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<1>
Accession Number
2038955798
Title
The transcriptional landscape of atrial fibrillation: A systematic review
and meta-analysis.
Source
PLOS ONE. 20(5 May) (no pagination), 2025. Article Number: e0323534. Date
of Publication: 01 May 2025.
Author
Gomez-Ochoa S.A.; Mohn M.; Malz M.V.; Ottenheijm R.; Lanzer J.D.; Wiedmann
F.; Kraft M.; Muka T.; Schmidt C.; Freichel M.; Levinson R.T.
Institution
(Gomez-Ochoa, Mohn, Levinson) Department of General Internal Medicine and
Psychosomatics, Heidelberg University Hospital, University of Heidelberg,
Heidelberg, Germany
(Mohn, Lanzer, Levinson) Institute for Computational Biomedicine,
Heidelberg University Faculty of Medicine, Heidelberg University Hospital,
University of Heidelberg, Heidelberg, Germany
(Malz, Ottenheijm, Freichel) Institute of Pharmacology, Heidelberg
University, Heidelberg, Germany
(Wiedmann, Kraft, Schmidt) Department of Cardiology, Heidelberg University
Hospital, University of Heidelberg, Heidelberg, Germany
(Wiedmann, Kraft, Schmidt) DZHK (German Center for Cardiovascular
Research), Partner Site Heidelberg/Mannheim, University of Heidelberg,
Heidelberg, Germany
(Wiedmann, Kraft, Schmidt) HCR, Heidelberg Center for Heart Rhythm
Disorders, University of Heidelberg, Heidelberg, Germany
(Muka) Epistudia, Bern, Switzerland
Publisher
Public Library of Science
Abstract
Background Despite advances in understanding atrial fibrillation (AF)
pathophysiology, there is limited agreement on the key genes driving its
pathophysiology. To understand the genome-wide transcriptomic landscape,
we performed a meta-analysis from studies reporting gene expression
patterns in atrial heart tissue from patients with AF and controls in
sinus rhythm (SR). Methods Bibliographic databases and data repositories
were systematically searched for studies reporting gene expression
patterns in atrial heart auricle tissue from patients with AF and controls
in sinus rhythm. We calculated the pooled differences in individual gene
expression from fourteen studies comprising 534 samples (353 AF and 181
SR) to create a consensus signature (CS), from which we identified
differentially regulated pathways, estimated transcription factor
activity, and evaluated its performance in classifying validation samples
as AF or SR. Results Despite heterogeneity in the top differentially
expressed genes across studies, the AF-CS in both chambers were robust,
showing a better performance in classifying AF status than individual
study signatures. Functional analysis revealed commonality in the
dysregulated cellular processes between chambers, including extracellular
matrix remodeling (highlighting epithelial mesenchymal transition, actin
filament organization, and actin binding hallmark pathways), cardiac
conduction (including cardiac muscle cell action potential, gated channel
activity, and cation channel activity pathways), metabolic derangements
(highlighting oxidative phosphorylation and asparagine n linked
glycosylation), and innate immune system activity (mainly neutrophil
degranulation, and TNFalpha signaling pathways). Finally, the AF-CS showed
a good performance differentiating AF from controls in three validation
datasets (two from peripheral blood and one from left ventricle samples).
Conclusions Despite variability in individual studies, this meta-analysis
elucidated conserved molecular pathways involved in AF pathophysiology
across its phenotypes and the potential of a transcriptomic signature in
identifying AF from peripheral blood samples. Our work highlights the
value of integrating published transcriptomics data in AF and the need for
better data deposition practices.<br/>Copyright &#xa9; 2025 Gomez-Ochoa 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.

<2>
Accession Number
2038977439
Title
Percutaneous or surgical revascularization in patients with severe left
main coronary artery disease in Latin America: A GRADE clinical practice
guideline.
Source
International Journal of Cardiology. 436 (no pagination), 2025. Article
Number: 133401. Date of Publication: 01 Oct 2025.
Author
Lamelas P.; Pompeu Sa M.; Izcovich A.; Bottaro F.; Tisi Bana M.; Sosa
Liprandi M.I.; Lanas F.; Vilca Mejia O.A.; Zuniga Luna M.; Aubanel P.;
Munera A.; Contreras Reyes J.; Bagur R.; Whitlock R.; Garcia Garcia H.;
Mamas M.; Cohen M.G.; Ricalde A.; Abizaid A.; Mendiz O.; Araya M.; Costa
R.; Santaera O.; Hidalgo P.; Caldonazo T.; Baranchuk A.; Ragusa M.A.
Institution
(Lamelas, Mendiz) Fundacion Favaloro, Buenos Aires, Argentina
(Lamelas, Whitlock) Health Research Methods, Evidence, and Impact,
McMaster University, Canada
(Pompeu Sa) Department of Cardiovascular Surgery, Pronto Socorro
Cardiologico de Pernambuco (PROCAPE), University of Pernambuco (UPE),
Brazil
(Izcovich) Hospital Aleman, Buenos Aires, Argentina
(Bottaro) Department of Internal Medicine, Hospital Britanico, Buenos
Aires, Argentina
(Tisi Bana) Department of Medicine, Hospital Universitario Austral, Pilar,
Buenos Aires, Argentina
(Sosa Liprandi) Sanatorio Guemes, Buenos Aires, Argentina
(Lanas) Universidad de la Frontera, Temuco, Chile
(Vilca Mejia) Department of Cardiovascular Surgery, Instuto de Coracao,
Universidade de Sao Paulo, Brazil
(Zuniga Luna) Department of Interventional Cardiology, Angiografia de
Occidente, Cali, Colombia
(Aubanel) Hospital del Prado, Tijuana, Mexico
(Munera) Clinica Rosario Tesoro, Cardioestudio, Medellin, Colombia
(Contreras Reyes) Department of Cardiac Surgery, Universidad de la
Frontera, Temuco, Chile
(Bagur) Western University, London, ON, Canada
(Whitlock) Department of Surgery, McMaster University, Hamilton, ON,
Canada
(Garcia Garcia) Washington Hospital Center, Washington, United States
(Mamas) Keele Cardiovascular Research Group, Keele University,
Staffordshire, United Kingdom
(Cohen) Cleveland Clinic Florida, Weston, Florida, United States
(Ricalde) Hospital ABC, Ciudad de Mexico, Mexico
(Abizaid) Instituto do Coracao, Sao Paulo, Brazil
(Araya) Clinica Alemana, Universidad del Desarrollo, Santiago de Chile,
Chile
(Costa) Instituto Dante Pazzanese de Cardiologia, Sao Paulo, Brazil
(Santaera) Clinica privada provincial de Merlo, Buenos Aires, Argentina
(Hidalgo) Policlinica Amado, Maracaibo, Bolivia
(Caldonazo) Department of Cardiothoracic Surgery, Jena University
Hospital, Jena, Germany
(Caldonazo) Department of Cardiothoracic Surgery, Weil Cornell Medicine,
New York, United States
(Baranchuk) Queens University, Kingston, ON, Canada
(Ragusa) Division Clinica Medica, Hospital Fernandez, Buenos Aires,
Argentina
Publisher
Elsevier Ireland Ltd
Abstract
Background: Severe left main coronary artery disease (LMD) poses a major
treatment challenge in Latin America, where both percutaneous coronary
intervention (PCI) and coronary artery bypass grafting (CABG) are used.
<br/>Method(s): This guideline was developed de novo using the GRADE
approach. A multidisciplinary panel reviewed evidence from a systematic
review of randomized trials comparing PCI and CABG, incorporating a
comprehensive literature search of patient values and preferences and
outcome utilities. Thresholds were assigned for each clinical outcome,
from small to large effect. <br/>Result(s): Five randomized trials
enrolling 4612 patients were included. At 30 days, PCI resulted in a large
reduction in major bleeding and a small reduction in strokes. At 5 years,
PCI was associated with a small to moderate increase of spontaneous
myocardial infarction and a moderate to large increase in repeat
revascularization. No important differences in short- or long-term
mortality were observed between PCI and CABG. The overall certainty of
evidence was rated low. There was a notable variability in patient values
and a close call on the balance of effects. <br/>Conclusion(s): For
patients in Latin America with severe left main coronary artery disease,
the guideline panel suggests either PCI or CABG. This is a conditional
recommendation, based on low certainty in the evidence (). It applies when
both procedures are clinically and anatomically appropriate and can be
performed at centers meeting acceptable standards. The decision should be
made through a shared decision-making process involving the patient and
the multidisciplinary care team.<br/>Copyright &#xa9; 2025 The Authors

