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<1>
Accession Number
2037723660
Title
Transcatheter or surgical aortic valve replacement in patients with severe
aortic stenosis aged 70 years or younger: A NOTION-2 substudy.
Source
American Heart Journal. 284 (pp 67-70), 2025. Date of Publication: 01 Jun
2025.
Author
Jorgensen T.H.; Thyregod H.G.H.; Savontaus M.; Bleie O.; Christiansen
E.H.; Niemela M.; Angeras O.; Gudmundsdottir I.J.; Laine M.; Ruck A.;
Prendergast B.; Leon M.; Sondergaard L.; De Backer O.
Institution
(Jorgensen, Thyregod, De Backer) Department of Cardiology, Rigshospitalet,
Copenhagen University Hospital, Copenhagen, Denmark
(Savontaus) Department of Cardiology, Turku University Hospital, Turku,
Finland
(Bleie) Department of Cardiology, Haukeland University Hospital, Bergen,
Norway
(Christiansen) Department of Cardiology, Skejby, Aarhus University
hospital, Aarhus, Denmark
(Niemela) Department of Cardiology, Oulu University Hospital, Oulu,
Finland
(Angeras) Department of Cardiology, Sahlgrenska University Hospital,
Goteborg, Sweden
(Gudmundsdottir) Department of Cardiology, Landspitali, Reykjavik, Iceland
(Laine) Department of Cardiology, Helsinki University Central Hospital,
Helsinki, Finland
(Ruck) Department of Cardiology, Karolinska University Hospital,
Stockholm, Sweden
(Prendergast) Department of Cardiology, St Thomas' Hospital and Cleveland
Clinic London, London, United Kingdom
(Leon) Department of Cardiology, Clinical Research Foundation and Columbia
University Hospital, New York, NY, United States
(Sondergaard) Abbott, Santa Clara, CA, United States
(De Backer) Institute of Clinical Medicine, University of Copenhagen,
Copenhagen, Denmark
Publisher
Elsevier Inc.
Abstract
This NOTION-2 sub-study revealed distinct outcomes for transcatheter
aortic valve replacement (TAVR) and surgical aortic valve replacement
(SAVR) in low surgical risk patients aged <= 70 years with a tricuspid or
bicuspid aortic valve stenosis (AS). One year after intervention, the risk
of death, stroke or rehospitalization in patients with tricuspid AS was
similar after TAVR when compared to SAVR (absolute risk difference: -2.0%;
95% confidence interval (CI): -11.8% to 7.7%) Conversely, in patients with
bicuspid AS, TAVR was associated with a significantly higher risk of
adverse outcomes (absolute risk difference: 13.8%; 95% CI: 1.2% to 26.3%).
These analyses are exploratory, but highlight the importance of tailoring
the intervention to the patient's clinical risk profile, life expectancy,
native aortic valve morphology and the anticipated risks associated with
TAVR or SAVR. Copyright © 2025 The Author(s)

<2>
Accession Number
2037723661
Title
Functional coronary angiography to indicate and guide revascularization in
STEMI patients with multivessel disease: Rationale and design of the
AIR-STEMI trial.
Source
American Heart Journal. 284 (pp 71-80), 2025. Date of Publication: 01 Jun
2025.
Author
Erriquez A.; Colaiori I.; Hakeem A.; Guiducci V.; Menozzi M.; Barbierato
M.; Arioti M.; D'Amario D.; Casella G.; Scarsini R.; Polimeni A.; Donazzan
L.; Benatti G.; Venturi G.; Ruozzi M.; Giordan M.; Monello A.; Moretti F.;
Versaci F.; Shah J.A.; Lakho A.A.; Mantovani F.; Cavazza C.; Bugani G.;
Lanzilotti V.; Gallo F.; Leone A.M.; Tebaldi M.; Pavasini R.; Piccolo R.;
Verardi F.M.; Farina J.; Caglioni S.; Cocco M.; Campo G.; Biscaglia S.
Institution
(Erriquez, Pavasini, Verardi, Farina, Caglioni, Cocco, Campo, Biscaglia)
Cardiovascular Institute, AOU di Ferrara, Ferrara, Italy
(Colaiori, Versaci) UOC UTIC Emodinamica e Cardiologia, Ospedale Santa
Maria Goretti, Latina, Italy
(Hakeem, Shah, Lakho) National Institute of Cardiovascular Diseases,
Karachi, Pakistan
(Guiducci, Mantovani) Cardiology Unit, Azienda USL-IRCCS Reggio Emilia, S.
Maria Nuova Hospital, Reggio Emilia, Italy
(Menozzi, Cavazza) Cardiovascular Department, Infermi Hospital, Rimini,
Italy
(Barbierato, Gallo) Interventional Cardiology, Department of
Cardio-Thoracic and Vascular Sciences, Ospedale dell'Angelo, Venice, Italy
(Arioti) Cardiology Department, S. Maria delle Croci Hospital, Ravenna,
Italy
(D'Amario) Dipartimento Medicina Translazionale, Azienda
Ospedaliero-Universitaria Maggiore della Carita, Dipartimento
Toraco-Cardio-Vascolare, Unita Operativa Complessa di Cardiologia, Novara,
Italy
(Casella, Bugani, Lanzilotti) U.O.C. Cardiologia, Ospedale Maggiore,
Bologna, Italy
(Scarsini) Cardiology Unit, AOU Integrata, Verona, Italy
(Polimeni) Division of Cardiology AOCS, Department of Pharmacy, Health and
Nutritional Sciences, University of Calabria, Cosenza, Italy
(Donazzan) Department of Cardiology, Ospedale Regionale San Maurizio,
Bolzano, Italy
(Benatti) Division of Cardiology, Parma University Hospital, Parma, Italy
(Venturi) Mater Salutis Hospital, Verona, Italy
(Ruozzi) Cardiology Unit, Ospedale Civile di Baggiovara, Modena, Italy
(Giordan) Unit of Interventional Cardiology, Ospedale Santa Maria della
Misericordia, Rovigo, Italy
(Monello) Cardiology Unit, Ospedale San Guglielmo da Saliceto, Piacenza,
Italy
(Moretti) Cardiology Unit, ASST Ospedale Papa Giovanni XXIII, Bergamo,
Italy
(Leone) Ospedale Isola Tiberina - Gemelli Isola, Rome, Italy
(Leone) Department of Cardiovascular and Thoracic Sciences, Catholic
University of the Sacred Heart, Rome, Italy
(Tebaldi) Cardiology Unit, Infermi Hospital, Faenza, Italy
(Piccolo) Department of Advanced Biomedical Sciences, Federico II
University of Naples, Naples, Italy
Publisher
Elsevier Inc.
Abstract
Background: Complete revascularization has been shown to be superior to
culprit-only treatment in patients with ST-segment elevation myocardial
infarction (STEMI) and multivessel disease. However, it remains unclear
whether complete revascularization should be guided by coronary physiology
or conventional angiography. Angiography-derived physiology may allow
functional assessment and procedural guidance using angiograms from
primary percutaneous coronary intervention (PCI), potentially maximizing
the benefits of a physiology-guided approach. We present the design of a
dedicated study that will address this research gap. Methods and Design:
The Functional Coronary Angiography to Indicate and Guide
Revascularization in STEMI Patients with Multivessel Disease (AIR-STEMI)
trial is a prospective, randomized, international, multicenter, open-label
study with blinded adjudicated evaluation of outcomes. After successful
treatment of the culprit lesion, patients will be randomized to receive
PCI of the nonculprit lesions guided by conventional angiography or by
angiography-derived fractional flow reserve (FFR). The primary endpoint is
the composite endpoint of all-cause death, any myocardial infarction (MI),
any cerebrovascular accident, or any revascularization. It will be
censored once the last enrolled patient reaches 1-year follow-up. The
secondary endpoint will be the composite of cardiovascular death or MI and
each single component of the primary endpoint. All endpoints will be
tested also at 3 and 5 years. The sample size for the study is a minimum
of 1,800 patients. Implications: The AIR-STEMI trial will provide novel
evidence on whether a specific complete revascularization strategy should
be applied to patients with STEMI and multivessel disease to improve their
clinical outcomes. Trial Registration: ClinicalTrials.gov
NCT05818475. Copyright © 2025 The Author(s)

<3>
Accession Number
2035745355
Title
Double-Blind, Randomized, Controlled Pilot Trial to Specify Collateral
Effect and Safety of Perioperative Dexmedetomidine in Patients Undergoing
Open Heart Surgery.
Source
Anesthesiology and Pain Medicine. 15(1) (no pagination), 2025. Article
Number: e157117. Date of Publication: 28 Feb 2025.
Author
Hatemi B.M.J.; Enayati A.; Ghorbani S.; Tahmasebi F.; Aljadayel H.A.;
Jabbari A.; Movafegh A.
Institution
(Hatemi) Ischemic Disorders Research Center, International Campus,
Golestan University of Medical Sciences, Gorgan, Iran, Islamic Republic of
(Hatemi) Department of Anesthesia Techniques, College of Health and
Medical Techniques, Al-Mustaqbal University, Babylon, Hillah, Iraq
(Enayati, Tahmasebi, Aljadayel) Ischemic Disorders Research Center,
Golestan University of Medical Sciences, Gorgan, Iran, Islamic Republic of
(Ghorbani) Cancer Research Center, Golestan University of Medical
Sciences, Gorgan, Iran, Islamic Republic of
(Jabbari) Department of Anesthesiology and Critical Care Medicine,
Ischemic Disorder Research Center, Golestan University of Medical
Sciences, Gorgan, Iran, Islamic Republic of
(Movafegh) Department of Anesthesiology, School of Medicine, Tehran
University of Medical Sciences, Tehran, Iran, Islamic Republic of
Publisher
Brieflands
Abstract
Background: This study aimed to assess the collateral effects and safety
of dexmedetomidine (Dex) during and one day after surgery in Iranian
patients undergoing open heart surgery, to expand the clinical
applications of Dex in Iran. Method(s): This pilot study was
conducted in Gorgan, Golestan province, Iran, in 2024. Both male and
female participants undergoing open heart surgery were randomly assigned
to either the Dex group (n = 10), receiving 0.5 microg/kg/h along with
standard anesthesia management, or the control group (n = 10). The primary
outcome was the percentage of patients experiencing adverse events.
Secondary outcomes included the stability of hemodynamic and respiratory
parameters, the occurrence of arrhythmias, and biological changes assessed
during and 24 hours after surgery. Result(s): Out of 45 participants,
20 were enrolled and analyzed. The comparison between groups showed that
observed adverse effects were higher in the control group (4 patients)
compared to the Dex group (1 patient), with common events being
hypotension, bradycardia, and tachycardia. Biological markers, such as
lactate and blood sugar (BS), increased in both groups, with the control
group showing a greater increase in both lactate and BS levels (P = 0.012
and P = 0.009, respectively) compared to the Dex group (P = 0.017 and P =
0.093, respectively). Additionally, there were no significant differences
in hemodynamic and respiratory markers between the groups (P > 0.05);
however, Dex improved and preserved hemodynamic and respiratory stability
more effectively. Conclusion(s): The addition of Dex to the
anesthesia protocol was safe and without adverse events, showing a
promising role in improving cardiac function in patients undergoing open
heart surgery. Copyright © 2025, Mohammed Jabbar Hatemi et al.

<4>
Accession Number
2033259545
Title
The association of right ventricular function with outcomes after cardiac
surgery: a systematic review.
Source
Canadian Journal of Anesthesia. 72(2) (pp 285-318), 2025. Article Number:
n71. Date of Publication: 01 Feb 2025.
Author
Alavi N.; Van Klei W.; Agyei K.; Zabida A.; Abraha M.; Salvatori M.;
Mashari A.; Bartoszko J.
Institution
(Alavi, Van Klei, Zabida, Salvatori, Mashari, Bartoszko) Department of
Anesthesia and Pain Management, Sinai Health System, Women's College
Hospital, University Health Network, Toronto, ON, Canada
(Alavi, Van Klei, Bartoszko) Institute of Medical Science, University of
Toronto, Temerty Faculty of Medicine, University of Toronto, Toronto, ON,
Canada
(Van Klei, Salvatori, Mashari, Bartoszko) Department of Anesthesiology &
Pain Medicine, University of Toronto, Toronto, ON, Canada
(Van Klei, Bartoszko) Peter Munk Cardiac Centre, University Health
Network, Toronto, ON, Canada
(Van Klei, Agyei, Abraha, Bartoszko) Temerty Faculty of Medicine,
University of Toronto, Toronto, ON, Canada
(Van Klei) Division of Anesthesiology, Intensive Care and Emergency
Medicine, University Medical Center Utrecht, Utrecht, Netherlands
(Bartoszko) Department of Anaesthesia and Pain Management, Toronto General
Hospital, 200 Elizabeth Street, 3EN-464, Toronto, ON, Canada
Publisher
Springer
Abstract
Purpose: Assessment of right ventricular (RV) function is recommended as
part of a comprehensive echocardiography exam, including before and after
cardiac surgery. Nevertheless, the prognostic implications of various
measures of RV function in patients undergoing cardiac surgery are not
well characterized. Our goal was to conduct a focused systematic review to
assess the association of quantitative parameters of RV function with
postoperative outcomes in patients undergoing cardiac surgery.
 Method(s): We conducted a systematic review of randomized controlled
trials or observational studies in adult (>= 18 yr) patients undergoing
cardiac surgery with a reported echocardiogram within six months of
surgery, intraoperatively, or shortly after surgery. We excluded case
reports and case series. Databases included PubMed and MEDLINE, and papers
published from 1 January 1990 to 22 April 2024 were searched for. The
primary predictors of interest were quantitative RV function parameters.
The primary outcome of interest was postoperative mortality up to five
years. The secondary outcome was all major adverse cardiac events (MACE).
 Result(s): We identified 7,187 potentially relevant studies, 27 of
which were included; all of these were observational studies. Right
ventricular fractional area change (RVFAC) was the most commonly reported
parameter, but was inconsistently associated with mortality and MACE.
Tricuspid annular plane systolic excursion (TAPSE) and strain were
consistently associated with mortality. The most consistent predictor of
MACE was RV myocardial performance index (MPI) across studies.
 Conclusion(s): Pre- and perioperative assessment of RV function using
at least two quantitative echocardiographic parameters may offer
prognostic information in patients undergoing cardiac surgery. Right
ventricular FAC, TAPSE, strain, and RV MPI have been frequently studied;
however, further research is needed to delineate the role of
echocardiographic RV quantification for perioperative prognostication.
Study registration: PROSPERO (CRD42023387383); first submitted 23 December
2022. Copyright © Canadian Anesthesiologists' Society 2025.

<5>
Accession Number
2006077092
Title
Cardiac amyloidosis therapy: A systematic review.
Source
Cardiogenetics. 11(1) (pp 10-17), 2021. Date of Publication: 01 Mar 2021.
Author
Iodice F.; Di Mauro M.; Esposito A.; Migliaccio M.G.; Iannuzzi A.; Pacileo
R.; Caiazza M.
Institution
(Iodice, Di Mauro, Esposito, Migliaccio, Iannuzzi, Pacileo, Caiazza)
Department of Translational Medical Sciences, University of Campania
"Luigi Vanvitelli", Naples, Italy
Publisher
Page Press Publications
Abstract
Heart involvement in Cardiac Amyloidosis (CA) results in a worsening of
the prognosis in almost all patients with both light-chain (AL) and
transthyretin amyloidosis (ATTR). The mainstream CA is a restrictive
cardiomyopathy with hypertrophic phenotype at cardiac imaging that
clinically leads to heart failure with preserved ejection fraction
(HFpEF). An early diagnosis is essential to reduce cardiac damage and to
improve the prognosis. Many therapies are available, but most of them have
late benefits to cardiac function; for this reason, novel therapies are
going to come soon. Copyright © 2021 by the authors. Licensee
MDPI, Basel, Switzerland.

<6>
Accession Number
2033060730
Title
Intravenous amino acids for kidney protection in patients undergoing
cardiac surgery: A systematic review and meta-analysis of randomized
controlled trials.
Source
Journal of International Medical Research. 53(2) (no pagination), 2025.
Date of Publication: 01 Feb 2025.
Author
Khan M.W.Z.; Hussain A.; Mian A.M.; Moeez A.; Inayat W.; Noor B.; Shah
I.A.; Osama M.; Khan B.; Sajid M.; Azeem T.; Ebad Ur Rehman M.; Ali A.;
Afridi U.K.
Institution
(Khan) Department of Medicine, Yale University School of Medicine, New
Haven, United States
(Ali, Mian, Moeez, Inayat, Noor, Shah, Osama, Sajid, Azeem, Ali)
Department of Medicine, Khyber Medical College, Peshawar, Pakistan
(Hussain) Department of Medicine, Liaquat University of Medical and Health
Sciences, Jamshoro, Pakistan
(Khan) Department of Medicine, Bacha Khan Medical College, Mardan,
Pakistan
(Ebad Ur Rehman) Department of Medicine, Rawalpindi Medical University,
Rawalpindi, Pakistan
(Afridi) Division of Cardiology, University of Maryland School of
Medicine, MD, United States
Publisher
SAGE Publications Ltd
Abstract
Objective: To evaluate the efficacy of intravenous (IV) amino acids in
preventing acute kidney injury (AKI) in patients undergoing cardiac
surgery. Method(s): PubMed, EMBASE, and Cochrane Library databases
were systematically searched for all relevant randomised controlled trials
(RCTs) published from inception to July 25, 2024. A random effects model
was used to pool the risk ratios (RR) for dichotomous outcomes, and the
combined data was visually represented using forest plots. Result(s):
3 studies involving 3646 patients were included in the meta-analysis. IV
amino acids did not significantly lower the overall AKI incidence compared
with control measures. However, they significantly reduced the risk of
Stage 1 AKI and Stage 3 AKI. No differences were observed between
intervention and control for Stage 2 AKI or need for kidney replacement
therapy. Conclusion(s): IV amino acids may offer protective benefits
against severe AKI stages in cardiac surgery patients. Further studies are
warranted to validate our findings. Copyright © The Author(s)
2025.

<7>
Accession Number
2032505171
Title
Thrombin generation after prothrombin complex concentrate or plasma
transfusion during cardiac surgery.
Source
Journal of Thrombosis and Thrombolysis. 58(2) (pp 309-318), 2025. Date of
Publication: 01 Feb 2025.
Author
Welsby I.J.; Schroeder D.R.; Ghadimi K.; Nuttall G.A.; Smith M.M.
Institution
(Welsby, Ghadimi) Department of Anesthesiology & Critical Care, Duke
University Medical Center, Erwin Road, Durham, NC, United States
(Schroeder) Department of Biomedical Statistics and Informatics, Mayo
Clinic College of Medicine and Science, Rochester, MN, United States
(Nuttall, Smith) Department of Anesthesiology and Perioperative Medicine,
Mayo Clinic College of Medicine and Science, Rochester, MN, United States
Publisher
Springer
Abstract
Thrombin generation (TG) is reduced after cardiac surgery using
cardiopulmonary bypass (CPB), contributing to coagulopathy and bleeding.
Plasma transfusion or four-factor prothrombin complex concentrate (PCC)
are commonly used to treat coagulopathic bleeding after CPB without
knowledge of how each may restore TG. To determine the effect of PCC
infusion on restoration of thrombin generation compared with plasma
transfusion, we performed a laboratory-based secondary analysis of a
randomized, controlled trial of adult patients undergoing cardiac surgery
to assess efficacy and safety of 4 F-PCC versus plasma for treatment of
perioperative coagulopathic bleeding after CPB. Participants were
randomized to receive either PCC (15 IU/kg) or plasma (10-15 ml/kg) after
separation from CPB. Participant blood samples were obtained at
pre-specified serial timepoints, with laboratory assays for TG and factor
levels subsequently performed. The primary outcome was change in thrombin
generation (TG) parameters after each randomized treatment through
postoperative day 5. Secondary outcomes included serially derived clotting
factor levels. Of 100 randomized participants, 99 were included in this
laboratory analysis (PCC group, N = 51; plasma group, N = 48). After
treatment, participants in the PCC group compared with those in the plasma
group showed higher endogenous thrombin potential (ETP, Median,
Interquartile range, IQR: 688 [371-1069] vs. 1088 [550-1691] nM minutes, P
= 0.01), a greater increase din ETP (P = 0.002) and peak TG (P = 0.01) in
the timepoints between heparin reversal and after treatment
administration. Both groups demonstrated similar values in all TG assays
by postoperative day 1 (P > 0.05). The PCC group also demonstrated higher
levels of proteins C, S, and Factors II, VII, IX and X, early after
treatment (P < 0.001 for all comparisons). Antithrombin levels were
initially higher in the plasma group after treatment (Median, IQR: 66%
[61-71%] vs. 56% [51-65%], P = 0.002) but differences did not persist
beyond postoperative day 3. In this laboratory analysis from a recent
randomized trial in adult cardiac surgery, PCC administration restored
thrombin generation more rapidly than plasma in the early postoperative
period without laboratory evidence of hypercoagulability.
ClinicalTrials.gov identifier: NCT02557672 [1]. Copyright © The
Author(s), under exclusive licence to Springer Science+Business Media,
LLC, part of Springer Nature 2024.

<8>
Accession Number
2032837570
Title
Correction to: Thoracic and cardiovascular surgeries in Japan during 2020:
Annual report by the Japanese Association for Thoracic Surgery (General
Thoracic and Cardiovascular Surgery, (2024), 72, 1, (61-94),
10.1007/s11748-023-01979-8).
Source
General Thoracic and Cardiovascular Surgery. 73(2) (pp 130-132), 2025.
Date of Publication: 01 Feb 2025.
Author
Matsumiya G.; Sato Y.; Takeuchi H.; Abe T.; Endo S.; Hirata Y.; Ishida M.;
Iwata H.; Kamei T.; Kawaharada N.; Kawamoto S.; Kohno K.; Kumamaru H.;
Minatoya K.; Motomura N.; Nakahara R.; Okada M.; Saji H.; Saito A.;
Shimizu H.; Suzuki K.; Takemura H.; Taketani T.; Toh Y.; Tatsuishi W.;
Yamamoto H.; Yasuda T.; Watanabe M.; Yoshimura N.; Tsuchida M.; Sawa Y.
Institution
(Matsumiya) Department of Cardiovascular Surgery, Chiba University
Graduate School of Medicine, Chiba, Japan
(Sato) Department of Thoracic Surgery, University of Tsukuba, Tsukuba,
Japan
(Takeuchi) Department of Surgery, Hamamatsu University School of Medicine,
Shizuoka, Japan
(Abe, Tatsuishi) Division of Cardiovascular Surgery, Department of General
Surgical Science, Gunma University, Maebashi, Japan
(Endo) Thoracic Surgery, Jichi Medical University Saitama Medical Center,
Omiya, Japan
(Hirata) Department of Cardiac Surgery, The University of Tokyo Hospital,
Tokyo, Japan
(Ishida) Cardiac Surgery, Handa City Hospita, Aichi, Japan
(Iwata) Department of General Thoracic Surgery, Gifu University Hospital,
Gifu, Japan
(Kamei) Department of Surgery, Graduate School of Medicine, Tohoku
University, Sendai, Japan
(Kawaharada) Department of Cardiovascular Surgery, Sapporo Medical
University School of Medicine, Sapporo, Japan
(Kawamoto) Department of Cardiovascular Surgery, Tohoku Medical and
Pharmaceutical University Hospital, Sendai, Japan
(Kohno) Department of Gastrointestinal Tract Surgery, Fukushima Medical
University, Fukushima, Japan
(Kumamaru, Yamamoto) Department of Healthcare Quality Assessment, Graduate
School of Medicine, The University of Tokyo, Kagoshima, Tokyo, Japan
(Minatoya) Department of Cardiovascular Surgery, Graduate School of
Medicine, Kyoto University, Kyoto, Japan
(Motomura) Department of Cardiovascular Surgery, Toho University Sakura
Medical Center, Chiba, Japan
(Nakahara) Division of Thoracic Surgery, Tochigi Cancer Center, Toshigi,
Japan
(Okada) Surgical Oncology, Hiroshima University, Hiroshima, Japan
(Saji) Department of Chest Surgery, St. Marianna University School of
Medicine, Kawasaki, Japan
(Saito) Department of Surgery, Yokohama City University, Graduate School
of Medicine, Yokohama, Japan
(Shimizu) Department of Cardiovascular Surgery, Keio University, Tokyo,
Japan
(Suzuki) Department of General Thoracic Surgery, Juntendo University
School of Medicine, Tokyo, Japan
(Takemura) Department of Cardiovascular Surgery, Kanazawa University,
Kanazawa, Japan
(Taketani) Department of Cardiovascular Surgery, Mitsui Memorial Hospital,
Tokyo, Japan
(Toh) Department of Gastroenterological Surgery, National Hospital
Organization Kyushu Cancer Center, Fukuoka, Japan
(Yasuda) Department of Surgery, Kindai University Faculty of Medicine,
Osaka, Japan
(Watanabe) Department of Gastroenterological Surgery, Cancer Institute
Hospital, Tokyo, Japan
(Yoshimura) Department of Thoracic and Cardiovascular Surgery, University
of Toyama, Graduate School of Medicine, Toyama, Japan
(Tsuchida) Division of Thoracic and Cardiovascular Surgery, Niigata
University Graduate School of Medical and Dental Sciences, Niigata, Japan
(Sawa) Osaka University, Graduate School of Medicine, Osaka Police
Hospital, Osaka, Japan
Publisher
Springer
Abstract
In the original publication of the article [1], the number of 30-day
hospital mortality and 30-day hospital mortality rate for the Stanford
type A acute aortic dissections in "Table 3 (1) Dissection" were published
incorrectly. The corrected part of the table is given in this Correction.
The corrected number of 30-day hospital mortality was 493, and hospital
mortality rate was 8.0%, respectively. (Table presented.) Thoracic aortic
aneurysm (total; 22,540) (1) Dissection (total; 10,855) Stanford type
Acute Chronic Concomitant operation A B A B Replaced site Cases 30-day
mortality Hospital mortality Cases 30-day mortality Hospital mortality
Cases 30-day mortality Hospital mortality Cases 30-day mortality Hospital
mortality AVP AVR MVP MVR CABG Others Hospital After discharge Hospital
After discharge Hospital After discharge Hospital After discharge
Ascending Ao 2071 146 (7.0) 1 (0.05) 189 (9.1) 1 0 0 0 187 6 (3.2) 0 8
(4.3) 1 0 0 0 61 137 22 8 110 32 Aortic Root 191 35 (18.3) 0 36 (18.8) 0 0
0 0 80 4 (5.0) 0 5 (6.3) 3 0 0 0 32 194 6 2 65 7 Arch 1954 135 (6.9) 1
(0.05) 174 (8.9) 31 0 0 0 355 9 (2.5) 0 13 (3.7) 172 5 (2.9) 0 6 (3.5) 54
113 10 5 118 25 Aortic root + asc. Ao. + Arch 167 23 (13.8) 0 26 (15.6) 0
0 0 0 47 1 (2.1) 0 3 (6.4) 6 0 0 0 23 143 2 0 35 2 Descending Ao 35 4
(11.4) 0 4 (11.4) 28 2 (7.1) 0 2 (7.1) 56 1 (1.8) 0 1 (1.8) 220 9 (4.1) 0
10 (4.5) 2 4 0 0 4 0 Thoracoabdominal 1 1 (100.0) 0 1 (100.0) 11 1 (9.1) 0
1 (9.1) 46 5 (10.9) 0 5 (10.9) 182 11 (6.0) 1 (0.5) 13 (7.1) 0 0 0 0 1 0
Simple TEVAR 101 9 (8.9) 0 11 (10.9) 442 30 (6.8) 0 34 (7.7) 264 2 (0.8) 0
3 (1.1) 1171 7 (0.6) 0 8 (0.7) 1 2 0 0 2 2 Open SG with BR 1213 101 (8.3)
2 (0.16) 133 (11.0) 62 3 (4.8) 0 3 (4.8) 207 8 (3.9) 0 11 (5.3) 237 4
(1.7) 0 7 (3.0) 61 115 10 2 104 16 Open SG without BR 435 32 (7.4) 0 45
(10.3) 28 2 (7.1) 0 3 (10.7) 52 2 (3.8) 0 4 (7.7) 82 3 (3.7) 0 3 (3.7) 20
45 1 0 30 2 Arch TEVAR with BR 14 1 (7.1) 0 1 (7.1) 123 6 (4.9) 0 10 (8.1)
73 2 (2.7) 0 2 (2.7) 364 7 (1.9) 0 8 (2.2) 1 0 0 0 0 0 Thoracoabdominal
TEVAR with BR 0 0 0 0 11 0 0 0 6 0 0 1 (16.7) 33 2 (6.1) 0 4 (12.1) 0 0 0
0 0 0 Other 18 6 (33.3) 0 6 (33.3) 13 3 (23.1) 0 3 (23.1) 10 0 0 0 51 2
(3.9) 0 2 (3.9) 0 2 0 0 1 1 Total 6200 493 (8.0) 4 (0.06) 626 (10.1) 750
47 (6.3) 0 56 (7.5) 1383 40 (2.9) 0 56 (4.0) 2522 50 (2.0) 1 (0.0) 61
(2.4) 255 755 51 17 470 87 (), % mortality Ao aorta, AVP aortic valve
repair, AVR aortic valve replacement, MVP mitral valve repair, MVR mitral
valve replacement, CABG coronary artery bypass grafting, TEVAR thoracic
endovascular aortic (aneurysm) repair Acute, within 2 weeks from the
onset Copyright © The Author(s) 2025.

<9>
Accession Number
2032798264
Title
Coronary CTA and CT-FFR in trans-catheter aortic valve implantation
candidates: a systematic review and meta-analysis.
Source
European Radiology. 35(3) (pp 1552-1569), 2025. Article Number: 210. Date
of Publication: 01 Mar 2025.
Author
Becker L.M.; Peper J.; van Ginkel D.-J.; Overduin D.C.; van Es H.W.;
Rensing B.J.M.W.; Timmers L.; ten Berg J.M.; Mohamed Hoesein F.A.A.;
Leiner T.; Swaans M.J.
Institution
(Becker, Peper, van Ginkel, Overduin, Rensing, Timmers, ten Berg, Swaans)
Department of Cardiology, St. Antonius Hospital, Nieuwegein, Netherlands
(Becker, Mohamed Hoesein, Leiner) Department of Radiology, University
Medical Center Utrecht, Utrecht, Netherlands
(van Es) Department of Radiology, St. Antonius Hospital, Nieuwegein,
Netherlands
(ten Berg) Cardiovascular Research Institute Maastricht (CARIM),
Maastricht, Netherlands
(Leiner) Department of Radiology, Mayo Clinics, Rochester, MN, United
States
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Objectives: Screening for obstructive coronary artery disease (CAD) with
coronary computed tomography angiography (CCTA) could prevent unnecessary
invasive coronary angiography (ICA) procedures during work-up for
trans-catheter aortic valve implantation (TAVI). CT-derived fractional
flow reserve (CT-FFR) improves CCTA accuracy in chest pain patients.
However, its reliability in the TAVI population is unknown. This
systematic review and meta-analysis assesses CCTA and CT-FFR in TAVI
candidates. Method(s): PubMed, Embase and Web of Science were
searched for studies regarding CCTA and/or CT-FFR in TAVI candidates.
Primary endpoint was correct identification and rule-out of obstructive
CAD. Results were pooled in a meta-analysis. Result(s): Thirty-four
articles were part of the meta-analysis, reporting results for CCTA and
CT-FFR in 7235 and 1269 patients, respectively. Reference standard was
mostly anatomical severity of CAD. At patient level, pooled CCTA
sensitivity was 94.0% and specificity 72.4%. CT-FFR sensitivity was 93.2%
and specificity 70.3% with substantial variation between studies. However,
in studies that compared both, CT-FFR performed better than CCTA.
Sensitivity of CCTA versus CT-FFR was 74.9% versus 83.9%, and specificity
was 65.5% versus 89.8%. Conclusion(s): Negative CCTA accurately rules
out CAD in the TAVI population. CCTA could lead to significant reduction
in pre-TAVI ICA, but false positives remain high. Diagnostic accuracy of
CT-FFR was comparable to that of CCTA in our meta-analyses, but in studies
performing a direct comparison, CT-FFR performed better than CCTA.
However, as most studies were small and used CT-FFR software exclusively
available for research, a large study on CT-FFR in TAVI work-up using
commercially available CT-FFR software would be appropriate before
considering routine implementation. Key Points: Question Coronary artery
disease (CAD) screening with invasive coronary angiography before
trans-catheter aortic valve implantation (TAVI) is often retrospectively
unnecessary, revealing no obstructive CAD. Findings Coronary CTA ruled out
CAD in approximately half of TAVI candidates. CT-derived fractional flow
reserve (CT-FFR) performed similarly overall but better than coronary CTA
in direct comparison. Clinical relevance Addition of coronary CTA to TAVI
planning-CT to screen for obstructive CAD could reduce negative invasive
coronary angiographies in TAVI work-up. CT-FFR could reduce false-positive
coronary CTA results, improving its gatekeeper function in this
population, but more data is necessary. Copyright © The
Author(s), under exclusive licence to European Society of Radiology 2024.

<10>
Accession Number
2037315022
Title
Best evidence topic: Transcatheter aortic valve implantation in
asymptomatic aortic stenosis patients.
Source
Cirugia Cardiovascular. 32(2) (pp 110-116), 2025. Date of Publication: 01
Mar 2025.
Author
Martin Gutierrez E.; Maiorano P.; Castillo Pardo L.; Meana Fernandez B.;
Ramos Barragan B.; Gualis Cardona J.; Castano Ruiz M.; Martinez Comendador
J.M.; Garrido Jimenez J.M.
Institution
(Martin Gutierrez, Maiorano, Castillo Pardo, Meana Fernandez, Ramos
Barragan, Gualis Cardona, Castano Ruiz) Servicio de Cirugia Cardiaca,
Complejo Asistencial Universitario de Leon, Leon, Spain
(Martinez Comendador) Servicio de Cirugia Cardiaca, Complexo Hospitalario
Universitario de A Coruna (CHUAC), A Coruna, Spain
(Garrido Jimenez) Servicio de Cirugia Cardiaca, Hospital Universitario
Virgen de las Nieves, Granada, Spain
Publisher
Sociedad Espanola de Cirugia Cardiovascular y Endovascular (SECCE)
Abstract
Background: Transcatheter aortic valve implantation (TAVI) has become the
most frequent option for severe aortic stenosis treatment. Patients with
severe aortic stenosis may present an increased risk of mortality in the
asymptomatic phase. Furthermore, the progression of their heart disease
may have prognostic implications. It is proposed to carry out a
bibliographic review to assess the benefit of TAVI in this context.
 Method(s): A systematic search in Pubmed and Cochrane was conducted,
identifying comparative studies on surgery and/or TAVI versus conservative
management in asymptomatic patients. Thus, an algorithm of better
management of patients with severe aortic stenosis would be developed
according to the available evidence. Result(s): After the selection
of papers and elimination of duplicates, 34 studies were full-text
analyzed, among which we remark: 6 meta-analyses, 4 reviews, 14 original
articles and 4 ongoing clinical trials were identified. Early surgery was
unanimously superior to conservative management in terms of survival. In
the case of TAVI, two studies demonstrated a better prognosis for
asymptomatic patients compared to symptomatic patients when their valve
disease was corrected with TAVI, and a sub-analysis of the Evolut Low Risk
trial demonstrated superior survival results for TAVI compared to surgery
and conservative treatment. Conclusion(s): In the absence of a solid
evidence, TAVI can be considered a valid treatment alternative for
patients with asymptomatic aortic stenosis, although this indication
relies on indirect evidence. More research is needed in this
field. Copyright © 2024 Sociedad Espanola de Cirugia
Cardiovascular y Endovascular

<11>
Accession Number
2031226595
Title
TAVI versus surgical aortic valve replacement. Where are the limits?.
Source
Cirugia Cardiovascular. 32(2) (pp 102-109), 2025. Date of Publication: 01
Mar 2025.
Author
Pinon M.
Institution
(Pinon) CAS Aortico, CAS Mitral y Tricuspide, Cirugia Cardiaca, Hospital
Alvaro Cunqueiro, Pontevedra, Vigo, Spain
Publisher
Sociedad Espanola de Cirugia Cardiovascular y Endovascular (SECCE)
Abstract
Transcatheter aortic valve implantation (TAVI) has experienced an increase
in the number of procedures of 50% with its expansion to low risk, over
the numbers obtained with high and intermediate risks. Recently, updates
have been made public in the follow-up of the main randomized clinical
studies (RCTs) in this group of patients. Although the results of these
studies have served as a basis for recommending TAVI in elderly patients
with intermediate or high risks, there are still several aspects that need
to be clarified before expanding, in an indiscriminate or unselected
manner to low-risk young patients. This review's aim is to analyze the
results available in the published evidence, as well as the most
significant variables that can affect their consistency, both in early and
long term; for consideration in individualized patient-centered decision
making. Copyright © 2024 Sociedad Espanola de Cirugia
Cardiovascular y Endovascular

<12>
[Use Link to view the full text]
Accession Number
2037744804
Title
Cost-effectiveness of angiographic quantitative flow ratio-guided coronary
intervention: A multicenter, randomized, sham-controlled trial.
Source
Chinese Medical Journal. (no pagination), 2025. Article Number:
10.1097/CM9.0000000000003484. Date of Publication: 2025.
Author
Zhao Y.; Guan C.; Wang Y.; Jin Z.; Yu B.; Fu G.; Chen Y.; Guo L.; Qu X.;
Zhang Y.; Dou K.; Wu Y.; Yang W.; Tu S.; Escaned J.; Fearon W.F.; Qiao S.;
Cohen D.J.; Krumholz H.M.; Xu B.; Song L.
Institution
(Zhao, Wang) Medical Research and Biometrics Center, National Center for
Cardiovascular Diseases, Beijing, China
(Guan, Dou, Wu, Yang, Qiao, Xu, Song) Department of Cardiology, National
Clinical Research Center for Cardiovascular Diseases, Fuwai Hospital,
National Center for Cardiovascular Diseases, Chinese Academy of Medical
Sciences, Peking Union Medical College, Beijing, China
(Jin) Department of Cardiology, Beijing Tiantan Hospital, Capital Medical
University, Beijing, China
(Yu) Department of Cardiology, The Second Affiliated Hospital of Harbin
Medical University, Heilongjiang, Harbin, China
(Fu) Department of Cardiology, Sir Run Run Shaw Hospital, Zhejiang
University School of Medicine, Zhejiang, Hangzhou, China
(Chen) Department of Cardiology, The Sixth Medical Center, Chinese PLA
General Hospital, Beijing, China
(Guo) Department of Cardiology, Peking University Third Hospital, Beijing,
China
(Qu) Department of Cardiology, Huadong Hospital Affiliated to Fudan
University, Shanghai, China
(Zhang) Department of Cardiology, Xuzhou Third People's Hospital, Xuzhou
Medical University, Jiangsu, Xuzhou, China
(Tu) Biomedical Instrument Institute, School of Biomedical Engineering,
Shanghai Jiao Tong University, Shanghai, China
(Escaned) Hospital Clinico San Carlos IDISSC, Complutense University of
Madrid, Madrid, Spain
(Fearon) Division of Cardiovascular Medicine, Stanford Cardiovascular
Institute, Stanford University School of Medicine, VA Palo Alto Health
Care System, Palo Alto, CA, United States
(Cohen) Cardiovascular Research Foundation, New York, NY, United States
(Cohen) St. Francis Hospital and Heart Center, Roslyn, NY, United States
(Krumholz) Section of Cardiovascular Medicine, Yale School of Medicine,
New Haven, CT, United States
(Krumholz) Center for Outcomes Research and Evaluation, Yale New Haven
Hospital, New Haven, CT, United States
(Krumholz) Department of Health Policy and Management, Yale School of
Public Health, New Haven, CT, United States
Publisher
Lippincott Williams and Wilkins
Abstract
Background: The FAVOR (Comparison of Quantitative Flow Ratio Guided and
Angiography Guided Percutaneous Intervention in Patients with Coronary
Artery Disease) III China trial demonstrated that percutaneous coronary
intervention (PCI) lesion selection using quantitative flow ratio (QFR)
measurement, a novel angiography-based approach for estimating fractional
flow reserve, improved two-year clinical outcomes compared with standard
angiography guidance. This study aimed to assess the cost-effectiveness of
QFR-guided PCI from the perspective of the current Chinese healthcare
system. Method(s): This study is a pre-specified analysis of the
FAVOR III China trial, which included 3825 patients randomized between
December 25, 2018, and January 19, 2020, from 26 centers in China.
Patients with stable or unstable angina pectoris or those >=72 hours
post-myocardial infarction who had at least one lesion with a diameter
stenosis between 50% and 90% in a coronary artery with a >=2.5 mm
reference vessel diameter by visual assessment were randomized to a
QFR-guided strategy or an angiography-guided strategy with 1:1 ratio.
During the two-year follow-up, data were collected on clinical outcomes,
quality-adjusted life-years (QALYs), estimated costs of index procedure
hospitalization, outpatient cardiovascular medication use, and
rehospitalization due to major adverse cardiac and cerebrovascular events
(MACCE). The primary analysis calculated the incremental
cost-effectiveness ratio (ICER) as the cost per MACCE avoided. An ICER of
10,000/MACCE event avoided was considered economically attractive in
China. Result(s): At two years, the QFR-guided group demonstrated a
reduced rate of MACCE compared to the angiography-guided group (10.8% vs.
14.7%, P <0.01). Total two-year costs were similar between the groups
(50,803 +/- 21,121 vs. 50,685 +/- 23,495, P = 0.87). The ICER for the
QFR-guided strategy was 3055 per MACCE avoided, and the probability of QFR
being economically attractive was 64% at a willingness-to-pay threshold of
10,000/MACCE avoided. Sensitivity analysis showed that QFR-guided PCI
would become cost-saving if the cost of QFR were below 3682 (current cost:
3800). Cost-utility analysis yielded an ICER of 56,163 per QALY gained,
with a 53% probability of being cost-effective at a willingness-to-pay
threshold of 85,000 per QALY gained. Conclusion(s): In patients
undergoing PCI, a QFR-guided strategy appears economically attractive
compared to angiographic guidance from the perspective of the Chinese
healthcare system. Copyright © 2025 The Chinese Medical
Association, produced by Wolters Kluwer, Inc.

<13>
Accession Number
2031772145
Title
Wearable devices as part of postoperative early warning score systems: a
scoping review.
Source
Journal of Clinical Monitoring and Computing. 39(1) (pp 233-244), 2025.
Date of Publication: 01 Feb 2025.
Author
Bignami E.G.; Panizzi M.; Bezzi F.; Mion M.; Bagnoli M.; Bellini V.
Institution
(Bignami, Panizzi, Bezzi, Mion, Bagnoli, Bellini) Anesthesiology, Critical
Care and Pain Medicine Division, Department of Medicine and Surgery,
University of Parma, Viale Gramsci 14, Parma, Italy
Publisher
Springer Science and Business Media B.V.
Abstract
Postoperative deterioration is often preceded by abnormalities in vital
parameters, but limited resources prevent their continuous monitoring in
patients with no indication to ICU admission. The development of new
technologies allowed the introduction of wearable devices (WDs), enabling
the possibility of postoperative monitoring in surgical wards. We
performed a Scoping Review to determine the current use of wearable
devices as part of Continuous Remote Early Warning Score (CREWS) systems
and their efficiency during postoperative period. This Scoping Review was
conducted according to PRISMA-ScR guidelines. PICO framework was used
before the search to define the review protocol. Systematic literature
research has been performed on PubMed, MeSH, MEDLINE and Embase,
considering a period between 2018 and February 2024. Prospective and
retrospective studies involving patients undergoing cardiac and
non-cardiac surgery are included. A total of 10 articles were included in
the review. 11 different CE/FDA approved wearable devices were used in the
studies analyzed. In all studies the WDs were applied the day of the
surgery. The use of WDs as part of CREWS systems is feasible and safe.
Furthermore, with the aid of other technologies (LoRa and Artificial
Intelligence), they shorten Length of Stay (LOS) and reduce the number of
ICU admissions with a reduction in healthcare costs. Continuous monitoring
in surgical departments can facilitate the correct and timely
identification of postoperative complications. This article is a starting
point for the development of new protocols and for the application of
these monitoring systems in clinical practice. Copyright © The
Author(s) 2024.

<14>
Accession Number
2037753474
Title
The left atrial appendage exclusion for prophylactic stroke reduction
(LEAAPS) trial: Rationale and design.
Source
American Heart Journal. 284 (pp 94-102), 2025. Date of Publication: 01 Jun
2025.
Author
Whitlock R.P.; McCarthy P.M.; Gerdisch M.W.; Ramlawi B.; Alexander J.H.;
Sultan I.; Rose D.Z.; Healey J.S.; Sharma Y.A.; Belley-Cote E.P.; Connolly
S.J.
Institution
(Whitlock) Department of Surgery, McMaster University, Hamilton, Ontario,
Canada
(Whitlock, Healey, Belley-Cote, Connolly) Population Health Research
Institute, Hamilton, Ontario, Canada
(McCarthy) Division of Cardiac Surgery, Department of Surgery, Bluhm
Cardiovascular Institute, Northwestern University Feinberg School of
Medicine and Northwestern Medicine, Chicago, IL, United States
(Gerdisch) Department of Cardiothoracic Surgery, Franciscan Health,
Indianapolis, IN, United States
(Ramlawi) Department of Cardiothoracic Surgery Research, Lankenau
Institute for Medical Research, Wynnewood, PA, United States
(Alexander) Duke Clinical Research Institute, Division of Cardiology, Duke
University, Durham, NC, United States
(Sultan) Department of Cardiothoracic Surgery, University of Pittsburgh
Medical Center, 5200 Centre Ave, Ste 715, Pittsburgh, PA, United States
(Rose) Department of Neurology, University of South Florida Morsani
College of Medicine, Tampa, FL, United States
(Sharma) AtriCure, Inc, OH, United States
Publisher
Elsevier Inc.
Abstract
Introduction: Left atrial appendage exclusion (LAAE) has been shown in
randomized trials to reduce ischemic stroke risk in patients undergoing
cardiac surgery with known atrial fibrillation (AF). Many patients
undergoing cardiac surgery without pre-existing AF are at risk of stroke
and may benefit from LAAE. Method(s): Left Atrial Appendage Exclusion
for Prophylactic Stroke Reduction (LeAAPS) is an international,
prospective, randomized, multicenter, blinded trial evaluating the
effectiveness of LAAE in preventing ischemic stroke or systemic embolism
in patients undergoing cardiac surgery at increased risk of AF and
ischemic stroke. The trial will enroll 6500 patients at increased risk of
stroke in whom a cardiac surgery is planned at 250 sites worldwide.
Eligible patients are >=18 years old, have no pre-existing AF but are at
increased risk for AF and stroke (based on age,
CHA<inf>2</inf>DS<inf>2</inf>-VASc score, left atrium size or brain
natriuretic peptide). Patients are randomized 1:1 to receive either LAAE
with AtriClip or no LAAE during cardiac surgery. Healthcare providers
outside of the operating room and the patient will be blinded to
allocation. The primary effectiveness endpoint is the first occurrence of
ischemic stroke, systemic arterial embolism, or surgical or endovascular
LAA closure. The powered secondary effectiveness endpoint is ischemic
stroke or systemic arterial embolism. The primary safety endpoint is the
occurrence of one of the following events (through 30 days): pericardial
effusion requiring percutaneous or surgical treatment, peri-operative
major bleeding, deep sternal wound infection, or myocardial infarction.
Other endpoints include mortality, rehospitalizations, clinically
diagnosed AF, transient ischemic attack, and cognitive and quality of life
assessments. Follow-up is every 6 months for a minimum of 5 years; primary
analysis occurs when 469 patients have had an ischemic stroke or systemic
embolism. Conclusion(s): The results of the LeAAPS trial will
demonstrate whether LAAE with AtriClip at the time of other routine
cardiac surgery reduces stroke or systemic arterial embolism during
long-term follow-up in patients at high risk of stroke without
pre-existing AF. Trial Registration: ClinicalTrials.gov, Identifier:
NCT05478304,
https://clinicaltrials.gov/study/NCT05478304?term=%20NCT05478304&rank=1.Copyright © 2024

<15>
Accession Number
2036263446
Title
5-Year Results From the AMPLATZER Amulet Left Atrial Appendage Occluder
Randomized Controlled Trial.
Source
Journal of the American College of Cardiology. 85(11) (pp 1141-1153),
2025. Date of Publication: 25 Mar 2025.
Author
Lakkireddy D.; Ellis C.R.; Thaler D.; Swarup V.; Gambhir A.; Hermiller J.;
Nielsen-Kudsk J.E.; Worthley S.; Nair D.; Schmidt B.; Horton R.; Gupta N.;
Anderson J.A.; Zhao H.; Alkhouli M.; Windecker S.
Institution
(Lakkireddy) Kansas City Heart Rhythm Institute and Research Foundation,
Overland Park, KS, United States
(Ellis) Vanderbilt Heart Institute, Nashville, TN, United States
(Thaler) Tufts Medical Center, Boston, MA, United States
(Swarup) Arizona Cardiovascular Research Center, Phoenix, AZ, United
States
(Gambhir) Northside Hospital Cardiovascular Institute, Atlanta, GA, United
States
(Hermiller) St Vincent Medical Group, Inc, Indianapolis, IN, United States
(Nielsen-Kudsk) Aarhus University Hospital, Aarhus, Denmark
(Worthley) Macquarie University Hospital, Macquarie Park, NSW, Australia
(Nair) St Bernards Healthcare Cardiology Associates, Batesville, AR,
United States
(Schmidt) Cardiovascular Center Bethanien, Frankfurt, Germany
(Horton) Texas Cardiac Arrhythmia, Austin, TX, United States
(Gupta) Los Angeles Medical Center, Los Angeles, CA, United States
(Anderson, Zhao) Abbott Structural Heart, Plymouth, MN, United States
(Alkhouli) Mayo Clinic, Rochester, MN, United States
(Windecker) University Hospital of Bern, Bern, Switzerland
Publisher
Elsevier Inc.
Abstract
Background: The Amulet IDE trial (AMPLATZER Amulet Left Atrial Appendage
Occluder [LAAO] Investigational Device Exemption [IDE] Trial) evaluated
the safety and effectiveness of the Amulet occluder (Abbott) in patients
with nonvalvular atrial fibrillation. The Amulet IDE trial is the largest
randomized LAAO trial, comparing the Amulet occluder with the Watchman 2.5
device (Boston Scientific). Objective(s): This analysis presents the
5-year results from the trial comparing the 2 devices head to head.
 Method(s): Patients enrolled in the Amulet IDE trial were at a high
risk of stroke or systemic embolism defined as a CHADS<inf>2</inf> score
>=2 or CHA<inf>2</inf>DS<inf>2</inf>-VASc score >=3. Oral anticoagulation
(OAC) use and key clinical outcomes are presented through 5 years.
 Result(s): A total of 1,878 patients were randomized, with 1,833
undergoing a device implantation attempt (n = 917, Amulet occluder; and n
= 916, Watchman device). A significantly higher percentage of patients
were free of OAC in the Amulet occluder group at each follow-up visit,
with 94.0% and 90.9% free of OAC at the last 5-year follow-up visit in the
Amulet and Watchman device groups, respectively (P = 0.009). The 5-year
clinical outcomes were similar between the Amulet and Watchman devices,
including the composite of ischemic stroke or systemic embolism (7.4% vs
7.1%; P = 0.851), the composite of stroke, systemic embolism, or
cardiovascular death (20.3% vs 20.7%; P = 0.666), major bleeding (20.1% vs
20.0%; P = 0.882), cardiovascular (CV) death (14.3% vs 15.4%; P = 0.429),
and all-cause death (28.7% vs 31.1%; P = 0.217). Annualized ischemic
stroke rates at 5 years were low and the same for Amulet (1.6%/y) and
Watchman (1.6%/y) devices. Strokes in patients with the Amulet occluder
were less severe (n = 38, nondisabling; n = 11, disabling; n = 11, fatal;
n = 12, unknown) than strokes in patients with the Watchman device (n =
19, nondisabling; n = 22, disabling; n = 17, fatal; n = 10, unknown).
Moreover, device factors (device-related thrombus or peridevice leak >=3
mm) preceded stroke events and CV deaths more frequently in patients with
the Watchman device (n = 63) compared with patients with the Amulet
occluder (n = 31). Conclusion(s): The 5-year outcomes from the
largest randomized LAAO clinical trial demonstrated the long-term safety
and effectiveness of the Amulet occluder and Watchman 2.5 devices. The
dual-seal Amulet occluder reduces atrial fibrillation-related
thromboembolic events while eliminating the need for long-term OAC.
(AMPLATZER Amulet Left Atrial Appendage Occluder [LAAO] Investigational
Device Exemption [IDE] Trial [Amulet IDE trial];
NCT02879448) Copyright © 2025 American College of Cardiology
Foundation

<16>
Accession Number
2037645517
Title
Flow-controlled versus pressure-controlled ventilation in thoracic surgery
with one-lung ventilation - A randomized controlled trial.
Source
Journal of Clinical Anesthesia. 103 (no pagination), 2025. Article Number:
111785. Date of Publication: 01 Apr 2025.
Author
Abram J.; Spraider P.; Martini J.; Velik-Salchner C.; Dejaco H.; Augustin
F.; Putzer G.; Hell T.; Barnes T.; Enk D.
Institution
(Abram, Spraider, Martini, Velik-Salchner, Dejaco, Putzer) Department of
Anesthesia and Intensive Care Medicine, Medical University of Innsbruck,
Anichstrasse 35, Innsbruck, Austria
(Augustin) Department of Visceral, Transplant and Thoracic Surgery,
Medical University of Innsbruck, Anichstrasse 35, Innsbruck, Austria
(Hell) Department of Mathematics, Faculty of Mathematics, Computer Science
and Physics, University of Innsbruck, Technikerstrasse 15, Innsbruck,
Austria
(Barnes) University of Greenwich, Old Royal Naval College, Park Row,
London, United Kingdom
(Enk) Faculty of Medicine, University of Munster, Albert-Schweitzer-Campus
1, Munster, Germany
Publisher
Elsevier Inc.
Abstract
Study objective: Comparison of flow-controlled ventilation (FCV) to
standard of pressure-controlled ventilation (PCV) in thoracic surgery
procedures requiring one-lung ventilation. Design(s): Prospective,
non-blinded, randomized, controlled trial. Setting(s): Operating
theater at a university hospital, Austria. Patient(s): Patients
scheduled for elective, thoracic surgery. Intervention(s):
Participants received ventilation randomly either with FCV or PCV
per-protocol for the duration of anesthesia. Measurements: The primary
endpoint was oxygenation assessed by paO<inf>2</inf> / FiO<inf>2</inf>
ratio 30 min after the start of OLV. Secondary endpoints included the
required minute volume for CO<inf>2</inf> removal, applied mechanical
power and incidence of postoperative pulmonary complications. Main
Result(s): A total of 46 patients were enrolled and 43 included in the
primary analysis. The primary endpoint paO<inf>2</inf> / FiO<inf>2</inf>
ratio was significantly higher in the FCV group (n = 21) compared to the
control group (PCV n = 22) (187 vs 136 mmHg, MD 39 (95 % CI 1 to 75); p =
0.047). The required respiratory minute volume to obtain comparable mild
hypercapnia during OLV was significantly lower in FCV (3.0 vs 4.5 l/min,
MD -1.3 (95 % CI -1.9 to -0.8); p < 0.001). The applied mechanical power
was also significantly lower (3.5 versus 7.6 J/min, MD -3.8 (95 % CI -5.3
to -2.7); p < 0.001). Conclusion(s): In this single-center randomized
controlled trial, flow-controlled ventilation improved gas exchange
parameters in terms of oxygenation and carbon dioxide removal during
one-lung ventilation in patients undergoing thoracic surgery and reduced
the mechanical impact of artificial ventilation. Copyright © 2025
The Authors

<17>
Accession Number
2037690496
Title
Comparison of the effects of an opioid-free anesthetic protocol with two
opioid-based protocols on the intraoperative cardiovascular response and
postoperative pain in cats undergoing elective ovariohysterectomy: A
prospective, randomized, blinded, clinical study.
Source
Topics in Companion Animal Medicine. 65 (no pagination), 2025. Article
Number: 100963. Date of Publication: 01 Mar 2025.
Author
Correia B.S.; Monteiro E.R.; Ferronatto J.V.B.; Pinho I.S.D.L.R.; Surita
L.E.; Alievi M.M.
Institution
(Correia, Monteiro, Ferronatto, Pinho, Surita, Alievi) Faculty of
Veterinary Medicine, Federal University of Rio Grande do Sul, Rio Grande
do Sul, Porto Alegre, Brazil
Publisher
W.B. Saunders
Abstract
This study compared the cardiovascular response to surgery and
postoperative pain between an opioid-free protocol and two opioid-based
protocols in cats undergoing elective ovariohysterectomy. Cats were
randomly allocated into three intramuscular premedication treatments: DEX
(dexmedetomidine 7 microg/kg, n = 12), DEXMET (dexmedetomidine 7 microg/kg
+ methadone 0.3 mg/kg, n = 13) and DEXMOR (dexmedetomidine 7 microg/kg +
morphine 0.3 mg/kg, n = 14). Preoperatively, all cats received meloxicam
0.1 mg/kg, subcutaneously. Anesthesia was induced with propofol and
maintained with sevoflurane. Heart rate (HR) and systolic arterial
pressure (SAP) were measured intraoperatively. Pain was assessed before
premedication (Baseline) and postoperatively for 6 h using the Glasgow
Composite Measure Pain Scale - Feline (CMPS-F) and Feline Grimace Scale
(FGS). Rescue analgesia was given for CMPS-F scores >= 5. In all groups,
HR and SAP increased intraoperatively, but tachycardia (HR > 200
beats/min) or hypertension (SAP > 180 mmHg) did not occur. Postoperative
CMPS-F scores were lower in DEXMET than in DEX; FGS scores in DEX and
DEXMOR were higher than in DEXMET. Rescue analgesia was administered to 50
%, 23 % and 29 % cats in groups DEX, DEXMET and DEXMOR, respectively (p >
0.05). The odds ratio (95 % confidence interval) of receiving
postoperative rescue analgesia within 6 h for opioid-free versus
opioid-based techniques was 2.86 (0.76-11.43). All protocols allowed
surgery to be performed without an exacerbated cardiovascular response.
Incorporating methadone or morphine in the protocol decreased the odds of
requiring postoperative rescue analgesia. Copyright © 2025
Elsevier Inc.

<18>
Accession Number
2031099052
Title
Implantation of a permanent pacemaker following orthotopic heart
transplantation: a systematic review and meta-analysis.
Source
Journal of Interventional Cardiac Electrophysiology. 68(1) (pp 167-177),
2025. Date of Publication: 01 Jan 2025.
Author
Pajareya P.; Srisomwong S.; Siranart N.; Kaewkanha P.; Chumpangern Y.;
Prasitlumkum N.; Kewcharoen J.; Chokesuwattanaskul R.; Tokavanich N.
Institution
(Pajareya, Siranart, Kaewkanha, Chokesuwattanaskul) Division of
Cardiovascular Medicine, Center of Excellence in Arrhythmia Research,
Cardiac Center, Faculty of Medicine, King Chulalongkorn Memorial Hospital,
Chulalongkorn University, Bangkok, Thailand
(Srisomwong) Faculty of Medicine, Vajira Hospital, Navamindradhiraj
University, Bangkok, Thailand
(Siranart, Prasitlumkum) Department of Cardiovascular Medicine, Mayo
Clinic, Rochester, United States
(Chumpangern) Faculty of Medicine, Siriraj Hospital, Mahidol University,
Bangkok, Thailand
(Kewcharoen) Division of Cardiovascular Medicine, Loma Linda University
Health, Loma Linda, CA, United States
(Tokavanich) Division of Cardiovascular Medicine, Frankel Cardiovascular
Center, University of Michigan Health, Ann Arbor, MI, United States
Publisher
Springer
Abstract
Background: Orthotopic heart transplant (OHT) is among the final
armamentariums for end-stage heart disease. Many patients who have had OHT
require a post-transplant permanent pacemaker (PPM) implantation due to an
abnormal conduction system. We aimed to evaluate the risk of mortality and
acute rejection in patients with OHT who had received PPM compared to
patients without PPM and to determine predictors for PPM placement in this
population. Method(s): We comprehensively searched for studies from
MEDLINE, EMBASE, and Cochrane databases from inception to September 2023.
Inclusion criteria focused on patients who had undergone OHT and PPM
implantation post-transplant. Data from each study were combined using a
random-effects model. Results were expressed as relative risk (RR) or odd
ratios (OR) with a 95% confidence interval (CI). Result(s): A total
of 9 studies were included in this meta-analysis incorporating a total of
54,848 patients (3.3% had PPM). The pooled all-cause mortality rate among
patients with PPM post-OHT was 26% (95% CI: 19-33%, I2 = 1%).
There were no differences between post-heart transplant patients with PPM
and those without PPM in risk of all-cause mortality (RR 0.76, 95% CI:
0.43-1.34; I2 = 45%) and acute rejection (RR 1.22, 95% CI:
0.74-2.00, I2 = 59%). Bi-atrial anastomosis was associated with
an increased risk of PPM implantation post-OHT (OR 7.74, 95% CI:
3.55-16.91, I2 = 0%), while pre-OHT mechanical circulatory
support (MCS) was associated with a decreased risk of PPM implantation
post-OHT (OR 0.45, 95% CI 0.27-0.76, I2 = 0%).
 Conclusion(s): There were no significant differences in all-cause
mortality or acute rejection between post-OHT recipients who required PPM
compared to those who did not receive PPM. Further, bi-atrial anastomosis
portended the need for PPM implantation, while MCS was associated with a
decreased occurrence of PPM. Copyright © The Author(s), under
exclusive licence to Springer Science+Business Media, LLC, part of
Springer Nature 2024.

<19>
Accession Number
2028037481
Title
Risk predictions of surgical wound complications based on a machine
learning algorithm: A systematic review.
Source
International Wound Journal. 21(1) (no pagination), 2024. Article Number:
e14665. Date of Publication: 01 Jan 2024.
Author
Zhang H.; Zhao J.; Farzan R.; Alizadeh Otaghvar H.
Institution
(Zhang) The Second Clinical Medical School, Lanzhou University, Lanzhou,
China
(Zhao) Department of Clinical Medicine, Health Science Center, Lanzhou
University, Lanzhou, China
(Farzan) Department of Plastic & Reconstructive Surgery, School of
Medicine, Guilan University of Medical Sciences, Rasht, Iran, Islamic
Republic of
(Alizadeh Otaghvar) of Plastic Surgery, Trauma and Injury Research Center,
Iran University of Medical Sciences, Tehran, Iran, Islamic Republic of
Publisher
John Wiley and Sons Inc
Abstract
Surgical wounds may arise due to harm inflicted upon soft tissue during
surgical intervention, and many complications and injuries may accompany
them. These complications can lead to prolonged hospitalization and poorer
clinical outcomes. Also, Machine learning (ML) is a Section of artificial
intelligence (AI) that has emerged in medical care and is increasingly
used for diagnosis, complications, prognosis and recurrence prediction.
This study aims to investigate surgical wound risk predictions and
management using a ML algorithm by R programming language analysis. The
systematic review, following PRISMA guidelines, spanned electronic
databases using search terms like 'machine learning', 'surgical' and
'wound'. Inclusion criteria covered experimental studies from 1990 to the
present on ML's application in surgical wound evaluation. Exclusion
criteria included studies lacking full text, focusing on ML in all
surgeries, neglecting wound assessment and duplications. Two authors
rigorously assessed titles, abstracts and full texts, excluding reviews
and guidelines. Ultimately, relevant articles were then analysed. The
present study identified nine articles employing ML for surgical wound
management. The analysis encompassed various surgical procedures,
including Cardiothoracic, Caesarean total abdominal colectomy, Burn
plastic surgery, facial plastic surgery, laparotomy, minimal invasive
surgery, hernia repair and unspecified surgeries. ML was skillful in
evaluating surgical site infections (SSI) in seven studies, while two
extended its use to burn-grade diagnosis and wound classification. Support
Vector Machine (SVM) and Convolutional Neural Network (CNN) were the most
utilized algorithms. ANN achieved a 96% accuracy in facial plastic surgery
wound management. CNN demonstrated commendable accuracies in various
surgeries, and SVM exhibited high accuracy in multiple surgeries and burn
plastic surgery. In sum, these findings underscore ML's potential for
significant improvements in postoperative management and the development
of enhanced care techniques, particularly in surgical wound
management. Copyright © 2024 The Authors. International Wound
Journal published by Medicalhelplines.com Inc and John Wiley & Sons Ltd.

