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<1>
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

<2>
Accession Number
2034169303
Title
Empowering treatment decisions: ChatGPT in severe coronary artery disease.
Source
Current Problems in Cardiology. 49(11) (no pagination), 2024. Article
Number: 102789. Date of Publication: November 2024.
Author
Savithri Nandeesha D.S.
Institution
(Savithri Nandeesha) Internal Medicine, Karnataka Institute of Medical
Sciences, Hubli, India
Publisher
Elsevier Inc.

<3>
Accession Number
2025028711
Title
Meta-analysis of phase-specific survival after transcatheter versus
surgical aortic valve replacement from randomized control trials.
Source
Journal of Thoracic and Cardiovascular Surgery. 168(3) (pp 796-808.e27),
2024. Date of Publication: September 2024.
Author
Yokoyama Y.; Shimoda T.; Sloan B.; Takagi H.; Fukuhara S.; Kuno T.
Institution
(Yokoyama, Sloan) Department of Surgery, St Luke's University Health
Network, Bethlehem, Pa, United States
(Shimoda) Department of Cardiovascular Surgery, University of Tsukuba
Hospital, Ibaraki, Japan
(Takagi) Department of Cardiovascular Surgery, Shizuoka Medical Center,
Shizuoka, Japan
(Fukuhara) Department of Cardiac Surgery, University of Michigan, Ann
Arbor, Mich, United States
(Kuno) Department of Cardiology, Montefiore Medical Center, Albert
Einstein College of Medicine, New York, NY, United States
Publisher
Elsevier Inc.
Abstract
Objective: Transcatheter aortic valve replacement (TAVR) is an established
alternative to surgical aortic valve replacement (SAVR) for severe
symptomatic aortic stenosis, although phase-specific survival and cause of
death are implicated following these procedures. Herein, we conducted a
phase-specific meta-analysis to compare outcomes after TAVR versus SAVR.
<br/>Method(s): A systematic search of databases was performed from
inception through December 2022 to identify randomized controlled trials
that compared outcomes of TAVR and SAVR. For each trial, the hazard ratio
(HR) with 95% confidence interval (CI) of outcomes of interest was
extracted for the following each specific phase: the very short-term (0-1
years after the procedure), short-term (1-2 years), and mid-term (2-5
years). Phase-specific HRs were separately pooled using the random-effects
model. <br/>Result(s): Our analysis included 8 randomized controlled
trials, which enrolled a total of 8885 patients with a mean age of 79
years. The survival after TAVR compared with SAVR was greater in the very
short-term periods (HR, 0.85; 95% CI, 0.74-0.98; P = .02) but similar in
the short-term periods. In contrast, lower survival was observed in the
TAVR group compared with the SAVR group in the mid-term periods (HR, 1.15;
95% CI, 1.03-1.29; P = .02). Similar temporal trends favoring SAVR in the
mid-term were present for cardiovascular mortality and rehospitalization
rates. In contrast, the rates of aortic valve reinterventions and
permanent pacemaker implantations were initially greater in the TAVR
group, although SAVR's superiority eventually disappeared in the mid-term.
<br/>Conclusion(s): Our analysis demonstrated phase-specific outcomes
following TAVR and SAVR.<br/>Copyright &#xa9; 2023 The American
Association for Thoracic Surgery

<4>
Accession Number
2034485427
Title
Association of H-FABP with cardiovascular events: A systematic review.
Source
Journal of Cardiovascular and Thoracic Research. 16(2) (pp 77-87), 2024.
Date of Publication: 2024.
Author
Venu A.P.; Rajkumar R.; Roy D.D.; Prabhakaran S.T.; Shankar K.; Jayapal
V.; Varalakshmi S.; Sreenivasan S.
Institution
(Venu, Sreenivasan) Meenakshi Academy of Higher Education and Research
(MAHER-Deemed to be University), West K.K Nagar, Tamil Nadu, Chennai,
India
(Rajkumar, Shankar, Varalakshmi) Meenakshi Medical College Hospital &
Research Institute, Meenakshi Academy of Higher Education and Research
(MAHER-Deemed to be University), Tamil Nadu, Kanchipuram, India
(Roy) Genetika Centre for Advanced Genetic Studies, Kerala,
Thiruvananthapuram, India
(Prabhakaran) Dr Moopen's Medical College, Kerala, Wayanad, India
(Jayapal) Hridayalaya Heart Foundation, Kerala, Thiruvananthapuram, India
Publisher
Tabriz University of Medical Sciences
Abstract
The research aimed to evaluate the association between heart-type fatty
acid binding protein (H-FABP) and cardiovascular events. We systematically
reviewed research that has been conducted to assess this relationship,
aiming to determine how useful H-FABP could be as a biomarker for
cardiovascular diseases, especially in the initial phases of acute
myocardial infarction (AMI) and acute coronary syndrome (ACS). Our goal
was to validate its diagnostic accuracy and clinical relevance. We
systematically searched through PubMed, Web of Science, and Google Scholar
databases to find pertinent publications related to cardiovascular
diseases and H-FABP, using various permutations, abbreviations, and
language variations of MeSH keywords. The final analysis included 12
studies in total. The final study comprised twelve studies, and it was
concluded that H-FABP demonstrated high sensitivity (64.3-91.5) and
specificity (73-100) for diagnosing Acute Myocardial Infarction (AMI) and
Acute Coronary Syndrome (ACS), especially within the first hours of
symptom onset. H-FABP demonstrates potential in enhancing the overall
diagnostic accuracy during the initial hours following the manifestation
of symptoms. However, the existing data do not provide sufficient evidence
to recommend the regular utilization of H-FABP as a preliminary risk
assessment approach in individuals who present with suspected cardiac
events. Additional investigations, with well-defined prospective cohorts,
are needed to validate the results observed.<br/>Copyright &#xa9; 2024 The
Author(s).

<5>
Accession Number
2034014040
Title
Efficacy and Safety of Bempedoic Acid for Prevention of Adverse
Cardiovascular Events and Diabetes Mellitus: A Systematic Review and
Meta-Analysis of Randomized Controlled Trials.
Source
American Journal of Therapeutics. 31(5) (pp e566-e572), 2024. Date of
Publication: 09 Aug 2024.
Author
Yasmin F.; Najeeb H.; Moeed A.; Ali E.; Umar M.; Ullah I.; Shah N.;
Alraies M.C.
Institution
(Yasmin) Yale University School of Medicine, New Haven, CT, United States
(Najeeb, Moeed, Ali) Dow University of Health Sciences, Karachi, Pakistan
(Umar) I.U. Health Ball Memorial Hospital, Muncie, IN, United States
(Ullah) Kabir Medical College, Gandhara University, Peshawar, Pakistan
(Shah) Duke University School of Medicine, Durham, NC, United States
(Alraies) Detroit Medical Center, Cardiovascular Institute, Detroit, MI,
United States
Publisher
Lippincott Williams and Wilkins

<6>
Accession Number
2032937760
Title
Effect of Low-dose Ketamine Infusion on Opioid Consumption in Children
Undergoing Open Cardiac Surgery: A Randomized Controlled Double-Blind
Study.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 38(10) (pp 2349-2355),
2024. Date of Publication: October 2024.
Author
Abdelfattah M.; Abdelbaser I.; Awad K.A.; Atallah A.M.; Sanad M.;
Sayedalahl M.
Institution
(Abdelfattah, Abdelbaser, Awad, Sayedalahl) Department of Anesthesia and
Surgical Intensive Care, Faculty of Medicine, Mansoura University,
Mansoura, Egypt
(Atallah) Faculty of Medicine, 6th October University, 6th of October
City, Egypt
(Sanad) Department of Cardiothoracic Surgery, Faculty of Medicine,
Mansoura University, Mansoura, Egypt
Publisher
W.B. Saunders
Abstract
Objective: This study was designed to evaluate the effect of low-dose
ketamine infusion on the perioperative consumption of opioids in pediatric
open cardiac surgery. <br/>Design(s): A randomized, controlled,
double-blinded single-center study was conducted. <br/>Setting(s): The
study took place in a tertiary care children's hospital.
<br/>Participant(s): Patients of both sexes aged 2-12 years who underwent
cardiac surgery were included. <br/>Intervention(s): Patients in the
ketamine group received a bolus of 0.3 mg/kg of ketamine before skin
incision followed by continuous intraoperative infusion of 0.25 mg/kg/h
and postoperative infusion of 0.1 mg/kg/h for 24 h. Patients in the
control groups received volumes of normal saline either bolus or
continuous infusion like that of the ketamine group. <br/>Measurements and
Main Results: The primary outcome was the total dose of fentanyl consumed
over the first 24 hours postoperatively. Secondary outcomes were
intraoperative fentanyl consumption, time to extubation, modified
objective pain score, and incidence of vomiting, pruritus, diplopia, or
hallucinations. A total of 80 patients were recruited but the final
analysis was done on 35 patients in the ketamine group and 34 in the
control group. Fentanyl consumption during surgery and in the first 24
hours postoperatively was significantly lower in the ketamine than the
control group. Patients in both the ketamine and control groups had
similar times to extubation. Modified objective pain scores were
significantly lower in the ketamine group than the control group. None of
the patients in either group had diplopia or hallucinations.
<br/>Conclusion(s): Low-dose ketamine infusion in children undergoing open
cardiac surgery reduced intra- and postoperative opioid consumption and
postoperative pain scores. Moreover, ketamine did not cause diplopia or
hallucinations.<br/>Copyright &#xa9; 2024 Elsevier Inc.

<7>
Accession Number
2031308013
Title
Risk prediction model for in-stent restenosis following PCI: a systematic
review.
Source
Frontiers in Cardiovascular Medicine. 11 (no pagination), 2024. Article
Number: 1445076. Date of Publication: 2024.
Author
Xiang Q.; Xiong X.-Y.; Liu S.; Zhang M.-J.; Li Y.-J.; Wang H.-W.; Wu R.;
Chen L.
Institution
(Xiang, Xiong) Department of Nursing, The 2nd Affiliated Hospital, Jiangxi
Medical College, Nanchang University, Nanchang, China
(Xiang, Liu, Zhang, Li, Wang, Wu, Chen) School of Nursing, Jiangxi Medical
College, Nanchang University, Nanchang, China
Publisher
Frontiers Media SA
Abstract
Introduction: The morbidity and mortality rates of coronary heart disease
are significant, with PCI being the primary treatment. The high incidence
of ISR following PCI poses a challenge to its effectiveness. Currently,
there are numerous studies on ISR risk prediction models after PCI, but
the quality varies and there is still a lack of systematic evaluation and
analysis. <br/>Method(s): To systematically retrieve and evaluate the risk
prediction models for ISR after PCI. A comprehensive search was conducted
across 9 databases from inception to March 1, 2024. The screening of
literature and extraction of data were independently carried out by two
investigators, utilizing the checklist for critical appraisal and data
extraction for systematic reviews of prediction modeling studies (CHARMS).
Additionally, the risk of bias and applicability were evaluated using the
Prediction Model Risk of Bias Assessment Tool (PROBAST). <br/>Result(s): A
total of 17 studies with 29 models were included, with a sample size of
175-10,004 cases, and the incidence of outcome events was 5.79%-58.86%.
The area under the receiver operating characteristic curve was
0.530-0.953. The top 5 predictors with high frequency were diabetes,
number of diseased vessels, age, LDL-C and stent diameter. Bias risk
assessment into the research of the risk of higher bias the applicability
of the four study better. <br/>Discussion(s): The overall risk of bias in
the current ISR risk prediction model post-PCI is deemed high. Moving
forward, it is imperative to enhance study design and specify the
reporting process, optimize and validate the model, and enhance its
performance.<br/>Copyright 2024 Xiang, Xiong, Liu, Zhang, Li, Wang, Wu and
Chen.

<8>
Accession Number
2030534277
Title
Cardiovascular Statistics - Brazil 2023.
Source
Arquivos Brasileiros de Cardiologia. 121(2) (no pagination), 2024. Article
Number: e20240079. Date of Publication: 2024.
Author
de Oliveira G.M.M.; Brant L.C.C.; Polanczyk C.A.; Malta D.C.; Biolo A.;
Nascimento B.R.; de Fatima Marinho de Souza M.; De Lorenzo A.R.; de Paiva
Fagundes A.A.; Schaan B.D.; de Souza e Silva C.G.; de Castilho F.M.;
Cesena F.H.Y.; Soares G.P.; Junior G.F.X.; Barreto-Filho J.A.S.; Passaglia
L.G.; Pinto-Filho M.M.; Machline-Carrion M.J.; Bittencourt M.S.; Neto
O.M.P.; Villela P.B.; Teixeira R.A.; Stein R.; Sampaio R.O.; Gaziano T.A.;
Perel P.; Roth G.A.; Ribeiro A.L.P.
Institution
(de Oliveira, de Souza e Silva, Soares, Villela) Instituto do Coracao
Edson Saad da Universidade Federal do Rio de Janeiro (UFRJ), Rio de
Janeiro, Brazil
(de Oliveira, De Lorenzo, de Souza e Silva, Villela) Universidade Federal
do Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
(Brant, Malta, Nascimento, de Fatima Marinho de Souza, de Castilho,
Junior, Passaglia, Pinto-Filho, Teixeira, Ribeiro) Universidade Federal de
Minas Gerais (UFMG), MG, Belo Horizonte, Brazil
(Brant, Nascimento, de Castilho, Passaglia, Pinto-Filho, Ribeiro) Hospital
das Clinicas da Universidade Federal de Minas Gerais (UFMG), MG, Belo
Horizonte, Brazil
(Polanczyk, Biolo, Schaan, Stein) Universidade Federal do Rio Grande do
Sul (UFRGS), Porto Alegre, Brazil
(Polanczyk, Biolo) Hospital Moinhos de Vento, Porto Alegre, Brazil
(Polanczyk, Biolo, Schaan) Hospital de Clinicas de Porto Alegre (HCPA),
Porto Alegre, Brazil
(Nascimento) Hospital Madre Teresa, MG, Belo Horizonte, Brazil
(de Fatima Marinho de Souza) Vital Strategies, New York, United States
(De Lorenzo) Instituto Nacional de Cardiologia, Rio de Janeiro, Brazil
(de Paiva Fagundes) Instituto D'Or de Pesquisa e Ensino (IDOR), Brasilia,
Brazil
(de Paiva Fagundes) Universidade de Brasilia (UNB), Brasilia, Brazil
(de Paiva Fagundes) Hospital DFStar, Rede DO'r, Brasilia, Brazil
(Cesena) Instituto Dante Pazzanese de Cardiologia, Sao Paulo, Brazil
(Soares) Curso de Medicina da Universidade de Vassouras, Vassouras RJ,
Brazil
(Barreto-Filho) Universidade Federal de Sergipe, SE, Aracaju, Brazil
(Barreto-Filho) Hospital Sao Lucas Rede Sao Luiz D'Or, SE, Aracaju, Brazil
(Machline-Carrion) epHealth UK, London, United Kingdom
(Machline-Carrion) Instituto epHealth, Sao Paulo, Brazil
(Bittencourt) Department of Medicine and Radiology University of
Pittsburgh, Pittsburgh, United States
(Neto) Faculdade de Medicina de Ribeirao Preto da Universidade de Sao
Paulo (USP), Sao Paulo, Brazil
(Sampaio) Faculdade de Medicina da Universidade de Sao Paulo (USP), Sao
Paulo, Brazil
(Sampaio) Instituto do Coracao (Incor) do Hospital das Clinicas da
Faculdade de Medicina da Universidade de Sao Paulo (HCFMUSP), Sao Paulo,
Brazil
(Gaziano) Division of Cardiovascular Medicine, Brigham and Women's
Hospital, Boston, United States
(Gaziano) Department of Health Policy and Management, Harvard T.H. Chan
School of Public Health, Boston, United States
(Perel) World Heart Federation, Geneva, Switzerland
(Perel) Centre for Global Chronic Conditions, London School of Hygiene and
Tropical Medicine, London, United Kingdom
(Roth) Division of Cardiology, Department of Medicine, University of
Washington, WA, United States
Publisher
Sociedade Brasileira de Cardiologia

<9>
Accession Number
2026342242
Title
Impact of early versus class I-triggered surgery on postoperative survival
in severe aortic regurgitation: An observational study from the Aortic
Valve Insufficiency and Ascending Aorta Aneurysm International Registry.
Source
Journal of Thoracic and Cardiovascular Surgery. 168(4) (pp 1011-1022.e3),
2024. Date of Publication: October 2024.
Author
Hanet V.; Schafers H.-J.; Lansac E.; de Kerchove L.; El Hamansy I.;
Vojacek J.; Contino M.; Pouleur A.-C.; Beauloye C.; Pasquet A.;
Vanoverschelde J.-L.; Vancraeynest D.; Gerber B.L.
Institution
(Hanet, de Kerchove, Pouleur, Beauloye, Pasquet, Vanoverschelde,
Vancraeynest, Gerber) Department of Cardiovascular Diseases, Cliniques
Universitaires St Luc, Pole de Recherche Cardiovasculaire (CARD), Institut
de Recherche Experimentale et Clinique IREC UCLouvain, Brussels, Belgium
(Schafers) Surgery Department, Homburg-Saarland University Medical Center,
Homburg, Germany
(Lansac) Surgery Department, Institut Mutualiste Montsouris, Paris, France
(El Hamansy) Surgery Department, Montreal Heart Institute, Montreal,
Canada
(Vojacek) Surgery Department, Charles University Hospital, Hradec Kralove,
Czechia
(Contino) Surgery Department, Socio Sanitaria Territoriale Universita
degli Studi di Milano, Milano, Italy
Publisher
Elsevier Inc.
Abstract
Objectives: Class I triggers for severe and chronic aortic regurgitation
surgery mainly rely on symptoms or systolic dysfunction, resulting in a
negative outcome despite surgical correction. Therefore, US and European
guidelines now advocate for earlier surgery. We sought to determine
whether earlier surgery leads to improved postoperative survival.
<br/>Method(s): We evaluated the postoperative survival of patients who
underwent surgery for severe aortic regurgitation in the international
multicenter registry for aortic valve surgery, Aortic Valve Insufficiency
and Ascending Aorta Aneurysm International Registry, over a median
follow-up of 37 months. <br/>Result(s): Among 1899 patients (aged 49 +/-
15 years, 85% were male), 83% and 84% had class I indication according to
the American Heart Association and European Society of Cardiology,
respectively, and most were offered repair surgery (92%). Twelve patients
(0.6%) died after surgery, and 68 patients died within 10 years after the
procedure. Heart failure symptoms (hazard ratio, 2.60 [1.20-5.66], P =
.016) and either left ventricular end-systolic diameter greater than 50 mm
or left ventricular end-systolic diameter index greater than 25
mm/m² (hazard ratio, 1.64 [1.05-2.55], P = .030) predicted
survival independently over and above age, gender, and bicuspid phenotype.
Therefore, patients who underwent surgery based on any class I trigger had
worse adjusted survival. However, patients who underwent surgery while
meeting early imaging triggers (left ventricular end-systolic diameter
index 20-25 mm/m² or left ventricular ejection fraction 50% to
55%) had no significant outcome penalty. <br/>Conclusion(s): In this
international registry of severe aortic regurgitation, surgery when
meeting class I triggers led to postoperative outcome penalty compared
with earlier triggers (left ventricular end-systolic diameter index 20-25
mm/m² or ventricular ejection fraction 50%-55%). This
observation, which applies to expert centers where aortic valve repair is
feasible, should encourage the global use of repair techniques and the
conduction of randomized trials.<br/>Copyright &#xa9; 2023 The American
Association for Thoracic Surgery

<10>
Accession Number
2033992005
Title
Changes in the Term Neonatal Electroencephalogram with General Anesthesia:
A Systematic Review with Narrative Synthesis.
Source
Anesthesiology. 141(4) (pp 670-680), 2024. Date of Publication: 01 Oct
2024.
Author
Corlette S.J.; Walker S.M.; Cornelissen L.; Brasher C.; Bower J.; Davidson
A.J.
Institution
(Corlette, Brasher, Davidson) Department of Anaesthesia and Pain
Management, Royal Children's Hospital, Melbourne, VIC, Australia
(Corlette, Davidson) Department of Paediatrics, Melbourne Medical School,
University of Melbourne, Melbourne, VIC, Australia
(Corlette) Murdoch Children's Research Institute, Melbourne, VIC,
Australia
(Walker) Paediatric Pain Research Group, Developmental Neurosciences,
University College London Great Ormond Street Institute of Child Health,
London, United Kingdom
(Cornelissen) Department of Anesthesiology, Critical Care and Pain
Medicine, Boston Children's Hospital, Boston, MA, United States
(Cornelissen) Harvard Medical School, Boston, MA, United States
(Brasher) Department of Critical Care, Melbourne Medical School,
University of Melbourne, Melbourne, VIC, Australia
(Bower) Royal Children's Hospital, Melbourne, VIC, Australia
(Bower) Faculty of Fine Arts and Music, University of Melbourne,
Melbourne, VIC, Australia
(Davidson) Melbourne Children's Trial Centre, Murdoch Children's Research
Institute, Melbourne, VIC, Australia
Publisher
Lippincott Williams and Wilkins
Abstract
Background: Although effects of general anesthesia on neuronal activity in
the human neonatal brain are incompletely understood,
electroencephalography provides some insight and may identify
age-dependent differences. <br/>Method(s): A systematic search (MEDLINE,
Embase, PubMed, and Cochrane Library to November 2023) retrieved English
language publications reporting electroencephalography during general
anesthesia for cardiac or noncardiac surgery in term neonates (37 to 44
weeks postmenstrual age). Data were extracted, and risk of bias (ROBINS-I
Cochrane tool) and quality of evidence (Grading of Recommendations
Assessment, Development, and Evaluation [GRADE] checklist) were assessed.
<br/>Result(s): From 1,155 abstracts, 9 publications (140 neonates; 55%
male) fulfilled eligibility criteria. Data were limited, and study quality
was very low. The occurrence of discontinuity, a characteristic pattern of
alternating higher and lower amplitude electroencephalography segments,
was reported with general anesthesia (94 of 119 neonates, 6 publications)
and with hypothermia (23 of 23 neonates, 2 publications). Decreased power
in the delta (0.5 to 4 Hz) frequency range was also reported with
increasing anesthetic dose (22 neonates; 3 publications).
<br/>Conclusion(s): Although evidence gaps were identified, both
increasing sevoflurane concentration and decreasing temperature are
associated with increasing discontinuity. <br/>Copyright &#xa9; 2024 The
Author(s).

<11>
Accession Number
2033192060
Title
Concomitant Tricuspid Valve Ring Annuloplasty During Mitral Valve Surgery
Versus Mitral Valve Surgery Alone: A Systematic Review and Meta-Analysis.
Source
Heart Lung and Circulation. 33(10) (pp 1383-1392), 2024. Date of
Publication: October 2024.
Author
Poon S.S.; Chan J.; Ahmed Y.; Aslam U.; Cianci V.; Sharma S.; Kumar P.
Institution
(Poon, Ahmed, Aslam, Cianci, Sharma, Kumar) Department of Cardiothoracic
Surgery, Morriston Hospital, Wales, Swansea, United Kingdom
(Chan) Department of Cardiothoracic Surgery, Bristol Royal Infirmary,
Bristol, United Kingdom
Publisher
Elsevier Ltd
Abstract
Aim: Although current guidelines recommend concomitant tricuspid
annuloplasty for moderate or greater tricuspid regurgitation (TR) and/or
dilated annulus, there remains significant variation in undertaking
concomitant tricuspid valve surgery (TVA) across different centres. This
meta-analysis aimed to compare the clinical outcomes of concomitant
tricuspid valve surgery for patients with moderate or greater TR and/or
dilated annulus at the time of mitral valve (MV) surgery. <br/>Method(s):
A systematic review of the literature using six databases. Eligible
studies include comparative studies on TVA concomitant with MV surgery
versus MV surgery alone. A meta-analysis was performed on studies
reporting outcomes of interest to quantify the effects of concomitant
tricuspid ring annuloplasty. <br/>Result(s): Two randomised controlled
trials and six cohort studies were included in the analysis. 1,941
patients were included in the analysis, of whom, 1,090 underwent
concomitant TVA and 851 underwent MV surgery alone. Pooled analysis
demonstrated that there was less progression of moderate/severe TR in the
concomitant group (3.0% vs 9.6%; odds ratio [OR] 0.29; 95% confidence
interval [CI] 0.13-0.55; p=0.0001). There was no significant difference in
in-hospital mortality (3.0% vs 3.8%; OR 0.79; 95% CI 0.47-1.34; p=0.38).
The rate of permanent pacemaker implantation was higher in the concomitant
group although this did not reach statistical significance (7.6% vs 5.3%;
OR 1.30; 95% CI 0.85-1.98; p=0.23). Cardiopulmonary bypass was longer in
the concomitant TVA group by 20 minutes (mean difference 13.9-26.0;
p<0.00001). <br/>Conclusion(s): Our study demonstrated that concomitant
tricuspid ring annuloplasty at the time of MV surgery is associated with a
significantly lower rate of TR progression without increasing the
operative mortality. There is a trend towards a higher permanent pacemaker
implantation rate although this did not reach statistical
significance.<br/>Copyright &#xa9; 2024

<12>
Accession Number
2031304394
Title
Routine beta-blocker therapy after acute coronary syndromes: The end of an
era?.
Source
European Journal of Clinical Investigation. (no pagination), 2024. Date
of Publication: 2024.
Author
Johner N.; Gencer B.; Roffi M.
Institution
(Johner, Gencer, Roffi) Cardiology Division, Geneva University Hospitals,
Geneva, Switzerland
(Gencer) Institute of Primary Healthcare (BIHAM), University of Bern,
Bern, Switzerland
(Gencer) Department of Cardiology, Lausanne University Hospital, Lausanne,
Switzerland
Publisher
John Wiley and Sons Inc
Abstract
Background: Beta-blocker therapy, a treatment burdened by side effects
including fatigue, erectile dysfunction and depression, was shown to
reduce mortality and cardiovascular events after acute coronary syndromes
(ACS) in the pre-coronary reperfusion era. Potential mechanisms include
protection from ventricular arrhythmias, increased ischaemia threshold and
prevention of left ventricular (LV) adverse remodelling. With the advent
of early mechanical reperfusion and contemporary pharmacologic secondary
prevention, the benefit of beta-blockers after ACS in the absence of LV
dysfunction has been challenged. <br/>Method(s): The present narrative
review discusses the contemporary evidence based on searching the PubMed
database and references in identified articles. <br/>Result(s): Recently,
the REDUCE-AMI trial-the first adequately powered randomized trial in the
reperfusion era to test beta-blocker therapy after myocardial infarction
with preserved left ventricular ejection fraction (LVEF)-showed no benefit
on the composite of all-cause death or myocardial infarction over a median
3.5-year follow-up. While the benefit of beta-blockers in patients with
reduced LVEF remains undisputed, their value in post-ACS patients with
mildly reduced systolic function (LVEF 41%-49%) has not been studied in
contemporary randomized trials; in this setting, observational studies
have suggested a reduction in cardiovascular events with these agents. The
adequate duration of beta-blocker therapy remains unknown, but
observational data suggests that any mortality benefit may be lost beyond
1-12 months after ACS in patients with LVEF >40%. <br/>Conclusion(s): We
believe that there is sufficient evidence to abandon routine beta-blocker
prescription in post-ACS patients with preserved LV systolic
function.<br/>Copyright &#xa9; 2024 The Author(s). European Journal of
Clinical Investigation published by John Wiley & Sons Ltd on behalf of
Stichting European Society for Clinical Investigation Journal Foundation.

<13>
Accession Number
2031304390
Title
The impact of stroke and bleeding on mortality and quality of life during
the first year after TAVI: A POPular TAVI subanalysis.
Source
Catheterization and Cardiovascular Interventions. (no pagination), 2024.
Date of Publication: 2024.
Author
van Nuland P.J.A.; van Ginkel D.J.; Overduin D.C.; Bor W.L.; Brouwer J.;
Nijenhuis V.J.; Peper J.; van't Hof A.W.J.; Vriesendorp P.A.; ten Berg
J.M.
Institution
(van Nuland, van Ginkel, Overduin, Bor, Brouwer, Nijenhuis, Peper, ten
Berg) Department of Cardiology, St. Antonius Hospital, Nieuwegein,
Netherlands
(van Nuland) Faculty of Health, Medicine and Life Sciences (FHML),
University Maastricht, Maastricht, Netherlands
(van't Hof, Vriesendorp, ten Berg) Department of Cardiology, Maastricht
University Medical Centre, Maastricht, Netherlands
(van't Hof, Vriesendorp) Department of Cardiology, Zuyderland Medical
Centre, Heerlen, Netherlands
(van't Hof, Vriesendorp, ten Berg) Cardiovascular Research Institute
Maastricht (CARIM), Maastricht, Netherlands
Publisher
John Wiley and Sons Inc
Abstract
Background: Bleeding and stroke are frequent complications after
transcatheter aortic valve implantation (TAVI). The mortality risk
associated with these events has been reported before, but data regarding
their impact on health-related quality of life (QoL) is limited.
<br/>Aim(s): To evaluate the impact of bleeding and stroke occurring
within 30 days after TAVI, on mortality and QoL during the first year
after TAVI. <br/>Method(s): POPular TAVI was a randomized clinical trial
that evaluated the addition of clopidogrel to aspirin or oral
anticoagulation in patients undergoing TAVI. Besides clinical outcomes,
QoL was assessed using the Short Form-12 and EuroQoL Five Dimensions
questionnaires before, and at 3, 6, and 12 months after TAVI.
<br/>Result(s): Major or life-threatening bleeding occurred in 81 patients
(8.3%) and was associated with an increased risk of death (hazard ratio
[HR] 1.95 [95% confidence interval (CI) 1.00-3.79]); minor bleeding
occurred in 104 patients (10.6%) and was not associated with mortality (HR
0.75 [95% CI 0.30-1.89]). Stroke occurred in 35 patients (3.6%) and was
associated with an increased risk of death (HR 2.90 [95% CI 1.23-6.83]).
Mean mental component summary (MCS-12) scores over time were lower in
patients with major or life-threatening bleeding (p = 0.01), and similar
in patients with minor bleeding, compared to patients without bleeding;
mean physical component summary (PCS-12) scores, EQ-5D index, and visual
analog scale (VAS) were similar between those patients. Mean MCS-12 scores
were lower in patients with stroke (p = 0.01), mean PCS-12, EQ-5D index,
and VAS were similar compared to patients without stroke.
<br/>Conclusion(s): Major or life-threatening bleeding and stroke were
associated with an increased risk of death and decreased mental QoL in the
first year after TAVI.<br/>Copyright &#xa9; 2024 Wiley Periodicals LLC.