<3>
Accession Number
2034927117
Title
The effect of five versus two personnel on bacterial air contamination
during preparation of sterile surgical goods in the operating room: a
randomised controlled trial.
Source
Antimicrobial Resistance and Infection Control. 14(1) (no pagination),
2025. Article Number: 68. Date of Publication: 01 Dec 2025.
Author
Wistrand C.; Soderquist B.; Sundqvist A.-S.
Institution
(Wistrand) Department of Cardiothoracic and Vascular Surgery, Orebro
University Hospital, O-house, 4th floor, SE, Orebro, Sweden
(Wistrand, Sundqvist) University Health Care Research Centre, Faculty of
Medicine and Health, Orebro University, Orebro, Sweden
(Soderquist) School of Medical Sciences, Faculty of Medicine and Health,
Orebro University, Orebro, Sweden
(Soderquist) Department of Laboratory Medicine, Faculty of Medicine and
Health, Orebro University, Orebro, Sweden
(Soderquist) Department of Orthopedics, Faculty of Medicine and Health,
Orebro University, Orebro, Sweden
Publisher
BioMed Central Ltd
Abstract
Background: Surgical site infection (SSI) and antimicrobial resistance are
a worldwide problem affecting patient safety. It is lacking randomised
controlled trials (RCT) regarding how the number of personnel in the
operating room (OR) affects the air quality. We aimed to investigate the
effect the number of personnel in the OR have on bacterial air
contamination during the preparation of sterile surgical goods, to
identify the species and antibiotic susceptibility of the bacteria
isolated, and to describe the number of SSIs together with causative
microorganisms. <br/>Method(s): This RCT used an intervention group in
which two individuals prepared the surgical goods and a control group in
which five individuals prepared the goods. Bacteria were isolated on
aerobic and anaerobic plates, and bacterial growth was measured as colony
forming units (CFU). All isolates were typed, and types known to cause SSI
were tested for susceptibility to eight antibiotics. Data were analysed
with the Mann-Whitney U test, the chi-square test, or Fisher's exact test.
<br/>Result(s): Results were based on 69 open-heart surgeries and 414
plates. When sterile surgical goods were prepared with two personnel, the
median CFU was 2 with an IQR of 2, compared with five personnel, the
median CFU was 5, with an IQR of 5 (p < 0.001). The 272 CFU represented 45
different bacterial species, with 38 species isolated in the control group
and 21 in the intervention group. The most frequently isolated bacteria
were Cutibacterium acnes (82/272, 30%), and Staphylococcus epidermidis
(36/272, 13%). Of the 36 S. epidermidis isolates, 11 (31%) were
drug-resistant, including three multidrug-resistant. One patient in the
control group was infected by Staphyloccocus aureus and Staphylococcus
lugdunensis, neither of which was isolated during the preparation of
sterile goods. One patient in the intervention group developed an SSI
caused by C. acnes, Corynebacterium kroppenstedtii, and S. epidermidis. C.
acnes and S. epidermidis were isolated during the preparation.
<br/>Conclusion(s): Minimising the number of personnel in the OR during
preparation of sterile surgical goods is important to reduce the bacterial
load. Trial registration: Prospectively 15 May 2022 at FoU Sweden (275659)
and retrospectively 22 October 2022 at ClinicalTrials.Gov
(NCT05597072).<br/>Copyright &#xa9; The Author(s) 2025.

<4>
Accession Number
2034870771
Title
Rapid ventricular pacing in cerebral aneurysm clipping: institutional
workflow, systematic review, and single-arm meta-analysis.
Source
Neurosurgical Review. 48(1) (no pagination), 2025. Article Number: 501.
Date of Publication: 01 Dec 2025.
Author
Wach J.; Vychopen M.; Weber F.; Arlt F.; Guresir E.
Institution
(Wach, Vychopen, Weber, Arlt, Guresir) Department of Neurosurgery,
University Hospital Leipzig, Liebigstr. 20, Leipzig, Germany
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Background: This study examines the safety and efficacy of rapid
ventricular pacing for cerebral aneurysm clipping, focusing on arrhythmia,
mortality, aneurysm obliteration, neurological deficits, and myocardial
damage assessed via postoperative troponin T levels, through an
institutional series, systematic review, and meta-analysis.
<br/>Method(s): Data were extracted from institutional database and
published studies investigating the use of RVP in both ruptured and
unruptured aneurysms. Outcomes analyzed included postoperative arrhythmia,
mortality, complete obliteration of aneurysms, pacing cycles, mean
arterial pressure (MAP) during pacing, pacing rates, and postoperative
troponin T levels. Pooled event rates and proportions were calculated
using a common effect model, and heterogeneity across studies was assessed
using I2 statistics. <br/>Result(s): In 15 institutional cases,
RVP-assisted aneurysm clipping achieved stable neurological outcomes, no
cardiac complications, and 94% aneurysm obliteration. Combined with
literature (141 patients), pooled arrhythmia and mortality rates were 1%
and 0%, respectively. Aneurysm obliteration was 92%, new neurological
deficits 4%, and troponin T levels 37.7 ng/L. Mean pacing rate, cycles,
and MAP were 187.4 bpm, 6.5, and 41.1 mmHg. <br/>Conclusion(s): The
findings suggest that rapid ventricular pacing in cerebral aneurysm
clipping is associated with a low risk of cardiac arrhythmia and
myocardial injury, while facilitating high rates of complete aneurysm
obliteration. This technique appears safe, with minimal impact on
postoperative mortality and neurological outcomes.<br/>Copyright &#xa9;
The Author(s) 2025.

<5>
Accession Number
2038953006
Title
Exploring the global research trends and precise therapeutic indications
of colchicine for coronary heart disease A bibliometric systematic review
and meta-analysis.
Source
Medicine (United States). 104(22) (no pagination), 2025. Article Number:
e42650. Date of Publication: 30 May 2025.
Author
Wang H.; Wang J.; Chen Q.; Zhou J.; Zhang N.
Institution
(Wang, Zhou) Department of Cardiovascular Medicine, The First Medical
Center of Chinese PLA General Hospital, Beijing, China
(Wang) Department of Pharmacy, Medical Supplies Center, Chinese PLA
General Hospital, Beijing, China
(Chen) Department of Emergency, Xiang' An Hospital, Xiamen University,
Fujian, Xiamen, China
(Zhang) Department of Infectious Diseases and Hepatology, Xiang' An
Hospital, Xiamen University, Fujian, Xiamen, China
Publisher
Lippincott Williams and Wilkins
Abstract
Background: Colchicine has garnered significant interest in its potential
role in reducing cardiovascular events in coronary heart disease (CHD)
patients. Recent studies have shown varying results regarding its
efficacy, particularly in stable CHD (SCHD) and acute coronary syndromes
(ACS). Additionally, the precise clinical indications and molecular
mechanisms of colchicine in the treatment of CHD remain ambiguous. Our
study aims to review the current research status of colchicine for CHD,
and explore future trends and potential beneficiary populations.
<br/>Method(s): We searched Web of Science Core Collection, PubMed,
Embase, and Cochrane Library databases for relevant research findings
regarding the application of colchicine for CHD from inception through
February 28, 2025. Bibliometric methods were performed to analyze research
trends in this field. Meta-analysis was conducted to investigate our
primary endpoints of interest, including recurrent myocardial infarction,
stroke, revascularization, and cardiovascular death. <br/>Result(s): The
overall trend of research in colchicine for CHD continued to increase from
2013 onward and peaked in 2021. Research hotspots can be summarized into 4
domains: (1) diseases and drug therapy, (2) molecular mechanisms of
colchicine, (3) network pharmacology, and (4) secondary prevention and
adverse effect monitoring. In addition, our meta-analysis revealed that
colchicine yielded a 20% relative reduction in recurrent myocardial
infarction (P < .05), a 46% relative reduction in stroke (P < .05), and a
34% relative reduction in revascularization (P < .05). Subgroup analyses
revealed a novel finding that colchicine showed a promising decline in the
primary endpoints among SCHD patients, whereas these benefits were absent
in ACS patients. <br/>Conclusion(s): Considering that the molecular
mechanisms of colchicine remain unclear, the global research results
suggested that it may be more suitable for SCHD patients with high
residual inflammation risk. This finding aligns with the growing body of
evidence supporting the role of inflammation in the progression of CHD.
However, the inconsistent results in ACS patients highlight the need for
large-scale, multicenter trials to better understand the clinical utility
of colchicine in different CHD subtypes. Moreover, progress in the
exploration of the underlying mechanisms and secondary prevention will
confer benefits to CHD patients who receive colchicine
therapy.<br/>Copyright &#xa9; 2025 the Author(s). Published by Wolters
Kluwer Health, Inc.

