EMBASE Cardiac Update AutoAlert: EPICORE Cardiac Surgery Blogger2

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<1>
Accession Number
2032635762
Title
The Clinical Impact of Paravalvular Leaks With Transcutaneous Aortic Valve
Implantation (TAVI) Versus Surgical Aortic Valve Replacement (SAVR): A
Systematic Review and Meta-Analysis.
Source
Heart Lung and Circulation. 33(9) (pp 1319-1330), 2024. Date of
Publication: September 2024.
Author
Moawad K.R.; Mohamed S.; Hammad A.; Barker T.
Institution
(Moawad, Mohamed, Hammad, Barker) Department of Cardio-Thoracic Surgery
University Hospital Coventry and Warwickshire NHS Trust, Coventry, United
Kingdom
(Moawad) Division of Surgical Sciences, University of Edinburgh,
Edinburgh, United Kingdom
Publisher
Elsevier Ltd
Abstract
Background: Aortic valve stenosis is a common cardiac condition that
requires intervention for symptomatic and/or prognostic reasons. The two
most common interventions are surgical aortic valve replacement (SAVR) and
transcatheter aortic valve implantation (TAVI). The ratio of TAVI:SAVR has
increased twofold over the past few years and is now being considered in
intermediate-risk patients as well. One of the significant benefits of
TAVI is that it is less invasive; however, one of the drawbacks is a high
paravalvular leaks (PVLs) rate compared to SAVR. To assess the impact of
PVLs on survival, progression of heart failure, and the need for
re-intervention. <br/>Method(s): We conducted a comprehensive systematic
literature search from the conception of TAVI 2002 until December 2022
through Embase (Ovid), MEDLINE (Ovid), Science Direct, and CENTRAL
(Wiley). We followed PRISMA guidelines and checklists. Review protocol
registration ID in PROSPERO: CRD42023393742. <br/>Result(s): We identified
28 studies that met our eligibility criteria, and only 24 studies were
suitable for pooling in a meta-analysis (including their hazard ratio with
a confidence interval of 95%) assessing our primary outcome (all-cause
mortality). The remaining four studies were narratively synthesised.
RevMan V5.4 (Version 5.4. Cochrane Collaboration, 2020) was utilised to
pool meta-analysis data to assess effect estimates of PVLs in both
intervention arms, using a random effect model for calculation (hazard
ratio 1.14 confidence interval 95% 1.08-1.21 [p<0.0001]), with a follow-up
duration between 30 days to 5 years. <br/>Conclusion(s): Patients with
mild or higher degrees of PVLs in both intervention arms incurred
unfavourable outcomes. The incidence of PVLs was significantly higher with
TAVI; even a mild degree led to poor quality of life and increased
all-cause mortality on long-term follow-up.<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)

<2>
Accession Number
2031271987
Title
Impact of obstructive sleep apnoea on postoperative outcomes of patients
undergoing coronary artery bypass grafting: a systematic review and
meta-analysis.
Source
Sleep and Breathing. (no pagination), 2024. Date of Publication: 2024.
Author
Ni Y.; Zhou Y.
Institution
(Ni) Respiratory medicine, Zhejiang Xinda Hospital, Huzhou, China
(Zhou) Department of Anesthesiology, Zhejiang Xinda Hospital, 288 Xinguang
Ave., Zhejiang Province, Huzhou 313000, China
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Objective: To assess the association between obstructive sleep apnoea
(OSA) and postoperative complications in patients after coronary artery
bypass graft (CABG). <br/>Method(s): PubMed, Embase, Web of Science and
Scopus databases were explored to identify relevant observational studies
that reported incidences of OSA in CABG patients, and assessed OSA using
standard objective methods such as polysomnography (PSG). The primary
outcomes of interest were risk of major adverse cardiac and
cerebrovascular events (MACCE) and all-cause mortality. Pooled effect
sizes were reported as odds ratio (OR) with 95% confidence intervals.
<br/>Result(s): Twelve studies were included. All studies, except one, had
a prospective cohort design. CABG patients with OSA had increased risk of
MACCE (OR 1.71, 95% CI: 1.16, 2.53), myocardial infarction (MI) (OR 2.21,
95% CI: 1.19, 4.13), pulmonary complications (OR 1.86, 95% CI: 1.03,
3.38), renal complications (OR 8.14, 95% CI: 2.07, 32.1), heart failure
(OR 1.86, 95% CI: 1.19, 2.89) and need for revascularization (OR 2.80, 95%
CI: 1.01, 7.75). However, risk of all-cause mortality (OR 1.63, 95% CI:
0.75, 3.52) was comparable in all patients. <br/>Conclusion(s): This study
showed that OSA significantly correlates with the increased risk of major
adverse events. Our results indicate that recognizing and managing OSA in
CABG patients is crucial for mitigating associated risks.<br/>Copyright
&#xa9; The Author(s), under exclusive licence to Springer Nature
Switzerland AG 2024.

<3>
Accession Number
2030212158
Title
One-year mortality and causes of death after stereotactic radiation
therapy for refractory ventricular arrhythmias: A systematic review and
pooled analysis.
Source
Trends in Cardiovascular Medicine. 34(7) (pp 488-496), 2024. Date of
Publication: October 2024.
Author
Benali K.; Zei P.C.; Lloyd M.; Kautzner J.; Guenancia C.; Ninni S.; Rigal
L.; Simon A.; Bellec J.; Vlachos K.; Sacher F.; Hammache N.; Sellal J.-M.;
de Crevoisier R.; Da Costa A.; Martins R.
Institution
(Benali, Da Costa) Section of Cardiac Electrophysiology, Saint-Etienne
University, Saint-Etienne, France
(Benali, Vlachos, Sacher) IHU LIRYC, Electrophysiology and Heart Modeling
Institute, Bordeaux, France
(Benali, Rigal, Simon, Martins) INSERM-LTSI, Rennes U1099, France
(Zei) Department of Cardiovascular Medicine, Brigham and Women's Hospital,
Boston, United States
(Lloyd) Section of Cardiac Electrophysiology, Emory University, Atlanta,
United States
(Kautzner) Institute for Clinical and Experimental Medicine, Prague,
Czechia
(Guenancia) Section of Cardiac Electrophysiology, Dijon University, Dijon,
France
(Ninni) Heart and Lung Institute, Lille University, Lille, France
(Bellec, de Crevoisier) Department of Radiation Oncology, Centre Eugene
Marquis, Rennes, France
(Hammache, Sellal) Section of Cardiac Electrophysiology, Nancy University,
Nancy, France
(Martins) Section of Cardiac Electrophysiology, Rennes University, Rennes,
France
Publisher
Elsevier Inc.
Abstract
Patients treated with cardiac stereotactic body radiation therapy
(radioablation) for refractory ventricular arrhythmias are patients with
advanced structural heart disease and significant comorbidities. However,
data regarding 1-year mortality after the procedure are scarce. This
systematic review and pooled analysis aimed at determining 1-year
mortality after cardiac radioablation for refractory ventricular
arrhythmias and investigating leading causes of death in this population.
MEDLINE/EMBASE databases were searched up to January 2023 for studies
including patients undergoing cardiac radioablation for the treatment of
refractory ventricular arrhythmias. Quality of included trials was
assessed using the NIH Tool for Case Series Studies (PROSPERO
CRD42022379713). A total of 1,151 references were retrieved and evaluated
for relevance. Data were extracted from 16 studies, with a total of 157
patients undergoing cardiac radioablation for refractory ventricular
arrhythmias. Pooled 1-year mortality was 32 % (95 %CI: 23-41), with almost
half of the deaths occurring within three months after treatment. Among
the 157 patients, 46 died within the year following cardiac radioablation.
Worsening heart failure appeared to be the leading cause of death (52 %),
although non-cardiac mortality remained substantial (41 %) in this
population. Age>=70yo was associated with a significantly higher 12-month
all-cause mortality (p<0.022). Neither target volume size nor radiotherapy
device appeared to be associated with 1-year mortality (p = 0.465 and p =
0.199, respectively). About one-third of patients undergoing cardiac
stereotactic body radiation therapy for refractory ventricular arrhythmias
die within the first year after the procedure. Worsening heart failure
appears to be the leading cause of death in this population.<br/>Copyright
&#xa9; 2023

<4>
Accession Number
2029659713
Title
Thoracic endovascular aortic repair for hyperacute, acute, subacute and
chronic type B aortic dissection: Meta-analysis of reconstructed
time-to-event data.
Source
Trends in Cardiovascular Medicine. 34(7) (pp 479-485), 2024. Date of
Publication: October 2024.
Author
Sa M.P.; Jacquemyn X.; Brown J.A.; Ahmad D.; Serna-Gallegos D.;
Arnaoutakis G.J.; Singh M.J.; Sultan I.
Institution
(Sa, Brown, Ahmad, Serna-Gallegos, Sultan) Department of Cardiothoracic
Surgery, University of Pittsburgh, Pittsburgh, PA, United States
(Sa, Brown, Ahmad, Serna-Gallegos, Singh, Sultan) UPMC Heart and Vascular
Institute, University of Pittsburgh Medical Center, Pittsburgh, PA, United
States
(Jacquemyn) Department of Cardiovascular Sciences, KU Leuven, Leuven,
Belgium
(Arnaoutakis) Division of Cardiovascular and Thoracic Surgery, Dell
Medical School, Austin, TX, United States
(Singh) Division of Vascular Surgery, University of Pittsburgh Medical
Centre, Pittsburgh, PA, United States
Publisher
Elsevier Inc.
Abstract
Since the optimal timing for thoracic endovascular aortic repair (TEVAR)
in the context of type B aortic dissections (TBAD) remains an open
question, we performed a systematic review with meta-analysis to evaluate
outcomes of TEVAR according to the phases of TBAD - hyperacute, acute,
subacute and chronic. We carried out a pooled meta-analysis of
time-to-event data extracted from studies published by June 2023 for the
following outcomes: all-cause mortality, aortic-related mortality, and
late aortic reinterventions. Thirteen studies met our eligibility
criteria, comprising 4,793 patients (10.3 % hyperacute, 51.9 % acute, 25.9
% subacute, 11.9 % chronic). Considering the overall population, we
observed a statistically significant difference between the groups
(Log-rank test, P < 0.0001) and the main differences were found in the
following comparisons: hyperacute versus acute (HR 1.61; 95 %CI 1.21-2.13;
P = 0.001); hyperacute versus chronic (HR 1.70; 95 %CI 1.17-2.46; P =
0.005); subacute versus acute (HR 0.78; 95 %CI 0.63-0.98; P = 0.032).
Considering the population with uncomplicated TBAD, we also observed a
statistically significant difference for all-cause death between the
groups (Log-rank test, P < 0.0001) and the main differences were found in
the comparisons for subacute versus acute (HR 0.72; 95 %CI 0.58-0.88; P =
0.002). Furthermore, we observed statistically significant differences
between the groups for aortic-related death (Log-rank test, P < 0.0001)
and late aortic reintervention (Log-rank test, P < 0.0001), all favoring
mostly the subacute phase as the optimal timing for TEVAR. In conclusion,
there seems to be a timing-specific difference in the outcomes of TEVAR
for TBAD pointing to the subacute phase as the optimal timing to achieve
better long-term outcomes.<br/>Copyright &#xa9; 2023 Elsevier Inc.

<5>
Accession Number
643691511
Title
Impact of pre-admission physical activity on benefits of physiology-guided
complete revascularization in older patients with myocardial infarction:
insights from the FIRE trial.
Source
European journal of preventive cardiology. 31(12) (pp 1451-1459), 2024.
Date of Publication: 06 Sep 2024.
Author
Pavasini R.; Campo G.; Serenelli M.; Tonet E.; Guiducci V.; Escaned J.;
Moreno R.; Casella G.; Cavazza C.; Varbella F.; Sacchetta G.; Arena M.;
Santos I.A.; Ibanes E.G.; Scarsini R.; D'Amico G.; Ruiz-Poveda F.L.; Diez
Gil J.L.; Pignatelli G.; Iannopollo G.; Colaiori I.; Santos R.C.; Marrone
A.; Fileti L.; Rigattieri S.; Barbato E.; Ocaranza-Sanchez R.; Biscaglia
S.
Institution
(Pavasini, Campo, Serenelli, Tonet, Marrone, Biscaglia) Cardiology Unit,
Azienda Ospedaliero Universitaria di Ferrara, Via Aldo Moro 8, Ferrara
44124, Italy
(Guiducci, Pignatelli) Cardiology Unit, S. Maria Nuova Hospital, Viale
Risorgimento 80, Italy
(Escaned) Cardiovascular Department, Hospital Clinico San Carlos IDISCC,
Complutense University of Madrid, Calle del Prof Martin Lagos s/n, Madrid
28040, Spain
(Moreno) Interventional Cardiology, University Hospital La Paz, Paseo La
Castellana ,261, Madrid 28046, Spain
(Casella, Iannopollo) Cardiology Unit, Ospedale Maggiore ,Largo Nigrisoli
2, Bologna 40133, Italy
(Cavazza) Cardiovascular Department, Infermi Hospital, Viale Luigi
Settembrini 2, Rimini 47923, Italy
(Varbella) Interventional Cardiology Unit, San Luigi Gonzaga University
Hospital, Orbassano, and Rivoli Infermi Hospital ASLTO3, Rivoli (TO)
10098, Italy
(Sacchetta) Cardiology Unit, Umberto I Hospital, ASP Siracusa, Via
Giuseppe Testaferrata, Siracusa 96100, Italy
(Arena) S.C. Cardiologia, Ospedale Sant'Andrea, La Spezia 19124, Italy
(Santos) Department of Cardiology, Centro de Investigacion Biomedica en
Red en Enfermedades Cardiovasculares (CIBERCV), Hospital Clinico
Universitario, Valladolid 47003, Spain
(Ibanes) Department of Cardiology, Centro de Investigation Biomedica end
Red en Enfermedades Cardiovasculares, H. Universitario y Politecnico La
Fe, Valencia 46026, Spain
(Scarsini) Cardiovascular Department, Azienda Ospedaliero Universitaria
Integrata di Verona, Piazzale Aristide Stefani, 1 - 37126 Verona, Italy
(D'Amico) Interventional Cardiology, Department of Cardio-Thoracic and
Vascular Sciences, Ospedale dell'Angelo ,Via Paccagnella ,12, 35128 Mestre
(Venice), Italy
(Ruiz-Poveda) Cardiovascular Department, Hospital General Universitario de
Ciudad Real, Ciudad Real 13001, Spain
(Diez Gil) Cardiology Unit, Hospital San Giovanni di Dio, Azienda
Sanitaria Provinciale Agrigento, Agrigento 92100, Italy
(Colaiori) Cardiology Unit, Ospedale Santa Maria Goretti, Via Lucia
Scaravelli, Latina 04100, Italy
(Santos) Department of Interventional Cardiology, Complexo Hospitalario
Universitario A Coruna (CHUAC), As Xubias ,84, 15006 A Coruna, Spain
(Fileti) Cardiology Department, S. Maria delle Croci Hospital, Viale Randi
5, Ravenna 48121, Italy
(Rigattieri, Barbato) Department of Clinical and Molecular Medicine,
Sapienza University of Rome, Via di Grottarossa, Italy
(Ocaranza-Sanchez) Servicio de Cardiologia, Hospital Universitario Lucus
Augusti, Lugo 27001, Spain
Abstract
AIMS: The present analysis from the Functional Assessment in Elderly
Myocardial Infarction Patients with Multivessel Disease (FIRE) trial aims
to explore the significance of pre-admission physical activity and assess
whether the benefits of physiology-guided complete revascularization apply
consistently to sedentary and active older patients. METHODS AND RESULTS:
Patients aged 75 years or more with myocardial infarction (MI) and
multivessel disease were randomized to receive physiology-guided complete
revascularization or culprit-only strategy. The primary outcome was a
composite of death, MI, stroke, or any revascularization within a year.
Secondary endpoints included the composite of cardiovascular death or MI,
as well as single components of the primary endpoint. Pre-admission
physical activity was categorized into three groups: (i) absent
(sedentary), (ii) light, and (iii) vigorous. Among 1445 patients, 692
(48%) were sedentary, whereas 560 (39%) and 193 (13%) performed light and
vigorous physical activity, respectively. Patients engaging in light or
vigorous pre-admission physical activity exhibited a reduced risk of the
primary outcome compared with sedentary individuals [light hazard ratio
(HR) 0.70, 95% confidence interval (CI) 0.55-0.91 and vigorous HR 0.14,
95% CI 0.07-0.91, respectively]. These trends were also observed for
death, cardiovascular death, or MI. When comparing physiology-guided
complete revascularization vs. culprit-only strategy, no significant
interaction was observed for primary and secondary endpoints when
stratified by sedentary or active status. <br/>CONCLUSION(S): In older
patients with MI, pre-admission physical activity emerges as a robust and
independent prognostic determinant. Physiology-guided complete
revascularization stands out an effective strategy in reducing ischaemic
adverse events, irrespective of pre-admission physical activity status.
CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov NCT03772743.<br/>Copyright
&#xa9; The Author(s) 2024. Published by Oxford University Press on behalf
of the European Society of Cardiology. All rights reserved. For
permissions, please e-mail: journals.permissions@oup.com.

<6>
Accession Number
645206542
Title
A systematic review and meta-analysis of differences between men and women
in short-term outcomes following coronary artery bypass graft surgery.
Source
Scientific reports. 14(1) (pp 20682), 2024. Date of Publication: 05 Sep
2024.
Author
Dumitriu LaGrange D.; Tessitore E.; Reymond P.; Mach F.; Huber C.
Institution
(Dumitriu LaGrange, Reymond, Huber) Cardiovascular Surgery Division,
Department of Surgery, Geneva University Hospitals, Geneva, Switzerland
(Dumitriu LaGrange, Tessitore, Reymond, Mach, Huber) Faculty of Medicine,
University of Geneva, Geneva, Switzerland
(Tessitore, Mach) Cardiology Division, Geneva University Hospitals,
Geneva, Switzerland
Abstract
We provide an update regarding the differences between men and women in
short-term postoperative mortality after coronary artery bypass grafting
(CABG) and highlight the differences in postoperative risk of stroke,
myocardial infarction, and new onset atrial fibrillation. We included 23
studies, with a total of 3,971,267 patients (70.7% men, 29.3% women), and
provided results for groups of unbalanced studies and propensity matched
studies. For short-term mortality, the pooled odds ratio (OR) from
unbalanced studies was 1.71 (with 95% CI 1.69-1.74, I2=0%, p=0.7), and
from propensity matched studies was 1.32 (95% CI 1.14-1.52, I2=76%,
p<0.01). For postoperative stroke, the pooled effects were OR=1.50 (95% CI
1.35-1.66, I2=83%, p<0.01) and OR=1.31 (95% CI 1.02-1.67, I2=81%, p<0.01).
For myocardial infarction, the pooled effects were OR=1.09 (95%
CI=0.78-1.53, I2=70%, p<0.01) and OR=1.03 (95% CI=0.86-1.24, I2=43%,
p=0.18). For postoperative atrial fibrillation, the pooled effect from
unbalanced studies was OR=0.89 (95% CI=0.82-0.96, I2=34%, p=0.18). The
short-term mortality risk after CABG is higher in women, compared to men.
Women are at higher risk of postoperative stroke. There is no significant
difference in the likelihood of postoperative myocardial infarction in
women compared to men. Men are at higher risk of postoperative atrial
fibrillation after CABG.<br/>Copyright &#xa9; 2024. The Author(s).

<7>
Accession Number
2031297670
Title
Cardiopulmonary bypass and VA-ECMO induced immune dysfunction: common
features and differences, a narrative review.
Source
Critical Care. 28(1) (no pagination), 2024. Article Number: 300. Date of
Publication: December 2024.
Author
Lesouhaitier M.; Belicard F.; Tadie J.-M.
Institution
(Lesouhaitier, Belicard, Tadie) Infectious Diseases and Intensive Care
Unit, Pontchaillou University Hospital, 2 rue Henri Le Guilloux, Rennes
35033, France
(Lesouhaitier, Belicard, Tadie) SITI, Pole de Biologie, Pontchaillou
University Hospital, Etablissement Francais du Sang Bretagne, 2 rue Henri
Le Guilloux, Rennes 35033, France
(Lesouhaitier, Belicard, Tadie) UMR 1236, Univ Rennes, INSERM,
Etablissement Francais du Sang Bretagne, Rennes, France
(Lesouhaitier, Tadie) CIC-1414, INSERM, Rennes, France
Publisher
BioMed Central Ltd
Abstract
Cardiopulmonary bypass (CPB) and veno-arterial extracorporeal membrane
oxygenation are critical tools in contemporary cardiac surgery and
intensive care, respectively. While these techniques share similar
components, their application contexts differ, leading to distinct immune
dysfunctions which could explain the higher incidence of nosocomial
infections among ECMO patients compared to those undergoing CPB. This
review explores the immune modifications induced by these techniques,
comparing their similarities and differences, and discussing potential
treatments to restore immune function and prevent infections. The immune
response to CPB and ECMO involves both humoral and cellular components.
The kinin system, complement system, and coagulation cascade are rapidly
activated upon blood contact with the circuit surfaces, leading to the
release of pro-inflammatory mediators. Ischemia-reperfusion injury and the
release of damage-associated molecular patterns further exacerbate the
inflammatory response. Cellular responses involve platelets, neutrophils,
monocytes, dendritic cells, B and T lymphocytes, and myeloid-derived
suppressor cells, all of which undergo phenotypic and functional
alterations, contributing to immunoparesis. Strategies to mitigate immune
dysfunctions include reducing the inflammatory response during CPB/ECMO
and enhancing immune functions. Approaches such as off-pump surgery,
corticosteroids, complement inhibitors, leukocyte-depleting filters, and
mechanical ventilation during CPB have shown varying degrees of success in
clinical trials. Immunonutrition, particularly arginine supplementation,
has also been explored with mixed results. These strategies aim to balance
the inflammatory response and support immune function, potentially
reducing infection rates and improving outcomes. In conclusion, both CPB
and ECMO trigger significant immune alterations that increase
susceptibility to nosocomial infections. Addressing these immune
dysfunctions through targeted interventions is essential to improving
patient outcomes in cardiac surgery and critical care settings. Future
research should focus on refining these strategies and developing new
approaches to better manage the immune response in patients undergoing CPB
and ECMO. Graphical abstract: Although often considered similar, CPB and
ECMO have distinct immune repercussions. Numerous immunomodulatory
strategies have been tested in cardiac surgery patients undergoing CPB to
mitigate the induced immunoparesis, but no clinical trials have been
conducted for patients on ECMO. C5aR (complement component 5a receptor),
CPB (cardiopulmonary bypass), DC (dendritic cells), ECMO (extracorporeal
membrane oxygenation), HLA-DR (human leukocyte antigen-DR isotype), NETs
(neutrophil extracellular traps), PD-1 (program cell death protein 1), ROS
(reactive oxygen species), TLR (toll-like receptor). Created with
BioRender.com (Figure presented.).<br/>Copyright &#xa9; The Author(s)
2024.

<8>
Accession Number
2031293897
Title
Outcomes of patients with active cancer after transcatheter aortic valve
replacement: an updated meta-analysis.
Source
Cardio-Oncology. 10(1) (no pagination), 2024. Article Number: 55. Date of
Publication: December 2024.
Author
Felix N.; Nogueira A.; Carvalho P.E.P.; Costa T.A.; Tramujas L.; Generoso
G.; Feldman S.; Garot P.; de Farias M.D.C.A.D.
Institution
(Felix, de Farias) Division of Medicine, Federal University of Campina
Grande, 795 Juvencio Arruda Avenue, Campina Grande, Brazil
(Nogueira) Division of Medicine, Bahiana School of Medicine and Public
Health, Salvador, Brazil
(Carvalho) Center for Coronary Artery Disease, Minneapolis Heart Institute
Foundation, Minneapolis, United States
(Costa) Department of Medicine, University of Colorado School of Medicine,
Aurora, CO, United States
(Tramujas) Hcor Research Institute, Sao Paulo, Brazil
(Generoso) Division of Cardiology, Hospital Sirio-Libanes, Sao Paulo,
Brazil
(Feldman) Division of Cardiology, Department of Internal Medicine, Weill
Cornell Medicine, New York, NY, United States
(Garot) Institut Cardiovasculaire Paris Sud (ICPS), Hopital Jacques
Cartier, Ramsay-Sante, Massy, France
Publisher
BioMed Central Ltd
Abstract
Background: Patients with active cancer and aortic stenosis may be
under-referred for valve interventions due to concerns over a prohibitive
risk. However, whether active cancer impacts outcomes after transcatheter
aortic valve replacement (TAVR) remains unknown. <br/>Method(s): We
searched PubMed, Embase, and Cochrane Library in December 2023 for studies
comparing the post-TAVR outcomes of patients with versus without active
cancer. We pooled odds ratios (OR) and adjusted hazard ratios (aHR) with
95% confidence intervals (CI) applying a random-effects model. Statistical
analyses were performed in R version 4.3.2. <br/>Result(s): We included
nine observational studies analyzing 133,906 patients, of whom 9,792
(7.3%) had active cancer. Compared with patients without cancer, patients
with active cancer had higher short- (OR 1.33; 95% CI 1.15-1.55; p <
0.001) and long-term mortality (OR 2.29; 95% CI 1.80-2.91; p < 0.001)
rates, not driven by cardiovascular mortality (OR 1.30; 95% CI 0.70-2.40;
p = 0.40), and higher major bleeding rates (OR 1.66; 95% CI 1.15-2.42; p =
0.008). The higher mortality rate was sustained in an adjusted analysis
(aHR 1.77; 95% CI 1.34-2.35; p < 0.001). There was no significant
difference in cardiac, renal, and cerebral complications at a follow-up
ranging from 180 days to 10 years. <br/>Conclusion(s): Patients with
active cancer undergoing TAVR had higher non-cardiovascular mortality and
bleeding rates, with comparable incidences of other complications. This
highlights the need for a shared decision and appropriate patient
selection considering cancer type, staging, bleeding risk, and optimal
timing for intervention. Graphical Abstract: (Figure
presented.).<br/>Copyright &#xa9; The Author(s) 2024.

<9>
Accession Number
2031280161
Title
To be or not to be on: aspirin and coronary artery bypass graft surgery.
Source
Frontiers in Cardiovascular Medicine. 11 (no pagination), 2024. Article
Number: 1451337. Date of Publication: 2024.
Author
Gupta A.K.; Kovoor J.G.; Leslie A.; Litwin P.; Stretton B.; Zaka A.;
Kovoor P.; Bacchi S.; Bennetts J.S.; Maddern G.J.
Institution
(Gupta, Kovoor, Stretton, Bacchi, Maddern) Discipline of Surgery,
University of Adelaide, Adelaide, SA, Australia
(Gupta) Department of Cardiothoracic Surgery, Royal North Shore Hospital,
Sydney, NSW, Australia
(Kovoor, Maddern) Australian Safety and Efficacy Register of New
Interventional Procedures-Surgical, Royal Australasian College of
Surgeons, Adelaide, SA, Australia
(Leslie, Stretton) Department of Medicine, Royal Adelaide Hospital,
Adelaide, SA, Australia
(Litwin, Zaka) Department of Medicine, Gold Coast University Hospital,
Southport, QLD, Australia
(Kovoor) Department of Cardiology, Westmead Hospital, Westmead, NSW,
Australia
(Bennetts) School of Medicine, Monash University, Melbourne, VIC,
Australia
(Bennetts) Department of Cardiothoracic Surgery, Victorian Heart Hospital,
Melbourne, NSW, Australia
(Maddern) Research, Audit and Academic Surgery, Royal Australasian College
of Surgeons, Adelaide, SA, Australia
Publisher
Frontiers Media SA
Abstract
Aspirin's role in secondary prevention for patients with known coronary
artery disease (CAD) is well established, validated by numerous landmark
trials over the past several decades. However, its perioperative use in
coronary artery bypass graft (CABG) surgery remains contentious due to the
delicate balance between the risks of thrombosis and bleeding. While
continuation of aspirin in patients undergoing CABG following acute
coronary syndrome is widely supported due to the high risk of
re-infarction, the evidence is less definitive for elective CABG
procedures. The literature indicates a significant benefit of aspirin in
reducing cardiovascular events in CAD patients, yet its impact on
perioperative outcomes in CABG surgery is less clear. Some studies suggest
increased bleeding risks without substantial improvement in cardiac
outcomes. Specific to elective CABG, evidence is mixed, with some data
indicating no significant difference in thrombotic or bleeding
complications whether aspirin is continued or withheld preoperatively.
Advancements in pharmacological therapies and perioperative care have
evolved significantly since the initial aspirin trials, raising questions
about the contemporary relevance of earlier findings. Individualized
patient assessments and the development of risk stratification tools are
needed to optimize perioperative aspirin use in CABG surgery. Further
research is essential to establish clearer guidelines and improve patient
outcomes. The objective of this review is to critically evaluate the
existing evidence into the optimal management of perioperative aspirin in
elective CABG patients.<br/>Copyright 2024 Gupta, Kovoor, Leslie, Litwin,
Stretton, Zaka, Kovoor, Bacchi, Bennetts and Maddern.