<14>
Accession Number
2034616063
Title
Has the role of troponin as a biomarker of cardiac complications after
non-cardiac surgery been fully understood?.
Source
Minerva Anestesiologica. 90(9) (pp 797-804), 2024. Date of Publication:
September 2024.
Author
Bacchetti G.; Orso D.; Bove T.
Institution
(Bacchetti, Bove) Department of Medical sciences (DaMe), University of
Udine, Udine, Italy
(Orso, Bove) Department of anesthesia and intensive care Medicine, asUFc
University Hospital of Udine, Udine, Italy
Publisher
Edizioni Minerva Medica
Abstract
Myocardial injury after non-cardiac surgery is a major issue with a rate
of almost 20%, as suggested by the literature. guidelines recommend
screening patients undergoing non-cardiac surgery who have at least one
cardiovascular risk factor. Clinical trials are characterized by a high
degree of heterogeneity. Myocardial injury definitions vary among studies,
and multiple troponin assays with different cut-offs are utilized.
Myocardial injury has a poorly understood pathophysiology. While some
studies only include troponin elevations that are thought to be caused by
ischemia, others do not. troponin elevation can be a result of
patient-related factors and comorbidities, including age, chronic renal
failure, and inflammatory status. Currently, there is no effective
strategy to prevent perioperative myocardial injury, and there are no
therapeutic options that significantly improve the outcome of patients
with myocardial injury. We have focused on this topic and on perioperative
myocardial injury to highlight the areas of research that remain
unexplored. (Cite this article as: Bacchetti g, orso D, Bove t. Has the
role of troponin as a biomarker of cardiac complications after non-cardiac
surgery been fully understood? Minerva anestesiol 2024;90:797-804. Doi:
10.23736/s0375-9393.24.18180-1)<br/>Copyright &#xa9; 2024 eDiZioNi MiNerVa
MeDica.

<15>
Accession Number
2031381262
Title
Iatrogenic pediatric unilateral vocal cord paralysis after cardiac
surgery: a review.
Source
Frontiers in Pediatrics. 12 (no pagination), 2024. Article Number:
1460342. Date of Publication: 2024.
Author
Callaghan A.; El-Hakim H.; Isaac A.
Institution
(Callaghan, El-Hakim, Isaac) Division of Pediatric Surgery, Department of
Surgery, Stollery Children's Hospital, University of Alberta, Edmonton,
AB, Canada
(El-Hakim, Isaac) Division of Otolaryngology-Head and Neck Surgery,
Department of Surgery, University of Alberta, Edmonton, AB, Canada
Publisher
Frontiers Media SA
Abstract
Unilateral vocal cord paralysis (UVCP) is a growing area of research in
pediatrics as it spans across many specialties including otolaryngology,
cardiology, general surgery, respirology, and speech language pathology.
Iatrogenic injury is the most common cause of UVCP, however there is a
wide range of data reporting the prevalence, symptom burden, and best
treatment practice for this condition. The literature included systematic
reviews and meta-analyses, retrospective studies and limited prospective
studies. Overall, the literature lacked consistency in the diagnosis,
treatment, and long-term outcomes of patients with UVCP. Many articles
conflated bilateral vocal cord paralysis (BVCP) with UVCP and had limited
data on the natural history of the condition. There was no consensus on
objective and subjective measurements to evaluate the condition or best
indications for requiring surgical intervention. Thyroplasty, injection
medialization (IM) and recurrent laryngeal nerve reinnervation (RLNR) were
the reported surgical interventions used to treat UVCP, however there was
limited data on short and long-term surgical outcomes in children. More
research is needed to determine the true prevalence, natural history,
indications for surgical intervention and long-term outcomes for pediatric
patients with this condition.<br/>Copyright 2024 Callaghan, El-Hakim and
Isaac.

<16>
Accession Number
2034618080
Title
The Impact of Novel X-Ray Systems and X-Ray System Optimization on Patient
Radiation Dose Administered During Cardiac Catheterization.
Source
Journal of Invasive Cardiology. 32(6) (pp 218-221), 2020. Date of
Publication: June 2020.
Author
Vemmou E.; Nikolakopoulos I.; Xenogiannis I.; Megaly M.; Omer M.A.;
Stanberry L.; Garberich R.; Rangan B.V.; Baran K.W.; Gossl M.; Sorajja P.;
Chavez I.; Mooney M.; Traverse J.; Wang Y.; Garcia S.; Poulose A.; Burke
M.N.; Brilakis E.S.
Institution
(Vemmou, Nikolakopoulos, Xenogiannis, Megaly, Omer, Stanberry, Garberich,
Rangan, Baran, Gossl, Sorajja, Chavez, Mooney, Traverse, Wang, Garcia,
Poulose, Burke, Brilakis) Minneapolis Heart Institute, Minneapolis Heart
Institute Foundation, Center for Coronary Artery Disease, Minneapolis, MN,
United States
Publisher
Cliggott Publishing Co.
Abstract
Introduction. The effect of x-ray system optimization on patient radiation
dose has received limited study. Methods. We analyzed patient radiation
dose in 1786 cardiac catheterization procedures (diagnostic coronary
angiography and/or percutaneous coronary intervention [PCI]) performed at
a single tertiary-care center before and after x-ray system optimization.
Results. After optimization, cineangiography dose-area product (DAP) dose
was lower in the overall group of patients who underwent diagnostic
angiography and/or PCI (1347 muGy*m² [IQR, 645-2345
muGy*m²] vs 1658 muGy*m² [IQR, 640-2757
muGy*m²]; P=.03), as well as in the diagnostic angiography
group (1795 muGy*m² [IQR, 1140-2994 muGy*m²] vs 2356
muGy*m² [IQR, 311-3576 muGy*m²]; P<.01) and PCI
group (2152 muGy*m² [IQR, 1338-3477 muGy*m²] vs 2562
muGy*m² [IQR, 1681-3859 muGy*m²]; P=.02).
Cineangiography DAP per exposure was also lower in the overall group (143
muGy*m² [IQR, 91-212 muGy*m²] vs 164
muGy*m² [IQR, 106-233 muGy*m²] per exposure; P<.01)
and in the diagnostic angiography group (158 muGy*m² [IQR,
102-225 muGy*m²] vs 184 muGy*m² [IQR, 125-271
muGy*m²] per exposure; P<.01). After optimization,
cineangiography air kerma (AK) dose (319 mGy [IQR, 197-531 mGy] vs 421 mGy
[IQR, 241-600 mGy]; P=.01) and cineangiography AK per exposure (20.7 mGy
[IQR, 12.9-29.0 mGy] vs 23.6 mGy [IQR, 14.1-32.9 mGy] per exposure; P=.03)
were also lower in the PCI group. There was no significant change in
fluoroscopy AK dose after optimization (20.7 mGy [IQR, 12.7-30.1 mGy] vs
20.4 mGy [IQR, 12.8-31.3 mGy] per minute; P=.71) and fluoroscopy DAP dose
(156 muGy*m² [IQR, 101-242 muGy*m²] vs 156
muGy*m² [IQR, 102-236 muGy*m²] per minute; P=.91).
Conclusion. X-ray system optimization was associated with lower
cineangiography DAP, but similar fluoroscopy radiation dose.<br/>Copyright
&#xa9; 2020 Cliggott Publishing Co.. All rights reserved.

<17>
Accession Number
2034526612
Title
Stroke Prevention with Prophylactic Left Atrial Appendage Occlusion in
Cardiac Surgery Patients Without Atrial Fibrillation: A Meta-Analysis of
Randomized and Propensity-Score Studies.
Source
Circulation: Cardiovascular Interventions. (no pagination), 2024. Date of
Publication: 2024.
Author
Baudo M.; Sicouri S.; Yamashita Y.; Senzai M.; McCarthy P.M.; Gerdisch
M.W.; Whitlock R.P.; Ramlawi B.
Institution
(Baudo, Sicouri, Yamashita, Senzai, Ramlawi) Department of Cardiac Surgery
Research, Lankenau Heart Institute, Main Line Health, Wynnewood, PA,
United States
(Yamashita, Ramlawi) Lankenau Institute for Medical Research, Department
of Cardiac Surgery, Lankenau Heart Institute, Main Line Health, Wynnewood,
PA, United States
(McCarthy) Division of Cardiac Surgery, Bluhm Cardiovascular Institute,
Northwestern Medicine, Chicago, IL, United States
(Gerdisch) Department of Cardiothoracic Surgery, Franciscan Health
Indianapolis, IN, United States
(Whitlock) Department of Health Research Methods, Evidence, and Impact,
McMaster University, Hamilton, ON, Canada
(Whitlock) Population Health Research Institute, Hamilton, ON, Canada
(Whitlock) Michael G. DeGroote School of Medicine, McMaster University,
Hamilton, ON, Canada
(Whitlock) Division of Critical Care, Department of Medicine, McMaster
University, Hamilton, ON, Canada
(Whitlock) Division of Cardiac Surgery, Department of Surgery, McMaster
University, Hamilton, ON, Canada
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND: The role of left atrial appendage occlusion (LAAO) in patients
without previous atrial fibrillation (AF) is not established. This
meta-analysis was conducted on patients with normal sinus rhythm who
underwent cardiac surgery, with and without concomitant LAAO, to evaluate
its effect on the incidence of cerebrovascular accidents (CVAs).
<br/>METHOD(S): A systematic review was conducted from inception until
December 2023 for randomized and propensity-score studies comparing CVA in
patients without AF undergoing cardiac surgery with or without LAAO.
<br/>RESULT(S): Six studies met our inclusion criteria with a total of
4130 patients: 2146 in the LAAO group and 1984 in the no-LAAO group. The
risk ratio of postoperative AF was 1.05 (95% CI, 0.86-1.28); P=0.628. The
CVA rates at 5 years were 6.8+/-1.0% in the no-LAAO group and 4.3+/-0.8%
in the LAAO group (log-rank P=0.021). The Cox regression analysis for CVA
in patients undergoing LAAO reported a hazard ratio of 0.65 (95% CI,
0.45-0.94); P=0.022. Landmark analysis at 4 years highlighted a
significant difference in overall survival between no-LAAO and LAAO
groups, 86+/-12.2% versus 89.6+/-11.0%; P=0.041. <br/>CONCLUSION(S): In
this meta-analysis of patients without previous AF undergoing cardiac
surgery, LAAO was associated with a decreased risk of CVA, no difference
in the incidence of postoperative atrial fibrillation, and a significant
overall survival benefit at a 4-year landmark analysis. Although these
findings support LAAO, the randomized LeAAPS trial (Left Atrial Appendage
Exclusion for Prophylactic Stroke Reduction Trial), LAA-CLOSURE trial (A
Randomized Prospective Multicenter Trial for Stroke Prevention by
Prophylactic Surgical Closure of the Left Atrial Appendage in Patients
Undergoing Bioprosthetic Aortic Valve Surgery), and LAACS-2 trial (Left
Atrial Appendage Closure by Surgery-2) will help define the effectiveness
of LAAO in patients undergoing cardiac surgery who have risk factors for
AF and CVA. REGISTRATION: URL: https://www.crd.york.ac.uk/prospero/;
Unique identifier: CRD42024496366.<br/>Copyright &#xa9; 2024 American
Heart Association, Inc.

<18>
Accession Number
2031369465
Title
Minimally Invasive Coronary Artery Bypass Grafting for Multivessel
Coronary Artery Disease: A Systematic Review.
Source
Innovations: Technology and Techniques in Cardiothoracic and Vascular
Surgery. (no pagination), 2024. Date of Publication: 2024.
Author
Sef D.; Thet M.S.; Hashim S.A.; Kikuchi K.
Institution
(Sef) Department of Cardiac Surgery, University Hospitals of Leicester,
United Kingdom
(Thet) Department of Surgery and Cancer, Faculty of Medicine, Imperial
College London & Imperial College Healthcare NHS Trust, United Kingdom
(Hashim) Department of Cardiothoracic Surgery, University of Malaya
Medical Centre, Kuala Lumpur, Malaysia
(Kikuchi) Department of Cardiovascular Surgery, Tokyo Bay Urayasu Ichikawa
Medical Center, Japan
Publisher
SAGE Publications Ltd
Abstract
Objective: We conducted a systematic review of all available evidence on
the feasibility and safety of minimally invasive coronary artery bypass
grafting (MICS CABG) in patients with multivessel coronary artery disease
(CAD). <br/>Method(s): A systematic literature search in PubMed, MEDLINE
via Ovid, Embase, Scopus, and Web of Science was performed to identify all
relevant studies evaluating outcomes of MICS CABG among patients with
multivessel CAD and including at least 15 patients with no restriction on
the publication date. <br/>Result(s): A total of 881 studies were
identified, of which 26 studies met the eligibility criteria. The studies
included a total of 7,556 patients. The average patient age was 63.3 years
(range 49.5 to 69.0 years), male patients were an average of 77.8% (54.0%
to 89.8%), and body mass index was 29.8 kg/m² (24.5 to 30.1
kg/m²). Early mortality and stroke were on average 0.6% (range
0% to 2.0%) and 0.4% (range 0% to 1.3%), respectively. The average number
of grafts was 2.8 (range 2.1 to 3.7). The average length of hospital stay
was 5.6 days (range 3.1 to 9.3 days). <br/>Conclusion(s): MICS CABG
appears to be a safe method in well-selected patients with multivessel
CAD. This approach is concentrated at dedicated centers, and there is no
widespread application, although it has potential to be widely applicable
as an alternative for surgical revascularization. However, large
randomized controlled studies with longer follow-up are still required to
compare the outcomes with conventional CABG and other revascularization
strategies.<br/>Copyright &#xa9; The Author(s) 2024.

<19>
Accession Number
2031349478
Title
Systematic review of clinical guidelines and consensus statements
concerning heparin and protamine dosing and monitoring of anticoagulation
levels for non-cardiac arterial procedures.
Source
Vascular. (no pagination), 2024. Date of Publication: 2024.
Author
Roosendaal L.C.; Doganer O.; Wiersema A.M.; Blankensteijn J.D.; Jongkind
V.
Institution
(Roosendaal, Wiersema, Jongkind) Department of Vascular Surgery,
Dijklander Ziekenhuis, Hoorn, Netherlands
(Roosendaal, Doganer, Wiersema, Blankensteijn, Jongkind) Department of
Vascular Surgery, Amsterdam UMC, Amsterdam, Netherlands
(Roosendaal, Doganer, Wiersema, Blankensteijn, Jongkind) Amsterdam
Cardiovascular Sciences, Microcirculation, Amsterdam, Netherlands
Publisher
SAGE Publications Ltd
Abstract
Objectives: This systematic review was performed to examine all published
practice Guidelines and Consensus Statements (together: GCS) on heparin
dosing and monitoring during non-cardiac arterial procedures (NCAP). The
objective was to scrutinize the recommendations and advice outlined within
these GCS documents and to evaluate the supporting evidence for these
recommendations. Additionally, the use of the activated clotting time
(ACT) and target ACT values were explored. <br/>Method(s): This systematic
review was performed in accordance with the PRISMA Guidelines. Medline and
Embase databases were searched to identify all GCSs in the English
language on NCAP. The final literature search was performed in January
2023. This search was supplemented by searching websites of relevant
professional vascular surgical organizations for GCSs. Titles and
abstracts were assessed by two independent reviewers. <br/>Result(s): Of
9716 titles identified, 27 GCSs met the predefined inclusion criteria: six
GCSs regarding carotid intervention, seven regarding procedures for
aneurysmal disease of the abdominal aorta and iliac arteries, 12 regarding
interventions for acute and chronic peripheral arterial occlusive disease
and two regarding open and endovascular interventions of thoraco-abdominal
aortic aneurysms. Administration of heparin is advised for al NCAP. There
was high variability concerning heparin dose: both standard dose as weight
based dosing (30-150 IU/kg) was advised. Recommendations on repeated
doses, ACT monitoring and heparin reversal using protamine also varied
widely. In none of the GCSs, the type of the ACT measuring device or used
cartridges were specified. <br/>Conclusion(s): Large variability was found
between the included GCSs with regard to the recommendations on heparin
dose and target ACT values during NCAP. Advice and recommendations in GCSs
were based on low-quality studies or without providing any reference at
all. The described variability in recommendations emphasizes the need for
large prospective (randomized) studies or the incorporation of data on
heparin and the use of ACT monitoring into verified vascular surgery
registries, to develop evidence-based, practical and uniform applicable
recommendations.<br/>Copyright &#xa9; The Author(s) 2024.

<20>
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

<21>
Accession Number
2028041857
Title
The effect of intravenous milrinone in adult critically ill patients: A
meta-analysis of randomized clinical trials.
Source
Journal of Critical Care. 79 (no pagination), 2024. Article Number:
154431. Date of Publication: February 2024.
Author
Xu J.; Zhang Y.; Jiang J.; Yang Y.; Guo F.
Institution
(Xu, Yang, Guo) Jiangsu Provincial Key Laboratory of Critical Care
Medicine, Department of Critical Care Medicine, Zhongda Hospital, School
of Medicine, Southeast University, Nanjing 210009, China
(Zhang) Department of Critical Care Medicine, Zhongda Hospital, School of
Medicine, Southeast University, Nanjing 210009, China
(Jiang) Department of Critical Care Medicine, Zhongda Hospital, School of
Medicine, Nanjing Central Hospital, Nanjing 210009, China
Publisher
W.B. Saunders
Abstract
Background: Milrinone is widely used for enhancing myocardial
contractility, however, there is inadequate data to suggest whether it is
preferable to other inotropic agents in critically ill patients. To
observe the effect of milrinone on prognosis in adult critically ill
patients, we conducted this meta-analysis. <br/>Method(s): A search of the
following databases was conducted: Medline, Elsevier, Cochrane Central
Register of Controlled Trials and Web of Science databases, and eligible
randomized controlled trials including adult critically ill patients were
screened. Two reviewers collected data separately, information was
retrieved including study design, center number, sample size, gender, age,
intervention and outcome. Data were analyzed using methods recommended by
the Cochrane Collaboration Review Manager 4.2 software. Random errors were
evaluated by trial sequential analysis (TSA). <br/>Result(s): Twenty
studies including 2036 critically ill patients which compared milrinone
with control group were enrolled. When compared to control group, there
was no significant difference of all-cause mortality, while the incidence
of ventricular arrhythmia decreased significantly in patients with cardiac
surgery who using milrinone, but not in patients with cardiac dysfunction
and shock. There was no significant reduction in the incidence of
myocardial infarction and no improvement of hemodynamic parameters in the
milrinone group. TSA indicated lack of firm evidence for a beneficial
effect. <br/>Conclusion(s): The meta-analysis showed when compared with
control group, although no significant reduction in mortality and the
incidence of myocardial infarction was found in the milrinone group, the
incidence of ventricular arrhythmia decreased significantly in patients
with cardiac surgery. More randomized controlled trials are needed to
determine the reliable and conclusive evidence for milrinone's
effects.<br/>Copyright &#xa9; 2023

<22>
Accession Number
2034380679
Title
A RANDOMIZED CONTROLLED DOUBLE-BLINDED STUDY OF DEXMEDETOMIDATE IN
PREVENTING INTRA OPERATIVE AND POST-OPERATIVE ARRYTHYMIAS IN PEDIATRIC
CONGENITAL HEART SURGERY.
Source
Journal of Cardiovascular Disease Research. 15(4) (pp 1887-1894), 2024.
Date of Publication: 2024.
Author
Janapati S.R.; Singh N.; Nagaraj
Institution
(Janapati) NMC Royal Hospital, Sharjah, United Arab Emirates
(Singh, Nagaraj) Department of Anesthesia, Sri Jayadeva Institute of
Cardiovascular Sciences and Research, Karnataka, Bangalore, India
Publisher
EManuscript Technologies
Abstract
Introduction: Dexmedetomidine, a selective alpha2-adrenergic agonist, is
commonly used for its sedative and analgesic properties in pediatric
patients undergoing cardiothoracic surgery. Despite its known benefits,
the efficacy of dexmedetomidine in reducing perioperative arrhythmias
remains unclear. The aim is to determine the impact of dexmedetomidine
administration on the incidence of supraventricular and ventricular
arrhythmias in pediatric patients undergoing cardiothoracic surgeries with
cardiopulmonary bypass. <br/>Material(s) and Method(s): This was a
prospective, randomized, double-blinded controlled trial involving 56
pediatric patients (aged 6 months to 10 years) undergoing cardiothoracic
procedures with CPB. Patients were randomly assigned into two groups using
a computer-generated number table: the dexmedetomidine group (Group A)
received a loading dose followed by a maintenance infusion of
dexmedetomidine, and the control group (Group B) did not receive
dexmedetomidine. Primary outcomes measured were the incidence of
supraventricular and ventricular arrhythmias. Secondary outcomes included
the duration of mechanical ventilation, hemodynamic stability, length of
CICU and hospital stay, and perioperative mortality. <br/>Result(s): There
were no statistically significant differences in the incidence of
supraventricular (p-values ranging from 0.75 to 0.88) or ventricular
arrhythmias (p-values from 0.76 to 0.85) between the dexmedetomidine and
control groups. Similarly, there were no significant differences in
secondary outcomes such as duration of mechanical ventilation, CICU and
hospital stay, or adverse events like bradycardia and hypotension.
<br/>Conclusion(s): Dexmedetomidine administration during the
perioperative period does not significantly reduce the incidence of
supraventricular and ventricular arrhythmias in pediatric patients
undergoing cardiothoracic surgeries. While it is effective for sedation
and maintaining hemodynamic stability, its specific role in preventing
perioperative arrhythmias may be limited and warrants further
investigation.<br/>Copyright &#xa9; 2024 EManuscript Technologies. All
rights reserved.

<23>
Accession Number
2033539319
Title
Antithrombotic Strategies According to Age: Insights from the AUGUSTUS
Trial.
Source
American Journal of Medicine. 137(10) (pp 958-965), 2024. Date of
Publication: October 2024.
Author
Guimaraes P.O.; Lopes R.D.; Wojdyla D.M.; Alexander J.H.; Goodman S.G.;
Aronson R.; Halvorsen S.; Sinnaeve P.; Vinereanu D.; Storey R.F.;
Berwanger O.; Windecker S.; Mehran R.; Granger C.B.; Alexander K.P.
Institution
(Guimaraes, Lopes, Wojdyla, Alexander, Granger, Alexander) Duke Clinical
Research Institute, Duke University School of Medicine, Durham, NC, United
States
(Guimaraes, Berwanger) Hospital Israelita Albert Einstein, Sao Paulo-SP,
Brazil
(Goodman) St. Michael's Hospital, Unity Health Toronto, University of
Toronto, Toronto, ON, Canada
(Goodman) Canadian VIGOUR Centre, University of Alberta, Edmonton, Canada
(Aronson) Bristol Myers Squibb, Lawrenceville, NJ, United States
(Halvorsen) University of Oslo, Oslo, Norway
(Sinnaeve) Department of Cardiovascular Medicine, University Hospitals
Leuven, Leuven, Belgium
(Sinnaeve) University of Leuven, Leuven, Belgium
(Vinereanu) University of Medicine and Pharmacy Carol Davila University,
Bucharest, Romania
(Vinereanu) Emergency Hospital of Bucharest, Bucharest, Romania
(Storey) Division of Clinical Medicine, University of Sheffield,
Sheffield, United Kingdom
(Storey) NIHR Sheffield Biomedical Research Centre, Sheffield Teaching
Hospital NHS Foundation Trust, Sheffield, United Kingdom
(Berwanger) George Institute for Global Health UK, London, United Kingdom
(Berwanger) Imperial College London, London, United Kingdom
(Windecker) Department of Cardiology, Inselspital, Bern University
Hospital, University of Bern, Bern, Switzerland
(Mehran) Icahn School of Medicine at Mount Sinai, NY, United States
Publisher
Elsevier Inc.
Abstract
Objective: We aimed to evaluate the safety and efficacy of antithrombotic
strategies by age in patients with atrial fibrillation and acute coronary
syndrome and/or percutaneous coronary intervention in AUGUSTUS.
<br/>Method(s): Patients were stratified into 3 age groups: <65, 65-74,
and >=75 years. Outcomes of interest were major or clinically relevant
non-major bleeding, major bleeding, death or rehospitalization, and
ischemic events. Treatment effects of apixaban vs. vitamin K antagonist
(VKA) and aspirin vs. placebo were assessed across age groups using Cox
models. <br/>Result(s): Of 4614 patients, 1267 (27.5%) were <65, 1802
(39.0%) were 65-74, and 1545 (33.5%) were >=75 years. Apixaban was
associated with lower rates of major or clinically relevant non-major
bleeding than VKA (<65: HR 0.69 [0.47-1.00]; 65-74: HR 0.57 [0.43-0.75];
>=75: HR 0.81 [0.63-1.04]). Death or hospitalization occurred less often
with apixaban, regardless of age. No differences were observed in rates of
ischemic events between apixaban and VKA according to age. Aspirin was
associated with higher rates of bleeding than placebo (<65: HR 1.67
[1.15-2.43]; 65-74: HR 2.32 [1.73-3.10]; >=75: HR 1.69 [1.31-2.19]). Rates
of death or rehospitalization and ischemic events were similar among
patients receiving aspirin or placebo across age groups.
<br/>Conclusion(s): Apixaban was associated with greater absolute
reduction in bleeding than VKA in older age groups, reflecting their
higher hemorrhagic risk. Aspirin increased bleeding in all age groups vs.
placebo. Our findings support the use of apixaban plus a purinergic
receptor P2Y<inf>12</inf> (P2Y<inf>12</inf>) inhibitor without aspirin in
patients with atrial fibrillation and recent acute coronary
syndrome/percutaneous coronary intervention, regardless of
age.<br/>Copyright &#xa9; 2024 Elsevier Inc.

<24>
Accession Number
2033299030
Title
Effect of Preoperative Recombinant Human Erythropoietin on the Need for
Blood Transfusion and Surgical Outcomes in Adult Patients Undergoing
Cardiac Surgery: A Systematic Review and Meta-Analysis with Trial
Sequential Analysis.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 38(10) (pp 2402-2411),
2024. Date of Publication: October 2024.
Author
Hakim S.M.; Ahmad A.H.M.; Amer A.M.
Institution
(Hakim, Ahmad, Amer) Department of Anesthesiology, Intensive Care and Pain
Management, Ain Shams University Faculty of Medicine, Cairo, Egypt
Publisher
W.B. Saunders
Abstract
This study aimed to examine the value of preoperative recombinant human
erythropoietin (rhEPO) administration to adults undergoing elective
cardiac surgery. Databases were searched for randomized controlled trials
(RCTs) comparing rhEPO plus standard treatment versus standard treatment
only. Primary outcomes were the need for and volume of homologous blood
transfusion (HBT). Secondary outcomes were the lengths of intensive care
unit (ICU) and hospital stay and the incidence of major adverse events.
There was very low certainty that rhEPO is associated with a reduction in
the need for HBT, with a number needed to treat of 5.6 (95% confidence
interval [CI], 3.9-12.5), and low certainty that it is associated with a
moderate reduction in HBT volume (Hedges g = -0.55; 95% CI, -0.79 to
-0.32). Meta-regression revealed that studies with a higher proportion of
females or older patients demonstrated less benefit of rhEPO in terms of
reduced consumption of HBT. Trial sequential analysis showed that rhEPO
was superior to standard treatment only for reducing the need for and
volume of HBT. Regarding secondary outcomes, there was moderate certainty
that rhEPO is associated with a limited reduction in the length of ICU
(Hedges g = -0.10; 95% CI, -0.19 to -0.01) and hospital stay (Hedges g =
-0.13; 95% CI = -0.25 to -0.02), and low certainty for increased risk of
myocardial infarction, with a number needed to harm of 36.1 (95% CI,
17.9-127.4). More well-designed, adequately powered RCTs are needed to
draw conclusions regarding the value of rhEPO.<br/>Copyright &#xa9; 2024
Elsevier Inc.

<25>
Accession Number
2031342572
Title
Transthoracic Cross Clamp versus Endoaortic Balloon Occlusion in Minimally
Invasive Mitral Valve Surgery: A Pooled Study with Subgroup Analyses.
Source
Journal of Clinical Medicine. 13(17) (no pagination), 2024. Article
Number: 4989. Date of Publication: September 2024.
Author
Magouliotis D.E.; Sicouri S.; Baudo M.; Yamashita Y.; Xanthopoulos A.;
Arjomandi Rad A.; Athanasiou T.; Ramlawi B.
Institution
(Magouliotis, Sicouri, Baudo, Yamashita, Ramlawi) Department of Cardiac
Surgery Research, Lankenau Institute for Medical Research, Main Line
Health, Wynnewood, PA 19096, United States
(Baudo, Yamashita, Ramlawi) Department of Cardiac Surgery, Lankenau Heart
Institute, Main Line Health, Wynnewood, PA 19096, United States
(Xanthopoulos) Department of Cardiology, University of Thessaly, Larissa
412 23, Greece
(Arjomandi Rad) Division of Medical Sciences, University of Oxford, Oxford
OX1 2JD, United Kingdom
(Athanasiou) Department of Surgery and Cancer, Imperial College London, St
Mary's Hospital, London W2 1NY, United Kingdom
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Objective: We assessed the available literature regarding patients
undergoing minimally invasive mitral valve surgery (MIMVS) with either
transthoracic clamping (TTC) or endoaortic balloon occlusion (EABO).
<br/>Method(s): Original research studies that evaluated the perioperative
outcomes of TTC versus EABO group were identified from 2000 to 2024. The
incidence of all-cause mortality, cerebrovascular accidents (CVA), and
aortic dissections were the primary endpoints. The cardiopulmonary bypass
(CPB), cross-clamp, and ventilation time, along with the incidence of
conversion to sternotomy, re-exploration, new-onset atrial fibrillation
(AF), postoperative acute kidney injury (AKI), ICU stay, and LOS were the
secondary endpoints. Subgroup analyses were performed regarding the EABO
cannulation approach (femoral and aortic) and MIMVS approach
(video-assisted and robotic-assisted). Sensitivity analyses were performed
with the leave-one-out method and by including risk-adjusted populations.
<br/>Result(s): Sixteen studies were included in both the qualitative and
quantitative syntheses. After pooling data from 6335 patients, both groups
demonstrated similar outcomes on all primary and secondary endpoints in
the non-adjusted and adjusted total cohort analyses. These outcomes were
further validated by the leave-one-out sensitivity analysis. In addition,
the aortic cannulation EABO was associated with a lower cross-clamp time,
followed by TTC and the femoral cannulation EABO approach. Furthermore, in
the video-assisted subgroup analysis, the EABO approach was associated
with a higher incidence of CVA, conversion to sternotomy, and longer ICU
stay compared to the TTC group. <br/>Conclusion(s): The present
meta-analysis indicates that both aortic occlusion techniques are safe and
feasible in the context of MIMVS. A future well-designed
randomized-control trial should further validate the current
outcomes.<br/>Copyright &#xa9; 2024 by the authors.