<6>
Accession Number
2038928891
Title
DAPAGLIFLOZIN ENHANCES SYSTOLIC AND DIASTOLIC FUNCTION IN CONCORDANCE WITH
CLINICAL RESPONSE IN PATIENTS WITH LEFT VENTRICULAR DYSFUNCTION.
Source
European Review for Medical and Pharmacological Sciences. 29(5) (pp
231-247), 2025. Date of Publication: 2025.
Author
Abou Warda A.E.; Duarte J.D.; Salem M.N.; Salem H.F.; Moharram A.N.;
Alzarea A.I.; Alsahli T.G.; Sultan H.; Alrashdi M.A.; Altebainawi A.F.;
Ibrahim B.E.; Alnahrawi S.I.; Megalaa K.K.; Zarif B.; Sarhan R.M.
Institution
(Abou Warda) Department of Clinical Pharmacy, Faculty of Pharmacy, October
6 University, Giza, Egypt
(Duarte) Department for Pharmacotherapy and Translational Research, Center
for Pharmacogenomics and Precision Medicine, University of Florida,
Gainesville, FL, United States
(Salem) Department of Internal Medicine, Faculty of Medicine, Beni-Suef
University, Beni-Suef, Egypt
(Salem) Department of Pharmaceutics & Industrial Pharmacy, Faculty of
Pharmacy, Beni-Suef University, Beni-Suef, Egypt
(Salem) Program of Pharmaceutical Production, 6th October Technology
University, Giza, Egypt
(Moharram) Department of Critical Care Medicine, Faculty of Medicine,
Cairo University, Giza, Egypt
(Alzarea, Alzarea) Department of Clinical Pharmacy, College of Pharmacy,
Jouf University, Sakaka, Saudi Arabia
(Alsahli) Department of Pharmacology, College of Pharmacy, Jouf
University, Sakaka, Saudi Arabia
(Sultan) Pharmaceutical Care Administration, Armed Forces Hospital
Southern Region, Asir, Khamis Mushait, Saudi Arabia
(Alrashdi) Department of Pharmacy, Alnoor Specialties Hospital, Kingdom of
Saudi Arabia, Makkah, Saudi Arabia
(Altebainawi) Department of Pharmaceutical Care Services, King Salman
Specialist Hospital, Hail Health Cluster, Hail, Saudi Arabia
(Altebainawi) Department of Clinical Pharmacy, College of Pharmacy,
University of Hail, Hail, Saudi Arabia
(Ibrahim, Alnahrawi, Megalaa, Zarif) National Heart Institute, General
Organization for Teaching Hospitals and Institutes, Cairo, Egypt
(Sarhan) Department of Clinical Pharmacy, Faculty of Pharmacy, Beni-Suef
University, Beni-Suef, Egypt
(Sarhan) Faculty of Pharmacy, Beni-Suef National University, Beni-Suef,
Egypt
Publisher
Verduci Editore s.r.l
Abstract
Objective: Sodium-glucose co-transporter-2 (SGLT2) inhibitors have
reshaped heart failure (HF) management. However, evidence regarding their
effects on cardiac structure, particularly for dapagliflozin, remains
inconsistent. This study evaluates dapagliflozin's impact on
echocardiographic parameters and its concordance with clinical response.
<br/>Material(s) and Method(s): A prospective, randomized controlled study
included HF patients with left ventricular (LV) dysfunction, divided into
dapagliflozin-treated and dapagliflozin-naive groups. Echocardiography and
speckle-tracking strain analysis were conducted at baseline and six
months. The primary outcome was the change in indexed LV mass. Secondary
outcomes included LV function, volumes, dimensions, functional mitral
regurgitation, global longitudinal strain (GLS), diastolic function, right
ventricular (RV) function, and clinical response assessed using the Kansas
City Cardiomyopathy Questionnaire (KCCQ) score. <br/>Result(s): Among 240
participants, 160 received dapagliflozin in addition to guideline-directed
medical therapy, while 80 were dapagliflozin-naive. Adjusted regression
analysis showed significant improvements in LV mass index (-43.51
g/m^2, 95% CI: -59.4 to -27.5, p < 0.0001), end-systolic volume
(-29.45 mL, 95% CI: -43.9 to -14.9, p < 0.0001), and end-diastolic volume
(-29.44 mL, 95% CI: -47.9 to -10.9, p = 0.0021). Improvements were also
observed in LV ejection fraction (5.15%, 95% CI: 2.84 to 7.45, p <
0.0001), GLS (-1.99%, 95% CI: -2.87 to -1.11, p < 0.0001), E/A ratio
(-0.56, 95% CI: -1.01 to -0.10, p = 0.016), effective regurgitant orifice
area (EROA) (-0.18 cm^2, 95% CI: -0.28 to -0.081, p = 0.0006),
tricuspid annular plane systolic excursion (TAPSE) (0.38 cm, 95% CI: 0.15
to 0.62, p = 0.0024), and composite clinical outcome (HR 0.65, 95% CI:
0.43-0.98, p = 0.043). LVEF, GLS, E/A ratio, TAPSE, inferior vena cava
diameter, and left atrial area correlated with clinical response.
<br/>Conclusion(s): Dapagliflozin emerges as a potential therapy for
patients with left ventricular dysfunction, enhancing LV systolic function
and diastolic performance, alongside a favorable clinical response. Future
studies with more extensive assessment of right ventricular function and
longer follow-up are warranted.<br/>Copyright &#xa9; 2025 Verduci Editore
s.r.l. All rights reserved.

<7>
Accession Number
2038953223
Title
Multivessel versus culprit vessel only percutaneous coronary intervention
in non-ST elevation myocardial infarction Systematic review and
meta-analysis.
Source
Medicine (United States). 104(22) (no pagination), 2025. Article Number:
e42527. Date of Publication: 30 May 2025.
Author
Khandait H.; Sachdeva S.; Patel A.; Ali R.; Abruzzo A.; Shrestha A.B.;
Jaiswal V.; Aryal B.; Aldaraysah M.; Naqi M.; Meshram N.; Bhattad V.B.
Institution
(Khandait, Aldaraysah, Naqi) Trinitas Regional Medical Center, RWJ
Barnabas Health, Elizabeth, NJ, United States
(Sachdeva) Wright Medical Center, Scranton, PA, United States
(Patel, Ali) Saint Michael's. Medical Center, Newark, NJ, United States
(Abruzzo) St George's School of Medicine, St. George's, Grenada
(Shrestha) Abdur Rahim Medical College, Dinajpur, Bangladesh
(Jaiswal) Larkin Community Hospital, South Miami, FL, United States
(Aryal) Interfaith Medical Center, Brooklyn, NY, United States
(Meshram) Washington University in St. Louis, St. Louis, MO, United States
(Bhattad) University of Missouri-Columbia, Columbia, MO, United States
Publisher
Lippincott Williams and Wilkins
Abstract
Background: Multivessel disease is common in non-ST elevation myocardial
infarction patients. However, whether multivessel percutaneous coronary
intervention is superior to culprit vessel percutaneous coronary
intervention is unknown. <br/>Method(s): A meta-analysis was conducted
including studies that compared multivessel percutaneous coronary
intervention (MV-PCI) and culprit vessel percutaneous coronary
intervention among non-ST elevation myocardial infarction patients.
Relative risk (RR) for mortality, myocardial infarction (MI), repeat
revascularization and procedural complications was calculated using a
random effects model. Seventeen studies were included in the
meta-analysis. <br/>Result(s): There was no difference in short-term
outcomes for mortality (RR 0.917, 95% CI 0.613-1.371, P = .672), MI (RR
0.960, 95% CI 0.612-1.507, P = .861), and stent thrombosis (RR 1.338, 95%
CI 0.655-2.733, P = .424). Long-term mortality and repeat
revascularization was significantly lower in the MV-PCI group (RR 0.746,
95% CI 0.644-0.865, P < .001 and RR 0.775, 95% CI 0.629-0.954, P = .016),
respectively. <br/>Conclusion(s): No significant difference was
demonstrated between the 2 strategies in the short-term outcomes. However,
long-term outcomes in the MV-PCI group were superior to culprit vessel
percutaneous coronary intervention in non-ST elevation myocardial
infarction patients with multivessel disease. Long-term outcomes included
mortality, repeat revascularization, stent thrombosis, and MI. However,
randomized controlled trials are needed to compare the safety and efficacy
of these strategies.<br/>Copyright &#xa9; 2025 the Author(s). Published by
Wolters Kluwer Health, Inc.

<8>
Accession Number
2032700925
Title
Efficacy of liposomal as compared to standard bupivacaine for intercostal
nerve blocks in patients undergoing minimally invasive thoracic surgery: a
systematic review and meta-analysis.
Source
Minimally Invasive Therapy and Allied Technologies. 34(3) (pp 219-229),
2025. Date of Publication: 2025.
Author
Chen R.; Wang Z.
Institution
(Chen, Wang) Department of Anesthesia, Shengzhou People's Hospital
(Shengzhou Branch of the First Affiliated Hospital of Zhejiang University
School of Medicine, the Shengzhou Hospital of Shaoxing University),
Shaoxing, China
Publisher
Taylor and Francis Ltd.
Abstract
Background: This review aimed to provide evidence on the efficacy of
liposomal bupivacaine as compared to standard bupivacaine for intercostal
nerve blocks (ICB) in patients undergoing minimally invasive thoracic
surgery. <br/>Method(s): Randomized controlled trials (RCTs) and
comparative observational studies published on the databases of PubMed,
CENTRAL, Web of Science, and Embase up to June 20, 2024, were included.
Total opioid consumption in morphine equivalents, pain scores, and length
of hospital stay (LOS) were compared. <br/>Result(s): Two RCTs and eight
observational studies were included. Eight hundred and four patients
received liposomal bupivacaine while 631 patients received standard
bupivacaine in the included studies. The meta-analysis showed that the use
of liposomal bupivacaine for ICB did not reduce opioid consumption as
compared to standard bupivacaine at 24 h, 48 h, and for the total duration
of hospitalization. Pain scores were also not significantly different
between the two groups at 24 h and 48 h. Meta-analysis showed that there
was no difference in the LOS between intervention and control groups.
Subgroup analysis based on study design also generated similar results.
<br/>Conclusion(s): Mostly low-quality evidence shows that liposomal
bupivacaine does not offer additional benefits over standard bupivacaine
when used for ICB in patients undergoing minimally invasive thoracic
surgery.<br/>Copyright &#xa9; 2024 Society of Medical Innovation and
Technology.

