Asians and others (89
vs. 92 mg/dL) and evolocumab lowered LDL-C (baseline to 48 weeks)
similarly in Asians and others from median 89 to 22mg/dL, and from 92 to
30mg/dL respectively. Compared with placebo, reductions with evolocumab in
annualized primary endpoint (PEP: CV death, MI, stroke, hospitalization
for unstable angina, coronary revascularization) events and in key
secondary endpoint (SEP: CV death, MI, stroke) events were comparable;
5.2% vs 4.2%; Relative Risk Reduction [RRR] (95%CI) 0.79 (0.61, 1.03), and
3.6% vs 2.7%; RRR(95%CI) 0.73 (0.53, 1.01) respectively in Asian patients
and 5.4% vs 4.6%, RRR(95%CI) 0.86 (0.79, 0.93), and 3.4% vs 2.8%,
RRR(95%CI) 0.81 (0.73, 0.89), in others (both p for treatment interactions
= ns). Serious adverse event rates were no higher among participants of
Asian versus other races (11.8% versus 12.5% respectively per annum), and
active study drug discontinuations due to adverse events were low in both
Asian and other subjects (1.5% vs 2.1% per annum). Conclusion Use of
evolocumab among Asian subjects was safe, lowered LDL-C comparably, and
reduced CVD events at least as effectively as in patients of non-Asian
background in FOURIER. No need was identified to modify the evolocumab
dose for individuals of Asian race. Copyright © 2019 American
College of Cardiology Foundation

<10>
Accession Number
2001652105
Title
USEFULNESS OF SKELETAL MUSCLE AREA DETECTED BY COMPUTED TOMOGRAPHY TO
PREDICT MORTALITY IN PATIENTS UNDERGOING TRANSCATHETER AORTIC VALVE
REPLACEMENT: A META-ANALYSIS.
Source
Journal of the American College of Cardiology. Conference: The American
College of Cardiology 68th Annual Scientific Sessions. New Orleans United
States. 73(9 Supplement 1) (pp 1105), 2019. Date of Publication: 12 Mar
2019.
Author
Soud M.; Alahdab F.; Ho G.; Cejudo-Tejeda M.; Kuku K.; Hideo-Kajita A.;
Garcia Garcia H.
Institution
(Soud, Alahdab, Ho, Cejudo-Tejeda, Kuku, Hideo-Kajita, Garcia Garcia)
MedStar Washington Hospital Center, Washington, DC, United States
(Soud, Alahdab, Ho, Cejudo-Tejeda, Kuku, Hideo-Kajita, Garcia Garcia) Mayo
Clinic Evidence-Based Practice Center, Rochester, MN, United States
Publisher
Elsevier Inc.
Abstract
Background Sarcopenia, loss of skeletal muscle mass, measured from the
readily available preoperative computed tomography (CT) images has
recently suggested as a predictor of outcomes in patients undergoing
transcatheter aortic valve replacement (TAVR). However, the results of
these studies are variable. Therefore, we performed a meta-analysis of the
current literature to evaluate sarcopenia as a predictor of outcome post
TAVR. Methods Databases were systematically searched between January 2008
and February 2018. We identified studies that reported CT-derived skeletal
muscle area (SMA) and survival outcomes post TAVR. We evaluated studies
for the incidence of early (<= 30 days) and late all-cause mortality (> 30
days) post TAVR. Results Eight studies with 1,881 patients were included
(mean age of 81.8 years +/- 12 years, 55.9% men). Mean body mass index
(BMI) was 28.2 kg/m2 +/- 1.1, mean Society of Thoracic Surgeons (STS) risk
score 7.0 +/- 0.6 and mean albumin level was 3.8 g/dL +/- 0.1. (odds ratio
[OR]: 0.49, 95% confidence interval [CI]: 0.28 to 0.83, p = 0.049; Figure
1A). Similarly, short-term mortality after TAVR was reduced in
non-sarcopenic patients, however, it was not statistically significant
(OR: 0.72; 95% CI: 0.44-1.18; P = 0.285; Figure 1B). Conclusion CT-derived
SMA provides value in predicting post-TAVR long-term outcomes for patients
undergoing TAVR. This is a simple risk assessment tool that may help in
making treatment decisions and planning for TAVR procedure. [Formula
presented] Copyright © 2019 American College of Cardiology
Foundation

<11>
Accession Number
2001651992
Title
PROPHYLACTIC DIALYSIS IN PATIENTS WITH RENAL DYSFUNCTION UNDERGOING
CORONARY ARTERY BYPASS SURGERY: SYSTEMATIC REVIEW AND META-ANALYSIS.
Source
Journal of the American College of Cardiology. Conference: The American
College of Cardiology 68th Annual Scientific Sessions. New Orleans United
States. 73(9 Supplement 1) (pp 247), 2019. Date of Publication: 12 Mar
2019.
Author
Trebejo M.O.M.; Mieszczanska H.
Institution
(Trebejo, Mieszczanska) Rochester Regional Health, Unity Hospital,
Rochester, NY, United States
(Trebejo, Mieszczanska) University of Rochester Medical Center, Rochester,
NY, United States
Publisher
Elsevier Inc.
Abstract
Background There is description of the outcomes of coronary artery bypass
surgery in patients with end-stage renal disease. However, there is
limited information of the outcome of patients with mild to moderate renal
failure not on dialysis. The aim of this study was to asses the effect of
prophylactic hemodialysis in the mortality and morbidity outcome in these
patients. Methods We included randomized controlled clinical trials
(RCTs). Types of participants: Adults above 18 years old, with a
preoperative creatinine level greater than 2 mg/dL, who underwent primary
elective coronary artery bypass surgery. Types of interventions:
Prophylactic preoperative dialysis vs no dialysis. Type of outcome
measures: mortality (primary outcome), length of hospital stay and post
operative complications (secondary outcomes) Electronic search included
Cochrane Central Register of Controlled Trials (CENTRAL) and
ClinicalTrials.gov. Heterogeneity was identified by visually inspecting
the forest plots and by using a standard Chi2 test with a
significance level of alpha = 0.1. We also considered the I2
statistic, where an I2 statistic >= 75% indicated a
considerable level of heterogeneity. Subgroup analysis and investigation
of heterogeneity: we will follow characteristics such as age, sex,
comorbidities, to introduce clinical heterogeneity and we plan to carry
out subgroup analyses. Sensitivity analysis: effect size (RR) and
different statistical models (fixed-effect and random-effects models).
Results Three RCTs were found. A total of 196 patients were included among
the three RCTs. Preoperative creatinine levels higher than 2.5 mg/dL are
associated with an increase risk of mortality and and prolonged length of
hospital stay after coronary artery bypass surgery. Perioperative
prophylactic hemodialysis decreases both operative mortality and morbidity
in these type of patients. Conclusion Prophylactic dialysis prior to CABG
decreases mortality in patients with renal insufficiency with nondialysis
dependent moderate renal dysfunction. Copyright © 2019 American
College of Cardiology Foundation

<12>
Accession Number
2001651971
Title
ST-ELEVATION MYOCARDIAL INFARCTION ASSOCIATED WITH INFECTIVE ENDOCARDITIS:
A SYSTEMATIC REVIEW.
Source
Journal of the American College of Cardiology. Conference: The American
College of Cardiology 68th Annual Scientific Sessions. New Orleans United
States. 73(9 Supplement 1) (pp 133), 2019. Date of Publication: 12 Mar
2019.
Author
Nazir S.; Elgin E.; Loynd R.; Zaman M.; Donato A.
Institution
(Nazir, Elgin, Loynd, Zaman, Donato) Reading Hospital-Tower Health, West
Reading, PA, United States
Publisher
Elsevier Inc.
Abstract
Background ST-Elevation Myocardial Infarction (STEMI) as a complication of
Infective Endocarditis (IE) is a rarely reported entity. No clear
guidelines exist with regards to the management of this medical emergency.
Methods We searched relevant articles on STEMI associated with IE and
extracted data on demographic variables, key clinical characteristics upon
presentation, treatment strategies and clinical outcomes. Results We
identified 100 patients from 95 articles (figure 1). The mean age at
presentation was 52.6 +/- 17 years with male preponderance (n=63, 63%,
p=0.01). Most patients (63/100, 63%) presented with STEMI as their first
manifestation of IE. Findings that suggested possible septic emboli were
not consistently present, including history of prosthetic valve placement
(15%), presence of other embolic disease (27%), fever (42%) elevated WBC
count (80%), and presence of murmur (88%). Atherosclerotic disease was
absent in 95% on cardiac catheterization. Eleven patients receiving tPA
fared poorly, with nine major bleeds; balloon angioplasty was successful
in 56% (9/16 cases), aspiration thombectomy in 68% (21/31 cases) and
coronary stenting in 81% (14/16 cases). The 30-day mortality was 43%.
Conclusion In the face of recent IE, new murmur, fever, elevated WBC count
or other embolic events, septic emboli should be considered as a cause for
STEMI. Best practices for management are not known, but thrombolytics
appear to carry significant bleeding and embolic risks [Formula
presented] Copyright © 2019 American College of Cardiology
Foundation

<13>
Accession Number
2001646096
Title
ASSESSMENT OF THE HIGH RISK AND UNMET NEED IN PATIENTS WITH CAD AND TYPE 2
DIABETES (ATHENA): US BURDEN OF ILLNESS IN THE DIABETES COLLABORATIVE
REGISTRY.
Source
Journal of the American College of Cardiology. Conference: The American
College of Cardiology 68th Annual Scientific Sessions. New Orleans United
States. 73(9 Supplement 1) (pp 39), 2019. Date of Publication: 12 Mar
2019.
Author
Wittbrodt E.; Bhalla N.; Sundell K.A.; Gao Q.; Dong L.; Cavender M.; Hunt
P.; Wong N.
Institution
(Wittbrodt, Bhalla, Sundell, Gao, Dong, Cavender, Hunt, Wong) AstraZeneca,
Gaithersburg, MD, United States
Publisher
Elsevier Inc.
Abstract
Background THEMIS is a large RCT (NCT01991795) in patients with type 2
diabetes (T2D) at high risk for cardiovascular (CV) events, but without a
history of MI or stroke, that compares the effect of ticagrelor vs placebo
(both with background ASA) for the prevention of major CV events. The
current study assessed the burden of illness, treatment patterns, and
selected outcomes, including major adverse CV events (MACE), in patients
with T2D similar to those eligible for THEMIS (THEMIS-like) and in a
broader T2D population (T2D-CAD) to inform the generalizability of THEMIS
results to patients treated in routine clinical practice. Methods This
retrospective, observational study encompassed two real-world populations
of pharmacologically treated T2D patients, 95% of whom were aged >65 years
and all who were at high risk for CV events. Data were collected for
2013-14 from the Diabetes Collaborative Registry linked to Medicare
administrative claims. Both cohorts included those with a history of PCI
or CABG, or angina. The T2D-CAD cohort also included those with use of
prescription antiplatelet therapy. Demographics, medications, and selected
CV events, including MACE and its components (MI, stroke, and death), were
collected and analyzed. Results Of the 56,040 patients with T2D and
history of CAD in the THEMIS-like cohort, 63% were men, and 73% had
undergone PCI or CABG. Of the 69,790 patients in the T2D-CAD cohort, 61%
were men, and 58% had undergone PCI or CABG. Mean (SD) age in both cohorts
was 74 (7) years. Use of oral antiplatelets (91% vs 92%), ASA (86% vs
83%), and RAAS inhibitors (80% for both) were similar in the THEMIS-like
and T2D-CAD cohorts, respectively. Mean (SD) follow-up time was 1.2 (0.6)
years. Estimated MACE rates were 15.9 (95% CI: 15.8, 15.9) and 17.1 (95%
CI: 17.0, 17.1) events per 100 person-years for the THEMIS-like and
T2D-CAD cohorts, respectively. For both cohorts, each MACE component
contributed similarly to the composite event rate. Conclusion Patients
similar to those enrolled in THEMIS have high CV event rates. The event
rates and use of CV medications were similar in both cohorts, indicating
that the THEMIS study population reflects the broader high-risk group of
of T2D patients with CAD. Copyright © 2019 American College of
Cardiology Foundation

<14>
Accession Number
2001646093
Title
IMPACT OF CORONARY ARTERY CALCIFICATION IN PATIENTS UNDERGOING
REVASCULARIZATION FOR LEFT MAIN CORONARY ARTERY DISEASE: INSIGHTS FROM THE
EXCEL TRIAL.
Source
Journal of the American College of Cardiology. Conference: The American
College of Cardiology 68th Annual Scientific Sessions. New Orleans United
States. 73(9 Supplement 1) (pp 1370), 2019. Date of Publication: 12 Mar
2019.
Author
Sorrentino S.; Mehran R.; Giustino G.; Liu M.; Kandzari D.; Morice M.C.;
Gershlick A.; Dressler O.; Sabik J.; Kappetein A.; Serruys P.; Stone G.
Institution
(Sorrentino, Mehran, Giustino, Liu, Kandzari, Morice, Gershlick, Dressler,
Sabik, Kappetein, Serruys, Stone) Cardiovascular Research Foundation, New
York, NY, United States
Publisher
Elsevier Inc.
Abstract
Background The prognostic impact of coronary artery calcification (CAC) in
pts undergoing revascularization for left main coronary artery disease
(LMCAD) is unclear. We aimed to determine the comparative effectiveness of
PCI vs CABG in pts with LMCAD and CAC. Methods In the EXCEL trial 1905 pts
with LMCAD and site-assessed low or intermediate SYNTAX scores were
randomized to PCI with everolimus-eluting stents vs CABG. Pts were
stratified by the presence or absence of moderate or severe (m/s) CAC of
the LM. The primary endpoint was the 3-year rate of death, myocardial
infarction (MI), or stroke. Results Among 1852 randomized pts in whom LM
CAC was assessed by the angiographic core lab, 1074 (58.0%) had m/s CAC.
Pts with compared to those without m/s CAC were older (68.0+/-8.6 vs
63.1+/-10.2 yrs, p<0.0001) and were more likely to have hypertension,
hyperlipidemia, diabetes and chronic kidney disease. Pts with vs. without
m/s CAC had a higher rate of the primary endpoint (16.4% vs 13.0%, HR
1.28, 95%CI 1.00-1.64), mainly driven by increased death (8.6% vs 4.8%, HR
1.85, 95%CI 1.26-2.72). The 30-day and 3-year outcomes of PCI vs. CABG
were consistent in pts with and without m/s CAC (Figure). Conclusion
Patients with m/s LM CAC undergoing revascularization are at increased
risk of adverse events. In the EXCEL trial, the presence of m/s LM CAC did
not impair the relative 30-day or 3-year outcomes of PCI compared with
CABG. [Formula presented] Copyright © 2019 American College of
Cardiology Foundation

<15>
Accession Number
2001644306
Title
DRUG RELATED PLATELET INHIBITION: IS THERE A ROLE FOR REDUCTION OF
CEREBRAL MICROEMBOLI IN TRANSCATHETER AORTIC VALVE IMPLANTATION PATIENTS?.
Source
Journal of the American College of Cardiology. Conference: The American
College of Cardiology 68th Annual Scientific Sessions. New Orleans United
States. 73(9 Supplement 1) (pp 1206), 2019. Date of Publication: 12 Mar
2019.
Author
Kalantzis C.; Voudris V.; Kosmas E.; Toutouzas K.; Iakovou I.; Latsios G.;
Kalogeras K.; Bei E.; Moldovan C.M.; Kariori M.; Katsarou O.; Kolokathis
A.-M.; Vrachatis D.; Katsianos E.; Siasos G.; Tousoulis D.; Vavuranakis M.
Institution
(Kalantzis, Vavuranakis, Voudris, Kosmas, Toutouzas, Iakovou, Latsios,
Kalogeras, Bei, Moldovan, Kariori, Katsarou, Kolokathis, Vrachatis,
Katsianos, Siasos, Tousoulis, Vavuranakis) Hippokration Hospital, Athens,
Greece
(Kalantzis, Vavuranakis, Voudris, Kosmas, Toutouzas, Iakovou, Latsios,
Kalogeras, Bei, Moldovan, Kariori, Katsarou, Kolokathis, Vrachatis,
Katsianos, Siasos, Tousoulis, Vavuranakis) Onassis Cardiac Surgery Center,
Athens, Greece
Publisher
Elsevier Inc.
Abstract
Background Whether non-thienopyridines may protect patients more
efficiently from microembolic events during TAVI has not been
investigated. We hypothesized that ticagrelor+ASA will reduce the number
of microemboli towards the cerebral circulation during TAVI comparing to
the combination of clopidogrel+ASA. Methods Consecutive patients (pts)
from PTOLEMAIOS study who underwent TAVI with EvolutTM R bioprosthesis,
were randomized into two groups. Group 1 patients treated with clopidogrel
plus ASA, Group 2 patients treated with ticagrelor plus ASA. All patients
received ASA 80mg od 7 days prior to the TAVI procedure and for 90 days
afterwards. Pts randomized in Group 2 received ticagrelor 90mg bid one day
prior to the procedure and for 90 days afterwards, while those randomized
in Group 1 received a loading dose of 300 mg one day prior to the TAVI,
followed by 75mg od for 90 days. The number of high intensity transient
signals (HITS) was assessed with Rimed Digi-LiteTM Transcranial Doppler on
both cerebral arteries peri-operatively during the following phases; Phase
0: 30 minutes prior to procedure initiation, Phase I: between access site
puncture and introduction of the delivery system, Phase II: during the
implantation of the bioprosthesis, until the removal of the delivery
system. Pts were evaluated by neurologist before TAVI and on discharge
day. Safety was evaluated by VARC-2 criteria. Results Thirty six pts were
evaluated (81+/-7 years, 23 males (64%)). Group 1 had higher number of
total (739+/-118 vs. 472+/-66, p<0.001) as well as Phase I HITS (426+/-96
vs. 208+/-75, p<0.001). All implantations were performed without
predilation. One cerebrovascular event was recorded in Group 1 and one
patient randomized to Ticagrelor developed major bleeding due to
conversion to femoral surgical cut-down. The average number of received
blood units, was higher in Ticagrelor compared to Clopidogrel group (Group
1: 0.7+/-0.8 vs. Group 2: 1.4+/-2.8, p: 0.886), without however, reaching
statistical significance. Conclusion The combination of ticagrelor+ASA
decreased the number of cerebrovascular embolic high-intensity signals
during TAVI. However, the long term clinical impact of this study needs to
be further evaluated. Copyright © 2019 American College of
Cardiology Foundation

<16>
Accession Number
2029481303
Title
THE ROLE OF CORONARY BYPASS SURGERY IN REDUCING MORTALITY AND ENHANCING
QUALITY OF LIFE AMONG HEART DISEASE PATIENTS.
Source
Journal of Population Therapeutics and Clinical Pharmacology. 31(5) (pp
244-250), 2024. Date of Publication: 01 May 2024.
Author
Moideen A.; Khan S.M.; Rawat A.; Safi R.A.; Batheja P.; Yadav I.; Khedari
M.A.; Ahmad T.
Institution
(Moideen) Dr. D.Y Patil Medical College, Hospital and Research Centre,
Department of Nephrology, Pune, India
(Khan) Department of Internal Medicine, India
(Rawat) Department of Cardiology, Himalayan Institute of Medical Science,
India
(Safi) Liaquat University of Medical & Health Sciences, Jamshoro,
Afghanistan
(Batheja) Department of Cardiac Surgery in NICVD, Karachi, Pakistan
(Yadav) Department of Internal Medicine, Samar Hospital and Research
Center, Nepal
(Khedari) Department of Internal Medicine, United States
(Ahmad) Department of Clinical Pharmacy, Faculty of Pharmaceutical
Sciences, Prince of Songkla University, Hat-Yai 90110, Thailand
Publisher
Codon Publications
Abstract
Background: Cardiovascular diseases are a predominant cause of mortality
in industrialized nations, contributing to approximately 30% of deaths and
imposing substantial economic burdens on healthcare systems. Coronary
heart disease, a major contributor to cardiovascular mortality,
necessitates effective management strategies to improve patient outcomes
and quality of life. Objective(s): This study aims to assess the role
of coronary bypass grafting (CABG) in treating coronary heart disease,
evaluating its success rates, complications, and the decision-making
process involved in selecting appropriate graft types for individual
cases. Method(s): We conducted a documentary bibliographic review
focusing on the theoretical aspects of coronary bypass surgery. The data
collection was primarily executed through electronic databases such as
PubMed and Google Scholar, utilizing health sciences descriptors and MESH
terms. The collected literature will undergo a thorough review to extract
relevant information about the effectiveness and challenges of CABG.
 Result(s): Preliminary findings underscore the crucial role of CABG
in reducing mortality rates, extending patient longevity, and enhancing
the quality of life for those suffering from coronary heart disease.
Despite the complexity and risks associated with the surgical procedure,
the success rate remains high. The choice of graft type, a critical
component of the surgical strategy, varies based on individual patient
conditions and has significant implications for outcomes.
 Conclusion(s): Coronary bypass grafting stands as a pivotal
intervention in cardiovascular medicine, especially for managing severe
coronary heart disease. While the procedure is technically demanding and
associated with various challenges, its high success rate and the
significant improvement in patient outcomes justify its continued use as a
treatment modality. Future research should focus on optimizing graft
selection processes and minimizing surgical risks to enhance patient
outcomes further. Copyright © 2024, Codon Publications. All
rights reserved.

<17>
Accession Number
2030953093
Title
Narrative Review: Surgical and Hybrid Management of Atrial Fibrillation.
Source
Cardiology and Therapy. (no pagination), 2024. Date of Publication: 2024.
Author
Trohman R.G.
Institution
(Trohman) Section of Electrophysiology, Division of Cardiology, Department
of Internal Medicine, Rush University Medical Center, 1653 W. Congress,
Chicago, IL 60612, United States
Publisher
Adis
Abstract
Although significant strides have been made in non-pharmacologic
management of atrial fibrillation (AF), these treatments remain a work in
progress. While catheter ablation is often effective for management of
paroxysmal AF, it is less successful in patients with persistent or
longstanding persistent AF. This review was undertaken to clarify the
risks, benefits, and alternatives to catheter ablation for
non-pharmacologic AF management. In order to clarify the roles of surgical
and hybrid ablation, this narrative review was undertaken by searching
MEDLINE to identify peer-reviewed clinical trials, randomized controlled
trials, meta-analyses, review articles, and other clinically relevant
studies. The search was limited to English-language reports published
between 1960 and 2023. Atrial fibrillation was searched using the terms
surgical ablation, catheter ablation, hybrid ablation, stroke prevention,
left atrial occlusion, and atrial excision. Google and Google Scholar, as
well as bibliographies of identified articles, were also reviewed for
additional references. The Cox-maze surgical approach is still the most
efficacious non-pharmacological treatment for AF. Hybrid ablation,
combining cardiac surgical and catheter ablation techniques, has become an
attractive option for persistent or longstanding persistent
AF. Copyright © The Author(s) 2024.

<18>
Accession Number
644979040
Title
Effect of In Vivo Administration of Fibrinogen Concentrate Versus
Cryoprecipitate on Ex Vivo Clot Degradation in Neonates Undergoing Cardiac
Surgery.
Source
Anesthesia and analgesia. (no pagination), 2024. Date of Publication: 08
Aug 2024.
Author
Downey L.A.; Moiseiwitsch N.; Nellenbach K.; Xiang Y.; Brown A.C.;
Guzzetta N.A.
Institution
(Downey, Guzzetta) From the Department of Anesthesiology, Emory University
School of Medicine, Atlanta, Georgia
(Downey, Guzzetta) Department of Anesthesiology, Children's Healthcare of
Atlanta, Atlanta, Georgia
(Moiseiwitsch, Nellenbach, Brown) Department of Biomedical Engineering of
University of North Carolina-Chapel Hill and North Carolina State
University, Raleigh, NC, United States
(Moiseiwitsch, Nellenbach, Brown) Comparative Medicine Institute, North
Carolina State University, Raleigh, NC, United States
(Xiang) Department of Population and Public Health Sciences, Keck School
of Medicine of University of Southern California, Los Angeles, CA, United
States
(Brown) Department of Material Science and Engineering, North Carolina
State University, Raleigh, NC, United States
Abstract
BACKGROUND: Neonates undergoing cardiac surgery require fibrinogen
replacement to restore hemostasis after cardiopulmonary bypass (CPB).
Cryoprecipitate is often the first-line treatment, but recent studies
demonstrate that fibrinogen concentrate (RiaSTAP; CSL Behring) may be
acceptable in this population. This investigator-initiated, randomized
trial compares cryoprecipitate to fibrinogen concentrate in neonates
undergoing cardiac surgery (ClinicalTrials.gov NCT03932240). The primary
end point was the percent change in ex vivo clot degradation from baseline
at 24 hours after surgery between groups. Secondary outcomes included
intraoperative blood transfusions, coagulation factor levels, and adverse
events. METHOD(S): Neonates were randomized to receive
cryoprecipitate (control group) or fibrinogen concentrate (study group) as
part of a post-CPB transfusion algorithm. Blood samples were drawn at 4
time points: presurgery (T1), after treatment (T2), arrival to the
intensive care unit (ICU) (T3), and 24 hours postsurgery (T4). Using the
mixed-effect models, we analyzed the percent change in ex vivo clot
degradation from a patient's presurgery baseline at each time point.
Intraoperative blood product transfusions, coagulation factor levels,
perioperative laboratory values, and adverse events were collected.
 RESULT(S): Thirty-six neonates were enrolled (intent to treat [ITT]).
Thirteen patients in the control group and seventeen patients in the study
group completed the study per protocol (PP). After normalizing to the
patient's own baseline (T1), no significant differences were observed in
clot degradation at T2 or T3. At T4, patients in the study group had
greater degradation when compared to those in the control group (826.5%,
95% confidence interval [CI], 291.1-1361.9 vs -545.9%, 95% CI, -1081.3 to
-10.4; P < .001). Study group patients received significantly less median
post-CPB transfusions than control group patients (ITT, 27.2 mL/kg
[19.0-36.9] vs 41.6 [29.2-52.4]; P = .043; PP 26.7 mL/kg [18.8-32.2] vs
41.2 mL/kg [29.0-51.4]; P < .001). No differences were observed in
bleeding or thrombotic events. CONCLUSION(S): Neonates who received
fibrinogen concentrate, as compared to cryoprecipitate, have similar
perioperative ex vivo clot degradation with faster degradation at 24 hours
postsurgery, less post-CPB blood transfusions, and no increased bleeding
or thrombotic complications. Our findings suggest that fibrinogen
concentrate adequately restores hemostasis and reduces transfusions in
neonates after CPB without increased bleeding or thrombosis
risk. Copyright © 2024 International Anesthesia Research Society.