<26>
Accession Number
2031308456
Title
Outcomes after transcatheter aortic valve replacement in cancer survivors
with prior chest radiation therapy: an updated systematic review and
meta-analysis.
Source
Cardio-Oncology. 10(1) (no pagination), 2024. Article Number: 61. Date of
Publication: December 2024.
Author
Yasmin F.; Moeed A.; Alam M.T.; Virwani V.; Khabir Y.; Shaikh A.; Vyas
A.V.; Alraies M.C.
Institution
(Yasmin) Yale University School of Medicine, New Haven, CT 06511, United
States
(Moeed, Alam, Khabir) Dow University of Health Sciences, PK, Karachi,
Pakistan
(Virwani, Shaikh) Aga Khan University Hospital, Karachi 74800, Pakistan
(Vyas) Lehigh Valley Heart and Vascular Institute, Allentown, PA, United
States
(Alraies) Detroit Medical Center, Detroit, MI, United States
(Yasmin) Yale School of Medicine, New Haven, CT 06511, United States
Publisher
BioMed Central Ltd
Abstract
Clinical outcomes for TAVR in cancer survivors with prior chest radiation
therapy (C-XRT) who develop symptomatic aortic-valve stenosis are not
adequately assessed in major clinical trials leading to conflicting
results. Hence, we conducted this meta-analysis to evaluate the, safety,
efficacy, and mortality outcomes of cancer survivors with prior C-XRT
undergoing TAVR. MEDLINE and Scopus were searched up to March 2024.
Observational studies and randomized controlled trials comparing severe
aortic stenosis patients with and without prior C-XRT undergoing TAVR with
at least one outcome of interest were shortlisted. Data were analyzed
using random-effects model to derive weighted mean differences, and risk
ratios with 95% confidence intervals. Six studies with 6,191 patients (278
C-XRT and 5,913 no-C-XRT) were included. All-cause mortality at 30-day (RR
1.63, p = 0.12) and 1-year interval (RR 1.59, p = 0.08) showed no
significant differences with prior C-XRT versus no-C-XRT. Worsening CHF
was the only post-procedural safety outcome significantly higher in
patients with prior C-XRT (RR 1.98, p = 0.0004) versus no- C-XRT. The
efficacy end-points i.e., improvement in LVEF (MD 1.24; -0.50, 2.98), and
aortic valve gradient (MD -0.63; -1.32, 0.05) were not significantly
different. TAVR has similar all-cause mortality, efficacy and safety
(except CHF worsening) among cancer survivors with and without a prior
history of C-XRT.<br/>Copyright &#xa9; The Author(s) 2024.

<27>
Accession Number
2031022177
Title
Aspirin-Free Strategy for Percutaneous Coronary Intervention in Patients
With Oral Anticoagulation: Prespecified Subgroup Analysis From the
STOPDAPT-3 Trial.
Source
Journal of the American Heart Association. 13(15) (no pagination), 2024.
Article Number: e034201. Date of Publication: 06 Aug 2024.
Author
Natsuaki M.; Watanabe H.; Morimoto T.; Yamamoto K.; Obayashi Y.; Nishikawa
R.; Ando K.; Suwa S.; Isawa T.; Takenaka H.; Ishikawa T.; Yamada M.;
Wakatsuki T.; Nozaki Y.; Kitahara H.; Kato R.; Kawai R.; Kobayashi Y.;
Ishii M.; Goto Y.; Ono K.; Kimura T.
Institution
(Natsuaki) Department of Cardiovascular Medicine, Saga University, Saga,
Japan
(Watanabe, Takenaka, Kimura) Division of Cardiology, Hirakata Kohsai
Hospital, Hirakata, Japan
(Morimoto) Department of Clinical Epidemiology, Hyogo College of Medicine,
Nishinomiya, Japan
(Yamamoto, Ando) Department of Cardiology, Kokura Memorial Hospital,
Kitakyusyu, Japan
(Obayashi, Nishikawa, Ono) Department of Cardiovascular Medicine, Graduate
School of Medicine, Kyoto University, Kyoto, Japan
(Suwa) Department of Cardiology, Juntendo University Shizuoka Hospital,
Izunokuni, Japan
(Ishikawa) Department of Cardiology, Sendai Kousei Hospital, Sendai, Japan
(Ishikawa) Department of Cardiology, Dokkyo Medical University Saitama
Medical Center, Koshigaya, Japan
(Yamada) Division of Cardiology, Shizuoka Saiseikai General Hospital,
Shizuoka, Japan
(Wakatsuki) Department of Cardiovascular Medicine, Tokushima University
Hospital, Tokushima, Japan
(Nozaki) Department of Cardiovascular Medicine, Hokko Memorial Hospital,
Sapporo, Japan
(Kitahara) Department of Cardiovascular Medicine, Chiba University
Hospital, Chiba, Japan
(Kato) Department of Cardiology, Higashiyamato Hospital, Higashiyamato,
Japan
(Kawai) Department of Cardiology, Tenri Hospital, Tenri, Japan
(Kobayashi) Department of Cardiovascular Center, Japanese Red Cross Osaka
Hospital, Osaka, Japan
(Ishii) Department of Cardiology, Kyoto Medical Center, Kyoto, Japan
(Goto) Department of Cardiology, Fukuoka Wajiro Hospital, Fukuoka, Japan
Publisher
American Heart Association Inc.
Abstract
BACKGROUND: The effects of aspirin-free strategy on bleeding and
cardiovascular events in patients undergoing percutaneous coronary
intervention with oral anticoagulation (OAC) have not been fully
elucidated. METHODS AND RESULTS: We conducted the prespecified subgroup
analysis based on the use of OAC, including vitamin K antagonist and
direct oral anticoagulants, within 7 days before percutaneous coronary
intervention in the STOPDAPT-3 (Short and Optimal Duration of Dual
Antiplatelet Therapy-3) trial, which randomly compared prasugrel
monotherapy (2984 patients) to dual antiplatelet therapy (DAPT) with
prasugrel and aspirin (2982 patients) in patients with acute coronary
syndrome or high bleeding risk. The coprimary end points were major
bleeding events (Bleeding Academic Research Consortium types 3 or 5) and
cardiovascular events (a composite of cardiovascular death, myocardial
infarction, definite stent thrombosis, or ischemic stroke) at 1 month.
Among 5966 study patients, there were 530 patients (8.9%) with OAC (no
aspirin: N=248, and DAPT: N=282) and 5436 patients (91.1%) without OAC (no
aspirin: N=2736, and DAPT: N=2700). Regardless of the use of OAC, the
effects of no aspirin compared with DAPT were not significant for the
bleeding end point (OAC: 4.45% and 4.27%, hazard ratio [HR], 1.04 [95% CI,
0.46-2.35]; no-OAC: 4.47% and 4.75%, HR, 0.94 [95% CI, 0.73-1.20]; P for
interaction=0.82), and for the cardiovascular end point (OAC: 4.84% and
3.20%, HR, 1.53 [95% CI, 0.64-3.62]; no-OAC: 4.06% and 3.74%, HR, 1.09
[95% CI 0.83-1.42]; P for interaction =0.46). <br/>CONCLUSION(S): The
no-aspirin strategy compared with the DAPT strategy failed to reduce major
bleeding events irrespective of the use of OAC. There was a numerical
excess risk of the no-aspirin strategy relative to the DAPT strategy for
cardiovascular events in patients with OAC.<br/>Copyright &#xa9; 2024 The
Author(s).

<28>
Accession Number
2030829606
Title
Cerebral embolic protection for stroke prevention during transcatheter
aortic valve replacement.
Source
Expert Review of Cardiovascular Therapy. 22(8) (pp 409-420), 2024. Date of
Publication: 2024.
Author
Basit J.; Ahmed M.; Kidess G.; Zaheer Z.; Fatima L.; Naveed H.; Hamza M.;
Fatima M.; Goyal A.; Loyalka P.; Alam M.; Alraies M.C.
Institution
(Basit, Ahmed) Department of Medicine, Rawalpindi Medical University,
Rawalpindi, Pakistan
(Kidess) Department of Internal Medicine, Wayne State University, MI,
United States
(Zaheer, Fatima) Department of Medicine, King Edward Medical University,
Lahore, Pakistan
(Fatima) Department of Medicine, Allama Iqbal Medical College, Lahore,
Pakistan
(Naveed) University of Houston/HCA kingwood Hospital, Houston, TX, United
States
(Hamza) Department of Hospital Medicine, Guthrie Cortland Medical Center,
Cortland, NY, United States
(Goyal) Department of Internal Medicine, Seth GS Medical College and KEM
Hospital, Mumbai, India
(Loyalka) Department of cardiology, HCA medical Center, Houston, TX,
United States
(Alam) Department of Interventional Cardiology, Baylor College of
Medicine, Houston, TX, United States
(Alraies) Cardiovascular Institute, Detroit Medical Center, Detroit, MI,
United States
Publisher
Taylor and Francis Ltd.
Abstract
Introduction: Cerebral Embolic Protection Device (CEPD) captures emboli
during Transcatheter Aortic Valve Replacement (TAVR). With recently
published pivotal trials and multiple cohort studies reporting new data,
there is a need to re-calibrate available statistical evidence.
<br/>Method(s): A systematic literature search was conducted across
databases from inception till February 2023. Dichotomous outcomes were
pooled using Odds Ratio (OR), while continuous outcomes were pooled using
Standardized Mean Difference (SMD) along with 95% corresponding intervals
(95% CIs). <br/>Result(s): Data was included from 17 studies (7 RCTs, 10
cohorts, n = 155,829). Use of CEPD was associated with significantly
reduced odds of stroke (OR = 0.60, 95% CI = 0.43-0.85, p = 0.003). There
was no significant difference in disabling stroke (p = 0.25),
non-disabling stroke (p = 0.72), and 30-day mortality (p = 0.10) between
the two groups. There were no significant differences between the two
groups for Diffusion-Weighted Magnetic Resonance Imaging (DW-MRI)
findings, acute kidney injury, risk of pacemaker implantation
life-threatening bleed, major bleed, minor bleed, worsening National
Institute of Health Stroke Scale (NIHSS), modified Rankin Scale (mRS) and
vascular complications (p > 0.05). <br/>Conclusion(s): The use of CEPD
during TAVR reduced the incidence of all-stroke (p = 0.003); however,
there were no significant differences in any of the other pooled outcomes
(p > 0.05). Registration: The protocol of this meta-analysis was
registered with the Open Science framework
[https://doi.org/10.17605/OSF.IO/7W564] before data acquisition was
started.<br/>Copyright &#xa9; 2024 Informa UK Limited, trading as Taylor &
Francis Group.

<29>
Accession Number
2029774978
Title
Ten-Year Outcome of Recanalization or Medical Therapy for Concomitant
Chronic Total Occlusion After Myocardial Infarction.
Source
Journal of the American Heart Association. 13(10) (no pagination), 2024.
Article Number: e033556. Date of Publication: 21 May 2024.
Author
van Veelen A.; Coerkamp C.F.; Somsen Y.B.O.; Ramunddal T.; Ioanes D.;
Laanmets P.; van der Schaaf R.J.; Eriksen E.; Bax M.; Suttorp M.J.;
Strauss B.H.; Barbato E.; Marques K.M.; Meuwissen M.; Bertrand O.; Ent M.;
Knaapen P.; Tijssen J.G.P.; Claessen B.E.P.M.; Hoebers L.P.C.; Elias J.;
Henriques J.P.S.
Institution
(van Veelen, Coerkamp, Tijssen, Claessen, Hoebers, Elias, Henriques)
Department of Cardiology, Heart Center, Amsterdam UMC, Location AMC,
Netherlands
(Somsen, Marques, Knaapen) Department of Cardiology, Heart Center,
Amsterdam UMC, Location VUMC, Netherlands
(Ramunddal, Ioanes) Amsterdam Cardiovascular Sciences, Amsterdam,
Netherlands
(Ramunddal, Ioanes) Department of Cardiology, Sahlgrenska University
Hospital, Gothenburg, Sweden
(Laanmets) Department of Cardiology, North-Estonia Medical Center,
Tallinn, Estonia
(van der Schaaf) Department of Cardiology, OLVG Hospital, Amsterdam,
Netherlands
(Eriksen) Department of Cardiology, Haukeland University Hospital, Bergen,
Norway
(Bax) Department of Cardiology, Haga Teaching Hospital, The Hague,
Netherlands
(Suttorp) Department of Cardiology, St. Antonius Hospital, Nieuwegein,
Netherlands
(Strauss) Department of Cardiology, Sunnybrook Health Sciences Centre,
Toronto, Canada
(Barbato) Department of Clinical and Molecular Medicine, Sapienza
University of Rome, Rome, Italy
(Meuwissen) Department of Cardiology, Amphia Hospital, Breda, Netherlands
(Bertrand) Department of Cardiology, Quebec HeartLung Institute, QC,
Canada
(Ent) Department of Cardiology, Maasstad Hospital, Rotterdam, Netherlands
(Hoebers) Department of Cardiology, Maastricht UMC+, Maastricht,
Netherlands
Publisher
American Heart Association Inc.
Abstract
BACKGROUND: The EXPLORE (Evaluating Xience and Left Ventricular Function
in PCI on Occlusions After STEMI) trial was the first and only randomized
trial investigating chronic total occlusion (CTO) percutaneous coronary
intervention (PCI) early after primary PCI for ST-segment-elevation
myocardial infarction, compared with medical therapy for the CTO. We
performed a 10-year follow-up of EXPLORE to investigate long-term safety
and clinical impact of CTO PCI after ST-segment-elevation myocardial
infarction, compared with no-CTO PCI. METHODS AND RESULTS: In EXPLORE, 302
patients post-ST-segment-elevation myocardial infarction with concurrent
CTO were randomized to CTO PCI within =1 week or no-CTO PCI. We performed
an extended clinical follow-up for the primary end point of major adverse
cardiac events, consisting of cardiovascular death, coronary artery bypass
grafting, or myocardial infarction. Secondary end points included
all-cause death, angina, and dyspnea. Median follow-up was 10 years
(interquartile range, 8-11 years). The primary end point occurred in 25%
of patients with CTO PCI and in 24% of patients with no-CTO PCI (hazard
ratio [HR], 1.11 [95% CI, 0.70-1.76]). Cardiovascular mortality was higher
in the CTO PCI group (HR, 2.09 [95% CI, 1.10-2.50]), but all-cause death
was similar (HR, 1.53 [95% CI, 0.93-2.50]). Dyspnea relief was more
frequent after CTO PCI (83% versus 65%, P=0.005), with no significant
difference in angina. <br/>CONCLUSION(S): This 10-year follow-up of
patients post-ST-segment-elevation myocardial infarction randomized to CTO
PCI or no-CTO PCI demonstrated no clinical benefit of CTO PCI in major
adverse cardiac events or overall mortality. However, CTO PCI was
associated with a higher cardiovascular mortality compared with no-CTO
PCI. Our long-term data support a careful weighing of effective symptom
relief against an elevated cardiovascular mortality risk in CTO PCI
decisions. REGISTRATION: URL: https://www.trialregister.nl; Unique
identifier: NTR1108.<br/>Copyright &#xa9; 2024, American Heart Association
Inc.. All rights reserved.

<30>
Accession Number
2034585743
Title
Efficacy and safety of therapeutic alpha-1-microglobulin RMC-035 in
reducing kidney injury after cardiac surgery: a multicentre, randomised,
double-blind, parallel group, phase 2a trial.
Source
eClinicalMedicine. 76 (no pagination), 2024. Article Number: 102830. Date
of Publication: October 2024.
Author
Zarbock A.; Larsson T.E.; Noiseux N.; Bohm J.; Laflamme M.; Matschke K.;
Burkert J.; de Varennes B.; Myjavec A.; Boning A.; Koyner J.L.; Engelman
D.; Reusch M.; Thielmann M.; Nazar B.A.; Brown C.; East C.; Iglesias A.G.;
Helms S.; Kress D.; Lamy A.; Mazer C.D.; Albaiceta G.M.; Carvajal I.M.;
Osaki S.; Copa G.R.; Ronco C.; Scavo V.; Shelstad R.; Swaminathan M.;
Szabo G.; Teman N.; Vojacek J.; Wahlers T.
Institution
(Zarbock) Department of Anaesthesiology, Intensive Care and Pain Medicine,
University Hospital Munster, Munster, Germany
(Larsson, Reusch) Guard Therapeutics International AB, Stockholm, Sweden
(Noiseux) Centre de Recherche du Centre Hospitalier de l'Universite de
Montreal, Montreal, Quebec, Canada
(Mazer) St. Michael's Hospital, University of Toronto, Toronto, Canada
(Bohm) Department of Cardiovascular Surgery, Institute Insure, German
Heart Center Munich, Technical University of Munich, Munich, Germany
(Laflamme) Institut Universitaire de Cardiologie et de Pneumologie de
Quebec, Quebec, Canada
(Matschke) Klinik fur Herzchirurgie, Herzzentrum Dresden
Universitatsklinik, Dresden, Germany
(Burkert) Fakultni Nemocnice v Motole, Prague, Czechia
(de Varennes) McGill University Health Centre - Royal Victoria Hospital,
Montreal, Canada
(Myjavec) Department of Cardiac Surgery, Charles University, Faculty of
Medicine and University Hospital in Hradec Kralove, Hradec Kralove,
Czechia
(Boning) Department of Cardiovascular Surgery, Justus-Liebig-University
Giessen, Germany
(Koyner) Section of Nephrology, University of Chicago, Chicago, IL, United
States
(Engelman) Division of Cardiac Surgery, Baystate Medical Center,
Springfield, MA, United States
(Thielmann) Klinik fur Thorax- und Kardiovaskulare Chirurgie,
Westdeutsches Herz- und Gefaszentrum Essen, Universitat Duisburg-Essen,
Germany
Publisher
Elsevier Ltd
Abstract
Background: Cardiac surgery invariably triggers acute kidney stress
causing adverse renal outcomes. The AKITA study evaluated the efficacy and
safety of RMC-035, a novel analogue of alpha-1-microglobulin, for reducing
cardiac surgery-associated kidney injury. <br/>Method(s): In this
randomised double-blind placebo-controlled phase 2a study, we randomly
assigned (1:1) adult hospitalised patients undergoing open-chest cardiac
surgery at high risk for acute kidney injury (AKI) at 21 sites in North
America and Europe to receive either RMC-035 (1.3 or 0.65 mg/kg) or
placebo (1:1) for 2 days (5 intravenous infusions), stratified by region
and renal function. Eligible patients had at least one pre-defined AKI
risk factor. Patients with severe renal impairment (estimated glomerular
filtration rate [eGFR] <30 mL/min/1.73 m²) were excluded. The
co-primary efficacy and safety endpoints were AKI (Kidney Disease:
Improving Global Outcomes definition) within 72 h after surgery and
nature, frequency, and severity of treatment-emergent adverse events
(TEAEs). Secondary endpoints included eGFR and Major Adverse Kidney Events
(MAKE) up to Day 90. Randomised patients who had received at least one
dose of study drug were analysed for primary and safety analyses.
Participants, investigators and sponsor were masked to treatment
allocation. This study is registered at ClinicalTrials.gov (NCT05126303)
and EudraCT (2021-004040-19). <br/>Finding(s): Patient enrolment was
stopped at interim analysis due to futility. Between March 31, 2022 and
July 12, 2023, 177 patients (RMC-035: 89, placebo: 88) were randomised and
treated. AKI rate for RMC-035 vs placebo was 50.6% (n = 45) and 39.8% (n =
35) (relative risk [RR]: 1.30, 90% confidence interval [90% CI]: 0.99,
1.71; p = 0.12). A short-lived creatinine increase was observed with the
higher RMC-035 dose. Treatment with RMC-035 was associated with improved
secondary renal outcomes at Day 90: placebo-adjusted eGFR change from
baseline 4.3 mL/min/1.73 m², 90% CI 0.51-8.12, p = 0.06; and
MAKE 6.7% (n = 6) vs 15.9% (n = 14); RR: 0.41, 90% CI: 0.19, 0.88, p =
0.05. The most frequently reported TEAEs for RMC-035 were chills (30.3%),
nausea (21.3%), anaemia (20.2%); and atrial fibrillation (29.5%), anaemia
(20.5%), hypervolemia (14.8%) for placebo. The majority of TEAEs in both
treatment groups were mild or moderate in severity. In the RMC-035 group,
26 (29.2%) patients experienced at least one severe or life-threatening
TEAE and in the placebo group 16 (18.2%) patients. There were 4 deaths per
treatment arm (one treatment-related, in placebo group).
<br/>Interpretation(s): In this proof-of-concept study, RMC-035 did not
reduce AKI 72 h after cardiac surgery. Evaluations may have been
confounded by a drug-induced transient creatinine increase in a subgroup
of patients. RMC-035 was associated with improved secondary renal
outcomes. These results merit further investigation and should be
interpreted with caution, as the study was not powered for these outcomes.
<br/>Funding(s): Guard Therapeutics.<br/>Copyright &#xa9; 2024 The
Author(s)

<31>
[Use Link to view the full text]
Accession Number
2034479567
Title
Recent advances in Del Nido cardioplegia: A comprehensive analysis of
randomized clinical trials in adult cardiac surgery.
Source
Medicine (United States). 103(36) (pp e39453), 2024. Date of Publication:
06 Sep 2024.
Author
Ahmed M.; Raja A.; Virwani V.; Raja S.; Hussain S.Y.; Moeed A.; Bai S.;
Abbas J.; Fadelallah Eljack M.M.; Asghar M.S.
Institution
(Ahmed, Raja, Hussain) Department of Internal Medicine, Shaheed Mohtarma
Benazir Bhutto Medical College Lyari, Karachi, Pakistan
(Virwani) Department of Internal Medicine, Aga Khan University and
Hospital, Karachi, Pakistan
(Raja, Moeed) Department of Internal Medicine, Dow University of Health
Sciences, Karachi, Pakistan
(Bai, Abbas) Department of Internal Medicine, Liaquat National Hospital
and Medical College, Karachi, Pakistan
(Fadelallah Eljack) University of Bakhtalruda, Faculty of Medicine and
Health Sciences, Al-Dewaym, Sudan
(Asghar) Division of Nephrology and Hypertension, Mayo Clinic, Rochester,
MN, United States
Publisher
Lippincott Williams and Wilkins
Abstract
Background: Del Nido cardioplegia (DNC) has extensively been used for
pediatric population undergoing cardiac surgery. However, its use in adult
cardiac surgeries have been limited thus, its benefits are not yet fully
known. This analysis was performed to evaluate the impact of DNC versus
any other type of cardioplegia in adult patients who are undergoing
cardiac surgery. <br/>Method(s): We systematically searched PubMed,
Cochrane Library, and Scopus from database inception till March 2023, and
moderate to high-quality randomized controlled trials were included which
compared DNC to other cardioplegia. The primary outcome was postoperative
stroke and/or transient ischemic attack (TIA). Secondary outcomes included
spontaneous rhythm return, postoperative myocardial infarction, all-cause
mortality, postoperative atrial fibrillation, defibrillation after
coronary reperfusion, postoperative intra-aortic balloon pump,
postoperative kidney injury, postoperative low cardiac output syndrome,
inotropic support, cardiopulmonary bypass time, cross-clamp time, blood
transfusion, cardioplegia volume, hospital stay, intensive care unit stay,
mechanical ventilation stay, postoperative left ventricular ejection
fraction, and cardiac markers. <br/>Result(s): In this meta-analysis, 13
studies were included with a patient population of 2207. Stroke and/or TIA
studies (risk ratio [RR]: 0.54, 95% CI [0.29, 1.00]) and all-cause
mortality studies (RR: 1.30, 95% CI [0.66, 2.56]) were insignificant. From
the secondary outcomes, spontaneous rhythm return (RR: 1.58, 95% CI [1.02,
2.45]), defibrillation after coronary reperfusion (RR: 0.49, 95% CI [0.30,
0.79]), inotropic support (RR: 0.70, 95% CI [0.57, 0.85]), composite risk
of stroke and/or TIA and/or acute kidney injury and mortality (RR: 0.72,
95% CI [0.53, 0.99]), cross-clamp time (mean difference [MD]: -6.01, 95%
CI [-11.14, -0.89]), blood transfusion (RR: 0.73, 95% CI [0.60, 0.90]),
cardioplegia volume (MD: -537.17, 95% CI [-758.89, -315.45]), troponin T
(MD: -1.71, 95% CI [-2.11, -1.32]), creatine phosphokinase-MB (MD: -2.96,
95% CI [-5.84, -0.07]) were significant. Whereas all other secondary
outcomes were found to be insignificant. <br/>Conclusion(s): No
significant difference was observed between patients undergoing Del Nido
administration in comparison to other cardioplegia solutions for the
primary outcome, stroke or/and TIA.<br/>Copyright &#xa9; 2024 Lippincott
Williams and Wilkins. All rights reserved.

<32>
Accession Number
2031493530
Title
Outcomes of mitral valve transcatheter edge-to-edge repair for patients
with hemodynamic instability: A systematic review and meta-analysis.
Source
Cardiovascular Revascularization Medicine. 67 (pp 19-28), 2024. Date of
Publication: October 2024.
Author
Yokoyama H.; Kokawa T.; Shigekiyo S.; Seno A.; Izumi T.; Ogura R.; Mahara
K.; Hosokawa S.
Institution
(Yokoyama, Kokawa, Shigekiyo, Seno, Izumi, Ogura, Mahara, Hosokawa)
Tokushima Red Cross Hospital, Tokushima, Japan
Publisher
Elsevier Inc.
Abstract
Background: The outcomes after mitral valve transcatheter edge-to-edge
repair (M-TEER) for the patients with severe mitral regurgitation (MR) in
hemodynamically unstable conditions, such as cardiogenic shock, still
remain unclear. We aimed to integrate previous publications regarding
M-TEER indicated for life-threatening conditions and indirectly
particularly compared the short-term outcomes thereof, with that of other
treatments. <br/>Method(s): We systematically searched the PubMed,
Cochrane, and MEDLINE databases for studies from inception to June 2023,
regarding M-TEER in patients with hemodynamic instability and severe MR.
The primary outcomes analyzed included the in-hospital and 30-day
mortality rates, and peri-procedural complications. <br/>Result(s): Of the
initial 820 publications, we conducted a meta-analysis of a total of 25
studies. The relative risk of moderate-to-severe or severe MR was 0.13 (95
% confidence interval [CI]: 0.10-0.18, I² = 45.2 %). The pooled
in-hospital and 30-day mortality rates were 11.8 % (95 % CI: 8.7-15.9,
I² = 96.4 %) and 14.1 % (95 % CI: 10.9-18.3, I² =
35.5 %), respectively. The 30-day mortality rate was statistically
significantly correlated with the residual moderate-to-severe or severe
MR, as per the meta-regression analysis (coefficient beta = 3.48 [95 % CI:
0.99-5.97], p = 0.006). Regarding peri-procedural complications, the
pooled rates of a stroke or transient ischemic attack, life-threatening or
major bleeding, acute kidney injury, and peri-procedural mitral valve
surgery were 2.3 % (95 % CI: 1.9-2.6), 7.6 % (95 % CI: 6.8-8.5), 32.9 %
(95 % CI: 31.6-34.3), and 1.0 % (95 % CI: 0.8-1.3), respectively.
<br/>Conclusion(s): This meta-analysis demonstrates that the relatively
higher rates of procedural complications were observed, nevertheless,
M-TEER can potentially provide favorable short-term outcomes even in
hemodynamically unstable patients. PROSPERO registration number:
CRD42023468946.<br/>Copyright &#xa9; 2024 The Authors

<33>
Accession Number
2034594491
Title
IN THE WAY: A CASE OF RIGHT VENTRICULAR OUTFLOW TRACT OBSTRUCTION CAUSED
BY LEFT VENTRICULAR ANEURYSM POSTINFERIOR WALL MYOCARDIAL INFARCTION.
Source
Chest. Conference: CHEST 2024 Annual Meeting. Boston Convention and
Exhibition Center, Boston United States. 166(4 Supplement) (pp A490),
2024. Date of Publication: October 2024.
Author
GONZALEZ A.; BAUR A.; SANCHEZ TRINIDAD J.; HUM A.; GONZALEZ G.; CONANT A.
Publisher
Elsevier Inc.
Abstract
SESSION TITLE: Cardiovascular Disease Case Reports Posters (H) SESSION
TYPE: Case Report Posters PRESENTED ON: 10/07/2024 12:30 pm - 01:15 pm
INTRODUCTION: Right ventricular outflow tract obstruction (RVOTO) is a
rare cause of acute hemodynamic instability. Majority of reported cases of
RVOTO were secondary to metastatic tumors, followed by congenital heart
defects. Here, we present a case of RVOTO caused by a left ventricular
aneurysm (LVA) in the setting of an inferior wall myocardial infarction
(MI). CASE PRESENTATION: A 58-year-old man presented with an inferior wall
MI. Left heart catheterization (LHC) revealed a 99 % occlusion in the
proximal right coronary artery requiring stenting. After LHC, the patient
had hypotension and was noticed to have a high-pitched systolic murmur
located at the left sternal border in the 5th intercostal space.
Echocardiogram showed a normal left ventricular size, overall mildly
decreased left ventricular systolic function, and a large LVA in the mid
inferior-posterior septal wall compressing the right ventricular outflow
tract. The patient was managed with inotropic support and ECMO, but 9 days
later he died due to intracranial hemorrhage. DISCUSSION: RVOTO secondary
to LVA is an unknown complication of MI which can lead to hemodynamic
collapse. This is the first reported case of RVOTO secondary to LVA after
an inferior wall MI. The most common etiology of RVOTO is mechanical
compression due to tumor metastasis, accounting for 42% of cases in the
current literature. RVOTO has also been reported as a complication of
cardiac surgery, as well as secondary to congenital cardiac disease or
hypertrophic cardiomyopathy. In contrast to left ventricular outflow tract
obstruction, which is usually managed with beta blockade to decrease
afterload; there is limited data on the management of RVOTO regardless of
its underlying cause. <br/>CONCLUSION(S): This case highlights a rare
cause of RVOTO secondary to LVA post inferior wall MI. RVOTO should be
considered as a potential diagnosis in hemodynamically unstable patients
post MI and should be evaluated via echocardiogram. REFERENCE #1: Zeng YH,
Calderone A, Rousseau-Saine N, Elmi-Sarabi M, Jarry S, Couture EJ, Aldred
MP, Dorval JF, Lamarche Y, Miles LF, Beaubien-Souligny W, Denault AY.
Right Ventricular Outflow Tract Obstruction in Adults: A Systematic Review
and Meta-analysis. CJC Open. 2021 Apr 9;3(9):1153-1168. doi:
10.1016/j.cjco.2021.03.011. PMID: 34746729; PMCID: PMC8551422.0. REFERENCE
#2: Zeng YH, Calderone A, Beaubien-Souligny W, Aldred MP, Couture EJ,
Hammoud A, Potes C, Lamarche Y, Denault AY. Right Ventricular Outflow
Tract Obstruction in the Intensive Care Unit: A Case Report of 2 Patients.
A A Pract. 2021 Dec 17;15(12):e01532. doi: 10.1213/XAA.0000000000001532.
PMID: 34928867; PMCID: PMC8715997. REFERENCE #3: J;, S. M. C. (n.d.). Left
ventricular outflow tract obstruction in ICU patients. Current opinion in
critical care. https://pubmed.ncbi.nlm.nih.gov/27054628/ DISCLOSURES: No
relevant relationships by Ariela Baur No relevant relationships by
Alexander Conant No relevant relationships by Alena Gonzalez No relevant
relationships by Gisela Gonzalez No relevant relationships by Avery Hum No
relevant relationships by Jeanette Sanchez Trinidad<br/>Copyright &#xa9;
2024 American College of Chest Physicians