<10>
Accession Number
2031280132
Title
Acute type A aortic dissection in patients with non-prior cardiac surgery
vs. prior cardiac surgery: a systematic review and meta-analysis.
Source
Frontiers in Cardiovascular Medicine. 11 (no pagination), 2024. Article
Number: 1438556. Date of Publication: 2024.
Author
Ahmed M.; Alim Ur Rahman H.; Fahim M.A.A.; Hussain Z.A.; Ahmed N.; Asghar
M.S.
Institution
(Ahmed) Shaheed Mohtarma Benazir Bhutto Medical College, Karachi, Lyari,
Pakistan
(Alim Ur Rahman, Fahim, Hussain) Dow Medical College, Dow University of
Health Sciences, Karachi, Pakistan
(Ahmed) Department of Internal Medicine, Rapides Regional Medical Center,
Alexandria, LA, United States
(Asghar) Department of Internal Medicine, AdventHealth, Orlando, FL,
United States
Publisher
Frontiers Media SA
Abstract
Background: Patients with prior cardiac surgery undergoing acute type A
aortic dissection (ATAAD) are thought to have worse clinical outcomes as
compared to the patients without prior cardiac surgery. <br/>Aim(s): To
compare the safety and efficacy of ATAAD in patients with prior cardiac
surgery. <br/>Method(s): We systematically searched PubMed, Cochrane
Library and Google Scholar from database inception until April 2024. We
included nine studies which consisted of a population of 524 in the prior
surgery group and 5,249 in the non-prior surgery group. Our primary
outcome was mortality. Secondary outcomes included reoperation for
bleeding, myocardial infarction, stroke, renal failure, sternal wound
infection, cardiopulmonary bypass (CPB) time, cross-clamp time, hospital
stay, and ICU stay. <br/>Result(s): Our pooled estimate shows a
significantly lower rate of mortality in the non-prior cardiac surgery
group compared to the prior cardiac surgery group (RR = 0.60, 95% CI =
0.48-0.74). Among the secondary outcomes, the rate of reoperation for
bleeding was significantly lower in the non-prior cardiac surgery group
(RR = 0.66, 95% CI = 0.50-0.88). Additionally, the non-prior cardiac
surgery group had significantly shorter CPB time (MD = -31.06, 95% CI =
-52.20 to -9.93) and cross-clamp time (MD = -21.95, 95% CI = -42.65 to
-1.24). All other secondary outcomes were statistically insignificant.
<br/>Conclusion(s): Patients with prior cardiac surgery have a higher
mortality rate as compared to patients who have not undergone cardiac
surgery previously. Patients with prior cardiac surgery have higher
mortality and longer CPB and cross-clamp times. Tailored strategies are
needed to improve outcomes in this high-risk group.<br/>Copyright 2024
Ahmed, Alim Ur Rahman, Fahim, Hussain, Ahmed and Asghar.

<11>
Accession Number
2031280116
Title
Case report: Additional variants induced sudden cardiac death among
pediatric ACM with DSG2 homozygous mutant genotype: a report of three
cases.
Source
Frontiers in Genetics. 15 (no pagination), 2024. Article Number: 1428796.
Date of Publication: 2024.
Author
Wei M.; Li Y.; Liu X.; Zhou K.; Qiu Y.; Liu L.; Huang L.; Liu Z.
Institution
(Wei, Li, Liu, Zhou, Qiu, Liu, Huang, Liu) Key Laboratory of Birth Defects
and Related Diseases of Women and Children of MOE, Department of
Pediatrics, West China Second University Hospital, Sichuan University,
Sichuan, Chengdu, China
Publisher
Frontiers Media SA
Abstract
Background: Mutations in genes encoding desmosomal proteins are the
leading cause of arrhythmogenic cardiomyopathy (ACM). The majority of the
inherited ACM cases demonstrate autosomal dominant genotype. Several cases
with the homozygous DSG2 c.1592T>G (p.F531C) variant genotype demonstrate
adverse clinical outcomes, but the roles of associated genetic mutations
are not clear. In this report, we describe three ACM cases with the
homozygous DSG2 c.1592T>G (p.F531C) variant genotype combined with
additional heterozygous cardiomyopathy-related genetic mutations that
cause aggravated clinical manifestations and worse clinical outcomes. Case
presentation: The three reported probands demonstrated similar clinical
presentations such as heart failure, cardiac enlargement, and lethal
arrhythmias. All of them experienced sudden cardiac death (SCD) before
undergoing implantable cardioverter defibrillator (ICD) or heart
transplantations. Whole-exome sequencing analysis demonstrated that the
three patients inherited the homozygous DSG2 c.1592T>G (p.F531C) variant.
Furthermore, probands I, II, and III also inherited additional
heterozygous cardiomyopathy-associated mutations, including DSP c.7883T>C,
SCN5a c.3577C>T, or MYH7 c.427C>T, respectively. These variants were
confirmed as pathogenetic variants. A systematic review of all the
reported ACM cases with the homozygous DSG2 variants suggested that the
additional genetic mutations contributed to the early age onset of ACM and
lethal cardiac events. <br/>Conclusion(s): In conclusion, we report three
rare cases of ACM with the same homozygous DSG2 variant in combination
with additional heterozygous mutations in cardiomyopathy-associated genes.
A systematic review of all the ACM cases with homozygous DSG2 variants
demonstrated that the additional genetic variants contributed to the
aggravated clinical manifestations and worse clinical symptoms of the ACM
patients because of homozygous DSG2 mutations, including early disease
onset and lethal cardiac events. Our data suggested that comprehensive
genetic evaluation should be performed to identify any potential
additional pathogenic variants that may significantly influence the
clinical prognosis and outcomes of patients with ACM. The knowledge of
underlying molecular mutations would be useful in designing better
therapeutic strategies for ACM patients with multiple genetic
mutations.<br/>Copyright &#xa9; 2024 Wei, Li, Liu, Zhou, Qiu, Liu, Huang
and Liu.

<12>
Accession Number
2030963314
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.

<13>
Accession Number
2030474552
Title
POStoperative INTELLiVENT-adaptive support VEntilation in cardiac surgery
patients (POSITiVE) II-study protocol of a randomized clinical trial.
Source
Trials. 25(1) (no pagination), 2024. Article Number: 449. Date of
Publication: December 2024.
Author
Bernardi M.H.; Bettex D.; Buiteman-Kruizinga L.A.; de Bie A.; Hoffmann M.;
de Kleijn J.; Serafini S.C.; Molenaar M.A.; Paulus F.; Persec J.; Neto
A.S.; Schuepbach R.; Severgnini P.; Sribar A.; Schultz M.J.; Tschernko E.
Institution
(Bernardi, Serafini, Schultz, Tschernko) Department of Anesthesia, General
Intensive Care and Pain Management--Division of Cardiothoracic and
Vascular Anesthesia & Critical Care Medicine, Medical University of
Vienna, Wahringer Gurtel 18-20, Vienna 1090, Austria
(Bettex, Hoffmann, Schuepbach) University Hospital Zurich and University
of Zurich, Zurich, Switzerland
(Buiteman-Kruizinga, Serafini, Molenaar, Paulus, Schultz) Department of
Intensive Care, Amsterdam UMC, Location AMC, Amsterdam, Netherlands
(Buiteman-Kruizinga) Department of Intensive Care, Reinier de Graaf
Hospital, Delft, Netherlands
(de Bie, de Kleijn) Department of Intensive Care, Catharina Hospital
Eindhoven, Eindhoven, Netherlands
(Serafini) Department of Surgical Sciences and Integrated Diagnostics
(DISC), University of Genoa, Genoa, Italy
(Persec, Sribar) Clinical Department of Anesthesiology, Resuscitation and
Intensive Care Medicine, University Hospital Dubrava, Zagreb, Croatia
(Neto) Department of Critical Care Medicine, Hospital Israelita Albert
Einstein, Sao Paolo, Brazil
(Neto) Australian and New Zealand Intensive Care Research Centre
(ANZIC-RC), School of Public Health and Preventive Medicine, Monash
University, Melbourne, Australia
(Neto) Department of Intensive Care, Austin Hospital, Melbourne Medical
School, University of Melbourne, Melbourne, Australia
(Severgnini) Cardiac Surgery Intensive Care Unit, ASST Dei Sette Laghi,
University of Insubria, Varese, Italy
Publisher
BioMed Central Ltd
Abstract
Background: One single-center randomized clinical trial showed that
INTELLiVENT-adaptive support ventilation (ASV) is superior to conventional
ventilation with respect to the quality of ventilation in post-cardiac
surgery patients. Other studies showed that this automated ventilation
mode reduces the number of manual interventions at the ventilator in
various types of critically ill patients. In this multicenter study in
patients post-cardiac surgery, we test the hypothesis that INTELLiVENT-ASV
is superior to conventional ventilation with respect to the quality of
ventilation. <br/>Method(s): "POStoperative INTELLiVENT-adaptive support
VEntilation in cardiac surgery patients II (POSITiVE II)" is an
international, multicenter, two-group randomized clinical superiority
trial. In total, 328 cardiac surgery patients will be randomized.
Investigators screen patients aged > 18 years of age, scheduled for
elective cardiac surgery, and expected to receive postoperative
ventilation in the ICU for longer than 2 h. Patients either receive
automated ventilation by means of INTELLiVENT-ASV or ventilation that is
not automated by means of a conventional ventilation mode. The primary
endpoint is quality of ventilation, defined as the proportion of
postoperative ventilation time characterized by exposure to predefined
optimal, acceptable, and critical (injurious) ventilatory parameters in
the first two postoperative hours. One major secondary endpoint is ICU
team staff workload, captured by the ventilator software collecting manual
settings on alarms. Patient-centered endpoints include duration of
postoperative ventilation and length of stay in ICU. <br/>Discussion(s):
POSITiVE II is the first international, multicenter, randomized clinical
trial designed to confirm that POStoperative INTELLiVENT-ASV is superior
to non-automated conventional ventilation and secondary to determine if
this closed-loop ventilation mode reduces ICU team staff workload. The
results of POSITiVE II will support intensive care teams in their choices
regarding the use of automated ventilation in postoperative care of
uncomplicated cardiac surgery patients. Trial registration:
Clinicaltrials.gov NCT06178510. Registered on December 4,
2023.<br/>Copyright &#xa9; The Author(s) 2024.

<14>
Accession Number
2034421850
Title
EFFECTS OF ESMOLOL ON HAEMODYNAMIC RESPONSE TO TRACHEAL EXTUBATION IN
DIABETIC AND NON- DIABETIC PATIENTS, COMPARATIVE, RANDOMIZED, PROSPECTIVE,
OBSERVATIONAL STUDY.
Source
Journal of Cardiovascular Disease Research. 15(7) (pp 2943-2950), 2024.
Date of Publication: 2024.
Author
Tanthry G.S.; Manisha J.; Archana S.; Karanth R.V.
Institution
(Tanthry) Department of Anaesthesiology, A.J. Institute of Medical
Sciences and Research Centre, Mangalore 575004, India
(Manisha, Archana) Department of Anaesthesiology, A.J. Institute of
Medical Sciences and Research Centre, Mangalore 575004, India
(Karanth) Medanta- The Medicity, Haryana, Gurugram 122001, India
Publisher
EManuscript Technologies
Abstract
Background and aims: Extubation after an elective intubation for GA
depends on patients preoperative status, the intraoperative course and
expected post operative recovery. Increased cardiovascular instability
during anaesthesia and abnormal cardiovascular responses to intubation and
extubation have been described in patients with diabetic autonomic
neuropathy. <br/>Aim(s): To assess the effectiveness of esmolol on
blocking the hemodynamic response to extubation in diabetic and
non-diabetic patients. Methodology: It is a comparative, randomized,
prospective, observational study. A total of 42 patients of ASA grade 1
and 2 of either sex, aged 30 to 80 years, scheduled for elective surgeries
under General Anaesthesia (GA) were randomly allocated into two groups of
21 each - Group A- Non-Diabetic, Esmolol received 1.5mg/kg IV 2 minutes
before extubation Group B- Diabetic, Esmolol received 1.5mg/kg IV 2
minutes before extubation. Heart rate (HR), Systolic arterial pressure
(SAP), Diastolic arterial pressure (DAP), and mean arterial pressure (MAP)
were recorded 1 minute before IV administration, during extubation at 1,
3, 5, and 10 minutes after extubation. Data analysis done using standard
statistical tests and SPSS for windows software. <br/>Result(s): HR and BP
values of the diabetic esmolol group were significantly lower as compared
to the non-diabetic esmolol group. In group 1, HR at administration of
drug, at extubation after 1,5 and 10 minutes was higher. In group 1, SAP
at administration of drug, extubation after 1,3, 5 minutes was higher. DAP
was higher in group 1. MAP was not statistically significant between two
groups. <br/>Conclusion(s): Use of esmolol 1.5mg/kg dose 2 minutes before
extubation is effective in diabetic and non-diabetic patients in
preventing tachycardia and hypertension without any serious side
effects.<br/>Copyright &#xa9; 2024 EManuscript Technologies. All rights
reserved.

<15>
Accession Number
2034498768
Title
Invasive and conservative management of elderly patients presenting with
acute coronary syndrome: A meta-analysis of randomized controlled trials
and adjusted observational studies.
Source
International Journal of Cardiology. 417 (no pagination), 2024. Article
Number: 132523. Date of Publication: 15 Dec 2024.
Author
Improta R.; Di Pietro G.; Piccialuti A.; De Filippo O.; Birtolo I.;
Severino P.; Tocci M.; Saade W.; Cammertoni F.; Vizza D.; Sardella G.;
D'Ascenzo F.; Stefanini G.; Mancone M.
Institution
(Improta, Di Pietro, Piccialuti, Birtolo, Severino, Tocci, Saade, Vizza,
Sardella, Mancone) Department of Clinical, Internal, Anesthesiology and
Cardiovascular Sciences, Umberto I Hospital, Sapienza University of Rome,
Italy
(De Filippo, D'Ascenzo, Mancone) Department of Medical Sciences,
University of Turin, Division of Cardiology, Cardiovascular and Thoracic
Department, "Citta della Salute e della Scienza" Hospital, Turin, Italy
(Cammertoni) Department of Cardiovascular Sciences, Cardiac Surgery Unit,
Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy
(Stefanini) Operative Unit of Clinical and Interventional Cardiology and
Intensive Coronary Care Unit, Humanitas Research Hospital, Milan, Italy
Publisher
Elsevier Ireland Ltd
Abstract
Background: Elderly patients are often under-represented in studies about
coronary revascularization in acute coronary syndromes (ACS) and
undertreated in clinical practice. We sought to evaluate differences in
outcomes between an initial invasive or conservative strategy in this
subset of patients, Methods: The analysis was performed following PRISMA
guidelines. Randomized controlled trials (RCTs) and adjusted observational
studies comparing an invasive and conservative strategy in old patients
with ACS were systematically identified. Random or fixed effect model was
used accordingly to heterogeneity testing results. Short-term mortality
was the primary outcome. 30-day and longer-term re-infarction, MACE and
all-cause mortality were secondary endpoints. Sensitivity analysis
including RCTs only were performed for the primary endpoint and 1 year
mortality and another analysis, stratifying NSTEMI and STEMI studies, was
performed for short-term mortality. <br/>Result(s): Invasive management
was associated with lower short and long-term mortality (30 days OR 0.64,
95 % CI 0.54-0.76, p < 0.001; 1 year HR 0.60, 95 % CI 0.52-0.78, p <
0.001; Long-term HR 0.62, 95 % CI 0.55-0.71, p < 0.001) compared to a
conservative strategy. In the short-term follow-up, the benefit was
preserved when differentiating for NSTEMI or STEMI studies but not when
considering only RCTs. Major bleedings were more frequent in the invasive
group (30 days OR 1.61, 95 % CI 1.39-1.87, p < 0.001). The mean difference
in length of stay was not significantly different between the two
strategies (mean difference in days 0.14, 95 % CI -0.79 to 1.06, p =
0.77). <br/>Conclusion(s): An initial invasive strategy might lead to
reduced short and long-term mortality in elderly patients presenting with
acute coronary syndrome but it is associated with increased bleeding
events rate. No difference in hospital stay length was observed. Results
were mainly driven by non-randomized studies.<br/>Copyright &#xa9; 2024
The Authors

<16>
Accession Number
2034380574
Title
A Meta-Analysis of Ultrasound Guided Nerve Blocks for Enhanced Recovery in
Adult Cardiac Surgery Patients.
Source
Heart Surgery Forum. 27(8) (pp E968-E975), 2024. Date of Publication:
2024.
Author
Dou D.; Wang L.; Zhang Y.; Yang L.; Liu Z.; Yan F.
Institution
(Dou, Wang, Zhang, Yang, Yan) Department of Anesthesiology, State Key
Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for
Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union
Medical College, Beijing 100037, China
(Liu) Department of Anesthesiology, Weihai Central Hospital, Shandong,
Weihai 264200, China
Publisher
Forum Multimedia Publishing LLC
Abstract
Background: Ultrasound-guided nerve blocks can both reduce intraoperative
opioid use and pain scores. However, its role in enhancing postoperative
recovery for adult cardiac patients requires further investigation. This
study examines the impact of ultrasound-guided nerve block on adult
cardiac patients' recovery. <br/>Method(s): We conducted a systematic
search for randomized controlled trials (RCTs) published between 2018 to
2022, focusing ultrasound-guided nerve block in adult cardiac surgery. The
search included Pubmed, Embase, and Cochrane databases, targeting studies
on elective thoracotomy. The outcomes analyzed included postoperative
extubation time, intensive care unit (ICU) stay time, and length of
hospital stay (LOS), using Review Manager software (Review Manager 5.4,
The Cochrane Collaboration, 2020, Beijing, China) for data synthesis and
analysis. <br/>Result(s): Out of 26 RCTs, eight studies involving
including 424 subjects were included in this meta-analysis. The results
showed that ultrasound-guided nerve block significantly reduced
postoperative extubation time (odds ratio [OR] = -2.16, 95% confidence
interval [CI]: -3.05 to -1.26), ICU stay (OR = -1.17, 95% CI: -1.40 to
-0.94), and overall hospitalization duration (OR = -0.96, 95% CI: -1.64 to
-0.29). <br/>Conclusion(s): Ultrasound-guided nerve block significantly
reduces the postoperative extubation time, ICU stay, and LOS, in adult
cardiovascular surgery. These benefits contribute substantially to
enhanced recovery after cardiac procedures.<br/>Copyright &#xa9; 2024
Forum Multimedia Publishing, LLC.

<17>
Accession Number
2034379512
Title
Comparison of Isoflurane and Sevoflurane in Cardiac Surgery: A comparative
trial.
Source
Journal of Cardiovascular Disease Research. 15(8) (pp 1631-1636), 2021.
Date of Publication: 2021.
Author
Gupta A.; Garg N.; Jain A.K.
Institution
(Gupta) Cardiac Anaesthesiology, Mahatma Gandhi Medical College and
Hospital, Rajasthan, Jaipur, India
(Garg) Microbiology, JNU Hospital, Rajasthan, Jaipur, India
(Jain) Department of Organ Transplant Anesthesia and Critical Care,
Mahatma Gandhi Medical College and Hospital, Rajasthan, Jaipur, India
Publisher
EManuscript Technologies
Abstract
Background Cardiac surgery often requires the use of inhalational
anesthetics to maintain anesthesia. Isoflurane and sevoflurane are
commonly used due to their cardioprotective properties. However,
differences in hemodynamic stability, recovery profile, and myocardial
protection between these two agents remain a subject of interest. This
study aims to compare the effects of isoflurane and sevoflurane in
patients undergoing cardiac surgery, focusing on hemodynamic parameters,
recovery time, and postoperative complications. Materials and Methods A
total of 100 patients scheduled for elective cardiac surgery were
randomized into two groups: Group I (n=50) received isoflurane, and Group
S (n=50) received sevoflurane as the primary anesthetic agent. Hemodynamic
parameters (heart rate, mean arterial pressure), time to extubation, and
incidence of postoperative complications (e.g., myocardial infarction,
arrhythmias) were recorded. Data were analyzed using appropriate
statistical tests, with a significance level set at p<0.05. Results Group
S (sevoflurane) exhibited significantly more stable hemodynamic parameters
compared to Group I (isoflurane), with an average mean arterial pressure
of 75 mmHg versus 70 mmHg in Group I (p=0.03). The time to extubation was
shorter in Group S (8.5 +/- 2.1 hours) compared to Group I (10.2 +/- 2.5
hours) (p=0.01). Additionally, the incidence of postoperative myocardial
infarction was lower in Group S (4%) compared to Group I (10%) (p=0.04).
No significant differences were observed in the occurrence of arrhythmias
between the two groups. Conclusion Sevoflurane demonstrated superior
hemodynamic stability, faster recovery times, and a lower incidence of
postoperative myocardial infarction compared to isoflurane in patients
undergoing cardiac surgery. Sevoflurane may be preferred for its enhanced
myocardial protection and quicker recovery profile.<br/>Copyright &#xa9;
2021 EManuscript Technologies. All rights reserved.

<18>
Accession Number
2034379499
Title
Hemodynamics in Coronary Artery Bypass Surgery: Effects of Intraoperative
Dexmedetomidine administration.
Source
Journal of Cardiovascular Disease Research. 15(8) (pp 1624-1630), 2021.
Date of Publication: 2021.
Author
Gupta A.; Jain A.K.; Marmat H.
Institution
(Gupta) Mahatma Gandhi Medical College and Hospital, Rajasthan, Jaipur,
India
(Jain) Department of Organ Transplant Anesthesia and Critical Care,
Mahatma Gandhi Medical College and Hospital, Rajasthan, Jaipur, India
(Marmat) Department of Medicine, Government Medical College, M.P., Ratlam,
India
Publisher
EManuscript Technologies
Abstract
Background Hemodynamic stability is crucial during coronary artery bypass
grafting (CABG) surgery to reduce perioperative complications.
Dexmedetomidine, an alpha-2 adrenergic agonist, has been increasingly used
for its sedative, analgesic, and sympatholytic properties. This study aims
to evaluate the effects of intraoperative dexmedetomidine administration
on hemodynamic parameters during CABG surgery. Materials and Methods A
randomized controlled trial was conducted on 120 patients undergoing
elective CABG surgery. Patients were randomly assigned into two groups:
Group D (dexmedetomidine, n=60) and Group C (control, n=60). Group D
received a loading dose of dexmedetomidine (0.5 microg/kg) followed by a
maintenance infusion of 0.4 microg/kg/h until the end of surgery. Group C
received an equivalent volume of saline as placebo. Hemodynamic
parameters, including heart rate (HR), mean arterial pressure (MAP), and
cardiac output (CO), were recorded at baseline, after induction, during
cardiopulmonary bypass, and postoperatively. Statistical analysis was
performed using ANOVA and t-tests. Results The administration of
dexmedetomidine significantly reduced HR and MAP compared to the control
group. At the end of surgery, Group D showed a 15% reduction in HR
(p<0.001) and a 20% decrease in MAP (p<0.001) compared to baseline.
Additionally, CO was better maintained in Group D, with an average CO of
5.5 L/min compared to 4.8 L/min in Group C (p=0.03). The incidence of
intraoperative hypotension was lower in Group D (10%) compared to Group C
(25%) (p=0.02). Postoperative recovery was also smoother in Group D, with
a lower requirement for vasoactive drugs. Conclusion Intraoperative
administration of dexmedetomidine during CABG surgery significantly
improves hemodynamic stability, reducing the incidence of intraoperative
hypotension and maintaining cardiac output. Dexmedetomidine may be a
valuable adjunct in managing patients undergoing cardiac
surgery.<br/>Copyright &#xa9; 2021 EManuscript Technologies. All rights
reserved.

<19>
Accession Number
2034503494
Title
Bypass versus Angioplasty in Severe Ischaemia of the Leg (BASIL)-2 Trial:
Analysis of the Timing and Causes of Death in Participants Randomised to
an Infrapopliteal Vein Bypass or Best Endovascular Treatment First
Revascularisation Strategy.
Source
European Journal of Vascular and Endovascular Surgery. (no pagination),
2024. Date of Publication: 2024.
Author
Bradbury A.W.; Hall J.; Moakes C.A.; Popplewell M.; Meecham L.; Bate G.R.;
Kelly L.; Diamantopoulos A.; Ganeshan A.; Houlind K.; Malmstedt J.; Patel
J.V.; Saratzis A.; Zayed H.
Institution
(Bradbury, Popplewell) College of Medical and Dental Sciences, University
of Birmingham, Birmingham, United Kingdom
(Hall, Moakes) Birmingham Clinical Trials Unit, Institute of Applied
Health Research, University of Birmingham, Birmingham, United Kingdom
(Meecham) University Hospital of Wales, Cardiff, United Kingdom
(Bate, Kelly, Ganeshan) University Hospitals Birmingham NHS Foundation
Trust, Birmingham, United Kingdom
(Diamantopoulos, Zayed) Guys and St. Thomas NHS Foundation Trust, London,
United Kingdom
(Houlind) Lillebaelt Hospital, University of Southern Denmark, Denmark
(Malmstedt) Department of Clinical Science and Education, Karolinska
Institutet, Stockholm, Sweden
(Malmstedt) Division of Vascular Surgery, Department of Surgery,
Sodersjukhuset, Stockholm, Sweden
(Patel) Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom
(Saratzis) University of Leicester, Leicester, United Kingdom
Publisher
W.B. Saunders Ltd
Abstract
Objective: The Bypass versus Angioplasty in Severe Ischaemia of the Leg
(BASIL)-2 trial enrolled participants with chronic limb threatening
ischaemia who required an infrapopliteal, with or without a
femoropopliteal, revascularisation procedure to restore limb perfusion.
Participants randomised to a vein bypass (VB) first revascularisation
strategy were over one third more likely than those randomised to a best
endovascular treatment (BET) first revascularisation strategy to die from
any cause during a median follow up of 40.0 (interquartile range 20.9,
60.6) months. The aim of the present study was to describe the timing and
causes of death in BASIL-2 as a first step towards trying to better
understand why randomisation to a VB first revascularisation strategy was
associated with this excess mortality. <br/>Method(s): A 10 person
international panel comprising vascular and endovascular surgeons as well
as vascular interventional radiologists, who had all been principal
investigators in BASIL-2, took part in a modified Delphi consensus
exercise to adjudicate the primary cause of death and, in particular,
whether the cause was primarily cardiac or non-cardiac. <br/>Result(s): In
151 of 168 deaths (89.9%), the Delphi panel achieved a consensus regarding
the cause of death being probably cardiac or non-cardiac. In the BET
group, 16 of 77 deaths (21%) were classified as probably cardiac compared
with 32 of 91 (35%) in the VB group (unadjusted subdistribution hazard
ratio 2.16, 95% confidence interval [CI] 1.20 - 3.87; unadjusted cause
specific hazard ratio 2.15, 95% CI 1.19 - 3.90). At the point of
randomisation, 64 of 344 (18.6%), 40 of 342 (11.7%), and 37 of 344 (10.8%)
participants had a previous myocardial infarction (MI), percutaneous
coronary intervention (PCI), and coronary artery bypass graft (CABG),
respectively. There was no evidence of varying treatment effects for cause
of death in subgroup analyses of previous PCI, CABG, or MI.
<br/>Conclusion(s): The excess mortality observed in the VB first
revascularisation strategy group in BASIL-2 was largely due to deaths that
were adjudicated by the Delphi panel as probably primarily cardiac. These
excess cardiac deaths were observed throughout follow up and there was no
evidence of non-proportional hazards. Further work is ongoing to try to
better understand the reasons for these findings.<br/>Copyright &#xa9;
2024 The Authors

<20>
Accession Number
2034463717
Title
Transcatheter Aortic Valve Implantation (TAVI) in Bicuspid Aortic Valve
Disease A Systematic Review.
Source
Cardiology in Review. (no pagination), 2024. Article Number:
10.1097/CRD.0000000000000784. Date of Publication: 2024.
Author
Goulden C.J.; Wright K.; Alim S.; Patel N.; Irfan M.; Onay D.; Sabet C.;
Nguyen D.; Harky A.
Institution
(Goulden) Liverpool University Hospitals Foundation Trust, Liverpool,
United Kingdom
(Wright) Barnsley Hospital NHS Foundation Trust, Barnsley, United Kingdom
(Alim, Irfan) St George's University of London, London, United Kingdom
(Patel) Kings College London, London, United Kingdom
(Onay) Yeditepe University, Faculty of Medicine, Istanbul, Turkey
(Sabet) Georgetown University Medical Center, Washington, DC, United
States
(Nguyen) Massachusetts General Hospital, Corrigan Minehan Heart Center,
Harvard Medical School, Boston, MA, United States
(Harky) Department of Cardiothoracic Surgery, Liverpool Heart and Chest
Hospital, Liverpool, United Kingdom
Publisher
Lippincott Williams and Wilkins
Abstract
Transcatheter aortic valve implantation (TAVI) is effective and safe, but
its outcomes for patients with bicuspid aortic valve (BAV) disease are
relatively unclear. A comprehensive search of PubMed, Medline, and Google
Scholar till November 2023 yielded studies evaluating TAVI in BAV
patients. Inclusion criteria were applied, and data were extracted on
clinical and procedural outcomes, including echocardiographic measures and
complications. Statistical analyses included descriptive statistics,
subgroup analysis, and sensitivity analysis. From the 29 studies covering
8045 BAV patients, the mean age was found to be 72.5 +/- 10.35 years with
a male predominance of 56.4% +/- 7.9%. TAVI was significantly beneficial,
decreasing the mean aortic gradient from 46.9 to 10.4 mm Hg postprocedure
and increasing aortic valve area, evidencing improved hemodynamics. A high
procedural success rate of 93.3% was noted, predominantly through femoral
access. However, complications included pacemaker need (12.6%), minor
bleeding, and acute kidney injury. All-cause mortality escalated from 3.7%
perioperatively to 16.8% after 1 year. Hazard ratios and P values
highlighted significant outcomes: perioperative hazard ratio for mortality
at 3.7% (P < 0.05), reduction in perioperative versus postoperative
gradients (P < 0.001), and increase in postoperative aortic valve area (P
< 0.001). The need for postdilatation was less than predilatation (P <
0.05), and significant differences were noted in device sizes (P < 0.05).
TAVI in BAV patients showed good perioperative outcomes but with moderate
complication rates. Notably, there was a significant rise in 1-year
mortality, underscoring the importance of careful patient selection and
strict postoperative care. More studies are necessary to determine
long-term results and refine procedures for this group.<br/>Copyright
&#xa9; 2024 Wolters Kluwer Health, Inc. All rights reserved.