<19>
Accession Number
644977922
Title
Global Research Trends in Postoperative Delirium and Its Risk Factors: A
Bibliometric and Visual Analysis.
Source
Journal of perianesthesia nursing : official journal of the American
Society of PeriAnesthesia Nurses. (no pagination), 2024. Date of
Publication: 07 Aug 2024.
Author
Liu X.; Huangfu Z.; Zhang X.; Ma T.
Institution
(Liu) School of Nursing, Shanxi Medical University, Taiyuan, Shanxi, China
(Huangfu) Department of Urology, First Affiliated Hospital of Naval
Medical University, Shanghai, China
(Zhang) Department of Obstetrics and Gynecology, National Center of
Gerontology, Beijing Hospital, Beijing, China; Institute of Geriatric
Medicine, Chinese Academy of Medical Science, Beijing, China; Peking Union
Medical College, Chinese Academy of Medical Sciences, Graduate School of
Peking Union Medical College, Beijing, China
(Ma) Department of Anesthesiology, First Hospital of Shanxi Medical
University, Taiyuan, Shanxi, China
Abstract
PURPOSE: Postoperative delirium (POD) is one of the most frequent
complications after surgery which is closely associated with many adverse
outcomes, including high mortality and low quality of life. This study
aims to carry out a bibliometric analysis of POD and its risk factors from
2012 to 2022 to reveal the research status and hot spots. DESIGN: This
study is a bibliometric and visualized analysis. METHOD(S): Relevant
publications between 2012 and 2022 were extracted from the Web of Science
Core Collection database. CiteSpace software (v6.1. R2, Drexel
University), VOSviewer software (v1.6.18, Leiden University), and the
Online Analysis Platform of Literature Metrology were used to analyze
research attributes. These publications were used to analyze research
attributes, including countries, journals, institutions, authors,
keywords, and burst detection, to predict trends and hot spots. FINDINGS:
We included a total of 1,324 related documents from 2012 to 2022. The
literature on POD has increased significantly since 2016. The United
States and Harvard University were the leading literature publishing
country (436/1324, 32.9%) and institution (112/1324, 8.5%). Anesthesia and
Analgesia was the most frequently published journal. Keywords analysis
with VOSviewer revealed that the keywords could be divided into five
clusters, including anesthesia techniques, cardiac surgery, risk factors,
intraoperative anesthesia monitoring, and postoperative cognitive
dysfunction. We included a total of 198 POD risk factors documents, and
the literature on POD risk factors increased. The People's Republic of
China and Harvard University were the leading literature publishing
country (53/198, 26.8%) and institution (12/198, 6.1%). Elderly, hip
surgery, frailty, postoperative pain, cardiac surgery, dementia, and
depression are keywords that are risk factors for POD. CONCLUSION(S):
The number of literature on POD in the field of anesthesia has increased
significantly. Risk factors and anesthesia techniques are still key areas
of research. Encephalogram, the use of sedatives, and perioperative
nursing may be the new research focus. Older adults, hip fractures,
cardiac surgery, liver transplants, dementia, and depression are hot words
in the field of POD risk factors. Copyright © 2024 The American
Society of PeriAnesthesia Nurses. Published by Elsevier Inc. All rights
reserved.

<20>
Accession Number
644975686
Title
Current Management and Therapy of Severe Aortic Stenosis and Future
Perspective.
Source
Journal of atherosclerosis and thrombosis. (no pagination), 2024. Date of
Publication: 08 Aug 2024.
Author
Takeji Y.; Tada H.; Taniguchi T.; Sakata K.; Kitai T.; Shirai S.; Takamura
M.
Institution
(Takeji, Tada, Sakata, Takamura) Department of Cardiovascular Medicine,
Kanazawa University Graduate School of Medical Sciences
(Taniguchi) Department of Cardiovascular Medicine, Kobe City Medical
Center General Hospital
(Kitai) Department of Heart Failure and Transplantation, National Cerebral
and Cardiovascular Center
(Shirai) Division of Cardiology, Kokura Memorial Hospital
Abstract
Intervention for severe aortic stenosis (AS) has dramatically progressed
since the introduction of transcatheter aortic valve replacement (TAVR).
Decades ago, controversies existed regarding comparing clinical outcomes
between TAVR and surgical aortic valve replacement (SAVR) in various risk
profiles. Recently, we discussed the durability of transcatheter heart
valves and their lifetime management after aortic valve replacement (AVR).
Regarding the management of AS, we discuss the appropriate timing of
intervention for severe aortic stenosis, especially in asymptomatic
patients. In spite of dramatic progression of intervention for AS, there
are no established medications available to prevent or slow the
progression of AS at present. Basic research and genome studies have
suggested several targets associated with the progression of aortic valve
calcification. Randomized controlled trials evaluating the efficacy of
medications to prevent AS progression are ongoing, which might lead to new
strategies for AS management. In this review, we summarize the current
management of AS and the drugs expected to prevent the progression of AS.

<21>
Accession Number
644975372
Title
Gender Gap in Cardiothoracic Surgery Randomized Controlled Trial and
posthoc analysis of Randomized Controlled Trial Authorship from 2014 to
2020.
Source
European journal of cardio-thoracic surgery : official journal of the
European Association for Cardio-thoracic Surgery. (no pagination), 2024.
Date of Publication: 07 Aug 2024.
Author
Shariff M.; Kumar A.; Stulak J.; Naumann K.E.; Blackmon S.; Saddoughi S.A.
Institution
(Shariff, Stulak, Blackmon, Saddoughi) Department of General Surgery, Mayo
Clinic, Rochester, United States
(Kumar) Department of Cardiology, Mayo Clinic, Rochester, United States
(Stulak, Naumann, Saddoughi) Department of Cardiovascular Surgery, Mayo
Clinic, Rochester, United States
(Blackmon, Saddoughi) Department of Thoracic Surgery, Mayo Clinic,
Rochester, United States
Abstract
OBJECTIVES: To estimate gender disparities among first and last
authorships in cardiothoracic randomized controlled trials(RCTs) and
association of gender with publications in high impact journals.
 METHOD(S): PubMed/MEDLINE database was searched from January 1st ,
2014-December 31st , 2020 using R statistical software via "easyPubMed"
package to retrieve pertinent data. The "gender" package was utilized to
determine gender using the United States Social Security Administration
Baby Name Data. The percentage of women first and last authors were
computed along with determining the uniqueness of the names. The
association of gender and publication in high impact peer-reviewed
journals was delineated. Jonckheere'e trend was computed. RESULT(S):
The database search retrieved total of 4820 RCTs. Of which, gender was
encoded for first author of 3247 [67%] RCTs, among which 911[28%] studies
had women as first authors with a similar trend across seven years [P
value 0.23]. Gender was encoded for last author of 3204 [66%] RCTs, of
which 622 [19%] studies had women as last authors with a similar trend
across seven years [P value 0.45]. A total of 627 studies were published
in high impact factor journals, among which 79[16%] studies had women
first authors and 67[13%] studies had women last authors.
 CONCLUSION(S): There is an obvious gender disparity of first and last
authors in cardiothoracic surgery related RCTs with a similar trend across
seven years. However, the post-hoc analysis did demonstrate a positive
trend with increase in the number of female first authors demonstrating
progress. Copyright © The Author(s) 2024. Published by Oxford
University Press on behalf of the European Association for Cardio-Thoracic
Surgery. All rights reserved.

<22>
Accession Number
2033926222
Title
Drug-Coated Balloon Angioplasty vs Plain Balloon Angioplasty in patients
with coronary In-Stent Restenosis: A systematic review and meta-analysis
of randomized controlled trials.
Source
Current Problems in Cardiology. 49(10) (no pagination), 2024. Article
Number: 102761. Date of Publication: October 2024.
Author
Sabina M.; Rivera-Martinez J.C.; Khanani A.; Rigdon A.; Owen P.; Massaro
J.
Institution
(Sabina, Rivera-Martinez, Khanani, Rigdon, Owen, Massaro) Lakeland
Regional Health Medical Center, 1664 Red Loop, Lakeland, FL 33801, United
States
Publisher
Elsevier Inc.
Abstract
Background: In-stent restenosis (ISR) remains a significant challenge in
interventional cardiology despite advancements in stent technology.
Drug-coated balloons (DCBs), which deliver antiproliferative agents
directly to the vessel wall, have emerged as a promising alternative to
plain balloon angioplasty for ISR treatment. This meta-analysis evaluates
the efficacy of DCBs compared to plain balloon angioplasty in patients
with coronary ISR. Method(s): A comprehensive search of PubMed and
Embase was conducted on June 27, 2024. The search identified randomized
controlled trials comparing DCBs and plain balloon angioplasty for ISR
treatment. Six trials involving 1,322 patients met the inclusion criteria.
Quality was assessed with the Cochrane Risk of Bias tool. Data extraction
and statistical analysis were performed using RevMan software, assessing
heterogeneity with the I2 statistic and publication bias using
funnel plots. Result(s): The analysis showed that DCBs significantly
reduced late in-stent and in-segment luminal loss (P < 0.001) and target
lesion revascularization (P = 0.02) compared to plain balloon angioplasty.
Major adverse cardiovascular events and the combined endpoint of target
lesion revascularization, myocardial infarction, and death also showed
highly significant improvements with DCB treatment (P < 0.00001 and P =
0.0002, respectively). However, no significant effect was observed on
myocardial infarction and mortality rates. Conclusion(s): DCBs
significantly reduce in-stent late luminal loss, target lesion
revascularization, and major adverse cardiovascular events compared to
plain balloon angioplasty. Copyright © 2024

<23>
Accession Number
2033676853
Title
Tranexamic Acid Use in the Surgical Arena: A Narrative Review.
Source
Journal of Surgical Research. 302 (pp 208-221), 2024. Date of Publication:
October 2024.
Author
Mergoum A.M.; Mergoum A.S.; Larson N.J.; Dries D.J.; Cook A.; Blondeau B.;
Rogers F.B.
Institution
(Mergoum, Mergoum, Larson, Dries, Blondeau, Rogers) Department of Surgery,
Regions Hospital, Saint Paul, Minnesota, United States
(Cook) Department of Surgery, University of Texas at Tyler School of
Medicine, Tyler, TX, United States
Publisher
Academic Press Inc.
Abstract
Introduction: Tranexamic acid (TXA) is a potent antifibrinolytic drug that
inhibits the activation of plasmin by plasminogen. While not a new
medication, TXA has quickly gained traction across a variety of surgical
subspecialties to prevent and treat bleeding. Knowledge on the use of this
drug is essential for the modern surgeon to continue to provide excellent
care to their patients. Method(s): A comprehensive review of the
PubMed database was conducted of articles published within the last 10 y
(2014-2024) relating to TXA and its use in various surgical
subspecialties. Seminal studies regarding the use of TXA older than 10 y
were included from the author's archives. Result(s): Indications for
TXA are not limited to trauma alone, and TXA is utilized across a variety
of surgical subspecialties from neurosurgery to hepatic surgery to control
hemorrhage. Overall, TXA is well tolerated with common dose-dependent
adverse effects, including headache, nasal symptoms, dizziness, nausea,
diarrhea, and fatigue. More severe adverse events are rare and easily
mitigated by not exceeding a dose of 50 mg/kg. Conclusion(s): The
administration of TXA as an adjunct to treat trauma saves lives. The
ability of TXA to induce seizures is dose dependent with identifiable risk
factors, making this serious adverse effect predictable. As for the
potential for TXA to cause thrombotic events, uncertainty remains. If this
association is proven to be real, the risk will likely be small, since the
use of TXA is still advantageous in most situations because of its
efficacy for a more common concern, bleeding. Copyright © 2024
Elsevier Inc.

<24>
[Use Link to view the full text]
Accession Number
2033741818
Title
Magnesium lithospermate B enhances the potential of human-induced
pluripotent stem cell-derived cardiomyocytes for myocardial repair.
Source
Chinese Medical Journal. 137(15) (pp 1857-1869), 2024. Date of
Publication: 05 Aug 2024.
Author
Fan C.; Qin K.; Iroegbu C.D.; Xiang K.; Gong Y.; Guan Q.; Wang W.; Peng
J.; Guo J.; Wu X.; Yang J.
Institution
(Fan, Qin, Iroegbu, Xiang, Gong, Guan, Wu, Yang) Department of
Cardiovascular Surgery, The Second Xiangya Hospital, Central South
University, Hunan, Changsha 410011, China
(Peng) Department of Pharmacology, Xiangya School of Pharmaceutical
Sciences, Central South University, Hunan, Changsha 410078, China
(Guo) Hunan Fangsheng Pharmaceutical Co., Ltd., Hunan, Changsha 410000,
China
(Wang) Department of Thoracic Surgery, The Affiliated Cancer Hospital of
Xiangya School of Medicine, Central South University, Hunan, Changsha
41000, China
Publisher
Lippincott Williams and Wilkins
Abstract
Background: We previously reported that activation of the cell cycle in
human-induced pluripotent stem cell-derived cardiomyocytes (hiPSC-CMs)
enhances their remuscularization capacity after human cardiac muscle patch
transplantation in infarcted mouse hearts. Herein, we sought to identify
the effect of magnesium lithospermate B (MLB) on hiPSC-CMs during
myocardial repair using a myocardial infarction (MI) mouse model.
 Method(s): In C57BL/6 mice, MI was surgically induced by ligating the
left anterior descending coronary artery. The mice were randomly divided
into five groups (n = 10 per group); a MI group (treated with
phosphate-buffered saline only), a hiPSC-CMs group, a MLB group, a
hiPSC-CMs + MLB group, and a Sham operation group. Cardiac function and
MLB therapeutic efficacy were evaluated by echocardiography and
histochemical staining 4 weeks after surgery. To identify the associated
mechanism, nuclear factor (NF)-kappaB p65 and intercellular cell adhesion
molecule-1 (ICAM1) signals, cell adhesion ability, generation of reactive
oxygen species, and rates of apoptosis were detected in human umbilical
vein endothelial cells (HUVECs) and hiPSC-CMs. Result(s): After 4
weeks of transplantation, the number of cells that engrafted in the
hiPSC-CMs + MLB group was about five times higher than those in the
hiPSC-CMs group. Additionally, MLB treatment significantly reduced tohoku
hospital pediatrics-1 (THP-1) cell adhesion, ICAM1 expression, NF-kappaB
nuclear translocation, reactive oxygen species production, NF-kappaB p65
phosphorylation, and cell apoptosis in HUVECs cultured under hypoxia.
Similarly, treatment with MLB significantly inhibited the apoptosis of
hiPSC-CMs via enhancing signal transducer and activator of transcription 3
(STAT3) phosphorylation and B-cell lymphoma-2 (BCL2) expression, promoting
STAT3 nuclear translocation, and downregulating BCL2-Associated X, dual
specificity phosphatase 2 (DUSP2), and cleaved-caspase-3 expression under
hypoxia. Furthermore, MLB significantly suppressed the production of
malondialdehyde and lactate dehydrogenase and the reduction in glutathione
content induced by hypoxia in both HUVECs and hiPSC-CMs in vitro.
 Conclusion(s): MLB significantly enhanced the potential of hiPSC-CMs
in repairing injured myocardium by improving endothelial cell function via
the NF-kappaB/ICAM1 pathway and inhibiting hiPSC-CMs apoptosis via the
DUSP2/STAT3 pathway. Copyright © 2024 The Chinese Medical
Association, produced by Wolters Kluwer, Inc.

<25>
Accession Number
2030611800
Title
Adverse cardiovascular outcomes associated with proton pump inhibitor use
after percutaneous coronary intervention: a systematic review and
meta-analysis.
Source
BMC Cardiovascular Disorders. 24(1) (no pagination), 2024. Article Number:
372. Date of Publication: December 2024.
Author
Padhi B.K.; Khatib M.N.; Zahiruddin Q.S.; Rustagi S.; Sharma R.K.; Sah R.;
Satapathy P.; Rao A.P.
Institution
(Padhi) Department of Community Medicine and School of Public Health,
Postgraduate Institute of Medical Education and Research, Chandigarh
160012, India
(Khatib) Division of Evidence Synthesis, Global Consortium of Public
Health and Research, Datta Meghe Institute of Higher Education, Wardha,
India
(Zahiruddin) South Asia Infant Feeding Research Network (SAIFRN), Division
of Evidence Synthesis, Global Consortium of Public Health and Research,
Datta Meghe Institute of Higher Education, Wardha, India
(Rustagi) School of Applied and Life Sciences, Uttaranchal University,
Uttarakhand, Dehradun, India
(Sharma) Graphic Era (Deemed to be University), Uttarakhand, Dehradun,
India
(Sharma) Graphic Era Hill University, Clement Town, Dehradun, India
(Sah) SR Sanjeevani Hospital, Siraha, Kalyanpur 56517, Nepal
(Sah) Department of Clinical Microbiology, Dr. D. Y. Patil Medical
College, Hospital and Research Centre, Dr. D. Y. Patil Vidyapeeth,
Maharashtra, Pune 411000, India
(Satapathy) Center for Global Health Research, Saveetha Medical College
and Hospital, Saveetha Institute of Medical and Technical Sciences,
Saveetha University, Chennai 602117, India
(Satapathy) Medical Laboratories Techniques Department, AL-Mustaqbal
University, Babil, Hillah 51001, Iraq
(Rao) Dept of Health Policy, Prasanna School of Public Health, Manipal
Academy of Higher Education, Manipal 576104, India
(Sah) Department of Public Health Dentistry, Dr. D.Y. Patil Dental College
and Hospital, Dr. D.Y. Patil Vidyapeeth, Maharashtra 411018, India
Publisher
BioMed Central Ltd
Abstract
Background: Proton pump inhibitors (PPIs) are commonly prescribed for
gastroprotection in patients undergoing percutaneous coronary intervention
(PCI), who are at increased risk of gastrointestinal bleeding due to
antiplatelet therapy. However, emerging evidence suggests that PPIs may
adversely impact cardiovascular outcomes. This systematic review and
meta-analysis sought to assess the relationship between using PPIs and
cardiovascular outcomes in patients following PCI. Method(s): We
searched various databases up to March 15, 2024, for observational studies
and randomized controlled trials (RCTs) assessing the cardiovascular
effects of PPIs in PCI patients. Data were extracted on study
characteristics, patient demographics, PPI use, and cardiovascular
outcomes. The Newcastle-Ottawa Scale and Cochrane Risk of Bias Tool 2
assessed study quality. Meta-analyses were conducted using a
random-effects model using R software version 4.3. Result(s): A total
of 21 studies involving diverse populations and study designs were
included. Observational studies suggested a moderate increase in risk for
composite cardiovascular diseases (CVD), myocardial infarction (MI), and
major adverse cardiac events (MACE) associated with PPI use, with pooled
hazard ratios (HRs) of 1.20 (95% CI: 1.093-1.308) for CVD, 1.186 (95% CI:
1.069-1.303) for MI, and 1.155 (95% CI: 1.001-1.309) for MACE. However,
RCTs showed no significant link between PPI therapy and negative
cardiovascular events (Relative Risk: 1.016, 95% CI: 0.878-1.175).
Substantial heterogeneity was observed among observational studies but not
RCTs. Conclusion(s): The findings indicate that while observational
studies suggest a potential risk of adverse cardiovascular events with
post-PCI use of PPI, RCTs do not support this association. Further
large-scale, high-quality studies are required to understand the
cardiovascular implications of individual PPIs better and optimize patient
management post-PCI. This analysis shows the complexity of PPI use in
patients with coronary artery diseases and the necessity to balance
gastroprotective benefits against potential cardiovascular
risks. Copyright © The Author(s) 2024.

<26>
Accession Number
2030551736
Title
Prospective Randomized Study of Ultrasound-Guided In-Plane Versus
Out-of-Plane Radial Artery Cannulation in Adult Cardiac Surgery Patients.
Source
Sri Lankan Journal of Anaesthesiology. 32(2) (pp 117-124), 2024. Date of
Publication: 2024.
Author
Arul A.R.; Vijayakumara D.; Rai G.
Institution
(Arul, Vijayakumara) Department of Anaesthesiology, Kasturba Medical
College, Karnataka, Manipal, India
(Rai) Department of Cardiothoracic Surgery, Kasturba Medical College,
Karnataka, Manipal, India
Publisher
College of Anaesthesiologists of Sri Lanka
Abstract
Background With the more frequent use of ultrasound in medical practice,
radial artery cannulation using ultrasound has proven to be better than
the traditional landmark technique. Ultrasound-guided techniques reduce
the risk of cannulation failure and complications like hematoma, arterial
spasm, etc. Ultrasound is helpful in obesity, pediatric age group, and
hemodynamically unstable patients with a feeble pulse. This study
performed a comparison between in-plane and out-of-plane ultrasound-guided
techniques for cannulation of the radial artery. Methodology This study
was prospective randomized and interventional. The study involved adult
patients scheduled to undergo cardiac surgery requiring arterial
cannulation. Institutional ethics committee approval and consent was taken
from the patients. A total of 128 patients were randomized into the
in-plane and the out-of-plane ultrasound groups. In the operation room,
radial artery cannulation was done under local anesthesia using a hockey
stick ultrasound probe. The objective of the study was to compare the
incidence of first-pass success rate, the number of attempts, number of
redirections, cannulation completion time and incidence of complications
in two groups. Results The demographic data was found to be comparable.
The in-plane group had a higher incidence of first attempt success as
compared to the out-of-plane group with a P value of 0.021. There was no
statistically significant difference in other clinical outcomes.
Conclusion The in-plane technique had a higher first-attempt success rate.
Hence it should be considered for use in routine practice to improve
patient care. Copyright © 2024, College of Anaesthesiologists of
Sri Lanka. All rights reserved.

<27>
Accession Number
2030534163
Title
Dynamic Hip Screw versus Proximal Femoral Nail in the Treatment of Stable
Intertrochanteric Fractures.
Source
International Journal of Pharmaceutical and Clinical Research. 16(7) (pp
872-879), 2024. Date of Publication: 2024.
Author
Iman S.; Talukdar M.; Singh A.K.
Institution
(Iman, Talukdar, Singh) Tezpur Medical College and Hospital, Assam, India
Publisher
Dr. Yashwant Research Labs Pvt. Ltd.
Abstract
Background: The choice between dynamic hip screw (DHS) and proximal
femoral nail (PFN) for the treatment of stable intertrochanteric fractures
of hip remains controversial. This study aimed to compare the outcomes of
these two implants in terms of early mobility, complications and
functional recovery. Method(s): A retrospective comparative study was
conducted on 100 patients with stable intertrochanteric fractures (AO/OTA
31-A1) treated with either DHS (n=50) or PFN (n=50). Intraoperative,
postoperative, radiographic, and functional outcomes were assessed. The
minimum follow-up period was 12 months. Result(s): The PFN group had
significantly shorter surgical times (55.2 +/- 10.8 min vs. 68.4 +/- 12.5
min, p<0.001), less blood loss (135.4 +/- 38.7 mL vs. 180.6 +/- 45.3 mL,
p<0.001), earlier mobility (2.5 +/- 0.9 days vs. 3.8 +/- 1.2 days,
p<0.001), better weight-bearing status at discharge (full: 48% vs. 20%,
p=0.002), and shorter hospital stays (6.8 +/- 1.9 days vs. 8.5 +/- 2.3
days, p<0.001) compared to the DHS group. At 12 months, the PFN group had
higher Harris Hip Scores (87.2 +/- 5.9 vs. 84.6 +/- 6.8, p=0.042) and
Parker Mobility Scores (7.8 +/- 1.3 vs. 7.2 +/- 1.5, p=0.033).
Complication rates were lower in the PFN group, but the differences were
not statistically significant. Conclusion(s): PFN may be associated
with better outcomes compared to DHS in the treatment of stable
intertrochanteric fractures, particularly in terms of early rehabilitation
and long-term functional recovery. Larger prospective studies are needed
to confirm these findings. Copyright © 2024, Dr. Yashwant
Research Labs Pvt. Ltd. All rights reserved.

<28>
[Use Link to view the full text]
Accession Number
2033950308
Title
Randomized Trial for Evaluation in Secondary Prevention Efficacy of
Combination Therapy-Statin and Eicosapentaenoic Acid (RESPECT-EPA).
Source
Circulation. 150(6) (pp 425-434), 2024. Date of Publication: 06 Aug 2024.
Author
Miyauchi K.; Iwata H.; Nishizaki Y.; Inoue T.; Hirayama A.; Kimura K.;
Ozaki Y.; Murohara T.; Ueshima K.; Kuwabara Y.; Tanaka-Mizuno S.;
Yanagisawa N.; Sato T.; Daida H.
Institution
(Miyauchi, Iwata, Nishizaki) Department of Cardiovascular Biology and
Medicine, Juntendo University, Graduate School of Medicine, Bunkyo-ku,
Tokyo, Japan
(Inoue) Japan Red Cross Society, Nasu Red Cross Hospital, Tochigi,
Otawara, Japan
(Inoue) Dokkyo Medical University, Mibu, Tochigi, Japan
(Hirayama) Osaka Anti-Tuberculosis Association, Osaka Fukujyuji Hospital,
Osaka, Neyagawa, Japan
(Kimura) Department of Cardiology, Yokohama City University, Medical
Center, Kanagawa, Japan
(Ozaki) Department of Cardiology, Fujita Health University, Aichi,
Toyoake, Japan
(Murohara) Department of Cardiology, Nagoya University, Graduate School of
Medicine, Aichi, Nagoya, Japan
(Ueshima) Medical Examination Center, Uji-Takeda Hospital, Kyoto, Uji,
Japan
(Kuwabara) Cancer Control Center, Osaka International Cancer Institute,
Osaka, Japan
(Tanaka-Mizuno) Department of Digital Health and Epidemiology, Graduate
School of Medicine, Kyoto University, Kyoto, Japan
(Yanagisawa) Medical Technology Innovation Center, Juntendo University,
Bunkyo-ku, Tokyo, Japan
(Daida) Faculty of Health Science, Juntendo University, Bunkyo-ku, Tokyo,
Japan
(Sato) Department of Biostatistics, Kyoto University, School of Public
Health, Kyoto, Japan
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND: Low plasma levels of eicosapentaenoic acid (EPA) are
associated with cardiovascular events. This trial aimed to assess the
clinical benefits of icosapent ethyl in patients with coronary artery
disease, a low EPA/arachidonic acid (AA) ratio, and statin treatment.
 METHOD(S): In this prospective, multicenter, randomized, open-label,
blinded end-point study, patients with stable coronary artery disease and
a low EPA/AA ratio (<0.4) were randomized to EPA (1800 of icosapent ethyl
administered daily) or control group. The primary end point was a
composite of cardiovascular death, nonfatal myocardial infarction,
nonfatal ischemic stroke, unstable angina pectoris, and coronary
revascularization. The secondary composite end points of coronary events
included sudden cardiac death, fatal and nonfatal myocardial infarction,
unstable angina requiring emergency hospitalization and coronary
revascularization, or coronary revascularization. RESULT(S): Overall,
3884 patients were enrolled at 95 sites in Japan. Among them, 2506
patients had a low EPA/AA ratio, and 1249 and 1257 patients were
randomized to the EPA and control group, respectively. The median EPA/AA
ratio was 0.243 (interquartile range, 0.180-0.314) and 0.235
(interquartile range, 0.163-0.310) in the EPA and control group,
respectively. Over a median period of 5 years, the primary end point
occurred in 112 of 1225 patients (9.1%) and 155 of 1235 patients (12.6%)
in the EPA and control group, respectively (hazard ratio, 0.79 [95% CI,
0.62-1.00]; P=0.055). Meanwhile, the secondary composite end point of
coronary events in the EPA group was significantly lower (81/1225 [6.6%]
versus 120/1235 [9.7%] patients; hazard ratio, 0.73 [95% CI, 0.55-0.97]).
Adverse events did not differ between the groups, but the rate of
new-onset atrial fibrillation was significantly higher in the EPA group
(3.1% versus 1.6%; P=0.017). CONCLUSION(S): Icosapent ethyl treatment
resulted in a numerically lower risk of cardiovascular events that did not
reach statistical significance in patients with chronic coronary artery
disease, a low EPA/AA ratio, and statin treatment. REGISTRATION: URL:
https://www.umin.ac.jp/ctr/; Unique identifier:
UMIN000012069. Copyright © 2024 American Heart Association, Inc.