<34>
Accession Number
2034594388
Title
ODDBALL ALERT: A RARE CASE OF PROSTHETIC VALVE ENDOCARDITIS BY PARVIMONAS
MICRA.
Source
Chest. Conference: CHEST 2024 Annual Meeting. Boston Convention and
Exhibition Center, Boston United States. 166(4 Supplement) (pp A493-A494),
2024. Date of Publication: October 2024.
Author
DESAI K.; EL-MAIS I.; SIVASUBRAMANIAN D.; ALSAADI A.; MISRA P.
Publisher
Elsevier Inc.
Abstract
SESSION TITLE: Cardiovascular Disease Case Reports Posters (F) SESSION
TYPE: Case Report Posters PRESENTED ON: 10/07/2024 12:30 pm - 01:15 pm
INTRODUCTION: Parvimonas micra is a gram-positive anaerobic coccus found
in the oral microbiome. It is majorly implicated in periodontal, soft
tissue, and bone infections. Its slow-growing nature, subacute
presentation, and delayed identification of cultures contribute to high
morbidity and long-term complications. It is very rarely associated with
infective endocarditis (IE). Per our knowledge, this is the fifth reported
case of Parvimonas IE. CASE PRESENTATION: A 79-year-old female with a
history of infective endocarditis status post mechanical mitral valve
replacement 12 years prior, on lifelong warfarin, right total knee
replacement 3 years prior, and a dental procedure with prophylactic
antibiotics a few weeks prior, initially presented with a right knee
periprosthetic joint infection requiring joint revision surgery. At that
time, she had no signs of systemic infection. Synovial and blood cultures
showed no growth throughout the hospital course. Transthoracic
echocardiogram did not show any vegetation. She was discharged on a 6-week
course of IV Ceftriaxone to empirically cover for Cutibacterium acnes.
Synovial culture later grew Parvimonas micra. One week later, she
presented with mild aphasia, dysarthria, left lower quadrant visual field
deficit (NIHSS 3), and a new 3/6 holosystolic murmur over the mitral area.
INR was supratherapeutic (6.2). Acute multifocal infarctions involving all
vascular territories of the brain were seen on MRI indicating an embolic
source. A Transesophageal echocardiogram (TEE) revealed new vegetations on
the posterior leaflet and ring of the prosthetic mitral valve suggestive
of infective endocarditis (IE). Repeat blood cultures were negative.
Despite broad-spectrum antibiotics, she had another embolic stroke with
new visual deficits. Repeat TEE noted an immobile infero-septal mitral
valve leaflet requiring a redo mitral valve replacement. The tissue
culture of the former prosthesis showed no growth. She was discharged on
IV ampicillin-sulbactam, however, eventually succumbed to multiple
post-operative complications. DISCUSSION: The incidence of infective
endocarditis by true obligate anaerobes is low (0.9%; 2-16%) [1,2],
Cutibacterium acnes being the most common. Parvimonas micra has only been
discussed in a few case reports[3,4,6]. No data is available on its
epidemiology. It is easy to miss due to transient bacteremia (negative
blood cultures), slow growth on cultures, and lack of tell-tale symptoms.
While it is now known to be resistant to doxycycline and clindamycin, it
remains susceptible to amoxicillin and metronidazole in vitro [5]. Our
case was unique in developing IE despite prophylactic antibiotics for the
dental procedure, lack of systemic symptoms of IE before the embolic
stroke, and negative serial blood cultures. Early TEE or new non-cultural
methods such as metagenomic Next Generation Sequencing (mNGS) can be used
for faster diagnosis. Timely surgical intervention after a suboptimal
response to antibiotics may help reduce morbidity. Patients who improve on
antibiotics may require surveillance echocardiograms and prophylactic
antibiotics before future invasive dental procedures. <br/>CONCLUSION(S):
Transient anaerobic bacteremia in patients with prosthetic valves is a
rare but important cause of fulminant infective endocarditis. REFERENCE
#1: 1. Brook I. Infective endocarditis caused by anaerobic bacteria. Arch
Cardiovasc Dis. 2008 Oct;101(10):665-76. doi: 10.1016/j.acvd.2008.08.008.
Epub 2008 Nov11. PMID: 19056073.2. Kestler M, Munoz P, Marin M, Goenaga
MA, Idigoras Viedma P, de Alarcon A, Lepe JA, Sousa Regueiro D,
Bravo-Ferrer JM, Pajaron M,Costas C, Garcia-Lopez MV, Hidalgo-Tenorio C,
Moreno M, Bouza E; Spanish Collaboration on Endocarditis (GAMES).
Endocarditis caused by anaerobicbacteria. Anaerobe. 2017 Oct;47:33-38.
doi: 10.1016/j.anaerobe.2017.04.002. Epub 2017 Apr 5. PMID: 28389412.
REFERENCE #2: 3. Gomez CA, Gerber DA, Zambrano E, BanaeiN, Deresinski S,
Blackburn BG. First case of infectious endocarditis caused by Parvimonas
micra. Anaerobe. 2015 Dec;36:53-5. doi:10.1016/j.anaerobe.2015.10.007.
Epub 2015 Oct 17. PMID: 26485192. 4. Ho D, Ang G, Er C, Yap SF, Meyyur
Aravamudan V. An Unusual Presentation ofParvimonas micra Infective
Endocarditis. Cureus. 2018 Oct 13;10(10):e3447. doi: 10.7759/cureus.3447.
PMID: 30555762; PMCID: PMC6294278.5. Rams TE, Sautter JD, van Winkelhoff
AJ. Antibiotic Resistance of Human Periodontal Pathogen Parvimonas micra
Over 10 Years. Antibiotics (Basel). 2020 Oct 17;9(10):709. doi:
10.3390/antibiotics9100709. PMID: 33080856; PMCID: PMC7602954. REFERENCE
#3: 6. Shimizu K, Horinishi Y, Sano C, Ohta R. Infection Route of
Parvimonas micra: A Case Report and Systematic Review. Healthcare (Basel).
2022 Sep 8;10(9):1727. doi: 10.3390/healthcare10091727. PMID: 36141340;
PMCID: PMC9498800 DISCLOSURES: No relevant relationships by Ayman Alsaadi
No relevant relationships by Khushi Desai No relevant relationships by
Ibrahim El-Mais No relevant relationships by Preeti Misra No relevant
relationships by Dhiran Sivasubramanian<br/>Copyright &#xa9; 2024 American
College of Chest Physicians

<35>
Accession Number
2034594359
Title
MEDICAL THERAPY VS CORONARY ARTERY BYPASS GRAFTING FOR CORONARY ARTERY
CHRONIC TOTAL OCCLUSION: A SYSTEMATIC REVIEW AND META-ANALYSIS.
Source
Chest. Conference: CHEST 2024 Annual Meeting. Boston Convention and
Exhibition Center, Boston United States. 166(4 Supplement) (pp A698-A699),
2024. Date of Publication: October 2024.
Author
EZENNA C.; JENIL FRANCO A.N.C.Y.; KRISHNA M.; JOSEPH M.; GBEGBAJE O.;
ZAIDI A.; RAMESH P.; ALUGBA G.; NELSON F.; PEREIRA V.; BAKHIT A.;
GOLDSWEIG A.
Publisher
Elsevier Inc.
Abstract
SESSION TITLE: Cardiovascular Disease Abstracts Posters (B) SESSION TYPE:
Original Investigation Posters PRESENTED ON: 10/08/2024 01:45 pm - 02:30
pm PURPOSE: Chronic total occlusion (CTO) of coronary arteries has become
increasingly prevalent among patients undergoing cardiac catheterization.
In recent years, percutaneous coronary intervention (PCI) has emerged as a
viable option for the management of CTO. However, given the complex nature
of CTO, many patients may not qualify for PCI and are left with the
options of medical therapy (MT) and surgical revascularization via
coronary artery bypass grafting (CABG). We conducted a meta-analysis to
compare clinical outcomes of MT versus CABG in patients with coronary CTO.
<br/>METHOD(S): A systematic review was conducted using PubMed, Embase,
and Cochrane databases through January 2024. Primary outcomes included
major adverse cardiovascular/cerebrovascular events (MACCE) and all-cause
mortality. Secondary outcomes included myocardial infarction (MI), stroke,
cardiac death, and heart failure. We used random effects models to
generate risk ratios (RRs) and 95% confidence intervals (CI<inf>95%</inf>)
with I² statistics to quantify heterogeneity. <br/>RESULT(S):
Seven observational studies with a total of 3355 patients met inclusion
criteria. Mean follow-up duration was 3.8 years. Compared to CABG, MT was
associated with a higher incidence of MACCE (RR=2.02; CI<inf>95%</inf>
1.04-3.92; P=0.04; I²=75%, Figure 1A), all-cause mortality
(RR=2.37; CI <inf>95%</inf> 1.97-2.84; P<0.00001; I²=0%,
Figure1B), MI (RR 1.86; CI <inf>95%</inf> 1.22-2.83; P=0.004;
I²=0%, Figure1C), cardiac death (RR=2.04; CI <inf>95%</inf>
1.31-3.18; P=0.002; I²=64%, Figure1D) and heart failure
(RR=6.10; CI <inf>95%</inf> 2.02-18.43; P=0.001; I²=21%), but a
lower risk of stroke (RR=0.30; CI <inf>95%</inf> 0.09-0.95; P=0.04;
I²=44%). <br/>CONCLUSION(S): CABG demonstrated more favorable
clinical outcomes in terms of MACCE, all-cause mortality, myocardial
infarction, cardiac death, and heart failure but confers a significant
risk of stroke compared to MT. CLINICAL IMPLICATIONS: For patients with
chronic total occlusion who are surgical candidates, coronary artery
bypass grafting may be preferred over medical therapy. DISCLOSURES: No
relevant relationships by Gabriel Alugba No relevant relationships by
Ahmed Bakhit No relevant relationships by Chidubem Ezenna No relevant
relationships by Oghenetejiri Gbegbaje Speaker relationship with Philips
Please note: 2022-present Added 03/24/2024 by Andrew Goldsweig, source=Web
Response, value=Consulting fee Consultant relationship with Inari Medical
Please note: 2022 Added 03/24/2024 by Andrew Goldsweig, source=Web
Response, value=Consulting fee Speaker/Speaker's Bureau relationship with
Edwards Lifesciences Please note: 2022 Added 03/24/2024 by Andrew
Goldsweig, source=Web Response, value=Honoraria No relevant relationships
by Ancy Jenil Franco No relevant relationships by Meghna Joseph No
relevant relationships by Mrinal Krishna No relevant relationships by
Favour Nelson No relevant relationships by Vinicius Pereira No relevant
relationships by Prasana Ramesh No relevant relationships by Ayesha
Zaidi<br/>Copyright &#xa9; 2024 American College of Chest Physicians

<36>
Accession Number
2034585502
Title
Correction notices: A Novel Inflammation-Based Risk Score Predicts
Mortality in Acute Type A Aortic Dissection Surgery: The Additive
Anti-inflammatory Action for Aortopathy and Arteriopathy Score (Mayo
Clinic Proceedings: Innovations, Quality & Outcomes (2022) 6(6) (497-510),
(S2542454822000571), (10.1016/j.mayocpiqo.2022.08.005)).
Source
Mayo Clinic Proceedings: Innovations, Quality and Outcomes. 8(5) (pp 481),
2024. Date of Publication: October 2024.
Author
Anonymous
Publisher
Elsevier B.V.
Abstract
Corrigendum to "A Novel Inflammation-Based Risk Score Predicts Mortality
in Acute Type A Aortic Dissection Surgery: The Additive Anti-inflammatory
Action for Aortopathy and Arteriopathy Score" Mayo Clinic Proceedings:
Innovations, Quality & Outcomes, Volume 6, Issue 6, December 2022, Pages
497-510 Hong Liu, MD, PhD; Si-Chong Qian, MD, PhD; Ying-Yuan Zhang, MD;
Ying Wu, MD; Liang Hong, MD; Ji-Nong Yang, MD; Ji-Sheng Zhong, MD; Yu-Qi
Wang, MD; Dong Kai Wu, MD, PhD; Guo-Liang Fan, MD; Jun-Quan Chen, MD, PhD;
Sheng-Qiang Zhang, MD; Xing-Xing Peng, MD; Yong-Feng Shao, MD, PhD;
Hai-Yang Li, MD, PhD; and Hong-Jia Zhang, MD, PhD From the Department of
Cardiovascular Surgery, the First Affiliated Hospital of Nanjing Medical
University, Nanjing, People's Republic of China (H.L., Y.-F.S.);
Department of Cardiovascular Surgery, Beijing Anzhen Hospital, Capital
Medical University, Beijing, People's Republic of China (S.-C.Q., H.-Y.L.,
H.-J.Z.); Department of Cardiovascular Surgery, the First Affiliated
Hospital of Guangzhou Medical University, Guangzhou, People's Republic of
China (Y.-Y.Z.); Department of Laboratory, the First Affiliated Hospital
of Shantou University Medical College, Shantou, People's Republic of China
(Y.W.); Department of Cardiovascular Surgery, Nanjing First Hospital,
Nanjing Medical University, Nanjing, People's Republic of China (L.H.);
Department of Cardiovascular Surgery, the Affiliated Hospital of Qingdao
University, Qingdao, People's Republic of China (J.-N.Y.); Department of
Cardiovascular Surgery, Xiamen Cardiovascular Hospital, Xiamen University,
Xiamen, People's Republic of China (J.-S.Z.); Department of Cardiovascular
Surgery, Teda International Cardiovascular Hospital, Chinese Academy of
Medical Sciences, Tianjin, People's Republic of China (Y.-Q.W.);
Department of Cardiovascular Surgery, Xiangya Hospital, Central South
University, Changsha, People's Republic of China (D.K.W.); Department of
Cardiovascular Surgery, Shanghai East Hospital, Tongji University,
Shanghai, People's Republic of China (G.-L.F.); Department of
Cardiovascular Surgery, Tianjin Chest Hospital, Tianjin Medical
University, Tianjin, People's Republic of China (J.-Q.C.); Department of
Cardiovascular Surgery, the First Affiliated Hospital of Bengbu Medical
College, Bengbu, People's Republic of China (S.-Q.Z.); and Department of
Cardiovascular Surgery, the First Affiliated Hospital of Guilin Medical
University, Guilin, People's Republic of China (X.-X.P.). The authors
regret there is a typo in Figure 1 and in Methods section. Figure 1 showed
that "Derivation cohort 3695 patients from Beijing Anzhen Hospital
(2016-2021)," we accidentally made a clerical error, Derivation cohort
3695 patients from Beijing Anzhen Hospital was collected from 2002 to
2021. So, 2016-2021 should be corrected to 2002-2021. Also, Page 501 in
Methods Model Validations, "The new mortality model was internally
validated using data on 571 patients from the same hospitals as the
derivation cohort (2016-2021)," 2016-2021 should be corrected to
2002-2021. The authors would like to apologize for any inconvenience
caused. DOI of original article:
https://doi.org/10.1016/j.mayocpiqo.2022.08.005 Hai-Yang Li, MD, PhD
ocean0203@163.com<br/>Copyright &#xa9; 2024 The Authors

<37>
Accession Number
2031389965
Title
Effect of Perioperative Active Warming on Postoperative Pain and Shivering
in Preschool Pediatric Patients: A Randomized Controlled Trial.
Source
Indian Pediatrics. 61(9) (pp 829-834), 2024. Date of Publication:
September 2024.
Author
Ciftci C.; Kara I.; Buyukcavlak M.; Aslanlar E.
Institution
(Ciftci, Buyukcavlak) Department of Anesthesiology and Reanimation, Konya
City Hospital, University of Health Sciences, Akabe mah. Adana Cevre Yolu
Cd. 135/1, Karatay, Konya 42020, Turkey
(Ciftci, Kara, Aslanlar) Department of Anesthesiology and Reanimation,
Faculty of Medicine, Selcuk University, Selcuklu, Konya, Turkey
Publisher
Springer
Abstract
Objective: To evaluate the effects of perioperative active warming on the
core body temperature, postoperative pain, shivering and agitation in
pediatric patients. <br/>Method(s): Children aged 2-6 years undergoing
elective surgery, including orthopedic soft tissue surgeries, ear nose
throat surgical procedures and general surgical interventions, all
performed under general anesthesia, were randomized to receive either
active warming (using the forced-air warming gowns, Bair Hugger, in the
pre- and postoperative period, and a carbon fiber blanket in
intraoperative period; Group A), or conventional warming using green
blankets pre-and post-operatively and a carbon fiber blanket
intraoperatively (Group B). Children undergoing emergency surgery,
surgeries involving major body cavities (abdominal, thoracic, cranial
surgery), or those with endocrinological pathologies, or baseline fever,
were excluded. Core body temperature (t-core), postoperative pain,
shivering and agitation scores were compared between the two groups.
<br/>Result(s): Seventy children were included, with 35 in each group. No
significant difference was observed between the groups in t-core values at
0 and 15 minutes preoperatively (P > 0.05). However, the value at 30
minutes preoperatively and all subsequent t-core values were higher in
Group A (P < 0.001). Postoperative pain and shivering scores at 0 minutes,
30 minutes and 6 hours were significantly lower in Group A compared to
Group B. No significant difference was observed in agitation scores in the
immediate postoperative period, although, Group A showed reduced agitation
at 30 minutes (P = 0.03). <br/>Conclusion(s): Active warming in the pre-
and post-operative period significantly maintained higher core
temperatures and reduced postoperative pain and shivering in children
undergoing surgery compared to those receiving conventional passive
warming measures in the pre- and post-operative period.<br/>Copyright
&#xa9; Indian Academy of Pediatrics 2024.

<38>
Accession Number
2034549315
Title
Effect of different priming fluids on extravascular lung water, cell
integrity and oxidative stress in cardiopulmonary bypass surgery.
Source
Cardiovascular Journal of Africa. 35(2) (pp 70-74), 2024. Date of
Publication: September 2024.
Author
Ulugol H.; Can M.G.; Aksu U.; Vardar K.; Okten M.; Toraman F.
Institution
(Ulugol, Can, Toraman) Department of Anesthesiology and Reanimation,
Acibadem Mehmet Ali Aydinlar University, Altunizade Hospital, Istanbul,
Turkey
(Aksu, Vardar) Department of Biology, Faculty of Science, University of
Istanbul, Istanbul, Turkey
(Okten) Department of Cardiovascular Surgery, Acibadem Mehmet Ali Aydinlar
University, Altunizade Hospital, Istanbul, Turkey
Publisher
Clinics Cardive Publishing (PTY)Ltd
Abstract
Background: Discussions continue on the ideal priming fluid in adult
cardiac surgery. The purpose of this prospective study was to evaluate the
effects of different types of priming fluids on extravascular lung water,
cell integrity and oxidative stress status. <br/>Method(s): Thirty
elective coronary artery bypass surgery patients were randomised
prospectively into two groups. The first group received colloid priming
fluid, while the second group received crystalloid priming fluid.
Extravascular lung water index, advanced oxidative protein products, total
thiol, free haemoglobin, ischaemic modified albumin and sialic acid levels
were measured. Moreover, intra-operative and postoperative outcomes were
reviewed. <br/>Result(s): There were no significant differences between
the groups with regard to extravascular lung water index, oxidative stress
parameters or cell integrity (p > 0.05). Similarly, no significant
differences were observed between the patients with regard to
intra-operative and postoperative outcomes (p > 0.05). <br/>Conclusion(s):
The presumed superiority of colloidal priming for cardiopulmonary bypass
could not be confirmed in our study.<br/>Copyright &#xa9; 2024 Clinics
Cardive Publishing (PTY)Ltd. All rights reserved.

<39>
Accession Number
2034595662
Title
Letter to the editor, "Effects of esketamine on postoperative negative
emotions and early cognitive disorders in patients undergoing non-cardiac
thoracic surgery: A randomized controlled trial".
Source
Journal of Clinical Anesthesia. 99 (no pagination), 2024. Article Number:
111610. Date of Publication: December 2024.
Author
Cagatay U.; Bandari M.
Institution
(Cagatay, Bandari) Department of Medicine, Rowan University School of
Osteopathic Medicine, Stratford, NJ
Publisher
Elsevier Inc.

<40>
Accession Number
2031296832
Title
Boosting the Beat: A Critical Showdown of Levosimendan and Milrinone in
Surgical and Non-Surgical Scenarios: A Narrative Review.
Source
Journal of Cardiovascular Pharmacology and Therapeutics. 29 (no
pagination), 2024. Date of Publication: January-December 2024.
Author
Quintero-Altare A.; Florez-Navas C.; Robayo-Amortegui H.; Rojas-Arrieta
M.; Tuta-Quintero E.; Bastidas-Goyes A.; Martinez-Delgado L.;
Casallas-Barrera J.O.; Poveda-Henao C.; Buitrago-Bernal R.
Institution
(Quintero-Altare, Florez-Navas, Robayo-Amortegui, Rojas-Arrieta,
Martinez-Delgado) Department of Medicine, Critical Care Resident,
Universidad de La Sabana, Cundinamarca, Chia, Colombia
(Robayo-Amortegui, Casallas-Barrera, Poveda-Henao, Buitrago-Bernal)
Department of Critical Care Medicine, Fundacion Clinica Shaio, Bogota,
Colombia
(Tuta-Quintero, Bastidas-Goyes) School of Medicine, Universidad de La
Sabana, Chia, Colombia
Publisher
SAGE Publications Ltd
Abstract
Acute heart failure, advanced cardiac failure, cardiac surgery, and sepsis
are conditions that require simultaneous treatment to stimulate
contractility and/or reduce systemic vascular resistance, with
levosimendan and milrinone being treatment options. This research's aim is
to review the current indications and evidence for these medications
across various scenarios. Evidence suggests that levosimendan is a
non-inferior alternative to dobutamine and superior to milrinone in
treating low cardiac output syndrome following cardiac surgery. In cases
of septic shock, levosimendan has been linked to lower mortality rates
compared to placebo, while milrinone's efficacy remains inconclusive.
Furthermore, postoperative patients undergoing correction for congenital
heart disease have shown reduced mechanical ventilation time and intensive
care unit stays when treated with levosimendan, although differences exist
between the populations assigned to each intervention. In conclusion,
levosimendan, compared to milrinone, appears to offer better hemodynamic
favorability in patients undergoing cardiac surgery. However, additional
research is necessary to further understand its impact on hemodynamic
outcomes, mortality, intensive care unit, and hospital stays in patients
with cardiogenic shock of both ischemic and non-ischemic etiologies, as
well as septic shock.<br/>Copyright &#xa9; The Author(s) 2024.

<41>
Accession Number
2031287198
Title
Abdominal obesity is associated with increased worsening renal function
risk in patients with heart failure with preserved ejection fraction.
Source
BMC Cardiovascular Disorders. 24(1) (no pagination), 2024. Article Number:
477. Date of Publication: December 2024.
Author
Zhang Q.; Tai S.; Zhou S.
Institution
(Zhang, Tai, Zhou) Department of Cardiovascular Medicine, The Second
Xiangya Hospital, Central South University, Hunan, Changsha 410011, China
Publisher
BioMed Central Ltd
Abstract
Background: Worsening renal function (WRF) is a frequent comorbidity of
heart failure with preserved ejection fraction (HFpEF). However, its
relationship with abdominal obesity in terms of HFpEF remains unclear.
This study aimed to evaluate the value of waist circumference (WC) and
body mass index (BMI) in predicting WRF and examine the correlation
between abdominal obesity and the risk of WRF in the HFpEF population.
<br/>Method(s): Data were obtained from the Treatment of Preserved Cardiac
Function Heart Failure with an Aldosterone Antagonist trial. Abdominal
obesity was defined as WC >= 102 cm for men and >= 88 cm for women. WRF
was defined as doubling of serum creatinine concentration from baseline.
Restricted cubic splines and receiver operating characteristic curves were
used to evaluate the value of WC and BMI in predicting WRF. Cumulative
incidence curves and cox proportional-hazards models were used to compare
patients with and without abdominal obesity. <br/>Result(s): We included
2,806 patients with HFpEF in our study (abdominal obesity, n: 2,065).
Although baseline creatinine concentrations did not differ, patients with
abdominal obesity had higher concentrations during a median follow-up time
of 40.9 months. Unlike BMI, WC exhibited a steady linear association with
WRF and was a superior WRF predictor. Patients with abdominal obesity
exhibited a higher risk of WRF after multivariable adjustment (hazard
ratio: 1.632; 95% confidence interval: 1.015-2.621; P: 0.043).
<br/>Conclusion(s): Abdominal obesity is associated with an increased risk
of WRF in the HFpEF population. Trial registration: URL:
https://beta.clinicaltrials.gov. Unique identifier:
NCT00094302.<br/>Copyright &#xa9; The Author(s) 2024.

<42>
Accession Number
2030608738
Title
Prognostic role of late gadolinium-enhanced MRI in confirmed and suspected
cardiac sarcoidosis: meta-analysis.
Source
International Journal of Cardiovascular Imaging. 40(8) (pp 1797-1807),
2024. Date of Publication: August 2024.
Author
Sekii R.; Kato S.; Horita N.; Utsunomiya D.
Institution
(Sekii) Department of Cardiology, Yokohama Hodogaya Central Hospital,
Kanagawa, Japan
(Kato, Utsunomiya) Department of Diagnostic Radiology, Yokohama City
University Graduate School of Medicine, Kanagawa, Japan
(Horita) Chemotherapy Center, Yokohama City University Hospital, Kanagawa,
Japan
Publisher
Springer Science and Business Media B.V.
Abstract
The prognostic implications of late gadolinium-enhanced (LGE) magnetic
resonance imaging (MRI) in the context of cardiac sarcoidosis (CS) have
attracted considerable attention. Nevertheless, a subset of studies has
undistinguished confirmed and suspected CS cases, thereby engendering
interpretative ambiguities. In this meta-analysis, we evaluated the
differences in cardiac MRI findings and their prognostic utility between
confirmed and suspected CS. A literature search was conducted using
PubMed, Web of Science, and Cochrane libraries to compare the findings of
cardiac MRI and its prognostic value in CS and suspected CS. A
meta-analysis was performed to compare the prevalence of LGE MRI, odds
ratios, and hazard ratios for predicting cardiac events in both groups. A
total of 21 studies encompassing 24 different populations were included in
the meta-analysis (CS: 393 cases, suspected CS: 2151 cases). CS had a
higher frequency of LGE of the left ventricle (87.2% vs. 36.4%, p <
0.0001) and right ventricle (62.1% vs. 23.8%, p = 0.04) than suspected CS.
In patients with suspected CS, the presence of left ventricular LGE was
associated with higher all-cause mortality [odds ratio: 5.70 (95%CI:
2.51-12.93), p < 0.0001, I² = 8%, p for heterogeneity = 0.37]
and ventricular arrhythmia [odds ratio: 15.51 (95%CI: 5.65-42.55), p <
0.0001, I² = 0, p for heterogeneity = 0.94]. In contrast, in
CS, not the presence but extent of left ventricular LGE was a significant
predictor of outcome (hazard ratio = 1.83 per 10% increase of %LGE (95%CI:
1.43-2.34, p < 0.001, I² = 15, p for heterogeneity = 0.31). The
presence of left ventricular LGE was a strong prognostic factor in
suspected sarcoidosis. However, the extremely high prevalence of left
ventricular LGE in confirmed CS suggests that the quantitative assessment
of LGE is useful for prognostic estimation.<br/>Copyright &#xa9; The
Author(s), under exclusive licence to Springer Nature B.V. 2024.

<43>
Accession Number
2029391317
Title
Percutaneous Versus Surgical Femoral Cannulation in Minimally Invasive
Cardiac Surgery: A Systematic Review and Meta-Analysis.
Source
Innovations: Technology and Techniques in Cardiothoracic and Vascular
Surgery. 19(3) (pp 247-253), 2024. Date of Publication: May/June 2024.
Author
Kirov H.; Caldonazo T.; Runkel A.; Fischer J.; Tasoudis P.; Mukharyamov
M.; Cancelli G.; Dell'Aquila M.; Doenst T.
Institution
(Kirov, Caldonazo, Runkel, Fischer, Mukharyamov, Doenst) Department of
Cardiothoracic Surgery, Friedrich-Schiller-University Jena, Germany
(Tasoudis) Division of Cardiothoracic Surgery, University of North
Carolina at Chapel Hill, NC, United States
(Cancelli, Dell'Aquila) Department of Cardiothoracic Surgery, Weill
Cornell Medicine, New York, NY, United States
Publisher
SAGE Publications Ltd
Abstract
Objective: Minimally invasive cardiac surgery (MICS) is increasing
worldwide. In most cases, the surgical technique includes cannulation of
the groin for the establishment of cardiopulmonary bypass, requiring a
second surgical incision (SC) for exposure and cannulation of the femoral
vessels. With the introduction of arterial closure devices, percutaneous
cannulation (PC) of the groin has become a possible alternative. We
performed a meta-analysis and systematic review to compare clinical
endpoints between the patients who underwent PC and SC for MICS.
<br/>Method(s): Three databases were assessed. The primary outcome was any
access site complication. Secondary outcomes were perioperative mortality,
any wound complication, any vascular complication, lymphatic
complications, femoral/iliac stenosis, stroke, procedural duration, and
hospital length of stay (LOS). A random effects model was performed.
<br/>Result(s): A total of 5 studies with 2,038 patients were included.
When compared with PC, patients who underwent SC showed a higher incidence
of any access site complication (odds ratio [OR] = 3.09, 95% confidence
interval [CI]: 1.87 to 5.10, P < 0.01), any wound complication (OR =
10.10, 95% CI: 3.31 to 30.85, P < 0.01), lymphatic complication (OR =
9.37, 95% CI: 2.15 to 40.81, P < 0.01), and longer procedural duration
(standardized mean difference = 0.31, 95% CI: 0.12 to 0.51, P < 0.01).
There was no significant difference between the 2 groups regarding
perioperative mortality, any vascular complication, femoral/iliac
stenosis, stroke, or hospital LOS. <br/>Conclusion(s): The analysis
suggests that surgical groin cannulation in MICS is associated with a
higher incidence of any access site complication (especially wound
complication and lymphatic fistula) and with a longer procedural time
compared with PC. There was no difference in perioperative
mortality.<br/>Copyright &#xa9; The Author(s) 2024.