<21>
Accession Number
2031288567
Title
Off-pump vs. on-pump coronary artery bypass grafting in patients with
chronic kidney disease: an updated systematic review and meta-analysis.
Source
International Urology and Nephrology. (no pagination), 2024. Date of
Publication: 2024.
Author
Ahmed M.; Majeed K.; Ali H.; Syed H.; Batool A.
Institution
(Ahmed, Majeed, Ali, Syed, Batool) Department of Internal Medicine,
Shaheed Mohtarma Benazir Bhutto Medical College Lyari, Karachi, Pakistan
Publisher
Springer Science and Business Media B.V.
Abstract
Background: In patients with chronic kidney disease (CKD), cardiovascular
disease is found to be the primary cause of mortality, and after coronary
artery bypass grafting (CABG), their prognosis deteriorates.
<br/>Method(s): We conducted a meta-analysis comparing off-pump CABG
versus on-pump CABG in CKD patients. We searched electronic databases,
including PubMed, Cochrane, and Google Scholar, using relevant keywords.
We included studies comparing off-pump CABG with on-pump CABG in patients
with chronic kidney disease, which was defined as an estimated glomerular
filtration rate (eGFR) < 60 ml/min per 1.73 m². Effect
estimates were synthesized using a random-effects model and expressed as
risk ratios (RR) for dichotomous outcomes and mean difference (MD) for
continuous outcomes, with corresponding 95% confidence intervals (CIs).
Our primary outcome was short-term mortality. <br/>Result(s): A total of
25 studies, of which 23 were observational and 2 were RCTs, were included
in this meta-analysis, comprising 234,585 patients (66,591 in the off-pump
group and 167,994 in the on-pump group). Our meta-analysis showed that
there was a significantly higher mortality rate in the on-pump CABG group
as compared to the off-pump CABG group (RR: 0.73, 95% CI [0.61, 0.88]; P =
0.0006, I² = 60%). <br/>Conclusion(s): Compared with OPCAB,
short-term mortality was significantly higher in ONCAB.<br/>Copyright
&#xa9; The Author(s), under exclusive licence to Springer Nature B.V.
2024.

<22>
Accession Number
645206205
Title
The cardioprotective effects of adenosine-induced cardioplegic arrest
versus saline in aortic valve replacement patients: A randomized
controlled trial.
Source
Scandinavian journal of surgery : SJS : official organ for the Finnish
Surgical Society and the Scandinavian Surgical Society. (pp
14574969241266716), 2024. Date of Publication: 05 Sep 2024.
Author
Mattila M.S.; Jarvela K.M.; Rantanen M.J.; Tuohinen S.; Nikus K.C.;
Laurikka J.O.
Institution
(Mattila) Heart Hospital Tampere University Hospital Tays Sydankeskus Oy
PL 2000 33521 Tampere Finland Faculty of Medicine and Health Technology
Tampere University Tampere Finland The Wellbeing Services County of
Pirkanmaa Tampere Finland, Finland
(Jarvela, Rantanen, Nikus, Laurikka) Heart Hospital, Tampere University
Hospital, Tampere, Finland
(Jarvela, Nikus, Laurikka) Faculty of Medicine and Health Technology,
Tampere University, Tampere, Finland
(Jarvela, Rantanen, Nikus, Laurikka) Wellbeing Services County of
Pirkanmaa, Tampere, Finland
(Tuohinen) Heart and Lung Center, Helsinki University Central Hospital,
HUS, Helsinki, Finland
Abstract
BACKGROUND AND AIMS: Adenosine is a widely used potent cardioprotective
drug, but the effect of an adenosine bolus in initial cardioplegia on
cardioprotection in aortic valve replacement (AVR) patients has not been
demonstrated. The aim of this double-blind randomized clinical trial was
to compare intra-aortic adenosine bolus with saline on the postoperative
myocardial function in patients undergoing AVR. <br/>METHOD(S): Aortic
valve stenosis patients scheduled for elective or urgent AVR surgery were
randomized to receive either a 20mg (4mL) single dose of adenosine or a
saline into the ascending aorta during the first cardioplegia infusion.
The primary outcome was cardiac index (CI (L/min/m2) at four timepoints
(before incision, after weaning from cardiopulmonary bypass (CPB), at 7
p.m. on the operation day, and at 6 a.m. the next morning). Secondary
outcomes included left ventricular stroke work index, right ventricular
stroke work index, and myocardial biomarkers at the same timepoints.
<br/>RESULT(S): Between November 2015 and March 2018, 45 patients were
recruited, 23 in the adenosine group and 22 in the placebo group. The last
follow-up date was 17 March 2018. There were no statistically significant
differences in CI (mean differences with 95% confidence interval (95% CI):
0.09L/min/m2 at baseline (-0.20 to 0.38), -1.39L/min/m2 (-3.47 to 0.70) at
post-CPB, -0.39L/min/m2 (-0.78 to 0.004) at 7 p.m., and -0.32L/min/m2
(-0.68 to 0.05) at 6 a.m., (p=0.066)), right ventricular stroke work
index, (p=0.24), or cardiac biomarkers between the groups. Left
ventricular stroke work index was lower in the adenosine group (-3.66gm/m2
(-11.13 to 3.81) at baseline, -17.42gm/m2 (-37.81 to 2.98) at post-CPB,
-3.36gm/m2 (-11.10 to 4.38) at 7 p.m., and -3.77gm/m2 (-10.19 to 2.66) at
6 a.m. (p=0.021)). <br/>CONCLUSION(S): There were no differences between
20mg adenosine bolus and saline in the first cardioplegia infusion in CI
improvement in AVR surgery for aortic valve stenosis.EudraCT number:
2014-001382-26.

<23>
Accession Number
645203155
Title
Prehabilitation Research: A Bibliometric Analysis of Past Trends and
Future Directions.
Source
American journal of physical medicine & rehabilitation. (no pagination),
2024. Date of Publication: 22 Aug 2024.
Author
Yoo M.; Jang C.W.
Institution
(Yoo) Department of Rehabilitation Medicine, Uijeongbu Eulji Medical
Center, Eulji University School of Medicine, South Korea
Abstract
OBJECTIVE: This study investigates the global research landscape of
prehabilitation, identifying current trends, dominant disciplines,
collaborative networks, and prominent articles in the field. DESIGN: For
our analysis, we employed the published prehabilitation literature indexed
in the Web of Science Core Collection database, spanning from 2002 to
2022. Additionally, we utilized CiteSpace (version 6.2; Drexel
University), a widely used information visualization software to perform
bibliometric analysis. <br/>RESULT(S): Analyzing 553 research articles, we
observe a consistent upward trend in prehabilitation publication and
citation activity. Interdisciplinary co-occurrence analysis highlights
strong connections with fields such as surgery, rehabilitation, oncology,
sports sciences, orthopedics, gastroenterology, and hepatology. Initially
centered around postoperative outcomes in major abdominal surgeries,
particularly for colorectal, pancreatic, and prostate cancers,
prehabilitation research expanded to include thoracic surgeries, focusing
on conditions like lung cancer and aortic valve replacement. Preoperative
exercise remains a core area, with increasing interest in multimodal
prehabilitation and its effectiveness based on patient group
characteristics. North America and Western Europe emerge as primary
contributors to prehabilitation research. <br/>CONCLUSION(S): Current
research concentrates on tailoring prehabilitation programs for specific
groups, and broadening their geographical scope would enhance the studies,
contributing valuable insights for medical practitioners shaping future
research efforts.<br/>Copyright &#xa9; 2024 Wolters Kluwer Health, Inc.
All rights reserved.

<24>
Accession Number
645196897
Title
Low-dose colchicine for the prevention of cardiovascular events after
percutaneous coronary intervention: rationale and design of the COL BE PCI
trial: Short title: Rationale and design of the COL BE PCI trial.
Source
American heart journal. (no pagination), 2024. Date of Publication: 02
Sep 2024.
Author
De Cock E.; Kautbally S.; Timmermans F.; Bogaerts K.; Hanet C.; Desmet W.;
Gurne O.; Vranckx P.; Hiltrop N.; Dujardin K.; Vanduynhoven P.; Vermeersch
P.; Pirlet C.; Hermans K.; Van Reet B.; Ferdinande B.; Aminian A.; Dewilde
W.; Guedes A.; Simon F.; De Roeck F.; De Vroey F.; Jukema J.W.; Sinnaeve
P.; Buysschaert I.
Institution
(De Cock) Department of Cardiology, AZ Sint-Jan Brugge AV, Bruges,
Belgium; Department of Cardiology, Ghent University Hospital, Ghent,
Belgium
(Kautbally, Gurne) Department of Cardiology, Cliniques Universitaires
St-Luc, Universite Catholique de Louvain, Brussels, Belgium
(Timmermans) Department of Cardiology, Ghent University Hospital, Ghent,
Belgium
(Bogaerts) Department of Public Health and Primary Care, KU Leuven,
I-BioStat, Leuven, Belgium and UHasselt, I-BioStat, Diepenbeek, Belgium
(Hanet, Guedes) Department of Cardiology, Universite Catholique de
Louvain, Yvoir, Belgium
(Desmet) Department of Cardiovascular Sciences, University of Leuven,
Leuven; Belgium & Department of Cardiovascular Medicine, University
Hospitals Leuven, Belgium
(Vranckx) Department of Cardiology and Intensive Care Medicine, Jessa
Ziekenhuis, Hasselt, Belgium
(Hiltrop) Department of Cardiology, AZ Groeninge, Kortrijk, Belgium
(Dujardin) Department of Cardiology, AZ Delta, Roeselare, Belgium
(Vanduynhoven) Department of Cardiology, Arrhythmia Clinic, ASZ Aalst,
Aalst, Belgium
(Vermeersch) Department of Cardiology, ZNA (Ziekenhuis Netwerk Antwerpen)
Middelheim, Antwerp, Belgium
(Pirlet) Department of Cardiology, Liege, Belgium
(Hermans) Department of Cardiology, AZ Sint-Lucas Ghent, Ghent, Belgium
(Van Reet) Department of Cardiology, AZ Turnhout, Turnhout, Belgium
(Ferdinande) Department of Cardiology, Hospital Oost-Limburg, Genk,
Belgium
(Aminian) Department of Cardiology, Centre Hospitalier Universitaire de
Charleroi, Charleroi, Belgium
(Dewilde) Department of Cardiology, Imelda Hospital Bonheiden, Bonheiden,
Belgium
(Simon) Department of Cardiology, Namur, Belgium
(De Roeck) Department of Cardiology, University Hospital Antwerp, Edegem,
Belgium
(De Vroey) Department of Cardiology, Grand Hopital de Charleroi,
Charleroi, Belgium
(Jukema) Department of Cardiology, Leiden University Medical Center,
Leiden, the Netherlands; Netherlands Heart Institute, Utrecht, the
Netherlands
(Sinnaeve) Department of Cardiovascular Sciences, University of Leuven,
Leuven, Belgium
(Buysschaert) Department of Cardiology, AZ Sint-Jan Brugge AV, Bruges,
Belgium
Abstract
Patients with coronary artery disease (CAD) remain vulnerable to future
major atherosclerotic events after revascularization, despite effective
secondary prevention strategies. Inflammation plays a central role in the
pathogenesis of CAD and recurrent events. To date, there is no specific
anti-inflammatory medicine available with proven effective,
cost-efficient, and favorable benefit-risk profile, except for colchicine.
Initial studies with colchicine have sparked major interest in targeting
atherosclerotic events with anti-inflammatory agents, but further studies
are warranted to enforce the role of colchicine role as a major treatment
pillar in CAD. Given colchicine's low cost and established acceptable
long-term safety profile, confirming its efficacy through a pragmatic
trial holds the potential to significantly impact the global burden of
cardiovascular disease. The COL BE PCI trial is an investigator-initiated,
multicenter, double-blind, event-driven trial. It will enroll 2,770
patients with chronic or acute CAD treated with percutaneous coronary
intervention (PCI) at 19 sites in Belgium, applying lenient in- and
exclusion criteria and including at least 30% female participants.
Patients will be randomized between 2 hours and 5 days post-PCI to receive
either colchicine 0.5 mg daily or placebo on top of contemporary optimal
medical therapy and without run-in period. All patients will have baseline
hsCRP measurements and a Second Manifestations of Arterial Disease (SMART)
risk score calculation. The primary endpoint is the time from
randomization to the first occurrence of a composite endpoint consisting
of all-cause death, spontaneous non-fatal myocardial infarction, non-fatal
stroke, or coronary revascularization. The trial is event-driven and will
continue until 566 events have been reached, providing 80% power to detect
a 21 % reduction in the primary endpoint taking a premature
discontinuation of 15% into account. We expect a trial duration of
approximately 44 months. The COL BE PCI Trial aims to assess the
effectiveness and safety of administering low-dose colchicine for the
secondary prevention in patients with both chronic and acute coronary
artery disease undergoing PCI. Trial registration: ClinicalTrials.gov:
NCT06095765.<br/>Copyright &#xa9; 2024. Published by Elsevier Inc.

<25>
Accession Number
2031248284
Title
Effect of perioperative sigh ventilation on postoperative hypoxemia and
pulmonary complications after on-pump cardiac surgery (E-SIGHT): study
protocol for a randomized controlled trial.
Source
Trials. 25(1) (no pagination), 2024. Article Number: 585. Date of
Publication: December 2024.
Author
Wang Z.; Cheng Q.; Huang S.; Sun J.; Xu J.; Xie J.; Cao H.; Guo F.
Institution
(Wang, Cheng, Huang, Xu, Xie, Guo) Jiangsu Provincial Key Laboratory of
Critical Care Medicine, Department of Critical Care Medicine, Zhongda
Hospital, School of Medicine, Southeast University, Nanjing 210009, China
(Sun) Department of Anesthesiology, Surgery and Pain Management, Zhongda
Hospital, School of Medicine, Southeast University, Nanjing 210009, China
(Cao) Department of Cardiothoracic Surgery, Zhongda Hospital, School of
Medicine, Southeast University, Nanjing 210009, China
Publisher
BioMed Central Ltd
Abstract
Background: Postoperative hypoxemia and pulmonary complications remain a
frequent event after on-pump cardiac surgery and mostly characterized by
pulmonary atelectasis. Surfactant dysfunction or hyposecretion happens
prior to atelectasis formation, and sigh represents the strongest stimulus
for surfactant secretion. The role of sigh breaths added to conventional
lung protective ventilation in reducing postoperative hypoxemia and
pulmonary complications among cardiac surgery is unknown. <br/>Method(s):
The perioperative sigh ventilation in cardiac surgery (E-SIGHT) trial is a
single-center, two-arm, randomized controlled trial. In total, 192
patients scheduled for elective cardiac surgery with cardiopulmonary
bypass (CPB) and aortic cross-clamp will be randomized into one of the two
treatment arms. In the experimental group, besides conventional lung
protective ventilation, sigh volumes producing plateau pressures of 35
cmH<inf>2</inf>O (or 40 cmH<inf>2</inf>O for patients with body mass index
> 35 kg/m²) delivered once every 6 min from intubation to
extubation. In the control group, conventional lung protective ventilation
without preplanned recruitment maneuvers is used. Lung protective
ventilation (LPV) consists of low tidal volumes (6-8 mL/kg of predicted
body weight) and positive end-expiratory pressure (PEEP) setting according
to low PEEP/FiO<inf>2</inf> table for acute respiratory distress syndrome
(ARDS). The primary endpoint is time-weighted average
SpO<inf>2</inf>/FiO<inf>2</inf> ratio during the initial post-extubation
hour. Main secondary endpoint is the severity of postoperative pulmonary
complications (PPCs) computed by postoperative day 7. <br/>Discussion(s):
The E-SIGHT trial will be the first randomized controlled trial to
evaluate the impact of perioperative sigh ventilation on the postoperative
outcomes after on-pump cardiac surgery. The trial will introduce and
assess a novel perioperative ventilation approach to mitigate the risk of
postoperative hypoxemia and PPCs in patients undergoing cardiac surgery.
Also provide the basis for a future larger trial aiming at verifying the
impact of sigh ventilation on postoperative pulmonary complications. Trial
registration: ClinicalTrials.gov NCT06248320. Registered on January 30,
2024. Last updated February 26, 2024.<br/>Copyright &#xa9; The Author(s)
2024.

<26>
Accession Number
2033192240
Title
Preoperative Nonselective Chest Computed Tomography Prior to Primary
Cardiac Surgery Results in Meaningful Change to Surgical Management:
Systematic Review and Pooled Prevalence Meta-Analysis.
Source
Heart Lung and Circulation. 33(9) (pp 1250-1258), 2024. Date of
Publication: September 2024.
Author
Indja B.; Chang J.; Flynn C.D.; Vallely M.
Institution
(Indja, Chang, Flynn, Vallely) Department of Cardiothoracic Surgery, St
George Hospital, Kogarah, NSW, Australia
(Vallely) Department of Cardiothoracic Surgery, Macquarie University
Hospital, Macquarie University, NSW, Australia
Publisher
Elsevier Ltd
Abstract
Background: Routine screening chest computed tomography (CT) prior to
primary cardiac surgery is advocated by some surgeons due to the purported
benefits of identifying significant aortic calcification that impacts
ongoing management, such as performing anaortic off-pump surgery or
adjusting cannulation strategy. Additionally, axial imaging can identify
incidental findings that may require concomitant or staged procedures such
as ascending aortic dilatation or pulmonary lesions. The objective of this
study was to quantify the impact that nonselective chest CT prior to
primary cardiac surgery had on subsequent management. <br/>Method(s): A
systematic review and pooled prevalence meta-analyses were performed in
accordance with Preferred Reporting Items for Systematic Reviews and
Meta-analyses guidelines. Included studies performed non-selective chest
CT prior to primary cardiac surgery. <br/>Result(s): A total of eight
studies, including 2,250 patients were included. The rate of mortality and
stroke was low (1% and 2%, respectively). Calcification of the ascending
aorta was identified in 15% of patients (95% confidence interval [CI]
5.0-26.0). A significant change to the surgical plan such as cannulation
strategy, off-pump surgery, cancellation, or an additional procedure was
required in 7% (95% CI 2.0-12.0). Clinically relevant incidental findings
requiring in-patient management or follow-up were identified in 10% (95%
CI 6.0-14.0). <br/>Conclusion(s): Nonselective CT chest prior to primary
cardiac surgery identifies clinically relevant findings that result in a
modification of the surgical plan in a significant population of patients
to address the risk of stroke associated with aortic calcification as well
as the identification of important incidental findings such as pulmonary
lesions.<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)

<27>
Accession Number
645172113
Title
Cerebrospinal fluid drainage for thoracic and thoracoabdominal aortic
aneurysm surgery.
Source
Cochrane Database of Systematic Reviews. 2012(11) (no pagination), 2012.
Article Number: CD003635. Date of Publication: 17 Oct 2012.
Author
Khan S.N.; Stansby G.
Institution
(Khan) Quaid-i-Azam International Hospital, Peshawar Road, Rawalpindi,
Pakistan
(Stansby) University of Newcastle upon Tyne, Department of Surgery,
Framlington Place, Newcastle upon Tyne NE24HH, United Kingdom
Publisher
John Wiley and Sons Ltd
Abstract
Background: During aortic aneurysm surgery, cross-clamping can lead to
inadequate blood supply to the spinal cord resulting in neurological
deficit. Cerebrospinal fluid drainage (CSFD) may increase the perfusion
pressure to the spinal cord and hence reduce the risk of ischaemic spinal
cord injury. <br/>Objective(s): To determine the effect of CSFD during
thoracic and thoracoabdominal aortic aneurysm (TAAA) surgery on the risk
of developing spinal cord injury. <br/>Search Method(s): For this update
the Cochrane Peripheral Vascular Diseases Group Trials Search Co-ordinator
searched the Specialised Register (last searched May 31 2012) and CENTRAL
(2012, Issue 5) for publications describing randomised controlled trials
of cerebrospinal fluid drainage for thoracic and thoracoabdominal aortic
aneurysm surgery. Reference lists of relevant articles were checked.
<br/>Selection Criteria: Randomised trials involving CSFD during thoracic
and TAAA surgery. <br/>Data Collection and Analysis: Both authors assessed
the quality of trials independently. SNK extracted data and GS verified
the data. <br/>Main Result(s): Three trials with a total of 287
participants operated on for Type I or II TAAA were included. In the first
trial of 98 participants, neurological deficits in the lower extremities
occurred in 14 (30%) of CSFD group and 17 (33%) controls. The deficit was
observed within 24 hours of the operation in 21 (68%), and from three to
22 days in 10 (32%) participants. CSFD did not have a significant benefit
in preventing ischaemic injury to the spinal cord. The second trial of 33
participants used a combination of CSFD and intrathecal papaverine. It
showed a statistically significant reduction in the rate of postoperative
neurological deficit (P = 0.039), compared to controls. Analysis was
undertaken after only one third of the estimated sample size had entered
the trial. In the third trial TAAA repair was performed on 145
participants. CSFD was initiated during the operation and continued for 48
hours after surgery. Paraplegia or paraparesis occurred in 9 of 74
participants (12.2%) in the control group versus 2 of 82 participants
(2.7%) receiving CSFD (P = 0.03). Overall, CSFD resulted in an 80%
reduction in the relative risk of postoperative deficits. Meta-analysis
showed an odds ratio (OR) of 0.48 (95 % confidence interval (CI) 0.25 to
0.92). For CSFD-only trials, OR was 0.57 (95% CI 0.28 to 1.17) and for
intention-to-treat analysis in CSFD-only studies, the OR remained
unchanged. Authors' conclusions: There are limited data supporting the
role of CSFD in thoracic and thoracoabdominal aneurysm surgery for
prevention of neurological injury. Further clinical and experimental
studies are indicated.<br/>Copyright &#xa9; 2012 The Cochrane
Collaboration. Published by John Wiley & Sons, Ltd.

<28>
Accession Number
2034468344
Title
Association of Amiodarone Use Prior to Orthotopic Heart Transplant with
Post-Transplant Graft Dysfunction and All-Cause Mortality: A Systematic
Review and Meta-Analysis.
Source
Journal of Cardiac Failure. (no pagination), 2024. Date of Publication:
2024.
Author
Ko E.; Ahmed M.; Nudy M.; Bussa R.; Bussa J.; Gonzalez M.; Naccarelli G.;
Soleimani B.; Maheshwari A.
Institution
(Ko, Bussa) Penn State Hershey Medical Center, Department of Internal
Medicine, Hershey, Pennsylvania, United States
(Ahmed, Nudy, Gonzalez, Naccarelli, Soleimani, Maheshwari) Penn State
Hershey Medical Center, Heart and Vascular Institute, Division of
Cardiology, Hershey, Pennsylvania, United States
(Nudy) Penn State Hershey Medical Center, Department of Public Health
Sciences, Hershey, Pennsylvania, United States
(Bussa) University of Massachusetts Amherst, Department of Biochemistry
and Molecular Biology, Amherst, Massachusetts, United States
Publisher
Elsevier B.V.
Abstract
Background: There is conflicting data on the association between
pre-orthotopic heart transplant (OHT) amiodarone use and post-OHT graft
dysfunction (GD) leading to heterogeneity in clinical practice.
<br/>Method(s): We performed a meta-analysis to evaluate whether pre-OHT
amiodarone use was associated with meaningful increases in the incidence
of GD, 30-day mortality, and 1-year mortality. Studies were identified by
searching PubMed and the Cochrane Register of Clinical Trials. The
Mantel-Haenszel method was used to calculate odds ratios (OR) and 95%
confidence intervals (CI<inf>95</inf>) for each endpoint. <br/>Result(s):
17 retrospective studies were identified that included 48,782 patients. 14
studies (n = 48,018) reported GD as an outcome. Pre-OHT amiodarone use was
associated with increased odds of GD (OR 1.3, CI<inf>95</inf> 1.2-1.5, p <
0.001). 10 studies (n = 45,875) reported 30-day mortality based on
amiodarone use. Pre-OHT amiodarone use was associated with increased odds
of 30-day mortality (OR 1.4, CI<inf>95</inf> 1.2-1.5, p < 0.001). 5
studies (n = 41,404) reported 1-year mortality based on amiodarone use.
Pre-OHT amiodarone use was associated with increased odds of 1-year
mortality (OR 1.2, CI<inf>95</inf> 1.1-1.4, p < 0.001). The increase in
absolute risk of GD, 30-day mortality, and 1-year mortality for patients
with pre-OHT amiodarone use was 1.3%, 1.2%, and 1.4%, respectively.
<br/>Conclusion(s): Pre-OHT amiodarone exposure was associated with
increased odds of GD, 30-day mortality, and 1-year mortality. The increase
in absolute risk for each endpoint was modest, and it is unclear to what
extent, if any, pre-OHT amiodarone use should influence assessment of OHT
candidacy.<br/>Copyright &#xa9; 2024

<29>
Accession Number
2034371911
Title
Periprocedural myocardial infarction after percutaneous coronary
intervention and long-term mortality: a meta-analysis.
Source
European Heart Journal. 45(33) (pp 3018-3027), 2024. Date of Publication:
01 Sep 2024.
Author
Paolucci L.; Mangiacapra F.; Sergio S.; Nusca A.; Briguori C.; Barbato E.;
Ussia G.P.; Grigioni F.
Institution
(Paolucci, Briguori) Interventional Cardiology Unit, Mediterranea
Cardiocentro, Naples, Italy
(Mangiacapra, Sergio, Nusca, Ussia, Grigioni) Research Unit of
Cardiovascular Science, Department of Medicine and Surgery, Universita
Campus Bio-Medico di Roma, Via Alvaro del Portillo 21, Rome 00128, Italy
(Mangiacapra, Nusca, Ussia, Grigioni) Fondazione Policlinico Universitario
Campus Bio-Medico, Via Alvaro del Portillo 200, Rome 00128, Italy
(Barbato) Department of Clinical and Molecular Medicine, Sapienza
University of Rome, Rome, Italy
Publisher
Oxford University Press
Abstract
Background and Aims Conflicting data are available regarding the
association between periprocedural myocardial infarction (PMI) and
mortality following percutaneous coronary intervention. The purpose of
this study was to evaluate the incidence and prognostic implication of PMI
according to the Universal Definition of Myocardial Infarction (UDMI), the
Academic Research Consortium (ARC)-2 definition, and the Society for
Cardiovascular Angiography and Interventions (SCAI) definition. Methods
Studies reporting adjusted effect estimates were systematically searched.
The primary outcome was all-cause death, while cardiac death was included
as a secondary outcome. Studies defining PMI according to biomarker
elevation without further evidence of myocardial ischaemia ('ancillary
criteria') were included and reported as 'definition-like'. Data were
pooled in a random-effect model. Results A total of 19 studies and 109 568
patients were included. The incidence of PMI was progressively lower
across the UDMI, ARC-2, and SCAI definitions. All PMI definitions were
independently associated with all-cause mortality [UDMI: hazard ratio (HR)
1.61, 95% confidence interval (CI) 1.32-1.97; I² 34%; ARC-2: HR
2.07, 95% CI 1.40-3.08, I² 0%; SCAI: HR 3.24, 95% CI 2.36-4.44,
I² 78%]. Including ancillary criteria in the PMI definitions
were associated with an increased prognostic performance in the UDMI but
not in the SCAI definition. Data were consistent after evaluation of major
sources of heterogeneity. Conclusions All currently available
international definitions of PMI are associated with an increased risk of
all-cause death after percutaneous coronary intervention. The magnitude of
this latter association varies according to the sensitivity and prognostic
relevance of each definition.<br/>Copyright &#xa9; The Author(s) 2024.

