EMBASE Cardiac Update AutoAlert: EPICORE Cardiac Surgery Blogger2

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<1>
Accession Number
2034292205
Title
A randomized comparison of the treatment sequence of percutaneous coronary
intervention and transcatheter aortic valve implantation: Rationale and
design of the TAVI PCI trial.
Source
American Heart Journal. 277 (pp 104-113), 2024. Date of Publication:
November 2024.
Author
Stahli B.E.; Linke A.; Westermann D.; Van Mieghem N.M.; Leistner D.M.;
Massberg S.; Alber H.; Mugge A.; Musumeci G.; Kesterke R.; Schneider S.;
Kastrati A.; Ford I.; Ruschitzka F.; Kasel M.A.; Kasel M.; Van Mieghem N.;
Savonitto S.; Witzenbichler B.; Swaans M.; Swedberg K.; Pocock S.;
Maggioni A.
Institution
(Stahli, Kesterke, Ruschitzka, Kasel) Department of Cardiology, University
Heart Center, University Hospital Zurich, Zurich, Switzerland
(Linke) Department of Internal Medicine and Cardiology, Technische
Universitat Dresden, Herzzentrum Dresden, University Clinic, Dresden,
Germany
(Westermann) Department of Cardiology and Angiology, Faculty of Medicine,
University Heart Center Freiburg-Bad Krozingen, University of Freiburg,
Freiburg, Germany
(Van Mieghem) Department of Cardiology, Cardiovascular Institute,
Thoraxcenter, Erasmus University Medical Center, Rotterdam, Netherlands
(Leistner) Department of Cardiology, University Heart Centre Frankfurt,
University Hospital Frankfurt; DZHK (German Centre for Cardiovascular
Research), Partner Site Rhine-Main, Frankfurt/Main, Germany
(Massberg) Medizinische Klinik und Poliklinik I, LMU Munich, DZHK (German
Centre for Cardiovascular Research), Partner Site Munich Heart Alliance,
LMU University Hospital, Munich, Germany
(Alber) Department of Internal Medicine and Cardiology, Landeskrankenhaus,
Klagenfurt, Austria
(Mugge) Department of Cardiology and Rhythmology, University Hospital St
Josef-Hospital, Ruhr University Bochum, Bochum, Germany
(Musumeci) SC Cardiologia, AO Ordine Mauriziano, Torino, Italy
(Schneider, Schneider) Institut fur Herzinfarktforschung (IHF),
Ludwigshafen, Germany
(Kastrati) Department of Cardiology, Deutsches Herzzentrum Munchen,
Technische Universitat Munchen, DZHK (German Center for Cardiovascular
Research), Partner Site Munich Heart Alliance, Munich, Germany
(Ford, Ford) Robertson Centre for Biostatistics, University of Glasgow,
Glasgow, United Kingdom
(Stahli, Ruschitzka, Kasel) Department of Cardiology, University Heart
Center, University Hospital Zurich, the Center for Translational and
Experimental Cardiology, and the Faculty of Medicine, Zurich, Switzerland
(Linke) Technische Universitat Dresden, Department of Internal Medicine
and Cardiology, Herzzentrum Dresden, University Clinic, Dresden, Germany
(Van Mieghem) Department of Cardiology, Thoraxcenter, Erasmus University
Medical Center, Rotterdam, Netherlands
(Massberg) Medizinische Klinik und Poliklinik I, LMU University Hospital,
LMU Munich, Munich, Germany
(Massberg) DZHK (German Centre for Cardiovascular Research), Partner Site
Munich Heart Alliance, Munich, Germany
(Westermann) Department of Cardiology and Angiology, University of
Freiburg Medical Center, Faculty of Medicine, University of Freiburg,
Freiburg, Germany
(Alber) Department of Cardiology, Public Hospital Klagenfurt am
Woerthersee, Klagenfurt am Woerthersee, Austria
(Mugge) University Hospital St Josef-Hospital, Cardiology and Rhythmology,
Ruhr University Bochum, Germany
(Leistner) Department of Medicine, Cardiology, Goethe University Hospital,
DZHK (German Center for Cardiovascular Research), Partner Site Rhein-Main,
Frankfurt, Germany
(Musumeci) Cardiology Department, Azienda Ospedaliera Ordine Mauriziano
Umberto I, Turin, Italy
(Kastrati) Klinik fur Herz und Kreislauferkrankungen, Deutsches
Herzzentrum Munchen, Technische Universitat Munchen, DZHK (German Center
for Cardiovascular Research), Partner Site Munich Heart Alliance, Munich,
Germany
(Savonitto) Service of Cardiology, Clinica San Martino, Malgrate, Italy
(Witzenbichler) Department of Cardiology and Pneumology, Helios
Amper-Klinikum, Dachau, Germany
(Swaans) Department of Cardiology, St. Antonius Hospital, Nieuwegein,
Netherlands
(Swedberg) Department of Emergency and Cardiovascular Medicine,
Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
(Pocock) Department of Medical Statistics, London School of Hygiene and
Tropical Medicine, London, United Kingdom
(Maggioni) ANMCO Research Center, Heart Care Foundation, Firenze, Italy
Publisher
Elsevier Inc.
Abstract
Background: About half of patients with severe aortic stenosis present
with concomitant coronary artery disease. The optimal timing of
percutaneous coronary intervention (PCI) and transcatheter aortic valve
implantation (TAVI) in patients with severe aortic stenosis and
concomitant coronary artery disease remains unknown. Study design: The
TAVI PCI trial is a prospective, international, multicenter, randomized,
2-arm, open-label study planning to enroll a total of 986 patients. It is
designed to investigate whether the strategy "angiography-guided complete
revascularization after (within 1-45 days) TAVI" is noninferior to the
strategy "angiography-guided complete revascularization before (within
1-45 days) TAVI" using the Edwards SAPIEN 3 or 3 Ultra Transcatheter Heart
Valve in patients with severe aortic stenosis and concomitant coronary
artery disease. Patients are randomized in a 1:1 ratio to one of the 2
treatment strategies. The primary end point is a composite of all-cause
death, nonfatal myocardial infarction, ischemia-driven revascularization,
rehospitalization (valve- or procedure-related including heart failure),
or life-threatening/disabling or major bleeding at 1 year.
<br/>Conclusion(s): The TAVI PCI trial tests the hypothesis that the
strategy "PCI after TAVI" is noninferior to the strategy "PCI before TAVI"
in patients with severe aortic stenosis and concomitant coronary artery
disease.<br/>Copyright &#xa9; 2024 Elsevier Inc.

<2>
Accession Number
2034250079
Title
Tissue-source effect on mesenchymal stem cells as living biodrugs for
heart failure: Systematic review and meta-analysis.
Source
World Journal of Cardiology. 16(8) (pp 469-483), 2024. Date of
Publication: 26 Aug 2024.
Author
Safwan M.; Bourgleh M.S.; Aldoush M.; Haider K.H.
Institution
(Safwan, Bourgleh, Aldoush, Haider) Department of Basic Sciences, Sulaiman
Al Rajhi University, Al Bukairiyah 51941, Saudi Arabia
Publisher
Baishideng Publishing Group Inc
Abstract
BACKGROUND Mesenchymal stem cells (MSCs), as living biodrugs, have entered
advanced phases of clinical assessment for cardiac function restoration in
patients with myocardial infarction and heart failure. While MSCs are
available from diverse tissue sources, bone-marrow-derived MSCs (BM-MSCs)
remain the most well-studied cell type, besides umbilical-cord-derived
MSCs (UC-MSCs). The latter offers advantages, including noninvasive
availability without ethical considerations. AIM To compare the safety and
efficacy of BM-MSCs and UC-MSCs in terms of left ventricular ejection
fraction (LVEF), 6-min walking distance (6MWD), and major adverse cardiac
events (MACEs). METHODS Five databases were systematically searched to
identify randomized controlled trials (RCTs). Thirteen RCTs (693 patients)
were included using predefined eligibility criteria. Weighted mean
differences and odds ratio (OR) for the changes in the estimated treatment
effects. RESULTS UC-MSCs significantly improved LVEF vs controls by 5.08%
[95% confidence interval (CI): 2.20%-7.95%] at 6 mo and 2.78% (95%CI:
0.86%-4.70%) at 12 mo. However, no significant effect was observed for
BM-MSCs vs controls. No significant changes were observed in the 6MWD with
either of the two cell types. Also, no differences were observed for
MACEs, except rehospitalization rates, which were lower only with BM-MSCs
(odds ratio 0.48, 95%CI: 0.24-0.97) vs controls. CONCLUSION UC-MSCs
significantly improved LVEF compared with BM-MSCs. Their advantageous
characteristics position them as a promising alternative to MSC-based
therapy.<br/>Copyright &#xa9;The Author(s) 2024. Published by Baishideng
Publishing Group Inc. All rights reserved.

<3>
Accession Number
2034190433
Title
Effectiveness of PCSK9 inhibitors: A Target Trial Emulation framework
based on Real-World Electronic Health Records.
Source
PLoS ONE. 19(8) (no pagination), 2024. Article Number: e0309470. Date of
Publication: 01 Aug 2024.
Author
Barbati G.; Gregorio C.; Scagnetto A.; Indennidate C.; Cappelletto C.; Di
Lenarda A.
Institution
(Barbati, Gregorio) Biostatistics Unit, Department of Medical Sciences,
University of Trieste, Trieste, Italy
(Gregorio) MOX-Modelling and Scientific Computing Laboratory, Department
of Mathematics, Politecnico di Milano, Milano, Italy
(Gregorio) Aging Research Center, Department of Neurobiology, Care
Sciences and Society, Karolinska Institutet and Stockholm University,
Stockholm, Sweden
(Scagnetto, Indennidate, Cappelletto, Di Lenarda) Cardiovascular Center,
Territorial Specialistic Department, University Hospital, Health Services
of Trieste, Trieste, Italy
Publisher
Public Library of Science
Abstract
Low-Density Lipoprotein (LDL) cholesterol is one of the main target for
cardiovascular (CV) prevention and therapy. In the last years, Proprotein
Convertase Subtilisin-Kexin type 9 inhibitors (PCSK9-i) has emerged as a
key therapeutic target to lower LDL and were introduced for prevention of
CV events. Recently (June 2022) the Italian Medicines Agency (AIFA)
modified the eligibility criteria for the use of PCSK9-i. We designed an
observational study to estimate the prevalence of eligible subjects and
evaluate the effectiveness of PCSK9-i applying a Target Trial Emulation
(TTE) approach based on Electronic Health Records (EHR). Subjects meeting
the eligibility criteria were identified from July 2017 (when PCSK9-i
became available) to December 2020. Outcomes were all-cause death and the
first hospitalization. Among eligible subjects, we identified those
treated at date of the first prescription. Inverse Probability of
Treatment Weights (IPTW) were estimated including demographic and clinical
covariates, history of treatment with statins and the month/year
eligibility date. Competing risk models on weighted cohorts were used to
derive the Average Treatment Effect (ATE) and the Conditional Average
Treatment Effect (CATE) in subgroups of interest. Out of 1976 eligible
subjects, 161 (8%) received treatment with PCSK9-i. Treated individuals
were slightly younger, predominantly male, had more severe CV conditions,
and were more often treated with statin compared to the untreated
subjects. The latter exhibited a higher prevalence of non-CV
comorbidities. A significant absolute and relative risk reduction of death
and a lower relative risk for the first hospitalization was observed. The
risk reduction for death was confirmed in CATE analysis. PCSk9-i were
prescribed to a minority of eligible subjects. Within the TTE framework,
the analysis confirmed the association between PCSK9-i and lower risk of
events, aligning with findings from randomized clinical trials (RCTs). In
our study, PCSK9-i provided protection specifically against all-cause
death, expanding upon the evidence from RCTs that had primarily focused on
composite CV outcomes.<br/>Copyright &#xa9; 2024 Barbati et al. This is an
open access article distributed under the terms of the Creative Commons
Attribution License, which permits unrestricted use, distribution, and
reproduction in any medium, provided the original author and source are
credited.

<4>
Accession Number
2033500609
Title
Comparing Left Bundle Branch Area vs Right-Ventricular Septal Pacing in
High-Degree Conduction Disease After Transcatheter Aortic Valve
Replacement: Randomized Trial Study Protocol.
Source
CJC Open. 6(9) (pp 1058-1065), 2024. Date of Publication: September 2024.
Author
Liskov S.; Olleik F.; Jarrett H.; Abramson S.; Kowey P.; Schaller R.D.;
Vijayaraman P.; Habibi M.; Bansal S.; Heimann M.; Cox S.; Keramati A.R.
Institution
(Liskov) Section of Cardiac Electrophysiology, Division of Cardiology,
Johns Hopkins Hospital, Baltimore, MD, United States
(Liskov, Jarrett, Abramson, Kowey, Bansal, Keramati) Lankenau Institute
for Medical Research, Wynnewood, PA, United States
(Olleik, Jarrett, Abramson, Kowey, Heimann, Cox, Keramati) Lankenau Heart
Institute, Lankenau Medical Center, Wynnewood, PA, United States
(Abramson, Kowey) Sidney Kimmel Medical College of Thomas Jefferson
University, Philadelphia, PA, United States
(Schaller) Electrophysiology Section, Cardiovascular Medicine Division,
Hospital of the University of Pennsylvania, Philadelphia, PA, United
States
(Vijayaraman) Geisinger Heart Institute, Wilkes-Barre, PA, United States
(Habibi) Valley Health System, Paramus, NJ, United States
Publisher
Elsevier Inc.
Abstract
Left bundle branch area pacing (LBBAP) is a novel method of
conduction-system pacing in the muscular interventricular septum. Although
LBBAP has been shown to produce physiologic electrical and mechanical
intraventricular synchrony, superiority of LBBAP, compared to right
ventricular septal pacing (RVSP) at preserving normal left-ventricular
(LV) systolic function after transcatheter aortic valve replacement (TAVR)
has not been demonstrated. Left Bundle BRAVE is an investigator-initiated,
multicentre, prospective, double-blinded, randomized, crossover study
investigating the superiority of LBBAP, compared to RVSP, with respect to
preservation of systolic function in patients with high-degree conduction
disease after TAVR. Adults with severe aortic stenosis and normal systolic
function who sustain high-grade atrioventricular block within 4 weeks of
TAVR are eligible. All subjects receive a biventricular pacemaker
generator with RVSP, and LBBAP leads. Participants are randomly assigned
to 9 months of each pacing mode, in series. The primary endpoint is change
in global longitudinal strain, tested in series with change in LV ejection
fraction, comparing RVSP to LBBAP. Secondary endpoints include the
following: echocardiographic markers of interventricular synchrony and
right ventricular performance; heart failure functional status and symptom
classification; 6-minute walk test results; pacemaker and lead
performance; and brain natriuretic peptide concentration. The Left Bundle
BRAVE study is designed to identify an upstream and clinically relevant
marker of superiority in LBBAP, compared to RVSP, at preventing
deterioration of LV function in patients with a high ventricular pacing
burden after TAVR. ClinicalTrials.gov identifier:
NCT05541679<br/>Copyright &#xa9; 2024 The Authors

<5>
Accession Number
2031143546
Title
Optimization of Hypothermic Protocols for Neurocognitive Preservation in
Aortic Arch Surgery: A Literature Review.
Source
Journal of Cardiovascular Development and Disease. 11(8) (no pagination),
2024. Article Number: 238. Date of Publication: August 2024.
Author
Llerena-Velastegui J.; Velastegui-Zurita S.; Zumbana-Podaneva K.;
Mejia-Mora M.; Jesus A.C.F.S.D.; Coelho P.M.
Institution
(Llerena-Velastegui, Velastegui-Zurita, Zumbana-Podaneva, Mejia-Mora)
Medical School, Pontifical Catholic University of Ecuador, Quito 170525,
Ecuador
(Llerena-Velastegui) Research Center, Center for Health Research in Latin
America (CISeAL), Quito 170530, Ecuador
(Jesus, Coelho) Medical School, Faculdade de Minas-FAMINAS-BH, Belo
Horizonte 31744-007, Brazil
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Shifts from deep to moderate hypothermic circulatory arrest (HCA) in
aortic arch surgery necessitate an examination of their differential
impacts on neurocognitive functions, especially structured verbal memory,
given its significance for patient recovery and quality of life. This
study evaluates and synthesizes evidence on the effects of deep (<=20.0
degreeC), low-moderate (20.1-24.0 degreeC), and high-moderate (24.1-28.0
degreeC) hypothermic temperatures on structured verbal memory preservation
and overall cognitive health in patients undergoing aortic arch surgery.
We evaluated the latest literature from major medical databases such as
PubMed and Scopus, focusing on research from 2020 to 2024, to gather
comprehensive insights into the current landscape of temperature
management during HCA. This comparative analysis highlights the viability
of moderate hypothermia (20.1-28.0 degreeC), supported by recent trials
and observational studies, as a method to achieve comparable
neuroprotection with fewer complications than traditional deep
hypothermia. Notably, low-moderate and high-moderate temperatures have
been shown to support substantial survival rates, with impacts on
structured verbal memory preservation that necessitate careful selection
based on individual surgical risks and patient profiles. The findings
advocate for a nuanced approach to selecting hypothermic protocols in
aortic arch surgeries, emphasizing the importance of tailoring temperature
management to optimize neurocognitive outcomes and patient recovery. This
study fills a critical gap in the literature by providing evidence-based
recommendations for temperature ranges during HCA, calling for ongoing
updates to clinical guidelines and further research to refine these
recommendations. The implications of temperature on survival rates,
complications, and success rates underpin the necessity for evolving
cardiopulmonary bypass techniques and cerebral perfusion strategies to
enhance patient outcomes in complex cardiovascular
procedures.<br/>Copyright &#xa9; 2024 by the authors.

<6>
Accession Number
645145599
Title
Immediate effects of upper limb exercises with and without deep breathing
on lung function after cardiac surgery - a randomized crossover trial.
Source
Journal of cardiothoracic surgery. 19(1) (pp 503), 2024. Date of
Publication: 28 Aug 2024.
Author
Reinhart M.; Jonsson M.; Enthoven P.; Westerdahl E.
Institution
(Reinhart, Jonsson, Westerdahl) Department of Physiotherapy, Faculty of
Medicine and Health, Orebro University, SE 70185, Sweden
(Reinhart, Enthoven) Department of Health, Medicine and Caring Sciences,
Division of Prevention, Rehabilitation and Community Medicine, Unit of
Physiotherapy, Linkoping University, Linkoping, SE 58183, Sweden
(Westerdahl) University Health Care Research Center, Faculty of Medicine
and Health, Orebro University, SE 70185, Sweden
Abstract
BACKGROUND: Open heart surgery, involving median sternotomy, may cause
diminished chest wall motion and restrictive pulmonary function in the
early postoperative period. Thoracic and upper extremity range of motion
(ROM) exercises are often recommended after surgery but have not been
evaluated regarding effect on lung volumes and oxygenation. The objective
of this study was to evaluate the immediate effect of upper limb
elevations, with or without simultaneous deep breathing, on lung function
after cardiac surgery. <br/>METHOD(S): In a randomized 2x2 crossover
trial, 22 adult patients (>18 years old) were assessed during one of the
first days after surgery in the spring of 2022 at Orebro University
Hospital, Sweden. Exercises involving five bilateral upper limb
elevations, performed either with simultaneous deep breathing (ROM-DB) or
without (ROM), while sitting in an upright position at the edge of the
bed, were evaluated. Peripheral oxygen saturation (Rad-5v; Masimo, Irvine,
USA) was the primary outcome. Tidal volume and respiratory rate were
recorded continuously during the exercises (Spiropalm; Cosmed, Rome,
Italy). Heart rate, pain, exertion and dyspnoea were evaluated before and
after the exercises. <br/>RESULT(S): Both ROM-DB and ROM momentarily
increased peripheral oxygen saturation (+1% +/- 1, p=0.004 and +1% +/- 1,
p<0.001, respectively), with no significant differences between these
exercises (p=0.525). ROM-DB significantly increased the VT compared with
ROM (798+/-316 vs. 602 mL+/-176, p=0.004). However, ROM-DB induced more
pronounced pain (p=0.012), exertion (p=0.035) and dyspnoea (p=0.013) than
ROM. <br/>CONCLUSION(S): Upper limb elevations improved oxygenation
momentarily, both performed with and without simultaneous deep breathing,
with no significant differences between these exercises. The additive deep
breathing improved tidal volume compared with upper limb elevations alone,
but induced more pain, exertion and dyspnoea during the performance of
exercise. TRIAL REGISTRATION: ClinicalTrials.gov
(NCT05278819).<br/>Copyright &#xa9; 2024. The Author(s).

<7>
Accession Number
2031217870
Title
Kinesiophobia in patients after cardiac surgery: a scoping review.
Source
BMC Cardiovascular Disorders. 24(1) (no pagination), 2024. Article Number:
469. Date of Publication: December 2024.
Author
Zeng Z.; Shen Y.; Wan L.; Yang X.; Hu Q.; Luo H.; He M.
Institution
(Zeng) School of Nursing, North Sichuan Medical College, Sichuan,
Nanchong, China
(Zeng, Shen, Wan, Yang, Hu, Luo, He) Affiliated with the School of
Medicine, Mianyang Central Hospital, University of Electronic Science and
Technology of China, Sichuan, Mianyang, China
(He) Department of Nursing, Affiliated with the School of Medicine,
Mianyang Central Hospital, University of Electronic Science and Technology
of China, No.12 Changjia Alley, Jingzhong Street, Fucheng District,
Sichuan, Mianyang 621000, China
Publisher
BioMed Central Ltd
Abstract
Background: This paper reviews the scope of research on kinesiophobia in
patients after cardiac surgery. Further, it reviews the current situation,
evaluation tools, risk factors, adverse effects, and intervention methods
of kinesiophobia to provide a reference for promoting early rehabilitation
of patients after cardiac surgery. <br/>Method(s): Guided by the scoping
methodology, the Web of Science, PubMed, CINAHL, Cochrane Library, China
Biomedical Literature Database, VIP Database, Wanfang Database, CNKI, and
other databases were searched from database inception until July 31, 2024.
The studies obtained were screened, summarised and systematically analysed
by two researchers. <br/>Result(s): Eighteen studies (16 cross-sectional
studies, one qualitative study, and one randomised controlled trial) were
included. The incidence of kinesiophobia in patients after cardiac surgery
was 39.20-82.57%, and the Tampa Scale for Kinesiophobia Heart (TSK-SV
Heart) was used to evaluate this incidence. The influencing factors of
kinesiophobia in patients after cardiac surgery included demographic
characteristics, pain severity, frailty, exercise self-efficacy,
disease-related factors, and psychosocial factors. Kinesiophobia led to
adverse health outcomes such as reduced recovery, prolonged hospital
stays, and decreased quality of life in patients after cardiac surgery,
and there were few studies on intervention methods for postoperative
kinesiophobia. <br/>Conclusion(s): The kinesiophobia assessment tools
suitable for patients after cardiac surgery should be improved, and
intervention methods to promote the early recovery of patients after major
clinical surgery and those with difficult and critical diseases should be
actively researched.<br/>Copyright &#xa9; The Author(s) 2024.

<8>
Accession Number
2034397053
Title
Long-Term Results Following Transcatheter Versus Surgical Aortic Valve
Replacement in Low-Risk Patients With Severe Aortic Stenosis: A Systematic
Review and Meta-Analysis of Randomized Trials.
Source
American Journal of Cardiology. 230 (pp 6-13), 2024. Date of Publication:
01 Nov 2024.
Author
Caminiti R.; Ielasi A.; Vetta G.; Parlavecchio A.; Rocca D.G.D.; Glauber
M.; Tespili M.; Vizzari G.; Micari A.
Institution
(Caminiti, Ielasi, Tespili) Unita Operativa Cardiologia Ospedaliera, IRCCS
Ospedale Galeazzi Sant'Ambrogio, Milan, Italy
(Vetta, Rocca) Heart Rhythm Management Centre, Postgraduate Program in
Cardiac Electrophysiology and Pacing, UniversitairZiekenhuis Brussel-Vrije
Universiteit Brussel, European Reference Networks Guard-Heart, Brussels,
Belgium
(Parlavecchio, Vizzari, Micari) Cardiology Unit, Department of Clinical
and Experimental Medicine, University of Messina, Messina, Italy
(Glauber) Mini-Invasive Cardiac Surgery Unit, IRCCS Ospedale Galeazzi
Sant'Ambrogio, Milan, Italy
(Caminiti, Ielasi, Tespili) Cardiology Division, IRCCS Galeazzi
Sant'Ambrogio Hospital, Milan, Italy
Publisher
Elsevier Inc.
Abstract
Transcatheter aortic valve replacement (TAVR) is a safe and effective
treatment option for patients with severe aortic stenosis at intermediate
or high surgical risk. Results after TAVR in low-risk patients are very
encouraging at midterm follow-up, whereas limited long-term (>=3 year)
data are available in this subset of patients. This meta-analysis aims to
compare the long-term follow-up after TAVR versus surgical aortic valve
replacement (SAVR) in low-risk patients. We searched databases up to July
7, 2024 for randomized clinical trials comparing TAVR versus SAVR in
low-risk patients (defined as Society of Thoracic Surgeons Predicted Risk
of Mortality score <4%) (PROSPERO ID: CRD42023480495). Primary outcome
analyzed was all-cause death at a minimum of 3 years of follow-up. The
secondary outcomes were cardiovascular death, disabling stroke, myocardial
infarction, aortic valve reintervention, endocarditis, new-onset atrial
fibrillation, permanent pacemaker implantation, and bioprosthetic valve
failure. A total of 3 randomized clinical trials with 2,644 patients (TAVR
n = 1,371 patients; SAVR n = 1,273 patients) were included. The follow-up
time was 6 +/- 2.9 years. TAVR resulted noninferior to SAVR for all-cause
death (risk ratio [RR] 0.99, 95% confidence interval [CI] 0.84 to 1.17, p
= 0.89, I² = 28%), cardiovascular death (RR 0.94, 95% CI 0.76
to 1.15, p = 0.54, I² = 0%), myocardial infarction (RR 1.06,
95% CI 0.71 to 1.57, p = 0.79, I² = 61%), aortic valve
reintervention, endocarditis, and bioprosthetic valve failure. New-onset
atrial fibrillation was more common in the SAVR group, whereas permanent
pacemaker implantation was more common in the TAVR group. In conclusion,
our meta-analysis showed that TAVR is associated with similar long-term
outcomes compared with SAVR in selected low-risk patients.<br/>Copyright
&#xa9; 2024 Elsevier Inc.

<9>
Accession Number
2030087576
Title
Is dental clearance before cardiac surgery necessary?.
Source
Cardiovascular Medicine. 27(2) (pp 47-51), 2024. Date of Publication:
2024.
Author
Celik M.; Nucera M.; Pregaldini F.; Pingpoh C.; Pilgrim T.; Siepe M.;
Reineke D.
Institution
(Celik, Nucera, Pregaldini, Pingpoh, Siepe, Reineke) Department of Cardiac
Surgery, University Hospital Inselspital Bern, University of Bern,
Switzerland
(Pilgrim) Department of Cardiology, University Hospital Inselspital Bern,
University of Bern, Switzerland
Publisher
EMH Schweizerischer Arzteverlag AG
Abstract
Background: Dental clearance is routinely performed before cardiac
surgery, as it is thought to be essential in reducing postoperative
bacteremia and endocarditis. However, there is a lack of evidence
supporting this routine. <br/>Objective(s): This study aimed to
investigate the impact of dental clearance on postoperative outcomes after
cardiac surgery. <br/>Method(s): This is a comprehensive review and
analysis of relevant studies published between January 1, 1990 and January
1, 2023 in two electronic databases (PubMed and EMBASE). Pooled estimates
in terms of relative risk (RR) or standardized mean difference were
calculated according to outcome measures. Risk of bias and quality of
studies were evaluated. A total of 7040 articles were found through the
MEDLINE, EMBASE and Cochrane databases. Five articles were found to be
eligible for inclusion in this review. <br/>Result(s): There is no
statistically significant benefit of preoperative dental clearance in
terms of postoperative outcomes, including all-cause mortality (RR 0.92,
95% Confidence Interval [CI] 0.43-1.97), prosthetic valve endocarditis (RR
1.32, 95% CI 0.51-3.43), postsurgical infection (RR 1.02, 95% CI
0.77-1.36), and length of hospital stay (weighted mean difference 4.00,
95% CI -2.70-10.70). <br/>Conclusion(s): Although the literature
emphasizes the importance of preoperative dental clearance, no significant
effect was seen with respect to all-cause mortality, infection,
endocarditis, and length of hospital stay.<br/>Copyright &#xa9; 2024, EMH
Schweizerischer Arzteverlag AG. All rights reserved.

<10>
Accession Number
2034347730
Title
Potassium Supplementation and Prevention of Atrial Fibrillation After
Cardiac Surgery The TIGHT K Randomized Clinical Trial.
Source
JAMA. (no pagination), 2024. Date of Publication: 2024.
Author
O'Brien B.; Campbell N.G.; Allen E.; Jamal Z.; Sturgess J.; Sanders J.;
Opondo C.; Roberts N.; Aron J.; Maccaroni M.R.; Gould R.; Kirmani B.H.;
Gibbison B.; Kunst G.; Zarbock A.; Kleine-Bruggeney M.; Stoppe C.; Pearce
K.; Hughes M.; Van Dyck L.; Evans R.; Montgomery H.E.; Elbourne D.
Institution
(O'Brien, Kleine-Bruggeney, Stoppe) Deutsches Herzzentrum der Charite,
Charite - Universitatsmedizin Berlin, Germany
(O'Brien, Sanders, Roberts) St Bartholomew's Hospital, Barts Health NHS
Trust, London, United Kingdom
(O'Brien) Outcomes Research Consortium, Cleveland, OH, United States
(Campbell) University of Manchester, Manchester Academic Health Science
Centre, Manchester, United Kingdom
(Campbell, Pearce) Manchester University, NHS Foundation Trust,
Manchester, United Kingdom
(Allen, Jamal, Sturgess, Opondo, Hughes, Van Dyck, Evans, Elbourne) London
School of Hygiene & Tropical Medicine, London, United Kingdom
(Sanders, Kunst, Hughes) King's College London, London, United Kingdom
(Aron) St George's University Hospital, NHS Foundation Trust, London,
United Kingdom
(Maccaroni) Basildon University Hospital NHS Trust, Basildon, United
Kingdom
(Gould) Leeds General Infirmary, Leeds, United Kingdom
(Kirmani) Liverpool Heart and Chest Hospital, Liverpool, United Kingdom
(Gibbison) University of Bristol, Bristol, United Kingdom
(Gibbison) University Hospitals Bristol, Weston NHS Foundation Trust,
Bristol, United Kingdom
(Kunst) King's College Hospital NHS Foundation Trust, London, United
Kingdom
(Zarbock) University Hospital Munster, Munster, Germany
(Stoppe) University Hospital, Wurzburg, Wurzburg, Germany
(Montgomery) University College London, London, United Kingdom
Publisher
American Medical Association
Abstract
IMPORTANCE Supplementing potassium in an effort to maintain high-normal
serum concentrations is a widespread strategy used to prevent atrial
fibrillation after cardiac surgery (AFACS), but is not evidence-based,
carries risks, and is costly. OBJECTIVE To determine whether a lower serum
potassium concentration trigger for supplementation is noninferior to a
high-normal trigger. DESIGN, SETTING, AND PARTICIPANTS This open-label,
noninferiority, randomized clinical trial was conducted at 23 cardiac
surgical centers in the United Kingdom and Germany. Between October 20,
2020, and November 16, 2023, patients with no history of atrial
dysrhythmias scheduled for isolated coronary artery bypass grafting (CABG)
surgery were enrolled. The last study patient was discharged from the
hospital on December 11, 2023. INTERVENTIONS Patients were randomly
assigned to a strategy of tight or relaxed potassium control (only
supplementing if serum potassium concentration fell below 4.5 mEq/L or 3.6
mEq/L, respectively). Patients wore an ambulatory heart rhythm monitor,
which was analyzed by a core laboratory masked to treatment assignment.
MAIN OUTCOMES AND MEASURES The prespecified primary end point was
clinically detected and electrocardiographically confirmed new-onset AFACS
in the first 120 hours after CABG surgery or until hospital discharge,
whichever occurred first. All primary outcome events were validated by an
event validation committee, which was masked to treatment assignment.
Noninferiority of relaxed potassium control was defined as a risk
difference for new-onset AFACS with associated upper bound of a 1-sided
97.5% CI of less than 10%. Secondary outcomes included other heart
rhythm-related events, clinical outcomes, and cost related to the
intervention. RESULTS A total of 1690 patients (mean age, 65 years; 256
[15%] females) were randomized. The primary end point occurred in 26.2% of
patients (n = 219) in the tight group and 27.8% of patients (n = 231) in
the relaxed group, which is a risk difference of 1.7% (95% CI, -2.6% to
5.9%). There was no difference between the groups in the incidence of at
least 1 AFACS episode detected by any means or by ambulatory heart rhythm
monitor alone, non-AFACS dysrhythmias, in-patient mortality, or length of
stay. Per-patient cost for purchasing and administering potassium was
significantly lower in the relaxed group (mean difference, $111.89 [95%
CI, $103.60-$120.19]; P < .001). CONCLUSIONS AND RELEVANCE For AFACS
prophylaxis, supplementation only when serum potassium concentration fell
below 3.6 mEq/L was noninferior to the current widespread practice of
supplementing potassium to maintain a serum potassium concentration
greater than or equal to 4.5 mEq/L. The lower threshold of supplementation
was not associated with any increase in dysrhythmias or adverse clinical
outcomes.<br/>Copyright &#xa9; 2024 American Medical Association. All
rights reserved.