<29>
[Use Link to view the full text]
Accession Number
2033916670
Title
Updates on the Global Prevalence and Etiology of Constrictive
Pericarditis: A Systematic Review.
Source
Cardiology in Review. 32(5) (pp 417-422), 2024. Date of Publication: 01
Sep 2024.
Author
Kosmopoulos M.; Liatsou E.; Theochari C.; Stavropoulos A.; Chatzopoulou
D.; Mylonas K.S.; Georgiopoulos G.; Schizas D.
Institution
(Kosmopoulos) From the Department of Medicine, University of Minnesota
Medical School, Minneapolis, MN, United States
(Liatsou, Schizas) First Department of Surgery, National and Kapodistrian
University of Athens, Laikon General Hospital, Athens, Greece
(Theochari) Third Department of Internal Medicine, National and
Kapodistrian University of Athens, Thoracic Diseases General Hospital
Sotiria, Athens, Greece
(Stavropoulos) Department of Medicine, Internal Medicine, North Bristol
NHS Trust, Bristol, United Kingdom
(Chatzopoulou) Department of Surgery, General Surgery, Frimley Health NHS
Trust, Frimley, Surrey, United Kingdom
(Mylonas) Department of Cardiac Surgery, Onassis Cardiac Surgery Center,
Athens, Greece
(Georgiopoulos) Department of Therapeutics, National and Kapodistrian
University of Athens, Faculty of Medicine, Alexandra Hospital, Greece
Publisher
Lippincott Williams and Wilkins
Abstract
Constrictive pericarditis is a rare disease with poorly understood
epidemiology. A systematic literature search was adopted to assess the
region- and period-specific traits of constrictive pericarditis through
Pubmed, EMBASE, and Scopus. Case reports and studies including less than
20 patients were excluded. The risk of bias was assessed through the Study
Quality Assessment Tools developed by the National Heart Lung Blood
Institute by 4 reviewers. Patient demographics, disease etiology, and
mortality were the primary assessed outcomes. One hundred thirty studies
with 11,325 patients have been included in this systematic review and
meta-analysis. The age at diagnosis of constrictive pericarditis has
markedly increased after 1990. Patients from Africa and Asia are
considerably younger compared with those from Europe and North America.
Moreover, there are differences in etiology, as tuberculosis remains the
dominant cause of constrictive pericarditis in Africa and Asia but has
been surpassed by history of previous chest surgery in North America and
Europe. The human immunodeficiency virus affects 29.1% of patients from
Africa diagnosed with constrictive pericarditis, a feature that is not
observed on any other continent. The early mortality rate after
hospitalization has improved. The variances of age at diagnosis and
etiology of constrictive pericarditis should be considered by the
clinician during the work-up of cardiac and pericardial diseases. An
underlying human immunodeficiency virus infection complicates a
significant portion of constrictive pericarditis cases in Africa. Early
mortality has improved across the world but remains high. Copyright
© 2023 Wolters Kluwer Health, Inc. All rights reserved.

<30>
Accession Number
2033724679
Title
EXAMINING THE EFFECTS OF CONNECTIVE TISSUE MASSAGE ON PAIN AFTER
THORACOTOMY - RANDOMIZED CONTROLLED TRIAL.
Source
Turkish Journal of Physiotherapy and Rehabilitation. 35(1) (pp 56-65),
2024. Date of Publication: 20 Apr 2024.
Author
Temel Aksu N.; Erdogan A.
Institution
(Temel Aksu) Department of Physical Therapy and Rehabilitation, Akdeniz
University, Antalya, Turkey
(Erdogan) Department Of Thoracic Surgery, Akdeniz University Faculty Of
Medicine, Antalya, Turkey
Publisher
Turkish Physiotherapy Association
Abstract
Purpose: The objective was evaluate the effect of a connective tissue
massage on pain, applied analgesic amounts and length of hospitalization
of the patients. Method(s): The study was a prospective, randomized,
controlled clinical trial and conducted at a thoracic surgery department
of university hospital. The patients were randomly allocated to 1 of 2
groups: a control group (n=27) and the experimental group (n=27). Standard
medical treatment, care and pulmonary rehabilitation program were applied
to both groups. In addition, a total of 5 sessions of connective tissue
massage were applied to the experimental group. Pain level of the patients
was evaluated at every 24 hours as of the zeroth postoperative day. VAS
was used as a one-dimensional scale for pain assessment. Totally applied
analgesic amounts and length of hospitalization of the patients were
recorded. Result(s): There was no statistically significant
difference between the experimental and control groups on the
postoperative 0th and 1st days. A statistically significant difference was
found between VAS averages on postoperative 2nd, 3rd, 4th, 5th, 6th and
7th days (p<0.001). Totally applied analgesic amounts of the the patients
decreased significantly from the postoperative 2nd day (p<0.05). The
length of hospital stay in the experimental group was short.
 Conclusion(s): The pain of the experimental group decreased
significantly and their pain on the postoperative 7th day was quite low
and therefore the need for analgesic drugs decreased
significantly. Copyright © 2024 Turkish Physiotherapy
Association. All rights reserved.

<31>
Accession Number
2033386181
Title
Episode Care Costs Following Catheter-Directed Reperfusion Therapies for
Pulmonary Embolism: A Literature-Based Comparative Cohort Analysis.
Source
American Journal of Cardiology. 225 (pp 178-189), 2024. Date of
Publication: 15 Aug 2024.
Author
Noman A.; Stegman B.; DuCoffe A.R.; Bhat A.; Hoban K.; Bunte M.C.
Institution
(Noman, Bunte) Department of Medicine, University of Missouri-Kansas City,
Kansas City, Missouri, United States
(Stegman) Department of Cardiology, CentraCare Heart and Vascular Center,
St. Cloud, Minnesota, United States
(DuCoffe) Department of Radiology, Inova Health System, Fairfax, Virginia,
United States
(Bhat) Department of Radiology, Section of Vascular and Interventional
Radiology, University of Missouri, Columbia, Missouri, United States
(Hoban) Department of Scientific Affairs, Inari Medical, Inc, Irvine,
California, United States
(Bunte) Department of Cardiology, Saint Luke's Mid America Heart
Institute, Kansas City, Missouri, United States
(Bunte) Department of Cardiology, Saint Luke's Hospital of Kansas City,
Kansas City, Missouri, United States
Publisher
Elsevier Inc.
Abstract
This analysis aimed to estimate 30-day episode care costs associated with
3 contemporary endovascular therapies indicated for treatment of pulmonary
embolism (PE). Systematic literature review was used to identify clinical
research reporting costs associated with invasive PE care and outcomes for
ultrasound-accelerated thrombolysis (USAT), continuous-aspiration
mechanical thrombectomy (CAMT), and volume-controlled-aspiration
mechanical thrombectomy (VAMT). Total episode variable care costs were
defined as the sum of device costs, variable acute care costs, and
contingent costs. Variable acute care costs were estimated using
methodology sensitive to periprocedural and postprocedural resource
allocation unique to the 3 therapies. Contingent costs included expenses
for thrombolytics, postprocedure bleeding events, and readmissions through
30 days. Through February 28, 2023, 70 sources were identified and used to
inform estimates of 30-day total episode variable costs. Device costs for
USAT, CAMT, and VAMT were the most expensive single component of total
episode variable costs, estimated at $5,965, $10,279, and $11,901,
respectively. Costs associated with catheterization suite utilization,
intensive care, and hospital length of stay, along with contingent costs,
were important drivers of total episode costs. Total episode variable care
costs through 30 days were $19,146, $20,938, and $17,290 for USAT, CAMT,
and VAMT, respectively. In conclusion, estimated total episode care costs
after invasive treatment for PE are heavily influenced by device expense,
in-hospital care, and postacute care complications. Regardless of device
cost, strategies that avoid thrombolytics, reduce the need for intensive
care unit care, shorten length of stay, and reduce postprocedure bleeding
and 30-day readmissions contributed to the lowest episode
costs. Copyright © 2024 The Authors

<32>
Accession Number
2033317576
Title
Platelet inhibitor withdrawal and outcomes after coronary artery surgery:
An individual patient data meta-analysis.
Source
European Journal of Cardio-thoracic Surgery. 66(1) (no pagination), 2024.
Article Number: ezae265. Date of Publication: 01 Jul 2024.
Author
Schoerghuber M.; Kuenzer T.; Biancari F.; Dalen M.; Hansson E.C.; Jeppsson
A.; Schlachtenberger G.; Siegemund M.; Voetsch A.; Pregartner G.; Lindenau
I.; Zimpfer D.; Berghold A.; Mahla E.; Zirlik A.
Institution
(Schoerghuber, Mahla) Division of Anaesthesiology and Intensive Care
Medicine 2, Medical University of Graz, Graz, Austria
(Kuenzer, Pregartner, Berghold) Institute for Medical Informatics,
Statistics and Documentation, Medical University of Graz, Graz, Austria
(Biancari) Department of Internal Medicine, South-Karelia Central
Hospital, University of Helsinki, Lappeenranta, Finland
(Dalen) Department of Cardiac Surgery, Karolinska University Hospital,
Stockholm, Sweden
(Dalen) Department of Molecular Medicine and Surgery, Karolinska
Institutet, Stockholm, Sweden
(Hansson, Jeppsson) Department of Molecular and Clinical Medicine,
Institute of Medicine, Sahlgrenska Academy, University of Gothenburg,
Gothenburg, Sweden
(Hansson, Jeppsson) Department of Cardiothoracic Surgery, Sahlgrenska
University Hospital, Gothenburg, Sweden
(Schlachtenberger) Department of Cardiothoracic Surgery, University
Hospital of Cologne, Cologne, Germany
(Siegemund) Department of Acute Medicine, University Hospital Basel,
Basel, Switzerland
(Siegemund) Department of Clinical Research, University of Basel, Basel,
Switzerland
(Voetsch) Department of Cardiovascular and Endovascular Surgery,
Paracelsus Medical University, Salzburg, Austria
(Lindenau) Department of Anaesthesiology and Intensive Care Medicine,
Hospital Oberwart, Oberwart, Austria
(Zimpfer) Division of Cardiac Surgery, University Heart Center Graz,
Medical University of Graz, Graz, Austria
(Zirlik) Division of Cardiology, University Heart Center Graz, Medical
University of Graz, Graz, Austria
Publisher
European Association for Cardio-Thoracic Surgery
Abstract
OBJECTIVES: To evaluate the association between guideline-conforming as
compared to shorter than recommended withdrawal period of P2Y<inf>12</inf>
receptor inhibitors prior to isolated on-pump coronary artery bypass
grafting (CABG) and the incidence of severe bleeding and ischaemic events.
Randomized controlled trials are lacking in this field. METHOD(S): We
searched PUBMED, Embase and other suitable databases for studies including
patients on P2Y<inf>12</inf> receptor inhibitors undergoing isolated CABG
and reporting bleeding and postoperative ischaemic events from 2013 to
March 2024. The primary outcome was incidence of Bleeding Academic
Research Consortium type 4 (BARC-4) bleeding defined as any of the
following: perioperative intracranial bleeding, reoperation for bleeding,
transfusion of >=5 units of red blood cells, chest tube output of >=2 l.
The secondary outcome was postoperative ischaemic events according to the
Academic Research Consortium 2 Consensus Document. Patient-level data
provided by each observational trial were synthesized into a single
dataset and analysed using a 2-stage IPD-MA. RESULT(S): Individual
data of 4837 patients from 7 observational studies were synthesized.
BARC-4 bleeding, 30-day mortality and postoperative ischaemic events
occurred in 20%, 2.6% and 5.2% of patients. After adjusting for EuroSCORE
II and cardiopulmonary bypass time, guideline-conforming withdrawal was
associated with decreased BARC-4 bleeding risk in patients on clopidogrel
[adjusted odds ratio (OR) 0.48; 95% confidence intervals (CI) 0.28-0.81; P
= 0.006] and a trend towards decreased risk in patients on ticagrelor
(adjusted OR 0.48; 95% CI 0.22-1.05; P = 0.067). Guideline-conforming
withdrawal was not significantly associated with 30-day mortality risk
(clopidogrel: adjusted OR 0.70; 95% CI 0.30-1.61; ticagrelor: adjusted OR
0.89; 95% CI 0.37-2.18) but with decreased risk of postoperative ischaemic
events in patients on clopidogrel (clopidogrel: adjusted OR 0.50; 95% CI
0.30-0.82; ticagrelor: adjusted OR 0.78; 95% CI 0.45-1.37). BARC-4
bleeding was associated with 30-day mortality risk (adjusted OR 4.76; 95%
CI 2.67-8.47; P < 0.001). CONCLUSION(S): Guideline-conforming
preoperative withdrawal of ticagrelor and clopidogrel was associated with
a 50% reduced BARC-4 bleeding risk when corrected for EuroSCORE II and
cardiopulmonary bypass time but was not associated with increased risk of
30-day mortality or postoperative ischaemic events. Copyright ©
2024 The Author(s).

<33>
Accession Number
2033303812
Title
Knowledge domain and emerging trends in the rupture risk of intracranial
aneurysms research from 2004 to 2023.
Source
World Journal of Clinical Cases. 12(23) (pp 5382-5403), 2024. Date of
Publication: 16 Aug 2024.
Author
Chen J.-C.; Luo C.; Li Y.; Tan D.-H.
Institution
(Chen, Luo, Li, Tan) Department of Neurosurgery, The First Affiliated
Hospital of Shantou University Medical College, Guangdong Province,
Shantou 515041, China
Publisher
Baishideng Publishing Group Inc
Abstract
BACKGROUND Intracranial aneurysms (IAs) pose significant health risks,
attributable to their potential for sudden rupture, which can result in
severe outcomes such as stroke and death. Despite extensive research, the
variability of aneurysm behavior, with some remaining stable for years
while others rupture unexpectedly, remains poorly understood. AIM To
employ bibliometric analysis to map the research landscape concerning risk
factors associated with IAs rupture. METHODS A systematic literature
review of publications from 2004 to 2023 was conducted, analyzing 3804
documents from the Web of Science Core Collection database, with a focus
on full-text articles and reviews in English. The analysis encompassed
citation and co-citation networks, keyword bursts, and temporal trends to
delineate the evolution of research themes and collaboration patterns.
Advanced software tools, CiteSpace and VOSviewer, were utilized for
comprehensive data visualization and trend analysis. RESULTS Analysis
uncovered a total of 3804 publications on IA rupture risk factors between
2006 and 2023. Research interest surged after 2013, peaking in 2023. The
United States led with 28.97% of publications, garnering 37706 citations.
Notable United States-China collaborations were observed. Capital Medical
University produced 184 publications, while Utrecht University boasted a
citation average of 69.62 per publication. "World Neurosurgery" published
the most papers, contrasting with "Stroke", the most cited journal. The
PHASES score from "Lancet Neurology" emerged as a vital rupture risk
prediction tool. Early research favored endovascular therapy,
transitioning to magnetic resonance imaging and flow diverters.
"Subarachnoid hemorrhage" stood out as a recurrent keyword. CONCLUSION
This study assesses global IA research trends and highlights crucial gaps,
guiding future investigations to improve preventive and therapeutic
approaches. Copyright © The Author(s) 2024. Published by
Baishideng Publishing Group Inc. All rights reserved.

<34>
Accession Number
2030923164
Title
Differential response to preoperative exercise training in patients
candidates to cardiac valve replacement.
Source
BMC Anesthesiology. 24(1) (no pagination), 2024. Article Number: 280. Date
of Publication: December 2024.
Author
Lopez-Hernandez A.; Gimeno-Santos E.; Navarro-Ripoll R.; Arguis M.J.;
Romano-Andrioni B.; Lopez-Baamonde M.; Teres S.; Sanz-de la Garza M.;
Martinez-Palli G.
Institution
(Lopez-Hernandez, Navarro-Ripoll, Arguis, Lopez-Baamonde, Martinez-Palli)
Anesthesiology Department, Hospital Clinic de Barcelona, Barcelona, Spain
(Lopez-Hernandez, Gimeno-Santos, Navarro-Ripoll, Arguis, Romano-Andrioni,
Lopez-Baamonde, Teres, Martinez-Palli) Prehabilitation Unit, Hospital
Clinic de Barcelona, Barcelona, Spain
(Gimeno-Santos, Navarro-Ripoll, Arguis, Sanz-de la Garza, Martinez-Palli)
August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona,
Spain
(Gimeno-Santos) Barcelona of Global Health Institute (ISGlobal) -
Universitat Pompeu Fabra (UPF), Barcelona, Spain
(Romano-Andrioni) Nutrition and Clinical Dietetics, Hospital Clinic de
Barcelona, Barcelona, Spain
(Sanz-de la Garza) Cardiovascular Institute, Hospital Clinic de Barcelona,
Barcelona, Spain
(Gimeno-Santos, Martinez-Palli) CIBER de Enfermedades Respiratorias
(CIBERES), Carlos III Health Institute, Madrid, Spain
Publisher
BioMed Central Ltd
Abstract
Background: There is lack of evidence regarding safety, effectiveness and
applicability of prehabilitation on cardiac surgery population,
particularly in patients candidates to cardiac valve replacement. The aim
of the study is to assess and compare the effect of a multimodal
prehabilitation program on functional capacity in patients with severe
aortic stenosis (AoS) and severe mitral regurgitation (MR) proposed for
valve replacement surgery. Method(s): Secondary analysis from a
randomised controlled trial whose main objective was to analyze the
efficacy of a 4-6 weeks multimodal prehabilitation program in cardiac
surgery on reducing postoperative complications. For this secondary
analysis, only candidates for valve replacement surgery were selected. The
primary outcome was the change in endurance time (ET) from baseline to
preoperative assessment measured by a cycling constant work-rate
cardiopulmonary exercise test. Result(s): 68 patients were included
in this secondary analysis, 34 (20 AoS and 14 MR) were allocated to the
prehabilitation group and 34 (20 AoS and 14 MR) to control group. At
baseline, patients with AoS had better left systolic ventricular function
and lower prevalence of atrial fibrillation compared to MR (p = 0.022 and
p = 0.035 respectively). After prehabilitation program, patients with MR
showed greater improvement in ET than AoS patients (101% vs. 66% increase
from baseline). No adverse events related to the prehabilitation program
were observed. Conclusion(s): A 4-6 week exercise training program is
safe and overall improves functional capacity in patients with severe AoS
and MR. However, exercise response is different according to the cardiac
valve type disfunction, and further studies are needed to know the factors
that predispose some patients to have better training response. Trial
registration: The study has been registered on the Registry of National
Institutes of Health ClinicalTrials.gov (NCT03466606)
(05/03/2018). Copyright © The Author(s) 2024.

<35>
Accession Number
2033982947
Title
Hemodynamic Effects of Pressure-Regulated Volume-Controlled Versus
Volume-Controlled Ventilation Mode in Patients with Diastolic Dysfunction
Undergoing Radical Cystectomy- A Cross Over Randomized Study.
Source
African Journal of Biological Sciences (South Africa). 6 (pp 2179-2195),
2024. Date of Publication: 2024.
Author
Ibrahim T.S.; Abdelsalam T.A.; Othman M.M.; Gad M.M.
Institution
(Ibrahim, Abdelsalam, Othman, Gad) Anesthesia Surgical Intensive Care and
Pain management Department, Faculty of Medicine, Mansoura university,
Egypt
Publisher
Institute of Advanced Studies
Abstract
Background: Management of hemodynamics remains one of the core tasks in
perioperative and critical care settings. The basis of hemodynamic
management in patients undergoing major surgery is formed by a rational
titration of fluids, vasopressors and inotropes. Objective(s): The
objective of this study was to investigate whether, the pressure regulated
volume-controlled mode (PRVC) in comparison with the volume-controlled
mode in patients with diastolic dysfunction, was associated with better
hemodynamic alterations and different vasopressors support during
anesthesia for radical cystectomy. Method(s): This study was a
randomized, cross-over single blinded study and included 86 adult patients
of both sexes with American Society of Anesthesiologists (ASA) physical
status I - II with diastolic dysfunction, the patients were randomly
assigned to group 0 (VCV-PRVC) and group 1 (PRVC-VCV) in a cross-over
manner according to a computer-generated randomization sequence.
Hemodynamic variables included stroke volume, stroke volume variation,
stroke index, cardiac output, cardiac index, systemic vascular resistance,
systemic vascular resistance index (SVRI), thoracic fluid content, and
corrected flow time, were measured by a Portable noninvasive cardiometry.
 Result(s): There were no statistically significant differences in
demographic data such as age, sex, ASA physical status, body weight,
height, body surface area (BSA), duration of surgery, anesthesia, cardiac
output, and cardiac index between the two modes of ventilation. Stroke
volume (SV) was significantly higher in the VCV group than in the PRVC
group at the 3-hour mark from the start of the resection. Regarding fluid
status parameters (SVV, FTc, and TFC), there was no statistically
significant difference in stroke volume variation (SVV) or (FTc) between
both modes. As regards to crystalloids, colloids, blood and plasma
transfusions, blood loss, and total fluids, there were no statistically
significant differences between both modes. Conclusion(s): no
significant differences in CO, CI, SV, SVI, and SVV. Both VCV and PRVC
ventilation modes could be used in patients with diastolic dysfunction
undergoing major abdominal surgery, showing. Copyright © 2024
African Science Publications. All rights reserved.

<36>
[Use Link to view the full text]
Accession Number
2033973648
Title
Left main revascularization guidelines: Navigating the data.
Source
Current Opinion in Cardiology. 39(5) (pp 437-443), 2024. Date of
Publication: 01 Sep 2024.
Author
Vallee A.; Rahmouni K.; Ponnambalam M.; Issa H.; Ruel M.
Institution
(Vallee, Rahmouni, Ponnambalam, Issa, Ruel) University of Ottawa Heart
Institute, University of Ottawa, Ottawa, ON, Canada
(Vallee) Cardiac and Vascular Surgery Department, Marie Lannelongue
Hospital, GHPSJ, Le Plessis Robinson, France
Publisher
Lippincott Williams and Wilkins
Abstract
Purpose of reviewThis article explores recent developments in left main
revascularization, with a focus on appraising the latest American and
European guidelines.Recent findingsRecent pooled data analysis from four
major randomized controlled trials (RCTs) for left main coronary artery
stenosis indicate an advantage for CABG over PCI in regard to freedom from
major adverse cardiovascular events, despite no significant difference in
mortality observed at 5years. Additional data support the use of CABG for
patients with left ventricular dysfunction, complex left main lesions,
diffuse coronary disease, and diabetes.SummaryThe data underpinning the
guidelines on each revascularization modality (PCI versus CABG) must
consider factors such as lesion complexity, diabetes, and left ventricular
dysfunction. Additionally, the findings of the four major RCTs upon which
the guidelines are based must be ascertained in light of the latest
advancements in these revascularization techniques. Copyright ©
2024 Wolters Kluwer Health, Inc. All rights reserved.

<37>
Accession Number
644964210
Title
Low-Dose Direct Oral Anticoagulation vs Dual Antiplatelet Therapy After
Left Atrial Appendage Occlusion: The ADALA Randomized Clinical Trial.
Source
JAMA cardiology. (no pagination), 2024. Date of Publication: 07 Aug 2024.
Author
Freixa X.; Cruz-Gonzalez I.; Cepas-Guillen P.; Millan X.; Antunez-Muinos
P.; Flores-Umanzor E.; Asmarats L.; Regueiro A.; Lopez-Tejero S.; Li
C.-H.P.; Sanchis L.; Rodes-Cabau J.; Arzamendi D.
Institution
(Freixa, Cepas-Guillen, Antunez-Muinos, Flores-Umanzor, Regueiro,
Lopez-Tejero, Sanchis, Rodes-Cabau) Department of Cardiology, Institut
Cardiovascular, IDIBAPS, Hospital Clinic of Barcelona, Barcelona, Spain
(Cruz-Gonzalez) Department of Cardiology, Hospital Universitario of
Salamanca, Salamanca, Spain
(Millan, Asmarats, Li, Arzamendi) Department of Cardiology, Hospital
Universitari de la Santa Creu i Sant Pau, IIB Sant Pau, Barcelona, Spain
(Rodes-Cabau) Quebec Heart and Lung Institute, Laval University, Quebec
City, QC, Canada
Abstract
Importance: Optimal antithrombotic therapy after percutaneous left atrial
appendage occlusion (LAAO) is not well established as no randomized
evaluation has been performed to date. Objective(s): To compare the
efficacy and safety of low-dose direct oral anticoagulation (low-dose
DOAC) vs dual antiplatelet therapy (DAPT) for 3 months after LAAO.
 Design, Setting, and Participant(s): The ADALA (Low-Dose Direct Oral
Anticoagulation vs Dual Antiplatelet Therapy After Left Atrial Appendage
Occlusion) study was an investigator-initiated, multicenter, prospective,
open-label, randomized clinical trial enrolling participants from June 12,
2019, to August 28, 2022 from 3 European sites. Patients who underwent
successful LAAO were randomly assigned 1:1 to low-dose DOAC vs DAPT for 3
months after LAAO. The study was prematurely terminated when only 60% of
the estimated sample size had been included due to lower recruitment rate
than anticipated due to the COVID-19 pandemic. Intervention(s): The
low-dose DOAC group received apixaban, 2.5 mg every 12 hours, and the DAPT
group received aspirin, 100 mg per day,plusclopidogrel, 75 mg per day, for
the first 3 months after LAAO. Main Outcomes and Measures: The
primary end point was a composite of safety (major bleeding) and efficacy
(thromboembolic events including stroke, systemic embolism, and
device-related thrombosis [DRT]) within the first 3 months after
successful LAAO. Secondary end points included individual components of
the primary outcome and all-bleeding events. Result(s): A total of 90
patients (mean [SD] age, 76.6[8.1] years; 60 male [66.7%]; mean [SD]
CHADS-VASc score, 4.0[1.5]) were included in the analysis (44 and 46
patients in the low-dose DOAC and DAPT groups, respectively). A total of
53 patients (58.8%) presented with previous major bleeding events (60
gastrointestinal [66.7%] and 16 intracranial [17.8%]). At 3 months,
low-dose DOAC was associated with a reduction of the primary end point
compared with DAPT (2 [4.5%] vs 10 [21.7%]; hazard ratio, 0.19; 95% CI,
0.04-0.88; P=.02). Patients in the low-dose DOAC group exhibited a lower
rate of DRT (0% vs 6 [8.7%]; P=.04) and tended to have a lower incidence
of major bleeding events (2 [4.6%] vs 6 [13.0%]; P=.17), with no
differences in thromboembolic events such as stroke and systemic embolism
between groups (none in the overall population). Conclusions and
Relevance: This was a small, randomized clinical trial comparing different
antithrombotic strategies after LAAO. Results show that use of low-dose
DOAC for 3 months after LAAO was associated with a better balance between
efficacy and safety compared with DAPT. However, the results of the study
should be interpreted with caution due to the limited sample size and will
need to be confirmed in future larger randomized trials. Trial
Registration: ClinicalTrials.gov Identifier: NCT05632445.