<30>
Accession Number
2034369831
Title
Ticagrelor monotherapy for acute coronary syndrome: an individual patient
data meta-analysis of TICO and T-PASS trials.
Source
European Heart Journal. 45(33) (pp 3045-3056), 2024. Date of Publication:
01 Sep 2024.
Author
Lee Y.-J.; Shin S.; Kwon S.W.; Suh Y.; Yun K.H.; Kang T.S.; Lee J.-W.; Cho
D.-K.; Park J.-K.; Bae J.-W.; Kang W.C.; Kim S.; Lee S.-J.; Hong S.-J.;
Ahn C.-M.; Kim J.-S.; Kim B.-K.; Ko Y.-G.; Choi D.; Jang Y.; Hong M.-K.
Institution
(Lee, Lee, Hong, Ahn, Kim, Kim, Ko, Choi, Hong) Severance Hospital, Yonsei
University, College of Medicine, 50-1 Yonsei-ro Seodaemun-gu, Seoul 03722,
South Korea
(Shin) Department of Cardiology, Ewha Womans University, College of
Medicine Seoul Hospital, Seoul, South Korea
(Kwon) Department of Cardiology, Inha University Hospital, Incheon, South
Korea
(Suh) Myongji Hospital, Hanyang University, College of Medicine, 55
Hwasu-ro 14 beon-gil Deokyang-gu, Goyang 10475, South Korea
(Yun) Department of Cardiology, Wonkwang University Hospital, Iksan, South
Korea
(Kang) Dankook University Hospital, Dankook University, College of
Medicine, Cheonan, South Korea
(Lee) Wonju Severance Christian Hospital, Yonsei University, Wonju College
of Medicine, Wonju, South Korea
(Cho) Yongin Severance Hospital, Yonsei University, College of Medicine,
Yongin, South Korea
(Park) Department of Cardiology, National Health Insurance Service, Ilsan
Hospital, Goyang, South Korea
(Bae) Department of Cardiology, Chungbuk National University, College of
Medicine, Cheongju, South Korea
(Kang) Department of Cardiology, Gachon University, Gil Medical Center,
Incheon, South Korea
(Kim) Department of Cardiology, Inje University, Haeundae Paik Hospital,
Busan, South Korea
(Jang) Department of Cardiology, CHA University, College of Medicine,
Seongnam, South Korea
Publisher
Oxford University Press
Abstract
Background and Aims In patients with acute coronary syndrome (ACS), dual
antiplatelet therapy (DAPT) with aspirin and a potent P2Y12 inhibitor is
recommended for 12 months after drug-eluting stent (DES) implantation.
Monotherapy with a potent P2Y12 inhibitor after short-term DAPT is an
attractive option to better balance the risks of ischaemia and bleeding.
Therefore, this study evaluated the efficacy and safety of ticagrelor
monotherapy after short-term DAPT, especially in patients with ACS.
Methods Electronic databases were searched from inception to 11 November
2023, and for the primary analysis, individual patient data were pooled
from the relevant randomized clinical trials comparing ticagrelor
monotherapy after short-term (<=3 months) DAPT with ticagrelor-based
12-month DAPT, exclusively in ACS patients undergoing DES implantation.
The co-primary endpoints were ischaemic endpoint (composite of all-cause
death, myocardial infarction, or stroke) and bleeding endpoint [Bleeding
Academic Research Consortium (BARC) type 3 or 5 bleeding] at 1 year.
Results Individual patient data from two randomized clinical trials
including 5906 ACS patients were analysed. At 1 year, the primary
ischaemic endpoint did not differ between the ticagrelor monotherapy and
ticagrelor-based DAPT groups [1.9% vs. 2.5%; adjusted hazard ratio (HR)
0.79; 95% confidence interval (CI) 0.56-1.13; P = .194]. The incidence of
the primary bleeding endpoint was lower in the ticagrelor monotherapy
group (2.4% vs. 4.5%; adjusted HR 0.54; 95% CI 0.40-0.72; P < .001). The
results were consistent in a secondary aggregate data meta-analysis
including the ACS subgroup of additional randomized clinical trials which
enrolled patients with ACS as well as chronic coronary syndrome.
Conclusions In ACS patients undergoing DES implantation, ticagrelor
monotherapy after short-term DAPT was associated with less major bleeding
without a concomitant increase in ischaemic events compared with
ticagrelor-based 12-month DAPT.<br/>Copyright &#xa9; The Author(s) 2024.

<31>
Accession Number
2034369817
Title
The puzzle of antiplatelet therapy in ACS: ticagrelor monotherapy is
another missing piece.
Source
European Heart Journal. 45(33) (pp 3057-3059), 2024. Date of Publication:
01 Sep 2024.
Author
van den Broek W.W.A.; ten Berg J.M.
Institution
(van den Broek, ten Berg) Department of Cardiology, St. Antonius Hospital,
Koekoekslaan 1, Nieuwegein 3435 CM, Netherlands
(ten Berg) Department of Cardiology, University Medical Center Maastricht,
Maastricht, Netherlands
Publisher
Oxford University Press

<32>
Accession Number
2034361677
Title
EFFICACY AND SAFETY OF PRE-EMPTIVE USE OF ORAL TAPENTADOL VERSUS ORAL
PREGABALIN FOR POST OPERATIVE ANALGESIA FOLLOWING CARDIAC SURGERY: A
COMPARATIVE STUDY.
Source
Journal of Cardiovascular Disease Research. 15(4) (pp 567-578), 2024. Date
of Publication: 2024.
Author
Shah R.J.; Sasturkar V.K.; Jambure N.; Annachhatre A.S.
Institution
(Shah, Sasturkar, Jambure, Annachhatre) MBBS, MD Anesthesia, Fellow in
Cardiovascular Anesthesia, Department of Anaesthesiology, MGM Medical
College, Sambhajinagar, Aurangabad, Maharashtra, India MBBS, MD
Anesthesia, Department of Anaesthesiology, MGM Medical College,
Sambhajinagar, Aurangabad, Maharashtra, India MBBS, MD Anesthesia, FCA
[Cardiovascular Anesthesia], Department of Anaesthesiology, MGM Medical
College, Sambhajinagar, Aurangabad, Maharashtra, India MBBS, MD
Anesthesia, FIACTA, FICCC, Department of Anaesthesiology, MGM Medical
College, Sambhajinagar, Aurangabad, Maharashtra, India
Publisher
EManuscript Technologies
Abstract
Background and Objective: After cardiac surgery, post operative pain is a
major concern for patient as well as surgeon. Establishment of analgesia
even before surgical incision is pre-emptive analgesia. Primary objective
of this study is comparison of duration of analgesia in patients who were
administered oral Tapentadol versus oral Pregabalin prior the surgery.
Methods and Material: A prospective randomised double-blind study was
conducted on 66 patients undergoing elective cardiac surgery using midline
sternotomy incision. Patients were divided into two groups-Group T and
Group P where patients were given oral Tapentadol 100 mg and oral
Pregabalin 150 mg respectively 2 hours prior the surgery. All patients
were monitored for duration of analgesia (time of first rescue analgesic
after extubation from time of ingestion of the drug), VAS score, heart
rate, mean arterial pressure, sedation score, intraoperative requirement
of fentanyl, side effects (if any). <br/>Result(s): There was no
statistical significant difference in duration of analgesia between two
groups (p value > 0.05). There was statistically significant difference in
intra operative fentanyl requirement (p value < 0.05), it was lower in
Group P than in Group T. The difference in Median VAS score at 0 hrs and
24 hrs post extubation was statistically significant, where VAS scores
were less in Group P than in Group T. <br/>Conclusion(s): Administration
of oral pregabalin as pre-emptive analgesic showed comparable duration of
analgesia but better safety profile in terms of haemodynamic stability and
less sedation as well as respiratory depression than oral
Tapentadol.<br/>Copyright &#xa9; 2024 EManuscript Technologies. All rights
reserved.

<33>
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.

<34>
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.

<35>
[Use Link to view the full text]
Accession Number
2034344665
Title
EXAMINING THE IMPACT OF PERMISSIBILITY HYPERCAPNIA ON POSTOPERATIVE
DELIRIUM AMONG ELDERLY PATIENTS UNDERGOING THORACOSCOPIC-LAPAROSCOPIC
ESOPHAGECTOMY: A SINGLE-CENTER INVESTIGATIVE STUDY.
Source
Shock. 62(3) (pp 319-326), 2024. Date of Publication: 01 Sep 2024.
Author
Song J.; Shao Y.-M.; Zhang G.-H.; Fan B.-Q.; Tao W.-H.; Liu X.-F.; Huang
X.-C.; Hu X.-W.
Institution
(Song, Zhang, Fan, Tao, Liu, Huang, Hu) Department of Anesthesiology, The
Second Affiliated Hospital of Anhui Medical University, Anhui, Hefei
230601, China
(Shao) Department of Anesthesiology, Long-Gang Central Hospital,
Guangdong, Shenzhen 518000, China
Publisher
Lippincott Williams and Wilkins
Abstract
Objective: This study explores how permissive hypercapnia, a key aspect of
lung-protective ventilation, impacts postoperative delirium in elderly
patients following thoracic surgery. <br/>Method(s): A single-center trial
at The Second Hospital of Anhui Medical University involved 136 elderly
patients undergoing thoracoscopic esophageal cancer resection. Randomly
assigned to maintain PaCO<inf>2</inf> 35-45 mm Hg (group N) or 46-55 mm Hg
(group H). <br/>Primary Outcome: postoperative delirium (POD) incidence
1-3 days post-surgery. Secondary endpoints included monitoring
rSO<inf>2</inf>, cardiovascular parameters (MAP, HR), pH, OI, and
respiratory parameters (VT, RR, Cdyn, PIP) at specific time points.
Perioperative tests assessed CRP/ALB ratio (CAR) and systemic inflammatory
index (SII). VAS scores were documented for 3 postoperative days.
<br/>Result(s): Postoperatively, group H showed significantly lower POD
incidence than group N (7.4% vs. 19.1%, P = 0.043). Group H exhibited
higher PaCO<inf>2</inf> and rSO<inf>2</inf> during surgery (P < 0.05).
Patients in group H maintained better cardiovascular stability with higher
blood pressure and lower heart rate on T2-4 (P < 0.05). Respiratory
parameters were more stable in group H with lower TV, RR, and PIP, and
higher Cdyn during OLV (P < 0.05). Group H had lower pH and higher OI at
T2-4 (P < 0.05). CRP and CAR levels rose less in group H on the first day
and 1 week later (P < 0.05). <br/>Conclusion(s): Maintaining
PaCO<inf>2</inf> at 46-55 mm Hg reduces POD incidence, possibly by
enhancing rSO<inf>2</inf> levels and stabilizing intraoperative
respiration/circulation.<br/>Copyright &#xa9; 2024 by the Shock Society.

<36>
Accession Number
2030882339
Title
Allopurinol versus Trimetazidine for the Treatment of Angina: A Randomized
Clinical Trial.
Source
Arquivos Brasileiros de Cardiologia. 121(8) (no pagination), 2024. Article
Number: e20230659. Date of Publication: 2024.
Author
Viana T.; de Melo R.M.V.; Azevedo D.F.C.; Figueiredo C.S.; Santana G.;
Damasceno L.M.; Latado L.; Tambuque L.; Barreto R.; Passos L.C.S.
Institution
(Viana, de Melo, Figueiredo, Santana) Universidade Federal da Bahia, BA,
Salvador, Brazil
(Azevedo, Damasceno, Latado, Tambuque, Barreto, Passos) Ana Nery Hospital,
BA, Salvador, Brazil
Publisher
Sociedade Brasileira de Cardiologia
Abstract
Background: Recently, it was demonstrated that allopurinol, a xanthine
oxidase inhibitor, has cardiovascular and anti-ischaemic properties and
may be a metabolic antianginal agent option. <br/>Objective(s): The
objective of this study was to evaluate the antianginal effect of
allopurinol as a third drug for patients with stable coronary artery
disease (CAD). <br/>Method(s): This was a randomized clinical trial
between 2018 and 2020 including patients with CAD who maintained angina
despite initial optimization with beta-blockers and calcium channel
blockers. The individuals were randomized 1:1 to 300 mg of allopurinol
twice daily or 35 mg of trimetazidine twice daily. The main outcome was
the difference in the angina frequency domain of the Seattle Angina
Questionnaire (SAQ-AF). A probability (p) value < 0.05 was considered
statistically significant. <br/>Result(s): A hundred and eight patients
were included in the randomization phase, with 54 (50%) in the allopurinol
group and 54 (50%) in the trimetazidine group. Six (5.6%) individuals, 3
from each group, were lost to follow-up for the primary outcome. In the
allopurinol and trimetazidine groups, the median SAQ-AF scores were 50
(30.0 to 70.0) and 50 (21.3 to 78.3), respectively. In both groups, the
SAQ-AF score improved, but the median of the difference compared to
baseline was lower in the allopurinol group (10 [0 to 30] versus 20 [10 to
40]; p < 0.001), as was the mean of the difference in the total SAQ score
(12.8 +/- 17.8 versus 21.2 +/- 15.9; p = 0.014). <br/>Conclusion(s): Both
allopurinol and trimetazidine improved the control of angina symptoms;
however, trimetazidine presented a greater gain compared to
baseline.<br/>Copyright &#xa9; 2024, Sociedade Brasileira de Cardiologia.
All rights reserved.

<37>
Accession Number
2031249744
Title
Catheter ablation alone versus catheter ablation with combined
percutaneous left atrial appendage closure for atrial fibrillation: a
systematic review and meta-analysis.
Source
Journal of Interventional Cardiac Electrophysiology. (no pagination),
2024. Date of Publication: 2024.
Author
Junarta J.; Siddiqui M.U.; Abaza E.; Zhang P.; Roshandel A.; Barbhaiya
C.R.; Jankelson L.; Park D.S.; Holmes D.; Chinitz L.A.; Aizer A.
Institution
(Junarta, Barbhaiya, Jankelson, Park, Holmes, Chinitz, Aizer) Leon H.
Charney Division of Cardiology, New York University Langone Health, 550
1st Ave, New York, NY 10016, United States
(Siddiqui) Jefferson Heart Institute, Thomas Jefferson University
Hospitals, Philadelphia, United States
(Abaza, Zhang, Roshandel) Department of Internal Medicine, New York
University Langone Health, New York, United States
Publisher
Springer
Abstract
Background: Combined catheter ablation (CA) with percutaneous left atrial
appendage closure (LAAC) may produce comprehensive treatment for atrial
fibrillation (AF) whereby rhythm control is achieved and stroke risk is
reduced without the need for chronic oral anticoagulation. However, the
efficacy and safety of this strategy is still controversial.
<br/>Method(s): This meta-analysis was reported according to the Preferred
Reporting Items for Systematic Review and Meta-Analyses guidelines.
Medline, Scopus, and Cochrane Central Register of Controlled Trials were
systematically searched to identify relevant studies. The risk of bias was
assessed using the Modified Newcastle-Ottawa scale and Cochrane risk of
bias tool. Eligible studies reported outcomes in patients with AF who
underwent combined CA and LAAC vs CA alone. Studies performing CA without
pulmonary vein isolation were excluded. <br/>Result(s): Eight studies
comprising 1878 patients were included (2 RCT, 6 observational). When
comparing combined CA and LAAC vs CA alone, pooled results showed no
difference in arrhythmia recurrence (risk ratio (RR) 1.04; 95% confidence
interval (CI) 0.82-1.33), stroke or systemic embolism (RR 0.78; 95% CI
0.27-2.22), or major periprocedural complications (RR 1.28; 95% CI
0.28-5.89). Total procedure time was shorter with CA alone (mean
difference 48.45 min; 95% CI 23.06-74.62). <br/>Conclusion(s): Combined CA
with LAAC for AF is associated with similar rates of arrhythmia-free
survival, stroke, and major periprocedural complications when compared to
CA alone. A combined strategy may be as safe and efficacious for patients
at moderate to high risk for bleeding events to negate the need for
chronic oral anticoagulation. Graphical Abstract: (Figure
presented.)<br/>Copyright &#xa9; The Author(s), under exclusive licence to
Springer Science+Business Media, LLC, part of Springer Nature 2024.

<38>
Accession Number
2031247035
Title
Recent advances in the treatment of refractory gastrointestinal
angiodysplasia.
Source
United European Gastroenterology Journal. (no pagination), 2024. Date of
Publication: 2024.
Author
Becq A.; Sidhu R.; Goltstein L.C.M.J.; Dray X.
Institution
(Becq) Gastroenterology Department, Paris-Est Creteil University, Henri
Mondor Hospital, AP HP, Creteil, France
(Sidhu) Division of Clinical Medicine, School of Medicine and Population
Health, University of Sheffield, Sheffield, United Kingdom
(Sidhu) Academic Unit of Gastroenterology and Hepatology, Sheffield
Teaching Hospitals, NHS Foundation Trust, Sheffield, United Kingdom
(Goltstein) Department of Gastroenterology and Hepatology, Radboud
University Medical Center, Nijmegen, Netherlands
(Dray) Sorbonne University, Center for Digestive Endoscopy, Saint Antoine
Hospital, AP HP, Paris, France
Publisher
John Wiley and Sons Inc
Abstract
Gastrointestinal angiodysplasia (GIA) is a common, acquired, vascular
abnormality of the digestive tract, and a frequent cause of bleeding.
Refractory GIA criteria usually include recurrent bleeding, transfusions
and/or repeat endoscopy. Pharmacological and interventional treatments
have been the subject of recent high-quality publications. This review
provides an overview of the latest updates on non-endoscopic management of
refractory GIA. Aortic valve replacement has shown its efficacy in Heyde
syndrome and should be considered if indicated. Anti-angiogenic drugs,
such as Octreotide and Thalidomide, are efficient treatments of refractory
GIA-related bleeding. Somatostatin analogs should, based on efficacy and
tolerance profile, be considered first. In the future, a better
understanding of the physiopathology of GIA might help develop
new-targeted therapies.<br/>Copyright &#xa9; 2024 The Author(s). United
European Gastroenterology Journal published by Wiley Periodicals LLC on
behalf of United European Gastroenterology.

<39>
Accession Number
2030550990
Title
Hypertrophic Cardiomyopathy: From Medical Treatment to Advanced Heart
Failure Therapies.
Source
Current Cardiology Reports. 26(9) (pp 985-994), 2024. Date of Publication:
September 2024.
Author
Mazur M.; Braksator W.; Popjes E.
Institution
(Mazur) Heart and Vascular Institute, Kaufman Center for Heart Failure,
Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH 44195,
United States
(Braksator) Department of Cardiology and Noninvasive Cardiovascular
Imaging, Faculty of Medicine, Medical University of Warsaw, Warsaw, Poland
(Popjes) Heart and Vascular Institute, Pennsylvania State Health Milton S.
Hershey Medical Center, Hershey, PA, United States
Publisher
Springer
Abstract
Purpose of Review: There has been much debate surrounding novel medical
therapies and heart transplantation listing challenges in patients with
hypertrophic cardiomyopathy (HCM). Recent Findings: Recent clinical trials
led to FDA approval of mavacamten (a cardiac myosin inhibitor), offering
symptom relief and potentially delaying/avoiding invasive septal reduction
therapies for some patients with HCM and left ventricular outflow
obstruction (LVOTO). For those with refractory symptoms and end-stage
heart failure, heart transplantation remains the gold standard. However,
the concern for the organ allocation system failing to prioritize those
individuals persists. <br/>Summary: HCM is a heterogeneous genetic
condition with variable penetration and clinical presentation. Even though
a large portion of patients remain asymptomatic, an important minority
develops debilitating symptoms refractory to medical therapy. Post-HT
short- and long-term outcomes are favorable. However, HT waitlist
mortality remains high. For highly selected patients with HCM, a left
ventricular assist device is a viable option.<br/>Copyright &#xa9; The
Author(s), under exclusive licence to Springer Science+Business Media,
LLC, part of Springer Nature 2024.

<40>
Accession Number
2030534962
Title
The Current State of Coronary Revascularization: Coronary Artery Bypass
Graft Surgery Versus Percutaneous Coronary Interventions.
Source
Current Cardiology Reports. 26(9) (pp 919-933), 2024. Date of Publication:
September 2024.
Author
Krittanawong C.; Rizwan A.; Khawaja M.; Newman N.; Escobar J.; Virk
H.U.H.; Alam M.; Al-Azzam F.; Yong C.M.; Jneid H.
Institution
(Krittanawong) Cardiology Division, NYU Langone Health and NYU School of
Medicine, New York, NY, United States
(Rizwan) Department of Medicine, Baylor College of Medicine, Houston, TX
77030, United States
(Khawaja, Newman) Division of Cardiology, Emory University School of
Medicine, Atlanta, GA 30322, United States
(Escobar) Division of Cardiology, Harlem Cardiology, NY 10035, United
States
(Virk) Harrington Heart & amp; Vascular Institute, Case Western Reserve
University, University Hospitals, Cleveland Medical Center, Cleveland,
United States
(Alam) Division of Cardiology, The Texas Heart Institute, Baylor College
of Medicine, Houston, TX 77030, United States
(Al-Azzam) Division of Cardiovascular Surgery, Mayo Clinic, Rochester, MN
55905, United States
(Yong) VA Palo Alto Medical Center, Department of Medicine, Stanford,
University and Stanford Cardiovascular Institute, Palo AltoStanford, CA,
United States
(Jneid) Division of Cardiology, University of Texas Medical Branch,
Houston, TX 77030, United States
Publisher
Springer
Abstract
Purpose of Review: The optimal revascularization strategy for coronary
artery disease depends on various factors, such as disease complexity,
patient characteristics, and preferences. Including a heart team in
complex cases is crucial to ensure optimal outcomes. Decision-making
between percutaneous coronary intervention and coronary artery bypass
grafting must consider each patient's clinical profile and coronary
anatomy. While current practice guidelines offer some insight into the
optimal revascularization approach for the various phenotypes of coronary
artery disease, the evidence to support either strategy continues to
evolve and grow. Given the large amount of contemporary data on
revascularization, this review aims to comprehensively summarize the
literature on coronary artery bypass grafting and percutaneous coronary
intervention in patients across the spectrum of coronary artery disease
phenotypes. Recent Findings: Contemporary evidence suggests that for
patients with triple vessel disease, coronary artery bypass grafting is
preferred over percutaneous coronary intervention due to better long-term
outcomes, including lower rates of death, myocardial infarction, and
target vessel revascularization. Similarly, for patients with left main
coronary artery disease, both percutaneous coronary intervention and
coronary artery bypass grafting can be considered, as they have shown
similar efficacy in terms of major adverse cardiac events, but there may
be a slightly higher risk of death with percutaneous coronary
intervention. For proximal left anterior descending artery disease, both
percutaneous coronary intervention and coronary artery bypass grafting are
viable options, but coronary artery bypass grafting has shown lower rates
of repeat revascularization and better relief from angina. The Synergy
Between PCI with Taxus and Cardiac Surgery score can help in
decision-making by predicting the risk of adverse events and guiding the
choice between percutaneous coronary intervention and coronary artery
bypass grafting. European and American guidelines both agree with
including a heart team that can develop and lay out individualized,
optimal treatment options with respect for patient preferences.
<br/>Summary: The debate between coronary artery bypass grafting versus
percutaneous coronary intervention in multiple different scenarios will
continue to develop as technology and techniques improve for both
procedures. Risk factors, pre, peri, and post-procedural complications
involved in both revascularization strategies will continue to be
mitigated to optimize outcomes for those patients for which coronary
artery bypass grafting or percutaneous coronary intervention provide
ultimate benefit. Methods to avoid unnecessary revascularization continue
to develop as well as percutaneous technology that may allow patients to
avoid surgical intervention when possible. With such changes,
revascularization guidelines for specific patient populations may change
in the coming years, which can serve as a limitation of this time-dated
review.<br/>Copyright &#xa9; The Author(s), under exclusive licence to
Springer Science+Business Media, LLC, part of Springer Nature 2024.