<11>
Accession Number
2034335668
Title
Coronary artery bypass grafting in acute coronary syndromes: modern
indications and approaches.
Source
Current Opinion in Cardiology. (no pagination), 2024. Date of
Publication: 2024.
Author
Sandner S.; Florian A.; Ruel M.
Institution
(Sandner, Florian) Department of Cardiac Surgery, Medical University of
Vienna, Vienna, Austria
(Sandner) Department of Cardiothoracic Surgery, Weill Cornell Medicine,
New York, NY, United States
(Ruel) Division of Cardiac Surgery, University of Ottawa Heart Institute,
Ottawa, ON, Canada
Publisher
Lippincott Williams and Wilkins
Abstract
Purpose of review Acute coronary syndromes (ACS) are a leading cause of
morbidity and mortality worldwide, with approximately 1.2 million
hospitalizations annually in the U.S. This review aims to explore the
contemporary evidence regarding revascularization strategies, including
percutaneous coronary intervention (PCI) and coronary artery bypass
grafting (CABG), in ACS patients. It also addresses the unresolved
questions concerning the optimal procedural aspects of surgery and
antithrombotic therapy for secondary prevention postsurgery. Recent
findings Recent studies highlight that while PCI is generally preferred
for its timeliness in high-risk non-ST-elevation ACS (NSTE-ACS) patients,
CABG offers a benefit in terms of cardiovascular events in those with
multivessel disease, particularly in the presence of diabetes and higher
coronary disease complexity. For ST-elevation myocardial infarction
(STEMI), CABG is less frequently utilized due to the preference for
primary PCI, but it remains crucial for patients with complex anatomy or
failed PCI. Furthermore, the optimal timing and type of antiplatelet
therapy post-CABG remain controversial, with current evidence supporting
the use of dual antiplatelet therapy (DAPT) to reduce ischemic events but
necessitating careful management to balance bleeding risks. Summary In
patients with ACS, the choice between PCI and CABG depends on the
complexity of coronary disease and patient comorbidities. CABG is
particularly beneficial for multivessel disease in NSTE-ACS and specific
STEMI cases where PCI is not feasible. The management of antiplatelet
therapy postsurgery requires a nuanced approach to minimize bleeding risks
while preventing thrombotic complications. Further randomized clinical
trials are needed to solidify these findings and guide clinical
practice.<br/>Copyright &#xa9; 2024 The Author(s).

<12>
Accession Number
2034304419
Title
Efficacy and safety of left atrial appendage closure procedure in patients
with non-valvular atrial fibrillation with contraindication and/or failure
for oral anticoagulants: A systematic review and meta-analysis.
Source
Clinics. 79 (no pagination), 2024. Article Number: 100465. Date of
Publication: 01 Jan 2024.
Author
Simoes R.D.S.; Bortoluzzi A.F.R.; Marinho J.C.N.; Galendi J.S.C.; Bernardo
W.M.
Institution
(Simoes, Bortoluzzi, Marinho, Galendi, Bernardo) Nucleo de Avaliacao de
Tecnologias em Saude da Unimed do Brasil, Unimed do Brasil, Sao Paulo, SP,
Brazil
Publisher
Universidade de Sao Paulo. Museu de Zoologia
Abstract
Background: With the aim of reducing the risk of Cerebrovascular Accident
(CVA) in patients with Non-Valvular Atrial Fibrillation (NVAF), Left
Atrial Appendage Occlusion (LAAO) devices are emerging as an alternative
to oral anticoagulants. <br/>Objective(s): To analyze the efficacy and
safety of the LAAO procedure in patients with NVAF and contraindications
and/or failure for oral anticoagulants. <br/>Method(s): The search for
evidence was carried out in the electronic databases Medline and Embase
till January 2024. Additional searches were conducted on Google Scholar.
The clinical trials registry database was also consulted. Two blinded
investigators performed the search, study selection, and data collection,
and assessed quality and risk of bias using the Cochrane tool for
randomized clinical trials. Meta-analyses of eligible trials were
performed using RevMan 5.4.1 software. The random effects model was used
for all analyses. <br/>Result(s): Five articles were selected, among which
three were non-inferiority randomized clinical trials that analyzed the
performance and safety of LAAO devices compared to the use of Vitamin K
Antagonists (AVKs) or Novel Oral Anticoagulants (NOACs). No randomized
clinical trials were found that analyzed populations with absolute
contraindications to oral anticoagulants. Having as primary outcomes
analyzed the occurrence of stroke (ischemic or hemorrhagic),
cardiovascular or unexplained death and systemic embolism, the
non-inferiority of the LAAO procedure compared to the use of oral
anticoagulants was verified. <br/>Conclusion(s): For patients with an
absolute contraindication to anticoagulation and/or failure to use oral
anticoagulants, evidence for the use of LAAO devices is
scarce.<br/>Copyright &#xa9; 2024

<13>
Accession Number
2034294565
Title
Efficacy of Single-port Thoracoscopic Resection of Benign Lung Tumors and
Its Impacts on Respiratory Function and Inflammatory Factors: A Randomized
Controlled Study.
Source
Iranian Journal of Allergy, Asthma and Immunology. 23(4) (pp 403-411),
2024. Date of Publication: 2024.
Author
Wang Q.; Deng M.; Wang B.
Institution
(Wang, Deng, Wang) Department of Cardiothoracic Surgery, Renmin Hospital,
Hubei University of Medicine, Shiyan, China
Publisher
Tehran University of Medical Sciences
Abstract
Peripheral benign lung tumors are often asymptomatic and incidentally
detected on chest radiographs. Surgical intervention is recommended when
feasible. Single-port thoracoscopic resection has emerged as a promising
technique for treating various chest diseases, including lung tumors. This
study aimed to assess the clinical efficacy of single-port thoracoscopic
resection for benign lung tumors and its impact on respiratory function
and inflammatory factors. A total of 128 eligible patients diagnosed with
benign lung tumors were randomly assigned to either the observation group
(undergoing single-port thoracoscopic resection) or the control group
(undergoing conventional thoracic surgery). Surgical outcomes,
complications, pulmonary and respiratory function, and inflammatory
factors were compared between the two groups. The observation group showed
significantly lower intraoperative bleeding, shorter hospitalization time,
and lower complication rates compared to the control group. Patients in
the observation group exhibited higher vital capacity (VC), forced vital
capacity (FVC), and total lung capacity (TLC) levels at 1/2 week and 1
month after surgery. Additionally, forced expiratory volume in one second
(FEV1) and maximum ventilation volume per minute (MVV) levels were higher
in the observation group post-surgery, with a lower Borg score. Levels of
C-reactive protein (CRP), precalcitonin (PCT), and tumor necrosis factor
(TNF-alpha) were lower in the observation group post-surgery. Single-port
thoracoscopic resection demonstrates favorable clinical efficacy for
treating benign lung tumors, reducing bleeding, and shortening hospital
stays. Furthermore, it improves lung and respiratory function while
reducing inflammatory factors. This technique is safe, effective, and
holds promise for wider application in managing benign lung
tumors.<br/>Copyright &#xa9; 2024 Wang et al.

<14>
Accession Number
2034284776
Title
Malnutrition and gastrointestinal complications following pediatric
cardiac surgery.
Source
International Tinnitus Journal. 28(1) (pp 54-59), 2024. Date of
Publication: 01 Apr 2024.
Author
Husain O.F.; Olaimat Y.R.; Alhalaki M.M.; Al-Rowwad K.A.; Al-Qawasmeh
R.S.; Muzher F.A.A.; Shaheen M.W.M.; Abusabra B.K.
Institution
(Husain, Olaimat, Alhalaki, Al-Rowwad, Al-Qawasmeh, Muzher, Shaheen,
Abusabra) Department of Pediatric, Jordan University Hospital, Jordan
Publisher
International Tinnitus Journal
Abstract
Complications are situations which occur as a consequence to a disease or
surgery that diverts from the treatment plan, and may lead to or be
associated with negative unpredicted outcome. Complications are not a
result of poor care that would constitute malpractice or neglect in the
medical field. within 30 days of surgery or after any type of Intervention
(1), difficulties might arise. These complications can happen inside or
outside of the hospital, and are mentioned as operational or procedural
complications. Difficulties here may arise during operations or
procedures, as well as postoperative and postprocedural issues.
encompasses numerous databases, treatments, and various modes of therapy
in a single language. A thorough plan has been prepared through the Multi
Social Database Committee for Pediatric and Congenital Heart Disease.
Although it is uncommon to encounter severe Gastrointestinal (GI)
complications following congenital cardiac surgery, it is difficult to
estimate their incidences with any degree of accuracy. This is caused in
part by the absence of a uniform reporting process. and a common
nomenclature for organ-specific complications. The goals of this review
are to find gastrointestinal problems and malnutrition after juvenile
heart surgery. Both manual and electronic search of literature was carried
out. The Multi Societal Database Committee for Pediatric and Congenital
Heart Disease has created an extensive inventory of GI issues that could
be related to congenital heart surgery. By employing this list, databases
and healthcare professionals can facilitate the comparison of treatment
modalities, the reporting of concerns, and the pursuit of refining the
quality of care for patients with congenital heart disease.<br/>Copyright
&#xa9; 2024 International Tinnitus Journal. All rights reserved.

<15>
Accession Number
644403570
Title
Perceived family-centered care and post-traumatic stress in parents of
infants cared for in the paediatric cardiac intensive care unit.
Source
Nursing in critical care. 29(5) (pp 1059-1066), 2024. Date of Publication:
01 Sep 2024.
Author
Lisanti A.J.; Min J.; Golfenshtein N.; Marino B.S.; Curley M.A.Q.;
Medoff-Cooper B.
Institution
(Lisanti, Curley, Medoff-Cooper) Department of Family and Community
Health, School of Nursing, University of Pennsylvania, Philadelphia, PA,
United States
(Lisanti, Curley, Medoff-Cooper) Research Institute, Children's Hospital
of Philadelphia, Philadelphia, PA, United States
(Min) Department of Biomedical and Health Informatics, Research Institute,
Children's Hospital of Philadelphia, Philadelphia, PA, United States
(Golfenshtein) Department of Nursing, University of Haifa, Haifa, Israel
(Marino) Department of Pediatric Cardiology, Cleveland Clinic Children's,
Cleveland, OH, United States
Abstract
BACKGROUND: Family-centred care (FCC), while a core value of paediatric
hospitals, has not been well-studied in the paediatric cardiac intensive
care unit (PCICU). AIM: To describe parents' perceptions of FCC provided
by nurses in the PCICU during their infant's recovery from neonatal
cardiac surgery and explore associations of perceptions of FCC on parent
post-traumatic stress (PTS) 4months post-discharge. STUDY DESIGN: Data
obtained from a previously conducted randomized clinical trial (RCT) on
telehealth home monitoring after neonatal cardiac surgery at three
free-standing paediatric hospitals were analysed from a subset of 164
parents who completed the FCC Scale at hospital discharge, which measures
a parent's experience of nursing care that embodies core principles of
FCC. The RCT intervention was provided after hospital discharge, having no
influence on parent's perception of FCC. The intervention also had no
effect on PTS. <br/>RESULT(S): Perceived FCC was lowest for items 'nurses
helped me feel welcomed' and 'nurses helped me feel important in my
child's care'. Having 12%-19% points lower perception of FCC at hospital
discharge was associated with parent experience of six or more PTS
symptoms, at least moderate PTS symptom severity, or PTS disorder
diagnosis at 4-month follow-up. Every 10% increase in parental perceptions
of FCC was associated with less PTS symptoms (beta=-0.29, SE=0.12; p=.02)
and lower PTS symptom cluster scores of arousal (beta=-0.18, SE=0.08;
p=.02). <br/>CONCLUSION(S): Parents who perceived lower FCC during their
infants' hospitalization were at increased risk for the development of PTS
symptoms, more PTS symptom severity and PTS disorder diagnosis 4-months
post-discharge. RELEVANCE TO CLINICAL PRACTICE: Nurses have a prominent
role to support the implementation of FCC for infants with cardiac defects
and their parents. FCC may positively influence overall parent mental
health and well-being, reducing the trauma and distress of the PCICU
experience.<br/>Copyright &#xa9; 2024 The Author(s). Nursing in Critical
Care published by John Wiley & Sons Ltd on behalf of British Association
of Critical Care Nurses.

<16>
Accession Number
2031185806
Title
Influence of Previous Coronary Artery Bypass Grafting on Clinical Outcomes
After Percutaneous Coronary Intervention: A Meta-Analysis of 250 684
Patients.
Source
Clinical Medicine Insights: Cardiology. 18 (no pagination), 2024. Date of
Publication: January-December 2024.
Author
Larik M.O.; Ahmed A.; Shahid A.R.; Irfan H.; Irfan A.; Jibran M.
Institution
(Larik, Shahid) Department of Medicine, Dow International Medical College,
Karachi, Pakistan
(Ahmed) Department of Medicine, King Edward Medical University/Mayo
Hospital, Lahore, Pakistan
(Irfan) Department of Medicine, Shaikh Khalifa Bin Zayed Al Nahyan Medical
and Dental College, Lahore, Pakistan
(Irfan) Department of Medicine, Dow Medical College, Karachi, Pakistan
(Jibran) Department of Internal Medicine, TidalHealth Peninsula Regional,
Salisbury, MD, United States
Publisher
SAGE Publications Ltd
Abstract
Background: Percutaneous coronary intervention (PCI), also known as
coronary angioplasty, is the preferred strategy for treating obstructive
coronary artery disease. Existing literature suggests the worsening of
clinical outcomes in patients with previous coronary artery bypass
grafting (CABG) history. In light of this, a comprehensive systematic
review and meta-analysis was performed. <br/>Method(s): Databases
including PubMed, Cochrane Library, and ScienceDirect were utilized for
the inclusive systematic search dating from inception to September 01,
2023. The risk of bias assessment was performed using the Newcastle-Ottawa
scale for cohort studies, and the Cochrane Risk of Bias Tool for
randomized controlled trials. <br/>Result(s): Ultimately, there were 16
eligible studies pooled together, involving a total of 250 684 patients,
including 231 552 CABG-naive patients, and 19 132 patients with a prior
history of CABG. Overall, patients with CABG history were associated with
significantly greater short-term mortality (P =.004), long-term mortality
(P =.005), myocardial infarction (P <.00001), major adverse cardiovascular
events (P =.0001), and procedural perforation (P <.00001). Contrastingly,
CABG-naive patients were associated with significantly greater risk of
cardiac tamponade (P =.02) and repeat CABG (P =.03). No significant
differences in stroke, bleeding, revascularization, or repeat PCI were
observed. <br/>Conclusion(s): Comparatively worsened clinical outcomes
were observed, as patients with prior CABG history typically exhibit
complex coronary anatomy, and have higher rates of comorbidities in
comparison to their CABG-naive counterparts. The refinement of current
procedural and surgical techniques, in conjunction with continued research
endeavors, are needed in order to effectively address this
trend.<br/>Copyright &#xa9; The Author(s) 2024.

<17>
Accession Number
2031181196
Title
Cardiac tamponade in people living with HIV: a systematic review of case
reports and case series.
Source
BMC Infectious Diseases. 24(1) (no pagination), 2024. Article Number: 882.
Date of Publication: December 2024.
Author
Keyvanfar A.; Najafiarab H.; Ramezani S.; Tehrani S.
Institution
(Keyvanfar, Tehrani) Infectious Diseases and Tropical Medicine Research
Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran,
Islamic Republic of
(Najafiarab) Preventative Gynecology Research Center, Shahid Beheshti
University of Medical Sciences, Tehran, Iran, Islamic Republic of
(Ramezani) School of Medicine, Faculty of Medicine, Babol University of
Medical Sciences, Babol, Iran, Islamic Republic of
Publisher
BioMed Central Ltd
Abstract
Background: Cardiac tamponade is a life-threatening condition requiring
prompt diagnosis and therapeutic intervention. Diagnosis and management of
cardiac tamponade in patients with human immunodeficiency virus (HIV)
infection pose a major challenge for clinicians. This study aimed to
investigate clinical characteristics, paraclinical findings, therapeutic
options, patient outcomes, and etiologies of cardiac tamponade in people
living with HIV. <br/>Method(s): Pubmed, Embase, Scopus, and Web of
Science databases were systematically searched for case reports or case
series reporting HIV-infected patients with cardiac tamponade up to
February 29, 2024. Baseline characteristics, clinical manifestations,
paraclinical findings, therapeutic options, patient outcomes, and
etiologies of cardiac tamponade were independently extracted by two
reviewers. <br/>Result(s): A total of 37 articles reporting 40
HIV-positive patients with cardiac tamponade were included. These patients
mainly experienced dyspnea, fever, chest pain, and cough. They were mostly
presented with abnormal vital signs, such as tachypnea, tachycardia,
fever, and hypotension. Physical examination predominantly revealed
elevated Jugular venous pressure (JVP), muffled heart sounds, and palsus
paradoxus. Echocardiography mostly indicated pericardial effusion, right
ventricular collapse, and right atrial collapse. Most patients underwent
pericardiocentesis, while others underwent thoracotomy, pericardiotomy,
and pericardiostomy. Furthermore, infections and malignancies were the
most common etiologies of cardiac tamponade in HIV-positive patients,
respectively. Eventually, 80.55% of the patients survived, while the rest
expired. <br/>Conclusion(s): Infections and malignancies are the most
common causes of cardiac tamponade in HIV-positive patients. If these
patients demonstrate clinical manifestations of cardiac tamponade,
clinicians should conduct echocardiography to diagnose it promptly. They
should also undergo pericardial fluid drainage and receive additional
therapy, depending on the etiology, to reduce the mortality
rate.<br/>Copyright &#xa9; The Author(s) 2024.

<18>
Accession Number
2030833162
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. 13(16) (no pagination), 2024.
Article Number: e034815. Date of Publication: 20 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)
Affiliations Cardiovascular Department, Humanitas Gavazzeni Hospital,
Bergamo, Italy
(Oliva, Chiarito, Cremonesi, Ferrante, Reimers, Condorelli, Stefanini,
Cao) Department of Biomedical Sciences, Humanitas University, MI, Pieve
Emanuele, Italy
(Oliva, Chiarito, Ferrante, Reimers, Condorelli, Stefanini) Cardio Center,
Humanitas Clinical and Research Hospital IRCCS, Rozzano, Italy
(Garot, Amabile, Cao) Institut Cardiovasculaire Paris Sud (ICPS), Hopital
Prive Jacques Cartier, RamsaySante, Massy, France
(Mehran) The Zena and Michael A. Wiener Cardiovascular Institute, Icahn
School of Medicine at Mount Sinai, New York, NY, United States
Publisher
American Heart Association Inc.
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 73 199 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%).
<br/>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.<br/>Copyright &#xa9; 2024 The Author(s).

<19>
Accession Number
2030801919
Title
Levosimendan and Atrial Fibrillation: A Meta-Analysis of Randomized
Controlled Trials.
Source
Arquivos Brasileiros de Cardiologia. 121(7) (no pagination), 2024. Article
Number: e20230856. Date of Publication: 2024.
Author
Wan H.; Feng J.; Ji P.; Chen W.; Zhang J.
Institution
(Wan, Feng, Ji, Chen, Zhang) Department of Emergency Medicine, The Second
Affiliated Hospital of Guangxi Medical University, Guangxi, Nanning, China
Publisher
Sociedade Brasileira de Cardiologia
Abstract
Background: Atrial fibrillation (AF) is a prevalent complication
associated with levosimendan; however, it remains uncertain whether there
are any disparities in the effects of levosimendan on non-postoperative
and postoperative AF. <br/>Objective(s): This study aimed to evaluate the
levosimendan effect on non-postoperative and postoperative AF by
conducting a meta-analysis of randomized control trials (RCTs).
<br/>Method(s): PubMed, Embase, Cochrane Library, and other databases were
searched. Pairs of reviewers identified RCTs that compared levosimendan
and placebo or other therapies, and the results reported AF events data.
Random effects models were used (at a significance level of 5%).
<br/>Result(s): Twenty-nine eligible trials comprising 6550 participants
were included, eleven of which evaluated the non-postoperative AF
incidence, and 18 included postoperative AF. The analysis revealed that
levosimendan elevated the AF risk significantly in the non-postoperative
group (OR, 1.62; 95% CI: 1.19-2.20; p=0.002) and reduced the AF incidence
in the postoperative group (OR, 0.65; 95% CI: 0.44-0.96; p=0.03). AF
occurrence decreased more significantly in patients who used levosimendan
after cardiac surgery (OR, 0.53; 95% CI: 0.32-0.88; p=0.02) than in
patients who used levosimendan before cardiac surgery (OR, 0.67; 95% CI:
0.42-1.06; p=0.09). Moreover, The AF risk was significantly elevated by
levosimendan large bolus dose (bolus dose>=12 mug/kg) (OR, 1.44; 95% CI:
1.10-1.88; p=0.004) and decreased by small bolus dose of levosimendan
(bolus dose<12 mug/kg) (OR, 0.64; 95% CI: 0.34-1.20; p=0.16).
<br/>Conclusion(s): Levosimendan was linked to an increased
non-postoperative AF incidence. The employment of levosimendan was
effective in preventing postoperative AF.<br/>Copyright &#xa9; 2024,
Sociedade Brasileira de Cardiologia. All rights reserved.

<20>
Accession Number
2034310534
Title
Effect on post-operative pulmonary complications frequency of high flow
nasal oxygen versus standard oxygen therapy in patients undergoing
esophagectomy for cancer: study protocol for a randomized controlled
trial-OSSIGENA study.
Source
Journal of Thoracic Disease. 16(8) (pp 5388-5398), 2024. Date of
Publication: 31 Aug 2024.
Author
Deana C.; Vecchiato M.; Azzolina D.; Turi S.; Boscolo A.; Pistollato E.;
Skurzak S.; Amici O.; Priolo S.; Tonini S.; Foti L.S.; Taddei E.; Aceto
P.; Martino A.; Ziccarelli A.; Cereser L.; Andreutti S.; De Carlo S.;
Lirussi K.; Barbariol F.; Cammarota G.; Polati E.; Forfori F.; Corradi F.;
Patruno V.; Navalesi P.; Maggiore S.M.; Lucchese F.; Petri R.; Bassi F.;
Romagnoli S.; Bignami E.G.; Vetrugno L.
Institution
(Deana, Andreutti, De Carlo, Lirussi, Barbariol, Lucchese, Bassi)
Anesthesia and Intensive Care 1, Department of Anesthesia and Intensive
Care, Health Integrated Agency of Friuli Centrale, Udine, Italy
(Vecchiato, Martino, Ziccarelli, Petri) General Surgery Unit, Department
of Surgery, Health Integrated Agency of Friuli Centrale, Udine, Italy
(Azzolina) Department of Preventive and Environmental Science, University
of Ferrara, Ferrara, Italy
(Azzolina) Clinical Trial and Biostatistics, Research and Development
Unit, University Hospital of Ferrara, Ferrara, Italy
(Turi) Department of Anesthesia and Intensive Care, IRCCS San Raffaele
Scientific Institute, Milan, Italy
(Boscolo, Pistollato, Navalesi) Department of Medicine, University of
Padua, Padua, Italy
(Boscolo, Navalesi) Anesthesia and Intensive Care Unit, Padua University
Hospital, Padua, Italy
(Boscolo) Department of Cardiac, Thoracic, Vascular Sciences, and Public
Health, University of Padova, Padua, Italy
(Skurzak) Section of Anesthesia and Intensive Care, Citta della Salute e
della Scienza, Turin, Italy
(Amici) Department of Anesthesia, ASST GOM Niguarda, Milan, Italy
(Priolo, Polati) Intensive Care and Anesthesia Unit, Azienda Ospedaliera
Universitaria Integrata (AOUI) Verona, Verona, Italy
(Tonini) Emergency Department, GB Morgagni-Pierantoni Hospital, Forli,
Italy
(Foti, Romagnoli) Department of Anesthesia and Critical Care, Azienda
Ospedaliero-Universitaria Careggi, Florence, Italy
(Taddei, Forfori, Corradi) Department of Surgical, Medical, Molecular
Pathology and Critical Care Medicine, University of Pisa, Pisa, Italy
(Aceto) Department of Emergency, Anesthesiologic and Reanimation Sciences,
Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
(Aceto) Department of Basic Biotechnological Science, Intensive and
Peri-Operative Clinics, Catholic University of the Sacred Heart, Rome,
Italy
(Cereser) Institute of Radiology, Department of Medicine, University of
Udine, University Hospital "S. Maria della Misericordia", Udine, Italy
(Cammarota) Department of Translational Medicine, Universita del Piemonte
Orientale, Novara, Italy
(Polati) Anesthesiology, Intensive Care and Pain Therapy Center,
Department of Surgery, University of Verona, Verona, Italy
(Patruno) Department of Pulmonology, S. Maria della Misericordia
University Hospital, Udine, Italy
(Maggiore, Vetrugno) Department of Anesthesiology, Critical Care Medicine
and Emergency, SS. Annunziata Hospital, Chieti, Italy
(Maggiore) Department of Innovative Technologies in Medicine and
Dentistry, Gabriele d'nnunzio University of Chieti-Pescara, Chieti, Italy
(Romagnoli) Health Science Department, Section of Anesthesia and Critical
Care, University of Florence, Florence, Italy
(Bignami) Anesthesiology, Critical Care and Pain Medicine Division,
Department of Medicine and Surgery, University of Parma, Parma, Italy
(Vetrugno) Department of Medical, Oral and Biotechnological Sciences,
University of Chieti-Pescara, Chieti, Italy
Publisher
AME Publishing Company
Abstract
Background: Postoperative pulmonary complications (PPCs) remain a
challenge after esophagectomy. Despite improvement in surgical and
anesthesiological management, PPCs are reported in as many as 40% of
patients. The main aim of this study is to investigate whether early
application of high-flow nasal cannula (HFNC) after extubation will
provide benefit in terms of reduced PPC frequency compared to standard
oxygen therapy. <br/>Method(s): Patients aged 18-85 years undergoing
esophagectomy for cancer treatment with radical intent, excluding those
with American Society of Anesthesiologists (ASA) score >3 and severe
systemic comorbidity (cardiac, pulmonary, renal or hepatic disease) will
be randomized at the end of surgery to receive HFNC or standard oxygen
therapy (Venturi mask or nasal goggles) after early extubation (within 12
hours after the end of surgery) for 48 hours. The main postoperative goals
are to obtain SpO<inf>2</inf> >=94% and adequate pain control. Oxygen
therapy after 48 hours will be stopped unless the physician deems it
necessary. In case of respiratory clinical worsening, patients will be
supported with the most appropriate tool (noninvasive ventilation or
invasive mechanical ventilation). Pulmonary [pneumonia, pleural effusion,
pneumothorax, atelectasis, acute respiratory distress syndrome (ARDS),
tracheo-bronchial injury, air leak, reintubation, and/or respiratory
failure] complications will be recorded as main outcome. Secondary
outcomes, including cardiovascular, surgical, renal and infective
complications will also be recorded. The primary analysis will be carried
out on 320 patients (160 per group) and performed on an intention-to-treat
(ITT) basis, including all participants randomized into the treatment
groups, regardless of protocol adherence. The primary outcome, the PPC
rate, will be compared between the two treatment groups using a chi-square
test for categorical data, or Fisher's exact test will be used if the
assumptions for the chi-square test are not met. <br/>Discussion(s):
Recent evidence demonstrated that early application of HFNC improved the
respiratory rate oxygenation index (ROX index) after esophagectomy but did
not reduce PPCs. This randomized controlled multicenter trial aims to
assess the potential effect of the application of HFNC versus standard
oxygen over PPCs in patients undergoing esophagectomy.<br/>Copyright
&#xa9; Journal of Thoracic Disease. All rights reserved.

<21>
Accession Number
2034350898
Title
Remimazolam Use in Cardiac Anesthesia: A Narrative Review.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2024.
Date of Publication: 2024.
Author
Muncan B.; Bennett-Guerrero E.
Institution
(Muncan) Department of Anesthesiology, Perioperative and Pain Medicine,
Stanford Medicine, Stanford, CA, United States
(Bennett-Guerrero) Professor and Vice-Chair, Department of Anesthesiology,
Stony Brook Medicine, Stony Brook, NY, United States
Publisher
W.B. Saunders
Abstract
Remimazolam, a novel ultra-short-acting intravenous benzodiazepine, has
garnered recent attention for its use as a general anesthetic. This
narrative review aims to summarize and analyze the available literature on
the effects of remimazolam use in cardiac surgical patients, including its
effects on hemodynamics, safety in patients with baseline myocardial
dysfunction, and impact on postoperative management including time to
emergence and extubation. Finally, there is discussion regarding potential
drawbacks of adopting remimazolam as a routine anesthetic for cardiac
surgery.<br/>Copyright &#xa9; 2024 Elsevier Inc.