<9>
Accession Number
2034779411
Title
Risk factors and mortality of postoperative acute kidney injury (AKI) in
newborns across geographical regions, surgical type, and national economic
levels: a systematic review and meta-analysis.
Source
European Journal of Medical Research. 30(1) (no pagination), 2025. Article
Number: 433. Date of Publication: 01 Dec 2025.
Author
Cui Y.; Luo Y.; Zhang D.; Zhang Q.; Huang Q.; Gong T.
Institution
(Cui, Luo, Zhang, Zhang, Huang, Gong) Department of Anesthesiology, School
of Medicine, The Affiliated Hospital, UESTC Chengdu Women's and Children's
Central Hospital, No.1617, Riyue Avenue, Qingyang District, Chengdu, China
Publisher
BioMed Central Ltd
Abstract
Background: It is noted that postoperative acute kidney injury (AKI) in
neonates is known to be associated with adverse outcomes, yet its
incidence and risk factors remain incompletely elucidated. The current
study aims to improve the understanding of postoperative AKI in neonates
by systematically evaluating its incidence, diagnostic criteria, risk
factors, and clinical outcomes, with particular attention to variations
across geographic regions, surgical types, the span of time, and national
economic statuses. <br/>Method(s): A comprehensive search of Pubmed,
Embase, OVID, Web of Science (WOS), Medline, and Cochrane Controlled
Register of Trials (CENTRAL) was conducted from inception to 30 September
2024. Studies meeting all the following inclusion criteria were enrolled:
1) Population: neonates aged <= 30 days; 2) Disease: postoperative AKI
diagnosed per KDIGO, pRIFLE, AKIN, nKDIGO, or others; 3) Study design:
prospective/retrospective cohort studies or case-control studies; 4)
Reporting data on postoperative incidence of AKI. The pooled proportion
(along with 95% confidence intervals [CI]) of postoperative AKI was
calculated. We also calculated pooled odds ratios (95% CI) for all-cause
mortality in neonates with postoperative AKI when compared with those
without AKI. <br/>Result(s): A total of 69 studies (10,519 cases) were
included in the meta-analysis. The pooled incidence of postoperative AKI
in neonates was 37% (95%CI 32-42, I² = 96.4%, P<0.01), with a
wide variability ranging from 0.0% to 74.8%. Several risk factors were
identified, including lower preoperative or intraoperative urinary output,
lower preoperative serum creatinine (SCr)/higher maximum postoperative
SCr, elevated vasoactive inotrope score (VIS)/hypotension, younger
corrected gestational age, prolonged cardiopulmonary bypass (CPB)
duration, hypothermia, sepsis, and preoperative ventilation. Furthermore,
28 studies involving 6714 patients reported data on AKI-associated
mortality with an overall incidence of 8.2%. Neonates who developed
postoperative AKI had 3.3 times higher odds of mortality as compared to
those without this complication. <br/>Conclusion(s): Postoperative AKI
affects one-third of neonates, and AKI-associated mortality remains high.
Future efforts should focus on developing earlier and more sensitive
detection methods. Systematic review registration number: This
meta-analysis was registered on https://www.crd.york.ac.uk/prospero/ with
the registration number CRD 42024602820 on October 29, 2024.<br/>Copyright
&#xa9; The Author(s) 2025.

<10>
Accession Number
2034196582
Title
Impact of cardiopulmonary bypass flow on the lower limit of cerebral
autoregulation during cardiac surgery: a randomized cross-over pilot
study.
Source
Journal of Clinical Monitoring and Computing. 39(3) (pp 571-580), 2025.
Date of Publication: 01 Jun 2025.
Author
Desebbe O.; Berna A.; Joosten A.; Raphael D.; Malapert G.; Rolo D.;
Taccone F.S.; Gergele L.
Institution
(Desebbe, Berna, Rolo) Department of Anesthesiology and perioperative
care, Ramsay Sante, Sauvegarde Clinic, Lyon, France
(Joosten) Department of Anesthesiology & Perioperative Care, University of
California Los Angeles, Los Angeles, CA, United States
(Raphael) Department of Anesthesiology & Perioperative Care, University of
California Irvine, Irvine, CA, United States
(Malapert) Department of Cardiac Surgery, Ramsay Sante, Sauvegarde Clinic,
Lyon, France
(Taccone) Department of Intensive Care, Hopital Universitaire de Bruxelles
(HUB), Universite Libre de Bruxelles, Brussels, Belgium
(Gergele) Department of Anesthesiology and Perioperative Care, Ramsay
Sante, Hopital Prive de la Loire, Saint-Etienne, France
(Desebbe) Department of Anesthesiology & Perioperative Medicine, Clinique
de la Sauvegarde, 480 avenue Ben Gourion, Lyon, France
Publisher
Springer Science and Business Media B.V.
Abstract
Assessment of cerebral autoregulation is challenging under different
hemodynamic conditions during cardiac surgery and must be rapidly
calculated in order to optimize mean arterial pressure (MAP). Whether
systemic flow during cardiopulmonary bypass impacts the lower limit of
cerebral autoregulation (LLA) remains unclear. Forty patients requiring
cardiac surgery were included in this randomized crossover study. Patients
assigned to the conventional/high blood flow arm received 20 min of
conventional cardiopulmonary bypass (CPB) blood flow (2.2
L/min.m^-2) followed by 20 min of high blood flow (2.8
L/min.m^-2), both during aortic cross clamping. Patients
assigned to the high/conventional arm received the same flows but in
reverse order. During each 20-minute period, MAP was gradually increased
from 40 to 90 mmHg, while PaCO<inf>2</inf>, hematocrit, depth of
anesthesia, central temperature and arterial oxygen tension were kept
constant. Continuous cerebral blood flow velocities of the middle cerebral
artery (Fv) were monitored using transcranial doppler. Cerebral
autoregulation was calculated using a Pearson's correlation coefficient
(Mean flow index, Mxa) between the MAP and Fv. Mxa values were then
plotted across MAP ranges. The LLA was defined as the corresponding MAP
value when Mxa initially decreased and crossed the threshold value of 0.4.
A mixed model, including the LLA as the dependent variable, the CPB flow
and period as fixed effects and patients as a random effect was used to
compare conventional and high CPB flows. Thirty-seven patients were
analyzed. The LLA mean difference between groups, adjusted on the period,
was - 2.8 (SE 2.4) mmHg with 95% CI [-7.8, + 2.1 mmHg], p = 0.2538). 24%
of patients presented an LLA < 65 mmHg during the conventional CPB flow
phase versus 35% during the high CPB flow phase. Increasing the
cardiopulmonary pump flow did not decrease the LLA during cardiac
surgery.<br/>Copyright &#xa9; The Author(s), under exclusive licence to
Springer Nature B.V. 2025.

<11>
Accession Number
2038969175
Title
Association between inflammatory bowel disease, current therapies, and
cardiovascular events: a review and meta-analysis of data from 2.2 million
individuals.
Source
Journal of Crohn's and Colitis. 19(5) (no pagination), 2025. Article
Number: jjaf078. Date of Publication: 01 May 2025.
Author
Thomas D.-R.; Huangfu G.; Yeaman F.; Sukudom S.; Lan N.S.R.; Dwivedi G.;
Thin L.
Institution
(Thomas, Huangfu, Sukudom, Lan, Dwivedi) Department of Cardiology, Fiona
Stanley Hospital, Perth, Australia
(Thomas, Huangfu, Sukudom, Lan, Dwivedi, Thin) Medical School, The
University of Western, Perth, Australia
(Yeaman, Thin) Department of Gastroenterology, Fiona Stanley Hospital,
Perth, Australia
(Lan, Dwivedi, Thin) Harry Perkins Institute of Medical Research, Perth,
Australia
Publisher
Oxford University Press
Abstract
Background/Aims: Inflammatory bowel disease (IBD) is associated with
increased cardiovascular (CV) risk. Advanced therapies that treat IBD may
modify this risk. Our systematic review and meta-analysis aim to
investigate the association between IBD, its subtypes (Crohn's disease and
ulcerative colitis), and its therapies, with CV disease. <br/>Method(s):
Medline, Embase, Scopus, and Web of Science were searched from January
2000 to November 2023. Studies examining the relationship between IBD and
the CV outcomes of incident myocardial infarction (MI), ischemic heart
disease (IHD), cerebrovascular accident (CVA), and major adverse
cardiovascular events (MACE) were included. Pooled hazard ratios (HRs)
were calculated using inverse-variance weighted random effects
meta-analysis. Incidence rate differences for MACE were derived from
studies comparing IBD therapies. <br/>Result(s): Fourteen studies
evaluating CV outcomes were included. Of the 2 232 375 individuals, 10.8%
were IBD patients, mean age was 47.3 years, and 48.4% were male.
Inflammatory bowel disease was significantly associated with MI (HR 1.29,
95% CI, 1.07-1.56, I² = 0.87), IHD (HR 1.16, 95% CI, 1.01-1.33,
I² = 0.60), CVA (HR 1.15, 95% CI, 1.09-1.20, I² =
0.30), and MACE (HR 1.19, 95% CI, 1.09-1.30, I² = 0.81).
Incidence rate differences (events per 1000 patient-years) for MACE,
calculated for 16 comparative studies, ranged from 90.3 fewer events in
tofacitinib compared with placebo to an excess of 17.9 events in a
vedolizumab group compared with anti-TNFalpha biologics.
<br/>Conclusion(s): There is an increased risk of MI, IHD, CVA, and MACE
in IBD patients. Management of IBD needs to consider these risks and how
it may be adjusted when selecting advanced therapies.<br/>Copyright &#xa9;
The Author(s) 2025. Published by Oxford University Press on behalf of
European Crohn's and Colitis Organisation. All rights reserved.