<41>
Accession Number
2034413831
Title
De-escalation to ticagrelor monotherapy versus 12 months of dual
antiplatelet therapy in patients with and without acute coronary
syndromes: a systematic review and individual patient-level meta-analysis
of randomised trials.
Source
The Lancet. 404(10456) (pp 937-948), 2024. Date of Publication: 07 Sep
2024.
Author
Valgimigli M.; Hong S.-J.; Gragnano F.; Chalkou K.; Franzone A.; da Costa
B.R.; Baber U.; Kim B.-K.; Jang Y.; Chen S.-L.; Stone G.W.; Hahn J.-Y.;
Windecker S.; Gibson M.C.; Song Y.B.; Ge Z.; Vranckx P.; Mehta S.; Gwon
H.-C.; Lopes R.D.; Dangas G.D.; McFadden E.P.; Angiolillo D.J.; Leonardi
S.; Heg D.; Calabro P.; Juni P.; Mehran R.; Hong M.-K.
Institution
(Valgimigli) Department of Biomedical Sciences, University of Italian
Switzerland, Lugano, Switzerland
(Valgimigli) Cardiocentro Ticino Institute, Ente Ospedaliero Cantonale,
Lugano, Switzerland
(Hong, Kim, Jang, Hong) Division of Cardiology, Severance Hospital, Yonsei
University College of Medicine, Seoul, South Korea
(Gragnano, Calabro) Department of Translational Medical Sciences,
University of Campania Luigi Vanvitelli, Caserta, Italy
(Chalkou, Heg) Department of Clinical Research, University of Bern, Bern,
Switzerland
(Franzone) Department of Advanced Biomedical Sciences, University of
Naples Federico II, Naples, Italy
(da Costa, Juni) Clinical Trial Service Unit and Epidemiological Studies
Unit, Nuffield Department of Population Health, University of Oxford,
Oxford, United Kingdom
(Baber) University of Oklahoma Health Sciences Center, Oklahoma City, OK,
United States
(Chen, Ge) Nanjing First Hospital, Nanjing Medical University, Nanjing,
China
(Stone, Dangas, Mehran) Icahn School of Medicine at Mount Sinai, New York,
NY, United States
(Hahn, Song, Gwon) Heart Vascular Stroke Institute, Samsung Medical
Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
(Windecker) Department of Cardiology, Bern University Hospital, University
of Bern, Bern, Switzerland
(Gibson) Division of Cardiology, Beth Israel Deaconess Medical Center,
Boston, MA, United States
(Vranckx) Department of Cardiology and Critical Care Medicine, Hartcentrum
Hasselt, Jessa Ziekenhuis, Belgium
(Mehta) Department of Medicine, McMaster University, Hamilton, Hamilton
Health Sciences, Hamilton, ON, Canada
(Lopes) Duke Clinical Research Institute, Duke University School of
Medicine, Durham, NC, United States
(McFadden) Department of Cardiology, Cork University Hospital, Cork,
Ireland
(Angiolillo) Division of Cardiology, University of Florida College of
Medicine, Jacksonville, FL, United States
(Leonardi) Department of Cardiology, University of Pavia and Fondazione
IRCCS Policlinico S Matteo, Pavia, Italy
Publisher
Elsevier B.V.
Abstract
Background: Dual antiplatelet therapy (DAPT) for 12 months is the standard
of care after coronary stenting in patients with acute coronary syndrome
(ACS). The aim of this individual patient-level meta-analysis was to
summarise the evidence comparing DAPT de-escalation to ticagrelor
monotherapy versus continuing DAPT for 12 months after coronary
drug-eluting stent implantation. <br/>Method(s): A systematic review and
individual patient data (IPD)-level meta-analysis of randomised trials
with centrally adjudicated endpoints was performed to evaluate the
comparative efficacy and safety of ticagrelor monotherapy (90 mg twice a
day) after short-term DAPT (from 2 weeks to 3 months) versus 12-month DAPT
in patients undergoing percutaneous coronary intervention with a coronary
drug-eluting stent. Randomised trials comparing P2Y<inf>12</inf> inhibitor
monotherapy with DAPT after coronary revascularisation were searched in
Ovid MEDLINE, Embase, and two websites (www.tctmd.com and
www.escardio.org) from database inception up to May 20, 2024. Trials that
included patients with an indication for long-term oral anticoagulants
were excluded. The risk of bias was assessed using the revised Cochrane
risk-of-bias tool. The principal investigators of the eligible trials
provided IPD by means of an anonymised electronic dataset. The three
ranked coprimary endpoints were major adverse cardiovascular or
cerebrovascular events (MACCE; a composite of all-cause death, myocardial
infarction, or stroke) tested for non-inferiority in the per-protocol
population; and Bleeding Academic Research Consortium (BARC) 3 or 5
bleeding and all-cause death tested for superiority in the
intention-to-treat population. All outcomes are reported as Kaplan-Meier
estimates. The non-inferiority was tested using a one-sided alpha of 0.025
with the prespecified non-inferiority margin of 1.15 (hazard ratio [HR]
scale), followed by the ranked superiority testing at a two-sided alpha of
0.05. This study is registered with PROSPERO (CRD42024506083).
<br/>Finding(s): A total of 8361 unique citations were screened, of which
610 records were considered potentially eligible during the screening of
titles and abstracts. Of these, six trials that randomly assigned patients
to ticagrelor monotherapy or DAPT were identified. De-escalation took
place a median of 78 days (IQR 31-92) after intervention, with a median
duration of treatment of 334 days (329-365). Among 23 256 patients in the
per-protocol population, MACCE occurred in 297 (Kaplan-Meier estimate
2.8%) with ticagrelor monotherapy and 332 (Kaplan-Meier estimate 3.2%)
with DAPT (HR 0.91 [95% CI 0.78-1.07]; p=0.0039 for non-inferiority;
tau²<0.0001). Among 24 407 patients in the intention-to-treat
population, the risks of BARC 3 or 5 bleeding (Kaplan-Meier estimate 0.9%
vs 2.1%; HR 0.43 [95% CI 0.34-0.54]; p<0.0001 for superiority;
tau²=0.079) and all-cause death (Kaplan-Meier estimate 0.9% vs
1.2%; 0.76 [0.59-0.98]; p=0.034 for superiority; tau²<0.0001)
were lower with ticagrelor monotherapy. Trial sequential analysis showed
strong evidence of non-inferiority for MACCE and superiority for bleeding
among the overall and ACS populations (the z-curve crossed the monitoring
boundaries or the required information size without crossing the futility
boundaries or approaching the null). The treatment effects were
heterogeneous by sex for MACCE (p interaction=0.041) and all-cause death
(p interaction=0.050), indicating a possible benefit in women with
ticagrelor monotherapy, and by clinical presentation for bleeding (p
interaction=0.022), indicating a benefit in ACS with ticagrelor
monotherapy. <br/>Interpretation(s): Our study found robust evidence that,
compared with 12 months of DAPT, de-escalation to ticagrelor monotherapy
does not increase ischaemic risk and reduces the risk of major bleeding,
especially in patients with ACS. Ticagrelor monotherapy might also be
associated with a mortality benefit, particularly among women, which
warrants further investigation. <br/>Funding(s): Cardiocentro Ticino
Institute, Ente Ospedaliero Cantonale.<br/>Copyright &#xa9; 2024 Elsevier
Ltd

<42>
Accession Number
2034403260
Title
A COMPARITIVE STUDY OF ETOMIDATE-LIPURO AND PROPOFOL-LIPURO INDUCTION
CHARACTERISTICS IN CARDIAC PATIENTS FOR NON-CARDIAC SURGERY.
Source
Journal of Cardiovascular Disease Research. 15(6) (pp 1509-1517), 2024.
Date of Publication: 2024.
Author
Ragashree C.M.; Harish G.L.K.; Mahilamani P.P.
Institution
(Ragashree, Harish) Department of Anaesthesia, Sree Mookambika Institute
of Medical Sciences, Tamilnadu, Kanyakumari, India
(Mahilamani) Department of Anaesthesia, Sree Mookambika Institute of
Medical Sciences, Tamilnadu, Kanyakumari, India
(Ragashree) Department of Anaesthesia, Sree Mookambika Institute of
Medical Sciences, Tamilnadu, Kanyakumari, India
Publisher
EManuscript Technologies
Abstract
Background: For cardiac patients, the induction of anesthesia is a crucial
stage. For these patients, the anesthetic induction methods are typically
chosen with hemodynamic stability and minimizing the stress response
during intubation. In order to compare the hemodynamic parameters during
induction and recovery using etomidate-lipuro and propofol-lipuro in
cardiac patients, this study was conducted. <br/>Material(s) and
Method(s): A prospective, randomized, double-blind study, 60 cardiac
patients of either sex who were scheduled for elective non-cardiac surgery
between the ages of 40-70 of American Society of Anesthesiologists Grade
II and III classifications were split into two groups of 30 each. The
premedication consisted of injections of fentanyl, midazolam, and
glycopyrrolate. Inj. propofol-Lipuro (2 mg/kg) were used for induction in
Group A, while Inj. etomidate-Lipuro (0.3 mg/kg) were used in Group B.
Inj. Rocuronium hydrobromide (0.6 mg/kg) were then administered for
intubation, and anesthesia was maintained with 40% oxygen, 60% N2O, and
0.5-2% isoflurane. Two groups were compared with respect to pain on
injection, the induction time, myoclonus and apnea. Hemodynamics,
Bispectral index scale, ETCO2, SPO2 and electrocardiography were monitored
before induction of anesthesia, immediately after induction, at
intubation, at 1,3,5 mins, and every 10 mins interval till the end of
surgery. <br/>Result(s): Incidence of apnea, pain on injection and
induction time was less, but myoclonus and post-operative nausea and
vomiting was more in Group B as compared to Group A. The mean heart rate
was comparable in the two groups. The mean systolic blood pressure
measured up to 15 mins was on the lower side in Group A as compared to
Group B. <br/>Conclusion(s): Both intravenous induction agents are useful
for anesthetizing cardiac patients; however, etomidate demonstrated
superior hemodynamic stability, faster induction, and a lower incidence of
apnea and injection pain when compared to propofol.<br/>Copyright &#xa9;
2024 EManuscript Technologies. All rights reserved.

<43>
Accession Number
2034370249
Title
The Effect of Stress Ball on Anxiety and Pain Levels in Angiography: A
Randomized Controlled Trial.
Source
Cardiovascular Therapeutics. 2024 (no pagination), 2024. Article Number:
5049092. Date of Publication: 2024.
Author
Yuksel D.; Gunes D.
Institution
(Yuksel) Bingol State Hospital, Bingol, Turkey
(Gunes) Firat University, Faculty of Health Science, Department of
Surgical Nursing, Elazig, Turkey
Publisher
Hindawi Limited
Abstract
Background: Coronary angiography, an invasive diagnostic procedure, often
induces pain and anxiety in patients. Despite the potential for
alleviating discomfort, the use of stress balls as a nonpharmacological
intervention during angiography remains underexplored. <br/>Objective(s):
This study is aimed at investigating the impact of stress ball application
on pain and anxiety levels in patients undergoing angiography.
<br/>Method(s): This randomized controlled trial was conducted on adult
patients undergoing angiography at a Cardiovascular Surgery Clinic in
Eastern Turkey between January 2023 and June 2023. A total of 120 patients
were randomly assigned to receive stress ball application in addition to
routine care. Data collection utilized the Numerical Rating Scale (NRS),
Patient Information Form, and State-Trait Anxiety Inventory (STAI).
<br/>Result(s): Analysis revealed a significantly lower increase in mean
NRS posttest scores among patients in the experimental group compared to
the control group (p<0.05). Additionally, the mean STAI posttest score
demonstrated a significant decrease (p<0.05) in the experimental group. A
positive and significant correlation was observed between the mean NRS and
STAI posttest scores among study group patients (p<0.05), indicating a
reduction in anxiety levels with decreasing pain. <br/>Conclusion(s): The
application of stress balls during angiography was associated with
decreased anxiety and pain levels in patients. Stress ball intervention
may serve as a beneficial adjunct to pharmacological treatments. This
study underscores the potential of nonpharmacological interventions in
enhancing patient comfort during invasive procedures.Trial Registration:
ClinicalTrials.gov Identifier: NCT06131606
(http://clinicaltrials.gov).<br/>Copyright &#xa9; 2024 Dilan Yuksel and
Dilek Gunes.

<44>
Accession Number
2031275412
Title
Comparison of postoperative analgesia by thoracoscopic-guided thoracic
paravertebral block and thoracoscopic-guided intercostal nerve block in
uniportal video-asssited thoracic surgery: a prospective randomized
controlled trial.
Source
World Journal of Surgical Oncology. 22(1) (no pagination), 2024. Article
Number: 238. Date of Publication: December 2024.
Author
Xu X.; Zhang M.; Li Y.; Du J.-H.; He J.-X.; Hu L.-H.
Institution
(Xu, Zhang, Li, Du, Hu) Department of Anesthesiology, The Affiliated
Lihuili Hospital of Ningbo University, No.57 Xingning road, Ningbo 315040,
China
(He) Department of Thoracic Surgery, The Affiliated Lihuili Hospital of
Ningbo University, Ningbo, China
Publisher
BioMed Central Ltd
Abstract
Background: Thoracoscopic-guided thoracic paravertebral nerve block
(TG-TPVB) and thoracoscopic-guided intercostal nerve block (TG-INB) are
two postoperative analgesia technology for thoracic surgery. This study
aims to compared the analgesic effect of TG-TPVB and TG-INB after
uniportal video-asssited thoracic surgery (UniVATS). <br/>Method(s):
Fifty-eight patients were randomly allocated to the TG-TPVB group and the
TG-INB group. The surgical time of nerve block, the visual analog scale
(VAS) scores, the consumption of sufentanil and the number of
patient-controlled intravenous analgesic (PCIA) presses within 24 h after
surgery, the incidence of adverse reactions were compared between the two
groups. <br/>Result(s): The VAS scores were significantly lower during
rest and coughing at 2, 6, 12, and 24 h in the TG-TPVB group than in the
TG-INB group (P < 0.05). The consumption of sufentanil and the number of
PCIA presses within 24 h after surgery were significantly lower in the
TG-TPVB group than in the TG-INB group (P < 0.001).The surgical time of
nerve block was significantly shorter in the TG-TPVB group than in the
TG-INB group (P < 0.001). The incidence of bleeding at the puncture point
was lower in the TG-TPVB group than that in the TG-INB group (P < 0.05).
<br/>Conclusion(s): TG-TPVB demonstrated superior acute pain relieve after
uniVATS, shorter surgical time and non-inferior adverse effects than
TG-INB.<br/>Copyright &#xa9; The Author(s) 2024.

<45>
Accession Number
2034413210
Title
SODIUM BICARBONATE INFUSION: TO PREVENT CARDIAC SURGERY ASSOCIATED ACUTE
KIDNEY INJURY.
Source
Journal of Cardiovascular Disease Research. 15(5) (pp 1774-1780), 2024.
Date of Publication: 2024.
Author
Vijayalakshmi B.
Institution
(Vijayalakshmi) Department of Cardiothoracic Surgery, Siddhartha Medical
College, Andhra Pradesh, Vijayawada, India
Publisher
EManuscript Technologies
Abstract
Introduction:Acute kidney injury (AKI) is a frequent and severe
postoperative complication in patients undergoing cardiac surgery with an
incidence varying from 36.3 to 52.0%. With increasing interest, this topic
has been specifically referred to as cardiac surgery-associated acute
kidney injury (CSA-AKI). CSA-AKI could contribute to increased in-hospital
mortality, 5-year mortality, 30-day readmission, requirement for renal
replacement therapy (RRT), ICU length of stay, and total postoperative
cost. <br/>Material(s) and Method(s):Informed and written consent was
obtained from all the patients. Study was done in the period of April 2023
to April 2024 at Department of Cardiothoracic surgery, Siddhartha Medical
College, Vijayawada, Andhra Pradesh, India. This study was a double-blind,
randomized controlled trial designed to assess if the administration of
sodium bicarbonate as a continuous infusion commenced prior to
cardiopulmonary bypass would result in less postoperative acute renal
dysfunction in patients undergoing cardiac surgery. This prospective study
enrolled 70 consecutive patients who underwent on pump cardiac surgery. A
Microsoft Excel based random-number generator was used to create the
randomization list. <br/>Result(s):The patients were distributed into two
groups on the basis of either they received sodium bicarbonate or sodium
chloride. No statistical difference between the groups was detected in
terms of age (41.83 +/- 13.742 vs 46.78 +/- 13.250) days, P=0.331; age
range, 18 year-80 years), weight (49.18 +/- 10.415 vs 56.18 +/- 17.668 kg,
P =0.183, and duration of CPB (93.2857 +/- 33.79913 vs 105.8429 +/-
41.68955 minutes, P=0.270) and in cross clamp time (67.1143 +/- 27.20110
vs 75.9143 +/- 37.93539 minutes, P=0.079). <br/>Conclusion(s):In patients
at high risk of CSA-AKI, bicarbonate infusion alkalinized both blood and
urine but did not result in a decrease in the prevalence of CSA-AKI. On
this basis of these results, we have concluded that, the use of
perioperative infusions of sodium bicarbonate may not reduce the CSA-AKI
in this patient group.<br/>Copyright &#xa9; 2024 EManuscript Technologies.
All rights reserved.

<46>
Accession Number
2034413100
Title
Impact of Local Forearm Heating on Pain Intensity and Hemorrhage in
Patients Undergoing Radial Artery Cardiac Catheterization: A Pilot Study.
Source
Anatolian Journal of Cardiology. 28(7) (pp 339-344), 2024. Date of
Publication: July 2024.
Author
Shamsian A.; Mehr A.Z.; Tayebi P.; Fathollahi M.S.; Amin K.; Shabani F.;
Daryabari Y.
Institution
(Shamsian, Shabani) Cardiovascular Nursing Research Center, Rajaie
Cardiovascular Medical and Research Center, Iran University of Medical
Sciences, Tehran, Iran, Islamic Republic of
(Mehr) Cardiovascular Intervention Research Center, Rajaie Cardiovascular
Medical and Research Center, Iran University of Medical Sciences, Tehran,
Iran, Islamic Republic of
(Tayebi, Daryabari) Department of Vascular and Endovascular Surgery,
Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran,
Islamic Republic of
(Fathollahi) Rajaie Cardiovascular Medical and Research Center, Iran
University of Medical Sciences, Tehran, Iran, Islamic Republic of
(Amin) Department of Cardiology, Faculty of Medicine, Babol University of
Medical Sciences, Babol, Iran, Islamic Republic of
Publisher
Turkish Society of Cardiology
Abstract
Background: Radial artery cardiac catheterization is a common diagnostic
and interventional procedure for cardiovascular conditions. Pain and
hemorrhage at the access site can cause patient discomfort and
complications. This pilot study investigates the potential of local
forearm heating to reduce pain and hemorrhage in patients undergoing
radial artery cardiac catheterization. <br/>Method(s): We enrolled 100
patients scheduled for radial artery cardiac catheterization and randomly
assigned them to the heating or control group. The heating group received
local forearm heating before sheath removal, while the control group did
not. Pain intensity was assessed with a visual analog scale, and
hemorrhage was measured by assessing ecchymosis or hematoma size at the
catheterization site. Hemodynamic parameters were also monitored.
Statistical analysis compared outcomes between the groups. <br/>Result(s):
Patients who received local forearm heating had significantly lower pain
intensity (4.15 +/- 2.73) compared to the control group (5.84 +/- 3.34)
(P= .009). Hemodynamic parameters and the extent of hemorrhage at the
catheterization site did not significantly differ between the heating and
control groups (P> .05). No adverse effects related to forearm heating
were reported. <br/>Conclusion(s): Local forearm heating is a promising
intervention to reduce pain intensity without increasing hemorrhage or
affecting hemodynamic parameters during radial artery cardiac
catheterization. This simple, noninvasive approach has the potential to
enhance patient comfort and safety post
procedure.<br/>Copyright@Author(s).

<47>
Accession Number
2034411844
Title
Effect of minimally invasive cardiac surgery on hospital length of stay: A
systematic review and meta-analysis.
Source
Acta Anaesthesiologica Belgica. 75(3) (pp 197-214), 2024. Date of
Publication: September 2024.
Author
Hoogma D.F.; van Bos T.; Polfliet F.; Verbrugghe P.; Oosterlinck W.; van
Den Eynde J.; Rex S.
Institution
(Hoogma, van Bos, Rex) University Hospitals Leuven, Department of
Anesthesiology, KU Leuven, Herestraat 49, Leuven B-3000, Belgium
(Hoogma, Verbrugghe, Oosterlinck, van Den Eynde, Rex) University of
Leuven, Biomedical Sciences Group, Department of Cardiovascular Sciences,
KU Leuven, Herestraat 49, Leuven 3000, Belgium
(Polfliet) Jessa Hospital, Department of Anesthesiology, Stadsomvaart 11,
Hasselt 3500, Belgium
(Verbrugghe, Oosterlinck) University Hospitals Leuven, Department of
Cardiac Surgery, KU Leuven, Herestraat 49, Leuven 3000, Belgium
Publisher
BeSARPP
Abstract
Background: Perioperative management using minimally invasive cardiac
surgery (MICS), compared to full sternotomy (FS) cardiac surgery, is
considered to improve postoperative recovery, and reduce hospital length
of stay (LOS). <br/>Method(s): A comprehensive systematic search was
conducted across MEDLINE/PubMed, Embase, and the Cochrane library to
identify RCT comparing MICS to FS approach for aortic valve, mitral valve,
and coronary artery bypass surgery. Meta-analysis of extracted data was
performed using random effects models. <br/>Result(s): A total of 33 RCTs
including 2920 patients were identified. Overall MD (95% CI) for hospital
and intensive care unit (ICU) LOS after MICS was significantly shorter
compared to FS (-0.88 days (-1.55;-0.20), p<0.013; 2606 patients) and
(-0.23 days (-0.41;-0.05), p=0.012; 2242 patients), respectively.
Additionally, postoperative blood loss was reduced with the use of MICS,
(-192.07 ml (-292.32;-91.82), p=0.002; 718 patients). There was no
evidence for differences between both groups in terms of postoperative
ventilation times, duration of surgery, reintervention rate, incidence of
postoperative atrial fibrillation or stroke, hospital mortality, or 1-year
mortality. <br/>Conclusion(s): Within the limitations of a meta-analysis,
MICS was found to be effective in promoting faster recovery by reducing
postoperative blood loss, ICU, and hospital LOS.<br/>Copyright &#xa9; 2024
BeSARPP. All rights reserved.

<48>
Accession Number
2031275600
Title
The Impact of Different Regional Anesthesia Techniques on the Incidence of
Chronic Post-surgical Pain in Patients Undergoing Video-Assisted
Thoracoscopic Surgery: A Network Meta-analysis.
Source
Pain and Therapy. (no pagination), 2024. Date of Publication: 2024.
Author
Zhao Y.; Guo Y.; Pan X.; Zhang X.; Yu F.; Cao X.
Institution
(Zhao, Pan, Zhang, Yu, Cao) Department of Anesthesiology, The First
Hospital of China Medical University, Shenyang 110001, China
(Guo) Department of General Surgery, Hepatobiliary and Splenic Surgery
Ward, Shengjing Hospital of China Medical University, Shenyang, China
Publisher
Adis
Abstract
Introduction: Chronic post-surgical pain (CPSP) remains a prevalent issue
following video-assisted thoracic surgery (VATS), despite advancements in
surgical techniques. Various regional anesthesia techniques, including
thoracic paravertebral block (PVB), intercostal nerve block (ICNB),
serratus anterior plane block (SAPB), erector spinae plane block (ESPB),
and thoracic epidural anesthesia (TEA), have been employed in VATS
procedures to mitigate this issue. This study aims to compare the efficacy
of these analgesia methods in reducing the incidence of CPSP in VATS
patients through a network meta-analysis. <br/>Method(s): A systematic
search was conducted in PubMed, the Cochrane Library, and EMBASE for
randomized controlled trials (RCTs) comparing the incidence of CPSP
associated with PVB, ICNB, SAPB, ESPB, and TEA. The occurrence of CPSP was
evaluated at both 2-3 months and 6 months post-surgery. <br/>Result(s):
Six RCTs, involving 652 patients, were included in the analysis of CPSP
incidence at 2-3 months, while seven RCTs, involving 715 patients, were
included for 6 months analysis. PVB, ICNB, or TEA reduced CPSP incidence
compared with control group (without regional anesthesia techniques) at
both 2-3 months and 6 months post-surgery. However, SAPB was found less
effective in reducing CPSP incidence at 2-3 months post-VATS compared to
PVB, ICNB, or TEA. <br/>Conclusion(s): PVB, ICNB, and TEA exhibit
significant effects on reducing CPSP incidence following VATS. Conversely,
SAPB is not recommended for reducing CPSP incidence post-VATS.
Nonetheless, considering the limitation of a small sample size in this
network meta-analysis, additional RCTs are necessary to validate these
conclusions and enhance the management of CPSP after VATS.<br/>Copyright
&#xa9; The Author(s) 2024.

<49>
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

<50>
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.

<51>
Accession Number
2031179157
Title
Clopidogrel Versus Aspirin as Monotherapy Following Dual Antiplatelet
Therapy in Patients With Acute Coronary Syndrome Receiving a Drug-Eluting
Stent: A Systematic Literature Review and Meta-Analysis.
Source
Clinical Cardiology. 47(9) (no pagination), 2024. Article Number: e24326.
Date of Publication: September 2024.
Author
Sibbing D.; Nicolas J.; Spirito A.; Vogel B.; Cao D.; Stipek W.; Kasireddy
E.; Qian A.; Khan I.; Mehran R.
Institution
(Sibbing) Department of Internal Medicine, Ludwig-Maximilians-Universitat
Munchen, Munich, Germany
(Nicolas, Spirito, Vogel, Cao, Mehran) Division of Cardiology, Icahn
School of Medicine at Mount Sinai, New York, NY, United States
(Stipek, Khan) Sanofi, Bridgewater, NJ, United States
(Kasireddy, Qian) Evidinno Research Outcomes Inc., Vancouver, BC, Canada
Publisher
John Wiley and Sons Inc
Abstract
Objective: This study aimed to evaluate the comparative effectiveness and
safety of clopidogrel versus aspirin as monotherapy following adequate
dual antiplatelet therapy (DAPT) in patients with acute coronary syndrome
(ACS). <br/>Method(s): MEDLINE, Embase, and CENTRAL were searched from
database inception to September 1, 2023. Randomized controlled trials
(RCTs) and observational studies evaluating the effectiveness or safety of
clopidogrel versus aspirin as monotherapy following DAPT in patients with
ACS who received a drug-eluting stent were included. Random-effects
meta-analyses were conducted to compare risks of major adverse
cardiovascular events (MACE) and clinically relevant bleeding.
<br/>Result(s): Of 6242 abstracts identified, three unique studies were
included: one RCT and two retrospective cohort studies. Studies included a
total of 7081 post-percutaneous coronary intervention ACS patients, 4260
of whom received aspirin monotherapy and 2821 received clopidogrel
monotherapy. Studies included variable proportions of patients with
ST-elevation myocardial infarction (STEMI), non-STEMI, and unstable
angina. From the meta-analysis, clopidogrel was associated with a 28%
reduction in the risk of MACE compared with aspirin (hazard ratio [HR]:
0.72; 95% confidence interval [CI]: 0.54, 0.98), with no significant
difference in clinically relevant bleeding (HR: 0.92; 95% CI: 0.68, 1.24).
<br/>Conclusion(s): Despite the paucity of published evidence on the
effectiveness and safety of clopidogrel versus aspirin in patients with
ACS post-drug-eluting stent implantation, this meta-analysis suggests that
clopidogrel versus aspirin may result in a lower risk of MACE, with a
similar risk of major bleeding. The present results are
hypothesis-generating and further large RCTs comparing antiplatelet
monotherapy options in ACS patients are warranted.<br/>Copyright &#xa9;
2024 The Author(s). Clinical Cardiology published by Wiley Periodicals,
LLC.

<52>
Accession Number
2029808831
Title
Coronary sodium [¹⁸F]fluoride activity predicts outcomes
post-CABG: a comparative evaluation with conventional metrics.
Source
European Journal of Nuclear Medicine and Molecular Imaging. 51(11) (pp
3235-3251), 2024. Date of Publication: September 2024.
Author
Gao M.; Wen W.; Li H.; Zheng Y.; Yun M.; Meng J.; Wang S.; Wang B.; Hu B.;
Mou T.; Yu Y.; Zhang X.; Li X.
Institution
(Gao, Wen, Yun, Meng, Hu, Mou, Zhang) Department of Nuclear Medicine,
Molecular Imaging Lab, Beijing Anzhen Hospital, Capital Medical
University, No.2, Anzhen Road, Chaoyang District, Beijing 10029, China
(Gao, Li, Zheng, Wang, Wang, Yu) Department of Cardiac Surgery, Beijing
Anzhen Hospital, Capital Medical University, No. 2, Anzhen Road, Chaoyang
District, Beijing 100029, China
(Li) Division of Nuclear Medicine, Department of Biomedical Imaging and
Image-guided Therapy, Vienna General Hospital, Medical University of
Vienna, Vienna, Austria
Publisher
Springer
Abstract
Purpose: The value of preoperative multidisciplinary approach remains
inadequately delineated in forecasting postoperative outcomes of patients
undergoing coronary artery bypass grafting (CABG). Herein, we aimed to
ascertain the efficacy of multi-modality cardiac imaging in predicting
post-CABG cardiovascular outcomes. <br/>Method(s): Patients with triple
coronary artery disease underwent cardiac sodium [¹⁸F]fluoride
([¹⁸F]NaF) positron emission tomography/computed tomography
(PET/CT), coronary angiography, and CT-based coronary artery calcium
scoring before CABG. The maximum coronary [¹⁸F]NaF activity
(target-to-blood ratio [TBR]<inf>max</inf>) and the global coronary
[¹⁸F]NaF activity (TBR<inf>global</inf>) was determined. The
primary endpoint was perioperative myocardial infarction (PMI) within
7-day post-CABG. Secondary endpoint included major adverse cardiac and
cerebrovascular events (MACCEs) and recurrent angina. <br/>Result(s): This
prospective observational study examined 101 patients for a median of 40
months (interquartile range: 19-47 months). Both TBR<inf>max</inf> (odds
ratio [OR] = 1.445; p = 0.011) and TBR<inf>global</inf> (OR = 1.797; P =
0.018) were significant predictors of PMI. TBR<inf>max</inf>>3.0 (area
under the curve [AUC], 0.65; sensitivity, 75.0%; specificity, 56.8%; p =
0.036) increased PMI risk by 3.661-fold, independent of external
confounders. Kaplan-Meier test revealed a decrease in MACCE survival rate
concomitant with an escalating TBR<inf>max</inf>. TBR<inf>max</inf>>3.6
(AUC, 0.70; sensitivity, 76.9%; specificity, 73.9%; p = 0.017) increased
MACCEs risk by 5.520-fold. Both TBR<inf>max</inf> (hazard ratio [HR],
1.298; p = 0.004) and TBR<inf>global</inf> (HR = 1.335; p = 0.011) were
significantly correlated with recurrent angina. No significant
associations were found between CAC and SYNTAX scores and between PMI
occurrence and long-term MACCEs. <br/>Conclusion(s): Quantification of
coronary microcalcification activity via [¹⁸F]NaF PET displayed
a strong ability to predict early and long-term post-CABG cardiovascular
outcomes, thereby outperforming conventional metrics of coronary
macrocalcification burden and stenosis severity. Trial registration: : The
trial was registered with the Chinese Clinical Trial Committee (number:
ChiCTR1900022527; URL:
www.chictr.org.cn/showproj.html?proj=37933).<br/>Copyright &#xa9; The
Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part
of Springer Nature 2024.