<20>
Accession Number
2037662112
Title
TEG 6s-Guided Algorithm for Optimizing Patient Blood Management in
Cardiovascular Surgery: Systematic Literature Review and Expert Opinion.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2025.
Date of Publication: 2025.
Author
Maxey-Jones C.; Seelhammer T.G.; Arabia F.A.; Cho B.; Cardonell B.; Smith
D.; Leo V.; Dias J.; Shore-Lesserson L.; Hartmann J.
Institution
(Maxey-Jones) CNY Medical Services, PLLC, Baldwinsville, NY
(Seelhammer) Mayo Clinic, Rochester, MN
(Arabia) Banner Health, Phoenix, AZ
(Cho) Johns Hopkins University, Baltimore, MD
(Cardonell) University of Missouri Columbia, Columbia, MO
(Smith) Spectrum Healthcare Partners, Portland, ME
(Leo, Dias, Hartmann) Haemonetics Corporation, Boston, MA
(Shore-Lesserson) Northwell, New Hyde Park, NY, and Anesthesiology, North
Shore University Hospital, Manhasset, NY
Publisher
W.B. Saunders
Abstract
Objectives: To propose a comprehensive TEG 6s-based intraoperative and/or
immediately postoperative treatment algorithm for bleeding patients
undergoing cardiac surgery. To achieve this, TEG-based treatment
algorithms in cardiac surgery were evaluated through a literature review
and structured expert opinion. Design(s): Systematic literature
review. Setting(s): Cardiac surgery. Participant(s): Adult
patients undergoing cardiac surgery with intraoperative and/or immediately
postoperative bleeding. Intervention(s): TEG-guided transfusion
algorithm. Measurements and Main Results: A literature search was
conducted for original studies reporting TEG-based treatment algorithms in
cardiac surgery settings. Of 304 identified manuscripts, fourteen met all
inclusion criteria, with two further articles identified through authors'
suggestions. There is limited evidence describing the use of TEG 6s assays
in cardiac surgery with only one study reporting a dedicated algorithm
using the TEG 6s device at a non-US center. Two additional studies
assessed TEG 6s assays. The remaining manuscripts reported algorithms
based on the TEG 5000 device. Following the author's review of the
available data, and feedback from expert opinion, a simple transfusion
algorithm was proposed as an initial framework for developing a TEG
6s-based protocol with consideration for the 2021 Society of Thoracic
Surgery/Society of Cardiovascular Anesthesiologists/American Society of
Extracorporeal Technology/Society for the Advancement of Patient Blood
Management Patient Blood Management Guidelines. Conclusion(s): A new
algorithm for cardiac surgery based on TEG 6s assays has been proposed
based on the available evidence and expert opinion for research alignment
and clinical validation. Copyright © 2025 The Author(s)

<21>
[Use Link to view the full text]
Accession Number
2036604226
Title
The effect of stand-alone and additional preoperative video education on
patients' knowledge of anaesthesia: A randomised controlled trial.
Source
European Journal of Anaesthesiology. 42(4) (pp 313-323), 2025. Date of
Publication: 01 Apr 2025.
Author
Van Den Heuvel S.F.; Jonker P.; Hoeks S.E.; Ismail S.Y.; Stolker R.J.;
Korstanje J.-W.H.
Institution
(Van Den Heuvel, Jonker, Hoeks, Stolker, Korstanje) Department of
Anaesthesiology, Erasmus MC University Medical Centre Rotterdam, CA,
Rotterdam, Netherlands
(Ismail) Department of Psychiatry, Erasmus MC University Medical Centre
Rotterdam, Rotterdam, Netherlands
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUNDFully digital preoperative information could save valuable time
and resources. However, compared with face to face consultations,
equivalent levels of safety, patient satisfaction and participation need
to be maintained when using other methods to inform patients. This trial
compared knowledge retention between preoperative stand-alone video
education and face-to-face education by an anaesthesiologist.OBJECTIVESTo
assess if video education, alone or combined with face-to-face education,
leads to better knowledge retention more than conventional face-to-face
education.DESIGNA randomised controlled trial with four arms: Video,
Anaesthesiologist, Video & Anaesthesiologist, and Reference for baseline
measurements and exploration of a test-enhanced learning effect.SETTINGA
Dutch tertiary care centre from February 2022 to February 2023.PATIENTSA
total of 767 adult patients undergoing preoperative consultation for
elective non-cardiothoracic surgery, with 677 included in the complete
case analysis.INTERVENTION(S)Stand-alone preoperative video education and
video education in combination with face-to-face education in the
preoperative outpatient clinic.MAIN OUTCOME MEASURESPrimary outcome,
measured by the Rotterdam Anaesthesia Knowledge Questionnaire, was
knowledge retention on day 0. Secondary outcomes included knowledge
retention at 14 and 42 days, preoperative anxiety, and the need for
additional information using the Amsterdam Preoperative Anxiety and
Information Scale. Other outcomes were satisfaction, self-assessed
knowledge, and test-enhanced learning effect.RESULTSStand-alone video
education led to higher Rotterdam Anaesthesia Knowledge Questionnaire
scores than face-to-face education on day 0: median [IQR], 87.5 [81.3 to
93.8] vs. 81.3 [68.8 to 87.5], P < 0.001. Combined education in the "Video
& Anaesthesiologist"group led to better knowledge retention compared with
both the "Anaesthesiologist"group and the Video group: 93.8 [87.5 to 93.8]
vs. 81.3 [68.8 to 87.5], P < 0.001; 93.8 [87.5 to 93.8] vs. 87.5 [81.3 to
93.8], P = 0.01, respectively. No differences in the patients'
preoperative anxiety and satisfaction levels were found.CONCLUSIONCompared
with face-to-face education by an anaesthesiologist, stand-alone video and
combined video education improve short-term knowledge retention, without
increasing patient anxiety.TRIAL REGISTRATIONClinicalTrials.gov
Identifier: NCT05188547. Copyright © 2024 The Author(s).
Published by Wolters Kluwer Health, Inc. on behalf of the European Society
of Anaesthesiology and Intensive Care.

<22>
Accession Number
2035757482
Title
The Effect of Neuromuscular Electrical Stimulation on Muscle Proteolysis,
Muscle Mass and Strength, Cardiorespiratory Fitness, Functional Activity,
and Quality of Life in Post-Cardiac Surgery Patients: A Narrative Review.
Source
Journal of Multidisciplinary Healthcare. 18 (pp 983-994), 2025. Date of
Publication: 2025.
Author
Nazir A.; Clementius B.; Rafa H.A.; Sakalia C.; Nurhalizah H.A.
Institution
(Nazir) Department of Physical Medicine and Rehabilitation, Faculty of
Medicine, Universitas Padjadjaran, Dr. Hasan Sadikin General Hospital,
West Java, Bandung, Indonesia
(Clementius) Medical Department, Ukrida Hospital, DKI Jakarta, Jakarta
Barat, Indonesia
(Rafa) Emergency Department, RSAU Lanud Sulaiman Kopo, West Java, Bandung,
Indonesia
(Sakalia) Emergency Department, Kartini Hospital, West Java, Bandung,
Indonesia
(Nurhalizah) Undergraduate Program, Faculty of Medicine, Mataram
University, West Nusa Tenggara, Mataram, Indonesia
Publisher
Dove Medical Press Ltd
Abstract
Advances in medical and surgical practices, along with enhanced cardiac
ICU services, have led to a substantial increase in cardiac surgeries
(CS). Consequently, CS is now more frequently performed on older patients
undergoing complex procedures, which results in higher rates of
postoperative complications (POC) such as muscle proteolysis, prolonged
hospital stays and worsened clinical and functional outcomes. These
complications can delay early mobilization (EM) programs and exercise as
core components of post-CS rehabilitation even though sometimes they fail
to prevent functional decline. Neuromuscular electrical stimulation (NMES)
has emerged as a physical modality to prevent muscle atrophy, improve
muscle strength (MS), and enhance overall functional ability in post-CS
patients with physical limitations. Therefore, NMES has been chosen for
post-operative patients with physical limitations. This review aimed to
describe the effects of NMES on muscle proteolysis, muscle mass (MM) and
strength (MS), cardiorespiratory fitness (CRF), functional activity, and
quality of life (QoL) in post-CS patients. Data were synthesized from
PubMed, Google Scholar, and CINAHL using relevant keywords, and the review
included six original articles and one systematic review. Findings
indicate that perioperative NMES does not significantly affect
proteolysis; however, postoperative NMES appears to increase metabolism
and reduce protein degradation, thereby preventing muscle weakness.
Although NMES has been shown to enhance MS, its impact on increasing MM
remains insignificant. Similarly, improvements in the 6-minute walk
distance (6MWD), a measure of CRF, were not statistically significant,
even if they were clinically meaningful. Secondary outcomes related to
functional activity and QoL also did not show significant improvements. In
conclusion, post-operative NMES stimulates protein anabolism and
insignificantly improves MS and MM without significantly enhancing CRF as
measured by 6MWD. This may explain the lack of significant improvements in
functional activity and QoL in post-CS patients. Copyright © 2025
Nazir et al. This work is published and licensed by Dove Medical Press
Limited.

<23>
Accession Number
2032057083
Title
Cost-Effectiveness of Three Different New-Generation Drug-Eluting Stents
in the Randomised BIO-RESORT Trial at 3 Years.
Source
PharmacoEconomics - Open. 9(1) (pp 137-145), 2025. Article Number:
e000064. Date of Publication: 01 Jan 2025.
Author
Ploumen E.H.; Wolcherink M.J.O.; Buiten R.A.; Pinxterhuis T.H.; Doggen
C.J.M.; Schotborgh C.E.; Danse P.W.; Scholte M.; van Houwelingen K.G.;
Zocca P.; Pouwels X.G.L.V.; von Birgelen C.
Institution
(Ploumen, Buiten, Pinxterhuis, van Houwelingen, Zocca, von Birgelen)
Department of Cardiology, Thoraxcentrum Twente, Medisch Spectrum Twente,
Koningsplein 1, Enschede, Netherlands
(Ploumen, Wolcherink, Pinxterhuis, Doggen, Pouwels, von Birgelen)
Department of Health Technology and Services Research, Faculty of
Behavioural, Management and Social Sciences, Technical Medical Centre,
University of Twente, Enschede, Netherlands
(Schotborgh) Department of Cardiology, Haga Hospital, The Hague,
Netherlands
(Danse) Department of Cardiology, Rijnstate Hospital, Arnhem, Netherlands
(Scholte) Department of Cardiology, Albert Schweitzer Hospital, Dordrecht,
Netherlands
Publisher
Adis
Abstract
Background and Objective: Evidence on health economic outcomes for
percutaneous coronary intervention (PCI) comparing different contemporary
drug-eluting stents (DES) with each other is scarce, as most previous
randomised DES trials did not assess such aspects. This prespecified
health economic evaluation of the Comparison of Biodegradable Polymer and
Durable Polymer Drug-Eluting Stents in an All Comers Population
(BIO-RESORT) trial aimed to compare at 3-year follow-up both health
effects and costs of PCI with one of three new-generation drug-eluting
stents (DES) in patients with obstructive coronary artery disease.
 Method(s): The randomised BIO-RESORT trial assessed in 3514 patients
the ultrathin-strut biodegradable polymer Orsiro sirolimus-eluting stent
(SES) and very-thin-strut Synergy everolimus-eluting (EES) stent versus
the thin-strut durable polymer Resolute Integrity zotarolimus-eluting
stent (ZES). In the current analysis, we used the perspective of a health
insurer in the Netherlands. The main endpoints were quality-adjusted life
years (QALYs), and costs for each treatment strategy. Bootstrapping with
5000 resamples was performed to capture the uncertainty of results.
 Result(s): Mean QALYs for each stent group were 2.566 for the SES,
2.551 for the EES, and 2.550 for the ZES. Mean costs per strategy were
14,670 for the SES, 14,946 for the EES, and 15,069 for the ZES. The SES
had the highest probability of being cost-effective for every
willingness-to-pay threshold up to 100,000 per QALY. Furthermore, in 79%
of modelling scenarios, the SES was more effective and cheaper than ZES.
 Conclusion(s): At 3-year follow-up, PCI with the SES had the highest
probability of being cost-effective due to greater effectiveness and lower
costs compared with the ZES and EES. These findings suggest that, due to
the overall high volume of coronary stenting in clinical practice, use of
this SES could result in substantial cost savings, complemented by slight
additional health benefits. Copyright © The Author(s) 2024.

<24>
Accession Number
2032346546
Title
Life-threatening complications in ophthalmic surgery: a systematic review.
Source
Eye (Basingstoke). 39(1) (pp 69-78), 2025. Article Number: 2262502. Date
of Publication: 01 Jan 2025.
Author
Ferrara M.; Romano V.; Longo L.; Rovati M.; Raimondi R.; Semeraro F.;
Aliberti S.; Romano M.R.
Institution
(Ferrara, Romano, Rovati, Semeraro) Department of Medical and Surgical
Specialties, Radiological Sciences, and Public Health, University of
Brescia, Brescia, Italy
(Ferrara, Romano, Semeraro) Eye Unit, ASST Spedali Civili di Brescia,
Brescia, Italy
(Ferrara) School of Medicine, University of Malaga, Malaga, Spain
(Longo, Aliberti, Romano) Department of Biomedical Sciences, Humanitas
University, Milan, Italy
(Raimondi) Newcastle Eye Centre, Royal Victoria Infirmary, Newcastle Upon
Tyne, United Kingdom
(Aliberti) IRCCS Humanitas Research Hospital, Respiratory Unit, Milan,
Italy
(Romano) Department of Ophthalmology, Humanitas Gavazzeni-Castelli,
Bergamo, Italy
Publisher
Springer Nature
Abstract
Ophthalmic surgical procedures are widely acknowledged for their safety
and efficacy. Undoubtedly, advances in ophthalmic surgery, along with the
improvement of anaesthetic techniques, have contributed to the reduction
in the occurrence of these events. However, although uncommon, systemic
severe and life-threatening adverse events can still occur and it is
imperative for an ophthalmologic surgeon to have a comprehensive
understanding of them to act in terms of proactive prevention, prompt
recognition, and optimal treatment, thus maximizing patients' outcomes.
Among life-threatening complication following ophthalmic surgery,
cardiovascular events represent the most common ones, including a range of
different clinical entities: the oculocardiac reflex, potentially leading
to haemodynamic instability and asystole; iatrogenic vascular air
embolism, in form of venous air embolism or "pefluorocarbon syndrome",
which can lead to obstruction of the pulmonary circulation, respiratory
distress and cardiovascular collapse; postoperative venous
thromboembolism, in the context of which the management of perioperative
antiplatelet and anticoagulant therapy has a crucial role. Furthermore,
among infectious complications, that are more commonly limited to the
ocular tissues, necrotizing fasciitis represents a potentially lethal
infection. This review aims to provide an up-to-date, evidence-based
overview of potential life-threatening complications associated with
ophthalmic surgery, exploring pathogenesis, risk factors, signs, symptoms,
and, briefly, management strategies. Copyright © The Author(s),
under exclusive licence to The Royal College of Ophthalmologists 2024.

<25>
Accession Number
2037640119
Title
Comparative randomised double blind study to evaluate the efficacy of
dexmedotomidine and nalbuphine used as an adjuvant with 0.5% ropivacaine
under epidural anaesthesia in patients of various infraumbilical
surgeries.
Source
International Journal of Life Sciences Biotechnology and Pharma Research.
14(2) (pp 765-769), 2025. Date of Publication: 01 Feb 2025.
Author
Dhaka R.; Chittora S.P.; Hayat G.
Institution
(Dhaka, Chittora, Hayat) Department of Anesthesiology, Jhalawar Medical
College, Jhalawar, India
Publisher
International Journal of Life Sciences Biotechnology and Pharma Research
Abstract
Background: Epidural anesthesia is a widely used technique for providing
anesthesia and postoperative analgesia in various lower abdomen and lower
limb surgeries. Objective(s): The current study was aimed to evaluate
the efficacy of dexmedetomidine and Nalbuphine as adjuvants with 0.5%
ropivacaine in epidural anesthesia. The study was focused on various
parameters, including the onset and duration of sensory and motor block,
sedation score, and duration of postoperative analgesia. Material(s)
and Method(s): 150 eligible patients were randomly allocated in 3 groups
using computerized random number table. Group C (n=50) - Ropivacaine 0.5%
(18ml) + Normal saline (2ml) (Total volume-20ml), Group N (n=50) -
Ropivacaine 0.5% (18ml) + Nalbuphine 200mug/kg (Total volume - 20ml),
Group D (n=50) - Ropivacaine 0.5% (18ml) + Dexmedetomidine 0.75 mug/kg
(Total volume 20ml). Result(s): Group Dpatients shows early onset of
sensory block, motor block, time taken to achieve maximum sensory and
motor block, along with longer duration of analgesia, compared to Group N
and Group C, with statistically significant differences observed at all
time points as indicated by the low p-values (p<0.001).
 Conclusion(s): dexmedetomidine is superior to Nalbuphine as an
adjuvant to ropivacaine in epidural anaesthesia for better sensory and
motor block characteristics and post operative pain
management. Copyright ©2025Int. J. LifeSci.Biotechnol.Pharma.Res.

<26>
Accession Number
2032362214
Title
Heart failure after left atrial appendage occlusion: Insights from the
LAAOS III randomized trial.
Source
European Journal of Heart Failure. 27(2) (pp 285-292), 2025. Date of
Publication: 01 Feb 2025.
Author
Krisai P.; Belley-Cote E.P.; McIntyre W.F.; Wong J.; Tsiplova K.; Brady
K.; Joseph P.; Johansson I.; Johnson L.; Xing L.Y.; Colli A.; McGuinness
S.; Punjabi P.; Reents W.; Rega F.; Budera P.; Royse A.G.; Paparella D.;
Connolly S.; Whitlock R.P.; Healey J.S.
Institution
(Krisai) Department of Cardiology and Cardiovascular Research Institute
Basel, University Hospital Basel, University of Basel, Basel, Switzerland
(Belley-Cote, McIntyre, Wong, Tsiplova, Brady, Joseph, Connolly, Whitlock,
Healey) McMaster University, Hamilton, ON, Canada
(Belley-Cote, McIntyre, Wong, Brady, Joseph, Connolly, Whitlock, Healey)
Hamilton Health Sciences, Hamilton, ON, Canada
(Belley-Cote, McIntyre, Wong, Brady, Joseph, Johansson, Johnson, Connolly,
Whitlock, Healey) Population Health Research Institute, Hamilton, ON,
Canada
(Johansson) Division of Cardiology, Department of Medicine K2, Karolinska
University Hospital Solna, Karolinska Institutet, Stockholm, Sweden
(Johnson) Department of Clinical Sciences Malmo, Lund University, Lund,
Sweden
(Xing) Department of Cardiology, Copenhagen University Hospital -
Rigshospitalet, Copenhagen, Denmark
(Colli) Department of Surgical, Medical and Molecular Pathology and
Critical Care, University of Pisa, Pisa, Italy
(McGuinness) Auckland City Hospital, Auckland, New Zealand
(Punjabi) National Heart and Lung Institute, Imperial College London,
London, United Kingdom
(Reents) Rhon-Klinikum Campus Bad Neustadt, Bad Neustadt, Germany
(Rega) Department of Cardiac Surgery, University Hospitals Leuven, Leuven,
Belgium
(Budera) Institute for Clinical and Experimental Medicine, Prague, Czechia
(Royse) University of Melbourne and Royal Melbourne Hospital, Melbourne,
VIC, Australia
(Paparella) Department Medicine and Surgical Science, University of
Foggia, and Santa Maria Hospital, GVM Care & Research, Bari, Italy
Publisher
John Wiley and Sons Ltd
Abstract
Aims: The left atrial appendage (LAA) produces natriuretic peptides and
its removal or occlusion might increase the risk of heart failure (HF). We
aimed to investigate the incidence of HF after LAA occlusion or removal
(LAAO) in the Left Atrial Appendage Occlusion Study (LAAOS III).
 Methods and Results: Patients (n = 4811) with atrial fibrillation
(AF) and a CHA<inf>2</inf>DS<inf>2</inf>-VASc score >=2, who were having
cardiac surgery for another indication, were randomized to undergo
surgical LAAO or not. We compared the composite outcome of HF-related
hospitalizations and HF death between the two groups. HF assessment
required clinical and radiographic evidence of HF. Analyses included a
landmark analysis before and after 30 days and subgroups. Mean age was
71.2 years, 67.5% were male and 57.0% had prior HF. Over a mean follow-up
of 3.8 years, 396 (8.3%) patients met the composite HF outcome: 209 (8.8%)
with LAAO (n = 2379) and 187 (7.8%) without LAAO (n = 2391) (hazard ratio
[HR] 1.12, 95% confidence interval [CI] 0.92-1.37, p = 0.25). There was no
difference between the two groups in the first 30 days (1.6% vs. 1.1%; p =
0.12) and thereafter (7.6% vs. 7.1%; p = 0.57). Subgroups based on age,
sex, body mass index, AF type, prior HF, cardiac rhythm or left
ventricular ejection fraction showed consistent results. There was no
difference in HF outcomes with LAAO between the cut-and-sew (HR 0.93, 95%
CI 0.70-1.23, p = 0.62) versus other closure methods (HR 1.05, 95% CI
0.77-1.41, p = 0.77). Conclusion(s): Left atrial appendage occlusion
or removal at the time of cardiac surgery does not appear to alter the
risk of HF-related hospitalization or death. Clinical Trial Registration:
ClinicalTrials.gov NCT01561651. Copyright © 2024 The Author(s).
European Journal of Heart Failure published by John Wiley & Sons Ltd on
behalf of European Society of Cardiology.

<27>
Accession Number
2032632695
Title
Hydroxocobalamin treatment for refractory hypotension and shock: a case
series.
Source
Canadian Journal of Anesthesia. 72(1) (pp 208-210), 2025. Article Number:
e0408. Date of Publication: 01 Jan 2025.
Author
Shechtman L.; Randhawa V.K.; Saoraya J.; Amaral M.; Marchesano R.; Tsang
L.; Yamashita S.; Adhikari N.K.J.; Scales D.C.; Fowler R.
Institution
(Shechtman, Randhawa, Saoraya, Adhikari, Scales, Fowler) Department of
Critical Care Medicine, Sunnybrook Health Sciences Centre, Toronto, ON,
Canada
(Amaral) Faculty of Arts and Sciences, University of Toronto, Toronto, ON,
Canada
(Marchesano, Tsang, Yamashita) Department of Pharmacy, Sunnybrook Health
Sciences Centre, Toronto, ON, Canada
(Adhikari, Scales, Fowler) Interdepartmental Division of Critical Care
Medicine, University of Toronto, Toronto, ON, Canada
Publisher
Springer

<28>
Accession Number
2037218551
Title
Safety Interventions in Cardiac Anesthesia: A Systematic Review.
Source
Joint Commission Journal on Quality and Patient Safety. 51(4) (pp
293-304), 2025. Date of Publication: 01 Apr 2025.
Author
O'Callaghan L.; Ahern S.; Doyle A.
Publisher
Joint Commission Resources, Inc.
Abstract
Background: The cardiac operating room is a complex, high-risk,
sociotechnical system. Risks in cardiac surgery and anesthesiology have
been extensively categorized, but less is known about effective risk
reduction strategies. A comprehensive understanding of effective,
evidence-based risk reduction strategies is necessary to improve patient
safety in cardiac anesthesia. Method(s): An advanced literature
search of MEDLINE, CINAHL, Embase, and Web of Science databases was
conducted to identify studies involving the introduction of a tool or
intervention to improve patient safety and human factors in cardiac
anesthesia. Studies were screened independently by two authors applying
prespecified inclusion and exclusion criteria. Risk reduction strategies
and safety initiatives identified were classified according to the Systems
Engineering Initiative for Patient Safety model. Data were extracted using
a standardized form and were narratively synthesized. Result(s): A
total of 18 studies were identified for inclusion using preoperative
briefing tools, intraoperative checklists, and postoperative handover
tools. Preoperative briefing tools were associated with a significant
reduction in patient mortality and length of hospital stay and also led to
adaptations to planned operation. Intraoperative checklists demonstrated
decreased bleeding, mortality, and blood transfusion requirements.
Postoperative handover tools were associated with improved information
transfer and teamwork. Conclusion(s): This review identified three
categories of tools that may be used to improve patient and organizational
outcomes. Many of these tools are simple to introduce and sustainable in
the long term and can be readily adapted to different
centers. Copyright © 2024 The Joint Commission

<29>
Accession Number
2037634074
Title
Intravenous amino acids for renal protection in patients receiving
temporary mechanical circulatory support: a secondary subgroup analysis of
the PROTECTION study.
Source
European Journal of Cardio-thoracic Surgery. 67(2) (no pagination), 2025.
Article Number: ezaf035. Date of Publication: 01 Feb 2025.
Author
Belletti A.; Pisano A.; Scandroglio A.M.; Garofalo E.; Calabro M.G.;
Ferrod F.; Monaco F.; Brambillasca C.; Baiardo Redaelli M.; Meroi F.;
Fominskiy E.; Vignale R.; Ajello S.; Venditto M.; Scquizzato T.; Porta S.;
Losiggio R.; Suriano P.; Pontillo D.; Orso D.; Tomasi E.; Paternoster G.;
Lomivorotov V.; Longhini F.; Landoni G.; Zangrillo A.; Maisano F.; Bellomo
R.; Pieri M.; D'Amico F.; Manazza M.; Marmiere M.; Marzaroli M.; Monti G.;
Oliva F.M.; Pruna A.; Turi S.; Veneziano M.; Vietri S.; Zaraca L.; Fraja
D.D.; Verniero L.; Bruni A.; Perrelli G.; Prezzi L.; Massaro C.; Ferrante
P.; Arangino C.; Angelini F.; Bacchetti G.; Vitielli M.; Gallicchio F.;
Bradic N.; Ti L.K.
Institution
(Belletti, Scandroglio, Calabro, Monaco, Brambillasca, Baiardo Redaelli,
Fominskiy, Ajello, Scquizzato, Losiggio, Pontillo, Landoni, Zangrillo,
Pieri) Department of Anesthesia and Intensive Care, IRCCS San Raffaele
Scientific Institute, Milan, Italy
(Pisano, Venditto, Porta) Monaldi Hospital, Cardiac Anesthesia and ICU,
AORN "Dei Colli, Naples, Italy
(Garofalo, Longhini) Department of Medical and Surgical Sciences, Magna
Graecia University of Catanzaro, Anesthesia and Intensive Care, Catanzaro,
Italy
(Ferrod) S.C. Anestesia e Rianimazione Cardiovascolare, A.O. Ordine
Mauriziano Umberto I di Torino, Torino, Italy
(Suriano) Dipartimento di Chirurgia Cardiovascolare, IRCCS Centro
Cadiologico Monzino, Unita Operativa di Anestesia E Terapia Intensiva,
Milan, Italy
(Meroi, Orso) Department of Emergency Santa Maria della Misericordia,
University Hospital of Udine, Azienda Sanitaria Universitaria Friuli
Centrale, Udine, Italy
(Vignale) San Carlo Hospital, Cardiovascular Anesthesia and ICU, Potenza,
Italy
(Tomasi) IRCCS San Raffaele Scientific Institute, Hospital Pharmacy,
Milan, Italy
(Paternoster) Department of Health Science Anesthesia and ICU, School of
Medicine,, University of Basilicata, San Carlo Hospital, Potenza, Italy
(Lomivorotov) Department of Anesthesiology and Perioperative Medicine,
Penn State Milton S. Hershey Medical Center, Penn State College of
Medicine, Hershey, PA, United States
(Landoni, Zangrillo, Maisano, Pieri) School of Medicine, Vita-Salute San
Raffaele University, Milan, Italy
(Maisano) Cardiac Surgery Department, San Raffaele University Hospital,
Milan, Italy
(Bellomo) Department of Critical Care, The University of Melbourne,
Melbourne, Australia
(Bellomo) Australian and New Zealand Intensive Care Research Centre,
Monash University, Melbourne, Australia
(Bellomo) Data Analytics Research and Evaluation Centre, Austin Hospital,
Melbourne, Australia
(Bellomo) Department of Intensive Care, Austin Hospital, Melbourne,
Australia
(Bellomo) Department of Intensive Care, Royal Melbourne Hospital,
Melbourne, Australia
Publisher
European Association for Cardio-Thoracic Surgery
Abstract
OBJECTIVES: In cardiac surgery patients, acute kidney injury (AKI)
frequently occurs in the setting of haemodynamic instability and treatment
with temporary mechanical circulatory support (tMCS). Recent evidence
suggests amino acids (AA) infusion may reduce AKI rate. However, the
effect of AA infusion in patients requiring tMCS may be less effective.
 METHOD(S): We performed a secondary analysis of the PROTECTION
multicentre randomized controlled trial including all patients treated
with tMCS. Patients undergoing elective cardiac surgery with
cardiopulmonary bypass were randomized to receive 2 g/kg ideal body
weight/day of intravenous AA to a maximum of 100 g/day or matching placebo
from operating room admission until up to 3 days, receipt of
renal-replacement therapy, discharge from ICU or death. The primary
outcome of the PROTECTION study was the rate of AKI, as in this secondary
analysis. A total of 3511 patients were randomized in the study.
 RESULT(S): We studied 232 patients who received tMCS, 112 randomized
to AA infusion and 120 to placebo. The median preoperative serum
creatinine value was significantly higher among AA group patients (AA:
1.08, interquartile range 0.90-1.26; placebo: 0.98, interquartile range
0.85-1.15; P = 0.02). The rate of AKI, however, was lower in patients
randomized to AA (44.6% vs 60.8%; relative risk 0.73; 95% confidence
interval (0.57-0.94); P = 0.01; number needed to treat = 6). We found no
significant differences in secondary outcomes. CONCLUSION(S):
Short-term AA infusion appears to reduce rate of AKI among patients
requiring tMCS. Use of AA in this population at high-risk for renal
failure appears justified. Copyright © 2025 The Author(s).

<30>
Accession Number
2037564994
Title
Effects of high-intensity interval training versus moderate-intensity
continuous training on cardiorespiratory and exercise capacity in patients
with coronary artery disease: A systematic review and meta-analysis.
Source
PLoS ONE. 20(2 February) (no pagination), 2025. Article Number: e0314134.
Date of Publication: 01 Feb 2025.
Author
Gao C.; Yue Y.; Wu D.; Zhang J.; Zhu S.
Institution
(Gao, Zhang, Zhu) Chengdu University of Traditional Chinese Medicine,
School of Nursing Chengdu, Sichuan, Chengdu, China
(Yue, Wu) Chengdu Fourth People's Hospital, Sichuan, Chengdu, China
Publisher
Public Library of Science
Abstract
Background With the increasing utilization of cardiac rehabilitation in
clinical treatment and prognosis for patients with cardiovascular
diseases, exercise training has become a crucial component. High-intensity
interval training (HIIT) and moderate-intensity continuous training (MICT)
are commonly employed in rehabilitating patients with cardiovascular
diseases. However, further investigation is required to determine whether
HIIT and MICT can effectively enhance the prognosis of patients with
coronary artery disease. Therefore, this study aims to assess the
effectiveness of HIIT and MICT interventions, optimal intervention
duration for different intensity levels of training, as well as effective
training modalities that improve cardiorespiratory function and exercise
capacity among patients. Methods We conducted a comprehensive search of
the Cochrane Library, PubMed, EMbase, Web of Science, and CINAHL databases
for randomized controlled trials (RCTs) pertaining to high-intensity
interval training (HIIT) and moderate-intensity continuous training (MICT)
interventions in patients with coronary artery disease from inception
until publication on September 26, 2024. Two independent researchers
assessed articles that met the inclusion criteria and analyzed the results
using Sata 17.0 software. Forest plots were employed to evaluate the
impact of HIIT and MICT on outcome indicators. Sensitivity analysis and
funnel plot assessment were performed to examine publication bias.
Subgroup analysis was conducted to determine optimal intervention duration
and training methods. Results A total of 22 studies with 1364 patients
were included in the study, including the HIIT group (n = 685) and the
MICT group (n = 679). The results showed that compared to MICT, HIIT
significantly increased PeakVO<inf>2</inf>(Peak oxygen uptake)[WMD =
1.42mL /kg/min 95%CI (0.87, 1.98), P = 0.870, I2 = 0%],
6MWT(6-minute walk test)[WMD = 18.60m 95%CI (2.29, 34.92), P = 0.789,
I2 = 0%], PHR(Peak heart rate)[WMD = 4.21bpm 95%CI (1.07,
7.36), P = 0.865, I2 = 0%], DBP(diastolic blood pressure)[WMD =
3.43mmHg 95%CI (1.09, 5.76), P = 0.004, I2 = 60.2%]. However,
in LVEF(left- ventricular ejection fraction)[WMD = 0.32mL 95%CI (-1.83,
2.46), P = 0.699, I2 = 0%], LVEDV(left ventricular
end-diastolic volume)[WMD = 0.91 ml 95%CI (-1.83, 2.46), P = 0.995,
I2 = 0%] and SBP(systolic blood pressure)[WMD = 1.85mmHg 95%CI
(-0.23, 3.93),P = 0.266, I2 = 18.2%], there was no significant
difference between HIIT and MICT. Conclusion Based on the findings of this
systematic review, HIIT demonstrates superior efficacy compared to MICT in
enhancing PeakVO<inf>2</inf>, PHR, 6MWT and DBP. However, no significant
differences were observed in LVEF, LVEDV, and SBP. In summary, HIIT
exhibits potential for improving cardiopulmonary function and exercise
capacity among patients with coronary artery disease. Copyright ©
2025 Gao et al. This is an open access article distributed under the terms
of the Creative Commons Attribution License, which permits unrestricted
use, distribution, and reproduction in any medium, provided the original
author and source are credited.

<31>
Accession Number
2037097840
Title
Characteristics and outcomes of cardiac amyloid disease after heart
transplantation: A systematic review and meta-analysis.
Source
Transplantation Reviews. 39(2) (no pagination), 2025. Article Number:
100908. Date of Publication: 01 Apr 2025.
Author
Rahimov D.; Yan V.Z.; Ahmad D.; Nasher N.; Tatum R.; Im M.; Storozynsky
E.; Rame J.E.; Rajagopal K.; Entwistle J.W.; Massey H.T.;
Tchantchaleishvili V.
Institution
(Rahimov, Yan, Ahmad, Nasher, Tatum, Im, Rajagopal, Entwistle, Massey,
Tchantchaleishvili) Department of Cardiac Surgery, Thomas Jefferson
University, Philadelphia, PA, United States
(Storozynsky, Rame) Division of Cardiology, Department of Medicine, Thomas
Jefferson University, Philadelphia, PA, United States
Publisher
Elsevier Inc.
Abstract
Purpose: Patients with systemic amyloidosis with cardiac involvement
require careful selection for heart transplantation (HTx) due to the
associated poor outcomes. Large databases do not provide sufficient
granularity to allow for differentiation between its major subtypes
[light-chain (AL) and transthyretin (ATTR) amyloidosis]. We sought to pool
the existing data on amyloidosis patients undergoing HTx, and perform
stratified analysis based on its major subtypes. Method(s):
Electronic search identified adult patients with amyloidosis undergoing
HTx. Cohort-level data for 340 patients from 19 studies were extracted and
analyzed. Patients were categorized based on amyloid subtype into AL and
ATTR groups. Result(s): AL amyloidosis was diagnosed at an earlier
age compared to ATTR [53 (95 % CI 48; 57) years vs. 63 (55; 71) years, p =
0.03], with greater incidence in the Caucasian population [75 % (60; 87)
vs. 39 % (21; 59), p <=0.01]. Females comprised 33 % (25; 41) of the
patients with greater preponderance in AL group [41 % (33; 48) vs. 21 %
(8; 36), p = 0.02]. AL patients also had higher involvement of >=two
organs [50 % (29; 70) vs. 15 % (3; 32), p = 0.01]. GI involvement [25 %
(6; 50) vs. 0 % (0; 8), p = 0.02], and renal involvement [20 % (8; 34) vs.
0 % (0; 2), p < 0.01] were virtually limited to AL, while ATTR patients
had more implantable cardioverter defibrillators placed [64 % (34; 90) vs.
15 % (6; 28), p < 0.01] and trended towards greater incidence of
neuropathy [24 % (9; 42) vs. 9 % (2; 19), p = 0.07]. The AL group had a
significantly higher incidence of recurrent amyloidosis [16 % (7; 27) vs.
0 % (0; 0), p <=0.01]. Pooled Kaplan-Meier survival analysis showed worse
long-term survival in the AL group (p = 0.02). Conclusion(s):
Patients with AL amyloidosis showed more widespread systemic involvement
and worse long-term survival after HTx compared to patients with ATTR
amyloidosis. Protocols for mitigating the recurrence of AL amyloidosis are
needed to improve survival in this high-risk subtype. Copyright ©
2025 Elsevier Inc.

<32>
Accession Number
2037571983
Title
Effect of geriatric care on health outcomes in older patients with cardiac
disease: A systematic review.
Source
Archives of Gerontology and Geriatrics. 132 (no pagination), 2025. Article
Number: 105786. Date of Publication: 01 May 2025.
Author
Raijmann R.C.M.A.; van Dalen T.N.; Koek H.L.; van der Meer M.G.;
Emmelot-Vonk M.H.; Keijsers C.J.P.W.
Institution
(Raijmann, Koek, Emmelot-Vonk) Department of Geriatrics, University
Medical Center Utrecht, Utrecht, Netherlands
(Raijmann, van Dalen, Keijsers) Department of Geriatrics, Jeroen Bosch
Hospital, 's-Hertogenbosch, Netherlands
(van der Meer) Department of Cardiology, University Medical Center
Utrecht, Utrecht, Netherlands
Publisher
Elsevier Ireland Ltd
Abstract
Background: As patients with cardiac disease age and become frail, their
care needs become more complex. Therefore geriatric care might benefit
these patients. This review summarizes current research investigating the
impact of geriatric care on clinical outcomes in older cardiac patients.
 Method(s): The MEDLINE, Embase, and Cochrane databases were searched
on 11 May 2023 for randomized controlled trials (RCTs) and observational
studies comparing additional geriatric care to usual care in older (+70)
cardiac patients. The Cochrane risk of bias tool and Robbins-E tool were
used for quality assessment of RCTs and observational studies
respectively. Data on mortality rates, readmissions, length of stay,
complications, discharge destinations, functional outcomes, and quality of
life (QoL) were extracted. Two authors independently selected studies,
extracted data and assess study quality. Result(s): Twelve articles
involving 3531 patients (average age 73-85 years; 44-59 % male) were
identified, mainly focussing on heart failure or patients requiring
cardiothoracic surgery. The studies had a moderate to high risk of bias.
Two out of three studies (n = 771) showed reduced complication rates (e.g.
delirium incidence) when comparing geriatric assessment to usual care.
Additionally, two out of three studies (n = 449), indicated improved QoL
scores for patients who received a geriatric care. No significant effects
were found for other outcomes. Conclusion(s): Low-quality evidence
suggests that geriatric care may be associated with lower complication
rates and an improved quality of life in older cardiac patients. However,
more research is needed to clarify the effect of a geriatric care in this
patient population. Registration: The study protocol was registered in the
international prospective register of systematic reviews (PROSPERO 2022
CRD42022337353) Copyright © 2025

<33>
Accession Number
2037436163
Title
Late Clinical Outcomes of Balloon-Expandable Valves in Small Annuli:
Results From the PARTNER Trials.
Source
JACC: Cardiovascular Interventions. 18(4) (pp 506-517), 2025. Date of
Publication: 24 Feb 2025.
Author
Hahn R.T.; Pibarot P.; Abbas A.; Makkar R.; Thourani V.H.; Genereux P.;
Kodali S.; Kapadia S.; Babaliaros V.; Ternacle J.; Theron A.; Cristell N.;
Clarke S.; Zhao Y.; Alu M.; Madhavan M.V.; Cohen D.J.; Leipsic J.; Webb
J.; Mack M.J.; Leon M.B.
Institution
(Hahn, Kodali, Madhavan, Leon) Department of Medicine, Columbia University
Irving Medical Center, New York, NY, United States
(Hahn, Cristell, Alu, Madhavan, Cohen, Leon) Clinical Trials Center,
Cardiovascular Research Foundation, New York, NY, United States
(Pibarot, Theron) Departement de Cardiologie, Institut Universitaire de
Cardiologie et de Pneumologie de Quebec, Universite Laval, Quebec City,
QC, Canada
(Abbas) Department of Cardiovascular Medicine, CHE-William Beaumont
University Hospital, Royal Oak, MI, United States
(Makkar) Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles,
CA, United States
(Thourani) Department of Cardiovascular Surgery, Marcus Valve Center,
Piedmont Heart Institute, Atlanta, GA, United States
(Genereux) Gagnon Cardiovascular Institute, Morristown Medical Center,
Morristown, NJ, United States
(Kapadia) Department of Cardiovascular Medicine, Cleveland Clinic,
Cleveland, OH, United States
(Babaliaros) Emory University School of Medicine, Atlanta, GA, United
States
(Ternacle) Haut-Leveque Cardiology Hospital, CHU Bordeaux, Pessac, France
(Theron) Assistance Publique-Hopitaux de Marseille, Marseille, France
(Clarke, Zhao) Edwards Lifesciences, Irvine, CA, United States
(Cohen) St. Francis Hospital, Roslyn, New York, United States
(Leipsic, Webb) Centre for Heart Valve Innovation, St. Paul's Hospital,
Vancouver, BC, Canada
(Mack) Baylor Scott & White Health, Plano, TX, United States
Publisher
Elsevier Inc.
Abstract
Background: Short-term clinical outcomes after transcatheter aortic valve
replacement (TAVR) are similar in individuals with small or large annuli.
The longer term impact of prosthesis-patient mismatch (PPM) and mean
gradient (MG) post-TAVR in these patients remains controversial.
 Objective(s): The aim of this study was to investigate 5-year
outcomes in patients with small vs large annuli. Method(s): Patients
from the PARTNER (Placement of Aortic Transcatheter Valves) 2 SAPIEN 3
intermediate-risk registry and the PARTNER 3 low-risk randomized
controlled trial were grouped according to small (<=430 mm2) or
large (>430 mm2) annular size. The primary endpoint was a
composite of all-cause death, disabling stroke, or heart failure
hospitalization. In addition, the relationships between both PPM and
post-TAVR MG and clinical outcomes were analyzed. Result(s): In
total, 1,355 patients were included: 476 with small annuli (376.7 +/- 41.9
mm2) and 879 with large annuli (518.3 +/- 58.0 mm2).
Patients with small annuli were older (age 79.6 +/- 7.1 years vs 78.7 +/-
7.8 years; P = 0.047), were more often female (75.0% vs 16.2%; P <
0.0001), had higher baseline Society of Thoracic Surgeons scores (4.3% +/-
1.93% vs 4.0% +/- 1.93%; P < 0.0001), and had higher left ventricular
ejection fractions (66.3% +/- 15.82% vs 59.7% +/- 13.68%; P < 0.0001).
Primary endpoint rates were similar at 1 year (7.8% vs 8.0%; P = 0.94) and
5 years (36.3% vs 35.8%; P = 0.83). Bioprosthetic valve failure was
infrequent at 5 years in both groups (2.9% vs 2.1%; P = 0.46). Among
female patients, outcomes were similar for small vs large annuli (primary
endpoint; 33.6% vs 34.2%; P = 0.90). Among patients with small annuli,
there was no association between 5-year outcomes and any severity of PPM
(P = 0.22) or 30-day MG (P for nonlinearity = 0.96). Conclusion(s):
Five-year clinical outcomes were excellent and comparable between patients
with small vs large aortic annuli. Outcomes in patients with small annuli
were not affected by 30-day MG or PPM. Copyright © 2025 The
Authors

<34>
Accession Number
2033466886
Title
Intraoperative hypotension and postoperative risks in non-cardiac surgery:
a meta-analysis.
Source
BMC Anesthesiology. 25(1) (no pagination), 2025. Article Number: 103. Date
of Publication: 01 Dec 2025.
Author
Qin G.; Du M.-C.; Yi K.-X.; Gong Y.
Institution
(Qin, Du, Yi, Gong) Institute of Anesthesiology and Critical Care
Medicine, Three Gorges University & Yichang Central People's Hospital,
Hubei, Yichang, China
Publisher
BioMed Central Ltd
Abstract
Background: Postoperative complications are often associated with the
severity and duration of intraoperative hypotension. However, the optimal
approach for managing intraoperative hypotension remains controversial.
The aim of this meta-analysis of randomized controlled trials was to
compare the incidence of common postoperative complications with different
treatment threshold of hypotension. Method(s): We searched PubMed,
the Cochrane Database, and Embase from August 2014 to August 2024 for
studies comparing different treatment threshold of hypotension (low [mean
arterial pressure < 60 mmHg], moderate [60-75 mmHg], and high [> 75
mmHg]). Only randomized controlled trials conducted during 2014-2024 were
included in this meta-analysis without language restrictions. Studies with
the following characteristics were included: randomized controlled study;
involved non-cardiac, non-obstetric surgery; included different blood
pressure management strategies; evaluated major postoperative
complications; and included acute kidney injury, myocardial injury,
altered consciousness, or infection. Data included patient age, type of
surgery, group criteria, and adverse events. Mantel-Haenszel method was
used for analysis. The primary outcomes were postoperative complications,
including acute kidney injury. The secondary outcomes included length of
hospital stay and all-cause mortality. Result(s): Of the 2160 studies
identified, eight randomized controlled trials with 9108 participants were
included. No significant differences in postoperative complications were
observed between the moderate and high mean arterial pressure treatment
threshold groups (risk ratio = 1.0, 95% confidence interval = 0.86-1.18, P
= 0.96). Sensitivity analysis confirmed these findings. Length of
hospitalization was not significantly different between the groups
(standardized mean difference = -0.39; 95% confidence interval = -0.69 to
1.31; P = 0.03). Limited data prevented meta-analysis of mean arterial
pressure management at lower treatment thresholds. Conclusion(s): The
results of this meta-analysis suggest no significant differences in
postoperative complications between moderate and high mean arterial
pressure management. Copyright © The Author(s) 2025.

<35>
Accession Number
2033387983
Title
Effectiveness of perioperative remimazolam in preventing postoperative
delirium: a systematic review and meta-analysis.
Source
European Journal of Medical Research. 30(1) (no pagination), 2025. Article
Number: 122. Date of Publication: 01 Dec 2025.
Author
Wang M.; Liu J.; Liu W.; Zhang X.; Zhang G.; Sun L.; Bi Y.; Wang H.; Dong
R.
Institution
(Wang) School of Anesthesiology, Shandong Second Medical University, No. 5
Donghai Middle Road, Qingdao, China
(Wang, Liu, Liu, Zhang, Sun, Bi, Dong) Department of Anesthesiology,
Qingdao Hospital, University of Health and Rehabilitation Sciences
(Qingdao Municipal Hospital), Qingdao, China
(Zhang) Department of Anesthesiology, Dezhou Third People'S Hospital,
Dezhou, China
(Wang) Department of Pediatrics, Qingdao Women and Children'S Hospital,
Qingdao University, No. 217 Liaoyang West Road, Qingdao, China
(Dong) Key Laboratory of Anesthesiology and Resuscitation, Huazhong
University of Science and Technology), Ministry of Education, Wuhan, China
Publisher
BioMed Central Ltd
Abstract
Background: To compare the POD rates in patients undergoing non-cardiac
surgery who received remimazolam perioperatively versus placebo or other
sedatives. Method(s): We systematically searched four major databases
(Cochrane Central Register of Controlled Trials, Web of Science, Embase,
and PubMed) for relevant randomized controlled trials (RCTs) up to July
11, 2024. Literature quality evaluation was used the bias risk table in
Review Manager 5.4. The primary outcome of interest was POD, and secondary
outcomes were the hypotension risk, bradycardia and, nausea and vomiting.
 Result(s): Across 11 trials involving 1985 participants, we recorded
309 cases of POD during follow-up. In trials where the control group
received saline, remimazolam decrease the risk of POD significantly by 70%
(RR 0.30, 95% CI [0.19, 0.46]; p < 0.00001). Statistical analysis did not
show significant difference in the risk of POD between the remimazolam
group and the groups receiving either dexmedetomidine (RR 1.23 [0.64,
2.37]; p = 0.53) or propofol (RR 0.83 [0.60, 1.16]; p = 0.28). Regarding
adverse events, remimazolam significantly reduces the morbidity of
hypotension compared to dexmedetomidine (RR 0.25 [0.10, 0.65]; p = 0.004)
and propofol (RR 0.45 [0.33, 0.60]; p < 0.00001). In addition, there were
no significant differences in the incidence of bradycardia (RR 0.85; 95%
CI [0.34-2.12], p = 0.72) and nausea and vomiting (RR 1.06; 95% CI
[0.74-1.51], p = 0.77) between remimazolam and the control group.
 Conclusion(s): During the perioperative period, using remimazolam can
lower POD risk after surgery for patients who had non-cardiac surgery, but
remimazolam does not work better than dexmedetomidine or propofol.
Compared with the dexmedetomidine and propofol, remimazolam also has
apparent advantages in preventing intraoperative
hypotension. Copyright © The Author(s) 2025.

<36>
Accession Number
2032808132
Title
Anatomic vs. Ischemia-Driven Strategies for Percutaneous Coronary
Revascularization in Chronic Coronary Syndrome: A Network Meta-Analysis.
Source
Catheterization and Cardiovascular Interventions. 105(4) (pp 761-771),
2025. Date of Publication: 01 Mar 2025.
Author
Giacobbe F.; Valente E.; Giannino G.; Yip H.C.; De Filippo O.; Bruno F.;
Conrotto F.; Iannaccone M.; Zoccai G.B.; Gasparini M.; Escaned J.; De
Ferrari G.M.; D'Ascenzo F.
Institution
(Giacobbe, Valente, Giannino, De Filippo, Bruno, Conrotto, De Ferrari,
D'Ascenzo) Division of Cardiology, Department of Medical Science, AOU
Citta della Salute e della Scienza di Torino, Turin, Italy
(Yip, Gasparini) Dipartimento di Scienze Matematiche, Politecnico di,
Torino, Italy
(Iannaccone) Division of Cardiology, San Giovanni Bosco Hospital, ASL
Citta di Torino, Turin, Italy
(Zoccai) Department of Medical Surgical Sciences and Biotechnologies,
Sapienza University, Latina, Italy
(Zoccai) Division of Cardiology, Maria Cecilia Hospital, GVM Care &
Research, Cotignola, Italy
(Escaned) DIvision of Cardiology, Hospital Clinico San Carlos Instituto
Cardiovascular, Comunidad de Madrid, Madrid, Spain
Publisher
John Wiley and Sons Inc
Abstract
Introduction: In patients with chronic coronary syndromes (CCS), the
benefit of percutaneous coronary intervention (PCI) added to optimal
medical therapy (OMT) remains unclear. The indication to PCI may be driven
either by angiographic evaluation or ischemia assessment, thus depicting
different potential strategies which have not yet been thoroughly
compared. Method(s): Randomized controlled trials (RCTs) comparing
OMT versus PCI angio-guided or versus PCI non-invasive or invasive
ischemia guided were identified and compared via network meta-analysis.
Major adverse clinical events (MACE), as defined by each included trial,
were the primary endpoint, while cardiovascular (CV) death, myocardial
infarction (MI), and unplanned revascularization the secondary ones.
 Result(s): 18 studies, encompassing 17,512 patients, were included,
with a mean follow-up of 3.5 years. PCI guided by ischemia defined either
invasively or not was associated with a reduced risk of MACE compared with
OMT alone. Furthermore, PCI guided by non-invasive assessment of ischemia
was associated with a reduced risk of MI compared with OMT (hazard ratio
[HR]: 0.61 [95% confidence interval: 0.37-0.94). This strategy ranked best
also in preventing CV death. Notably, iFR and FFR guided approaches showed
the highest probability of performing best for reduction of subsequent
revascularizations. Conclusion(s): In patients with CCS,
ischemia-guided PCI, either by invasive or non-invasive assessment,
resulted in a reduced risk of MACE compared with OMT alone. The use of
invasive or non-invasive tests influenced the benefit of ischemia-driven
PCI: non-invasive tests significantly reduced risk of MI compared with
OMT, while iFR or FFR showed the highest probability of reducing the need
of subsequent revascularization. Copyright © 2025 Wiley
Periodicals LLC.

<37>
Accession Number
2032881548
Title
Rotational Atherectomy Followed by Modified (Cutting or Scoring) Balloon
Versus Plain Balloon Before Drug-Eluting Stent Implantation for Calcified
Coronary Lesions: A Meta-Analysis.
Source
Catheterization and Cardiovascular Interventions. 105(4) (pp 909-926),
2025. Date of Publication: 01 Mar 2025.
Author
Khalefa B.B.; Ayyad M.; Alqeeq B.F.; Albandak M.; Ayyad A.; Awad A.K.;
Gonnah A.R.; Roberts D.H.
Institution
(Khalefa, Awad) Faculty of Medicine, Ain Shams University, Cairo, Egypt
(Ayyad) Department of Internal Medicine, Rutgers New Jersey Medical
School, Newark, NJ, United States
(Alqeeq) Faculty of Medicine, Islamic University of Gaza, Gaza, Palestine
(Albandak) Department of Internal Medicine, University of Toledo, Toledo,
OH, United States
(Ayyad) Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
(Gonnah) Imperial College Healthcare NHS Trust, London, United Kingdom
(Roberts) Lancashire Cardiac Centre, Blackpool, United Kingdom
(Roberts) Honorary, University of Liverpool, Liverpool, United Kingdom
Publisher
John Wiley and Sons Inc
Abstract
Coronary calcification is a major factor leading to stent under-expansion,
and subsequent adverse events. This meta-analysis aimed to evaluate the
short and long-term outcomes of rotational atherectomy (RA), followed by
modified balloon (cutting or scoring) (MB) versus plain balloon before
drug-eluting stent implantation for calcified coronary lesions. We
searched PubMed, Web of Science (WOS), Scopus, and the Cochrane Library
Central Register of Controlled Trials (CENTRAL), from inception until 30
January 2024. The risk ratio (RR) with a 95% confidence interval (CI) was
used to compare dichotomous outcomes, while continuous outcomes were
reported in form of mean difference (MD). Our study included seven studies
with 309 patients undergoing RA followed by MB angioplasty, and 414
patients had RA followed by conventional plain balloon angioplasty, before
stent implantation. Our analysis revealed no significant difference
in-hospital mortality (RR = 0.64, 95% CI [0.18, 2.23], p = 0.49), or
long-term mortality (RR = 0.65, 95% CI [0.18, 2.36], p = 0.51). MACE were
significantly lower in the cutting balloon group (RR = 0.58, 95% CI [0.37,
0.92], p = 0.02). Angiographic minimum lumen diameter, and change in
percent diameter stenosis were significantly higher in the MB group (MD =
0.19, 95% CI [0.08, 0.31], p = < 0.01), and (MD = 3.75, 95% CI [0.76,
6.74], p = 0.01) respectively. No difference was found regarding target
lesion revascularization (RR: 0.50, 95% CI [0.24, 1.04], p = 0.06), or
target vessel revascularization (RR: 0.71, 95% CI [0.38, 1.33], p = 0.28).
RA followed by MB is as safe plain balloon angioplasty before stent
implantation in moderate to severely calcified coronary lesions. Moreover,
it is associated with significantly better immediate angiographic
outcomes, and significantly lower MACE. Copyright © 2025 Wiley
Periodicals LLC.

<38>
Accession Number
2033165076
Title
Bempedoic Acid: A Review in Cardiovascular Risk Reduction in
Statin-Intolerant Patients.
Source
American Journal of Cardiovascular Drugs. 25(1) (pp 7-16), 2025. Article
Number: e069116. Date of Publication: 01 Jan 2025.
Author
McGuigan A.; Blair H.A.
Institution
(McGuigan, Blair) Springer Nature, Private Bag 65901, Mairangi Bay,
Auckland, New Zealand
Publisher
Adis
Abstract
Oral bempedoic acid (NEXLETOL in the USA; Nilemdo in
the EU) and the fixed dose combination (FDC) of bempedoic acid/ezetimibe
(NEXLIZET in the USA; Nustendi in the EU) are
approved to reduce cardiovascular (CV) risk in statin-intolerant patients
who are at high risk for, or have, CV disease. A first-in-class therapy,
bempedoic acid inhibits the adenosine triphosphate-citrate lyase enzyme in
the cholesterol biosynthesis pathway. In the multinational phase III CLEAR
Outcomes trial in statin-intolerant patients, once-daily bempedoic acid
180 mg significantly reduced the risk of the primary endpoint (a
four-component major adverse CV event composite of CV death, nonfatal
myocardial infarction, nonfatal stroke, or coronary revascularization)
compared with placebo. Bempedoic acid was generally well tolerated and,
unlike statins, was associated with a low incidence of musculoskeletal
adverse events (AEs). In conclusion, bempedoic acid as a monotherapy or
adjunctive to other lipid-lowering therapies expands the treatment options
available for the pharmacological reduction of CV risk in
statin-intolerant patients, supporting achievement of low-density
lipoprotein cholesterol (LDL-C) targets required for CV risk
reduction. Copyright © Springer Nature Switzerland AG 2025.

<39>
Accession Number
2033416636
Title
Comparing cross-over stenting and focal ostial stenting for ostial left
anterior descending coronary artery lesions: a systematic review and
meta-analysis.
Source
BMC Cardiovascular Disorders. 25(1) (no pagination), 2025. Article Number:
131. Date of Publication: 01 Dec 2025.
Author
Khairy A.M.; Hafez A.H.; Elshahat A.; Emara A.; Aboueisha H.; Fahmy M.I.;
Abdelaziz A.; Yasseen I.
Institution
(Khairy, Hafez, Yasseen) Cardiology Department, Faculty of Medicine,
Al-Azhar University, Cairo, Egypt
(Khairy, Hafez, Elshahat, Emara, Aboueisha, Fahmy, Abdelaziz) Medical
Research Group of Egypt (MRGE), Cairo, Egypt
(Elshahat, Emara, Abdelaziz) Faculty of Medicine, Al-Azhar University,
Cairo, Egypt
(Aboueisha) Faculty of Medicine, Suez Canal University, Ismailia, Egypt
(Fahmy) Faculty of Medicine, Mansoura University, Mansoura, Egypt
Publisher
BioMed Central Ltd
Abstract
Background: The ideal revascularization approach for ostial left anterior
descending coronary artery (L.A.D.) lesions continues to be a matter of
debate. Two primary stenting strategies are often contemplated for
managing these lesions: focal ostial stenting (F.O.S.) and the provisional
strategy, alternatively termed cross-over stenting (C.O.S.) from the LM to
the L.A.D. artery. Aim(s): Our objective is to assess the efficacy of
C.O.S. vs. F.O.S. techniques in patients with ostial L.A.D. lesions who
underwent percutaneous coronary intervention (P.C.I.). Method(s): We
systematically searched five electronic databases to identify relevant
studies. The data was pooled as odds ratio (O.R.) with its 95% confidence
interval (C.I.) using the DerSimonian-Laird random effect model in STATA
17 MP. Significance was determined by a p-value > 0.05 between
intervention subgroups. Result(s): Nine articles with a total of 1492
patients were included in the meta-analysis. The pooled O.R. for Major
Adverse Cardiovascular Events (MACE) was 0.88 (95% C.I. [0.39, 1.99], P =
0.76), indicating comparable rates between F.O.S. and C.O.S. For all-cause
death, the O.R. was 1.46 (95% C.I. [0.53, 4.02], P = 0.46), with no
significant differences between the compared techniques. Cardiovascular
death showed no preference between treatments (O.R.=0.99, 95% C.I. [0.30,
3.31], P = 0.99), and similarly for myocardial infarction (O.R.=0.74, 95%
C.I. [0.38, 1.44], P = 0.37). Conclusion(s): Our meta-analysis
comparing C.O.S. and F.O.S. for L.A.D. lesions revealed similar efficacy
in clinical and angiographic outcomes. Copyright © The Author(s)
2024.

<40>
Accession Number
2033448017
Title
Pericardial Fluid Biomarkers as Early Predictors for Postoperative Atrial
Fibrillation-A Systematic Review.
Source
Diagnostics. 15(4) (no pagination), 2025. Article Number: 408. Date of
Publication: 01 Feb 2025.
Author
Mitu F.; Adam C.A.; Richter P.; Costache A.-D.; Gavril R.S.; Cojocaru C.;
Tarus A.; Enache M.; Cumpat C.M.; Leon M.M.; Tinica G.
Institution
(Mitu, Adam, Richter, Costache, Gavril, Cojocaru, Tarus, Enache, Cumpat,
Leon, Tinica) Department of Medical and Surgical Specialties I, II and
III, "Grigore T. Popa" University of Medicine and Pharmacy, University
Street No. 16, Iasi, Romania
(Mitu, Adam, Costache, Gavril, Cojocaru, Cumpat, Leon) Cardiovascular
Rehabilitation Clinic, Clinical Rehabilitation Hospital, Pantelimon Halipa
Street No. 14, Iasi, Romania
(Mitu, Tinica) Academy of Medical Sciences, Bucharest, Romania
(Mitu, Tinica) Academy of Romanian Scientists, Iasi, Romania
(Richter) Rheumatology Clinic, Clinical Rehabilitation Hospital,
Pantelimon Halipa Street No. 14, Iasi, Romania
(Tarus, Enache, Tinica) Cardiovascular Surgery Clinic, Prof. Dr. George I.
M. Georgescu" Cardiovascular Diseases Institute, Iasi, Romania
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
(1) Background: Postoperative atrial fibrillation (POAF) is one of the
most common complications of cardiac surgery, frequently occurring in the
first 2-4 days after surgery. With a variable incidence depending on the
type of surgery, research in recent years has focused on identifying
predisposing factors with the aim of correcting them and thus decreasing
the risk of cardiovascular and total morbidity and mortality. The analysis
of pericardial fluid allowed the identification of biomarkers
(interleukin-6, mitochondrial DNA, myeloperoxidase or natriuretic
peptides) whose presence postoperatively was associated with increased
risk of POAF. (2) Material(s) and Method(s): We conducted a search on
EMBASE and PubMed and identified 75 articles, of which 10 entered the
final analysis. (3) Results: Patients who develop POAF accumulate large
amounts of interleukin 6, mitochondrial DNA, myeloperoxidase, or secondary
atrial natriuretic peptide as a consequence of the associated inflammatory
status, atrial remodeling, or disturbance of homeostasis of various ions.
There are also observations that their levels in the pericardium correlate
with blood levels, but further studies on larger cohorts of patients are
needed to provide new evidence in this regard. (4) Conclusion(s):
Early recognition of patients at risk of developing POAF based on
easy-to-dose and easy-to-use biochemical biomarkers, whose association
with POAF has been demonstrated so far in small cohorts of patients, has
both therapeutic and prognostic implications, which justifies further
research on large cohorts of patients. Copyright © 2025 by the
authors.

<41>
Accession Number
646547800
Title
Non-vitamin K antagonist oral anticoagulants (NOACs) after transcatheter
aortic valve replacement (TAVR): a network meta-analysis.
Source
Cochrane Database of Systematic Reviews. 2025(2) (no pagination), 2025.
Article Number: CD013745. Date of Publication: 24 Feb 2025.
Author
Al Said S.; Kaier K.; Nury E.; Alsaid D.; Gibson C.M.; Bax J.; Westermann
D.; Meerpohl J.J.
Institution
(Al Said, Westermann) Department of Cardiology and Angiology, University
Heart Center Freiburg Bad Krozingen, Medical Center - University of
Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
(Kaier) Institute for Medical Biometry and Statistics, Faculty of Medicine
and Medical Center, University of Freiburg, Freiburg, Germany
(Nury, Alsaid, Meerpohl) Institute for Evidence in Medicine, Medical
Center - University of Freiburg, Faculty of Medicine, University of
Freiburg, Freiburg, Germany
(Nury) Department of General Practice and Primary Care, University Medical
Center Hamburg-Eppendorf, Hamburg, Germany
(Gibson) Cardiology Division, Beth Israel Deaconess Medical Center,
Harvard Medical School, Boston, MA, United States
(Bax) Department of Cardiology, Leiden University Medical Center, Leiden,
Netherlands
(Meerpohl) Cochrane Germany, Cochrane Germany Foundation, Freiburg,
Germany
Publisher
John Wiley and Sons Ltd
Abstract
Background: Balancing the risk of thromboembolism and bleeding after
transcatheter aortic valve replacement (TAVR) remains clinically
challenging. Questions regarding the efficacy and safety of non-vitamin K
oral anticoagulants (NOACs) after TAVR still need to be definitively
answered. Objective(s): To evaluate the efficacy and safety of NOACs
after TAVR in individuals with and without indication for anticoagulation.
 Search Method(s): We searched CENTRAL, MEDLINE, Embase, Web of
Science, ClinicalTrials.gov, and WHO ICTRP on 7 October 2023 together with
reference checking and citation searching to identify additional studies.
 Selection Criteria: We searched for randomised controlled trials
(RCTs) that compared NOACs versus antiplatelet therapy or vitamin K
antagonists (VKAs) after TAVR in adults with or without an indication for
anticoagulation. Data Collection and Analysis: We used standard
Cochrane methods and conducted random-effects pair-wise analyses and
network meta-analyses (NMAs). Our primary outcomes were all-cause
mortality, cardiovascular mortality, stroke, and major bleeding. We used
GRADE to assess the certainty of evidence. Main Result(s): We
included four RCTs with 4808 participants in the NMA. Of these, one
compared rivaroxaban versus antiplatelet therapy in people without an
indication for anticoagulation after TAVR; one compared apixaban versus
antiplatelet therapy in people without an indication for anticoagulation
or versus VKA in people with an indication for anticoagulation after TAVR;
one compared edoxaban versus VKA in people with an indication for
anticoagulation after TAVR; and one compared edoxaban with antiplatelet
therapy in people without an indication for anticoagulation after TAVR.
The mean age of trial participants was 81 years. Follow-up duration ranged
from 6 to 18 months. Overall, we judged the risk of bias in the included
trials to be low in all domains except for blinding, which was assessed as
high in all four studies. No studies evaluated dabigatran. In people
without an indication for anticoagulation, rivaroxaban and apixaban may
increase all-cause mortality after TAVR as compared to antiplatelet
therapy (rivaroxaban: risk ratio (RR) 1.67, 95% confidence interval (CI)
1.13 to 2.46; studies = 1, participants = 1644; moderate-certainty
evidence; apixaban: RR 1.71, 95% CI 0.97 to 3.02; studies = 1,
participants = 1049; low-certainty evidence), while edoxaban may result in
little or no difference (RR 1.59, 95% CI 0.27 to 9.36; studies = 1,
participants = 229; low-certainty evidence). Low-certainty evidence
suggests little or no difference between rivaroxaban, apixaban, or
edoxaban and antiplatelet therapy in cardiovascular mortality
(rivaroxaban: RR 1.28, 95% CI 0.78 to 2.10; studies = 1, participants =
1644; apixaban: RR 1.30, 95% CI 0.64 to 2.65; studies = 1, participants =
1049; edoxaban: RR 7.44, 95% CI 0.39 to 142.38; studies = 1, participants
= 229) and between rivaroxaban or edoxaban and antiplatelets in stroke
(rivaroxaban: RR 1.19, 95% CI 0.71 to 2.00; studies = 1, participants =
1644; edoxaban: RR 1.06, 95% CI 0.15 to 7.42; studies = 1, participants =
229). While rivaroxaban versus antiplatelets probably increases major
bleeding after TAVR (RR 1.98, 95% CI 1.07 to 3.65; studies = 1,
participants = 1644; moderate-certainty evidence), there may be little or
no difference between apixaban and antiplatelet therapy (RR 1.07, 95% CI
0.70 to 1.64; studies = 1, participants = 1049; low-certainty evidence).
It is unclear if edoxaban has an effect on major bleeding, although the
point estimate suggests increased bleeding (versus antiplatelets: RR 2.13,
95% CI 0.54 to 8.30; studies = 1, participants = 229; low-certainty
evidence). In people with an indication for anticoagulation, low-certainty
evidence suggests apixaban or edoxaban may result in little to no
difference in our predefined primary efficacy outcomes after TAVR when
compared to VKA (all-cause mortality: apixaban: RR 1.02, 95% CI 0.59 to
1.77; studies = 1, participants = 451; edoxaban: RR 0.91, 95% CI 0.69 to
1.20; studies = 1, participants = 1426; cardiovascular mortality:
apixaban: RR 1.43, 95% CI 0.76 to 2.70; studies = 1, participants = 451;
edoxaban: RR 1.07, 95% CI 0.72 to 1.57; studies = 1, participants = 1426;
stroke: apixaban: RR 1.28, 95% CI 0.35 to 4.70; studies = 1, participants
= 451; edoxaban: RR 0.83, 95% CI 0.51 to 1.34; studies = 1, participants =
1426). While apixaban may result in a similar rate of bleeding as VKA in
this population, edoxaban probably increases major bleeding after TAVR in
people with an indication for anticoagulation (apixaban: RR 0.90, 95% CI
0.53 to 1.54; studies = 1, participants = 451; low-certainty evidence;
edoxaban: RR 1.44, 95% CI 1.08 to 1.93; studies = 1, participants = 1426;
moderate-certainty evidence). Authors' conclusions: In people without an
indication for oral anticoagulation, rivaroxaban and apixaban may increase
all-cause mortality when compared to antiplatelet therapy, while edoxaban
may result in little or no difference. There might be little or no
difference between rivaroxaban, apixaban, or edoxaban and antiplatelet
therapy in cardiovascular mortality, and between rivaroxaban or edoxaban
and antiplatelets in stroke. While rivaroxaban probably increases major
bleeding following TAVR, there might be little or no difference between
apixaban and antiplatelet therapy, and the effect of edoxaban on major
bleeding remains unclear. In people with an indication for
anticoagulation, apixaban and edoxaban may be as effective as VKA in
preventing all-cause mortality, cardiovascular death, and stroke. Apixaban
may lead to a similar rate of major bleeding as VKA in this population.
However, edoxaban probably increases major bleeding following TAVR when
compared to VKA. Our NMA did not show superiority of one NOAC over another
for any of the primary outcomes. Head-to-head trials directly comparing
NOACs against each other are required to increase the certainty of the
evidence. Copyright © 2025 The Cochrane Collaboration. Published
by John Wiley & Sons, Ltd.