<22>
Accession Number
2031100257
Title
Intranasal administration of insulin on the incidence of postoperative
delirium in middle-aged patients undergoing elective on-pump cardiac
surgery (INIPOD-MOPS): a prospective double-blinded randomized control
study protocol.
Source
Trials. 25(1) (no pagination), 2024. Article Number: 565. Date of
Publication: December 2024.
Author
Yang M.; Yang G.; Lu T.; Cao L.; Xiao C.; Liang Y.; Ding J.; Jiang X.;
Wang W.; Chen F.; Du Z.; Li H.
Institution
(Yang, Yang, Lu, Cao, Xiao, Liang, Ding, Jiang, Wang, Chen, Du, Li)
Department of Anesthesiology, Xinqiao Hospital of Chongqing, Second
Affiliated Hospital of Army Medical University, PLA, Chongqing 400037,
China
Publisher
BioMed Central Ltd
Abstract
Background: Delirium, marked by acute cognitive decline, poses a
life-threatening issue among older individuals, especially after cardiac
surgery, with prevalence ranging from 15 to 80%. Postoperative delirium is
linked to increased morbidity and mortality. Although clinical trials
suggest preventability, there is limited research on intranasal insulin
(INI) for cardiac surgery-related delirium. INI has shown promise in
managing cognitive disorders. It rapidly elevates brain hormone levels,
enhancing memory even in non-impaired individuals. While effective in
preventing delirium in gastrointestinal surgery, its impact after cardiac
surgery remains understudied, especially for middle-aged patients.
<br/>Method(s): This is a prospective randomized, double-blind,
single-center controlled trial. A total of 76 eligible participants
scheduled for elective on-pump cardiac surgery will be enrolled and
randomly assigned in a 1:1 ratio to either receive Intranasally
administered insulin (INI) or intranasally administered normal saline. The
primary outcome of our study is the incidence of postoperative delirium
(POD). Secondary outcomes include duration of ICU, postoperative hospital
length of stay, all in-hospital mortality, the change in MMSE scores pre-
and post-operation, and incidence of postoperative cognitive dysfunction
at 1 month, 3 months, and 6 months after operation. Moreover, we will
subjectively and objectively evaluate perioperative sleep quality to
investigate the potential impact of nasal insulin on the development of
delirium by influencing sleep regulation. <br/>Discussion(s): Our study
will aim to assess the impact of intranasal administration of insulin on
the incidence of postoperative delirium in middle-aged patients undergoing
on-pump elective cardiac surgery. If intranasal insulin proves to be more
effective, it may be considered as a viable alternative for preventing
postoperative delirium. Trial registration: ChiCTR ChiCTR2400081444.
Registered on March 1, 2024.<br/>Copyright &#xa9; The Author(s) 2024.

<23>
Accession Number
2030527850
Title
Comprehensive meta-analysis of surgical procedure for congenital
diaphragmatic hernia: thoracoscopic versus open repair.
Source
Pediatric Surgery International. 40(1) (no pagination), 2024. Article
Number: 182. Date of Publication: December 2024.
Author
Shibuya S.; Paraboschi I.; Giuliani S.; Tsukui T.; Matei A.; Olivos M.;
Inoue M.; Clarke S.A.; Yamataka A.; Zani A.; Eaton S.; De Coppi P.
Institution
(Shibuya, Eaton, De Coppi) Stem Cell and Regenerative Medicine Section,
Developmental Biology and Cancer Research & amp; Teaching Department,
Zayed Centre for Research Into Rare Disease in Children, Great Ormond
Street Institute of Child Health, University College London, 30 Guilford
Street, London WC1N 1E, United Kingdom
(Shibuya, Tsukui, Yamataka) Department of Pediatric General and Urogenital
Surgery, Juntendo University School of Medicine, 3-1-3 Hongo, Bunkyo City,
Tokyo 113-8431, Japan
(Paraboschi) Department of Biomedical and Clinical Science, University of
Milano, Milan, Italy
(Giuliani, Zani, De Coppi) Department of Specialist Neonatal and
Paediatric Surgery, Great Ormond Street Hospital for Children, NHS
Foundation Trust, London, United Kingdom
(Matei) Division of General and Thoracic Surgery, The Hospital for Sick
Children, Toronto, ON, Canada
(Olivos, Clarke) Chelsea and Westminster NHS Foundation Trust, London,
United Kingdom
(Inoue) Department of Pediatric Surgery, Fujita Health University, Aichi,
Japan
(Zani) Department of Surgery, University of Toronto, Toronto, ON, Canada
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Purpose: Previous studies have shown a higher recurrence rate and longer
operative times for thoracoscopic repair (TR) of congenital diaphragmatic
hernia (CDH) compared to open repair (OR). An updated meta-analysis was
conducted to re-evaluate the surgical outcomes of TR. <br/>Method(s): A
comprehensive literature search comparing TR and OR in neonates was
performed in accordance with the PRISMA statement (PROSPERO:
CRD42020166588). <br/>Result(s): Fourteen studies were selected for
quantitative analysis, including a total of 709 patients (TR: 308 cases,
OR: 401 cases). The recurrence rate was higher [Odds ratio: 4.03, 95% CI
(2.21, 7.36), p < 0.001] and operative times (minutes) were longer [Mean
Difference (MD): 43.96, 95% CI (24.70, 63.22), p < 0.001] for TR compared
to OR. A significant reduction in the occurrence of postoperative bowel
obstruction was observed in TR (5.0%) compared to OR (14.8%) [Odds ratio:
0.42, 95% CI (0.20, 0.89), p = 0.02]. <br/>Conclusion(s): TR remains
associated with higher recurrence rates and longer operative times.
However, the reduced risk of postoperative bowel obstruction suggests
potential long-term benefits. This study emphasizes the importance of
meticulous patient selection for TR to mitigate detrimental effects on
patients with severe disease.<br/>Copyright &#xa9; The Author(s) 2024.

<24>
Accession Number
2033537213
Title
Outcomes associated with postoperative cognitive dysfunction: a systematic
review and meta-analysis.
Source
Age and Ageing. 53(7) (no pagination), 2024. Article Number: afae160. Date
of Publication: 01 Jul 2024.
Author
Suraarunsumrit P.; Srinonprasert V.; Kongmalai T.; Suratewat S.;
Chaikledkaew U.; Rattanasiri S.; McKay G.; Attia J.; Thakkinstian A.
Institution
(Suraarunsumrit, Srinonprasert, Kongmalai, Chaikledkaew, Thakkinstian)
Mahidol University Health Technology Assessment (MUHTA) Graduate Program,
Mahidol University, Bangkok, Thailand
(Suraarunsumrit, Srinonprasert) Division of Geriatric Medicine, Department
of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University,
Bangkok, Thailand
(Suraarunsumrit, Srinonprasert, Kongmalai) Siriraj Health Policy Unit,
Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok,
Thailand
(Kongmalai) Division of Endocrinology and Metabolism, Department of
Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University,
Bangkok, Thailand
(Suratewat) Department of Emergency Medicine, Yanhee Hospital, Bangkok
10700, Thailand
(Chaikledkaew) Social Administrative Pharmacy Division, Department of
Pharmacy, Faculty of Pharmacy, Mahidol University, Bangkok, Thailand
(Rattanasiri, Thakkinstian) Department of Clinical Epidemiology and
Biostatistics, Faculty of Medicine Ramathibodi Hospital, Mahidol
University, Bangkok, Thailand
(McKay) Centre for Public Health, School of Medicine, Dentistry, and
Biomedical Sciences, Queen's University Belfast, Belfast, United Kingdom
(Attia) School of Medicine and Public Health, University of Newcastle,
Callaghan, NSW, Australia
Publisher
Oxford University Press
Abstract
Background: Postoperative cognitive dysfunction (POCD) manifests as a
subtle decline in cognition, potentially leading to unfavourable
postoperative outcomes. We explored the impact of POCD on physical
function, length of hospital stay (LOS), dementia and mortality outcomes.
<br/>Method(s): PubMed and Scopus were searched until May 2023. All
studies of major surgical patients that assessed POCD and outcomes of
interest were included. POCD effects were stratified by surgery type
(cardiac and noncardiac) and time of POCD assessment (<30 and >=30 days
postsurgery). <br/>Result(s): Of 2316 studies, 20 met the inclusion
criteria. POCD was not associated with functional decline postsurgery.
Patients who experienced POCD postcardiac surgery had an increased
relative risk (RR) of death of 2.04 [(95% CI: 1.18, 3.50); I² =
0.00%]. Sensitivity analyses showed associations with intermediate-term
mortality among noncardiac surgical patients, with an RR of 1.84 [(95% CI:
1.26, 2.71); I² = 0.00%]. Patients who developed POCD <30 days
postcardiac and noncardiac surgeries experienced longer LOS than those who
did not [mean difference (MD) = 1.37 days (95% CI: 0.35, 2.39);
I² = 92.38% and MD = 1.94 days (95% CI: 0.48, 3.40);
I² = 83.29%, respectively]. Postoperative delirium (POD) may
contribute to the heterogeneity observed, but limited data were reported
within the studies included. <br/>Conclusion(s): Patients undergoing
cardiac and noncardiac surgeries who developed POCD <30 days postsurgery
had poorer outcomes and an increased risk of premature death. Early
recognition of perioperative neurocognitive disorders in at-risk patients
may enable early intervention. However, POD may confound our findings,
with further studies necessary to disentangle the effects of POD from POCD
on clinical outcomes.<br/>Copyright &#xa9; The Author(s) 2024.

<25>
Accession Number
2033050267
Title
Hypothermia for expanded criteria organ donors in kidney transplantation
in France (HYPOREME): a multicentre, randomised controlled trial.
Source
The Lancet Respiratory Medicine. 12(9) (pp 693-702), 2024. Date of
Publication: September 2024.
Author
Canet E.; Brule N.; Pere M.; Feuillet F.; Blancho G.; Martin-Lefevre L.;
Garandeau C.; Asehnoune K.; Rozec B.; Duveau A.; Dube L.; Pierrot M.;
Humbert S.; Tirot P.; Boyer J.-M.; Labadie F.; Robert R.; Benard T.;
Kerforne T.; Thierry A.; Lesieur O.; Vincent J.-F.; Lesouhaitier M.;
Larmet R.; Vigneau C.; Goepp A.; Bouju P.; Quentin C.; Egreteau P.-Y.;
Huet O.; Renault A.; Le Meur Y.; Venhard J.-C.; Buchler M.; Voellmy M.-H.;
Herve F.; Schnell D.; Courte A.; Glotz D.; Amrouche L.; Hazzan M.; Kamar
N.; Moal V.; Bourenne J.; Le Quintrec M.; Morelon E.; Kamel T.; Grimbert
P.; Heng A.-E.; Merville P.; Garin A.; Hiesse C.; Fermier B.; Mousson C.;
Guyot-Colosio C.; Bouvier N.; Rerolle J.-P.; Durrbach A.; Drouin S.;
Caillard S.; Frimat L.; Girerd S.; Albano L.; Rostaing L.; Bertrand D.;
Hertig A.; Westeel P.-F.; Montini F.; Delpierre E.; Dorez D.; Alamartine
E.; Ouisse C.; Sebille V.; Reignier J.
Publisher
Elsevier Ltd
Abstract
Background: Expanded criteria donors help to increase graft availability,
but provide organs with an increased risk of delayed graft function. We
aimed to investigate whether donor hypothermia decreases the risk of
delayed graft function compared with normothermia. <br/>Method(s): We did
this multicentre, randomised, controlled, parallel-arm trial at 53
intensive care units and transplant centres in France. We included
expanded criteria donors in whom death was diagnosed based on neurological
criteria, in compliance with French law, and the recipients of their
kidney grafts. Eligible expanded criteria donors were older than 60 years
or were aged 50-59 years and had at least two other risk factors (history
of hypertension, creatinine >132 mumol/L, or cerebrovascular cause of
death). Donors were randomly assigned to hypothermia (34-35degreeC) or
normothermia (36.5-37.5degreeC). Machine perfusion was used routinely.
Randomisation was done using a computer-generated, interactive,
web-response system, in permuted blocks (block size six), stratified by
centre. Outcome assessors were masked; investigator masking was not
feasible. The primary outcome was the proportion of kidney recipients with
delayed graft function, defined as renal replacement therapy within 7 days
after transplantation, assessed in the modified intention-to-treat (mITT)
population, which included all recipients who received at least one kidney
from an expanded criteria donor, with the exception of those under
guardianship. Secondary outcomes in expanded criteria donors were the
number of organs recovered and transplanted, kidney function, body
temperature, total volume of fluids administered, blood pressure and need
for vasopressors and inotropes, and adverse events (cardiovascular events,
metabolic disturbances, and coagulation disorders). Secondary outcomes in
kidney recipients were duration of hospital stay, kidney graft function
and vital status at day 7, day 28, 3 months, and 1 year after
transplantation, and adverse events (infections, cardiovascular events,
and surgical complications). Secondary outcomes were assessed in the mITT
population. The trial was registered at ClinicalTrials.gov, NCT03098706.
<br/>Finding(s): Between Nov 9, 2017, and March 3, 2021, 365 donors were
randomly assigned, of whom 298 (151 [51%] male, 147 [49%] female) provided
kidneys to 526 recipients (323 [61%] male, 203 [39%] female). 251
recipients in the hypothermia group and 275 recipients in the normothermia
group were included in the analysis. Graft function was delayed in 40
(16%) of 251 recipients in the hypothermia group and 58 (21%) of 275
recipients in the normothermia group (odds ratio 0.71 [95% CI 0.44-1.13];
p=0.14; absolute difference -5.2% [95% CI 11.8-1.5]). Compared with donors
in the normothermia group, donors in the hypothermia group had higher
highest mean arterial pressure (115 mm Hg [SD 22] vs 108 mm Hg [20];
p=0.001). 1 year after transplantation, recipients in the hypothermia
group had a lower mean creatinine concentration (152.4 mumol/L [SD 59.1]
vs 169.7 mumol/L [51.4]; p=0.0351) and a higher mean creatinine clearance
(42.3 mL/min/1.73 m² [15.8] vs 40.5 mL/min/1.73 m²
[17.9]; p=0.0414) than those in the normothermia group. No significant
differences between groups were identified for any other secondary
outcomes. <br/>Interpretation(s): Hypothermia in expanded criteria donors
whose organs were routinely stored using machine perfusion did not
decrease the frequency of delayed kidney graft function. However,
hypothermia was associated with a lower serum creatinine concentration and
a higher creatinine clearance 1 year after transplantation.
<br/>Funding(s): French Ministry of Health and French Intensive Care
Society.<br/>Copyright &#xa9; 2024 Elsevier Ltd

<26>
Accession Number
2031091249
Title
Risk Factors and Outcomes Associated With the Development of Persistent
Acute Kidney Injury in Non-Renal Solid Organ Transplant Recipients:
Systematic Review and Meta-Analysis.
Source
Clinical Transplantation. 38(9) (no pagination), 2024. Article Number:
e15444. Date of Publication: September 2024.
Author
Saraiva I.E.; Hamahata N.; Sakhuja A.; Chen X.; Minturn J.S.; Sanchez
P.G.; Chan E.G.; Kaczorowski D.J.; Al-Khafaji A.; Kellum J.A.; Gomez H.
Institution
(Saraiva, Hamahata, Al-Khafaji, Kellum, Gomez) Department of Critical Care
Medicine, Center for Critical Care Nephrology, University of Pittsburgh,
Pittsburgh, PA, United States
(Sakhuja) Department of Medicine and Institute for Critical Care Medicine,
Icahn School of Medicine, Mount Sinai, New York, NY, United States
(Chen) Department of Biostatistics, School of Public Health, University of
Pittsburgh, Pittsburgh, PA, United States
(Minturn, Al-Khafaji, Kellum, Gomez) Department of Critical Care Medicine,
The CRISMA Center, University of Pittsburgh, Pittsburgh, PA, United States
(Sanchez, Chan, Kaczorowski) Department of Cardiothoracic Surgery,
University of Pittsburgh, Pittsburgh, PA, United States
Publisher
John Wiley and Sons Inc
Abstract
Persistent acute kidney injury (pAKI), compared with acute kidney injury
(AKI) that resolves in <72 h, is associated with worse prognosis in
critically ill patients. Definitions and prognosis of pAKI are not well
characterized in solid organ transplant patients. Our aims were to
investigate (a) definitions and incidence of pAKI; (b) association with
clinical outcomes; and (c) risk factors for pAKI among heart, lung, and
liver transplant recipients. We systematically reviewed the literature
including PubMed, Embase, Web of Science, and Cochrane from inception to
8/1/2023 for human prospective and retrospective studies reporting on the
development of pAKI in heart, lung, or liver transplant recipients. We
assessed heterogeneity using Cochran's Q and I². We identified
25 studies including 6330 patients. AKI (8%-71.6%) and pAKI (2.7%-55.1%)
varied widely. Definitions of pAKI included 48-72 h (six studies), 7 days
(three studies), 14 days (four studies), or more (12 studies). Risk
factors included age, body mass index (BMI), diabetes, preoperative
chronic kidney disease (CKD), intraoperative vasopressor use, and
intraoperative circulatory support. pAKI was associated with new onset of
CKD (odds ratio [OR] 1.41-11.2), graft dysfunction (OR 1.81-8.51), and
long-term mortality (OR 3.01-13.96), although significant heterogeneity
limited certainty of CKD and graft dysfunction outcome analyses. pAKI is
common and is associated with worse mortality among liver and lung
transplant recipients. Standardization of the nomenclature of AKI will be
important in future studies (PROSPERO CRD42022371952).<br/>Copyright
&#xa9; 2024 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

<27>
Accession Number
2033100463
Title
Alirocumab and cardiovascular outcomes according to sex and lipoprotein(a)
after acute coronary syndrome: a report from the ODYSSEY OUTCOMES study.
Source
Journal of Clinical Lipidology. 18(4) (pp e548-e561), 2024. Date of
Publication: 01 Jul 2024.
Author
Bittner V.A.; Schwartz G.G.; Bhatt D.L.; Chua T.; De Silva H.A.; Diaz R.;
Goodman S.G.; Harrington R.A.; Jukema J.W.; McGinniss J.; Pordy R.; Garon
G.; Scemama M.; White H.D.; Steg P.G.; Szarek M.
Institution
(Bittner) Division of Cardiovascular Disease, University of Alabama at
Birmingham, Birmingham, United Kingdom
(Schwartz) Division of Cardiology, University of Colorado School of
Medicine, Aurora, CO, United States
(Bhatt) Mount Sinai Heart, Icahn School of Medicine at Mount Sinai Health
System, New York, NY, United States
(Chua) National Heart Centre, Singapore, Singapore
(De Silva) Clinical Trials Unit, Department of Pharmacology, Faculty of
Medicine, University of Kelaniya, Sri Lanka
(Diaz) Estudios Cardiologicos Latino America, Instituto Cardiovascular de
Rosario, Rosario, Argentina
(Goodman) Canadian VIGOUR Centre, University of Alberta, Edmonton,
Alberta, Canada
(Goodman) St. Michael's Hospital, University of Toronto, Toronto, Ontario,
Canada
(Harrington) Stanford Center for Clinical Research, Department of
Medicine, Stanford University, Stanford, CA, United States
(Jukema) Department of Cardiology, Leiden University Medical Center,
Leiden, Netherlands
(Jukema) Netherlands Heart Institute, Utrecht, Netherlands
(McGinniss, Pordy) Regeneron Pharmaceuticals, Inc, Tarrytown, NY, United
States
(Garon) SanofiMontrealCanada
(Scemama) Sanofi Research and Development, Paris, France
(White) Green Lane Cardiovascular Research Unit, Te Whatu Ora - Health New
Zealand, Te Toka Tumai, University of Auckland, Auckland, New Zealand
(Steg) Universite Paris-Cite, Institut Universitaire de France, Assistance
Publique-Hopitaux de Paris, Hopital Bichat, FACT (French Alliance for
Cardiovascular Trials), INSERM U1148, Paris, France
(Szarek) CPC Clinical Research and Division of Cardiology, University of
Colorado School of Medicine, Aurora, CO, United States
(Szarek) State University of New York, Downstate Health Sciences
University, Brooklyn, NY, United States
Publisher
Elsevier Ltd
Abstract
BACKGROUND: The ODYSSEY OUTCOMES trial (NCT01663402) compared the effects
of the proprotein convertase subtilisin/kexin type 9 inhibitor alirocumab
with placebo on major adverse cardiovascular events (MACE) in patients
with recent acute coronary syndrome (ACS). <br/>OBJECTIVE(S): We assessed
efficacy and safety of alirocumab versus placebo according to sex and
lipoprotein(a) level. <br/>METHOD(S): This prespecified analysis compared
the effects of alirocumab versus placebo on lipoproteins, MACE (coronary
heart disease death, non-fatal myocardial infarction, fatal/non-fatal
ischemic stroke, unstable angina requiring hospitalization), death, total
cardiovascular events, and adverse events in 4762 women and 14,162 men
followed for a median of 2.8 years. In post-hoc analysis, we evaluated
total cardiovascular events according to sex, baseline lipoprotein(a), and
treatment. <br/>RESULT(S): Women were older, had higher baseline
low-density lipoprotein cholesterol (LDL-C) levels (89.6 vs 85.3 mg/dL)
and lipoprotein(a) (28.0 vs 19.3 mg/dL) and had more co-morbidities than
men. At 4 months, alirocumab lowered LDL-C by 49.4 mg/dL in women and 54.0
mg/dL in men and lipoprotein(a) by 9.7 and 8.1 mg/dL, respectively (both p
< 0.0001). Alirocumab reduced MACE, death, and total cardiovascular events
similarly in both sexes. In the placebo group, lipoprotein(a) was a risk
factor for total cardiovascular events in women and men. In both sexes,
reduction of total cardiovascular events was greater at higher baseline
lipoprotein(a), but this effect was more evident in women than men
(p<inf>interaction</inf>=0.08). Medication adherence and adverse event
rates were similar in both sexes. <br/>CONCLUSION(S): Alirocumab improves
cardiovascular outcomes after ACS irrespective of sex. Reduction of total
cardiovascular events was greater at higher baseline
lipoprotein(a).<br/>Copyright &#xa9; 2024

<28>
Accession Number
2032939245
Title
Sex, racial, ethnic, and geographical disparities in major adverse
cardiovascular outcome of glucagon-like peptide-1 receptor agonists among
patients with and without diabetes mellitus: A meta-analysis of
placebo-controlled randomized controlled trials.
Source
Journal of Clinical Lipidology. 18(4) (pp e588-e601), 2024. Date of
Publication: 01 Jul 2024.
Author
Rivera F.B.; Bantayan N.R.B.; Aparece J.P.; Cruz L.L.A.; Magallong J.V.;
Pine P.L.; Idian-Javier A.M.N.; Lumbang G.N.O.; Lerma E.V.;
Lara-Breitinger K.M.; Gulati M.; Vijayaraghavan K.
Institution
(Rivera) Department of Medicine, Lincoln Medical Center, New York, NY,
United States
(Bantayan, Cruz) University of the Philippines College of Medicine,
Manila, United States
(Aparece, Magallong) Department of Medicine, Texas Tech University Health
Sciences Center, El Paso, TX, United States
(Pine, Idian-Javier) AteneoSchool of Medicine and Public Health, Pasig,
Philippines, United States
(Lumbang) Department of Medicine, Cebu Institute of Medicine, Cebu,
Minnesota, (MN), United States
(Lerma) Section of Nephrology, University of Illinois at Chicago College
of Medicine, Chicago, IL, United States
(Lara-Breitinger) Department of Cardiovascular Medicine, Mayo Clinic,
Rochester, United States
(Gulati) Department of Cardiology, Barbra Streisand Women's Heart Center,
Cedars-Sinai Smidt Heart Institute, Los Angeles, CA, United States
(Vijayaraghavan) University of Arizona, Phoenix, AZ, United States
Publisher
Elsevier Ltd
Abstract
BACKGROUND: Glucagon-like peptide-1 receptor agonists (GLP-1RAs) have been
pivotal in the management of type 2 diabetes mellitus (T2DM) and in the
reduction of major adverse cardiovascular events (MACE). Notably, large
cardiovascular outcomes trials (CVOTs) demonstrate significant disparities
in inclusion, based on sex, race, ethnicity, and geographical regions.
<br/>OBJECTIVE(S): We examined the impact of GLP-1RA on MACE in patients
with or without T2DM, based on sex, race, ethnicity, and geography.
<br/>METHOD(S): A literature search for placebo controlled randomized
controlled trials on GLP-1RA treatment was conducted. Thorough data
extraction and quality assessment were carried out, focusing on key
outcome, and ensuring a robust statistical analysis using a random effects
model to calculate log odds ratio (OR) with 95% confidence intervals
(CIs). <br/>RESULT(S): A total of 8 CVOTs comprising 71,616 patients were
included. Compared with placebo, GLP-1RAs significantly reduced MACE in
both sexes (females: logOR -0.19, (95% CI, -0.28 to -0.10), p < 0.01)
versus (males: logOR -0.17, (95% CI, -0.23 to -0.10), p < 0.01), (p
interaction NS), and among Asians (logOR -34 (95% CI, -0.53 to -0.15), p <
0.01), and Whites (logOR -17 (95% CI, -0.25 to -0.09), p < 0.01), with no
difference in MACE among Blacks and Hispanics. Odds of MACE were also
reduced in Asia (logOR -31 (95% CI, -0.50 to -0.11), p < 0.01), and Europe
(logOR -27 (95% CI, -0.40 to -0.13), p < 0.01), but there was no
statistical difference in MACE in North America and Latin America.
<br/>CONCLUSION(S): Significant reductions in MACE with GLP-1RA treatment
were demonstrated between both sexes and across certain ethnicities and
certain geographical regions.<br/>Copyright &#xa9; 2024

<29>
Accession Number
2031273437
Title
Palliative care in the cardiovascular intensive care unit: A systematic
review of current literature.
Source
Cardiovascular Revascularization Medicine. 66 (pp 68-73), 2024. Date of
Publication: September 2024.
Author
Belur A.D.; Mehta A.; Bansal M.; Wieruszewski P.M.; Kataria R.; Saad M.;
Clancy A.; Levine D.J.; Sodha N.R.; Burtt D.M.; Rachu G.S.; Abbott J.D.;
Vallabhajosyula S.
Institution
(Belur) Division of Cardiovascular Medicine, Department of Medicine,
University of Louisville School of Medicine, Louisville, KY, United States
(Mehta) Department of Medicine, University of Connecticut School of
Medicine, Farmington, CT, United States
(Bansal) Department of Medicine, East Carolina University Brody School of
Medicine, Greenville, NC, United States
(Wieruszewski) Departments of Pharmacy and Anesthesiology, Mayo Clinic,
Rochester, MN, United States
(Kataria, Saad, Levine, Burtt, Abbott, Vallabhajosyula) Division of
Cardiology, Department of Medicine, Warren Alpert Medical School of Brown
University, Providence, RI, United States
(Kataria, Saad, Levine, Sodha, Burtt, Abbott, Vallabhajosyula) Lifespan
Cardiovascular Institute, Providence, RI, United States
(Clancy) Department of Pharmacy, Lifespan Health System, Providence, RI,
United States
(Sodha) Division of Cardiothoracic Surgery, Department of Surgery, Warren
Alpert Medical School of Brown University, Providence, RI, United States
(Rachu) Division of Geriatrics and Palliative Medicine, Department of
Medicine, Warren Alpert Medical School of Brown University, Providence,
RI, United States
Publisher
Elsevier Inc.
Abstract
Background: There has been an evolution in the disease severity and
complexity of patients presenting to the cardiac intensive care unit
(CICU). There are limited data evaluating the role of palliative care in
contemporary CICU practice. <br/>Method(s): PubMed Central, CINAHL,
EMBASE, Medline, Cochrane Library, Scopus, and Web of Science databases
were evaluated for studies on palliative care in adults (>=18 years)
admitted with acute cardiovascular conditions - acute myocardial
infarction, cardiogenic shock, cardiac arrest, advanced heart failure,
post-cardiac surgery, spontaneous coronary artery dissection, Takotsubo
cardiomyopathy, and pulmonary embolism - admitted to the CICU, coronary
care unit or cardiovascular intensive care unit from 1/1/2000 to 8/8/2022.
The primary outcome of interest was the utilization of palliative care
services. Secondary outcomes of included studies were also addressed.
Meta-analysis was not performed due to heterogeneity. <br/>Result(s): Of
5711 citations, 30 studies were included. All studies were published in
the last seven years and 90 % originated in the United States.
Twenty-seven studies (90 %) were retrospective analyses, with a majority
from the National Inpatient Sample database. Heart failure was the most
frequent diagnosis (47 %), and in-hospital mortality was reported in 67 %
of studies. There was heterogeneity in the timing, frequency, and
background of the care team that determined palliative care consultation.
In two randomized trials, there appeared to be improvement in quality of
life without an impact on mortality. <br/>Conclusion(s): Despite the
growing recognition of the role of palliative care, there are limited data
on palliative care consultation in the CICU.<br/>Copyright &#xa9; 2024
Elsevier Inc.

<30>
Accession Number
2029423777
Title
Intensive care unit admission criteria: a scoping review.
Source
Journal of the Intensive Care Society. 25(3) (pp 296-307), 2024. Date of
Publication: August 2024.
Author
Soares J.; Leung C.; Campbell V.; Van Der Vegt A.; Malycha J.; Andersen C.
Institution
(Soares, Leung, Andersen) Department of Intensive Care, Royal North Shore
Hospital, Sydney, NSW, Australia
(Campbell) School of Medicine and Dentistry, Griffith University, Sunshine
Coast, QLD, Australia
(Van Der Vegt) Centre for Health Services Research, The University of
Queensland, Prince Alexandra Hospital, Brisbane, QLD, Australia
(Malycha) The Central Adelaide Local Health Network Critical Care
Department, Adelaide, SA, Australia
(Andersen) The George Institute for Global Health, University of New South
Wales, Sydney, NSW, Australia
(Andersen) Northern Clinical School, Sydney Medical School, The University
of Sydney, Sydney, NSW, Australia
Publisher
SAGE Publications Inc.
Abstract
Background: Effectively identifying deteriorated patients is vital to the
development and validation of automated systems designed to predict
clinical deterioration. Existing outcome measures used for this purpose
have significant limitations. Published criteria for admission to high
acuity inpatient areas may represent markers of patient deterioration and
could inform the development of alternate outcome measures.
<br/>Objective(s): In this scoping review, we aimed to characterise
published criteria for admission of adult inpatients to high acuity
inpatient areas including intensive care units. A secondary aim was to
identify variables that are extractable from electronic health records
(EHRs). Data sources: Electronic databases PubMed and ProQuest EBook
Central were searched to identify papers published from 1999 to date of
search. We included publications which described prescriptive criteria for
admission of adult inpatients to a clinical area with a higher level of
care than a general hospital ward. Charting methods: Data was extracted
from each publication using a standardised data-charting form. Admission
criteria characteristics were summarised and cross-tabulated for each
criterion by population group. <br/>Result(s): Five domains were
identified: diagnosis-based criteria, clinical parameter criteria,
organ-support criteria, organ-monitoring criteria and patient baseline
criteria. Six clinical parameter-based criteria and five needs-based
criteria were frequently proposed and represent variables extractable from
EHRs. Thresholds for objective clinical parameter criteria varied across
publications, and by disease subgroup, and universal cut-offs for criteria
could not be elucidated. <br/>Conclusion(s): This study identified
multiple criteria which may represent markers of deterioration. Many of
the criteria are extractable from the EHR, making them potential
candidates for future automated systems. Variability in admission criteria
and associated thresholds across the literature suggests clinical
deterioration is a heterogeneous phenomenon which may resist being defined
as a single entity via a consensus-driven process.<br/>Copyright &#xa9;
The Intensive Care Society 2024.