<53>
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).

<54>
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).

<55>
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.

<56>
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.

<57>
[Use Link to view the full text]
Accession Number
2034285560
Title
2024 AHA/ACC/AMSSM/HRS/PACES/SCMR Guideline for the Management of
Hypertrophic Cardiomyopathy: A Report of the American Heart
Association/American College of Cardiology Joint Committee on Clinical
Practice Guidelines.
Source
Circulation. 149(23) (pp e1239-e1311), 2024. Date of Publication: 04 Jun
2024.
Author
Ommen S.R.; Ho C.Y.; Asif I.M.; Balaji S.; Burke M.A.; Day S.M.; Dearani
J.A.; Epps K.C.; Evanovich L.; Ferrari V.A.; Joglar J.A.; Khan S.S.; Kim
J.J.; Kittleson M.M.; Krittanawong C.; Martinez M.W.; Mital S.; Naidu
S.S.; Saberi S.; Semsarian C.; Times S.; Waldman C.B.
Institution
(Ommen, Ho, Martinez, Mital, Naidu, Saberi, Semsarian) AMSSM
Representative, United States
(Asif, Burke, Day, Dearani, Epps) HRS Representative, United States
(Balaji, Waldman) Lay Stakeholder Representative, United States
(Evanovich, Joglar) AHA/ACC Joint Committee on Clinical Practice
Guidelines Liaison, United States
(Evanovich, Kittleson) SCMR Representative, United States
(Ferrari) Joint Committee on Performance Measures Representative, United
States
(Khan) PACES Representative, United States
(Kim) ACC/AHA Joint Committee on Clinical Data Standards Representative,
United States
(Krittanawong) Joint ACC/AHA Staff Representative, United States
(Times) Former Joint Committee on Clinical Practice Guidelines Member,
United States
Publisher
Lippincott Williams and Wilkins
Abstract
AIM: The "2024 AHA/ACC/AMSSM/HRS/PACES/SCMR Guideline for the Management
of Hypertrophic Cardiomyopathy"provides recommendations to guide
clinicians in the management of patients with hypertrophic cardiomyopathy.
<br/>METHOD(S): A comprehensive literature search was conducted from
September 14, 2022, to November 22, 2022, encompassing studies, reviews,
and other evidence on human subjects that were published in English from
PubMed, EMBASE, the Cochrane Library, the Agency for Healthcare Research
and Quality, and other selected databases relevant to this guideline.
Additional relevant studies, published through May 23, 2023, during the
guideline writing process, were also considered by the writing committee
and added to the evidence tables, where appropriate. STRUCTURE:
Hypertrophic cardiomyopathy remains a common genetic heart disease
reported in populations globally. Recommendations from the "2020 AHA/ACC
Guideline for the Diagnosis and Treatment of Patients With Hypertrophic
Cardiomyopathy"have been updated with new evidence to guide
clinicians.<br/>Copyright &#xa9; 2024 by the American Heart Association,
Inc.

<58>
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.

<59>
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.

<60>
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.

<61>
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.

<62>
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.

<63>
[Use Link to view the full text]
Accession Number
2033992028
Title
Mechanical circulatory support devices in adults with congenital heart
disease.
Source
Current Opinion in Organ Transplantation. 29(5) (pp 310-315), 2024. Date
of Publication: 01 Oct 2024.
Author
Garba D.L.; Joseph S.; Cedars A.
Institution
(Garba, Cedars) Johns Hopkins Hospital, Baltimore, MD, United States
(Joseph) Thomas Jefferson Hospital, Philadelphia, PA, United States
Publisher
Lippincott Williams and Wilkins
Abstract
Purpose of review Mechanical circulatory support is used frequently as a
method of stabilizing patients with end stage heart failure who are unable
to safely await allograft availability. While this technology has been
fundamentally important in supporting patients with normal cardiac
anatomy, it is still used infrequently in adult patients with congenital
heart disease and end-stage heart failure. Here, we review the data on
mechanical circulatory support technology in this small but growing
population of patients with chronic heart disease prone to the development
of circulatory failure. Recent findings Mechanical circulatory support
(MCS) has been increasingly employed in adults with congenital heart
disease (ACHD) as a bridge to transplant. The new United Network for Organ
Sharing listing system favoring temporary MCS use with a higher listing
status offers another tool to stabilize ACHD patients and potentially
shorten wait times. Both temporary and Durable MCS could help improve
transplant candidacy and posttransplant outcomes in select groups of ACHD
patients. Summary Durable and temporary MCS have the potential to
significantly improve access to transplant and overall transplant outcomes
in ACHD patients.<br/>Copyright &#xa9; 2024 Lippincott Williams and
Wilkins. All rights reserved.

<64>
Accession Number
2033478692
Title
Improving Cardiac Rehabilitation Adherence in Patients With Lower
Socioeconomic Status A Randomized Clinical Trial.
Source
JAMA Internal Medicine. 184(9) (pp 1095-1104), 2024. Date of Publication:
03 Sep 2024.
Author
Gaalema D.E.; Khadanga S.; Savage P.D.; Yant B.; Katz B.R.; DeSarno M.;
Ades P.A.
Institution
(Gaalema, Yant, Katz) Department of Psychiatry, University of Vermont
Larner College of Medicine, Burlington, United States
(Gaalema) Department of Medicine, Division of Cardiology, University of
Texas Medical Branch, Galveston, United States
(Khadanga, Savage, Ades) Department of Medicine, Division of Cardiology,
University of Vermont, Burlington, United States
(DeSarno) Biomedical Statistics Research Core, University of Vermont,
Burlington, United States
Publisher
American Medical Association
Abstract
IMPORTANCE Participation in cardiac rehabilitation is associated with
significant decreases in morbidity and mortality. Despite the proven
benefits, cardiac rehabilitation is severely underutilized in certain
populations, specifically those with lower socioeconomic status (SES).
OBJECTIVE To assess the efficacy of early case management and/or financial
incentives for increasing cardiac rehabilitation adherence among patients
with lower SES. DESIGN, SETTING, AND PARTICIPANTS This randomized clinical
trial enrolled patients from December 2018 to December 2022. Participants
were followed up for 1 year with assessors and cardiac rehabilitation
staff blinded to study condition. Patients with lower SES with a cardiac
rehabilitation-qualifying diagnosis (myocardial infarction, coronary
artery bypass graft, percutaneous coronary intervention, heart valve
replacement/repair, or stable systolic heart failure) were recruited. Then
patients attended one of 3 cardiac rehabilitation programs at 1 university
or 2 community-based hospitals. A consecutively recruited sample was
randomized and stratified by age (<57 vs >=57 years) and smoking status
(current smoker vs nonsmoker or former smoker). INTERVENTION Participants
were randomized 2:3:3:3 to either a usual care control, case management
starting in-hospital, financial incentives for completing cardiac
rehabilitation sessions, or both interventions (case management plus
financial incentives). Interventions were in place for 4 months following
informed consent. MAIN OUTCOMES AND MEASURES The main outcome was cardiac
rehabilitation adherence (proportion of patients completing >=30
sessions). The a priori hypothesis was that interventions would improve
adherence, with the combined intervention performing best. RESULTS Of 314
individuals approached, 11 were ineligible, and 94 declined participation.
Of the 209 individuals who were randomized, 17 were withdrawn. A total of
192 individuals (67 [35%] female; mean [SD] age, 58 [11] years) were
included in the analysis. Interventions significantly improved cardiac
rehabilitation adherence with 4 of 36 (11%), 13 of 51 (25%), 22 of 53
(42%), and 32 of 52 (62%) participants completing at least 30 sessions in
the usual care, case management, financial incentives, and case management
plus financial incentives conditions, respectively. The financial
incentives and case management plus financial incentives conditions
significantly improved cardiac rehabilitation adherence vs usual care
(adjusted odds ratio [AOR], 5.1 [95% CI, 1.5-16.7]; P = .01; AOR, 13.2
[95% CI, 4.0-43.5]; P < .001, respectively), and the case management plus
financial incentives condition was superior to both case management or
financial incentives alone (AOR, 5.0 [95% CI, 2.1-11.9]; P < .001; AOR,
2.6 [95% CI, 1.2-5.9]; P = .02, respectively). Interventions were received
well by participants: 86 of 105 (82%) in the financial incentives
conditions earned at least some incentives, and 96 of 103 participants
(93%) assigned to a case manager completed the initial needs assessment.
CONCLUSION AND RELEVANCE In this randomized clinical trial, financial
incentives improved cardiac rehabilitation adherence in a population with
higher risk and lower SES with additional benefit from adding case
management.<br/>Copyright &#xa9; 2024 American Medical Association. All
rights reserved.

<65>
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.

<66>
Accession Number
2034421787
Title
Letter to the Editor: Comparative efficacy and safety of mitral valve
repair versus mitral valve replacement in rheumatic heart disease: A
high-value care systematic review and meta-analysis.
Source
Current Problems in Cardiology. 49(12) (no pagination), 2024. Article
Number: 102821. Date of Publication: December 2024.
Author
Barbosa L.M.; Queiroz I.
Institution
(Barbosa) Department of Medicine, Federal University of Minas Gerais, Belo
Horizonte, Brazil
(Queiroz) Department of Medicine, Catholic University of Pernambuco,
Recife, Brazil
Publisher
Elsevier Inc.

<67>
Accession Number
2034369110
Title
Extracorporeal Membrane Oxygenation-Supported Patient Outcome Undergoing
Transcatheter Aortic Valve Replacement.
Source
ASAIO Journal. (no pagination), 2024. Article Number:
10.1097/MAT.0000000000002305. Date of Publication: 2024.
Author
Banga A.; Bansal V.; Pattnaik H.; Amal T.; Agarwal A.; Guru P.K.
Institution
(Banga) Department of Medicine, Mount Auburn Hospital, Cambridge, MA,
United States
(Bansal) Department of Critical Care Medicine, Mayo Clinic, Rochester, MN,
United States
(Pattnaik) Department of Medicine, Lady Hardinge Medical College,
University of Delhi, Royal Oak, MI, United States
(Amal) Department of Internal Medicine, William Beaumont University
Hospital, Royal Oak, MI, United States
(Agarwal, Guru) Department of Critical Care Medicine, Mayo Clinic Florida,
Jacksonville, FL, United States
Publisher
Lippincott Williams and Wilkins
Abstract
The efficacy and safety of extracorporeal membrane oxygenation (ECMO)
support during transcatheter aortic valve replacement (TAVR) remains
unknown. We conducted a meta-analysis to compare benefit and risk of ECMO
in TAVR patients. Bibliographic databases were searched from inception to
January 1, 2024. Included studies involved patients >=18 years old
undergoing TAVR and using ECMO emergently or prophylactically. Mortality
and procedure success were primary outcomes. Peri- or postoperative
complications were the secondary outcomes. We identified 11 observational
studies, including 2,275 participants (415 ECMO and 1,860 non-ECMO). The
unadjusted mortality risk in ECMO-supported patient was higher than
non-ECMO patients (odds ratio [OR] 1.73). The mortality unadjusted risk
remained high (OR 3.89) and statistically significant for prophylactic
ECMO. Prophylactic ECMO had lower mortality risk compared with emergent
ECMO (OR 0.17). Extracorporeal membrane oxygenation-supported patients had
lower procedural success rate (OR 0.10). Extracorporeal membrane
oxygenation patients undergoing TAVR had significantly increased risk of
bleeding (OR 3.32), renal failure (OR 2.38), postoperative myocardial
infarction (OR 1.89), and stroke (OR 2.32) compared with non-ECMO
patients. Clinical results are not improved by ECMO support in patients
with high-risk TAVR. Prophylactic ECMO outperforms emergent. Overall, ECMO
support increases mortality and postoperative complications. Transcatheter
aortic valve replacement outcomes may improve with prophylactic ECMO in
high-risk situations.<br/>Copyright &#xa9; ASAIO 2024.

<68>
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.

<69>
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

<70>
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.

<71>
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.

<72>
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.

<73>
Accession Number
645170110
Title
Use of Corticosteroids on Prophylaxis of New-Onset Atrial Fibrillation
after Cardiac Surgery.
Source
QJM: An International Journal of Medicine. Conference: 43th Annual Ain
Shams Medical Congress. Cairo Egypt. 117(Supplement 1) (pp i39-i40), 2024.
Date of Publication: June 2024.
Author
Abdelsattar M.; Radwan A.; Wadie Nashed S.; Elagamy A.E.; Elshaer E.M.H.
Institution
(Abdelsattar, Radwan, Wadie Nashed, Elagamy, Elshaer) Intensive Care
Department, Faculty of Medicine, Ain Shams University, Egypt
Publisher
Oxford University Press
Abstract
Background: Most cardiac operations are performed under cardiopulmonary
bypass(CPB); however, it is well known that cardiopulmonary bypass often
causes systemic inflammatory response syndrome (SIRS). Cardiac tissue
inflammation induced by the CPB and surgical trauma has been previously
hypothesized to cause POAF. The relationship between inflammation and
atrial fibrillation after cardiac surgery is further strengthened by
studies that showed that corticosteroid (CS) prophylaxis can reduce the
occurrence of atrial fibrillation after cardiac surgery. Aim of the Work:
to determine the efficacy of corticosteroids in prophylaxis of POAF and
shorten length of intensive care unit (ICU) and hospital stay.
<br/>Patients and Methods: This is randomized controlled clinical trial on
84 patients who underwent their first elective cardiac surgery under
cardiopulmonary bypass in Ain Shams University Hospitals. Patients were
randomized into two equal groups (n=42 each) as the control group who
underwent a standard cardiopulmonary bypass without any additional
medication which was performed under the supervision of a specialized
elite and experts in their specialization, and the Methylprednisolone (MP)
group who was given 1 g of methylprednisolone (divided into 250mg every 6h
once in the ICU), The primary outcome is the overall occurrence of
postoperative AF during the first 72 hours after cardiac surgery.
Secondary outcomes are the length of hospital stay, and intensive care
unit (ICU) stay. <br/>Result(s): This study revealed that using
corticosteroids effective in reducing the incidence of POAF without
increasing the incidence of postoperative complications and adverse
effects due to corticosteroids therapy. This study showed decreased risk
of developing AF in patients undergoing cardiac surgery. The incidence of
POAF was found be significant lower in MP group 16.7% (7 patients
developed AF) versus 35.7% in the control group (15 patients developed AF)
(p 0.047). <br/>Conclusion(s): Use of Corticosteroids is effective in
prophylaxis of POAF in patients undergoing elective cardiac surgery in
terms of reducing its incidence and decreasing the length of ICU and
hospital stay.

<74>
Accession Number
645169693
Title
The Efficacy of Ultrasound Guided Bilateral Transversus Thoracic Plane
Block for Postoperative Pain Control in Cardiac Surgery.
Source
QJM: An International Journal of Medicine. Conference: 43th Annual Ain
Shams Medical Congress. Cairo Egypt. 117(Supplement 1) (pp i13), 2024.
Date of Publication: June 2024.
Author
Fahim J.N.Z.; Hassan B.E.E.; Abd-Elsalam E.H.; El-Shourbagy M.S.
Institution
(Fahim, Hassan, Abd-Elsalam, El-Shourbagy) 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 strategies intended to improve
patients' experience and outcomes. Traditionally, analgesia in these types
of surgeries has depended on large doses of I.V. opioids. Aim of the Work:
The aim of the study was to evaluate the effect of postoperative bilateral
US guided TTPB block on postoperative pain control in patients undergoing
cardiac surgery through mid-line sternotomy compared to systemic
analgesia. <br/>Patients and Methods: This study is a randomized clinical
trial study at Ain-shams University Hospitals, Cairo, Egypt. In our study,
patients were randomly allocated into two groups with 40 patients in each
group. Group 1 (study group) received TTP block., whereas Group 2(control
group) received systemic analgesics. The two groups were compared
regarding their demographic data (age, sex, body weight and height), A
numerical rating scale (NRS) for sternal pain, morphin consumption during
24 hours after extubation and time of first rescue analgesia, heart rate
and blood pressure in icu, time of extubation, ICU length of stay, total
length stay of the hospital. <br/>Result(s): Our study showed that when
compared to general anesthesia with systemic opioids, TTPB block is
associated with significantly better postoperative pain control.
<br/>Conclusion(s): Tranversus thoracic plaine 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.

<75>
Accession Number
645169684
Title
Three years' registry on myocardial perfusion imaging patients in Ain
shams university nuclear cardiology unit.
Source
QJM: An International Journal of Medicine. Conference: 43th Annual Ain
Shams Medical Congress. Cairo Egypt. 117(Supplement 1) (pp i58), 2024.
Date of Publication: June 2024.
Author
Alzebak O.; Mansour H.; Rayan M.; Adel A.
Institution
(Alzebak, Mansour, Rayan, Adel) Department of Cardiology, Faculty of
Medicine, Ain Shams University, Egypt
Publisher
Oxford University Press
Abstract
Background: The development in nuclear myocardial perfusion imaging (MPI)
has provided diagnostic and prognostic implications in CAD patients,
leading to an explosive increase in the performanceofthesestudies.
Thisexpansionofimagingspectrumisassociatedwithwidespread concern regarding
imaging utilization and increased healthcare costs. There is no
comparative data that guide the use of these modalities with respect to
appropriateness and patients' benefit. Targeted data collection, through
registry studies, enable analysis of both quality and outcomes with big
advantages of reflecting real world daily practice and identifying the
gaps in care which may not otherwise be feasible in high-quality
randomized control trials. <br/>Objective(s): To explore the extent to
which stress myocardial perfusion imaging (MPI) studies met published
appropriate use criteria (AUC), and the real world practice in the nuclear
cardiology unit of Ain shams University. <br/>Patients and Methods: It was
a retrospective cohort study that included 2598 patients who underwent
myocardial perfusion imaging in Ain Shams university nuclear cardiology
unit throughout the period from January 2017 to December2019. All patients
were subjected to thorough demographic data, history of cardiovascular
risk factors (arterial hypertension, diabetes mellitus, smoking, family
history of premature cardiovascular diseases), indication of the test,
preprocedural ECG, ejection fraction by echocardiography, previous
coronary angiography and PCI or CABG, calculation of pretest probability
and Framingham risk score, determination of appropriateness use criteria
and stress-rest Tc 99m imaging to detect the presence of ischemia and one
day Tc 99m imaging to detect viability. <br/>Result(s): The study included
2598 patients with mean age of 57.76 years, with male predominance
(68.1%), 38.2% were diabetics and 53% had hypertension. The most common
indications to undergo MPI was the exclusion of CAD as a cause of chest
pain in 38.8% of patients followed by the evaluation of symptomatic post
PCI patients in 21.9%. Moreover 63.8% of patients showed appropriate
tests, while 18.6% of patients showed uncertain tests. Whereas 17.6% of
patients had inappropriate studies. 81% of appropriate tests showed
positive results of SPECT. Whereas in the inappropriate and the uncertain
category, the negative test for ischemia predominated. <br/>Conclusion(s):
We have established that appropriateness criteria are effective in
identifying appropriateness of SPECT in a university center located in
Cairo. Also, we concluded that in our unit the appropriate tests were more
prominent than inappropriate and unclassified tests. Most of the
appropriate studies were positive for ischemia. While, most of the
inappropriate and uncertain tests were normal and the commonest cause of
referral for MPI was exclusion of CAD as a cause of chest pain.

<76>
Accession Number
645169389
Title
Short-term outcomes of complete coronary revascularization compared to
staged revascularization during primary percutaneous coronary intervention
in patients with multivessel coronary artery disease: Presenting with ST
segment elevation myocardial infarction.
Source
QJM: An International Journal of Medicine. Conference: 43th Annual Ain
Shams Medical Congress. Cairo Egypt. 117(Supplement 1) (pp i54), 2024.
Date of Publication: June 2024.
Author
Alnashar I.A.; Almissiri A.M.; Guindy R.R.; Zahran M.
Institution
(Alnashar) National Heart Institute, Cairo, Giza, Egypt
(Almissiri, Guindy, Zahran) Department of Cardiology, Ain Shams
University, Cairo, Egypt
Publisher
Oxford University Press
Abstract
Background: Complete revascularization has been recently popularized for
management of ST-Segment-Elevation Myocardial Infarction (STEMI) patients
with multivessel disease scheduled for Primary Percutaneous Coronary
Intervention (PPCI). We assessed the three months outcomes of Compete
Revascularization (CR) compared to staged revascularization in patients
with multivessel disease undergoing PPCI. <br/>Material(s) and Method(s):
We conducted a randomized, openlabel, comparative trial on STEMI patients
with multivessel disease indicated for PPCI in the setting of STEMI.
Patients were randomly assigned to undergo PCI revascularization of the
nonculprit lesions during the index procedure, Complete Revascularization
(CR) or within 30 days later after discharge, Staged Revascularization
(SR). The primary endpoint was the composite of all-cause mortality,
re-infarction, Heart Failure (HF), recurrence of angina symptoms,
cerebrovascular stroke, and need for revascularization. <br/>Result(s): A
total of 100 patients were randomized in 1:1 ratio. The primary end point
occurred in 24% of the patients in CR and 20% in SR group (p=0.62). The
incidence of HF (14% vs. 12%; p=0.76), repeated revascularization (4% in
each group), persistent angina (8% vs. 2%, p=0.16), all-cause mortality
(2% in each group), MI (4% in each group), stent thrombosis (0% vs. 4%;
p=0.15), and cerebrovascular accident (0% vs. 2%; p=0.32).
<br/>Conclusion(s): Staged revascularization provided comparable
short-term benefits to complete revascularization in STEMI patients with
multivessel disease undergoing PPCI. The present trial demonstrated that
complete revascularization was associated with a trend towards higher
incidence of stent thrombosis and CVA than staged revascularization.

<77>
Accession Number
645169256
Title
Levosimendan versus Milrinone in Improving Pulmonary Hypertension after
Cardiac Surgery.
Source
QJM: An International Journal of Medicine. Conference: 43th Annual Ain
Shams Medical Congress. Cairo Egypt. 117(Supplement 1) (pp i7), 2024. Date
of Publication: June 2024.
Author
El Aziz Fahmy N.M.A.; Marcos F.A.A.E.; Gouda H.S.H.; Senada M.G.M.
Institution
(El Aziz Fahmy, Marcos, Gouda, Senada) Department of Anesthesiology,
Intensive Care and Pain Management, Faculty of Medicine, Ain Shams
University, Egypt
Publisher
Oxford University Press
Abstract
Background: Pulmonary hypertension is a multifactorial disease with a high
morbidity and mortality, right ventricular function is the most important
predictor of morbidity and mortality in patients suffering from pulmonary
hypertension. Milrinone, a phosphodiesterase III inhibitor is commonly
used during post cardiopulmonary bypass (CPB) period in combination with
adrenaline or noradrenaline to decrease pulmonary artery pressure and to
provide synergistic positive inotropic effect. Levosimendan is a calcium
sensitizing agent with inotropic, pulmonary vasodilatory, and
cardioprotective properties. This study compared levosimendan with
milrinone in improving pulmonary hypertension after cardiac surgeries.
<br/>Objective(s): To compare between levosimendan and milrinone in
improving pulmonary hypertension after cardiac surgeries. <br/>Patients
and Methods: In this study 40 Patients were assigned randomly by using a
computer-generated table of random numbers, placing them in sealed
envelopes, into two groups: Group M: 20 Patients were received milrinone
Group L:20 Patients were received levosimandan. <br/>Result(s): In this
study we compared levosimendan vs milrinone, in levosimendan group there
was more significant increase of post operative TAPSE, in milrnone group
there was more significant decrease of PAP and RVSP. There was
statistically significant difference groups received milrinone in pre,
post operative AST, ALT as there was increase in post operative AST and
ALT, groups were compared in demographic data (in terms of age, sex,
weight and height) and there was no statistically significant difference
between groups, were compared as regard CPB and type of surgery and there
was no statistically significant difference between groups, were compared
in post operative data (in terms of systolic, diastolic blood pressure,
heart rate, SPO2, CVP, UOP and extubation time), there was no
statistically significant difference between groups, were compared in
kidney function (in term of pre and post operative serum creatinine),
there was no statistically significant difference between groups, were
compared in acid base data (in term of post operative PH), there was no
statistically significant difference between groups, were compared in
weaning from ventilators (within 24 hours post operative) and there was no
statistically significant difference between groups. <br/>Conclusion(s):
We concluded that in levosimendan group there was more significant
increase in post operative TAPSI, in milrinone group there was more
significant decrease of PAP and RVSP and in milrinone group there was
increase in post operative AST/ALT.

<78>
Accession Number
645165985
Title
Pioneering Pre- and Post-Operative Integrative Care to Improve Thoracic
Cancer Quality of Care - The Thoracic Peri-Operative Integrative Surgical
Care Evaluation (POISE) Trial - Stage i.
Source
Journal of Complementary and Integrative Medicine. Conference: 2020 INCAM
Research Symposium. Saskatoon, SK Canada. 20(2) (pp eA21), 2023. Date of
Publication: June 2023.
Author
Seely D.; Legacy M.; Fazekas A.; Conte E.; Delic E.; Anstee C.; Asmis T.;
Auer R.; Thavorn K.; Fergusson D.; Ramsay T.; Finley C.; Kanji S.; Seely
A.
Institution
(Seely, Legacy, Conte) Ottawa Integrative Cancer Centre, Canada
(Seely, Conte) Canadian College of Naturopathic Medicine, Canada
(Seely, Legacy, Fazekas, Delic, Anstee, Asmis, Auer, Thavorn, Fergusson,
Ramsay, Kanji, Seely) Ottawa Hospital Research Institute, Canada
(Finley) St. Joseph's Healthcare & McMaster University, Canada
(Auer, Seely) University of Ottawa, Department of Surgery, Canada
Publisher
Walter de Gruyter GmbH
Abstract
Background: Despite enormous advances in thoracic surgery and oncology,
patients still experience detrimental effects to health-related quality of
life. This three-stage project has the overarching goal of improving care
for thoracic cancer patients using an integrative approach to care. In
stage I, we evaluated the safety and feasibility of delivering integrative
care interventions in a pragmatic study. <br/>Objective(s): (1) Determine
the safety and feasibility of the study protocol, (2) assess compliance
with study interventions, (3) assess communication between practitioners,
(4) evaluate the qualitative experience of care, (5) refine the
interventions. <br/>Method(s): In this single-arm study, 22 participants
undergoing complete resection for lung, gastric, or esophageal cancer were
enrolled and followed for one year post-surgery. Participants received
usual hospital care combined with complementary care administered by a
naturopathic doctor (ND). Complementary care included natural health
products (NHPs), nutrition guidance, physical activity recommendations,
and psychological practices. Feasibility was determined by assessment
completion rates and appointment attendance; compliance was assessed
through pill counts and subjective ND ratings; qualitative experiences
were captured through semi-structured interviews; safety was determined by
adverse events (AEs); interventions were refined based on clinical
experience and patient feedback. <br/>Result(s): 14 of 22 participants
successfully completed the study; 4 were screen fails, 1 died before
starting the study, and 3 withdrew. ND and hospital visits were well
attended (89% and 96%, respectively). Questionnaire completion rate was
100%. Mean NHP compliance was 76.5%, ranging from 42.4% - 96.2% for
individual NHPs. No serious or severe AEs related to the intervention were
reported. There were no communication barriers, and qualitative interviews
provided rich data regarding patient experiences. Conclusions The study
protocol was feasible and safe. The project will progress to stage II, a
pilot randomized control trial, with an amended protocol based on data
collected from stage I.