<42>
Accession Number
2032812009
Title
Transcatheter Aortic Valve Replacement in Hypertrophic Cardiomyopathy: A
Systematic Review and Meta-Analysis.
Source
Catheterization and Cardiovascular Interventions. 105(4) (pp 754-760),
2025. Date of Publication: 01 Mar 2025.
Author
Ahmed A.; Kaddoura R.; Aggarwal A.; Zinyandu T.; Webber F.; Davila C.;
Zarich S.
Institution
(Ahmed, Aggarwal, Zinyandu, Webber) Department of Internal Medicine,
Bridgeport Hospital, Yale New Haven Health, Bridgeport, CT, United States
(Kaddoura) Department of Pharmacy, Heart Hospital, Hamad Medical
Corporation, Doha, Qatar
(Davila, Zarich) Division of Cardiovascular Diseases, Bridgeport Hospital,
Yale New Haven Health, Bridgeport, CT, United States
Publisher
John Wiley and Sons Inc
Abstract
Background: The co-existence of severe aortic stenosis (AS) and
hypertrophic cardiomyopathy (HCM) is not uncommon. Surgical intervention
is the gold standard management. Patients with high surgical risk might
undergo transcatheter aortic valve replacement (TAVR). However, TAVR
outcomes are unclear in this population. We aimed to investigate the
impact of HCM on the outcomes of TAVR. Aim(s): We aim to investigate
the outcomes of TAVR in patients with HCM. Method(s): We
systematically searched PubMed, EMBASE, and Scopus for studies that
compared outcomes of TAVR procedure between patients with HCM and those
without it. Using the random-effects model, the odds ratios (OR) with 95%
confidence interval (CI) were reported. Result(s): We screened 102
articles and identified three observational cohort studies. Compared to
patients who underwent TAVR without underlying HCM, TAVR for AS co-existed
with HCM was associated with higher rates of mortality (OR 5.79; 95% CI:
3.38; 9.91, p < 0.0001), cardiogenic shock (OR 4.55; 95% CI: 3.40; 6.08, p
< 0.0001), aortic dissection (OR 4.95; 95% CI: 3.17; 7.74, p < 0.0001),
vascular complications (OR 2.10; 95% CI: 1.27; 3.47, p = 0.004), and renal
impairment (OR 1.80; 95% CI: 1.36; 2.40, p < 0.0001). There was no
difference between the comparison groups in terms of complete heart block,
new permanent pacemaker implantation, or bleeding. Conclusion(s): In
patients with severe AS and HCM, TAVR was associated with significantly
higher occurrence of mortality, cardiogenic shock, aortic dissection,
vascular complications, and renal impairment as well as the need for
mechanical ventilation than patients who did not have HCM. Copyright
© 2025 Wiley Periodicals LLC.

<43>
Accession Number
2033334296
Title
Heart disease in pregnancy and adverse outcomes: an umbrella review.
Source
Frontiers in Medicine. 12 (no pagination), 2025. Article Number: 1489991.
Date of Publication: 2025.
Author
Zhang J.; Ren Y.; Li B.; Cao Q.; Wang X.; Yu H.
Institution
(Zhang, Ren, Wang, Yu) Department of Obstetrics and Gynecology, West China
Second University Hospital, Sichuan University, Sichuan, Chengdu, China
(Zhang, Ren, Cao, Wang, Yu) Key Laboratory of Birth Defects and Related
Diseases of Women and Children (Sichuan University), Ministry of
Education, Sichuan, Chengdu, China
(Li) Clinical Trial Center, National Medical, Products Administration Key
Laboratory for Clinical Research and Evaluation of Innovative Drugs, West
China Hospital, Sichuan University, Sichuan, Chengdu, China
(Cao) Department of Reproductive Medical Center, West China Second
University Hospital, Sichuan University, Sichuan, Chengdu, China
Publisher
Frontiers Media SA
Abstract
Background: Heart disease in pregnancy encompasses both congenital heart
disease and maternal-acquired heart disease, both of which are associated
with an increased risk of various adverse outcomes for mothers and their
offspring. Objective(s): The objective of the study was to review and
summarize the evidence regarding the association between heart disease in
pregnancy and adverse outcomes in mothers and their offspring. Data
sources: A comprehensive search was conducted in Embase, PubMed, Web of
Science, and the Cochrane Database of Systematic Reviews from inception to
March 2024. The protocol for this review was registered in PROSPERO
(CRD42024519144). Study eligibility criteria: This review included
systematic reviews and meta-analyses that examined the association between
heart disease in pregnancy and adverse outcomes for mothers and their
offspring. Study appraisal and synthesis methods: Data were independently
extracted by two reviewers. The quality of the systematic reviews and
meta-analyses was assessed using the A Measurement Tool to Assess
Systematic Reviews 2 (AMSTAR2), while Grading of Recommendations,
Assessment, Development, and Evaluation (GRADE) was used to evaluate the
strength of the evidence for each outcome. Result(s): A total of 12
meta-analyses and systematic reviews were included, which documented 156
adverse outcomes for mothers and 65 adverse outcomes for offspring.
Evidence was found for both primary and secondary adverse outcomes.
Adverse outcomes for mothers were death, cardiac events (cardiac arrest,
heart failure, surgery, arrhythmia, anesthesia or sedation, endocarditis,
mitral regurgitation, myocardial infarction, NYHA III-IV, restenosis,
syncope, and others), pulmonary events (respiratory failure, pulmonary
edema, and respiratory support), embolism, cerebrovascular events,
postpartum hemorrhage, arterial events, delivery mode, and hospital stay.
Adverse outcomes for offspring were death, pregnancy loss, growth
restriction, low birth weight, preterm birth, recurrence, and uncertainty.
No publication bias was detected using Egger's test. The overall AMSTAR 2
confidence rating for the included meta-analyses and systematic reviews
was moderate. The majority (55.3%) of the evidence evaluated by GRADE was
of low quality, while the remaining outcomes were categorized as having
"very low"-quality evidence. Conclusion(s): Current evidence links
heart disease during pregnancy to adverse maternal outcomes, including
death and cardiac, pulmonary, and cerebrovascular events, as well as
increased mortality risk for offspring. Many meta-analyses in this field
have limitations that raise concerns about their validity, highlighting
the need for high-quality prospective studies. Copyright © 2025
Zhang, Ren, Li, Cao, Wang and Yu.

<44>
Accession Number
2033226800
Title
Risk of major adverse cardiovascular events in CYP2C19 LoF genotype guided
clopidogrel against alternative antiplatelets for CAD patients undergoing
PCI: Meta-analysis.
Source
Clinical and Translational Science. 18(2) (no pagination), 2025. Article
Number: e70080. Date of Publication: 01 Feb 2025.
Author
Biswas M.; Murad M.A.; Ershadian M.; Kali M.S.K.; Sukasem C.
Institution
(Biswas, Murad) Department of Pharmacy, University of Rajshahi, Rajshahi,
Bangladesh
(Biswas, Ershadian, Sukasem) Division of Pharmacogenomics and Personalized
Medicine, Department of Pathology, Faculty of Medicine Ramathibodi
Hospital, Mahidol University, Bangkok, Thailand
(Biswas, Ershadian, Sukasem) Laboratory for Pharmacogenomics, Ramathibodi
Hospital, Somdech Phra Debaratana Medical Center SDMC, Bangkok, Thailand
(Kali) Department of Pharmacy, Daffodil International University, Dhaka,
Bangladesh
(Sukasem) The Preventive Genomics & Family Check-Up Services Center,
Bumrungrad International Hospital, Pharmacogenomics and Precision Medicine
Clinic, Bangkok, Thailand
(Sukasem) MRC Centre for Drug Safety Science, Department of Pharmacology
and Therapeutics, Institute of Systems, Molecular and Integrative Biology,
University of Liverpool, Liverpool, United Kingdom
Publisher
John Wiley and Sons Inc
Abstract
Selection of rational antagonists of P2Y<inf>12</inf> receptor for CAD
patients who inherit CYP2C19 LoF alleles remains still conflicting. This
study compared the clinical outcomes in CAD patients inheriting CYP2C19
LoF alleles undergoing PCI and treated with clopidogrel against
alternative antagonists of P2Y<inf>12</inf> receptor. A thorough
literature search was performed across multiple scientific databases
following the PRISMA guidelines and PICO model. Setting the statistical
significance at p < 0.05 and RevMan software was used to calculate the
risk ratios (RRs). Estimation of the pooled analysis revealed a
significant 62% increased risk of major adverse cardiovascular events
(MACE) in CAD patients inheriting CYP2C19 LoF alleles and treated with
clopidogrel against those treated with alternative P2Y<inf>12</inf>
receptor antagonists such as prasugrel or ticagrelor (RR 1.62; 95% CI
1.42-1.86; p < 0.00001). In addition, Asian CAD patients were found at a
significantly higher risk of MACE (RR 1.93; 95% CI: 1.49-2.49; p <
0.00001) juxtaposed to CAD patients of other ethnicities (RR 1.51; 95% CI:
1.29-1.78; p < 0.00001). Conversely, between these two treatment groups,
taking clopidogrel against prasugrel/ticagrelor, who possess CYP2C19 LoF
alleles, no significant differences in bleeding events were observed (RR
0.94; 95% CI 0.79-1.11; p = 0.47). CAD patients undergoing PCI who
inherited CYP2C19 LoF alleles and treated with clopidogrel were associated
with significantly higher risk of MACE against those treated with
alternative antagonists of P2Y<inf>12</inf> receptor, that is, prasugrel
or ticagrelor. Copyright © 2025 The Author(s). Clinical and
Translational Science published by Wiley Periodicals LLC on behalf of
American Society for Clinical Pharmacology and Therapeutics.

<45>
Accession Number
2033391418
Title
Urgent Focus on the Surgical Risks of People Living With HIV: A Systematic
Review and Meta-Analysis.
Source
Journal of Medical Virology. 97(2) (no pagination), 2025. Article Number:
e70260. Date of Publication: 01 Feb 2025.
Author
Li K.; Luo L.; Ji Y.; Zhang Q.
Institution
(Li, Ji, Zhang) Department of Orthopedics, Beijing Ditan Hospital,
National Medical Center for Infectious Diseases, Capital Medical
University, Beijing, China
(Luo) Department of Psychiatry, Peking University Sixth Hospital, National
Medical Center for Psychiatry, Peking University, Beijing, China
Publisher
John Wiley and Sons Inc
Abstract
With the widespread promotion and application of antiretroviral therapy in
clinical practice, people living with HIV (PLWH) have the potential to
live as long as non-HIV people and the probability of surgery for PLWH has
been increasing dramatically. However, the overall postoperative outcome
and risk are still unclear. We performed comprehensive and methodical
searches in PubMed, Embase, and Web of Science without date and language
restrictions. Study outcomes included: (1) cure rate, (2) mortality, (3)
reoperation rate, (4) incidence of any postoperative complications, (5)
length of stay, and (6) operation duration. NOS scores were employed to
evaluate bias risk, while publication bias was assessed using funnel plots
and Egger tests. Review Manager version 5.4.1, R version 4.4.1, and Stata
version 14.0 were employed to determine quantitative analysis, considering
a significance level of p < 0.05. A total of 50 studies were included,
involving 54 565 PLWH undergoing surgical treatment. Synthesis analysis
showed that the mortality (OR = 1.70, 95% CI: 1.58-1.83, p < 0.00001),
reoperation rate (OR = 1.78, 95% CI: 1.36-2.34, p < 0.00001), complication
rate (OR = 1.56, 95% CI: 1.26-1.95, p < 0.00001), LOS (OR = 1.63, 95% CI:
1.28-1.99, p < 0.00001), and operation time (OR = 7.37, 95% CI:
1.14-13.59, p = 0.02) were increased in PLWH. However, there was no
significant difference in the cure rate compared to the control group (OR
= 1.27, 95% CI: 0.90-1.79, p = 0.18). Subgroup analysis showed that
complication rates increased again in orthopedic (OR = 1.65, 95% CI:
1.34-2.05, p < 0.00001) and general surgery (OR = 1.72, 95% CI: 1.08-2.74,
p = 0.02). However, the type of procedure, publication quality, study
type, and patient origin were not sources of complication rate
heterogeneity. Meta-regression showed that CD4 count had no effect on
complication rate, but the anti-retroviral therapy rate had 34.89%
explanatory power. There is an increased risk of postoperative death,
reoperation, complications, and prolonged hospital stay and surgical
duration in PLWH. However, conducting extensive prospective studies across
multiple centers is crucial to validate these findings. Copyright
© 2025 Wiley Periodicals LLC.

<46>
Accession Number
2033457217
Title
Different extubation protocols for adult cardiac surgery: a systematic
review and pairwise and network meta-analysis.
Source
BMC Anesthesiology. 25(1) (no pagination), 2025. Article Number: 104. Date
of Publication: 01 Dec 2025.
Author
Luo R.Y.; Fan Y.Y.; Wang M.T.; Yuan C.Y.; Sun Y.Y.; Huang T.C.; Jing J.Y.
Institution
(Luo, Fan, Wang, Yuan, Sun, Jing) Zhejiang Provincial People'S Hospital,
People'S Hospital of Hangzhou Medical College, No. 158 Shangtang Rd,
Zhejiang, Hangzhou, China
(Luo, Fan) School of Nursing, Zhejiang Chinese Medical University,
Zhejiang, China
(Huang) Intensive Care Unit, the Second Affiliated Hospital, School of
Medicine, Zhejiang University, Zhejiang Province, Hangzhou, China
Publisher
BioMed Central Ltd
Abstract
Background: With the advancement of ultra-fast track anesthesia, early
extubation following cardiac surgery has become a prevailing trend. While
there are significant benefits associated with early extubation, its high
failure rate warrants further investigation, and the effectiveness of
various extubation strategies in cardiac surgery still requires
validation. Method(s): An extensive literature search was performed
in the PubMed, Scopus, Embase, and Web of Science databases, encompassing
studies without language restrictions. Eligible studies were those that
compared the outcomes of various extubation strategies. Result(s):
Primary outcome was the success rate of the extubation protocol. Secondary
outcomes were time to extubation, intensive care unit (ICU) length of stay
(LOS), complications and mortality rate. Data from 12 studies, which
included a total of 1454 participants, were included in the analysis. The
pairwise meta-analysis revealed that late extubation was significantly
more effective than immediate extubation strategies (relative risk [RR] =
1.52, 95% confidence interval [CI] = 1.21-1.91, P = 0.0001). In the
network meta-analysis (NMA), the late extubation protocol was associated
with a significantly lower risk of extubation failure compared to early
extubation and extubation on the table (RR = 0.76, 95% CI: 0.5-1.16; RR =
0.22, 95% CI: 0.05-0.91). Furthermore, according to the SUCRA plot, late
extubation was ranked as the most effective strategy for reducing
extubation failure (94%). Conclusion(s): Our findings indicate that a
late extubation strategy, as opposed to early (within a specified time
frame) or immediate extubation, is correlate with a substantially higher
rate of successful extubation. Despite this, the early extubation strategy
seems to offer better cost-effectiveness and safety profiles. The
selection of an appropriate extubation strategy should be personalized,
taking into account the patient's preoperative characteristics and the
circumstances encountered during surgery. Trial registration: The study
protocol adheres to the PRISMA statement and checklist. The protocol was
registered at PROSPERO (CRD42024529051). Copyright © The
Author(s) 2025.

<47>
Accession Number
2037117486
Title
Reporting of nutritional screening, status, and intake in trials of
nutritional and physical rehabilitation following critical illness: a
systematic review.
Source
American Journal of Clinical Nutrition. 121(3) (pp 703-723), 2025. Date of
Publication: 01 Mar 2025.
Author
Rabheru R.; Langan A.; Merriweather J.; Connolly B.; Whelan K.; Bear D.E.
Institution
(Rabheru, Bear) Department of Nutrition and Dietetics, Guy's and St
Thomas' NHS Foundation Trust, London, United Kingdom
(Rabheru, Whelan, Bear) Department of Nutritional Sciences, King's College
London, London, United Kingdom
(Langan) Department of Nutrition and Dietetics, Barts Health NHS Trust,
London, United Kingdom
(Merriweather) Critical Care, Royal Infirmary of Edinburgh, Edinburgh,
United Kingdom
(Merriweather) Department of Nutrition and Dietetics, Royal Infirmary of
Edinburgh, Edinburgh, United Kingdom
(Connolly) Wellcome-Wolfson Institute for Experimental Medicine, School of
Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast,
Belfast, United Kingdom
(Connolly) Department of Physiotherapy, The University of Melbourne,
Australia
(Bear) Department of Critical Care, Guy's and St Thomas' NHS Foundation
Trust, London, United Kingdom
Publisher
Elsevier B.V.
Abstract
Background: Surviving critical illness leads to prolonged physical and
functional recovery with both nutritional and physical rehabilitation
interventions for prevention and treatment being investigated. Nutritional
status and adequacy may influence outcome, but no consensus on which
nutritional-related variables should be measured and reported in clinical
trials exists. Objective(s): This study aimed to undertake a
systematic review investigating the reporting of nutritional screening,
nutritional status, and nutritional intake/delivery in randomized
controlled trials (RCTs) evaluating nutritional and/or physical
rehabilitation on physical and functional recovery during and following
critical illness. Method(s): Five electronic databases (MEDLINE, Web
of Science, EMBASE, CINAHL, and Cochrane) were searched (last update 9
August, 2023). Search terms included both free text and standardized
indexed terms. Studies included were RCTs assessing nutritional and/or
physical interventions either during or following intensive care unit
(ICU) admission in adults (18 y or older) with critical illness, and who
required invasive mechanical ventilation for any duration during ICU
admission. Study quality was assessed using the Cochrane Collaboration
Risk of Bias tool for RCTs and descriptive data synthesis was performed
and presented as counts (%). n t Results: In total, 123 RCTs (30
nutritional, 87 physical function, and 6 combined) were included. Further,
>=1 nutritional variable was measured and/or reported in 99 (80%) of the
studies including BMI (n = 69), body weight (n = 57), nutritional status
(n = 11), nutritional risk (n = 10), energy delivery (n = 41), protein
delivery (n = 35), handgrip strength (n = 40), and other
nutritional-related muscle variables (n = 41). Only 3 studies were
considered to have low risk of bias in all categories. Conclusion(s):
Few RCTs of physical rehabilitation measure and report nutritional or
related variables. Future studies should measure and report specific
nutritional factors that could impact physical and functional recovery to
support interpretation where studies do not show benefit. This protocol
was preregistered at PROSPERO as CRD42022315122. Copyright © 2025
The Authors

<48>
[Use Link to view the full text]
Accession Number
2035905643
Title
Effect of a Machine Learning-Derived Early Warning Tool with Treatment
Protocol on Hypotension during Cardiac Surgery and ICU Stay: The
Hypotension Prediction 2 (HYPE-2) Randomized Clinical Trial.
Source
Critical Care Medicine. 53(2) (pp e328-e340), 2025. Date of Publication:
01 Feb 2025.
Author
Schuurmans J.; Rellum S.R.; Schenk J.; Van Der Ster B.J.P.; Van Der Ven
W.H.; Geerts B.F.; Hollmann M.W.; Cherpanath T.G.V.; Lagrand W.K.;
Wynandts P.R.; Paulus F.; Driessen A.H.G.; Terwindt L.E.; Eberl S.;
Hermanns H.; Veelo D.P.; Vlaar A.P.J.
Institution
(Schuurmans, Rellum, Schenk, Van Der Ster, Van Der Ven, Hollmann,
Wynandts, Terwindt, Eberl, Hermanns, Veelo) Department of Anesthesiology,
Amsterdam UMC, University of Amsterdam, Amsterdam Cardiovascular Sciences,
Amsterdam, Netherlands
(Schuurmans, Rellum, Schenk, Cherpanath, Lagrand, Paulus, Terwindt, Vlaar)
Department of Intensive Care, Amsterdam UMC, University of Amsterdam,
Amsterdam Cardiovascular Sciences, Amsterdam, Netherlands
(Schenk) Department of Epidemiology and Data Science, Amsterdam UMC,
University of Amsterdam, Amsterdam Public Health, Amsterdam, Netherlands
(Geerts) Medical Affairs, Healthplus.ai B.V., Amsterdam, Netherlands
(Wynandts) Laboratory of Experimental Intensive Care and Anesthesiology,
Amsterdam UMC, Location AMC, Amsterdam, Netherlands
(Driessen) Department of Cardiothoracic Surgery, Amsterdam UMC, University
of Amsterdam, Heart Center, Amsterdam, Netherlands
Publisher
Lippincott Williams and Wilkins
Abstract
OBJECTIVES: Cardiac surgery is associated with perioperative
complications, some of which might be attributable to hypotension. The
Hypotension Prediction Index (HPI), a machine-learning-derived early
warning tool for hypotension, has only been evaluated in noncardiac
surgery. We investigated whether using HPI with diagnostic guidance
reduced hypotension during cardiac surgery and in the ICU. DESIGN:
Randomized clinical trial conducted between May 2021 and February 2023.
SETTING: Single-center study conducted in an academic hospital in the
Netherlands. PATIENTS: Adults undergoing elective on-pump coronary artery
bypass grafting, with or without single heart valve surgery, were enrolled
if a mean arterial pressure (MAP) greater than or equal to 65 mm Hg was
targeted during the surgical off-pump phases and ICU stay. After
eligibility assessment, 142 of 162 patients approached gave informed
consent for participation. INTERVENTIONS: Patients randomized 1:1 received
either diagnostic guidance in addition to standard care if HPI reached
greater than or equal to 75 (n = 72) or standard care alone (n = 70).
MEASUREMENTS AND MAIN RESULTS: The primary outcome was the severity of
hypotension, measured as time-weighted average (TWA) of MAP less than 65
mm Hg. Secondary outcomes encompassed hypertension severity and
intervention disparities. Of 142 patients randomized, 130 were included in
the primary analysis. The HPI group showed 63% reduction in median TWA of
hypotension compared with the standard care group, with a median of
differences of -0.40 mm Hg (95% CI, -0.65 to -0.27; p < 0.001). In the HPI
group, patients spent a median 28 minutes (95% CI, 17-44 min) less in
hypotension, with a measurement duration of 322 minutes in the HPI group
and 333 minutes in the standard care group. No significant differences
were observed in hypertension severity, treatment choice, or fluid,
vasopressors, and inotrope amounts. CONCLUSION(S): Using HPI combined
with diagnostic guidance on top of standard care significantly decreased
hypotension severity in elective cardiac surgery patients compared with
standard care. Copyright © 2024 by the Society of Critical Care
Medicine and Wolters Kluwer Health, Inc. All Rights Reserved.

<49>
Accession Number
2037182365
Title
Impact of Underdosing of Direct Oral Anticoagulants on Clinical Outcomes
in Patients With Atrial Fibrillation Undergoing Percutaneous Coronary
Intervention.
Source
Circulation Journal. 89(2) (pp 195-203), 2025. Date of Publication: 01 Feb
2025.
Author
Kitahara H.; Yamazaki T.; Hiraga T.; Suzuki S.; Ohno Y.; Harada J.;
Fukushima K.; Asano T.; Ishio N.; Uchiyama R.; Miyahara H.; Okino S.; Sano
M.; Kuriyama N.; Yamamoto M.; Sakamoto N.; Kanda J.; Kobayashi Y.
Institution
(Kitahara, Yamazaki, Hiraga, Kobayashi) Department of Cardiovascular
Medicine, Chiba University, Graduate School of Medicine, Chiba, Japan
(Suzuki) Department of Cardiovascular Medicine, Eastern Chiba Medical
Center, Chiba, Japan
(Ohno) Department of Cardiovascular Medicine, Narita Red Cross Hospital,
Chiba, Japan
(Harada) Division of Cardiology, Chiba Cerebral and Cardiovascular Center,
Chiba, Japan
(Fukushima) Department of Cardiology, Matsudo City General Hospital,
Chiba, Japan
(Asano) Department of Cardiology, Chiba Rosai Hospital, Chiba, Japan
(Ishio) Department of Cardiology, Chiba Aoba Municipal Hospital, Chiba,
Japan
(Uchiyama) Department of Cardiovascular Medicine, Japan Community
Healthcare Organization, Chiba Hospital, Chiba, Japan
(Miyahara) Department of Cardiology, Chiba Kaihin Municipal Hospital,
Chiba, Japan
(Okino) Department of Cardiology, Funabashi Municipal Medical Center,
Chiba, Japan
(Sano) Department of Cardiology, Chiba Emergency Medical Center, Chiba,
Japan
(Kuriyama) Cardiovascular Center, Miyazaki Medical Association Hospital,
Miyazaki, Japan
(Yamamoto) Department of Cardiology, Kimitsu Central Hospital, Chiba,
Japan
(Sakamoto) Division of Cardiology, Chibaken Saiseikai Narashino Hospital,
Chiba, Japan
(Kanda) Department of Cardiovascular Medicine, Asahi General Hospital,
Chiba, Japan
Publisher
Japanese Circulation Society
Abstract
Background: Underdoses of direct oral anticoagulants (DOAC) are sometimes
prescribed due to bleeding risk concerns in patients with atrial
fibrillation (AF). We investigated the prevalence of DOAC underdosing and
its impact on clinical outcomes in AF patients undergoing percutaneous
coronary intervention (PCI). Methods and Results: This multicenter
observational cohort study enrolled patients with AF on DOAC undergoing
PCI between January 2015 and March 2021 at 15 institutions across Japan.
Clinical outcomes within 1 year, including major adverse cardiovascular
events (MACE), all-cause mortality, ischemic stroke, and major bleeding
events, were evaluated. Of 623 patients enrolled, 167 (26.8%) received
underdoses, 224 (36.0%) received appropriate low doses, 210 (33.7%)
received appropriate standard doses, and 22 (3.5%) received overdoses.
Clinical outcomes were compared between patients with underdoses (n=167)
and appropriate doses (n=434). Although the incidence of MACE, all-cause
mortality, and major bleeding events did not differ significantly between
the 2 groups (log-rank P=0.850, P=0.163, and P=0.711, respectively),
ischemic stroke occurred more frequently in the underdose than
appropriate-dose group (log-rank P=0.011). After propensity score
matching, the same result was observed for the frequency of ischemic
stroke (log-rank P=0.026). Conclusion(s): Compared with appropriate
doses of DOAC, DOAC underdosing was associated with a higher incidence of
ischemic stroke, despite no significant difference in MACE, all-cause
mortality, and major bleeding events in AF patients undergoing
PCI. Copyright © 2025 Japanese Circulation Society. All rights
reserved.

<50>
Accession Number
2037671252
Title
Efficacy of Acoramidis on All-Cause Mortality and Cardiovascular
Hospitalization in Transthyretin Amyloid Cardiomyopathy.
Source
Journal of the American College of Cardiology. 85(10) (pp 1003-1014),
2025. Date of Publication: 18 Mar 2025.
Author
Judge D.P.; Alexander K.M.; Cappelli F.; Fontana M.; Garcia-Pavia P.;
Gibbs S.D.J.; Grogan M.; Hanna M.; Masri A.; Maurer M.S.; Obici L.; Soman
P.; Cao X.; Lystig T.; Tamby J.-F.; Siddhanti S.; Castano A.; Katz L.; Fox
J.C.; Mahaffey K.W.; Gillmore J.D.
Institution
(Judge) Division of Cardiology, Medical University of South Carolina,
Charleston, SC, United States
(Alexander) Division of Cardiovascular Medicine, Department of Medicine,
Stanford University School of Medicine, Palo Alto, CA, United States
(Alexander, Mahaffey) Stanford Center for Clinical Research, Stanford
School of Medicine, Palo Alto, CA, United States
(Cappelli) Tuscan Regional Amyloidosis Centre, Careggi University
Hospital, Florence, Italy
(Fontana, Gillmore) National Amyloidosis Centre, University College
London, Royal Free Hospital, London, United Kingdom
(Garcia-Pavia) Department of Cardiology, Hospital Universitario Puerta de
Hierro Majadahonda and Centro Nacional de Investigaciones Cardiovasculares
(CNIC), Madrid, Spain
(Gibbs) Victorian and Tasmanian Amyloidosis Service, Eastern Health,
Melbourne, VIC, Australia
(Gibbs) Epworth HealthCare, East Melbourne, VIC, Australia
(Grogan) Department of Cardiovascular Medicine, Mayo Clinic, Rochester,
MN, United States
(Hanna) Cleveland Clinic, Cleveland, OH, United States
(Masri) Division of Cardiology, Oregon Health & Science University,
Portland, OR, United States
(Maurer) Department of Medicine, Columbia University Irving Medical
Center, New York, NY, United States
(Obici) Amyloidosis Research and Treatment Centre, Fondazione IRCCS
Policlinico San Matteo, Pavia, Italy
(Soman) Division of Cardiology, University of Pittsburgh Medical Center,
Pittsburgh, PA, United States
(Cao, Lystig, Tamby, Siddhanti, Castano, Katz, Fox) BridgeBio Pharma, Inc,
San Francisco, CA, United States
Publisher
Elsevier Inc.
Abstract
Background: Transthyretin amyloid cardiomyopathy (ATTR-CM) is an
underdiagnosed chronic disease associated with progressive heart failure
that results in impaired quality of life, repeated hospitalizations, and
premature death. Acoramidis is a selective, oral transthyretin stabilizer
recently approved by the U.S. Food and Drug Administration for the
treatment of ATTR-CM. In a phase 3, randomized, double-blind study
(ATTRibute-CM [Efficacy and Safety of AG10 in Subjects With Transthyretin
Amyloid Cardiomyopathy]), acoramidis was well tolerated and showed
clinical efficacy in improving the primary endpoint, a hierarchical
combination of all-cause mortality (ACM), cardiovascular-related
hospitalization (CVH), N-terminal pro-B-type natriuretic peptide level,
and 6-minute walk distance. Objective(s): The goal of this study was
to characterize the efficacy of acoramidis on ACM and CVH. Method(s):
In ATTRibute-CM, participants with ATTR-CM were randomized 2:1 to receive
acoramidis hydrochloride (800 mg twice daily) or placebo for 30 months.
Efficacy analyses were conducted in the modified intention-to-treat
population (participants with a baseline estimated glomerular filtration
rate >=30 mL/min/1.73 m2). CVH and the composite of ACM or
first CVH were plotted by using Kaplan-Meier curves and summarized with a
stratified Cox proportional hazards model. The annualized frequency of CVH
was analyzed by using a negative binomial regression model. Subgroup
analyses were conducted for the composite of ACM or first CVH.
 Result(s): Of the 632 participants randomized to treatment, 611 (97%)
were included in efficacy analyses (acoramidis, n = 409; placebo, n =
202). Compared with placebo, acoramidis reduced the occurrence of the
composite of ACM or first CVH (acoramidis, 35.9%; placebo, 50.5%; HR:
0.64; 95% CI: 0.50-0.83; P = 0.0008) and of first CVH (acoramidis, 26.7%;
placebo, 42.6%; HR: 0.60; 95% CI: 0.45-0.80; P = 0.0005), with
Kaplan-Meier curves separating at month 3 and continuing to diverge
through month 30. Annualized frequency of CVH was reduced with acoramidis
compared with placebo (acoramidis, 0.22; placebo, 0.45; relative risk
ratio: 50%; 95% CI: 0.36-0.70; P < 0.0001). The efficacy of acoramidis on
the composite of ACM or first CVH was consistent across subgroups.
Acoramidis was well tolerated, with no safety signals of potential
clinical concern identified. Conclusion(s): In participants with
ATTR-CM, acoramidis reduced the composite of ACM or first CVH vs placebo,
with an early effect driven by a reduction in CVH. (Efficacy and Safety of
AG10 in Subjects With Transthyretin Amyloid Cardiomyopathy [ATTRibute-CM];
NCT03860935) Copyright © 2025 The Authors

<51>
Accession Number
2035751487
Title
ROLE OF TRIMETAZIDINE IN PREVENTING MYOCARDIAL INJURY IN PATIENTS
UNDERGOING OFF PUMP CABG.
Source
International Journal of Medicine and Public Health. 15(1) (pp 581-585),
2025. Date of Publication: 01 Jan 2025.
Author
Iqbal K.; Mir B.A.; Siddique S.; Wani I.A.; Iram N.I.; Manjubhargava P.;
Mehmood S.
Institution
(Iqbal) Department of CTVS at Eras Lucknow Medical College and Hospital,
India
(Mir) Department of Microbiology at Era's Lucknow Medical College and
Hospital, India
(Siddique, Manjubhargava, Mehmood) Department of Cardiology at Era's
Lucknow Medical College and Hospital, India
(Wani) Department of Cardiology at Career Institute of Medical Sciences
and Hospital, India
(Iram) Department of Pathology at Era's Lucknow Medical College and
Hospital, India
Publisher
Pink Petals Publications Pvt Ltd
Abstract
Background: Off-Pump coronary artery bypass graft surgery (OPCABG)
continues to be the main stay of surgical coronary revascularization for
coronary artery disease in India. We evaluated the role of Trimetazidine
(TMZ) in prevention of myocardial injury in patients undergoing OPCABG.
 Material(s) and Method(s): A randomized prospective study was carried
out to evaluate the efficacy of Trimetazidine in the prevention of
myocardial tissue injury by measuring pre-operative and post-operative
levels of cardiac troponin I (cTnI) at 8, 24 and 48 hours in patients
undergoing elective OPCABG surgery. Seventy patients undergoing elective
CABG were included in the study and were randomly (Covariate adaptive
randomization) assigned to two groups, TMZ and Control (no TMZ) group.
Thirty-five patients, received 80 mg of TMZ once daily in the
pre-operative period (started a week before admission), were assigned to
the TMZ group and thirty-five patients who did not receive TMZ, were
assigned to the control group. Result(s): In a study involving 150
enrolled cases, it was observed that 24 individuals experienced
hypoglycemia within the first 72 hours of life. The occurrence of
hypoglycemia observed in our study was 16%. Hypoglycemia occurred more
frequently in neonates born to mothers under the age of 30; however, this
association was not statistically significant. The incidence of
hypoglycemia was observed to be higher in infants born via LSCS. In our
research, we analyzed a total of 150 enrolled cases, of which 112 were
classified as term, 30 as preterm, and 8 as post term. Our research
identified 20 instances classified as small for gestational age (SGA).
Among these, 13 were categorized as Term SGA, while 7 were identified as
Preterm SGA. Conclusion(s): Despite similar pre-operative baseline
characteristics and pre-operative cTnI values, post-operative cTnI values
showed a rising trend in both the groups, with the values peaking at 8
hours and thereafter following a gradual declining trend at 24 and 48
hours. However, the rise in cTnI levels, were significantly higher in the
control group as compared to the TMZ group, in the post-operative
period. Copyright © 2025, Pink Petals Publications Pvt Ltd. All
rights reserved.

<52>
Accession Number
2011486117
Title
European Resuscitation Council Guidelines 2021: Executive summary.
Source
Resuscitation. 161 (pp 1-60), 2021. Date of Publication: 01 Apr 2021.
Author
Perkins G.D.; Graesner J.-T.; Semeraro F.; Olasveengen T.; Soar J.; Lott
C.; Van de Voorde P.; Madar J.; Zideman D.; Mentzelopoulos S.; Bossaert
L.; Greif R.; Monsieurs K.; Svavarsdottir H.; Nolan J.P.
Institution
(Perkins, Nolan) Warwick Clinical Trials Unit, Warwick Medical School,
University of Warwick, Coventry, United Kingdom
(Perkins) University Hospitals Birmingham, Birmingham, United Kingdom
(Graesner) University Hospital Schleswig-Holstein, Institute for Emergency
Medicine, Kiel, Germany
(Semeraro) Department of Anaesthesia, Intensive Care and Emergency Medical
Services, Maggiore Hospital, Bologna, Italy
(Olasveengen) Department of Anesthesiology, Oslo University Hospital and
Institute of Clinical Medicine, University of Oslo, Norway
(Soar) Southmead Hospital, North Bristol NHS Trust, Bristol, United
Kingdom
(Lott) Department of Anesthesiology, University Medical Center, Johannes
Gutenberg-University Mainz, Germany
(Van de Voorde) Department of Emergency Medicine, Faculty of Medicine
Ghent University, Ghent, Belgium
(Van de Voorde) EMS Dispatch Center, East-West Flanders, Federal
Department of Health, Belgium
(Madar) Department of Neonatology, University Hospitals Plymouth,
Plymouth, United Kingdom
(Zideman) Thames Valley Air Ambulance, Stokenchurch, United Kingdom
(Mentzelopoulos) National and Kapodistrian University of Athens Medical
School, Athens, Greece
(Bossaert) University of Antwerp, Antwerp, Belgium
(Greif) Department of Anaesthesiology and Pain Medicine, Bern University
Hospital, University of Bern, Bern, Switzerland
(Greif) School of Medicine, Sigmund Freud University Vienna, Vienna,
Austria
(Monsieurs) Department of Emergency Medicine, Antwerp University Hospital
and University of Antwerp, Belgium
(Svavarsdottir) Akureyri Hospital, Akureyri, Iceland
(Svavarsdottir) University of Akureyri, Akureyri, Iceland
(Nolan) Royal United Hospital, Bath, United Kingdom
Publisher
Elsevier Ireland Ltd
Abstract
Informed by a series of systematic reviews, scoping reviews and evidence
updates from the International Liaison Committee on Resuscitation, the
2021 European Resuscitation Council Guidelines present the most up to date
evidence-based guidelines for the practice of resuscitation across Europe.
The guidelines cover the epidemiology of cardiac arrest; the role that
systems play in saving lives, adult basic life support, adult advanced
life support, resuscitation in special circumstances, post resuscitation
care, first aid, neonatal life support, paediatric life support, ethics
and education. Copyright © 2021

<53>
Accession Number
2031579945
Title
Complications in the TAVI implant. Prevention, resolution and associated
morbimortality.
Source
Cirugia Cardiovascular. 32(2) (pp 52-57), 2025. Date of Publication: 01
Mar 2025.
Author
Garrido-Martin P.
Institution
(Garrido-Martin) Hospital Universitario de Canarias, Tenerife, Spain
Publisher
Sociedad Espanola de Cirugia Cardiovascular y Endovascular (SECCE)
Abstract
Introduction: Degenerative aortic stenosis is the most common valvular
pathology in the population over 65 years of age, incidence of 2-7%.
Currently, transcatheter aortic valve implantation is a standard therapy
in these symptomatic patients. This procedure is associated with
relatively high rates of complications, which can be serious. The
objective of this work is to provide an update and detailed description of
the most important complications of the transcatheter aortic valve
procedure in terms of etiology, prevalence, diagnosis, prognosis,
prevention and treatment. Method(s): Bibliographic review of current
evidence on the most important complications of transcatheter aortic valve
implantation, their prevention and resolution. Result(s): Rhythm
disorders, vascular complications, prosthetic regurgitation, cardiac
perforation..., are among others some of the possible complications that
appear in 2-10% of cases, and are associated with an increase mortality of
up to 2 or 3 times. Conclusion(s): Complications of the transcatheter
aortic valve procedure are frequent and often serious, so it is essential
to know the predisposing factors, prevention and treatment strategies.
Careful patient selection, quality infrastructure, training and
accreditation, multidisciplinary collaboration are essential for optimal
prognosis and a decrease in possible complications. Copyright ©
2024 Sociedad Espanola de Cirugia Cardiovascular y Endovascular

<54>
[Use Link to view the full text]
Accession Number
2037273694
Title
Economic Outcomes With Precision Diagnostic Testing Versus Usual Testing
in Stable Chest Pain: Results From the PRECISE Randomized Trial.
Source
Circulation: Cardiovascular Quality and Outcomes. 18(2) (pp e011008),
2025. Date of Publication: 01 Feb 2025.
Author
Chew D.S.; Mark D.B.; Li Y.; Nanna M.G.; Kelsey M.D.; Daniels M.R.;
Davidson-Ray L.; Baloch K.N.; Rogers C.; Patel M.R.; Anstrom K.J.; Curzen
N.; Vemulapalli S.; Douglas P.S.
Institution
(Chew) Libin Cardiovascular Institute and O'Brien Institute for Public
Health, University of Calgary, Calgary, Canada
(Mark, Li, Kelsey, Daniels, Davidson-Ray, Baloch, Patel, Vemulapalli,
Douglas) Duke Clinical Research Institute, Duke University, Durham, NC,
United States
(Mark, Kelsey, Daniels, Patel, Vemulapalli, Douglas) Division of
Cardiology, Duke University Medical Center, Durham, NC, United States
(Nanna) Section of Cardiovascular Medicine, Yale University School of
Medicine, New Haven, CT, United States
(Rogers) HeartFlow, Inc, Mountain View, CA, United States
(Anstrom) Gillings School of Global Public Health, University of North
Carolina, Chapel Hill, United States
(Curzen) Faculty of Medicine, Cardiothoracic Unit, University of
Southampton, United Kingdom
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND: The PRECISE (Prospective Randomized Trial of the Optimal
Evaluation of Cardiac Symptoms and Revascularization) demonstrated that a
precision diagnostic strategy reduced the primary composite of death,
nonfatal myocardial infarction, or catheterization without obstructive
coronary artery disease by 65% in patients with nonacute chest pain
compared with usual testing. Medical cost was a prespecified secondary end
point. METHOD(S): PRECISE randomized 2103 patients between December
2018 and May 2021 to usual testing or a precision strategy that used
deferred testing for the lowest risk patients (20%) and coronary computed
tomographic angiography with selective computed tomography-derived
fractional flow reserve for the remainder. Resource use consumption data
were collected from all study participants and hospital cost data from US
participants (n=1125) to estimate total medical costs. The primary and
secondary economic outcomes were total costs at 12 months and at 45 days,
respectively, from the US health care system perspective. The mean cost
differences between the 2 strategies were reported by intention-to-treat.
 RESULT(S): At 45 days, total costs were similar between the precision
strategy and usual testing (mean difference, $182 [95% CI, -$555 to
$661]). By 12 months, percutaneous coronary intervention and coronary
artery bypass surgery had been performed in 7.2% and 2.0% of precision
strategy patients and 3.5% and 1.7% of usual testing patients,
respectively. At 1 year, precision strategy costs were $5299 versus $4821
for usual testing (mean difference, $478 [95% CI, -$889 to $1437];
P=0.43). Precision care decreased mean per-patient diagnostic cost by 27%
and increased mean per-patient revascularization costs by 67%.
 CONCLUSION(S): In the PRECISE trial, the precision strategy, a
risk-based approach endorsed by current clinical practice guidelines,
improved the clinical efficiency of testing and had similar costs to usual
testing at 45 days and a nonsignificant $478 cost difference at 1
year. Copyright © 2025 The Authors.

<55>
Accession Number
2032120492
Title
Association of physical function with hospital readmissions among older
adults: A systematic review.
Source
Journal of Hospital Medicine. 20(3) (pp 277-287), 2025. Date of
Publication: 01 Mar 2025.
Author
Thomas E.M.; Smith J.; Curry A.; Salsberry M.; Ridgeway K.; Hunt B.;
Desanto K.; Falvey J.R.
Institution
(Thomas, Salsberry) School of Health and Rehabilitation Sciences, The Ohio
State University, Columbus, OH, United States
(Smith) Kinesiology Department, University of Connecticut, Storrs, CT,
United States
(Curry) Rehabilitation Services Department, Washington Hospital Healthcare
System, Fremont, CA, United States
(Ridgeway) Rehabilitation Therapy Services Department, University of
Colorado Hospital, UCHealth, Aurora, CO, United States
(Ridgeway) Physical Therapy Program, School of Medicine, University of
Colorado Anschutz Medical Campus, Aurora, CO, United States
(Hunt) Rehabilitation Services Department, Intermountain Health, Canyons
Region, Salt Lake, UT, United States
(Desanto) Strauss Health Sciences Library, University of Colorado Anschutz
Medical Campus, Aurora, CO, United States
(Falvey) Department of Physical Therapy and Rehabilitation Science and
Department of Epidemiology and Public Health, University of Maryland
School of Medicine, Baltimore, MD, United States
Publisher
John Wiley and Sons Inc
Abstract
Background: Hospital readmissions pose significant burdens on healthcare
systems, particularly among older adults. While efforts to reduce
readmissions have historically focused on medical management, emerging
evidence suggests physical function may also play a role in successful
care transitions. However, there is a limited understanding of the
relationship between functional measures and readmission risk. This
systematic review aims to assess the association between physical function
impairments and hospital readmissions. Objective(s): This systematic
review aims to assess the association between physical function
impairments and hospital readmissions. Method(s): A systematic review
was conducted following PRISMA guidelines, with studies identified through
databases including PubMed, CINAHL, Embase, and others published January
1, 2010-December 31, 2022. Inclusion criteria encompassed observational
studies of adults aged 50 and older in the United States, reporting
readmissions within 90 days of discharge and assessing physical function
across domains of the International Classification of Function model. Data
extraction and risk of bias assessment were independently conducted by two
authors using theScottish Intercollegiate Guidelines Network (SIGN) tool.
 Result(s): Seventeen studies, representing 80,008 participants, were
included in this systematic review. Patient populations included a wide
array of medical populations, including general medical inpatients and
those undergoing cardiac surgery. Across various functional measures
assessed before or during admission, impairments were consistently
associated with increased risk for hospital readmissions up to 90 days
after admission. Measures of participation, including life-space mobility,
were also associated with increased readmission risk. Conclusion(s):
Functional impairments are robust predictors of hospital readmissions in
older adults. Routine assessment of physical function during
hospitalization can improve risk stratification and may support successful
care transitions, particularly in older adults. Copyright © 2024
The Author(s). Journal of Hospital Medicine published by Wiley Periodicals
LLC on behalf of Society of Hospital Medicine.

<56>
Accession Number
644109810
Title
Effects of open-label sesame oil applied to cardiac surgery patients in
preventing amiodarone-induced phlebitis: A randomized controlled trial.
Source
Nursing in critical care. 30(2) (pp e13085), 2025. Date of Publication: 01
Mar 2025.
Author
Gulsen M.; Arslan S.
Institution
(Gulsen, Arslan) Surgical Nursing Department, Faculty of Health Sciences,
Cukurova University, Adana, Turkey
Abstract
BACKGROUND: Amiodarone is a prophylactic rhythm-regulating drug used to
prevent arrhythmia; However, especially during infusion, it has the
potential to cause a number of complications, especially phlebitis. AIM:
The aim of the study is to determine the effects of sesame oil, which has
the potential to prevent phlebitis that may occur during amiodarone
infusion administered to patients after cardiac surgery. DESIGN: This
prospective, two-arm (1:1), block randomized controlled interventional
study. METHOD(S): This study was conducted with 44 patients treated
in the coronary intensive care unit of a university hospital, who received
parenteral infusion of amiodarone. Sesame oil was applied superficially by
applying 10 drops to a 10 cm perimeter of the cannula for 10 min. This
application was repeated every 8 h during the 24-h amiodarone infusion. No
intervention was made to the patients in the control group. However,
standard nursing care measures and a standard transparent dressing were
applied to the patients in both groups during the peripheral catheter
application phase. Patients in the intervention and control groups were
evaluated in terms of phlebitis at the end of every 24 h using the Visual
Infusion Phlebitis Scale. The study was reported according to the CONSORT
declaration. RESULT(S): Phlebitis symptoms occurred in 15/22 (68.2%)
of the patients in the intervention group on the first day, 3/22 (13.6%)
on the second day and 2/22 (9.1%) of the patients on the third day, while
in the control group, 20/22 (90.9%) of the patients had phlebitis on the
first day and 2/22 (9.1%) on the second day. The incidence of phlebitis
was 20/22 (90.9%) in the intervention group and 22/22 (100%) in the
control group. There was no statistically significant difference in
phlebitis symptoms between groups. CONCLUSION(S): The research
results showed that the application of sesame oil did not significantly
reduce the frequency of phlebitis. However, a trend indicating delayed
onset of phlebitis symptoms was observed in the sesame oil group.
Nevertheless, larger sample studies are needed. These studies are expected
to assist in determining the effects of sesame oil on phlebitis more
precisely and provide stronger support for the results. RELEVANCE TO
CLINICAL PRACTICE: Training of nurses on non-pharmacological methods
should be supported and opportunities should be given for their
application. Copyright © 2024 The Authors. Nursing in Critical
Care published by John Wiley & Sons Ltd on behalf of British Association
of Critical Care Nurses.

<57>
Accession Number
2033481171
Title
An increase in micro-vessels beneath the pleural surface on computed
tomography as a preoperative predictor of pleural adhesions: a prospective
study.
Source
Surgery Today. (no pagination), 2025. Article Number: e0154694. Date of
Publication: 2025.
Author
Kawamura T.; Kobayashi N.; Yanagihara T.; Goto Y.; Ichimura H.; Sato Y.
Institution
(Kawamura, Kobayashi, Yanagihara, Goto, Ichimura, Sato) Department of
Thoracic Surgery, University of Tsukuba Hospital, 2-1-1 Amakubo, Ibaraki,
Tsukuba, Japan
Publisher
Springer
Abstract
Purpose: Pleural adhesions, which may be present in varying degrees and
involve blood vessels, often complicate thoracic surgery. The blood flow
within pleural adhesions can be identified on computed tomography (CT) as
micro-vessels beneath the pleural surface (MVBP). We conducted a
prospective study to assess if MVBP can be detected on preoperative CT to
predict intraoperative pleural adhesions. Method(s): This prospective
study investigated the preoperative CT images of patients scheduled to
undergo surgery for lung tumors. MVBP was defined as positive when lung
vessels were identified below the pleura on CT. MVBP was evaluated for
each lung segment, and intraoperative findings of pleural adhesions on the
segments were then recorded. Result(s): This study included 173
patients, with 1532 segments evaluated. Pleural adhesions were found in 51
patients and confirmed in 92 segments. The number of segments evaluated
preoperatively as MVBP-positive was 134 (9%), of which 36 (26.9%) had
pleural adhesions. Multivariable analysis identified that MVBP was an
independent significant predictor (odds ratio = 2.29, 95% confidence
interval 1.09-4.80, P = 0.028) of pleural adhesions on a per-patient
basis. Conclusion(s): MVBP is a valuable predictor of pleural
adhesions. The method is useful in clinical practice because it does not
require additional examinations and is easy to assess. Copyright
© The Author(s) 2025.

<58>
Accession Number
2037646302
Title
Assessment of quitting versus using aspirin therapy in patients with
stabilized coronary artery disease after stenting who require long-term
oral anticoagulation: Rationale for and design of the AQUATIC double-blind
randomized trial.
Source
Archives of Cardiovascular Diseases. (no pagination), 2025. Date of
Publication: 2025.
Author
Didier R.; Lemesle G.; Montalescot G.; Steg P.H.G.; Vicaut E.; Mottier D.;
Bauters C.; Mabo P.; Simon T.; Bouleti C.; Andrieu S.; Angoulvant D.;
Vanzetto G.; Kerneis M.; Cayla G.; Gilard M.
Institution
(Didier, Gilard) Department of Cardiology, Inserm UMR 1304 (GETBO), Brest
University Hospital, Western Brittany Study Group, Brest, France
(Lemesle) Heart and Lung Institute, Inserm U1011, Institut Pasteur de
Lille, University Hospital of Lille, Lille, France
(Montalescot, Kerneis) Allies in Cardiovascular Trials Initiatives and
Organized Networks (ACTION) Study Group, Inserm UMRS 1166, hopital
Pitie-Salpetriere, AP-HP, Sorbonne universite, Paris, France
(Steg) Inserm U1148/LVTS, French Alliance for Cardiovascular Trials
(FACT), AP-HP, universite Paris-Cite, Bobigny, France
(Vicaut) Clinical Research Unit, Fernand-Widal Hospital, Paris, France
(Mottier) Department of Internal Medicine and Pneumology, Inserm UMR 1304
(GETBO), CIC Inserm 1412, F-CRIN INNOVTE, universite de Bretagne
Occidentale, Brest University Hospital, Brest, France
(Bauters) Inserm 1167, Institut Pasteur de Lille, University Hospital of
Lille, universite de Lille, Lille, France
(Mabo) Department of Cardiology, CHU de Rennes, Rennes, France
(Simon) Department of Clinical Pharmacology and Clinical Research Platform
of East of Paris, AP-HP, Sorbonne universite, Paris, France
(Simon) Inserm U 1148/LVTS, French Alliance for Cardiovascular Trials
(FACT), AP-HP, Paris, France
(Bouleti) CIC Inserm 1402, Department of Cardiology, University of
Poitiers, Poitiers, France
(Andrieu) Department of Cardiology, hopital Henri-Duffaut, Avignon, France
(Angoulvant) Department of Cardiology, CHRU de Tours, Tours, France
(Angoulvant) Inserm UMR 1327 - ISCHEMIA, universite de Tours, Tours,
France
(Vanzetto) Department of Cardiology, Grenoble University Hospital, La
Tronche, France
(Cayla) Department of Cardiology, Nimes University Hospital, Montpellier
University, ACTION Study Group, Nimes, France
Publisher
Elsevier Masson s.r.l.
Abstract
Background: Antithrombotic management in patients with chronic coronary
syndrome and previous stent implantation who require long-term oral
anticoagulation is highly challenging in daily practice, especially in
those at high residual risk of coronary and vascular events. Dual therapy
with oral anticoagulation and aspirin may lead to a higher risk of
bleeding, whereas stopping aspirin in high-risk patients with coronary
artery disease after percutaneous coronary intervention may lead to
recurrent ischaemic events. Aim(s): To assess the optimal
antithrombotic regimen that should be pursued long term (often lifelong)
in these patients. Method(s): The AQUATIC study is a prospective,
randomized, double-blind, placebo-controlled, parallel-group, multicentre
study conducted in patients with chronic coronary syndrome at high risk of
ischaemic events (i.e., stent implantation [> 6 months before inclusion]
in a context of previous acute coronary syndrome and/or with high-risk
features of ischaemic event recurrences) and requiring long-term oral
anticoagulation. For superiority, we ensure 80% power at level alpha =
0.05 to detect a 25% reduction in hazard in the experimental group
relative to the control group. Overall, 2000 patients will be randomized
in a 1:1 ratio to receive either oral anticoagulation and aspirin or oral
anticoagulation and placebo. The primary efficacy endpoint is a composite
of cardiovascular death, myocardial infarction, stroke, systemic embolism,
coronary revascularization and acute limb ischaemia. Major bleeding
according to the International Society on Thrombosis and Haemostasis
definition is a secondary safety endpoint that will be assessed as a
priority. Conclusion(s): The AQUATIC trial will test the efficacy and
safety of adding aspirin to long-term oral anticoagulation in patients
with chronic coronary syndrome and previous coronary stenting who are at
high residual risk of recurrent ischaemic events and require oral
anticoagulation. Copyright © 2025

<59>
Accession Number
2032373521
Title
The role of multimodal imaging in the diagnosis of prosthetic valve and
intracardiac device endocarditis: A review.
Source
International Journal of Cardiovascular Imaging. 41(3) (pp 409-417), 2025.
Date of Publication: 01 Mar 2025.
Author
Daniel E.; El-Nayir M.; Ezeani C.; Nwaezeapu K.; Ogedegbe O.J.; Khan M.
Institution
(Daniel, El-Nayir, Nwaezeapu, Ogedegbe, Khan) Trinity Health Ann Arbor,
Ypsilanti, MI, United States
(Ezeani) Baton Rouge General Medical Center, LA, United States
Publisher
Springer Science and Business Media B.V.
Abstract
Infective endocarditis (IE) is a severe cardiac condition associated with
substantial morbidity and mortality. Traditionally, the modified Duke's
criteria have been used to establish the diagnosis of IE, which includes
using transthoracic and transesophageal echocardiography. While
echocardiography performs well in diagnosing native valve endocarditis,
its diagnostic accuracy decreases in patients with prosthetic valves or
implanted cardiac devices such as pacemakers and defibrillators. Given
these limitations and advancements in cardiac imaging, including
multimodal computed tomography, magnetic resonance imaging, and positron
emission tomography, there has been growing interest in the utility of
these techniques for diagnosing prosthetic valve endocarditis (PVE) and
Cardiovascular implantable electronic device infection (CIEDI). Although
numerous studies have investigated the value of these imaging modalities,
their findings have been inconsistent. This article aims to reevaluate the
role of advanced imaging in diagnosing PVE and CIEDI and its impact on
managing prosthetic valves and device-related infective endocarditis.
Methods A comprehensive literature search was conducted in PubMed,
Cochrane library, Google Scholar, Embase, and other relevant databases.
Key terms such as 'infective endocarditis,' 'multimodal imaging,'
'prosthetic valve endocarditis,' '18F-FDG PET,' 'cardiac MRI,' and
'cardiac CT' were used to identify studies that investigated the role of
these imaging modalities in diagnosing PVE and CIEDI. Publications with
full text including randomized controlled trials, retrospective studies,
case reports, case series, reviews of literature, and society guidelines
were included. Copyright © The Author(s), under exclusive licence
to Springer Nature B.V. 2024.

<60>
Accession Number
2037646331
Title
Hybrid coronary revascularization versus traditional coronary artery
bypass grafting for left main coronary artery disease.
Source
Cardiovascular Revascularization Medicine. (no pagination), 2025. Date of
Publication: 2025.
Author
Hebbo E.; Barker M.; Gold D.A.; Hassan M.E.; Sawan M.; Rab T.; Nicholson
W.J.; Halkos M.E.; Jaber W.A.; Sandesara P.B.
Institution
(Hebbo, Barker, Gold, Hassan, Sawan, Rab, Nicholson, Jaber, Sandesara)
Emory Clinical Cardiovascular Research Institute, Division of Cardiology,
Department of Medicine, Emory University School of Medicine, Atlanta, GA,
United States
(Halkos) Division of Cardiothoracic Surgery, Emory University, Atlanta,
GA, United States
Publisher
Elsevier Inc.
Abstract
Background: The current recommended intervention for significant left main
(LM) stenosis, especially in patients with complex and high SYNTAX score
disease, is coronary artery bypass grafting (CABG). Hybrid coronary
revascularization (HCR) combines robotic coronary artery bypass and
percutaneous coronary intervention, offering a less invasive approach for
patients with LM disease. Objective(s): We compare clinical outcomes
between HCR and CABG in patients with LM disease. Method(s): We
retrospectively screened all patients treated for LM disease between 2019
and 2023 at a single institution. Propensity matching was used for
baseline characteristics. The primary outcome was major adverse
cardiovascular events (MACE) at 30 days, 6 months and 1 year. Secondary
outcomes included death, myocardial infarction, repeat revascularization
and stroke. Result(s): Out of a total of 761 patients treated for LM
disease, 59 HCR patients were propensity matched to 59 CABG patients and
were included in the final analysis. SYNTAX score was >33 for 49.1 % of
HCR patients and 67.3 % of CABG patients (p = 0.15). Hospital length of
stay was significantly shorter for HCR patients compared to CABG (4.07
days vs. 7.58 days, p < 0.001). MACE were significantly lower in the HCR
group at 30 days (0 % vs 10.2 %; p = 0.01), 6 months (0 % vs 17 %; p =
0.002) and 1 year (2.4 % vs 20.5 %; p = 0.01) compared to CABG group.
Additionally, there was a lower rate of repeat revascularization at 6
months in the HCR group (0 % vs 10.9 %; p = 0.02). Conclusion(s):
This retrospective study demonstrates that HCR is a safe and viable
alternative to CABG in patients with LM disease. Randomized clinical
trials comparing the two treatment modalities are needed to confirm these
findings. Copyright © 2025 Elsevier Inc.

<61>
Accession Number
2032037538
Title
Pooled comparative analysis of transcatheter aortic valve replacement
versus surgical aortic valve replacement in patients with left ventricular
assist device.
Source
General Thoracic and Cardiovascular Surgery. 73(2) (pp 125-129), 2025.
Article Number: n71. Date of Publication: 01 Feb 2025.
Author
Magouliotis D.E.; Giamouzis G.; Athanasiou T.; Spiliopoulos K.; Briasoulis
A.; Skoularigis J.; Triposkiadis F.; Xanthopoulos A.
Institution
(Magouliotis) Department of Cardiac Surgery Research, Lankenau Institute
for Medical Research, Main Line Health, Wynnewood, PA, United States
(Magouliotis, Spiliopoulos) Unit of Quality Improvement, Department of
Cardiothoracic Surgery, University of Thessaly, Larissa, Greece
(Giamouzis, Skoularigis, Triposkiadis, Xanthopoulos) Department of
Cardiology, University Hospital of Larissa, Larissa, Greece
(Athanasiou) Department of Surgery and Cancer, Imperial College London,
London, United Kingdom
(Briasoulis) Department of Clinical Therapeutics, Faculty of Medicine,
Alexandra Hospital, National and Kapodistrian University of Athens,
Athens, Greece
Publisher
Springer
Abstract
A thorough literature search was conducted on patients with Left
Ventricular Assist Device (LVAD) and aortic insufficiency undergoing
transcatheter aortic valve replacement (TAVR). We identified all original
research studies that compared the long-term outcomes of surgical
transcatheter aortic valve replacement (SAVR) versus TAVR for patients
with LVAD, published between 1990 and 2023. The primary endpoint was the
composite of in-hospital mortality, stroke, transient ischemic attack,
myocardial infarction (MI), pacemaker implantation, vascular complications
and cardiac tamponade. Secondary endpoints were the median overall
survival (OS), the incidence of acute kidney injury (AKI), any bleeding
needing transfusions or reintervention and cost. A total of fourteen
studies and 358 patients were included (TAVR: 242; SAVR: 116). The
composite outcome, the incidence of AKI, the bleeding needing transfusion,
along with cost were significantly higher in the SAVR group. In addition,
there was no significant difference between TAVR and SAVR in terms of
median OS. The median OS in the TAVR group was 18 months. Finally, the
most common causes of death were progression of heart failure and
pneumonia. The present meta-analysis indicates that TAVR is associated
with enhanced outcomes compared to SAVR for patients with LVAD presenting
aortic insufficiency. Further well-designed original studies with greater
sample sizes are necessary to validate our findings. Copyright ©
The Author(s), under exclusive licence to The Japanese Association for
Thoracic Surgery 2024.

<62>
Accession Number
2030617613
Title
Meta-analysis of BITA versus SITA grafting in diabetic patients: evidence
from propensity score-matched studies.
Source
General Thoracic and Cardiovascular Surgery. 73(2) (pp 80-87), 2025. Date
of Publication: 01 Feb 2025.
Author
Nolan J.; Wijaya A.R.; Harta I.K.A.P.
Institution
(Nolan, Wijaya) Faculty of Medicine, Udayana University, Denpasar,
Indonesia
(Harta) Cardiothoracic and Vascular Surgery Department, Prof IGNG Ngoerah
General Hospital, Denpasar, Indonesia
Publisher
Springer
Abstract
Background: It has been demonstrated that the use of bilateral internal
thoracic artery (BITA) grafting in coronary artery bypass grafting (CABG)
improves long-term survival in comparison to the use of a single internal
thoracic artery (SITA) graft. However, the optimal transplantation
technique for diabetic patients remains undetermined. The purpose of this
meta-analysis was to compare the effectiveness and safety of BITA and SITA
CABG in diabetic patients. Method(s): A comprehensive search of
Google Scholar, Science Direct, and PubMed was conducted for studies with
propensity score-matched comparing between BITA and SITA grafting in
diabetic patients. The main goal was to know mid- to long-term mortality,
and the supplementary results included incidence of deep sternal wound
infection, 30-day mortality, and incidence of reoperation due to
hemorrhage. Result(s): The meta-analysis included 11 studies
involving 3762 diabetic patients with matched propensity scores. Compared
to SITA grafting, BITA grafting was associated with a significant
reduction in long-term mortality (HR 0.78; 95% CI 0.67-0.91), P = 0.03,
I2 = 54%. There were no significant differences between the two
groups in terms of 30-day mortality, reoperation for bleeding,
cerebrovascular accident, or renal failure. Conclusion(s): BITA
grafting appears to provide better overall survival than SITA grafting in
patients with diabetes. However, using BITA grafting is associated with a
greater risk of deep sternal wound infection. These findings may help
guide the choice of grafting technique in diabetic patients undergoing
CABG. Copyright © The Author(s), under exclusive licence to The
Japanese Association for Thoracic Surgery 2024.

<63>
Accession Number
2033478930
Title
Echocardiographic Evaluation of the Post-Heart Transplant Patient.
Source
Current Cardiology Reports. 27(1) (no pagination), 2025. Article Number:
63. Date of Publication: 01 Dec 2025.
Author
Karatasakis A.; Kiamanesh O.; Cheng R.K.; Kirkpatrick J.N.; Dudzinski D.M.
Institution
(Karatasakis, Cheng, Kirkpatrick) Division of Cardiology, Department of
Medicine, University of Washington, Seattle, WA, United States
(Kiamanesh) Division of Cardiology, Department of Cardiac Sciences,
University of Calgary, Calgary, AB, Canada
(Kirkpatrick) Department of Bioethics and Humanities, University of
Washington, Seattle, WA, United States
(Dudzinski) Section of Critical Care Cardiology and Echocardiography
Laboratory, Division of Cardiology, Department of Medicine, Massachusetts
General Hospital, Boston, MA, United States
Publisher
Springer
Abstract
Purpose of Review: Significant practice variability exists with respect to
the role and frequency of echocardiography after heart transplantation. We
sought to illustrate key studies relating to the utility and diagnostic
accuracy of echocardiography for the post-heart transplant patient. Recent
Findings: Several echocardiographic parameters correlate with acute heart
transplant rejection, but there is enough heterogeneity between study
results or in diagnostic accuracy, such that it precludes parameter use in
isolation to rule out rejection. Newer techniques such as strain
echocardiography may have better sensitivity. Similarly, resting and
stress echocardiography can be combined with modern techniques such as
myocardial contrast echocardiography to diagnose and prognosticate cardiac
allograft vasculopathy, but studies have again demonstrated variable
accuracy. Summary: Echocardiography remains an accessible tool in the
evaluation and management of patients after heart transplantation. This
modality can guide clinical judgment with real-time data and several
fairly sensitive parameters for the detection of rejection, cardiac
allograft vasculopathy, and other abnormalities. Often, auxiliary
diagnostic modalities need to be combined to optimize diagnostic
accuracy. Copyright © The Author(s), under exclusive licence to
Springer Science+Business Media, LLC, part of Springer Nature 2025.