<44>
Accession Number
2033538360
Title
Standard versus High Cardiopulmonary Bypass Flow Rate: A Randomized
Controlled Subtrial Comparing Brain Injury Biomarker Release.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 38(10) (pp 2204-2212),
2024. Date of Publication: October 2024.
Author
Keiller A.C.; Axelsson M.; Bragadottir G.; Lannemyr L.; Wijk J.; Blennow
K.; Zetterberg H.; Bagge R.O.
Institution
(Keiller) Department of Perfusion, Sahlgrenska University Hospital,
Gothenburg, Sweden
(Keiller) Department of Surgery, Institute of Clinical Sciences,
Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
(Keiller, Bagge) Wallenberg Centre for Molecular and Translational
Medicine, University of Gothenburg, Gothenburg, Sweden
(Axelsson) Department of Clinical Neuroscience, Institute of Neuroscience
and Physiology at Sahlgrenska Academy, University of Gothenburg,
Gothenburg, Sweden
(Bragadottir, Lannemyr, Wijk) Department of Cardiothoracic Anesthesia and
Intensive Care, Sahlgrenska University Hospital, Gothenburg, Sweden
(Lannemyr, Wijk) Department of Anesthesiology and Intensive Care Medicine,
Sahlgrenska Academy, University of Gothenburg, Sweden
(Blennow, Zetterberg) Department of Psychiatry and Neurochemistry,
Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the
University of Gothenburg, Molndal, Sweden
(Blennow, Zetterberg) Clinical Neurochemistry Laboratory, Sahlgrenska
University Hospital, Molndal, Sweden
(Blennow) Paris Brain Institute, ICM, Pitie-Salpetriere Hospital, Sorbonne
University, Paris, France
(Blennow) Neurodegenerative Disorder Research Center, Division of Life
Sciences and Medicine, and Department of Neurology, Institute on Aging and
Brain Disorders, University of Science and Technology of China and First
Affiliated Hospital of USTC, Hefei, China
(Zetterberg) Department of Neurodegenerative Disease, UCL Institute of
Neurology, Queen Square, London, United Kingdom
(Zetterberg) UK Dementia Research Institute at UCL, London, United Kingdom
(Zetterberg) Hong Kong Center for Neurodegenerative Diseases, Hong Kong,
Clear Water Bay, China
(Zetterberg) Wisconsin Alzheimer's Disease Research Center, University of
Wisconsin School of Medicine and Public Health, University of
Wisconsin-Madison, Madison, WI, United States
(Bagge) Department of Surgery, Sahlgrenska University Hospital,
Gothenburg, Sweden
(Bagge) Sahlgrenska Center for Cancer Research, Department of Surgery,
Institute of Clinical Sciences, Sahlgrenska Academy, University of
Gothenburg, Gothenburg, Sweden
Publisher
W.B. Saunders
Abstract
Objectives: To compare brain injury biomarker release levels between two
different cardiopulmonary bypass (CPB) flow rates in elective cardiac
surgery and to explore differences in postoperative delirium between
groups and associations between age, sex, CPB time, oxygen levels, and
near-infrared spectroscopy, and biomarker levels. <br/>Design(s): A
randomized controlled substudy trial Setting: Sahlgrenska University
Hospital, Sweden Participants: Forty patients undergoing elective cardiac
surgery with CPB Intervention: Patients were assigned at random to either
a standard (2.4 L/min/m²) or a high (2.9 L/min/m²)
CPB flow rate. <br/>Measurements and Main Results: Glial fibrillary acidic
protein, neurofilament light chain, total-tau, and phosphorylated-tau217
were sampled in plasma before anesthesia induction, after 60 minutes on
CPB, and at 30 minutes, 24 hours, and 72 hours post-CPB. Mixed models for
repeated measures were used to analyze differences in biomarker levels
between groups and to assess relationships, which showed no differences
between the 2 flow rate groups. There also was no difference in the
occurrence of delirium between the 2 groups. Associations were found
between age and increased neurofilament light chain levels. Female sex,
oxygen delivery >330 mL/min/m², and near-infrared spectroscopy
level >60% were associated with lower biomarker levels.
<br/>Conclusion(s): An increased flow rate did not have any significant
effects on biomarker levels compared to a standard flow rate. Several
associations were identified between treatment characteristics and
biomarker levels. No difference in delirium was seen.<br/>Copyright &#xa9;
2024 The Author(s)

<45>
Accession Number
2033438070
Title
Transcatheter Aortic Valve Replacement in Low-Risk Patients at Four or
More Years.
Source
American Journal of Medicine. 137(10) (pp 1008-1011.e1), 2024. Date of
Publication: October 2024.
Author
Connolly J.E.; Andabili S.H.A.; Joseph E.; Resar J.; Rahman F.
Institution
(Connolly, Andabili, Joseph, Resar, Rahman) Department of Medicine,
Division of Cardiology, The Johns Hopkins Hospital, Baltimore, Md, United
States
Publisher
Elsevier Inc.
Abstract
Background: Transcatheter aortic valve replacement (TAVR) is accepted as
an alternative to surgical aortic valve replacement (SAVR) in patients
with severe symptomatic aortic valve stenosis. Prior studies have shown
that TAVR has comparable or superior outcomes to SAVR in intermediate and
high-risk patients. However, there is paucity of data about outcome of
TAVR vs SAVR in low-surgical-risk patients evaluated at 4 or more years
post-procedure. <br/>Method(s): A systematic review of all published
randomized controlled trials comparing TAVR and SAVR in low-risk patients
was completed. A random-effects model meta-analysis was performed to study
major outcomes, including all-cause mortality, stroke, myocardial
infarction, and aortic valve reintervention. <br/>Result(s): Three
randomized trials comprising 2644 patients (1371 TAVR and 1273 SAVR) with
a mean age of 74.3 +/- 5.8 years were included in this analysis. There was
no significant difference in all-cause and cardiovascular mortality,
stroke, myocardial infarction, or aortic valve reintervention between the
TAVR and SAVR groups at long-term follow-up. Transcatheter aortic valve
replacement was associated with higher rate of pacemaker implantation,
whereas SAVR was associated with more atrial fibrillation.
<br/>Conclusion(s): At 4 or more years of follow-up, TAVR is safe and has
comparable outcomes to SAVR in low-surgical-risk patients. Possibility of
TAVR and its risks and benefits should be discussed with low-surgical-risk
patients.<br/>Copyright &#xa9; 2024 Elsevier Inc.

<46>
Accession Number
2033296812
Title
Systematic Review and Meta-analysis of the Impact of Surgeon-Physician
Co-management Models on Short Term Outcomes for Vascular Surgery
Inpatients.
Source
European Journal of Vascular and Endovascular Surgery. 68(3) (pp 336-345),
2024. Date of Publication: September 2024.
Author
Foley M.P.; Westby D.; Walsh S.R.
Institution
(Foley, Westby, Walsh) University College Hospital Galway, Galway, Ireland
(Foley, Walsh) Royal College of Surgeons in Ireland, Dublin, Ireland
(Walsh) Lambe Institute of Translational Research, University of Galway,
Galway, Ireland
(Walsh) National Surgical Research Support Centre, Royal College of
Surgeons in Ireland, Dublin, Ireland
Publisher
W.B. Saunders Ltd
Abstract
Objective: As the population ages, vascular surgeons are treating
progressively older, multimorbid patients at risk of peri-operative
complications. An embedded physician has been shown to improve outcomes in
general and orthopaedic surgery. This systematic review and meta-analysis
aimed to investigate the impact of surgeon-physician co-management models
on morbidity and mortality rates in vascular inpatients. <br/>Data
Sources: PubMed, Scopus, Embase, conference abstract listings, and
clinical trial registries. Review Methods: Studies comparing adult
vascular surgery inpatients under co-management with standard of care were
eligible. The relative risks (RRs) of death, medical complications, and 30
day re-admission between co-management and standard care were calculated.
The effect of co-management on the mean length of stay was calculated
using weighted means. Risk of bias was assessed using the Methodological
Index for Non-Randomised Studies, and certainty assessment with the GRADE
analysis tools. <br/>Result(s): No randomised controlled trials were
identified. Eight single institution studies between 2011 and 2020 with 7
410 patients were included. All studies were observational using
before-after methodology. Studies were of high to moderate risk of bias,
and outcomes were of very low GRADE certainty of evidence. Co-management
was associated with a statistically significant lower relative risk of
death (RR 0.64, 95% confidence interval [CI] 0.44 - 0.92; p = .02),
cardiac complications (RR 0.47, 95% CI 0.25 - 0.87; p = .02), and
infective complications (RR 0.49, 95% CI 0.35 - 0.67; p < .001) in
vascular inpatients. No statistically significant differences in length of
stay (standard mean difference -0.6 days, 95% CI -1.44 - 0.24 days; p =
.16) and 30 day re-admission (RR 0.96, 95% CI 0.84 - 1.08; p = .49) were
noted. <br/>Conclusion(s): Early results of physician and surgeon
co-management for vascular surgery inpatients showed promising results
from very low certainty data. Further well designed, prospective studies
are needed to determine how to maximise the impact of physicians within a
vascular service to improve patient outcomes while using hospital
resources effectively.<br/>Copyright &#xa9; 2024 European Society for
Vascular Surgery

<47>
Accession Number
2033208334
Title
Analgesic Effect and Sleep Quality of Low-Dose Dexmedetomidine in Cardiac
Surgical Patients After Ultrafast-Track Extubation: A Randomized Clinical
Trial.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 38(10) (pp 2324-2333),
2024. Date of Publication: October 2024.
Author
Lertkovit S.; Vacharaksa K.; Khamtuikrua C.; Tocharoenchok T.;
Chartrungsan A.; Sangarunakul N.; Suphathamwit A.
Institution
(Lertkovit, Vacharaksa, Khamtuikrua, Suphathamwit) Division of
Cardiothoracic Anesthesia, Department of Anesthesiology, Faculty of
Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
(Tocharoenchok, Chartrungsan) Division of Cardiothoracic Surgery,
Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol
University, Bangkok, Thailand
(Sangarunakul) Integrated Perioperative Geriatric Excellent Research
Center, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok,
Thailand
Publisher
W.B. Saunders
Abstract
Objective: To compare the analgesic and sleep quality effects of
dexmedetomidine infusion versus placebo in patients undergoing cardiac
surgery with ultra-fast track extubation. <br/>Design(s): The randomized,
double-blind clinical trial study. <br/>Setting(s): At a single academic
center hospital. <br/>Participant(s): We included patients aged 25 to 65
scheduled for elective cardiac surgery under general anesthesia with
cardiopulmonary bypass from October 2021 to December 2022.
<br/>Intervention(s): After immediate extubation in the operating room,
the patients who were allocated at first after providing their consent to
either the dexmedetomidine group (Dex) or the placebo group (Placebo)
received continuous infusion of dexmedetomidine (0.2 mug/kg/h) or saline
for 12 hours postoperatively. <br/>Measurements and Main Results: The
groups' demographic and perioperative variables were not statistically
significant. Total morphine consumption in milligrams at 12 and 24 hours
after administered study drug, total sleep time in hours by BIS value
<=85, and sleep quality with the Richard-Campbell Sleep Questionnaire were
compared. The analysis included 22 Dex and 23 Placebo patients. The
consumption of morphine was not statistically different between the Dex
and Placebo groups at 12 and 24 hours (p = 0.707 and p = 0.502,
respectively). The Dex group had significantly longer sleep time (8.7 h
[7.8, 9.5]) than the Placebo group (5.8 h [2.9, 8.5]; p = 0.007). The Dex
group also exhibited better sleep quality (7.9 [6.7, 8.7] vs 6.6 [5.2,
8.0]; p = 0.038). <br/>Conclusion(s): Sedation with low-dose
dexmedetomidine infusion for ultra-fast track extubation following cardiac
surgery enhances sleep duration and quality.<br/>Copyright &#xa9; 2024
Elsevier Inc.

<48>
Accession Number
2033162560
Title
Factors Influencing Successful Weaning From Venoarterial Extracorporeal
Membrane Oxygenation: A Systematic Review.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 38(10) (pp 2446-2458),
2024. Date of Publication: October 2024.
Author
Zhao Y.; Wang H.; Cheng Y.; Zhang J.; Zhao L.
Institution
(Zhao, Wang, Zhao) Department of Cardiology, The Second Hospital of Jilin
University, Jilin, Changchun, China
(Cheng) Department of Cardiology, The First Hospital of Jilin University,
Jilin, Changchun, China
(Zhang) School of Pharmaceutical Sciences, Jilin University, Jilin,
Changchun, China
Publisher
W.B. Saunders
Abstract
With advancements in extracorporeal life support (ECLS) technologies,
venoarterial extracorporeal membrane oxygenation (VA-ECMO) has emerged as
a crucial cardiopulmonary support mechanism. This review explores the
significance of VA-ECMO system configuration, cannulation strategies, and
timing of initiation. Through an analysis of medication management
strategies, complication management, and comprehensive preweaning
assessments, it aims to establish a multidimensional evaluation framework
to assist clinicians in making informed decisions regarding weaning from
VA-ECMO, thereby ensuring the safe and effective transition of
patients.<br/>Copyright &#xa9; 2024 Elsevier Inc.

<49>
Accession Number
2032938098
Title
Effect of Ciprofol on Left Ventricular Myocardial Strain and Myocardial
Work in Children Undergoing Cardiac Surgery: A Single-center Double-blind
Randomized Noninferiority Study.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 38(10) (pp 2341-2348),
2024. Date of Publication: October 2024.
Author
Qin X.; Dan Y.; Wang H.; Sun L.; Ji W.; Bai J.; Mamtili I.; Zhang K.;
Zheng J.
Institution
(Qin, Dan, Sun, Ji, Bai, Zhang, Zheng) Department of Anesthesiology,
Shanghai Children's Medical Center, Shanghai Jiao Tong University School
of Medicine, Shanghai, China
(Qin, Dan, Sun, Ji, Bai, Zhang, Zheng) Department of Anesthesiology,
National Children's Medical Center, Shanghai, China
(Qin, Mamtili) Department of Anesthesiology, Shanghai Xuhui Central
Hospital, Shanghai, China
(Bai, Zhang) Department of Anesthesiology, Shanghai Children's Medical
Center Hainan Branch, Shanghai Jiao Tong University School of Medicine,
Shanghai, China
(Wang) GE Healthcare, Shanghai, China
Publisher
W.B. Saunders
Abstract
Objective: The current work was designed to compare the effects of
ciprofol and propofol on left ventricular systolic function and myocardial
work by noninvasive speckle-tracking echocardiography in children
undergoing surgical repair of atrial septal or ventricular septal defects.
<br/>Design(s): A single-center double-blind randomized noninferiority
study was conducted. <br/>Setting(s): The research occurred at a tertiary
care center affiliated with Shanghai Jiao Tong University, China.
<br/>Participant(s): One hundred and twelve children aged 1 month to 16
years undergoing atrial septal or ventricular septal defect surgery with
cardiopulmonary bypass were included. <br/>Intervention(s): One hundred
and twelve children were allocated randomly to receive ciprofol (n = 67)
or propofol (n = 45) in a 1.5:1 ratio. Ciprofol or propofol were
intravenously infused at loading doses of 0.4 mg/kg or 2.0 mg/kg,
respectively, over 30 seconds, depending on the physical condition of each
patient. When the bispectral index was maintained between 45 and 55 after
induction, transthoracic echocardiography, including apical two-chamber,
three-chamber, and four-chamber views, were collected bedside.
<br/>Measurements and Main Results: Of the 112 patients enrolled, 104
completed the study. Global longitudinal strain in the ciprofol and
propofol groups after anesthesia was -17.3% (95% confidence interval [CI]
-18.0% to -16.6%) and -17.8% (95% CI -18.7 to -17.0%) in the full analysis
set and -17.5% (95% CI -18.2% to -16.9%) and -17.8% (95% CI -18.7% to
-17.0%) in the per-protocol set, respectively. The noninferiority margin
was set at 2% and confirmed with a lower limit of two-sided 95% CI for the
intergroup difference of 1.58% in the full analysis set and 1.34% in the
per-protocol set. There were no significant differences between the groups
in left ventricular systolic and diastolic function and myocardial work
indices. Postoperative vasoactive-inotropic score, NT-proBNP, duration of
mechanical ventilation, and the length of stay in the cardiac intensive
care unit and hospital were also comparable between the two groups (all p
> 0.05). <br/>Conclusion(s): Ciprofol did not show different effects on
myocardial function and postoperative outcomes from propofol. Further, on
the sensitive cardiac systole marker global longitudinal strain, ciprofol
demonstrated noninferiority to propofol. Ciprofol might be an alternative
solution for cardiac anesthesia in children with congestive heart disease
with mild lesion.<br/>Copyright &#xa9; 2024 Elsevier Inc.

<50>
Accession Number
2034517347
Title
Optical coherence tomography-guided versus angiography-guided percutaneous
coronary intervention for patients with complex lesions (OCCUPI): an
investigator-initiated, multicentre, randomised, open-label, superiority
trial in South Korea.
Source
The Lancet. 404(10457) (pp 1029-1039), 2024. Date of Publication: 14 Sep
2024.
Author
Hong S.-J.; Lee S.-J.; Lee S.-H.; Lee J.-Y.; Cho D.-K.; Kim J.W.; Kim
S.M.; Hur S.-H.; Heo J.H.; Jang J.-Y.; Koh J.S.; Won H.; Lee J.-W.; Hong
S.J.; Kim D.-K.; Choe J.C.; Lee J.B.; Kim S.-J.; Yang T.-H.; Lee J.-H.;
Hong Y.J.; Ahn J.-H.; Lee Y.-J.; Ahn C.-M.; Kim J.-S.; Ko Y.-G.; Choi D.;
Hong M.-K.; Jang Y.; Kim B.-K.
Institution
(Hong, Lee, Lee, Lee, Ahn, Kim, Ko, Choi, Hong, Kim) Division of
Cardiology, Severance Cardiovascular Hospital, Yonsei University College
of Medicine, Seoul, South Korea
(Lee) Division of Cardiology, Kangbuk Samsung Hospital, Sungkyunkwan
University School of Medicine, Seoul, South Korea
(Cho) Division of Cardiology, Yongin Severance Hospital, Yonsei University
College of Medicine, Yongin, South Korea
(Kim) Division of Cardiology, Korea University Guro Hospital, Seoul, South
Korea
(Kim) Division of Cardiology, Chungbuk National University Hospital,
Cheongju, South Korea
(Hur) Division of Cardiology, Keimyung University Dongsan Hospital, Daegu,
South Korea
(Heo) Division of Cardiology, Kosin University Gospel Hospital, Busan,
South Korea
(Jang) Division of Cardiology, National Health Insurance Service Ilsan
Hospital, Goyang, South Korea
(Koh) Division of Cardiology, Gyeongsang National University Jinju
Hospital, Jinju, South Korea
(Won) Division of Cardiology, Chung-Ang University Hospital, Seoul, South
Korea
(Lee, Lee) Division of Cardiology, Wonju Severance Christian Hospital,
Wonju, South Korea
(Hong) Division of Cardiology, Korea University Anam Hospital, Seoul,
South Korea
(Kim) Division of Cardiology, Inje University Haeundae Paik Hospital,
Busan, South Korea
(Choe) Division of Cardiology, Pusan National University Hospital, Busan,
South Korea
(Lee) Division of Cardiology, Daegu Catholic University Medical Center,
Daegu, South Korea
(Kim) Division of Cardiology, Kyung Hee University Hospital, Seoul, South
Korea
(Yang) Division of Cardiology, Inje University Busan Paik Hospital, Busan,
South Korea
(Hong) Division of Cardiology, Chonnam National University Hospital,
Gwangju, South Korea
(Ahn) Division of Cardiology, Gyeongsang National University Changwon
Hospital, Changwon, South Korea
(Jang) Division of Cardiology, CHA Gangnam Medical Center, CHA University
College of Medicine, Seoul, South Korea
Publisher
Elsevier B.V.
Abstract
Background: Despite the detailed imaging information provided by optical
coherence tomography (OCT) during percutaneous coronary intervention
(PCI), clinical benefits of this imaging technique in this setting remain
uncertain. The aim of the OCCUPI trial was to compare the clinical
benefits of OCT-guided versus angiography-guided PCI for complex lesions,
assessed as the rate of major adverse cardiac events at 1 year.
<br/>Method(s): This investigator-initiated, multicentre, randomised,
open-label, superiority trial conducted at 20 hospitals in South Korea
enrolled patients aged 19-85 years for whom PCI with drug-eluting stents
was clinically indicated. After diagnostic angiography, clinical and
angiographic findings were assessed to identify patients who met the
criterion of having one or more complex lesions. Patients were randomly
assigned 1:1 to receive PCI with OCT guidance (OCT-guidance group) or
angiography guidance without OCT (angiography-guidance group).
Web-response permuted-block randomisation (mixed blocks of four or six)
was used at each participating site to allocate patients. The allocation
sequence was computer-generated by an external programmer who was not
involved in the rest of the trial. Outcome assessors were masked to group
assignment. Patients, follow-up health-care providers, and data analysers
were not masked. PCI was done according to conventional standard methods
with everolimus-eluting stents. The primary endpoint was major adverse
cardiac events (a composite of cardiac death, myocardial infarction, stent
thrombosis, or ischaemia-driven target-vessel revascularisation), 1 year
after PCI. The primary analysis was done in the intention-to-treat
population. The margin used to establish superiority was 1.0 as a hazard
ratio. This trial is registered with ClinicalTrials.gov (NCT03625908) and
is completed. <br/>Finding(s): Between Jan 9, 2019, and Sept 22, 2022,
1604 patients requiring PCI with drug-eluting stents for complex lesions
were randomly assigned to receive either OCT-guided PCI (n=803) or
angiography-guided PCI (n=801). 1290 (80%) of 1604 patients were male and
314 (20%) were female. The median age of patients at randomisation was 64
years (IQR 57-70). 1588 (99%) patients completed 1-year follow-up. The
primary endpoint occurred in 37 (5%) of 803 patients in the OCT-guided PCI
group and 59 (7%) of 801 patients in the angiography-guided PCI group
(absolute difference -2.8% [95% CI -5.1 to -0.4]; hazard ratio 0.62 [95%
CI 0.41 to 0.93]; p=0.023). Rates of stroke, bleeding events, and
contrast-induced nephropathy were not significantly different across the
two groups. <br/>Interpretation(s): Among patients who required
drug-eluting stent implantation for complex lesions, OCT guidance resulted
in a lower incidence of major adverse cardiac events at 1 year compared
with angiography guidance. These findings indicate the existence of a
therapeutic benefit of OCT as an intravascular imaging technique for PCI
guidance in patients with complex coronary lesions. <br/>Funding(s):
Abbott Vascular and Cardiovascular Research Center. Translation: For the
Korean translation of the abstract see Supplementary Materials
section.<br/>Copyright &#xa9; 2024 Elsevier Ltd

<51>
[Use Link to view the full text]
Accession Number
2034525858
Title
Advances in understanding and managing pediatric heart failure and
transplant.
Source
Current Opinion in Pediatrics. 36(5) (pp 489-495), 2024. Date of
Publication: 01 Oct 2024.
Author
Xu W.; Richmond M.
Institution
(Xu, Richmond) Pediatric Advanced Cardiac Care and Transplantation,
Division of Pediatric Cardiology, Columbia University, Vagelos College of
Physicians and Surgeons, New York, NY, United States
Publisher
Lippincott Williams and Wilkins
Abstract
Purpose of reviewThis article highlights the most recent advances in a
review of the current literature in the field of pediatric heart failure
and transplantation.Recent findingsDiagnostically, the identification of
new genetic factors has contributed to a deeper understanding of
cardiomyopathy in children. Novel medications like sacubitril/valsartan
and Sodium-Glucose cotransporter-2 (SGLT2) inhibitors, which are now
standard in the adult population are being studied in pediatric population
and offer new promise of pediatric heart failure treatment. Ventricular
assist devices are more commonly used in cardiomyopathy patients and
single ventricle patients as a bridge to transplant. Recent pediatric
heart transplant society (PHTS) data demonstrated that waitlist survival
improved significantly over the past decades (i) and new treatments such
as daratumumab and eculizumab have been used in high-risk populations and
demonstrate promising results. TEAMMATE trial is the first multicenter
randomized clinical trial (RCT) in pediatric heart transplant (HT) to
evaluate the safety and efficacy of everolimus (EVL) and low-dose
tacrolimus (TAC) compared to standard-dose TAC and mycophenolate mofetil
(MMF). It will provide valuable information about the safety and efficacy
of EVL, TAC, and MMF (ii).Donor cell-free DNA has been used more in
pediatric transplant recipients and has significantly decreased invasive
EMB (iii).SummaryThis past 5 years have witness dramatic progress in the
field of pediatric heart failure and transplantation including more use of
mechanical support in heart failure patients with various underlying
etiology, especially use of mechanical support in single ventricle
patients and the use of sacubitril/valsartan and SGLT2 inhibitors in the
pediatric population. The problem of the highly sensitized transplant
recipient remains, although novel therapeutics have been added to our
toolbox of options to maintain healthy allograft function. Ongoing
research aims to further enhance our understanding and management of
pediatric heart failure, emphasizing the need for continued innovation in
this complex field. <br/>Copyright &#xa9; 2024 Wolters Kluwer Health, Inc.
All rights reserved.

<52>
Accession Number
2034522127
Title
Outcomes of Surgical Versus Transcatheter Aortic Valve Replacement in
Obese Patients: A Systematic Review and Meta-Analysis.
Source
Cardiology in Review. (no pagination), 2024. Article Number:
10.1097/CRD.0000000000000767. Date of Publication: 2024.
Author
Domondon I.A.A.; Jeyakumar D.; Raake M.; Halaharvi S.P.; Zafar F.;
Contreras Vazquez S.A.; Abarca Y.A.; Goli S.R.; Rohra D.; Shah F.;
Sikander M.; Al-Tawil M.
Institution
(Domondon) Emergency Medicine Department, Portsmouth Hospitals University
NHS Trust, Portsmouth, United Kingdom
(Jeyakumar) Internal Medicine Department, Government Sivagangai Medical
College, Tamil Nadu Dr. M.G.R Medical University, Sivagangai, India
(Raake) Faculty of Medicine, Annamalai University, Cuddalore, Chidambaram,
India
(Halaharvi) Department of Cardiology, JSS Medical College, Rajiv Gandhi
University of Health Sciences, Mysore, India
(Zafar) Department of Cardiology, Internal Medicine, Dow University of
Health Sciences, Karachi, Pakistan
(Contreras Vazquez) Benemerita Universidad Autonoma de Puebla, Facultad de
Medicina, Puebla, Mexico
(Abarca) Department of Cardiology, Tecnologico de Monterrey, Escuela de
Medicina y Ciencias de la Salud, Mexico City, Mexico
(Goli) Department of Cardiology, College of Medicine, Zhengzhou
University, Henan Province, Henan, China
(Rohra) Department of Cardiology, Lokmanya Tilak Municipal Medical College
& General Hospital, Mumbai, India
(Shah) Internal Medicine Department, Liaquat University of Medical and
Health Sciences, Jamshoro, Pakistan
(Sikander) Department of Cardiology, School of Medicine, University of
Texas Rio Grande Valley, TX, United States
(Al-Tawil) Faculty of Medicine, Al-Quds University, East Jerusalem,
Palestine
Publisher
Lippincott Williams and Wilkins
Abstract
Transcatheter aortic valve implantation (TAVI) has been increasingly
preferred over surgical aortic valve replacement (SAVR) for treating
patients with severe aortic stenosis and intermediate to high surgical
risk. Recent studies have indicated that obesity may confer protective
benefits in cardiac surgery, known as the obesity paradox. We conducted a
systematic review and meta-analysis to explore how obesity influences
outcomes of TAVI versus SAVR. We searched and reviewed relevant studies
comparing TAVI and SAVR in obese patients with aortic stenosis indexed in
PubMed, Embase, and Scopus databases. Data from 5 studies with 16,161
patients (TAVI, n = 2951; SAVR, n = 13,210) were included. There was a
lower incidence of postprocedural in-hospital mortality [risk ratio (RR),
0.64; 95% confidence interval (CI), 0.41-0.98; P = 0.04], acute kidney
injury (RR, 0.53; 95% CI, 0.38-0.73; P = 0.0001), and shorter duration of
in-hospital stay (mean difference: -3.35; 95% CI, -4.93 to -1.76; P =
0.0001) in TAVI versus SAVR. There was no significant difference in the
risk of postoperative stroke (RR, 0.93; 95% CI, 0.29-3.02; P = 0.91),
major bleeding (RR, 0.71; 95% CI, 0.47-1.07; P = 0.10), and myocardial
infarction (RR, 0.64; 95% CI, 0.39-1.06; P = 0.08) between TAVI and SAVR.
Higher incidences of PPM implantation (RR, 2.0; 95% CI, 1.38-2.90; P =
0.0003) and major vascular complications (RR, 1.51; 95% CI, 1.01-2.27; P =
0.05) were observed with TAVI. In obese patients, TAVI offers similar
results as in the general population when compared with SAVR, except for
increased vascular complications. An individualized approach can lead to
optimal outcomes in this subpopulation. <br/>Copyright &#xa9; 2024 Wolters
Kluwer Health, Inc. All rights reserved.