<79>
Accession Number
2034365058
Title
The Effect of Ketamine Administration on the Incidence of Delirium After
Coronary Artery Bypass Graft Surgery: A Scoping Review.
Source
Journal of Cellular and Molecular Anesthesia. 9(3) (no pagination), 2024.
Article Number: e147124. Date of Publication: July 2024.
Author
Maroufi S.S.; Kiaei M.M.; Aligholizadeh M.; Saei A.; Sangi S.; Akbarpour
P.
Institution
(Maroufi) Department of Anesthesia, School of Allied Medicine, Iran
university of Medical Sciences, Tehran, Iran, Islamic Republic of
(Kiaei) Hasheminejad Kidney Center, School of Medicine, Iran University of
Medical Sciences, Tehran, Iran, Islamic Republic of
(Aligholizadeh, Sangi, Akbarpour) Department of Anesthesia Technology,
School of Allied Medical Sciences, Iran University of Medical Sciences,
Tehran, Iran, Islamic Republic of
(Saei) Research Center for Trauma in Police Operations, Directorate of
Health, Rescue & Treatment, Police Headquarter, Tehran, Iran, Islamic
Republic of
Publisher
Shahid Beheshti University of Medical Sciences, Anesthesiology Research
Center
Abstract
Context: Delirium is a common complication observed in patients undergoing
open-heart surgery, leading to adverse outcomes and increased healthcare
costs. Ketamine, an N-methyl-D-aspartate (NMDA) receptor antagonist with
analgesic and neuroprotective properties, has been reported to have
potential protective effects against delirium. In this scoping review, we
aim to explore the existing literature on the effect of ketamine
administration in open-heart surgery on the incidence of delirium.
<br/>Evidence Acquisition: In the latter part of 2023, a retrospective
analysis was conducted to investigate the impact of administering ketamine
on delirium occurrence following coronary artery bypass surgery.
Researchers utilized Medical Subject Headings (MeSH) to identify key terms
and searched various databases, including Scopus, Web of Science, PubMed,
and Cochrane, as well as search engines like Google Scholar, alongside
Iran SID and Iran ISC databases. Following the elimination of duplicates
and irrelevant studies, the review encompassed six studies from Iran,
Turkey, Canada, the United States, and Thailand. <br/>Result(s): The
search strategy yielded 1100 articles, of which 100 were excluded due to
duplicates. After excluding conference papers, systematic reviews,
unrelated languages, unavailable full texts, and book chapters, 87
full-text studies were reviewed. Finally, 6 studies (5 studies in English
and one study in Persian) met the inclusion criteria and were analyzed.
<br/>Conclusion(s): Recent trials have shown that the effect of ketamine
administration on the incidence of delirium after coronary artery bypass
graft (CABG) surgery is equivocal. While some studies suggest that
ketamine may serve as a promising solution for reducing the incidence of
delirium, others suggest that it may lead to adverse experiences and raise
concerns about its safety. Further research in this area is necessary to
optimize postoperative recovery and minimize risks. Currently, physicians
must carefully evaluate the potential benefits and side effects of
ketamine for each patient and be aware of the latest
evidence.<br/>Copyright &#xa9; 2024, Sedigh Maroufi et al.

<80>
Accession Number
2034402986
Title
ASSESSMENT OF HEMODYNAMIC STRESS RESPONSE DURING LARYNGOSCOPY USING
MACINTOSH AND AIRTRAQ LARYNGOSCOPE IN PATIENT UNDERGOING CABG.
Source
Journal of Cardiovascular Disease Research. 15(5) (pp 1614-1622), 2024.
Date of Publication: 2024.
Author
Kene G.S.; Yashvanth R.; Amin R.; Akhil Rao U.K.; Sharath S.; Chowta S.
Institution
(Kene, Yashvanth, Amin, Akhil Rao, Sharath, Chowta) Department of
Anaesthesiology and Critical Care, Srinivas Medical College and Hospital,
Mukka, Karnataka, Mangalore, India
Publisher
EManuscript Technologies
Abstract
Background: Cardiac surgical patients are prone to develop hemodynamic
instability on induction of anaesthesia. Stress response to laryngoscopy &
endotracheal intubation is common in surgical patients. One of the most
recently introduced laryngoscope device is Airtraq optical laryngoscope
which is a single use rigid video laryngoscope that has been developed to
facilitate endotracheal intubation and provide direct view of glottis
without alignment of mouth, pharynx and trachea. <br/>Method(s): The study
was conducted at Srinivas Institute of Medical Sciences and Research
Centre, Mangalore. It is a randomised prospective study with 60 patients
meeting inclusion criteria in all patients following parameters systolic,
diastolic and mean systemic blood pressure, heart rate, percentage change
in rate pressure product (RPP) and ST-T changes were noted.
<br/>Result(s): This study shows that Airtraq is an excellent laryngoscope
in maintaining hemodynamic stability in CABG patient as compared to
Macintosh laryngoscope. Airtraq takes shorter time to intubate and also
requires fewer external maneuvers during laryngoscopy without causing any
ST-T changes or desaturations. <br/>Conclusion(s): Airtraq is a safe and
efficient laryngoscope for use in patients undergoing CABG surgery
compared to Macintosh laryngoscope.<br/>Copyright &#xa9; 2024 EManuscript
Technologies. All rights reserved.

<81>
Accession Number
2034402893
Title
COMPARATIVE ANALYSIS OF THE ANALGESIC BENEFITS OF FENTANYL, REMIFENTANIL,
AND MORPHINE WITH INTRAVENOUS PATIENT-CONTROLLED ANALGESIA FOLLOWING
CARDIOVASCULAR SURGERY.
Source
Journal of Cardiovascular Disease Research. 15(6) (pp 1477-1484), 2024.
Date of Publication: 2024.
Author
Fatima P.D.; Ragashree C.M.; Nivatha K.
Institution
(Fatima, Ragashree, Nivatha) Department of Anaesthesia, Sree Mookambika
Institute of Medical Sciences, Tamilnadu, Kanyakumari, India
Publisher
EManuscript Technologies
Abstract
Background: This study compared the analgesic effects of morphine and
fentanyl, two more opioid agents, with remifentanil following cardiac
procedure. <br/>Material(s) and Method(s): 75 adult patients scheduled for
elective OPCABG procedure with adequate left ventricle function (ejection
fraction >40%,left ventricular end-diastolic pressure [LVEDP] <18 mmHg)
were studied.The following patients were excluded from the study: those
who had an intraoperative intra-aortic balloon pump insertion, were older
than 70 years old, had unstable angina, abnormal hepatic or renal
function, had undergone a previous sternotomy, or were undergoing
emergency surgery. Result :Pain was assessed by using a visual analog
scale (0-10), and sedation was assessed with the Ramsay sedation score
(1-6) 30 minutes, 1, 2, 4, 12, and 24 hours after extubation. The number
of boluses and demands, time to extubation, and side effects were
analyzed. Visual analog scale, sedation scores, and mean extubation times
were similar in all groups. Total number of boluses and demands were
statistically more in the remifentanil group. Regarding the side effects,
nausea and vomiting was higher in group M (p < 0.05), whereas itching was
prominent in group F (p < 0.05). <br/>Conclusion(s):Despite the different
durations of these 3 opioid agents, the infusion dose of remifentanil was
as effective as morphine and fentanyl after CABG surgery with fewer side
effects.<br/>Copyright &#xa9; 2024 EManuscript Technologies. All rights
reserved.

<82>
Accession Number
2034402840
Title
A study of Comparative efficacy of Double Lumen Tube and EZ Blocker for
Lung Isolation Surgeries: A Randomized Comparative Study.
Source
Journal of Cardiovascular Disease Research. 15(6) (pp 978-996), 2024. Date
of Publication: 2024.
Author
Chandela G.; Kanaujia S.K.; Gautam S.; Rai A.; Kumar S.
Institution
(Chandela, Kanaujia, Gautam) Department of Anesthesiology, King George
Medical University, Lucknow, India
(Kumar) Department of General Surgery, King George Medical University,
Lucknow, India
(Rai, Kumar) Department of Thoracic Surgery, King George Medical
University, Lucknow, India
Publisher
EManuscript Technologies
Abstract
Background: Single Lung Ventilation or One-Lung ventilation (OLV) is often
necessary for thoracic surgeries involving lung, esophagus, aorta, or
mediastinum. Various airway devices, like DLTs and bronchus blockers,
facilitate one lung ventilation, with DLTs being the most widely used
globally. However, DLT intubation has drawbacks, prompting the development
of bronchus blockers like EZ-Blocker. The EZ-Blocker features a Y-shaped
design with cuffs on both ends, simplifying placement and reducing
complications. Limited trials have compared EZ-Blocker to DLT or other
blockers. This study aims to evaluate EZ-Blocker against DLT for Lung
Isolation Surgeries in Indian settings, filling a gap in existing
research. <br/>Method(s): 46 adult patients who had to undergo elective
thoracic surgery requiring thoracotomy and SLV were included in this
prospective, randomized, single-blinded study with blinding of the outcome
assessor. Patients were randomly assigned to one of the 2 groups: DLT or
EZ Blocker group. The time for placement of device, which included time
for device preparation and time for placement of the device, was recorded
along with the number of repositioning after positioning of patient. After
the surgery, the surgeon rated the quality of the collapse of lung and
patient's sore throat, and hoarseness were recorded. <br/>Result(s): The
time for placement of DLT (170.47 sec) was significantly faster than EZ
Blocker (230.7 sec), as was the time for successful intubation and time
for preparation for DLT faster than EZ. Number of repositioning required
were more in the EZ Blocker group (52.2%) compared to DLT Group (43.5%).
Quality of lung collapse was rated better for DLT (60.9%) than EZ Blocker
(39.2%) whereas post-operative complications of intubation were more in
the DLT group owing to its larger external diameter. <br/>Conclusion(s):
EZ Blocker is a reliable option for single lung ventilation (SLV) during
thoracic surgery, particularly in patients with limited mouth opening.
Despite having fewer post-operative complications like sore throat and
hoarseness compared to the DLT, the DLT outperforms the EZ Blocker in
terms of preparation time, placement time, number of repositioning needed,
and surgeon satisfaction score. Therefore, for lung isolation surgeries,
the DLT is the preferred choice for achieving optimal one lung ventilation
(OLV).<br/>Copyright &#xa9; 2024 EManuscript Technologies. All rights
reserved.

<83>
Accession Number
2030245377
Title
Gender-based disparities in outcomes of coronary bifurcation stenting in
patients undergoing percutaneous coronary intervention: A systematic
review and meta-analysis.
Source
American Journal of Cardiovascular Disease. 14(3) (pp 136-143), 2024. Date
of Publication: 2024.
Author
Khanal R.; Hamza M.; Najam M.; Basit S.A.; Wajid Z.; Rashdi A.; Patel N.;
Razzaq S.; Shah R.; Harmouch K.M.; Alyami B.; Bahar Y.; Aamir M.;
Abu-Mahfouz M.; Sattar Y.; Alraies M.C.
Institution
(Khanal) Department of Internal Medicine, Wayne Health University/Detroit
Medical Center, Detroit, MI, United States
(Hamza) Guthrie Medical Group, Cortland, NY, United States
(Najam) Department of Internal Medicine, University of Texas Rio Grande
Valley, Weslaco, TX, United States
(Basit) The Wright Center for GME, Scranton, PA, United States
(Wajid) Wayne State University School of Medicine, Detroit, MI, United
States
(Rashdi) Windsor Heart Institute, Windsor, ON, Canada
(Patel) New York Medical College/Landmark Medical Center, Woonsocket, RI,
United States
(Razzaq, Harmouch) Detroit Medical Center/Wayne State University, Detroit,
MI, United States
(Shah) University of Florida/Malcolm Randall Veterans Affairs Medical
Center, Gainesville, FL, United States
(Alyami, Sattar) Department of Cardiology, West Virginia University,
Morgantown, WV, United States
(Bahar) Wayne State University, Detroit, MI, United States
(Aamir) Department of Cardiology, Lehigh Valley Health Network, Allentown,
PA, United States
(Abu-Mahfouz, Alraies) Cardiovascular Institute, Detroit Medical Center,
Detroit, MI, United States
Publisher
E-Century Publishing Corporation
Abstract
Introduction: Around 15-20% of lesions necessitating percutaneous coronary
interventions (PCI) are attributed to coronary bifurcation lesions. We aim
to study gender-based differences in PCI outcomes among bifurcation
stents. <br/>Method(s): 3 studies were included after thorough systematic
search using MEDLINE (EMBASE and PubMed). CRAN-R software using the
Metabin module was used for statistical analysis. Pooled odds ratios (OR)
were calculated using the random effect model and the Mantel-Haenszel
method, with a 95% confidence interval (CI) used to determine statistical
significance. Heterogeneity was assessed using Higgins I2. <br/>Result(s):
Women exhibited a higher risk of in-hospital mortality (OR 0.67, 95% CI
0.58-0.76, I2 = 0%, P < 0.0001), post-procedural bleeding (OR 0.53, 95% CI
0.47-0.6, I2 = 0%, P < 0.0001) and post-procedure stroke (OR 0.72, 95% CI
0.52-1.0, I2 = 0%, P < 0.06) as compared to men. However, there were no
significant differences in terms of myocardial infarction (OR 0.84, 95% CI
0.22-3.27, I2 = 49.4%, P < 0.80) and cardiac tamponade (OR 0.63, 95% CI
0.06; 5.72, I2 = 0%, P < 0.6821) in both groups. <br/>Conclusion(s): Our
study reveals a noteworthy increase in in-hospital mortality in women,
which could be attributed to a higher rate of major bleeding, advanced
age, increased co-morbidities, and complex pathophysiology of the lesion
in comparison to men. Further studies are required to gain a better
understanding of the precise mechanisms thus enhancing procedural
outcomes.<br/>Copyright &#xa9; 2024, Institute of China Studies. All
rights reserved.

<84>
Accession Number
645174432
Title
In patients with NSTE-ACS and previous CABG, routine invasive vs.
conservative management does not improve outcomes.
Source
Annals of internal medicine. (no pagination), 2024. Date of Publication:
03 Sep 2024.
Author
Mukherjee D.
Institution
(Mukherjee) Texas Tech University Health Sciences Center at El Paso, El
Paso, TX, United States
Abstract
SOURCE CITATION: Kelham M, Vyas R, Ramaseshan R, et al. Non-ST-elevation
acute coronary syndromes with previous coronary artery bypass grafting: a
meta-analysis of invasive vs. conservative management. Eur Heart J.
2024;45:2380-2391. 38805681.

<85>
Accession Number
645162141
Title
Enhancing Guidewire Efficacy for Trans-radial Access: The EAGER Randomized
Controlled Trial.
Source
Circulation. Cardiovascular interventions. (no pagination), 2024. Date of
Publication: 31 Aug 2024.
Author
Bland A.C.; Meere W.; Mikhail P.; Chuah E.; Redwood E.; Ferreira D.;
Howden N.; Perkovic A.; Saunders S.L.; Kelty A.; Kull T.; Hill A.; Spina
R.; Sarathy K.; May A.; Parkinson M.; Ishak M.; Collins N.; Boyle A.;
William M.; Jeyaprakash P.; Ford T.J.
Institution
(Bland, Saunders, William, Ford) Cardiology Department, Gosford Hospital,
Central Coast Local Health District, Gosford, Australia; School of
Medicine and Public Health, The University of Newcastle, Newcastle,
Australia
(Meere, Mikhail, Chuah, Redwood, Howden, Perkovic, Kelty, Kull, Hill,
Spina, Sarathy, May, Parkinson, Ishak, Jeyaprakash) Cardiology Department,
Gosford Hospital, Central Coast Local Health District, Gosford, Australia
(Ferreira) Cardiology Department, John Hunter Hospital, Hunter New England
Local Health District, Newcastle, Australia
(Collins, Boyle) Cardiology Department, John Hunter Hospital, Hunter New
England Local Health District, Newcastle, Australia; School of Medicine
and Public Health, The University of Newcastle, Newcastle, Australia
Abstract
Background: The 1.5mm 'Baby J' hydrophilic narrow J tipped wire is a
development of the standard 0.035" 3mm J tipped peripheral guidewire,
designed to improve efficiency of transradial coronary procedures by
safely navigating small caliber radial arteries to the aorta. There is
currently a lack of evidence comparing the procedural success and safety
of different peripheral guidewires used in transradial cardiac procedures.
We compared the efficacy and safety of a narrow J tipped hydrophilic
0.035" wire (intervention - RadifocusTM 'Baby J' guidewire, TERUMO Co.,
Tokyo, Japan). versus standard fixed core (FC) 0.035" J wire (control).
<br/>Method(s): Investigator initiated, blinded, Australian, multicenter
randomized trial in patients undergoing clinically indicated coronary
angiography and/or PCI. Randomized 1:1 via sealed envelope method to use
either the control or the intervention guidewire. The primary endpoint
(technical success) was defined as gaining aortic root access with the
randomized guidewire. <br/>Result(s): 330 patients were randomized between
October 2022 - June 2023 (median age 69 years, 36% female, BMI 29 kg/m2).
The primary endpoint was achieved more frequently in the intervention
group [96% v 84%; mean difference 12% (95% CI 5.7-18.3); p<0.001]. Women
assigned to the control wire experienced a higher failure rate compared to
men (31% v 8% in men; p<0.001). Fluoroscopy time was significantly shorter
in the baby J group (median 344 versus 491 seconds; p=0.024). The main
mechanisms of failure using the control wire were radial artery spasm
(15/26; 57%) and subclavian tortuosity (5/26; 19.2%). There were no
differences in overall procedure times, MACE, or vascular complications
between guidewires. <br/>Conclusion(s): A narrow 1.5mm J tipped
hydrophilic guidewire resulted in greater technical success and reduced
fluoroscopy time compared to the standard 3mm J tip non-hydrophilic
guidewire. The guidewire is safe and demonstrated key incremental benefits
for the trans-radial approach particularly in women.

<86>
Accession Number
645160728
Title
Randomised study for the Optimal Treatment of symptomatic patients with
low-gradient severe Aortic valve Stenosis and preserved left ventricular
ejection fraction (ROTAS trial).
Source
Heart (British Cardiac Society). (no pagination), 2024. Date of
Publication: 28 Aug 2024.
Author
Galli E.; Le Ven F.; Coisne A.; Sportouch C.; Le Tourneau T.; Lavie-Badie
Y.; Bernard A.; Eicher J.-C.; Dreyfus J.; Ternacle J.; Baleynaud S.;
Auffret V.; Le Pabic E.; Pibarot P.; Oger E.; Donal E.
Institution
(Galli, Auffret, Donal) Univ Rennes, CHU Rennes, Inserm, Rennes, France
(Le Ven) Hopital Cavale Blanche, CHRU Brest, Brest, France
(Coisne) University of Lille, Inserm, Institut Pasteur de Lille, CHU
Lille, Lille, France
(Sportouch) Clinique du Millenaire, Montpellier, France
(Le Tourneau) CHU Nantes, CNRS, INSERM, l'Institut du Thorax, Nantes,
France
(Lavie-Badie) Department of Cardiology, Rangueil University Hospital,
Toulouse, France
(Bernard) Service de Cardiologie, CHU Tours, Tours, France
(Eicher) Unite de Rythmologie et Insuffisance Cardiaque, Centre de
Competences des Cardiomyopathies, Service de Cardiologie, Hopital Francois
Mitterrand, CHU Dijon-Bourgogne, Dijon, France
(Dreyfus) Cardiology Department, Centre Cardiologique du Nord, Saint
Denis, France
(Ternacle) Bordeaux University Hospital, Bordeaux, France
(Baleynaud) Department of Cardiology, Centre Hospitalier Bretagne Sud,
Lorient, France
(Le Pabic, Oger) CHU Rennes, Inserm, CIC 1414, Rennes, France
(Pibarot) Institut Universitaire de Cardiologie et de Pneumologie de
Quebec (Quebec Heart and Lung Institute), Laval University, QC, Canada
Abstract
BACKGROUND: The best management of symptomatic patients with low-gradient
(LG) severe aortic stenosis (AS) and preserved left ventricular ejection
fraction (LVEF) has not been established. The Randomised study for the
Optimal Treatment of symptomatic patients with low-gradient severe Aortic
valve Stenosis (ROTAS) trial aimed to assess the superiority of aortic
valve replacement (AVR) versus medical treatment (MT) in this specific
group of AS patients. <br/>METHOD(S): Patients with symptomatic LG severe
AS and preserved LVEF (>50%) underwent dobutamine stress echocardiography
and/or CT-aortic calcium score to confirm AS severity and were then
randomised 1:1 to AVR or MT. The primary endpoint was a composite of
overall death and/or cardiovascular hospitalisation. <br/>RESULT(S): The
ROTAS study was stopped early because of insufficient recruitment. In the
end, only 52 patients (age 79+/-7 years; women 54%; NYHA III-IV 27%;
median STS score 3.3%) were included in the study. During follow-up (mean:
14+/-7 months), the primary endpoint occurred in 12 (23%) patients.
Compared with MT, AVR was not associated with a significant prognostic
benefit (events: 5/26 (19%) vs 7/26 (27%) (HR 0.76, 95%CI 0.24 to 2.39,
p=0.63). During follow-up, 11 (42%) patients in the MT group developed
class I criteria for AVR or severe symptoms justifying a cross-over to the
AVR group. <br/>CONCLUSION(S): Because of the small number of included
patients and short follow-up the ROTAS trial was underpowered and unable
to demonstrate a difference in the study endpoint between treatment arms.
In patients in the MT arm, a regular echocardiographic and clinical
assessment might be useful to disclose those developing class I
indications of AVR or severe AS-related symptoms. TRIAL REGISTRATION
NUMBER: NCT01835028.<br/>Copyright &#xa9; Author(s) (or their employer(s))
2024. No commercial re-use. See rights and permissions. Published by BMJ.

<87>
Accession Number
645160657
Title
Effect Of Adding Integrated Core and Graduated Upper Limb Exercises to
Inpatient Cardiac Rehabilitation on Sternal Instability After Coronary
Artery Bypass Grafting; A Randomized Controlled Trial.
Source
Archives of physical medicine and rehabilitation. (no pagination), 2024.
Date of Publication: 30 Aug 2024.
Author
Mehani S.H.M.; Helmy Z.M.; Ali H.M.; Mohamed Mahmoud M.I.
Institution
(Mehani, Ali) Faculty of Physical Therapy, Beni-Suef University, Physical
Therapy Department for Cardiovascular / Respiratory Disorders and
Geriatrics
(Helmy) Faculty of Physical Therapy, Cairo University, Physical Therapy
Department for Cardiovascular / Respiratory Disorders and Geriatrics
(Mohamed Mahmoud) Faculty of Physical Therapy, Beni-Suef University.,
Physical Therapy Department for Cardiovascular / Respiratory Disorders and
Geriatrics
Abstract
OBJECTIVE: To evaluate the effect of adding integrated core and graduated
resistance upper limb exercises to inpatient cardiac rehabilitation
program in patients with acute sternal instability after coronary artery
bypass grafting (CABG). DESIGN: This was a single-center, randomized,
controlled, parallel-group intervention study. SETTINGS: This study was
conducted at the National Heart Institute. PARTICIPANTS: Forty post-CABG
patients with sternal instability aged 50-60 years completed this study
and were randomized into two groups: an intervention group (n=20) and an
active control group (n=20). INTERVENTION: The intervention group (A)
received a routine inpatient rehabilitation program from the first
postoperative day plus integrated core and graduated resistance upper limb
exercises, which started from the seventh postoperative day for
approximately four weeks, while the control group (B) received only the
routine inpatient rehabilitation program. MAIN OUTCOME MEASURES: Sternal
separation measured by ultrasonography, visual analogue scale for
measuring pain, and activities of daily living (ADL) index were main
outcome measures. <br/>RESULT(S): Patients in the intervention group (A)
showed a significant reduction in sternal separation from the supine and
long sitting positions, while those in the control group (B) showed a
significant increase in sternal separation (p=0.0001). Both groups showed
a reduction in pain, and an increase in the ADL score was observed in
Group A. There was a significant interaction between the time and group
effects (p=0.0001). <br/>CONCLUSION(S): Adding integrated core and
graduated upper limb exercises to inpatient cardiac rehabilitation for
patients with sternal instability after coronary artery bypass grafting
significantly improved sternal healing, pain, and ADL.<br/>Copyright
&#xa9; 2024. Published by Elsevier Inc.

<88>
Accession Number
645160580
Title
Rare Genetic Variants in LDLR, APOB, and PCSK9 are Associated with Aortic
Stenosis.
Source
Circulation. (no pagination), 2024. Date of Publication: 02 Sep 2024.
Author
Ramo J.; Jurgens S.J.; Kany S.; Choi S.H.; Wang X.; Smirnov A.N.; Friedman
S.F.; Maddah M.; Khurshid S.; Ellinor P.T.; Pirruccello J.P.
Institution
(Ramo) Cardiovascular Disease Initiative, Broad Institute of MIT and
Harvard, Cambridge, MA; Cardiovascular Research Center, Massachusetts
General Hospital, Boston, MA; Department of Medicine, Brigham and Women's
Hospital, Boston, MA; Institute for Molecular Medicine Finland (FIMM),
Helsinki Institute of Life Science (HiLIFE), University of Helsinki,
Helsinki, Finland
(Jurgens) Cardiovascular Disease Initiative, Broad Institute of MIT and
Harvard, Cambridge, MA; Cardiovascular Research Center, Massachusetts
General Hospital, Boston, MA; Department of Experimental Cardiology,
Amsterdam Cardiovascular Sciences, Heart Failure & Arrhythmias, Amsterdam
UMC, University of Amsterdam, Amsterdam, Netherlands
(Kany) Cardiovascular Disease Initiative, Broad Institute of MIT and
Harvard, Cambridge, MA; Cardiovascular Research Center, Massachusetts
General Hospital, Boston, MA; Department of Cardiology, University Heart
and Vascular Center Hamburg-Eppendorf, Hamburg, Germany; German Center for
Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Lubeck, Hamburg,
Germany
(Choi) Department of Biostatistics, Boston University, Boston, MA, United
States
(Wang) Cardiovascular Disease Initiative, Broad Institute of MIT and
Harvard, Cambridge, MA; Wellcome Trust Sanger Institute, Hinxton, UK;
University of Cambridge, Cambridge, UK
(Smirnov, Friedman, Maddah) Broad Institute of MIT and Harvard, Cambridge,
MA, United States
(Khurshid) Cardiovascular Disease Initiative, Broad Institute of MIT and
Harvard, Cambridge, MA; Cardiovascular Research Center, Massachusetts
General Hospital, Boston, MA; Demoulas Center for Cardiac Arrhythmias,
Massachusetts General Hospital, Boston, MA
(Ellinor) Cardiovascular Disease Initiative, Broad Institute of MIT and
Harvard, Cambridge, MA; Cardiovascular Research Center, Massachusetts
General Hospital, Boston, MA; Cardiology Division, Massachusetts General
Hospital, Boston, MA; Harvard Medical School, Boston, MA
(Pirruccello) Division of Cardiology, University of California San
Francisco, San Francisco, CA; Cardiovascular Disease Initiative, Broad
Institute of MIT and Harvard, Cambridge, MA; Bakar Computational Health
Sciences Institute, University of California San Francisco, San Francisco,
CA; Institute for Human Genetics, University of California San Francisco,
San Francisco, CA
Abstract
Background: Despite a proposed causal role for low-density lipoprotein
cholesterol (LDL-C) in aortic stenosis (AS), randomized controlled trials
of lipid-lowering therapy failed to prevent severe AS. We aimed to assess
the impact on AS and peak velocity across the aortic valve conferred by
lifelong alterations in LDL-C levels mediated by protein-disrupting
variants in three clinically significant genes for LDL metabolism (LDLR,
APOB, PCSK9). <br/>Method(s): We utilized sequencing data and electronic
health records from UK Biobank (UKB) and All of Us and magnetic resonance
imaging data from UKB. We identified predicted protein-disrupting variants
with the LOFTEE and AlphaMissense algorithms and evaluated their
associations with LDL-C and peak velocity across the aortic valve (UK
Biobank), as well as diagnosed AS and aortic valve replacement (UK Biobank
+ All of Us). <br/>Result(s): We included 421,049 unrelated participants
(5,621 with AS) in UKB and 195,519 unrelated participants (1,087 with AS)
in All of Us. Carriers of protein-disrupting variants in LDLR had higher
mean LDL-C (UKB: +42.6 mg/dl, P=4.4e-237) and greater risk of AS
(meta-analysis: odds ratio [OR] =3.52 [95% CI 2.39-5.20], P=2.3e-10) and
aortic valve replacement (meta-analysis: OR=3.78 [95% CI 2.26-6.32],
P=4.0e-7). Carriers of protein-disrupting variants in APOB or PCSK9 had
lower mean LDL-C (UKB: -32.3 mg/dl, P<5e-324) and lower risk of AS
(meta-analysis: OR=0.49 [0.31-0.75], P=0.001) and aortic valve replacement
(meta-analysis: OR=0.54 [0.30-0.97], P=0.04). Among 57,371 UKB imaging
substudy participants, peak velocities across the aortic valve were
greater in carriers of protein-disrupting variants in LDLR (+12.2cm/s,
P=1.6e-5) and lower in carriers of protein-disrupting variants in PCSK9
(-6.9cm/s, P=0.022). <br/>Conclusion(s): Rare genetic variants that confer
lifelong higher or lower LDL-C levels are associated with substantially
increased and decreased risk of AS, respectively. Early and sustained
lipid-lowering therapy may slow or prevent AS development.