<64>
Accession Number
2037505823
Title
Machine learning for predicting outcomes of transcatheter aortic valve
implantation: A systematic review.
Source
International Journal of Medical Informatics. 197 (no pagination), 2025.
Article Number: 105840. Date of Publication: 01 May 2025.
Author
Sulaiman R.; Atick Faisal M.A.; Hasan M.; Chowdhury M.E.H.; Bensaali F.;
Alnabti A.; Yalcin H.C.
Institution
(Sulaiman, Atick Faisal, Hasan, Yalcin) Biomedical Research Center, QU
Health, Qatar University, Doha, Qatar
(Atick Faisal, Chowdhury, Bensaali) Department of Electrical Engineering,
Qatar University, Doha, Qatar
(Alnabti) Heart Hospital, Hamad Medical Corporation, Doha, Qatar
(Yalcin) Department of Biomedical Sciences, College of Health Sciences, QU
Health, Qatar University, Doha, Qatar
(Yalcin) Department of Mechanical and Industrial Engineering, Qatar
University, Doha, Qatar
Publisher
Elsevier Ireland Ltd
Abstract
Background: Transcatheter aortic valve implantation (TAVI) therapy has
demonstrated its clear benefits such as low invasiveness, to treat aortic
stenosis. Despite associated benefits, still post-procedural complications
might occur. The severity of these complications depends on pre-existing
clinical conditions and patient specific complex anatomical features.
Accurate prediction of TAVI outcomes will assist in the precise risk
assessment for patients undergoing TAVI. Throughout the past decade,
different machine learning (ML) approaches have been utilized to predict
outcomes of TAVI. This systematic review aims to assess the application of
ML in TAVI for the purpose of outcome prediction. Method(s):
Preferred Reporting Items for Systematic Reviews and Meta-Analyses
(PRISMA) guideline was adapted for searching the PubMed and Scopus
databases on ML use in TAVI outcomes prediction. Once the studies that
meet the inclusion criteria were identified, data from these studies were
retrieved and were further examined. 17 parameters relevant to TAVI
outcomes were carefully identified for assessing the quality of the
included studies. Result(s): Following the search of the mentioned
databases, 78 studies were initially retrieved, and 17 of these studies
were included for further assessment. Most of the included studies focused
on mortality prediction, utilizing datasets of varying sizes and diverse
ML algorithms. The most employed ML algorithms were random forest,
logistics regression, and gradient boosting. Among the studied parameters,
serum creatinine, age, BMI, hemoglobin, and aortic valve mean gradient
were identified as key predictors for TAVI outcomes. These predictors were
found to be well aligned with established associations in current
literature. Conclusion(s): ML presents a promising opportunity for
improving the success and safety of TAVI and enhancing patient-centered
care. While currently retrospective studies with low generalizability and
heterogeneity form the basis of ML TAVI research, future prospective
investigations with highly heterogeneous patient TAVI cohorts will be
critically important for firmly establishing the applicability of ML in
predicting TAVI outcomes. Copyright © 2025

<65>
Accession Number
2035763894
Title
Ex vivo Coronary Angiography: Safety of Iopromide in Cold Preservation of
Pig Hearts.
Source
Brazilian Journal of Cardiovascular Surgery. 40(2) (no pagination), 2025.
Article Number: e20240080. Date of Publication: 2025.
Author
Zhulkov M.O.; Sirota D.A.; Zykov I.S.; Poveshchenko O.V.; Surovtseva M.A.;
Kim I.A.; Protopopov A.V.; Sabetov A.K.; Agaeva K.A.; Makaev A.G.; Nadeev
A.P.; Kliver V.E.; Kliver E.E.; Volkov A.M.; Karmadonova N.A.; Smirnov
Y.M.; Limanskiy A.D.; Tarkova A.R.; Chernyavskiy A.M.
Institution
(Zhulkov, Sirota, Zykov, Poveshchenko, Surovtseva, Kim, Protopopov,
Sabetov, Agaeva, Makaev, Nadeev, Kliver, Volkov, Karmadonova, Smirnov,
Limanskiy, Tarkova, Chernyavskiy) Adult Cardiac Surgery Department,
Meshalkin National Medical Research Center, Novosibirsk, Russian
Federation
(Sirota, Kliver, Chernyavskiy) Department of Cardiovascular Surgery,
Novosibirsk State Medical University, Novosibirsk, Russian Federation
(Poveshchenko, Surovtseva, Kim) Cell Technology Laboratory, Research
Institute of Clinical and Experimental Lymphology - Branch of the
Institute of Cytology and Genetics, Siberian Branch of the Russian Academy
of Sciences, Novosibirsk, Russian Federation
Publisher
Sociedade Brasileira de Cirurgia Cardiovascular
Abstract
Objective: To evaluate the effects of intracoronary iopromide (Ultravist,
Germany) administration on the recovery of cardiac pump function and
cardiomyocytes metabolism during ex vivo cold preservation of pig hearts
in the early posttransplant period. Method(s): Three-month-old mini
pigs weighing 73 +/- 2.8 kg were used as experimental models (n=12).
Physiological parameters were obtained with the IntelliVue MP70 system
(Philips, Netherlands). Blood samples were taken from the coronary sinus
to evaluate myocardial ischemia markers - troponin I, creatine
phosphokinase-MB, lactate dehydrogenase, and lactate - and apex biopsy was
performed before and after the ischemia period according to the protocol.
Myocardial samples were taken from the left ventricle and prepared
according to the protocol either. Result(s): Twelve orthotopic heart
transplantations were performed during the study. Sample size was divided
into two groups with six each. Cardiac output was 5.11 (4.99; 5.41) l/min
and 5.77 (4.97; 6.62) l/min (P-0.0009) after 120 minutes of cardiac
activity in both groups. Change of lactate dehydrogenase, creatine
phosphokinase-MB, and troponin I levels in the coronary sinus blood were
significantly higher in the early reperfusion period. However, there were
no statistically significant differences between the groups (P>0.05).
Myocardial oxygen consumption was considerably reduced during reperfusion
but returned to baseline by 60 minutes of postischemia without significant
differences between groups (P>0.05). Conclusion(s): We observed that
intracoronary iopromide administration was safe during the ex vivo stage
cold preservation phase of the study. Intracoronary iopromide
administration did not affect cardiac pump function and cardiomyocytes
metabolism in the early posttransplant period. Copyright © 2025,
Sociedade Brasileira de Cirurgia Cardiovascular. All rights reserved.

<66>
Accession Number
2037618856
Title
Intraoperative Oxygenation and Microcirculatory Changes Following Off-pump
Coronary Artery Bypass Grafting: An Exploratory Secondary Analysis of a
Randomized Clinical Trial.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2025.
Date of Publication: 2025.
Author
Nam K.; Chung J.; Ju J.-W.; Cho Y.J.; Jeon Y.
Institution
(Nam, Chung, Ju, Cho, Jeon) Department of Anesthesiology and Pain
Medicine, Seoul National University Hospital, Seoul National University
College of Medicine, Seoul, South Korea
Publisher
W.B. Saunders
Abstract
Objectives: The effect of perioperative hyperoxia on microcirculation
after cardiac surgery remains inconclusive. We evaluated the relationship
between intraoperative fractional inspired oxygen and microcirculation
after off-pump coronary artery bypass grafting (OPCAB). Design(s):
Exploratory secondary analysis of a multicenter cluster-randomized trial.
 Setting(s): Three teaching hospitals. Participant(s): Adult
patients who underwent OPCAB. Intervention(s): Seven postoperative
microcirculatory parameters, including De Backer scores and the proportion
of perfused vessels via sublingual microscopy (from all and small
vessels), and thenar muscle tissue oxygenation, occlusion slope, and
recovery slope via the vascular occlusion test, were compared between
patients receiving 30% and 80% oxygen intraoperatively. Generalized
estimating equations were used to account for intracluster correlation.
 Measurements and Main Results: The analysis included 52 and 51
patients from the 30% and 80% oxygen groups, respectively, for sublingual
microscopy and 59 and 53 patients for the vascular occlusion test.
Although all microcirculatory parameters were similar between groups, the
80% oxygen group had higher De Backer scores for all vessels (mean, 9.8
+/- 2.9 mm-1 vs. 8.7 +/- 2.0 mm-1; p = 0.011) and
small vessels (4.0 +/- 1.8 mm-1 vs. 3.4 +/- 1.1
mm-1; p = 0.024) than the 30% oxygen group at the end of
surgery. The 80% oxygen group also exhibited greater thenar muscle tissue
oxygenation immediately before vascular occlusion (78.4% +/- 10.5 vs.
74.0% +/- 9.3; p = 0.031) and a higher recovery score (4.1%.s-1
+/- 1.7 vs. 3.2%.s-1 +/- 1.4; p = 0.001). Conclusion(s):
Patients receiving 80% oxygen during OPCAB had significantly better
postoperative microcirculatory profiles than those receiving 30% oxygen.
These findings highlight the potential for optimizing perioperative
oxygenation to improve or mitigate microcirculatory impairment, thereby
reducing postoperative complications. Copyright © 2025 Elsevier
Inc.

<67>
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. 57(2) (pp 463-477), 2025. Article
Number: 750828. Date of Publication: 01 Feb 2025.
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.
 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. 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%). Conclusion(s): Compared with OPCAB,
short-term mortality was significantly higher in ONCAB. Copyright
© The Author(s), under exclusive licence to Springer Nature B.V.
2024.

<68>
[Use Link to view the full text]
Accession Number
2034916712
Title
International incidence of melanoma in heart transplant recipients: a
meta-analysis.
Source
Melanoma Research. 35(1) (pp 24-30), 2025. Date of Publication: 01 Feb
2025.
Author
Campillo P.; Kesler A.; Ramirez C.A.; Ramirez C.J.; Daher J.C.; Grimm M.;
Sabina M.; Bizanti A.
Institution
(Campillo, Kesler, Ramirez, Ramirez, Daher, Grimm, Sabina, Bizanti)
Department of Internal Medicine, Lakeland Regional Health Medical Center,
Lakeland, FL, United States
Publisher
Lippincott Williams and Wilkins
Abstract
The incidence of heart transplants in the USA has increased by 85.8% since
2011, resulting in a growing population of recipients requiring long-term
immunosuppressive therapy. While essential for preventing organ rejection,
this therapy significantly increases melanoma risk. This meta-analysis
investigates the incidence and risk factors of melanoma in heart
transplant recipients. A systematic review and meta-analysis were
conducted following Preferred Reporting Items for Systematic Reviews and
Meta-Analyses guidelines, including observational studies reporting
melanoma incidence in heart transplant recipients. Relative risk (RR) was
synthesized from standardized incidence ratios, hazard ratios, incidence
rate ratios, and standardized mortality ratios. The meta-analysis
incorporated 10 studies, including 22 415 heart transplant recipients. The
pooled RR was 2.21 (95% confidence interval: 1.32-3.71; P = 0.003),
indicating a significantly elevated melanoma risk. This study highlights
the critical need for preventive dermatological strategies in heart
transplant recipients and calls for further research into the impact of
different immunosuppressive regimens on melanoma risk. Despite
limitations, these findings offer valuable insights for optimizing
long-term patient care. Copyright © 2024 The Author(s).

<69>
Accession Number
2037619302
Title
Long-term clinical efficacy of transfemoral transcatheter aortic valve
implantation with three different platforms.
Source
Cardiovascular Revascularization Medicine. (no pagination), 2025. Date of
Publication: 2025.
Author
Dipietro E.; Costa G.; Cali M.; Strazzieri O.; Motta S.C.; Frittitta V.;
Comis A.; Sammartino S.; La Rosa L.; Sgroi C.; Deste W.; Veroux P.;
Lentini S.; Inserra M.C.; Cannizzaro M.T.; Garretto V.; Tamburino C.;
Barbanti M.
Institution
(Dipietro, Costa, Cali, Frittitta, Comis, Sammartino, La Rosa, Sgroi,
Deste, Tamburino) Division of Cardiology, A.O.U. Policlinico "G.
Rodolico-San Marco", Catania, Italy
(Strazzieri, Barbanti) Cardiology Unit, Umberto I Hospital, ASP 4 di Enna,
Enna, Italy
(Motta) Cardiology Unit, Umberto I Hospital, ASP 8 di Siracusa, Siracusa,
Italy
(Veroux) Vascular Surgery and Organ Transplant Unit, University Hospital
of Catania, Catania, Italy
(Lentini) Division of Cardiac Surgery, G. Rodolico - San Marco Policlinic
University Hospital, Catania, Italy
(Inserra, Cannizzaro, Garretto) Division of Radiology, G. Rodolico - San
Marco Policlinic University Hospital, Catania, Italy
(Barbanti) Universita degli Studi di Enna "Kore", Enna, Italy
Publisher
Elsevier Inc.
Abstract
Background: Long-term durability and outcomes of transcatheter aortic
valve implantation (TAVI) have been reported only with first generation
devices. Objective(s): To compare clinical efficacy of TAVI with
Sapien 3 (Edwards Lifesciences), Evolut R/PRO (Medtronic) or Acurate Neo
(Boston Scientific) transcatheter heart valves (THVs) at long-term.
 Method(s): Consecutive TAVI patients treated with Sapien 3, Evolut
R/PRO and Acurate Neo THVs at Policlinico G. Rodolico of Catania with at
least 5 years follow-up were included in this analysis. Patients were
divided into three different groups according to the TAVI device used.
Outcomes were compared after inverse probability of treatment weighting
adjustment. The primary endpoint was the composite of all-cause death,
disabling stroke and heart failure (HF) re-hospitalization at 7 years. The
co-primary endpoint was valve-related clinical efficacy according to Valve
Academic Research Consortium 3 (VARC-3) definition, at 7 years.
 Result(s): From September 2014 to December 2018, 383 tranfemoral TAVI
patients receiving Sapien 3 (n = 131, 34.2 %), Evolut R/PRO (n = 134, 34.9
%), or Acurate Neo (n = 118, 30.8 %) devices were compared. At 7 years,
the composite primary endpoint did not differ among study groups (60.2 %
vs. 51.6 % vs. 62.1 % for Sapien 3, Evolut R/PRO and Acurate Neo,
respectively, p<inf>log-rank</inf> = 0.50). The co-primary endpoint was
also similar (2.2 % vs. 1.2 % vs. 4.2 %, for Sapien 3, Evolut R/PRO and
Acurate Neo, respectively, p<inf>log-rank</inf> = 0.86).
 Conclusion(s): Clinical efficacy of TAVI with Sapien 3, Evolut R/PRO
and Acurate Neo devices was sustained and comparable up to 7 years. Low
and similar rates of valve degeneration were reported among the three
devices. Randomized clinical trials are necessary to corroborate these
findings and to assess the impact of specific hemodynamic differences
among the three THV platforms in the context of long-term clinical
efficacy. Copyright © 2025 Elsevier Inc.

<70>
Accession Number
2032458521
Title
Effect of Kuanxiong Aerosol on Perioperative Coronary Microcirculation in
Patients with Unstable Angina Undergoing Elective PCI: A Pilot Randomized
Controlled Trial.
Source
Chinese Journal of Integrative Medicine. 31(3) (pp 206-214), 2025. Date of
Publication: 01 Mar 2025.
Author
Liu Z.-H.; Xing W.-L.; Liu H.-X.; Shang J.-J.; Li A.-Y.; Zhou Q.; Zhang
Z.-M.; Li Z.-B.; Chen K.-J.
Institution
(Liu, Xing, Liu, Shang, Li, Zhou, Zhang, Li) Cardiovascular Department,
Beijing Hospital of Traditional Chinese Medicine, Capital Medical
University, Beijing, China
(Chen) Xiyuan Hospital, China Academy of Chinese Medical Sciences,
Beijing, China
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Objective: To evaluate the immediate effect of Kuanxiong Aerosol (KXA) on
perioperative coronary microcirculation in patients with unstable angina
(UA) suffering from elective percutaneous coronary intervention (PCI).
 Method(s): From February 2021 to July 2023, UA inpatients who
underwent PCI alone in the left anterior descending (LAD) branch were
included. Random numbers were generated to divide patients into the trial
group and the control group at a ratio of 1:1. The index of coronary
microcirculation resistance (IMR) was measured before PCI, and the trial
group was given two sprays of KXA, while the control group was not given.
IMR was measured again after PCI, cardiac troponin I (cTnI) and creatine
kinase isoenzyme-MB (CK-MB) were detected before and 24 h after surgery,
and major cardiovascular adverse events (MACEs) were recorded for 30 days.
The data statistics and analysis personnel were blinded. Result(s):
Totally 859 patients were screened, and 62 of them were involved into this
study. Finally, 1 patient in the trial group failed to complete the
post-PCI IMR and was excluded, 30 patients were included for data
analysis, while 31 patients in the control group were enrolled in data
analysis. There was no significant difference in baseline data (age,
gender, risk factors, previous history, biochemical index, and drug
therapy, etc.) between the two groups. In addition, differences in IMR,
cTnI and CK-MB were not statistically significant between the two groups
before surgery. After PCI, the IMR level of the trial group was
significantly lower than that of the control group (19.56 +/- 14.37 vs.
27.15 +/- 15.03, P=0.048). Besides, the incidence of perioperative
myocardial injury (PMI) was lower in the trial group, but the difference
was not statistically significant (6.67% vs. 16.13%, P=0.425). No MACEs
were reported in either group. Conclusion(s): KXA has the potential
of improving coronary microvascular dysfunction. This study provides
reference for the application of KXA in UA patients undergoing elective
PCI. (Registration No. ChiCTR2300069831) Copyright © The Chinese
Journal of Integrated Traditional and Western Medicine Press and
Springer-Verlag GmbH Germany, part of Springer Nature 2024.

<71>
[Use Link to view the full text]
Accession Number
2037605881
Title
Left Ventricular Entry to Reduce Brain Lesions during Catheter Ablation: A
Randomized Trial.
Source
Circulation. (no pagination), 2025. Date of Publication: 2025.
Author
Marcus G.M.; Tung R.; Gerstenfeld E.P.; Hue T.F.; Lin F.; Cheng J.; Weiss
J.P.; Tzou W.S.; Hsia H.; Ehdaie A.; Cooper D.H.; Bunch T.J.; Arkles J.;
Nazer B.; Lee A.; Hadjis A.; Nguyen D.T.; Chelu M.G.; Moss J.; Hsu J.C.;
Valderrabano M.; Bhave P.D.; Beaser A.D.; Kanagasundram A.; Wazni O.;
Bradfield J.; Wall G.; Chang K.; Yang M.; Montenegro G.; Jarrott S.;
Kramer J.H.; Kim A.S.; Morris Y.M.; Dillon W.P.
Institution
(Marcus, Gerstenfeld, Hsia, Lee, Moss, Wall, Chang, Yang, Montenegro)
Division of Cardiology, University of California, San Francisco, United
States
(Hue, Lin) Department of Epidemiology and Biostatistics, University of
California, San Francisco, United States
(Cheng) Oral Epidemiology & Dental Public Health, University of
California, San Francisco, United States
(Jarrott, Kramer, Kim) Department of Neurology, University of California,
San Francisco, United States
(Morris) University of California, San Francisco, United States
(Dillon) Department of Radiology and Biomedical Imaging, University of
California, San Francisco, United States
(Tung, Weiss) Division of Cardiology, University of Arizona, College of
Medicine-Phoenix, Banner University Medical Center, United States
(Tzou) Division of Cardiology, University of Colorado, Anschutz Medical
Center, Aurora, United States
(Ehdaie) Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles,
United States
(Cooper) Cardiovascular Division, Washington University, School of
Medicine, St. Louis, United States
(Bunch) Division of Cardiovascular Medicine, University of Utah, Salt Lake
City, United States
(Arkles) Cardiovascular Division, University of Pennsylvania,
Philadelphia, United States
(Nazer) Division of Cardiology, University of Washington, Seattle, United
States
(Hadjis) Division of Cardiology, Hopital du Sacre-Coeur de Montreal,
University of Montreal, Canada
(Nguyen) Department of Cardiovascular Medicine, Mayo Clinic, Rochester,
MN, United States
(Chelu) Department of Medicine-Cardiology, Cardiovascular Research
Institute, Baylor College of Medicine, Texas Heart Institute, Baylor St.
Luke's Medical Center, Houston, United States
(Hsu) Division of Cardiology, University of California, San Diego, United
States
(Valderrabano) Department of Cardiology, Houston Methodist Hospital, TX,
United States
(Bhave) Department of Cardiovascular Medicine, Wake Forest School of
Medicine, Winston-Salem, NC, United States
(Beaser) Section of Cardiology, University of Chicago, IL, United States
(Kanagasundram) Division of Cardiovascular Medicine, Vanderbilt University
Medical Center, Nashville, TN, United States
(Wazni) Department of Cardiovascular Medicine, Cleveland Clinic, OH,
United States
(Bradfield) Cardiac Arrhythmia Center, University of California, Los
Angeles, United States
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND: Catheter ablation of ventricular arrhythmias, one of the most
rapidly growing procedures in cardiac electrophysiology, is associated
with magnetic resonance imaging-detected brain lesions in more than half
of cases. Although a retrograde aortic approach is conventional, modern
tools enable entry through a transseptal approach that may avoid
embolization of debris from the arterial system. We sought to test the
hypothesis that a transseptal puncture would mitigate brain injury
compared with a retrograde aortic approach. METHOD(S): The TRAVERSE
trial (Transseptal Versus Retrograde Aortic Ventricular Entry to Reduce
Systemic Emboli) was a multicenter randomized controlled comparative
effectiveness trial. Patients with left ventricular arrhythmias undergoing
catheter ablation procedures were randomly assigned to a transseptal
puncture approach compared (1:1) with a retrograde aortic approach. The
primary outcome was the presence of an acute brain lesion detected by
magnetic resonance imaging. Secondary outcomes included clinically
manifest complications, procedural efficacy, and 6-month neurocognitive
assessments. RESULT(S): Among the 62 patients randomly assigned to a
retrograde aortic approach with postoperative brain magnetic resonance
imaging, 28 (45%) exhibited an acute brain lesion compared with 19 of the
69 (28%) of those randomized to a transseptal puncture (P=0.036). No
differences in clinically manifest complications or procedural efficacy
were observed. More patients in the retrograde aortic arm were categorized
as having a high likelihood of cognitive impairment at 6 months (33%
compared with 19% of those in the transseptal arm), but substantial loss
to follow-up was present. CONCLUSION(S): Among patients undergoing
left ventricular catheter ablation procedures, a transseptal approach
reduced the risk of acute brain lesions by nearly half compared with a
retrograde aortic approach without sacrificing safety or efficacy. Given a
likely embolic pathogenesis, the brain magnetic resonance imaging findings
may reflect a propensity to other organ damage; these findings may extend
to other procedures requiring left ventricular entry. Copyright ©
2025 American Heart Association, Inc.

<72>
Accession Number
2037651613
Title
Fasting vs No Fasting Prior to Percutaneous Cardiovascular Procedures: A
Meta-Analysis of Randomized Controlled Trials.
Source
JACC: Cardiovascular Interventions. 18(5) (pp 682-684), 2025. Date of
Publication: 10 Mar 2025.
Author
Maqsood M.H.; Tamis-Holland J.E.; Mamas M.A.; Capodanno D.; Bhatt D.L.;
Bangalore S.
Publisher
Elsevier Inc.

<73>
Accession Number
2037555922
Title
Neurodevelopmental Outcomes after Nitric Oxide during Cardiopulmonary
Bypass for Open Heart Surgery: A Randomized Clinical Trial.
Source
JAMA Network Open. 8(2) (no pagination), 2025. Article Number: e202458040.
Date of Publication: 05 Feb 2025.
Author
Long D.A.; Gibbons K.S.; Horton S.B.; Johnson K.; Buckley D.H.F.; Erickson
S.; Festa M.; D'Udekem Y.; Alphonso N.; Le Marsney R.; Winlaw D.S.;
Masterson K.; Van Loon K.; Young P.J.; Schibler A.; Schlapbach L.J.; Butt
W.
Institution
(Long) School of Nursing, Centre for Healthcare Transformation, Queensland
University of Technology, Brisbane, Australia
(Long, Schlapbach) Paediatric Intensive Care Unit, Queensland Children's
Hospital, Children's Health Queensland, Brisbane, Australia
(Long, Gibbons, Johnson, Le Marsney, Schlapbach) Children's Intensive Care
Research Program, Child Health Research Centre, The University of
Queensland, Brisbane, Australia
(Horton) Cardiac Surgical Unit, Royal Children's Hospital, Melbourne, VIC,
Australia
(Horton, D'Udekem, Butt) Faculty of Medicine, Department of Paediatrics,
University of Melbourne, Melbourne, VIC, Australia
(Horton, Masterson, Butt) Clinical Sciences Theme, Murdoch Children's
Research Institute, Melbourne, VIC, Australia
(Buckley) Paediatric Intensive Care Unit, Starship Children's Hospital,
Auckland, New Zealand
(Erickson) Paediatric Critical Care, Perth Children's Hospital, The
University of Western Australia, Crawley, WA, Australia
(Festa) Kids Critical Care Research, Paediatric Intensive Care Unit,
Children's Hospital at Westmead, Westmead, NSW, Australia
(Festa) Sydney Children's Hospital Network, Sydney, NSW, Australia
(D'Udekem) Children's National Hospital, The George Washington University,
School of Medicine and Health Sciences, Washington, DC, United States
(Alphonso) Cardiac Surgery, Queensland Children's Hospital, Brisbane,
Australia
(Alphonso) School of Medicine, Children's Health Clinical Unit, The
University of Queensland, Brisbane, Australia
(Winlaw) Heart Centre for Children, The Children's Hospital at Westmead,
Westmead, NSW, Australia
(Winlaw) Sydney Children's Hospital Network, Faculty of Medicine and
Health, University of Sydney, Sydney, NSW, Australia
(Masterson) Paediatric Intensive Care Unit, Royal Children's Hospital
Melbourne, Melbourne, VIC, Australia
(Van Loon, Butt) Department of Anaesthesiology, University Medical Center
Utrecht, Wilhelmina Children's Hospital, Utrecht, Netherlands
(Young) Intensive Care Unit, Wellington Hospital, Wellington, New Zealand
(Young) Medical Research Institute of New Zealand, Wellington, New Zealand
(Young) Australian and New Zealand Intensive Care Research Centre, Monash
University, Melbourne, VIC, Australia
(Young, Butt) Department of Critical Care, University of Melbourne,
Melbourne, VIC, Australia
(Schibler) James Cook University, Townsville, QLD, Australia
(Schibler) Critical Care Research Group, Wesley Medical Research, St
Andrew's War Memorial Hospital, Brisbane, QLD, Australia
(Schlapbach) Department of Intensive Care and Neonatology, University
Children's Hospital Zurich, University of Zurich, Zurich, Switzerland
(Schlapbach) Children's Research Center, University Children's Hospital
Zurich, University of Zurich, Zurich, Switzerland
(Butt) Central Clinical School, Faculty of Medicine, Monash University,
Melbourne, VIC, Australia
Publisher
American Medical Association
Abstract
Importance: Children with congenital heart defects who undergo
cardiopulmonary bypass (CPB) surgery are at risk for delayed or impaired
neurodevelopmental outcomes. Nitric oxide (NO) added to the CPB oxygenator
may reduce systemic inflammation due to CPB and improve recovery from
surgery, including improved neurodevelopmental outcomes.
 Objective(s): To investigate neurodevelopment, health-related quality
of life (HRQOL), and factors associated with impaired neurodevelopment at
12 months post surgery in infants who received CPB with NO or standard
CPB. Design, Setting, and Participant(s): This double-masked
randomized clinical trial was conducted in 6 centers in Australia, New
Zealand, and the Netherlands between July 19, 2017, and April 28, 2021,
with a preplanned prospective follow-up 12 months postrandomization
completed on August 5, 2022. The cohort included 1364 infants younger than
2 years who underwent open heart surgery with CPB for congenital heart
disease. Intervention(s): The intervention group received NO 20 ppm
into the CPB oxygenator. The control group received standard CPB.
 Main Outcomes and Measures: The primary outcome was neurodevelopment,
defined as the Ages and Stages Questionnaire, Third Edition (ASQ-3) total
score. Secondary outcomes were HRQOL and functional status as measured by
Pediatric Quality of Life Inventory and modified Pediatric Overall
Performance Category scores, respectively. Sensitivity analyses modeled
the outcome for patients lost to follow-up. Result(s): Of 1318
infants alive 12 months after randomization, follow-up was performed in
927, with 462 patients in the NO group and 465 in the standard care group
(median [IQR] age at follow-up, 16.6 [13.7-19.8] months; median [IQR] time
since randomization, 12.7 [12.1-13.9] months; 516 male [55.7%]). There
were no differences between the NO and standard care groups in ASQ-3 total
score (mean [SD], 196.6 [75.4] vs 198.7 [73.8], respectively; adjusted
mean difference, -2.24; 95% CI, -11.84 to 7.36). There were no differences
in secondary outcomes. Prematurity (gestational age <37 weeks),
univentricular lesions, congenital syndromes, and longer intensive care
unit length of stay were associated with lower ASQ-3 total scores in
adjusted multivariable analyses. Conclusions and Relevance: In this
randomized clinical trial of infants with congenital heart disease, NO
administered via the CPB oxygenator did not improve neurodevelopmental
outcomes or HRQOL 12 months after open heart surgery. Further research
should explore homogenous cohorts with higher surgical risk and
higher-dose or alternative therapies. Trial Registration: ANZCTR
Identifier: ACTRN12617000821392. Copyright © 2025 Long DA et al.
JAMA Network Open.

<74>
Accession Number
2033384849
Title
Comparative Efficacy and Safety of Low-Dose Direct Oral Anticoagulants
Versus Dual Antiplatelet Therapy Following Left Atrial Appendage Occlusion
in Patients With Nonvalvular Atrial Fibrillation: A Systematic Review and
Meta-Analysis.
Source
Catheterization and Cardiovascular Interventions. (no pagination), 2025.
Date of Publication: 2025.
Author
Ibrahim A.; Shalabi L.; Zreigh S.; Ramadan S.; Mourad S.; Eljadid G.;
Beshr M.; Abdelaziz A.; Elhadi M.; Sabouret P.; Mamas M.
Institution
(Ibrahim, Mourad, Abdelaziz) Faculty of Medicine, Alexandria University,
Alexandria, Egypt
(Shalabi) Faculty of Medicine, Gharyan University, Gharyan, Libyan Arab
Jamahiriya
(Zreigh) Faculty of Medicine, Ankara Yildirim Beyazit University, Ankara,
Turkey
(Ramadan, Eljadid) Faculty of Medicine, Ain Shams University, Cairo, Egypt
(Beshr) Faculty of Medicine and Health Sciences, Sana'a University,
Sana'a, Yemen
(Elhadi) Korea University College of Medicine, Seoul, Seongbuk-gu, South
Korea
(Sabouret) National College of French Cardiologists, Paris, France
(Sabouret) ACTION Study Group, Pitie-Salpetriere Hospital, Sorbonne
University, Paris, France
(Mamas) Keele Cardiovascular Research Group, Keele University,
Stoke-on-Trent, United Kingdom
Publisher
John Wiley and Sons Inc
Abstract
Background: Left atrial appendage occlusion (LAAO) is an alternative to
chronic oral anticoagulation (OAT) for stroke prevention in nonvalvular
atrial fibrillation (NVAF) patients with contraindications to OAT.
Postprocedure antithrombotic therapy (ATT) is essential to reduce the risk
of device-related thrombosis (DRT), but the optimal regimen remains
uncertain. Aim(s): This study aims to compare the safety and efficacy
of low-dose direct oral anticoagulants (DOACs) versus dual antiplatelet
therapy (DAPT) following LAAO. Method(s): A comprehensive search of
PubMed, Scopus, Cochrane, and Web of Science was conducted in August 2024.
Studies comparing low-dose DOACs and DAPT post-LAAO were included. The
primary outcomes were a composite efficacy endpoint (DRT, strokes, and
systemic embolism [SE]) and major bleeding events as the safety endpoint.
Secondary outcomes included all bleeding events, all-cause mortality, and
a composite of efficacy and safety endpoints. Result(s): Four studies
with 727 patients were included. Low-dose DOACs were associated with lower
rates of the primary composite efficacy endpoint compared to DAPT (OR =
0.36; 95% CI [0.16, 0.85], p = 0.01). No significant difference in major
bleeding events was observed (OR = 0.36; 95% CI [0.11, 1.18]; p = 0.091;
I2 = 0%). Compared to DAPT, low-dose DOACs were also associated with lower
rates of DRT events (OR = 0.36; 95% CI [0.16, 0.79], p = 0.011).
 Conclusion(s): Low-dose DOACs effectively reduce thromboembolic
events post-LAAO without increasing bleeding risk. These findings support
their use as a viable ATT option, but larger trials are needed to confirm
optimal regimens. Copyright © 2025 Wiley Periodicals LLC.

<75>
Accession Number
2029870651
Title
Difference in coagulation systems of large animal species used in
cardiovascular research: a systematic review.
Source
Journal of Artificial Organs. 28(1) (pp 1-14), 2025. Date of Publication:
01 Mar 2025.
Author
Staelens L.; Langenaeken T.; Rega F.; Meuris B.
Institution
(Staelens, Langenaeken, Rega, Meuris) Department of Cardiovascular
Diseases, Research Unit of Cardiac Surgery, University Hospitals Leuven,
Herestraat 49, Leuven, Belgium
Publisher
Springer
Abstract
Preclinical testing using animal models is indispensable in cardiovascular
research. However, the translation to clinical practice of these animal
models is questionable since it is not always clear how representative
they are. This systematic review intends to summarize the interspecies
differences in the coagulation profile of animal models used in
cardiovascular research. It aims to guide future research in choosing the
optimal animal species. A literature search of PubMed, Embase, Web of
Science (Core Collection) and Cochrane Library was performed using a
search string that was well defined and not modified during the study. An
overview of the search terms used in each database can be found in the
appendix. Articles describing coagulation systems in large animals were
included. We identified 30 eligible studies of which 15 were included.
Compared to humans, sheep demonstrated a less active external pathway of
coagulation. Sheep had a higher platelet count but the platelet
activatability and response to biomaterials were lower. Both sheep and
pigs displayed no big differences in the internal coagulation system
compared to humans. Pigs showed results very similar to those of humans,
with the exception of a higher platelet count and stronger platelet
aggregation in pigs. Coagulation profiles of different species used for
preclinical testing show strong variation. Adequate knowledge of these
differences is key in the selection of the appropriate species for
preclinical cardiovascular research. Future thrombogenicity research
should compare sheep to pig in an identical experimental
setup. Copyright © The Author(s) 2024.

<76>
Accession Number
2033382376
Title
Perioperative Mechanical Circulatory Support for Cardiac Assistance in
Thoracic Surgery: A Scoping Review.
Source
Artificial Organs. (no pagination), 2025. Date of Publication: 2025.
Author
Agosta V.T.; D'Andria Ursoleo J.; Bottussi A.; Bugo S.; Monaco F.
Institution
(Agosta, D'Andria Ursoleo, Bottussi, Bugo, Monaco) Department of
Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute,
Milan, Italy
Publisher
John Wiley and Sons Inc
Abstract
Background: Patients with pre-existing severe cardiovascular comorbidities
are often deemed ineligible for potentially life-saving thoracic surgeries
and are referred to other conservative therapies. However, this patient
population may theoretically benefit from the timely perioperative
implantation of temporary mechanical circulation support (tMCS) to both
mitigate the surgical stress and stabilize hemodynamics. We performed a
scoping review to summarize the evidence regarding the use of tMCS in
thoracic surgery. Method(s): We conducted a systematic search across
PubMed/MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials,
Web of Science, Scopus, and Google Scholar from their inception, aided by
a search string encompassing a combination of terms for the key research
concepts: i) tMCS devices; ii) thoracic surgery procedures (except lung
transplantation); and iii) the adult population. Result(s): Fifteen
studies pertinent to the research question, which summarized data from 28
patients, were retrieved for inclusion. In 14 patients, tMCS implantation
occurred as a "pre-emptive" strategy, while the remaining patients had
tMCS implanted either intra and/or postoperatively as a "bail-out"
strategy. Specifically, 14 patients required an intra-aortic balloon pump,
10 veno-arterial extracorporeal membrane oxygenation, two required a
multidevice strategy, and one cardiopulmonary bypass. The relative risk
analysis revealed that the mortality rate in the pre-emptive group was
half that of the bail-out group. Additionally, the risk of both infectious
and vascular complications was lower in the pre-emptive group compared to
the bail-out tMCS strategy. Conclusion(s): We found that the timely
implantation of tMCS in thoracic surgery-either to mitigate patients'
heightened cardiovascular risk or as a rescue strategy in the event of
life-threatening surgical complications-may lead to better patient
outcomes, as well as allowing them to undergo curative surgery with an
acceptable safety profile, characterized by overall good survival rates
and a low incidence of device-related complications. Copyright ©
2025 The Author(s). Artificial Organs published by International Center
for Artificial Organ and Transplantation (ICAOT) and Wiley Periodicals
LLC.

<77>
Accession Number
2033439689
Title
Aortopexy for Tracheomalacia in Children: A Systematic Review and
Meta-Analysis.
Source
Journal of Clinical Medicine. 14(4) (no pagination), 2025. Article Number:
1367. Date of Publication: 01 Feb 2025.
Author
Zanini A.; Mazzoleni S.; Arcieri L.; Giordano R.; Marianeschi S.; Macchini
F.
Institution
(Zanini, Mazzoleni, Macchini) Pediatric Surgery, ASST Grande Ospedale
Metropolitano Niguarda, Milan, Italy
(Arcieri, Marianeschi) Pediatric Cardiac Surgery, ASST Grande Ospedale
Metropolitano Niguarda, Milan, Italy
(Giordano) Advanced Biomedical Sciences, Adult and Pediatric Cardiac
Surgery, University of Naples Federico II, Via Pansini 5, Naples, Italy
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Introduction: Aortopexy is the most common surgical option for the
treatment of severe tracheomalacia (TM) in children. Despite being
described over 75 years ago, several aspects of the procedure remain
controversial. Material(s) and Method(s): A systematic review of
aortopexy was conducted following the PRISMA guidelines. All original
articles describing at least one case of aortopexy performed in children
for the treatment of TM were included. Patients' characteristics, surgical
indications, approaches and details were collected. Outcomes were
reviewed, and potential factors associated with procedural success were
investigated. Result(s): Of 243 papers, 17 were included in this
review, encompassing a total of 473 patients who underwent aortopexy. Of
these, 65.3% were male, with a mean age at surgery of 12.2 months (5
days-18 years). Primary TM accounted for 7.9% of cases, while 92.1% were
secondary to other anomalies, including esophageal atresia (54.1%),
aberrant innominate artery (16.1%) and vascular rings (8.3%). There is a
general consensus on the surgical indication for TM with severe symptoms,
although the definition of severity is not well established. Overall
success was 84%, but 40.8% of patients experienced some persistent
symptoms. Sternotomy and thoracotomy were the most successful approaches
(92.6% and 84.2%, respectively). Thoracoscopy had a similar success rate
to sternotomy when pericardiotomy, thymectomy and pledgeted suture were
performed (86.4% vs. 92.6% p = 0.41). Conclusion(s): Aortopexy is
associated with good outcomes, but no evidence-based guidelines are
currently available. Success appears to be associated with specific
surgical steps rather than the surgical approach. Prospective studies are
desirable for establishing precise guidelines. Copyright © 2025
by the authors.

<78>
Accession Number
2037792458
Title
EFFICACY OF CATHETER ABLATION FOR ATRIAL FIBRILLATION IN PATIENTS WITH
HEART FAILURE: AN UPDATED META-ANALYSIS.
Source
Journal of the American College of Cardiology. Conference: American
College of Cardiology, (ACC) Meeting 2025. Chicago United States. 85(12
Supplement) (pp 210), 2025. Date of Publication: 01 Apr 2025.
Author
Gill H.; Singh S.; Tantry U.; Bliden K.; Gurbel P.A.; Kanjwal M.; Lundgren
S.; Naksuk N.
Institution
(Gill, Singh, Tantry, Bliden, Gurbel, Kanjwal, Lundgren, Naksuk) Sinai
Hospital of Baltimore, Baltimore city, MD, United States
Publisher
Elsevier Inc.
Abstract
Background Guidelines recommend consideration of catheter ablation for
atrial fibrillation (AF) in patients with heart failure (HF) with the
randomized controlled trials (RCTs) showing conflicting results. We aimed
to perform a meta-analysis of the available studies. Methods Online
databases were searched for RCTs comparing catheter ablation to
control(medical therapy or atrioventricular node ablation with pacing) for
AF in patients with HF. Outcomes of interest were all-cause death,
cardiovascular (CV) death, heart transplantation and change in left
ventricular ejection fraction (LVEF). Pooled odds ratio(OR) and mean
difference (MD) along with 95% confidence interval (CI) were calculated
using a random-effects model. Results A total of 11 RCTs with 2,434
patients (catheter ablation n=1,218, control n=1,216) were included.
Around 82% of patients were men, mean age was 63 years, and the mean
duration of follow-up was 21 months. HF patients undergoing catheter
ablation for AF had lower risk of all-cause of death (OR 0.57, 95% CI 0.43
to 0.74, p < 0.0001) (Figure), CV death (OR 0.48,95% CI 0.31 to 0.75, p
= 0.001), need of heart transplantation (OR 0.17, 95% CI 0.03 to0.95, p =
0.04) and greater improvement in LVEF (MD 5.89, 95% CI 4.34 to 7.43, p
<0.00001) as compared to control. Conclusion As compared with medical
therapy or atrioventricular node ablation with pacing, catheterablation
for AF in patients with HF is associated with significant reduction in
mortality andgreater improvement in LVEF. [Formula
presented] Copyright © 2025 American College of Cardiology
Foundation

<79>
Accession Number
2037793873
Title
ISCHEMIC STROKE INCIDENCE IN TRANSCATHETER AORTIC VALVE REPLACEMENT VERSUS
SURGICAL AORTIC VALVE REPLACEMENT: A COMPARATIVE SYSTEMATIC REVIEW AND
META ANALYSIS.
Source
Journal of the American College of Cardiology. Conference: American
College of Cardiology, (ACC) Meeting 2025. Chicago United States. 85(12
Supplement) (pp 808), 2025. Date of Publication: 01 Apr 2025.
Author
Saeed S.; karmani V.K.; Riaz A.
Institution
(Saeed, karmani, Riaz) Charleston Area Medical Center, Charleston, WV,
United States
Publisher
Elsevier Inc.
Abstract
Background This systematic review and meta-analysis compare ischemic
stroke incidence between transcatheter aortic valve replacement (TAVR) &
surgical aortic valve replacement (SAVR). Methods We conducted a
systematic review and meta-analysis following PRISMA guidelines, searching
PubMed, Google Scholar, & Cochrane CENTRAL from inception to December
2023. We evaluated stroke and transient ischemic attack (TIA) incidence at
30 days & 1-year post-procedure, using odds ratios (ORs) with 95%
confidence intervals (CIs) and a random-effects model for data synthesis.
Heterogeneity was assessed with I2 statistics, and analyses were performed
using Review Manager 5.4 Results We screened 4,549 articles and included 8
studies: 5 randomized controlled trials and 3 observational studies. In 6
studies on 30-day stroke incidence, no significant difference was found
between TAVR and SAVR patients (OR 0.83, 95% CI 0.59 to 1.17, p=0.30, I2
3%). 7 studies showed similar 1-year stroke risks (OR 0.92, 95% CI 0.64 to
1.33, p=0.67, I2 52%). For transient ischemic attacks (TIAs), no
significant difference within 30 days (OR 0.93, 95% CI 0.24 to 3.63,
p=0.92, I2 52%), but a higher 1-year TIA risk in TAVR patients (OR 1.15,
95% CI 0.72 to 1.82, p=0.56, I2 0%), though not statistically significant.
Conclusion Our findings showed no significant differences in TIA and
ischemic stroke occurrences between TAVR and SAVR patients at 30 days and
1 year post-procedure. [Formula presented] Copyright © 2025
American College of Cardiology Foundation

<80>
Accession Number
2037795461
Title
CHANGES IN APOLIPOPROTEIN B AND LOW-DENSITY LIPOPROTEIN CHOLESTEROL AND
CARDIOVASCULAR EVENTS WITH PEMAFIBRATE THERAPY.
Source
Journal of the American College of Cardiology. Conference: American
College of Cardiology, (ACC) Meeting 2025. Chicago United States. 85(12
Supplement) (pp 457), 2025. Date of Publication: 01 Apr 2025.
Author
Everett B.; Glynn R.J.; Visseren F.; MacFadyen J.G.; Zaharris E.; Siqueira
A.; Plutzky J.; Santos R.; Libby P.; Pradhan A.D.; Ridker P.M.
Institution
(Everett, Glynn, Visseren, MacFadyen, Zaharris, Siqueira, Plutzky, Santos,
Libby, Pradhan, Ridker) Brigham and Women's Hospital, Boston, MA, United
States
(Everett, Glynn, Visseren, MacFadyen, Zaharris, Siqueira, Plutzky, Santos,
Libby, Pradhan, Ridker) Harvard Medical School, Boston, MA, United States
Publisher
Elsevier Inc.
Abstract
Background The PROMINENT trial found that pemafibrate lowered
triglycerides (TG) by 26% but did not reduce cardiovascular (CV) events.
These neutral effects might relate to modest elevations in apolipoprotein
B (apoB) and low-density lipoprotein cholesterol (LDL-C) seen with
pemafibrate. Methods PROMINENT randomized patients with type 2 diabetes
(T2D) and TG 200 to 499 mg/dL to pemafibrate 0.2 mg twice daily or
placebo. We divided the patients on active therapy into groups with the
largest absolute and relative (percent) change (increase or decrease) in
apoB and LDL-C, and then used adjusted Cox proportional hazards models to
estimate the effect of pemafibrate as compared to placebo on the trial
primary CV outcome (MI, stroke, coronary revascularization, CV death).
Results In 9,541 patients with baseline and 4-month follow up apoB and
LDL-C, patients on active pemafibrate had a mean 26.2% reduction in TG,
12.3% increase in LDL-C and 4.8% increase in apoB. We observed no
significant reduction in the rate of primary CV outcome for those on
active therapy with the largest absolute and relative reductions in apoB
(-15.0 mg/dL or -15.4%) or LDL-C (-11 mg/dL or -11.5%; Figure). No
significant increase in the rate of CV outcomes was observed for those
with increases in apoB or LDL-C. Conclusion In this analysis of
post-randomization on-treatment levels of apoB and LDL-C, elevations in
apoB or LDL-C in patients on active pemafibrate did not associate with
differences in CV outcomes compared to placebo. [Formula
presented] Copyright © 2025 American College of Cardiology
Foundation

<81>
Accession Number
2037787675
Title
THE RISK OF STROKE AND VASCULAR COMPLICATIONS IN CANCER PATIENTS WITH
AORTIC STENOSIS UNDERGOING TAVR: A SYSTEMATIC REVIEW AND META-ANALYSIS.
Source
Journal of the American College of Cardiology. Conference: American
College of Cardiology, (ACC) Meeting 2025. Chicago United States. 85(12
Supplement) (pp 2860), 2025. Date of Publication: 01 Apr 2025.
Author
Odat R.M.; Jain H.; Nguyen D.; Alshwayyat S.; Aldamen A.; Ghabally M.;
Hammadeh B.; Jaradat M.; Alqudah M.F.; Altaweel A.; Sabet C.; Yasin J.
Institution
(Odat, Jain, Nguyen, Alshwayyat, Aldamen, Ghabally, Hammadeh, Jaradat,
Alqudah, Altaweel, Sabet, Yasin) Jordan University of Science and
Technology, Irbid, Jordan
(Odat, Jain, Nguyen, Alshwayyat, Aldamen, Ghabally, Hammadeh, Jaradat,
Alqudah, Altaweel, Sabet, Yasin) Harvard T.H. Chan School of Public
Health, Harvard University, Boston, MA, United States
Publisher
Elsevier Inc.
Abstract
Background Transcatheter aortic valve replacement (TAVR) is the standard
treatment for patients with aortic stenosis (AS), especially those at high
surgical risk. Cancer patients frequently have additional cardiovascular
risks due to the effects of cancer and its treatments. However, the impact
of cancer on stroke and vascular complications after TAVR remains unclear.
This study aims to explore the influence of cancer on these complications
to improve management strategies for cancer patients undergoing TAVR.
Methods We conducted a meta-analysis of studies published in the Embase,
PubMed, Scopus, and Cochrane databases to identify included studies using
a preferred search strategy. The primary outcome was the occurrence of
stroke and vascular complications in patients with and without cancer. We
used the review manager version 5.4 to perform the analysis. Results
Twelve studies with 285,638 participants were included in the analysis.
Patients with cancer who underwent TAVR had lower stroke risk than those
without cancer (OR: 0.76, 95% CI: 0.71- 0.81), with no heterogeneity (I2
=0). There was no difference in risk vascular complications between the
two groups (OR= 0.96, 95% CI: 0.736-1.271). Conclusion Our study provides
evidence that cancer patients who have undergone TAVR have a considerably
lower risk of stroke than those without cancer. However, there were no
statistically significant differences in vascular complications between
patients with and without cancer. [Formula presented] Copyright ©
2025 American College of Cardiology Foundation

<82>
Accession Number
2037786662
Title
CARDIOVASCULAR OUTCOMES OF TARGETED THERAPIES FOR TRANSTHYRETIN-ASSOCIATED
AMYLOID CARDIOMYOPATHY.
Source
Journal of the American College of Cardiology. Conference: American
College of Cardiology, (ACC) Meeting 2025. Chicago United States. 85(12
Supplement) (pp 1466), 2025. Date of Publication: 01 Apr 2025.
Author
Ibrahim S.; Ozaeta J.C.; Allihien S.-M.; Berchie P.O.; Kesiena O.; Afari
M.E.
Institution
(Ibrahim, Ozaeta, Allihien, Berchie, Kesiena, Afari) AU/ UGA Piedmont
Athens Regional Medical Center, Athens, GA, United States
(Ibrahim, Ozaeta, Allihien, Berchie, Kesiena, Afari) Maine Medical Center,
Portland, ME, United States
Publisher
Elsevier Inc.
Abstract
Background Transthyretin-associated amyloid cardiomyopathy (ATTR-CM) is a
progressive and life-threatening condition caused by the deposition of
misfolded transthyretin (ATTR) fibrils in cardiac tissue. Recent
disease-modifying therapies have improved surrogate outcomes, but their
impact on hard outcomes such as all-cause mortality, the need for
orthotopic heart transplantation (OHT), and CV hospitalizations remains
debated. Methods We searched the MEDLINE, Cochrane Central Registry of
Controlled Trials, Embase, and clinicalTrials.gov databases up to
September 2024. We included studies reporting on targeted therapies for
ATTR-CM and focused on clinically relevant outcomes: all-cause mortality,
the need for OHT, and CV hospitalizations. A pooled analysis was performed
for any therapy with multiple studies reporting these outcomes,
calculating odds ratios (ORs) with 95% confidence intervals (CIs). Results
Twelve studies, including 5 RCTs, met the inclusion criteria. Targeted
therapies evaluated include tafamidis, vutrisiran, acoramidis, diflunisal,
and patisiran. Tafamidis significantly reduced all-cause mortality or the
need for OHT (OR 0.20 [95% CI: 0.10, 0.41]; p<0.001) and CV
hospitalizations (OR 0.42 [95% CI: 0.23, 0.77]; p=0.005). Similarly,
vutrisiran reduced all-cause mortality or OHT (OR 0.69 [95% CI: 0.49,
0.98]; p=0.04). Acoramidis reduced CV-related hospitalizations by 50% (OR
0.50 [95% CI: 0.36, 0.70]; p<0.001) and significantly reduced all-cause
mortality and CV-related hospitalization (OR 0.65 [95% CI: 0.50, 0.83];
p<0.001). Diflunisal also significantly reduced all-cause mortality or OHT
(OR 0.12 [95% CI: 0.03, 0.55]; p=0.006). However, patisiran did not show a
statistically significant reduction in either all-cause mortality (OR 0.47
[95% CI: 0.21, 1.05]; p=0.07) or CV hospitalizations (OR 0.96 [95% CI:
0.66, 1.41]; p=0.85). Conclusion Our study highlights the efficacy of
tafamidis, vutrisiran, acoramidis, and diflunisal in significantly
improving all-cause mortality, OHT, and CV hospitalizations in patients
with ATTR-CM. Conversely, patisiran did not demonstrate significant
benefits on the evaluated outcomes. Copyright © 2025 American
College of Cardiology Foundation

<83>
Accession Number
2037789399
Title
INTRAOPERATIVE REMOVAL OF TICAGRELOR IN PATIENTS UNDERGOING URGENT CABG: A
POOLED ANALYSIS OF THE STAR-T RANDOMIZED TRIAL AND THE INTERNATIONAL STAR
REGISTRY.
Source
Journal of the American College of Cardiology. Conference: American
College of Cardiology, (ACC) Meeting 2025. Chicago United States. 85(12
Supplement) (pp 1844), 2025. Date of Publication: 01 Apr 2025.
Author
Mack M.J.; Storey R.F.; Whitlock R.; Schmoeckel M.M.M.; Chu M.; Taylor B.;
Zias E.A.; Liu D.; Hassan K.; Thielmann M.; Meyer A.L.; De Neve N.Y.;
Sellke F.W.; Schneider D.J.; Thourani V.H.; Douketis J.; Mazer C.D.; Steg
P.G.; Capodanno D.; Zeymer U.; Matejic-Spasic M.; Wendt D.; Fan W.;
Deliargyris E.N.; Gibson C.M.
Institution
(Mack, Storey, Whitlock, Schmoeckel, Chu, Taylor, Zias, Liu, Hassan,
Thielmann, Meyer, De Neve, Sellke, Schneider, Thourani, Douketis, Mazer,
Steg, Capodanno, Zeymer, Matejic-Spasic, Wendt, Fan, Deliargyris, Gibson)
CytoSorbents Corp, Princeton, NJ, United States
Publisher
Elsevier Inc.
Abstract
Background Guidelines recommend ticagrelor discontinuation for at least 3
days prior to CABG. STAR-T was a North American randomized, double-blind,
sham-controlled trial investigating intraoperative ticagrelor removal with
a polymer bead device to reduce perioperative bleeding in cardiac surgery.
The European STAR Registry (STAR-R) collects real world outcomes with
antithrombotic drug removal by the same device. Methods STAR-T patients
were randomized 1:1 to device or sham; all STAR-R patients received the
device. Device use was during cardiopulmonary bypass (CPB).
Inclusion/exclusion criteria from STAR-T were applied to STAR-R to
identify patients on ticagrelor undergoing isolated CABG before washing
out. Device-treated patients were pooled and compared to STAR-T controls.
Primary endpoint was a composite of fatal bleeding, severe/massive
bleeding per Universal Definition for Perioperative Bleeding (UDPB >=3),
and 24-hr chest tube drainage (CTD) analyzed by unmatched hierarchical win
ratio. Secondary endpoints were 12- and 24-hr CTD and severe clinical
bleeding events (SCBE= delayed sternal closure, re-exploration for
bleeding, or cardiac tamponade). Results The pooled cohort comprised 153
device-treated patients and 60 controls undergoing isolated CABG. Mean age
was 64.4+/-9.6 yr; 84% were male. Baseline characteristics were balanced,
but device-treated patients had shorter time from last ticagrelor dose to
CABG (28.8+/-16.4 vs. 38.6+/-14.6 hrs, p<0.001). Operation (4.3+/-1.3 vs.
4.2+/-1.2 hrs, p=0.710) and CPB (95.3+/-35.9 vs. 94+/-34.4 min, p=0.801)
durations were not different. The primary endpoint was met with win ratio
1.72; 95% CI 1.18, 2.49; p=0.003. CTD volumes [mL, Q1, Q3] were also
significantly reduced by the device (12-hr: 354 [250, 546] vs. 487
[372-655], p=0.0008; 24-hr: 580 [410-790] vs. 765 [552-1008], p=0.003).
SCBE were numerically but not significantly reduced by the device (5.9%
vs. 8.3%, p=0.516). Conclusion Pooled data from a randomized trial and a
real-world registry show that intraoperative ticagrelor removal with a
polymer bead device reduces the severity of perioperative bleeding in
patients undergoing CABG before completing the recommended
washout. Copyright © 2025 American College of Cardiology
Foundation

<84>
Accession Number
2037786596
Title
DISPARITIES WHILE LISTING FOR ORTHOTOPIC HEART TRANSPLANTATION: A
SYSTEMATIC REVIEW AND META-ANALYSIS.
Source
Journal of the American College of Cardiology. Conference: American
College of Cardiology, (ACC) Meeting 2025. Chicago United States. 85(12
Supplement) (pp 1220), 2025. Date of Publication: 01 Apr 2025.
Author
Pajareya P.; Thamthanaruk A.; Siranart N.; Nokkhuntong V.; Techasatian W.;
Wattanachayakul P.
Institution
(Pajareya, Thamthanaruk, Siranart, Nokkhuntong, Techasatian,
Wattanachayakul) King Chulalongkorn Memorial Hospital, Bangkok, Thailand
Publisher
Elsevier Inc.
Abstract
Background Disparities may arise during the listing process for orthotopic
heart transplantation (OHT). This study investigates factors that
contribute to disparities in outcomes at listing. Methods A literature was
searched up to July 2024, focusing on disparities in organ transplant
outcomes. Primary endpoint was recipient acceptance. Secondary endpoints
were waitlist urgency (status 1, 1A, or 1A exception), waitlist mortality
(death while on the list), and waitlist duration (time from listing to
transplantation). Results A total of 34 studies involving 426,184 patients
at listing for OHT were included. Disparities in race, gender, and
insurance were not associated with recipient acceptance rate. For waitlist
urgency, black race and low SES were linked to higher rates of listing in
status 1 (OR 1.29; 95%CI 1.06-1.55; I2=0% and OR 1.19; 95%CI
1.05-1.36, I2=0%, respectively). For waitlist mortality, there
was no significant association in race, gender, insurance, and transplant
center volume. Mean waitlist duration was higher for patients with
Hispanic compared to other races which is neither white, black, nor
Hispanic (Mean 5.15 days; 95%CI: 3.65-6.65, I2=100% and Mean
4.19 days; 95%CI: 4.03-4.35, I2=98.9%, respectively).
Conclusion Disparities exist in the listing process for OHT. Addressing
these problems is crucial for achieving equitable access to care for all
patients with end-stage heart diseases. [Formula presented] Copyright
© 2025 American College of Cardiology Foundation

<85>
Accession Number
2037787472
Title
CONTINUATION OR INTERRUPTION OF ORAL ANTICOAGULATION DURING TAVI: A
SYSTEMATIC REVIEW AND META-ANALYSIS.
Source
Journal of the American College of Cardiology. Conference: American
College of Cardiology, (ACC) Meeting 2025. Chicago United States. 85(12
Supplement) (pp 1082), 2025. Date of Publication: 01 Apr 2025.
Author
Martins J.; Borges R.; Berton G.G.; Chaves A.L.; Vizentin V.K.; Macedo E.;
sousa P.A.M.G.; Benicio A.F.C.; Vieira P.; Soares E.; Fukunaga C.
Institution
(Martins, Borges, Berton, Chaves, Vizentin, Macedo, sousa, Benicio,
Vieira, Soares, Fukunaga) Federal University of Para, Belem, Brazil
Publisher
Elsevier Inc.
Abstract
Background Many patients undergoing transcatheter aortic valve
implantation (TAVI) require long-term oral anticoagulation (OAC), but it's
unclear whether to continue or interrupt OAC during the procedure. This
review compares both strategies for bleeding and thromboembolic outcomes.
Methods We searched PubMed, Embase, and Cochrane Central for studies
comparing continuation versus interruption of OAC in TAVI patients with an
indication for OAC, including vitamin K antagonists and direct oral
anticoagulants. Risk ratios (RR) with 95% confidence intervals (CI) were
pooled using a random-effects model. Sensitivity analysis used the
Hartung-Knapp-Sidik-Jonkman method. Results We included 3 studies,
including 1 randomized controlled trial (RCT), with 2,773 patients, of
whom 1,314 (47.4%) continued OAC during TAVI. At 30 days, there was no
significant difference all-cause mortality (RR 0.74; 95% CI 0.45-1.20;
p=0.22; Figure 1A), any bleeding (RR 1.08; 95% CI 0.81-1.43; p=0.60) or
major bleeding (RR 0.90; 95% CI 0.67-1.21; p=0.48). However, the risk of
stroke was numerically lower in continued OAC group (RR 0.65; 95% CI
0.42-1.01; p=0.05), with a significant reduction in the sensitivity
analysis (RR 0.65; 95% CI 0.47-0.90; p=0.03; Figure 1B). Conclusion In
patients with an indication for OAC undergoing TAVI, uninterrupted
anticoagulation is associated with similar thrombotic and hemorrhagic
outcomes compared to interrupted OAC, with a potentially significant
reduction in stroke risk. [Formula presented] Copyright © 2025
American College of Cardiology Foundation

<86>
Accession Number
2037789407
Title
LINK BETWEEN CARDIAC ALLOGRAFT VASCULOPATHY AND METABOLIC SYNDROME: A
SYSTEMATIC REVIEW AND META-ANALYSIS.
Source
Journal of the American College of Cardiology. Conference: American
College of Cardiology, (ACC) Meeting 2025. Chicago United States. 85(12
Supplement) (pp 1382), 2025. Date of Publication: 01 Apr 2025.
Author
Pajareya P.; Chuanchai W.; Siranart N.; Phutinart S.; Techasatian W.;
Wattanachayakul P.
Institution
(Pajareya, Chuanchai, Siranart, Phutinart, Techasatian, Wattanachayakul)
King Chulalongkorn Memorial Hospital, Bangkok, Thailand
Publisher
Elsevier Inc.
Abstract
Background Metabolic syndrome (MetS) is increasingly prevalent globally
and is linked to inflammation in cardiac tissues. Cardiac allograft
vasculopathy (CAV) is a significant inflammatory condition and a leading
cause of graft failure after orthotopic heart transplantation (OHT). The
relationship between MetS and CAV remains poorly understood. Methods A
literature search was conducted up until September 2024, including studies
that reported associations between MetS or its components (obesity,
hypertension, dyslipidemia, and diabetes mellitus) and CAV. The primary
endpoint was the development of CAV after OHT. Results were presented as
odds ratios (OR) or hazard ratios (HR) with 95% confidence intervals (CI),
employing both random and fixed-effect models based on heterogeneity.
Results A total of 12 studies involving 2,937 patients were included. The
prevalence of MetS was high before OHT (32%, 95% CI: 2441%, I2= 75%) and
increased after OHT (37%, 95% CI: 18-61%, I2= 83%). MetS was significantly
associated with CAV (OR 1.99, 95% CI: 1.28-3.09, I2= 36%). Key components
of MetS linked to CAV included obesity (OR 1.54, 95% CI: 1.11-2.13, I2=
0%), dyslipidemia (OR 1.87, 95% CI: 1.49-2.36, I2= 0%). Post-transplant
diabetes mellitus increases the risk of CAV with HR of 1.71 (95% CI:
1.56-1.88, I2= 0%). Conclusion The high prevalence of MetS both before and
after OHT is associated with an increased risk of CAV, highlighting the
need for targeted interventions to manage MetS in heart transplant
recipients. [Formula presented] Copyright © 2025 American College
of Cardiology Foundation

<87>
Accession Number
2037793471
Title
IMPACT OF HIGH INTENSITY STATIN THERAPY ON SHORT-TERM AND LONG-TERM
OUTCOMES AFTER CORONARY ARTERY BYPASS GRAFTING: A SYSTEMATIC REVIEW AND
META-ANALYSIS.
Source
Journal of the American College of Cardiology. Conference: American
College of Cardiology, (ACC) Meeting 2025. Chicago United States. 85(12
Supplement) (pp 1153), 2025. Date of Publication: 01 Apr 2025.
Author
Najeeb H.; Javed J.; Bacha Z.; Rehman Z.; Ali M.A.; Khan S.H.; Khan M.;
Noor H.; Rehman A.; Aamir M.; Shamshad T.; Yousaf A.
Institution
(Najeeb, Javed, Bacha, Rehman, Ali, Khan, Khan, Noor, Rehman, Aamir,
Shamshad, Yousaf) Carle Foundation Hospital, Urbana, IL, United States
(Najeeb, Javed, Bacha, Rehman, Ali, Khan, Khan, Noor, Rehman, Aamir,
Shamshad, Yousaf) Lehigh Valley Health Network, Allentown, PA, United
States
Publisher
Elsevier Inc.
Abstract
Background Post-coronary artery bypass grafting (CABG), aggresive statin
therapy offers long-term survival. This study compares highintensity,
offering LDL reduction >=50%, versus moderate-intensity with 30-49% LDL
reduction statin regimens in CABG patients. Methods MEDLINE, Embase, and
Science Citation Index were searched until August 2024 for trials and
cohort studies comparing high and moderate statin intensity in CABG
patients. Clinical outcomes were MACCE (Major Adverse Cardiac and
Cerebrovascular Events), all-cause mortality, and myocardial infarction
(MI), cardiovascular deaths and LDL-c levels. Graft-related outcomes were
atherosclerotic progression of grafts and number of patients with
progression. Results 14 studies comprising 49,871 patients (18,818
High-Intensity; 31,053 Moderate) were included. High-intensity therapy
significantly lowered the risk of MI (RR 0.80 P= 0.03), MACCE (RR 0.76
P<0.00001), all-cause mortality (RR 0.78 P< 0.0001), cardiovascular deaths
(RR 0.78 P = 0.001) and LDL-c levels (MD -41.70 P<0.00001) in CABG
patients. There was a significant reduction in graft atherosclerosis (RR
0.69 P <0.00001) and patients with graft atherosclerosis (RR 0.73
P<0.00001). Conclusion The use of high-intensity statins substantially
reduced the risk of clinical events while slowing graft atherosclerosis in
postCABG patients. [Formula presented] Copyright © 2025 American
College of Cardiology Foundation