<12>
Accession Number
2034729462
Title
The experience of immersive virtual reality in patients with heart failure
during cardiac rehabilitation: a qualitative study.
Source
Frontiers in Medicine. 12 (no pagination), 2025. Article Number: 1578399.
Date of Publication: 2025.
Author
Micheluzzi V.; Casu G.; Burrai F.; Canu A.; Sircana A.; Merella P.; Laconi
A.; Chelo A.; Cozzula P.; Piredda M.; Vellone E.
Institution
(Micheluzzi, Vellone) Department of Biomedicine and Prevention, University
of Rome "Tor Vergata", Rome, Italy
(Micheluzzi, Casu, Canu, Sircana, Merella, Laconi, Chelo, Cozzula)
Clinical and Interventional Cardiology, University Hospital of Sassari,
Sassari, Italy
(Casu, Burrai, Merella, Laconi, Chelo) Department of Medicine, Surgery and
Pharmacy, University of Sassari, Sassari, Italy
(Piredda) Research Unit of Nursing Science, Department of Medicine and
Surgery, Campus Bio-Medico of Rome University, Rome, Italy
(Vellone) Faculty of Nursing and Midwifery, Wroclaw Medical University,
Wroclaw, Poland
Publisher
Frontiers Media SA
Abstract
Background: To alleviate symptoms and reduce adverse outcomes associated
with heart failure, international guidelines strongly recommend cardiac
rehabilitation. However, patient adherence to rehabilitation programs
remains suboptimal, leading to unfavorable effects on key cardiac
outcomes. Immersive virtual reality (iVR) is a promising intervention to
improve adherence to cardiac rehabilitation and enhance clinical outcomes.
This study aims to explore patients' experiences with iVR during cardiac
rehabilitation. <br/>Method(s): A qualitative descriptive study was
embedded within a randomized controlled two-arm trial involving twenty-two
patients who were referred to undergo eight cardiac rehabilitation
sessions, held twice a week for 30min each. The intervention group
experienced iVR in natural settings, while the control group received
standard care. Semi-structured individual interviews were conducted in
person after the intervention group's eighth rehabilitation session. These
interviews were audio-recorded, transcribed verbatim, and analyzed using
content analysis. <br/>Result(s): Data from twenty-two interviews reached
saturation. Content analysis generated four main categories and nine
subcategories: (1) cognitive and emotional benefits of iVR (acceptability
and enrichment of the rehabilitation experience, positive emotions,
cognitive engagement); (2) impact on rehabilitation (physical engagement,
perceived effort); (3) customizable intervention (variety of scenarios,
quality and beauty of the videos); (4) negative aspects of the iVR
(discomfort with the equipment, negative feelings toward the iVR devices).
<br/>Conclusion(s): IVR is an innovative and customizable intervention
that enhances the rehabilitation experience by providing cognitive,
emotional, and physical benefits. It improves key aspects of
rehabilitation, including time perception, motivation, enjoyment, effort
perception, and anxiety management, highlighting its potential in cardiac
rehabilitation. However, certain technological challenges, such as
discomfort with the equipment, must be addressed to optimize the user
experience.<br/>Copyright &#xa9; 2025 Micheluzzi, Casu, Burrai, Canu,
Sircana, Merella, Laconi, Chelo, Cozzula, Piredda and Vellone.

<13>
Accession Number
645614933
Title
Effectiveness of Non-Pharmacological Interventions in Improving Sleep
Quality After Cardiac Surgery: A Systematic Review and Meta-Analysis.
Source
Journal of clinical nursing. 34(6) (pp 2461-2463), 2025. Date of
Publication: 01 Jun 2025.
Author
Xie Q.-Q.; Tang M.-Y.
Institution
(Xie) Department of Cardiovascular Medicine, Zhejiang Provincial People's
Hospital (Affiliated People's Hospital), People's Hospital of Hangzhou
Medical College, Zhejiang Chinese Medical University, Zhejiang, China
(Tang) Department of Cardiovascular Medicine, Nursing Department, Zhejiang
Provincial People's Hospital (Affiliated People's Hospital), People's
Hospital of Hangzhou Medical College, Zhejiang, China

<14>
Accession Number
2034777572
Title
Mind the (research) gap: a retrospective observational study on the
utilization of new medical technologies and related research activities in
German hospitals.
Source
Health Research Policy and Systems. 23(1) (no pagination), 2025. Article
Number: 72. Date of Publication: 01 Dec 2025.
Author
Rombey T.; Eckhardt H.; Felgner S.; Dreger M.; Campione A.; Ermann H.;
Ehlig D.; Rodiger H.; Panteli D.; Henschke C.
Institution
(Rombey, Eckhardt, Campione, Ermann, Rodiger, Panteli) Department of
Health Care Management, Technische Universitat Berlin, Berlin, Germany
(Felgner, Dreger, Henschke) Department of Health Care Management and
Berlin Centre for Health Economics Research (BerlinHECOR), Technische
Universitat Berlin, Berlin, Germany
(Ehlig) Chair of Health Economics, Policy and Management, School of
Medicine (Med-HSG), Universitat St. Gallen, St. Gallen, Switzerland
(Henschke) Institute of General Practice and Interprofessional Care,
University Hospital Tubingen, Tubingen, Germany
Publisher
BioMed Central Ltd
Abstract
Objectives: Hospitals play a major role in generating clinical evidence on
new medical technologies. Thus far, the extent of German hospitals'
contribution to the evidence base has not been sufficiently investigated.
This study aims to: (1) examine the utilization of new medical
technologies in German hospitals and its relationship to different
hospital characteristics; (2) investigate the participation of German
hospitals in research on these technologies and the association between
hospital characteristics and research involvement; and (3) investigate the
contribution of German hospitals to international research activities,
including the levels of evidence of any studies conducted. <br/>Method(s):
Using a systematically derived sample of 13 new medical technologies and
various data sources, we retrospectively analyzed the utilization of and
research activities by German hospitals between 2005 and 2017 and explored
which hospital characteristics they were associated with. The data were
analyzed descriptively and are expressed as bar plots, box plots,
quartiles, and crude odds ratios (ORs). <br/>Result(s): The proportion of
German hospitals using new technologies while also being involved in
related clinical research was relatively low (ranging from 0.3% to 29.4%,
except for transcatheter aortic valve implantation (TAVI), with 60.7%),
particularly for prospective studies. Research involvement was positively
associated with university hospital status, larger bed capacity, and
public ownership. Overall, the research involving German hospitals
predominantly consisted of single-arm studies and not randomized
controlled trials (RCTs). <br/>Conclusion(s): Our study identified a gap
between hospitals using new medical technologies and their involvement in
evidence generation. This imbalance can contribute to uncertainty
regarding the actual efficacy, effectiveness and safety of new medical
technologies. To ensure evidence-based patient care, it is therefore
essential to strengthen the link between research and practice, in both
directions. A first step to achieve this could entail restricting the use
of new medical technologies to specialized innovation centers (e.g.,
university hospitals, specialized hospitals) during the initial years of
their utilization to ensure an adequate evidence base is generated before
widespread implementation.<br/>Copyright &#xa9; The Author(s) 2025.

<15>
Accession Number
2038499255
Title
Efficacy of enhanced recovery programmes for cardiac surgery: a systematic
review and meta-analysis.
Source
British Journal of Anaesthesia. 135(1) (pp 31-39), 2025. Date of
Publication: 01 Jul 2025.
Author
Hoogma D.F.; Meeusen I.; Coppens S.; Verbrugghe P.; van den Eynde J.;
Engelman D.T.; Grant M.C.; Stoppe C.; Rex S.
Institution
(Hoogma, Coppens, Rex) Department of Anesthesiology, University Hospitals
Leuven, KU Leuven, Leuven, Belgium
(Hoogma, Coppens, Verbrugghe, van den Eynde, Rex) Biomedical Sciences
Group, Department of Cardiovascular Sciences, University of Leuven, KU
Leuven, Leuven, Belgium
(Meeusen) Biomedical Sciences, University of Leuven, KU Leuven, Leuven,
Belgium
(Verbrugghe) Department of Cardiac Surgery, University Hospitals Leuven,
KU Leuven, Leuven, Belgium
(Engelman) Heart and Vascular Program, Baystate Medical Center,
Springfield, MA, United States
(Grant) Department of Anesthesiology and Critical Care Medicine, Johns
Hopkins University School of Medicine, Baltimore, MD, United States
(Stoppe) Department of Anaesthesiology, Intensive Care, Emergency and Pain
Medicine, University Hospital Wurzburg, Wurzburg, Germany
(Stoppe) Department of Cardiac Anesthesiology and Intensive Care Medicine,
Charite Berlin, Berlin, Germany
Publisher
Elsevier Ltd
Abstract
Background: The terms fast-track (FT) and enhanced recovery after surgery
(ERAS) are often mistakenly used interchangeably. Fast-track cardiac
anaesthesia focuses on perioperative strategies, whereas ERAS (or enhanced
recovery programme [ERP]) encompasses a wider range of strategies designed
to enhance overall recovery. Evidence is needed to demonstrate the
additive value of ERP above FT in cardiac surgery. We conducted a
meta-analysis to investigate the comparative efficacy of ERP and FT
programmes in cardiac surgery. <br/>Method(s): We systematically searched
PubMed, Embase, and Web of Science for randomised trials and prospective
observational trials investigating ERP or FT programmes in cardiac surgery
(up to November 16, 2024). Following PRISMA guidelines, two reviewers
independently selected studies, extracted data, and assessed risk of bias.
Data were pooled using a random-effects model. The primary efficacy
outcome was hospital length of stay (LOS). <br/>Result(s): A total of 6368
articles were identified, of which 18 studies, with 2625 patients, were
included. Compared with control, a significant reduction in hospital LOS
(mean difference [95% confidence interval (CI)] -1.40 days [-2.19 to
-0.61], P=0.001), ICU LOS (-13.22 h [-21.75 to -4.68], P=0.006), and
ventilation time (-4.68 h [-7.85 to -1.52], P=0.008) was identified when
ERP or FT programmes were implemented. ERP demonstrated an additive value
above FT for hospital LOS (2.11 days [-3.52 to 0.71] vs -0.30 days [-0.88
to 0.27], respectively; P=0.003). <br/>Conclusion(s): In cardiac surgery,
ERP can reduce LOS in the ICU and hospital and ventilatory time. Moreover,
it is suggested that ERPs, including preoperative, intraoperative, and
postoperative interventions, are preferred above only intraoperative FT
strategies. Systematic review protocol: PROSPERO
(CRD42022382409).<br/>Copyright &#xa9; 2025 British Journal of Anaesthesia