<38>
Accession Number
644962813
Title
Intraoperative Oxygen Treatment, Oxidative Stress, and Organ Injury
Following Cardiac Surgery: A Randomized Clinical Trial.
Source
JAMA surgery. (no pagination), 2024. Date of Publication: 07 Aug 2024.
Author
Lopez M.G.; Shotwell M.S.; Hennessy C.; Pretorius M.; McIlroy D.R.;
Kimlinger M.J.; Mace E.H.; Absi T.; Shah A.S.; Brown N.J.; Billings F.T.
Institution
(Lopez, Pretorius, McIlroy, Billings) Department of Anesthesiology,
Vanderbilt University Medical Center and Vanderbilt University School of
Medicine, Nashville, TN, United States
(Shotwell, Hennessy) Department of Biostatistics, Vanderbilt University
Medical Center and Vanderbilt University School of Medicine, Nashville,
TN, United States
(Kimlinger) Vanderbilt University Medical Center and Vanderbilt University
School of Medicine, Nashville, TN, United States
(Mace) Department of Surgery, Vanderbilt University Medical Center and
Vanderbilt University School of Medicine, Nashville, TN, United States
(Absi, Shah) Department of Cardiac Surgery, Vanderbilt University Medical
Center and Vanderbilt University School of Medicine, Nashville, TN, United
States
(Brown, Billings) Department of Medicine, Vanderbilt University Medical
Center and Vanderbilt University School of Medicine, Nashville, TN, United
States
Abstract
Importance: Liberal oxygen (hyperoxia) is commonly administered to
patients during surgery, and oxygenation is known to impact mechanisms of
perioperative organ injury. Objective(s): To evaluate the effect of
intraoperative hyperoxia compared to maintaining normoxia on oxidative
stress, kidney injury, and other organ dysfunctions after cardiac surgery.
 Design, Setting, and Participant(s): This was a participant- and
assessor-blinded, randomized clinical trial conducted from April 2016 to
October 2020 with 1 year of follow-up at a single tertiary care medical
center. Adult patients (>18 years) presenting for elective open cardiac
surgery without preoperative oxygen requirement, acute coronary syndrome,
carotid stenosis, or dialysis were included. Of 3919 patients assessed,
2501 were considered eligible and 213 provided consent. Of these, 12 were
excluded prior to randomization and 1 following randomization whose
surgery was cancelled, leaving 100 participants in each group.
 Intervention(s): Participants were randomly assigned to hyperoxia
(1.00 fraction of inspired oxygen [FiO2]) or normoxia (minimum FiO2 to
maintain oxygen saturation 95%-97%) throughout surgery. Main Outcomes
and Measures: Participants were assessed for oxidative stress by measuring
F2-isoprostanes and isofurans, for acute kidney injury (AKI), and for
delirium, myocardial injury, atrial fibrillation, and additional secondary
outcomes. Participants were monitored for 1 year following surgery.
 Result(s): Two hundred participants were studied (median [IQR] age,
66 [59-72] years; 140 male and 60 female; 82 [41.0%] with diabetes).
F2-isoprostanes and isofurans (primary mechanistic end point) increased on
average throughout surgery, from a median (IQR) of 73.3 (53.1-101.1) pg/mL
at baseline to a peak of 85.5 (64.0-109.8) pg/mL at admission to the
intensive care unit and were 9.2 pg/mL (95% CI, 1.0-17.4; P=.03) higher
during surgery in patients assigned to hyperoxia. Median (IQR) change in
serum creatinine (primary clinical end point) from baseline to
postoperative day 2 was 0.01 mg/dL (-0.12 to 0.19) in participants
assigned hyperoxia and -0.01 mg/dL (-0.16 to 0.19) in those assigned
normoxia (median difference, 0.03; 95% CI, -0.04 to 0.10; P=.45). AKI
occurred in 21 participants (21%) in each group. Intraoperative oxygen
treatment did not affect additional acute organ injuries, safety events,
or kidney, neuropsychological, and functional outcomes at 1 year.
 Conclusion(s): Among adults receiving cardiac surgery, intraoperative
hyperoxia increased intraoperative oxidative stress compared to normoxia
but did not affect kidney injury or additional measurements of organ
injury including delirium, myocardial injury, and atrial fibrillation.
Trial Registration: ClinicalTrials.gov Identifier: NCT02361944.

<39>
Accession Number
2020097446
Title
P1.09-03 Multidisciplinary Thoracic Tumors Board Survey in Spain.
Source
Journal of Thoracic Oncology. Conference: IASLC 2022 WCLC World Conference
on Lung Cancer. San Antonio United States. 17(9 Supplement) (pp S107),
2022. Date of Publication: September 2022.
Author
Massuti B.; Nadal E.; Camps C.; Carcereny E.; Cobo M.; Domine M.;
Garcia-Campelo M.R.; Gonzalez-Larriba J.L.; Guirado M.; Hernando-Trancho
F.; Rodriguez-Abreu D.; Sanchez A.; Sullivan I.; Provencio M.
Institution
(Massuti) Hospital Universitario Alicante Dr Balmis ISABIAL, Alicante,
Spain
(Nadal) Institut Catala d'Oncologia L'Hospitalet, Barcelona, Spain
(Camps) Hospital General Universitario Valencia, Valencia, Spain
(Carcereny) Institut Catala d'Oncologia Badalona, Badalona (Barcelona),
Spain
(Cobo) Hospital Regional Universitario Malaga, Malaga, Spain
(Domine) Fundacion Jimenez Diaz, Madrid, Spain
(Garcia-Campelo) Complejo Hospitalario Universitario A Coruna, A Coruna,
Spain
(Gonzalez-Larriba, Hernando-Trancho) Hospital Clinico Universitario San
Carlos, Madrid, Spain
(Guirado) Hospital General Universitario Elche, ES, Elche, Spain
(Rodriguez-Abreu) Hospital Universitario Insular de Gran Canaria., Las
Palmas, Spain
(Sanchez) Consorci Hospitalari Provincial Castello, Castellon, Spain
(Sullivan) Hospital Sant Pau, Barcelona, Spain
(Provencio) Hospital Universitario Puerta de Hierro, Madrid, Spain
Publisher
Elsevier Inc.
Abstract
Introduction: Increasing complexity in diagnosis and management of lung
cancer requires collaboration of multiple specialists. In Spain there are
few Cancer Centers. Medical Oncology is in the center of cancer care
covering academic and community hospitals but other resources like
Thoracic Surgery, Nuclear Medicine and Radiotherapy are limited to larger
centers. Spanish Lung Cancer Group/Grupo Espanol Cancer Pulmon performed a
survey to describe current structure, network and standard operational
procedures (SOPs) of Thoracic Tumor Boards (TTB) in the country.
 Method(s): Between April-June 2021, 92 hospitals with different
complexity level (< 300 beds, 301-500 beds and > 500 beds) distributed at
different regions in Spain answered an online survey. The survey covered
different items about facilities' characteristics, access to diagnostic
techniques, biomarkers and NGS access and operational organization.
 Result(s): -Overall facilities: Pneumology, Radiology, Pathology and
Medical Oncology Units in 100% of centers, Radiotherapy in 75%, Nuclear
Medicine in 63%, Molecular Diagnostic Unit 61% and Thoracic Surgery in
59%. Fast diagnostic pathways in 90%. - Molecular diagnosis: NGS access
53%. Liquid biopsy 72% (65% in house). Biomarkers reflex ordered by
pathologist 59%.- Significant differences were found between Academic and
Community centers for: EBUS disposal (60 vs 98%), NGS access (36 vs 68%),
mediastinoscopy facilities (32 vs 100%), SBRT (32 vs 98%), clinical trials
recruitment rate (12 vs 55%), timelines control (16 vs 35%)- Tumor Board
Coordinator: medical oncologist 49%, pneumologist 37%, thoracic surgeon
11%. Members of MTB: mean 7 different specialties. Weekly meetings in 96%
of centers. Mixed format (presential and virtual) in 36%. Specific case
manager in 39%. Molecular biologist 19%. Palliative Care 12%.- Mean
patients per session: 10. All new cases presented in 65%. Stage
distribution: St I-II (16%), St III (42%), St IV (42%). Discussion before
and after surgery in 67%. - Timeline evaluation recorded in 24%. Mean time
from decision to treatment: 3.7 week (w) for surgery, 2.6 w for
radiotherapy and 1.4 w for systemic treatment. - Reference guidelines
used: ESMO 72%, SEOM (Spanish Medical Oncology Society) 65%, NCCN 61% -
SOPs in 69%, Continuous Medical Education activity 39%.
 Conclusion(s): Multidisciplinary Thoracic Tumors Boards are
implemented at every center of Spanish Lung Cancer Group but differs
according complexity level of the center. Facilities and access to
diagnostic tools and therapeutic options show significant differences
especially for EBUS, NGS and SBRT. Timelines recording from initial
symptom to diagnosis and treatment and outcomes metrics need to be
implemented more widely. Specific case managers could be a key tool for
improvement. Virtually meetings for tumor boards are feasible and increase
the TTB networking could be useful to preserve equity for lung cancer
patients. Keywords: Thoracic Tumors Board, Molecular diagnosis, Lung
Cancer Network Copyright © 2022

<40>
Accession Number
2020097316
Title
EP13.01-017 Assessing Variance Between Radiology versus Multidisciplinary
Clinic Recommendations in the Pulmonary Nodule and Lung Screening Clinic.
Source
Journal of Thoracic Oncology. Conference: IASLC 2022 WCLC World Conference
on Lung Cancer. San Antonio United States. 17(9 Supplement) (pp S526),
2022. Date of Publication: September 2022.
Author
Noonan E.; Lennes I.
Institution
(Noonan, Lennes) Massachusetts General Hospital, Boston/MA/USA
Publisher
Elsevier Inc.
Abstract
Introduction: A multidisciplinary approach presents many benefits to
treating patients. When providers from an array of expertise come
together, health outcomes of patients can be enhanced. The Pulmonary
Nodule and Lung Screening Clinic is a multidisciplinary clinic that
consists of a collaboration between the Cancer Center, Thoracic Imaging,
Pulmonary Medicine, Radiation Oncology and Thoracic Surgery. Providers of
each department assess the best treatment for patients attending the
PNLSC. We analyzed if there are significant benefits of having multiple
providers assess each patient by comparing the recommendation from the
PNLSC in comparison to the recommendation from the Radiology Department.
 Method(s): Patients recommended to the PNLSC are evaluated in a group
setting by the following types of providers: Medical Oncologist,
Radiologist, Surgeon, Radiation Oncologist, Pulmonologist, Nurse
Practitioner. Patients are referred to the PNLSC after pulmonary nodules
are incidentally found on CT scans or through low-dose computed tomography
(LDCT) screening. The providers assess the imaging scans of each patient
as well as past medical history to recommend the best plan of action.
Routine radiology recommendations include: follow-up CT Scan interval,
biopsy, intervention, PET Scan, other, or no specific recommendation.
Recommendations by the multidisciplinary clinic include: Follow-up Scan
(LDCT, CT, MRI, PET/PET CT), Biopsy, Surgery, Radiation, Other, or a
combination. Data was analyzed between the radiology recommendation and
multidisciplinary clinic recommendation and placed into the following
categories: discordant-less aggressive vs. discordant-more aggressive vs.
concordant-equal. Result(s): Data was collected using Research
Electronic Database Capture (REDCap). Forty-four dates (between February
12, 2021 through February 4, 2022) of PNCSL were analyzed which included a
total of 742 patients. Completed assessments indicate that 50% of clinic
recommendations are concordant to that of the radiology recommendations,
33% of clinic recommendations are discordant-more aggressive than the
radiology recommendations and 17% of clinic recommendations are
discordant-less aggressive than the radiology recommendations.
 Conclusion(s): Preliminary data shows that half of clinic
recommendations are concordant and equally aggressive than that of
radiology recommendations. However, a significant percentage of the data
shows that clinic recommendations are discordant with more aggressive
recommendations than that of the original radiology recommendations.
Therefore, this may indicate that the use of a multidisciplinary clinic,
with intra-specialty discussion is beneficial to the treatment of
patient's pulmonary nodules as compared to a single radiology provider
determining the correct follow-up. Research is needed to determine if
these results remain consistent dependent on the patient's smoking status
and number of visits to the PNLSC. [Formula presented] Keywords:
Pulmonary, multidisciplinary, radiology Copyright © 2022

<41>
Accession Number
2030847339
Title
Disparities in perioperative mortality outcomes between First Nations and
non-First Nations peoples in Australia: protocol for a systematic review
and planned meta-analysis.
Source
Systematic Reviews. 13(1) (no pagination), 2024. Article Number: 208. Date
of Publication: December 2024.
Author
Waugh E.B.; Hare M.J.L.; Story D.A.; Romero L.; Mayo M.; Smith-Vaughan H.;
Reilly J.R.
Institution
(Waugh) Department of Anaesthesia and Perioperative Medicine, Royal Darwin
Hospital, Darwin, NT, Australia
(Waugh, Hare, Mayo, Smith-Vaughan) Menzies School of Health Research,
Charles Darwin University, Darwin, NT, Australia
(Waugh) Flinders University, Adelaide, SA, Australia
(Hare) Endocrinology Department, Royal Darwin Hospital, Darwin, NT,
Australia
(Waugh, Story, Reilly) Department of Critical Care, the University of
Melbourne, Melbourne, VIC, Australia
(Story) Department of Anaesthesia, Austin Health, Melbourne, VIC,
Australia
(Romero) The Ian Potter Library, Alfred Health, Melbourne, VIC, Australia
Publisher
BioMed Central Ltd
Abstract
Background: Health inequities persist among First Nations people living in
developed countries. Surgical care is pivotal in addressing a significant
portion of the global disease burden. Evidence regarding surgical outcomes
among First Nations people in Australia is limited. The perioperative
mortality rate (POMR) indicates timely access to safe surgery and predicts
long-term survival after major surgery. This systematic review will
examine POMR among First Nations and non-First Nations peoples in
Australia. Method(s): A systematic search strategy using MEDLINE,
Embase, Emcare, Global Health, and Scopus will identify studies that
include First Nations people and non-First Nations people who underwent a
surgical intervention under anaesthesia in Australia. The primary focus
will be on documenting perioperative mortality outcomes. Title and
abstract screening and full-text review will be conducted by independent
reviewers, followed by data extraction and bias assessment using the
ROBINS-E tool. Meta-analysis will be considered if there is sufficient
homogeneity between studies. The quality of cumulative evidence will be
evaluated following the Grading of Recommendations, Assessment,
Development and Evaluation (GRADE) criteria. Discussion(s): This
protocol describes the comprehensive methodology for the proposed
systematic review. Evaluating disparities in perioperative mortality rates
between First Nations and non-First Nations people remains essential in
shaping the discourse surrounding health equity, particularly in
addressing the surgical burden of disease. Systematic review registration:
PROSPERO CRD42021258970. Copyright © Crown 2024.

<42>
Accession Number
2033912092
Title
Comparison of Drug-Coated Balloons With Drug-Eluting Stents in Patients
With In-Stent Restenosis: A Systematic Review and Meta-Analysis.
Source
American Journal of Cardiology. 227 (pp 57-64), 2024. Date of Publication:
15 Sep 2024.
Author
Kumar M.; Kumar N.; Haider M.; Upreti P.; Bahar A.R.; Hamza M.; Turkmani
M.; Basit S.A.; Rajak K.; Middlebrook C.; Bahar Y.; Ali S.; Sattar Y.;
Alraies M.C.
Institution
(Kumar) John H. Stroger Jr. Hospital of Cook County, Chicago, Illinois,
United States
(Kumar) Department of Internal Medicine, Wayne State University School of
Medicine, Detroit, MI, United States
(Haider) Department of Internal Medicine, Carle Foundation Hospital, Carle
Illinois College of Medicine, Urbana, Illinois, United States
(Upreti) Sands-Constellation Heart Institute, Rochester Regional Health,
Rochester, New York, United States
(Bahar) Department of Internal Medicine, Wayne State University/DMC,
Detroit, MI, United States
(Hamza) Department of Internal Medicine, Guthrie Medical Group, Cortland,
NY, United States
(Turkmani) Department of Internal Medicine, McLaren Healthcare, Oakland,
Michigan, United States
(Basit) The Wright Center for GME, Scranton, PA, United States
(Rajak) Department of Internal Medicine, University of Pittsburgh Medical
Center, Pittsburgh, PA, United States
(Middlebrook) College of Osteopathic Medicine, Michigan State University,
East Lansing, MI, United States
(Bahar) Wayne State University, Detroit, MI, United States
(Ali) Department of Internal Medicine, Louisiana State University,
Shreveport, LA, United States
(Sattar) Department of Cardiology, West Virginia University, Morgantown,
West Virginia, United States
(Alraies) Cardiovascular Institute, DMC Heart Hospital, Detroit Medical
Center, Detroit, MI, United States
Publisher
Elsevier Inc.
Abstract
In-stent restenosis (ISR) is the gradual narrowing of the stented coronary
segment, presenting as angina or leading to an acute myocardial
infarction. Although its incidence has decreased with the use of newer
drug-eluting stents (DES), it still carries significant mortality and
morbidity risks. We compared the 2 most common interventions for managing
DES-related ISR: drug-coated balloons (DCBs) and DES. Electronic databases
were searched to identify all randomized controlled trials comparing DCB
with DES in patients with DES-ISR. The Mantel-Haenszel method with a
random-effects model was used to calculate pooled risk ratios. Five trials
comprising 1,100 patients (577 in DCB and 523 in DES group) were included
in the final study. The mean follow-up was 42 months. DCB was found to
have a higher risk for target lesion revascularization (risk ratio 1.41, p
= 0.02) compared with DES. No difference was observed in all-cause
mortality, target vessel revascularization, myocardial infarction, or
stroke between the 2 intervention arms. In conclusion, management of
DES-ISR with DCB has a higher risk of target lesion revascularization
compared with re-stenting with DES. The 2 therapeutic interventions are
comparable in terms of efficacy and safety profile. Copyright ©
2024 Elsevier Inc.

<43>
Accession Number
2033893754
Title
Effect of Pre-Operative Anti-Platelets Therapy on Perioperative Bleeding
and Blood Transfusion in Patients Undergoing Elective Cardiac Surgery.
Source
African Journal of Biological Sciences (South Africa). 6(12) (pp
5995-6003), 2024. Date of Publication: 2024.
Author
Mahdy A.M.; Al-Taher E.M.; Helmy A.M.; Kamhawy G.A.; Tawadros P.Z.; Fayad
E.A.; Abdel-Ghaffar M.E.E.
Institution
(Mahdy, Al-Taher, Helmy, Kamhawy, Abdel-Ghaffar) Department of Anesthesia
and Intensive Care, Faculty of Medicine, Suez Canal University, Ismailia,
Egypt
(Tawadros) Department of Anesthesia, Surgical Intensive Care, and Pain
Management, Faculty of Medicine, Cairo University, Cairo, Egypt
(Fayad) Department of Cardiothoracic Surgery, Faculty of Medicine, Suez
Canal University, Ismailia, Egypt
Publisher
Institute of Advanced Studies
Abstract
Background: Hemorrhage during the operative period is a widespread
occurrence in cases undergoing cardiac operations. Hemorrhaging can range
from being insignificant and not needing treatment to being severe and
potentially fatal. Aim(s): To evaluate pre-operative anti-platelet
therapy as an independent risk factor for perioperative bleeding & blood
transfusion. Patients and Methods: This prospective controlled
randomized clinical trial has been carried out on 32 adult cases who
underwent elective surgeries on bypass cardiac surgery at the operative
theatre of Suez-Canal University Teaching Hospital from October 2019 to
July 2022. Result(s): There was statistically insignificant variation
among the CABG and non-CABG patients in the amount of products of blood
transfused either post-bypass or in the first twenty-four hours
post-operatively in the ROTEM group and in the classic group. In the ROTEM
group, there was a statistically significant reduction in non-CABG
patients in terms of blood loss post-operatively (P 0.013). A
statistically insignificant distinction has been observed among non-CABG
and CABG patients regarding the amount of blood loss post-operatively in
the classical group. Conclusion(s): Anti-platelet therapy may be an
independent risk factor for postoperative blood loss, but not for blood
product transfusion, and this variable could require future research with
a larger sample size. Copyright © 2024 African Science
Publications. All rights reserved.

<44>
Accession Number
2033713448
Title
Spotlight on hot topics: subclinical atrial fibrillation, risk
stratification of channelopathies, and cardioprotection.
Source
European Heart Journal. 45(29) (pp 2579-2583), 2024. Date of Publication:
01 Aug 2024.
Author
Crea F.
Institution
(Crea) Center of Excellence of Cardiovascular Sciences, Ospedale Isola
Tiberina - Gemelli Isola, Rome, Italy
(Crea) Catholic University of the Sacred Heart, Rome, Italy
Publisher
Oxford University Press

<45>
Accession Number
2033713446
Title
Anticoagulation for transient atrial fibrillation post-coronary bypass:
high quality evidence needed.
Source
European Heart Journal. 45(29) (pp 2631-2633), 2024. Date of Publication:
01 Aug 2024.
Author
Andreotti F.; De Caterina R.
Institution
(Andreotti) Cardiovascular Science Department, Fondazione Policlinico
Universitario A. Gemelli IRCCS, Largo Gemelli 8, Rome 00168, Italy
(Andreotti) CardioThoracic Department, Catholic University Medical School,
Rome, Italy
(De Caterina) School of Cardiology, University of Pisa, Pisa, Italy
(De Caterina) Cardiology Division, Pisa University Hospital, Via Paradisa,
2, Pisa 56124, Italy
Publisher
Oxford University Press

<46>
Accession Number
2033713439
Title
Cardiac shockwave therapy in addition to coronary bypass surgery improves
myocardial function in ischaemic heart failure: the CAST-HF trial.
Source
European Heart Journal. 45(29) (pp 2634-2643), 2024. Date of Publication:
01 Aug 2024.
Author
Holfeld J.; Nagele F.; Polzl L.; Engler C.; Graber M.; Hirsch J.; Schmidt
S.; Mayr A.; Troger F.; Pamminger M.; Theurl M.; Schreinlechner M.;
Sappler N.; Ruttmann-Ulmer E.; Schaden W.; Cooke J.P.; Ulmer H.; Bauer A.;
Gollmann-Tepekoylu C.; Grimm M.
Institution
(Holfeld, Nagele, Polzl, Engler, Graber, Hirsch, Schmidt, Ruttmann-Ulmer,
Gollmann-Tepekoylu, Grimm) University Clinic of Cardiac Surgery, Medical
University of Innsbruck, Anichstrasse 35, Innsbruck 6020, Austria
(Nagele, Graber, Cooke) Center for Cardiovascular Regeneration, Houston
Methodist Research Institute, Houston, TX, United States
(Mayr, Troger, Pamminger) Department of Radiology, Medical University of
Innsbruck, Innsbruck, Austria
(Theurl, Schreinlechner, Sappler, Bauer) Department of Internal Medicine
III, Medical University of Innsbruck, Innsbruck, Austria
(Schaden) The Research Center in Cooperation with AUVA, Ludwig Boltzmann
Institute for Traumatology, Vienna, Austria
(Schaden) SoftWave Tissue Regeneration Technologies, Kennesaw, GA, United
States
(Ulmer) Institute of Medical Statistics and Informatics, Medical
University of Innsbruck, Innsbruck, Austria
Publisher
Oxford University Press
Abstract
Background and In chronic ischaemic heart failure, revascularisation
strategies control symptoms but are less effective in improving left
venAims tricular ejection fraction (LVEF). The aim of this trial is to
investigate the safety of cardiac shockwave therapy (SWT) as a novel
treatment option and its efficacy in increasing cardiac function by
inducing angiogenesis and regeneration in hibernating myocardium. Methods
In this single-blind, parallel-group, sham-controlled trial (cardiac
shockwave therapy for ischemic heart failure, CAST-HF; NCT03859466)
patients with LVEF <=40% requiring surgical revascularisation were
enrolled. Patients were randomly assigned to undergo direct cardiac SWT or
sham treatment in addition to coronary bypass surgery. The primary
efficacy endpoint was the improvement in LVEF measured by cardiac magnetic
resonance imaging from baseline to 360 days. Results Overall, 63 patients
were randomized, out of which 30 patients of the SWT group and 28 patients
of the Sham group attained 1-year follow-up of the primary endpoint.
Greater improvement in LVEF was observed in the SWT group (DELTA from
baseline to 360 days: SWT 11.3%, SD 8.8; Sham 6.3%, SD 7.4, P = .0146).
Secondary endpoints included the 6-minute walking test, where patients
randomized in the SWT group showed a greater DELTA from baseline to 360
days (127.5 m, SD 110.6) than patients in the Sham group (43.6 m, SD
172.1) (P = .028) and Minnesota Living with Heart Failure Questionnaire
score on day 360, which was 11.0 points (SD 19.1) for the SWT group and
17.3 points (SD 15.1) for the Sham group (P = .15). Two patients in the
treatment group died for non-device-related reasons. Conclusions In
conclusion, the CAST-HF trial indicates that direct cardiac SWT, in
addition to coronary bypass surgery improves LVEF and physical capacity in
patients with ischaemic heart failure. Copyright © The Author(s)
2024.