<31>
Accession Number
2034275193
Title
CARDIOVASCULAR STENT ADVERSE REACTION: REVIEW AND META-ANALYSIS.
Source
African Journal of Biological Sciences (South Africa). 6(14) (pp
6811-6833), 2024. Date of Publication: 2024.
Author
Aggarwal M.; Thakkar A.; Sinha J.
Institution
(Aggarwal, Sinha) Department of Pharmacy, School of Health Sciences,
Sushant University, Haryana, Gurugram 122003, India
(Thakkar) Pumas-AI. Inc., United States
Publisher
Institute of Advanced Studies
Abstract
According to the degree of risk involved, MDR divided medical devices into
four classes: Class A (low risk), Class B (low moderate risk), Class C
(moderate high risk), and Class D (high risk). Cardiovascular devices that
come under the D Category include bioresorbable vascular scaffold systems,
drug-eluting stents, and heart valves. Stents are intricate, tiny, hollow
structures with a cylindrical shape that are arranged into a ring pattern
using struts and connecting components. The major drawback is
postprocedural complications associated with stent implantation such as
inflammation, thrombogenesis, and hyper-proliferation of vascular smooth
muscle cells. Thus, estimating the prevalence of adverse events following
stent implantation is the primary objective of the current research. A
meta-analysis of the literature on adverse events resulting from stent
implantation was conducted for this study. A computerized search of the
primary database literature was conducted from 2000 onwards. In total 102
case studies were selected as per inclusion/exclusion criteria. All
studies were thoroughly examined about the type of stent, patient gender,
age, reaction start time, adverse event, clinical presentation,
treatments, and outcomes. Meta-analysis studies confirmed an incremental
rise in adverse events with a significant increase in mortality and the
risk of death was almost doubled with the presence of any co-morbidity. A
lower target-lesion revascularization and incidence of stent thrombosis
with newer-generation devices as compared to 1st generation DES and BMS.
With the development and improvement of coronary stents, particularly
second-generation DESs, the long-term outcome after PCI has improved
dramatically. However, the combination of personalized medicine and an
improved stent platform with cell-selective drugs has the potential to
solve the remaining challenges and improve the care of coronary artery
disease patients.<br/>Copyright &#xa9; 2024 Institute of Advanced Studies.
All rights reserved.

<32>
Accession Number
2031487898
Title
Pericardiotomy and atrial fibrillation after isolated coronary artery
bypass grafting: A systematic review and meta-analysis of 16 randomised
controlled trials.
Source
Cardiovascular Revascularization Medicine. 66 (pp 27-32), 2024. Date of
Publication: September 2024.
Author
San T.M.M.; Han K.P.P.; Ismail M.; Thu L.M.; Thet M.S.
Institution
(San) Department of Surgery, Pyin Oo Lwin General Hospital, University of
Medicine Mandalay, Myanmar
(Han) Department of Medicine, Mandalay General Hospital, Mandalay, Myanmar
(Ismail) Department of Neurosurgery, Khalifa Gul Nawaz Hospital, Medical
Teaching Institution, Bannu, Pakistan
(Thu) Department of Trauma & Orthopaedic, Colchester General Hospital,
Colchester, United Kingdom
(Thet) Department of Surgery and Cancer, Imperial College London, United
Kingdom
Publisher
Elsevier Inc.
Abstract
Background: Atrial fibrillation (AF) and pericardial effusion are notable
complications following coronary artery bypass grafting (CABG),
contributing to increased morbidity and healthcare costs. Posterior
pericardiotomy has been proposed to mitigate these complications. This
systematic review and meta-analysis aim to evaluate the efficacy of
posterior pericardiotomy in reducing postoperative AF and pericardial
effusion in isolated CABG patients. <br/>Material(s) and Method(s): A
comprehensive literature search, adhering to PRISMA guidelines, was
conducted across PubMed, MEDLINE via Ovid, Embase, Scopus, the Central
Register of Controlled Trials (CENTRAL), and ClinicalTrials.gov up to
December 2023. Only randomised controlled trials (RCTs) comparing
prophylactic posterior pericardiotomy to control treatments in adult CABG
patients were included. The primary outcomes assessed were the incidences
of postoperative AF and pericardial effusion. <br/>Result(s): The
meta-analysis incorporated 16 RCTs with a total of 2414 patients. The
findings demonstrated a significant reduction in the incidence of
postoperative AF (Odds Ratio = 0.34, 95 % CI: 0.25-0.48, P < 0.00001) and
pericardial effusion (Odd Ratio = 0.24, 95 % CI: 0.15-0.38, P < 0.0001) in
the group undergoing posterior pericardiotomy. However, the analysis
revealed substantial heterogeneity and publication bias in the included
studies. <br/>Conclusion(s): The posterior pericardiotomy is effective in
reducing the incidences of AF and pericardial effusion in patients
undergoing isolated CABG. Despite the positive outcomes, the presence of
heterogeneity and publication bias warrants a cautious interpretation of
the results and underscores the need for further multicentre RCTs in this
area.<br/>Copyright &#xa9; 2024 The Authors

<33>
Accession Number
2030993296
Title
Population Pharmacokinetics and Target Attainment of Allopurinol and
Oxypurinol Before, During, and After Cardiac Surgery with Cardiopulmonary
Bypass in Neonates with Critical Congenital Heart Disease.
Source
Clinical Pharmacokinetics. 63(8) (pp 1205-1220), 2024. Date of
Publication: August 2024.
Author
Chu W.-Y.; Nijman M.; Stegeman R.; Breur J.M.P.J.; Jansen N.J.G.; Nijman
J.; van Loon K.; Koomen E.; Allegaert K.; Benders M.J.N.L.; Dorlo T.P.C.;
Huitema A.D.R.; Beynum I.M.V.; ten Cate F.E.U.; Helbing W.A.; Taverne
Y.J.H.J.; de Boode W.P.; Bogers A.J.C.C.; Joosten K.F.M.; van de Woestijne
P.C.; de Liefde I.I.; van Dijk A.; Meijer N.I.F.; Simons S.H.P.H.P.; van
der Lee R.; Cornette J.M.J.; van Haren N.E.M.; Bos A.F.; Berger R.M.F.;
Accord R.E.; Arrigoni S.C.; Duin L.K.; Kneyber M.J.J.; Kooi E.M.W.; van
der Maaten J.M.A.A.; Meiners L.C.; Mebius M.J.; Marchie G.J.D.S.; Vanagt
W.Y.; Claessens N.H.P.; van Wijk B.; Schoof P.H.; Talacua H.; Steenhuis
T.J.; ter Heide H.; van Iperen G.G.; Bosch R.; Groenendaal F.; Derks J.B.;
de Heus R.; Bekker M.N.; Wosten-van R.M.A.; Haaren N.V.B.-V.; Cianci D.;
Nikolakopoulos S.; Roes K.C.B.; Lalmohamed A.; Rademaker K.; Ardine de Wit
G.
Institution
(Chu, Dorlo, Huitema) Department of Pharmacy and Pharmacology, The
Netherlands Cancer Institute, Amsterdam, Netherlands
(Chu, Dorlo) Department of Pharmacy, Uppsala University, Uppsala, Sweden
(Nijman, Stegeman, Benders) Department of Neonatology, Wilhelmina
Children's Hospital, University Medical Center (UMC) Utrecht, Utrecht
University, Utrecht, Netherlands
(Nijman, Stegeman, Breur) Department of Pediatric Cardiology, Wilhelmina
Children's Hospital, UMC Utrecht, Utrecht University, Utrecht, Netherlands
(Nijman) Utrecht Brain Center, UMC Utrecht, Utrecht University, Utrecht,
Netherlands
(Stegeman, Jansen) Department of Pediatrics, Beatrix Children's Hospital,
UMC Groningen, University of Groningen, Groningen, Netherlands
(Jansen, Nijman, Koomen) Department of Pediatric Intensive Care,
Wilhelmina Children's Hospital, UMC Utrecht, Utrecht University, Utrecht,
Netherlands
(van Loon) Department of Anaesthesiology, Wilhelmina Children's Hospital,
UMC Utrecht, Utrecht University, Utrecht, Netherlands
(Allegaert) Department of Development and Regeneration, and Pharmaceutical
and Pharmacological Sciences, KU Leuven, Leuven, Belgium
(Allegaert) Department of Clinical Pharmacy, Erasmus Medical Center,
Rotterdam, Netherlands
(Huitema) Department of Pharmacology, Princess Maxima Center for Pediatric
Oncology, Utrecht, Netherlands
(Huitema) Department of Clinical Pharmacy, UMC Utrecht, Utrecht
University, Utrecht, Netherlands
Publisher
Adis
Abstract
Background: The CRUCIAL trial (NCT04217421) is investigating the effect of
postnatal and perioperative administration of allopurinol on postoperative
brain injury in neonates with critical congenital heart disease (CCHD)
undergoing cardiac surgery with cardiopulmonary bypass (CPB) shortly after
birth. <br/>Objective(s): This study aimed to characterize the
pharmacokinetics (PK) of allopurinol and oxypurinol during the
preoperative, intraoperative, and postoperative phases in this population,
and to evaluate target attainment of the current dosing strategy.
<br/>Method(s): Nonlinear mixed-effects modeling was used to develop
population PK models in 14 neonates from the CRUCIAL trial who received up
to five intravenous allopurinol administrations throughout the postnatal
and perioperative periods. Target attainment was defined as achieving an
allopurinol concentration >2 mg/L in at least two-thirds of the patients
during the first 24 h after birth and between the start and 36 h after
cardiac surgery with CPB. <br/>Result(s): A two-compartment model for
allopurinol was connected to a one-compartment model for oxypurinol with
an auto-inhibition effect on the conversion, which best described the PK.
In a typical neonate weighing 3.5 kg who underwent cardiac surgery at a
postnatal age (PNA) of 5.6 days, the clearance (CL) of allopurinol and
oxypurinol at birth was 0.95 L/h (95% confidence interval 0.75-1.2) and
0.21 L/h (0.17-0.27), respectively, which subsequently increased with PNA
to 2.97 L/h and 0.41 L/h, respectively, before CPB. During CPB,
allopurinol and oxypurinol CL decreased to 1.38 L/h (0.9-1.87) and 0.12
L/h (0.05-0.22), respectively. Post-CPB, allopurinol CL increased to 2.21
L/h (1.74-2.83), while oxypurinol CL dropped to 0.05 L/h (0.01-0.1).
Target attainment was 100%, 53.8%, and 100% at 24 h postnatally, 24 h
after the start of CPB, and 36 h after the end of cardiac surgery,
respectively. The combined concentrations of allopurinol and oxypurinol
maintained >= 90% inhibition of xanthine oxidase (IC90<inf>XO</inf>)
throughout the postnatal and perioperative period. <br/>Conclusion(s): The
minimal target concentration of allopurinol was not achieved at every
predefined time interval in the CRUCIAL trial; however, the dosing
strategy used was deemed adequate, since it yielded concentrations well
exceeding the IC90<inf>XO</inf>. The decreased CL of both compounds during
CPB suggests influence of the hypothermia, hemofiltration, and the
potential sequestration of allopurinol in the circuit. The reduced CL of
oxypurinol after CPB is likely attributable to impaired kidney
function.<br/>Copyright &#xa9; The Author(s) 2024.

<34>
Accession Number
2034276112
Title
Framework Development for Reducing Attrition in Digital Dietary
Interventions: Systematic Review and Thematic Synthesis.
Source
Journal of Medical Internet Research. 26 (no pagination), 2024. Article
Number: e58735. Date of Publication: 2024.
Author
Wang J.; Mahe J.; Huo Y.; Huang W.; Liu X.; Zhao Y.; Huang J.; Shi F.; Li
Z.; Jiang D.; Li Y.; Perceval G.; Zhao L.; Zhang L.
Institution
(Wang, Mahe, Huo, Huang, Liu, Zhang) The School of Public Health and
Preventive Medicine, Monash University, Melbourne, Australia
(Wang, Mahe, Huo, Huang, Liu, Perceval, Zhang) Suzhou Industrial Park
Monash Research Institute of Science and Technology, Monash University,
Suzhou, China
(Zhao) The George Institute for Global Health, University of New South
Wales, Sydney, Australia
(Zhao) The George Institute for Global Health, Beijing, China
(Huang) The Jockey Club School of Public Health and Primary Care, Faculty
of Medicine, Chinese University of Hong Kong, Hong Kong, Hong Kong
(Shi) East China Aviation Personnel Medical Appraisal Center, Shanghai,
China
(Li) Tsinghua Vanke School of Public Health, Tsinghua University,
Shenzhen, China
(Jiang, Li, Zhao) School of Economics and Management, Southeast
University, Nanjing, China
Publisher
JMIR Publications Inc.
Abstract
Background: Dietary behaviors significantly influence health outcomes
across populations. Unhealthy diets are linked to serious diseases and
substantial economic burdens, contributing to approximately 11 million
deaths and significant disability-adjusted life years annually. Digital
dietary interventions offer accessible solutions to improve dietary
behaviors. However, attrition, defined as participant dropout before
intervention completion, is a major challenge, with rates as high as
75%-99%. High attrition compromises intervention validity and reliability
and exacerbates health disparities, highlighting the need to understand
and address its causes. <br/>Objective(s): This study systematically
reviews the literature on attrition in digital dietary interventions to
identify the underlying causes, propose potential solutions, and integrate
these findings with behavior theory concepts to develop a comprehensive
theoretical framework. This framework aims to elucidate the behavioral
mechanisms behind attrition and guide the design and implementation of
more effective digital dietary interventions, ultimately reducing
attrition rates and mitigating health inequalities. <br/>Method(s): We
conducted a systematic review, meta-analysis, and thematic synthesis. A
comprehensive search across 7 electronic databases (PubMed, MEDLINE,
Embase, CENTRAL, Web of Science, CINAHL Plus, and Academic Search
Complete) was performed for studies published between 2013 and 2023.
Eligibility criteria included original research exploring attrition in
digital dietary interventions. Data extraction focused on study
characteristics, sample demographics, attrition rates, reasons for
attrition, and potential solutions. We followed ENTREQ (Enhancing the
Transparency in Reporting the Synthesis of Qualitative Research) and
PRISMA (Preferred Reporting Items for Systematic Reviews and
Meta-Analyses) guidelines and used RStudio (Posit) for meta-analysis and
NVivo for thematic synthesis. <br/>Result(s): Out of the 442 identified
studies, 21 met the inclusion criteria. The meta-analysis showed mean
attrition rates of 35% for control groups, 38% for intervention groups,
and 40% for observational studies, with high heterogeneity
(I²=94%-99%) indicating diverse influencing factors. Thematic
synthesis identified 15 interconnected themes that align with behavior
theory concepts. Based on these themes, the force-resource model was
developed to explore the underlying causes of attrition and guide the
design and implementation of future interventions from a behavior theory
perspective. <br/>Conclusion(s): High attrition rates are a significant
issue in digital dietary interventions. The developed framework
conceptualizes attrition through the interaction between the driving force
system and the supporting resource system, providing a nuanced
understanding of participant attrition, summarized as insufficient
motivation and inadequate or poorly matched resources. It underscores the
critical necessity for digital dietary interventions to balance
motivational components with available resources dynamically. Key
recommendations include user-friendly design, behavior-factor activation,
literacy training, force-resource matching, social support, personalized
adaptation, and dynamic follow-up. Expanding these strategies to a
population level can enhance digital health equity. Further empirical
validation of the framework is necessary, alongside the development of
behavior theory-guided guidelines for digital dietary
interventions.<br/>Copyright &#xa9;Jian Wang, Jinli Mahe, Yujia Huo,
Weiyuan Huang, Xinru Liu, Yang Zhao, Junjie Huang, Feng Shi, Zhihui Li,
Dou Jiang, Yilong Li, Garon Perceval, Lindu Zhao, Lin Zhang.

<35>
Accession Number
2034264824
Title
Adverse outcomes with left atrial appendage occlusion device implantation
in chronic and end stage kidney disease: A systemic review and
meta-analysis.
Source
Cardiovascular Revascularization Medicine. (no pagination), 2024. Date of
Publication: 2024.
Author
Gill G.S.; Shailly S.; Chakrala T.; Palicherla A.; Ponna P.K.; Alla V.M.;
Kanmanthareddy A.
Institution
(Gill) Minneapolis Heart Institute, Abbott Northwestern Hospital,
Minneapolis, MN, United States
(Shailly) Division of Nephrology, University of Michigan, Ann Arbor, MI,
United States
(Chakrala) Department of Medicine, University of Florida, Gainesville, FL,
United States
(Palicherla) Department of Medicine, Creighton University School of
Medicine, Omaha, NE, United States
(Ponna) Department of Medicine, Louisiana State University, Shreveport,
LA, United States
(Alla, Kanmanthareddy) Division of Cardiovascular Disease, Creighton
University School of Medicine, Omaha, NE, United States
Publisher
Elsevier Inc.
Abstract
Background: Chronic kidney disease (CKD) and end stage renal disease
(ESRD) are associated with increased risk of bleeding events, including
hemorrhagic stroke, and periprocedural and gastrointestinal bleeding among
patients with atrial fibrillation who are on anticoagulation. Safety of
percutaneous left atrial appendage occlusion (LAAO) among this patient
population has been uncertain with studies showing contradictory results.
<br/>Method(s): PubMed and Google Scholar databases were queried for
studies comparing outcomes among patients with and without significant
CKD, and with and without ESRD who underwent LAAO device implantation.
Data on outcomes from the selected studies were extracted and analyzed
using random effects model. Heterogeneity was assessed using I²
test. <br/>Result(s): Data from eleven studies with 61,724 patients with
and without kidney disease were included in the final analyses. There was
an increased risk of in-hospital mortality (OR 2.76, 95 % CI [1.15-6.64];
p = 0.02) and peri-procedural bleeding (1.51 [1.33-1.71]; p < 0.01)
associated with kidney disease. There was no significant difference in
risk of stroke (1.19 [0.70-2.03]; p = 0.53), pericardial effusion (1.22
[0.77-1.92]; p = 0.40), vascular complications (1.18 [0.92-1.52]; p =
0.20), or device related thrombus (1.13 [0.53-2.40]; p = 0.75).
<br/>Conclusion(s): This study shows an increased risk of complications
among patients with kidney disease, who undergo LAAO device implantation.
These findings suggest the need for studies with randomized control design
specifically designed to compare outcomes with LAAO versus anticoagulation
in the CKD and ESRD populations.<br/>Copyright &#xa9; 2024 Elsevier Inc.

<36>
Accession Number
2031172266
Title
Predictors for prescription of noninvasive ventilation in the
postoperative period of cardiac surgery: a systematic review.
Source
Annals of Medicine. 56(1) (no pagination), 2024. Article Number: 2394848.
Date of Publication: 2024.
Author
Goncalves de Lima J.; de Medeiros V.M.G.; Gomes de Jesus F.; Sarmento dos
Santos T.; Rega de Oliveira J.; Rosa de Oliveira C.; Mediano M.F.F.;
Rodrigues Junior L.F.
Institution
(Goncalves de Lima, de Medeiros, Gomes de Jesus, Sarmento dos Santos,
Mediano, Rodrigues Junior) Education and Research Department, National
Institute of Cardiology, Rio de Janeiro, Brazil
(Rega de Oliveira, Rosa de Oliveira) Physiotherapy Service, National
Institute of Cardiology, Rio de Janeiro, Brazil
(Mediano) Evandro Chagas National Institute of Infectious Disease, Oswaldo
Cruz Foundation, Rio de Janeiro, Brazil
(Rodrigues Junior) Department of Physiological Sciences, Biomedical
Institute, Federal University of the State of Rio de Janeiro, Rio de
Janeiro, Brazil
Publisher
Taylor and Francis Ltd.
Abstract
Introduction: The postoperative (PO) period after cardiac surgery is
associated with the occurrence of respiratory complications. Noninvasive
positive pressure ventilation (NIPPV) is largely used as a ventilatory
support strategy after the interruption of invasive mechanical
ventilation. However, the variables associated with NIPPV prescription are
unclear. <br/>Objective(s): To describe the literature on predictors of
NIPPV prescription in patients during the PO period of cardiac surgery.
<br/>Material(s) and Method(s): This systematic review was registered on
the International Prospective Register of Systematic Reviews (PROSPERO)
platform in December 2021 (CRD42021291973). Bibliographic searches were
performed in February 2022 using the PubMed, Lilacs, Embase and PEDro
databases, with no year or language restrictions. The Predictors for the
prescription of NIPPV were considered among patients who achieved curative
NIPPV. <br/>Result(s): A total of 349 articles were identified, of which
four were deemed eligible and were included in this review. Three studies
were retrospective studies, and one was a prospective safety pilot study.
The total sample size in each study ranged from 109 to 1657 subjects, with
a total of 3456 participants, of whom 283 realized NIPPV. Curative NIPPV
was the only form of NIPPV in 75% of the studies, which presented this
form of prescription in 5-9% of the total sample size, with men around 65
years old being the majority of the participants receiving curative NIPPV.
The main indication for curative NIPPV was acute respiratory failure. Only
one study realized prophylactic NIPPV (28% of 32 participants). The main
predictors for the prescription of curative NIPPV in the PO period of
cardiac surgery observed in this study were elevated body mass index
(BMI), hypercapnia, PO lung injury, cardiogenic oedema and pneumonia.
<br/>Conclusion(s): BMI and lung alterations related to gas exchange
disturbances are major predictors for NIPPV prescription in patients
during the PO period of cardiac surgery. The identification of these
predictors can benefit clinical decision-making regarding the prescription
of NIPPV and help conserve human and material resources, thereby
preventing the indiscriminate use of NIPPV.<br/>Copyright &#xa9; 2024 The
Author(s). Published by Informa UK Limited, trading as Taylor & Francis
Group.

<37>
Accession Number
2031099052
Title
Implantation of a permanent pacemaker following orthotopic heart
transplantation: a systematic review and meta-analysis.
Source
Journal of Interventional Cardiac Electrophysiology. (no pagination),
2024. Date of Publication: 2024.
Author
Pajareya P.; Srisomwong S.; Siranart N.; Kaewkanha P.; Chumpangern Y.;
Prasitlumkum N.; Kewchareon J.; Chokesuwattanaskul R.; Tokavanich N.
Institution
(Pajareya, Siranart, Kaewkanha, Chokesuwattanaskul) Division of
Cardiovascular Medicine, Center of Excellence in Arrhythmia Research,
Cardiac Center, Faculty of Medicine, King Chulalongkorn Memorial Hospital,
Chulalongkorn University, Bangkok, Thailand
(Srisomwong) Faculty of Medicine, Vajira Hospital, Navamindradhiraj
University, Bangkok, Thailand
(Siranart, Prasitlumkum) Department of Cardiovascular Medicine, Mayo
Clinic, Rochester, United States
(Chumpangern) Faculty of Medicine, Siriraj Hospital, Mahidol University,
Bangkok, Thailand
(Kewchareon) Division of Cardiovascular Medicine, Loma Linda University
Health, Loma Linda, CA, United States
(Tokavanich) Division of Cardiovascular Medicine, Frankel Cardiovascular
Center, University of Michigan Health, Ann Arbor, MI, United States
Publisher
Springer
Abstract
Background: Orthotopic heart transplant (OHT) is among the final
armamentariums for end-stage heart disease. Many patients who have had OHT
require a post-transplant permanent pacemaker (PPM) implantation due to an
abnormal conduction system. We aimed to evaluate the risk of mortality and
acute rejection in patients with OHT who had received PPM compared to
patients without PPM and to determine predictors for PPM placement in this
population. <br/>Method(s): We comprehensively searched for studies from
MEDLINE, EMBASE, and Cochrane databases from inception to September 2023.
Inclusion criteria focused on patients who had undergone OHT and PPM
implantation post-transplant. Data from each study were combined using a
random-effects model. Results were expressed as relative risk (RR) or odd
ratios (OR) with a 95% confidence interval (CI). <br/>Result(s): A total
of 9 studies were included in this meta-analysis incorporating a total of
54,848 patients (3.3% had PPM). The pooled all-cause mortality rate among
patients with PPM post-OHT was 26% (95% CI: 19-33%, I² = 1%).
There were no differences between post-heart transplant patients with PPM
and those without PPM in risk of all-cause mortality (RR 0.76, 95% CI:
0.43-1.34; I² = 45%) and acute rejection (RR 1.22, 95% CI:
0.74-2.00, I² = 59%). Bi-atrial anastomosis was associated with
an increased risk of PPM implantation post-OHT (OR 7.74, 95% CI:
3.55-16.91, I² = 0%), while pre-OHT mechanical circulatory
support (MCS) was associated with a decreased risk of PPM implantation
post-OHT (OR 0.45, 95% CI 0.27-0.76, I² = 0%).
<br/>Conclusion(s): There were no significant differences in all-cause
mortality or acute rejection between post-OHT recipients who required PPM
compared to those who did not receive PPM. Further, bi-atrial anastomosis
portended the need for PPM implantation, while MCS was associated with a
decreased occurrence of PPM.<br/>Copyright &#xa9; The Author(s), under
exclusive licence to Springer Science+Business Media, LLC, part of
Springer Nature 2024.

<38>
Accession Number
645100602
Title
The Efficacy of Ultrasound Guided Bilateral Pectoralis Nerve Block for
Postoperative Pain Control in Cardiac Surgery, Randomized Control Trial.
Source
QJM: An International Journal of Medicine. Conference: 42nd Annual
International Ain Shams Medical Congress. Virtual. 116(Supplement 1) (pp
i39-i40), 2023. Date of Publication: June 2023.
Author
Elshaer A.N.; Abd ElMalek F.A.; Abdel-Aal Abdel-Mouty Taher I.; Elhelaly
O.R.M.
Institution
(Elshaer, Abd ElMalek, Abdel-Aal Abdel-Mouty Taher, Elhelaly) Department
of Anesthesia,Intensive Care and Pain Management, Faculty of Medicine, Ain
Shams University, Egypt
Publisher
Oxford University Press
Abstract
Background: Cardiothoracic surgeries are associated with significant pain.
Optimal analgesia is a vital part of enhanced recovery after surgery
strategies intended to improve patients' perioperative experience and
outcomes. Traditionally, analgesia in these types of surgeries has
depended on large doses of I.V. opioids. This is particularly pertinent
given the current focus on removing needless perioperative opioid
administration, and thereby decreasing the potential for opioid side
effects. Aim of the Work: The aim of the study was to evaluate the effect
of postoperative bilateral US guided Pecs block on postoperative pain
control in patients undergoing cardiac surgery through mid-line sternotomy
compared to systemic analgesia. <br/>Patients and Methods: Approval was
obtained from the research ethics committee of Faculty of Medicine; Ain
Shams University and a written informed consent was taken from each
patient to participate in the study, patients were randomly allocated into
two groups with 15 patients in each group. Group 1 (control group)
received systemic analgesics, whereas Group 2 (study group) received pecs
block. <br/>Result(s): Our study showed that when compared to general
anesthesia with systemic opioids, PECs block is associated with
significantly better postoperative pain control. <br/>Conclusion(s): Pecs
block is technically simple, safe and very effective technique and can be
used as a part of multimodal analgesia in postoperative cardiac surgical
patients for better patient comfort and satisfaction and also helps in
superior pulmonary rehabilitation, thus assisting in better outcome and
less unwanted side effects of systemic analgesics.

<39>
Accession Number
645100534
Title
Anterior versus Posterior Approach in Surgical Treatment of Tuberculous
Spondylodiscitis of Thoracic and Lumbar Spine.
Source
QJM: An International Journal of Medicine. Conference: 42nd Annual
International Ain Shams Medical Congress. Virtual. 116(Supplement 1) (pp
i257), 2023. Date of Publication: June 2023.
Author
Ibrahim F.M.F.; Ibrahim Z.H.; Ahmed A.M.
Institution
(Ibrahim, Ibrahim, Ahmed) Orthopedic and Spinal Surgery, Faculty of
Medicine, Ain Shams University, Egypt
Publisher
Oxford University Press
Abstract
Background: Spinal tuberculosis is the most common encountered
extra-pulmonary form of the disease and accounts for around 50% of
musculoskeletal tuberculosis cases, thoracic spine is the most commonly
affected, and involvement of lumbar and lumbosacral region is less common,
spinal tuberculosis can cause severe neurological deficits, kyphotic
deformities, and paraplegia. Aim of the Work: The aim of this study is
review the literature comparing the clinical, radiological and functional
outcome of anterior versus posterior surgical debridement and fixation in
patients with thoracic and lumbar tuberculous spondylodiscitis.
<br/>Patients and Methods: In this meta-analysis, we combined 25 studies
that compared the clinical outcomes of the anterior and posterior
approaches in treating 1797 patients with thoracic and lumber spinal TB.
This study was approved by the Ethics Committee of Ain Shams University
Faculty of Medicine. Written informed consent was not needed because of
the study design (systematic review). Based on patient safety and the
efficacy of the procedures, we raised three clinically crucial questions
to determine the optimal surgical procedure in treating thoracic and
lumbar tuberculosis. The primary data used as evidence to answer these
questions were obtained from the treatment results, such as the radiologic
data and patient-related outcomes. <br/>Result(s): The results showed that
there is no statically significant different in the operative time for the
anterior approach (220.8-51.5 minutes) versus posterior approach
(213.9-69.3 minutes), and no statistically significant difference was
detected. Blood loss was significantly greater in the anterior approach
(1125.0-275.5 mL) than in the posterior approach (710.4-192.4 mL).
<br/>Conclusion(s): The posterior approach showed a higher potential for
maintaining the correction of deformity and a lower overall surgical
complication rate; however, both groups showed no statistically
significant differences in operative time, blood loss, radiological and
clinical outcome; therefore posterior approach could be used as an
alternative procedure to treat thoracic and lumbar tuberculosis patients
in terms of pain control, Cobb's angle, and reduction of complications,
however; posterior-only approach alone cannot be used in cases of anterior
abscess formation or multilevel involvement where an anterior debridement
is mandatory, so; when deciding among the two procedures for treatment of
thoracic and lumbar spinal tuberculosis, surgeons must thoroughly consider
the patient's specific features of spinal tuberculosis, the surgeon's own
surgical experience, the risks of surgical complications ranging from
neurological to structural, and the different possible outcomes.