<53>
Accession Number
2034518262
Title
Is tranexamic acid appropriate for all patients undergoing high-risk
surgery?.
Source
Current Opinion in Critical Care. (no pagination), 2024. Article Number:
10.1097/MCC.0000000000001207. Date of Publication: 2024.
Author
Abad-Motos A.; Garcia-Erce J.A.; Gresele P.; Paramo J.A.
Institution
(Abad-Motos) Anesthesia and Critical Care Department, Donostia University
Hospital, Donostia-San Sebastian, Spain
(Abad-Motos) Patient Blood Management Working Group, The Spanish Society
of Anesthesiology and Critical Care (SEDAR), Pamplona, Spain
(Garcia-Erce) Blood and Tissue Bank, Navarra Health Department, Pamplona,
Spain
(Gresele) Department of Medicine and Surgery, Perugia University, Perugia,
Italy
(Paramo) Hematology Department, University Clinic of Navarra, Pamplona,
Spain
Publisher
Lippincott Williams and Wilkins
Abstract
Purpose of review Tranexamic acid (TXA), an antifibrinolytic agent,
reduces surgical bleeding in a variety of procedures, such as cardiac,
orthopedic, abdominal, and urologic surgery, cesarean section, and
neurosurgery. However, there are surgical interventions for which its use
is not yet widespread, and some caution persists because of concerns
regarding thrombotic risk. The purpose of this review is to analyze the
most recent evidence in various subgroups of surgical specialties and the
association of TXA with thrombotic events and other side effects (e.g.
seizures). Recent findings Recent clinical trials and meta-analyses have
shown that the efficacy and safety vary according to the clinical context,
timing of administration, and dose. Some reports found that TXA reduces
major bleeding by 25% without a significant increase in thrombotic events.
Summary Wider use of TXA has the potential to improve surgical safety,
avoid unnecessary blood use, and save healthcare funds.<br/>Copyright
&#xa9; 2024 Wolters Kluwer Health, Inc. All rights reserved.

<54>
Accession Number
2033297679
Title
Addressing the Need to Improve Long Term Survival Following Lower
Extremity Revascularisation in a Randomised Controlled Trial.
Source
European Journal of Vascular and Endovascular Surgery. 68(4) (pp 541-542),
2024. Date of Publication: October 2024.
Author
Krievins D.; Erglis A.; Zarins C.K.
Institution
(Krievins) Department of Vascular Surgery, Pauls Stradins Clinical
University Hospital, Riga, Latvia
(Krievins, Erglis) Faculty of Medicine, University of Latvia, Riga, Latvia
(Erglis) Department of Cardiology, Pauls Stradins Clinical University
Hospital, Riga, Latvia
(Zarins) HeartFlow Inc., Mountain View, CA, United States
Publisher
W.B. Saunders Ltd

<55>
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.

<56>
Accession Number
2030827301
Title
Clinical presentation and surgical outcomes in patients with Shone's
complex: a systematic review.
Source
General Thoracic and Cardiovascular Surgery. 72(10) (pp 621-640), 2024.
Date of Publication: October 2024.
Author
Ahmed H.S.; Jayaram P.R.; Gupta D.
Institution
(Ahmed, Jayaram, Gupta) Department of Medicine, Bangalore Medical College
and Research Institute, K.R Road, Karnataka, Bangalore 560002, India
Publisher
Springer
Abstract
Objective: Shone's complex comprises of a combination of congenital
cardiac anomalies causing obstructions in the left ventricle's inflow and
outflow tracts. This systematic review aims to evaluate the clinical
features and surgical outcomes of Shone's complex. <br/>Method(s): An
electronic literature search of PubMed and Scopus was performed to
identify relevant studies related to the presentation, management, and
outcomes of Shone's complex. Two reviewers independently performed
selection. Data on study characteristics, participant demographics,
interventions, outcomes, and follow-up durations were extracted and
analyzed. <br/>Result(s): A total of 691 papers were identified, with 18
studies included in the final analysis. The majority of the studies (n =
12) focused on the pediatric age group. The most common clinical
presentations were coarctation of the aorta (n = 17) and mitral stenosis
(n = 12). Surgical interventions often involved staged approaches,
prioritizing outflow before inflow obstructions. Mitral valve repair was
preferred over replacement due to better long-term outcomes (n = 8).
Biventricular repair was recommended due to improved postoperative
outcomes, but often needed reoperations. Reoperations were common,
primarily due to recurrent coarctation (n = 10), subaortic stenosis (n =
8), and mitral valve dysfunction (n = 7). Pulmonary hypertension (n = 10)
and arrhythmias (n = 11) were significant complications. Most patients
were in modified Ross/NYHA functional class 1 on follow-up. Mortality
rates ranged from 4 to 28%, with better outcomes associated with early and
strategic surgical interventions. <br/>Conclusion(s): Early diagnosis and
biventricular repair were associated with better outcomes while
transplantation was often an eventuality. Standardized diagnostic
criteria, long-term follow-up, and consensus guidelines are needed to
improve the management of this congenital heart disease.<br/>Copyright
&#xa9; The Author(s), under exclusive licence to The Japanese Association
for Thoracic Surgery 2024.

<57>
Accession Number
2028991774
Title
Effect of preoperative vitamin D on postoperative atrial fibrillation
incidence after coronary artery bypass grafting.
Source
General Thoracic and Cardiovascular Surgery. 72(10) (pp 649-655), 2024.
Date of Publication: October 2024.
Author
Alirezaei T.; Ansari Aval Z.; Karamian A.; Hayati A.
Institution
(Alirezaei) Cardiology Department of Shohaday-e-Tajrish Hospital, Shahid
Behesti University of Medical Science, Tehran, Iran, Islamic Republic of
(Ansari Aval) Cardiovascular Research Center, Shahid Beheshti University
of Medical Sciences, Tehran, Iran, Islamic Republic of
(Karamian) School of Medicine, Lorestan University of Medical Sciences,
Khorramabad, Iran, Islamic Republic of
(Hayati) School of Medicine, Shahid Beheshti University of Medical
Sciences, Tehran, Iran, Islamic Republic of
Publisher
Springer
Abstract
Background: Post-operative atrial fibrillation (POAF) is associated with
adverse long-term cardiovascular events. <br/>Objective(s): This study
investigated the effects of a high-dose vitamin D administered
preoperatively on the postoperative atrial fibrillation (POAF) incidence
in patients with vitamin D deficiency following coronary artery bypass
grafting (CABG) surgery. <br/>Method(s): This randomized controlled
clinical trial was conducted on 246 CABG patients with vitamin D
deficiency. All patients were randomly divided into intervention and
control groups including 123 cases for each group. In the intervention
group, from 3 days before surgery, they received a daily dose of 150,000
units of vitamin D orally (50,000 units of Vit D tablet three times a day)
and the patients in the control group received placebo tablets before
surgery. All patients in the intervention group were assessed continuously
for the occurrence of POAF during the recovery period. <br/>Result(s): In
terms of gender, age, and BMI there were no significant differences
between intervention and control groups. Our findings showed that the use
of vitamin D supplements did not cause a significant change in the
duration of intubation and hospitalization. The ratio of POAF following
CABG surgery in the control and treatment groups was 26% and 11.4%,
respectively (odds ratio = 0.36; 95% CI = 0.18-0.72; P = 0.003).
<br/>Conclusion(s): Our findings revealed that high-dose vitamin D
supplementation before CABG surgery significantly reduced the incidence of
POAF. Further multicenter randomized trials with larger sample sizes are
certainly warranted to confirm our results.<br/>Copyright &#xa9; The
Author(s), under exclusive licence to The Japanese Association for
Thoracic Surgery 2024.

<58>
Accession Number
2034583513
Title
European Society of Clinical Microbiology and Infectious Diseases/European
Committee on infection control clinical guidelines on pre-operative
decolonization and targeted prophylaxis in patients colonized by
multidrug-resistant Gram-positive bacteria before surgery.
Source
Clinical Microbiology and Infection. (no pagination), 2024. Date of
Publication: 2024.
Author
Righi E.; Mutters N.T.; Guirao X.; Dolores del Toro M.; Eckmann C.;
Friedrich A.W.; Giannella M.; Presterl E.; Christaki E.; Cross E.L.A.;
Visentin A.; Sganga G.; Tsioutis C.; Tacconelli E.; Kluytmans J.
Institution
(Righi, Visentin, Tacconelli) Division of Infectious Diseases, Department
of Diagnostics and Public Health, University of Verona, Verona, Italy
(Mutters) University Hospital Bonn, Institute for Hygiene and Public
Health, Bonn, Germany
(Guirao) Department of General Surgery, Surgical Endocrine Unit, Surgical
Site Prevention Unit, Consorci Corporacio Sanitaria Parc Tauli, Sabadell,
Spain
(Dolores del Toro) Division of Infectious Diseases and Microbiology,
University Hospital Virgen Macarena, Seville, Spain
(Dolores del Toro) Department of Medicine, University of Sevilla, Centro
de Investigacion Biomedica en Red en Enfermedades Infecciosas
(CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
(Eckmann) Department of Klinikum Hannoversch-Muenden, Academic Hospital of
Goettingen University, Gottingen, Germany
(Friedrich) University Hospital Munster, Munster, Germany
(Giannella) Department of Infectious Diseases Unit, IRCCS Azienda
Ospedaliero Universitaria di Bologna, Bologna, Italy
(Giannella) Department of Medical and Surgical Sciences, University of
Bologna, Bologna, Italy
(Presterl) Department of Infection Control and Hospital Epidemiology,
Medical University of Vienna, Austria (on behalf of the ESCMID Study Group
on Nosocomial Infections - ESGNI), Vienna, Austria
(Christaki) Department of Internal Medicine, Faculty of Medicine, School
of Health Sciences, University of Ioannina, Ioannina, Greece
(Cross) Department of Global Health and Infection, Brighton and Sussex
Medical School, Brighton, United Kingdom
(Sganga) Department of Emergency Surgery and Trauma, Fondazione
Policlinico Universitario A. Gemelli IRCCS, Universita Cattolica Del Sacro
Cuore, Rome, Italy
(Tsioutis) School of Medicine, European University Cyprus, Nicosia, Cyprus
(Kluytmans) Department of Medical Microbiology, University Medical Center
Utrecht, Utrecht University, Netherlands
Publisher
Elsevier B.V.
Abstract
Scope: The aim of these guidelines is to provide recommendations for
decolonization and perioperative antibiotic prophylaxis (PAP) in
multidrug-resistant Gram-positive bacteria (MDR-GPB) adult carriers before
inpatient surgery. <br/>Method(s): These European Society of Clinical
Microbiology and Infectious Diseases/European Committee on Infection
Control guidelines were developed following a systematic review of
published studies targeting methicillin-resistant Staphylococcus aureus
(MRSA), vancomycin-resistant enterococci, methicillin-resistant
coagulase-negative Staphylococci, and pan-drug-resistant-GPB. Critical
outcomes were the occurrence of surgical site infections (SSIs) caused by
the colonizing MDR-GPB and SSIs-attributable mortality. Important outcomes
included the occurrence of SSIs caused by any pathogen, hospital-acquired
infections, all-cause mortality, and adverse events associated with the
interventions, including resistance development to the agents used and the
incidence of Clostridioides difficile infections. The last search of all
databases was performed on 1 November 2023. The level of evidence and the
strength of each recommendation were defined according to the Grading of
Recommendations Assessment, Development, and Evaluation approach.
Consensus of a multidisciplinary expert panel was reached for the final
list of recommendations. Antimicrobial stewardship considerations were
included. Recommendations: The guideline panel reviewed the impact of
decolonization, targeted PAP, and combined interventions (e.g.
decolonization and targeted PAP) on the risk of SSIs and other outcomes in
MDR-GPB carriers, according to the type of bacteria and type of surgery.
We recommend screening for S. aureus before high-risk operations, such as
cardiothoracic and orthopaedic surgery. Decolonization with intranasal
mupirocin with or without a chlorhexidine bath is recommended in patients
colonized with S. aureus before cardiothoracic and orthopaedic surgery and
suggested in other surgeries. The addition of vancomycin to standard
prophylaxis is suggested for MRSA carriers in cardiothoracic surgery,
orthopaedic surgery, and neurosurgery. Combined interventions (e.g.
decolonization and targeted prophylaxis) are suggested for MRSA carriers
undergoing cardiothoracic and orthopaedic surgery. No recommendation could
be made regarding screening, decolonization and targeted prophylaxis for
vancomycin-resistant enterococci because of the lack of data. No evidence
was retrieved for methicillin-resistant coagulase-negative Staphylococci
and pan-drug-resistant-GPB. Careful consideration of the laboratory
workload and involvement of antimicrobial stewardship and infection
control teams are warranted before implementing screening procedures or
performing changes in PAP policy. Future research should focus on novel
decolonizing techniques, on the monitoring of resistance to decolonizing
agents and PAP regimens, and on standardized combined interventions in
high-quality studies.<br/>Copyright &#xa9; 2024 The Authors

<59>
Accession Number
2034583145
Title
Chronic total occlusions and coronary artery bypass grafting outcomes.
Source
Journal of Thoracic and Cardiovascular Surgery. (no pagination), 2024.
Date of Publication: 2024.
Author
Gikandi A.; Stock E.M.; Dematt E.; Quin J.; Hirji S.; Biswas K.; Zenati
M.A.
Institution
(Gikandi, Quin, Hirji, Zenati) Division of Cardiac Surgery, Veterans
Affairs (VA) Boston Healthcare System, Harvard Medical School, Boston,
Mass, United States
(Gikandi, Hirji, Zenati) Division of Cardiac Surgery, Brigham and Women's
Hospital, Harvard Medical School, Boston, Mass, United States
(Stock, Dematt, Biswas) VA Cooperative Studies Program Coordinating
Center, Office of Research and Development, U.S. Department of Veterans
Affairs, Perry Point, MD, United States
Publisher
Elsevier Inc.
Abstract
Objective: To investigate the association between the presence and
grafting of chronic total occlusions (CTOs) and coronary artery bypass
grafting (CABG) outcomes. <br/>Method(s): This was a post hoc analysis of
the Randomized Endograft vs Open Prospective (REGROUP) trial, which
randomized veterans undergoing isolated on-pump CABG to endoscopic versus
open vein harvest (2014-2017). Patients were stratified on the basis of
the presence of at least 1 CTO vessel (a 100% occluded coronary lesion for
greater than or equal to 3 months) and according to whether all CTO
vessels were bypassed. Rates of major cardiac adverse events (MACE) were
compared. <br/>Result(s): At least 1 CTO was present in 453 of 1149
patients (39.4%). Over a median follow-up of 4.7 years (interquartile
range, 3.84-5.45), MACE rates were 23.4% versus 22.2% for the CTO versus
no CTO group, respectively (adjusted hazard ratio [aHR], 0.92; 95%
confidence interval [CI], 0.70-1.20). MACE rates for patients with
complete CTO grafting versus not were 23.1% versus 25.0%, respectively
(aHR, 0.95; 95% CI, 0.57-1.57). In patients with right coronary dominance
undergoing left anterior descending artery grafting, bypassing a right
coronary artery CTO was associated with significantly lower rates of
all-cause mortality (aHR, 0.38; 95% CI, 0.17-0.83). <br/>Conclusion(s): In
this REGROUP trial subanalysis, neither CTO presence or complete grafting
of CTO vessels was associated with significantly different rates of MACE.
However, the finding of possible survival benefit among a subgroup of
patients undergoing grafting of a dominant RCA CTO vessel alongside left
anterior descending artery grafting warrants additional
study.<br/>Copyright &#xa9; 2024 The American Association for Thoracic
Surgery

<60>
Accession Number
2034583143
Title
Percutaneous coronary intervention with drug-eluting stents versus
coronary bypass surgery for coronary artery disease: A Bayesian
perspective.
Source
Journal of Thoracic and Cardiovascular Surgery. (no pagination), 2024.
Date of Publication: 2024.
Author
Kawczynski M.J.; Gabrio A.; Maessen J.G.; van 't Hof A.W.J.; Brophy J.M.;
Gollmann-Tepekoylu C.; Sardari Nia P.; Vriesendorp P.A.; Heuts S.
Institution
(Kawczynski, Maessen, Sardari Nia, Heuts) Department of Cardiothoracic
Surgery, Maastricht University Medical Centre (MUMC+), Maastricht,
Netherlands
(Kawczynski, Maessen, van 't Hof, Sardari Nia, Vriesendorp, Heuts)
Cardiovascular Research Institute Maastricht (CARIM), Maastricht
University, Maastricht, Netherlands
(Gabrio) Department of Methodology and Statistics, University Maastricht,
Maastricht, Netherlands
(van 't Hof, Vriesendorp) Department of Cardiology, Maastricht University
Medical Centre (MUMC+), Maastricht, Netherlands
(van 't Hof) Department of Cardiology, Zuyderland Medisch Centrum,
Heerlen, Netherlands
(Brophy) McGill University Health Centre, Centre for Health Outcome
Research (CORE), Montreal, QC, Canada
(Gollmann-Tepekoylu) Department of Cardiac Surgery, Medical University of
Innsbruck, Innsbruck, Austria
Publisher
Elsevier Inc.
Abstract
Objectives: Coronary revascularization is frequently performed for
coronary artery disease (CAD). This study aims to assess the totality of
randomized evidence comparing percutaneous coronary intervention with
drug-eluting stents (DES-PCI) with coronary artery bypass grafting (CABG)
for CAD. <br/>Method(s): A systematic search was applied to 3 electronic
databases, including randomized trials comparing DES-PCI with CABG for CAD
with 5-year follow-up. A Bayesian hierarchical meta-analytic model was
applied. The primary outcome was all-cause mortality at 5 years; secondary
outcomes were stroke, myocardial infarction, and repeat revascularization.
End points were reported in median relative risks (RRs) and absolute risk
differences, with 95% credible intervals (CrIs). Kaplan-Meier curves were
used to reconstruct individual patient data. <br/>Result(s): Six studies
comprising 8269 patients (DES-PCI, n = 4134; CABG, n = 4135) were
included. All-cause mortality at 5 years was increased with DES-PCI
(median RR, 1.23; 95% CrI, 1.01-1.45), with a median absolute risk
difference of +2.3% (95% CrI, 0.1%-4.5%). For stroke, myocardial
infarction, and repeat revascularization, the median RRs were 0.79 (95%
CrI, 0.54-1.25), 1.84 (95% CrI, 1.23-2.75), and 1.80 (95% CrI, 1.51-2.16)
for DES-PCI, respectively. In a sample of 1000 patients undergoing DES-PCI
instead of CABG for CAD, a median of 23 additional deaths, 46 myocardial
infarctions, and 85 repeat revascularizations occurred at 5 years, whereas
10 strokes were prevented. <br/>Conclusion(s): The current data suggest a
clinically relevant benefit of CABG over DES-PCI at 5 years in terms of
mortality, myocardial infarction, and repeat revascularization, despite an
increased risk of stroke. These findings may guide the heart-team and the
shared decision-making process.<br/>Copyright &#xa9; 2024 The Authors

<61>
Accession Number
2034580994
Title
Liraglutide effects on epicardial adipose tissue micro-RNAs and
intra-operative glucose control.
Source
Nutrition, Metabolism and Cardiovascular Diseases. (no pagination), 2024.
Date of Publication: 2024.
Author
Iacobellis G.; Goldberger J.J.; Lamelas J.; Martinez C.A.; Sterling C.M.;
Bodenstab M.; Frasca D.
Institution
(Iacobellis, Bodenstab) Division of Endocrinology, Diabetes and
Metabolism, Department of Medicine, University of Miami Miller School of
Medicine, Miami, FL, United States
(Goldberger, Martinez, Sterling) Division of Cardiology, Department of
Medicine, University of Miami Miller School of Medicine, Miami, FL, United
States
(Lamelas) Division of Cardiothoracic Surgery, DeWitt Daughtry Department
of Surgery, University of Miami Miller School of Medicine, Miami, FL,
United States
(Frasca) Department of Microbiology and Immunology, University of Miami
Miller School of Medicine, Miami, FL, United States
(Frasca) Sylvester Comprehensive Cancer Center, University of Miami Miller
School of Medicine, Miami, FL, United States
Publisher
Elsevier B.V.
Abstract
Background and aim: Epicardial adipose tissue (EAT) plays a role in
coronary artery disease (CAD). EAT has regional distribution throughout
the heart and each location may have a different genetic profile and
function. Glucagon like peptide-1 receptor analogs (GLP-1RAs) reduce
cardiovascular risk. However, the short-term effects of GLP-1RA on
microRNA (miRNA) profile of each EAT location is unknown. Objective was to
evaluate if EAT miRNAs were different between coronary (CORO-EAT), left
atrial EAT (LA-EAT) and subcutaneous fat (SAT), and liraglutide can
modulate EAT miRNAs expression. <br/>Methods and Results: This was a
12-week randomized, double-blind, placebo-controlled study in 38 patients
with type 2 diabetes (T2DM) and coronary artery disease (CAD) who were
started on either liraglutide or placebo for a minimum of 4 up to 12 weeks
prior to coronary artery by-pass grafting (CABG). Fat samples were
collected during CABG. miR16, miR155 and miR181a were significantly higher
in CORO-EAT and in LA-EAT than SAT (p < 0.01 and p < 0.05) in overall
patients. miR16 and miR181-a were significantly higher in CORO-EAT than
SAT (p < 0.01), and miR155 and miR181a were higher in LA-EAT than SAT (p <
0.05) in the liraglutide group. Liraglutide-treated patients had better
intra-op glucose control than placebo (146 +/- 21 vs 160 +/- 21 mg/dl, p <
0.01). <br/>Conclusion(s): Our study shows that CORO- and LA-miRNAs
profiles were significantly different than SAT miRNAs in overall patients
and miRNAs were significantly higher in CORO-EAT and LA-EAT than SAT in
the liraglutide group. Pre-op liraglutide was also associated with better
intra operative glucose control than placebo independently of weight
loss.<br/>Copyright &#xa9; 2024 The Italian Diabetes Society, the Italian
Society for the Study of Atherosclerosis, the Italian Society of Human
Nutrition and the Department of Clinical Medicine and Surgery, Federico II
University

<62>
Accession Number
2034537354
Title
Going the distance: Long-term follow-up of the randomized, prospective
Scandinavian heart transplant everolimus de novo study with early
calcineurin inhibitors avoidance (SCHEDULE) trial.
Source
Journal of Heart and Lung Transplantation. (no pagination), 2024. Date of
Publication: 2024.
Author
Gamero M.T.; Brailovsky Y.; Eisen H.J.
Institution
(Gamero, Brailovsky, Eisen) Jefferson Heart Institute, Thomas Jefferson
University, Philadelphia, Pennsylvania, United States
Publisher
Elsevier Inc.

<63>
Accession Number
2034479809
Title
Coronary bypass surgery for multivessel disease after percutaneous
coronary intervention in acute coronary syndromes: why, for whom, how
early?.
Source
European Heart Journal. 45(34) (pp 3124-3131), 2024. Date of Publication:
07 Sep 2024.
Author
Besola L.; Colli A.; De Caterina R.
Institution
(Besola, Colli) Cardiac Surgery Division, Pisa University Hospital,
Department of Surgical, Medical and Molecular Pathology and Critical Care,
University of Pisa, Via Paradisa 2, Pisa 56124, Italy
(De Caterina) Cardiology Division, Pisa University Hospital, Department of
Surgical, Medical and Molecular Pathology and Critical Care, University of
Pisa, Via Paradisa 2, Pisa 56124, Italy
Publisher
Oxford University Press
Abstract
Multivessel coronary artery disease is present in ~50% of patients with
acute coronary syndrome and, compared with single-vessel disease, entails
a higher risk of new ischaemic events and a worse prognosis. Randomized
controlled trials have shown the superiority of 'complete
revascularization' over culprit lesion-only treatment. Trials, however,
only included patients treated with percutaneous coronary intervention
(PCI), and evidence regarding complete revascularization with coronary
artery bypass graft (CABG) surgery after culprit lesion-only PCI ('hybrid
revascularization') is lacking. The CABG after PCI is an open,
non-negligible therapeutic option, for patients with non-culprit left main
and/or left anterior descending coronary artery disease where evidence in
chronic coronary syndrome patients points in several cases to a preference
of CABG over PCI. This valuable but poorly studied 'PCI first-CABG later'
option presents, however, relevant challenges, mostly in the need of
interrupting post-stenting dual antiplatelet therapy (DAPT) for surgery to
prevent excess bleeding. Depending on patients' clinical characteristics
and coronary anatomical features, either deferring surgery after a safe
interruption of DAPT or bridging DAPT interruption with intravenous
short-acting antithrombotic agents appears to be a suitable option.
Off-pump minimally invasive surgical revascularization, associated with
less operative bleeding than open-chest surgery, may be an adjunctive
strategy when revascularization cannot be safely deferred and DAPT is not
interrupted. Here, the rationale, patient selection, optimal timing, and
adjunctive strategies are reviewed for an ideal approach to hybrid
revascularization in post-acute coronary syndrome patients to support
physicians' choices in a case-by-case patient-tailored
approach.<br/>Copyright &#xa9; The Author(s) 2024. Published by Oxford
University Press on behalf of the European Society of Cardiology. All
rights reserved.

<64>
Accession Number
645226247
Title
The association of midregional pro-adrenomedullin (MR-proADM) at ICU
admission and fluid overload in patients post elective cardiac surgery.
Source
Scientific reports. 14(1) (pp 20897), 2024. Date of Publication: 08 Sep
2024.
Author
Pfortmueller C.A.; Ott I.; Muller M.; Wilson D.; Schefold J.C.; Messmer
A.S.
Institution
(Pfortmueller, Ott, Schefold, Messmer) Department of Intensive Care
Medicine, Inselspital, Bern University Hospital, University of Bern, Bern,
Switzerland
(Muller) Department of Emergency Medicine, Inselspital, Bern University
Hospital, University of Bern, Bern, Switzerland
(Wilson) Organ Dysfunction and Resuscitation Research Group, Vall d'Hebron
Institute of Research, Barcelona, Spain
Abstract
Postoperative fluid overload (FO) after cardiac surgery is common and
affects recovery. Predicting FO could help optimize fluid management. This
post-hoc analysis of the HERACLES randomized controlled trial evaluated
the predictive value of MR-proADM for FO post-cardiac surgery. MR-proADM
levels were measured at four different timepoints in 33 patients
undergoing elective cardiac surgery. Patients were divided into FO (>5%
weight gain) and no-FO at ICU discharge. The primary outcome was the
predictive power of MR-proADM at ICU admission for FO at discharge.
Secondary outcomes included the predictive value of MR-proADM for FO on
day 6 post-surgery and changes over time. The association between
MR-proADM and FO at ICU discharge or day 6 post-surgery was not
significant (crude odds ratio (cOR): 4.3 (95% CI 0.5-40.9, p=0.201) and
cOR 1.1 (95% CI 0.04-28.3, p=0.954)). MR-proADM levels over time did not
differ significantly between patients with and without FO at ICU discharge
(p=0.803). MR-proADM at ICU admission was not associated with fluid
overload at ICU discharge in patients undergoing elective cardiac surgery.
MR-proADM levels over time were not significantly different between
groups, although elevated levels were observed in patients with
FO.<br/>Copyright &#xa9; 2024. The Author(s).

<65>
Accession Number
2031344160
Title
A Comparison of Conventional Rotating Method and Non-Rotating Method for
Double-Lumen Tube Insertion Using a Customized Rigid J-Shaped Stylet for
One-Lung Ventilation: A Randomized Controlled Trial.
Source
Journal of Clinical Medicine. 13(17) (no pagination), 2024. Article
Number: 5302. Date of Publication: September 2024.
Author
Lee S.; Han S.J.; Park J.; Kim Y.-H.; Hong B.; Oh C.; Yoon S.-H.
Institution
(Lee, Kim, Hong, Oh, Yoon) Department of Anesthesiology and Pain Medicine,
Chungnam National University Hospital, Daejeon 35015, South Korea
(Lee, Park, Kim, Hong, Oh, Yoon) Department of Anesthesiology and Pain
Medicine, College of Medicine, Chungnam National University, Daejeon
35015, South Korea
(Han) Department of Thoracic and Cardiovascular Surgery, College of
Medicine, Chungnam National University Hospital, Daejeon 35015, South
Korea
(Park) Department of Anesthesiology and Pain Medicine, Sejong Chungnam
National University Hospital, Sejong 30099, South Korea
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Background: The conventional double-lumen tube (DLT) insertion method
requires a rotatory maneuver that was developed using direct laryngoscopy
and may not be optimal for video laryngoscopy. This study compared a new
non-rotatory maneuver with the conventional method for DLT insertion using
video laryngoscopy. <br/>Method(s): Patients scheduled for thoracic
surgery requiring one-lung ventilation were randomly assigned to either
the rotating (R) or non-rotating (NR) method groups. All patients were
intubated using a customized rigid J-shaped stylet, a video laryngoscope,
and a left-sided silicone DLT. The conventional rotatory maneuver was
performed in the R group. In the NR group, the stylet was inserted with
its tip oriented anteriorly (12 o'clock direction) while maintaining the
bronchial lumen towards the left (9 o'clock direction). After reaching the
glottic opening, the tube was inserted using a non-rotatory maneuver,
maintaining the initial orientation. The primary endpoint was the
intubation time. Secondary endpoints included first-trial success rate,
sore throat, hoarseness, and airway injury. <br/>Result(s): Ninety
patients (forty-five in each group) were included. The intubation time was
significantly shorter in the NR group compared to the R group (22.0 [17.0,
30.0] s vs. 28.0 [22.0, 34.0] s, respectively), with a median difference
of 6 s (95% confidence interval [CI], 3-11 s; p = 0.017). The NR group had
a higher first-attempt success rate and a lower incidence of sore throats.
<br/>Conclusion(s): The non-rotatory technique with video laryngoscopy
significantly reduced intubation time and improved first-attempt success
rate, offering a viable and potentially superior alternative to the
conventional rotatory technique.<br/>Copyright &#xa9; 2024 by the authors.