<88>
Accession Number
2037792038
Title
EVOLOCUMAB AND RATE OF COMPLEX CORONARY REVASCULARIZUATION DURING 8-YEAR
FOLLOW-UP - ANALYSIS OF 6,635 PATIENTS FROM THE FOURIER OLE TRIAL.
Source
Journal of the American College of Cardiology. Conference: American
College of Cardiology, (ACC) Meeting 2025. Chicago United States. 85(12
Supplement) (pp 1734), 2025. Date of Publication: 01 Apr 2025.
Author
Haller P.M.; Gaba P.; Thomas C.; De Paiva Fagundes A.A.; Oyama K.; De
Mendonca Furtado R.H.; Zelniker T.A.; Kuder J.; Murphy S.A.; Giugliano
R.P.; Sabatine M.S.; Bergmark B.
Institution
(Haller, Gaba, Thomas, De Paiva Fagundes, Oyama, De Mendonca Furtado,
Zelniker, Kuder, Murphy, Giugliano, Sabatine, Bergmark) Brigham and
Women's Hospital, Boston, MA, United States
Publisher
Elsevier Inc.
Abstract
Background In FOURIER, the PCSK9i evolocumab (Evo) significantly reduced
the rate of MACE and coronary revascularization (revasc). However, the
effect of Evo on incident complex coronary revasc. during long-term
follow-up is not known. Methods In FOURIER, pts with ASCVD and LDL-C
>=70mg/dL were randomized to Evo or placebo (Pbo). At the end of the
trial, pts had the option to be treated with Evo in the open label
extension (OLE) at participating sites. All cases of coronary revasc were
centrally reviewed; complex revasc was defined as CABG or complex PCI
(GLOBAL LEADERS definition). KM event rates through 8 yrs were compared
between pts randomized in the parent trial to Evo or Pbo (Fig. A). Results
Of 27,564 pts in FOURIER, 6,635 pts continued in OLE (total median
follow-up 7.2 years). In pts originally randomized to Pbo vs Evo in the
parent trial, there were 478 vs 370 cases of complex revasc, respectively.
Evo reduced the risk for complex coronary revasc by 24% (HR 0.76 [0.67,
0.87], p<0.001; Fig. A) during long-term follow-up. This effect was
consistent across components of the complex revasc definition and
secondary outcomes, and was significant for complex PCI, CABG, and PCI for
in-stent restenosis (Fig. B). Conclusion Compared to delayed treatment
initiation (during OLE), earlier treatment with Evo significantly reduced
the likelihood of complex revasc. events during long-term follow-up.
[Formula presented] Copyright © 2025 American College of
Cardiology Foundation

<89>
Accession Number
2037793417
Title
INVASIVE OR CONSERVATIVE MANAGEMENT OF CHRONIC CORONARY DISEASE PATIENTS
WITH A HISTORY OF CORONARY HEART DISEASE: INSIGHTS FROM THE ISCHEMIA
TRIALS.
Source
Journal of the American College of Cardiology. Conference: American
College of Cardiology, (ACC) Meeting 2025. Chicago United States. 85(12
Supplement) (pp 982), 2025. Date of Publication: 01 Apr 2025.
Author
Zhou Y.; Gong W.; Nie S.
Institution
(Zhou, Gong, Nie) Beijing Anzhen Hospital, Capital Medical University,
Beijing, China
Publisher
Elsevier Inc.
Abstract
Background Among patients with a history of coronary heart disease (CHD)
and chronic coronary disease (CCD), it is unclear whether invasive
strategy improves outcomes when added to medical therapy. Methods The
International Study of Comparative Health Effectiveness with Medical and
Invasive Approaches (ISCHEMIA) Trials (ISCHEMIA and ISCHEMIA-Chronic
Kidney Disease) randomized 5,956 patients with CCD to an invasive or a
conservative management. History of CHD was defined by baseline medical
history of prior myocardial infarction (MI), percutaneous coronary
intervention, or coronary artery bypass grafting. The primary outcome was
cardiovascular (CV) death or MI. Results There were 1,794 (30%)
participants who had a history of CHD. At 4 years, patients with a history
of CHD were more likely to experience CV death or MI than those without a
history of CHD (18.2% vs. 14.5%); those with a history of CHD randomized
to the invasive versus conservative strategy had a lower rate of the CV
death or MI (15.9% vs. 20.6%, difference, -4.7%; 95% CI: -8.8%, -0.6%),
whereas those without a history of CHD did not (13.9% vs. 15.0%,
difference, -1.1%; 95% CI: -3.7%, 1.5%). After adjustment, invasive
strategy still significantly reduced CV death or MI in patients with CHD
history (adjusted HR: 0.77; 95% CI: 0.62, 0.97). Conclusion Patients with
CCD and a history of CHD exhibited higher rates of CV death or MI, and
derive incremental benefit from invasive management compared with initial
medical therapy alone. [Formula presented] Copyright © 2025
American College of Cardiology Foundation

<90>
Accession Number
2037793899
Title
IMPACT OF COLCHICINE FOLLOWING PULMONARY VEIN ISOLATION ON ATRIAL
FIBRILLATION RECURRENCE, A META-ANALYSIS.
Source
Journal of the American College of Cardiology. Conference: American
College of Cardiology, (ACC) Meeting 2025. Chicago United States. 85(12
Supplement) (pp 138), 2025. Date of Publication: 01 Apr 2025.
Author
Fretz T.; Kayani A.M.A.; Lemus-Zamora R.E.; Garcia A.
Institution
(Fretz, Kayani, Lemus-Zamora, Garcia) Indiana University, Indianapolis,
IN, United States
Publisher
Elsevier Inc.
Abstract
Background Recurrence of atrial fibrillation (AF) following pulmonary vein
isolation (PVI) is common. Colchicine is a widely available
anti-inflammatory that has been shown to reduce perioperative AF following
cardiac surgery. Inflammation is hypothesized to be a driver of AF and is
particularly important following PVI given the elevated inflammatory state
following the procedure. It is plausible colchicine may reduce recurrent
AF following PVI given its anti-inflammatory properties. Methods A
comprehensive search of PubMed, Cochrane Library, and Embase was performed
from inception to September 2024 in order to identify all studies that
compared subjects undergoing PVI and treatment with colchicine or placebo.
Two independent reviewers extracted data and disagreements were resolved
by a third author. Effect estimates were pooled using a random-effects
model and reported as odds ratios for dichotomous outcomes with 95%
confidence intervals for each. Results Among 149 studies identified on
initial search, eight studies met criteria for inclusion, comprising 2,195
patients (average age 66.1; 68.9% male). Average duration of follow up was
just under 9 months. Colchicine is associated with a statistically
significant lower incidence of AF following ablation compared to placebo
(OR: 0.61; [0.45, 0.82], p=0.001). Conclusion The use of colchicine is
associated with a reduced recurrence of AF following PVI compared to
placebo. Copyright © 2025 American College of Cardiology
Foundation

<91>
Accession Number
2037793784
Title
EFFICACY OF BOTULINUM TOXIN IN PREVENTING ATRIAL FIBRILLATION IN
POST-CARDIOVASCULAR SURGERY PATIENTS: A META-ANALYSIS.
Source
Journal of the American College of Cardiology. Conference: American
College of Cardiology, (ACC) Meeting 2025. Chicago United States. 85(12
Supplement) (pp 98), 2025. Date of Publication: 01 Apr 2025.
Author
Canola L.E.C.; Flores Y.; Calderon-Fernandez A.; Nogueira C.V.; Nogueira
B.V.; Montano K.P.Z.; Trejo L.A.R.; Calvario E.
Institution
(Canola, Flores, Calderon-Fernandez, Nogueira, Nogueira, Montano, Trejo,
Calvario) Universidad Nacional de Piura, Piura, Peru
Publisher
Elsevier Inc.
Abstract
Background Postoperative atrial fibrillation (AF) is a common complication
after cardiovascular surgery, often leading to morbidity. Botulinum toxin
(BT) injections have emerged as a potential intervention to prevent AF.
This meta-analysis evaluates the efficacy of BT in reducing the incidence
of postoperative AF. Methods A database search was conducted until
September 5st, 2024, identifying studies comparing Botulinum Toxin
injections to placebo for the prevention of post-operative atrial
fibrillation in cardiovascular surgery patients. Analyzed outcomes
included the incidence of post-operative AF, mean AF burden, and the need
for antiarrhythmic drug therapy. Risk ratios (RR) with 95% confidence
intervals (CI) were calculated using a random-effects model to account for
inter-study heterogeneity. Results Five randomized controlled trials
involving 520 patients were analyzed. The analysis showed that BT
significantly reduced the incidence of AF at 12 months (RR: 0.13, 95% CI:
[0.03, 0.50], p = 0.003) and 36 months (RR: 0.47, 95% CI: [0.22, 0.98], p
= 0.04). Additionally, BT also decreased the need for antiarrhythmic drug
therapy at 36 months (RR: 0.53, 95% CI: [0.32, 0.87], p = 0.01).
Conclusion Botulinum Toxin has demonstrated efficacy in reducing atrial
fibrillation (AF) incidence and mitigating the burden of antiarrhythmic
drug therapy in patients undergoing cardiovascular surgery. However,
further large-scale studies are warranted to substantiate these findings.
[Formula presented] Copyright © 2025 American College of
Cardiology Foundation

<92>
Accession Number
2037787587
Title
PRE-PROCEDURAL FASTING IN PERCUTANEOUS CARDIAC PROCEDURES: A SYSTEMATIC
REVIEW AND META-ANALYSIS OF RANDOMIZED TRIALS.
Source
Journal of the American College of Cardiology. Conference: American
College of Cardiology, (ACC) Meeting 2025. Chicago United States. 85(12
Supplement) (pp 965), 2025. Date of Publication: 01 Apr 2025.
Author
Kritya M.; Maurya P.; Lingamsetty S.S.P.; Jain H.; Zulfiqar E.; Tariq
M.D.; Doma M.; Felix I.F.
Institution
(Kritya, Maurya, Lingamsetty, Jain, Zulfiqar, Tariq, Doma, Felix) Armed
Forces Medical College, Pune, India
Publisher
Elsevier Inc.
Abstract
Background Fasting is commonly practiced before percutaneous cardiac
procedures (PCP) despite limited evidence supporting its benefits or
evaluating potential risks. Herein, we aimed to perform a systematic
review and meta-analysis to critically appraise the role of fasting before
PCP. Methods We searched PubMed, Embase, and Cochrane for randomized
controlled trials (RCTs) comparing limited fasting (LF) and routine
fasting (RF) in patients undergoing PCP. LF and RF were defined as fasting
for <=2 hours and >=6 hours respectively. A randomeffects model was
adopted to estimate pooled risk ratios (RR) with 95% confidence intervals
(CI). Statistical analysis was performed using R version 4.4.1. Results We
included 5 RCTs with 2,707 patients, of whom 1,329 (49%) were randomized
to LF. The mean age was 67.35+/-3 years and 70% were male. LF was
comparable to RF in risk of aspiration pneumonia (RR 2.20; 95% CI
0.29-17.02; p=0.45) and nausea/vomiting (RR 1.10; 95% CI 0.65-1.87;
p=0.72; Figure A). Moreover, no significant difference between the groups
was observed for risks of hypoglycemia (RR 0.78; 95% CI 0.45-1.33; p=0.35;
Figure B), hypotension needing intravenous fluid boluses (RR 0.48; 95% CI
0.17-1.36; p=0.17; Figure C) or the risk of acute kidney injury (AKI) (RR
1.48; 95% CI 0.79-2.76; p=0.22). Conclusion In this meta-analysis of RCTs
among patients undergoing PCP, LF was associated with similar rates of
aspiration pneumonia, nausea/vomiting, hypoglycemia, hypotension, and AKI,
when compared to RF. [Formula presented] Copyright © 2025
American College of Cardiology Foundation

<93>
Accession Number
2037793855
Title
CLINICAL OUTCOME OF MITRACLIP IN MODERATE TO SEVERE FUNCTIONAL MITRAL
REGURGITATION WITH HEART FAILURE: A META-ANALYSIS.
Source
Journal of the American College of Cardiology. Conference: American
College of Cardiology, (ACC) Meeting 2025. Chicago United States. 85(12
Supplement) (pp 2232), 2025. Date of Publication: 01 Apr 2025.
Author
Ullah I.; Khan O.A.; Khan A.W.; Ishaq M.; Khan E.; Ullah Z.; Ahmad O.;
Soliman O.I.; Cortese B.
Institution
(Ullah, Khan, Khan, Ishaq, Khan, Ullah, Ahmad, Soliman, Cortese) Case
Western Reserve Universtiy, Cleveland, OH, United States
Publisher
Elsevier Inc.
Abstract
Background Mitral regurgitation (MR) is one of the most common
valvulopathy. Surgical repair is the default procedure to correct MR;
however, being invasive, it carries a risk of complications in certain
patients. Mitral valve percutaneous repair (Mitraclip) is a less invasive
alternative. Methods in this meta-analysis, we pooled the clinical
performance of this procedure on moderate-to-severe functional mitral
regurgitation from multiple randomized clinical trials across different
major databases. A random-effects model was used to calculate pooled odds
ratios (OR) with 95% confidence intervals (CI). The primary endpoint of
this study was a composite of all-cause mortality and the need for
hospitalization at 2 years. Results 3 RCTs with 1423 patients (Mitraclip
n=704, Medical therapy n=719) were included, of which 72.1% were male. The
mean age was 70.8 +/- 10.6 years, and the average duration of follow-up
was 20 months. The composite primary endpoint all-cause mortality (OR
0.63, p = 0.005) and need for hospitalization (OR 0.20, p=0.003) was
decreased in mitraclip at 24 months follow-up. We did not observe
differences for cardiovascular death, myocardial infarction, or stroke at
1 year (p <0.05). Mitraclip was associated with a significant reduction in
the need for heart transplantation (OR 0.52, p=0.03) Conclusion Our study
observed a decrease in the composite of all-cause mortality in the
Mitraclip group. However, additional large clinical trials are needed to
determine the procedure's safety. [Formula presented] Copyright ©
2025 American College of Cardiology Foundation

<94>
Accession Number
2037787709
Title
PERIOPERATIVE AND CARDIOVASCULAR OUTCOMES WITH CONTINUATION VERSUS
DISCONTINUATION OF ANTIHYPERTENSIVE MEDICATIONS BEFORE NON-CARDIAC
SURGERY: A SYSTEMATIC REVIEW AND META-ANALYSIS.
Source
Journal of the American College of Cardiology. Conference: American
College of Cardiology, (ACC) Meeting 2025. Chicago United States. 85(12
Supplement) (pp 2617), 2025. Date of Publication: 01 Apr 2025.
Author
Ahmed M.; Fatima E.; Ahsan A.; Shafiq A.; Zulfiqar E.; Paray N.B.; Carver
C.; Durrani T.; Ullah M.Z.S.; Ullah I.; Jeelani M.S.; Gardezi S.K.M.;
Rehman N.U.; Mazhar J.; Hasan A.; Ahmed F.; Ahmed R.
Institution
(Ahmed, Fatima, Ahsan, Shafiq, Zulfiqar, Paray, Carver, Durrani, Ullah,
Ullah, Jeelani, Gardezi, Rehman, Mazhar, Hasan, Ahmed, Ahmed) Rawalpindi
Medical University, Rawalpindi, Pakistan
(Ahmed, Fatima, Ahsan, Shafiq, Zulfiqar, Paray, Carver, Durrani, Ullah,
Ullah, Jeelani, Gardezi, Rehman, Mazhar, Hasan, Ahmed, Ahmed) National
Heart & Lung Institute, Imperial College London, London, United Kingdom
Publisher
Elsevier Inc.
Abstract
Background The current guidelines regarding the continuation or
discontinuation of antihypertensive medications before noncardiac surgery
are conflicting. This meta-analysis aims to evaluate whether continuing or
withholding antihypertensive medication therapy before noncardiac surgery
influences perioperative mortality and complications. Methods A thorough
literature search was performed across PubMed/MEDLINE, Embase, and the
Cochrane Library from their inception up to September 10, 2024 to identify
eligible randomized controlled trials (RCTs) and cohort studies. Clinical
outcomes were evaluated using a random-effects model to pool odds ratios
(ORs) with 95% confidence intervals (CIs). Results The analysis included
16 studies with a total of 41,949 patients on antihypertensive therapy
before noncardiac surgery. Discontinuing antihypertensive medication
therapy was associated with a significantly lower incidence of
intraoperative hypotension (OR = 0.47; 95% CI = 0.28 to 0.81) than
continuing the therapy. However, there was no statistically significant
difference in reducing mortality (OR = 1.10; 95% CI = 0.86 to 1.40), major
adverse cardiovascular events (MACE) (OR = 1.27; 95% CI = 0.75 to 2.16),
myocardial infarction (OR = 0.83; 95% CI = 0.27 to 2.59) or stroke (OR =
0.70; 95% CI = 0.36 to 1.36) between two groups. Conclusion Discontinuing
antihypertensive medication before noncardiac surgery reduces
intraoperative hypotension with nonsignificant effects on mortality and
MACE. [Formula presented] Copyright © 2025 American College of
Cardiology Foundation

<95>
Accession Number
2037786660
Title
FASTING VS. NON-FASTING BEFORE CATHETERIZATION LABORATORY PROCEDURES: A
SYSTEMATIC REVIEW AND META-ANALYSIS OF RANDOMIZED CONTROLLED TRIALS.
Source
Journal of the American College of Cardiology. Conference: American
College of Cardiology, (ACC) Meeting 2025. Chicago United States. 85(12
Supplement) (pp 2521), 2025. Date of Publication: 01 Apr 2025.
Author
Muniz J.; De hollanda morais B.A.D.A.; Suciu-Bogdan C.; Neto A.O.G.;
Camara S.
Institution
(Muniz, De hollanda morais, Suciu-Bogdan, Neto, Camara) Schmieder Klinik
Heidelberg, Heidelberg, Germany
(Muniz, De hollanda morais, Suciu-Bogdan, Neto, Camara) INCOR, Sao Paulo,
Brazil
Publisher
Elsevier Inc.
Abstract
Background Current guidelines recommend routine fasting prior to
percutaneous coronary procedures and cardiac device implantation under
conscious sedation. Data to support this practice have been limited. We
aimed to compare the safety and patient well-being of a non-fasting
strategy relative to standard fasting in patients who undergo
catheterization laboratory procedures under conscious sedation. Methods
This systematic review and meta-analysis was performed according to the
Cochrane Collaboration and the Preferred Reporting Items for Systematic
Reviews and Meta-Analysis (PRISMA) statement guidelines. Data were
gathered from PubMed, Embase and Cochrane databases until September 2024.
We included randomized controlled trials comparing fasting vs. non-fasting
prior to cardiac catheterization and cardiac implantable electronic device
(CIED) procedures. Outcomes included hypoglycemia, intraprocedural
hypotension, nausea/vomiting, acute kidney injury, length of hospital stay
and overall patient satisfaction. Results We included 6 RCTs comprising
2689 patients, of whom 2375 (88.3%) underwent non-urgent cardiac
catheterization and 314 (11.7%) elective CIED procedures. The non-fasting
strategy was significantly associated with an improvement in the overall
patient satisfaction, when compared to the fasting strategy (RR -0.82;
95%CI -1.41,-0.23; p<0.001). The pooled analysis demonstrated the
noninferiority of the non-fasting strategy, with no significant
differences in the incidences of intraprocedural hypotension (RR 0.69;
95%CI 0.46- 1.03; p=0.07), nausea/vomiting (RR 1.04; 95%CI 0.69-1.59;
p=0.84), hypoglycemia (RR 0.79; 95%CI 0.46- 1.35; p=0.38), acute kidney
injury (RR 1.48; 95%CI 0.79-2.76; p=0.22) and length of hospital stay
(RR-0.17; 95%CI -0.66-0.31; p=0.48) in comparison to the fasting strategy.
Conclusion These findings suggest that a non-fasting strategy prior to
catheterization laboratory procedures is as safe as the standard fasting.
The non-fasting strategy was significantly associated with improved
overall patient satisfaction compared to the fasting
strategy. Copyright © 2025 American College of Cardiology
Foundation

<96>
Accession Number
2037792607
Title
CHIMNEY STENTING VS BASILICA FOR PREVENTING ACUTE CORONARY OBSTRUCTION
DURING TRANSCATHETER AORTIC VALVE REPLACEMENT: A SYSTEMATIC REVIEW AND
META-ANALYSIS.
Source
Journal of the American College of Cardiology. Conference: American
College of Cardiology, (ACC) Meeting 2025. Chicago United States. 85(12
Supplement) (pp 847), 2025. Date of Publication: 01 Apr 2025.
Author
Basit J.; Ahmed M.; Nadeem Z.A.; Upreti P.; Hamza M.; Yasmin F.; Alraies
M.C.
Institution
(Basit, Ahmed, Nadeem, Upreti, Hamza, Yasmin, Alraies) Rawalpindi Medical
University, Rawalpindi, Pakistan
(Basit, Ahmed, Nadeem, Upreti, Hamza, Yasmin, Alraies) Wayne State
University, Detroit, MI, United States
Publisher
Elsevier Inc.
Abstract
Background Coronary obstruction (CO) is a rare, but a potentially fatal
complication of transcatheter aortic valve replacement (TAVR).
Chimney/Snorkel stenting and Bioprosthetic Aortic Scallop Intentional
Laceration to Prevent Iatrogenic Coronary Artery Obstruction (BASILICA)
are two techniques to prevent CO during TAVR. We conducted a meta-analysis
to directly compare the safety and efficacy of these two techniques.
Methods We electronically searched MEDLINE, Embase and Scopus for all
relevant articles. All studies that reported outcomes for Chimney vs
BASILICA stenting for CO during TAVR were included. Odds ratios (ORs) were
used to pool dichotomous outcomes using Mantel Haenszel method. The
statistical analysis was conducted on CRAN-R using the random effects
model. A p-value of <0.05 was considered statistically significant.
Results A total of three studies(n=310) were included in the
meta-analysis. Chimney stenting was found comparable to BASILICA in terms
of mortality (OR 3.32, 95% CI 0.90-12.24, I2 = 0%, p <0.05).
There were no significant differences between the two techniques for
stroke (OR=0.82, 95% CI 0.18-3.67, I2 = 0%, p <0.05), and major
vascular complications (OR=2.18, 95% CI=0.19-25.65, I2 = 69%, p
<0.05) (Figure) Conclusion Chimney stenting and BASILICA are similar in
terms of efficacy and safety to prevent CO during TAVR. Large scale
randomized studies are needed to establish definitive evidence. [Formula
presented] Copyright © 2025 American College of Cardiology
Foundation

<97>
Accession Number
2037790755
Title
DEL NIDO VERSUS CONVENTIONAL CARDIOPLEGIA ON ISOLATED CORONARY ARTERY
BYPASS GRAFTING: A META-ANALYSIS.
Source
Journal of the American College of Cardiology. Conference: American
College of Cardiology, (ACC) Meeting 2025. Chicago United States. 85(12
Supplement) (pp 1843), 2025. Date of Publication: 01 Apr 2025.
Author
Yamashita Y.; Baudo M.; Sicouri S.; Spragan D.D.; Torregrossa G.; Ramlawi
B.; Sutter F.P.
Institution
(Yamashita, Baudo, Sicouri, Spragan, Torregrossa, Ramlawi, Sutter)
Lankenau Medical Center, Wynnewood, PA, United States
Publisher
Elsevier Inc.
Abstract
Background The optimal strategy for myocardial protection during aortic
cross-clamping in cardiac surgery remains controversial. Recently, del
Nido cardioplegia, an extracellular crystalloid solution known for its
ability to prolong the duration of cardiac arrest, has been successfully
used in single-dose administration for aortic cross-clamp times of up to
90 minutes. However, because coronary artery disease and myocardial
hypertrophy in adults may affect the delivery and distribution of
cardioplegia, the efficacy of del Nido cardioplegia in coronary artery
bypass grafting (CABG) warrants further clarification. The purpose of this
study was to evaluate the effects of del Nido cardioplegia compared to
conventional cardioplegic solutions on operative outcomes in isolated
CABG. Methods A comprehensive search of PubMed, Scopus, and CENTRAL was
performed up to July 2024 for a meta-analysis comparing del Nido with
conventional cardioplegic solutions in isolated CABG. A random-effects
model was employed to estimate the pooled effect size. Subgroup analyses
were conducted using outcomes from randomized controlled trials,
propensity score analyses, or multivariable analyses. Results The analysis
included 24 studies (4 randomized controlled trials and 5 propensity
score-matched studies), with a total of 34,737 patients. Operative
mortality was similar between the del Nido and other cardioplegia groups
(p=0.262). The rates of postoperative stroke and atrial fibrillation were
also comparable across both groups. However, the del Nido group had a
significantly lower incidence of postoperative myocardial infarction and
renal failure, with pooled odds ratios of 0.43 (95% confidence interval:
0.24; 0.77) and 0.61 (0.45; 0.81), respectively. These significant
differences were further supported by subgroup analyses. Conclusion In
patients undergoing isolated CABG, del Nido cardioplegia provides
mortality results comparable to other cardioplegic solutions. In addition,
del Nido may be potentially protective by reducing the risk of myocardial
infarction and renal failure. Copyright © 2025 American College
of Cardiology Foundation

<98>
Accession Number
2037793892
Title
PROTAMINE FOR HEPARIN REVERSAL AFTER TRANSFEMORAL TRANSCATHETER AORTIC
VALVE REPLACEMENT: A FREQUENTIST NETWORK META-ANALYSIS.
Source
Journal of the American College of Cardiology. Conference: American
College of Cardiology, (ACC) Meeting 2025. Chicago United States. 85(12
Supplement) (pp 814), 2025. Date of Publication: 01 Apr 2025.
Author
Krishna M.M.; Joseph M.; Ezenna C.G.; Pereira V.; Goldsweig A.M.
Institution
(Krishna, Joseph, Ezenna, Pereira, Goldsweig) Medical College
Thiruvananthapuram, Thiruvananthapuram, India
(Krishna, Joseph, Ezenna, Pereira, Goldsweig) University of Massachusetts
- Baystate Medical Center, Springfield, MA, United States
Publisher
Elsevier Inc.
Abstract
Background Vascular and bleeding complications after transcatheter aortic
valve replacement (TAVR) cause morbidity and mortality. Routine
administration of protamine for heparin reversal after TAVR could reduce
these complications, however, data remains scarce. We did a network
meta-analysis comparing full-dose protamine, half-dose protamine, and no
protamine administration after transfemoral TAVR. Methods PubMed, Scopus,
and Cochrane Central were searched for studies comparing TAVR outcomes
with and without protamine administration. A frequentist network
meta-analysis was conducted to estimate risk ratios and 95% confidence
intervals for each comparison. P-scores provided a ranking of treatments.
Results Six studies (2 randomized controlled trials, 4 observational) with
3,260 patients were included in the analysis. Full-dose protamine reduced
the risk of major bleeding and transfusion requirement compared with no
protamine. The risk of major bleeding, minor bleeding, transfusion
requirement, and major vascular complications was reduced with full-dose
protamine compared with half-dose protamine. In the analysis of p-scores,
full-dose protamine was likely to have lower major, minor, and
life-threatening bleeding, major vascular complications, stroke, and
transfusion requirement. Conclusion Full-dose protamine after transfemoral
TAVR reduced the risk of bleeding, transfusion requirement, and major
vascular complications and can be used for heparin reversal. [Formula
presented] Copyright © 2025 American College of Cardiology
Foundation

<99>
Accession Number
2037786584
Title
THE PROGNOSTIC VALUE OF NEUTROPHIL TO LEUKOCYTE RATIO IN RISK
STRATIFICATION AND OUTCOMES OF TRANSCATHETER AORTIC VALVE REPLACEMENT: A
SYSTEMATIC REVIEW AND META-ANALYSES.
Source
Journal of the American College of Cardiology. Conference: American
College of Cardiology, (ACC) Meeting 2025. Chicago United States. 85(12
Supplement) (pp 2423), 2025. Date of Publication: 01 Apr 2025.
Author
Sharma A.; Tiwari A.; Kumar H.; Naut E.; Rached E.A.
Institution
(Sharma, Tiwari, Kumar, Naut, Rached) UConn Health, Farmington, CT, United
States
Publisher
Elsevier Inc.
Abstract
Background The neutrophil-to-leukocyte ratio (NLR) is a key biomarker for
systemic inflammation and has been associated with outcomes in various
cardiovascular therapies. This meta-analysis aims to explore the
predictive utility of NLR in risk stratification and clinical outcomes
after transcatheter aortic valve replacement (TAVR). Methods We conducted
a comprehensive search of electronic databases, including PubMed, Embase,
and Cochrane, to identify studies that investigated the relationship
between NLR and TAVR outcomes. A total of 64 studies were included,
comprising data from 15,683 patients. Data on patient demographics,
procedural details, NLR levels, and clinical outcomes were extracted from
studies meeting established criteria. Pooled analyses of all-cause
mortality and cardiovascular mortality were performed, and hazard ratios
(HR) were calculated. Results The meta-analysis revealed that a higher NLR
is significantly associated with increased all-cause and cardiovascular
mortality after TAVR. Specifically, each unit increase in NLR resulted in
a 16% increase in all-cause mortality (HR 1.16, 95% CI 1.12-1.20) and a
25% increase in cardiovascular mortality (HR 1.25, 95% CI 1.20-1.30).
Furthermore, a reduction in NLR from baseline to one-year postprocedure
was associated with a lower risk of death or rehospitalization between one
and three years, with a relative risk reduction of 30% (RR 0.70, 95% CI
0.60-0.81) for patients showing a decrease in NLR. Conclusion The NLR
serves as a valuable biomarker for predicting risk and clinical outcomes
in patients undergoing TAVR. Higher NLR readings correlate with increased
mortality risk, making it a useful tool for patient risk assessment.
Further research is needed to establish standardized NLR thresholds for
clinical application in TAVR patient management. Copyright © 2025
American College of Cardiology Foundation

<100>
Accession Number
2037793936
Title
A SYSTEMATIC REVIEW AND META-ANALYSIS OF HYBRID TOTALLY THORACOSCOPIC
ABLATION EFFICACY AND SAFETY FOR NON-PAROXYSMAL ATRIAL FIBRILLATION.
Source
Journal of the American College of Cardiology. Conference: American
College of Cardiology, (ACC) Meeting 2025. Chicago United States. 85(12
Supplement) (pp 139), 2025. Date of Publication: 01 Apr 2025.
Author
Ellenbogen K.A.; Kasirajan V.; Khoynezhad A.B.; Doll N.; Suwalski P.; Sahu
J.; Meador M.; Hahn A.; Ndikintum N.F.I.I.; Kiankhooy A.
Institution
(Ellenbogen, Kasirajan, Khoynezhad, Doll, Suwalski, Sahu, Meador, Hahn,
Ndikintum, Kiankhooy) Virginia Commonwealth University, Richmond, VA,
United States
(Ellenbogen, Kasirajan, Khoynezhad, Doll, Suwalski, Sahu, Meador, Hahn,
Ndikintum, Kiankhooy) Cedars-Sinai Cardiac Surgery at Huntington Health,
Pasadena, CA, United States
Publisher
Elsevier Inc.
Abstract
Background Hybrid epicardial-endocardial ablation isolates the pulmonary
veins and left atrial posterior wall by totally thoracoscopic (TT)
surgical ablation with epicardial left atrial appendage (LAA) exclusion
followed by endocardial catheter ablation and has been used for advanced
atrial fibrillation (AF). Methods A literature search identified hybrid TT
ablation studies that reported serious adverse events (SAE) within 30d and
efficacy through 12mo (freedom from any atrial arrythmia <30s, off
anti-arrhythmic drugs [AADs], if reported). Inclusion criteria included
primary clinical studies of non-paroxysmal AF (NPAF) treated with bipolar
radiofrequency clamsp/pens for epicardial ablation but excluded subxiphoid
hybrid procedures and endocardial LAA closure. Efficacy and safety event
proportions and 95% confidence intervals (CI) were pooled with
fixed-effect/random-effects models and tested for heterogeneity. Results
Of 21 included studies, 75.5% of patients were male with mean ages of
57-70yr. Half had persistent AF and 43.5% had longstanding persistent AF.
The pooled SAE rate was 5% (66/1128; 95% CI 3.3%, 7.5%). Pooled efficacy
through 12mo was 75.3% (747/992; 95% CI 72.4%, 78.1%) (Figure 1).
Heterogeneity for safety and efficacy were not detected (p=0.25 and
p=0.59, respectively). Conclusion This meta-analysis showed favorable 12mo
efficacy of hybrid TT ablation, on/off AADs, and acceptable safety in
patients with NPAF. [Formula presented] Copyright © 2025 American
College of Cardiology Foundation

<101>
Accession Number
2037791558
Title
SELF-EXPANDING VERSUS BALLOON-EXPANDABLE VALVES IN PATIENTS WITH SMALL
ANNULUS AORTIC STENOSIS: RANDOMIZED, PAIRED AND PROPENSITY MATCHED
STUDIES: A SYSTEMATIC REVIEW AND META-ANALYSIS.
Source
Journal of the American College of Cardiology. Conference: American
College of Cardiology, (ACC) Meeting 2025. Chicago United States. 85(12
Supplement) (pp 1138), 2025. Date of Publication: 01 Apr 2025.
Author
Portilho N.; Braite M.; Machado M.; Scheffer E.; Lara L.; Cavalcante
D.V.S.
Institution
(Portilho, Braite, Machado, Scheffer, Lara, Cavalcante) Federal District
Military Firefighter Brigade, Brasilia, Brazil
Publisher
Elsevier Inc.
Abstract
Background Transcatheter aortic valve implantation (TAVI) is the standard
treatment for severe aortic stenosis, but the comparative outcomes between
self-expanding valves (SEV) and balloon-expandable valves (BEV) in
patients with a small annulus remain unclear. This meta-analysis evaluated
the performance of SEV versus BEV in these patients. Methods A systematic
search of PubMed, Embase and Cochrane databases was conducted for
randomized controlled and paired group studies comparing SEV and BEV in
patients with aortic annulus <430 mm2. Statistical analysis was performed
using R (version 2024.4.2 Build 764). Results We included 13 studies with
3,643 patients (median age 82), of whom 48,3% were treated with SEV. SEV
was associated with significantly lower rates of moderate to severe
prosthesis-patient mismatch (PPM) (RR 0.47; 95% CI 0.36, 0.61; p<0.001), a
larger effective orifice area (SMD 0.48; 95% CI 0.25, 0.71; p<0.001) and a
lower mean transvalvular gradient (MD -3.71mmHg; 95% CI -4.69, -2.73;
p<0.01) compared with BEV. No significant differences were found in 1-year
mortality (RR 0.87; 95% CI 0.68, 1.11; p=0.25) or moderate to severe
aortic regurgitation (RR 1.45; 95% CI 0.80, 2.61; p=0.22). However, SEV
had a higher rate of permanent pacemaker implantation at 30 days (RR 1.44;
95% CI 1.01, 2.04; p=0.042). Conclusion SEV demonstrated better
hemodynamic performance in patients with a small annulus, but it was
associated with an increased need for permanent pacemaker implantation.
[Formula presented] Copyright © 2025 American College of
Cardiology Foundation

<102>
Accession Number
2037794367
Title
FRACTIONAL FLOW RESERVE-GUIDED COMPLETE REVASCULARIZATION VERSUS CULPRIT
ONLY REVASCULARIZATION IN ACUTE ST-SEGMENT ELEVATION MYOCARDIAL INFARCTION
AND MULTIVESSEL DISEASE PATIENTS: A META-ANALYSIS.
Source
Journal of the American College of Cardiology. Conference: American
College of Cardiology, (ACC) Meeting 2025. Chicago United States. 85(12
Supplement) (pp 1754), 2025. Date of Publication: 01 Apr 2025.
Author
Bejugam V.R.; Ahsan A.; Anser U.; Siddiqui E.; Sadiq N.; Shuja H.; Saad
M.; Bakhtiyar A.; Khan M.I.; Mian F.H.; Daudpota U.F.; Anum N.; Husnain
M.; Asghar M.S.; Moeed A.; Alam M.
Institution
(Bejugam, Ahsan, Anser, Siddiqui, Sadiq, Shuja, Saad, Bakhtiyar, Khan,
Mian, Daudpota, Anum, Husnain, Asghar, Moeed, Alam) Liaquat National
Medical College, Karachi, Pakistan
Publisher
Elsevier Inc.
Abstract
Background Optimal treatment for non-culprit lesions in STEMI and
multivessel disease remains unclear. This study aims to compare the
clinical outcomes of fractional flow reserve-guided complete
revascularization (FFR-CR) versus culprit-only revascularization (COR) in
these patients. Methods PubMed, Scopus, and EMBASE were searched for
randomized controlled trials (RCTs) comparing FFR-CR with COR in
multivessel disease patients. Our primary outcome was major adverse
cardiovascular events (MACE) and secondary outcomes included myocardial
infarction (MI), all-cause mortality, major bleeding, stroke, re-PCI, and
coronary artery bypass grafting (CABG). Results Four RCTs with 3173
participants (1452 in FFR-CR and 1721 in COR) were included. FFR-CR showed
a significantly reduced risk of MACE (RR=0.67, p=0.03) and re-PCI
(RR=0.37, p<0.00001) when compared to COR. No significant difference was
observed in MI (RR=0.98, p=0.94), all-cause mortality (RR=1.10, P=0.48),
major bleeding (RR=0.95, p=0.87), stroke (1.09, p=0.85), and CABG
(RR=1.25, p=0.76). Meta-regression did not find age, hypertension, current
smoking status, diabetes mellitus, or previous MI significant predictors
of MACE. Conclusion FFR-CR significantly reduces the risk of MACE and
re-PCI compared to culprit-only PCI. However, more large-scale RCTs are
warranted to solidify the utility of FFR-CR. [Formula
presented] Copyright © 2025 American College of Cardiology
Foundation

<103>
Accession Number
2037790511
Title
CONTINUED VERSUS INTERRUPTED ORAL ANTICOAGULATION DURING TRANSCATHETER
AORTIC VALVE REPLACEMENT IN PATIENTS WITH ATRIAL FIBRILLATION: A
META-ANALYSIS.
Source
Journal of the American College of Cardiology. Conference: American
College of Cardiology, (ACC) Meeting 2025. Chicago United States. 85(12
Supplement) (pp 945), 2025. Date of Publication: 01 Apr 2025.
Author
Jain H.; Patel N.; Jain J.; Amanullah K.; Wasir A.S.; Ahmed M.; Ahmed F.;
Al-Shammari A.S.; Ahmed R.; Khan R.; Sethi P.; Alexander T.
Institution
(Jain, Patel, Jain, Amanullah, Wasir, Ahmed, Ahmed, Al-Shammari, Ahmed,
Khan, Sethi, Alexander) All India Institute of Medical Sciences (AIIMS),
Jodhpur, India
(Jain, Patel, Jain, Amanullah, Wasir, Ahmed, Ahmed, Al-Shammari, Ahmed,
Khan, Sethi, Alexander) Corpus Christi Heart Clinic, Corpus Christi, TX,
United States
Publisher
Elsevier Inc.
Abstract
Background A substantial number of patients undergoing transcatheter
aortic valve replacement (TAVR) require long-term oral anticoagulation
(OAC) due to comorbidities. This study examines whether continuing oral
anticoagulation peri-procedurally during TAVR is as safe and effective as
interrupting it. Methods A systematic search of the major databases was
performed to identify relevant studies. Effect estimates were calculated
using risk ratios (RR) and 95% CIs by pooling data employing the
inverse-variance random effects model. Statistical significance was set at
p<0.05. Results 4 studies were included with 2962 patients undergoing TAVR
with continued OAC (n=1318) and interrupted OAC (n=1644). The pooled
analysis demonstrates TAVR with continued OAC comparable risks for
all-cause mortality [RR: 0.91; 95% CI: 0.62, 1.34; p = 0.64],
cardiovascular mortality [RR: 0.89; 95% CI: 0.43, 1.84; p = 0.76], stroke
[RR: 0.67; 95% CI: 0.42, 1.08; p = 0.09], closure device failure [RR:
0.86; 95% CI: 0.47, 1.59; p = 0.64], major/life-threatening bleeding [RR:
0.93; 95% CI: 0.74, 1.15; p = 0.49], and major vascular complications [RR:
0.97; 95% CI: 0.79, 1.20; p = 0.80] compared to TAVR with interrupted OAC.
Conclusion In patients undergoing TAVR, continued OAC shows comparable
safety and efficacy to interrupted OAC. These findings demonstrate that
continuing OAC in the periprocedural period may be a viable option in
patients with AF due to comorbidities requiring anticoagulants. [Formula
presented] Copyright © 2025 American College of Cardiology
Foundation

<104>
Accession Number
2037788278
Title
SEX DIFFERENCES IN PATIENTS WITH AORTIC STENOSIS UNDERGOING TRANSCATHETER
AORTIC VALVE REPLACEMENT: A SYSTEMATIC REVIEW AND META-ANALYSIS.
Source
Journal of the American College of Cardiology. Conference: American
College of Cardiology, (ACC) Meeting 2025. Chicago United States. 85(12
Supplement) (pp 2278), 2025. Date of Publication: 01 Apr 2025.
Author
Tavakoli K.; mohammadi N.S.H.; Fallahtafti P.; Shamshiri S.; Taheri M.;
Ebrahimi P.; Bahiraie P.; Karimi E.; Alishahi M.M.; Pazoki M.; Anaraki N.;
Khanipour R.; Khalique O.K.; May H.T.; Thachil R.; Iskander M.H.; Waheed
A.; Hosseini K.
Institution
(Tavakoli, mohammadi, Fallahtafti, Shamshiri, Taheri, Ebrahimi, Bahiraie,
Karimi, Alishahi, Pazoki, Anaraki, Khanipour, Khalique, May, Thachil,
Iskander, Waheed, Hosseini) Tehran Heart Center, Tehran, Iran, Islamic
Republic of
Publisher
Elsevier Inc.
Abstract
Background Comparisons of outcomes after transcatheter aortic valve
replacement (TAVR) between male and female patients are limited. This
study aimed to evaluate sex-specific differences in outcomes following
TAVR. Methods A systematic search of PubMed, EMBASE, Scopus, and Cochrane
Library was conducted through August 2024 to identify studies reporting
sex-stratified outcomes in adults with aortic stenosis undergoing TAVR.
Data were pooled using a random-effects model (DerSimonian and Laird
method) to assess outcomes at 30 days, 1 year, and long-term. Results
Seventy-seven studies, comprising 84,478 females and 85,015 males, were
included. At 30 days, females had a higher risk of stroke (RR = 1.33, 95%
CI: 1.14-1.54) and major vascular complications (RR = 1.76, 95% CI:
1.49-2.08). By 1 year, males had a higher risk of mortality (RR = 0.85,
95% CI: 0.81-0.90) and pacemaker implantation (RR = 0.77, 95% CI:
0.69-0.87), while females were at higher risk of major bleeding (RR =
1.31, 95% CI: 1.19-1.43) and major vascular complications (RR = 1.86, 95%
CI: 1.47-2.34). There were no significant differences in long-term
mortality between the sexes. Conclusion This systematic review and
meta-analysis indicate that females are at greater risk for early stroke
and vascular complications after TAVR, while males are at increased risk
of 1-year mortality and pacemaker implantation. These findings emphasize
the need for sexspecific considerations in the management of patients
undergoing TAVR. [Formula presented] Copyright © 2025 American
College of Cardiology Foundation

<105>
Accession Number
2037791915
Title
PROPHYLACTIC ADMINISTRATION OF LEVOSIMENDAN TO PEDIATRIC PATIENTS
UNDERGOING CONGENITAL HEART SURGERY - A META-ANALYSIS OF RCTS.
Source
Journal of the American College of Cardiology. Conference: American
College of Cardiology, (ACC) Meeting 2025. Chicago United States. 85(12
Supplement) (pp 791), 2025. Date of Publication: 01 Apr 2025.
Author
Shehab M.; Hassan I.; Khalifa O.; Reda S.; Araj M.S.A.; Ali Y.; Taha M.;
Aloran M.
Institution
(Shehab, Hassan, Khalifa, Reda, Araj, Ali, Taha, Aloran) Faculty of
Medicine, Cairo university, Cairo, Egypt
(Shehab, Hassan, Khalifa, Reda, Araj, Ali, Taha, Aloran) Faculty of
Medicine, Suez Canal University, Ismailia, Egypt
Publisher
Elsevier Inc.
Abstract
Background Levosimendan, an inodilator, has shown the potential to improve
cardiac function and prevent acute kidney injury (AKI) in pediatric
cardiac surgery patients. However, evidence supporting its postoperative
benefits compared to placebo or other inodilators remains limited. This
meta-analysis investigates the impact of levosimendan on postoperative
outcomes compared to other inotropes in pediatric patients undergoing
cardiac surgery with cardiopulmonary bypass (CPB). Methods A comprehensive
online search was done on 4 databases PubMed, Web of Science, Scopus, and
Cochrane, for randomized control trials up to March 31, 2024. Search,
extraction, analysis, and writing were done according to Prisma
guidelines. Details of each step were registered on PROSPERO with the ID
CRD42024571657. Outcomes were analyzed using mean differences (MD) and
risk ratios (RR) with 95% confidence intervals (CI). Results We found
eleven RCTs, with 706 patients undergoing cardiac repair surgery with CPB.
Compared to other inotropes, Levosimendan demonstrated trends towards
reduced mortality (RR 0.45, CI (0.19 to 1.08), p=0.07), lower incidence of
low cardiac output syndrome (RR 0.79, CI (0.57 to 1.11), p=0.17), cardiac
index (MD 0.71, CI (-0.77 to 2.19), p=0.35) and mixed venous oxygen
saturation (MD 2.04, CI (-0.72 to 4.80), p=0.15). However, none of these
were statistically significant. Moreover, acute kidney injury incidence
(RR 1.10, CI (0.65 to 1.87), p=0.73), dialysis requirement (RR 1.12, CI
(0.47 to 2.67), p=0.79), or lactate levels (MD -0.06, CI (-0.19 to 0.07),
p=0.35) showed no statistically significant differences between both
groups. Conclusion Levosimendan did not show statistically significant
additional benefits compared to other inotropes in pediatric cardiac
surgery outcomes. While there were non-significant trends toward reduced
mortality and improved hemodynamics, larger studies are needed to
establish its efficacy and safety in this population. Copyright ©
2025 American College of Cardiology Foundation

<106>
Accession Number
2037792536
Title
EFFECT OF ATORVASTATIN PLUS ASPIRIN IN PERIOPERATIVE MYOCARDIAL INJURY IN
CANCER PATIENTS: A PROSPECTIVE, RANDOMIZED, PLACEBO-CONTROLLED STUDY.
Source
Journal of the American College of Cardiology. Conference: American
College of Cardiology, (ACC) Meeting 2025. Chicago United States. 85(12
Supplement) (pp 2574), 2025. Date of Publication: 01 Apr 2025.
Author
Ramos L.W.F.; Ramos M.V.F.; Wolf P.; Magalhaes L.; Ramos B.C.F.; Ramos
E.E.
Institution
(Ramos, Ramos, Wolf, Magalhaes, Ramos, Ramos) Brazilian Institute for
Cancer Control, Sao Paulo, Brazil
Publisher
Elsevier Inc.
Abstract
Background Perioperative myocardial injury (PMI) is increasingly
recognized as a frequent perioperative cardiac complication following
major non-cardiac surgery and an important contributor to postoperative
morbi-mortality. There is currently no defined treatment for PMI. We aimed
to determine whether the combination of atorvastatin plus aspirin reduces
postoperative adverse outcomes in this population. Methods Cancer patients
aged 60 or over or those with two or more cardiovascular risk factors
regardless of age who had elevated troponin (hs cTI exceed 99th
percentile of the upper reference limit) in the postoperative period of
non-cardiac surgery under general anesthesia were randomized 1:1 to
receive atorvastatin (80 mg/day) associated with aspirin (100 mg/day -
group 1) from the first day postoperative or placebo (group 2) from the
first day postperative. The remaining patients (no criteria for PMI -
group 3) were usually treated. Cardiovascular outcomes (MACE) or death
from any cause were assessed at 210 days. Variables such as age, sex,
duration and type of surgery, surgical risk (ASA), cardiac risk factors
and presence of co-morbidities were also analyzed. Results Between Jan/23
and Jan/24, 455 patients (59.4+4.9 years, 55% female) undergoing
non-cardiac surgical intervention were evaluated. Sixty-five (14.3%)
patients had elevated cTI. Thirty four (8.7%) adverse events were observed
in group 3. Of the 33 patients from group 1, 6 had adverse events within
210 days versus 14/32 from group 2 (18.1% x 43.7% RR=2.41 CI95%=1.10-5.49,
p=0.03). We also compared group 2 with group 3 (43.7% x 8.7% RR=5.02
CI95%=2.94-8.06, p<0.0001) and group 1 with group 3 (18.1% x 8.7% RR=2.09
CI95%=0.93- 4.29, p=0.11). There was no statistically significant
difference between the variables analyzed. Conclusion These results
suggest that PMI in cancer patients impacts the postoperative outcomes.
The use of Aspirin plus Atorvastatin showed benefit in the 210 days
follow-up and may be of value in this setting. Long-term studies with a
larger number of participants are needed to confirm these initial
findings. Copyright © 2025 American College of Cardiology
Foundation

<107>
Accession Number
2037793180
Title
NATIVE CORONARY ARTERY OR BYPASS GRAFT PERCUTANEOUS CORONARY INTERVENTION
IN PATIENTS WITH PREVIOUS HISTORY OF CORONARY ARTERY BYPASS SURGERY: A
SYSTEMATIC REVIEW AND META-ANALYSIS.
Source
Journal of the American College of Cardiology. Conference: American
College of Cardiology, (ACC) Meeting 2025. Chicago United States. 85(12
Supplement) (pp 1115), 2025. Date of Publication: 01 Apr 2025.
Author
Bahar A.R.; Hamza M.; Ishaq S.; Hanmandlu A.; Husainy B.; Bahar Y.;
Alraies M.C.
Institution
(Bahar, Hamza, Ishaq, Hanmandlu, Husainy, Bahar, Alraies) Wayne State
University, Detroit, MI, United States
Publisher
Elsevier Inc.
Abstract
Background Acute coronary syndrome (ACS) after coronary artery bypass
grafting (CABG) is common, but data on percutaneous coronary intervention
(PCI) outcomes in native vs. grafted arteries are limited. This
meta-analysis compares PCI outcomes between the two to inform treatment
strategies. Methods A literature search using PubMed and Embase identified
relevant studies. A random-effects model and the Mantel-Haenszel method
were used to calculate odds ratios (OR) for dichotomous outcomes with 95%
confidence intervals (CI). Results Twenty-three observational studies
included 19,378 patients with PCI in grafted arteries and 34,428 in native
arteries. PCI in native arteries was associated with reduced all-cause
mortality (OR 0.67, 95% CI 0.61-0.86, p<0.01), major adverse
cardiovascular events (MACE) (OR 0.52, 95% CI 0.48-0.56, p<0.001),
myocardial infarction (MI) (OR 0.60, 95% CI 0.44-0.81, p<0.001), and total
vessel revascularization (TVR) (OR 0.63, 95% CI 0.52-0.77, p<0.001).
Bleeding and stroke were not significant. Conclusion PCI in native
arteries significantly reduced all-cause mortality, MI, MACE, and TVR
compared to grafted arteries, suggesting a higher disease burden in
grafted vessels. Further research is needed to guide clinical decisions.
[Formula presented] Copyright © 2025 American College of
Cardiology Foundation

<108>
Accession Number
2037786477
Title
INTRACARDIAC ECHOCARDIOGRAPHY VERSUS TRANSESOPHAGEAL ECHOCARDIOGRAPHY
GUIDANCE ON LEFT ATRIAL APPENDAGE OCCLUSION IN PATIENTS WITH ATRIAL
FIBRILLATION: A SYSTEMATIC REVIEW AND META-ANALYSIS.
Source
Journal of the American College of Cardiology. Conference: American
College of Cardiology, (ACC) Meeting 2025. Chicago United States. 85(12
Supplement) (pp 152), 2025. Date of Publication: 01 Apr 2025.
Author
Ranabhat C.; Khan U.; Amin A.M.; Imran M.; Majeed Z.; Rehman W.; Ramadan
S.M.; Nawaz A.; Chaudhry K.; Ain N.U.
Institution
(Ranabhat, Khan, Amin, Imran, Majeed, Rehman, Ramadan, Nawaz, Chaudhry,
Ain) University of Maryland Medical Center, Midtown Campus, Baltimore, MD,
United States
Publisher
Elsevier Inc.
Abstract
Background Intracardiac echocardiography (ICE) is an innovative technique
that has emerged as an alternative to transesophageal echocardiography
(TEE) to guide the implantation of a left atrial appendicular obstruction
(LAAO) device in patients with nonvalvular atrial fibrillation who cannot
tolerate anticoagulants. Methods We conducted comprehensive searches
across PubMed, CENTRAL, WOS, Scopus, and EMBASE until March 2024. Pooled
data were reported using risk ratio (RR) for dichotomous outcomes and mean
difference (MD) for continuous outcomes, along with a 95% confidence
interval (CI). This systematic review and meta-analysis was registered
with PROSPERO ID: CRD42024542537. Results We included 20 studies with a
total of 110,026 patients. ICE was associated with significantly high
procedure success rate compared to TEE [RR: 0.99370 with 95% CI (0.98878,
0.99864), P = 0.01), but there was no difference in Procedure duration
[MD: 3.07 with 95% CI (-4.67, 10.80), P= 0.44], and adverse events [RR:
0.86 with 95% CI (0.71, 1.05), P = 0.14) between the two groups. However,
compared to ICE, the TEE patients required more than one device [RR: 1.39
with 95% CI (1.23, 1.57), P<0.01), and ICE reported an increased incidence
of pericardial effusion compared to TEE [RR: 0.65 with 95% CI (0.50,
0.85), P < 0.01). Conclusion Our meta-analysis concluded that ICE is
associated with similar safety and efficacy in guiding LAAO compared to
TEE. However, ICE is a feasible and safe alternative that reduces exposure
to general anesthesia and associated potential risks. Copyright ©
2025 American College of Cardiology Foundation

<109>
Accession Number
2037793182
Title
LONGER-TERM RANDOMIZED CONTROL TRIALS COMPARING DRUG-ELUTING WITH BARE
METAL STENTS IN SAPHENOUS VEIN GRAFT INTERVENTION: AN UPDATED
META-ANALYSIS.
Source
Journal of the American College of Cardiology. Conference: American
College of Cardiology, (ACC) Meeting 2025. Chicago United States. 85(12
Supplement) (pp 1155), 2025. Date of Publication: 01 Apr 2025.
Author
Lak H.M.; Awan U.; Shekhar S.; Hassan H.
Institution
(Lak, Awan, Shekhar, Hassan) Cleveland Clinic, Cleveland, OH, United
States
Publisher
Elsevier Inc.
Abstract
Background Drug-eluting stents (DES) are preferred over bare metal stents
(BMS) for native coronary artery revascularization unless contraindicated.
However, the preferred stent choice for saphenous venous graft (SVG)
percutaneous coronary interventions (PCI) is unclear due to conflicting
results. Methods Seven RCTs involving 1639 patients met the inclusion
criteria and were analyzed. Endpoints were major adverse cardiac events
(MACE), cardiovascular mortality, all-cause mortality, myocardial
infarction (MI), target vessel revascularization (TVR), target lesion
revascularization (TLR), in-stent thrombosis & MACE. Results Overall,
348/827 (42.1%) patients in the DES group and 360/812 (44.3%) in the BMS
group experienced MACE. After a mean follow up of 44.4 months, there was
no significant difference in the incidence of MACE (OR 0.86 [0.66, 1.11];
p = 0.24), cardiovascular mortality(OR 0.89 [0.57, 1.40]; p = 0.62),
all-cause mortality (OR 1.02 [0.72, 1.46]; p = 0.90), MI (OR0.84 [0.57,
1.23]; p = 0.37), stent thrombosis (OR 1.14 [0.43, 3.02]; p = 0.79), TVR
(OR 0.72[0.48, 1.09]; p = 0.12) and TLR (OR 0.99 [0.57, 1.73], p = 0.97)
between DES and BMS groups. The short-term follow-up (mean 11 months) of
1592 patients showed a lower rate of MACE (OR0.72 [0.52, 0.99]; p = 0.04),
TVR (OR 0.54 [0.29, 1.00]; p = 0.05) and binary in-stent re-stenosis (OR
0.47 [0.26, 0.87]; p = 0.02) in DES group as compared with BMS. However,
this benefit was lost at long-term follow-up (mean 44.4 months) [MACE (OR
0.84 [0.64, 1.10]; p =0.21), TVR (OR 0.72 [0.48, 1.09]; p = 0.12)] among
1582 patients. Conclusion There was no difference in cardiovascular
mortality, all-cause mortality, MI, in-stent thrombosis, and TLR in both
short-term and long-term follow-up. Copyright © 2025 American
College of Cardiology Foundation

<110>
Accession Number
2037786813
Title
OUTCOMES OF PROTAMINE IN PATIENTS UNDERGOING TRANSCATHETER AORTIC VALVE
REPLACEMENT: A SYSTEMATIC REVIEW AND META-ANALYSIS.
Source
Journal of the American College of Cardiology. Conference: American
College of Cardiology, (ACC) Meeting 2025. Chicago United States. 85(12
Supplement) (pp 555), 2025. Date of Publication: 01 Apr 2025.
Author
Haider M.Z.; Qadeer A.; Khawar M.; Komel A.; Khan M.; Khalid Y.; Zain S.;
Mal M.; Aziz S.; Aamir M.; Qian C.; Kirchoff R.; Balla S.
Institution
(Haider, Qadeer, Khawar, Komel, Khan, Khalid, Zain, Mal, Aziz, Aamir,
Qian, Kirchoff, Balla) Mayo Clinic, Pheonix, AZ, United States
(Haider, Qadeer, Khawar, Komel, Khan, Khalid, Zain, Mal, Aziz, Aamir,
Qian, Kirchoff, Balla) West Virginia University, WV, United States
Publisher
Elsevier Inc.
Abstract
Background Protamine is used to reverse anticoagulation during
cardiovascular procedures like transcatheter aortic valve replacement
(TAVR). However, the outcomes of protamine in TAVR patients remain
debated. We aim to evaluate these outcomes. Methods A comprehensive
literature search was conducted across multiple databases (EMBASE, OVID,
Scopus, PubMed, ClinicalTrials. gov, and Web of Science). We extracted
baseline characteristics and evaluated outcomes. Odds ratios (OR) with 95%
confidence intervals (CI) were calculated. Statistical significance was
assigned at p<0.05. Results Six studies with a total of 3,901 patients
were included. Protamine was associated with a significant reduction in
the risk of major bleeding events (OR: 0.47 [CI 0.30-0.74], p = 0.001),
major vascular complications (OR: 0.51 [CI 0.37-0.70], p < 0.0001), and
the need for RBC transfusions (OR: 0.67 [CI 0.51-0.88], p = 0.004).
However, there was no significant difference in the incidence of 30-day
mortality (OR: 0.93 [CI 0.62-1.41], p = 0.75), stroke or ischemic events
(OR: 0.77 [CI 0.43-1.37], p = 0.37) and minor vascular complications (OR:
0.81 [CI 0.62-1.06], p = 0.12)-figure 1. Conclusion Our results suggest
protamine is safe and effective in reducing major bleeding, major vascular
complications, and the need for RBC transfusions after TAVR. Large-scale
randomized studies are needed to confirm these results and assess
long-term outcomes. [Formula presented] Copyright © 2025 American
College of Cardiology Foundation

<111>
Accession Number
2037790182
Title
ISCHEMIC STROKE AFTER LEFT ATRIAL APPENDAGE CLOSURE: A REVIEW OF
RANDOMIZED CLINICAL TRIALS.
Source
Journal of the American College of Cardiology. Conference: American
College of Cardiology, (ACC) Meeting 2025. Chicago United States. 85(12
Supplement) (pp 5), 2025. Date of Publication: 01 Apr 2025.
Author
Gandhi D.; Ganesan A.V.; Vaz C.; Prakash A.
Institution
(Gandhi, Ganesan, Vaz, Prakash) New york Medical College at St. Mary's
Hospital, Passaic, NJ, United States
Publisher
Elsevier Inc.
Abstract
Background Left atrial appendage closure (LAAC) has been suggested as an
alternative to oral anticoagulation (OAC) to prevent cardioembolic events
among patients with atrial fibrillation unable to take anticoagulants.
However, its superiority in stroke prevention is still being determined.
In this review, we aim to explore the incidence of stroke and other
determinants among these patients. Methods We searched PUBMED database for
randomized clinical trials (RCT), including LAAC and OAC (warfarin and
direct oral anticoagulants), published between 2008 -2024. STATA software
was for two-sample t-test and regression analysis to evaluate possible
patient risk factors for stroke post-LAAC. Results Five RCTs with 3615
patients (3032 in LAAC, 583 in OAC) were analyzed. The mean follow-up
period was 22.62 months (95% CI: 11.15-34.09). Patients in the device
group had a mean age of 74.39 years (95% CI: 73.15 - 75.63) and a
CHA<inf>2</inf>DS<inf>2</inf>-VASc score of 3.68 (95% CI: 2.88-4.48).
Comparisons of patients' characteristics, such as age, sex, history of
hypertension, and diabetes, among those in LAAC and those on OAC showed no
significant differences. The CHA<inf>2</inf>DS<inf>2</inf>-VASc score
difference was -0.73 (95% CI: -2.53 - 1.06, p = 0.37). Similarly, history
of heart failure (p = 0.38), hypertension (p = 0.71), and diabetes (p =
0.50) did not differ significantly in the two groups. Logistic regression
analysis showed no statistically significant associations between
nonmodifiable risk factors, age (p = 0.34, odds ratio (OR): 1.61, 95% CI:
0.61 - 4.26). and sex (male: OR: 0.99 p = 0.88, female: OR 1.02 p = 0.74)
or modifiable risk factors, heart failure (p = 0.56), hypertension (p =
0.46), and diabetes (p = 0.38) in predicting stroke in both groups.
Moreover, the odds of ischemic stroke (OR: 1.13, p = 0.32, 95% CI:
0.89-1.44), hemorrhagic stroke (OR 1.29, p=0.570), or death (OR 0.99, p=
0.879) were similar in both groups. Conclusion LAAC is an efficacious
non-pharmacological alternative to OAC. No significant difference was
found between the use of these two modalities in ischemic stroke
prevention. Further studies with extended follow-up periods are warranted
to understand risk factors for ischemic stroke after LAAC. Copyright
© 2025 American College of Cardiology Foundation

<112>
Accession Number
2037793396
Title
EFFECTS OF COENZYME Q10 ON POSTOPERATIVE ARRHYTHMIAS AND OUTCOMES IN
CARDIAC SURGERY: A SYSTEMATIC REVIEW AND META-ANALYSIS.
Source
Journal of the American College of Cardiology. Conference: American
College of Cardiology, (ACC) Meeting 2025. Chicago United States. 85(12
Supplement) (pp 104), 2025. Date of Publication: 01 Apr 2025.
Author
Saeed A.; Awamleh N.A.; Jain H.; Younis O.; Arshad M.M.; Al-Sharif Z.;
Qubbaj F.; Ghlailat M.; Tuffaha Y.; Amanullah K.; Ahmed R.
Institution
(Saeed, Awamleh, Jain, Younis, Arshad, Al-Sharif, Qubbaj, Ghlailat,
Tuffaha, Amanullah, Ahmed) University of Jordan, Amman, Jordan
(Saeed, Awamleh, Jain, Younis, Arshad, Al-Sharif, Qubbaj, Ghlailat,
Tuffaha, Amanullah, Ahmed) All India Institute of Medical Sciences,
Jodhpur, India
Publisher
Elsevier Inc.
Abstract
Background Postoperative arrhythmias (POAs) often complicate cardiac
surgeries and increase stroke and mortality risk. Coenzyme Q10 (CoQ10), a
mitochondrial electron transport chain component, may reduce oxidative
stress and improve cardiac function, potentially preventing POAs. Methods
PubMed, Cochrane and EMBASE were systematically searched for studies on
CoQ10's effects on cardiac surgery outcomes. Meta-analysis was performed
using R's "meta" package with random-effects model, synthesizing results
as risk ratios (RR) or mean differences (MD) with 95% confidence intervals
(CI). Results Eleven studies involving 622 patients were included.
Compared to placebo (n=301), 321 patients taking CoQ10 showed
significantly reduced POAs (RR = 0.50, 95% CI: 0.35-0.73, p = 0.0004,
Figure 1A) and low output state (LOS) (RR = 0.58, 95% CI: 0.370.91, p =
0.0186, Figure 1B). Although reductions in hospital stay (MD = -1.23 days,
95% CI: -3.85 to 1.38, p = 0.23), improvements in cardiac function
indicators (LVSWI: MD = 4.45, 95% CI: -10.37 to 19.27, p = 0.41; Cardiac
Index: MD = 0.08, 95% CI: -0.38 to 0.53, p = 0.63), and decreases in
myocardial injury biomarkers (troponin: MD = -0.26, 95% CI: -1.45 to 0.93,
p = 0.57; CK-MB: MD = -4.42, 95% CI: -17.55 to 8.70, p = 0.28) were
observed, reflecting cardioprotective trends, yet none reached statistical
significance. No side effects were reported. Conclusion Preoperative CoQ10
reduces POAs and LOS, showing potential myocardial protection with a
favorable safety profile. [Formula presented] Copyright © 2025
American College of Cardiology Foundation

<113>
Accession Number
2037791299
Title
COMPARATIVE EFFICACY OF THIRD-GENERATION SELF-EXPANDING TRANSCATHETER
HEART VALVES: A NETWORK META-ANALYSIS.
Source
Journal of the American College of Cardiology. Conference: American
College of Cardiology, (ACC) Meeting 2025. Chicago United States. 85(12
Supplement) (pp 2290), 2025. Date of Publication: 01 Apr 2025.
Author
Samimi S.; Saravanan P.B.; Korra R.N.; Sarkar R.; Kumar N.; Shaji S.;
Patel B.M.; Kharsa C.; Thakkar S.; Khan S.; Aoun J.; Zaid S.; Faza N.N.;
Atkins M.; Little S.H.; Zoghbi W.A.; Reardon M.J.; Kleiman N.S.; Goel S.S.
Institution
(Samimi, Saravanan, Korra, Sarkar, Kumar, Shaji, Patel, Kharsa, Thakkar,
Khan, Aoun, Zaid, Faza, Atkins, Little, Zoghbi, Reardon, Kleiman, Goel)
Section of Cardiology, Baylor College of Medicine, Michael E DeBakey VA
Medical Center, Houston, TX, United States
(Samimi, Saravanan, Korra, Sarkar, Kumar, Shaji, Patel, Kharsa, Thakkar,
Khan, Aoun, Zaid, Faza, Atkins, Little, Zoghbi, Reardon, Kleiman, Goel)
Houston Methodist DeBakey Heart and Vascular Center, Houston, TX, United
States
Publisher
Elsevier Inc.
Abstract
Background The landscape of transcatheter heart valves (THVs) for severe
aortic stenosis (AS) is evolving, with third-generation devices aiming to
reduce paravalvular leakage (PVL) and permanent pacemaker implantation
(PPI). Comparative data on new self-expanding prostheses remain limited.
Methods We systematically searched Medline, Scopus, Embase, and Cochrane
central up to June 1, 2024, identifying randomized clinical trials and
observational studies comparing self-expandable THVs. A frequentist
random-effects network meta-analysis estimated odds ratios (ORs) and 95%
confidence intervals (CIs). P-scores ranked the THVs based on clinical
performance. Results Fourteen studies involving 12,698 patients were
included. The NavitorTM valve showed lower incidence of moderate or
greater PVL compared to EvolutTM Pro/Pro+ (OR=0.12; 95% CI=0.02-0.68) and
PorticoTM (OR=0.19; 95% CI=0.04-0.91), with the lowest PVL risk
(P-score=0.98; tau2=0; I2=0%; P=0.83). The Acurate NeoTM/Neo2TM valve
reduced PPI odds compared to EvolutTM Pro/Pro+ (OR=0.51; 95%
CI=0.30-0.87), PorticoTM (OR=0.36; 95% CI=0.08-0.83), and NavitorTM
(OR=0.26; 95% CI=0.20-0.66), corresponding to the lowest PPI risk
(P-score=0.99; tau2=0.14; I2=46.7%; P=0.06). Conclusion The NavitorTM
valve appeared superior in reducing moderate or greater PVL, while the
Acurate NeoTM/Neo2TM valve had the lowest PPI risk among third-generation
THVs. Further head-to-head studies are necessary to confirm these results.
[Formula presented] Copyright © 2025 American College of
Cardiology Foundation