<40>
Accession Number
645100424
Title
<129>Silymarin for the Prevention of Contrast Induced Nephropathy after
Percutaneous Coronary Intervention in Patients with Acute ST Segment
Elevation MI.
Source
QJM: An International Journal of Medicine. Conference: 42nd Annual
International Ain Shams Medical Congress. Virtual. 116(Supplement 1) (pp
i57-i58), 2023. Date of Publication: June 2023.
Author
Malik A.; Atteya A.E.R.; Missiri A.E.L.
Institution
(Malik, Atteya, Missiri) Cardiology Department, Ain Shams University,
Egypt
Publisher
Oxford University Press
Abstract
Aim and Objectives: To study the role of a single dose of silymarin in the
prevention of CIN in patients with acute ST elevation MI undergoing
primary percutaneous coronary intervention <br/>Patients and Methods: The
study included 200 patients with acute ST segment elevation myocardial
infarction who underwent primary coronary angiography and percutaneous
coronary intervention in the cardiology department, Ain Shams university.
In the ER before the intervention, patients were randomized into 2 groups.
study group: Including 100 patients who received 300mg Aspirin, 600mg
clopidogrel and single dose of silymarin 140 mg. Control group: Including
100 patients who received 300mg Aspirin and 600mg clopidogrel. A nonionic,
iso-osmolar contrast material was used. Serum creatinine was measured
before and 48 h after injection of the contrast material. CIN was defined
as an increase in creatinine of >= 0.5 mg/dL or >= 25% from the baseline.
<br/>Result(s): Serum creatinine was increased by 0.18 plusmn; 0.28 mg/dL
with silymarin and by 0.35 plusmn; 0.42 mg/dL in non-silymarin group after
contrast material injection with statistically significant difference
(P-value 0.011). CIN occurred less frequently in silymarin group (12) than
in nonsilymarin group (28) with statistically significant difference
(P-value = 0.005). The contrast volume was higher in study group in
comparison to the contrast volume in the control group which was a high
statistically significant difference between the two groups with (P- value
0.000). There was a high statistically significant difference between the
2 groups regarding the whole time of the procedure and florotime with
P-value=(0.003) and (0.002) respectively. There was statistically
significant increase in the percentage of patients with baseline renal
impairment in study group than control group with 38(38%) VS 22 (22%)
respectively with (P-value = 0.014). While there was no statistically
significant difference found between control group and study group
regarding percentage of patients with HF symptoms, DM and HTN with (Pvalue
= 0.451, 0.568 and 0.774) respectively. Regarding random blood sugar and
Mehran score, there was no statistically significant difference between
control group and study group. There was a high statistically significant
difference between the 2 groups regarding the LVEF with (P-value = 0.000).
There was a statistically significant difference found between control
group and study group in diastolic blood pressure with (P-value 0.044).
While there was no statistically significant difference between both
groups in systolic blood pressure and heart rate. there was no
statistically significant difference found between control group and study
group regarding baseline demographic and anthropometric measures including
age, gender, weight, height and BMI. <br/>Conclusion(s): We found a trend
toward the efficacy of silymarin in preventing contrast-induced renal
dysfunction. Abbreviations: HF: heart failure; CIN: contrast induced
nephropathy; BMI: body mass index HR: heart rate; RI: renal impairment;
STEMI: st elevation myocardial infarction; CKD: chronic kidney disease;
CABG: coronary artery bypass graft; RBS: random blood sugar; AMI: acute
myocardial infarction; GFR: glomerular filtration rate; CAD: coronary
artery disease; IQR: interquartile range; ECG: electrocardiography; LVEF:
left ventricle ejection fraction; DM: diabetes Miletus; PCI: Percutaneous
coronary intervention; HTN: hypertension; S.cr: serum creatinine.

<41>
Accession Number
645100273
Title
Off Pump CABG Improves Postoperative Incidence of Coagulopathy Compared
with CABG on Pump.
Source
QJM: An International Journal of Medicine. Conference: 42nd Annual
International Ain Shams Medical Congress. Virtual. 116(Supplement 1) (pp
i31), 2023. Date of Publication: June 2023.
Author
Hammad M.I.M.; El-Bokl F.F.; Abd-Elmigeed Eltaher W.M.; Shorbagy M.S.
Institution
(Hammad, El-Bokl, Abd-Elmigeed Eltaher, Shorbagy) Anesthesia,Intensive
Care and Pain Management Department, Faculty of Medicine, Ain Shams
University, Egypt
Publisher
Oxford University Press
Abstract
Background: Coronary artery bypass grafting remains the standard treatment
for patients with extensive coronary artery disease. Coronary surgery
without use of cardiopulmonary bypass avoids the deleterious systemic
inflammatory effects of the extracorporeal circuit. However there is an
ongoing debate surrounding the clinical outcomes after on-pump versus
offpump coronary artery bypass (ONCAB versus OPCAB) grafting surgery. Aim
of the Work: To compare the incidence of postoperative coagulopathy
transfusion of blood product therapy, (Packed RBCs, FFP and platelet
concentrate) bleeding (amount of blood in chest tube drains) and
reexploration, that occur in adults off pump CABG surgery in comparison to
on pump CABG. <br/>Patients and Methods: We enrolled sixty consecutive
adult patients scheduled for isolated CABG surgery (with a median
sternotomy) with or without cardiopulmonary bypass pump. The patients are
allocated in two groups where thirty patients in each group (group A - On
pump - ONCAB- conventional surgery) and (group B - Off pump - OPCAB -
beating heart) after obtaining their written informed consent.
<br/>Result(s): The clinical outcome measure was the incidence of bleeding
in group B less than group A. In our study there was highly significant
increase in the amount of blood in drains, transfusion requirements and
need for re-exploration within twenty four hours after surgery in group A
than group B. <br/>Conclusion(s): We concluded that off pump cardiac
surgery is better than on pump procedure in decreasing risk of bleeding,
post-operative transfusion requirements and risk of reexploration.

<42>
Accession Number
645100249
Title
Effect of Preoperative Intravenous Iron for Anemic Patients on Outcomes
after Cardiac Surgery: A Systematic Review.
Source
QJM: An International Journal of Medicine. Conference: 42nd Annual
International Ain Shams Medical Congress. Virtual. 116(Supplement 1) (pp
i9), 2023. Date of Publication: June 2023.
Author
Fahmy S.M.H.; Hakim M.A.; Daniel S.H.; El-Gendy A.E.A.
Institution
(Fahmy, Hakim, Daniel, El-Gendy) Department of Anesthesiology,Intensive
Care and Pain Manegement, Faculty of Medicine, Ain Shams University, Egypt
Publisher
Oxford University Press
Abstract
Background: Iron-deficiency anemia is a global health problem and a common
medical condition seen in everyday clinical practice and especially with
patients going through cardiac surgery. The most rapid and effective
method of correcting anemia is by transfusion of red blood cells. However,
blood transfusion itself is not without risk. Treatment of perioperative
anemia using iron replacement therapy is, in contrast to blood
transfusion, a safe, cheap, and relatively convenient therapy Aim of the
Work: This study aims to perform a systematic review regarding the effect
of preoperative intravenous iron therapy on the need for perioperative
blood transfusion and the incidence of major morbidity in anemic patients
undergoing cardiac surgery. Search Methodology: The review was conducted
according to the Preferred Reporting Items for Systematic Reviews and
Meta- Analyses (PRISMA) guidelines, and articles were identified by
searching PubMed, Web of Science, EMBASE, COCHRANE Database of systematic
reviews (CDSR), Scopus, and Web of Science. Quality of the studies was
assessed using the Cochrane Risk of Bias Tool 2 (ROB-2) and Risk of Bias
in Non-randomized Studies tool (ROBANS). The primary outcomes are change
in hemoglobin and hematocrit after cardiac surgery and perioperative need
for blood transfusion, while secondary outcomes are postoperative length
of hospital stay and incidence of major adverse outcomes. <br/>Result(s):
Of the articles reviewed a total of six randomized controlled trials (RCT)
and seven non-randomized observational studies (NRSI) were included in the
review. Across studies, 1,732 patients were enrolled. The quality of the
RCTs was mostly high, while the quality of the NRSTs was low, primarily
due to issues related to blinding of assessors. Two studies showed higher
hemoglobin with iron therapy, and only one study showed significant
differences in multiple outcomes such as transfusion and morbidity.
Hospital stay was reported in 4 studies and averaged 9 days.
<br/>Conclusion(s): Our results showed benefits of preoperative
intravenous iron administration in reducing the likelihood of allogeneic
blood transfusion and providing a modest increase a modest increase in
hemoglobin concentration in anemic patients undergoing caridac surgery.

<43>
Accession Number
645100187
Title
Study of the Acute Hemodynamic Effects of Inhaled Milrinone versus Inhaled
Nitroglycerin on Mechanically Ventilated Patients with Pulmonary
Hypertension after Mitral Valve Replacement Surgeries.
Source
QJM: An International Journal of Medicine. Conference: 42nd Annual
International Ain Shams Medical Congress. Virtual. 116(Supplement 1) (pp
i7-i8), 2023. Date of Publication: June 2023.
Author
Sultan S.S.A.; El-Sayed Ismael Mostafa W.; El-Komos Samaan P.M.; Abdel
A.K.; Hassan G.; Saeed A.S.F.
Institution
(Sultan, El-Sayed Ismael Mostafa, El-Komos Samaan, Abdel, Hassan, Saeed)
Anaesthesiology,Intensive Care and Pain management Department, Faculty of
Medicine, Ain Shams University, Egypt
Publisher
Oxford University Press
Abstract
Background: Pulmonary hypertension is a usual complication of
long-standing mitral valve disease. Perioperative pulmonary hypertension
is a risk factor for right ventricular failure and is an important cause
of morbidity and mortality in patients with pulmonary hypertension
undergoing mitral valve surgery. Aim of the Work: To compare inhaled
milrinone and inhaled nitroglycerin hemodynamic effects on mechanically
ventilated patients with pulmonary hypertension after mitral valve
replacement surgery by measuring invasive blood pressure, heart rate,
central venous pressure and bedside transthoracic echocardiography to
assess pulmonary artery pressure. <br/>Patients and Methods: The study was
conducted in National Heart Institute, Giza, Egypt during the six months
between October, 2020 and March, 2021. This study was conducted on 40
patients. Patients were randomized on the basis of computergenerated
random numbers into two equal groups (20 patients each) Using PASS11
program for sample size calculation. In group A, patients received inhaled
nitroglycerin (50 m/kg) and in group B, patients received inhaled
milrinone (50 m/kg) through jet nebulizer. <br/>Result(s): Both inhaled
milrinone and inhaled nitroglycerin proved to be selective pulmonary
vasodilators, since they induced significant reductions in mPAP, SPAP, and
DPAP. The favorable effects of both agents on the pulmonary vasculature
was confirmed by both hemodynamic and echocardiographic measurements. At
the same time, both agents were devoid of systemic side effects, since
mean arterial pressure, systolic arterial pressure and diastolic arterial
pressure were not affected. <br/>Conclusion(s): There was no significance
between two groups, so inhaled nitroglycerin appears to be an effective,
easy to administer, inexpensive, available and save alternative for
treatment of PH in mechanically ventilated patients after mitral valve
replacement surgeries as there was no significance between two groups.

<44>
Accession Number
645100114
Title
Albumin as Early Fluid Bolus Therapy after Cardiac Surgery in the Critical
Care Units.
Source
QJM: An International Journal of Medicine. Conference: 42nd Annual
International Ain Shams Medical Congress. Virtual. 116(Supplement 1) (pp
i6), 2023. Date of Publication: June 2023.
Author
Noureldin B.; Hakim K.; Ali H.; Abdelsalam A.
Institution
(Noureldin, Hakim, Ali, Abdelsalam) Anesthesia,Intensive Care and Pain
Management Department, Faculty of Medicine, Ain Shams University, Egypt
Publisher
Oxford University Press
Abstract
Introduction: After cardiac surgery, the use of intravenous fluids to
reach specific goals is associated with improved clinical outcomes and
shortened intensive care units (ICU) stay. Although type of fluid doesn't
seem to be of a great importance. Clinicians will have been involved in
many local debates about the best fluid. Absence of evidence about what is
the ideal fluid in this situation push researchers to conduct clinical
trials in this context. Aim of the Work: The aim of this study is to
investigate the cardiovascular effect of using 20% albumin in patients
after cardiac surgery. <br/>Method(s): This was a double blinded RCT that
was conducted at Department of Critical Care Medicine, Ain Shams
University Hospital over plusmn; months on post-cardiac surgery
mechanically ventilated patients with a clinical decision to administer
fluid bolus therapy, that was assessed for enrollment. <br/>Result(s):
There was no statistically significant difference between two groups
regarding delta serum chloride at 24h post-op (mmol/L) and renal
replacement therapy post-operatively in ICU, and there was statistically
significant difference found between two groups regarding ICU, and
Hospital stay, duration of mechanical ventilation, total dose nor
epinephrine/ kg in the first 24h post-op (microg/kg), time to cessation of
nor epinephrine infusion (h) and Delta serum creatinine at 24 h post-op
(mg/dl). <br/>Conclusion(s): In patients admitted to ICU following cardiac
surgery, FBT with 20% albumin, when compared to crystalloid FBT, achieved
equivalent cardiovascular optimization with smaller volumes of
resuscitation fluid, less positive cumulative balance, and without
evidence of any negative sequelae. Moreover, the use of 20% albumin for
FBT was associated with lower amounts of vasopressor being delivered and
shorter duration.

<45>
Accession Number
645100020
Title
Potential Benefit of Combined Topical and Intravenous Administration of
Tranexamic Acid in Congenital Heart Surgery.
Source
QJM: An International Journal of Medicine. Conference: 42nd Annual
International Ain Shams Medical Congress. Virtual. 116(Supplement 1) (pp
i3), 2023. Date of Publication: June 2023.
Author
El Dein Abdelaziz F.K.; Sharaf S.I.I.; Seif E.M.K.A.; Ismail A.M.T.A.
Institution
(El Dein Abdelaziz, Sharaf, Seif) Department of Anesthesiology,Intensive
Care and Pain Management, Faculty of Medicine, Ain Shams University, Egypt
(Ismail) Faculty of Medicine, Ain Shams University, Egypt
Publisher
Oxford University Press
Abstract
Objective: Pediatric patients who undergo repair of congenital heart
diseases on cardiopulmonary bypass are at great risk of postoperative
bleeding. The major causes of bleeding are thrombocytopenia, platelets
dysfunction, hemodilution and increased fibrinolysis during
cardiopulmonary bypass (CPB). Non-surgical postoperative bleeding occurs
due to micro-vascular bleeding from pericardial and mediastinal tissues
when blood comes in contact with non-endothelial surfaces of the
Cardio-Pulmonary Bypass (CPB) machine, compounded by liberal use of
heparin and a complex interaction of humoral and cellular pathways. Aim of
the Work: The aim of the study is to asses if there is potential benefit
of intrapericardial topical application of tranexamic acid when it is
combined with the intravenous administration in reduction of postoperative
bleeding after pediatric cardiac surgery on cardiopulmonary bypass (CPB).
<br/>Patients and Methods: Type of the study: Interventional, randomized
and double blinded clinical trial. Study Setting: The operating theaters
of Ain Shams University Hospitals. Study period: Over one year (from March
2020 to March 2021). Standard management: Intravenous Tranexamic acid
(TxA) injection. <br/>Result(s): The estimated blood loss postoperatively
in first 24 hrs. Were less in the combined group than the IV group.
Requirements of blood transfusion also were statically significant in
combined group than IV group from aspects of volume of PRBCs transfusion,
Total number of patients exposed to transfusion and transfusion rate.
There is no difference regarding ICU stay and need of surgical re
exploration. <br/>Conclusion(s): The combined use of low dose IV and
topical intrapericardial tranexamic acid in children with congenital heart
disease undergoing on pump cardiac surgery reduced the risk of
post-operative bleeding and need for blood products transfusion when
compared to the administration of IV tranexamic acid only suggesting a
potential benefit of topical tranexamic acid in hemostasis.

<46>
Accession Number
2030833542
Title
Preoperative Concerns of Older Patients Undergoing Non-cardiac Surgery: A
Systematic Review and Meta-analysis.
Source
Open Anesthesia Journal. 18 (no pagination), 2024. Article Number:
e25896458322437. Date of Publication: 2024.
Author
Qu M.; Liu W.; Yan E.; Saripella A.; Englesakis M.; He D.; Chung F.
Institution
(Qu) Queen's University School of Medicine, Queen's University, Kingston,
ON, Canada
(Liu) Michael DeGroote School of Medicine, McMaster University, Hamilton,
ON, Canada
(Yan, Saripella, Chung) Department of Anesthesia and Pain Management,
Toronto Western Hospital, University Health Network, University of
Toronto, Toronto, ON, Canada
(Yan, Chung) Institute of Medical Science, Temerty Faculty of Medicine,
University of Toronto, ON, Canada
(Englesakis) Library & Information Services, University Health Network,
Toronto, ON, Canada
(He) Department of Anesthesiology and Pain Medicine, Mount Sinai Hospital,
University of Toronto, Toronto, ON, Canada
Publisher
Bentham Science Publishers
Abstract
Background: Older adults (>= 50 years) possess unique preoperative
concerns influenced by age-related needs, perceptions, and health status.
When left unaddressed, these concerns are risk factors for postoperative
morbidity and mortality. Despite the aging demographic, these concerns in
older patients have not been systematically examined. This systematic
review and meta-analysis aims to summarize the preoperative concerns of
older patients. <br/>Method(s): Five databases were searched from January
1, 2000 to March 26, 2023. Studies with 1) patients >= 50 years undergoing
non-cardiac surgery; 2) concerns identified preoperatively with validated
instruments; 3) at least one preoperative concern reported (mean, degree
or incidence of concern); 4) randomized controlled trials, prospective
cohort, or cross-sectional studies were included. Concerns were classified
into domains and subdomains. Meta-analysis was performed when two or more
studies assessed concerns utilizing the same instrument. <br/>Result(s):
Seventeen studies with 1,777 patients were included. The mean age was 68.3
+/- 9.9 years, with 51.4% female. Surgeries were classified as mixed,
orthopedic (elective or emergent), and high-burden (abdominal, vascular,
oncological). Concerns were categorized into domains: 1) anesthesia, 2)
surgery, 3) pain, 4) complications, 5) medical experience, 6) recovery and
rehabilitation, and 7) impact on daily life. Patients reported a greater
degree of anxiety relating to surgery than anesthesia: 1.54 (95% CI:
1.12-1.95, P<0.00001). The top three concerns across all surgeries (mixed,
orthopedic, and high-burden) were complications, pain, and
rehabilitation/recovery. Pain and complications were the greatest concerns
in elective orthopedic procedures and emergent procedures, respectively.
In high-burden surgeries, patients were primarily concerned about
complications. <br/>Conclusion(s): Surgery-related concerns were 50%
greater than anesthesia-related concerns. The three main concerns in older
patients were complications, pain, and rehabilitation/recovery. The top
concerns varied among specific surgical types. These findings emphasize
the importance of tailoring preoperative counseling to address specific
fears of each surgical population.<br/>Copyright &#xa9; 2024 The
Author(s).

<47>
Accession Number
2034348291
Title
The Association Between Renal Desaturation Measured Using Near-Infrared
Spectroscopy and Postoperative Acute Kidney Injury: A Systematic Review.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2024.
Date of Publication: 2024.
Author
Wang B.; Shi H.; Yao Y.; Liu S.; Shi C.
Institution
(Wang, Shi) Department of Anesthesiology, Peking University International
Hospital, Beijing, China
(Shi) Department of Anesthesiology, Shijingshan Hospital, Beijing, China
(Yao) Department of Anesthesiology, National Center for Cardiovascular
Diseases, Chinese Academy of Medical Sciences, Fuwai Hospital, Peking
Union Medical College, Beijing, China
(Liu) Department of Cardiac Surgery, Peking University International
Hospital, Beijing, China
Publisher
W.B. Saunders
Abstract
Objectives: The objective of this systematic review was to clarify the
status of near-infrared spectroscopy (NIRS) in monitoring perioperative
renal regional tissue oxygen saturation (rSO<inf>2</inf>) and determine
whether there is evidence supporting its use in predicting postoperative
acute kidney injury (AKI). <br/>Design(s): A systematic search of
electronic databases was conducted to identify all clinical studies that
utilized NIRS to monitor renal rSO<inf>2</inf> during the perioperative
period to observe postoperative AKI. <br/>Setting(s): Studies published
online as of May 31, 2024, were included in the review.
<br/>Participant(s): Studies involving human participants undergoing
surgery with a predefined outcome of AKI were included.
<br/>Intervention(s): Regional tissue oxygen saturation was measured using
NIRS. <br/>Measurements and Main Results: A total of 144 records were
identified in the primary search after removing duplicates. After
screening, 18 studies were included in the analysis, consisting of 3
case-control studies and 15 prospective cohort studies. Thirteen reports
focused on pediatric surgery, whereas five reports focused on adult
surgery. Sixteen studies involved cardiovascular surgery with
cardiopulmonary bypass, and two studies focused on liver surgery. All
studies received a quality score of 7 or above. Significant heterogeneity
and mostly short follow up periods were noted. <br/>Conclusion(s): Renal
desaturation may indicate AKI in patients; however, further studies are
required to substantiate this relationship. Additional clinical trials are
necessary to evaluate normal values and establish the exact threshold of
renal rSO<inf>2</inf> that signifies a meaningful decline in renal
function.<br/>Copyright &#xa9; 2024

<48>
Accession Number
645115512
Title
Safety and Patient Experience With Early Mobilization After Transcatheter
Aortic Valve Implantation: A Randomized Trial.
Source
The Journal of cardiovascular nursing. (no pagination), 2024. Date of
Publication: 23 Jul 2024.
Author
Kirk B.H.; Norgaard M.W.; Palm P.; Norekval T.M.; De Backer O.
Abstract
BACKGROUND: Immobilization after transcatheter aortic valve replacement
(TAVR) is the standard treatment for preventing access-related
complications. However, the length of bed rest varies, and possible
complications and patient experience remain unexplored. <br/>OBJECTIVE(S):
In this pilot study, our aim was to investigate safety and efficacy after
bed rest after TAVR. <br/>METHOD(S): This single-center randomized trial
included 298 patients. Patients were randomized to standard 6 hours (n =
149) or 3 hours (n = 149) of bed rest after TAVR. The primary safety
endpoint was a composite of access-related bleeding (Bleeding Academic
Research Consortium type >= 2), hematoma (>5 cm), pseudoaneurysm, and
vascular complications requiring intervention. The primary efficacy
endpoint was patient-reported back pain, rated >=6 on a numeric rating
scale 24 hours post procedure. The secondary endpoints were the individual
components of the primary safety endpoint, patient-reported pain,
urination problems, and comfort. <br/>RESULT(S): The primary safety
endpoint occurred in 14 (9.4%) and 12 (8.1%) patients in the 6-hour and
3-hour immobilization groups, respectively (risk ratio, 0.86 [95%
confidence interval, 0.41-1.79]; P = .68). There were no significant
differences in individual bleeding or vascular complication endpoints.
Patients with 3 hours of bed rest reported less back pain (P < .001),
fewer urination problems (P < .001), and better comfort (P < .001) than
patients with 6 hours of bed rest. <br/>CONCLUSION(S): Mobilization as
early as 3 hours after TAVR was shown to be safe, not resulting in a
higher rate of bleeding or vascular complications as compared with 6 hours
of bed rest. However, there was a difference in patient-reported back
pain, urination problems, and comfort, favoring early
mobilization.<br/>Copyright &#xa9; 2024 Wolters Kluwer Health, Inc. All
rights reserved.

<49>
Accession Number
2034188787
Title
Safety and Effectiveness of Acceleration Training as Cardiac
Rehabilitation Immediately After Open Heart Surgery.
Source
Circulation Journal. 88(9) (pp 1432-1439), 2024. Date of Publication: 01
Sep 2024.
Author
Kanazawa Y.; Saito S.; Okubo S.; Matsuoka T.; Hirota S.; Yokoyama S.;
Tezuka M.; Takei Y.; Tsuchiya G.; Konishi T.; Ogata K.; Shibasaki I.;
Nakajima T.; Fukuda H.
Institution
(Kanazawa, Okubo, Matsuoka, Hirota, Yokoyama, Tezuka, Takei, Tsuchiya,
Konishi, Ogata, Shibasaki, Fukuda) Department of Cardiac and Vascular
Surgery, School of Medicine, Dokkyo Medical University, Tochigi, Japan
(Nakajima) Department of Medical KAATSU Training, Dokkyo Medical
University, Tochigi, Japan
(Saito) Division of Cardiovascular Surgery, Department of Surgery, Osaka
University, Osaka, Japan
Publisher
Japanese Circulation Society
Abstract
Background: We examined the safety and efficacy of acceleration training
(AT) in patients immediately after cardiac surgery. <br/>Methods and
Results: This randomized controlled study included patients who underwent
open-heart surgery using cardiopulmonary bypass. Of these patients, 31
received regular cardiac rehabilitation (CR) and 39 received AT in
addition to regular CR (AT group). AT was provided using a vibration
platform (Power Plate Pro7^TM and Power
plate personal; Performance Health System, Chicago, IL, USA).
The AT group performed 5 static resistance training sessions: squats, wide
stance squats, toe stands, banded squats, and front lunges. Each vibration
session lasted 30 s. We evaluated the short physical performance battery,
anterior mid-thigh thickness, maximum voluntary isometric contraction of
the knee extensors, and serum intercellular adhesion molecule (ICAM-1) and
vascular cell adhesion molecule (VCAM-1) concentrations as indicators of
endothelial function. The observation period was during hospitalization
and lasted approximately 20 days. No adverse events occurred during AT.
Ultrasound revealed a significantly lower reduction in muscle mass at
discharge in the AT group. No significant differences were observed in
ICAM-1 and VCAM-1 concentrations between the 2 groups preoperatively,
postoperatively, or at discharge. <br/>Conclusion(s): AT is considered
safe and effective for patients immediately after open-heart surgery. AT,
along with regular CR, may prevent skeletal muscle mass loss, muscle
weakness, and physical function loss immediately after open-heart
surgery.<br/>Copyright &#xa9; 2024 Japanese Circulation Society. All
rights reserved.

<50>
Accession Number
2034298905
Title
Management of Fluid Overload in Patients With Severe Aortic Stenosis
(EASE-TAVR): A Randomized Controlled Trial.
Source
JACC: Cardiovascular Interventions. 17(17) (pp 2054-2066), 2024. Date of
Publication: 09 Sep 2024.
Author
Halavina K.; Koschutnik M.; Dona C.; Autherith M.; Petric F.; Rockel A.;
Spinka G.; Danesh D.; Puchinger J.; Wiesholzer M.; Mascherbauer K.;
Heitzinger G.; Dannenberg V.; Koschatko S.; Jantsch C.; Winter M.-P.;
Goliasch G.; Kammerlander A.A.; Bartko P.E.; Hengstenberg C.; Mascherbauer
J.; Nitsche C.
Institution
(Halavina, Koschutnik, Dona, Autherith, Petric, Rockel, Spinka,
Mascherbauer, Heitzinger, Dannenberg, Koschatko, Jantsch, Winter,
Goliasch, Kammerlander, Bartko, Hengstenberg, Nitsche) Department of
Internal Medicine 2, Division of Cardiology, Medical University of Vienna,
Vienna, Austria
(Danesh, Puchinger, Mascherbauer) Department of Internal Medicine 3,
University Hospital St. Polten, Karl Landsteiner University of Health
Sciences, Krems, Austria
(Wiesholzer) Department of Internal Medicine 1, University Hospital St.
Polten, Karl Landsteiner University of Health Sciences, Krems, Austria
Publisher
Elsevier Inc.
Abstract
Background: Fluid overload (FO) subjects patients with severe aortic
stenosis (AS) to increased risk for heart failure and death after valve
replacement and can be objectively quantified using bioimpedance
spectroscopy (BIS). <br/>Objective(s): The authors hypothesized that in AS
patients with concomitant FO, BIS-guided decongestion could improve
prognosis and quality of life following transcatheter aortic valve
replacement (TAVR). <br/>Method(s): This randomized, controlled trial
enrolled 232 patients with severe AS scheduled for TAVR. FO was defined
using a portable whole-body BIS device according to previously established
cutoffs (>=1.0 L and/or >=7%). Patients with FO (n = 111) were randomly
assigned 1:1 to receive BIS-guided decongestion (n = 55) or decongestion
by clinical judgment alone (n = 56) following TAVR. Patients without FO (n
= 121) served as a control cohort. The primary endpoint was the composite
of hospitalization for heart failure and/or all-cause death at 12 months.
The secondary endpoint was the change from baseline to 12 months in the
Kansas City Cardiomyopathy Questionnaire. <br/>Result(s): The occurrence
of the primary endpoint at 12 months was significantly lower in the
BIS-guided vs the non-BIS-guided decongestion group (7/55 [12.7%, all
deaths] vs 18/56 [32.1%, 9 hospitalizations for heart failure and 9
deaths]; HR: 0.36; 95% CI: 0.15-0.87; absolute risk reduction = -19.4%).
Outcomes in the BIS-guided decongestion group were identical to the
euvolemic control group (log-rank test, P = 0.7). BIS-guided decongestion
was also associated with a higher increase in the Kansas City
Cardiomyopathy Questionnaire score from baseline compared to
non-BIS-guided decongestion (P = 0.001). <br/>Conclusion(s): In patients
with severe AS and concomitant FO, quantitatively guided decongestive
treatment and associated intensified management post-TAVR was associated
with improved outcomes and quality of life compared to decongestion by
clinical judgment alone. (Management of Fluid Overload in Patients
Scheduled for Transcatheter Aortic Valve Replacement [EASE-TAVR];
NCT04556123)<br/>Copyright &#xa9; 2024 The Authors

<51>
Accession Number
2034302246
Title
Cardiac Papillary Fibroelastoma and Cerebrovascular Events: A Systematic
Review.
Source
CJC Open. (no pagination), 2024. Date of Publication: 2024.
Author
Neupane G.; Sharma R.; Parajuli R.; Mathews A.; Khalili H.
Institution
(Neupane) Department of Internal Medicine, Mercy Hospital, Springfield,
MO, United States
(Sharma) Department of Internal Medicine, Florida Atlantic University,
Boca Raton, FL, United States
(Parajuli) Odum School of Ecology, University of Georgia, Athens, GA,
United States
(Parajuli) Department of Geosciences, Florida Atlantic University, Boca
Raton, FL, United States
(Mathews) Department of Cardiology, Tampa General Hospital, FL, United
States
(Khalili) Department of Cardiology, Memorial Healthcare System, FL, United
States
Publisher
Elsevier Inc.
Abstract
Background: Cardiac papillary fibroelastomas (CPFs) are benign endocardial
tumours with embolic potential. This article is a systematic review to
identify the clinical profile, diagnosis, tumour characteristics, and
treatment modalities in patients with CPF presenting with stroke or
transient ischemic attack (TIA). <br/>Method(s): This systematic review
was conducted using the PubMed and Embase databases, including case
reports and/or series and observational studies (for a search period of up
until April 2022). A descriptive summary of case reports and/or series,
and a narrative summary of observational studies, were completed.
<br/>Result(s): A total of 161 cases were identified from 133 case reports
and 11 case series. The mean age of patients was 54.8 years, and 46.6%
were male. TIA and stroke were reported in 32.3% and 67.8%, respectively.
The most common stroke territory was multiple brain sites (36.6%). The
mean tumour size was 11.8 mm. Most of the tumours were left-sided (98.7%).
The mitral valve was the most involved valve (38.9%), with the anterior
leaflet being the commonest site (61.3%). A total of 91.4% of tumours were
independently mobile; 10.6% of tumours missed by transthoracic
echocardiography were identified on transesophageal echocardiography.
Antiplatelet and anticoagulation treatment were used in 87.9% and 12.1% of
cases, respectively. Simple excision, valve repair, and valve replacement
were performed in 66.7%, 16.7%, and 16.7%, respectively. The logistic
regression model revealed that age was the only significant predictor; an
increase in the log-odds of recurrent cerebrovascular events occurred with
increasing age. <br/>Conclusion(s): CPFs are a differential diagnosis of
cryptogenic stroke, especially if the initial workup for stroke is
negative. Transesophageal echocardiography serves as a better imaging
tool, compared to transthoracic echocardiography, in identifying CPF.
Although the consensus for CPF management remains controversial, surgical
excision is the primary approach for left-sided CPF presenting as stroke
or TIA.<br/>Copyright &#xa9; 2024 The Authors

<52>
Accession Number
2034302116
Title
Outcomes following TAVR in patients with cardiogenic shock: A systematic
review and meta-analysis.
Source
Cardiovascular Revascularization Medicine. (no pagination), 2024. Date of
Publication: 2024.
Author
Jabri A.; Ayyad M.; Albandak M.; Al-Abdouh A.; Madanat L.; Khalefa B.B.;
Alhuneafat L.; Ayyad A.; Lemor A.; Mhanna M.; Al Jebaje Z.; Fadel R.;
Gonzalez P.E.; O'Neill B.; Bagur R.; Hanson I.D.; Abbas A.E.; Frisoli T.;
Lee J.; Wang D.D.; Aggarwal V.; Alaswad K.; O'Neill W.W.; Aronow H.D.;
AlQarqaz M.; Villablanca P.
Institution
(Ayyad, Al Jebaje, Fadel, Gonzalez, O'Neill, Frisoli, Lee, Wang, Aggarwal,
Alaswad, O'Neill, Aronow, AlQarqaz, Villablanca) Division of
Cardiovascular Medicine, Henry Ford Hospital, Michigan State University,
College of Human Medicine, Detroit, MI, United States
(Albandak, Al-Abdouh) Division of Hospital Medicine, University of
Kentucky, Lexington, KY, United States
(Jabri, Madanat, Hanson, Abbas) Department of Cardiovascular Medicine,
William Beaumont University Hospital, Oakland University William Beaumont
School of Medicine, Royal Oak, MI, United States
(Khalefa, Alhuneafat) Cardiovascular Division, University of Minnesota,
Minneapolis, MN, United States
(Lemor) Division of Cardiovascular Disease, Department of Medicine,
University of Mississippi Medical Center, Jackson, MS, United States
(Mhanna) Division of Cardiovascular Medicine, University of Iowa, IA,
United States
(Bagur) Division of Cardiology, Department of Medicine, London Health
Sciences Centre, Western University, Canada Department of Epidemiology and
Biostatistics, Western University, London, ON, Canada
(Ayyad) Department of Internal Medicine, Rutgers New Jersey Medical
school, Newark, NJ, United States
Publisher
Elsevier Inc.
Abstract
Background: While transcatheter aortic valve replacement (TAVR) has
broadened treatment options for critically ill patients, outcomes among
those with concomitant cardiogenic shock (CS) are not well-explored.
<br/>Method(s): We conducted a comprehensive search of major databases for
studies comparing outcomes following TAVR in patients with and without CS
since inception up to October 31, 2023. Our meta-analysis included five
non-randomized observational. Dichotomous outcomes were assessed using the
Mantel-Haenszel method (risk ratio, 95 % CI), and continuous outcomes were
evaluated using mean difference and 95 % CI with the inverse variance
method. Statistical heterogeneity was determined using the inconsistency
test (I²). <br/>Result(s): Among 26,283 patients across five
studies, 30-day mortality was higher in the CS group (7267 patients; 27.6
%) compared to those without CS (OR 3.41, 95 % CI [2.01, 5.76], p < 0.01),
as well as 30-day major vascular complications (OR 1.72, 95 % CI [1.54,
1.92], p < 0.01). At 1-year follow-up, there was no statistically
significant difference in mortality rates between the compared groups (OR
2.68, 95 % CI [0.53, 13.46], p = 0.12). No significant between-group
differences were observed in the likelihood of 30-day aortic valve
reintervention (OR 3.20, 95 % CI [0.63, 16.22], p = 0.09) or post-TAVR
aortic insufficiency (OR 0.91, 95 % CI [0.33, 2.51], p = 0.73).
Furthermore, 30-day stroke, pacemaker implantation, and in-hospital major
bleeding were comparable between both cohorts. <br/>Conclusion(s): Among
patients undergoing TAVR, short-term mortality is higher but one-year
outcomes are similar when comparing those with, to those without, CS.
Future studies should examine whether TAVR outcomes are improved when the
procedure is delayed to optimize CS and when delay is not possible,
whether particular management strategies lead to more favorable
periprocedural outcomes.<br/>Copyright &#xa9; 2024 Elsevier Inc.