<16>
Accession Number
2034753704
Title
The clinical use of platelet transfusions: A systematic literature review
and meta-analysis on behalf of the International Collaboration for
Transfusion Medicine Guidelines.
Source
Transfusion. 65(6) (pp 1155-1169), 2025. Date of Publication: 01 Jun 2025.
Author
Jug R.; La Rocca U.; Al-Riyami A.Z.; Bathla A.; Metcalf R.A.; White S.K.;
Stanworth S.J.; Nahirniak S.
Institution
(Jug) Department of Pathology, University of Cincinnati, Cincinnati, OH,
United States
(La Rocca) Italian National Blood Center, National Institute of Health,
Sapienza University of Rome, Rome, Italy
(Al-Riyami) Department of Hematology, Sultan Qaboos University Hospital,
University Medical City, Muscat, Oman
(Al-Riyami) College of Medicine and Health Sciences, Sultan Qaboos
University, Muscat, Oman
(Bathla) Canadian Blood Services, Toronto, Canada
(Metcalf, White) Department of Pathology, University of Utah, Salt Lake
City, UT, United States
(Stanworth) NHS Blood and Transplant, University of Oxford, Oxford, United
Kingdom
(Stanworth) Oxford University Hospitals NHS Trust, University of Oxford,
Oxford, United Kingdom
(Stanworth) Radcliffe Department of Medicine, University of Oxford,
Oxford, United Kingdom
(Nahirniak) Department of Laboratory Medicine and Pathology, University of
Alberta, Edmonton, AB, Canada
(Nahirniak) Alberta Precision Laboratories, Edmonton, AB, Canada
Publisher
John Wiley and Sons Inc
Abstract
Background: Platelets are frequently transfused, but supply and potential
harms highlight the importance of appropriate use. Study Design and
Methods: Our systematic review (SR) followed a predefined protocol.
Eligible studies included SRs, randomized controlled trials (RCTs), and
matched cohort observational studies between 1946 and March 2025.
Populations included were hypoproliferative thrombocytopenia,
periprocedural prophylaxis, cardiovascular surgery, consumptive
thrombocytopenia, and intracranial hemorrhage. The intervention was
restrictive versus liberal platelet transfusion strategies on outcomes of
mortality and bleeding. Duplicate screening and data extraction occurred.
Meta-analysis used Mantel-Haenszel method of random effects model.
<br/>Result(s): Twenty-one RCTs, 24 observational studies, and 20 SRs were
included. The evidence quality varied. For hypoproliferative
thrombocytopenia, 11 RCTs were analyzed, with 9 RCTs at moderate risk of
bias (ROB). Two RCTs were identified for dengue, with high ROB for
bleeding. One RCT was identified each in cardiovascular surgery,
intracranial hemorrhage, and periprocedural prophylaxis. Meta-analyses
indicated no significant effect for outcomes of mortality or bleeding by
strategy, but confidence intervals (CIs) were wide. Effect estimates were
1.32 [0.93, 1.86] for all-cause mortality in hypoproliferative
thrombocytopenia, 0.80 [0.38, 1.70] in cardiovascular surgery, and 0.69
[0.47, 1.03] in critically ill neonates or dengue patients.
<br/>Discussion(s): A consistent lack of benefit with liberal platelet
transfusion was observed across analyzed populations, although wide
confidence intervals do not exclude clinically meaningful impacts.
Important research gaps are highlighted in areas where the RCT data is
limited.<br/>Copyright &#xa9; 2025 The Author(s). Transfusion published by
Wiley Periodicals LLC on behalf of AABB.

<17>
Accession Number
2034803706
Title
Imaging-guided PCI improves outcomes in patients with multivessel disease
a meta-analysis of randomized and observational trials comparing treatment
of ACS.
Source
Cardiovascular Revascularization Medicine. 75 (pp 84-89), 2025. Date of
Publication: 01 Jun 2025.
Author
Saganowich J.; Powell J.; Mixon T.A.; Exaire J.E.; Otsuki H.; Fearon W.;
Widmer R.J.
Institution
(Saganowich, Powell, Mixon, Widmer) Texas A&M School of Medicine, Bryan,
TX, United States
(Mixon, Exaire, Widmer) Division of Cardiology, Department of Internal
Medicine Baylor Scott and White, Temple, TX, United States
(Otsuki, Fearon) Division of Cardiovascular Medicine and Stanford
Cardiovascular Institute, Stanford University, CA, United States
(Widmer) Medical Director of the Baylor Scott and White Cath/EP Labs &
Research Institute, Temple, TX, United States
Publisher
Elsevier Inc.
Abstract
Objective: This meta-analysis sought to investigate if IVUS-guided PCI
(IVUS-PCI) can improve outcomes compared to standard PCI and CABG in
patients with multivessel CAD. <br/>Background(s): Coronary artery disease
(CAD) is traditionally revascularized by either percutaneous coronary
intervention (PCI) or coronary artery bypass (CABG) with a historical
benefit of CABG over PCI in multivessel CAD. Intravascular
ultrasound-guided PCI (IVUS-PCI) may improve outcomes compared to
angiography alone. <br/>Method(s): We undertook a systematic search using
PubMed, MEDLINE, EMBASE, Web of Science, and Ovid from 2017 through 2022.
We included randomized controlled trials and observational trials
comparing PCI vs CABG for multivessel CAD evaluated by two independent
reviewers. We extracted baseline data and major adverse cardiovascular
events (MACE; death from any cause, MI, stroke, or repeat
revascularization) at one year. Three trials were selected based on study
arm criteria: FAME 3, BEST, and Syntax II. <br/>Result(s): IVUS-PCI
significantly reduced death from any cause (OR 0.45, CI 0.272-0.733, p =
0.001), repeat revascularization (OR 0.62, CI 0.41-0.95, p = 0.03), and
showed a non-significant reduction in MACE (OR 0.74, CI 0.54-1.01, p =
0.054) when compared to CABG. IVUS-PCI significantly reduced MACE (OR
0.52, CI 0.38-0.72, p < 0.001) and showed a non-significant reduction in
death (OR 0.66, CI 0.36-1.18, p = 0.16) and numerically reduced repeat
revascularization (OR 0.66, CI95 0.431-1.02, p = 0.06) when compared to
PCI without IVUS. <br/>Conclusion(s): IVUS-PCI reduces cardiovascular
outcomes in patients with multivessel disease compared to CABG and
angiographically-guided PCI at one year. These results reinforce the
importance of IVUS-PCI in complex CAD and provide evidence for improved
PCI outcomes compared to CABG for multivessel CAD.<br/>Copyright &#xa9;
2024 Elsevier Inc.

<18>
Accession Number
2036544876
Title
The Effect of Intravenous Dexmedetomidine During Surgery in the Prevention
of Shivering After General Anesthesia in Patients Undergoing Spinal
Surgery: A Randomized Clinical Trial.
Source
Anesthesiology and Pain Medicine. 15(2) (no pagination), 2025. Article
Number: e159077. Date of Publication: 01 Apr 2025.
Author
Shokri M.; Bakhtiari Z.; Kargar B.; Hajialigol A.
Institution
(Shokri) School of Medicine, Tabriz University of Medical Sciences,
Tabriz, Iran, Islamic Republic of
(Bakhtiari) Tabriz University of Medical Sciences, Tabriz, Iran, Islamic
Republic of
(Kargar) Islamic Azad University of Medical Sciences, Tehran, Iran,
Islamic Republic of
(Hajialigol) Alborz Office of Universal Scientific Education and Research
Network (USERN), Alborz University of Medical Sciences, Karaj, Iran,
Islamic Republic of
Publisher
Brieflands
Abstract
Background: Postoperative shivering is an involuntary, spontaneous, and
repetitive contraction of skeletal muscles that causes patient
restlessness, increased oxygen consumption, wound infection, surgical
bleeding, and cardiac events. Patients undergoing spine surgery in the
prone position are particularly susceptible to hypothermia.
<br/>Objective(s): Given the importance of controlling postoperative
shivering in these patients, the present study aimed to investigate the
effect of intraoperative dexmedetomidine (Dex) infusion in preventing
shivering after general anesthesia in patients undergoing spine surgery in
the prone position. <br/>Method(s): In this double-blind randomized
clinical trial, 60 American Society of Anesthesiologists (ASA) class I or
II patients undergoing vertebral surgery in the prone position were
enrolled. Patients in the study group (n = 30) received Dex infusion
during surgery, while those in the placebo group (n = 30) received an
equivalent volume of 0.9% normal saline. Hemodynamic variables, frequency
and severity of shivering, and drug side effects were recorded.
<br/>Result(s): The mean arterial pressure (MAP) at 90 minutes (P =
0.022), immediately before extubation (P = 0.001), and after extubation (P
= 0.001), as well as HR values at 60 minutes (P = 0.020), 90 minutes (P =
0.001), immediately before extubation (P = 0.001), and after extubation (P
= 0.001), were significantly lower in the study group compared to the
placebo group. The frequency of bradycardia (26.7% vs. 0%, P = 0.002) and
hypotension (20% vs. 0%, P = 0.012) was significantly higher in the study
group. At all evaluated times, the mean body temperature in the study
group was significantly higher than in the placebo group (P < 0.05). The
frequency (10% vs. 30%, P = 0.003) and intensity (P = 0.001) of shivering
in the study group were significantly lower than in the placebo group.
<br/>Conclusion(s): This study demonstrated that the preventive use of Dex
infusion during surgery reduces the frequency and severity of
postoperative shivering in patients undergoing spinal surgery in the prone
position. However, this method was associated with hypotension and
bradycardia in some patients.<br/>Copyright &#xa9; 2025, Shokri et al.