<47>
Accession Number
2033713435
Title
Anticoagulation for post-operative atrial fibrillation after isolated
coronary artery bypass grafting: a meta-analysis.
Source
European Heart Journal. 45(29) (pp 2620-2630), 2024. Date of Publication:
01 Aug 2024.
Author
van de Kar M.R.D.; van Brakel T.J.; van't Veer M.; van Steenbergen G.J.;
Daeter E.J.; Crijns H.J.G.M.; van Veghel D.; Dekker L.R.C.; Otterspoor
L.C.
Institution
(van de Kar, van Brakel, van't Veer, van Steenbergen, van Veghel, Dekker,
Otterspoor) Department of Cardiology and Cardiothoracic Surgery, Catharina
Hospital, P.O. Box 1350, Eindhoven 5602 ZA, Netherlands
(van't Veer, Dekker) Department of Biomedical Engineering, Eindhoven
University of Technology, Eindhoven, Netherlands
(Daeter) Department of Cardiothoracic Surgery, Antonius Hospital, Utrecht,
Netherlands
(Crijns) Department of Cardiology, Cardiovascular Research Centre
Maastricht (CARIM), Maastricht UMC+, Maastricht, Netherlands
Publisher
Oxford University Press
Abstract
Background and This study aimed to evaluate clinical outcomes in patients
developing post-operative atrial fibrillation (POAF) after coronary Aims
artery bypass grafting (CABG) and characterize variations in oral
anticoagulation (OAC) use, benefits, and complications. Methods A
systematic search identified studies on new-onset POAF after CABG and OAC
initiation. Outcomes included risks of thromboembolic events, bleeding,
and mortality. Furthermore, a meta-analysis was conducted on these
outcomes, stratified by the use or non-use of OAC. Results The identified
studies were all non-randomized. Among 1 698 307 CABG patients, POAF
incidence ranged from 7.9% to 37.6%. Of all POAF patients, 15.5% received
OAC. Within 30 days, thromboembolic events occurred at rates of 1.0%
(POAF: 0.3%; non-POAF: 0.8%) with 2.0% mortality (POAF: 1.0%; non-POAF:
0.5%). Bleeding rates were 1.1% for POAF patients and 2.7% for non-POAF
patients. Over a median of 4.6 years, POAF patients had 1.73
thromboembolic events, 3.39 mortality, and 2.00 bleeding events per 100
person-years; non-POAF patients had 1.14, 2.19, and 1.60, respectively. No
significant differences in thromboembolic risks [effect size -0.11 (-0.36
to 0.13)] and mortality [effect size -0.07 (-0.21 to 0.07)] were observed
between OAC users and non-users. However, OAC use was associated with
higher bleeding risk [effect size 0.32 (0.06-0.58)]. Conclusions In
multiple timeframes following CABG, the incidence of complications in
patients who develop POAF is low. The use of OAC in patients with POAF
after CABG is associated with increased bleeding risk. Copyright
© The Author(s) 2024.

<48>
Accession Number
2030417140
Title
Optimizing Patient Blood Management in Cardiac Surgery: A Systematic
Review.
Source
Iranian Journal of Blood and Cancer. 16(2) (pp 34-50), 2024. Date of
Publication: June 2024.
Author
Ghazzay Alotaibi S.; Ammar Alnouri M.; Mahmoud Sulaiman R.; Abduljaleel
A.A.; Foad Bogari A.; Nabeel Mufti H.
Institution
(Ghazzay Alotaibi, Ammar Alnouri) Cardiac Center, King Fahd Armed Forces
Hospital, Ministry of Defense, Jeddah, Saudi Arabia
(Mahmoud Sulaiman) Family Medicine Department, Dr. Sulaiman Fakeeh
Hospital, Jeddah, Saudi Arabia
(Abduljaleel, Foad Bogari) King Fahad General Hospital, Jeddah, Saudi
Arabia
(Nabeel Mufti) King Faisal Cardiac Center, King Abdul-Aziz Medical City,
Ministry of National Guard Health Affairs, Jeddah, Saudi Arabia
Publisher
Iranian Pediatric Hematology and Oncology Society
Abstract
Background: Heart diseases are typically treated with cardiac surgery,
which often requires preoperative, intraoperative, and postoperative blood
transfusion. However, blood transfusion is a risk factor for serious
complications after cardiac surgery, including death. Patient Blood
Management (PBM) programs were developed to mitigate the risks of blood
transfusion by reducing its use in cardiac surgery. Objective(s):
This systematic review aims to study the currently published literature on
PBM strategies that effectively reduce the rates of preoperative,
intraoperative, and postoperative blood transfusion for cardiac surgery.
Methodology: This systematic review analyzed preoperative blood management
strategies in cardiac surgery, focusing on studies published between 2018
and 2024 designed to reduce blood transfusion rates. The study utilized a
modified 2022 protocol for systematic reviews and meta-analysis, grading
evidence using a 2008 system, and selected 21 studies for a systematic
review. Result(s): The studies identified 12 PBM strategies,
including iron therapy, Aminocaproic acid, Cardiopulmonary by-pass system,
cell salvage, Perfusion Blood Collection, gel foam patches, Large-volume
acute normovolemic hemodilution, Platelets Transfusion Therapy, Modified
Ultrafiltration, TEM-based algorithms, and restrictive management of SVO2,
which significantly reduced blood transfusion volumes and rates before,
during, and after cardiac surgery. Conclusion(s): The 12 PBM
strategies identified are valuable additions to the current list, but
further clinical evaluation is needed to improve their efficacy and safety
in cardiac surgery. Copyright © 2024, Iranian Pediatric
Hematology and Oncology Society. All rights reserved.

<49>
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. 47(8) (pp 1087-1095), 2024.
Date of Publication: August 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.

<50>
Accession Number
2030877921
Title
Cardiac papillary fibroelastomas: Unveiling a rare right atrial
presentation with surgical insights-A case report and review of the
literature.
Source
Clinical Case Reports. 12(8) (no pagination), 2024. Article Number: e9207.
Date of Publication: August 2024.
Author
Davani D.N.; Alizadehasl A.; Aliabadi A.Y.; Bazrgar A.; Pouraliakbar H.;
Jebelli S.F.H.; Najdaghi S.; Zonooz Y.A.
Institution
(Davani, Najdaghi) Heart Failure Research Center, Cardiovascular Research
Institute, Isfahan University of Medical Science, Isfahan, Iran, Islamic
Republic of
(Alizadehasl, Aliabadi, Jebelli, Zonooz) Cardio-Oncology Research Center,
Rajaie Cardiovascular Medical and Research Center, Iran University of
Medical Sciences, Tehran, Iran, Islamic Republic of
(Bazrgar) Student Research Committee, School of Medicine, Shiraz
University of Medical Sciences, Shiraz, Iran, Islamic Republic of
(Pouraliakbar) Department of Radiology, Rajaie Cardiovascular Medical and
Research Centre, Iran University of Medical Sciences, Tehran, Iran,
Islamic Republic of
Publisher
John Wiley and Sons Inc
Abstract
Cardiac papillary fibroelastomas (CPF) are rare, benign tumors with
thromboembolic potential. We present a 40-year-old male with a right
atrial CPF, referred with acute chest pain. Advanced imaging and surgical
excision with tricuspid valve repair were crucial, emphasizing the need
for early detection and intervention in symptomatic and asymptomatic
cases. Copyright © 2024 The Author(s). Clinical Case Reports
published by John Wiley & Sons Ltd.

<51>
Accession Number
2032820129
Title
Outcome-based Risk Assessment of Non-HLA Antibodies in Heart
Transplantation: A Systematic Review.
Source
Journal of Heart and Lung Transplantation. 43(9) (pp 1450-1467), 2024.
Date of Publication: September 2024.
Author
Panicker A.J.; Prokop L.J.; Hacke K.; Jaramillo A.; Griffiths L.G.
Institution
(Panicker, Griffiths) Mayo Clinic Graduate School of Biomedical Sciences,
Mayo Clinic, Rochester, Minnesota, United States
(Panicker) Department of Immunology, Mayo Clinic, Rochester, Minnesota,
United States
(Panicker, Griffiths) Department of Cardiovascular Medicine, Mayo Clinic,
Rochester, Minnesota, United States
(Prokop) Mayo Clinic Libraries, Mayo Clinic, Rochester, Minnesota, United
States
(Hacke, Jaramillo) Department of Laboratory Medicine and Pathology, Mayo
Clinic, Phoenix, Arizona, United States
(Griffiths) Department of Physiology & Biomedical Engineering, Mayo
Clinic, Rochester, Minnesota, United States
Publisher
Elsevier Inc.
Abstract
Background: Current monitoring after heart transplantation (HT) employs
repeated invasive endomyocardial biopsies (EMB). Although positive EMB
confirms rejection, EMB fails to predict impending, subclinical, or
EMB-negative rejection events. While non-human leukocyte antigen (non-HLA)
antibodies have emerged as important risk factors for antibody-mediated
rejection after HT, their use in clinical risk stratification has been
limited. A systematic review of the role of non-HLA antibodies in
rejection pathologies has the potential to guide efforts to overcome
deficiencies of EMB in rejection monitoring. Method(s): Databases
were searched to include studies on non-HLA antibodies in HT recipients.
Data collected included the number of patients, type of rejection, non-HLA
antigen studied, association of non-HLA antibodies with rejection, and
evidence for synergistic interaction between non-HLA antibodies and
donor-specific anti-human leukocyte antigen antibody (HLA-DSA) responses.
 Result(s): A total of 56 studies met the inclusion criteria. Strength
of evidence for each non-HLA antibody was evaluated based on the number of
articles and patients in support versus against their role in mediating
rejection. Importantly, despite previous intense focus on the role of
anti-major histocompatibility complex class I chain-related gene A (MICA)
and anti-angiotensin II type I receptor antibodies (AT1R) in HT rejection,
evidence for their involvement was equivocal. Conversely, the strength of
evidence for other non-HLA antibodies supports that differing rejection
pathologies are driven by differing non-HLA antibodies.
 Conclusion(s): This systematic review underscores the importance of
identifying peri-HT non-HLA antibodies. Current evidence supports the role
of non-HLA antibodies in all forms of HT rejection. Further investigations
are required to define the mechanisms of action of non-HLA antibodies in
HT rejection. Copyright © 2024 International Society for the
Heart and Lung Transplantation

<52>
Accession Number
2032635661
Title
The impact of cardiovascular and lung comorbidities in patients with
pulmonary arterial hypertension: A systematic review and meta-analysis.
Source
Journal of Heart and Lung Transplantation. 43(9) (pp 1383-1394), 2024.
Date of Publication: September 2024.
Author
Gialamas I.; Arvanitaki A.; Rosenkranz S.; Wort S.J.; Radegran G.;
Badagliacca R.; Giannakoulas G.
Institution
(Gialamas) Third Department of Cardiology, National and Kapodistrian
University of Athens, Sotiria Chest Disease Hospital, Athens, Greece
(Arvanitaki, Giannakoulas) First Department of Cardiology, AHEPA
University Hospital, Aristotle University of Thessaloniki, Thessaloniki,
Greece
(Arvanitaki, Wort) National Pulmonary Hypertension Service, Royal Brompton
Hospital, Guy's & St. Thomas' NHS Foundation Trust, London, United Kingdom
(Rosenkranz) Clinic III for Internal Medicine, Department of Cardiology,
Heart Center at the University of Cologne and Cologne Cardiovascular
Research Center (CCRC), University of Cologne, Cologne, Germany
(Wort) National Heart and Lung Institute, Imperial College London, London,
United Kingdom
(Radegran) Department of Clinical Sciences Lund, The Section for
Cardiology, Lund University, Lund, Sweden
(Radegran) The Haemodynamic Lab, The Section for Heart Failure and
Valvular Disease, Heart and Lung Medicine, Skane University Hospital,
Lund, Sweden
(Badagliacca) Department of Cardiovascular and Respiratory Sciences,
Sapienza University of Rome, Rome, Italy
Publisher
Elsevier Inc.
Abstract
Background: Contemporary patients with pulmonary arterial hypertension
(PAH) are older and exhibit cardiovascular or/and lung comorbidities. Such
patients have typically been excluded from major PAH drug trials. This
systematic review compares baseline characteristics, hemodynamic
parameters, and mortality rate between PAH patients with significant
number of comorbidities compared to those with fewer or no comorbidities.
 Method(s): A systematic literature search in PubMed, Web of Science,
and Cochrane databases was conducted searching for studies comparing PAH
patients with more than 2 cardiovascular comorbidities or/and at least a
lung comorbidity against those with fewer comorbidities. Result(s):
Seven observational studies were included. PAH patients with comorbidities
were older, with an almost equal female-to-male ratio, shorter 6-minute
walk distance, higher N-terminal pro-brain natriuretic peptide levels, and
lower lung diffusion for carbon monoxide. In terms of hemodynamics, they
had higher mean right atrial pressure and pulmonary artery wedge pressure,
lower mean pulmonary arterial pressure, pulmonary vascular resistance and
mixed venous oxygen saturation. Pooled analysis of 6 studies demonstrated
a higher mortality risk for PAH patients with comorbidities compared to
those without (HR 1.86, 95% CI 1.20 to 2.89, p < 0.001, I2 = 92%), with
the subgroup of PAH patients with lung comorbidities having an even higher
mortality risk (test for subgroup differences: p < 0.001). Combination
drug therapy for PAH was less frequently used in patients with
comorbidities. Conclusion(s): Cardiovascular and lung comorbidities
impact the clinical characteristics and outcomes of PAH patients,
highlighting the need for optimal phenotyping and tailored management for
this high-risk population. Copyright © 2024 International Society
for the Heart and Lung Transplantation

<53>
Accession Number
2030347678
Title
Depression and Implantable Cardioverter-Defibrillator Implantation in
Black Patients at Risk for Sudden Cardiac Death.
Source
Journal of the American Heart Association. 13(14) (no pagination), 2024.
Article Number: e033291. Date of Publication: 16 Jul 2024.
Author
Boursiquot B.C.; Young R.; Alhanti B.; Sullivan L.T.; Maul A.J.; Khedagi
A.; Sears S.F.; Jackson L.R.; Thomas K.L.
Institution
(Boursiquot) Columbia University Irving Medical Center, New York, NY,
United States
(Young, Alhanti, Jackson, Thomas) Duke Clinical Research Institute,
Durham, NC, United States
(Sullivan, Maul, Khedagi, Jackson, Thomas) Duke University Medical Center,
Durham, NC, United States
(Sears) East Carolina University, Greenville, NC, United States
Publisher
American Heart Association Inc.
Abstract
BACKGROUND: Black patients meeting indications for implantable
cardioverter-defibrillators (ICDs) have lower rates of implantation
compared with White patients. There is little understanding of how mental
health impacts the decision-making process among Black patients
considering ICDs. Our objective was to assess the association between
depressive symptoms and ICD implantation among Black patients with heart
failure. METHODS AND RESULTS: This is a secondary analysis of the VIVID
(Videos to Address Racial Disparities in ICD Therapy via Innovative
Designs) randomized trial, which enrolled self-identified Black
individuals with chronic systolic heart failure. Depressive symptoms were
assessed by the Patient Health Questionnaire-2 and the Mental Component
Summary of the 12-Item Short-Form Health Survey. Decisional conflict was
measured by an adapted Decisional Conflict Scale (DCS). ANCOVA was used to
assess differences in Decisional Conflict Scale scores. Multivariable
logistic regression was used to examine the association between depressive
symptoms and ICD implantation. Among 306 participants, 60 (19.6%) reported
depressed mood, and 142 (46.4%) reported anhedonia. Participants with the
lowest Mental Component Summary of the 12-Item Short-Form Health Survey
scores (poorer mental health and higher likelihood of depression) had
greater decisional conflict regard-ing ICD implantation compared with
those with the highest Mental Component Summary of the 12-Item Short-Form
Health Survey scores (adjusted mean difference in Decisional Conflict
Scale score, 3.2 [95% CI, 0.5-5.9]). By 90-day follow-up, 202 (66.0%)
participants underwent ICD implantation. There was no association between
either the Patient Health Questionnaire-2 score or the Mental Component
Summary of the 12-Item Short-Form Health Survey score and ICD
implantation. CONCLUSION(S): Depressed mood and anhedonia were
prevalent among ambulatory Black patients with chronic systolic heart
failure considering ICD implantation. The presence of depressive symptoms
did not impact the likelihood of ICD implantation in this
population. Copyright © 2024, American Heart Association Inc..
All rights reserved.

<54>
Accession Number
2029858401
Title
A Systematic review on randomized clinical trials for direct oral
anticoagulant in subjects with acute coronary syndrome: primary and
secondary outcomes.
Source
Pharmacy Practice. 22(2) (no pagination), 2024. Article Number: 3032. Date
of Publication: Apr-Jun 2024.
Author
Almazrouei N.; Elnour A.A.; Al-Khidir I.Y.; Alharbi F.M.; Alshammari H.S.;
Altwalah S.F.; Alshammari A.H.; Alshammari T.A.; Alhajaji I.K.; Alshammari
M.H.; Aljohani N.; Khaled Y.; Alanazi S.E.; Beshir S.A.; Menon V.
Institution
(Almazrouei) Department of Pharmacy Practice and Pharmacotherapeutics,
Faculty of Pharmacy, University of Sharjah, United Arab Emirates
(Elnour) Program of Clinical Pharmacy, College of Pharmacy, Al Ain
University, AAU Health and Biomedical Research Center, Al Ain University,
Abu Dhabi campus-UAE, Abu Dhabi, United Arab Emirates
(Al-Khidir) Department of Clinical Pharmacy and Pharmacy Practice, College
of Pharmacy, Najran University, Saudi Arabia
(Alharbi, Alshammari, Altwalah, Alshammari, Alshammari, Alhajaji,
Alshammari) University of Hail (UOH), Hail, Saudi Arabia
(Aljohani, Khaled, Alanazi) College of Pharmacy, University of Hail (UOH),
Hail, Saudi Arabia
(Beshir) Department of Clinical Pharmacy and Pharmacotherapeutics, Dubai
Pharmacy College for Girls, Dubai, United Arab Emirates
(Menon) Department of Pharmacy Practice, College of Pharmacy, Gulf Medical
University, United Arab Emirates
Publisher
Grupo de Investigacion en Atencion Farmaceutica
Abstract
Background: In recent years, direct oral anticoagulant (DOAC) has been
projected for secondary prevention of recurrent ischemic events post-acute
coronary syndrome (ACS). However, there is still uncertainty about the
efficacy/safety of DOACs in sub-populations. We hypothesized that for
those with ACS, the use of DOAC in addition to antiplatelet therapy proves
non-inferiority/superiority/or safety in terms of reduction in ischemic
events or bleeding. This review aimed to evaluate the efficacy and safety
of DOAC in addition to single antiplatelet therapy (SAPT) or dual
antiplatelet therapy (DAPT) as antithrombotic therapy in subjects with
ACS. Method(s): We have followed the methods of the PRISMA guideline
to report the systematic review findings of included randomized controlled
trials (RCTs), including adult patients with ACS. The intention to treat
analysis was evaluated in all included trials, and the adverse events were
reported. Finding(s): A total of 13 trials (105322 subjects) were
included in this systematic review. In subjects (both genders) with STEMI,
the combination of rivaroxaban and aspirin (DATT) was associated with
lower mortality in comparison with aspirin alone with or without PCI.
Adding low-dose rivaroxaban to aspirin improved the primary efficacy
outcome in subjects with a previous MI and those without. In subjects with
STEMI or NSTEMI with or without PCI, the effects of DATT (rivaroxaban plus
aspirin) were inferior to SAPT (aspirin therapy) for the primary safety
endpoint and superior for primary efficacy outcome (MACE, CV death, MI,
stroke). The twice-daily 2.5 mg dose of rivaroxaban reduced cardiovascular
death rates but increased major bleeding rates. In subjects with AF who
had successful PCI, a full-dose anticoagulation therapy with edoxaban 60
mg OD plus a P2Y12 inhibitor is non-inferior to triple antithrombotic
therapy (TATT) with VKA about the risks of major or non-major bleeding
events. Implications: Compared with TATT, DATT is associated with lower
bleeding risks and mortality in subjects with ACS. While for subjects with
ACS (STEMI/NSTEMI) with/without PCI, DATT (rivaroxaban plus aspirin) was
superior to SAPT for primary efficacy outcome (MACE, CV death, MI,
stroke). Nevertheless, based on current guidelines for subjects with ACS
and co-existing AF, DOAC should be preferred over VKA supported by a
favorable risk/benefit profile. The newer and more potent P2Y12 inhibitors
(ticagrelor and prasugrel) are recommended over the former clopidogrel.
Further, research needs to address the evidence-based indications of the
DOAC members in subjects with specific comorbidities (e.g., AF, HF) and
the transitioning between antithrombotic regimens. Copyright ©
the Authors.

<55>
Accession Number
2028914506
Title
Electroencephalographic guided propofol-remifentanil TCI anesthesia with
and without dexmedetomidine in a geriatric population:
electroencephalographic signatures and clinical evaluation.
Source
Journal of Clinical Monitoring and Computing. 38(4) (pp 803-815), 2024.
Date of Publication: August 2024.
Author
Mehler D.M.; Kreuzer M.; Obert D.P.; Cardenas L.F.; Barra I.; Zurita F.;
Lobo F.A.; Kratzer S.; Schneider G.; Sepulveda P.O.
Institution
(Mehler, Kreuzer, Obert, Kratzer, Schneider) Department of Anesthesiology
and Intensive Care, School of Medicine, Technical University of Munich,
Munich, Germany
(Obert) Department of Anesthesia, Critical Care, and Pain Medicine,
Massachusetts's General Hospital, Boston, MA, United States
(Obert) Harvard Medical School, Boston, MA, United States
(Cardenas, Barra, Zurita, Sepulveda) Department of Anesthesiology,
Hospital Base San Jose, Osorno/Universidad Austral, Valdivia, Chile
(Lobo) Anesthesiology Institute, Cleveland Clinic Abu Dhabi, United Arab
Emirates, Abu Dhabi, United Arab Emirates
Publisher
Springer Science and Business Media B.V.
Abstract
Elderly and multimorbid patients are at high risk for developing
unfavorable postoperative neurocognitive outcomes; however, well-adjusted
and EEG-guided anesthesia may help titrate anesthesia and improve
postoperative outcomes. Over the last decade, dexmedetomidine has been
increasingly used as an adjunct in the perioperative setting. Its
synergistic effect with propofol decreases the dose of propofol needed to
induce and maintain general anesthesia. In this pilot study, we evaluate
two highly standardized anesthetic regimens for their potential to prevent
burst suppression and postoperative neurocognitive dysfunction in a
high-risk population. Prospective, randomized clinical trial with
non-blinded intervention. Operating room and post anesthesia care unit at
Hospital Base San Jose, Osorno/Universidad Austral, Valdivia, Chile. 23
patients with scheduled non-neurologic, non-cardiac surgeries with age >
69 years and a planned intervention time > 60 min. Patients were randomly
assigned to receive either a propofol-remifentanil based anesthesia or an
anesthetic regimen with dexmedetomidine-propofol-remifentanil. All
patients underwent a slow titrated induction, followed by a target
controlled infusion (TCI) of propofol and remifentanil (n = 10) or
propofol, remifentanil and continuous dexmedetomidine infusion (n = 13).
We compared the perioperative EEG signatures, drug-induced changes, and
neurocognitive outcomes between two anesthetic regimens in geriatric
patients. We conducted a pre- and postoperative Montreal Cognitive
Assessment (MoCa) test and measured the level of alertness postoperatively
using a sedation agitation scale to assess neurocognitive status. During
slow induction, maintenance, and emergence, burst suppression was not
observed in either group; however, EEG signatures differed significantly
between the two groups. In general, EEG activity in the propofol group was
dominated by faster rhythms than in the dexmedetomidine group. Time to
responsiveness was not significantly different between the two groups (p =
0.352). Finally, no significant differences were found in postoperative
cognitive outcomes evaluated by the MoCa test nor sedation agitation scale
up to one hour after extubation. This pilot study demonstrates that the
two proposed anesthetic regimens can be safely used to slowly induce
anesthesia and avoid EEG burst suppression patterns. Despite the patients
being elderly and at high risk, we did not observe postoperative
neurocognitive deficits. The reduced alpha power in the
dexmedetomidine-treated group was not associated with adverse
neurocognitive outcomes. Copyright © The Author(s), under
exclusive licence to Springer Nature B.V. 2024.

<56>
Accession Number
2028711729
Title
Transcatheter valvular interventions after heart transplantation: A
systematic review.
Source
Trends in Cardiovascular Medicine. 34(6) (pp 362-368), 2024. Date of
Publication: August 2024.
Author
Cuko B.; Baudo M.; Busuttil O.; Taymoor S.; Nubret K.; Lafitte S.; Beurton
A.; Ouattara A.; De Vincentiis C.; Labrousse L.; Pernot M.; Leroux L.;
Modine T.
Institution
(Cuko, Busuttil, Taymoor, Nubret, Lafitte, Labrousse, Pernot, Leroux,
Modine) Department of Cardiology and Cardio-Vascular Surgery, Hopital
Cardiologique de Haut-Leveque, Bordeaux University Hospital, Pessac,
France
(Baudo) Department of Cardiac Surgery, ASST Spedali Civili di Brescia,
University of Brescia, Brescia, Italy
(Baudo) Department of Cardiac Surgery, University Hospitals Leuven,
Leuven, Belgium
(Beurton, Ouattara) Department of Cardiovascular Anesthesia and Critical
Care, Hopital Cardiologique de Haut-Leveque, Bordeaux University Hospital,
Pessac, France
(De Vincentiis) Department of Cardiac Surgery, IRCCS Policlinico San
Donato, Milan, Italy
Publisher
Elsevier Inc.
Abstract
An increasing number of patients experience late valvular disease after
heart transplantation (HTx). While mostly being primarily addressed
through surgical interventions, transcatheter valve procedures to treat
these conditions are rising, particularly for unsuitable surgical
candidates. This review aims at analyzing the outcomes of transcatheter
valvular procedures in this subset of patients. A systematic review was
conducted including studies reporting on adult patients requiring any form
of transcatheter valvular intervention after a previous HTx. Studies
involving a surgical approach, heterotopic heart transplants, or
concomitant procedures performed during the transplant itself were
excluded. Twenty-five articles with a total of 33 patients met the
inclusion criteria, 10 regarding the aortic valve (14 patients), 5 the
mitral valve (6 patients), and 6 the tricuspid valve (13 patients). In two
cases, the procedure was recommended to stabilize the valvular lesion
before re-transplantation, as both were very young patients. Overall, the
mean time from heart transplantation to reintervention was 14.7 +/- 9.5
years. The mean follow-up was 15.5 +/- 13.5 months, and only one patient
died 22.3 months after the intervention. There is a growing emergence of
transcatheter interventions for valvular disease after heart
transplantation, especially in cases where surgery is deemed high-risk or
prohibitive. A different strategy may also be considered in young patients
to permit longer allograft life before later re-transplantation. Although
encouraging outcomes have been documented, additional research is required
to establish the most appropriate approach within this specific subset of
patients. Copyright © 2023 Elsevier Inc.