<66>
Accession Number
2031340265
Title
Influence of Anesthetic Regimes on Extracellular Vesicles following Remote
Ischemic Preconditioning in Coronary Artery Disease.
Source
International Journal of Molecular Sciences. 25(17) (no pagination), 2024.
Article Number: 9304. Date of Publication: September 2024.
Author
Pham P.N.V.; Yahsaly L.; Ochsenfarth C.; Giebel B.; Schnitzler R.; Zahn
P.; Frey U.H.
Institution
(Pham, Ochsenfarth, Frey) Department of Anesthesiology, Intensive Care,
Pain and Palliative Care, Marien Hospital Herne, Ruhr-University Bochum,
Bochum 44801, Germany
(Yahsaly) Department of Cardiology, University Hospital Essen, University
of Duisburg-Essen, Essen 45147, Germany
(Giebel) Institute for Transfusion Medicine, University Hospital Essen,
University of Duisburg-Essen, Essen 45147, Germany
(Schnitzler, Zahn) Department of Anesthesiology, Intensive Care and Pain
Medicine, BG University Hospital Bergmannsheil, Ruhr-University Bochum,
Bochum 44789, Germany
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Remote ischemic preconditioning (RIPC) reduces ischemia-reperfusion injury
in aortocoronary bypass surgery, potentially via extracellular vesicles
(EVs) and their micro-RNA content. Clinical data implicate that propofol
might inhibit the cardioprotective RIPC effect. This prospective,
randomized study investigated the influence of different anesthetic
regimes on RIPC efficacy and EV micro-RNA signatures. We also assessed the
impact of propofol on cell protection after hypoxic conditioning and
EV-mediated RIPC in vitro. H9c2 rat cardiomyoblasts were subjected to
hypoxia, with or without propofol, and subsequent simulated
ischemia-reperfusion injury. Apoptosis was measured by flow cytometry.
Blood samples of 64 patients receiving anesthetic maintenance with
propofol or isoflurane, along with RIPC or sham procedures, were analyzed,
and EVs were enriched using a polymer-based method. Propofol
administration corresponded with increased Troponin T levels (4669 +/-
435.6 pg/mL), suggesting an inhibition of the cardioprotective RIPC
effect. RIPC leads to a notable rise in miR-21 concentrations in the group
receiving propofol anesthesia (fold change 7.22 +/- 6.6). In vitro
experiments showed that apoptosis reduction was compromised with propofol
and only occurred in an EV-enriched preconditioning medium, not in an
EV-depleted medium. Our study could clinically and experimentally confirm
propofol inhibition of RIPC protection. Increased miR-21 expression could
provide evidence for a possible inhibitory mechanism.<br/>Copyright &#xa9;
2024 by the authors.

<67>
Accession Number
2031329517
Title
Outcomes of Valve-in-Valve (VIV) Transcatheter Aortic Valve Replacement
(TAVR) after Surgical Aortic Valve Replacement with Sutureless Surgical
Aortic Valve Prostheses PercevalTM: A Systematic Review of Published
Cases.
Source
Journal of Clinical Medicine. 13(17) (no pagination), 2024. Article
Number: 5164. Date of Publication: September 2024.
Author
Owais T.; Bisht O.; El Din Moawad M.H.; El-Garhy M.; Stock S.; Girdauskas
E.; Kuntze T.; Amer M.; Lauten P.
Institution
(Owais, Stock, Girdauskas) Department of Cardiac Surgery, University
Hospital Augsburg, Augsburg 86156, Germany
(Owais) Department of Cardiothoracic Surgery, Cairo University, Giza
12163, Egypt
(Bisht) Department of Cardiology and Angiology, Regiomed Klinikum Coburg,
Coburg 96450, Germany
(El Din Moawad) Department of Clinical Pharmacy, Faculty of Pharmacy,
Alexandria 21513, Egypt
(El-Garhy) Department of Cardiology, Heart Vascular Center, Rotenburg an
der Fulda 36199, Germany
(Kuntze, Lauten) Heart Center, Zentralklinik Bad Berka, Bad Berka 99437,
Germany
(Amer) Department of Cardiac Surgery, Heart Centre Siegburg-Wuppertal,
University Witten-Herdecke, Wuppertal 42103, Germany
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Background: Valve-in-Valve (VIV) transcatheter aortic valve replacement
(TAVR) is a potential solution for malfunctioning surgical aortic valve
prostheses, though limited data exist for its use in Perceval valves.
<br/>Method(s): searches were performed on PubMed and Scopus up to 31 July
2023, focusing on case reports and series addressing VIV replacement for
degenerated Perceval bioprostheses. <br/>Result(s): Our analysis included
57 patients from 27 case reports and 6 case series. Most patients (68.4%)
were women, with a mean age of 76 +/- 4.4 years and a mean STS score of
6.1 +/- 4.3%. Follow-up averaged 9.8 +/- 8.9 months, the mean gradient
reduction was 15 +/- 5.9 mmHg at discharge and 13 +/- 4.2 mmHg at
follow-up. Complications occurred in 15.7% of patients, including
atrioventricular block III in four patients (7%), major bleeding or
vascular complications in two patients (3.5%), an annular rupture in two
patients (3.5%), and mortality in two patients (3.5%). No coronary
obstruction was reported. Balloon-expanding valves were used in 61.4% of
patients, predominantly the Sapien model. In the self-expanding group
(38.6%), no valve migration occurred, with a permanent pacemaker
implantation rate of 9%, compared to 5.7% for balloon-expanding valves.
<br/>Conclusion(s): VIV-TAVR using both balloon-expanding and
self-expanding technologies is feasible after the implantation of Perceval
valves; however, it should be performed by experienced operators with
experience both in TAVR and VIV procedures.<br/>Copyright &#xa9; 2024 by
the authors.

<68>
Accession Number
645227130
Title
Clopidogrel Versus Aspirin as Chronic Maintenance Antiplatelet Monotherapy
in Patients After Percutaneous Coronary Intervention With Chronic Kidney
Disease: A Post Hoc Analysis of the HOST-EXAM Trial.
Source
Journal of the American Heart Association. (pp e035269), 2024. Date of
Publication: 09 Sep 2024.
Author
Kang J.; Park S.-H.; Park K.W.; Koo B.-K.; Lee H.; Han M.; Hwang D.; Yang
H.-M.; Chae I.-H.; Shin W.-Y.; Oh J.H.; Kim Y.H.; Park T.-H.; Kim B.S.;
Han J.-K.; Shin E.-S.; Kim H.-S.
Institution
(Kang, Park, Park, Koo, Lee, Han, Hwang, Yang, Han, Kim) Department of
Internal Medicine, Cardiovascular Center Seoul National University
Hospital Seoul South Korea
(Chae) Department of Internal Medicine Seoul National University Bundang
Hospital Seongnam South Korea
(Shin) Department of Internal Medicine Soonchunhyang University Cheonan
Hospital Cheonan South Korea
(Oh) Department of Cardiology, Samsung Changwon Hospital Sungkyunkwan
University School of Medicine Changwon South Korea
(Kim) Department of Internal Medicine Kangwon National University School
of Medicine Chuncheon South Korea
(Park) Department of Internal Medicine Dong-A University Hospital Busan
South Korea
(Kim) Department of Internal Medicine, Kangbuk Samsung Hospital
Sungkyunkwan University Seoul South Korea
(Shin) Department of Internal Medicine Ulsan University Hospital Ulsan
South Korea
Abstract
BACKGROUND: Clopidogrel monotherapy improved clinical outcomes compared
with aspirin monotherapy during a chronic maintenance period in patients
who underwent coronary stenting in the HOST-EXAM (Harmonizing Optimal
Strategy for Treatment of Coronary Artery Stenosis-Extended Antiplatelet
Monotherapy) trial. However, it is uncertain whether the beneficial effect
of clopidogrel over aspirin is different according to the renal function.
METHODS AND RESULTS: We conducted a post hoc analysis of the HOST-EXAM
trial. Chronic kidney disease (CKD) was defined as baseline estimated
glomerular filtration rate <60mL/min per 1.73m2. The primary end point was
a composite of all-cause death, nonfatal myocardial infarction, stroke,
readmission due to acute coronary syndrome, and Bleeding Academic Research
Consortium bleeding type >=3, during the 2-year follow up. Among the 5438
patients enrolled in the HOST-EXAM trial, 4844 patients (mean age,
63.3+/-10.6years; 74.9% men) with a baseline creatinine value were
analyzed in this study. A total of 508 (10.5%) patients had CKD, who were
at higher risk of the primary end point compared with those without CKD
(hazard ratio [HR], 2.01 [95% CI, 1.51-2.67]). Clopidogrel monotherapy was
associated with a lower rate of the primary end point in both patients
with CKD (HR, 0.74 [95% CI, 0.44-1.25]) and patients without CKD (HR, 0.71
[95% CI, 0.56-0.91]). No significant interaction was observed between the
treatment effect and CKD status (P for interaction=0.889).
<br/>CONCLUSION(S): During the chronic maintenance period after coronary
stenting, the risk of thrombotic and bleeding events was significantly
higher in patients with CKD compared with those without CKD. There was no
statistical difference in the treatment effect of clopidogrel monotherapy
in those with versus without CKD.

<69>
Accession Number
645226548
Title
Dual ProGlide versus ProGlide and Angio-Seal for Femoral Access Hemostasis
after Transcatheter Aortic Valve Replacement: A Randomized Comparative
Trial.
Source
The Canadian journal of cardiology. (no pagination), 2024. Date of
Publication: 06 Sep 2024.
Author
Yeh C.-F.; Kao H.-L.; Ko T.-Y.; Chen C.-K.; Tsai C.-H.; Huang C.-C.; Chen
Y.-H.; Chan C.-Y.; Lin M.-S.
Institution
(Yeh, Kao, Tsai, Huang, Chen, Lin) Division of Cardiology, Department of
Internal Medicine and Cardiovascular Center, National Taiwan University
Hospital, Taipei, Taiwan (Republic of China)
(Ko) Division of Cardiology, Department of Internal Medicine and
Cardiovascular Center, National Taiwan University Hospital, Taipei,
Taiwan; Graduate Institute of Clinical Medicine, Medical College, National
Taiwan University, Taipei, Taiwan
(Chen) Department of Internal Medicine, National Taiwan University
Hospital Hsin-Chu Branch, Hsin-Chu, Taiwan (Republic of China)
(Chan) Division of Cardiovascular Surgery, Department of Surgery and
Cardiovascular Center, National Taiwan University Hospital, Taipei, Taiwan
(Republic of China)
Abstract
BACKGROUND: Vascular complications increase morbidity and mortality after
transcatheter aortic valve replacements(TAVR), often related to failures
in vascular closure devices(VCD). We intended to compare the dual Perclose
ProGlide(PP) strategy to the hybrid combination of PP and Angio-Seal(AS)
for femoral access hemostasis after TAVR. <br/>METHOD(S): A randomized
controlled trial with 257 patients comparing dual PP to one PP and one
AS(AS+PP) for vascular closure after transfemoral TAVR was conducted. The
primary endpoint was the composite of TAVR access site-related vascular
complications and life-threatening type 2/3 or 1 bleeding according to
VARC-3. Secondary endpoints included additional VCD use and significant
peripheral ischemia related to arteriotomy closure within one year.
Modified VCD failure, defined as failure to achieve hemostasis within 5
minutes or requiring additional endovascular maneuvers, was also recorded.
<br/>RESULT(S): The AS+PP combination yielded lower rates of the primary
endpoint(18.2% vs 29.8%; p = 0.0381), vascular complication(18.2% vs
29.8%; p = 0.0381), additional VCD usage(0.8% vs 19.0%; p < 0.0001), and
modified VCD failure(9.9% vs 33.1%; p < 0.0001) than the dual PP. Bleeding
complication rates were similar between the two groups. Three-month
follow-up vascular duplex tests showed similar common femoral artery(CFA)
diameters and peak systolic velocities(PSV) between the two groups, but
additional intervention had higher PSV and smaller CFA diameters than
those without. <br/>CONCLUSION(S): The combined PP+AS for large-bore
femoral access hemostasis following TAVR promises to be more effective and
safer than dual PP in terms of vascular complications. Moreover,
additional intervention for vascular complications resulted in smaller CFA
diameters(ClinicalTrials.gov number, NCT05491070).<br/>Copyright &#xa9;
2024. Published by Elsevier Inc.

<70>
Accession Number
2034517346
Title
Drug-coated balloon angioplasty with rescue stenting versus intended
stenting for the treatment of patients with de novo coronary artery
lesions (REC-CAGEFREE I): an open-label, randomised, non-inferiority
trial.
Source
The Lancet. 404(10457) (pp 1040-1050), 2024. Date of Publication: 14 Sep
2024.
Author
Gao C.; He X.; Ouyang F.; Zhang Z.; Shen G.; Wu M.; Yang P.; Ma L.; Yang
F.; Ji Z.; Wang H.; Wu Y.; Fang Z.; Jiang H.; Wen S.; Li F.; Zhou J.; Zhu
B.; Liu Y.; Zhang R.; Zhang T.; Wang P.; Liu J.; Jiang Z.; Xia J.; van
Geuns R.-J.; Capodanno D.; Garg S.; Onuma Y.; Wang D.; Serruys P.W.; Tao
L.
Institution
(Gao, He, Liu, Li, Zhou, Zhu, Liu, Zhang, Zhang, Wang, Liu, Tao)
Department of Cardiology, Xijing Hospital, Fourth Military Medical
University, Xi'an, China
(Ouyang) Department of Cardiovascular Medicine, Zhuzhou Hospital
Affiliated to Xiangya School of Medicine, Central South University,
Zhuzhou, China
(Zhang) Department of Cardiovascular Medicine, Center for Circadian
Metabolism and Cardiovascular Disease and Key Laboratory of Geriatric
Cardiovascular and Cerebrovascular Disease, Southwest Hospital, Army
Medical University, Southwest Hospital, Chongqing, China
(Shen) Department of Cardiology, Ankang Hospital of Traditional Chinese
Medicine, Ankang, China
(Wu) Department of Cardiology, Xiangtan Central Hospital, Xiangtan, China
(Yang) Department of Cardiology, China-Japan Union Hospital of Jilin
University, Changchun, China
(Ma) Department of Cardiology, The First Affiliated Hospital of USTC,
Hefei, China
(Yang) Department of Cardiology, The First Hospital of Kunming, Kunming,
China
(Ji) Department of Cardiology, Tangshan Workers Hospital, Tangshan, China
(Wang) Department of Cardiology, West China Hospital of Sichuan
University, Chengdu, China
(Wu) Department of Cardiology, The Second Affiliated Hospital of Nanchang
University, Nanchang, China
(Fang) Department of Cardiology, The Second Xiangya Hospital of Central
South University, Changsha, China
(Jiang) Department of Cardiology, Renmin Hospital of Wuhan University,
Wuhan, China
(Wen) Department of Cardiology, Tianjin Fourth Central Hospital, Tianjin,
China
(Jiang) Beijing KeyTech Statistical Consulting, Beijing, China
(Xia) Department of Health Statistics, Fourth Military Medical University,
Xi'an, China
(van Geuns) Department of Cardiology, Radboud UMC, Nijmegen, Netherlands
(Capodanno) Department of Cardiology, Azienda Ospedaliero-Universitaria
Policlinico G Rodolico-San Marco, University of Catania, Catania, Italy
(Garg) Department of Cardiology, Royal Blackburn Hospital, Blackburn,
United Kingdom
(Garg) School of Medicine, University of Central Lancashire, Preston,
United Kingdom
(Onuma, Serruys) Department of Cardiology, School of Medicine, University
of Galway, Galway, Ireland
(Wang) Biostatistics Unit, Liverpool School of Tropical Medicine,
Liverpool, United Kingdom
Publisher
Elsevier B.V.
Abstract
Background: The long-term impact of drug-coated balloon (DCB) angioplasty
for the treatment of patients with de novo coronary artery lesions remains
uncertain. We aimed to assess the non-inferiority of DCB angioplasty with
rescue stenting to intended drug-eluting stent (DES) deployment for
patients with de novo, non-complex coronary artery lesions.
<br/>Method(s): REC-CAGEFREE I was an open-label, randomised,
non-inferiority trial conducted at 43 sites in China. After successful
lesion pre-dilatation, patients aged 18 years or older with de novo,
non-complex coronary artery disease (irrespective of target vessel
diameter) and an indication for percutaneous coronary intervention were
randomly assigned (1:1), via a web-based centralised system with block
randomisation (block size of two, four, or six) and stratified by site, to
paclitaxel-coated balloon angioplasty with the option of rescue stenting
due to an unsatisfactory result (DCB group) or intended deployment of
second-generation thin-strut sirolimus-eluting stents (DES group). The
primary outcome was the device-oriented composite endpoint (DoCE;
including cardiovascular death, target vessel myocardial infarction, and
clinically and physiologically indicated target lesion revascularisation)
assessed at 24 months in the intention-to-treat (ITT) population (ie, all
participants randomly assigned to treatment). Non-inferiority was
established if the upper limit of the one-sided 95% CI for the absolute
risk difference was smaller than 2.68%. Safety was assessed in the ITT
population. This study is registered with ClinicalTrials.gov, NCT04561739.
It is closed to accrual and extended follow-up is ongoing.
<br/>Finding(s): Between Feb 5, 2021, and May 1, 2022, 2272 patients were
randomly assigned to the DCB group (1133 [50%]) or the DES group (1139
[50%]). Median age at the time of randomisation was 62 years (IQR 54-69),
1574 (69.3%) of 2272 were male, 698 (30.7%) were female, and all patients
were of Chinese ethnicity. 106 (9.4%) of 1133 patients in the DCB group
received rescue DES after unsatisfactory DCB angioplasty. As of data
cutoff (May 1, 2024), median follow-up was 734 days (IQR 731-739). At 24
months, the DoCE occurred in 72 (6.4%) of 1133 patients in the DCB group
and 38 (3.4%) of 1139 in the DES group, with a risk difference of 3.04% in
the cumulative event rate (upper boundary of the one-sided 95% CI 4.52;
p<inf>non-inferiority</inf>=0.65; two-sided 95% CI 1.27-4.81; p=0.0008);
the criterion for non-inferiority was not met. During intervention, no
acute vessel closures occurred in the DCB group and one (0.1%) of 1139
patients in the DES group had acute vessel closure. Periprocedural
myocardial infarction occurred in ten (0.9%) of 1133 patients in the DCB
group and nine (0.8%) in the DES group. <br/>Interpretation(s): In
patients with de novo, non-complex coronary artery disease, irrespective
of vessel diameter, a strategy of DCB angioplasty with rescue stenting did
not achieve non-inferiority compared with the intended DES implantation in
terms of the DoCE at 2 years, which indicates that DES should remain the
preferred treatment for this patient population. <br/>Funding(s): Xijing
Hospital and Shenqi Medical. Translation: For the Chinese translation of
the abstract see Supplementary Materials section.<br/>Copyright &#xa9;
2024 Elsevier Ltd

<71>
Accession Number
2034517331
Title
Optimal patient and mechanical circulatory support device selection in
acute myocardial infarction cardiogenic shock.
Source
The Lancet. 404(10457) (pp 992-993), 2024. Date of Publication: 14 Sep
2024.
Author
Jentzer J.C.; Hibbert B.
Institution
(Jentzer) Department of Cardiovascular Medicine, Mayo Clinic, Rochester,
MN 55905, United States
(Hibbert) CAPITAL Research Group, Division of Cardiology, University of
Ottawa Heart Institute, Ottawa, ON, Canada
Publisher
Elsevier B.V.

<72>
Accession Number
2034160213
Title
Systematic Review and Meta-Analysis of the Outcomes After Hepatic Artery
Reconstruction in Pediatric Liver Transplantation Using a Microscope
Versus Surgical Loupe.
Source
Transplantation Proceedings. 56(7) (pp 1585-1592), 2024. Date of
Publication: September 2024.
Author
Koh Z.J.; Wu A.G.; Yew A.; Lee Y.Y.; Loh D.L.; Nyo Y.L.; Mali V.P.
Institution
(Koh, Lee, Loh, Nyo, Mali) Department of Paediatric Surgery, National
University Hospital, Singapore, Singapore
(Wu, Yew) Yong Loo Lin School of Medicine, National University of
Singapore, Singapore, Singapore
Publisher
Elsevier Inc.
Abstract
Background: To review the impact of the operating microscope (OM) for
reconstruction of the hepatic artery (HA) by comparing the outcomes with
standard loupe reconstruction (SL) in pediatric liver transplantation
(LT). <br/>Method(s): Studies comparing the application of OM and SL for
the reconstruction of the HA in primary pediatric LT were included from a
systematic search of MEDLINE, Cochrane Library and EMBASE from inception
to June 2022. Re-transplantation, dual grafts and auxiliary transplants
were excluded. Primary outcome was the rate of HA thrombosis (HAT).
Secondary outcomes were graft loss and mortality. <br/>Result(s): There
were 1261 liver recipients from 9 included studies published until June
2022. There were 484 patients in the OM group and 777 patients in the SL
group. HAT incidence with OM was significantly lower with OR = 0.18 (95%
CI: 0.07-0.48). The 1-year graft survival was significantly better in the
OM group with OR = 2.77 (95% CI: 1.13-6.80). 1-year overall mortality was
also significantly lower with OM with OR = 0.39 (0.18-0.86). The use of OM
did not significantly impact the incidence of HAT in the living donor
liver transplant subgroup. Differences in time for hepatic HA
reconstruction, total operating time and length of hospital stay did not
reach statistical significance. <br/>Conclusion(s): The use of OM has
reduced the risk of HAT, graft loss and mortality in pediatric liver
transplantation. Adoption of microsurgical principles in general may have
contributed to the improved outcomes with SL reconstruction of HA in
pediatric LT.<br/>Copyright &#xa9; 2024 Elsevier Inc.

<73>
Accession Number
2033050883
Title
Editor's Choice - Prognostic Factors and Models to Predict Mortality
Outcomes in Patients with Peripheral Arterial Disease: A Systematic
Review.
Source
European Journal of Vascular and Endovascular Surgery. 68(3) (pp 361-377),
2024. Date of Publication: September 2024.
Author
Porras C.P.; Teraa M.; Damen J.A.A.; Hazenberg C.E.V.B.; Bots M.L.;
Verhaar M.C.; Vernooij R.W.M.
Institution
(Porras, Verhaar, Vernooij) Department of Nephrology and Hypertension,
University Medical Centre Utrecht, Utrecht, Netherlands
(Porras, Damen, Bots, Vernooij) Julius Centre for Health Sciences and
Primary Care, University Medical Centre Utrecht, Utrecht University,
Utrecht, Netherlands
(Teraa, Hazenberg) Department of Vascular Surgery, University Medical
Centre Utrecht, Utrecht, Netherlands
Publisher
W.B. Saunders Ltd
Abstract
Objective: Predicting adverse outcomes in patients with peripheral
arterial disease (PAD) is a complex task owing to the heterogeneity in
patient and disease characteristics. This systematic review aimed to
identify prognostic factors and prognostic models to predict mortality
outcomes in patients with PAD Fontaine stage I - III or Rutherford
category 0 - 4. <br/>Data Sources: PubMed, Embase, and Cochrane Database
of Systematic Reviews were searched to identify studies examining
individual prognostic factors or studies aiming to develop or validate a
prognostic model for mortality outcomes in patients with PAD. Review
Methods: Information on study design, patient population, prognostic
factors, and prognostic model characteristics was extracted, and risk of
bias was evaluated. <br/>Result(s): Sixty nine studies investigated
prognostic factors for mortality outcomes in PAD. Over 80 single
prognostic factors were identified, with age as a predictor of death in
most of the studies. Other common factors included sex, diabetes, and
smoking status. Six studies had low risk of bias in all domains, and the
remainder had an unclear or high risk of bias in at least one domain.
Eight studies developed or validated a prognostic model. All models
included age in their primary model, but not sex. All studies had similar
discrimination levels of > 70%. Five of the studies on prognostic models
had an overall high risk of bias, whereas two studies had an overall
unclear risk of bias. <br/>Conclusion(s): This systematic review shows
that a large number of prognostic studies have been published, with
heterogeneity in patient populations, outcomes, and risk of bias. Factors
such as sex, age, diabetes, hypertension, and smoking are significant in
predicting mortality risk among patients with PAD Fontaine stage I - III
or Rutherford category 0 - 4.<br/>Copyright &#xa9; 2024 The Author(s)

<74>
Accession Number
2032816789
Title
Rapid Acute Coronary Syndrome Evaluation Over One Hour With
High-Sensitivity Cardiac Troponin I: A United States-Based Stepped-Wedge,
Randomized Trial.
Source
Annals of Emergency Medicine. 84(4) (pp 399-408), 2024. Date of
Publication: October 2024.
Author
Miller J.; Cook B.; Gandolfo C.; Mills N.L.; Mahler S.; Levy P.; Parikh
S.; Krupp S.; Nour K.; Klausner H.; Gindi R.; Lewandowski A.; Hudson M.;
Perrotta G.; Zweig B.; Lanfear D.; Kim H.; Dangoulian S.; Tang A.; Todter
E.; Khan A.; Keerie C.; Bole S.; Nasseredine H.; Oudeif A.; Abou Asala E.;
Mohammed M.; Kazem A.; Malette K.; Singh-Kucukarslan G.; Xu N.; Wittenberg
S.; Morton T.; Gunaga S.; Affas Z.; Tabbaa K.; Desai P.; Alsaadi A.;
Mahmood S.; Schock A.; Konowitz N.; Fuchs J.; Joyce K.; Shamoun L.; Babel
J.; Broome A.; Digiacinto G.; Shaheen E.; Darnell G.; Muller G.; Heath G.;
Bills G.; Vieder J.; Rockoff S.; Kim B.; Colucci A.; Plemmons E.; McCord
J.
Institution
(Miller, Cook, Krupp, Klausner, Perrotta, Tang, Todter, Khan, Bole,
Nasseredine, Oudeif, Abou Asala, Mohammed, Kazem, Malette,
Singh-Kucukarslan, Morton, Alsaadi, Mahmood, Schock, Konowitz, Fuchs,
Joyce, Darnell, Heath, Vieder) Henry Ford Hospital, Detroit, MI, United
States
(Gandolfo, Parikh, Nour, Gindi, Hudson, Zweig, Lanfear, Kim, McCord) Heart
and Vascular Institute Henry Ford Health, Detroit, MI, United States
(Mills, Keerie, Babel) The Usher Institute, University of Edinburgh,
Edinburgh, United Kingdom
(Mahler, Shamoun, Broome) Wake Forest University School of Medicine
Winston-Salem, NC
(Levy, Dangoulian, Xu, Wittenberg, Desai) Wayne State University School of
Medicine, Detroit, MI, United States
(Lewandowski, Bills, Rockoff) Henry Ford West Bloomfield Hospital, West
Bloomfield, MI, United States
(Gunaga, Digiacinto, Shaheen, Muller, Plemmons) Henry Ford Wyandotte
Hospital Wyandotte, MI
(Affas, Tabbaa, Colucci) Henry Ford Macomb Hospital, Clinton Township, MI
(Kim) Henry Ford Allegiance Hospital, Jackson, MI
Publisher
Elsevier Inc.
Abstract
Study objective: The real-world effectiveness and safety of a 0/1-hour
accelerated protocol using high-sensitivity cardiac troponin (hs-cTn) to
exclude myocardial infarction (MI) compared to routine care in the United
States is uncertain. The objective was to compare a 0/1-hour accelerated
protocol for evaluation of MI to a 0/3-hour standard care protocol.
<br/>Method(s): The RACE-IT trial was a stepped-wedge, randomized trial
across 9 emergency departments (EDs) that enrolled 32,609 patients
evaluated for possible MI from July 2020 through April 2021. Patients
undergoing high-sensitivity cardiac troponin I testing with concentrations
less than or equal to 99th percentile were included. Patients who had MI
excluded by the 0/1-hour protocol could be discharged from the ED.
Patients in the standard care protocol had 0- and 3-hour troponin testing
and application of a modified HEART score to be eligible for discharge.
The primary endpoint was the proportion of patients discharged from the ED
without 30-day death or MI. <br/>Result(s): There were 13,505 and 19,104
patients evaluated in the standard care and accelerated protocol groups,
respectively, of whom 19,152 (58.7%) were discharged directly from the ED.
There was no significant difference in safe discharges between standard
care and the accelerated protocol (59.5% vs 57.8%; adjusted odds ratio
(aOR)=1.05, 95% confidence interval [CI] 0.95 to 1.16). At 30 days, there
were 90 deaths or MIs with 38 (0.4%) in the standard care group and 52
(0.4%) in the accelerated protocol group (aOR=0.84, 95% CI 0.43 to 1.68).
<br/>Conclusion(s): A 0/1-hour accelerated protocol using high-sensitivity
cardiac troponin I did not lead to more safe ED discharges compared with
standard care.<br/>Copyright &#xa9; 2024 American College of Emergency
Physicians

<75>
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)

<76>
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.

<77>
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.

<78>
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.

<79>
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.

<80>
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

<81>
Accession Number
2034435230
Title
Comparison of rotational atherectomy and conventional angioplasty for
calcified coronary stenosis with high calcium score detected by
multi-slice CT coronary angiography.
Source
African Journal of Biological Sciences (South Africa). 6(14) (pp
9119-9136), 2024. Date of Publication: August 2024.
Author
Elyamani E.; Mabruk M.; Boshra H.
Institution
(Elyamani, Mabruk, Boshra) Faculty of Medicine, Beni-Suef University,
Egypt
Publisher
Institute of Advanced Studies
Abstract
Objectives: comparing the clinical outcomes of rotational atherectomy (RA)
and conventional PCI methods on heavily calcified lesions in patients with
high calcium scores detected. <br/>Method(s): This was a clinical trial
conducted on 30 patients aged above 18 years, their angiography proved
coronary artery disease, having anginal symptoms and/or reproducible
ischemia in the target area by ECG, functional stress testing, or
fractional flow reserve, their calcium score more than 1000 on MS-CT
coronary angiography. Patients were randomly assigned to 2 groups: Group A
rotational atherectomy followed by DES implantation and Group B PCI
through balloon predilatation using noncompliant balloons to facilitate
device crossing followed by DES implantation. Angiographic assessment
immediately after revascularization & 6 months later on was performed.
<br/>Result(s): Strategy success, the primary endpoint of the trial, was
significantly more common in the RA group (46.6% in the conventional PCI
group versus 100% in the RA group; P=0.0447). The main driving factor for
strategy failure was the need to crossover to RA in the conventional PCI
group (33.3% versus 0%; P= 0.042). The reasons for crossing over in the
conventional PCI group were, the lesion was not crossable by any balloon
in 1 case, the lesion was not adequately dilatable in 3 cases and the
stent was not deliverable despite adequate pre-dilatation in 1 case.
<br/>Conclusion(s): Lesion preparation with upfront RA before DES
implantation is feasible in nearly all patients with complex calcified
coronary lesions (as high as >1000 ca-score as detected by MS-CT) and is
more commonly successful as a primary strategy compared with conventional
PCI using non-compliant balloons.<br/>Copyright &#xa9; 2024 Institute of
Advanced Studies. All rights reserved.

<82>
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.

<83>
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.