<114>
Accession Number
2037791249
Title
SAFETY AND EFFICACY OF PERCUTANEOUS TRANSCATHETER EDGE-TO-EDGE MITRAL
VALVE REPAIR FOR FUNCTIONAL MITRAL REGURGITATION IN HEART FAILURE: A
META-ANALYSIS.
Source
Journal of the American College of Cardiology. Conference: American
College of Cardiology, (ACC) Meeting 2025. Chicago United States. 85(12
Supplement) (pp 958), 2025. Date of Publication: 01 Apr 2025.
Author
Jain H.; Patel N.; Jain J.; Amanullah K.; Ahmed M.; Goyal A.; Ahmed F.;
Amanullah M.; Ahmed R.; Khan R.; Sethi P.; Alexander T.
Institution
(Jain, Patel, Jain, Amanullah, Ahmed, Goyal, Ahmed, Amanullah, Ahmed,
Khan, Sethi, Alexander) All India Institute of Medical Sciences (AIIMS),
Jodhpur, India
(Jain, Patel, Jain, Amanullah, Ahmed, Goyal, Ahmed, Amanullah, Ahmed,
Khan, Sethi, Alexander) Texas Tech University Health Sciences, Lubbock,
TX, United States
Publisher
Elsevier Inc.
Abstract
Background Percutaneous transcatheter mitral valve repair (TMVR) with
MitraClip for functional mitral regurgitation (FMR) in heart failure is a
novel alternative intervention, with limited evidence compared with
medical therapy alone. Methods A systematic search of the major databases
was performed to identify relevant randomized controlled trials (RCTs).
Effect estimates were calculated using standardized mean difference (SMD)
and risk ratios (RR) with 95% CIs by pooling data employing a random
effects model. Statistical significance was set at p<0.05. Results 3 RCTs
were included with 1423 patients [TMVR = 704; medical therapy = 719]. TMVR
demonstrated a significant decrease in the risk of all-cause mortality
[RR: 0.78; 95% CI: 0.64, 0.94; p = 0.01], unplanned hospitalization for
heart failure (HHF) in 24 months [RR: 0.70; 95% CI: 0.52, 0.93; p = 0.01],
composite death and HHF [RR: 0.74; 95% CI: 0.60, 0.93; p = 0.01], and
increase in 6-min walk distance from baseline [SMD: 0.25; 95% CI: 0.05,
0.44; p = 0.01] compared to medical therapy. TMVR showed an insignificant
trend toward reduction in cardiovascular mortality [RR: 0.80; 95% CI:
0.62, 1.04] compared to medical therapy. Conclusion TMVR with MitraClip
leads to significant reductions in all-cause mortality, unplanned HHF, and
improvement in the 6-minute walk test, compared to medical therapy alone
for FMR in heart failure. However, it does not lead to a significant
reduction in cardiovascular mortality. [Formula presented] Copyright
© 2025 American College of Cardiology Foundation

<115>
Accession Number
2037792035
Title
ARTIFICIAL-INTELLIGENCE BASED PREDICTION MODEL FOR THIRTY-DAY MORTALITY OF
TAVR PATIENTS IN CHINA: A NATIONAL STUDY FROM NTCVR COHORT.
Source
Journal of the American College of Cardiology. Conference: American
College of Cardiology, (ACC) Meeting 2025. Chicago United States. 85(12
Supplement) (pp 2347), 2025. Date of Publication: 01 Apr 2025.
Author
Zhu Q.; Liu X.; Wang J.-A.
Institution
(Zhu, Liu, Wang) The Second Affiliated Hospital of Zhejiang Univeristy
School of Medicine, Hangzhou, China
(Zhu, Liu, Wang) State Key Laboratory of Transvascular Implantation
Devices, Hangzhou, China
Publisher
Elsevier Inc.
Abstract
Background Currently, there is still no universal risk-stratification
model for patients undergoing transcatheter aortic valve replacement
(TAVR). We aim to develop an artificial-intelligence (AI) based prediction
models for 30-day TAVR mortality among Chinese patients. Methods 6,294
patients were included from Feb 2017 to Nov 2022 in over 80 medical
centers throughout China. Patients from 2 randomly selected provinces were
allocated as external validation set, the rest were then divided into
training set (80%) and internal validation set (20%). Multiple AI based
algorithm (5 methods for feature engineering, 15 methods for model
derivation) were used for model development. Results 15 variables were
included into the final model. After comparison between 1125 AI based
models, ANOVA T-score for feature engineering and C5.0 for model
derivation were the best algorithm. C-index was 0.765 for internal
validation cohort and 0.682 for external validation cohort. Left coronary
height measured in cardiac CTA, planned circulatory support, hemoglobin
level, left ventricular ejection fraction and diameter of diastolic
inter-ventricular septum were the top 5 predictors using SHAP
interpretation for AI-based model. Conclusion An AI-based prediction
models for 30-day TAVR mortality among Chinese patients was feasible and
effective, and novel predictors from multi-modality data (CT,
echocardiogram, etc.) enhanced the robustness of the model. [Formula
presented] Copyright © 2025 American College of Cardiology
Foundation

<116>
Accession Number
2037786417
Title
CARDIOPROTECTIVE ROLE OF PERIOPERATIVE DEXMEDETOMIDINE AGAINST INCIDENCE
OF JUNCTIONAL ECTOPIC TACHYCARDIA FOLLOWING CORRECTIVE SURGERY FOR
CONGENITAL HEART DEFECTS: A META-ANALYSIS.
Source
Journal of the American College of Cardiology. Conference: American
College of Cardiology, (ACC) Meeting 2025. Chicago United States. 85(12
Supplement) (pp 301), 2025. Date of Publication: 01 Apr 2025.
Author
Patel N.; Kumar A.; Parikh A.; Singh D.; Jha M.; Jain H.; Kulkarni A.; Rai
A.; Shah K.P.; Madan H.
Institution
(Patel, Kumar, Parikh, Singh, Jha, Jain, Kulkarni, Rai, Shah, Madan) GMERS
Vadnagar, Vadnagar, India
(Patel, Kumar, Parikh, Singh, Jha, Jain, Kulkarni, Rai, Shah, Madan) All
India Institute of Medical Sciences (AIIMS), Jodhpur, India
Publisher
Elsevier Inc.
Abstract
Background Junctional ectopic tachycardia (JET) is one of the most common
postoperative rhythm disturbances observed in pediatric patients following
the surgical correction of various congenital heart defects with a
cardiopulmonary bypass. Dexmedetomidine has a notably high ratio of a2/a1
activity and sympatho-adrenergic effect, thereby it is hypothesized to
provide therapeutic support in controlling tachyarrhythmia. Methods A
comprehensive search of the major databases was conducted to retrieve
eligible studies, comparing the efficacy and patient outcomes of
Dexmedetomidine for control of JET. The random-effects model was used to
generate pooled incidences of outcomes with 95% confidence intervals
(CIs). Results A total of 6 RCTs were analysed comprising 829 children
scheduled for elective surgery, of which 419 were exposed to
dexmedetomidine in the perioperative period. Dexmedetomidine significantly
reduced the incidence of JET [RR: 0.39; 95% CI: 0.27, 0.57; p < 0.00001]
and ventilation time [MD: -6.13; 95% CI: -11.98, -0.27; p = 0.04]. No
significant differences were found in VIS [MD: -1.10; 95% CI: -2.64, 0.44;
p = 0.16], ICU stay [MD: -10.64; 95% CI: -50.06, 10.78; p = 0.21], or
hospital stay [MD: -41.51; 95% CI: -123.96, 40.94; p = 0.32]. Conclusion
After thorough review, multiple studies have provided conclusive evidence
of significant reduction in incidence of JET following perioperative
exposure to dexmedetomidine which hints towards its proficiency in
improving patient outcomes. [Formula presented] Copyright © 2025
American College of Cardiology Foundation

<117>
Accession Number
2037793926
Title
ORAL ANTICOAGULATION IN TAVR: DOES INTERRUPTION OR CONTINUATION AFFECT
MAJOR CARDIOVASCULAR OUTCOMES? A SYSTEMATIC REVIEW & META-ANALYSIS OF
2,957 PATIENTS.
Source
Journal of the American College of Cardiology. Conference: American
College of Cardiology, (ACC) Meeting 2025. Chicago United States. 85(12
Supplement) (pp 848), 2025. Date of Publication: 01 Apr 2025.
Author
Calderon-Fernandez A.; Bay B.M.; Granados E.A.M.; Jimenez X.R.; Acosta
A.V.; Batiz F.
Institution
(Calderon-Fernandez, Bay, Granados, Jimenez, Acosta, Batiz) Universidad
Autonoma de Baja California, Tijuana, Mexico
Publisher
Elsevier Inc.
Abstract
Background Managing oral anticoagulation (OAC) in patients undergoing
transcatheter aortic valve replacement (TAVR) is crucial to balance
thromboembolic risk and bleeding complications. This meta-analysis
evaluates whether interrupting or continuing OAC impacts key
cardiovascular outcomes in TAVR patients. Methods We searched in PUBMED
and EMBASE until September 8th, 2024, identifying studies on 2,957
patients undergoing TAVR with OAC interruption or continuation. Primary
outcomes were 30-day mortality, major vascular complications, stroke from
any cause, and early safety (freedom from death from any cause). A
random-effects model calculated risk ratios (RR) with 95% confidence
intervals (CI) and heterogeneity was assessed with the Chi-squared test
and I2 statistic. Results No significant differences were found in 30-day
mortality (RR: 1.11, 95% CI: [0.65, 1.87], p = 0.71), stroke risk was
slightly higher in the interruption group (RR: 1.53, 95% CI: [0.99, 2.37],
p = 0.05). Major vascular complications (RR: 1.03, 95% CI: [0.79, 1.34], p
= 0.84) and early safety (RR: 1.04, 95% CI: [0.95, 1.14], p = 0.43) were
similar between groups. Conclusion Interrupting OAC in TAVR patients did
not significantly impact 30-day mortality, stroke, or complications,
though a trend toward higher stroke risk was noted. Continuing OAC may
lower stroke risk without raising other complications. Standardizing
VARC-3 criteria and longer-term studies are essential to improve
consistency and comparability. [Formula presented] Copyright ©
2025 American College of Cardiology Foundation

<118>
Accession Number
2037792815
Title
EFFICACY AND SAFETY OF BEMPEDOIC ACID IN PATIENTS >=75 YEARS: ANALYSIS OF
CLEAR OUTCOMES.
Source
Journal of the American College of Cardiology. Conference: American
College of Cardiology, (ACC) Meeting 2025. Chicago United States. 85(12
Supplement) (pp 2631), 2025. Date of Publication: 01 Apr 2025.
Author
Mukherjee D.; Nicholls S.J.; Lincoff A.M.; Broestl C.; Li M.; Herout P.;
Bloedon L.; Mancini G.B.J.; Nissen S.E.
Institution
(Mukherjee, Nicholls, Lincoff, Broestl, Li, Herout, Bloedon, Mancini,
Nissen) Texas Tech University Health Services Center, El Paso, TX, United
States
(Mukherjee, Nicholls, Lincoff, Broestl, Li, Herout, Bloedon, Mancini,
Nissen) Esperion Therapeutics, Inc, Ann Arbor, MI, United States
Publisher
Elsevier Inc.
Abstract
Background CLEAR Outcomes enrolled 13,970 patients with statin intolerance
(SI) and LDL-C >=100 mg/dL who had or were at high risk for cardiovascular
(CV) disease. Bempedoic acid (BA) reduced risk of MACE4 (CV death,
nonfatal myocardial infarction, nonfatal stroke or coronary
revascularization) by 13% compared to placebo (PBO). This dataset provides
an opportunity to characterize the safety and effects of BA in older
patients with SI. Methods Efficacy, adverse event and tolerability data
from patients aged >=75 years at the time of enrollment were analyzed.
Results Of the 2,107 (15%) patients aged >=75 years (mean 78.3 +/- 2.8),
30% were primary prevention, 53% were female. Baseline LDL-C (mean, mg/dL)
was 138.4 (+/-32.5) BA and 137.6 (+/-34.1) PBO; 60.1% were not on any
baseline lipid lowering drugs. Over a median 3.4 years follow up, 64.8% BA
patients completed study drug vs 61.8% on PBO. Reductions in LDL-C and
hsCRP were like those observed in the other prespecified age subgroups;
MACE4 rates were greater and there was a smaller effect size that was not
heterogeneous (p<inf>int</inf> = 0.6) compared to those >75 years (Table
1). Adverse event rates were higher in those aged =75 years but the
differences between BA and PBO were generally consistent across age
groups; musculoskeletal adverse events were 16.0% BA vs 18.4% PBO.
Conclusion Among patients aged?>75 years bempedoic acid was well-tolerated
with efficacy and safety comparable to younger subgroups and can be
considered a viable strategy for managing hypercholesterolemia. [Formula
presented] Copyright © 2025 American College of Cardiology
Foundation

<119>
Accession Number
2037793648
Title
SEX-BASED DISPARITIES IN OUTCOMES AFTER TRANSCATHETER AORTIC VALVE
REPLACEMENT WITH NEWER-GENERATION VALVES: A SYSTEMATIC REVIEW AND
META-ANALYSIS.
Source
Journal of the American College of Cardiology. Conference: American
College of Cardiology, (ACC) Meeting 2025. Chicago United States. 85(12
Supplement) (pp 812), 2025. Date of Publication: 01 Apr 2025.
Author
Othman A.A.; Zreigh S.M.M.; Benhammou M.; Al-Allawee A.S.M.; Guerguer W.;
Haidarah A.; Almzainy S.; Shawesh Q.E.; Khalid S.; nounou M.V.; Alzu'bi
M.; Abuajamieh M.; Elmezayen R.; Elhadi M.
Institution
(Othman, Zreigh, Benhammou, Al-Allawee, Guerguer, Haidarah, Almzainy,
Shawesh, Khalid, nounou, Alzu'bi, Abuajamieh, Elmezayen, Elhadi) Near East
University, Faculty of Medicine, Nicosia, Cyprus
(Othman, Zreigh, Benhammou, Al-Allawee, Guerguer, Haidarah, Almzainy,
Shawesh, Khalid, nounou, Alzu'bi, Abuajamieh, Elmezayen, Elhadi) Ankara
Yildirim Beyazit University, Faculty of Medicine, Ankara, Turkey
Publisher
Elsevier Inc.
Abstract
Background Gender-specific characteristics in patients undergoing
transcatheter aortic valve replacement (TAVR) for aortic stenosis (AS) may
influence clinical outcomes and hemodynamics. This study aims to evaluate
the outcomes of TAVR with newer generation valves in females compared to
males. Methods We systematically searched PubMed, Scopus, Embase, Cochrane
and Web of Science for studies focusing on newergeneration valves up to
August 2024. The primary outcomes were 30-day and 1-year all-cause
mortality, in-hospital mortality, and cardiovascular mortality (CVM),
while the secondary outcomes included complications such as stroke,
bleeding, and paravalvular leakage (PVL). Data analyses were conducted
using Comprehensive Meta-Analysis version 3. Results We included 13
studies with a total of 42,199 patients (21,208 males and 20,991 females).
Our findings revealed that females had a 78% higher risk of 30-day
all-cause mortality compared to males (RR = 1.78, 95% CI 1.11-2.86, P =
0.017) and a 75% higher risk of in-hospital mortality (RR = 1.75, 95% CI
1.44-2.11, P < 0.001). However, all-cause mortality in 1 year (RR=0.813,
CI 95% 0.60-1.103, P=0.183) and CVM (RR=0.915, CI 95% 0.63-1.32, P = 0.63)
showed no significant difference between male and female. Secondary
outcomes demonstrated that females had a 74% higher risk of major vascular
complications (RR = 1.74, 95% CI 1.26-2.41, P = 0.001), an increased risk
of stroke (RR = 1.22, 95% CI 1.05-1.42, P = 0.008) and a higher risk of
major and life-threatening bleeding complications (RR = 1.20, 95% CI
1.06-1.37, P = 0.006) compared to males. No significant difference was
observed between the genders in the incidence of PVL (RR = 1.16, CI 95 %
0.86-1.56, P = 0.32). Conclusion Our study revealed gender disparities in
patients undergoing TAVR with newer generation valves, demonstrating that
females are at a markedly higher risk of 30-day all-cause mortality,
in-hospital mortality, stroke, major and life-threatening bleeding, and
major vascular complications compared to males. Therefore, Further studies
are needed to identify the risks and factors of these disparities, as well
as address women with appropriate supervision to reduce these
events. Copyright © 2025 American College of Cardiology
Foundation

<120>
Accession Number
2037787684
Title
TRANSCATHETER AND REDO-SURGICAL MITRAL VALVE REPLACEMENT IN MITRAL VALVE
PROSTHESIS FAILURE: A SYSTEMATIC REVIEW AND META-ANALYSIS.
Source
Journal of the American College of Cardiology. Conference: American
College of Cardiology, (ACC) Meeting 2025. Chicago United States. 85(12
Supplement) (pp 834), 2025. Date of Publication: 01 Apr 2025.
Author
Rahman S.U.; Shaukat M.T.; Rehman W.; Mohsin A.; Rehman A.U.; Saeed F.;
Gill S.I.; Majithia A.; Dani S.S.
Institution
(Rahman, Shaukat, Rehman, Mohsin, Rehman, Saeed, Gill, Majithia, Dani)
Lahey Hospital and Medical Center, Burlington, MA, United States
(Rahman, Shaukat, Rehman, Mohsin, Rehman, Saeed, Gill, Majithia, Dani)
King Edward Medical University, Lahore, Pakistan
Publisher
Elsevier Inc.
Abstract
Background Transcatheter mitral valve replacement (TMVR) is emerging as a
promising alternative to conventional redo-surgical mitral valve
replacement (SMVR) in patients with mitral valve prosthesis failure. We
conducted a meta-analysis of cohort studies to compare the safety and
clinical outcomes of transcatheter mitral valve replacement (TMVR),
encompassing both valve-in-valve (ViV) and valve-in-ring (ViR) procedures
to SMVR for mitral valve prosthesis failure. Methods PubMed/MEDLINE,
Cochrane Library, and clinicaltrials.gov were systematically searched
according to predefined inclusion and exclusion criteria. Several efficacy
and safety outcomes were pooled and reported as risk ratios (RRs) with 95%
confidence intervals (CIs). Results Sixteen retrospective cohort studies,
with 18,949 patients were quantitatively synthesized. Compared to
redo-SMVR, TMVR cohort exhibited lower in-hospital mortality (OR=0.70; 95%
CI 0.57-0.86), stroke incidence (OR=0.48; 95% CI 0.32-0.71), renal
dysfunction (OR=0.51; 95% CI 0.41-0.64), heart block (OR=0.54; 95% CI
0.35-0.83), need for pacemaker implantation (OR=0.29; 95% CI 0.24-0.35),
major cardiac complications (OR=0.43; 95% CI 0.32-0.59), length of
hospital and ICU stay (MD=-6.22, 95% CI -8.06 - -4.38 days; MD=1.77, 95%
CI -2.52 - -1.02 days, respectively), and need for exploration for
bleeding complications (OR=0.28; 95% CI 0.16-0.50). To minimize
heterogeneity, we performed subgroup analysis for in-hospital mortality,
which remained significant (OR=0.44; 95% CI 0.36-0.54) on propensity score
matching. Conversely, paravalvular leak (OR=22.12; 95% CI 2.81-174.16) and
left ventricular outflow tract (LVOT) obstruction (OR=7.15; 95% CI
1.18-43.37) were significantly higher with TMVR. There were no significant
differences in 30-day mortality, 1-year mortality, major vascular
complications, and atrial fibrillation. Conclusion Our meta-analysis
suggests that TMVR offers a safe, effective and less invasive alternative
to SMVR for patients with mitral valve prosthesis failure. However, the
associated risks of paravalvular leak and LVOT obstruction require careful
monitoring. Copyright © 2025 American College of Cardiology
Foundation

<121>
Accession Number
2037790242
Title
CONTINUATION VS INTERRUPTION OF ORAL ANTICOAGULATION DURING TRANSCATHETER
AORTIC VALVE REPLACEMENT: A META-ANALYSIS.
Source
Journal of the American College of Cardiology. Conference: American
College of Cardiology, (ACC) Meeting 2025. Chicago United States. 85(12
Supplement) (pp 1078), 2025. Date of Publication: 01 Apr 2025.
Author
Krishna M.M.; Narciso I.; Joseph M.; Pereira V.; Ezenna C.G.; Lajczak P.;
Sanchez L.R.P.; Schincariol M.; Goldsweig A.M.
Institution
(Krishna, Narciso, Joseph, Pereira, Ezenna, Lajczak, Sanchez, Schincariol,
Goldsweig) Medical College Thiruvananthapuram, Thiruvananthapuram, India
(Krishna, Narciso, Joseph, Pereira, Ezenna, Lajczak, Sanchez, Schincariol,
Goldsweig) University of Massachusetts - Baystate Medical Center,
Springfield, MA, United States
Publisher
Elsevier Inc.
Abstract
Background More than one-third of patients undergoing transcatheter aortic
valve replacement (TAVR) have an indication for oral anticoagulation.
Current guidelines recommend interruption of OAC during TAVR in patients
with high bleeding risk based upon limited evidence. We performed a
meta-analysis to compare outcomes with continuation of oral
anticoagulation (cOAC) vs. interruption of oral anticoagulation (iOAC)
during TAVR. Methods We systematically searched PubMed, Scopus, and
Cochrane Central databases for studies comparing cOAC with iOAC during
TAVR. Random effects models were applied to generate odds ratios (ORs)
with 95% confidence intervals (CIs). Heterogeneity was assessed using I2
statistics. Results Systematic review identified 4 studies (1 randomized
controlled trial, 3 observational) including 2,957 patients (cOAC 47.54%).
The odds of stroke were reduced with cOAC (OR 0.62; 95%CI 0.40-0.97;
p=0.036; I2=0%) compared with iOAC. The composite safety outcome of
ischemic, bleeding, and vascular events, all-cause mortality, myocardial
infarction, major vascular complications, major or lifethreatening
bleeding, and any bleeding were comparable between the groups. Conclusion
cOAC reduced stroke after TAVR without affecting other complications. cOAC
may be preferred over iOAC during TAVR. [Formula presented] Copyright
© 2025 American College of Cardiology Foundation

<122>
Accession Number
2037790157
Title
PERIOPERATIVE RISK OF NON-CARDIAC SURGERY IN PATIENTS WITH AORTIC
STENOSIS: A SYSTEMATIC REVIEW AND META-ANALYSIS.
Source
Journal of the American College of Cardiology. Conference: American
College of Cardiology, (ACC) Meeting 2025. Chicago United States. 85(12
Supplement) (pp 2318), 2025. Date of Publication: 01 Apr 2025.
Author
Place A.; Rodrigues T.S.; Lee M.G.; Naimo P.; Batchelor R.; Norman S.;
Wilson W.; Lefkovits J.; Koshy A.N.
Institution
(Place, Rodrigues, Lee, Naimo, Batchelor, Norman, Wilson, Lefkovits,
Koshy) Royal Melbourne Hospital, Melbourne, Australia
(Place, Rodrigues, Lee, Naimo, Batchelor, Norman, Wilson, Lefkovits,
Koshy) Austin Health Melbourne, Australia
Publisher
Elsevier Inc.
Abstract
Background Aortic stenosis (AS) is a recognized risk factor for
complications following non-cardiac surgery (NCS). ACC/AHA guidelines
highlight a gap in high-quality data to guide management of patients with
AS prior to NCS. This systematic review and meta-analysis aimed to
evaluate the perioperative risks associated with NCS in patients with AS.
Methods Systematic review was conducted using MEDLINE and EMBASE
databases. The primary endpoint of this study was all-cause in-hospital or
30-days mortality. Secondary endpoints included myocardial infarction(MI)
and heart failure(HF). Results Nineteen studies (n =100,486) were included
to estimate a pooled mortality risk in AS patients undergoing NCS. The
overall mortality risk in AS patients of any severity was 3.8% (95% CI
3.7% - 3.9%). This increased to 9.6% (95% CI 7.7% - 12.1%) in severe AS.
Meta-analysis of fourteen comparative studies (n =2,885,254) assessing
outcomes in AS and non-AS patients demonstrated an increased risk of
mortality in AS patients (RR 1.58, 95% CI [1.18-2.12] p=0.003
I2=90%) (Figure 1). AS patients also had an increased risk of
MI (RR 1.8 95% CI [1.2, 2.7] p=0.0003 I2=84%) and HF (RR 2.06,
[1.2, 3.6] p=0.01 I2 =82%). [Formula presented] Conclusion
Severe AS elevates the risk of mortality during NCS, with mortality rate
approaching 1 in 10. Compared to non-AS patients, those with AS are at
considerably higher risk of MI and HF. These findings aid in preoperative
planning for potential bridging therapies to mitigate complications in
this high-risk cohort. Copyright © 2025 American College of
Cardiology Foundation

<123>
Accession Number
2037792036
Title
EFFECT OF RED BLOOD CELL TRANSFUSION STRATEGY AMONG ANEMIC PATIENTS WITH
ACUTE MYOCARDIAL INFARCTION UNDERGOING REVASCULARIZATION: A PRE-SPECIFIED
ANALYSIS OF THE MYOCARDIAL ISCHEMIA AND TRANSFUSION TRIAL.
Source
Journal of the American College of Cardiology. Conference: American
College of Cardiology, (ACC) Meeting 2025. Chicago United States. 85(12
Supplement) (pp 1863), 2025. Date of Publication: 01 Apr 2025.
Author
Rao S.V.; Brooks M.M.; Vlachos H.; Steg P.G.; Simon T.; Aronow H.D.;
Goldsweig A.M.; Ho K.; Dehghani P.; Caixeta A.M.; Quraishi A.-U.-R.;
Siddiqi O.; Robinson S.; Traverse J.H.; Fergusson D.A.; Potter B.J.;
Schulman-Marcus J.; Keating F.K.; Carson J.
Institution
(Rao, Brooks, Vlachos, Steg, Simon, Aronow, Goldsweig, Ho, Dehghani,
Caixeta, Quraishi, Siddiqi, Robinson, Traverse, Fergusson, Potter,
Schulman-Marcus, Keating, Carson) New York University Grossman School of
Medicine, New York, NY, United States
Publisher
Elsevier Inc.
Abstract
Background The randomized MINT trial showed that liberal vs. restrictive
transfusion (Tx) may reduce 30d death/M in anemic MI pts.
Revascularization (REV) relieves coronary obstruction & may reduce the
adverse effect of anemia on outcomes, thus the effect of Tx strategy on
outcomes may vary by the occurrence of REV. Methods In this pre-specified
analysis of the MINT trial (N=3504) that randomized patients with MI & Hgb
<= 10 g/dL to liberal (maintain Hgb >= 10 g/dL) or restrictive (maintain
Hgb >= 8 g/dL) Tx, pts were grouped by REV (PCI or CABG) or no REV before
randomization but during index hospitalization (N=1002). The primary
outcome was 30d death/MI (adjudicated). Secondary outcomes were 30d death,
30d MI, 30d death/recurrent MI/ischemia driven revasc/readmission for
ischemic cardiac diagnosis, & 30d cardiac death (not adjudicated).
Multivariable log binomial regression with interaction terms determined
the association between REV, assigned Tx strategy & outcomes. Results Pts
undergoing REV (99% PCI) were younger, more female, and had fewer
comorbidities than those who did not. There was no significant interaction
between REV & assigned Tx strategy for any outcome except cardiac death.
Compared with liberal Tx, restrictive Tx was associated with increased
adjusted risk of cardiac death only among pts who did not undergo REV [RR
2.45 (1.58, 3.81), p-int 0.006] (Table). Conclusion In anemic MI pts not
undergoing REV, a restrictive Tx strategy may be associated with an
increased risk of cardiac death. [Formula presented] Copyright ©
2025 American College of Cardiology Foundation

<124>
Accession Number
2037793890
Title
CORONARY REVASCULARIZATION BEFORE TRANSCATHETER AORTIC VALVE IMPLANTATION
- A META-ANALYSIS OF OUTCOMES.
Source
Journal of the American College of Cardiology. Conference: American
College of Cardiology, (ACC) Meeting 2025. Chicago United States. 85(12
Supplement) (pp 1038), 2025. Date of Publication: 01 Apr 2025.
Author
Hariyanto J.; Meeus R.; Fukunaga C.; Rao A.
Institution
(Hariyanto, Meeus, Fukunaga, Rao) Pelita Harapan University, Tangerang,
Indonesia
Publisher
Elsevier Inc.
Abstract
Background Considering PCI before TAVI is crucial for optimizing patient
management and improving outcomes. To address the uncertainty around its
timing and necessity, we conducted a systematic review and meta-analysis
comparing outcomes of PCI versus no PCI before TAVI. Methods We searched
PubMed, Scopus, and Cochrane for studies comparing PCI versus no PCI
before TAVI. We calculated pooled odds ratios (OR) with 95% confidence
interval (CI) with RStudio using a random-effects model. Results Across 4
studies, 880 patients underwent PCI, while 1818 did not. From in-hospital
up to 30 days, there was no significant difference in all-cause mortality
(OR: 1.04; 95% CI 0.62 - 1.74; p=0.876), stroke (OR: 2.65; 95% CI 0.92 -
7.68; p=0.072; I2=65%), major bleeding (OR: 1.87; 95% CI 0.90 - 3.88;
p=0.095), major (OR: 1.54; 95% CI 0.63 - 3.76; p=0.340) or minor vascular
complications (OR: 1.40; 95% CI 0.43 - 4.58; p=0.579) and pacemaker
implantation (OR: 1.01; 95% CI 0.77 - 1.31; p=0.95) between PCI and no PCI
before TAVI. Leave-one-out analysis confirmed consistency across outcomes.
Conclusion Our findings indicate that PCI may not provide additional
benefit pre-TAVI. Routine PCI before TAVI may not be necessary, and
decisions should be individualized based on patient risk and clinical
judgment. [Formula presented] Copyright © 2025 American College
of Cardiology Foundation

<125>
Accession Number
2037788344
Title
DIRECT ORAL ANTICOAGULATION VERSUS DUAL ANTIPLATELET THERAPY AFTER LEFT
ATRIAL APPENDAGE OCCLUSION: A SYSTEMATIC REVIEW AND META-ANALYSIS.
Source
Journal of the American College of Cardiology. Conference: American
College of Cardiology, (ACC) Meeting 2025. Chicago United States. 85(12
Supplement) (pp 228), 2025. Date of Publication: 01 Apr 2025.
Author
Qamar I.; Abideen Z.U.; Aimen S.; Waseem M.H.; Tahir M.F.; Ramzan N.U.H.;
Cheema A.H.
Institution
(Qamar, Abideen, Aimen, Waseem, Tahir, Ramzan, Cheema) UPMC Medical
Education/Mercy, Pittsburgh, PA, United States
Publisher
Elsevier Inc.
Abstract
Background Percutaneous left atrial appendage occlusion (LAAO) is a stroke
prevention strategy for nonvalvular atrial fibrillation (NVAF), but the
optimal post-procedure antithrombotic therapy remains controversial.
Methods PubMed, ScienceDirect and the Cochrane Library were searched until
September 2024. The Risk Ratios (RR) and 95% Confidence Interval (CI) were
pooled for the dichotomous outcomes using Review Manager 5.4.1. The
Cochrane RoB 2.0 tool and Newcastle Ottawa Scale were used for quality
assessment. Publication bias was assessed through funnel plots. Results
Six studies encompassing 17,147 patients were included. DOACs
significantly reduced the risk of stroke after LAAO compared to DAPT
(RR=0.57; 95% CI: [0.39,0.85]; p=0.005; I2=0%). DOACs also
reduced the incidence of device-related thrombosis (DRT) after the
procedure (RR=0.20; 95% CI:[0.05,0.87]; p=0.03; I2=0%), major
bleeding (RR=0.60; 95% CI:[0.51,0.70]; p<0.00001; I2=0%) and
myocardial infarction (MI) (RR=0.32; 95% CI:[0.18,0.59]; p=0.0002;
I2=0%) compared to DAPT. It was significantly superior to DAPT
regarding allcause mortality (RR=0.72; 95% CI: [0.60,0.87]; p=0.0006;
I2=0%). Conclusion DOACs significantly reduced the risk of
stroke, MI, DRT, and mortality compared to DAPT, making it a safer and
more effective option for patients undergoing LAAO. [Formula
presented] Copyright © 2025 American College of Cardiology
Foundation

<126>
Accession Number
2037793405
Title
RECURRENT THROMBOSIS IN PATIENTS WITH MECHANICAL PROSTHETIC VALVE: 3:YEAR
FOLLOW:UP OF A RANDOMIZED CONTROLLED TRIAL.
Source
Journal of the American College of Cardiology. Conference: American
College of Cardiology, (ACC) Meeting 2025. Chicago United States. 85(12
Supplement) (pp 2227), 2025. Date of Publication: 01 Apr 2025.
Author
Pasebani Y.; Fashi Z.H.; Birgani A.H.; Mehdizadeh K.; Parsaee M.; Farrashi
M.; Rafati A.; Barati S.; Kohansal E.; Saedi S.; Mohebbi B.; Naderi N.;
Maleki M.; khajali Z.; De Caterina R.; Sadeghipour P.
Institution
(Pasebani, Fashi, Birgani, Mehdizadeh, Parsaee, Farrashi, Rafati, Barati,
Kohansal, Saedi, Mohebbi, Naderi, Maleki, khajali, De Caterina,
Sadeghipour) Rajaie Cardiovascular Medical and research institute, Tehran,
Iran, Islamic Republic of
Publisher
Elsevier Inc.
Abstract
Background Rethrombosis rate after successful thrombolytic therapy (TT) is
unknown. We previously compared different TT regimens for mechanical
prosthetic valve thrombosis (MPVT) in an RCT. Here we report 3-year
rethrombosis rate and its determinants after successful TT. Methods After
index RCT completion, patients consenting to be followed up entered a
3-year prospective cohort for routine INR monitoring and 6-month on-site
visit. The main outcome was recurrent MPVT rate. Patients' quality of
life, warfarin adherence and warfarin knowledge were obtained via
validated questionnaires at 3-year follow-up. Results Of 84 patients 66
with TT success in index RCT entered the study. A total of 23 rethrombosis
episodes occurred in 18 (27%). Of 66 patients 14 (21%), 3 (4.5%) and 1
(1.5%) had 1, 2 and 3 rethrombosis episodes, respectively (Figure 1). A
Cox-proportional hazard regression (adjusted for age, sex, atrial
fibrillation, time from index surgery, MPVT history and time in
therapeutic range), showed that rethrombosis was associated with an MPVT
history before index event (HR 6.01, 95% CI 1.8-23.7, P=0.004) and lower
age (HR 0.93, 95% CI 0.88-0.98, P=0.01). The questionnaires' results are
given in Figure 1. Conclusion We observed a high (27%) rethrombosis rate
emphasizing the need for close monitoring of at-risk patients. Despite
imposing immediate TT results, its longevity compared to surgery requires
more study. Questionnaires revealed a need for consulting programs to
raise patient awareness. [Formula presented] Copyright © 2025
American College of Cardiology Foundation

<127>
Accession Number
2037791839
Title
IMPACT OF ADJUNCTIVE LIPID-MODIFYING THERAPY IN THE CLEAR OUTCOMES TRIAL.
Source
Journal of the American College of Cardiology. Conference: American
College of Cardiology, (ACC) Meeting 2025. Chicago United States. 85(12
Supplement) (pp 428), 2025. Date of Publication: 01 Apr 2025.
Author
Menon V.; Bloedon L.; Li M.; Lincoff A.M.; Nicholls S.J.; Powell H.;
Nissen S.E.
Institution
(Menon, Bloedon, Li, Lincoff, Nicholls, Powell, Nissen) Cleveland Clinic,
Cleveland, OH, United States
(Menon, Bloedon, Li, Lincoff, Nicholls, Powell, Nissen) Esperion
Therapeutics, Inc, Ann Arbor, MI, United States
Publisher
Elsevier Inc.
Abstract
Background Randomization of statin intolerant patients to bempedoic acid
(BA) resulted in a 13% reduction in the risk of MACE4 (CV death, nonfatal
myocardial infarction, nonfatal stroke or coronary revascularization)
compared to placebo (PBO) in the Clear Outcomes trial (n= 13,970). During
the median 40.6 month follow up, add in lipid modifying therapy (LMT) was
observed in 1,749 (12.5%) patients. As part of a prespecified sensitivity
analysis we evaluated the impact of LMT on the overall trial results.
Methods MACE4 in the BA and PBO groups was evaluated by censoring patient
data at the time of starting the first cross-in LMT therapy plus 30 days.
Concomitant medications were recorded through the end of study visit.
Results A first MACE4 event occurred in 819 (11.7%) and 927 (13.3%)
patients randomized to BA and PBO, respectively. Cross-in LMT was observed
in 660 (9.4%) BA and 1,089 (15.6%) PBO patients. The majority of first
MACE4 (92.9% and 90.9% of events in the BA and PBO groups, respectively)
occurred before any cross-in LMT. Statins were used most often, with all
cross-in LMT usage higher in PBO. When LMT cross-in patient data was
censored, BA reduced MACE4 similar to the full analysis set (Table 1).
Conclusion A minority of patients in Clear Outcomes (PBO < BA) were
treated with LMT during the trial. The timing of LMT initiation in < 90%
of subjects occurred after the observed first MACE event. Consequently,
censored data at LMT initiation shows negligible impact of LMT cross-in on
the overall primary endpoint. [Formula presented] Copyright ©
2025 American College of Cardiology Foundation

<128>
Accession Number
2037787481
Title
REMOTE ISCHEMIC PRECONDITIONING PROMISES CARDIOPROTECTIVE AND
ANTI-ARRYTHMIC EFFECTS IN THE TREATMENT OF ATRIAL FIBRILLATION: A
SYSTEMATIC REVIEW OF CLINICAL TRIALS.
Source
Journal of the American College of Cardiology. Conference: American
College of Cardiology, (ACC) Meeting 2025. Chicago United States. 85(12
Supplement) (pp 183), 2025. Date of Publication: 01 Apr 2025.
Author
Fatima T.; Thapa R.; Naeem S.; Irshad T.; Ali S.; Usman M.; Sehar A.;
Mehmood Q.; Saddique M.N.; Fatima F.; Ullah P.S.S.; Iqbal U.; Farooq Z.
Institution
(Fatima, Thapa, Naeem, Irshad, Ali, Usman, Sehar, Mehmood, Saddique,
Fatima, Ullah, Iqbal, Farooq) Crozer Chester Hospital, Pennsylvania, PA,
United States
(Fatima, Thapa, Naeem, Irshad, Ali, Usman, Sehar, Mehmood, Saddique,
Fatima, Ullah, Iqbal, Farooq) King Edward Medical University, Lahore,
Pakistan
Publisher
Elsevier Inc.
Abstract
Background Remote ischemic preconditioning (RIPC) is a promising
intervention to reduce myocardial injury and arrhythmias in cardiac
surgery. This systematic review assesses cardioprotective and
antiarrhythmic effects of RIPC in atrial fibrillation treatment across
randomized controlled clinical trials (RCTs). Methods A systematic
literature search following PRISMA guidelines was conducted across PubMed,
Cochrane, and Google Scholar. RCTs comparing RIPC to control or sham
procedure were included, focusing on outcomes like cardioprotection,
antiarrhythmic effects, reduction of inflammatory markers, and incidence
of Major Adverse Cardiac and Cerebral Events (MACCE). A p-value <= 0.05
was considered statistically significant. Study selection, data
extraction, and quality assessment were conducted using the Cochrane risk
of bias tool (ROB2.0). Meta-analysis was not performed due to study
heterogeneity, and lack of direct comparisons. Results Out of 1,790
studies screened, 10 RCTs with a total sample of 2,382 patients met the
inclusion criteria. The RIPC group had 1,188 patients, and the control
group had 1,194. The mean age was around 60 years with a balanced gender
distribution. Cardiac surgery, particularly coronary artery bypass
grafting and atrial fibrillation ablation, was the most common
intervention, with follow-up ranging from 24 hours to 12 months. RIPC
significantly improved Thrombolysis in Myocardial Infarction (TIMI) flow
rates (p = 0.001), reduced corrected TIMI frame count (p < 0.0001), and
lowered post-surgery ventricular tachycardia. It also maintained sinus
rhythm at 12 months (80.8% in RIPC vs. 69.6% in control) and reduced early
recurrence of atrial fibrillation (p < 0.05). Additionally, RIPC lowered
inflammatory markers like high-sensitivity C-reactive protein (p = 0.001)
and interleukin-6 (p = 0.008). No significant difference was found in the
incidence of MACCE between groups. Conclusion RIPC shows strong
cardioprotective, antiarrhythmic, and anti-inflammatory effects in cardiac
interventions. However, its impact on preventing MACCE is uncertain.
Larger RCTs are needed to confirm these findings and assess its long-term
clinical value. Copyright © 2025 American College of Cardiology
Foundation

<129>
Accession Number
2037786765
Title
INTRAVASCULAR IMAGING-GUIDED OR ANGIOGRAPHY-GUIDED COMPLEX PCI - A
META-ANALYSIS OF RANDOMIZED CONTROLLED TRIALS.
Source
Journal of the American College of Cardiology. Conference: American
College of Cardiology, (ACC) Meeting 2025. Chicago United States. 85(12
Supplement) (pp 1159), 2025. Date of Publication: 01 Apr 2025.
Author
Ochani R.; Qadri S.F.; Fatima E.; Ahmed S.; Rashid H.; Tariq H.F.; Basit
T.; Shahbaz M.U.; Dawach S.; Rohra A.; Hanif M.; Yasmin F.; Alraies M.C.;
Chaudhuri D.
Institution
(Ochani, Qadri, Fatima, Ahmed, Rashid, Tariq, Basit, Shahbaz, Dawach,
Rohra, Hanif, Yasmin, Alraies, Chaudhuri) SUNY Upstate Medical University,
Syracuse, NY, United States
Publisher
Elsevier Inc.
Abstract
Background The effectiveness of IVUS in PCI is widely evident. However,
the benefits of IVUS in the setting of complex PCI remain ambiguous. The
study aims to explore inconsistencies and evaluate the efficacy of IVUS
compared to angiography in patients with complex PCI. Methods A literature
search was conducted across four databases (PubMed, Google Scholar,
Scopus, and Cochrane) from its inception to September 2024 for trials
comparing IVUS-guided versus Angiography-guided complex PCI (n=16). Forest
plots were made using a random effects model and relative risk (RR) was
calculated. Results IVUS-guided complex PCI significantly lowered MACE
with 33% reduction (p=0.010) and CVS mortality with 44% reduction
(p<0.0001) compared to angiography-guided PCI. However, the reduction in
death from any cause was non-significant (p=0.12). Similarly, TVR
(p<0.00001), TLR (p<0.00001), target vessel failure (p<0.00001) and the
risk of stent thrombosis (p=0.0003) was significantly reduced. However,
there was a non-significant reduction in MI (p=0.28), target
vessel-related MI (p=0.31) and CABG (p=0.28). Conclusion IVUS
significantly reduced various CVS outcomes, particularly stent thrombosis
and CVS mortality, which have not been previously reported. Target vessel
failure also favored IVUS-guided procedures over angiography. Although
MACE, TVR, and TLR were significantly reduced, the occurrence of MI in
patients with complex PCI remains unclear. [Formula
presented] Copyright © 2025 American College of Cardiology
Foundation

<130>
Accession Number
2037791627
Title
EFFICACY AND SAFETY OF LEFT ATRIAL APPENDAGE OCCLUSION IN PATIENTS WITH
PRIOR INTRACRANIAL HEMORRHAGE: A SYSTEMATIC REVIEW OF OBSERVATIONAL
STUDIES.
Source
Journal of the American College of Cardiology. Conference: American
College of Cardiology, (ACC) Meeting 2025. Chicago United States. 85(12
Supplement) (pp 1137), 2025. Date of Publication: 01 Apr 2025.
Author
Hammad A.; Ahmad A.; Vasudev R.; Shamoon F.E.
Institution
(Hammad, Ahmad, Vasudev, Shamoon) St Joseph's University Medical Center,
Paterson, NJ, United States
(Hammad, Ahmad, Vasudev, Shamoon) Englewood Health, Englewood, NJ, United
States
Publisher
Elsevier Inc.
Abstract
Background Percutaneous left atrial appendage occlusion (LAAO) is emerging
as an alternative to anticoagulation in patients with nonvalvular atrial
fibrillation (NVAF) to reduce ischemic stroke risk, particularly in those
at high bleeding risk. This systematic review evaluates the efficacy and
safety of LAAO devices in patients with a history of intracranial
hemorrhage providing insights into procedural and long-term follow-up
outcomes in this high-risk population, where data remain limited. Methods
A systematic review was performed using PubMed, Embase, and Cochrane
Central Register of Controlled Trials. Observational studies reporting
outcomes of percutaneous LAAO in patients with prior intracranial
hemorrhage were included. Results A total of 16 observational studies (9
retrospective and 7 prospective) involving 1,126 patients met the
inclusion criteria. The mean CHADS-VASc score was 4.6 +/- 1.3, and the
mean HAS-BLED score was 3.93 +/- 0.95. The mean follow-up duration was 18
+/- 11.9 months, with follow-up ranging from 6 months to 3.6 years. LAAO
device was successfully implanted in 99.1% of patients. Periprocedural
complications included device embolization 5 (0.53%), device-related
thrombosis 2 (0.2%), pericardial effusion 12 (1.26%), and intracranial
hemorrhage 4 (0.42%). During follow-up, there were 34 (3%) recurrent
intracranial hemorrhages, 27 (2.3%) ischemic strokes, and 57 (4.9%)
all-cause deaths. These findings reflect similarly low complication rates
seen in prior seminal trials of percutaneous LAAO in broader populations.
Conclusion Percutaneous LAAO for reducing ischemic stroke risk in
nonvalvular atrial fibrillation patients with a history of intracranial
hemorrhage appears to be an effective and relatively safe treatment
option. Future randomized controlled trials are necessary to further
assess and confirm the effectiveness of this treatment
approach. Copyright © 2025 American College of Cardiology
Foundation

<131>
Accession Number
2037791709
Title
IMPACT OF EX VIVO MACHINE PERFUSION PRESERVATION VERSUS STANDARD COLD
STORAGE ON CARDIAC FUNCTION FOLLOWING DONATION AFTER BRAIN DEATH: A
SYSTEMATIC REVIEW AND META-ANALYSIS.
Source
Journal of the American College of Cardiology. Conference: American
College of Cardiology, (ACC) Meeting 2025. Chicago United States. 85(12
Supplement) (pp 1545), 2025. Date of Publication: 01 Apr 2025.
Author
Kieling S.V.; Azevedo L.; Kliemann B.
Institution
(Kieling, Azevedo, Kliemann) University of Vale do Rio dos Sinos, Sao
Leopoldo, Brazil
(Kieling, Azevedo, Kliemann) Federal University of Santa Maria, Santa
Maria, Brazil
Publisher
Elsevier Inc.
Abstract
Background While standard cold storage (SCS) for hearts donated after
brain death (DBD) remains the conventional method for organ preservation,
ischemic time continues to present a significant challenge. Ex vivo
machine perfusion (EVMP) has emerged as a promising technique for
enhancing organ preservation by preventing ischemia and minimizing organ
damage. Methods PubMed, Scopus and Cochrane database were searched for
randomized controlled trials and observational studies that compared EVMP
to SCS in patients who underwent heart transplantation (HTx) from DBD
donors. The outcomes analyzed included (1) cold ischemic time (CIT); (2)
early graft rejection; (3) severe primary dysfunction; and (4) overall
survival. Heterogeneity was assessed using I2 statistics.
Results A total of 2373 patients from 17 studies were included, with 553
(23.30%) undergoing HTx from DBD donors preserved through EVMP. In the
pooled data, EVMP was associated with a lower CIT (MD -65.59; P<0.001).
There was no significant difference between EVMP and SCS in the outcomes
of early graft rejection (RR 0.54; P=0.199), severe primary dysfunction
(RR 1.30; P= 0.748) and overall survival (OR 1.29; P=0.888). Conclusion
Our meta-analysis suggests that EVMP is more effective than SCS in
reducing CIT for organ preservation in HTx from DBD donors. However, the
absence of significant differences between groups highlights the need to
consider clinical benefits, cost, feasibility and applicability of each
method. [Formula presented] Copyright © 2025 American College of
Cardiology Foundation

<132>
Accession Number
2037791962
Title
TRANSCATHETER VERSUS SURGICAL AORTIC VALVE REPLACEMENT IN PATIENTS WITH
SMALL AORTIC ANNULUS: A SYSTEMATIC REVIEW AND META-ANALYSIS.
Source
Journal of the American College of Cardiology. Conference: American
College of Cardiology, (ACC) Meeting 2025. Chicago United States. 85(12
Supplement) (pp 2326), 2025. Date of Publication: 01 Apr 2025.
Author
Oliveira V.; Antunes A.G.O.; Nishikubo M.E.; Lopes L.; Oliveira I.; Sousa
A.; Moreira H.G.
Institution
(Oliveira, Antunes, Nishikubo, Lopes, Oliveira, Sousa, Moreira) Federal
University of Goias, Goiania, Brazil
(Oliveira, Antunes, Nishikubo, Lopes, Oliveira, Sousa, Moreira) The Johns
Hopkins University, Baltimore, MD, United States
Publisher
Elsevier Inc.
Abstract
Background Small aortic annulus (SAA) is associated to suboptimal results
after aortic valve replacement. The optimal treatment for aortic disease
in SAA remains unclear. Methods We performed a systematic review and
meta-analysis comparing transcatheter aortic valve replacement (TAVR) and
surgical aortic valve replacement (SAVR) in SAA patients. Risk ratios
(RRs) and 95% confidence intervals (CIs) were pooled using a
random-effects model. We conducted searches in PubMed, Embase, and
Cochrane databases. Results Our meta-analysis included 9 studies with
2,548 patients. TAVR was associated with significantly lower risk of
severe (RR 0.53; 95% CI 0.38-0.73; P<0.01; Figure 1) and moderate
prosthesis-patient mismatch (PPM) (RR 0.67; 95% CI 0.54-0.84; P<0.01).
However, SAVR was associated to reduced risk of moderate/severe aortic
regurgitation (RR 3.90; 95% CI 2.57-5.93; P<0.001) and the need for new
pacemaker implantation (RR 2.30; 95% CI 1.62-3.26; P<0.01). There were no
significant differences in all-cause mortality (RR 0.58; 95% CI 0.27-1.21;
P=0.15), stroke (RR 1.83; 95% CI 0.68-4.89; P=0.23), myocardial infarction
(RR 0.64; 95% CI 0.21-1.92; P=0.42), and major bleeding (RR 1.04; 95% CI
0.59-1.83; P=0.89). Conclusion This meta-analysis suggests lower risk of
severe and moderate PPM associated to TAVR compared to SAVR in SAA
patients, albeit with higher risk of aortic regurgitation and new
pacemaker implant. Further randomized controlled trials are warranted to
validate our findings. [Formula presented] Copyright © 2025
American College of Cardiology Foundation

<133>
Accession Number
2037793373
Title
PROTAMINE ADMINISTRATION FOR HEPARIN REVERSAL IN TRANSCATHETER AORTIC
VALVE REPLACEMENT: A META-ANALYSIS OF UP-TO-DATE EVIDENCE.
Source
Journal of the American College of Cardiology. Conference: American
College of Cardiology, (ACC) Meeting 2025. Chicago United States. 85(12
Supplement) (pp 855), 2025. Date of Publication: 01 Apr 2025.
Author
Naeem F.; Tabassum S.; Rakab M.; Tawfik A.; Saad M.; Neppala S.; Nadeem
A.; Aisha E.; Seri A.R.; Alraies M.C.; Abdelazeem B.; Daggubati R.B.
Institution
(Naeem, Tabassum, Rakab, Tawfik, Saad, Neppala, Nadeem, Aisha, Seri,
Alraies, Abdelazeem, Daggubati) West Virginia University/ Princeton
Community Hospital, Princeton, WV, United States
Publisher
Elsevier Inc.
Abstract
Background Heparin is routinely administered for anticoagulation during
Transcatheter aortic valve replacement (TAVR). While protamine can
counteract heparin, its efficacy and safety post-TAVR are not well known.
Methods We searched PubMed, Cochrane Central, Scopus, Google Scholar, and
ClinicalTrials.gov for studies evaluating protamine use post-TAVR.
Outcomes of interest were ischemic events, bleeding events,vascular
complications, and 30-day-all-cause mortality. Clinical outcomes were
assessed using a random effects model to pool odds ratios (ORs) with 95%
confidence intervals (CIs). Results The analysis included four studies
incorporating 1,569 patients. Protamine was not associated with an
increased risk of ischemic events (OR=0.66, 95% CI [0.19, 2.24], p=0.50)
and had no significant impact onpreventing life-threatening bleeding
events (OR: 0.30, 95% CI [0.06, 1.62], p= 0.16), major bleeding (OR: 0.59,
95% CI [0.26, 1.34], p= 0.21), or minor bleeding (OR: 0.77, 95% CI [0.38,
1.55], p= 0.46). However, protamine significantly reduced the risk of
major vascular complications (OR: 0.32, 95% CI [0.11, 0.89], p= 0.03) with
no impact on minor vascular complications (P= 0.23) and 30-day all-cause
mortality (P= 0.85). Conclusion Protamine for heparin reversal post-TAVR
is not associated with an increased risk of ischemic events. It reduces
the risk of major vascular complications, with no impact on bleeding,
minor vascular complications, and 30-day all-cause mortality. [Formula
presented] Copyright © 2025 American College of Cardiology
Foundation

<134>
Accession Number
2037793095
Title
SHORT-TERM OUTCOMES OF ACURATE NEO/NEO2 VERSUS EVOLUT PRO/PRO+ AND SAPIEN
3 ULTRA IN TRANSCATHETER AORTIC VALVE REPLACEMENT: A META-ANALYSIS.
Source
Journal of the American College of Cardiology. Conference: American
College of Cardiology, (ACC) Meeting 2025. Chicago United States. 85(12
Supplement) (pp 2309), 2025. Date of Publication: 01 Apr 2025.
Author
Balda S.; Veintemilla-Burgos F.; Ochoa G.M.; Leone T.; Kronfle R.; Diaz
I.; Panchana-Lascano M.; Velasquez C.V.; Cherrez I.; Al-Tawil M.;
Almaghrabi S.; Haneya A.
Institution
(Balda, Veintemilla-Burgos, Ochoa, Leone, Kronfle, Diaz, Panchana-Lascano,
Velasquez, Cherrez, Al-Tawil, Almaghrabi, Haneya) Universidad Catolica de
Santiago de Guayaquil, Guayaquil, Ecuador
(Balda, Veintemilla-Burgos, Ochoa, Leone, Kronfle, Diaz, Panchana-Lascano,
Velasquez, Cherrez, Al-Tawil, Almaghrabi, Haneya) Trier Heart Center,
Trier, Germany
Publisher
Elsevier Inc.
Abstract
Background Transcatheter aortic valve replacement (TAVR) is a standard
treatment for severe aortic stenosis. ACURATE Neo/Neo2 is a new valve for
TAVR. Other options include Sapien 3 Ultra and Evolut PRO/PRO+. Methods We
performed the meta-analysis in accordance with PRISMA 2020 statement,
retrieving articles from Pubmed, Scopus, and Embase. Cohort studies and
RCTs comparing ACURATE vs. Evolut or Sapien for TAVR were included.
Outcomes were compared using VARC-3 clinical endpoints. Results Nine
articles were included. There was no difference in technical success,
incidence of stroke, or paravalvular leakage (PVL) between the valves.
There was a significant difference in new permanent pacemaker implantation
for both valves (Figure 1), favoring the ACURATE group. The ACURATE valve
was linked to significantly higher rates of major vascular complications
(RR 1.50; [1.01-2.23]; p=0.04) and bleeding (RR 1.69;[1.24-2.32]; p=0.001)
when compared to the Evolut group. When compared to the Sapien group,
patients who received the ACURATE valve had higher risk for moderate to
severe aortic regurgitation (RR 3.85; [2.40-6.18];p<0.001). Conclusion The
findings of our study suggest that ACURATE Neo/Neo2 is a promising option
in TAVR, especially in reducing the need for PPM. However, the differences
in regurgitation and vascular complications highlight the need for further
studies to better define the most suitable patient populations for each
valve type. [Formula presented] Copyright © 2025 American College
of Cardiology Foundation

<135>
Accession Number
2037792977
Title
SEALING THE DEAL: A META-ANALYSIS OF SUTURE-ONLY AND HYBRID CLOSURE
TECHNIQUES FOR FEMORAL ACCESS HEMOSTASIS AFTER PERCUTANEOUS CARDIOVASCULAR
PROCEDURES.
Source
Journal of the American College of Cardiology. Conference: American
College of Cardiology, (ACC) Meeting 2025. Chicago United States. 85(12
Supplement) (pp 854), 2025. Date of Publication: 01 Apr 2025.
Author
Banga A.; Saeed M.S.; Misra S.; Ying X.; Patino C.; Rathore S.S.; Janga
L.S.N.; Ramirez A.E.Q.; Manandhar R.; Ahmed F.; Gurav J.S.; Florea V.;
Scimeca G.; Guillen R.H.; Xu D.; Mautong H.
Institution
(Banga, Saeed, Misra, Ying, Patino, Rathore, Janga, Ramirez, Manandhar,
Ahmed, Gurav, Florea, Scimeca, Guillen, Xu, Mautong) Mount Auburn
Hospital, Harvard Medical School, Cambridge, MA, United States
Publisher
Elsevier Inc.
Abstract
Background Vascular complications and bleeding increase morbidity and
mortality after percutaneous cardiovascular procedures, including
transcatheter aortic valve replacements (TAVR) and percutaneous
endovascular aneurysm repair (pEVAR), often from vascular closure device
(VCD) failure. We compared isolated suture-based (IS) strategy to a suture
and plug-based hybrid (HSP) technique for femoral access hemostasis after
TAVR and pEVAR. Methods We performed a systematic literature search of
randomized controlled trials (RCT) and observational studies using PubMed,
Embase, Cochrane Library, ScienceDirect, and ClinicalTrial.gov. We
calculated the odds ratio (OR) and 95% confidence interval (CI) for
individual endpoints of vascular complications, bleeding, VCD failure, and
mortality, using random effect models to report overall effect sizes.
Results A total of seven studies, including one RCT and six observational
studies, with 1,980 patients (IS: 956; HSP: 1,024) were analyzed. For IS,
all studies used Dual Perclose Proglide (PP), with one also using Prostyle
XL VCD. For HSP, five studies used PP+Angioseal, and one each PP+Femo-seal
and PP+Exo-seal. IS strategy showed a significantly higher risk of
vascular complications, bleeding, VCD failure, and mortality than HSP
(Figure). Conclusion Adopting the HSP technique for femoral access
hemostasis after TAVR or pEVAR is associated with better patient outcomes,
especially with fewer vascular complications, bleeding, and VCD failures.
[Formula presented] Copyright © 2025 American College of
Cardiology Foundation

<136>
Accession Number
2037792589
Title
PROGNOSTIC VALUE OF STRESS-ONLY VERSUS STRESS-AND-REST SPECT MYOCARDIAL
PERFUSION IMAGING IN PATIENTS WITH NO PERFUSION DEFECTS: A COHORT STUDY
AND METAANALYSIS.
Source
Journal of the American College of Cardiology. Conference: American
College of Cardiology, (ACC) Meeting 2025. Chicago United States. 85(12
Supplement) (pp 2045), 2025. Date of Publication: 01 Apr 2025.
Author
Shaikh A.; El Yaman A.; Alwan M.; Sayed A.; Ahmed A.I.; Al-Mallah M.H.
Institution
(Shaikh, El Yaman, Alwan, Sayed, Ahmed, Al-Mallah) Houston Methodist
Academic Institute, Houston, TX, United States
Publisher
Elsevier Inc.
Abstract
Background Contemporary literature evaluating differences in outcomes
between stress and stress-rest SPECT MPI in patients with normal stress
studies is scarce. Methods A retrospective cohort study including all
patients with normal stress MPI from 2016 to 2024 was conducted. Adjusted
survival analysis using Cox proportional hazard models were used to
evaluate differences in outcomes. Models were adjusted for age, sex, BMI,
ethnicity, stressor type, cardiovascular risk factors and history of
cardiac procedures. A meta-analysis evaluating all-cause mortality
including additional data from two previous studies was also conducted.
Results were presented as hazard ratios (HR) with 95% confidence intervals
(CI) using a random effects model. Results A total of 19,833 patients were
included with a median follow-up of 2.38 years (IQR = 0.36 - 5.00). There
were 1,217 deaths and 2,403 MACE events. After multivariable adjustment,
there were no differences in mortality (HR: 0.91, CI 0.79 - 1.03) or MACE
(HR: 0.84, 0.77 - 0.93). There was also no difference in outcomes between
subgroups including gender, diabetes, known CAD, BMI and smoking status.
The meta-analysis showed no differences between the two SPECT protocols
(HR=0.93, CI 0.84 - 1.04, P=0.217), Figure 1. Heterogeneity was low (I2 =
9%). Conclusion In patients with normal stress scans, there was no
difference in outcomes between stress-only vs stress-rest SPECT MPI. After
normal stress scans, additional rest imaging should not be routinely
performed. [Formula presented] Copyright © 2025 American College
of Cardiology Foundation

<137>
Accession Number
2037788913
Title
OPTIMAL PHARMACOLOGICAL INTERVENTION FOR POST-OPERATIVE DELIRIUM
PREVENTION IN PATIENTS UNDERGOING CARDIAC SURGERY: A SYSTEMATIC REVIEW AND
BAYESIAN NETWORK META-ANALYSIS OF RANDOMIZED CONTROLLED TRIALS.
Source
Journal of the American College of Cardiology. Conference: American
College of Cardiology, (ACC) Meeting 2025. Chicago United States. 85(12
Supplement) (pp 2812), 2025. Date of Publication: 01 Apr 2025.
Author
Barbosa L.M.; Queiroz I.; Araujo B.; Ruelas M.G.; Defante M.L.R.; Felix
I.F.; Tavares A.; Pimentel T.; Ferreira R.; Rivera A.; Righetto B.B.; De
Oliveira H.M.; Mendes B.X.; Nunes M.C.P.; Marques M.
Institution
(Barbosa, Queiroz, Araujo, Ruelas, Defante, Felix, Tavares, Pimentel,
Ferreira, Rivera, Righetto, De Oliveira, Mendes, Nunes, Marques) Federal
University of Minas Gerais, Belo Horizonte, Brazil
(Barbosa, Queiroz, Araujo, Ruelas, Defante, Felix, Tavares, Pimentel,
Ferreira, Rivera, Righetto, De Oliveira, Mendes, Nunes, Marques) Mayo
Clinic, Rochester, MN, United States
Publisher
Elsevier Inc.
Abstract
Background Post-operative delirium (POD) after cardiac surgery is a known
predictor of worse outcomes. No drug is universally agreed for POD
prevention in this scenario. This network meta-analysis evaluates the
optimal intervention for POD prevention in patients undergoing cardiac
surgery. Methods We searched MEDLINE, EMBASE, and Cochrane databases for
randomized controlled trials (RCTs) comparing interventions in cardiac
surgery patients. A Bayesian and Frequentist network meta-analyses were
performed, pooling risk ratio (RR) with a 95% credibility interval (CrI)
for POD incidence and mortality. Treatments were ranked using surface
under the cumulative ranking (SUCRA) for the Bayesian method. Results Our
meta-analysis included 59 RCTs with 19 different treatments, with a total
of 23,168 patients, of whom 2,810 developed POD. Dexmedetomidine (DEX),
DEX with melatonin, and ketamine were associated with lower incidences of
POD compared to placebo. In SUCRA, DEX with melatonin showed the highest
likelihood of POD prevention, and sevoflurane showed the lowest
likelihood. For mortality, any treatment had a significant decrease
compared to placebo, although propofol exhibits the highest likelihood in
SUCRA analysis. Conclusion In cardiac surgery patients, DEX with and
without melatonin had the lowest POD incidence. There were no significant
differences in mortality reduction. DEX has been shown consistently to be
the optimal drug in decreasing POD Incidence. [Formula
presented] Copyright © 2025 American College of Cardiology
Foundation