<53>
Accession Number
2034298316
Title
Proton pump inhibitors and cardiovascular adverse events: a meta-analysis
of randomized controlled trials.
Source
American Journal of Gastroenterology. (no pagination), 2024. Article
Number: 10.14309/ajg.0000000000003058. Date of Publication: 2024.
Author
Mosholder A.D.; Hada M.; Leishear K.
Institution
(Mosholder, Hada, Leishear) Division of Epidemiology 1, U.S. Food and Drug
Administration Center for Drug Evaluation and Research, Silver Spring, MD,
United States
Publisher
Wolters Kluwer Health
Abstract
Some observational studies suggest a cardiovascular risk from proton pump
inhibitor (PPI) treatment, but observational data may be subject to bias.
We conducted a meta-analysis of randomized controlled trial data on
cardiovascular events during PPI treatment. Methods Manufacturers of PPIs
provided data from their PPI clinical trial programs. We included
randomized trials with at least 100 subjects, treatment duration >30 days,
and a non-PPI comparator (active or placebo). We obtained person-time of
exposure per trial, to calculate summary incidence rate ratios (primary
analysis) and incident rate differences (secondary analysis). Our primary
composite outcome was major adverse cardiovascular events-plus (MACE+),
which included nonfatal myocardial infarction, nonfatal stroke, fatal
cardiovascular adverse events, hospitalization for unstable angina, or
coronary revascularization; events were adjudicated blindly. Results
Cardiovascular outcomes were infrequent in randomized trials of PPIs and
our primary analysis found no overall association (summary incident rate
ratio, MACE+ events, PPI:placebo, 0.72 (95% confidence interval [CI]
0.42-1.26). There was some heterogeneity by indication category, and by
the incidence rate difference metric, gastroesophageal reflux disorder
(GERD) trials had 1.04 (95% CI 0.58, 1.50) excess MACE+ events per 100
person-years of treatment versus placebo. Comparisons to active controls
generally showed positive incidence rate differences with PPI treatment.
Discussion Overall, we found no association of cardiovascular events with
PPI treatment. Cardiovascular events appeared more frequent with PPI
treatment in GERD trials, but results from this subgroup should be
interpreted with the limitations of the analysis in mind, including sparse
outcome counts and lack of individual patient data.<br/>Copyright &#xa9;
2024 by The American College of Gastroenterology.

<54>
Accession Number
2034280448
Title
Effect of Inspiratory Muscle Training on Outcomes after Cardiac Surgery: A
Comprehensive Meta-Analysis of Randomized Controlled Trials.
Source
Journal of Cardiopulmonary Rehabilitation and Prevention. (no
pagination), 2024. Date of Publication: 2024.
Author
Fang L.; Cheng A.; Zhu Z.; Shao M.; Wang G.
Institution
(Fang, Cheng, Zhu, Shao, Wang) Cardiorpulmonary Rehabilitation Ward
Zhejiang Rehabilitation Medical Center (The Affiliated Rehabilitation
Hospital of Zhejiang Chinese Medical University) Hangzhou Zhejiang
Province China; and Rehabilitation Medicine Department 2 The Third
Affiliated Hospital of Zhejiang University of Traditional Chinese Medicine
Hangzhou Zhejiang Province China.
Publisher
Lippincott Williams and Wilkins
Abstract
Purpose: Inspiratory muscle training (IMT) has emerged as a potential
intervention to improve respiratory outcomes for patients undergoing
cardiac surgery. However, the extent of the IMT effects on preoperative
and postoperative respiratory metrics remains uncertain. Hence, we
designed this study to determine the effects of IMT on various outcomes of
patients undergoing cardiac surgery. <br/>Method(s): We conducted a
comprehensive meta-analysis of studies evaluating the impact of
preoperative and postoperative IMT on various respiratory variables and
postsurgical outcomes. We synthesized data from multiple studies,
encompassing diverse patient populations and IMT protocols. The key
outcomes included the maximal inspiratory pressure (MIP), forced
expiratory volume in 1 sec (FEV1), forced vital capacity (FVC), and
others. <br/>Result(s): Our meta-analysis results showed that preoperative
IMT significantly improved the MIP values with a pooled standard mean
difference (SMD) of 0.62. The hospital stay length was also reduced with a
SMD of - 0.4. Other variables such as FEV1 and FVC also improved
significantly. Postoperative IMT improved the MIP and peak flow rate
values, but the evidence was less robust than with preoperative
interventions. We observed high heterogeneity across studies for several
outcomes and found evidence of publication bias for some postoperative
measures. <br/>Conclusion(s): Both preoperative and postoperative IMT
offer benefits for patients undergoing operations, especially by enhancing
respiratory muscle strength and potentially reducing hospital stays.
However, the presence of heterogeneity and publication bias underscores
the need for further standardized research to consolidate these findings
and standardize IMT protocols for optimal patient outcomes. <br/>Copyright
&#xa9; 2024 Wolters Kluwer Health, Inc. All rights reserved.

<55>
Accession Number
2034254619
Title
Comparison Between Histidine-Tryptophan-Ketoglutarate Cardioplegia and
Cold Blood Cardioplegia for Myocardial Protection in Tetralogy of Fallot
Patients Undergoing Surgical Repair: A Randomized Clinical Trial.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2024.
Date of Publication: 2024.
Author
Abdel Twab S.M.; Kamal F.; Fouad A.
Institution
(Abdel Twab, Kamal, Fouad) Department of Anaesthesiology, Intensive Care,
and Pain Management, Faculty of Medicine, Ain Shams University, Cairo,
Egypt
Publisher
W.B. Saunders
Abstract
Objectives: This study was conducted to compare the efficacy of
histidine-tryptophan-ketoglutarate (HTK) cardioplegia and cold blood
cardioplegia (CBC), especially for postoperative right ventricular (RV)
function after tetralogy of Fallot repair. <br/>Design(s): Randomized,
double-blinded, parallel-group, controlled clinical trial.
<br/>Setting(s): Ain Shams University Hospitals. <br/>Participant(s): A
total of 100 children (1 to 5 years old) scheduled for tetralogy of Fallot
repair. <br/>Intervention(s): Patients were allocated (double-blinded 1:1
allocation ratio) to either the HTK group that received HTK cardioplegia
(30 mL/kg via antegrade route) or the CBC group that received cold blood
cardioplegia with blood-to-Ringer solution (4:1) in a volume of 20 mL/kg.
<br/>Measurements and Main Results: The HTK group showed a statistically
significant reduction of the vasoactive inotropic score on admission to
the pediatric intensive care unit (13.0 +/- 4.1) in comparison to the CBC
group (15.5 +/- 5.4), with a p value of 0.011. However, after 24 hours,
the vasoactive-inotropic score was comparable. Lactate level during the
first 24 hours was 6.2 +/- 0.7 mmol/L in the HTK group and 6.9 +/- 0.4
mmol/L in the CBC group (p < 0.0001). Serial troponin measurements were
lower in the HTK group (1.49 +/- 0.45) compared to the CBC group (1.69 +/-
0.18) at the first 72 hours postoperatively (p = 0.005). Postoperative
echocardiographic assessment of RV function by means of tricuspid annular
plane systolic excursion and myocardial performance index were better in
the HTK group than in the CBC grpup (p < 0.05). <br/>Conclusion(s): HTK
cardioplegia may offer better cardiac protection to pediatric patients
undergoing tetralogy of Fallot repair than our institutional standard CBC
with better recovery for the hypertrophic RV.<br/>Copyright &#xa9; 2024
Elsevier Inc.

<56>
Accession Number
2034254213
Title
Percutaneous Versus Surgical Cutdown Access for Transfemoral Transcatheter
Aortic Valve Implantation: A Systematic Review and Meta-Analysis Focusing
on Propensity-Score Matched Studies.
Source
Heart Lung and Circulation. (no pagination), 2024. Date of Publication:
2024.
Author
Riaz S.; Kasam Shiva P.K.; Manimekalai Krishnamurthi J.S.; Shah R.S.;
Cherukuri A.M.K.; Bhatia P.; Arul S.; Multani M.; Singh A.; Suyambu J.;
Asif K.; Al-Tawil M.
Institution
(Riaz) Department of Medicine, Allama Iqbal Medical College, Lahore,
Pakistan
(Kasam Shiva) Bangalore Medical College and Research Institute, Bangalore,
India
(Manimekalai Krishnamurthi) Department of Medicine, Madras Medical
College, Chennai, India
(Shah) Department of Medicine, G.M.E.R.S. Medical College, Gandhinagar,
India
(Cherukuri) Department of Medicine, Guntur Medical College, Guntur, India
(Bhatia) Seth GS Medical College and KEM Hospital, Mumbai, India
(Arul, Suyambu) University of Perpetual Help System DALTA Jonelta
Foundation School of Medicine, Manila, Philippines
(Multani) Adesh Institute of Medical Sciences and Research, Punjab, India
(Singh) Government Medical College and Hospital, Chandigarh, India
(Asif) Department of Medicine, Dr. Ruth K. M. Pfau Civil Hospital Karachi,
Karachi, Pakistan
(Al-Tawil) Faculty of Medicine, Al-Quds University Jerusalem, Palestine,
Palestine
Publisher
Elsevier Ltd
Abstract
Background: Transcatheter aortic valve implantation (TAVI) has emerged as
a potential alternative for aortic valve surgery to treat aortic valve
stenosis. There is limited evidence on the comparative outcomes of TAVI
access approaches, specifically the percutaneous (PC) vs surgical cutdown
(SC) approach. This study aimed to assess the short-term outcomes in
patients undergoing PC vs SC access for transfemoral transcatheter aortic
valve replacement. <br/>Method(s): PubMed, SCOPUS, and EMBASE were
searched to identify relevant studies. The primary outcomes were
short-term all-cause mortality, bleeding, vascular complications, and
length of in-hospital stay for patients who underwent transfemoral TAVI.
Both matched and unmatched observational studies were included and
subgroup analyses were performed. This systematic review and meta-analysis
was performed in line with the PRISMA guidelines. <br/>Result(s): Fifteen
observational studies involving 7,545 patients (3,033 underwent the PC
approach and 2,466 underwent the SC approach) were included. There were no
clinically significant between-group differences in short-term mortality,
bleeding, length of in-hospital stay, or major vascular complications.
However, minor vascular complications were significantly higher in
patients who underwent PC-TAVI (p=0.007). In the matched subgroup, all
outcomes were comparable between both groups, with the largest difference
being observed in minor vascular complications more frequently occurring
in the PC group (p=0.08). <br/>Conclusion(s): The evidence shows that
outcomes were comparable between the two methods of access, rendering both
the PC and SC approaches equally effective for transfemoral TAVI. However,
it is worth noting that minor vascular complications were more pronounced
in the PC group.<br/>Copyright &#xa9; 2024 Australian and New Zealand
Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society
of Australia and New Zealand (CSANZ)

<57>
Accession Number
2034253555
Title
Postoperative Hydration in Children Using Intermittent Boluses of Balanced
Salt Solution: Results of a Randomized Control Trial.
Source
Journal of Pediatric Surgery. (no pagination), 2024. Article Number:
161660. Date of Publication: 2024.
Author
Johnston W.R.; Mak Croughan A.L.; Hwang R.; Collins S.; Washington A.;
Neary K.; Mattei P.
Institution
(Johnston, Mak Croughan, Hwang, Collins, Washington, Neary, Mattei)
General, Thoracic, and Fetal Surgery, Children's Hospital of Philadelphia,
Philadelphia, PA, United States
(Johnston) Hospital of the University of Pennsylvania, Philadelphia, PA,
United States
(Mattei) Children's Hospital of Philadelphia, Pediatric, Thoracic, and
Fetal Surgery, 3501 Civic Center Blvd, Philadelphia, PA 19103, United
States
Publisher
W.B. Saunders
Abstract
Background: Postoperative maintenance fluids are traditionally provided
via hypotonic dextrose containing fluids administered intravenously by
continuous infusion. We hypothesized that scheduled weight-based boluses
of balanced salt solution would be more physiologic, reduce fluid volumes,
and improve patient comfort. <br/>Method(s): As part of an IRB-approved
randomized controlled trial (Boluses of Ringer's in Surgical Kids, BRiSK),
we randomized patients aged 1-21 years undergoing elective abdominal or
thoracic surgery to post-operatively receive weight-based
D<inf>5</inf>0.45NS+20mEq/L KCl at a continuous rate or intermittent
boluses of Lactated Ringer's solution until oral liquid toleration.
Patients with nephropathy, diabetes, or receiving parenteral nutrition
were excluded. We analyzed electrolytes, urine output, fluid volume, and
adverse events. <br/>Result(s): We enrolled and randomized 60 patients: 29
to continuous fluids and 31 to bolus fluids. One patient from the bolus
group dropped out. No patients crossed over due to difficulties with
application of the bolus protocol. There were no baseline differences
between groups with a mean age of 12.6 +/- 1.4yr and weight of 50.9 +/-
7.2 kg. There were no serious adverse events or electrolyte disturbances
in either group. Patients in the bolus group received significantly less
total fluid than those in the continuous group (0.43 mL/kg/h vs 1.1
mL/kg/h, p < 0.001) with no difference in urine output [1.4 +/- 0.2
mL/kg/h vs 1.6 +/- 0.3 mL/kg/h, p = 0.211]. There were two episodes of
mild hypoglycemia in the bolus group compared to seven episodes of mild
hyperglycemia in the continuous group. <br/>Conclusion(s): Administration
of post-operative intravenous fluids as boluses of balanced salt solution
is feasible, safe, and results in significantly less fluid administered
compared to a traditional continuous protocol. <br/>Level of Evidence:
II.<br/>Copyright &#xa9; 2024 Elsevier Inc.

<58>
Accession Number
2034253482
Title
Percutaneous coronary intervention versus coronary artery bypass grafting
for left main disease according to age: A meta-analysis.
Source
Journal of Thoracic and Cardiovascular Surgery. (no pagination), 2024.
Date of Publication: 2024.
Author
De Filippo O.; Di Franco A.; Improta R.; Di Pietro G.; Leone A.; Pecoraro
M.; Meynet P.; Carbone M.L.; Di Lorenzo E.; Bruno F.; Demetres M.; Carmeci
A.; Conrotto F.; Mancone M.; De Ferrari G.M.; Gaudino M.; D'Ascenzo F.
Institution
(De Filippo, Pecoraro, Meynet, Carbone, Bruno, Carmeci, Conrotto, De
Ferrari, D'Ascenzo) Division of Cardiology, Cardiovascular and Thoracic
Department, AOU Citta della Salute e della Scienza di Torino and
Department of Medical Sciences, University of Turin, Turin, Italy
(Di Franco, Gaudino) Department of Cardiothoracic Surgery, Weill Cornell
Medicine, New York, NY, United States
(Improta, Di Pietro, Mancone) Department of Clinical, Internal,
Anesthesiological and Cardiovascular Sciences, Umberto I Hospital, La
Sapienza University of Rome, Rome, Italy
(Leone, Di Lorenzo) Division of Cardiology, SG Moscati Hospital, Avellino,
Italy
(Leone) Department of Advanced Biomedical Sciences, University of Naples
Federico II, Naples, Italy
(Demetres) Samuel J. Wood Library and C.V. Starr Biomedical Information
Center, Weill Cornell Medicine, New York, NY, United States
Publisher
Elsevier Inc.

<59>
Accession Number
2034152699
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: 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
Publisher
American Medical Association
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 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
PARTICIPANTS 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. INTERVENTIONS The low-dose DOAC group received
apixaban, 2.5 mg every 12 hours, and the DAPT group received aspirin, 100
mg per day, plus clopidogrel, 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.
RESULTS 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.<br/>Copyright &#xa9; 2024 American Medical Association.
All rights reserved.

<60>
Accession Number
2034152688
Title
Edetate Disodium-Based Chelation for Patients With a Previous Myocardial
Infarction and Diabetes TACT2 Randomized Clinical Trial.
Source
JAMA. (no pagination), 2024. Date of Publication: 2024.
Author
Lamas G.A.; Anstrom K.J.; Navas-Acien A.; Boineau R.; Nemeth H.; Huang Z.;
Wen J.; Rosenberg Y.; Stylianou M.; Jones T.L.Z.; Joubert B.R.; Yu Q.;
Santella R.M.; Mon A.C.; Ujueta F.; Escolar E.; Nathan D.M.; Fonseca V.A.;
Aude Y.W.; Ehrman J.K.; Elliott T.; Prashad R.; Lewis E.F.; Lopes R.D.;
Farkouh M.E.; Elliott A.-M.; Newman J.D.; Mark D.B.
Institution
(Lamas, Mon, Ujueta, Escolar) Columbia University Division of Cardiology,
Mount Sinai Medical Center, Miami Beach, FL, United States
(Anstrom) Gillings School of Global Public Health, University of North
Carolina, Chapel Hill, United States
(Navas-Acien, Santella) Department of Environmental Health Sciences,
Columbia University, Mailman School of Public Health, New York, NY, United
States
(Boineau, Yu) National Center for Complementary and Integrative Health,
National Institutes of Health, Bethesda, MD, United States
(Nemeth, Huang, Wen, Lopes, Elliott, Mark) Duke Clinical Research
Institute, Duke University, Durham, NC, United States
(Rosenberg, Stylianou) National Heart, Lung, and Blood Institute, National
Institutes of Health, Bethesda, MD, United States
(Jones) National Institute of Diabetes and Digestive and Kidney Diseases,
National Institutes of Health, Bethesda, MD, United States
(Joubert) National Institute of Environmental Health Sciences, National
Institutes of Health, Durham, NC, United States
(Nathan) Massachusetts General Hospital Diabetes Research Center, Harvard
Medical School, Boston, United States
(Fonseca) Tulane University School of Medicine, New Orleans, LA, United
States
(Aude) DHR Health Heart Institute, McAllen, TX, United States
(Ehrman) Division of Cardiovascular Medicine, Henry Ford Hospital,
Detroit, MI, United States
(Elliott) BC Diabetes Research Institute, Vancouver, BC, Canada
(Prashad) Ocala Research Institute, Ocala, FL, United States
(Lewis) Stanford University School of Medicine, Palo Alto, CA, United
States
(Farkouh) University of Toronto, Toronto, ON, Canada
(Newman) New York University School of Medicine, New York, United States
Publisher
American Medical Association
Abstract
IMPORTANCE In 2013, the Trial to Assess Chelation Therapy (TACT) reported
that edetate disodium (EDTA)-based chelation significantly reduced
cardiovascular disease (CVD) events by 18% in 1708 patients with a prior
myocardial infarction (MI). OBJECTIVE To replicate the finding of TACT in
individuals with diabetes and previous MI. DESIGN, SETTING, AND
PARTICIPANTS A 2 x 2 factorial, double-masked, placebo-controlled,
multicenter trial at 88 sites in the US and Canada, involving participants
who were 50 years or older, had diabetes, and had experienced an MI at
least 6 weeks before recruitment compared the effect of EDTA-based
chelation vs placebo infusions on CVD events and compared the effect of
high doses of oral multivitamins and minerals with oral placebo. This
article reports on the chelation vs placebo infusion comparisons.
INTERVENTIONS Eligible participants were randomly assigned to 40 weekly
infusions of an EDTA-based chelation solution or matching placebo and to
twice daily oral, high-dose multivitamin and mineral supplements or
matching placebo for 60 months. This article addresses the chelation
study. MAIN OUTCOMES AND MEASURES The primary end point was the composite
of all-cause mortality, MI, stroke, coronary revascularization, or
hospitalization for unstable angina. Median follow-up was 48 months.
Primary comparisons were made from patients who received at least 1
assigned infusion. RESULTS Of the 959 participants (median age, 67 years
[IQR, 60-72 years]; 27% females; 78% White, 10% Black, and 20% Hispanic),
483 received at least 1 chelation infusion and 476 at least 1 placebo
infusion. A primary end point event occurred in 172 participants (35.6%)
in the chelation group and in 170 (35.7%) in the placebo group (adjusted
hazard ratio [HR], 0.93; 95% CI, 0.76-1.16; P = .53). The 5-year primary
event cumulative incidence rates were 45.8% for the chelation group and
46.5% for the placebo group. CV death, MI, or stroke events occurred in 89
participants (18.4%) in the chelation group and in 94 (19.7%) in the
placebo group (adjusted HR, 0.89; 95% CI, 0.66-1.19). Death from any cause
occurred in 84 participants (17.4%) in the chelation group and in 84
(17.6%) in the placebo group (adjusted HR, 0.96; 95% CI, 0.71-1.30).
Chelation reduced median blood lead levels from 9.03 mug/L at baseline to
3.46 mug/L at infusion 40 (P < .001). Corresponding levels in the placebo
group were 9.3 mug/L and 8.7 mug/L, respectively. CONCLUSIONS AND
RELEVANCE Despite effectively reducing blood lead levels, EDTA chelation
was not effective in reducing cardiovascular events in stable patients
with coronary artery disease who have diabetes and a history of
MI.<br/>Copyright &#xa9; 2024 American Medical Association. All rights
reserved.

<61>
Accession Number
2031171704
Title
Sutureless Aortic Valve Replacement with Perceval Bioprosthesis Superior
to Transcatheter Aortic Valve Implantation: A Promising Option for the
Gray-Zone of Aortic Valve Replacement Procedures-A State-of-the-Art
Systematic Review, Meta-Analysis, and Future Directions.
Source
Journal of Clinical Medicine. 13(16) (no pagination), 2024. Article
Number: 4887. Date of Publication: August 2024.
Author
Ali-Hasan-Al-Saegh S.; Takemoto S.; Shafiei S.; Yavuz S.; Arjomandi Rad
A.; Amanov L.; Merzah A.S.; Salman J.; Ius F.; Kaufeld T.; Schmack B.;
Popov A.-F.; Sabashnikov A.; Ruhparwar A.; Zubarevich A.; Weymann A.
Institution
(Ali-Hasan-Al-Saegh, Amanov, Merzah, Salman, Ius, Kaufeld, Schmack, Popov,
Ruhparwar, Zubarevich, Weymann) Department of Cardiothoracic,
Transplantation and Vascular Surgery, Hannover Medical School,
Carl-Neuberg-Strase 1, Hannover 30625, Germany
(Takemoto) Center for Transplantation Sciences, Department of Surgery,
Massachusetts General Hospital and Harvard Medical School, Boston, MA
02114, United States
(Takemoto) Department of Cardiovascular Surgery, Kyushu University
Graduate School of Medical Sciences, Fukuoka 812-8582, Japan
(Shafiei) Department of Cardiac and Thoracic Vascular Surgery, Marburg
University Hospital, Marburg 35043, Germany
(Yavuz) Department of Cardiovascular Surgery, University of Health
Sciences, Bursa Yuksek Ihtisas Training and Research Hospital, Bursa
16310, Turkey
(Arjomandi Rad) Medical Sciences Division, University of Oxford, Oxford
OX1 2JD, United Kingdom
(Sabashnikov) Department of Cardiothoracic Transplantation and Mechanical
Circulatory Support, Royal Brompton & Harefield NHS Foundation Trust,
Harefield Hospital, Harefield UB9 6JH, United Kingdom
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Background: The management of patients with aortic valve pathologies can
sometimes fall into a "gray zone", where the optimal treatment approach is
not straightforward. The comparative benefits of sutureless aortic valve
replacement (SUAVR) using the Perceval bioprosthesis versus transcatheter
aortic valve implantation (TAVI) for the "gray zone" of aortic valve
replacement procedures remain a topic of debate. To further explore this
issue, we conducted a study with pairwise, single-arm, and
Kaplan-Meier-based meta-analyses to compare the outcomes of SUAVR with the
Perceval bioprosthesis versus TAVI, as well as to evaluate the efficacy,
safety, and durability of SUAVR with the Perceval bioprosthesis over
mid-term and long-term follow-up periods. <br/>Method(s): The PubMed,
PubMed Central, OVID Medline, Cochrane Library, Embase, and Web of Science
databases were systematically searched. All study types were included,
except study protocols and animal studies, without time restrictions. The
final search was carried out in May 2024. <br/>Result(s): No statistically
significant differences were observed in permanent pacemaker implantation
(PPI) rates between the two groups. SUAVR showed a lower incidence of
new-onset myocardial infarction but was associated with higher rates of
new-onset atrial fibrillation and major bleeding. TAVI had higher rates of
left bundle branch block and major vascular complications.
<br/>Conclusion(s): Our findings show that SUAVR has a lower incidence of
complications and a favorable mid-term overall survival compared to TAVI.
SUAVR has more advantages compared to TAVI and can be considered a
valuable and promising option for the "grey zone" of aortic valve
pathologies.<br/>Copyright &#xa9; 2024 by the authors.

<62>
Accession Number
2031170268
Title
A Systematic Review of Ongoing Registered Research Studies on
Post-Operative Atrial Fibrillation after Cardiac Surgery.
Source
Journal of Clinical Medicine. 13(16) (no pagination), 2024. Article
Number: 4948. Date of Publication: August 2024.
Author
Quan I.; Belley-Cote E.P.; Spence J.; Wang A.; Sidhom K.; Wang M.K.; Conen
D.; Sun B.; Shankar A.U.; Whitlock R.P.; Devereaux P.J.; Healey J.S.;
McIntyre W.F.
Institution
(Quan, Wang, Sidhom, Sun, Shankar) Faculty of Health Sciences, McMaster
University, Hamilton, ON L8L 2X2, Canada
(Belley-Cote, Spence, Wang, Conen, Whitlock, Devereaux, Healey, McIntyre)
Population Health Research Institute, Hamilton, ON L8L 2X2, Canada
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Background/Objectives: New-onset atrial fibrillation (AF) after cardiac
surgery is associated with patient-important outcomes. Uncertainty
persists regarding its prevention, detection, and management. This review
seeks to identify, compile, and describe ongoing registered research
studies involving patients with or at risk for post-operative AF (POAF)
after cardiac surgery. <br/>Method(s): We searched clinical trial
registries in January 2023 for studies focusing on POAF prediction,
prevention, detection, or management. We extracted data from each record
and performed descriptive analyses. <br/>Result(s): In total, 121 studies
met the eligibility criteria, including 82 randomized trials. Prevention
studies are the most common (n = 77, 63.6%), followed by prediction (n =
21, 17.4%), management (n = 16, 13.2%), and detection studies (n = 7,
5.8%). POAF after cardiac surgery is an area of active research.
<br/>Conclusion(s): There are many ongoing randomized prevention studies.
However, two major clinical gaps persist; future randomized trials should
compare rate and rhythm control in patients who develop POAF, and
long-term follow-up studies should investigate strategies to monitor for
AF recurrence in patients with POAF.<br/>Copyright &#xa9; 2024 by the
authors.