<19>
Accession Number
2028062108
Title
Comparison Between Drug-Coated Balloon and Stents in Large De Novo
Coronary Artery Disease: A Systematic Review and Meta-Analysis of RCT
Data.
Source
Cardiovascular Drugs and Therapy. 39(3) (pp 677-686), 2025. Date of
Publication: 01 Jun 2025.
Author
Ma Z.; Liu K.; Hu Y.; Hu X.; Wang B.; Li Z.
Institution
(Ma, Liu, Hu, Hu, Wang, Li) Division of Cardiology, Departments of
Internal Medicine, Liyuan Hospital, Tongji Medical College, Huazhong
University of Science and Technology, Wuhan, China
Publisher
Springer
Abstract
Purpose: Although a number of studies involving small-vessel de novo
coronary disease showed clinical benefits of drug-coated balloons (DCB),
the role of DCB in large vessel lesions is still unclear. <br/>Method(s):
We searched main electronic databases for randomized controlled trials
(RCTs) comparing DCB with stents for large vessel de novo coronary artery
disease. The primary endpoint was major cardiovascular adverse events
(MACE), composite cardiovascular death (CD), myocardial infarction (MI),
or target lesion revascularization (TLR). <br/>Result(s): This study
included 7 RCTs with 770 participants. DCB were associated with a marked
risk reduction in MACE [Risk Ratio (RR): 0.48; 95% confidence interval
[CI]: 0.24 to 0.97; P = 0.04], TLR (RR: 0.53; 95% CI: 0.25 to 1.14; P =
0.10), and late lumen loss [standard mean difference (SMD): -0.57; 95% CI:
-1.09 to -0.05; P = 0.03] as compared with stents. There is no significant
difference in MI (RR: 0.58; 95% CI: 0.21 to 1.54; P = 0.27), CD (RR: 0.33;
95% CI: 0.06 to 1.78; P = 0.19), and minimal lumen diameter (SMD: -0.34;
95% CI: -0.72 to 0.05; P = 0.08) between groups. In subgroup analyses, the
risk reduction of MACE persisted in patients with chronic coronary
syndrome (RR: 0.25; 95% CI: 0.07 to 0.89; P = 0.03), and patients
receiving DCB vs. bare metal stent (RR: 0.19; 95% CI: 0.05 to 0.73; P =
0.01). In addition, there was no significant difference between the DCB
group and the drug eluting stent group for MACE (RR: 0.69; 95% CI: 0.30 to
1.60; P = 0.38). <br/>Conclusion(s): DCB may be an effective therapeutic
option in patients with large vessel de novo coronary artery
disease.<br/>Copyright &#xa9; The Author(s) 2024.

<20>
Accession Number
2039062767
Title
Continuation versus Interruption of Oral Anticoagulation during TAVI.
Source
New England Journal of Medicine. 392(5) (pp 438-449), 2025. Date of
Publication: 30 Jan 2025.
Author
Van Ginkel D.J.; Bor W.L.; Aarts H.M.; Dubois C.; De Backer O.;
Rooijakkers M.J.P.; Rosseel L.; Veenstra L.; Van Der Kley F.; Van Bergeijk
K.H.; Van Mieghem N.M.; Agostoni P.; Voskuil M.; Schotborgh C.E.;
Ijsselmuiden A.J.J.; Van Der Heyden J.A.S.; Hermanides R.S.; Barbato E.;
Mylotte D.; Fabris E.; Frambach P.; Dujardin K.; Ferdinande B.; Peper J.;
Rensing B.J.W.M.; Timmers L.; Swaans M.J.; Brouwer J.; Nijenhuis V.J.;
Overduin D.C.; Adriaenssens T.; Kobari Y.; Vriesendorp P.A.;
Montero-Cabezas J.M.; El Jattari H.; Halim J.; Van Den Branden B.J.L.;
Leonora R.; Vanderheyden M.; Lauterbach M.; Wykrzykowska J.J.; Van 'T Hof
A.W.J.; Van Royen N.; Tijssen J.G.P.; Delewi R.; Ten Berg J.M.
Institution
(Van Ginkel, Bor, Peper, Rensing, Timmers, Swaans, Brouwer, Nijenhuis,
Overduin, Ten Berg) Department of Cardiology, St. Antonius Hospital,
Nieuwegein, Netherlands
(Aarts, Tijssen, Delewi) Department of Cardiology, Amsterdam UMC,
Amsterdam, Netherlands
(Aarts, Voskuil) Department of Cardiology, University Medical Center
Utrecht, Utrecht, Netherlands
(Rooijakkers, Nijenhuis, Van Royen) Department of Cardiology, Radboud
University Medical Center, Nijmegen, Netherlands
(Veenstra, Ijsselmuiden, Vriesendorp, Van 'T Hof) Department of
Cardiology, Maastricht University Medical Center, Maastricht, Netherlands
(Veenstra, Vriesendorp, Van 'T Hof, Ten Berg) Cardiovascular Research
Institute Maastricht, Maastricht, Netherlands
(Van Der Kley, Montero-Cabezas) Department of Cardiology, Leiden
University Medical Center, Leiden, Netherlands
(Van Bergeijk, Wykrzykowska) Department of Cardiology, University Medical
Center Groningen, Groningen, Netherlands
(Van Mieghem) Department of Cardiology, Erasmus University Medical Center,
Rotterdam, Netherlands
(Schotborgh) Department of Cardiology, Haga Hospital, the Hague,
Netherlands
(Ijsselmuiden, Halim, Van Den Branden) Department of Cardiology, Amphia
Hospital, Breda, Netherlands
(Hermanides, Leonora) Department of Cardiology, Isala Hospital, Zwolle,
Netherlands
(Halim) Department of Cardiology, Elisabeth-Tweesteden Hospital, Tilburg,
Netherlands
(Dubois, Adriaenssens) Department of Cardiovascular Medicine, University
Hospital Leuven, Leuven, Belgium
(Rosseel) Department of Cardiology, Algemeen Stedelijk Hospital Aalst,
Aalst, Belgium
(Barbato, Vanderheyden) Cardiovascular Center Aalst, Onze Lieve Vrouw
Hospital, Aalst, Belgium
(Agostoni, El Jattari) Department of Cardiology, Hospital Network Antwerp
(ZNA) Middelheim, Antwerp, Belgium
(Van Der Heyden) Department of Cardiology, Sint-Jan Hospital, Bruges,
Belgium
(Dujardin) Department of Cardiology, AZ Delta, Roeselare, Belgium
(Ferdinande) Department of Cardiology, Hospital Oost-Limburg, Genk,
Belgium
(De Backer, Kobari) Heart Center, Rigshospitalet, Copenhagen University
Hospital, Copenhagen, Denmark
(Barbato) Department of Clinical and Molecular Medicine, Sapienza
University of Rome, Rome, Italy
(Fabris) Cardiothoracovascular Department, University of Trieste, Trieste,
Italy
(Mylotte) Department of Cardiology, University Hospital Galway, Galway,
Ireland
(Frambach, Lauterbach) Department of Cardiology, Institut National de
Chirurgie Cardiaque et de Cardiologie Interventionnelle, Luxembourg
Publisher
Massachussetts Medical Society
Abstract
Background One third of patients undergoing transcatheter aortic-valve
implantation (TAVI) have an indication for oral anticoagulation owing to
concomitant diseases. Interruption of oral anticoagulation during TAVI may
decrease the risk of bleeding, whereas continuation may decrease the risk
of thromboembolism. Methods We conducted an international, open-label,
randomized, noninferiority trial involving patients who were receiving
oral anticoagulants and were planning to undergo TAVI. Patients were
randomly assigned in a 1:1 ratio to periprocedural continuation or
interruption of oral anticoagulation. The primary outcome was a composite
of death from cardiovascular causes, stroke from any cause, myocardial
infarction, major vascular complications, or major bleeding within 30 days
after TAVI. Results A total of 858 patients were included in the modified
intention-to-treat population: 431 were assigned to continuation and 427
to interruption of oral anticoagulation. A primary-outcome event occurred
in 71 patients (16.5%) in the continuation group and in 63 (14.8%) in the
interruption group (risk difference, 1.7 percentage points; 95% confidence
interval [CI], -3.1 to 6.6; P=0.18 for noninferiority). Thromboembolic
events occurred in 38 patients (8.8%) in the continuation group and in 35
(8.2%) in the interruption group (risk difference, 0.6 percentage points;
95% CI, -3.1 to 4.4). Bleeding occurred in 134 patients (31.1%) in the
continuation group and in 91 (21.3%) in the interruption group (risk
difference, 9.8 percentage points; 95% CI, 3.9 to 15.6). Conclusions In
patients undergoing TAVI with a concomitant indication for oral
anticoagulation, periprocedural continuation was not noninferior to
interruption of oral anticoagulation during TAVI with respect to the
incidence of a composite of death from cardiovascular causes, stroke,
myocardial infarction, major vascular complications, or major bleeding at
30 days.<br/>Copyright &#xa9; 2024 Massachusetts Medical Society.