<57>
[Use Link to view the full text]
Accession Number
2033675401
Title
Effect of nitric oxide delivery via cardiopulmonary bypass circuit on
postoperative oxygenation in adults undergoing cardiac surgery (NOCARD
trial): A randomised controlled trial.
Source
European Journal of Anaesthesiology. 41(9) (pp 677-686), 2024. Date of
Publication: 01 Sep 2024.
Author
Azem K.; Novakovsky D.; Krasulya B.; Fein S.; Iluz-Freundlich D.; Uhanova
J.; Kornilov E.; Eidelman L.A.; Kaptzon S.; Gorfil D.; Aravot D.; Barac
Y.; Aranbitski R.
Institution
(Azem, Novakovsky, Krasulya, Fein, Iluz-Freundlich, Kornilov, Eidelman)
Department of Anaesthesia, Rabin Medical Centre, Beilinson Hospital, Petah
Tikva, Israel
(Kaptzon, Gorfil, Aravot, Barac) Department of Cardiovascular and Thoracic
Surgery, Rabin Medical Centre, Beilinson Hospital, Petah Tikva, Israel
(Uhanova, Kaptzon) Department of Internal Medicine, Rady Faculty of Health
Sciences, University of Manitoba, Canada
(Kaptzon) Department of Neurobiology, Weizmann Institute of Science,
Rehovot, Israel
(Azem, Novakovsky, Krasulya, Fein, Iluz-Freundlich, Uhanova, Kornilov,
Eidelman, Gorfil, Aravot, Barac, Aranbitski) Sackler Faculty of Medicine,
Tel Aviv University, Tel Aviv, Israel
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUNDCardiac surgery involving cardiopulmonary bypass induces a
significant systemic inflammatory response, contributing to various
postoperative complications, including pulmonary dysfunction, myocardial
and kidney injuries.OBJECTIVETo investigate the effect of Nitric Oxide
delivery via the cardiopulmonary bypass circuit on various postoperative
outcomes.DESIGNA prospective, single-centre, double-blinded, randomised
controlled trial.SETTINGRabin Medical Centre, Beilinson Hospital,
Israel.PATIENTSAdult patients scheduled for elective cardiac surgery were
randomly allocated to one of the study groups.INTERVENTIONSFor the
treatment group, 40 ppm of nitric oxide was delivered via the
cardiopulmonary bypass circuit. For the control group, nitric oxide was
not delivered.OUTCOME MEASURESThe primary outcome was the incidence of
hypoxaemia, defined as a paO2/FiO2 ratio less than 300 within 24 h
postoperatively. The secondary outcomes were the incidences of low cardiac
output syndrome and acute kidney injury within 72 h
postoperatively.RESULTSNinety-eight patients were included in the final
analysis, with 47 patients allocated to the control group and 51 to the
Nitric Oxide group. The Nitric Oxide group exhibited significantly lower
hypoxaemia rates at admission to the cardiothoracic intensive care unit
(47.1 vs. 68.1%), P = 0.043. This effect, however, varied in patients with
or without baseline hypoxaemia. Patients with baseline hypoxaemia who
received nitric oxide exhibited significantly lower hypoxaemia rates (61.1
vs. 93.8%), P = 0.042, and higher paO2/FiO2 ratios at all time points, F
(1,30) = 6.08, P = 0.019. Conversely, this benefit was not observed in
patients without baseline hypoxaemia. No significant differences were
observed in the incidence of low cardiac output syndrome or acute kidney
injury. No substantial safety concerns were noted, and toxic
methaemoglobin levels were not observed.CONCLUSIONSPatients with baseline
hypoxaemia undergoing cardiac surgery and receiving nitric oxide exhibited
lower hypoxaemia rates and higher paO2/FiO2 ratios. No significant
differences were found regarding postoperative pulmonary complications and
overall outcomes.TRIAL REGISTRATIONNCT04807413. Copyright © 2024
European Society of Anaesthesiology and Intensive Care.

<58>
Accession Number
2033664978
Title
Social drivers in atrial fibrillation occurrence, screening, treatment,
and outcomes: systematic-narrative hybrid review.
Source
European Heart Journal, Supplement. 26(Supplement_4) (pp iv50-iv60), 2024.
Date of Publication: 01 Jul 2024.
Author
Frost L.; Johnsen S.P.; Benjamin E.J.; Trinquart L.; Vinter N.
Institution
(Frost, Vinter) Department of Cardiology, Diagnostic Centre, University
Clinic for Development of Innovative Patient Pathways, Silkeborg Regional
Hospital, Falkevej 1, Silkeborg 8600, Denmark
(Frost) Department of Clinical Medicine, Aarhus University Hospital, Palle
Juul-Jensens Boulevard 99, Aarhus N 8200, Denmark
(Johnsen, Trinquart, Vinter) Department of Clinical Medicine, Danish
Center for Health Services Research, Aalborg University, Selma Lagerlofs
Vej 249, Gistrup 9260, Denmark
(Benjamin) Department of Medicine, Boston Medical Center, Boston
University Chobanian and Avedisian School of Medicine, 715 Albany St,
Boston, MA 02118, United States
(Benjamin) Department of Epidemiology, Boston University School of Public
Health, 715 Albany St, Boston, MA 02118, United States
(Trinquart) Tufts Clinical and Translational Science Institute, Tufts
University, 35 Kneeland St, Boston, MA 02111, United States
(Trinquart) Institute for Clinical Research and Health Policy Studies,
Tufts Medical Center, 800 Washington St, Boston, MA 0211, United States
(Trinquart) Department of Biostatistics, Boston University School of
Public Health, 801 Massachusetts Avenue, Boston, MA 02118, United States
Publisher
Oxford University Press
Abstract
The importance of social drivers of health (SDOH) in the occurrence,
detection, treatment, and outcome of atrial fibrillation (AF) has
attracted increasing attention. Addressing SDOH factors may suggest
opportunities to prevent AF and its complications. We aimed to conduct a
structured narrative review and summarize current knowledge on the
association between race and ethnicity, SDOH, including rural vs. urban
habitation, education, income, and neighbourhood, and the risk of AF, its
management, and complications. We identified 537 references in PubMed and
473 references in Embase. After removal of duplicates, we screened the
abstracts of 975 references, resulting in 113 references that were
examined for eligibility. Subsequently, 34 references were excluded
leaving 79 references for the review. Evidence of a social gradient in AF
incidence and prevelance were conflicting. However, we found substantial
evidence indicating social inequities in the detection of AF, access to
treatment, and outcomes such as healthcare utilization, bleeding, heart
failure, stroke, dementia, work disability, and death. Inequities are
reported across various health care systems and constitute a global
problem affecting several continents, although data from Africa and South
America are lacking. Given the documented social inequities in AF
detection, management, and outcomes, there is an urgent need for
healthcare systems, policymakers, and society to identify and implement
effective interventions that can reduce inequities and improve outcomes in
individuals with AF. Copyright © The Author(s) 2024. Published by
Oxford University Press on behalf of the European Society of Cardiology.

<59>
[Use Link to view the full text]
Accession Number
2033664039
Title
Self-rated health and risk of incident cardiovascular events among
individuals with hypertension.
Source
Journal of Hypertension. 42(9) (pp 1573-1580), 2024. Date of Publication:
01 Sep 2024.
Author
Kazibwe R.; Muhammad A.I.; Singleton M.J.; Evans J.K.; Chevli P.A.;
Namutebi J.H.; Kazibwe J.; Epiu I.; German C.; Soliman E.Z.; Shapiro M.D.;
Yeboah J.
Institution
(Kazibwe, Chevli) Department of Medicine, Wake Forest University School of
Medicine, Winston-Salem, NC, United States
(Muhammad) Department of Medicine, Section on Hospital Medicine, Wisconsin
College of Medicine, Milwaukee, WI, United States
(Singleton) Department of Medicine, Section on Cardiovascular Medicine,
WellSpan Health, York, PA, United States
(Evans) Department of Biostatistics and Data Science, Wake Forest
University School of Medicine, NC, United States
(Namutebi) Wake Forest University, School of Graduate Studies,
Winston-Salem, NC, United States
(Kazibwe) Department of Cardiology, Sheffield Teaching Hospital,
Sheffield, United Kingdom
(Epiu) Prince of Wales Clinical School, University of New South Wales
Sydney, Sydney, Australia
(German) Department of Medicine, Section on Cardiovascular Medicine,
University of Chicago, Illinois, United States
(Soliman, Shapiro, Yeboah) Department of Medicine, Section on
Cardiovascular Medicine, Wake Forest University School of Medicine,
Winston-Salem, NC, United States
Publisher
Lippincott Williams and Wilkins
Abstract
Background: The relationship between self-rated health (SRH) and
cardiovascular events in individuals with hypertension, but without
diabetes mellitus, is understudied. Method(s): We performed a post
hoc analysis of data from SPRINT (Systolic Blood Pressure Intervention
Trial). SRH was categorized into excellent, very good, good and fair/poor.
Using multivariable Cox regression, we estimated hazard ratios and 95%
confidence intervals (CIs) for the association of SRH with both all-cause
mortality and a composite of cardiovascular events (the primary outcome),
which was defined to include myocardial infarction (MI), other acute
coronary syndromes, stroke, acute decompensated heart failure, and
cardiovascular death. Result(s): We included 9319 SPRINT participants
(aged 67.9+/-9years, 35.6% women) with a median follow-up of 3.8years.
Compared with SRH of excellent, the risk [hazard ratio (95% CI)] of the
primary outcome associated with very good, good, and fair/poor SRH was
1.11(0.78-1.56), 1.45 (1.03-2.05), and 1.87(1.28-2.75), respectively.
Similarly, compared with SRH of excellent, the risk of all-cause mortality
[hazard ratio (95% CI)] associated with very good, good, and fair/poor SRH
was 1.13 (0.73-1.76), 1.72 (1.12-2.64), and 2.11 (1.32-3.38),
respectively. Less favorable SRH (LF-SRH) was also associated with a
higher risk of each component of the primary outcome and serious adverse
events (SAE). Conclusion(s): Among individuals with hypertension, SRH
is independently associated with the risk of incident cardiovascular
events, all-cause mortality, and SAE. Our study suggest that guidelines
should consider the potential significance of including SRH in the
clinical history of patients with hypertension. Copyright © 2024
Wolters Kluwer Health, Inc. All rights reserved.

<60>
[Use Link to view the full text]
Accession Number
2033659082
Title
Comparison of the outcomes of concurrent versus staged TAVR combined with
PCI in patients with severe aortic stenosis and coronary artery disease: A
systematic review and meta-analysis.
Source
Coronary Artery Disease. 35(6) (pp 481-489), 2024. Date of Publication: 01
Sep 2024.
Author
Zhang X.; Geng W.; Yan S.; Zhang K.; Liu Q.; Li M.
Institution
(Zhang, Geng, Yan, Zhang, Liu, Li) Department of Cardiology, Baoding First
Central Hospital, Baoding City, China
Publisher
Lippincott Williams and Wilkins
Abstract
Background The optimal timing for percutaneous coronary intervention (PCI)
in patients undergoing transcatheter aortic valve replacement (TAVR)
remains uncertain. This research aims to evaluate the results of patients
diagnosed with severe aortic valve stenosis and coronary artery disease
who undergo either simultaneous or staged PCI therapy during TAVR
procedures. Methods We retrieved all relevant studies from our
self-constructed databases up to January 2, 2024, encompassing databases
such as Embase, Medline, Cochrane Library, and PubMed. Results A total of
nine studies were included, and the results showed that both surgical
modalities had good safety profiles in the early and long-term stages. For
early endpoint events, the risk of all-cause mortality and major bleeding
within 30 years was similar in the staged TAVR + PCI and the
contemporaneous TAVR + PCI (P > 0.05). Additionally, the risk of
myocardial infarction, stroke, acute kidney injury and pacemaker
implantation within 30 days or perioperatively is similar (P > 0.05). For
long-term endpoint events, the risk of all-cause mortality, myocardial
infarction and stroke was similar in the two groups at >=2 years (P >
0.05). Conclusion In patients undergoing TAVR who required coronary
revascularization, no significant differences were observed in the early
and long-term outcomes between those receiving concurrent TAVR and PCI
versus staged surgery. Copyright © 2024 The Author(s).

<61>
Accession Number
2033658321
Title
Assessment of feasibility of opioid-free anesthesia combined with
preoperative thoracic paravertebral block and postoperative intravenous
patient-controlled analgesia oxycodone with non-opioid analgesics in the
perioperative anesthetic management for video-assisted thoracic surgery.
Source
Anaesthesiology Intensive Therapy. 56(2) (pp 98-107), 2024. Date of
Publication: 2024.
Author
Copik M.M.; Sadowska D.; Smereka J.; Czyzewski D.; Misiolek H.D.; Bialka
S.
Institution
(Copik, Misiolek, Bialka) Department of Anaesthesiology and Intensive
Care, Faculty of Medical Sciences in Zabrze, Medical University of
Silesia, Katowice, Poland
(Sadowska) Clinical Department of Internal Medicine,, Dermatology and
Allergology, Faculty of Medical Sciences in Zabrze, Medical University of
Silesia, Katowice, Poland
(Smereka) Department of Emergency Medical Service, Wroclaw Medical
University, Wroclaw, Poland
(Czyzewski) Department of Chest Surgery, Faculty of Medical Sciences in
Zabrze, Medical University of Silesia, Katowice, Poland
Publisher
Termedia Publishing House Ltd.
Abstract
Background: This study, conducted between December 2015 and March 2018 at
a single university hospital, explored the feasibility and safety of
opioid-free anesthesia combined with preoperative thoracic paravertebral
block (ThPVB) for patients undergoing elective video-assisted
thoracoscopic surgery (VATS). The aim was to assess the impact of this
approach on postoperative pain levels and opioid consumption.
 Method(s): Sixty-four patients scheduled for elective VATS were
randomly assigned to either the intervention group, receiving opioid-free
anesthesia with ThPVB, or the control group, managed with standard general
anesthesia. Postoperatively, both groups received oxycodone
patient-controlled analgesia along with non-opioid analgesics. Pain
intensity was measured using the Numeric Pain Rating Scale (NRS) and
Prince Henry Hospital Pain Score (PHHPS). The total dose of postoperative
oxycodone and the occurrence of opioid-related adverse events were
recorded during the 24-hour follow-up period. Result(s): Patients in
the intervention group showed significantly lower pain levels at 20 and 24
hours post-procedure (P = 0.015, P = 0.021, respectively) compared to the
control group. Notably, oxycodone consumption at 24 hours was
significantly higher in the control group (p < 0.0001). No serious adverse
events were observed during the study period. Conclusion(s): This
study demonstrates the feasibility and safety of opioid-free anesthesia
combined with ThPVB for elective VATS. The approach significantly reduces
postoperative pain and the need for opioids, supporting its potential as
an effective and balanced perioperative anesthetic strategy. Copyright
© 2024 Termedia Publishing House Ltd.. All rights reserved.

<62>
Accession Number
2033509246
Title
Safety and perioperative outcomes of uniportal versus multiportal
video-Assisted thoracoscopic surgery.
Source
Journal of Minimal Access Surgery. 20(3) (pp 294-300), 2024. Date of
Publication: 2024.
Author
Alanwar M.; Elsharawy M.; Brik A.; Ahmady I.; Shemais D.S.
Institution
(Alanwar, Elsharawy, Brik, Ahmady, Shemais) Department of Cardiothoracic
Surgery, Faculty of Medicine, Zagazig University, Zagazig, Egypt
Publisher
Wolters Kluwer Medknow Publications
Abstract
Introduction: Uniportal video-Assisted thoracoscopic surgery (U-VATS) has
recently become an alternative approach for many minimally invasive
thoracic procedures, but although its surgical effectiveness has been
proven, still its feasibility and safety are debated and unclear.The
objective of this study was to compare the safety and perioperative
outcomes of U-VATS versus multiportal VATS (M-VATS). Patients and
Methods: This was a comparative follow-up randomised controlled clinical
trial, carried out on 36 randomly selected eligible patients, and
fulfilling the inclusion and exclusion criteria for VATS, they were
assigned randomly into two groups: Study Group I including 18 patients
undergoing U-VATS with conventional treatment using standard chest tube
drainage and Control Group II including 18 patients undergoing M-VATS)
with the same conventional treatment using standard chest tube drainage
and served as a comparable control group. Result(s): Patients in the
U-VATS Group 1 had faster operation time, and with reduced blood loss,
pleural drainage and post-operative hospitalisation, they also experienced
lower average post-operative pain score on comparison with those in M-VATS
Group II (P < 0.001), respectively. For either group, there were no
hospital deaths or infections. There was no noticeable difference between
the two groups in terms of the number of resected lymph nodes or the rates
of intraoperative or post-operative complications (P > 0.05).
 Conclusion(s): U-VATS is feasible and safe in eligible selected
patients with favourable short-Term perioperative outcomes (operative
time, duration of pleural drainage, post-operative pain, early ambulation,
duration of hospital stay as well as the risk of perioperative
complications), and it can be considered the preferred approach in
minimally invasive thoracic procedures that open up for the possibility of
fast-Track thoracic surgeries. Copyright © 2024 Journal of
Minimal Access Surgery.

<63>
Accession Number
2030863134
Title
Systematic Review of Randomized Clinical Trials on Direct Oral
Anticoagulants in Pediatric Heart Diseases.
Source
Clinical and Applied Thrombosis/Hemostasis. 30 (no pagination), 2024. Date
of Publication: January-December 2024.
Author
Guan C.; Guo L.; Liang S.
Institution
(Guan) Department of Cardiology, Wuhan Third Hospital, Tongren Hospital of
Wuhan University, Hubei, Wuhan, China
(Guo) Department of Cardiology, Jiangxi Provincial People's Hospital, The
First Affiliated Hospital of Nanchang Medical College, Jiangxi, Nanchang,
China
(Liang) Faculty of Medicine, Macau University of Science and Technology,
Macao
Publisher
SAGE Publications Inc.
Abstract
Background: Direct oral anticoagulants (DOACs) have been widely applied in
adults for thrombosis prophylaxis. However, the effect of DOACs in
pediatric patients with congenital or acquired heart diseases who need
anticoagulation therapy remains unclear. Method(s): We systematically
searched the databases of PubMed, Embase, and the Cochrane Library, as
well as the ClinicalTrials.gov registry and the World Health
Organization's International Clinical Trials Registry Platform until June
2024 to identify relevant randomized clinical trials (RCTs). If the number
of included studies was less than 5, we performed a narrative review to
assess the effect of DOACs in pediatric patients. Result(s): Four
studies were included. In the UNIVERSE study, thrombotic events occurred
in 2% of the rivaroxaban group and 9% of the aspirin group, with bleeding
events in 36% and 41%, respectively. The ENNOBLE-ATE study showed no
thromboembolic events in the edoxaban group and 1.7% in the SOC group
(rate difference: -0.07%, 95% CI: -0.22 to 0.07%). Major bleeding rates
were similar (rate difference: -0.03%, 95% CI: -0.18 to 0.12%). The
SAXOPHONE trial showed no thromboembolic events in either group and
similar major bleeding rates (-0.8%, 95% CI: -8.1 to 3.3%). In the
DIVERSITY trial, 81% of dabigatran patients achieved the primary outcome
versus 59.3% in the SOC group (Odds ratio: 0.342, 95% CI: 0.081-1.229). No
major bleeding occurred in either group. Conclusion(s): Existing
studies suggest that the use of DOACs hold promise as an effective and
safe alternative for preventing and treating thromboembolism in pediatric
patients with heart conditions. Copyright © The Author(s) 2024.

<64>
Accession Number
2030857974
Title
The association between pulse wave velocity and heart failure: a
systematic review and meta-analysis.
Source
Frontiers in Cardiovascular Medicine. 11 (no pagination), 2024. Article
Number: 1435677. Date of Publication: 2024.
Author
Esmaeili Z.; Bahiraie P.; Vaziri Z.; Azarboo A.; Behnoush A.H.; Khalaji
A.; Bazrgar A.; Tayebi P.; Ziaie N.
Institution
(Esmaeili, Azarboo, Behnoush, Khalaji) School of Medicine, Tehran
University of Medical Sciences, Tehran, Iran, Islamic Republic of
(Bahiraie) School of Medicine, Shahid Beheshti University of Medical
Sciences, Tehran, Iran, Islamic Republic of
(Vaziri) School of Medicine, Babol University of Medical Sciences, Babol,
Iran, Islamic Republic of
(Bazrgar) School of Medicine, Shiraz University of Medical Sciences,
Shiraz, Iran, Islamic Republic of
(Tayebi) Department of Vascular and Endovascular Surgery, Rouhani
Hospital, Babol University of Medical Sciences, Babol, Iran, Islamic
Republic of
(Ziaie) Clinical Research Development Unit of Rouhani Hospital, Babol
University of Medical Sciences, Babol, Iran, Islamic Republic of
(Ziaie) Department of Cardiology, Babol University of Medical Sciences,
Babol, Iran, Islamic Republic of
Publisher
Frontiers Media SA
Abstract
Background: The arterial stiffness measured by pulsed wave velocity (PWV)
is associated with heart failure (HF). However, the effectiveness of
arterial stiffness and PWV as prognostic indicators in patients with HFpEF
and HFrEF is still unclear. In this systematic review and meta-analysis,
we synthesized the prognostic value of PWV and arterial stiffness in HF
patients. Method(s): Four databases, including Embase, PubMed,
Scopus, and Web of Science, were systematically searched for published
studies assessing the relationship between PWV and HF from inception up to
August 31, 2023. The Newcastle-Ottawa Scale (NOS) was used to assess the
quality of the included studies. The standardized mean difference (SMD)
and their corresponding 95% confidence intervals (CI) were used to compare
PWV in HF (HFrEF and HFpEF) and controls. Meta-regressions based on age,
year of publication, sample size, and gender (male percentage) were also
conducted. Result(s): The systematic search yielded 5,977 results, of
which 58 met our inclusion criteria and 24 were analyzed quantitatively.
Studies included 64,687 patients with a mean age of 53.7 years, and 41,803
(67.3%) were male. Meta-analysis of 19 studies showed that PWV was
significantly higher in HF patients compared to the controls (SMD 1.04,
95% CI 0.43-1.66, P < 0.001, I2 = 93%). Moreover, nine studies
have measured PWV among HFrEF and HFpEF patients and found no significant
difference (SMD -0.51, 95% CI -1.03 to 0.02, P = 0.057, I2 = 95%).
Moreover, increased PWV was linked to an increased chance of developing
new-onset HF in individuals with cardiovascular risk factors.
 Conclusion(s): Patients with HF exhibit significantly higher arterial
stiffness, as indicated by PWV, compared to the normal population.
However, this association was not significant between HFrEF and HFpEF
patients. Future research is warranted to establish the potential
prognostic role of PWV in HF. Systematic Review Registration:
https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023479683,
PROSPERO (CRD42023479683). Copyright 2024 Esmaeili, Bahiraie, Vaziri,
Azarboo, Behnoush, Khalaji, Bazrgar, Tayebi and Ziaie.

<65>
Accession Number
2030828988
Title
The implementation of EMI-Heart, a family-tailored early motor
intervention in infants with complex congenital heart disease, in
practice: a feasibility RCT.
Source
Pilot and Feasibility Studies. 10(1) (no pagination), 2024. Article
Number: 105. Date of Publication: December 2024.
Author
Mitteregger E.; Dirks T.; Theiler M.; Kretschmar O.; Latal B.
Institution
(Mitteregger, Latal) Child Development Center, University Children's
Hospital Zurich, Steinwiesstrasse 75, Zurich CH-8032, Switzerland
(Mitteregger, Latal) Children's Research Center, University Children's
Hospital Zurich, Zurich, Switzerland
(Mitteregger, Kretschmar, Latal) University of Zurich, Zurich, Switzerland
(Dirks) Lecturer Emerita, Paediatric, Physiotherapy, Groningen,
Netherlands
(Theiler) Swiss Parents' Association for Children with Heart Disease
(Elternvereinigung fur das Herzkranke Kind), Aarau, Switzerland
(Kretschmar) Department of Pediatric Cardiology, University Children's
Hospital Zurich, Zurich, Switzerland
Publisher
BioMed Central Ltd
Abstract
Background: Children with congenital heart disease (CHD) who undergo
open-heart surgery are at risk of developmental impairment, including
motor delay, which contributes to parental concerns. Additionally, parents
experience prolonged stress associated with their child's disease. There
is a lack of early motor interventions in infants with CHD accounting for
parental burdens. We developed a family-tailored early motor intervention
(EMI-Heart), aiming to promote motor development in infants with CHD and
family well-being. The primary aim was to evaluate the feasibility of the
study design and the intervention. The secondary aim was to evaluate
differences between the intervention and the control group in motor
outcomes and family well-being at baseline (3-5 months), post-treatment
(6-8 months), and at follow-up (12 months). Method(s): In this
single-centre feasibility randomized control trial (RCT), infants with CHD
after open-heart surgery without genetic or major neurological
comorbidities were randomly allocated to EMI-Heart or the control group
(standard of care). EMI-Heart's key elements promote postural functional
activities and encourage parental sensitivity to infants' motor and
behaviour cues. Infants assigned to EMI-Heart received nine sessions of
early motor intervention at home, in the hospital, and online for a
duration of 3 months by a paediatric physiotherapist. We performed
descriptive statistics for feasibility and secondary outcomes.
 Result(s): The recruitment rate was 59% (10/17), all participating
families completed the study (10/10), and the intervention duration was
3.9 months (+/- 0.54), including nine intervention sessions per family.
Median acceptability to parents was 3.9 (1 = not agree-4 = totally agree,
Likert scale). The paediatric physiotherapist considered the intervention
as feasible. The comparison of motor outcomes did not show differences
between groups. However, we detected improved reliable change scores in
family well-being outcomes for families of the intervention group compared
to the controls. Conclusion(s): Our research indicates that EMI-Heart
is a feasible intervention for infants with CHD after open-heart surgery.
The intervention was highly acceptable both to parents and to the
paediatric physiotherapist. Online treatment sessions offer a valuable
alternative to home and hospital visits. This feasibility RCT provides a
foundation for a future full trial. Trial registration:
ClinicalTrials.gov, NCTT04666857. Registered 23.11.2020. Copyright
© The Author(s) 2024.

<66>
Accession Number
2030533818
Title
The Advent of Artificial Intelligence into Cardiac Surgery: A Systematic
Review of Our Understanding.
Source
Brazilian Journal of Cardiovascular Surgery. 39(5) (no pagination), 2024.
Article Number: e20230308. Date of Publication: 2024.
Author
Bhushan R.; Grover V.
Institution
(Bhushan) Department of Cardiovascular and Thoracic Surgery, All India
Institute of Medical Sciences (AIIMS), Patna, India
(Grover) Department of Cardiac surgery, Atal Bihari Vajpayee Institute of
Medical Sciences (ABVIMS) and Dr Ram Manohar Lohia (RML) Hospital, New
Delhi, India
Publisher
Sociedade Brasileira de Cirurgia Cardiovascular
Abstract
When faced with questions about artificial intelligence (AI), many
surgeons respond with scepticism and rejection. However, in the realm of
cardiac surgery, it is imperative that we embrace the potential of AI and
adopt a proactive mindset. This systematic review utilizes PubMed to
explore the intersection of AI and cardiac surgery since 2017. AI has
found applications in various aspects of cardiac surgery, including
teaching aids, diagnostics, predictive outcomes, surgical assistance, and
expertise. Nevertheless, challenges such as data computation errors,
vulnerabilities to malware, and privacy concerns persist. While AI has
limitations, its restricted capabilities without cognitive and emotional
intelligence should lead us to cautiously and partially embrace this
advancing technology to enhance patient care. Copyright © 2024,
Sociedade Brasileira de Cirurgia Cardiovascular. All rights reserved.