<63>
Accession Number
2031170159
Title
A Green Lantern for the Surgeon: A Review on the Use of Indocyanine Green
(ICG) in Minimally Invasive Surgery.
Source
Journal of Clinical Medicine. 13(16) (no pagination), 2024. Article
Number: 4895. Date of Publication: August 2024.
Author
Fransvea P.; Miccini M.; Rondelli F.; Brisinda G.; Costa A.; Garbarino
G.M.; Costa G.
Institution
(Fransvea, Brisinda) Emergency Surgery and Trauma, Fondazione Policlinico
Universitario "A. Gemelli" IRCCS Roma, Catholic University of Sacred
Heart, Rome 00136, Italy
(Miccini) Department of Surgery, Sapienza University of Rome, Rome 00185,
Italy
(Rondelli) Department of Medicine and Surgery, University of Perugia,
Perugia 06123, Italy
(Costa) UniCamillus School of Medicine, Saint Camillus International,
University of Health and Medical Sciences, Rome 00131, Italy
(Garbarino) Department of Surgery, Ospedale Sant'Eugenio, ASL RM2, Rome
00144, Italy
(Costa) Department of Life Science, Health, and Health Professions, Link
Campus University, Rome 00165, Italy
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Indocyanine green (ICG) fluorescence imaging has revolutionized surgical
practice across various medical and surgical specialties. This article
reviews the clinical applications of ICG in abdominal, urological,
thoracic, and gynecological surgery. ICG fluorescence imaging has been
widely adopted in general surgery for various applications, including
perfusion assessment, intraoperative visualization of the ureter, and
tumor localization. It is particularly valuable in evaluating anastomotic
leaks and aiding in precise tumor resection during minimally invasive
surgeries. Studies have shown mixed results on its effectiveness in
reducing anastomotic leak rates, highlighting the need for further
research. In thoracic surgery, ICG facilitates the identification and
resection of pulmonary bullae, as well as the precise localization of
pulmonary nodules during video-assisted surgery. In urology, ICG aids in
localizing renal tumors and guiding selective arterial occlusion during
partial nephrectomy. Its role in identifying the lymphatic pathway in
prostate cancer and sentinel lymph node biopsy in gynecological cancer is
also discussed. Despite its benefits, the use of ICG fluorescence faces
challenges such as limited tissue penetration, the potential for false
results, a lack of standardized protocols, and high equipment costs.
Nonetheless, it remains a powerful tool that could improve surgical
outcomes.<br/>Copyright &#xa9; 2024 by the authors.

<64>
Accession Number
2031154413
Title
Comparative Efficacy of Colchicine and Intensive Low-density Lipoprotein
Cholesterol Lowering in Patients with Atherosclerotic Diseases receiving
Statins: A Network Meta-analysis of Randomized Controlled Trials.
Source
Cardiovascular Drugs and Therapy. (no pagination), 2024. Date of
Publication: 2024.
Author
Ou Z.; Wang F.; Chen Y.; Liu X.; Ran B.; Yin Y.; Cui K.
Institution
(Ou, Wang, Ran, Cui) Department of Cardiology, Chongqing General Hospital
of Chongqing University, Chongqing, China
(Ou, Wang, Ran, Cui) Department of Cardiology, Chongqing General Hospital,
No. 118 Xingguang Avenue, Liangjiang New Area, Chongqing 401120, China
(Chen, Yin) Department of Cardiology, The Second Affiliated Hospital of
Chongqing Medical University, Chongqing, China
(Liu) Department of Cardiology, Graduate School of Medicine, Keio
University, Tokyo, Japan
Publisher
Springer
Abstract
Aims: Adding intensive low-density lipoprotein cholesterol
(LDL-C)-lowering agents or colchicine to statin has been shown to result
in additional cardiovascular benefits for patients with atherosclerotic
cardiovascular diseases (ASCVD). We aimed to compare the efficacy and
safety of these supplementary agents in patients with ASCVD receiving
statin. <br/>Method(s): We performed a systematic review and frequentist
network meta-analysis of randomized controlled trials. The primary
efficacy endpoint was the main adverse cardiovascular event (MACE), and
the secondary efficacy endpoints were myocardial infarct, stroke, coronary
revascularization, cardiovascular death, and all-cause mortality,
respectively. The safety endpoints were treatment discontinuation and
non-cardiovascular death. We obtained estimates for efficacy outcomes and
safety endpoints and presented these estimates as risk ratio (RR) with 95%
confidence intervals. We ranked the comparative efficacy and safety of all
drugs with P-scores. <br/>Result(s): Seventeen trials totaling 85,823
participants treated with colchicine (5926 participants), intensive LDL-C
lowering (37,854 participants) via proprotein convertase subtilisin/kexin
type 9 (PCSK9) inhibitor, Niemann-Pick C1-like 1 protein (NPC1L1)
inhibitor or ATP citrate lyase (ACL) inhibitor, or statin alone (42,043
participants) were included. Colchicine was associated with a greater
reduction in the risk of MACE (RR 0.72, 0.69-0.91), stroke (RR 0.55,
0.33-0.92), and coronary revascularization (RR 0.73, 0.60-0.90) compared
with NPC1L1 inhibitor, and it provided a larger reduction in the risk of
MACE (RR 0.79, 0.69-0.91) compared to PCSK9 inhibitor. However, colchicine
was associated with increased risk of non-cardiovascular death compared
with NPC1L1 inhibitor (RR 1.48, 1.04-2.10) and PCSK9 inhibitor (RR 1.57,
1.08-2.27). Although no regimen prolonged survival, colchicine had worse
performance on non-cardiovascular death and all-cause mortality.
<br/>Conclusion(s): In patients with ASCVD receiving statin, colchicine
seems to be more effective than intensive LDL-C-lowering therapy with
PCSK9 inhibitor or NPC1L1 inhibitor for cardiovascular prevention.
However, using colchicine as an alternative to intensive LDL-C-lowering
therapy may need to be weighed against the cardiovascular benefits and the
potential harms of higher non-cardiovascular death. Trial Registration:
PROSPERO Identifier: CRD42023441385<br/>Copyright &#xa9; The Author(s),
under exclusive licence to Springer Science+Business Media, LLC, part of
Springer Nature 2024.

<65>
Accession Number
645096091
Title
Pulmonary artery banding in infants and young children with end-stage left
ventricular dilated cardiomyopathy-Cohort Study.
Source
International journal of surgery (London, England). (no pagination),
2024. Date of Publication: 26 Aug 2024.
Author
Zeng M.; Yang F.; Yue C.; Wei W.; Ma K.; Dou Z.; Li Q.; Wang X.; Li S.
Institution
(Zeng, Yang, Wei) Department of Pediatric Cardiac Center, National Center
for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical
Sciences and Peking Union Medical College, China
(Yue, Li, Wang) Department of Pediatric Intensive Care Unit, National
Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of
Medical Sciences and Peking Union Medical College, China
(Ma, Dou, Li) Department of Pediatric Cardiac Surgery Center, National
Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of
Medical Sciences and Peking Union Medical College, China
Abstract
BACKGROUND: Dilated cardiomyopathy (DCM) is the most common cardiomyopathy
and 40-50% patients may die or need heart transplant in 5 years after
diagnosis. Although heart transplantation being the most effective
life-saving option of end-stage DCM, scarcity of donors and series of
complications prevent many patients from receiving timely treatment.
Pulmonary artery banding (PAB) is recently described as an alternative
strategy for end-stage DCM, with low left ventricular function (LVEF) but
preserved right ventricular function, may potentially restore heart
function and delay the need for heart transplantation, but current
clinical evidence is still insufficient. On the other hand, the medication
treatment of DCM in pediatric patients is mostly based on the experience
of adults. It remains unclear whether PAB combing medication treatment
could benefit infants and young children patients. The aim of this study
was to assess the short-term efficacy of PAB combined with medication
therapy in infants and young children with end stage DCM, comparing with
medication therapy alone. <br/>METHOD(S): This is a retrospective analysis
of 18 consecutive pediatric patients aged ranging from 1 month to 44
months old who diagnosed with end-stage DCM (LVEF30%) with preserved right
ventricular function between 2019 and 2023 in our hospital. All patients
had been treated with conventional medications for two months. Then they
were divided in two groups: PAB surgery group (6/18), and non-surgery
group (12/18). Regardless of whether surgery was performed, both groups
continued to receive medication treatment. Recovery of ventricular
function was primary endpoints. Secondary endpoints included 180-day
mortality and severe heart failure (LVEF<=30%). <br/>RESULT(S): We found
there were no differences in age, weight, height, BMI, renal function,
liver function, pulmonary hypertension, tricuspid valve regurgitation,
mitral valve regurgitation and genetic abnormalities between those with
and without PAB surgery. Comparing with non-surgery group, 5 patients in
surgery group regain the normal cardiac ejection fraction (LVEF>=50%)
(5/6, 83.3% vs. 4/12, 33.3%, P=0.131). A total of 3 patients had sudden
death in non-surgery group, and there was no death in surgery group
(P=0.180). 5 patients (5/12, 41.7%) still remain the low heart failure
(LVEF<=40%) after 6 months of enrollment only given medical therapy, and
none of patients present with LVEF<=40% in PAB surgery group (0/6, 0% vs.
8/12, 67.7%, P=0.034). <br/>CONCLUSION(S): Pulmonary artery banding is
safe and effective in infants and young children with end-stage DCM with
preserved right ventricular function. Combined with conventional heart
failure medication therapy, it may provide short-term benefits
post-operatively, decrease the cardiogenic shock, and act as a bridge to
recovery and potentially reduce the need for heart transplantation.
Long-term effects remain further observation, and larger randomized
controlled trials would be more persuasive in validating its
efficacy.<br/>Copyright &#xa9; 2024 The Author(s). Published by Wolters
Kluwer Health, Inc.

<66>
Accession Number
645092192
Title
State of the Art Review: Aortic Valve Repair in Infants and Children.
Source
The Annals of thoracic surgery. (no pagination), 2024. Date of
Publication: 21 Aug 2024.
Author
Chiu P.; Higgins H.A.; Baird C.W.
Institution
(Chiu, Higgins, Baird) Department of Cardiac Surgery, Boston Children's
Hospital, Mass, Boston, United States
Abstract
BACKGROUND: Congenital aortic and truncal valve disease is challenging in
infants and children given the lack of available prostheses in very small
sizes and the limited durability of homograft aortic valve replacement.
<br/>METHOD(S): A comprehensive literature search was performed using the
PubMed database. Studies were included either if the report included
patients less than 1 year of age or if the technique was tailored to
accommodate for somatic growth. <br/>RESULT(S): Techniques for aortic and
truncal valve repair addressing each aspect of the aortic valve complex -
the aorta, aortic annulus, commissures, and cusps - were reviewed. The
incidence of reoperation following aortic or truncal valve repair is
significant at 10-years ranging from 30% to 70% depending on the
underlying diagnosis and the repair technique utilized. A significant
challenge in interpreting the published literature relates to the lack of
anatomic data available in the publications limiting the ability to make
direct comparisons between operative techniques and also limits the
ability to draw conclusions regarding these techniques as applied to
varied etiologies. <br/>CONCLUSION(S): A comprehensive understanding of
the aortic valve complex is necessary to achieve adequate results in
pediatric aortic valve repair given the high variability in these
valves.<br/>Copyright &#xa9; 2024. Published by Elsevier Inc.

<67>
Accession Number
2034175336
Title
Exploring the Acceptable Delay for Elective Treatment of Patients With an
Abdominal Aortic Aneurysm: A Reflection During a Pandemic and an
Exploratory Analysis.
Source
Journal of Surgical Research. 302 (pp 555-560), 2024. Date of Publication:
October 2024.
Author
Leveille N.; Laurendeau A.; Drudi L.M.; Elkouri S.
Institution
(Leveille, Drudi, Elkouri) Faculte de medecine de l'Universite de
Montreal, Montreal, QC, Canada
(Laurendeau) Faculte de medecine de l'Universite Laval, Quebec, QC, Canada
(Drudi, Elkouri) Centre de recherche du Centre Hospitalier de l'Universite
de Montreal (CRCHUM), Montreal, QC, Canada
Publisher
Academic Press Inc.
Abstract
Introduction: This study sought to determine the rupture risk of
asymptomatic abdominal aortic aneurysms (AAAs) undergoing interventions as
a function of time to establish a maximal acceptable surgical delay.
<br/>Method(s): A literature review was performed from inception to August
30, 2021, to assess the risk of rupture of aneurysms over time. The
analysis was limited to men with asymptomatic AAAs. The data on AAA
rupture risk according to diameter and follow-up time were extracted. The
acceptable mortality risk for AAA patients as a function of surgical delay
was further evaluated. This acceptable mortality risk was based on the
acceptable risk of cardiovascular death associated with the accepted
delays of coronary revascularization in coronary artery disease
populations. Data on estimated surgical delays and risks were extracted
using a free web-based software (WebPlotDigitizer) and plotted using
Microsoft Excel. <br/>Result(s): Our study identified minimal evidence as
it pertains to AAA rupture risk as a function of surgical delay. The data
on rupture risk of AAAs according to diameter and time were extracted from
a single review and a single meta-analysis (Figure 1). The acceptable
delays of semiurgent and nonurgent invasive treatment for coronary artery
disease found in literature are 6 and 12 wks respectively. These
acceptable delays are associated with an estimated acceptable
cardiovascular mortality risk threshold of 0.47% at 6 and 12 wks. Using
this threshold of estimated maximum acceptable risk and the data on the
natural history of AAAs found in our review, we found that the acceptable
surgical delays for AAAs would be estimated at 13-27 ds for AAAs >= 7 cm,
20-42 ds for 6-6.9 cm, and 32-49 ds for 5.5-5.9 cm (Figure 1).
<br/>Conclusion(s): This study identified estimated surgical delays for
patients with AAAs based on the acceptable maximum risk. These estimations
may be used cautiously to triage patients with asymptomatic AAAs,
particularly in the setting of triaging patients during local and global
crises.<br/>Copyright &#xa9; 2024

<68>
Accession Number
2030614401
Title
Reverse left ventricular remodeling after aortic valve replacement for
aortic stenosis: a systematic review and meta-analysis.
Source
Frontiers in Cardiovascular Medicine. 11 (no pagination), 2024. Article
Number: 1407566. Date of Publication: 2024.
Author
Sousa Nunes F.; Amaral Marques C.; Isabel Pinho A.; Sousa-Pinto B.; Beco
A.; Ricardo Silva J.; Saraiva F.; Macedo F.; Leite-Moreira A.; Sousa C.
Institution
(Sousa Nunes, Beco, Ricardo Silva, Saraiva, Leite-Moreira, Sousa)
Cardiovascular R&D Centre-UnIC@RISE, Department of Surgery and Physiology,
Faculty of Medicine of the University of Porto, Porto, Portugal
(Sousa Nunes) Department of Cardiology, Local Health Unit of Gaia and
Espinho, Vila Nova de Gaia, Portugal
(Amaral Marques, Isabel Pinho, Macedo, Leite-Moreira, Sousa) Department of
Cardiology, Local Health Unit of Sao Joao, Porto, Portugal
(Sousa-Pinto) MEDCIDS-Department of Community Medicine, Information and
Health Decision Sciences, Faculty of Medicine, University of Porto, Porto,
Portugal
(Sousa-Pinto) CINTESIS@RISE-Health Research Network, MEDCIDS, Faculty of
Medicine, University of Porto, Porto, Portugal
Publisher
Frontiers Media SA
Abstract
Reverse left ventricular (LV) remodeling after aortic valve replacement
(AVR), in patients with aortic stenosis, is well-documented as an
important prognostic factor. With this systematic review and
meta-analysis, we aimed to characterize the response of the unloaded LV
after AVR. We searched on MEDLINE/PubMed and Web of Science for studies
reporting echocardiographic findings before and at least 1 month after AVR
for the treatment of aortic stenosis. In total, 1,836 studies were
identified and 1,098 were screened for inclusion. The main factors of
interest were structural and dynamic measures of the LV and aortic valve.
We performed a random-effects meta-analysis to compute standardized mean
differences (SMD) between follow-up and baseline values for each outcome.
Twenty-seven studies met the eligibility criteria, yielding 11,751
patients. AVR resulted in reduced mean aortic gradient (SMD: (Formula
presented.) mmHg, 95% CI: (Formula presented.) to (Formula presented.),
(Formula presented.)), LV mass (SMD: (Formula presented.) g, 95% CI:
(Formula presented.) to (Formula presented.), (Formula presented.)),
end-diastolic LV diameter (SMD: (Formula presented.) mm, 95% CI: (Formula
presented.) to (Formula presented.), (Formula presented.)), end-diastolic
LV volume (SMD: (Formula presented.) ml, 95% CI: (Formula presented.) to
3.51, (Formula presented.)), increased effective aortic valve area (SMD:
1.10 cm², 95% CI: 1.01 to 1.20, (Formula presented.)), and LV
ejection fraction (SMD: 2.35%, 95% CI: 1.31 to 3.40%, (Formula
presented.)). Our results characterize the extent to which reverse
remodeling is expected to occur after AVR. Notably, in our study, reverse
remodeling was documented as soon as 1 month after AVR.<br/>Copyright 2024
Sousa Nunes, Amaral Marques, Isabel Pinho, Sousa-Pinto, Beco, Ricardo
Silva, Saraiva, Macedo, Leite-Moreira and Sousa.

<69>
Accession Number
2034273777
Title
Persistent acute kidney injury biomarkers: A systematic review and
meta-analysis.
Source
Clinica Chimica Acta. 564 (no pagination), 2025. Article Number: 119907.
Date of Publication: 01 Jan 2025.
Author
Shi K.; Jiang W.; Song L.; Li X.; Zhang C.; Li L.; Feng Y.; Yang J.; Wang
T.; Wang H.; Zhou L.; Yu J.; Zheng R.
Institution
(Shi, Jiang, Song, Li, Zhang, Li, Feng, Yang, Wang, Wang, Zhou, Yu, Zheng)
Department of Critical Care Medicine, Northern Jiangsu People's Hospital
Affiliated Yangzhou University, Yangzhou 225001, China
Publisher
Elsevier B.V.
Abstract
Background: Various biomarkers reportedly predict persistent acute kidney
injury (AKI) despite their varying predictive performance across clinical
trials. This study aims to compare the accuracy of various biomarkers in
predicting persistent AKI in different populations and regions.
<br/>Method(s): In this meta-analysis, we searched for urinary C-C motif
chemokine ligand 14 (CCL14), Tissue inhibitor of
metalloproteinase-2&insulin-like growth factor-binding protein-7
(TIMP-2&IGFBP7), Neutrophil Gelatinase-Associated Lipocalin (NGAL), plasma
Cystatin C (pCysC), Soluble urokinase plasminogen activator receptor
(suPAR), Proenkephalin (PenK) and urinary dickkopf-3:urinary creatinine
(uDKK3:uCr) from various databases including Medline, PubMed, Embase, and
Cochrane. This was geared towards predicting persistent AKI in adults (>18
years). Hierarchically summarized subject work characteristic curves
(HSROC) and diagnostic odds ratio (DOR) values were used to summarize the
diagnostic accuracy of the biomarkers. Further, meta-regression and
subgroup analyses were carried out to identify sources of heterogeneity as
well as evaluate the best predictive biomarkers in different populations
and regions. <br/>Result(s): We screened 31 studies from 2,356 studies and
assessed the diagnostic value of 7 biomarkers for persistent AKI. Overall,
CCL14 had the best diagnostic efficacy with an AUC of 0.79 (95 % CI
0.75-0.82), whereas TIMP-2 & IGFBP7, NGAL, and pCysC had diagnostic
efficacy of 0.75 (95 % CI 0.71-0.79),0.71 (95 % CI 0.67-0.75), and 0.7007,
respectively. Due to a limited number of studies, PenK, uDKK3:uCr, and
suPAR were not subjected to meta-analysis; however, relevant literature
reported diagnostic efficacy above 0.70. Subgroup analyses based on
population, region, biomarker detection time, AKI onset time, and AKI
duration revealed that in the intensive care unit (ICU) population, the
AUC of CCL14 was 0.8070, the AUC of TIMP-2 & IGFBP7 was 0.726, the AUC of
pCysC was 0.72, and the AUC of NGAL was 0.7344; in the sepsis population,
the AUC of CCL14 was 0.85, the AUC of TIMP-2&IGFBP7 was 0.7438, and the
AUC of NGAL was 0.544; in the post-operative population, the AUC of CCL14
was 0.83-0.93, the AUC of TIMP-2&IGFBP7 was 0.71, and the AUC of pCysC was
0.683. Regional differences were observed in biomarker prediction of
persistent kidney injury, with AUCs of 0.8558 for CCL14, 0.7563 for TIMP-2
& IGFBP7, and 0.7116 for NGAL in the Eurasian American population. In the
sub-African population, TIMP-2 & IGFBP7 had AUCs of 0.7945, 0.7418 for
CCL14, 0.7097 for NGAL, and 0.7007 for pCysC. for TIMP-2 & IGFBP7 was
0.7945, AUC for CCL14 was 0.7418, AUC for NGAL was 0.7097, and AUC for
pCysC was 0.7007 in the sub-African population. Duration of biomarker
detection, AKI onset, and AKI did not influence the optimal predictive
performance of CCL14. Subgroup analysis and meta-regression of
CCL14-related studies revealed that CCL14 is the most appropriate
biomarker for predicting persistent stage 2-3 AKI, with heterogeneity
stemming from sample size and AKI staging. <br/>Conclusion(s): This
meta-analysis discovered CCL14 as the best biomarker to predict persistent
AKI, specifically persistent stage 2-3 AKI.<br/>Copyright &#xa9; 2024 The
Authors

<70>
Accession Number
2033192140
Title
Effect of Remote Ischemic Conditioning on Organ Transplantation: A
Meta-Analysis of Randomized Controlled Trials.
Source
Transplantation Proceedings. 56(6) (pp 1457-1468), 2024. Date of
Publication: July 2024.
Author
Zhang M.; Ma X.; Wang X.; Zhang C.; Zheng M.; Ma W.; Dai Y.
Institution
(Zhang, Dai) Department of Surgery of Stomach and Small Intestine, Yunnan
Cancer Hospital, Yunnan, Kunming, China
(Ma, Ma) Department of Anesthesiology, Yunnan Cancer Hospital, Yunnan,
Kunming, China
(Wang) Southern Central Hospital of Yunnan Province (The First People's
Hospital of Honghe State), Yunnan, Kunming, China
(Zhang) Department of Graduation, Kunming Medical University, Yunnan,
Kunming, China
(Zheng) Department of Pediatrics, Kunming Maternal and Child Health
Centre, Yunnan, Kunming, China
Publisher
Elsevier Inc.
Abstract
Background: Remote ischemic conditioning (RIC) has shown great advantages
in protecting organs from ischemia-reperfusion loss and applied research
on RIC continues to increase. We performed a systematic review and
meta-analysis to comprehensively investigate the value of RIC for
different organ transplantation. <br/>Method(s): We searched PubMed,
EMBASE, and the Cochrane Library from inception to November 1, 2023, for
randomized controlled trials investigating whether RIC has an advantage in
organ transplantation (including heart, lung, liver, and kidney) compared
with controls. The primary outcomes varied according to the transplanted
organ, including liver transplantation (graft loss, early allograft
dysfunction, acute kidney injury, days in hospital, and mortality); kidney
transplantation (delayed graft function, acute rejection (AR), graft loss,
50% decrease in serum creatinine, glomerular filtration rate, days in
hospital, and mortality); heart and lung transplantation (AR, mortality).
Two investigators independently selected suitable trials, assessed trial
quality, and extracted the data. <br/>Result(s): A total of 11 randomized
controlled trials were included in this study, including six kidney
transplants, three liver transplants, and one heart and lung transplant
each, with 561 RIC cases and 564 controls, and a total of 1125 patients.
The results showed that RIC did not reduce mortality in transplant
patients compared with controls (liver transplant: RR0.9, 95% confidence
interval [0.31-2.66]; kidney transplant: RR 0.76, 95% confidence interval
[0.17-3.33]), graft failure rate (liver transplantation: RR 0.3, 95%
confidence interval [0.07, 1.19]; kidney transplantation: RR 0.89, 95%
confidence interval [0.35, 2.27]), length of hospital stay (liver
transplantation: standard mean difference [SMD] 0.14, 95% confidence
interval [-0.15, 0.42]; kidney transplantation: SMD -0.1, 95% confidence
interval [-0.3, 0.11]). In addition, RIC did not improve early liver
function after liver transplantation (RR 0.97, 95% confidence interval
[0.55,1.7]), acute kidney injury after liver transplantation (RR 1.17 95%
confidence interval [0.9, 1.54]), delayed functional recovery after renal
transplantation (RR 0.84, 95% confidence interval [0.62, 1.15]), AR rate
(RR 1.04, 95% confidence interval [0.72, 1.49]), 50% serum creatinine
decline rate (RR 1.1, 95% confidence interval [0.88, 1.37]), glomerular
filtration rate 3 months after surgery (SMD 0.13, 95% confidence interval
[-0.05, 0.31]) and postoperative 12 months glomerular filtration rate (SMD
0.13, 95% confidence interval [-0.06, 0.31]). <br/>Conclusion(s): Remote
ischemic modulation does not improve clinical outcomes in patients
undergoing organ transplantation (heart, lung, liver, and
kidney).<br/>Copyright &#xa9; 2024 The Author(s)

<71>
Accession Number
2031096829
Title
Comparative effectiveness and safety of four traditional Chinese medicine
injections with invigorating blood circulation, equivalent effect of
anticoagulation or antiplatelet in acute myocardial infarction: a Bayesian
network meta-analysis.
Source
Frontiers in Pharmacology. 15 (no pagination), 2024. Article Number:
1400990. Date of Publication: 2024.
Author
Chen J.; Shang J.; Liu H.; Li X.; Lai X.; Lou Y.; Zhou H.
Institution
(Chen, Shang, Liu, Li, Lai, Lou, Zhou) Department of Cardiology, Beijing
Hospital of Traditional Chinese Medicine Affiliated to Capital Medical
University, Beijing, China
Publisher
Frontiers Media SA
Abstract
Background: Traditional Chinese medicine injections with invigorating
blood circulation (TCMI-IBCs), which have been used as antithrombosis
therapies, are widely employed by Chinese clinicians as adjuvant therapy
for acute myocardial infarction (AMI). <br/>Objective(s): A Bayesian
network meta-analysis was conducted to contrast the effectiveness and
safety of four TCMI-IBCs in AMI. <br/>Method(s): Eight Databases were
thoroughly searched before 31 December 2023, for randomized controlled
trials (RCTs) focusing on the application of TCMI-IBCs combined with
conventional treatments (CT) to treat AMI. All-cause mortality (ACM) was
the major endpoint. Secondary outcomes included bleeding events, malignant
arrhythmia (MA), recurrent myocardial infarction (RMI), left ventricular
ejection fraction (LVEF), and adverse events. Stata17.0 and GeMTC software
were employed for Bayesian network meta-analysis. <br/>Result(s): A total
of 73 eligible RCTs involving 7,504 patients were enrolled. Puerarin
injection (PI), Danhong injection (DI), sodium Tanshinone IIA Sulfonate
injection (STSI), and Danshen Chuanxiongqin injection (DCI) combined with
CT can significantly reduce the occurrence of ACM and improve LVEF in AMI
(P < 0.05), while without significant impact on bleeding events or MA (P >
0.05). STSI + CT would be the optimal treatment strategy in lowering RMI
and ACM. DI + CT was the most likely to be the optimal strategy in
reducing MA occurrence and improving LVEF. CT was likely the most
effective strategy in reducing bleeding events. However, DI + CT exhibited
the least favorable safety. <br/>Conclusion(s): TCMI-IBCs + CT had
potential benefits in the treatment of AMI. STSI + CT showed the most
favorable performance in treating AMI, followed by DI combined with CT.
Systematic Review Registration:
https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=384067,
identifier CRD42022384067.<br/>Copyright &#xa9; 2024 Chen, Shang, Liu, Li,
Lai, Lou and Zhou.

<72>
Accession Number
2030712312
Title
SURVIVAL OUTCOMES AFTER LEFT MAIN CORONARY ARTERY BYPASS GRAFTING VERSUS
STENTING IN DIABETIC PATIENTS: INSIGHTS FROM PAKISTAN.
Source
Journal of Population Therapeutics and Clinical Pharmacology. 31(6) (pp
2434-2440), 2024. Date of Publication: 01 Jun 2024.
Author
Bashar K.U.; Khan F.R.; Rauf M.A.; Ali U.; Khan A.; Khan A.N.
Institution
(Bashar, Ali, Khan) NICVD, Karachi, Pakistan
(Khan) Lady Reading Hospital, Peshawar, Pakistan
(Rauf) Kuwait Teaching Hospital/Peshawar Medical College, Peshawar,
Pakistan
(Khan) Khyber Teaching Hospital, Peshawar, Pakistan
Publisher
Codon Publications
Abstract
Background: Coronary artery disease (CAD) remains a leading cause of
morbidity and mortality, particularly among diabetic patients. The optimal
revascularization strategy for diabetic patients with left main coronary
artery disease remains controversial. This study compares the long-term
survival outcomes and quality of life between coronary artery bypass
grafting (CABG) and percutaneous coronary intervention (PCI) with stenting
in diabetic patients. <br/>Method(s): This prospective cohort study was
conducted at a tertiary care hospital in Pakistan from January 2018 to
December 2023. A total of 303 diabetic patients with left main coronary
artery disease were randomized to receive either CABG (n=152) or PCI with
stenting (n=151). Data on demographics, clinical histories, and outcomes
were collected at baseline, 1 month, 6 months, 1 year, and annually up to
5 years. Primary outcomes included all-cause mortality and major adverse
cardiac events (MACE). Secondary outcomes included rehospitalization for
cardiac causes and quality of life assessed by the Minnesota Living with
Heart Failure Questionnaire (MLHFQ). Statistical analysis was performed
using SPSS version 25.0, with survival curves estimated using the
Kaplan-Meier method and comparisons made using the log-rank test.
<br/>Result(s): At the 5-year follow-up, the CABG group exhibited
significantly lower rates of all-cause mortality (10% vs. 20%, p<0.05) and
MACE (25% vs. 35%, p<0.05) compared to the PCI group. Rehospitalization
rates were lower (30% vs. 45%, p<0.01), and quality of life scores were
higher (25 +/- 5 vs. 35 +/- 6, p<0.01) in the CABG group. Cox proportional
hazards regression analysis indicated that CABG was associated with a
significantly lower hazard ratio for all-cause mortality and MACE after
adjusting for covariates. <br/>Conclusion(s): CABG offers superior
long-term survival and quality of life compared to PCI in diabetic
patients with left main coronary artery disease. These findings support
CABG as the preferred revascularization strategy in this high-risk
population, underscoring the need for personalized treatment planning in
complex cardiac interventions.<br/>Copyright &#xa9; 2024, Codon
Publications. All rights reserved.