<84>
Accession Number
619230288
Title
Rivaroxaban with or without aspirin in patients with stable coronary
artery disease: an international, randomised, double-blind,
placebo-controlled trial.
Source
The Lancet. 391(10117) (pp 205-218), 2018. Date of Publication: 20 - 26
January 2018.
Author
Connolly S.J.; Eikelboom J.W.; Bosch J.; Dagenais G.; Dyal L.; Lanas F.;
Metsarinne K.; O'Donnell M.; Dans A.L.; Ha J.-W.; Parkhomenko A.N.; Avezum
A.A.; Lonn E.; Lisheng L.; Torp-Pedersen C.; Widimsky P.; Maggioni A.P.;
Felix C.; Keltai K.; Hori M.; Guzik T.J.; Bhatt D.L.; Branch K.R.H.; Cook
Bruns N.; Berkowitz S.D.; Anand S.S.; Varigos J.D.; Fox K.A.A.; Yusuf S.;
SALA J.; CARTASEGNA L.U.I.S.; VICO M.; HOMINAL M.A.; HASBANI E.; CACCAVO
A.; ZAIDMAN C.; VOGEL D.; HRABAR A.; SCHYGIEL P.O.; CUNEO C.; LUQUEZ
H.U.G.O.; MACKINNON I.J.; AHUAD GUERRERO R.A.; COSTABEL J.P.; BARTOLACCI
I.P.; MONTANA O.; BARBIERI M.; GOMEZ VILAMAJO O.; GARCIA DURAN R.O.;
SCHIAVI L.B.; GARRIDO M.; INGARAMO A.; BORDONAVA A.P.; PELAGAGGE M.J.;
NOVARETTO L.; ALBISU DI GENNERO J.P.; IBANEZ SAGGIA L.M.; ALVAREZ M.; VITA
N.A.; MACIN S.M.; DRAN R.D.; CARDONA M.; GUZMAN L.U.I.S.; SARJANOVICH
R.J.; CUADRADO J.; NANI S.; LITVAK BRUNO M.R.; CHACON C.; MAFFEI L.E.;
GRINFELD D.; VENSENTINI N.; MAJUL C.R.; LUCIARDI H.L.; GONZALEZ COLASO
P.D.C.; FERRE PACORA F.A.; VAN DEN HEUVEL P.A.U.L.; VERHAMME P.; ECTOR
B.A.V.O.; DEBONNAIRE P.; VAN DE BORNE P.; LEROY J.E.A.N.; SCHROE H.;
VRANCKX P.; ELEGEERT I.V.A.N.; HOFFER E.; DUJARDIN K.A.R.L.; INDIO DO
BRASIL C.; PRECOMA D.; ABRANTES J.A.; MANENTI E.; REIS G.; SARAIVA
J.O.S.E.; MAIA L.; HERNANDES M.; ROSSI P.; ROSSI DOS SANTOS F.; ZIMMERMANN
S.L.; RECH R.; ABIB E.; LEAES P.; BOTELHO R.; DUTRA O.; SOUZA W.; BRAILE
M.; IZUKAWA N.I.L.O.; NICOLAU J.C.; TANAJURA L.F.; SERRANO JUNIOR C.V.;
MINELLI C.; NASI L.A.; OLIVEIRA L.; DE CARVALHO CANTARELLI M.J.; TYTUS R.;
PANDEY S.; LONN E.V.A.; CHA J.; VIZEL S.A.U.L.; BABAPULLE M.; LAMY A.;
SAUNDERS K.; BERLINGIERI J.; KIAII B.O.B.; BHARGAVA R.; MEHTA P.; HILL L.;
FELL D.; LAM A.N.D.Y.; AL-QOOFI F.; BROWN C.; PETRELLA R.; RICCI J.A.;
GLANZ A.; NOISEUX N.; BAINEY K.; MERALI F.; HEFFERNAN M.; DELLA SIEGA A.;
DAGENAIS G.R.; DAGENAIS F.; BRULOTTE S.; NGUYEN M.; HARTLEIB M.; GUZMAN
R.; BOURGEOIS R.; RUPKA D.; KHAYKIN Y.; GOSSELIN G.; HUYNH T.H.A.O.; PILON
C.; CAMPEAU J.E.A.N.; PICHETTE F.; DIAZ A.; JOHNSTON J.; SHUKLE P.; HIRSCH
G.; RHEAULT P.A.U.L.; CZARNECKI W.; ROY A.; NAWAZ S.H.A.H.; FREMES S.;
SHUKLA D.; JANO G.; COBOS J.L.; CORBALAN R.; MEDINA M.; NAHUELPAN L.;
RAFFO C.; PEREZ L.U.I.S.; POTTHOFF S.; STOCKINS B.; SEPULVEDA P.; PINCETTI
C.; VEJAR M.; TIAN H.; WU X.; KE Y.; JIA K.; YIN P.; WANG Z.; YU L.; WU
S.; WU Z.; LIU S.W.; BAI X.J.; ZHENG Y.A.N.G.; YANG P.I.N.G.; YANG Y.M.;
ZHANG J.; GE J.; CHEN X.P.; HU T.H.; ZHANG R.; ZHENG Z.H.E.; CHEN X.I.N.;
TAO L.; LI J.; HUANG W.; FU G.; LI C.; DONG Y.; WANG C.; ZHOU X.; KONG
Y.E.; SOTOMAYOR A.; ACCINI MENDOZA J.L.; CASTILLO H.; URINA M.; AROCA G.;
PEREZ M.; MOLINA DE SALAZAR D.I.; SANCHEZ VALLEJO G.; FERNANDO M.J.;
GARCIA H.; GARCIA L.H.; ARCOS E.; GOMEZ J.U.A.N.; CUERVO MILLAN F.;
TRUJILLO DADA F.A.; VESGA B.; MORENO SILGADO G.A.; ZIDKOVA E.V.A.; LUBANDA
J.-C.; KALETOVA M.; KRYZA R.; MARCINEK G.; RICHTER M.; SPINAR J.; MATUSKA
J.I.R.I.; TESAK M.; MOTOVSKA Z.; BRANNY M.; MALY J.I.R.I.; MALY M.; WIENDL
M.; FOLTYNOVA CAISOVA L.; SLABY J.; VOJTISEK P.E.T.R.; PIRK J.A.N.;
SPINAROVA L.; BENESOVA M.; CANADYOVA J.; HOMZA M.; FLORIAN J.; POLASEK R.;
COUFAL Z.; SKALNIKOVA V.; BRAT R.; BRTKO M.; JANSKY P.E.T.R.; LINDNER J.;
MARCIAN P.; STRAKA Z.; TRETINA M.; DUARTE Y.C.; POW CHON LONG F.; SANCHEZ
M.; LOPEZ J.O.S.E.; PERUGACHI C.; MARMOL R.; TRUJILLO F.; TERAN P.;
TUOMILEHTO J.; TUOMILEHTO H.; TUOMINEN M.-L.; KANTOLA I.; STEG G.; ABOYANS
V.; LECLERCQ F.; FERRARI E.; BOCCARA F.; MESSAS E.; MISMETTI P.; SEVESTRE
M.A.; CAYLA G.; MOTREFF P.; STOERK S.; DUENGEN H.A.N.S.-D.I.R.K.;
STELLBRINK C.; GUEROCAK O.; KADEL C.; BRAUN-DULLAEUS R.; JESERICH M.;
OPITZ C.; VOEHRINGER H.-F.; APPEL K.-F.; WINKELMANN B.; DORSEL T.; NIKOL
S.; DARIUS H.; RANFT J.; SCHELLONG S.; JUNGMAIR W.; DAVIERWALA P.; VORPAHL
M.A.R.C.; BAJNOK L.; LASZLO Z.; NOORI E.; VERESS G.; VERTES A.; ZSARY A.;
KIS E.R.N.O.; KORANYI L.; BAKAI J.; BODA Z.; POOR F.; JARAI Z.; KEMENY V.;
BARTON J.O.H.N.; MCADAM B.; MURPHY A.; CREAN P.; MAHON N.; CURTIN R.;
MACNEILL B.; DINNEEN S.E.A.N.; HALABI M.; ZIMLICHMAN R.; ZELTSER D.;
TURGEMAN Y.O.A.V.; KLAINMAN E.; LEWIS B.; KATZ A.M.O.S.; ATAR S.; NIKOLSKY
E.; BOSI S.; NALDI M.; FAGGIANO P.; ROBBA D.; MOS L.; SINAGRA G.; COSMI
F.; OLTRONA VISCONTI L.; CARMINE D.M.; DI PASQUALE G.; DI BIASE M.;
MANDORLA S.A.R.A.; BERNARDINANGELI M.; PICCINNI G.C.; GULIZIA M.M.;
GALVANI M.; VENTURI F.; MOROCUTTI G.; BALDIN M.G.; OLIVIERI C.; PERNA
G.P.; CIRRINCIONE V.; KANNO T.; DAIDA H.; OZAKI Y.; MIYAMOTO N.; HIGASHIUE
S.; DOMAE H.; HOSOKAWA S.; KOBAYASHI H.; KURAMOCHI T.; FUJII K.; MIZUTOMI
K.; SAKU K.; KIMURA K.; HIGUCHI Y.; ABE M.; OKUDA H.; NODA T.; MITA T.;
HIRAYAMA A.; ONAKA H.; INOKO M.; HIROKAMI M.; OKUBO M.; AKATSUKA Y.;
IMAMAKI M.; KAMIYA H.; MANITA M.; HIMI T.; UENO H.; HISAMATSU Y.U.J.I.;
AKO J.; NISHINO Y.; KAWAKAMI H.; YAMADA Y.; KORETSUNE Y.; YAMADA T.;
YOSHIDA T.; SHIMOMURA H.; KINOSHITA N.; TAKAHASHI A.; YUSOFF K.; WAN AHMAD
W.A.; ABU HASSAN M.R.; KASIM S.; ABDUL RAHIM A.A.; MOHD ZAMRIN D.; MACHIDA
M.; HIGASHINO Y.; UTSU N.; NAKANO A.; NAKAMURA S.; HASHIMOTO T.; ANDO K.;
SAKAMOTO T.; PRINS F.J.; LOK D.I.R.K.; MILHOUS J.G.-J.; VIERGEVER
E.R.I.C.; WILLEMS F.; SWART H.E.N.K.; ALINGS M.; BREEDVELD R.O.B.; DE
VRIES K.E.E.S.-J.A.N.; VAN DER BORGH R.; OEI F.; ZOET-NUGTEREN S.; KRAGTEN
H.A.N.S.; HERRMAN J.P.; VAN BERGEN P.A.U.L.; GOSSELINK M.; HOEKSTRA E.;
ZEGERS E.; RONNER E.; DEN HARTOG F.; BARTELS G.; NIEROP P.; VAN DER ZWAAN
C.O.E.N.; VAN ECK J.; VAN GORSELEN E.; GROENEMEIJER B.; HOOGSLAG P.; DE
GROOT M.R.; LOYOLA A.; SULIT D.J.; REY N.; ABOLA M.T.; MORALES D.;
PALOMARES E.; ABAT M.E.; ROGELIO G.; CHUA P.; DEL PILAR J.C.; ALCARAZ
J.D.; EBO G.; TIRADOR L.; CRUZ J.; ANONUEVO J.O.H.N.; PITARGUE A.; JANION
M.; GAJOS G.; ZABOWKA M.; RYNKIEWICZ A.; BRONCEL M.; SZUBA A.; CZARNECKA
D.; MAGA P.; STRAZHESKO I.; VASYUK Y.U.R.Y.; SIZOVA Z.; POZDNYAKOV
Y.U.R.Y.; BARBARASH O.L.G.A.; VOEVODA M.; POPONINA T.; REPIN A.; OSIPOVA
I.; EFREMUSHKINA A.N.N.A.; NOVIKOVA N.I.N.A.; AVERKOV O.L.E.G.;
ZATEYSHCHIKOV D.; VERTKIN A.; AUSHEVA A.Z.A.; COMMERFORD P.; SEEDAT S.;
VAN ZYL L.; ENGELBRECHT J.A.N.; MAKOTOKO E.M.; PRETORIUS C.E.; MOHAMED
Z.A.I.D.; HORAK A.; MABIN T.; KLUG E.R.I.C.; BAE J.A.N.G.-H.O.; KIM C.;
KIM C.H.O.N.G.-J.I.N.; KIM D.O.N.G.-S.O.O.; KIM Y.J.; JOO S.; HA
J.O.N.G.-W.O.N.; PARK C.S.; KIM J.Y.; KIM Y.O.U.N.G.-K.W.O.N.; JARNERT C.;
MOOE T.; DELLBORG M.; TORSTENSSON I.; ALBERTSSON P.E.R.; JOHANSSON
L.A.R.S.; AL-KHALILI F.; ALMROTH H.; ANDERSSON T.; PANTEV E.M.I.L.;
TENGMARK B.E.N.G.T.-O.L.O.V.; LIU B.O.; RASMANIS G.; WAHLGREN C.-M.;
MOCCETTI T.; TSELUYKO V.I.R.A.; VOLKOV V.; KOVAL O.; KONONENKO L.;
PROKHOROV O.; VDOVYCHENKO V.; BAZYLEVYCH A.; RUDENKO L.; VIZIR V.;
KARPENKO O.; MALYNOVSKY Y.; KOVAL V.; STOROZHUK B.; COTTON J.;
VENKATARAMAN A.S.O.K.; MORIARTY A.; CONNOLLY D.; DAVEY P.; SENIOR
R.O.X.Y.; BIRDI I.; CALVERT J.O.H.N.; DONNELLY P.; TREVELYAN J.; CARTER
J.; PEACE A.; AUSTIN D.; KUKREJA N.; HILTON T.; SRIVASTAVA S.; WALSH R.;
FIELDS R.; HAKAS J.; PORTNAY E.; GOGIA H.; SALACATA A.; HUNTER J.J.;
BACHARACH J.M.; SHAMMAS N.; SURESH D.; SCHNEIDER R.; GURBEL P.A.U.L.;
BANERJEE S.; GRENA P.A.U.L.; BEDWELL N.O.E.L.; SLOAN S.; LUPOVITCH S.;
SONI A.; GIBSON K.; SANGRIGOLI R.; MEHTA R.; I-HSUAN TSAI P.; GILLESPIE
E.V.E.; DEMPSEY S.; HAMROFF G.; BLACK R.; LADER E.; KOSTIS J.B.; BITTNER
V.E.R.A.; MCGUINN W.; BRANCH K.; MALHOTRA V.; MICHAELSON S.; VACANTE M.;
MCCORMICK M.; ARIMIE R.; CAMP A.L.A.N.; DAGHER G.; KOSHY N.M.; THEW S.;
COSTELLO F.; HEIMAN M.A.R.K.; CHILTON R.; MORAN M.; ADLER F.; COMEROTA A.;
SEIWERT A.; FRENCH W.; SEROTA H.; HARRISON R.; BAKAEEN F.; OMER S.;
CHANDRA L.; WHELAN A.L.A.N.; BOYLE A.; ROBERTS-THOMSON P.; ROGERS J.;
CARROLL P.; COLQUHOUN D.; SHAW J.; BLOMBERY P.; AMERENA J.O.H.N.; HII C.;
ROYSE A.; SINGH B.; SELVANAYAGAM J.; JANSEN S.; LO W.; HAMMETT C.; POULTER
R.; NARASIMHAN S.; WIGGERS H.; NIELSEN H.; GISLASON G.; KOBER L.A.R.S.;
HOULIND K.I.M.; BOENELYKKE SOERENSEN V.; DIXEN U.; REFSGAARD J.E.N.S.;
ZEUTHEN E.; SOEGAARD P.; HRANAI M.; GASPAR L.; PELLA D.; HATALOVA K.;
DROZDAKOVA E.; COMAN I.O.A.N.; DIMULESCU D.; VINEREANU D.; CINTEZA M.;
SINESCU C.; ARSENESCU C.; BENEDEK I.M.R.E.; BOBESCU E.; DOBREANU D.A.N.;
GAITA D.A.N.; IANCU A.; ILIESIU A.; LIGHEZAN D.; PETRESCU L.; PIRVU O.;
TEODORESCU I.; TESLOIANU D.A.N.; VINTILA M.M.; CHIONCEL O.
Institution
(Connolly, Eikelboom, Dyal, Lonn, Anand, Yusuf) Population Health Research
Institute, McMaster University and Hamilton Health Sciences, Hamilton, ON,
Canada
(Bosch) School of Rehabilitation Science, McMaster University, Hamilton,
ON, Canada
(Dagenais) Institut Universitaire de Cardiologie et Pneumologie de Quebec,
Quebec, QC, Canada
(Lanas) Universidad de la Frontera, Temuco, Chile
(Metsarinne) Department of Medicine, Turku University Central Hospital and
Turku University, Turku, Finland
(O'Donnell) Department of Medicine, National University of Ireland,
Galway, Ireland
(Dans) Department of Medicine, University of Philippines, Manila,
Philippines
(Ha) Yonsei University College of Medicine, Seoul, South Korea
(Parkhomenko) Institute of Cardiology, Kiev, Ukraine
(Avezum) Instituto Dante Pazzanese de Cardiologia & University Santo
Amaro, Sao Paulo, Brazil
(Lisheng) FuWai Hospital, CAMS, Beijing, China
(Torp-Pedersen) University of Aalborg, Aalborg, Denmark
(Widimsky) Charles University, Prague, Czechia
(Maggioni) ANMCO Research Center, Florence, Italy
(Felix) Universidad Tecnologica Equinoccial, Facultad de Ciencias de la
Salud Eugenio, Espejo, Quito, Ecuador
(Keltai) Department of Medicine, Semmelweis University, Budapest, Hungary
(Hori) Osaka International Cancer Institute, Osaka, Japan
(Yusoff) Universiti Teknologi Mara, Selangor, Malaysia
(Guzik) Collegium Medicum Jagiellonian University, Krakow, Poland
(Guzik) University of Glasgow, Glasgow, United Kingdom
(Bhatt) Brigham and Women's Hospital Heart & Vascular Center and Harvard
Medical School, Boston, MA, United States
(Branch) Department of Medicine, University of Washington Medical Centre,
Seattle, WA, United States
(Cook Bruns) Bayer AG, Wuppertal, Germany
(Berkowitz) Bayer AG, Parsippany, NJ, United States
(Varigos) Monash University, Melbourne, VIC, Australia
(Fox) Department of Medicine, University of Edinburgh, Edinburgh, United
Kingdom
Publisher
Lancet Publishing Group
Abstract
Background: Coronary artery disease is a major cause of morbidity and
mortality worldwide, and is a consequence of acute thrombotic events
involving activation of platelets and coagulation proteins. Factor Xa
inhibitors and aspirin each reduce thrombotic events but have not yet been
tested in combination or against each other in patients with stable
coronary artery disease. <br/>Method(s): In this multicentre,
double-blind, randomised, placebo-controlled, outpatient trial, patients
with stable coronary artery disease or peripheral artery disease were
recruited at 602 hospitals, clinics, or community centres in 33 countries.
This paper reports on patients with coronary artery disease. Eligible
patients with coronary artery disease had to have had a myocardial
infarction in the past 20 years, multi-vessel coronary artery disease,
history of stable or unstable angina, previous multi-vessel percutaneous
coronary intervention, or previous multi-vessel coronary artery bypass
graft surgery. After a 30-day run in period, patients were randomly
assigned (1:1:1) to receive rivaroxaban (2.5 mg orally twice a day) plus
aspirin (100 mg once a day), rivaroxaban alone (5 mg orally twice a day),
or aspirin alone (100 mg orally once a day). Randomisation was computer
generated. Each treatment group was double dummy, and the patients,
investigators, and central study staff were masked to treatment
allocation. The primary outcome of the COMPASS trial was the occurrence of
myocardial infarction, stroke, or cardiovascular death. This trial is
registered with ClinicalTrials.gov, number NCT01776424, and is closed to
new participants. <br/>Finding(s): Between March 12, 2013, and May 10,
2016, 27 395 patients were enrolled to the COMPASS trial, of whom 24 824
patients had stable coronary artery disease from 558 centres. The
combination of rivaroxaban plus aspirin reduced the primary outcome more
than aspirin alone (347 [4%] of 8313 vs 460 [6%] of 8261; hazard ratio
[HR] 0.74, 95% CI 0.65-0.86, p<0.0001). By comparison, treatment with
rivaroxaban alone did not significantly improve the primary outcome when
compared with treatment with aspirin alone (411 [5%] of 8250 vs 460 [6%]
of 8261; HR 0.89, 95% CI 0.78-1.02, p=0.094). Combined rivaroxaban plus
aspirin treatment resulted in more major bleeds than treatment with
aspirin alone (263 [3%] of 8313 vs 158 [2%] of 8261; HR 1.66, 95% CI
1.37-2.03, p<0.0001), and similarly, more bleeds were seen in the
rivaroxaban alone group than in the aspirin alone group (236 [3%] of 8250
vs 158 [2%] of 8261; HR 1.51, 95% CI 1.23-1.84, p<0.0001). The most common
site of major bleeding was gastrointestinal, occurring in 130 [2%]
patients who received combined rivaroxaban plus aspirin, in 84 [1%]
patients who received rivaroxaban alone, and in 61 [1%] patients who
received aspirin alone. Rivaroxaban plus aspirin reduced mortality when
compared with aspirin alone (262 [3%] of 8313 vs 339 [4%] of 8261; HR
0.77, 95% CI 0.65-0.90, p=0.0012). <br/>Interpretation(s): In patients
with stable coronary artery disease, addition of rivaroxaban to aspirin
lowered major vascular events, but increased major bleeding. There was no
significant increase in intracranial bleeding or other critical organ
bleeding. There was also a significant net benefit in favour of
rivaroxaban plus aspirin and deaths were reduced by 23%. Thus, addition of
rivaroxaban to aspirin has the potential to substantially reduce morbidity
and mortality from coronary artery disease worldwide. <br/>Funding(s):
Bayer AG.<br/>Copyright &#xa9; 2018 Elsevier Ltd

<85>
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.

<86>
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.

<87>
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.

<88>
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

<89>
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.

<90>
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).

<91>
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.

<92>
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.

<93>
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.

<94>
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)

<95>
Accession Number
2032626401
Title
Intraprostatic Injection of Tranexamic Acid Decrease Blood Loss During
Monopolar Transurethral Resection of the Prostate: A Randomized Controlled
Clinical Trial.
Source
Urology. 191 (pp 119-126), 2024. Date of Publication: September 2024.
Author
Diab T.; El Hamshary S.A.; Abou Elezz A.; El-Dakhakhny A.S.
Institution
(Diab, El Hamshary, Abou Elezz, El-Dakhakhny) Urology Department, Faculty
of Medicine, Benha University, Benha, Egypt
Publisher
Elsevier Inc.
Abstract
Objective: To assess the role of intraprostatic injection of tranexamic
acid (TXA) in reducing blood loss during transurethral resection of the
prostate (TURP). <br/>Method(s): We conducted a randomized, controlled,
double-blind trial involving 60 patients with benign prostatic hyperplasia
aged 50-85 years, undergoing monopolar TURP. Patients' prostatic weights
ranged from 50 to 80 g. They were divided equally into two groups: group I
received an intraprostatic injection of 1 g of TXA (Cyklokapron) dissolved
in 50 mL of 0.9 % saline at multiple sites, while group II (control)
received a 60 mL saline injection. Comprehensive clinical assessments and
standard laboratory tests, including screenings for TXA hypersensitivity,
were performed for all patients. <br/>Result(s): Group I exhibited
significantly lower intraoperative blood loss and hemoglobin concentration
in irrigation fluid immediately postsurgery and at the 6-hour
postoperative mark compared to group II (P < .05). Coagulation
parameters-activated partial thromboplastin time, prothrombin time,
fibrinogen level, and thrombin clotting time-showed no significant
differences between the groups preoperatively or at 6 and 24 hours
postoperatively. No thromboembolic events or other complications were
reported in either group. <br/>Conclusion(s): The intraprostatic injection
of TXA during monopolar TURP is safe, with minimal adverse effects, and
effectively reduces blood loss. Registration: The study was registered on
ClinicalTrials.gov No (ID: NCT05913466).<br/>Copyright &#xa9; 2024
Elsevier Inc.

<96>
Accession Number
2031104877
Title
Prevalence of pulmonary nodules detected incidentally on noncancer-related
imaging: a review.
Source
Internal Medicine Journal. 54(9) (pp 1440-1449), 2024. Date of
Publication: September 2024.
Author
Das A.; Bonney A.; Manser R.
Institution
(Das) The University of Melbourne, Melbourne Medical School, Royal
Melbourne Hospital Clinical School, Melbourne, VIC, Australia
(Bonney, Manser) Department of Respiratory and Sleep Medicine, Royal
Melbourne Hospital, Melbourne, VIC, Australia
Publisher
John Wiley and Sons Inc
Abstract
Pulmonary nodules are common incidental findings requiring surveillance.
Follow-up recommendations vary depending on risk factors, size and solid
or subsolid characteristics. This review aimed to evaluate the prevalence
of clinically significant nodules detected on noncancer-dedicated imaging
and the prevalence of part-solid and ground-glass nodules. We conducted a
systematic search of literature and screened texts for eligibility.
Clinically significant nodules were noncalcified nodules >4-6 mm.
Prevalence estimates were calculated for all studies and risk of bias was
assessed by one reviewer. Twenty-four studies were included, with a total
of 30 887 participants, and 21 studies were cross-sectional in design.
Twenty-two studies used computed tomography (CT) imaging with
cardiac-related CT being the most frequent. Prevalence of significant
nodules was highest in studies with large field of view of the chest and
low size thresholds for reporting nodules. The prevalence of part-solid
and ground-glass nodules was only described in two cardiac-related CT
studies. The overall risk of bias was low in seven studies and moderate in
17 studies. While current literature frequently reports incidental nodules
on cardiovascular-related CT, there is minimal reporting of subsolid
characteristics. Unclear quantification of smoking history and
heterogeneity of imaging protocol also limits reliable evaluation of
nodule prevalence in nonscreening cohorts.<br/>Copyright &#xa9; 2024 The
Author(s). Internal Medicine Journal published by John Wiley & Sons
Australia, Ltd on behalf of Royal Australasian College of Physicians.

<97>
Accession Number
2034280448
Title
Effect of Inspiratory Muscle Training on Outcomes After Cardiac Surgery.
Source
Journal of Cardiopulmonary Rehabilitation and Prevention. 44(5) (pp
324-332), 2024. Date of Publication: 01 Sep 2024.
Author
Fang L.; Cheng A.; Zhu Z.; Shao M.; Wang G.
Institution
(Fang, Cheng, Zhu, Shao, Wang) Cardiorpulmonary Rehabilitation Ward,
Zhejiang Rehabilitation Medical Center (The Affiliated Rehabilitation
Hospital of Zhejiang Chinese Medical University), Hangzhou, Zhejiang
Province, China; and Rehabilitation Medicine Department 2, The Third
Affiliated Hospital of Zhejiang University of Traditional Chinese
Medicine, Hangzhou, Zhejiang Province, China.
Publisher
Lippincott Williams and Wilkins
Abstract
Purpose: Inspiratory muscle training (IMT) has emerged as a potential
intervention to improve respiratory outcomes for patients undergoing
cardiac surgery. However, the extent of the IMT effects on preoperative
and postoperative respiratory metrics remains uncertain. Hence, we
designed this study to determine the effects of IMT on various outcomes of
patients undergoing cardiac surgery. <br/>Method(s): We conducted a
comprehensive meta-analysis of studies evaluating the impact of
preoperative and postoperative IMT on various respiratory variables and
postsurgical outcomes. We synthesized data from multiple studies,
encompassing diverse patient populations and IMT protocols. The key
outcomes included the maximal inspiratory pressure (MIP), forced
expiratory volume in 1 sec (FEV1), forced vital capacity (FVC), and
others. <br/>Result(s): Our meta-analysis results showed that preoperative
IMT significantly improved the MIP values with a pooled standard mean
difference (SMD) of 0.62. The hospital stay length was also reduced with a
SMD of - 0.4. Other variables such as FEV1 and FVC also improved
significantly. Postoperative IMT improved the MIP and peak flow rate
values, but the evidence was less robust than with preoperative
interventions. We observed high heterogeneity across studies for several
outcomes and found evidence of publication bias for some postoperative
measures. <br/>Conclusion(s): Both preoperative and postoperative IMT
offer benefits for patients undergoing operations, especially by enhancing
respiratory muscle strength and potentially reducing hospital stays.
However, the presence of heterogeneity and publication bias underscores
the need for further standardized research to consolidate these findings
and standardize IMT protocols for optimal patient outcomes.<br/>Copyright
&#xa9; 2024 Wolters Kluwer Health, Inc. All rights reserved.

<98>
Accession Number
645212764
Title
Colchicine in Patients with Coronary Disease Undergoing Coronary Artery
Bypass Surgery - A Meta-Analysis of Randomized Controlled Trials.
Source
The American journal of cardiology. (no pagination), 2024. Date of
Publication: 05 Sep 2024.
Author
Kirov H.; Caldonazo T.; Runkel A.; Medin D.; Fischer J.; Dallan L.R.;
Mukharyamov M.; Mejia O.A.; Jatene F.B.; Doenst T.
Institution
(Kirov, Caldonazo, Runkel, Medin, Fischer, Mukharyamov) Department of
Cardiothoracic Surgery, Friedrich-Schiller-University Jena, Jena, Germany
(Dallan, Mejia, Jatene) Department of Cardiovascular Surgery, Heart
Institute - University of Sao Paulo Medical School, Sao Paulo, Brazil
(Doenst) Department of Cardiothoracic Surgery,
Friedrich-Schiller-University Jena, Jena, Germany
Abstract
BACKGROUND: Recent randomized evidence has shown that low dose colchicine
lowers the risk of cardiovascular events in patients with chronic coronary
artery disease (CAD). Colchicine has also been used in coronary artery
bypass grafting (CABG) with individual studies suggesting protective
effects for postoperative atrial fibrillation (POAF). We performed a
meta-analysis of studies assessing the effect of colchicine on outcomes in
CABG surgery. <br/>METHOD(S): We systematically searched three libraries
(MEDLINE, Web of Science and The Cochrane Library) selecting all
randomized control trials including patients who underwent CABG and were
randomized for perioperative administration of colchicine versus standard
of care. Primary outcome was incidence of POAF. Inverse variance method
(DerSimonian&Laird) and random effects model were performed. The
leave-one-out analysis was carried out as a sensitivity analysis to
address possible outliers. <br/>RESULT(S): From 205 screened studies, five
met the inclusion crieteria and were selected. The data from 839 patients
were included in the final analysis. Included studies were published
between 2014 and 2022. The perioperative administration of colchicine was
associated with the reduction of POAF rates after CABG when compared to
standard of care (relative risk; RR= 0.54, 95% confidence interval, CI,
0.40-0.73, p<0.01). The leave-one-out analysis confirmed the robustness of
the analysis, with minimal variations of the confidence interval.
<br/>CONCLUSION(S): This meta-analysis of randomized studies suggests that
the perioperative administration of colchicine is associated with
significant reduction of POAF after CABG.<br/>Copyright &#xa9; 2024.
Published by Elsevier Inc.