<67>
Accession Number
2033505379
Title
Attenuation of hemodynamic responses to endotracheal extubation with
different doses of Diltiazem with Lignocaine: A randomized control study.
Source
European Journal of Cardiovascular Medicine. 13(4) (pp 496-507), 2023.
Date of Publication: 2023.
Author
Atram S.; Dhruv M.K.
Institution
(Atram) dept of anaesthesia, grant govt medical college Mumbai, India
(Dhruv) dept.of anaesthesia, grant govt medical college Mumbai, India
Publisher
Healthcare Bulletin
Abstract
Background: Endotracheal extubation is one of the frequently performed
procedure in the practice of Anaesthesia. This study was done to observe
the haemodynamic responses during tracheal extubation and to compare the
efficacy of IV diltiazem 0.3 mg/kg wih IV Lidocaine 1 mg/kg versus 0.2
mg/kg and 0.1 mg /kg IV Diltiazem with 1mg/kg IV Lignocaine in attenuating
the hemodynamic response to tracheal extubation. Method(s): 120
patients aged 20 to 60 yrs, belonging to ASA I and II, normotensive were
included in the study and they were randomly allocated into 3 groups of 40
each. *Group -I The patient who receive injection Diltiazem 0.1mg/kg and
inj Lignocaine 1mg/kg i.v. (n=40) * Grade -II The patients who receive
injection Diltiazem 0.2mg/kg and inj.Lignocaine 1mg/kg i.v. (n=40) *Group
-III The patients who receive injection Diltiazem 0.3mg/kg and
inj.Lignocaine 1mg/kg i.v. (n=40) 2 min before extubation. At the end of
the surgery, heart rate (HR), systolic blood pressure (SBP) diastolic
blood pressure (DBP) and mean arterial pressure [MAP] were recorded served
as base line values. Result(s): After tracheal extubation, all the
haemodynamic parameters increase from base line,0.3 mg/kg inj. Diltiazem
along with 1mg/kg inj Lignocaine provide better haemodynamic stability
when compared with 0.1 mg/kg and 0.2 mg/kg inj Diltiazem along with inj.
Lignocaine 1mg/kg each. 0.2 mg/kg inj.Diltiazem along with 1mg/kg inj
Lignocaine provide better haemodynamic stability when compared with 0.1 mg
inj Diltiazem with inj. Lignocaine 1mg/kg. Conclusion(s): Based on
the findings of our study, we concluded that combination effect of Inj.
Lignocaine and Inj. Diltiazem, Attenuate the hemodynamic response to
extubation. 0.3mg/kg Diltiazem with 1mg/kg Lignocaine is superior to
0.2mg/kg and 0.1 mg/kg Diltiazem with 1mg/kg Lignocaine in attenuating the
hemodynamic response to extubation. 0.2mg/kg Diltiazem with 1mg/kg
Lignocaine is superior to 0.1mg/kg Diltiazem with 1mg /kg lignocaine in
attenuating the hemodynamic response to extubation. Further studies are
required to evaluate the advantage, beneficial effect and safety of
Diltiazem in comparison with other drugs when used for the purpose of
attenuating the hemodynamic changes associated with
extubation. Copyright © 2023 Healthcare Bulletin. All rights
reserved.

<68>
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. 133(3) (pp 647-657), 2024. Date of
Publication: September 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

<69>
Accession Number
2031582211
Title
Cost-Effectiveness of Cardiovascular Magnetic Resonance for Rejection
Surveillance After Cardiac Transplantation in the Australian Health Care
System.
Source
Heart Lung and Circulation. 33(8) (pp 1173-1183), 2024. Date of
Publication: August 2024.
Author
Pouliopoulos J.; Anthony C.; Imran M.; Graham R.M.; McCrohon J.; Holloway
C.; Kotlyar E.; Muthiah K.; Keogh A.M.; Hayward C.S.; Macdonald P.S.;
Jabbour A.
Institution
(Pouliopoulos, Imran, Graham, McCrohon, Holloway, Kotlyar, Muthiah, Keogh,
Hayward, Macdonald, Jabbour) Heart and Lung Transplant Unit, St. Vincent's
Hospital, Sydney, NSW, Australia
(Pouliopoulos, Hayward, Macdonald, Jabbour) Victor Chang Cardiac Research
Institute, Sydney, NSW, Australia
(Pouliopoulos, Graham, Keogh, Macdonald, Jabbour) School of Clinical
Medicine, University of New South Wales, Sydney, NSW, Australia
(Anthony, Graham) Alfred Health and Monash University, Melbourne, VIC,
Australia
Publisher
Elsevier Ltd
Abstract
Background: Heart transplantation is an effective treatment for end-stage
congestive heart failure, however, achieving the right balance of
immunosuppression to maintain graft function while minimising adverse
effects is challenging. Serial endomyocardial biopsies (EMBs) are
currently the standard for rejection surveillance, despite being invasive.
Replacing EMB-based surveillance with cardiac magnetic resonance
(CMR)-based surveillance for acute cardiac allograft rejection has shown
feasibility. This study aimed to assess the cost-effectiveness of
CMR-based surveillance in the first year after heart transplantation.
 Method(s): A prospective clinical trial was conducted with 40
orthotopic heart transplant (OHT) recipients. Participants were randomly
allocated into two surveillance groups: EMB-based, and CMR-based. The
trial included economic evaluations, comparing the frequency and cost of
surveillance modalities in relation to quality-adjusted life years (QALYs)
within the first year post-transplantation. Sensitivity analysis
encompassed modelled data from observed EMB and CMR arms, integrating two
hypothetical models of expedited CMR-based surveillance. Result(s):
In the CMR cohort, 238 CMR scans and 15 EMBs were conducted, versus (vs)
235 EMBs in the EMB group. CMR surveillance yielded comparable rejection
rates (CMR 74 vs EMB 94 events, p=0.10) and did not increase
hospitalisation risk (CMR 32 vs EMB 46 events, p=0.031). It significantly
reduced the necessity for invasive EMBs by 94%, lowered costs by an
average of AUD$32,878.61, and enhanced cumulative QALY by 0.588 compared
with EMB. Sensitivity analysis showed that increased surveillance with
expedited CMR Models 1 and 2 were more cost-effective than EMB (all
p<0.01), with CMR Model 1 achieving the greatest cost savings
(AUD$34,091.12+/-AUD$23,271.86 less) and utility increase (+0.62+/-1.49
QALYs, p=0.011), signifying an optimal cost-utility ratio. Model 2 showed
comparable utility to the base CMR model (p=0.900) while offering the
benefit of heightened surveillance frequency during periods of elevated
rejection risk. Conclusion(s): CMR-based rejection surveillance in
orthotopic heart transplant recipients provides a cost-effective
alternative to EMB-based surveillance. Furthermore, it reduces the need
for invasive procedures, without increased risk of rejection or
hospitalisation for patients, and can be incorporated economically for
expedited surveillance. These findings have important implications for
improving patient care and optimising resource allocation in
post-transplant management. Copyright © 2024 Australian and New
Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac
Society of Australia and New Zealand (CSANZ)

<70>
Accession Number
2030834238
Title
Ex vivo heart perfusion: an updated systematic review.
Source
Heart Failure Reviews. 29(5) (pp 1079-1096), 2024. Date of Publication:
September 2024.
Author
Pradegan N.; Di Pasquale L.; Di Perna D.; Gallo M.; Lucertini G.; Gemelli
M.; Beyerle T.; Slaughter M.S.; Gerosa G.
Institution
(Pradegan, Lucertini, Gemelli, Gerosa) Cardiac Surgery Unit,
Cardio-thoraco-vascular and Public Health Department, Padova University
Hospital, Padua, Italy
(Di Pasquale) Division of Congenital Cardiovascular Surgery, Pediatric
Heart Centre and Children's Research Centre, University Children's
Hospital Zurich, Zurich, Switzerland
(Di Perna) Centre Hospitalier Annecy Genevois, Epagny-Metz-Tessy, France
(Gallo, Beyerle, Slaughter) Department of Cardiothoracic Surgery,
University of Louisville, 201 Abraham Flexner Way, Suite 1200, Louisville,
KY 40202, United States
Publisher
Springer
Abstract
Due to the discrepancy between patients awaiting a heart transplant and
the availability of donor hearts, strategies to expand the donor pool and
improve the transplant's success are crucial. This review aims to
summarize current knowledge on the ex vivo heart preservation (EVHP)
experience as an alternative to standard cold static storage (CSS). EVHP
techniques can improve the preservation of the donor's heart before
transplantation and allow for pre-transplant organ
evaluation. Copyright © The Author(s), under exclusive licence to
Springer Science+Business Media, LLC, part of Springer Nature 2024.

<71>
Accession Number
2028833073
Title
Assessing the impact of risk-based data monitoring on outcomes for a
paediatric multicentre randomised controlled trial.
Source
Clinical Trials. 21(4) (pp 461-469), 2024. Date of Publication: August
2024.
Author
Le Marsney R.; Johnson K.; Chumbes Flores J.; Coetzer S.; Darvas J.;
Delzoppo C.; Jolly A.; Masterson K.; Sherring C.; Thomson H.; Ergetu E.;
Gilholm P.; Gibbons K.S.
Institution
(Le Marsney, Johnson, Ergetu, Gilholm, Gibbons) Children's Intensive Care
Research Program, Child Health Research Centre, The University of
Queensland, South Brisbane, QLD, Australia
(Johnson) Paediatric Intensive Care Unit, Queensland Children's Hospital,
Children's Health Queensland, Brisbane, QLD, Australia
(Chumbes Flores, Jolly, Thomson) Paediatric Intensive Care Unit, Perth
Children's Hospital, Perth, WA, Australia
(Coetzer, Sherring) Paediatric Intensive Care Unit, Starship Child Health,
Auckland, New Zealand
(Darvas) Paediatric Intensive Care Unit, The Children's Hospital at
Westmead, Sydney, NSW, Australia
(Delzoppo, Masterson) Paediatric Intensive Care Unit, Royal Children's
Hospital Melbourne, Melbourne, VIC, Australia
(Delzoppo, Masterson) Murdoch Children's Research Institute, Melbourne,
VIC, Australia
Publisher
SAGE Publications Ltd
Abstract
Background/Aims: Regulatory guidelines recommend that sponsors develop a
risk-based approach to monitoring clinical trials. However, there is a
lack of evidence to guide the effective implementation of monitoring
activities encompassed in this approach. The aim of this study was to
assess the efficiency and impact of the risk-based monitoring approach
used for a multicentre randomised controlled trial comparing treatments in
paediatric patients undergoing cardiac bypass surgery. Method(s):
This is a secondary analysis of data from a randomised controlled trial
that implemented targeted source data verification as part of the
risk-based monitoring approach. Monitoring duration and source to database
error rates were calculated across the monitored trial dataset. The
monitored and unmonitored trial dataset, and simulated trial datasets with
differing degrees of source data verification and cohort sizes were
compared for their effect on trial outcomes. Result(s): In total,
106,749 critical data points across 1,282 participants were verified from
source data either remotely or on-site during the trial. The total time
spent monitoring was 365 hours, with a median (interquartile range) of 10
(7, 16) minutes per participant. An overall source to database error rate
of 3.1% was found, and this did not differ between treatment groups. A low
rate of error was found for all outcomes undergoing 100% source data
verification, with the exception of two secondary outcomes with error
rates >10%. Minimal variation in trial outcomes were found between the
unmonitored and monitored datasets. Reduced degrees of source data
verification and reduced cohort sizes assessed using simulated trial
datasets had minimal impact on trial outcomes. Conclusion(s):
Targeted source data verification of data critical to trial outcomes,
which carried with it a substantial time investment, did not have an
impact on study outcomes in this trial. This evaluation of the
cost-effectiveness of targeted source data verification contributes to the
evidence-base regarding the context where reduced emphasis should be
placed on source data verification as the foremost monitoring
activity. Copyright © The Author(s) 2024.

<72>
[Use Link to view the full text]
Accession Number
2033916667
Title
Landiolol: An Ultra-Short-Acting beta-Blocker.
Source
Cardiology in Review. 32(5) (pp 468-472), 2024. Date of Publication: 01
Sep 2024.
Author
Rao S.J.; Kanwal A.; Danilov A.; Frishman W.H.
Institution
(Rao) From the Department of Medicine, MedStar Union Memorial Hospital,
Baltimore, MD, United States
(Kanwal, Frishman) Department of Cardiology, Westchester Medical Center,
Valhalla, NY, United States
(Kanwal) George Washington University School of Medicine, Washington, DC,
United States
(Danilov) New York Medical College, Valhalla, NY, United States
(Frishman) Department of Medicine, New York Medical College, Valhalla, NY,
United States
Publisher
Lippincott Williams and Wilkins
Abstract
Landiolol is an ultra-short-acting, highly cardio-selective, beta-blocker,
that is currently approved for clinical use in Japan and the European
Union, for the treatment of tachyarrhythmias. Landiolol is highly
cardio-selective with high beta1 selectivity and receptor affinity,
resulting in a more potent chronotropic effect and less potent hypotensive
effect compared with other beta-blockers such as esmolol and propranolol.
Based on the recent randomized controlled trials, low-dose landiolol may
have a beneficial role in the prevention and management of postoperative
atrial fibrillation following noncardiac and cardiac surgeries, including
on-pump and off-pump coronary artery bypass grafting and valve surgery.
Additionally, landiolol may have potential utility for myocardial salvage
and prevention of postpercutaneous coronary intervention myocardial
infarction. Furthermore, the use of landiolol may also have a therapeutic
effect for rate control of sepsis-related tachyarrhythmias. Positive
results of recent randomized controlled trials should continue to inspire
clinicians to conduct further, larger studies, to find new potential
clinical applications for this novel drug. Copyright © 2023
Wolters Kluwer Health, Inc. All rights reserved.

<73>
Accession Number
2033982757
Title
Risk Factors of Ischemic Stroke in Patients With Atrial Fibrillation After
Transcatheter Aortic Valve Implantation from the Randomized ENVISAGE-TAVI
AF Trial.
Source
American Journal of Cardiology. 227 (pp 98-104), 2024. Date of
Publication: 15 Sep 2024.
Author
Hengstenberg C.; Unverdorben M.; Mollmann H.; Van Mieghem N.M.; Thiele H.;
Nordbeck P.; Rassaf T.; Moreno R.; Mehran R.; Jin J.; Lang I.; Veltkamp
R.; Dangas G.D.
Institution
(Hengstenberg, Lang) Division of Cardiology, Department of Internal
Medicine II, Vienna General Hospital, Medical University, Vienna, Austria
(Unverdorben, Jin) Daiichi Sankyo, Inc., Basking Ridge, NJ, United States
(Mollmann) Department of Internal Medicine, St. Johannes Hospital,
Dortmund, Germany
(Van Mieghem) Department of Cardiology, Cardiovascular Institute,
Thoraxcenter, Erasmus University Medical Center, Rotterdam, Netherlands
(Thiele) Department of Internal Medicine/Cardiology, Heart Center Leipzig
at University of Leipzig, Leipzig, Germany
(Nordbeck) Department of Internal Medicine I, University Hospital
Wurzburg, Wurzburg, Germany
(Rassaf) Clinic for Cardiology and Vascular Medicine, Westgerman Heart and
Vascular Center, University Duisburg-Essen, Essen, Germany
(Moreno) Department of Cardiology, University Hospital La Paz, Madrid,
Spain
(Mehran, Dangas) Division of Cardiology, Zena and Michael A. Wiener
Cardiovascular Institute, Mount Sinai Hospital, New York, New York, United
States
(Veltkamp) Department of Neurology, Alfried Krupp Krankenhaus, Essen,
Germany
(Veltkamp) Department of Neurology, University Hospital Heidelberg,
Heidelberg, Germany
(Veltkamp) Department of Brain Sciences, Imperial College London, London,
United Kingdom
(Dangas) School of Medicine, National and Kapodistrian University of
Athens, School of Medicine, Athens, Greece
Publisher
Elsevier Inc.
Abstract
In patients with prevalent or incident atrial fibrillation (AF) after
successful transcatheter aortic valve implantation (TAVI) enrolled in the
EdoxabaN Versus standard of care and theIr effectS on clinical outcomes in
pAtients havinG undergonE Transcatheter Aortic Valve Implantation - in
Atrial Fibrillation (ENVISAGE-TAVI AF) trial, the incidence of ischemic
stroke (IS) and any stroke was numerically less in the edoxaban group than
in the vitamin K antagonist (VKA) group. The present study aimed to
identify risk factors associated with IS in an on-treatment subanalysis in
patients from ENVISAGE-TAVI AF who received >=1 dose of edoxaban or VKA.
Baseline patient characteristics were compared in patients with and those
without IS. Numerical variables were compared using a 1-way analysis of
variance; categorical variables were compared using Fisher's exact test.
Stepwise Cox regression determined patient characteristics associated with
the first IS event. Of 1,377 patients, 41 (3.0%) experienced an IS, and
1,336 (97.0%) did not; baseline demographics and clinical characteristics
were well balanced between groups. Most ISs occurred within 180 days of
TAVI for edoxaban (57.9%) and VKA (68.2%). The rate of IS was 2.0/100
person-years for edoxaban versus 2.7/100 person-years for VKA.
Independently associated with IS were history of systemic embolic events
(hazard ratio 2.96, 95% confidence interval 1.26 to 7.00, p = 0.01) and
pre-TAVI use of VKAs (hazard ratio 2.17, 95% confidence interval 1.12 to
4.20, p = 0.02). In conclusion, although the overall incidence of IS was
small for patients with AF on edoxaban or VKA after successful TAVI,
patients with a history of systemic embolic events or pre-TAVI use of VKAs
may be at greater risk of IS after TAVI. Copyright © 2024 The
Author(s)

<74>
Accession Number
2030481848
Title
Semaglutide and Cardiovascular Outcomes by Baseline HbA<inf>1c</inf> and
Change in HbA<inf>1c</inf> in People With Overweight or Obesity but
Without Diabetes in SELECT.
Source
Diabetes Care. 47(8) (pp 1360-1369), 2024. Date of Publication: August
2024.
Author
Lingvay I.; Deanfield J.; Kahn S.E.; Weeke P.E.; Toplak H.; Scirica B.M.;
Rydeen L.; Rathor N.; Plutzky J.; Morales C.; Lincoff A.M.; Lehrke M.;
Jeppesen O.K.; Gajos G.; Colhoun H.M.; Cariou B.; Ryan D.
Institution
(Lingvay) Department of Internal Medicine/Endocrinology and Peter
O'Donnell Jr. School of Public Health, University of Texas Southwestern
Medical Center, Dallas, TX, United States
(Deanfield) Institute of Cardiovascular Science, University College
London, London, United Kingdom
(Kahn) VA Puget Sound Health Care System and University of Washington,
Seattle, WA, United States
(Weeke, Rathor, Jeppesen) Novo Nordisk A/S, Soborg, Denmark
(Toplak) Division of Endocrinology and Diabetology, Department of
Medicine, Medical University of Graz, Graz, Austria
(Scirica) TIMI Study Group, Division of Cardiovascular Medicine, Brigham
and Women's Hospital, Harvard Medical School, Boston, MA, United States
(Rydeen) Department of Medicine K2, Karolinska Institute, Stockholm,
Sweden
(Plutzky) Cardiovascular Division, Brigham and Women's Hospital, Harvard
Medical School, Boston, MA, United States
(Morales) Vithas Hospital, Sevilla, Spain
(Lincoff) Department of Cardiovascular Medicine, Cleveland Clinic, and
Cleveland Clinic Lerner College of Medicine, Case Western Reserve
University, Cleveland, OH, United States
(Lehrke) University of Aachen, Aachen, Germany
(Gajos) Department of Coronary Artery Disease and Heart Failure,
Jagiellonian University Medical College, Krakoow, Poland
(Colhoun) Institute of Genetics and Cancer, University of Edinburgh,
Edinburgh, United Kingdom
(Cariou) L'institut du thorax, INSERM, CNRS, CHU Nantes, Nantes
Universitoe, Nantes, France
(Ryan) Pennington Biomedical Research Center, Baton Rouge, LA, United
States
Publisher
American Diabetes Association Inc.
Abstract
OBJECTIVE To evaluate the cardiovascular effects of semaglutide by
baseline glycated hemoglobin (HbA<inf>1c</inf>) and change in
HbA<inf>1c</inf> in a prespecified analysis of Semaglutide Effects on
Cardiovascular Outcomes in People With Overweight or Obesity (SELECT).
RESEARCH DESIGN AND METHODS In SELECT, people with overweight or obesity
and atherosclerotic cardiovascular disease without diabetes were
randomized to weekly semaglutide 2.4 mg or placebo. The primary end point
of first major adverse cardiovascular event (MACE) (cardiovascular
mortality, nonfatal myocardial infarction, or stroke) was reduced by 20%
with semaglutide versus placebo. Analysis of outcomes included first MACE,
its individual components, expanded MACE (cardiovascular mortality,
nonfatal myocardial infarction, or stroke; coronary revascularization; or
hospitalization for unstable angina), a heart failure composite (heart
failure hospitalization or urgent medical visit or cardiovascular
mortality), coronary revascularization, and all-cause mortality by
baseline HbA<inf>1c</inf> subgroup and categories of HbA<inf>1c</inf>
change (<20.3, 20.3 to 0.3, and >0.3 percentage points) from baseline to
20 weeks using the intention-to-treat principle with Cox proportional
hazards. RESULTS Among 17,604 participants (mean age 61.6 years, 72.3%
male), baseline HbA<inf>1c</inf> was <5.7% for 33.5%, 5.7% to <6.0% for
34.6%, and 6.0% to <6.5% for 31.9%. Cardiovascular risk reduction with
semaglutide versus placebo was not shown to be different across baseline
HbA<inf>1c</inf> groups and was consistent with that of the overall study
for all end points, except all-cause mortality. Cardiovascular outcomes
were also consistent across subgroups of HbA<inf>1c</inf> change.
CONCLUSIONS In people with overweight or obesity and established
atherosclerotic cardiovascular disease but not diabetes, semaglutide
reduced cardiovascular events irrespective of baseline HbA<inf>1c</inf> or
change in HbA<inf>1c</inf>. Thus, semaglutide is expected to confer
cardiovascular benefits in people with established atherosclerotic
cardiovascular disease who are normoglycemic at baseline and/or in those
without HbA<inf>1c</inf> improvements. Copyright © 2024 by the
American Diabetes Association.

<75>
Accession Number
2030904077
Title
The Anatomy of the Thoracic Duct and Cisterna Chyli: A Meta-Analysis with
Surgical Implications.
Source
Journal of Clinical Medicine. 13(15) (no pagination), 2024. Article
Number: 4285. Date of Publication: August 2024.
Author
Plutecki D.; Bonczar M.; Wilk J.; Necka S.; Joniec M.; Elsaftawy A.;
Matuszyk A.; Walocha J.; Koziej M.; Ostrowski P.
Institution
(Plutecki) Collegium Medicum, Jan Kochanowski University, Kielce 25-369,
Poland
(Bonczar, Wilk, Necka, Joniec, Matuszyk, Walocha, Koziej, Ostrowski)
Department of Anatomy, Jagiellonian University Medical College, Krakow
33-332, Poland
(Bonczar, Wilk, Necka, Walocha, Koziej, Ostrowski) Youthoria-Youth
Research Organization, Krakow 30-363, Poland
(Elsaftawy) Chiroplastica-Lower Silesian Centre of Hand and Aesthetic
Surgery, Wroclaw 54-117, Poland
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Background: The thoracic duct (TD) and the cisterna chyli (CC) exhibit a
high degree of variability in their topographical and morphometric
properties. Material(s) and Method(s): PubMed, Scopus, Embase, Web of
Science, Cochrane Library, and Google Scholar were searched to identify
all studies that included information regarding the morphometric and
topographical characteristics of the TD and CC. Result(s): The most
frequent location of the TD termination was the left venous angle, with a
pooled prevalence of 45.29% (95% CI: 25.51-65.81%). Moreover, the TD
terminated most commonly as a single vessel (pooled prevalence = 78.41%;
95% CI: 70.91-85.09%). However, it divides into two or more terminating
branches in approximately a quarter of the cases. The pooled prevalence of
the CC was found to be 55.49% (95% CI: 26.79-82.53%). Conclusion(s):
Our meta-analysis reveals significant variability in the anatomy of the TD
and CC, particularly regarding TD termination patterns. Despite the
predominance of single-vessel terminations, almost a quarter of cases
exhibit branching, highlighting the complexity of the anatomy of the TD.
These findings demonstrate the importance of detailed anatomical knowledge
for surgeons to minimize the risk of accidental injury during head and
neck, as well as thoracic surgeries. Our study provides essential insights
that can enhance surgical safety and efficacy, ultimately improving
patient outcomes. Copyright © 2024 by the authors.

<76>
Accession Number
2033955335
Title
Effect of remimazolam versus propofol on hypotension after anesthetic
induction in patients undergoing coronary artery bypass grafting: A
randomized controlled trial.
Source
Journal of Clinical Anesthesia. 98 (no pagination), 2024. Article Number:
111580. Date of Publication: November 2024.
Author
Ju J.-W.; Lee D.J.; Chung J.; Lee S.; Cho Y.J.; Jeon Y.; Nam K.
Institution
(Ju, Lee, Chung, Cho, Jeon, Nam) Department of Anesthesiology and Pain
Medicine, Seoul National University Hospital, Seoul National University
College of Medicine, Seoul, South Korea
(Lee) Department of Anesthesiology and Pain Medicine, Ajou University
Medical Center, Ajou University School of Medicine, Gyeonggi Province,
Suwon, South Korea
Publisher
Elsevier Inc.
Abstract
Study Objective: There is scarce evidence on the hemodynamic stability of
remimazolam during anesthetic induction in patients with significant
coronary artery disease. This study aims to compare the effects of
remimazolam and propofol on post-induction hypotension in patients
undergoing coronary artery bypass grafting (CABG). Design(s):
Randomized controlled trial. Setting(s): Tertiary teaching hospital.
 Patient(s): Adult patients undergoing isolated CABG.
 Intervention(s): Patients were randomly allocated to received either
remimazolam (n = 50) or propofol (n = 50) for anesthetic induction. The
remimazolam group received an initial infusion at 6 mg/kg/h, which was
later adjusted to 1-2 mg/kg/h to maintain a bispectral index of 40-60
after loss of consciousness. In the propofol group, a 1.5 mg/kg bolus of
propofol was administered, followed by 1-1.5% sevoflurane inhalation as
needed to achieve the target bispectral index. Measurements: The primary
outcome was the area under the curve (AUC) below the baseline mean
arterial pressure (MAP) during the first 10 min after anesthetic
induction. Secondary outcomes included the AUC for MAP <65 mmHg and the
requirement for vasopressors. Main Result(s): The remimazolam group
demonstrated a significantly lower AUC under the baseline MAP compared to
the propofol group (mean [SD], 169.8 [101.0] mmHg.min vs. 220.6 [102.4]
mmHg.min; mean difference [95% confidence interval], 50.8 [10.4-91.2]
mmHg.min; P = 0.014). Additionally, the remimazolam group had a reduced
AUC for MAP <65 mmHg (7.3 [10.3] mmHg.min vs. 13.9 [14.9] mmHg.min; P =
0.007) and a lower frequency of vasopressor use compared to the propofol
group (60% vs. 88%, P = 0.001). Conclusion(s): Remimazolam may offer
improved hemodynamic stability during anesthetic induction in patients
undergoing CABG, suggesting its potential advantage over propofol for
patients with significant coronary artery disease in terms of hemodynamic
stability. Copyright © 2024 Elsevier Inc.