<73>
Accession Number
2030712271
Title
COMPARATIVE STUDY OF THE IMPACT OF LOADING DOSES OF ATORVASTATIN AND
ROSUVASTATIN ON THE IMMEDIATE POST-PCI TIMI FLOW IN PATIENTS RECEIVING
PRIMARY PERCUTANEOUS CORONARY INTERVENTION.
Source
Journal of Population Therapeutics and Clinical Pharmacology. 31(6) (pp
3216-3222), 2024. Date of Publication: 01 Jun 2024.
Author
Bilal M.; Abbas Z.; Irfan R.; Ahmed M.S.; Mateen H.; Naqvi S.Z.R.
Institution
(Bilal) Emergency Department, Type D Hospital Oghi Mansehra, KPK, Pakistan
(Abbas) Quaid-e-Azam Medical College, Bhawalpur, Pakistan
(Irfan) Hayatabad Medical Complex Peshawar, Pakistan
(Ahmed) Department of Internal Medicine, King Edward Medical University/
Mayo Hospital Lahore, Pakistan
(Mateen) Pharmacology Department, Islam Medical College, Sialkot, Pakistan
(Naqvi) Central Park Medical College Lahore, Pakistan
Publisher
Codon Publications
Abstract
Objective This study aims to assess and contrast the immediate effects of
administering loading doses of atorvastatin and rosuvastatin on
Thrombolysis in Myocardial Infarction (TIMI) flow following primary
percutaneous coronary intervention (PCI) in patients with acute myocardial
infarction. Methodology From April 2023 to April 2024, a prospective
randomized controlled trial was conducted at XYZ Hospital involving 110
eligible patients to compare the effects of administering a loading dose
of rosuvastatin (40 mg) versus atorvastatin (80 mg) on Thrombolysis In
Myocardial Infarction (TIMI) flow immediately following percutaneous
coronary intervention (PCI), left ventricular ejection fraction (LVEF) at
discharge, and Major Adverse Cardiovascular Events (MACE) over a one-month
period in patients with ST-elevation myocardial infarction (STEMI).
Eligible participants were adults aged 18 and older with confirmed STEMI
requiring primary PCI, excluding those with contraindications to statin
therapy, severe hepatic or renal impairments, pregnancy, lactation, recent
clinical trial participation, or ineligibility for PCI. Baseline
demographic and clinical data were collected, including age, gender, BMI,
smoking status, and medical history. TIMI flow grades post-PCI were
assessed, with TIMI-3 indicating complete perfusion. Secondary endpoints
included peak troponin-I levels 24 hours post-PCI and LVEF at discharge.
MACE were monitored during a one-month follow-up. Statistical analyses
were performed using multivariable regression to adjust for confounders,
and results were analyzed with IBM SPSS Statistics version 25. The study
adhered to ethical standards, with informed consent obtained and approval
from the institute's ethical review board. Results Both groups, each
comprising 55 patients, were comparable in terms of mean age, gender
distribution, BMI, and cardiovascular risk factors. No significant
differences were found in the extent of coronary artery disease, with
similar rates of single, two, and three-vessel disease. Post-PCI TIMI-3
flow, indicating complete perfusion, was achieved in 81.8% of the
rosuvastatin group and 83.6% of the atorvastatin group. Secondary
endpoints, including peak highly-sensitive troponin-I levels and left
ventricular ejection fraction (LVEF) at discharge, showed no significant
differences between the groups. Major adverse cardiovascular events (MACE)
within one month were also comparable, occurring in 5.5% of the
rosuvastatin group and 9.1% of the atorvastatin group. The study concluded
that both statins provided similar outcomes in terms of coronary blood
flow restoration and cardiac function post-PCI. Conclusion Our study shows
that pre-loading patients with both rosuvastatin and atorvastatin are
effective in restoring coronary blood flow after primary PCI in STEMI
patients. The similar TIMI-3 flow grades and peak troponin levels indicate
both statins are equally capable of reducing acute myocardial damage.
Rosuvastatin also showed a trend towards fewer major adverse
cardiovascular events and improved LV ejection fraction. The management of
acute coronary syndrome with high-intensity statins is supported by these
findings.<br/>Copyright &#xa9; 2024, Codon Publications. All rights
reserved.

<74>
Accession Number
2030712223
Title
EFFECT OF PERIOPERATIVE EXERCISES ON KINESIOPHOBIA AND QUALITY OF LIFE IN
PATIENTS UNDERGOING OPEN HEART SURGERY WITH FORWARD HEAD POSTURE.
Source
Journal of Population Therapeutics and Clinical Pharmacology. 31(6) (pp
2186-2194), 2024. Date of Publication: 01 Jun 2024.
Author
Omer A.; Shadmehr A.; Awan W.A.; Malik A.N.; Arif M.; Altaf S.; Zaffar K.;
Moghadam B.A.
Institution
(Omer, Shadmehr, Moghadam) School of Rehabilitation, Tehran University of
Medical Sciences, Tehran, Iran, Islamic Republic of
(Awan, Malik) Islamabad College of Physiotherapy, Margalla Institute of
Health Sciences, Rawalpindi, Pakistan
(Arif) Riphah College of Rehabilitation & Allied Health Sciences, Riphah
International University, Islamabad, Pakistan
(Altaf) Department of Rehabilitation Sciences, Shifa Tameer e Millat
University, Islamabad, Pakistan
(Zaffar, Zaffar) Chandka Medical College, Larkana, Pakistan
Publisher
Codon Publications
Abstract
Open heart surgery is a major procedure that can significantly impact
quality of life (QoL). Forward head posture (FHP) is a prevalent condition
that also adversely affects QoL. Objective was to compare the effect of
perioperative exercises on kinesiophobia and quality of life in persons
undergoing open heart surgery (OHS) with forward head posture. This
prospective, parallel-group, randomized controlled trial included 32
patients undergoing open heart surgery via median sternotomy with FHP,
recruited from Rawalpindi Institute of Cardiology, Pakistan. Participants
were randomized into two groups: 1) standard cardiac rehabilitation (CR)
protocol, 2) CR protocol with therapeutic exercises for FHP. The
intervention included a combination of stretching and strengthening
exercises. Outcomes assessed were Health-related QoL (SF-36) and Tampa
scale for Kinesiophobia (TSK); assessed at 4 weeks before surgery (T1),
one day before surgery (T2), day of discharge (T3) & 4 weeks
post-discharge (T4). One-way ANOVA and Repeated measures ANOVA were used
to test hypotheses and evaluate changes from baseline to various time
points. The between-group comparison indicated significant differences in
TSK scores at all time points T1 (p = 0.029), T2 (p = 0.008), T3 (p =
0.001), and T4 (p = 0.022) while all domains of SF-36 showed no
significant differences (p>0.05) at all time points. The study concludes
that both standard CR and CR + therapeutic exercise for FHP showed equal
effects on QoL of patients while kinesiophobia was greater in the group
performing exercises for FHP.<br/>Copyright &#xa9; 2024, Codon
Publications. All rights reserved.

<75>
Accession Number
2030486104
Title
Empagliflozin Effects in Patients with ST-Elevation Myocardial Infarction
Undergoing Primary PCI: The EMI-STEMI Randomized Clinical Trial.
Source
American Journal of Cardiovascular Drugs. 24(5) (pp 673-684), 2024. Date
of Publication: September 2024.
Author
Khani E.; Aslanabadi N.; Mehravani K.; Rezaei H.; Afsharirad H.;
Entezari-Maleki T.
Institution
(Khani, Afsharirad) Student Research Committee, Tabriz University of
Medical Sciences, Tabriz, Iran, Islamic Republic of
(Aslanabadi, Mehravani, Entezari-Maleki) Cardiovascular Research Center,
Tabriz University of Medical Sciences, Tabriz, Iran, Islamic Republic of
(Rezaei, Entezari-Maleki) Department of Clinical Pharmacy, Faculty of
Pharmacy, Tabriz University of Medical Sciences, Tabriz, Iran, Islamic
Republic of
Publisher
Adis
Abstract
Introduction: Empagliflozin, a sodium-glucose cotransporter 2 (SGLT2)
inhibitor, improves cardiovascular outcomes in heart failure patients, but
data regarding the efficacy of empagliflozin in the setting of acute
myocardial infarction (AMI) is still unclear. The current study aimed to
evaluate whether treatment with empagliflozin before primary percutaneous
coronary intervention (PCI) improves parameters associated with patients'
outcomes. <br/>Method(s): We randomly assigned 101 non-diabetic and
non-heart failure patients with ST-elevation myocardial infarction (STEMI)
who underwent primary PCI to receive either empagliflozin (10 mg before
PCI and once daily for 40 days) or placebo, in addition to the standard
treatment. The primary outcomes were changes in left ventricular ejection
fraction (LVEF) 40 days after PCI, changes in cardiac troponin I (cTnI)
and estimates of its area under the curve (AUC) and the peak level, and
resolution of ST-segment in > 50% of leads 90 min after PCI.
<br/>Result(s): No significant difference was observed in terms of the
occurrence of ST-segment resolution > 50% (46.0% versus 45.0%; p = 0.92)
and the mean level of cTnI at each time point between the two groups. The
estimated mean [standard deviation (SD)] AUC of cTnI was 955.0 (595.7) ng
h/ml in the intervention and 999.7 (474.7) ng h/ml in the control groups
(p = 0.85) without any significant difference in peak cTnI level. The mean
(SD) LVEF 40 days after primary PCI was significantly higher in
empagliflozin-treated patients than the placebo group [43.2% (5.8%) versus
39.2% (6.7%); p = 0.002]. <br/>Conclusion(s): In this study, no
significant differences were observed across the groups in terms of cTnI
levels and ST-segment resolution in patients with STEMI undergoing primary
PCI. However, it shed light on the potential benefits of empagliflozin in
improving LVEF following STEMI. Registration: Iranian Registry of Clinical
Trials Platform (https://irct.behdasht.gov.ir/) identifier number
IRCT20111206008307N42.<br/>Copyright &#xa9; The Author(s), under exclusive
licence to Springer Nature Switzerland AG 2024.

<76>
Accession Number
2029535724
Title
Differences in glycemic trends due to reconstruction methods after
proximal gastrectomy from the perspective of continuous
glucose-monitoring.
Source
Surgery Today. 54(9) (pp 1104-1111), 2024. Date of Publication: September
2024.
Author
Shoda K.; Kubota T.; Kawaguchi Y.; Akaike H.; Maruyama S.; Higuchi Y.;
Nakayama T.; Saito R.; Takiguchi K.; Furuya S.; Shiraishi K.; Amemiya H.;
Kawaida H.; Ichikawa D.
Institution
(Shoda, Kawaguchi, Akaike, Maruyama, Higuchi, Nakayama, Saito, Takiguchi,
Furuya, Shiraishi, Amemiya, Kawaida, Ichikawa) First Department of
Surgery, Faculty of Medicine, University of Yamanashi, 1110 Shimokato,
Yamanashi, Chuo 4093898, Japan
(Kubota) Division of Digestive Surgery, Department of Surgery, Kyoto
Prefectural University of Medicine, 465 Kajii-Cho, Kawaramachi-Hirokoji,
Kamigyo-Ku, Kyoto 6028566, Japan
Publisher
Springer
Abstract
Purpose: In recent years, clinicians have focused on the importance of
preventing hypoglycemia. We evaluated the impact of different
reconstruction procedures after proximal gastrectomy on glycemic
variability in non-diabetic patients with gastric cancer. <br/>Method(s):
This prospective observational study was conducted between April 2020 and
March 2023. Flash continuous glucose-monitoring, a novel method for
assessing glycemic control, was used to evaluate the glycemic profiles
after gastrectomy. A flash continuous glucose-monitoring sensor was placed
subcutaneously at the time of discharge, and glucose trends were evaluated
for 2 weeks. <br/>Result(s): The anastomotic methods for proximal
gastrectomy were esophagogastrostomy in 10 patients and double-tract
reconstruction in 10 patients. The time below this range (glucose levels <
70 mg/dL) was significantly higher in the double-tract reconstruction
group than in the esophagogastrostomy group (p = 0.049). A higher
nocturnal time below this range was significantly correlated with an older
age and double-tract reconstruction (p = 0.025 and p = 0.025,
respectively). <br/>Conclusion(s): These findings provide new insights
into reconstruction methods after proximal gastrectomy by assessing
postoperative hypoglycemia in non-diabetic patients with gastric
cancer.<br/>Copyright &#xa9; The Author(s) under exclusive licence to
Springer Nature Singapore Pte Ltd. 2024.

<77>
[Use Link to view the full text]
Accession Number
2034214666
Title
A Randomized Trial of Intravenous Amino Acids for Kidney Protection.
Source
New England Journal of Medicine. 391(8) (pp 687-698), 2024. Date of
Publication: 22 Aug 2024.
Author
Landoni G.; Monaco F.; Ti L.K.; Baiardo Redaelli M.; Bradic N.; Comis M.;
Kotani Y.; Brambillasca C.; Garofalo E.; Scandroglio A.M.; Viscido C.;
Paternoster G.; Franco A.; Porta S.; Ferrod F.; Calabro M.G.; Pisano A.;
Vendramin I.; Barucco G.; Federici F.; Severi L.; Belletti A.; Cortegiani
A.; Bruni A.; Galbiati C.; Covino A.; Baryshnikova E.; Giardina G.;
Venditto M.; Kroeller D.; Nakhnoukh C.; Mantovani L.; Silvetti S.; Licheri
M.; Guarracino F.; Lobreglio R.; Di Prima A.L.; Fresilli S.; Labanca R.;
Mucchetti M.; Lembo R.; Losiggio R.; Bove T.; Ranucci M.; Fominskiy E.;
Longhini F.; Zangrillo A.; Bellomo R.
Institution
(Landoni, Monaco, Baiardo Redaelli, Scandroglio, Franco, Calabro, Barucco,
Belletti, Galbiati, Giardina, Nakhnoukh, Licheri, Di Prima, Fresilli,
Labanca, Mucchetti, Lembo, Losiggio, Fominskiy, Zangrillo) The Department
of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute,
Milan, Italy
(Landoni, Zangrillo) Vita-Salute San Raffaele University, Milan, Italy
(Brambillasca) Dipartimento di Chirurgia Cardiovascolare, Unita Operativa
di Anestesia e Terapia Intensiva, IRCCS Centro Cadiologico Monzino, Milan,
Italy
(Comis, Viscido, Porta, Ferrod) S.C. Anestesia e Rianimazione
Cardiovascolare, A.O. Ordine Mauriziano Umberto I di Torino, Turin, Italy
(Garofalo, Bruni, Longhini) The Department of Medical and Surgical
Sciences, University Hospital 'R. Dulbecco', Magna Graecia University,
Catanzaro, Italy
(Paternoster, Covino) Cardiovascular Anesthesia and ICU San Carlo
Hospital, Potenza, Italy
(Pisano, Venditto) Cardiac Anesthesia and ICU, AORN 'Dei Colli', Monaldi
Hospital, Naples, Italy
(Vendramin, Bove) The Department of Medicine, University of Udine, Rome,
Italy
(Vendramin) The Division of Cardiac Surgery, Azienda Sanitaria
Universitaria Friuli Centrale, Rome, Italy
(Bove) The Department of Anesthesia and Intensive Care Medicine, ASUFC
University, Hospital of Central Friuli, Rome, Italy
(Federici) Udine, UOC Anestesia e Rianimazione, Azienda Ospedaliero
Universitaria Sant'Andrea, Rome, Italy
(Severi) UO Complessa Anestesia e Rianimazione, Dipartimento
Cardio-Toraco-Vascolare, Azienda Ospedaliera San Camillo Forlanini, Rome,
Italy
(Cortegiani) The Department of Precision Medicine in Medical, Surgical and
Critical Care, University of Palermo, Palermo, Italy
(Baryshnikova, Ranucci) The Department of Cardiovascular Anesthesia and
Intensive Care, IRCCS Policlinico San Donato, San Donato Milanese, Italy
(Kroeller) IRCCS Humanitas Research Hospital, Anestesia e Terapia
Intensiva Cardiochirurgica, Rozzano, Italy
(Mantovani) The Department of Anesthesia, ICU Maria Cecilia Hospital GVM
Care and Research, Cotignola, Italy
(Silvetti) The Department of Cardiac Anesthesia and Intensive Care,
Ospedale Policlinico San Martino IRCCS, IRCCS Cardiovascular Network,
Genoa, Italy
(Guarracino) The Department of Cardiothoracic and Vascular Anaesthesia and
Intensive Care, Azienda Ospedaliero Universitaria Pisana, Pisa, Italy
(Lobreglio) The Department of Anesthesia, Intensive Care and Emergency,
'Citta della Salute e della Scienza' University Hospital, Turin, Italy
(Ti) The Department of Anaesthesia, National University Hospital,
Singapore
(Bradic) The Clinic of Anesthesiology, Resuscitation, and Intensive
Medicine, University Hospital Dubrava, Zagreb, Croatia
(Kotani) The Department of Intensive Care Medicine, Kameda Medical Center,
Kamogawa, Japan
(Bellomo) The Department of Critical Care, University of Melbourne, The
Australian and New Zealand Intensive Care Research Centre, Monash
University, Melbourne, VIC, Australia
(Bellomo) The Department of Intensive Care, Austin Hospital, Melbourne,
VIC, Australia
(Bradic) University North, Department of Nursing, Varazdin, Croatia
(Cortegiani) The Department of Anesthesia Analgesia Intensive Care and
Emergency, University Hospital Policlinico Paolo Giaccone, Palermo, Italy
Publisher
Massachussetts Medical Society
Abstract
Background Acute kidney injury (AKI) is a serious and common complication
of cardiac surgery, for which reduced kidney perfusion is a key
contributing factor. Intravenous amino acids increase kidney perfusion and
recruit renal functional reserve. However, the efficacy of amino acids in
reducing the occurrence of AKI after cardiac surgery is uncertain. Methods
In a multinational, double-blind trial, we randomly assigned adult
patients who were scheduled to undergo cardiac surgery with
cardiopulmonary bypass to receive an intravenous infusion of either a
balanced mixture of amino acids, at a dose of 2 g per kilogram of ideal
body weight per day, or placebo (Ringer's solution) for up to 3 days. The
primary outcome was the occurrence of AKI, defined according to the Kidney
Disease: Improving Global Outcomes creatinine criteria. Secondary outcomes
included the severity of AKI, the use and duration of kidney-replacement
therapy, and all-cause 30-day mortality. Results We recruited 3511
patients at 22 centers in three countries and assigned 1759 patients to
the amino acid group and 1752 to the placebo group. AKI occurred in 474
patients (26.9%) in the amino acid group and in 555 (31.7%) in the placebo
group (relative risk, 0.85; 95% confidence interval [CI], 0.77 to 0.94;
P=0.002). Stage 3 AKI occurred in 29 patients (1.6%) and 52 patients
(3.0%), respectively (relative risk, 0.56; 95% CI, 0.35 to 0.87).
Kidney-replacement therapy was used in 24 patients (1.4%) in the amino
acid group and in 33 patients (1.9%) in the placebo group. There were no
substantial differences between the two groups in other secondary outcomes
or in adverse events. Conclusions Among adult patients undergoing cardiac
surgery, infusion of amino acids reduced the occurrence of
AKI.<br/>Copyright &#xa9; 2024 Massachusetts Medical Society.

<78>
[Use Link to view the full text]
Accession Number
2034199027
Title
Outcomes of Heart Transplantation from Donation after Circulatory Death:
An Up-to-date Systematic Meta-analysis.
Source
Transplantation. 108(9) (pp e264-e275), 2024. Date of Publication: 01 Sep
2024.
Author
Zong J.; Ye W.; Yu J.; Zhang X.; Cui J.; Chen Z.; Li Y.; Wang S.; Ran S.;
Niu Y.; Luo Z.; Li X.; Zhao J.; Hao Y.; Xia J.; Wu J.
Institution
(Zong, Ye, Yu, Zhang, Cui, Chen, Li, Wang, Ran, Niu, Luo, Li, Zhao, Hao,
Xia, Wu) Department of Cardiovascular Surgery, Union Hospital, Tongji
Medical College, Huazhong University of Science and Technology, Hubei,
Wuhan, China
(Zong, Ye, Chen, Xia, Wu) Center for Translational Medicine, Union
Hospital, Tongji Medical College, Huazhong University of Science and
Technology, Hubei, Wuhan, China
(Yu, Zhang, Cui, Li, Wang, Ran, Niu, Luo, Li, Zhao, Hao, Xia, Wu) Hubei
Key Laboratory of Biological Targeted Therapy, Union Hospital, Tongji
Medical College, Huazhong University of Science and Technology, Hubei,
Wuhan, China
(Xia, Wu) Key Laboratory of Organ Transplantation, Ministry of Education,
Chinese Academy of Medical Sciences, Hubei, Wuhan, China
(Xia, Wu) NHC Key Laboratory of Organ Transplantation, Chinese Academy of
Medical Sciences, Hubei, Wuhan, China
(Xia, Wu) Key Laboratory of Organ Transplantation, Chinese Academy of
Medical Sciences, Hubei, Wuhan, China
(Xia, Wu) Institute of Translational Medicine, Tongji Medical College,
Huazhong University of Science and Technology, Hubei, Wuhan, China
Publisher
Lippincott Williams and Wilkins
Abstract
Background. Donation after circulatory death (DCD) heart transplantation
(HTx) significantly expands the donor pool and reduces waitlist mortality.
However, high-level evidence-based data on its safety and effectiveness
are lacking. This meta-analysis aimed to compare the outcomes between DCD
and donation after brain death (DBD) HTxs. Methods. Databases, including
MEDLINE, Embase, CINAHL, and the Cochrane Central Register of Controlled
Trials, were systematically searched for randomized controlled trials and
observational studies reporting the outcomes of DCD and DBD HTxs published
from 2014 onward. The data were pooled using random-effects models. Risk
ratios (RRs) with 95% confidence intervals (CIs) were used as the summary
measures for categorical outcomes and mean differences were used for
continuous outcomes. Results. Twelve eligible studies were included in the
meta-analysis. DCD HTx was associated with lower 1-y mortality rate (DCD
8.13% versus DBD 10.24%; RR=0.75; 95% CI, 0.59-0.96; P=0.02) and 5-y
mortality rate (DCD 14.61% versus DBD 20.57%; RR=0.72; 95% CI, 0.54-0.97;
P=0.03) compared with DBD HTx. Conclusions. Using the current DCD
criteria, HTx emerges as a promising alternative to DBD transplantation.
The safety and feasibility of DCD hearts deserve further exploration and
investigation.<br/>Copyright &#xa9; 2024 Wolters Kluwer Health, Inc. All
rights reserved.

<79>
Accession Number
2034227256
Title
Protective effects of fructose-1,6-bisphosphate postconditioning on
myocardial ischaemia-reperfusion injury in patients undergoing valve
replacement: a randomized, double-blind, placebo-controlled clinical
trial.
Source
European Journal of Cardio-thoracic Surgery. 66(2) (no pagination), 2024.
Article Number: ezae306. Date of Publication: 01 Aug 2024.
Author
Xu H.; Wang M.; Zhao T.; Yu X.; Wang F.
Institution
(Xu, Wang, Wang) Affiliated Hospital, North Sichuan Medical College,
Nanchong, China
(Zhao) Department of Anesthesiology, North Sichuan Medical College,
Nanchong, China
(Yu) Second Affiliated Hospital of North Sichuan Medical College,
Nanchong, China
Publisher
European Association for Cardio-Thoracic Surgery
Abstract
OBJECTIVES: 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. <br/>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, CK,
high-sensitivity C-reactive protein, alpha-hydroxybutyrate dehydrogenase
and cardiac troponin I, the spontaneous cardiac rhythm recovery profile,
the extracorporeal circulation time and duration of surgery, intensive
care unit and postoperative hospitalization. <br/>RESULT(S): Forty
patients were randomly assigned to receive intervention and included in
the analysis. The serum concentrations of CK-MB, lactate dehydrogenase,
CK, cardiac troponin I, alpha-hydroxybutyrate dehydrogenase and
high-sensitivity C-reactive protein at T<inf>1~4</inf> were lower in the
FDP group than in the NS group (P<0.001). Compared with the NS group, the
dosage of dopamine administered 1-90 min 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 P1/4 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). <br/>CONCLUSION(S): The FDP
postconditioning could improve both myocardial ischaemia-reperfusion
injury and the spontaneous cardiac rhythm recovery during cardiac valve
surgery with extracorporeal circulation.<br/>Copyright &#xa9; The
Author(s) 2024. Published by Oxford University Press on behalf of the
European Association for Cardio-Thoracic Surgery. All rights reserved.

<80>
Accession Number
2031086962
Title
An Updated Comprehensive Review of Existing Transcatheter Aortic Valve
Replacement Access.
Source
Journal of Cardiovascular Translational Research. (no pagination), 2024.
Date of Publication: 2024.
Author
Sheng W.; Dai H.; Zheng R.; Aihemaiti A.; Liu X.
Institution
(Sheng, Dai, Zheng, Aihemaiti, Liu) Department of Cardiology, the Second
Affiliated Hospital Zhejiang University School of Medicine, Hangzhou
310009, China
(Sheng, Dai, Zheng, Aihemaiti, Liu) Internal Medicine, Zhejiang University
School of Medicine, Hangzhou 310058, China
(Liu) Binjiang Institute of Zhejiang University, Zhejiang, Hangzhou
310052, China
Publisher
Springer
Abstract
For the past 20 years, transcatheter aortic valve replacement (TAVR) has
been the treatment of choice for symptomatic aortic stenosis. The
transfemoral (TF) access is considered the gold standard approach for
TAVR. However, TF-TAVR cannot be performed in some patients; thus,
alternative accesses are required. Our review paper generalises the TAVR
accesses currently available, including the transapical, transaortic,
trans-subclavian/axillary, transcarotid, transcaval, and suprasternal
approaches. Their advantages and disadvantages have been analysed. Since
there is no standard recommendation for an alternative approach, access
selection depends on the expertise of the local cardiac team, patient
characteristics, and access properties. Each TAVR centre is recommended to
master a minimum of one non-TF access alternative. Of note, more evidence
is required to delve into the clinical outcomes of each approach, at both
early and long-term (Figure 1). Graphical Abstract: (Figure
presented.).<br/>Copyright &#xa9; The Author(s), under exclusive licence
to Springer Science+Business Media, LLC, part of Springer Nature 2024.

<81>
Accession Number
645092396
Title
Preoperative prophylactic insertion of intraaortic balloon pumps in
critically ill patients undergoing coronary artery bypass surgery: a
meta-analysis of RCTS.
Source
Journal of cardiothoracic surgery. 19(1) (pp 489), 2024. Date of
Publication: 23 Aug 2024.
Author
Hu Y.; Fan M.; Zhang P.; Li R.
Institution
(Hu, Li) Weifang Medical University, Weifang 261042, China
(Fan) Yunnan Technology and Business University, Kunming, China
(Zhang) Department of Critical Care Medicine, Affiliated Hospital of
Weifang Medical University, Weifang 261031, China
Abstract
BACKGROUND: The intra-aortic balloon pump (IABP) technique plays a crucial
role in providing circulatory support for patients experiencing
hemodynamic instability. This study aimed to assess the effectiveness and
safety of preoperative prophylactic IABP insertion in patients undergoing
acute critical coronary artery bypass grafting (CABG). <br/>METHOD(S): A
comprehensive search was conducted in PubMed, Cochrane Library, and Embase
databases, covering the period from January 1995 to September 2022.
<br/>RESULT(S): The incidence of renal insufficiency, mechanical
ventilation exceeding 24 h, and bleeding events in the IABP group did not
exhibit significant differences compared to the control group (relative
risk [RR]=0.85, P=0.26; RR=0.81, P=0.08; RR=0.95, P=0.87). However, the
hospital mortality rate was significantly lower in the IABP group than in
the control group (RR=0.54, P=0.0007), and the length of ICU stay was
shorter in the IABP group (mean difference [MD] = -1.12, P<0.000001). The
IABP group also exhibited a lower incidence of low cardiac output syndrome
(LCOS%) compared to the control group (RR=0.61, P<0.0001), and a lower
incidence of major adverse cardiac and cerebrovascular events (MACCE%)
(RR=0.70, P=0.001). No significant publication bias was observed in the
funnel plot analysis. <br/>CONCLUSION(S): Preoperative prophylactic
insertion of IABP is currently considered beneficial in improving outcomes
for critically ill patients undergoing CABG. This technique reduces
hospital mortality, shortens ICU stays, and lowers the incidence of LCOS%
and MACCE%.<br/>Copyright &#xa9; 2024. The Author(s).

<82>
Accession Number
2034227539
Title
Extracorporeal Cardiopulmonary Resuscitation Use among Children with
Cardiac Disease in the ICU: A Meta-Analysis and Meta-Regression of Data
Through March 2024.
Source
Pediatric Critical Care Medicine. (no pagination), 2024. Article Number:
10.1097/PCC.0000000000003594. Date of Publication: 2024.
Author
Sperotto F.; Daverio M.; Amigoni A.; Gregori D.; Dorste A.; Kobayashi
R.L.; Thiagarajan R.R.; Maschietto N.; Alexander P.M.
Institution
(Sperotto, Kobayashi, Thiagarajan, Maschietto, Alexander) Department of
Cardiology, Boston Children's Hospital, Boston, MA, United States
(Sperotto, Kobayashi, Thiagarajan, Maschietto, Alexander) Department of
Pediatrics, Harvard Medical School, Boston, MA, United States
(Daverio, Amigoni) Pediatric Intensive Care Unit, Department of Women's
and Children's Health, University of Padova, Padova, Italy
(Gregori) Laboratories of Epidemiological Methods and Biostatistics,
Department of Environmental Medicine and Public Health, University of
Padova, Padova, Italy
(Dorste) Boston Children's Hospital Library, Boston Children's Hospital,
Boston, MA, United States
Publisher
Lippincott Williams and Wilkins
Abstract
Objective: Epidemiologic data on extracorporeal cardiopulmonary
resuscitation (ECPR) use in children with cardiac disease after
in-hospital cardiac arrest (IHCA) are lacking. We aimed to investigate
trends in ECPR use over time in critically ill children with cardiac
disease. <br/>Data Sources: We performed a secondary analysis of a recent
systematic review (PROSPERO CRD42020156247) to investigate trends in ECPR
use in children with cardiac disease. PubMed, Web of Science, Embase, and
Cumulative Index to Nursing and Allied Health Literature were screened
(inception to September 2021). For completeness of this secondary
analysis, PubMed was also rescreened (September 2021 to March 2024). Study
Selection: Observational studies including epidemiologic data on ECPR use
in children with cardiac disease admitted to an ICU. <br/>Data Extraction:
Data were extracted by two independent investigators. The risk of bias was
assessed using the National Heart Lung and Blood Institutes Quality
Assessment Tools. Random-effects meta-analysis was used to compute a
pooled proportion of subjects undergoing ECPR; meta-regression was used to
assess trends in ECPR use over time. <br/>Data Synthesis: Of the 2664
studies identified, 9 (17,669 patients) included data on ECPR use in
children with cardiac disease. Eight were cohort studies, 1 was a
case-control, 8 were retrospective, 1 was prospective, 6 were
single-center, and 3 were multicenter. Seven studies were included in the
meta-analysis; all were judged of good quality. By meta-analysis, we found
that a pooled proportion of 21% (95% CI, 15-29%) of pediatric patients
with cardiac disease experiencing IHCA were supported with ECPR. By
meta-regression adjusted for category of patients (surgical vs. general
cardiac), we found that the use of ECPR in critically ill children with
cardiac disease significantly increased over time (p = 0.026).
<br/>Conclusion(s): About one-fifth of critically ill pediatric cardiac
patients experiencing IHCA were supported with ECPR, and its use
significantly increased over time. This may partially explain the
increased trends in survival demonstrated for this
population.<br/>Copyright &#xa9; 2024 Lippincott Williams and Wilkins. All
rights reserved.