<138>
Accession Number
2037786586
Title
PERFORMANCE OF THE STS RISK SCORE IN PREDICTING SHORT- AND LONG-TERM
OUTCOMES IN IMPELLA-SUPPORTED HIGH-RISK PCI: INSIGHTS FROM THE PROTECT III
STUDY.
Source
Journal of the American College of Cardiology. Conference: American
College of Cardiology, (ACC) Meeting 2025. Chicago United States. 85(12
Supplement) (pp 856), 2025. Date of Publication: 01 Apr 2025.
Author
Falah B.; Thompson J.; Shah Y.; Shah T.; Cohen D.J.; Ascione G.; Melo P.;
Redfors B.; Basir M.B.; Batchelor W.B.; Lemor A.; Truesdell A.G.; Grines
C.L.; O'Neill W.W.
Institution
(Falah, Thompson, Shah, Shah, Cohen, Ascione, Melo, Redfors, Basir,
Batchelor, Lemor, Truesdell, Grines, O'Neill) Cardiovascular Research
Foundation, New York, NY, United States
Publisher
Elsevier Inc.
Abstract
Background The Society of Thoracic Surgeons (STS) risk score is
established for coronary artery bypass grafting but unstudied in patients
(pts) undergoing Imeplla-supported high-risk percutaneous coronary
intervention (HRPCI). We used the STS risk score to predict pt outcomes in
this population. Methods Patients from the cVAD PROTECT III study
(NCT04136392) were stratified into 3 groups by STS risk score. Major
adverse cardiovascular and cerebrovascular event (MACCE: composite of
all-cause death, myocardial infarction, stroke/transient ischemic attack,
and repeat revascularization) rate was assessed at 30 and 90d; all-cause
mortality was assessed to 1y. Results Of the 1237 pts enrolled in the cVAD
PROTECT III study, 58.8% had low STS score, 25.5% intermediate, and 15.7%
high. Patients with higher STS scores were associated with older age and
more comorbidities. MACCE rates were significantly higher at 30 and 90
days in the intermediate and high STS groups (30d: 5.1% for low, 10.1% for
intermediate, 17.6% for high, p<0.0001; 90d: 8.2%, 14.6%, and 24.8%,
overall p<0.001). All-cause mortality differed significantly at all time
points (Figure, Panel A). The STS risk score C-index for 30day mortality
was of 0.72 (95% CI: 0.66-0.77, p<0.0001) with acceptable calibration
(Hosmer-Lemeshow p=0.13) (Figure, Panel B). Conclusion The STS score
stratifies risk in Impella-supported HRPCI, with higher scores predicting
increased MACCE and mortality, aiding clinical decision-making. [Formula
presented] Copyright © 2025 American College of Cardiology
Foundation

<139>
Accession Number
2037788104
Title
CLOSING THE GAP: EXAMINING REPRESENTATION OF WOMEN IN ISCHEMIC HEART
DISEASE GUIDELINE STUDIES.
Source
Journal of the American College of Cardiology. Conference: American
College of Cardiology, (ACC) Meeting 2025. Chicago United States. 85(12
Supplement) (pp 1788), 2025. Date of Publication: 01 Apr 2025.
Author
Abdelnour J.; Alameh A.; Anaya F.; Driscoll K.; Abdelnour N.; Yaghmour R.;
Gulati M.; Nandar P.P.
Institution
(Abdelnour, Alameh, Anaya, Driscoll, Abdelnour, Yaghmour, Gulati, Nandar)
MetroHealth Hospital-Case Western University, Cleveland, OH, United States
Publisher
Elsevier Inc.
Abstract
Background Cardiovascular disease (CVD) is the leading cause of death in
the U.S. despite advancements, women experience worse outcomes than men,
partly due to their underrepresentation in clinical trials. This study
evaluates the enrollment of women in clinical studies cited in the
American College of Cardiology (ACC) and American Heart Association (AHA)
guidelines on chest pain, chronic coronary artery disease (CCAD), and
coronary revascularization. Methods We analyzed studies cited in 2021 and
2023 ACC/AHA guidelines on chest pain, CCAD, and revascularization. Data
extraction included study characteristics and the percentage of women
participants. The participation-to-prevalence ratio (PPR) was calculated
by comparing the percentage of women in trials with the disease prevalence
among women. Results A total of 1,690 studies were analyzed, with women
representing 29.5% in revascularization, 33.3% in CCAD, and 40% in chest
pain studies. Notably, 15 studies had no women participants. RCT
participation of women was consistently lower than in non-RCT studies. The
PPR for CCAD, revascularization, and chest pain were 68.2%, 68.8%, and
83.2%, respectively. Conclusion Despite increased awareness, women remain
underrepresented in clinical trials informing ACC/AHA guidelines for
ischemic heart disease. The lack of progress highlights the need for more
proactive measures to ensure gender equity in cardiovascular research to
improve healthcare outcomes for all patients. [Formula
presented] Copyright © 2025 American College of Cardiology
Foundation

<140>
Accession Number
2037786334
Title
NEW ORAL ANTICOAGULANT THERAPY VERSUS WARFARIN IN PATIENTS WITH MECHANICAL
HEART VALVES: A META-ANALYSIS OF RANDOMIZED CONTROLLED TRIALS.
Source
Journal of the American College of Cardiology. Conference: American
College of Cardiology, (ACC) Meeting 2025. Chicago United States. 85(12
Supplement) (pp 2253), 2025. Date of Publication: 01 Apr 2025.
Author
Obi O.; Lajczak P.; Nweze U.; sonye P.; Ononuju I.; Ariahu N.; Lee T.;
Adibe E.O.
Institution
(Obi, Lajczak, Nweze, sonye, Ononuju, Ariahu, Lee, Adibe) New York
Institute of Technology College of Osteopathic Medicine, Glen Cove, NY,
United States
Publisher
Elsevier Inc.
Abstract
Background Vitamin K antagonists are the only oral anticoagulants approved
to prevent valve thrombosis and valve-related thromboembolism in patients
with mechanical heart valves. Data regarding the efficacy and safety of
anticoagulation with New oral anticoagulant (NOAC) therapy in patients
with mechanical heart valves are limited. Methods PubMed, Embase and
Cochrane library were systematically searched for randomized controlled
trials (RCTs) comparing NOACs to Warfarin in patients with mechanical
heart valves with primary outcome of all-cause mortality. Risk ratio (RR)
and their 95% confidence interval (CI) were computed using the
random-effect model. Heterogeneity was examined with I2
statistics. Results We included 3 RCTs comparing NOACs to Warfarin in 1159
patients with mechanical heart valves. The pooled analysis showed that the
incidence of all-cause mortality (RR = 0.47; 95% CI [0.10; 2.25];
I2 = 12%; p = 0.348; Figure 1A), major bleeding (RR = 0.95; 95%
CI [0.34; 2.68]; I2 = 61%; p = 0.925; Figure 1B), Transient
ischemic attack (TIA) (RR = 0.58; 95% CI [0.11; 2.97]; I2 =
23%; p = 0.515; Figure 1C), valve thrombosis (RR = 6.17; 95% CI [0.78;
48.70]; I2 = 0%; p = 0.084; Figure 1D), stroke (RR = 3.82; 95%
CI [0.20; 73.79]; I2 = 69%; p = 0.375; Figure 1E), and
myocardial infarction (RR = 0.32; 95% CI [0.03; 2.99]; I2 = 0%;
p = 0.316; Figure 1F) did not differ between groups. Conclusion Our
meta-analysis showed that NOACs did not have superior efficacy and safety
to Warfarin in patients with mechanical heart valves. [Formula
presented] Copyright © 2025 American College of Cardiology
Foundation

<141>
Accession Number
2037791284
Title
MORBIDITY AND MORTALITY OF PATIENTS WITH ANTIPHOSPHOLIPID ANTIBODY
SYNDROME UNDERGOING HEART VALVE SURGERY A META-ANALYSIS.
Source
Journal of the American College of Cardiology. Conference: American
College of Cardiology, (ACC) Meeting 2025. Chicago United States. 85(12
Supplement) (pp 2333), 2025. Date of Publication: 01 Apr 2025.
Author
Khan S.Z.; Khan A.; Khan M.A.; Ghoweba M.; Alkhalfan F.; Khokhlov L.;
Chaudhury P.
Institution
(Khan, Khan, Khan, Ghoweba, Alkhalfan, Khokhlov, Chaudhury) University of
Cincinnati, Cincinnati, OH, United States
Publisher
Elsevier Inc.
Abstract
Background Cardiac involvement in antiphospholipid antibody syndrome (APS)
is very prevalent. About 4-6% of heart-involvement patients will undergo
heart valve surgery. In this systemic review, we will identify factors
associated with adverse outcomes in patients with APS undergoing heart
valve surgeries. Methods We searched Medline, Embase, and Cochrane Library
from inception until August 31, 2023. The primary variables of interest
were short- and long-term mortality, hemorrhage, and stroke. We analyzed
the difference of outcomes between mechanical and bioprosthetic valves. We
used a random effects model to combine the studies and to assess for a
difference in outcomes between mechanical and bioprosthetic valves.
Results A total of six studies met the criteria for inclusion in this
systemic review. The mitral valve was the most commonly affected valve
(70% of patients) followed by the aortic valve (40%). The most common
early complication (less than 30 days) was major bleeding (8.4%) followed
by mortality (7.5%). The mean follow-up was 51 months and the most common
late complication was ischemic stroke or TIA (16%). There was no
statistically significant difference between serious adverse events and
mortality between mechanical vs bioprosthetic valves however an increased
trend towards mortality in the mechanical valve group was noted.
Conclusion Surgery in patients with APS carries high complications risk
due to disease (thromboembolism) and the treatment (anticoagulation).
[Formula presented] Copyright © 2025 American College of
Cardiology Foundation

<142>
Accession Number
2037791565
Title
NON-FASTING VERSUS FASTING BEFORE PERCUTANEOUS CATHETERIZATION CARDIAC
PROCEDURES: A SYSTEMATIC REVIEW AND META-ANALYSIS OF RANDOMIZED CONTROLLED
TRIALS.
Source
Journal of the American College of Cardiology. Conference: American
College of Cardiology, (ACC) Meeting 2025. Chicago United States. 85(12
Supplement) (pp 1096), 2025. Date of Publication: 01 Apr 2025.
Author
Balbaa E.; Ibrahim A.A.; Ali K.; Bazzazeh M.; Ramadan S.; Gadelmawla A.F.;
Elshimy A.; Altobaishat O.; Tabassum S.; Abuelazm M.
Institution
(Balbaa, Ibrahim, Ali, Bazzazeh, Ramadan, Gadelmawla, Elshimy,
Altobaishat, Tabassum, Abuelazm) Rosalind Franklin University of Medicine
and Science, North Chicago, IL, United States
(Balbaa, Ibrahim, Ali, Bazzazeh, Ramadan, Gadelmawla, Elshimy,
Altobaishat, Tabassum, Abuelazm) Alexandria University, Alexandria, Egypt
Publisher
Elsevier Inc.
Abstract
Background Despite the absence of scientific evidence, fasting before
coronary procedures is still recommended to minimize complications Methods
A systematic review and meta-analysis of randomized controlled trials
(RCTs); retrieved from PubMed, Embase, CENTRAL, Scopus, and WOS up to
September 2024. Dichotomous outcomes were pooled as risk ratios (RR),
while continuous outcomes were pooled as standardized mean difference
(SMD). PROSPERO ID: CRD420245586147. Results Five RCTs with 2034 patients
were included. There was no significant difference between both groups in
patients' satisfaction [SMD: -0.65; 95% CI (-1.39, 0.09), P= 0.08], intra
or postoperative aspiration [RR: 1.00; 95% CI (0.20, 4.96), P= 1.00],
nausea and or vomiting [RR: 0.89; 95% CI (0.46, 1.76), P= 0.75],
postoperative pneumonia [RR: 0.60; 95% CI (0.14, 2.51), P= 0.49],
emergency intubation [RR: 0.99; 95% CI (0.10, 9.51), P= 1.00], anti-emetic
use [RR: 0.49; 95% CI (0.24, 1.03), P= 0.06], and hypoglycemia [RR: 0.74;
95% CI (0.43, 1.28), P= 0.28]. Conclusion Non-fasting strategy is not
inferior to traditional fasting protocol and does not increase the risk of
complications in patients undergoing minimally invasive percutaneous
cardiac procedures. [Formula presented] Copyright © 2025 American
College of Cardiology Foundation

<143>
Accession Number
2037793179
Title
ISOLATED NATIVE VALVE ENDOCARDITIS FOLLOWING TRANSCATHETER AORTIC VALVE
IMPLANTATION: CHARACTERISTICS OF A RARE FORM OF VALVULAR INFECTION.
Source
Journal of the American College of Cardiology. Conference: American
College of Cardiology, (ACC) Meeting 2025. Chicago United States. 85(12
Supplement) (pp 2315), 2025. Date of Publication: 01 Apr 2025.
Author
Khasnavis S.; Bhatia K.; Alhuarrat M.A.D.; Faillace R.T.; Grushko M.J.;
Schenone A.L.
Institution
(Khasnavis, Bhatia, Alhuarrat, Faillace, Grushko, Schenone) Jacobi North
Central Bronx Hospital, Bronx, NY, United States
Publisher
Elsevier Inc.
Abstract
Background Prosthetic valve endocarditis (PVE) is a known complication of
prosthetic valve implantation (PVI). PVE with concurrent native valve
endocarditis is also a well known phenomenon. The incidence of isolated
native valve endocarditis (INVE) after PVI is rare. The goal of this
review is to elaborate on the associated factors, management, and outcomes
in INVE. Methods A systematic review was done using PubMed, Embase,
Cochrane Library, and Web of Science. INVE was characterized and compared
to PVE in incidence, site of PVI, gender, treatment, comorbidities,
pathogens, PVI type, and mortality. Cases involving intravenous drug use
were excluded from the analysis. Chi squared analysis was done between
predictors and outcomes. P value <0.05 was deemed significant. Results
INVE was reported in 122/659 cases of valvular infective endocarditis (IE)
after transcatheter aortic valve implantation (TAVI). They were 72.9%
mitral INVE and 27.1% right heart INVE. The remaining 537 cases involved
PVE. Transfemoral TAVI had been done in more cases of INVE than PVE (89.3%
vs 80.6%, p<0.025). Males were less likely to have INVE than PVE (56.6% vs
68.3%, p<0.025). Antibiotic therapy without surgery was more often the
treatment of choice for INVE vs PVE (94% vs 87%, p<0.05). Comorbidity
percentages were not very different for INVE vs PVE including for atrial
fibrillation and diabetes (45.1% vs 43.8% and 38.5% vs 35.4%, p>0.10).
Gram positive infections were seen in 92.6% INVE vs 90.2% PVE (p>0.10).
TAVI types were not significantly different between the groups (p>0.10).
Mortality rates after 2 years of follow up were not significantly
different between the groups (51.6% vs 52.7%, p>0.10). Conclusion INVE
makes up a notable proportion of valvular IE cases after TAVI. It is
associated with many of the factors seen in TAVI IE and particularly with
transfemoral PVI. It is also more amenable to antibiotic therapy than is
TAVI IE. Given INVE's mortality rate and capacity to manifest on different
valves, thorough cardiac evaluations should be done if IE is suspected
after TAVI. INVE after non-TAVI prostheses is a lesser known phenomenon
that warrants further investigation to develop a more comprehensive theory
about INVE. Copyright © 2025 American College of Cardiology
Foundation

<144>
Accession Number
2037790258
Title
SAFETY AND EFFICACY OF LEFT ATRIAL APPENDAGE OCCLUSION VERSUS DIRECT ORAL
ANTICOAGULATION IN PATIENTS WITH ATRIAL FIBRILLATION: A SYSTEMATIC REVIEW
AND METAANALYSIS OF 4,266 PATIENTS.
Source
Journal of the American College of Cardiology. Conference: American
College of Cardiology, (ACC) Meeting 2025. Chicago United States. 85(12
Supplement) (pp 244), 2025. Date of Publication: 01 Apr 2025.
Author
Cheema A.H.; Waseem M.H.; Abideen Z.U.; Aimen S.; Anwer M.U.; Ramzan
N.U.H.; Parimi K.; Sagheer U.
Institution
(Cheema, Waseem, Abideen, Aimen, Anwer, Ramzan, Parimi, Sagheer)
University of Pittsburgh Medical Center, Mercy Hospital, Pittsburgh, PA,
United States
Publisher
Elsevier Inc.
Abstract
Background Direct anticoagulants (DOACs) are preferred over warfarin for
stroke prevention in atrial fibrillation (AF), but the long-term safety
and efficacy of DOACs compared to Left Atrial Appendage Occlusion (LAAO)
remain unclear. This meta-analysis compared the safety and efficacy of
LAAO and DOACs. Methods PubMed, Embase, and Cochrane Central were searched
up till September 2024. The primary endpoint was the risk of stroke/ TIA.
Secondary endpoints were cardiovascular mortality, systemic embolism (SE),
and clinically relevant bleeding. The Risk Ratios (RR) were pooled along
with a 95% Confidence Interval (CI) for dichotomous outcomes in Review
Manager 5.4.1. Quality assessment was done through the Cochrane RoB2.0
tool and Newcastle Ottawa Scale. Publication bias was analyzed through
funnel plots. Results Five studies pooling 4,266 patients were included.
The cardiovascular mortality showed no significant difference between the
LAAO and DOACs group (RR=0.85; 95%CI: [0.49,1.47]; p=0.56;
I2=70%). The risk of ischemic stroke or TIA (RR=1.07;
95%CI:[0.78,1.46]; p=0.67; I2=0%), systemic embolism (RR= 0.25;
95%CI:[0.03,2.27]; p=0.22; I2=0%), and clinically relevant
bleeding (RR=0.76; 95%CI:[0.52,1.12]; p=0.17; I2=70%) were
comparable between the two groups. Conclusion LAAO and DOACs have
comparable efficacy and safety outcomes. Hence the choice of technique
depends on patient profiles, risk factors, and preferences for long-term
stroke prevention in AF. [Formula presented] Copyright © 2025
American College of Cardiology Foundation

<145>
Accession Number
2037793147
Title
IT IS TIME TO REEVALUATE FASTING GUIDELINES FOR INVASIVE CARDIAC
PROCEDURES: A POOLED ANALYSIS OF RANDOMIZED CLINICAL TRIALS.
Source
Journal of the American College of Cardiology. Conference: American
College of Cardiology, (ACC) Meeting 2025. Chicago United States. 85(12
Supplement) (pp 1028), 2025. Date of Publication: 01 Apr 2025.
Author
Shin Y.; Erqou S.; Tomdio A.N.; Guzman L.A.
Institution
(Shin, Erqou, Tomdio, Guzman) Mary Washington Healthcare, Fredericksburg,
VA, United States
Publisher
Elsevier Inc.
Abstract
Background Fasting before invasive cardiac procedures remains the standard
practice, despite being debated for over a decade and recommended in both
anesthesia and cardiology guidelines. However, fasting often causes
patient dissatisfaction, delays in care, and safety concerns. The lack of
robust randomized data has prevented updates to these guidelines.
Recently, new randomized trials have contributed valuable evidence. This
study aims to perform a pooled analysis of earlier and recent trials to
assess the safety and efficacy of non-fasting protocols versus traditional
fasting (NPO) guidelines in cardiac procedures. Methods A systematic
review was conducted using databases like PubMed, focusing exclusively on
randomized controlled trials (RCTs). Six RCTs, comprising 2,571 patients,
met inclusion criteria. Five studies involved coronary procedures, while
one included pacemaker implantations. Results A summary table presents
study characteristics and key findings. Aspiration pneumonitis occurred in
only one patient across all studies. Other safety outcomes were comparable
or favored non-fasting protocols. Conclusion This analysis suggests that
non-fasting protocols are safe and enhance patient satisfaction. The
findings support revising NPO guidelines for cardiac procedures to permit
more liberal oral intake. [Formula presented] Copyright © 2025
American College of Cardiology Foundation

<146>
Accession Number
2037786484
Title
WATCHMAN FLX VERSUS AMPLATZER AMULET DEVICE FOR LEFT ATRIAL APPENDAGE
OCCLUSION: A SYSTEMATIC REVIEW AND META-ANALYSIS.
Source
Journal of the American College of Cardiology. Conference: American
College of Cardiology, (ACC) Meeting 2025. Chicago United States. 85(12
Supplement) (pp 875), 2025. Date of Publication: 01 Apr 2025.
Author
Bittar V.; De Paula Carvalho P.E.; Felix N.S.; Nogueira A.; Garot P.
Institution
(Bittar, De Paula Carvalho, Felix, Nogueira, Garot) Centro Universitario
das Faculdades Associadas de Ensino, Sao Joao da Boa Vista, Brazil
Publisher
Elsevier Inc.
Abstract
Background The comparative safety and efficacy of the new Watchman FLX
versus Amulet devices remains unclear in the setting of left atrial
appendage occlusion (LAAO). Methods We systematically searched PubMed,
EMBASE, and Cochrane databases to identify studies comparing the new
Watchman FLX versus Amulet in patients with atrial fibrillation (AF)
undergoing percutaneous LAAO. We pooled risk ratios (RR) with 95%
confidence intervals (CI) for binary endpoints. All statistical analyses
were performed using R software version 4.3.1 with a random-effects model.
Results Six studies encompassing 1,129 patients with AF undergoing LAAO
were included. 687 (60.8%) patients underwent LAAO with Watchman FLX.
There was no significant difference between Watchman FLX versus Amulet in
terms of device-related thrombus (RR 1.63; 95% CI 0.89-2.98; p=0.11), peri
device leak (RR 0.73; 95% CI 0.29-1.89; p=0.52), or stroke/transient
ischemic attack (RR 2.49; 95% CI 0.62-9.96; p=0.20). Conclusion In this
meta-analysis, we found no differences between the new Watchman FLX and
the Amulet LAAO device with regards to leak or thromboembolic events.
[Formula presented] Copyright © 2025 American College of
Cardiology Foundation

<147>
Accession Number
2037790872
Title
DEVICE LEAK SURVEILLANCE IN PATIENTS WITH ATRIAL FIBRILLATION AFTER
TRANSCATHETER LEFT ATRIAL APPENDAGE CLOSURE: A META-ANALYSIS OF CARDIAC
COMPUTED TOMOGRAPHY VERSUS TRANSESOPHAGEAL ECHOCARDIOGRAPHY.
Source
Journal of the American College of Cardiology. Conference: American
College of Cardiology, (ACC) Meeting 2025. Chicago United States. 85(12
Supplement) (pp 2025), 2025. Date of Publication: 01 Apr 2025.
Author
Tan B.E.-X.; Baqai F.; Padilla F.A.; Medina H.M.
Institution
(Tan, Baqai, Padilla, Medina) Baylor College of Medicine, Houston, TX,
United States
(Tan, Baqai, Padilla, Medina) The Texas Heart Institute, Houston, TX,
United States
Publisher
Elsevier Inc.
Abstract
Background In pivotal WATCHMAN trials, transesophageal echocardiography
(TEE) was the preferred imaging method for device surveillance after left
atrial appendage closure (LAAC). We performed a meta-analysis to evaluate
the utility of cardiac computed tomography angiography (CCTA) compared to
TEE for post-LAAC surveillance. Methods We conducted a literature search
of 5 electronic databases to identify studies using both CCTA and TEE in
the same patients after LAAC. We pooled outcomes for any residual leak,
significant peri-device leak (PDL) <5mm, and device-related thrombus (DRT)
using a random effect model (Mantel-Haenszel). Results Fifteen studies
with 1182 patients (27% WATCHMAN, 72% Amplatzer Cardiac Plug or Amulet, 1%
LAmbre) who underwent both CCTA and TEE were included with a mean
follow-up of 1.5-6 months (34% females, mean age 72.7 years, mean
CHA<inf>2</inf>-DS<inf>2</inf>-VASc 4.2). CCTA was associated with higher
odds of detecting residual leak compared to TEE (62.3% vs 37.0%; OR 2.23;
95% CI 1.37 - 3.64; I2=77%). There were no significant
differences in detecting PDL <5mm (3.4% vs 1.0%; OR 3.0; 95% CI 0.7 -
13.2) and DRT (1.7% vs 1.7%; OR 1.0; 95% CI 0.4 - 2.6) on CCTA versus TEE.
Conclusion Following LAAC, more residual leaks were identified on CCTA
compared to TEE, with no differences in the detection rates of PDL <5mm
and DRT. CCTA offers a less invasive imaging option without the need for
sedation, potentially improving patient satisfaction, and serves as an
excellent alternative to TEE for post-LAAC surveillance. [Formula
presented] Copyright © 2025 American College of Cardiology
Foundation

<148>
Accession Number
2037793646
Title
COMPARISON OF THE MINIMALISTIC APPROACH USING COMPUTED TOMOGRAPHY
ANGIOGRAPHY (CCTA) GUIDED VERSUS NON-CCTA GUIDED PERCUTANEOUS LEFT ATRIAL
APPENDAGE CLOSURE: A SYSTEMATIC REVIEW AND META-ANALYSIS.
Source
Journal of the American College of Cardiology. Conference: American
College of Cardiology, (ACC) Meeting 2025. Chicago United States. 85(12
Supplement) (pp 2013), 2025. Date of Publication: 01 Apr 2025.
Author
Balbaa E.; Rakab M.; Gadelmawla A.F.; Ali K.; Tawfik A.; Elgendy A.;
AL-Ihribat A.R.; Sahito A.M.; Zoubi B.M.A.; Altobaishat O.; Abuelazm M.
Institution
(Balbaa, Rakab, Gadelmawla, Ali, Tawfik, Elgendy, AL-Ihribat, Sahito,
Zoubi, Altobaishat, Abuelazm) Rosalind Franklin University of Medicine and
Science, North Chicago, IL, United States
(Balbaa, Rakab, Gadelmawla, Ali, Tawfik, Elgendy, AL-Ihribat, Sahito,
Zoubi, Altobaishat, Abuelazm) Alexandria University, Alexandria, Egypt
Publisher
Elsevier Inc.
Abstract
Background The additive value of using computed tomography angiography
(CCTA) guided versus non-CCTA guided percutaneous left atrial appendage
closure is still unclear. Methods A systematic review and meta-analysis of
studies retrieved from PubMed, Embase, CENTRAL, Scopus, and WOS up to
September 2024. Dichotomous outcomes were pooled as risk ratios (RR),
while continuous outcomes were pooled as mean difference (MD) along the
corresponding 95% confidence interval (CI). Results Five studies with 914
patients were included. The CCTA-guided group had a significantly higher
device implantation success [RR: 1.07; 95% CI (1, 1.17), P= 0.05], a lower
peri-device leakage [RR: 0.61; 95% CI (0.47, 0.78), P= 0.0001], a lower
device resizing [RR: 0.48; 95% CI (0.30, 0.77), P= 0.0002], and a lower
procedure time [MD: -8.87 min; 95% CI (-17.8, -0.57), P= 0.036]. There was
no significant difference between both groups in devise-related
embolization [P= 0.34], radiation dose [P= 0.36], and contract utilization
[P= 0.92]. Conclusion LAAO, using a minimalistic CCTA approach, can
increase the implantation success rate, decrease the rate of peri-device
leakage, improve device selection accuracy, and shorten the procedure time
without increasing the contrast utilization or radiation dose. [Formula
presented] Copyright © 2025 American College of Cardiology
Foundation

<149>
Accession Number
2037788257
Title
ASSESSING THE ACCURACY OF SELF-REPORTED CARDIOVASCULAR OUTCOMES: A
SYSTEMATIC REVIEW.
Source
Journal of the American College of Cardiology. Conference: American
College of Cardiology, (ACC) Meeting 2025. Chicago United States. 85(12
Supplement) (pp 1839), 2025. Date of Publication: 01 Apr 2025.
Author
Vashist A.; Sun X.; Caraballo C.; Grimshaw A.; Sawano M.; Herrin J.; Lu
Y.; Khera R.; Spertus J.A.; Krumholz H.M.
Institution
(Vashist, Sun, Caraballo, Grimshaw, Sawano, Herrin, Lu, Khera, Spertus,
Krumholz) Center for Outcomes Research and Evaluation, Yale-New Haven
Hospital, New Haven, CT, United States
Publisher
Elsevier Inc.
Abstract
Background Self-reported cardiovascular outcomes, including myocardial
infarction and ischemic stroke, frequently differ from medical record
data. These discrepancies pose challenges for epidemiological studies and
registries, where accurate event reporting is critical for understanding
population-level trends in ischemic heart disease. In light of the
increasing use of electronic medical records in research, it is essential
to examine the accuracy of self-reported cardiovascular events. This study
systematically reviewed prospectively conducted studies evaluating the
accuracy of self-reported new-onset cardiovascular events when compared
with health system-generated data. Methods We searched six databases for
studies published before June 2023. Two study investigators independently
screened all retrieved abstracts to identify full-text articles meeting
the study criteria and assessing the accuracy of self-reported
cardiovascular events such as ischemic stroke, myocardial infarction,
percutaneous coronary intervention, and coronary artery bypass graft
surgery. We report study information and sensitivity, specificity,
positive and negative predictive value, percent underreported and
overreported, and percent agreement, of self-report-using health system
data as the reference. Results Of 16,041 identified citations, 24 met
study inclusion criteria. Of these, 4 were randomized clinical trials and
18 were prospective cohort studies. The positive predictive value of
self-reported cardiovascular events ranged from 25% to 85% (median 52%)
with sensitivity ranging from 29 to 98% (median 67%). Specificity and
negative predictive value ranged from 67-100% (median: 99%) and 71-100%
(median: 99%), respectively. No substantial heterogeneity was detected
when stratified by study location, participant age, or study year.
Conclusion The accuracy of self-reported cardiovascular events, including
ischemic heart disease, varies widely, with a tendency for underreporting
when compared to health system data. These findings highlight the need for
more robust data collection strategies in population studies of
cardiovascular diseases. Copyright © 2025 American College of
Cardiology Foundation

<150>
Accession Number
2037789400
Title
CAUSES OF REHOSPITALIZATIONS AMONG PATIENTS WITH OR WITHOUT ICD PLACEMENT
FOLLOWING REVASCULARIZATION AFTER SURVIVING VENTRICULAR FIBRILLATION/
VENTRICULAR TACHYCARDIA ARREST.
Source
Journal of the American College of Cardiology. Conference: American
College of Cardiology, (ACC) Meeting 2025. Chicago United States. 85(12
Supplement) (pp 185), 2025. Date of Publication: 01 Apr 2025.
Author
Patel N.N.; Odeleye V.; Patel M.; Paul T.K.
Institution
(Patel, Odeleye, Patel, Paul) University of Tennessee Health Science
Center, Nashville, TN, United States
(Patel, Odeleye, Patel, Paul) Ascension St Thomas Hospital, Nashville, TN,
United States
Publisher
Elsevier Inc.
Abstract
Background There is limited data available on the utility of the
Implantable Cardioverter Defibrillator (ICD) placement in the survivors of
Ventricular Fibrillation (VF)/ Ventricular Tachycardia (VT) arrest who
underwent revascularization. Methods Patients surviving VT/VF arrest who
underwent revascularization between 2016 and 2020, were identified in the
National Readmission Data. The patients were grouped into those who
received the ICD and those who did not. Chi-square statistics and the
multivariable regression analysis were performed STATA v. 17. Results A
total of 259,382 weighted hospitalizations were identified who underwent
revascularization with either PCI or CABG after VF/ VT arrest. Among this
population, 226, 310 patients (mean age: 64.37 +/- 12.36) did not receive
ICD while 33,071 patients received ICD (mean age: 67.86 +/- 10.52). The
patients in the ICD group had a higher prevalence of HFrEF (65.99% vs
31.33%, p <0.001); dyslipidemia (73.6% vs 66.96%, p <0.001); hypertension
(86.91% vs 76.02%, p <0.001); prior myocardial infarction (41.77% vs
17.21%, p <0.001); prior PCI (41.65% vs 17.64%, p <0.001); prior CABG
(23.61% vs 7.15%, p <0.001); obstructive sleep apnea (15.39% vs 9.29%, p
<0.001); pulmonary hypertension (9.91% vs 6.29%, p <0.001); peripheral
vascular disease (67% vs 10.63%, p <0.001); and atrial fibrillation
(41.97% vs 25%, p <0.001) compared to the non ICD group. Overall, the ICD
group had higher rates of readmission at 30 days (14.04% vs 7.99%), 90
days (33.48% vs 19.19%) and at 180 days (65.50% vs 35.15%). The most
common cause of readmission in the ICD group was ventricular tachycardia,
accounting for 33.48%, 30.27%, and 29.42% of the readmissions at 30, 90,
and 180 days respectively. In the nonICD group, the most common cause of
readmission was non-ST elevation MI. Conclusion Patients who received ICD
had comparatively higher comorbidities at baseline. Patients in the ICD
group had a higher rate of readmission, however, a substantial proportion
of readmissions were due to ICD shock after VT/VF. Randomized controlled
trials are needed to explore the outcomes of the ICD placement in such
patients. Copyright © 2025 American College of Cardiology
Foundation

<151>
Accession Number
2037790240
Title
COMPARATIVE OUTCOMES OF INTRACARDIAC VERSUS TRANSESOPHAGEAL
ECHOCARDIOGRAPHY FOR LEFT ATRIAL APPENDAGE OCCLUSION: A SYSTEMATIC REVIEW
AND META-ANALYSIS.
Source
Journal of the American College of Cardiology. Conference: American
College of Cardiology, (ACC) Meeting 2025. Chicago United States. 85(12
Supplement) (pp 2145), 2025. Date of Publication: 01 Apr 2025.
Author
Ahmed H.; Ismayl M.; Mangat M.; Aboeata A.S.A.; Goldsweig A.M.; Anavekar
N.S.
Institution
(Ahmed, Ismayl, Mangat, Aboeata, Goldsweig, Anavekar) Creighton University
School of Medicine, Omaha, NE, United States
(Ahmed, Ismayl, Mangat, Aboeata, Goldsweig, Anavekar) Mayo Clinic School
of Medicine, Rochester, MN, United States
Publisher
Elsevier Inc.
Abstract
Background Transesophageal echocardiography (TEE) has long been the
standard imaging modality for guiding left atrial appendage occlusion
(LAAO). However, intracardiac echocardiography (ICE) is gaining traction
as an alternative approach. Despite its growing use, the comparative
safety and efficacy of ICE versus TEE in LAAO guidance remain unclear.
Methods A comprehensive search was conducted for studies comparing
outcomes of ICE-guided versus TEE-guided LAAO through October 2024.
Primary outcomes assessed were all-cause mortality, cardiac tamponade,
device-related thrombus, major bleeding, peridevice leaks, and stroke.
Pooled risk ratios (RR) with 95% confidence intervals (CI) were calculated
using a fixed-effects model. Results Seven studies, comprising a total of
36,182 patients, were identified and included in the analysis. No
significant differences were observed between ICE-guided and TEE-guided
LAAO in all-cause mortality (RR 1.27; 95% CI 0.86-1.88), cardiac tamponade
(RR 0.87; 95% CI 0.35-2.13), device-related thrombus (RR 0.81; 95% CI
0.25-2.67), major bleeding (RR 0.68; 95% CI 0.34-1.39), peri-device leaks
(RR 0.78; 95% CI 0.53-1.15), or stroke (RR 0.43; 95% CI 0.15-1.21).
Conclusion Our findings suggest that ICE-guided LAAO is comparable to
TEE-guided LAAO in terms of safety and efficacy across key clinical
outcomes. Given these comparable results, ICE may serve as a practical
alternative to TEE for LAAO guidance. Further studies are needed to
confirm our findings. [Formula presented] Copyright © 2025
American College of Cardiology Foundation

<152>
Accession Number
2037791253
Title
EXPLORING THE IMPACT OF BEMPEDOIC ACID ON LIPID PROFILES AND
CARDIOVASCULAR EVENTS; AN UMBRELLA REVIEW OF META-ANALYSIS.
Source
Journal of the American College of Cardiology. Conference: American
College of Cardiology, (ACC) Meeting 2025. Chicago United States. 85(12
Supplement) (pp 516), 2025. Date of Publication: 01 Apr 2025.
Author
Saeed S.; karmani V.K.; Riaz A.; Amir A.
Institution
(Saeed, karmani, Riaz, Amir) Charleston Area Medical Center, Charleston,
WV, United States
Publisher
Elsevier Inc.
Abstract
Background This umbrella review synthesizes evidence from meta-analyses to
evaluate the effects of bempedoic acid on lipid profiles and
cardiovascular events. Methods While adhering to the PRIOR guidelines,
PubMed, Google Scholar, Web of Science, and Scopus were searched from the
database inception to July 2024 to identify relevant articles. The
outcomes were total cholesterol, LDL-cholesterol (LDL-C), HDL-cholesterol
(HDL-C), Non-HDL Cholesterol, Triglyceride (TAG), Apolipoprotein B (APOB),
Major Cardiovascular Events (MACE), Cardiovascular Mortality, Myocardial
Infarction. A Corrected Covered Area (CCA) assessment was performed to
determine overlap among reviews. Each included review was assessed for its
quality and rigor via the AMSTAR-2 tool. Results We studied 18
meta-analyses, revealing mixed findings on cardiovascular mortality. Goyal
et al. (2024) reported a risk ratio (RR) of 0.81 (95% CI 0.61-1.08),
suggesting potential benefits, while other studies, like Filippo et al.
(2023) and Zhang et al. (2023), found no significant associations. In
contrast, 11 reviews indicated a reduced risk of major adverse
cardiovascular events (MACE), with RRs between 0.75 and 0.88. Bempedoic
acid significantly lowers the risk of myocardial infarction (MI) with RRs
around 0.76. Evidence also points to a lower risk of unstable angina,
coronary revascularization (RRs between 0.74 and 0.82), and
non-revascularization (RRs and ORs of 0.41). Bempedoic acid consistently
reduces LDL cholesterol (mean differences from -17.5% to -33.91%), total
cholesterol (MDs from -12.69% to -34.41%), and non-HDL cholesterol (MDs
from -12.3% to -23.27%), with variable effects on HDL cholesterol (MDs
from -1.29% to -5.18%) and mixed results for triglycerides. Conclusion
Bempedoic acid significantly reduces the risk of MACE, nonfatal myocardial
infarction, and both coronary and non-coronary revascularization. While
the evidence on cardiovascular mortality is mixed, bempedoic acid proves
effective for improving lipid profiles and offers a valuable treatment
option for patients intolerant to statins. Further research is needed to
assess its long-term benefits and broader applicability. Copyright
© 2025 American College of Cardiology Foundation

<153>
Accession Number
2037786016
Title
ANTITHROMBOTIC MONOTHERAPY OR COMBINATION THERAPY FOR ATRIAL FIBRILLATION
WITH STABLE CORONARY ARTERY DISEASE: A META-ANALYSIS OF RANDOMIZED TRIALS.
Source
Journal of the American College of Cardiology. Conference: American
College of Cardiology, (ACC) Meeting 2025. Chicago United States. 85(12
Supplement) (pp 173), 2025. Date of Publication: 01 Apr 2025.
Author
Reddy R.K.; Koeckerling D.; Howard J.P.; Lip G.Y.H.; Ahmad Y.
Institution
(Reddy, Koeckerling, Howard, Lip, Ahmad) National Heart and Lung
Institute, Imperial College London, London, United Kingdom
(Reddy, Koeckerling, Howard, Lip, Ahmad) Nuffield Department of Population
Health and St Anne's College, University of Oxford, Oxford, United Kingdom
Publisher
Elsevier Inc.
Abstract
Background In patients with atrial fibrillation (AF) and stable coronary
artery disease (CAD), international guidelines recommend anticoagulation
monotherapy (SAT) after periods on dual therapy (DAT) to varying degrees,
due to limited evidence. We performed a metaanalysis of randomized
controlled trials (RCTs) to test the safety and efficacy of SAT compared
with DAT. Methods This investigation was registered on PROSPERO
[CRD42024590457]. Only RCTs enrolling patients with AF and stable CAD were
eligible. The prespecified co-primary outcomes were major bleeding and
all-cause death. Prespecified secondary outcomes included cardiovascular
death, myocardial infarction (MI), stroke, coronary revascularization and
the composite of net adverse cardiovascular events (NACE). Data were
pooled using random effects modeling in the intention-to-treat
populations. Results Four RCTs enrolling 4092 patients were eligible,
(SAT=2049, DAT=2046). SAT reduced the risk of major bleeding by 43% with
no difference in the risk of all-cause death (Figure). Rates of
cardiovascular death (RR 0.90, 95% CI 0.49-1.65, P=0.74,
I2=25%), MI (RR 1.57, 95% CI 0.79-3.12, P=0.20,
I2=0%), stroke (RR 0.88, 95% CI 0.57-1.36, P=0.57,
I2=0%), coronary revascularization (RR 0.83, 95% CI 0.461.50,
P=0.54, I2=0%) and NACE (RR 0.65, 95% CI 0.42-1.02, P=0.06,
I2=80%) were similar. [Formula presented] Conclusion In
patients with AF and stable CAD, SAT reduces major bleeding compared with
DAT. All-cause death and secondary endpoints were similar. Copyright
© 2025 American College of Cardiology Foundation

<154>
Accession Number
2037786143
Title
IMPACT OF SODIUM-GLUCOSE COTRANSPORT-2 (SGLT2) INHIBITORS ON CLINICAL
OUTCOMES IN PATIENTS AFTER TRANSCATHETER AORTIC VALVE REPLACEMENT.
Source
Journal of the American College of Cardiology. Conference: American
College of Cardiology, (ACC) Meeting 2025. Chicago United States. 85(12
Supplement) (pp 1065), 2025. Date of Publication: 01 Apr 2025.
Author
Dimala C.A.; Saxena R.; Gilani S.; Rangasetty U.C.; Kumfa P.; Jneid H.
Institution
(Dimala, Saxena, Gilani, Rangasetty, Kumfa, Jneid) The University of Texas
Medical Branch, Galveston, TX, United States
Publisher
Elsevier Inc.
Abstract
Background Sodium-Glucose Cotransport-2 (SGLT2) inhibitors are known to
improve cardiovascular outcomes in patients with heart failure, diabetes
and coronary artery disease. However, there is little evidence of how
these medications may influence post-procedural outcomes in patients
undergoing transcatheter aortic valve replacement (TAVR). This study aims
to explore the impact of SGLT2 inhibitor use on clinical outcomes and
cardiovascular mortality in patients who have undergone TAVR in a
real-world setting. Methods Of the 64,151 patients (5,673 on and 58,478
not on SGLT-2 inhibitors) with TAVR identified between 2004 and 2024 from
the TriNetX global health research network, 1:1 propensity score matching
was done for 11,252 US adults aged 18 and above (5,626 on and 5626 not on
SGLT2 inhibitors) to ensure groups had balanced demographics and clinical
characteristics. Kaplan-Meier analysis was used to evaluate the
association between SGLT2 use and 1-year and 5-year mortality. Statistical
significance was set at p<0.05. Results Despite no significant difference
in 1-year adjusted all-cause mortality between both groups (HR = 0.92,
95%CI: 0.78 - 1.10, p=0.369), there was a significantly lower 5-year
mortality in patients on SGLT2 inhibitors (HR = 0.874, 95%CI: 0.79 - 0.97,
p=0.012) compared to those not on SGLT2 inhibitors, with a survival
probability of 74.8% compared to 72.0%. Sub-group analysis revealed no
significant difference between both groups in terms of; acute kidney
injury (AKI) at 30 days (RR = 0.99, 95%CI: 0.89 - 1.11, p=0.877),
myocardial infarction or stroke at 1 year (RR = 1.01, 95%CI: 0.95 - 1.10,
p=0.622) and TAVR re-intervention at 1 year (RR = 1.01, 95%CI: 0.77 -
1.33, p=0.944). Conclusion In a real-world setting, SGLT2 inhibitor use
was associated with a significantly lower 5-year mortality post TAVR and
these survival benefits did not appear to be due to lowering the risk of
AKI, myocardial infarction or stroke or repeat TAVR intervention.
Randomized controlled studies may be necessary to further explore the
possibly independent benefit of SGLT2 inhibitors in patients post
TAVR. Copyright © 2025 American College of Cardiology Foundation

<155>
Accession Number
2037787046
Title
THE SAFETY OF CONCOMITANT SURGICAL ABLATION IN NON-MITRAL VALVE CARDIAC
SURGERY: A RANDOMIZED CONTROL TRIALS AND PROPENSITY SCORE META-ANALYSIS.
Source
Journal of the American College of Cardiology. Conference: American
College of Cardiology, (ACC) Meeting 2025. Chicago United States. 85(12
Supplement) (pp 1141), 2025. Date of Publication: 01 Apr 2025.
Author
Barbosa G.S.; Katsuyama E.; Fernandes J.M.; Coan A.C.C.; Fukunaga C.;
Prata A.; Naieli A.; Silva A.; Gioli-Pereira L.
Institution
(Barbosa, Katsuyama, Fernandes, Coan, Fukunaga, Prata, Naieli, Silva,
Gioli-Pereira) Faculdade Santa Marcelina, Sao Paulo, Brazil
(Barbosa, Katsuyama, Fernandes, Coan, Fukunaga, Prata, Naieli, Silva,
Gioli-Pereira) Albert Einstein Israelite Hospital, Sao Paulo, Brazil
Publisher
Elsevier Inc.
Abstract
Background The safety of surgical ablation (SA) with concomitant mitral
valve surgery is well established; however, there is a lack of data
evaluating patients undergoing non-mitral valve (NMV) cardiac surgery.
Methods We systematically searched PubMed, Embase, and Cochrane databases
for randomized clinical trials (RCTs) and propensity score-matched (PSM)
observational studies comparing patients who underwent NMV cardiac surgery
with those who had concomitant SA. The outcomes assessed included
postoperative stroke and in-hospital mortality. Risk Ratios (RRs) and 95%
confidence intervals (CIs) were pooled with a random-effects model using
(R version 4.3.2.). Results Our meta-analysis included 2 RCTs and 5 PSM
observational studies, encompassing 39,348 patients, of whom 18,395
(46.74%) received concomitant SA. The median patient age was 72 years,
with a median follow-up duration of 18 months. The concomitant SA group
showed no difference in postoperative stroke (RR: 0.93; 95%CI: 0.73 to
1.20; p=0.358; Fig.1A) and in-hospital mortality (RR: 1.07; 95%CI: 0.83 to
1.37; p=0.524; Fig.1B) compared with patients who had only undergone NMV
surgery. Conclusion The endpoints of postoperative stroke and in-hospital
mortality showed no significant differences between patients who underwent
SA during NMV cardiac surgery and those who underwent NMV surgery without
SA. [Formula presented] Copyright © 2025 American College of
Cardiology Foundation

<156>
Accession Number
2037791141
Title
MEDIUM-TERM OUTCOMES AFTER TRANSCATHETER MITRAL VALVE REPLACEMENT IN
NATIVE (NON-CALCIFIED) VALVES, DEGENERATED BIOPROSTHESES, RINGS AND MITRAL
ANNULAR CALCIFICATION: A SYSTEMATIC REVIEW AND META-ANALYSIS.
Source
Journal of the American College of Cardiology. Conference: American
College of Cardiology, (ACC) Meeting 2025. Chicago United States. 85(12
Supplement) (pp 2295), 2025. Date of Publication: 01 Apr 2025.
Author
Zorman M.; Dangas K.; Vibhishanan J.; Li C.K.H.; Piankova P.; Coronelli
M.; Johnson N.; Cassar M.P.; Martins J.F.; Newton J.; Dawkins S.; Guerrero
M.E.; Cahill T.J.
Institution
(Zorman, Dangas, Vibhishanan, Li, Piankova, Coronelli, Johnson, Cassar,
Martins, Newton, Dawkins, Guerrero, Cahill) Mayo Clinic, Rochester, MN,
United States
(Zorman, Dangas, Vibhishanan, Li, Piankova, Coronelli, Johnson, Cassar,
Martins, Newton, Dawkins, Guerrero, Cahill) Oxford Heart Centre, Oxford,
United Kingdom
Publisher
Elsevier Inc.
Abstract
Background Transcatheter mitral valve replacement (TMVR) has become a
feasible alternative to surgery in patients with native noncalcified
mitral valve disease (valve-in-native-valve, ViNV), as well as those with
degenerated bioprostheses (valve-in-valve, ViV), rings (valve-in-ring,
ViR), and mitral annular calcification (valve-in-MAC, ViMAC). Comparative
data on the medium-term outcome between different TMVR interventions in
the real-world setting are limited. Methods A comprehensive literature
search of Medline, Embase and Cochrane Library (January 2000 to January
2024) was conducted. Valve thrombosis was defined as subclinical or
clinical thrombosis in the absence of endocarditis. Valve reintervention
was defined as any surgical or transcatheter procedure related to mitral
bioprosthesis dysfunction. Results A total of 42 studies were eligible for
inclusion, including 7731 patients with a median follow-up of 10.5 months.
The mean age was 74.5 years, and 42.1% (3255/7731) of patients were male.
In total, 948 (12.3%) patients underwent ViNV, 5102 (66.0%) ViV, 1060
(13.7%) ViR, and 621 (8.0%) ViMAC. The overall 1-year survival was 14.2%
(930/6536). ViMAC patients had significantly worse in-hospital, 30-day,
and 1-year survival than ViV and ViR, while other subgroup differences
were not significant (p>0.05). After the index admission, ViMAC patients
had a 3.64-fold higher valve reintervention rate than ViNV (incidence 23.5
vs 5.5, adjusted incidence ratio [aIR] 5.73, 95%CI 1.91-18.13, p<0.01),
with comparable rates between ViMAC and ViR. The overall incidence of
valve thrombosis and infective endocarditis after TMVR was 5.68 (95%CI
3.71-8.78) and 2.72 (95%CI 1.77-4.17) events per 100-patient-years, with
no significant differences by TMVR intervention (p>0.05). Conclusion
Patients undergoing ViMAC have significantly worse overall survival and a
higher requirement for valve re-intervention than other TMVR subgroups.
Valve thrombosis and infective endocarditis after TMVR occur at notable
rates, consistent among different TMVR subgroups. Copyright ©
2025 American College of Cardiology Foundation

<157>
Accession Number
2037788184
Title
EFFICACY AND SAFETY OF TRANSULNAR ARTERY ACCESS VERSUS TRANSRADIAL ARTERY
ACCESS IN PATIENTS UNDERGOING CARDIAC PROCEDURES: A SYSTEMATIC REVIEW AND
METAANALYSIS OF RANDOMIZED CONTROLLED TRIALS.
Source
Journal of the American College of Cardiology. Conference: American
College of Cardiology, (ACC) Meeting 2025. Chicago United States. 85(12
Supplement) (pp 1117), 2025. Date of Publication: 01 Apr 2025.
Author
Al-Shamari M.; Zreigh S.M.M.; Mosa A.; Waqas D.; Htet Y.; Iqbal I.; Ashraf
E.; javaid S.; Farooq I.; Feyisa M.A.; Rehman M.E.U.; Cheema H.A.;
Mohammad A.M.; Ahmad A.; Rehman W.; Ahmed R.
Institution
(Al-Shamari, Zreigh, Mosa, Waqas, Htet, Iqbal, Ashraf, javaid, Farooq,
Feyisa, Rehman, Cheema, Mohammad, Ahmad, Rehman, Ahmed) Mass General
Brigham Salem Hospital, salem, MA, United States
Publisher
Elsevier Inc.
Abstract
Background Transradial artery access (TRA) is the favored approach for
percutaneous coronary intervention (PCI) and coronary angiography
(CAG).However, transulnar artery access (TUA) has emerged as an
alternative, particularly when TRA is not feasible. This systematic review
and meta-analysis aims to compare the efficacy and safety of TUA versus
TRA in patients undergoing PCI and CAG. Methods From inception to August
2024, a systematic search of electronic databases, including MEDLINE,
Embase, and the Cochrane Central Register of Controlled Trials, was
conducted. The primary outcomes were procedural success and puncture
success rates. Secondary outcomes included puncture attempts, procedure
time, and complications such as hematoma and arterial spasm. Data were
synthesized using a random-effects model, and heterogeneity was assessed
using the I2 statistic. Results Nine RCTs involving 6,089 patients were
included. Meta-analysis revealed no significant difference in procedural
success between TUA and TRA (RR: 0.93, 95% CI: 0.82-1.06, p = 0.28, I2 =
99%). Similarly, puncture success rates were comparable between TUA and
TRA (RR: 0.95, 95% CI: 0.91-1.00, p = 0.06, I2 = 83%). Secondary outcomes
showed no significant differences in puncture attempts or hematoma
incidence, but TRA was associated with a shorter procedure time (MD: 0.89,
95% CI: 0.27-1.50, p = 0.005). Conclusion TUA provides a viable
alternative to TRA for PCI and CAG, with similar success rates and
complication profiles. However, TRA remains superior in terms of procedure
time. Further large-scale RCTs are warranted to confirm these findings and
refine clinical guidelines. Copyright © 2025 American College of
Cardiology Foundation

<158>
Accession Number
2037788331
Title
THE RISK OF ATRIOVENTRICULAR NODE DYSFUNCTION FOLLOWING TRANSCATHETER
AORTIC VALVE IMPLANTATION ACROSS DIFFERENT VALVE TYPES: A SYSTEMATIC
REVIEW WITH METAANALYSIS.
Source
Journal of the American College of Cardiology. Conference: American
College of Cardiology, (ACC) Meeting 2025. Chicago United States. 85(12
Supplement) (pp 1124), 2025. Date of Publication: 01 Apr 2025.
Author
Albalbissi K.; Abdulelah Z.A.; Al-Dqour M.; Hassan M.; Abdulelah A.
Institution
(Albalbissi, Abdulelah, Al-Dqour, Hassan, Abdulelah) Royal Papworth
Hospital, Cambridge, United Kingdom
(Albalbissi, Abdulelah, Al-Dqour, Hassan, Abdulelah) University of Jordan,
Amman, Jordan
Publisher
Elsevier Inc.
Abstract
Background Aortic stenosis is among the most prevalent cardiovascular
diseases that is expected to exponentially increase in prevalence in the
upcoming years. Transcatheter aortic valve implantation (TAVI) presents a
clinically proven efficacious and safe alternative to surgical repair in
patients with high surgical risk. Nonetheless, several complications could
be implicated with TAVI, most common of which is atrioventricular (AV)
node dysfunction or block (AVB). Methods To evaluate the risk of
developing AV block following TAVI across the different valve types, a
systematic review with metaanalysis was performed. The following databases
were searched; PubMed, Scopus, Cochrane Library, and ClinicalTrials.gov.
We used the following keywords in the search; ((Transcatheter aortic valve
implantation OR Transcatheter aortic valve replacement OR TAVI) AND
(Atrioventricular node dysfunction OR Atrioventricular block OR AV block
OR AVB)). The studies were included if they reported the prevalence of AVB
in patients undergoing TAVI with a specified type of valve such as
balloon-expandable valve (BEV), self-expandable valve (SEV), and
mechanical-expandable valve (MEV). Results A total of 827 articles were
initially identified and eventually only 176 studies were thoroughly
reviewed. Finally, 122 articles (66 BEV, 48 SEV and 8 MEV) were included
in this systematic review and meta-analysis with the total number of
included patients being 65,491. The prevalence of patients who underwent
BEV and developed an AVB were 17% (95%CI 0.16-0.17). Moreover, the
prevalence of AVB in patients who had a SEV implant were 11% (95%CI
0.11-0.11) whereas patient who underwent a MEV implant had a high
prevalence of AVB of 33% (95%CI 0.31-0.35). The overall prevalence of AVB
in patients undergoing a TAVI were 19% (95%CI 0.11-0.29) using random
effects model. Using this model also showed significant heterogeneity
(P-value<0.01, I2=100%). Conclusion TAVI-associated AVB prevalence based
on the currently available literature is 19%, with MEV demonstrating the
highest prevalence of around 33% in comparison to SEV and
BEV. Copyright © 2025 American College of Cardiology Foundation

<159>
Accession Number
2037787663
Title
OUTCOMES OF CONCOMITANT MITRAL INTERVENTION IN HYPERTROPHIC OBSTRUCTIVE
CARDIOMYOPATHY SURGERY? A SYSTEMATIC REVIEW AND META-ANALYSIS OF
CONTEMPORARY EVIDENCE.
Source
Journal of the American College of Cardiology. Conference: American
College of Cardiology, (ACC) Meeting 2025. Chicago United States. 85(12
Supplement) (pp 2284), 2025. Date of Publication: 01 Apr 2025.
Author
Domondon I.A.; De Guzman R.; Bruno C.J.; Jaffar-Karballai M.; Alroobi A.;
Siddique M.; Bitar M.; Enaya H.; Al-Tawil M.; Haneya A.
Institution
(Domondon, De Guzman, Bruno, Jaffar-Karballai, Alroobi, Siddique, Bitar,
Enaya, Al-Tawil, Haneya) Portsmouth Hospitals University NHS Trust,
Portsmouth, United Kingdom
(Domondon, De Guzman, Bruno, Jaffar-Karballai, Alroobi, Siddique, Bitar,
Enaya, Al-Tawil, Haneya) Stockport NHS Foundation Trust, Stockport, United
Kingdom
Publisher
Elsevier Inc.
Abstract
Background The 2020 American Heart Association Guidelines advise not to
perform mitral valve replacement (MVR) during septal myectomy (SM) to
alleviate outflow obstruction. This study aimed at reviewing outcomes
after concomitant mitral valve (MV) intervention versus SM alone. Methods
We conducted a comprehensive literature search across Embase, PubMed and
Scopus. Studies published up to June 15, 2024, were considered. We
included studies that compared SM alone to concomitant MV repair or
replacement. Subgroup analyses based on MV intervention were performed.
Results Seven studies met our criteria, including one randomized and six
observational studies. Total sample size was 17,565 patients with
hypertrophic cardiomyopathy (11,849 SM, 2,303 SM + MVR and 3,390 SM+MV
repair). Patients who underwent SM+MV intervention had more pronounced
preoperative MV regurgitation. SM + MVR was associated with significantly
higher early mortality. However, no difference in early mortality in
patients who underwent SM+MV repair when compared to SM alone. Thirty-days
systolic anterior motion and early peak pressure left ventricular outflow
tract gradient was significantly lower in patients who underwent SM+MV
repair when compared to SM alone. [Formula presented] Conclusion Current
observational evidence suggests an increased risk of inpatient mortality
in patients who underwent SM + MVR. SM+MV repair did not affect early
mortality but was linked to improved outcomes. Future comprehensive and
matched studies are warranted. Copyright © 2025 American College
of Cardiology Foundation

<160>
Accession Number
2037794715
Title
CARDIOVASCULAR EFFICACY OF TIRZEPATIDE IN PATIENTS WITH TYPE 2 DIABETES
MELLITUS: AN INDIVIDUAL PARTICIPANT DATA META-ANALYSIS OF 8 RANDOMIZED
CLINICAL TRIALS.
Source
Journal of the American College of Cardiology. Conference: American
College of Cardiology, (ACC) Meeting 2025. Chicago United States. 85(12
Supplement) (pp 415), 2025. Date of Publication: 01 Apr 2025.
Author
Aminorroaya A.; Camargos A.P.; Oikonomou E.K.; Khera R.
Institution
(Aminorroaya, Camargos, Oikonomou, Khera) Yale School of Medicine, New
Haven, CT, United States
Publisher
Elsevier Inc.
Abstract
Background The combined GIP/GLP-1 RA, tirzepatide, improves glycemic
control and promotes weight loss in T2DM, but its effects on MACE remain
inconclusive. We conducted an individual participant data meta-analysis to
assess the cardiovascular efficacy of tirzepatide. Methods We included 8
RCTs comparing tirzepatide with placebo, insulin, or GLP-1 RAs.
Individual-level data were pooled to assess the efficacy of tirzepatide
vs. comparators for MACE, defined as a composite of acute coronary
syndrome, coronary revascularization, stroke, hospitalization for heart
failure, and cardiovascular death. We fit a mixed-effects Cox proportional
hazards model to evaluate MACE as the outcome, with the intervention as a
fixed effect and the trial as a random effect, using inverse probability
weighting at the trial level. Doseresponse effects were assessed for
tirzepatide at doses of 5, 10, and 15 mg/week vs. comparators. Results Of
8,122 participants (age, 59 years [IQR, 51-66] and 43% women), 192 had
MACE over a median of 46 weeks [44-57]. Tirzepatide significantly reduced
the risk of MACE by 19% vs. comparators (HR, 0.81 [95% CI, 0.67-0.99]).
While 10 and 15 mg/week of tirzepatide reduced MACE risk (HR, 0.74
[0.60-0.91] and 0.64 [0.52-0.80], respectively), there was no difference
for 5 mg/week (HR, 1.05 [0.87-1.27]) compared with the control arm.
Conclusion Tirzepatide reduces the risk of MACE by 19% in T2DM patients,
with the effect primarily observed at doses of 10 mg/week or higher.
[Formula presented] Copyright © 2025 American College of
Cardiology Foundation

<161>
Accession Number
2037790637
Title
COLCHICINE FOR ATRIAL FIBRILLATION PREVENTION AFTER CATHETER ABLATION: A
SYSTEMATIC REVIEW AND META-ANALYSIS.
Source
Journal of the American College of Cardiology. Conference: American
College of Cardiology, (ACC) Meeting 2025. Chicago United States. 85(12
Supplement) (pp 60), 2025. Date of Publication: 01 Apr 2025.
Author
Soliman Y.; Mouffokes A.; Hukamdad M.; Allababidi M.; Hassaballa H.
Institution
(Soliman, Mouffokes, Hukamdad, Allababidi, Hassaballa) University of
Chicago, Chicago, IL, United States
Publisher
Elsevier Inc.
Abstract
Background Colchicine is commonly prescribed after cardiac surgery to
lower the risk of atrial fibrillation (AF). However, its impact on the
results of catheter ablation (CA) for AF remains a subject of debate.
Methods We conducted a comprehensive search of PubMed, EMBASE, Scopus, the
Cochrane Controlled Register of Trials (CENTRAL), and Web of Science for
all pertinent trials. We included studies evaluating the short- or
long-term efficacy of colchicine in preventing atrial fibrillation
recurrence following catheter ablation. We used risk ratios (RR) for
dichotomous variables. The primary outcome measured was the risk of atrial
fibrillation recurrence. Results A total of 10 studies were included.
Colchicine significantly reduced the risk of AF recurrence at <= 1-month
treatment course (RR: 0.76, 95% CI [0.65, 0.89], I2 = 35%) and
at 3 months course (RR: 0.58, 95% CI [0.43, 79], I2 = 0%).
Subgrouping based on study design showed consistency between RCTs (RR:
0.67, 95% CI [0.47, 0.94], I2 = 59%) and observational studies
(RR: 0.74, 95% CI [0.64, 0.87], I2 = 26%). In terms of
follow-up, colchicine reduced AF risk at <= 3 months follow-up (RR: 0.75,
95% CI [0.57, 0.98], I2 = 37%) and at < 3 months (RR: 0.74, 95%
CI [0.63, 0.87], I2 = 28%). Colchicine showed no difference in
the risk of pericarditis but increased the risk of diarrhea. Conclusion
Colchicine may be an effective treatment for preventing atrial
fibrillation recurrence after catheter ablation. [Formula
presented] Copyright © 2025 American College of Cardiology
Foundation

<162>
Accession Number
2037787190
Title
EFFECT OF THE GLP-1 RECEPTOR AGONIST SEMAGLUTIDE ON TOTAL CARDIOVASCULAR
EVENTS IN PATIENTS WITH CARDIOVASCULAR DISEASE AND OVERWEIGHT OR OBESITY
BUT NO DIABETES IN THE SELECT TRIAL.
Source
Journal of the American College of Cardiology. Conference: American
College of Cardiology, (ACC) Meeting 2025. Chicago United States. 85(12
Supplement) (pp 378), 2025. Date of Publication: 01 Apr 2025.
Author
Lincoff A.M.; Colhoun H.; Emerson S.; Hovingh G.K.; Kabakci G.; Kahn S.;
Lingvay I.; De Souza Almeida Matos A.L.; Morales C.; Rasmussen S.; Saraiva
J.F.K.; Scirica B.M.; Tinahones F.J.; De Borne P.V.; Verma S.; Weeke
P.E.K.; Ryan D.; Deanfield J.E.
Institution
(Lincoff, Colhoun, Emerson, Hovingh, Kabakci, Kahn, Lingvay, De Souza
Almeida Matos, Morales, Rasmussen, Saraiva, Scirica, Tinahones, De Borne,
Verma, Weeke, Ryan, Deanfield) Cleveland Clinic, Cleveland, OH, United
States
Publisher
Elsevier Inc.
Abstract
Background Semaglutide, a GLP-1 agonist, reduced the first occurrence of
major adverse cardiovascular (CV) events (MACE) by 20% among patients
(pts) with prior CV disease (CVD) and overweight or obesity without
diabetes in the SELECT trial. These pts remain at risk, however, for
subsequent ischemic events. Methods This prespecified secondary analysis
of the SELECT trial was to determine the effect of semaglutide on total CV
events. Pts aged >=45 years with CVD and body mass index >=27
kg/m2 without diabetes were randomized 1:1 to weekly
subcutaneous semaglutide 2.4 mg or placebo. The outcome was total (first
and subsequent) events of an expanded MACE-5 (CV death, non-fatal MI,
non-fatal stroke, coronary revascularization, or hospitalization for
unstable angina). Results In 17,604 pts followed for a mean of 39.8
months, 1,947 (64%) first endpoint events and 1,084 (36%) subsequent
events occurred. Coronary revascularization represented 27.2% of first
events and 72.9% of subsequent events; non-fatal MI was 26.2% of first
events and 10.3% of subsequent events. Semaglutide reduced first MACE-5
events (hazard ratio 0.80; 95% CI 0.73-0.87; P<0.001) and total MACE-5
events (mean ratio [MR] 0.78; 95% CI 0.70-0.86; P<0.001) (Figure).
Reductions in total events were driven by fewer non-fatal MIs (MR 0.69;
95% CI 0.58-0.82; P<0.001) and coronary revascularizations (MR 0.74; 95%
CI 0.65-0.84; P<0.001). Conclusion Semaglutide reduces the burden of first
and total CV events in pts with CVD and obesity or overweight. [Formula
presented] Copyright © 2025 American College of Cardiology
Foundation

<163>
Accession Number
646711069
Title
Can Closed-Incision Negative Pressure Therapy (Cinpt) Help Prevent Wound
Infections In High Risk Patients Undergoing Laparotomy?.
Source
European Surgical Research. Conference: 54th Congress of the European
Society for Surgical Research. Geneva Switzerland. 60(Supplement 2) (pp
101), 2019. Date of Publication: 01 Aug 2019.
Author
Pozzetti G.; Guendil B.; Abbassi Z.
Institution
(Pozzetti, Guendil, Abbassi) Hopital du Valais Romand, Sion, Switzerland
(Abbassi) HUG, Geneve, Switzerland
Publisher
S. Karger AG
Abstract
Background: Surgical site infections are a potentially avoidable surgical
complication. An evidence-based way to achieve a reduction of this
complication is imperative in 2019. Closed-incision negative pressure
therapy (CiNPT) device Prevena has been used successfully to diminish
SSIs. It is supposed to enhance healing process by wound cleansing and
subcutaneous tissue immobilization. No prospective trial in high-risk
patients undergoing laparotomy is known. Material(s) and Method(s):
Single center prospective study comparing CiNPT vs standard wound
dressing, from January 2018 in General Surgery HVR, Sion, with one-month
follow-up. Prevena was placed for 7 days on patients undergoing urgent
laparotomic procedure or two criteria placing them at high risk for wound
infection. Primary endpoint: Incisional SSI at discharge. Secondary
endpoints: Incisional SSI at 30 days, all-cause mortality. Result(s):
We installed 39 Prevena onto 23 non peritonitic patients and 16 patients
having Inflammatory (12.5%), purulent (62.5%) or stercoral peritonitis
(25%). In non peritonitic patients we had a total of 5 (21%) early
infections with only one needing a redo procedure. None of them had an
infected wound at one-month follow-up. In this group only 3 patients
arrived at one-month control with an infected wound. In the peritonitis
group we counted 6 (37.5) wound infections before discharge, half of which
with a concomitant deep tissue infection. None of those patients got to
follow-up with a wound infection (3 reoperations). Only 2 (12.5) other
patients got to our control with a SSSI. Conclusion(s): This is an
interesting therapy device with mixed results in General Surgery. CiNPT
demonstrated his efficacy in orthopaedic, cardiothoracic and vascular
surgery settings with fewer early and late incisional infections. Those
surgical branches are less subject to contamination than GI surgery. Our
results are a good starting point to enlarge our study to a non-randomized
clinical trial comparing Prevena to standard wound care, acting as a
matched control group.