<77>
Accession Number
2033955252
Title
Course of the effects of LDL-cholesterol reduction on cardiovascular risk
over time: A meta-analysis of 60 randomized controlled trials.
Source
Atherosclerosis. 396 (no pagination), 2024. Article Number: 118540. Date
of Publication: September 2024.
Author
Burger P.M.; Dorresteijn J.A.N.; Koudstaal S.; Holtrop J.; Kastelein
J.J.P.; Jukema J.W.; Ridker P.M.; Mosterd A.; Visseren F.L.J.
Institution
(Burger, Dorresteijn, Holtrop, Visseren) Department of Vascular Medicine,
University Medical Centre Utrecht, Utrecht, Netherlands
(Koudstaal) Department of Cardiology, Green Heart Hospital, Gouda,
Netherlands
(Kastelein) Department of Vascular Medicine, Amsterdam University Medical
Centre, Amsterdam, Netherlands
(Jukema) Department of Cardiology, Leiden University Medical Centre,
Leiden, Netherlands
(Jukema) Netherlands Heart Institute, Utrecht, Netherlands
(Ridker) Centre for Cardiovascular Disease Prevention, Brigham and Women's
Hospital, Harvard Medical School, Boston, United States
(Mosterd) Department of Cardiology, Meander Medical Centre, Amersfoort,
Netherlands
Publisher
Elsevier Ireland Ltd
Abstract
Background and aims: Individuals with or at high risk of cardiovascular
disease (CVD) often receive long-term treatment with low-density
lipoprotein cholesterol (LDL-C) lowering therapies, but whether the
effects of LDL-C reduction remain stable over time is uncertain. This
study aimed to establish the course of the effects of LDL-C reduction on
cardiovascular risk over time. Method(s): Randomized controlled
trials (RCTs) of LDL-C lowering therapies were identified through a search
in MEDLINE and EMBASE (1966-January 2023). The primary analyses were
restricted to statins, ezetimibe, and proprotein convertase
subtilisin-kexin type 9 (PCSK9) inhibitors, with other therapies included
in sensitivity analyses. Random-effects meta-analyses were performed to
establish the hazard ratio (HR) for major vascular events (cardiovascular
death, myocardial infarction, unstable angina, coronary revascularization,
or stroke) per 1 mmol/L LDL-C reduction. Course of the effects over time
was assessed using random-effects meta-regression analyses for the
association between follow-up duration, age, and the HR for major vascular
events per 1 mmol/L LDL-C reduction. Additionally, treatment-by-time
interactions were evaluated in an individual participant data
meta-analysis of six atorvastatin trials. Result(s): A total of 60
RCTs were identified (408,959 participants, 51,425 major vascular events).
The HR for major vascular events per 1 mmol/L LDL-C reduction was 0.78 (95
% confidence interval [CI] 0.75-0.81). Follow-up duration was not
associated with a change in the HR for major vascular events (HR for
change per year 0.994; 95 % CI 0.970-1.020; p = 0.66). The HR attenuated
with increasing age in primary prevention (HR for change per 5 years
1.097; 95 % CI 1.031-1.168; p = 0.003), but not secondary prevention (HR
for change per 5 years 0.987; 95 % CI 0.936-1.040; p = 0.63). Consistent
results were found for statin trials only, and all trials combined. In the
individual participant data meta-analysis (31,310 participants, 6734 major
vascular events), the HR for major vascular events did not significantly
change over follow-up time (HR for change per year 0.983; 95 % CI
0.943-1.025; p = 0.42), or age (HR for change per 5 years 1.022; 95 % CI
0.990-1.055; p = 0.18). Conclusion(s): Based on available RCT data
with limited follow-up duration, the relative treatment effects of LDL-C
reduction are stable over time in secondary prevention, but may attenuate
with higher age in primary prevention. Copyright © 2024 The
Authors

<78>
[Use Link to view the full text]
Accession Number
2033916668
Title
Alternative Approaches to Coronary Artery Bypass Grafting Versus
Percutaneous Coronary Intervention, How Do They Compare?: A Systematic
Review and Meta-Analysis.
Source
Cardiology in Review. 32(5) (pp 392-401), 2024. Date of Publication: 01
Sep 2024.
Author
El-Andari R.; Bozso S.J.; Fialka N.M.; Kang J.J.H.; Hassanabad A.F.;
Nagendran J.
Institution
(El-Andari, Bozso, Kang, Nagendran) From the Division of Cardiac Surgery,
Department of Surgery, University of Alberta, Edmonton, AB, Canada
(Fialka) Faculty of Medicine and Dentistry, University of Alberta,
Edmonton, AB, Canada
(Hassanabad) Section of Cardiac Surgery, Department of Cardiac Sciences,
Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary,
AB, Canada
Publisher
Lippincott Williams and Wilkins
Abstract
Coronary artery disease (CAD) is a leading cause of mortality worldwide.
Severe symptomatic CAD is treated with coronary artery bypass grafting
(CABG) or percutaneous coronary intervention (PCI). Alternative CABG
(ACABG) approaches including thoracotomy, off-pump, total endoscopic, and
robotic-assisted CABG are increasing in prevalence to address the
increased early risk of CABG. This systematic review and meta-analysis
aims to review the contemporary literature comparing outcomes after ACABG
and PCI. Pubmed, Medline, and Embase were systematically searched by 2
authors for articles comparing the outcomes after ACABG and PCI. A total
of 1154 articles were screened, and 11 were included in this review. The
RevMan 5.4 software was used to perform a meta-analysis of the pooled
data. Individual studies found rates of long-term survival, major adverse
cardiovascular and cerebrovascular events (MACCE), myocardial infarction
(MI), and repeat revascularization either favored ACABG or did not differ
significantly. Pooled estimates of the compiled data identified rates of
MACCE, MI, and repeat revascularization favored ACABG. The results of this
review demonstrated the favorable rates of long-term mortality, MACCE, MI,
and repeat revascularization for ACABG in addition to similar short-term
mortality and stroke when compared with PCI. Advancement of both CABG and
PCI continues to improve patient outcomes. With the increasing prevalence
of ACABG, similar studies will need to be undertaken with further direct
comparisons between ACABG and PCI. Finally, hybrid revascularization
should continue to be explored for its combined benefits of long-term
outcomes, short-term safety, and ability to achieve complete
revascularization. Copyright © 2023 Wolters Kluwer Health, Inc.
All rights reserved.

<79>
Accession Number
2033653151
Title
Psychologically-enhanced cardiac rehabilitation for psychological and
functional improvement in patients with cardiovascular disease: a
systematic review with meta-analysis and future research directions.
Source
Physiotherapy (United Kingdom). 125 (no pagination), 2024. Article Number:
101412. Date of Publication: December 2024.
Author
Wrzeciono A.; Mazurek J.; Cieslik B.; Kiper P.; Gajda R.;
Szczepanska-Gieracha J.
Institution
(Wrzeciono, Szczepanska-Gieracha) Department of Physiotherapy, Wroclaw
University of Health and Sport Sciences, Wroclaw 51-612, Poland
(Mazurek) University Rehabilitation Centre, Wroclaw Medical University,
Wroclaw 50-367, Poland
(Cieslik, Kiper) Healthcare Innovation Technology Lab, IRCCS San Camillo
Hospital, Venezia 30126, Italy
(Gajda) Department of Kinesiology and Health Prevention, Jan Dlugosz
University in Czestochowa, Czestochowa 42-200, Poland
(Gajda) Center for Sports Cardiology at the Gajda-Med Medical Center in
Pultusk, Pultusk 06-102, Poland
Publisher
Elsevier Ltd
Abstract
Objective: To systematically review the effectiveness of
psychologically-enhanced cardiac rehabilitation (CR) in improving
psychological and functional outcomes in patients with cardiovascular
disease. Data sources: A systematic search was performed in PubMed,
Scopus, Cochrane Library, Embase, and Web of Science, up to January 31,
2024. Study selection: Two reviewers independently identified randomized
clinical trials that evaluated the effectiveness of
psychologically-enhanced CR in improving psychological and functional
outcomes in patients with cardiovascular disease. The search yielded 1848
results. Finally, data from 14 studies (1531 participants) were included
in the review. Data extraction and data synthesis: Information regarding
cardiac rehabilitation phase, duration of the intervention, group
characteristics, measured outcomes, and the conclusions drawn by the
authors was extracted. The Revised Cochrane risk-of-bias tool for
Randomized Trials was used to evaluate the methodological quality.
 Result(s): Pooled results indicate that psychologically-enhanced CR
is more effective than specific cardiac training alone in maintaining
lower resting blood pressure, with a mean difference of -3.09 (95% CI:
-5.18 to -1.00). Furthermore, psychologically-enhanced CR shows
superiority in improving patients' quality of life compared to specific
cardiac training alone, with a standardized mean difference of 0.15 (95%
CI: 0.01 to 0.31). Analyses of depression and anxiety level, exercise
tolerance, and blood lipid profile did not show significant differences
between the two treatment conditions. Conclusion(s):
Psychologically-enhanced CR shows a positive effect on reducing resting
blood pressure and improving the quality of life. However, the supportive
methods were of limited effectiveness in addressing the psychological
aspects of health. Systematic Review Registration Number: PROSPERO
CRD42022304063. Contribution of the paper: * Psychologically-enhanced
cardiac rehabilitation (CR) has the potential to improve the effectiveness
of CR. * Limited effectiveness in the psychological aspects of health
requires consideration. * New therapeutic solutions to manage mental
health during CR should be sought. Copyright © 2024 Chartered
Society of Physiotherapy

<80>
Accession Number
2033643850
Title
Effect of music on hemodynamic fluctuations in women during induction of
general anesthesia: A prospective randomized controlled multicenter trial.
Source
Clinics. 79 (no pagination), 2024. Article Number: 100462. Date of
Publication: 01 Jan 2024.
Author
Wang J.; Jiang L.; Chen W.; Wang Z.; Miao C.; Zhong J.; Xiong W.
Institution
(Wang, Jiang, Chen, Wang, Miao, Zhong, Xiong) Department of
Anesthesiology, Zhongshan Hospital, Fudan University, Shanghai, China
Publisher
Universidade de Sao Paulo. Museu de Zoologia
Abstract
Background: The authors aim to investigate the effect of music on
hemodynamic fluctuations during induction of general anesthesia and
reducing preoperative anxiety for women who underwent elective non-cardiac
surgery. Method(s): It is a multicenter, double-blind, randomized,
parallel-group clinical trial. Patients were randomized 1:1 to either a
Music Intervention group (MI) or a Control group (Control). The MI
participants listened to their preferred music for more than 30 minutes in
the waiting area. The State-Trait Anxiety Inventory (STAI) was used to
measure anxiety levels in the groups, and hemodynamic parameters (Heart
Rate [HR], Mean Arterial Pressure [MAP]) were continuously recorded before
induction (T0), at loss of consciousness (T1), immediately before
intubation (T2), and after intubation (T3). Intubation-related adverse
events were also recorded. The primary outcome was the incidence of MAP
changes more than 20 % above baseline during T0-T2. Result(s): A
total of 164 patients were included in the final analyses. The incidence
of MAP instability during T0-T2 was lower in the MI, and the 95 %
Confidence Interval for the rate difference demonstrated the superiority
of MI. HR instability was less frequent in MI participants both in T0-T2
and T2-T3. The overall incidence of preoperative anxiety was 53.7 %
(88/164). After the music intervention, the mean score of STAI was
significantly lower in the MI than in the Control, with a between-group
difference of 8.01. Conclusion(s): Preoperative music intervention
effectively prevented hemodynamic instability during anesthesia induction
and significantly reduced preoperative anxiety in women undergoing
elective non-cardiac surgery. Copyright © 2024

<81>
Accession Number
2030828903
Title
Early anti-coagulation therapy in new-onset atrial fibrillation after
coronary artery bypass grafting: a randomized trial pilot study.
Source
BMC Cardiovascular Disorders. 24(1) (no pagination), 2024. Article Number:
404. Date of Publication: December 2024.
Author
Ghavami M.; Hosseini K.; Abdshah A.; Abadi S.R.F.; Akbarzadeh D.;
Mohammadi I.; Kalhor P.; Sadeghian S.
Institution
(Ghavami, Hosseini, Kalhor, Sadeghian) Tehran Heart Center, Cardiovascular
Diseases Research Institute, Tehran University of Medical Sciences, North
Kargar Street, Tehran 1411713138, Iran, Islamic Republic of
(Abdshah) School of Medicine, Tehran University of Medical Sciences,
Tehran, Iran, Islamic Republic of
(Abdshah) Department of Public Health Sciences, Miller School of Medicine,
University of Miami, Miami, FL, United States
(Abadi, Akbarzadeh, Mohammadi) Student Research Committee, School of
Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran,
Islamic Republic of
Publisher
BioMed Central Ltd
Abstract
Background: New-onset postoperative atrial fibrillation (POAF) is a common
complication after coronary artery bypass grafting (CABG) surgery,
increasing the risk of embolism and stroke. There is a lack of information
on the use of anticoagulants in this context. The choice between Warfarin
and Direct oral anticoagulants (DOACs) also is not well-established. This
randomized study aimed to compare the feasibility and safety of Warfarin
and Rivaroxaban in preventing thrombotic events in POAF patients after
isolated CABG. Method(s): A total of 66 patients were randomized
parallelly with 1:1 allocation to receive either Rivaroxaban (n = 34) or
Warfarin (n = 32). Major bleeding events within 30 days after discharge
were the primary outcome. Secondary outcomes included minor bleeding
events and thrombotic episodes. Clinical characteristics, medication
regimens, and left atrial diameter were assessed. Statistical analyses
were performed using appropriate tests. Result(s): No thrombotic
episodes were observed in either treatment arm. No major bleeding events
occurred in either group. Four minor bleeding events were reported, with
no significant difference between the treatment groups (P = 0.6). Patients
with atrial fibrillation had significantly larger left atrial diameters
compared to those with normal sinus rhythm (40.5 vs. 37.8 mm, P = 0.01).
 Conclusion(s): This pilot study suggests that Warfarin and
Rivaroxaban are both safe and effective for preventing thrombotic episodes
in POAF patients after isolated CABG. No significant differences in major
bleeding events were observed between the two anticoagulants. These
findings may support the preference for DOACs like Rivaroxaban due to
their convenience and easier maintenance. Trial registration: Number
IRCT20200304046696N1, Date 18/03/2020
https//irct.behdasht.gov.ir/. Copyright © The Author(s) 2024.

<82>
Accession Number
2033680033
Title
Comparison of 4% Albumin and Ringer's Acetate on Hemodynamics in On-pump
Cardiac Surgery: An Exploratory Analysis of a Randomized Clinical Trial.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2024.
Date of Publication: 2024.
Author
Vlasov H.; Wilkman E.; Petaja L.; Suojaranta R.; Hiippala S.; Tolonen H.;
Jormalainen M.; Raivio P.; Juvonen T.; Pesonen E.
Institution
(Vlasov, Wilkman, Petaja, Suojaranta, Hiippala, Pesonen) Department of
Anesthesiology and Intensive Care Medicine, University of Helsinki and
Helsinki University Hospital, Helsinki, Finland
(Tolonen, Raivio, Juvonen) HUS Pharmacy, University of Helsinki and
Helsinki University Hospital, Helsinki, Finland
(Jormalainen) Department of Cardiac Surgery, Heart and Lung Center,
University of Helsinki and Helsinki University Hospital, Helsinki, Finland
Publisher
W.B. Saunders
Abstract
Objectives: Compare hemodynamics between 4% albumin and Ringer's acetate.
 Design(s): Exploratory analysis of the double-blind randomized
ALBumin In Cardiac Surgery trial. Setting(s): Single-center study in
Helsinki University Hospital. Participant(s): We included 1,386
on-pump cardiac surgical patients. Intervention(s): We used 4%
albumin or Ringer's acetate administration for cardiopulmonary bypass
priming, volume replacement intraoperatively and 24 hours postoperatively.
 Measurements and Main Results: Hypotension (time-weighted average
mean arterial pressure of <65 mmHg) and hyperlactatemia (time-weighted
average blood lactate of >2 mmol/L) incidences were compared between trial
groups in the operating room (OR), and early (0-6 hours) and late (6-24
hours) postoperatively. Associations of hypotension and hyperlactatemia
with the ALBumin In Cardiac Surgery primary outcome (>=1 major adverse
event [MAE]) were studied. In these time intervals, hypotension occurred
in 118, 48, and 17 patients, and hyperlactatemia in 313, 131, and 83
patients. Hypotension and hyperlactatemia associated with MAE occurrence.
Hypotension did not differ between the groups (albumin vs Ringer's: OR,
8.8% vs 8.5%; early postoperatively, 2.7% vs 4.2%; late postoperatively,
1.2% vs 1.3%; all p > 0.05). In the albumin group, hyperlactatemia was
less frequent late postoperatively (2.9% vs 9.1%; p < 0.001), but not
earlier (OR, 22.4% vs 23.6%; early postoperatively, 7.9% vs 11.0%; both p
> 0.025 after Bonferroni-Holm correction). Conclusion(s): In on-pump
cardiac surgery, hypotension and hyperlactatemia are associated with the
occurrence of >=1 MAE. Compared with Ringer's acetate, albumin did not
decrease hypotension and decreased hyperlactatemia only late
postoperatively. Albumin's modest hemodynamic effect is concordant with
the finding of no difference in MAEs between albumin and Ringer's acetate
in the ALBumin In Cardiac Surgery trial. Copyright © 2024 The
Author(s)

<83>
Accession Number
2030840705
Title
Electronic Glycemic Management System Improved Glycemic Control and
Reduced Complications in Patients With Diabetes Undergoing Coronary Artery
Bypass Surgery: A Randomized Controlled Trial.
Source
Journal of Diabetes Science and Technology. (no pagination), 2024. Date
of Publication: 2024.
Author
Camara de Souza A.B.; Toyoshima M.T.K.; Cukier P.; Lottenberg S.A.; Bolta
P.M.P.; Lima E.G.; Serrano Junior C.V.; Nery M.
Institution
(Camara de Souza, Cukier, Lottenberg, Nery) Department of Endocrinology
and Metabolism, Hospital das Clinicas da Faculdade de Medicina da
Universidade de Sao Paulo, Sao Paulo, Brazil
(Toyoshima) Oncoendocrinology Service, Instituto do Cancer do Estado de
Sao Paulo Octavio Frias de Oliveira, Hospital das Clinicas da Faculdade de
Medicina da Universidade de Sao Paulo, Sao Paulo, Brazil
(Bolta, Lima, Serrano Junior) Instituto do Coracao, Hospital das Clinicas
da Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, Brazil
Publisher
SAGE Publications Inc.
Abstract
Background: In-hospital hyperglycemia poses significant risks for patients
with diabetes mellitus undergoing coronary artery bypass graft (CABG)
surgery. Electronic glycemic management systems (eGMSs) like InsulinAPP
offer promise in standardizing and improving glycemic control (GC) in
these settings. This study evaluated the efficacy of the InsulinAPP
protocol in optimizing GC and reducing adverse outcomes post-CABG.
 Method(s): This prospective, randomized, open-label study was
conducted with 100 adult type 2 diabetes mellitus (T2DM) patients
post-CABG surgery, who were randomized into two groups: conventional care
(gCONV) and eGMS protocol (gAPP). The gAPP used InsulinAPP for insulin
therapy management, whereas the gCONV received standard clinical care. The
primary outcome was a composite of hospital-acquired infections, renal
function deterioration, and symptomatic atrial arrhythmia. Secondary
outcomes included GC, hypoglycemia incidence, hospital stay length, and
costs. Result(s): The gAPP achieved lower mean glucose levels (167.2
+/- 42.5 mg/dL vs 188.7 +/- 54.4 mg/dL; P =.040) and fewer patients-day
with BG above 180 mg/dL (51.3% vs 74.8%, P =.011). The gAPP received an
insulin regimen that included more prandial bolus and correction insulin
(either bolus-correction or basal-bolus regimens) than the gCONV (90.3% vs
16.7%). The primary composite outcome occurred in 16% of gAPP patients
compared with 58% in gCONV (P <.010). Hypoglycemia incidence was lower in
the gAPP (4% vs 16%, P =.046). The gAPP protocol also resulted in shorter
hospital stays and reduced costs. Conclusion(s): The InsulinAPP
protocol effectively optimizes GC and reduces adverse outcomes in T2DM
patients' post-CABG surgery, offering a cost-effective solution for
inpatient diabetes management. Copyright © 2024 Diabetes
Technology Society.

<84>
Accession Number
2033684912
Title
Coronary artery disease and heart failure: Late-breaking trials presented
at American Heart Association scientific session 2023.
Source
World Journal of Cardiology. 16(7) (pp 389-396), 2024. Date of
Publication: 26 Jul 2024.
Author
Mondal A.; Srikanth S.; Aggarwal S.; Alle N.R.; Odugbemi O.; Ogbu I.;
Desai R.
Institution
(Mondal) Department of Internal Medicine, Nazareth Hospital, Philadelphia,
PA 19152, United States
(Srikanth) Department of Internal Medicine, East Carolina University
Greenville, Greenville, NC 27834, United States
(Aggarwal) Department of Internal Medicine, Hamdard Institute of Medical
Sciences and Research, New Delhi 110062, India
(Alle) Department of Medicine, Narayana Medical College, Andhra Pradesh,
Nellore 524003, India
(Odugbemi) Department of Internal Medicine, Lincoln Medical Center, Bronx,
NY 10451, United States
(Ogbu) Department of Internal Medicine, Mountainview Hospital Sunrise GME,
Las Vegas, NV 89108, United States
(Desai) AtlantaGA 30079, United States
Publisher
Baishideng Publishing Group Inc
Abstract
The late-breaking science presented at the 2023 scientific session of the
American Heart Association paves the way for future pragmatic trials and
provides meaningful information to guide management strategies in coronary
artery disease and heart failure (HF). The dapagliflozin in patient with
acute myocardial infarction (DAPA-MI) trial showed that dapagliflozin use
among patients with acute MI without a history of diabetes mellitus or
chronic HF has better cardiometabolic outcomes compared with placebo, with
no difference in cardiovascular outcomes. The MINT trial showed that in
patients with acute MI and anemia (Hgb < 10 g/dL), a liberal transfusion
goal (Hgb >= 10 g/dL) was not superior to a restrictive strategy (Hgb 7-8
g/dL) with respect to 30-day all-cause death and recurrent MI. The
ORBITA-2 trial showed that among patients with stable angina and coronary
stenoses causing ischemia on little or no antianginal therapy,
percutaneous coronary intervention results in greater improvements in
anginal frequency and exercise times compared with a sham procedure. The
ARIES-HM3 trial showed that in patients with advanced HF who received a
HeartMate 3 levitated left ventricular assist device and were
anticoagulated with a vitamin K antagonist, placebo was noninferior to
daily aspirin with respect to the composite endpoint of bleeding and
thrombotic events at 1 year. The TEAMMATE trial showed that everolimus
with low-dose tacrolimus is safe in children and young adults when given
>= 6 months after cardiac transplantation. Providing patients being
treated for HF with reduced ejection fraction (HFrEF) with specific
out-of-pocket (OOP) costs for multiple medication options at the time of
the clinical encounter may reduce 'contingency planning' and increase the
extent to which patients are taking the medications decided upon. The
primary outcome, which was cost-informed decision-making, defined as the
clinician or patient mentioning costs of HFrEF medication, occurred in 49%
of encounters with the checklist only control group compared with 68% of
encounters in the OOP cost group. Copyright © The Author(s) 2024.
Published by Baishideng Publishing Group Inc. All rights reserved.

<85>
Accession Number
644926618
Title
Protective effect of sevoflurane on myocardial ischemia-reperfusion
injury: a systematic review and meta-analysis.
Source
International journal of surgery (London, England). (no pagination),
2024. Date of Publication: 02 Aug 2024.
Author
Nasiri-Valikboni A.; Rashid M.; Azimi A.; Zarei H.; Yousefifard M.
Institution
(Nasiri-Valikboni, Azimi, Zarei, Yousefifard) Physiology Research Center,
Iran University of Medical Sciences, Tehran, Iran, Islamic Republic of
(Rashid) Student Research Committee, Babol University of Medical Sciences,
Babol, Iran, Islamic Republic of
Abstract
BACKGROUND: Myocardial ischemia-reperfusion (I/R) injury significantly
impacts recovery in both cardiac and non-cardiac surgeries, potentially
leading to severe cardiac dysfunction. Sevoflurane, a volatile anesthetic,
is reputed for its protective effects against myocardial I/R injury,
although evidence remains inconclusive. This systematic review and
meta-analysis aim to clarify the cardioprotective efficacy of sevoflurane.
 METHOD(S): The systematic search of databases including Medline,
Embase, Scopus, and Web of Science, was supplemented with a manual search
to retrieve studies using rat or mouse models of myocardial I/R injury,
comparing sevoflurane pretreatment (>= 24 hours before I/R),
preconditioning (within 24 hours before I/R), or post-conditioning (after
I/R) against non-treated controls. The outcomes were cardiac function,
myocardial infarct size, apoptosis, inflammation, oxidative stress, and
cardiac biomarkers. Using the random effects model, standardized mean
differences (SMD) were pooled to perform meta-analyses. RESULT(S):
Fifty-one studies, encompassing 8189 subjects, were included in the
meta-analysis. Pretreatment with Sevoflurane significantly reduced infarct
size. Sevoflurane preconditioning exhibited positive effects on left
ventricular parameters and ejection fraction, and reduced infarct size,
apoptosis, and oxidative stress. Post-conditioning with Sevoflurane
demonstrated improvements in cardiac function, including enhanced left
ventricular parameters and reduced infarct size, apoptosis, inflammation,
oxidative stress, and cardiac biomarkers. CONCLUSION(S): Sevoflurane
demonstrates a significant protective effect against myocardial I/R injury
in animal models. These findings support the potential clinical utility of
sevoflurane as an anesthetic choice in preventing and managing myocardial
I/R injury during surgeries. Copyright © 2024 The Author(s).
Published by Wolters Kluwer Health, Inc.

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