<89>
Accession Number
645158003
Title
Invited editorial on "Outcome of aortic valve replacement versus
conservative treatment in asymptomatic patients with severe aortic
stenosis - Five years follow-up of the AVATAR randomized controlled trial"
by Banovic et al.
Source
European heart journal. (no pagination), 2024. Date of Publication: 01
Sep 2024.
Author
Martinsson A.; Jeppsson A.
Institution
(Martinsson) Department of Cardiology, Sahlgrenska University Hospital,
Gothenburg, Sweden
(Martinsson, Jeppsson) Department of Molecular and Clinical Medicine,
Institute of Medicine, Sahlgrenska Academy, University of Gothenburg,
Gothenburg, Sweden
(Jeppsson) Department of Cardiothoracic Surgery, Sahlgrenska University
Hospital, Gothenburg, Sweden

<90>
Accession Number
645155975
Title
Fasting vs no fasting prior to catheterisation laboratory procedures: the
SCOFF trial.
Source
European heart journal. (no pagination), 2024. Date of Publication: 01
Sep 2024.
Author
Ferreira D.; Hardy J.; Meere W.; Butel-Simoes L.; Sritharan S.; Ray M.;
French M.; McGee M.; O'Connor S.; Whitehead N.; Turner S.; Healey P.;
Davies A.; Morris G.; Jackson N.; Barlow M.; Ford T.; Leask S.; Oldmeadow
C.; Attia J.; Sverdlov A.; Collins N.; Boyle A.; Wilsmore B.
Institution
(Ferreira, Hardy, Butel-Simoes, Sritharan, Ray, French, Turner, Davies,
Morris, Jackson, Barlow, Sverdlov, Collins, Boyle, Wilsmore)
Cardiovascular Department, John Hunter Hospital, Newcastle, Australia
(Ferreira, Attia, Sverdlov, Collins, Boyle, Wilsmore) School of Medicine
and Public Health, Newcastle University, Australia
(Ferreira, Leask, Oldmeadow, Attia, Sverdlov, Collins, Boyle) Hunter
Medical Research Institute, Newcastle, Australia
(Meere) Cardiology Department, Gosford Hospital, Gosford, Australia
(McGee, O'Connor, Ford) Department of Medicine, Tamworth Rural Referral
Hospital, Tamworth, Australia
(Whitehead) Department of Cardiology, Calvary Mater Hospital, Newcastle,
Australia
(Healey) Department of Anaesthesia, John Hunter Hospital, Newcastle,
Australia
Abstract
BACKGROUND AND AIMS: Current guidelines recommend 6 hours of solid food
and 2 hours of clear liquid fasting for patients undergoing cardiac
procedures with conscious sedation. There are no data to support this
practice, and previous single centre studies support the safety of
removing fasting requirements. The objective of this study was to
determine the non-inferiority of a no fasting strategy to fasting prior to
cardiac catheterisation procedures which require conscious sedation.
<br/>METHOD(S): This is a multicentre, investigator-initiated,
non-inferiority randomised trial conduced in Australia with a prospective
open label blinded endpoint design. Patients referred for coronary
angiography, percutaneous coronary intervention or cardiac implantable
electronic device (CIED) related procedures were enrolled. Patients were
randomised 1:1 to fasting as normal (6 hours solid food and 2 hours clear
liquid) or no fasting requirements (encouraged to have regular meals but
not mandated to do so). Recruitment occurred from 2022 to 2023. The
primary outcome was a composite of aspiration pneumonia, hypotension,
hyperglycaemia and hypoglycaemia assessed with a Bayesian approach.
Secondary outcomes included patient satisfaction score, new ventilation
requirement (non-invasive and invasive), new intensive care unit
admission, 30-day readmission, 30-day mortality, 30-day pneumonia.
<br/>RESULT(S): 716 patients were randomised with 358 in each group. Those
in the fasting arm had significantly longer solid food fasting (13.2
versus 3.0 hours, Bayes factor >100 indicating extreme evidence of
difference) and clear liquid fasting times (7.0 versus 2.4 hours, Bayes
factor >100). The primary composite outcome occurred in 19.1% of patients
in the fasting arm and 12.0% of patients in the no fasting arm. The
estimate of the mean posterior difference in proportions in the primary
composite outcome was -5.2% (95% CI -9.6 to -0.9, ) favouring no fasting.
This result confirms non-inferiority (posterior probability >99.5%) and
superiority (posterior probability 99.1%) of no fasting for the primary
composite outcome. The no fasting arm had improved patient satisfaction
scores with a posterior mean difference of 4.02 points (95% CI 3.36 to
4.67, Bayes factor >100). Secondary outcome events were similar.
<br/>CONCLUSION(S): In patients undergoing cardiac catheterisation and
CIED related procedures, no fasting was non-inferior and superior to
fasting for the primary composite outcome of aspiration pneumonia,
hypotension, hyperglycaemia and hypoglycaemia. Patient satisfaction scores
were significantly better with no fasting. This supports removing fasting
requirements for patients undergoing cardiac catheterisation laboratory
procedures that require conscious sedation.<br/>Copyright &#xa9; The
Author(s) 2024. Published by Oxford University Press on behalf of the
European Society of Cardiology. All rights reserved. For commercial
re-use, please contact reprints@oup.com for reprints and translation
rights for reprints. All other permissions can be obtained through our
RightsLink service via the Permissions link on the article page on our
site-for further information please contact

<91>
Accession Number
645152278
Title
Aortic valve replacement versus conservative treatment in asymptomatic
severe aortic stenosis: long-term follow-up of the AVATAR trial.
Source
European heart journal. (no pagination), 2024. Date of Publication: 01
Sep 2024.
Author
Banovic M.; Putnik S.; Da Costa B.R.; Penicka M.; Deja M.A.; Kotrc M.;
Kockova R.; Glaveckaite S.; Gasparovic H.; Pavlovic N.; Velicki L.;
Salizzoni S.; Wojakowski W.; Van Camp G.; Gradinac S.; Laufer M.; Tomovic
S.; Busic I.; Bojanic M.; Ristic A.; Klasnja A.; Matkovic M.; Boskovic N.;
Zivic K.; Jovanovic M.; Nikolic S.D.; Iung B.; Bartunek J.
Institution
(Banovic, Putnik, Tomovic, Busic, Ristic, Matkovic) Belgrade Medical
School, University of Belgrade, Serbia
(Banovic, Ristic, Boskovic, Zivic) Cardiology Department, University
Clinical Center of Serbia, Belgrade, Serbia
(Putnik, Matkovic) Cardiac-Surgery Department, University Clinical Center
of Serbia, Belgrade, Serbia
(Da Costa, Van Camp, Bartunek) Clinical Trial Service Unit and
Epidemiological Studies Unit, Nuffield Department of Population Health,
University of Oxford, Oxford, United Kingdom
(Penicka) Cardiovascular Center, OLV Hospital, Aalst, Belgium
(Deja) Department of Cardiac Surgery, Medical University of Silesia,
Katowice, Poland
(Kotrc) Department of Cardiology, Institute for Clinical and Experimental
Medicine, Prague, Czechia
(Kockova) Charles University, Faculty of medicine Hradec Kralove, Czechia
(Glaveckaite) Clinic of Cardiac and Vascular Diseases, Institute of
Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius,
Lithuania
(Gasparovic) Department of Cardiac Surgery, University of Zagreb School of
Medicine and University Hospital Center Zagreb, Zagreb, Croatia
(Pavlovic) University Hospital Dubrava, Zagreb, Croatia
(Velicki) Faculty of Medicine, University of Novi Sad, Serbia and
Institute of Cardiovascular Diseases Vojvodina, Sremska Kamenica, Novi
Sad, Serbia
(Salizzoni) Cardiovascular and Thoracic Department, University of Turin,
Italy
(Wojakowski) Division of Cardiology and Structural Heart Diseases, Medical
University of Silesia, Katowice, Poland
(Gradinac) Sabah Al Ahmad Cardiac Center, Amiri Hospital, Kuwait
(Laufer) Mach Ventures, Menlo Park, CA, United States
(Bojanic) Anesteziology Department, "Institute Banjica"; Serbia
(Klasnja) University Clinical Center "Bezanijska Kosa", Serbia
(Jovanovic) General Hospital "Pozarevac", Serbia
(Nikolic) Redwood CityCAUnited States
(Iung) Cardiology Department, Bichat Hospital APHP and Universite
Paris-Cite, France
Abstract
BACKGROUND AND AIMS: The question of when and how to treat truly
asymptomatic patients with severe aortic stenosis (AS) and normal left
ventricular (LV) systolic function is still subject to debate and ongoing
research. Here, the results of extended follow-up of the AVATAR trial are
reported (NCT02436655, clinical trials.gov). <br/>METHOD(S): The AVATAR
trial randomly assigned patients with severe, asymptomatic AS and LV
ejection fraction >=50% to undergo either early surgical aortic valve
replacement (AVR) or conservative treatment with watchful waiting
strategy. All patients had negative exercise stress testing. The primary
hypothesis was that early AVR will reduce a primary composite endpoint
comprising all-cause death, acute myocardial infarction, stroke or
unplanned hospitalization for heart failure (HF), as compared to
conservative treatment strategy. <br/>RESULT(S): A total of 157 low-risk
patients (mean age 67 years, 57% men, mean Society of Thoracic Surgeons
score 1.7%) were randomly allocated to either early AVR group (n=78) or
conservative treatment group (n=79). In an intention-to-treat analysis,
after a median follow-up of 63 months, the primary composite endpoint
outcome event occurred in 18/78 patients (23.1%) in the early surgery
group and in 37/79 patients (46.8%) in the conservative treatment group
(hazard ratio [HR] early surgery vs. conservative treatment 0.42; 95%
confidence interval [CI] 0.24-0.73, p=0.002). The Kaplan-Meier estimates
for individual endpoints of all-cause death and HF hospitalization were
significantly lower in the early surgery compared with the conservative
group (HR 0.44; 95% CI 0.23-0.85, p=0.012 for all-cause death, and HR
0.21; 95% CI 0.06-0.73, p=0.007 for HF hospitalizations).
<br/>CONCLUSION(S): The extended follow-up of the AVATAR trial
demonstrates better clinical outcomes with early surgical AVR in truly
asymptomatic patients with severe AS and normal LV ejection fraction
compared with patients treated with conservative management on watchful
waiting. TRIAL REGISTRATION NUMBER: NCT02436655
(ClinicalTrials.gov).<br/>Copyright &#xa9; The Author(s) 2024. Published
by Oxford University Press on behalf of the European Society of
Cardiology. All rights reserved. For commercial re-use, please contact
reprints@oup.com for reprints and translation rights for reprints. All
other permissions can be obtained through our RightsLink service via the
Permissions link on the article page on our site-for further information
please contact

<92>
Accession Number
645150852
Title
Benefit of isolated surgical valve repair or replacement for functional
tricuspid regurgitation and long-term outcomes stratified by the
TRI-SCORE.
Source
European heart journal. (no pagination), 2024. Date of Publication: 30
Aug 2024.
Author
Dreyfus J.; Juarez-Casso F.; Sala A.; Carnero-Alcazar M.; Eixeres-Esteve
A.; Bohbot Y.; Bazire B.; Flagiello M.; Riant E.; Mbaki Y.; Tomasi J.;
Senage T.; Rahmouni El Idrissi K.; Coisne A.; Eyharts D.; Doguet F.; Viau
F.; Eggenspieler F.; Heuts S.; Sardari Nia P.; Heitzinger G.; Galloo X.;
Ajmone Marsan N.; Benfari G.; Badano L.; Muraru D.; Maisano F.; Topilsky
Y.; Michelena H.; Enriquez-Sarano M.; Bax J.; Bartko P.; Selton-Suty C.;
Habib G.; Lavie-Badie Y.; Modine T.; Chan V.; Le Tourneau T.; Donal E.;
Lim P.; Radu C.; Bernick J.; Wells G.A.; Tribouilloy C.; Iung B.; Obadia
J.-F.; De Bonis M.; Crestanello J.; Messika-Zeitoun D.
Institution
(Dreyfus, Bazire, Riant) Department of Cardiology, Centre Cardiologique du
Nord, Saint-Denis, France
(Juarez-Casso, Crestanello) Department of Cardiovascular Surgery, Mayo
Clinic, Rochester, United States
(Sala, De Bonis) Vita-Salute San Raffaele University, Department of
Cardiac Surgery, IRCCS San Raffaele Scientific Institute, Milan, Italy
(Carnero-Alcazar) Department of Cardiac Surgery, Hospital Clinico San
Carlos, Madrid, Spain
(Eixeres-Esteve) Cardiac Surgery Department, Hospital 12 de Octubre,
Madrid, Spain
(Bohbot, Tribouilloy) Department of Cardiology, Amiens University
Hospital, Amiens, France
(Bohbot, Tribouilloy) Jules Verne University of Picardie, Amiens, France
(Flagiello, Obadia) Department of Cardiovascular Surgery and
Transplantation, Louis Pradel Cardiovascular Hospital, Claude Bernard
University, Bron, France
(Mbaki, Donal) Cardiology Department, INSERM, CHU de RENNES, Universite de
Rennes-1, Rennes, France
(Tomasi) Department of Cardiac Surgery, CHU de RENNES, Universite de
Rennes-1, Rennes, France
(Senage) Department of Cardiac surgery, Universite de Nantes, CHU de
Nantes, Nantes, France
(Rahmouni El Idrissi, Chan) Division of Cardiac surgery, University of
Ottawa Heart Institute, Ottawa, ON, Canada
(Coisne) Department of Clinical Physiology and Echocardiography - Heart
Valve Clinic, CHU Lille, Lille, France
(Coisne) Institut Pasteur de Lille, U1011- EGID, Univ. Lille, Inserm, CHU
Lille, Lille, France
(Eyharts, Lavie-Badie) Heart Valve Center, Toulouse University Hospital,
Toulouse, France
(Doguet) Department of Cardiology and Cardio-Vascular Surgery, CHU Charles
Nicolle, Rouen, France
(Viau, Habib) Cardiology Department, APHM, La Timone Hospital, France
(Eggenspieler, Selton-Suty) Cardiology Department, CHU Nancy-Brabois,
Nancy, France
(Heuts, Sardari Nia) Department of Cardio-Thoracic Surgery, Maastricht
University Medical Center (MUMC+), Maastricht, Netherlands
(Heuts, Sardari Nia) Cardiovascular Research Institute Maastricht (CARIM),
University Maastricht, Maastricht, Netherlands
(Heitzinger, Bartko) Department for Internal Medicine II, Cardiology,
Medical University of Vienna, Vienna, Austria
(Galloo, Ajmone Marsan, Bax) Department of Cardiology, Leiden University
Medical Center, Leiden, Netherlands
(Galloo) Department of Cardiology, Free University Brussels (VUB),
University Hospital Brussels (UZ Brussel), Brussels, Belgium
(Benfari, Michelena) Cardiovascular disease Department, Mayo Clinic,
Rochester, United States
(Benfari) Section of Cardiology, Department of Medicine, University of
Verona, Italy
(Badano, Muraru) Department of Cardiology, Istituto Auxologico Italiano,
IRCCS, Milan, Italy
(Badano, Muraru) Department of Medicine and Surgery, University of
Milano-Bicocca, Milan, Italy
(Maisano) Cardiac Surgery and Heart Valve Center, Ospedale San Raffaele,
University Vita Salute, Milano, Italy
(Topilsky) Department of Cardiology, Tel Aviv Medical Center, Sackler
Faculty of Medicine, Tel Aviv, Israel
(Enriquez-Sarano) Minneapolis Heart Institute, Minneapolis, MN, United
States
(Modine) Department of Cardiology and Cardio-Vascular Surgery, Hopital
Cardiologique de Haut-Leveque, Bordeaux University Hospital, Bordeaux,
France
(Le Tourneau) CNRS, INSERM, l'institut du thorax, Universite de Nantes,
CHU de Nantes, Nantes, France
(Lim) Cardiology Department, Expert Valve Center, Henri Mondor Hospital,
Creteil, France
(Radu) Department of Cardiac Surgery, AP-HP, Henri Mondor Hospital,
Creteil, France
(Bernick, Wells) Cardiovascular Research Methods Center, University of
Ottawa Heart Institute, Ottawa, Canada
(Iung) Cardiology Department, Bichat Hospital, APHP, INSERM LVTS U1148,
Universite de Paris, France
(Messika-Zeitoun) Division of Cardiology, University of Ottawa Heart
Institute, Ottawa, Canada
Abstract
BACKGROUND AND AIMS: Severe tricuspid regurgitation (TR) is associated
with increased mortality rates, but benefit of its correction and ideal
timing are not clearly determined. This study aimed to identify patient
subsets who might benefit from surgery. <br/>METHOD(S): In TRIGISTRY, an
international cohort study of consecutive patients with severe isolated
functional TR (33 centers, 10 countries), survival rates up to 10 years
were compared between patients who underwent isolated tricuspid valve (TV)
surgery (repair or replacement) and those conservatively managed, overall
and according to TRI-SCORE category (low: <=3, intermediate: 4-5, high:
>=6). <br/>RESULT(S): 1,217 were managed conservatively, and 551 underwent
isolated TV surgery (200 repairs, 351 replacements). TRI-SCORE
distribution was 33% low, 32% intermediate, and 35% high. At 10 years,
survival rates were similar between surgical and conservative management
(41% vs. 36%; hazard ratio [HR] 0.97; 95% confidence interval [CI]
0.88-1.08, P=0.57). Surgery improved survival compared to conservative
management in the low TRI-SCORE category (72% vs. 44%; HR 0.27; 95% CI
0.20-0.37, P<0.0001), but not in the intermediate (36% vs. 37%, HR 1.17;
95%CI 0.98-1.40, P=0.09) or high categories (20% vs. 24%; HR 1.06; 95% CI
0.91-1.25, P=0.45). Both repair and replacement improved survival in the
low TRI-SCORE category (84% and 61% vs. 44%; HR 0.11; 95% CI 0.06-0.19,
P<0.0001, and HR 0.65; 95% CI 0.47-0.90, P=0.009). Repair showed benefit
in the intermediate category (59% vs. 37%; HR 0.49; 95% CI 0.35-0.68,
P<0.0001) while replacement was possibly harmful (25% vs. 37%; HR 1.43;
95% CI 1.18-1.72, P=0.0002). <br/>CONCLUSION(S): Higher survival rates
were observed with repair than replacement and benefit of intervention
declined as TRI-SCORE increased with no benefit of any type of surgery in
the high TRI-SCORE category. These results emphasize the importance of
timely intervention and patient selection to achieve the best outcomes and
the need for randomized controlled trials. TRIAL REGISTRATION: TRIGISTRY:
ClinicalTrials.gov, NCT05825898.<br/>Copyright &#xa9; The Author(s) 2024.
Published by Oxford University Press on behalf of the European Society of
Cardiology. All rights reserved. For commercial re-use, please contact
reprints@oup.com for reprints and translation rights for reprints. All
other permissions can be obtained through our RightsLink service via the
Permissions link on the article page on our site-for further information
please contact

<93>
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.

<94>
Accession Number
2031177851
Title
Empagliflozin and left atrial function in patients with type 2 diabetes
mellitus and coronary artery disease: insight from the EMPA-HEART
CardioLink-6 randomized clinical trial.
Source
Cardiovascular Diabetology. 23(1) (no pagination), 2024. Article Number:
319. Date of Publication: December 2024.
Author
Pourafkari M.; Connelly K.A.; Verma S.; Mazer C.D.; Teoh H.; Quan A.;
Goodman S.G.; Rai A.; Ng M.Y.; Deva D.P.; Triverio P.; Jiminez-Juan L.;
Yan A.T.; Ge Y.
Institution
(Pourafkari, Rai, Deva, Jiminez-Juan, Yan) Department of Medical Imaging,
St. Michael's Hospital, Toronto, Canada
(Connelly, Goodman, Yan, Ge) Division of Cardiology, Terrence Donnelly
Heart Centre, St Michael's Hospital, 30 Bond Street, Toronto, ON M5B 1W8,
Canada
(Connelly, Verma, Mazer, Goodman, Deva, Jiminez-Juan, Yan, Ge) University
of Toronto, Toronto, Canada
(Connelly, Verma, Goodman, Yan) Keenan Research Centre, Li Ka Shing
Knowledge Institute, St Michael's Hospital, Toronto, Canada
(Verma, Teoh, Quan) Division of Cardiac Surgery, St Michael's Hospital,
Toronto, Canada
(Mazer) Department of Anesthesia, St Michael's Hospital, Toronto, Canada
(Teoh) Division of Endocrinology and Metabolism, St Michael's Hospital,
Toronto, Canada
(Ng) Department of Diagnostic Radiology, Li Ka Shing Faculty of Medicine,
University of Hong Kong, Hong Kong
(Triverio) Department of Electrical & amp; Computer Engineering, Institute
of Biomedical Engineering, University of Toronto, Toronto, Canada
Publisher
BioMed Central Ltd
Abstract
Background: Sodium-glucose cotransporter-2 (SGLT2) inhibitors have
demonstrated reduction in heart failure outcomes in patients with type 2
diabetes mellitus, although the exact mechanism of benefit remains
unclear. Alteration in left atrial (LA) function due to chronic pressure
or volume overload is a hallmark of heart failure. <br/>Objective(s): To
evaluate the effect of the SGLT2 inhibitor empagliflozin on LA volume and
function. <br/>Method(s): 90 patients with coronary artery disease and
type 2 diabetes (T2DM) were randomized to empagliflozin (n = 44) or
placebo (n = 46), and underwent cardiac magnetic resonance (CMR) imaging
at baseline and after 6 months. The main outcome was change in LA volume;
LA function, including active and passive components, was also measured by
a blinded reader. <br/>Result(s): At baseline, there was no significant
difference in LA volumes between the empagliflozin (indexed maximum LA
volume 26.4 +/- 8.4mL/m², minimum LA volume 11.1 +/-
5.7mL/m²) and placebo (indexed maximum LA volume 28.7 +/-
8.2mL/m², minimum LA volume 12.6 +/- 5.0mL/m²)
groups. After 6 months, changes in LA volumes did not differ with adjusted
difference (empagliflozin minus placebo): 0.99 mL/m² (95% CI:
-1.7 to 3.7 mL/m²; p = 0.47) for indexed maximum LA volume, and
0.87 mL/m² (95% CI: -0.9 to 2.6 mL/m²; p = 0.32) for
indexed minimum LA volume. Changes in total LA emptying fraction were also
similar, with between-group adjusted mean difference - 0.01 (95% CI: -0.05
to 0.03, p = 0.59). <br/>Conclusion(s): SGLT2 inhibition with
empagliflozin for 6 months did not have a significant impact on LA volume
and function in patients with T2DM and coronary artery disease. (Effects
of Empagliflozin on Cardiac Structure in Patients with Type 2 Diabetes
[EMPA-HEART]; NCT02998970).<br/>Copyright &#xa9; The Author(s) 2024.

<95>
Accession Number
2027797824
Title
Robotic assisted thoracoscopic surgery in children: a narrated review.
Source
Journal of Pediatric Endoscopic Surgery. 6(3) (pp 107-114), 2024. Date of
Publication: September 2024.
Author
Aithal S.; Sinha A.; Pathak M.
Institution
(Aithal, Sinha, Pathak) Department of Pediatric Surgery, All India
Institute of Medical Sciences, Jodhpur, India
Publisher
Springer
Abstract
Aim: This study reviewed the literature on the robotic assisted
thoracoscopic surgery in children. <br/>Method(s): A systematic search of
Pubmed and Scopus databases was performed for "robotic" AND
"thoracoscopic" AND "pediatric". Excluded articles included the articles
for which fulltext in English was not available, duplicate articles, and
review articles. Demographic characteristics, type of the surgery
performed, age and weight of the child, duration of the surgery, ports
employed, complications and length of hospital stay were analysed.
<br/>Result(s): The database search retrieved 115 articles, after
excluding the articles which were not meeting inclusion criteria, 24
articles (184 patients) were selected for the review. Indication for
majority of the robotic assisted thoracoscopic surgery included lung
resection like lobectomy or segmentectomy (25.5%), followed by thymectomy
(19%). Neonatal robotic assisted thoracoscopic surgery was performed for
trachea- esophageal fistula and congenital diaphragmatic hernia, with
higher conversion rate to thoracoscopic or open surgery (61.5%). Though
mean age was not mentioned for majority of the patients, it was 82.5
months for 131 patients, which included outliers like neonates. Mean age
of the neonates at the time of the surgery was 7.2 days. Robotic assisted
thoracoscopic surgery has been performed in children weighing as less as
2.8 kg, and the mean weight for all the patients included in the study was
26.4 kg. Reported complication rate was 7% and all of the described
complications were Clavein- Dindo class II, which were managed
conservatively. <br/>Discussion(s): Until recently, robotic assisted
surgery in pediatric patients were limited to abdominal surgeries.
However, increasing number of thoracoscopic surgeries are being performed
in children with robotic assistance. RATS have been performed in children
weighing as low as 2.8 kg. Reported conversion rate is higher for neonates
undergoing robotic surgery due to difficulty in manoeuvring the
instruments. With similar complication rate and conversion rate as
thoracoscopic surgery, RATS can be employed in children. Due to steep
learning curve for robotic surgery, the operative time is expected to
reduce over the time. We conclude that the RATS is safe and feasible in
children, with better outcome. Non-availability of the appropriate sized
instruments especially for neonates is the major disadvantage faced for
the pediatric patients which needs attention.<br/>Copyright &#xa9; The
Author(s), under exclusive licence to Springer Nature Singapore Pte Ltd
2024.

<96>
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

<97>
Accession Number
2030903619
Title
A Systematic Review and Meta-Analysis of the Effects of Statin Therapy on
Heart Transplantation.
Source
Reviews on Recent Clinical Trials. 19(4) (pp 256-266), 2024. Date of
Publication: 2024.
Author
Mardani-Nafchi H.; Hashemi Rafsanjani S.M.R.; Heidari-Soureshjani S.;
Abbaszadeh S.; Gholamine B.; Naghdi N.
Institution
(Mardani-Nafchi) Department of Pharmacology, Shahid Beheshti University of
Medical Sciences, Tehran, Iran, Islamic Republic of
(Hashemi Rafsanjani) Faculty of Medicine, Tehran Medical Sciences, Islamic
Azad University, Tehran, Iran, Islamic Republic of
(Heidari-Soureshjani) Modeling in Health Research Center, Shahrekord
University of Medical Sciences, Shahrekord, Iran, Islamic Republic of
(Abbaszadeh) Department of Biochemistry and Genetics, School of Medicine,
Lorestan University of Medical Sciences, Khorramabad, Iran, Islamic
Republic of
(Gholamine, Naghdi) Department of Pharmacology, School of Medicine, Shahid
Beheshti University of Medical Sciences, Tehran, Iran, Islamic Republic of
Publisher
Bentham Science Publishers
Abstract
Background: Most of the mortality after Heart Transplantation (HT) is
attributed to severe cardiac allograft vasculopathy (CAV) and rejection.
<br/>Objective(s): This meta-analysis aimed to investigate the effects of
postoperative statin therapy on outcomes (mortality, rejection, and CAV in
HT patients). <br/>Method(s): This systematic review and meta-analysis was
performed on publications between 1980 and October 2023 in Web of Science,
Scopus, PubMed, Cochrane, Science Direct, Google Scholar, and Embase
databases. Heterogeneity was assessed using Chi-square, I2, and forest
plots. Publication bias was evaluated using Begg's and Egger's tests.
Analyses were performed in Stata 15 with significance at p < 0.05.
<br/>Result(s): This meta-analysis included 17 studies comprising 4,627
participants and conducted between 1995 to 2021. Compared to non-users,
the odds of mortality were lower among statin users (OR= 0.49, 95% CI:
0.32-0.75, p < 0.001). The odds of CAV were also reduced with statin use
(OR= 0.71, 95% CI: 0.53-0.96, p = 0.027). The odds of rejection were not
significantly different (OR= 0.69, 95% CI: 0.41-1.15, p = 0.152). However,
rejection odds were lower with statins in RCTs (OR= 0.42, 95% CI:
0.21-0.82, p = 0.012) but not in case-control studies (OR= 0.87, 95% CI:
0.49-1.52, p = 0.615). No publication bias was observed with Begg's test,
but Egger's test showed possible bias. <br/>Conclusion(s): This
meta-analysis found postoperative statin use associated with lower
mortality and CAV, but not overall rejection, though RCT subgroup analysis
showed decreased rejection with statins. Statin therapy may improve
prognosis in HT patients.<br/>Copyright &#xa9; 2024 Bentham Science
Publishers.