<164>
Accession Number
2033511294
Title
RETRACTION: Effects of Quality Nursing on the Surgical Site Wound
Infections in Patients Undergoing Cardiothoracic Surgery: A
Meta-Analysis(International Wound Journal, (2024), 21, 1, (e14553),
10.1111/iwj.14553).
Source
International Wound Journal. 22(3) (no pagination), 2025. Article Number:
e70284. Date of Publication: 01 Mar 2025.
Author
Lv X.; Zhou A.; Chen M.; Qi C.; Zhang Q.
Publisher
John Wiley and Sons Inc
Abstract
RETRACTION: X. Lv, A. Zhou, M. Chen, C. Qi, and Q. Zhang, "Effects of
Quality Nursing on the Surgical Site Wound Infections in Patients
Undergoing Cardiothoracic Surgery: A Meta-Analysis," International Wound
Journal 21, no. 1 (2024): e14553, https://doi.org/10.1111/iwj.14553. The
above article, published online on 15 January 2024, in Wiley Online
Library (http://onlinelibrary.wiley.com/), has been retracted by agreement
between the journal Editor in Chief, Professor Keith Harding; and John
Wiley & Sons Ltd. Following an investigation by the publisher, all parties
have concluded that this article was accepted solely on the basis of a
compromised peer review process. The editors have therefore decided to
retract the article. The authors did not respond to our notice regarding
the retraction. Copyright © 2025 The Author(s). International
Wound Journal published by Medicalhelplines.com Inc and John Wiley & Sons
Ltd.

<165>
Accession Number
646691556
Title
High-dose inhaled NO for the prevention of nosocomial pneumonia after
cardiac surgery under cardiopulmonary bypass: A proof-of-concept
prospective randomised study.
Source
Pulmonology. 31(1) (pp 2471706), 2025. Date of Publication: 31 Dec 2025.
Author
Kalashnikova T.P.; Kamenshchikov N.O.; Arsenyeva Y.A.; Podoksenov Y.K.;
Kravchenko I.V.; Kozulin M.S.; Tyo M.A.; Churilina E.A.; Kim E.B.; Svirko
Y.S.; Kozlov B.N.; Boshchenko A.A.
Institution
(Kalashnikova, Kamenshchikov, Arsenyeva, Podoksenov, Kravchenko, Kozulin,
Tyo, Churilina, Kim, Svirko, Kozlov, Boshchenko) Cardiology Research
Institute, Tomsk National Research Medical Center, Russian Academy of
Sciences, Tomsk, Russian Federation
Abstract
OBJECTIVE: This study aimed to assess the safety and potential efficacy of
high-dose inhaled nitric oxide therapy for the prevention of postoperative
pneumonia in cardiac surgery patients. METHOD(S): A prospective
randomised controlled pilot study included 74 patients with moderate risk
of postoperative pneumonia after elective cardiac surgery under
cardiopulmonary bypass. Patients were randomised into two groups. The main
group (NO-group) (n = 37) received inhaled nitric oxide at a dose of 200
ppm for 30 minutes 2 times a day for 5 days or until pneumonia developed.
The control group received conventional postoperative care (n = 37). The
primary endpoint was the incidence of postoperative pneumonia during
in-hospital stay. RESULT(S): Preventive nitric oxide inhalations were
associated with a reduced incidence of postoperative nosocomial pneumonia
(2 (5.4%) cases in the main group (NO-group) vs. 9 (24.3%) cases in the
control group, p = 0.046; OR = 0.178, 95% CI = 0.036-0.89)). There was no
decrease in either peak expiratory flow, or peak inspiratory flow in
comparison with the preoperative values in the NO-group. Inhaled nitric
oxide therapy is safe. It did not lead to an increase in the incidence of
acute kidney injury. CONCLUSION(S): High-dose inhaled nitric oxide
therapy is safe and effective for the prevention of postoperative
nosocomial pneumonia in cardiac surgery.

<166>
Accession Number
2037753435
Title
Intrapleural Fibrinolytics Versus Thoracic Surgery for Complicated Pleural
Infections: A Systematic Review and Meta-Analysis.
Source
Heart Lung and Circulation. (no pagination), 2025. Date of Publication:
2025.
Author
Rodrigues A.L.S.D.O.; Salomao I.F.A.; Scabello I.F.; Vieira C.M.;
Cavalcante D.V.S.; de Melo Neto G.J.; de Lima D.P.; de Carvalho R.L.C.
Institution
(Rodrigues, Scabello, de Lima, de Carvalho) University Center of Joao
Pessoa (UNIPE), Paraiba, Joao Pessoa, Brazil
(Salomao) Department of Anesthesiology, Hospital Regional Unimed Missoes,
Santo Angelo, Brazil
(Vieira) Federal University of Amazonas (UFAM), Amazonas, Manaus, Brazil
(Cavalcante) Federal University of Maranhao (UFMA), Sao Luis - Maranhao,
Brazil
(de Melo Neto) University Center Facid (UniFacid), Teresina, Brazil
(de Lima, de Carvalho) Department of Thoracic Surgery, Hospital
Metropolitano Dom Jose Maria Pires Joao Pessoa, Paraiba, Brazil
Publisher
Elsevier Ltd
Abstract
Background: Intrapleural fibrinolytic therapy (IPFT) is an option for
complicated pleural effusion (CPE). However, concerns remain about its use
compared with thoracic surgery (TS). Therefore, we conducted a systematic
review and meta-analysis to assess the length of stay associated with IPFT
compared to TS in treating CPE. Method(s): We searched PubMed,
Embase, and Cochrane Library databases for studies that compared TS with
IPFT in patients with complicated pleural infections. We used a
random-effects model with a 95% confidence interval (CI) to pool the data.
R version 4.4.1 was used for statistical analysis and heterogeneity was
examined using I2 statistics. Result(s): A total of 16
studies, including 13 randomised controlled trials, involving a total of
764 were analysed. Of whom, 40% underwent IPFT. The success rate was
higher in the TS group (odds ratio 0.3; 95% CI 0.11-0.78; p=0.014;
I2=47%), and had a significantly shorter length of stay (mean
difference 2.76; 95% CI 1.40-4.13; p<0.001; I2=92%) compared
with the IPFT group. There were no statistical differences between groups
in the mortality endpoint. Considering only the paediatric population,
there were also no statistically significant differences for length of
stay (mean difference 1.32; 95% CI -2.37 to 5.01; p=0.08;
I2=91%) or success rates (odds ratio 0.86; 95% CI 0.27-2.74;
p=0.74; I2=0%). Conclusion(s): Our findings suggest that
TS is an effective treatment for pleural infections. There is no
significant increase in adverse events, and both treatments are equally
effective and safe. Copyright © 2024 Australian and New Zealand
Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society
of Australia and New Zealand (CSANZ)

<167>
Accession Number
2037745280
Title
A systematic review and meta-analysis of the hemodynamics and outcomes of
the Myval balloon-expandable valve in patients with severe aortic stenosis
and with aortic regurgitation.
Source
IJC Heart and Vasculature. 58 (no pagination), 2025. Article Number:
101641. Date of Publication: 01 Jun 2025.
Author
Hasabo E.A.; Aboali A.A.; Hemmeda L.; Elgadi A.; Alrawa S.S.; Ahmed A.S.;
Abdalmotalib M.M.; Eissa A.Y.H.; Fadelallah Eljack M.M.; Sultan S.;
Soliman O.
Institution
(Hasabo, Soliman) Royal College of Surgeons in Ireland (RCSI) University
of Medicine and Health Sciences, Dublin, Ireland
(Hasabo, Soliman) Precision Cardiovascular Medicine & Innovation Institute
(PCMI), Cardiovascular Research Institute Dublin (CVRI), Mater Private
Network, Eccles Street, Dublin, Ireland
(Aboali) Damanhour Teaching Hospital, General Organization for Teaching
Hospitals and Institutes, Damanhour, Egypt
(Aboali) Faculty of Medicine, Alexandria University, Alexandria, Egypt
(Hemmeda, Elgadi, Alrawa, Ahmed, Abdalmotalib, Eissa) Faculty of Medicine,
University of Khartoum, Khartoum, Sudan
(Fadelallah Eljack) Faculty of Medicine, University of Bakht Alruda, Al
Dwuaym, Sudan
(Sultan) Department of Vascular and Endovascular Surgery, Western Vascular
Institute, University College Hospital, Galway, Ireland
(Soliman) Euro Heart Foundation, Netherlands
Publisher
Elsevier Ireland Ltd
Abstract
Introduction: Transcatheter aortic valve implantation (TAVI) has been
growing rapidly. We aim to evaluate the performance and outcomes of the
Myval transcatheter heart valve (THV) in patients with severe aortic
stenosis and its use in quantitative videodensimetry, transcatheter
valve-in-valve (ViV), and non-calcified aortic regurgitation (NCAR).
 Method(s): A systematic search was done in PubMed, Scopus, Web of
Science, Embase, and Cochrane from inception to October 2024. We used the
relevant keywords to include studies that reported the outcomes of
patients with severe aortic stenosis who underwent TAVI using the Myval
THV and off-label usage in transcatheter ViV and NCAR. Data analysis was
done using R software. Result(s): A total of 29 studies were included
in this study. The results of the mean aortic gradient at discharge,
30-day, one-year, and 2-year were 9.25 mmHg (95 % CI [8.20, 10.29]), 8.46
(95 % CI [7.57, 9.34]). 10.63 (95 % CI [9.12, 12.14]), and 7.2 (95 % CI
[6.78, 7.63]), respectively. Additionally, the pooled percentages of
patients with >= moderate aortic regurgitation were found in 1 % (95 % CI
[1,2]) at discharge, 3 % (95 % CI [2,4]) at 30-day, 4 % (95 % CI [2,7]) at
one-year follow-up and 5 % (95 % CI [3,8]) at 2-year. Furthermore, usage
of the Myval THV in transcatheter ViV and NCAR led to a reduction in mean
aortic gradient and incidence of aortic regurgitation, respectively.
 Conclusion(s): The Myval THV showed good safety and efficacy outcomes
in short- and long-term follow-ups following the TAVI. Also, it showed
promising results during transcatheter ViV and NCAR. Copyright ©
2025 The Author(s)

<168>
Accession Number
2037749519
Title
Right Ventricular Dysfunction in Cardiac Anesthesia: Perioperative
Assessment and Underlying Mechanisms.
Source
Reviews in Cardiovascular Medicine. 26(2) (no pagination), 2025. Article
Number: 26286. Date of Publication: 01 Feb 2025.
Author
Hori K.; Watanabe R.; Tsujikawa S.; Hino H.; Matsuura T.; Mori T.
Institution
(Hori, Watanabe, Tsujikawa, Hino, Matsuura, Mori) Department of
Anesthesiology, Osaka Metropolitan University, Graduate School of
Medicine, Osaka, Japan
Publisher
IMR Press Limited
Abstract
The importance of right ventricular (RV) function has often been
overlooked until recently; however, RV function is now recognized as a
significant prognostic predictor in medically managing cardiovascular
diseases and cardiac anesthesia. During cardiac surgery, the RV is often
exposed to stressful conditions that could promote perioperative RV
dysfunction, such as insufficient cardioplegia, volume overload, pressure
overload, or pericardiotomy. Recent studies have shown that RV dysfunction
during cardiac anesthesia could cause difficulty in weaning from
cardiopulmonary bypass or even poor postoperative outcomes. Severe
perioperative RV failure may be rare, with an incidence rate ranging from
0.1% to 3% in the surgical population; however, in patients who are
hemodynamically unstable after cardiac surgery, almost half reportedly
present with RV dysfunction. Notably, details of RV function, particularly
during cardiac anesthesia, remain largely unclear since long-standing
research has focused predominantly on the left ventricle (LV). Thus, this
review aims to provide an overview of the current perspective on the
perioperative assessment of RV dysfunction and its underlying mechanisms
in adult cardiac surgery. This review provides an overview of the basic RV
anatomy, physiology, and pathophysiology, facilitating an understanding of
perioperative RV dysfunction; the most challenging aspect of studying
perioperative RV is assessing its function accurately using the limited
modalities available in cardiac surgery. We then summarize the currently
available methods for evaluating perioperative RV function, focusing on
echocardiography, which presently represents the most practical tool in
perioperative management. Finally, we explain several perioperative
factors affecting RV function and discuss the possible mechanisms
underlying RV failure in cardiac surgery. Copyright © 2025 The
Author(s).

<169>
Accession Number
646683309
Title
Impact of Chronic Inflammatory Diseases on Clinical Outcomes in Patients
undergoing Aortic Valve Replacement: A Systematic Review and
Meta-analysis.
Source
Angiology. (pp 33197251322934), 2025. Date of Publication: 26 Feb 2025.
Author
Theodoropoulou T.; Apostolos A.; Ktenopoulos N.; Koliastasis L.;
Tsalamandris S.; Mourouzis I.; Pantos C.; Tsioufis K.; Toutouzas K.
Institution
(Theodoropoulou, Apostolos, Ktenopoulos, Koliastasis, Tsalamandris,
Tsioufis, Toutouzas) Unit for Structural Heart Diseases and
Valvulopathies, First Department of Cardiology, Athens School of Medicine,
Hippokration Hospital, Athens, Greece
(Mourouzis, Pantos) Department of Pharmacology, National and Kapodistrian
University of Athens, Athens, Greece
Abstract
Patients with autoimmune chronic inflammatory disease (CID) are at an
increased risk of valvular heart disease, including aortic valve stenosis,
insufficiency, or both. The impact of CID on the prognosis of surgical or
transcatheter aortic valve replacement (AVR) remains unclear. This
meta-analysis aims to evaluate the impact of CID on major clinical
outcomes in this population. A comprehensive literature search of PubMed,
Cochrane, and Embase databases was conducted to identify relevant studies.
The primary endpoint was 30-day all-cause mortality between patients with
CID and controls. Secondary endpoints included, long-term all-cause
mortality, stroke and in-hospital infection. Statistical analysis included
Risk Ratio (RR) with 95% confidence interval (CI) using the random-effects
model. Five studies involving 572,351 patients were included in the
meta-analysis. Patients with CID had a greater 30-day mortality (RR =
1.17, 95% CI: 1.09, 1.27; P < .001) and a higher rate of in-hospital
infection (RR = 2.13, 95% CI: 1.03, 4.41; P < .001). No differences were
observed in the other secondary endpoints. Patients with CID are at an
increased risk of short-term all-cause mortality and in-hospital
infections after AVR. Further studies are required to validate our results
and define the optimal management of these patients.

<170>
Accession Number
2033490625
Title
Non-fasting versus fasting before percutaneous cardiac procedures: a
systematic review and meta-analysis of randomized controlled trials.
Source
Perioperative Medicine. 14(1) (no pagination), 2025. Article Number: 24.
Date of Publication: 01 Dec 2025.
Author
Balbaa E.; Ibrahim A.A.; Bazzazeh M.; Tabassum S.; Ramadan S.; Gadelmawla
A.F.; Elshimy A.; Altobaishat O.; Abuelazm M.
Institution
(Balbaa, Bazzazeh, Elshimy) Faculty of Medicine, Alexandria University,
Alexandria, Egypt
(Ibrahim, Gadelmawla) Faculty of Medicine, Menoufia University, Menoufia,
Egypt
(Tabassum) Department of Medicine, King Edward Medical University, Lahore,
Pakistan
(Ramadan) Faculty of Medicine, Ain Shams University, Cairo, Egypt
(Altobaishat) Faculty of Medicine, Jordan University of Science and
Technology, Irbid, Jordan
(Abuelazm) Faculty of Medicine, Tanta University, Tanta, Egypt
Publisher
BioMed Central Ltd
Abstract
Background and objective: Despite the absence of scientific evidence,
fasting before percutaneous cardiac catheterization is still recommended
to minimize complications. This systematic review and meta-analysis aimed
to compare the outcomes of non-fasting protocols in patients undergoing
percutaneous cardiac procedures. Material(s) and Method(s): A
systematic search of PubMed, Scopus, WOS, Embase, and Cochrane was
conducted until September 2024. Dichotomous outcomes were pooled using
risk ratio (RR), while continuous outcomes were pooled using standardized
mean difference (SMD). PROSPERO ID: CRD42024586147. Result(s): Five
RCTs with 2034 patients were included. There was no significant difference
between both groups regarding patient satisfaction score [SMD - 0.65, 95%
CI (- 1.39, 0.09), P = 0.08], intra/postoperative aspiration (RR 1.00, 95%
CI [0.20, 4.96], P = 1.00), postprocedural pneumonia (RR 0.60, 95% CI
[0.14, 2.51], P = 0.49), emergency endotracheal intubation (RR 0.99, 95%
CI [0.10, 9.51], P = 1.00), nausea/vomiting (RR 0.89, 95% CI [0.46, 1.76],
P = 0.75), anti-emetic use (RR 0.49, 95% CI [0.24, 1.03], P = 0.06),
hypoglycemia (RR 0.74, 95% CI [0.43, 1.28], P = 0.28), and the need for
inotrope/vasopressor therapy (RR 1.03, 95% CI [0.81, 1.30], P = 0.82).
However, the non-fasting approach significantly decreased the sensation of
tiredness/fatigue (SMD - 0.31 with 95% CI [- 0.51, - 0.11], P < 0.001).
 Conclusion(s): The non-fasting protocol demonstrated comparable
efficacy, safety, and overall satisfaction to the conventional fasting
approach. Review registration : PROSPERO CRD42024586147. Copyright
© The Author(s) 2025.

<171>
Accession Number
2033511068
Title
Venous excess ultrasound score association with acute kidney injury in
critically ill patients: a systematic review and meta-analysis of
observational studies.
Source
Ultrasound Journal. 17(1) (no pagination), 2025. Article Number: 16. Date
of Publication: 01 Dec 2025.
Author
Melo R.H.; Gioli-Pereira L.; Melo E.; Rola P.
Institution
(Melo, Gioli-Pereira, Melo) Hospital Municipal Vila Santa Catarina
Dr.Gilson de Cassia Marques de Carvalho; Hospital Israelita Albert
Einstein, Av. Santa Catarina, 2785 - Vila Santa Catarina, SP, Sao Paulo,
Brazil
(Rola) University of Montreal, Montreal, Canada
Publisher
Springer-Verlag Italia s.r.l.
Abstract
Background: Systemic venous congestion assessed by the venous excess
ultrasound score (VExUS), has been associated with acute kidney injury
(AKI) in patients undergoing cardiac surgery. However, there is a lack of
evidence of this association in the general critically ill patients. Study
Design and Methods: PubMed, Embase, and Cochrane databases were searched
for observational prospective studies that included critically ill
patients and analyzed VExUS score on the first day of admission to the
ICU. The main outcome was occurrence of AKI. Secondary outcome was
all-cause mortality. Statistical analysis was performed using Review
Manager 5.4.1. Odds ratios (OR) with 95% confidence interval were pooled
using a random-effects model. The Quality in Prognosis Studies (QUIPS)
tool was used to assess risk of bias. Publication bias was assessed via
funnel plot and heterogeneity was examined with I2 statistics.
 Result(s): Our analysis included 1036 patients from nine studies, of
whom 17.4% presented venous congestion according to VExUS definition. In
critically ill patients presenting with venous congestion (VExUS score >=
2), the incidence of AKI was significantly higher as compared with those
without congestion (OR 2.63, 95% CI 1.06-6.54; p = 0.04; I2 =
74%). The association was notably stronger in cardiac surgery patients (OR
3.86, 95% CI 2.32-6.42; p < 0.00001; i2 = 0%). There was no
significant association between venous congestion and all-cause mortality
(OR 1.25, 95% CI 0.71-2.19; p = 0.44; i2 = 8%).
 Conclusion(s): These findings suggest that VExUS score may correlate
with an elevation in the incidence AKI in critically ill patients, with a
more pronounced effect observed within the subgroup of patients undergoing
cardiac surgery. There was no statistically significant association
between VExUS score and all-cause mortality. Clinical Trial Registration:
PROSPERO under protocol number CRD535513. Copyright © The
Author(s) 2025.

<172>
Accession Number
2035865498
Title
Preoperative liraglutide modulates control of fat and glucose metabolism
during cardiopulmonary bypass surgery.
Source
Endocrine Connections. 14(4) (no pagination), 2025. Article Number:
e240427. Date of Publication: 01 Apr 2025.
Author
van Wilpe R.; Hulst A.H.; Thiessen S.E.; Devries J.H.; Preckel B.;
Hermanides J.
Institution
(van Wilpe, Hulst, Preckel, Hermanides) Department of Anesthesiology,
Amsterdam UMC, Location AMC, University of Amsterdam, Amsterdam,
Netherlands
(Preckel, Hermanides) Amsterdam Public Health Research Institute,
Amsterdam UMC, Amsterdam, Netherlands
(Hulst) Amsterdam Cardiovascular Sciences Research Institute, Amsterdam
UMC, Amsterdam, Netherlands
(Thiessen) Critical Care Department, Ziekenhuis Oost-Limburg, Genk,
Belgium
(Devries) Department of Endocrinology, Amsterdam UMC, Location AMC,
University of Amsterdam, Amsterdam, Netherlands
(Hulst, Devries, Hermanides) Amsterdam Gastroenterology Endocrinology
Metabolism, Amsterdam UMC, Amsterdam, Netherlands
Publisher
BioScientifica Ltd.
Abstract
Introduction: Glucagon-like peptide-1 receptor agonists reduce insulin
requirements and improve glucose control when administered before cardiac
surgery. An increase in endogenous insulin release is the most likely
mechanism, but this has never been studied in the setting of cardiac
surgery. We hypothesized that liraglutide increases pancreatic insulin
secretion during cardiac surgery with cardiopulmonary bypass (CPB).
 Method(s): We performed a planned prospective substudy of a
multicenter randomized-controlled trial (GLOBE trial, NTR6323). Patients
undergoing cardiac surgery with CPB were randomized to receive either two
preoperative subcutaneous injections of liraglutide or a matching placebo.
We measured hormone concentrations before and after surgery, including
insulin, glucagon, C-peptide and free fatty acid (FFA), and calculated
HOMA-B, HOMA-IR and insulin/glucagon ratios. We compared between-group and
before and after surgery differences in outcomes. Result(s):
Metabolic hormone concentrations were measured in 37 participants. HOMA-B
revealed that liraglutide increased insulin secretion relative to glycemia
(258 +/- 179 vs 116 +/- 180, difference (95% CI): 142 (24-261), P =
0.004). While insulin, C-peptide and glucagon levels did not differ
significantly between groups, the insulin/glucagon ratios were
significantly higher in the liraglutide group (preoperatively: 1.09 +/-
0.45 vs 0.79 +/- 0.35 difference (95% CI):-0.30 (-0.57 to-0.03), P =
0.039). Overall, postoperative insulin levels decreased >60% from
preoperative insulin levels (55 +/- 31 to 21 +/- 9.8, difference (95%
CI):-29 (-36 to-22), P < 0.001). Conclusion(s): Preoperative
liraglutide administration increased beta-cell function, measured as
HOMA-B, and higher insulin/ glucagon ratios. These results could explain
the lower glucose and FFA concentrations in the liraglutide-treated
patients. Interestingly, in both groups, we observed a remarkable drop in
insulin and other hormone levels over the course of surgery. Copyright
© 2025 the author(s).

<173>
Accession Number
646679059
Title
Evaluating the Appropriate Use Criteria for Coronary Revascularization in
Stable Ischemic Heart Disease Using Randomized Data From the ISCHEMIA
Trial.
Source
Circulation. Cardiovascular quality and outcomes. (pp e010849), 2025.
Date of Publication: 26 Feb 2025.
Author
Slater J.; Maron D.J.; Jones P.G.; Bangalore S.; Reynolds H.R.; Fu Z.;
Stone G.W.; Kirby R.; Hochman J.S.; Spertus J.A.
Institution
(Slater, Bangalore, Reynolds, Hochman) NYU Grossman School of Medicine,
S.B., NY, United States
(Maron) Department of Medicine, Stanford University School of Medicine
(Jones, Fu, Spertus) University of Missouri - Kansas City (UMKC)'s
Healthcare Institute for Innovations in Quality and Saint Luke's Mid
America Heart Institute (P.G.J., J.A.S
(Stone) Icahn School of Medicine at Mount Sinai, NY, United States
(Kirby) National Heart Lung and Blood Institute, National Institutes of
Health, Bethesda, United States
Abstract
BACKGROUND: The appropriate use criteria for revascularization of stable
ischemic heart disease have not been evaluated using randomized data.
Using data from the randomized ISCHEMIA trial (International Study of
Comparative Health Effectiveness with Medical and Invasive Approaches;
July 2012 to January 2018, 37 countries), the health status benefits of an
invasive strategy over a conservative one were examined within appropriate
use criteria scenarios. METHOD(S): Among 1833 participants mapped to
36 appropriate use criteria scenarios, symptom status was assessed using
the Seattle Angina Questionnaire-7 at 1 year for each scenario and for
each of the 6 patient characteristics used to define the scenarios.
Coronary anatomy and SYNTAX(Synergy between percutaneous coronary
intervention with Taxus and cardiac surgery) scores were measured using
coronary computed tomography angiography. Treatment effects are expressed
as an odds ratio for a better health status outcome with an invasive
versus conservative treatment strategy using Bayesian hierarchical
proportional odds models. Differences in the primary clinical outcome were
similarly examined. RESULT(S): The mean age was 63 years, 81% were
male, and 71% were White. Diabetes was present in 28% and multivessel
disease in 51%. Most clinical scenarios favored invasive for better 1-year
health status. The benefit of an invasive strategy on Seattle Angina
Questionnaire angina frequency scores was reduced for asymptomatic
patients (odds ratio [95% credible interval], 1.16 [0.66-1.71] versus 2.26
[1.75-2.80]), as well as for those on no antianginal medications.
Diabetes, number of diseased vessels, proximal left anterior descending
coronary artery location, and SYNTAX score did not effectively identify
patients with better health status after invasive treatment, and minimal
differences in clinical events were observed. CONCLUSION(S): Applying
the randomization scheme from the ISCHEMIA trial to appropriate clinical
scenarios revealed baseline symptoms and antianginal therapy to be the
primary drivers of health status benefits from invasive management.
Consideration should be given to reducing the patient characteristics
collected to generate appropriateness ratings to improve the feasibility
of future data collection. REGISTRATION: URL:
https://www.clinicaltrials.gov; Unique identifier: NCT01471522.

<174>
Accession Number
646685642
Title
2025 ACC/AHA/ACEP/NAEMSP/SCAI Guideline for the Management of Patients
With Acute Coronary Syndromes: A Report of the American College of
Cardiology/American Heart Association Joint Committee on Clinical Practice
Guidelines.
Source
Journal of the American College of Cardiology. (no pagination), 2025.
Date of Publication: 27 Feb 2025.
Author
Rao S.V.; O'Donoghue M.L.; Ruel M.; Rab T.; Tamis-Holland J.E.; Alexander
J.H.; Baber U.; Baker H.; Cohen M.G.; Cruz-Ruiz M.; Davis L.L.; de Lemos
J.A.; DeWald T.A.; Elgendy I.Y.; Feldman D.N.; Goyal A.; Isiadinso I.;
Menon V.; Morrow D.A.; Mukherjee D.; Platz E.; Promes S.B.; Sandner S.;
Sandoval Y.; Schunder R.; Shah B.; Stopyra J.P.; Talbot A.W.; Taub P.R.;
Williams M.S.; Jneid H.; Beavers C.J.; Merchant F.M.; Beckie T.; Nazir N.;
Blankenship J.; So D.; Diercks D.; Tomey M.; Lo B.; Welt F.; Louis C.
Abstract
AIM: The "2025 ACC/AHA/ACEP/NAEMSP/SCAI Guideline for the Management of
Patients With Acute Coronary Syndromes" incorporates new evidence since
the "2013 ACCF/AHA Guideline for the Management of ST-Elevation Myocardial
Infarction" and the corresponding "2014 AHA/ACC Guideline for the
Management of Patients With Non-ST-Elevation Acute Coronary Syndromes" and
the "2015 ACC/AHA/SCAI Focused Update on Primary Percutaneous Coronary
Intervention for Patients With ST-Elevation Myocardial Infarction." The
"2025 ACC/AHA/ACEP/NAEMSP/SCAI Guideline for the Management of Patients
With Acute Coronary Syndromes" and the "2021 ACC/AHA/SCAI Guideline for
Coronary Artery Revascularization" retire and replace, respectively, the
"2016 ACC/AHA Guideline Focused Update on Duration of Dual Antiplatelet
Therapy in Patients With Coronary Artery Disease." METHODS: A
comprehensive literature search was conducted from July 2023 to April
2024. Clinical studies, systematic reviews and meta-analyses, and other
evidence conducted on human participants were identified that were
published in English from MEDLINE (through PubMed), EMBASE, the Cochrane
Library, Agency for Healthcare Research and Quality, and other selected
databases relevant to this guideline. STRUCTURE: Many recommendations from
previously published guidelines have been updated with new evidence, and
new recommendations have been created when supported by published
data. Copyright © 2025 American College of Cardiology Foundation,
and the American Heart Association, Inc. Published by Elsevier Inc. All
rights reserved.

<175>
Accession Number
2037712271
Title
Connections Between Oxidative Stress, Inflammation, and Cardiovascular
Risk Factors in CABG Patients Undergoing Remote Ischemic Preconditioning.
Source
Romanian Journal of Cardiology / Revista Romana de Cardiologie. (no
pagination), 2025. Date of Publication: 2025.
Author
Luca C.; Boieriu A.; Neculoiu D.; Tint D.
Institution
(Luca, Boieriu, Neculoiu, Tint) Facuty of Medicine, Transilvania
University, Brasov, Romania
(Luca) Cardiovascular Rehabilitation Hospital, Dr. Benedek Geza,
Cardiology Department, Covasna, Romania
(Boieriu) Emergency Clinical County Hospital, Cardiology Department,
Brasov, Romania
(Neculoiu) Emergency Clinical County Hospital, Clinical Laboratory
Department, Brasov, Romania
(Tint) Clinicco Hospital, Cardiology Department, Brasov, Romania
Publisher
Sciendo
Abstract
Background: Coronary artery bypass grafting (CABG) is a common treatment
for advanced coronary artery disease (CAD), but it often exacerbates
oxidative stress and inflammation, heightening cardiovascular risk and
negatively affecting health outcomes. Remote ischemic preconditioning
(RIPC), a novel intervention, offers potential cardioprotective effects by
modulating oxidative and inflammatory pathways. However, the impact of
RIPC on biomarkers associated with oxidative stress and inflammation, and
its broader implications for cardiovascular risk, remain unclear. This
study explores the influence of RIPC on key biomarkers in patients with
severe CAD undergoing CABG. We conducted a case-control study involving 80
severe CAD patients scheduled for CABG. Participants were divided equally
into experimental (RIPC-treated) and control groups. Biomarkers -
Superoxide dismutase-1 (SOD-1), IL-1, and IL-6 - were measured via ELISA
at three stages: pre-surgery (V1), immediately post-surgery (V2), and one
week after surgery (V3). Both groups were similar at baseline. The RIPC
group demonstrated significant increases in SOD-1 levels and reductions in
IL-1 and IL-6 levels compared to controls at V2 and V3 (p < 0.05). These
findings highlight RIPC's ability to mitigate oxidative stress and
inflammation during and after CABG. RIPC effectively enhances
antioxidative defenses (SOD-1) and reduces inflammation (IL-1, IL-6),
suggesting its potential to improve outcomes in CABG patients. Further
investigation could establish RIPC as a valuable cardioprotective approach
in clinical practice. Copyright © 2025 Cezar Luca et al.,
published by Sciendo.

<176>
Accession Number
646678981
Title
Effects of Different Exercise Interventions on Fall Risk and Gait
Parameters in Frail Patients After Open Heart Surgery: A Pilot Study.
Source
Medicina (Kaunas, Lithuania). 61(2) (no pagination), 2025. Date of
Publication: 24 Jan 2025.
Author
Stonkuviene V.; Kubilius R.; Lendraitiene E.
Institution
(Stonkuviene, Kubilius, Lendraitiene) Department of Rehabilitation,
Faculty of Nursing, Medical Academy, Lithuanian University of Health
Sciences, Kaunas, Lithuania
Abstract
Background and Objectives: Research on the effectiveness of different
exercise programs on reducing fall risk and improving gait parameters
among frail patients after open heart surgery is scarce. Therefore, the
aim of this study was to evaluate and compare the effects of different
exercise interventions on fall risk and gait parameters in frail patients
after open heart surgery during inpatient rehabilitation. Material(s)
and Method(s): A prospective randomized study was conducted at Kulautuva
Hospital of Rehabilitation, Hospital of Lithuanian University of Health
Sciences Kauno Klinikos, from July 2021 to November 2023. A total of 105
pre-frail and frail patients were randomized into three groups: control
(CG, n = 35), intervention 1 (IG-1, n = 35), and intervention 2 (IG-2, n =
35). All three groups completed a conventional rehabilitation program that
included aerobic training tailored based on each person's health status
six times/week. The IG-1 additionally received multicomponent dynamic
aerobic balance and strength training three times/week, and the IG-2
received a combined computer-based interactive program three times/week.
The overall stability index, as an outcome of fall risk, Short Physical
Performance Battery (SPPB) score, and gait parameters (geometry, stance,
and timing) were assessed before and after rehabilitation. Result(s):
Of the 105 patients, 87 completed the study. The median age of the
patients was 71 years (range: 65-88); 64.76% were male. After
rehabilitation, within-group comparisons showed a significant improvement
in the overall stability index, SPPB, and all phase gait parameters in all
groups. Of all geometry gait parameters, none of the groups showed a
significant improvement in step width, and foot rotation was significantly
reduced only in the IG-2. All timing gait parameters improved in the CG
and IG-2 after rehabilitation, while in the IG-1, only gait speed was
significantly improved. Between-group comparisons after rehabilitation
revealed significant differences in the overall stability index among the
groups and in all phase gait parameters except for stance phase between
the IG-1 and the IG-2. The greatest significant difference was documented
for the double stance phase between the IG-1 and the IG-2, and the
smallest was recorded for the single limb support phase. Significantly
greater differences in step time and stride time were found in the IG-1
and the IG-2 than in the CG. Conclusion(s): All applied interventions
were effective in reducing fall risk based on the overall stability index.
However, interactive exercise interventions decreased fall risk based on
the overall stability index by one-fifth as compared to the conventional
rehabilitation program. The incorporation of interactive exercise
interventions in rehabilitation resulted in improved double stance phase,
stride time, and step time parameters, but did not have any effect on gait
speed as compared to other exercise interventions.

<177>
Accession Number
2033519875
Title
Impact of single-port versus three-port video-assisted thoracic surgery
lobectomy on postoperative pain and quality of life in early-stage
non-small cell lung cancer patients: a meta-analysis.
Source
BMC Cancer. 25(1) (no pagination), 2025. Article Number: 400. Date of
Publication: 01 Dec 2025.
Author
Zhang L.; Luo J.; Wu X.
Institution
(Zhang, Luo) Department of Cardiothoracic Surgery, Mianyang Central
Hospital, Sichuan Province, Mianyang City, China
(Wu) Department of Obstetrics and Gynecology, Mianyang Central Hospital,
No. 12, Changjia Lane, Jinzhong Street, Fucheng District, Sichuan
Province, Mianyang City, China
Publisher
BioMed Central Ltd
Abstract
Objective: This meta-analysis aims to evaluate the impact of these two
techniques on postoperative pain and quality of life in early-stage NSCLC
patients. Method(s): A comprehensive literature search was conducted
in PubMed, Cochrane Library, Web of Science, and CNKI databases.
Randomized controlled trials and cohort studies comparing single-port and
three-port VATS lobectomy for early-stage NSCLC were included. The primary
outcomes were operating time, postoperative complications, and 24-hour
postoperative visual analog scale (VAS) pain scores. The Newcastle-Ottawa
Scale (NOS) was used to assess study quality. Meta-analysis was performed
using random-effects models, and heterogeneity was assessed using the I2
statistic. Result(s): Fifteen studies involving 3,228 patients (801
in the single-port group and 2427 in the three-port group) were included.
The meta-analysis revealed that single-port VATS lobectomy was associated
with a longer operating time (SMD: 0.61, 95% CI: 0.29 to 0.93, p < 0.001)
compared to the three-port approach. However, single-port VATS
demonstrated a lower incidence of postoperative complications (RR: 0.73,
95% CI: 0.59 to 0.90, p < 0.001). There was no significant difference in
24-hour postoperative VAS pain scores between the two groups (SMD: 0.02,
95% CI: -1.41 to 1.45, p > 0.05), although substantial heterogeneity was
observed (I2 = 98.1%). Conclusion(s): This meta-analysis suggests
that single-port VATS lobectomy may offer advantages in terms of reduced
postoperative complications compared to the three-port approach, despite
longer operating times. However, the impact on immediate postoperative
pain remains inconclusive due to high heterogeneity among
studies. Copyright © The Author(s) 2025.

<178>
Accession Number
2037721388
Title
The MATTERHORN trial: Percutaneous MitraClip vs surgical repair in
heart-failure-related secondary mitral regurgitation.
Source
Global Cardiology Science and Practice. 2025(1) (no pagination), 2025.
Article Number: 2. Date of Publication: 2025.
Author
Kotit S.
Institution
(Kotit) Aswan Heart Centre (AHC), Aswan, Egypt
Publisher
HBKU Press
Abstract
Introduction: Functional mitral regurgitation (FMR) is a common
complication of heart failure and is associated with poor prognosis and
increased morbidity and mortality. Surgical mitral valve repair (MVRe) and
MitraClip transcatheter edge-to-edge repair (M-TEER) are used to improve
FMR, however, there has not been sufficient comparison between the
benefits of both approaches. The MATTERHORN trial aimed to compare the
efficacy and safety outcomes of percutaneous versus surgical repair in
high-risk patients with heart failure and FMR, to determine the
noninferiority of transcatheter edge-to-edge therapy in this population.
Study and results: 208 patients were randomized in a 1:1 ratio to either
M-TEER with MitraClip device or surgical mitral valve repair or
replacement. The average age was 70.5+/-7.9 years, 39.9% were female, mean
LVEF was 43.0 +/-11.7%, 85.7% of patients had NYHA class III or IV, 96.0%
had Mitral regurgitation grade >=3, 38.2% had grade 4+, median effective
regurgitant orifice area was 0.22cm2 and the mean regurgitant
fraction was 57.0+/-21.0%. Successful repair was seen in 96.1% in the
M-TEER group and 98.6% in the surgery group. At 1 year, at least one
primary endpoint event (death, hospitalization for heart failure, mitral
valve re-intervention, implantation of an assist device, or stroke)
occurred in 16.7% of the M-TEER group and 22.5% of the surgery group.
All-cause death occurred in 8.3% and 10.3% of patients, respectively.
Recurrence of MR grade >=3 at 1 year and mitral valve reintervention was
8.9% and 5% in the M-TEER group and 1.5% and 2% in the surgical group,
respectively. Overall, 41.0% of the patients in the intervention group and
77.3% in the surgery group had at least one adverse event, of which 35%
and 66%, respectively, were serious. Lessons learned: Transcatheter
edge-to-edge repair demonstrated noninferiority to surgery for a composite
of death, rehospitalization for heart failure, stroke, reintervention, or
assist device implantation at 1-year. M-TEER exhibited significantly fewer
major adverse events within 30 days post-procedure, albeit with a slightly
higher MR recurrence rate at one year. This study underscores the
potential of M-TEER as a less-invasive, yet effective, alternative to
surgery for FMR, mitigating surgical risks and offering a faster recovery
path, especially for patients deemed unsuitable for surgery. However,
long-term data is crucial for guiding policies. Copyright © 2025
HBKU Press. All rights reserved.

<179>
Accession Number
646679557
Title
Ultrasound-guided ulnar versus radial artery cannulation in children
undergoing major non-cardiac surgery: a randomized controlled
non-inferiority trial.
Source
Minerva anestesiologica. (no pagination), 2025. Date of Publication: 26
Feb 2025.
Author
Sarhan K.A.; Mohamed R.; El Ghobashy M.; Elkholy M.; Alkonaiesy R.; Nawwar
K.; Seif N.
Institution
(Sarhan) Department of Anesthesia and Critical Care Medicine, Faculty of
Medicine, Cairo University, Cairo, Egypt
(Mohamed, Elkholy, Alkonaiesy, Nawwar, Seif) Department of Anesthesia and
Critical Care Medicine, Faculty of Medicine, Cairo University, Cairo,
Egypt
(El Ghobashy) Radiology Department, Cairo University, Cairo, Egypt

<180>
Accession Number
2037738077
Title
Clinical impact of CCT-FFR as first-strategy in patients with symptomatic
stable coronary artery disease: A systematic review and meta-analysis.
Source
Journal of Cardiovascular Computed Tomography. (no pagination), 2025.
Date of Publication: 2025.
Author
Di Pietro G.; Improta R.; De Filippo O.; Bruno F.; Birtolo L.I.; Bruno E.;
Galea N.; Francone M.; Dewey M.; D'Ascenzo F.; Mancone M.
Institution
(Di Pietro, Improta, Birtolo, Bruno, Mancone) Department of Clinical,
Internal, Anesthesiological and Cardiovascular Sciences, Umberto I
Hospital, La Sapienza University of Rome, Italy
(De Filippo, Bruno, D'Ascenzo) Division of Cardiology, Cardiovascular and
Thoracic Department, AOU Citta della Salute e della Scienza di Torino and
Department of Medical Sciences, University of Turin, Italy
(Galea) Department of Radiological, Oncological and Pathological Sciences,
Sapienza University of Rome, Viale Regina Elena 324, Rome, Italy
(Francone) IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano,
Milan, Italy
(Francone) Department of Biomedical Sciences, Humanitas University, Pieve
Emanuele, Milan, Italy
(Dewey) Department of Radiology, Charite - Universitatsmedizin Berlin,
corporate member of Freie Universitat Berlin and Humboldt-Universitat zu
Berlin, Berlin, Germany
Publisher
Elsevier Inc.
Abstract
Despite the promising results, the clinical implications of the CCT-FFR is
already debated. This metanalysis aimed to determine the potential
benefits of incorporating FFRCT into stable CAD management. After
searching for studies comparing outcomes of patients with suspected stable
CAD who underwent CCT-FFR as a first strategy versus non-urgent
cardiovascular testing after a clinical judgment, we calculated odds
ratios (ORs) and 95 % confidence intervals (CIs) using a random-effects or
fixed-effects meta-analysis model depending on heterogeneity significance.
5 studies (3 RCTs and 2 observational studies) globally encompassing 5282
patients (CCT-FFR = 2604 patients, Control Group = 2678 patients) were
included in the quantitative analysis. The rates of ICA overall (OR 1.57,
95%CI 1.36-1.81, p value < 0.001) and those without obstructive CAD (OR
6.63, 95%CI 4.79-9.16, p value < 0.001) were reduced in the CCTAFFR group,
as compared to the control group. Moreover, CCT-FFR patients underwent
coronary revascularization more frequently than patients in the control
arm (OR 0.48,CI 0.38-0.62, p value < 0.001). There was no significance
difference between the two strategies in terms of 1 year MACE (OR 1.11,CI
0.86-1.44, p value 0.42), nonfatal MI (OR 0.73, CI 0.41-1.33, p value
0.31), all-cause mortality (OR 1.29,CI 0.47-3.54, p value 0.63) and
unplanned revascularization for angina (OR 0.99, 95%CI 0.65-1.49, p value
0.95). In conclusion, in the management of stable CAD, the use of CCT-FFR
was associated with lower overall rates of ICA but higher rates of
coronary revascularization with comparable 1-year clinical
impact. Copyright © 2025 The Authors

<181>
Accession Number
2037734157
Title
Training and Assessment of Nontechnical Skills in Cardiothoracic Surgery:
Current Literature Review.
Source
Journal of Surgical Education. 82(5) (no pagination), 2025. Article
Number: 103480. Date of Publication: 01 May 2025.
Author
Okoli C.C.; Nwanna-Nzewunwa O.C.; Buchanan S.
Institution
(Okoli) Division of General Surgery, Maine Medical Center, Portland,
Maine, United States
(Nwanna-Nzewunwa) Division of Cardiothoracic Surgery, UT Southwestern
Medical Center, Dallas, Texas, United States
(Buchanan) Division of Cardiac Surgery, Maine Medical Center, Portland,
Maine, United States
Publisher
Elsevier Inc.
Abstract
Background: This review explores the surgical and psychological literature
on cardiothoracic (CT) surgeons' intraoperative nontechnical skills (NTS).
Successful task performance depends on the seamless integration of
technical skills (TS) and NTS. This paper aims to identify the training
and assessment modalities for NTS in cardiothoracic surgery (CTS).
 Method(s): PubMed, Cochrane Library, BioMed Central, Medline, EDINA
BIOSIS, Web-of-Knowledge, PsychINFO, and ScienceDirect were searched
through to December 2023. Additionally, a manual search of the referenced
work of each included article and relevant reviews in PubMed were
performed to avoid missing any important data. Original research articles
were included if they described NTS training modalities and their
assessment in cardiac or thoracic surgeries. Exclusion criteria included
any study without full-text availability, non-peer-reviewed publications,
studies without extractable data, and duplicates. Retrieved articles were
screened, and data extracted in duplicate by 2 independent reviewers.
 Result(s): The literature search found 371 relevant references
related to cardiothoracic surgery, 17 articles were included in this
literature review, and 12 training tools were identified.
 Conclusion(s): This review demonstrates the need for additional work
to create reliable training and assessment methods for NTS in
CTS. Copyright © 2025 Association of Program Directors in Surgery

<182>
[Use Link to view the full text]
Accession Number
2037678992
Title
Aortic Valve Replacement Versus Conservative Management in Patients With
Asymptomatic Aortic Stenosis: A Systematic Review and Meta-Analysis of
Randomized Controlled Trials.
Source
Cardiology in Review. (no pagination), 2025. Article Number:
10.1097/CRD.0000000000000879. Date of Publication: 2025.
Author
Shahid S.; Jain H.; Shahzad M.; Dey D.; Batool A.; Passey S.; Patel R.;
Vempati R.
Institution
(Shahid) The Department of Cardiology, Khawaja Muhammad Safdar Medical
College, Sialkot, Pakistan
(Jain) Department of Cardiology, All India Institute of Medical Sciences
(AIIMS), Jodhpur, Jodhpur, India
(Shahzad) Department of Internal Medicine, Dow University of Health
Sciences, Karachi, Pakistan
(Dey) Department of Internal Medicine, Medical College Kolkata, Kolkata,
India
(Batool) Department of Internal Medicine, Allama Iqbal Medical College,
Lahore, Pakistan
(Passey) Department of Internal Medicine, University of Connecticut Health
Center, Hartford, CT, United States
(Patel) Department of Internal Medicine, University of North Carolina
Health Blue Ridge, Morganton, NC, United States
(Vempati) Department of Internal Medicine, Trinity Health Oakland/Wayne
State University Program, Pontiac, MI, United States
Publisher
Lippincott Williams and Wilkins
Abstract
Aortic valve replacement (AVR) is recommended for symptomatic severe
aortic stenosis (AS) patients. However, evidence of its role in
asymptomatic patients with severe AS remains controversial. Hence, a
systematic review and meta-analysis of randomized controlled trials
comparing AVR to conservative management in patients with asymptomatic
severe AS was conducted. A systematic literature search was performed on
electronic databases including MEDLINE (via PubMed), Embase, and Cochrane
CENTRAL Library until November 2024. A random effects model was used to
pool individual risk ratios (RRs) with their corresponding 95% confidence
intervals (CIs) using Review Manager Version 5.4.1 to calculate pooled
effect estimates. Three randomized controlled trials with 1203 patients
(42% females) were included. On pooled analysis, AVR significantly reduced
the risk of hospitalization for heart failure (RR = 0.11, CI: 0.02-0.56, P
= 0.008) compared with conservative care. However, there were no
significant differences between the 2 groups in all-cause mortality (RR =
0.63, CI: 0.36-1.11, P = 0.11), stroke (RR = 0.59, CI: 0.35-1.01, P =
0.05), myocardial infarction (RR = 0.43, CI: 0.06-2.92, P = 0.38), or
thromboembolic events (RR = 0.54, CI: 0.13-2.29, P = 0.40). In
asymptomatic patients with severe AS, AVR significantly reduces the risk
of hospitalization due to heart failure, with comparable risks in terms of
all-cause mortality, myocardial infarction, stroke, and thromboembolic
events compared with conservative management. Copyright © 2025
Wolters Kluwer Health, Inc. All rights reserved.

<183>
Accession Number
646655423
Title
Physical therapist characteristics and therapeutic relationship process
construct factors that improve patient health outcomes in physical
therapy: a systematic review.
Source
Physiotherapy theory and practice. (pp 1-16), 2025. Date of Publication:
23 Feb 2025.
Author
Rodriguez-Nogueira O.; Alba-Perez E.; Alvarez-Alvarez M.J.; Moreno-Poyato
A.R.
Institution
(Rodriguez-Nogueira, Alba-Perez, Alvarez-Alvarez) Department of Nursing
and Physical Therapy, Faculty of Health Sciences, University of Leon,
Leon, Spain
(Moreno-Poyato) Department of Public Health, Mental Health and Maternal
and Child Health Nursing, Faculty of Medicine and Health Sciences,
Universitat de Barcelona, Hospitalet del Llobregat, Spain
Abstract
BACKGROUND: It appears that the therapeutic relationship in physiotherapy
practice facilitates the success of patient health outcomes, although the
process by which it is carried out has been poorly studied.
 OBJECTIVE(S): To explore the influence of the therapeutic
relationship on any patient health outcomes in physical therapy settings.
 METHOD(S): PubMed, Web of Science, Scopus, CINAHL, LILACS and Dialnet
databases were systematically searched following PRISMA guidelines. The
searches were completed in August 2024. Qualitative and quantitative
studies measuring the therapeutic relationship and assessing its influence
on health outcomes of patients treated with physical therapy were
included. RESULT(S): The search yielded a total of 769 results. 13
studies ultimately retained for analysis. A total of 1555 individuals were
studied who had suffered injuries such as low back pain; osteoarthritis;
underwent cardiac surgery; hip fracture and elite athletes recovering from
injuries. The results obtained were classified into three main themes:
characteristics and skills of physical therapists (interpersonal,
organizational, leadership and communication skills), therapeutic
relationship factors (shared decision making, trusting relationships,
motivating the patient and individualization of care) and patient health
outcomes influenced by therapeutic relationship (functional outcomes,
disability, pain intensity, outcome expectations, perceived global effect,
adherence, self-efficacy, sports performance and lung function).
 CONCLUSION(S): Through physical therapist's soft skills, therapeutic
relationship factors are built under the paradigm of person-centered care
and shared decision making, having a positive influence on certain patient
health outcomes. Therefore, evidence support that therapeutic relationship
contributes to improved patient health outcomes.

<184>
Accession Number
646651086
Title
Comparison of the Latest ESC, ACC/AHA/ACCP/HRS, and CCS Guidelines on the
Management of Atrial Fibrillation.
Source
JACC. Clinical electrophysiology. (no pagination), 2025. Date of
Publication: 29 Jan 2025.
Author
Wolfes J.; Ellermann C.; Frommeyer G.; Eckardt L.
Institution
(Wolfes, Ellermann, Frommeyer, Eckardt) Department of Cardiology II
(Electrophysiology), University Hospital Munster, Munster, Germany
Abstract
The introduction of evidence-based and structured guidelines has
undoubtedly improved the care of cardiologic patients and in many cases
simplified decision-making for the treatment team. The European Society of
Cardiology in collaboration with the European Association for
Cardio-Thoracic Surgery, the American College of Cardiology, the American
Heart Association, the American College of Clinical Pharmacy, and the
Heart Rhythm Society, and the Canadian Cardiovascular Society/Canadian
Heart Rhythm Society have developed guidelines for the management of
patients with atrial fibrillation. Because all 3 guidelines refer to
almost the same scientific data, their recommendations are undoubtedly
largely in agreement. Nevertheless, there are some interesting differences
based on different interpretations of the same study, different
publication dates, or differences in local conditions and health care
resources. The following article aims at lining out these similarities and
differences. Copyright © 2025 The Authors. Published by Elsevier
Inc. All rights reserved.

<185>
Accession Number
646656800
Title
Traumatic chylothorax management post-coronary artery bypass grafting - A
systematic review.
Source
Asian cardiovascular & thoracic annals. (pp 2184923251321541), 2025. Date
of Publication: 23 Feb 2025.
Author
Carmichael G.J.; Prinsloo D.; Bentley C.; Prinsloo R.; Kovoor J.G.; Jacob
M.O.; Gupta A.
Institution
(Carmichael, Prinsloo, Bentley, Prinsloo, Kovoor, Jacob) University of
Melbourne, Melbourne, VIC, Australia
(Carmichael, Kovoor, Jacob) Grampians Health, Ballarat, VIC, Australia
(Prinsloo) Western Hospital, Footscray, VIC, Australia
(Bentley) St Vincent's Hospital, VIC, Australia
(Prinsloo) Cairns and Hinterland Hospital and Health Service, Cairns, QLD,
Australia
(Gupta) Department of Surgery, University of Adelaide, Adelaide, SA,
Australia
Abstract
INTRODUCTION: Coronary artery bypass graft (CABG) surgery is performed
globally around 400,000 times annually. Despite its benefits, CABG can
lead to complications, including chylothorax, a rare condition where chyle
accumulates in the pleural cavity due to thoracic duct trauma. Currently,
there are no international guidelines for traumatic chylothorax management
post-CABG. This is the first systematic review to provide a comprehensive
overview of the current state of management for chylothorax post-CABG.
 METHOD(S): This systematic review was conducted by searching EMBASE,
Cochrane, Ovid and PubMed databases on 16 June 2024. The inclusion
criteria focused on studies addressing post-CABG chylothorax management
and reporting clinical outcomes. Data was extracted from 11 studies
focusing on graft type, complications and management strategies.
 RESULT(S): This review included 11 case report studies with 14 cases
of post-CABG chylothorax. Conservative management was attempted in all
cases, with varying components such as total parenteral nutrition, nil by
mouth, octreotide and low-fat diets. High-output chylothorax (>1000
mL/day) often necessitated surgical intervention after an average of 12.5
days of conservative management. Surgical approaches included thoracic
duct ligation, embolisation and pleurodesis. Surgical ligation was
effective in three cases, while thoracic duct embolisation was successful
in one case. CONCLUSION(S): Chylothorax post-CABG is managed
initially with conservative strategies, but high-output cases often
necessitate surgical intervention. This review highlights the need for
standardised guidelines, regarding the timing of surgical escalation and
the use of octreotide and somatostatin. Further research should focus on
higher-powered studies to validate these findings and establish clinical
guidelines for managing chylothorax post-CABG.

<186>
Accession Number
646654491
Title
Effects of naloxegol on transit recovery in patients undergoing cardiac
surgery: A randomized, double-blind, placebo-controlled trial.
Source
Anaesthesia, critical care & pain medicine. (pp 101498), 2025. Date of
Publication: 21 Feb 2025.
Author
Laghlam D.; Gibert H.; Merzoug M.; Leclerc D.; Coroyer L.; Estagnasie P.;
Squara P.; Nguyen L.S.; Geri G.
Institution
(Laghlam, Coroyer, Estagnasie, Squara, Nguyen, Geri) From the Department
of Cardiology and Critical Care, 48 Ter boulevard Victor Hugo,
Neuilly-sur-Seine, France
(Gibert, Leclerc) From the Department of Cardiovascular Anesthesiology, 48
Ter boulevard Victor Hugo, Neuilly-sur-Seine, France
(Merzoug) From the Department of Clinical Research, 48 Ter boulevard
Victor Hugo, Neuilly-sur-Seine, France
Abstract
BACKGROUND: Paralytic ileus is a major surrounding after cardiac surgery
and worsens patients' prognosis. METHOD(S): We conducted a
single-centre, randomized, double-blind, placebo-controlled phase 3 study.
We enrolled patients over 18 years old who underwent non-urgent cardiac
surgery. Eligible patients were randomly allocated to Naloxegol or
matching placebo in an equal ratio. The participants were randomly
assigned to one of the following groups: (1) Naloxegol 12,5 mg 2 hours
before index surgery, and then Naloxegol 25 mg once daily, or (2) matching
placebo. Naloxegol or placebo was administered for up to 5 days and
permanently stopped if the patient had transit recovery. The primary
endpoint was the time of postoperative gastrointestinal transit recovery
after the index cardiac surgery, defined as the time in hours between the
anaesthetic induction and the emission of the first significant stool.
 RESULT(S): Between October 14, 2020, and January 28, 2022, 299
participants were included in modified intention-to-treat efficacy
analyses (151 in the Naloxegol group and 148 in placebo). The mean age was
62 +/- 10.1 years old, 81.6% were male, 53.8% had hypertension, 20.7% had
diabetes mellitus, and the median body mass index was 25.9 (IQR 23.7-29.4)
kg/m2. Time-to-transit recovery did not differ between Naloxegol group and
placebo (76.0, [IQR 69.3-93.5] vs. 78.3, [IQR 70.0-95.8] hours, p value =
0.40). We did not observe any difference in the prespecified secondary
efficacy between both groups. Pain levels and a number of serious adverse
events were not different in both groups. CONCLUSION(S): Naloxegol
was not found to be effective in improving the transit time recovery after
elective cardiac surgery. The trial was registered on clinicaltrials.gov
(NCT04433390) on June 16, 2020. Copyright © 2025. Published by
Elsevier Masson SAS.

<187>
Accession Number
646645480
Title
Surgical outcomes of cardiac surgery in patients with antiphospholipid
syndrome and systemic lupus erythematosus: A systematic review.
Source
Asian cardiovascular & thoracic annals. (pp 2184923251321066), 2025. Date
of Publication: 21 Feb 2025.
Author
Agarwal R.; Mudgal S.; Rout S.; Arnav A.
Institution
(Agarwal) Department of Cardiothoracic Surgery, All India Institute of
Medical Sciences (AIIMS) Deoghar, Jharkhand, India
(Mudgal) College of Nursing, All India Institute of Medical Sciences
(AIIMS) Deoghar, Jharkhand, India
(Rout) Department of Cardiology, All India Institute of Medical Sciences
(AIIMS) Deoghar, Jharkhand, India
(Arnav) Department of Surgical Oncology, All India Institute of Medical
Sciences (AIIMS) Deoghar, Jharkhand, India
Abstract
BACKGROUND: Antiphospholipid syndrome and systemic lupus erythematosus are
autoimmune inflammatory conditions involving multiple organs and sharing
various clinical aspects. Owing to the scarcity of data about the surgical
outcomes of these autoimmune disorders, we conducted a systematic review
to assess the outcomes for patients with these diagnoses undergoing heart
surgery and contextualize the findings regarding high-risk cardiac
surgeries. METHOD(S): A thorough search of PubMed, Embase and Scopus
used Preferred Reporting Items for Systematic Reviews and Meta-Analyses
standards to find articles that involved patients who underwent heart
surgery and had antiphospholipid syndrome and systemic lupus
erythematosus. Inclusion criteria concentrated on a definitive diagnosis,
while case reports and studies lacking data on surgical outcomes were
excluded. Using the Joanna Briggs Institute's methodologies, quality
evaluation categorized studies according to their risk of bias.
 RESULT(S): Fourteen studies with 277 patients and a prevalence of
middle-aged females met the inclusion criteria out of 6381 papers. The
major preoperative comorbidity in the cohort was a history of
thromboembolic events (43%). Thromboembolic complications (6%) and
catastrophic antiphospholipid syndrome (2%), even with appropriate
anticoagulation, were notable early post-operative outcomes. Six percent
of people died within 30 days. Data from follow-up studies showed a 14%
death rate and a 23% frequency of thromboembolic events.
 CONCLUSION(S): With the striking exception of a high frequency of
thromboembolic complications and catastrophic antiphospholipid syndrome,
surgical results in patients with antiphospholipid syndrome and systemic
lupus erythematosus are analogous to those in high-risk cardiac
procedures. Improving surgical care for this susceptible population
requires an understanding of these hazards.

<188>
Accession Number
646646835
Title
Impact of non-invasive ventilation before and after cardiac surgery for
preventing cardiac and pulmonary complications: a clinical randomized
trial.
Source
Chest. (no pagination), 2025. Date of Publication: 19 Feb 2025.
Author
Goret M.; Pluchon K.; Le Mao R.; Badra A.; Oilleau J.-F.; Morvan Y.;
Beaumont M.; Desanglois G.; Guegan M.; Barnier A.; Gut-Gobert C.; Tromeur
C.; Leroyer C.; Choplain J.-N.; Khalifa A.; Bezon E.; Couturaud F.
Institution
(Goret, Beaumont, Barnier, Gut-Gobert) Univ_Brest, INSERM U1304 Groupe
d'Etude de la Thrombose de Bretagne Occidentale (GETBO), F 29200, Brest,
France; Department of internal medicine, vascular medicine and chest
diseases, CHU_Brest, Brest, France; INSERM CIC1412, CHU_Brest, Brest,
France
(Pluchon, Oilleau, Morvan, Choplain, Khalifa) Department of
cardio-thoracic and vascular surgery, Brest, France
(Le Mao, Tromeur, Leroyer, Couturaud) Univ_Brest, INSERM U1304 Groupe
d'Etude de la Thrombose de Bretagne Occidentale (GETBO), F 29200, Brest,
France; Department of internal medicine, vascular medicine and chest
diseases, CHU_Brest, Brest, France; INSERM CIC1412, CHU_Brest, Brest,
France; F-CRIN INNOVTE, Saint-Etienne, France
(Badra, Bezon) Department of cardio-thoracic and vascular surgery,
CHU_Brest, Brest, France; INSERM 1078, Univ_Brest, France
(Desanglois, Guegan) Department of internal medicine, vascular medicine
and chest diseases, CHU_Brest, Brest, France; INSERM CIC1412, CHU_Brest,
Brest, France
Abstract
BACKGROUND: The immediate postoperative period following heart surgery
poses a substantial risk of life-threatening complications notably acute
pulmonary and cardiac failure. Non-invasive ventilation (NIV) use may
reduce the incidence of pulmonary and/or heart failure. RESEARCH QUESTION:
Is the use of NIV before and after cardiac surgery associated with a lower
rate of acute pulmonary and heart failure in patients at risk for
post-operative complications? STUDY DESIGN AND METHODS: We designed a
prospective, randomized, monocentric trial comparing pre- and
post-operative NIV in cardiac surgery to standard care. Adult patients
classified at risk of post-operative cardiac or pulmonary failure were
allocated to receive NIV for five days before and five days after surgery
in addition to usual care versus usual care alone. The primary outcome was
the composite of predefined and adjudicated cardio-respiratory failure at
one month after cardiac surgery. RESULT(S): Two hundred and sixteen
patients were included. During the one-month follow-up period after
surgery, the composite outcome occurred in 59/107 (55.1%) patients in the
NIV group and in 87/109 (79.8%) patients in the No-NIV group (RR 0.69
95%CI [0.57-0.84]; p<0.001). The benefit was persistent at three months.
There was no difference between the two groups in terms of intubation need
and length of hospital stay in cardiac and pulmonary surgery intensive
care unit and in cardiac and pulmonary surgery unit. INTERPRETATION: The
use of NIV before and after cardiac surgery reduces the rate of
cardiopulmonary failure after high-risk cardiac surgery. Copyright
© 2025. Published by Elsevier Inc.

<189>
Accession Number
646658273
Title
A randomised trial comparing usual versus strict home blood pressure
control in elderly patients with hypertension: protocol and initial
progress.
Source
Blood pressure. (pp 1-16), 2025. Date of Publication: 24 Feb 2025.
Author
Zhang D.-Y.; Zhang Y.-Q.; An D.-W.; Cheng Y.-B.; Tang S.-T.; Liu M.; Li
J.; Staessen J.A.; Wang J.-G.; Li Y.
Institution
(Zhang, Zhang, An, Cheng, Staessen, Wang, Li) Department of Cardiovascular
Medicine, Shanghai Institute of Hypertension, Shanghai Key Laboratory of
Hypertension, National Research Centre for Translational Medicine, State
Key Laboratory of Medical Genomics, Ruijin Hospital, Shanghai Jiao Tong
University School of Medicine, Shanghai, China
(Tang) Liaobu Community Health Center, Guangdong Province, China
(Liu) Henan Province People's Hospital, Zhengzhou, Henan, China
(Li) Department of Epidemiology, Tongji University School of Medicine,
Shanghai, China
(Staessen) Non-Profit Research Association Alliance for the Promotion of
Preventive Medicine, Mechelen, Belgium
(Staessen) Biomedical Research Group, Faculty of Medicine, University of
Leuven, Leuven, Belgium
Abstract
Objective. The optimal level of home blood pressure (HBP) for the
prevention of cardiovascular complications is unknown. The Home Blood
Pressure Intervention in the Community Trial (HomeBP, [NCT05858944]) is
addressing this issue by randomising elderly hypertensive patients to
standard or tight HBP control.Methods and analysis. HomeBP is an
investigator-initiated randomised clinical trial with open design and
blinded endpoint evaluation. Eligible patients of either sex, aged 60-80
years, having uncontrolled home hypertension (>=135/85 mm Hg) after
medication for at least 2 weeks will be recruited nationwide in China at
up to 200 community healthcare centres. After stratification for centre
and the presence of office hypertension (>=140/90 mm Hg), 10,000 patients
will be randomised in a 1:1 proportion to a target HBP of 125-134/75-84 mm
Hg or <125/75 mm Hg and followed up for 4 years. The primary outcome is a
composite of cardiovascular death, non-fatal myocardial infarction,
coronary revascularisation, unstable angina pectoris or heart failure
requiring hospitalisation, and non-fatal stroke. Follow-up visits are
scheduled monthly for 3 months after randomisation and 3-monthly
thereafter. Patients record HBP for 7 consecutive days before every visit.
A unique feature of the trial is the information technology setup,
allowing the secure and instantaneous flow of HBP and other data to the
study coordinating centre, where a standardised HBP report is generated.
Hypertension specialists at Ruijin Hospital, Shanghai and at local
tertiary hospitals provide treatment recommendations, which are
transmitted to the caregivers at the community centres, who then fine-tune
the treatment recommendations in a shared decision process with the
patients to meet the values and clinical needs of the patients. Currently,
2281 patients have been randomised with no between-group differences in
the baseline characteristics.Trial registration number. URL:
https://www.clinicaltrials.gov; Unique identifier: NCT05858944.

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