<21>
Accession Number
2033335079
Title
Balloon-versus self-expandable transcatheter aortic valve implantation in
small aortic annuli: a meta-analysis of randomized and propensity studies.
Source
Cardiovascular Intervention and Therapeutics. 40(3) (pp 607-618), 2025.
Date of Publication: 01 Jul 2025.
Author
Baudo M.; Sicouri S.; Yamashita Y.; Magouliotis D.; Cabrucci F.; Carnila
S.; Ramlawi B.
Institution
(Baudo, Sicouri, Yamashita, Magouliotis, Cabrucci, Carnila, Ramlawi)
Department of Cardiac Surgery Research, Lankenau Institute for Medical
Research, Main Line Health, 100 E Lancaster Avenue, Wynnewood, PA, United
States
(Yamashita, Ramlawi) Department of Cardiac Surgery, Lankenau Heart
Institute, Main Line Health, Wynnewood, PA, United States
Publisher
Springer
Abstract
The hemodynamic and clinical differences between balloon- (BEV) and
self-expandable valves (SEV) are critical for patients with a small aortic
annulus (SAA). This meta-analysis aims to evaluate the clinical and
hemodynamic performance of these two systems in patients with severe
aortic stenosis and SAA. A systematic review was conducted from inception
to June 2024 for randomized and propensity-score studies comparing BEV and
SEV outcomes in patients with a SAA. Reconstructed individual patient data
(IPD) from Kaplan Meier curves was pooled for overall survival and
rehospitalization for heart failure. Nine studies with 2856 patients met
our inclusion criteria: 1427 in the BEV group and 1429 in the SEV group.
SEV demonstrated superior hemodynamic performance, including improved iEOA
(Standardized Mead Difference [SMD]: 0.52, p = 0.0012), lower mean
gradients (SMD: - 0.89, p < 0.0001), and reduced PPM (Odds Ratio [OR]:
0.38, p < 0.0001) compared to BEV. BEV presented lower new pacemaker rates
compared to SEV (OR: 1.52, p = 0.0447). There were no significant
differences between SEV and BEV in terms of rates of > mild paravalvular
leaks, early stroke, and Valve Academic Research Consortium-defined
outcomes. Reconstructed IPD showed no significant differences in overall
survival (Hazard Ratio [HR]: 0.95, p = 0.584) and rehospitalization for
heart failure (HR: 1.05, p = 0.828) during follow-up. In patients with SAA
undergoing TAVI the use of BEV was associated with higher frequency of PPM
and/or pressure gradients. Similar early stroke, survival and
rehospitalization rates were reported. Pacemaker rates were higher with
SEV. Long-term follow-up studies are required, especially with
newer-generation devices.<br/>Copyright &#xa9; The Author(s) under
exclusive licence to Japanese Association of Cardiovascular Intervention
and Therapeutics 2025.

<22>
Accession Number
2034524148
Title
Cerebral embolic protection in transcatheter aortic valve implantation
(TAVI): a pooled analysis of 4091 patients.
Source
Cardiovascular Intervention and Therapeutics. 40(3) (pp 490-505), 2025.
Date of Publication: 01 Jul 2025.
Author
Balata M.; Gbreel M.I.; Elkasaby M.H.; Badran A.S.; Hassan M.; Westenfeld
R.; Pfister R.; Zimmer S.; Becher M.U.; Nickenig G.; Sugiura A.
Institution
(Balata, Becher) Department of Internal Medicine and Cardiology,
Friedrich-Alexander University of Erlangen-Nuremberg, Erlangen, Germany
(Gbreel) Faculty of Medicine, October 6 University, Giza, Egypt
(Elkasaby) Faculty of Medicine, Al-Azhar University, Cairo, Egypt
(Badran) Faculty of Medicine, Ain Shams University, Cairo, Egypt
(Hassan) Department of Immunology, Theodor Bilharz Research Institute,
Giza, Egypt
(Westenfeld) Department of Internal Medicine and Cardiology, University
Hospital Duesseldorf, Dusseldorf, Germany
(Pfister) Department of Internal Medicine and Cardiology, University
Hospital Cologne, Cologne, Germany
(Zimmer, Nickenig, Sugiura) Department of Internal Medicine and Polyclinic
II, University Hospital Bonn, Bonn, Germany
Publisher
Springer
Abstract
Background: Transcatheter aortic valve implantation (TAVI) is increasingly
used for severe aortic stenosis, but debris embolization during the
procedure can lead to strokes, impacting survival and quality of life. The
role of cerebral embolic protection devices (CEPDs) in mitigating stroke
risk remains debated. We aim to evaluate the impact of CEPDs on the risk
of stroke and neurocognitive outcomes after TAVI. <br/>Method(s): Six
databases (PubMed, Scopus, Web of Science, Cochrane, Embase, and Ovid)
were searched until 20 January 2023. Original randomized controlled trials
(RCTs) were only included and critically appraised using the Cochrane risk
of bias (ROB) tool. <br/>Result(s): Seven RCTs (4091 patients) were
analyzed. CEPDs significantly reduced the risk of disabling stroke within
2-5 days post-TAVI (relative risk = 0.455, 95% CI: [0.214, 0.967]; p =
0.041). However, there was no significant difference in disabling stroke
risk between the two groups at the 30-day follow-up (relative risk =
1.295, 95% CI: [0.373, 4.493]; p = 0.684). No significant differences were
observed in non-disabling or overall stroke rates at 2-5 days, 30 days, or
90 days. Additionally, CEPDs did not significantly affect risks of
life-threatening bleeding, major vascular complications, mortality, or
acute kidney injury. <br/>Conclusion(s): CEPDs are effective in reducing
disabling stroke risk in the immediate post-TAVI period (2-5 days) but did
not significantly affect the rates of non-disabling stroke, overall
stroke, or disabling stroke after 30 days when compared to non-CEPD use.
These findings suggest that CEPDs may offer short-term
neuroprotection.<br/>Copyright &#xa9; The Author(s) under exclusive
licence to Japanese Association of Cardiovascular Intervention and
Therapeutics 2025.

<23>
Accession Number
2039030131
Title
Pulsed Field or Cryoballoon Ablation for Paroxysmal Atrial Fibrillation.
Source
New England Journal of Medicine. 392(15) (pp 1497-1507), 2025. Date of
Publication: 17 Apr 2025.
Author
Reichlin T.; Kueffer T.; Badertscher P.; Juni P.; Knecht S.; Thalmann G.;
Kozhuharov N.; Krisai P.; Jufer C.; Maurhofer J.; Heg D.; Pereira T.V.;
Mahfoud F.; Servatius H.; Tanner H.; Kuhne M.; Roten L.; Sticherling C.
Institution
(Reichlin, Kueffer, Thalmann, Kozhuharov, Jufer, Maurhofer, Servatius,
Tanner, Roten) Department of Cardiology, Inselspital, Bern University
Hospital, University of Bern, Bern, Switzerland
(Badertscher, Knecht, Krisai, Mahfoud, Kuhne, Sticherling) Department of
Cardiology, University Hospital Basel, University of Basel, Basel,
Switzerland
(Juni, Pereira) Clinical Trial Service Unit, Epidemiological Studies Unit,
Nuffield Department of Population Health, University of Oxford, Oxford,
United Kingdom
(Heg) Department of Clinical Research, University of Bern, Bern,
Switzerland
Publisher
Massachussetts Medical Society
Abstract
Background Pulmonary-vein isolation is an effective treatment for
paroxysmal atrial fibrillation. Pulsed field ablation (PFA) is a
nonthermal ablation method with few adverse effects beyond the myocardium.
Data are lacking on outcomes after PFA as compared with cryoballoon
ablation as assessed with continuous rhythm monitoring. Methods In this
randomized noninferiority trial in Switzerland, we randomly assigned
patients with symptomatic paroxysmal atrial fibrillation in a 1:1 ratio to
undergo PFA or cryoablation. All the patients received an implantable
cardiac monitor to detect atrial tachyarrhythmias. The primary end point
was the first recurrence of an atrial tachyarrhythmia between day 91 and
day 365 after ablation. We assessed noninferiority using a margin of 20
percentage points for the difference in the cumulative incidence of
recurrence. The safety end point was a composite of procedure-related
complications. Results A total of 105 patients were assigned to undergo
PFA, and 105 were assigned to undergo cryoablation. A recurrence of atrial
tachyarrhythmia was observed between day 91 and day 365 in 39 patients in
the PFA group and in 53 patients in the cryoablation group (Kaplan-Meier
cumulative incidence, 37.1% and 50.7%, respectively; between-group
difference, -13.6 percentage points; 95% confidence interval, -26.9 to
-0.3; P<0.001 for noninferiority, P=0.046 for superiority). The safety end
point occurred in 1 patient (1.0%) with PFA and in 2 patients (1.9%) with
cryoablation. Conclusions Among patients with symptomatic paroxysmal
atrial fibrillation, PFA was noninferior to cryoballoon ablation with
respect to the incidence of a first recurrence of atrial tachyarrhythmia,
as assessed by continuous rhythm monitoring. (Funded by Inselspital and
others; SINGLE SHOT CHAMPION ClinicalTrials.gov number,
NCT05534581.)<br/>Copyright &#xa9; 2025 Massachusetts Medical Society.

<24>
Accession Number
2036583415
Title
Comparison of the Effects of Blood Cardioplegia and Del Nido Cardioplegia
on Postoperative Intensive Care Needs, Drainage, and Renal Functions in
Patients Undergoing Isolated Coronary Artery Bypass.
Source
Brazilian Journal of Cardiovascular Surgery. 40(4) (no pagination), 2025.
Article Number: e20240237. Date of Publication: 2025.
Author
Sarigol Y.; Yildirim S.; Isik M.; Tanyeli O.; Dereli Y.; Ege E.; Gormus N.
Institution
(Sarigol, Yildirim, Isik, Tanyeli, Dereli, Ege, Gormus) Department of
Cardiovascular Surgery, Necmettin Erbakan University, Faculty of Medicine
Hospital, Konya, Turkey
Publisher
Sociedade Brasileira de Cirurgia Cardiovascular
Abstract
Objective: A variety of cardioplegia techniques with different components
are implemented to ensure myocardial protection, in addition to keeping
the operational field immobile and free of blood during cardiac surgery.
The implemented cardioplegia has unwanted negative effects on other end
organs. In this study, our aim was to compare the effects of Del Nido
cardioplegia and blood cardioplegia solutions on postoperative intensive
care duration, drainage, and renal functions for patients undergoing
cardiopulmonary bypass and bypass graft operations. <br/>Method(s):
Selections were made from patients undergoing elective bypass graft
operations in our clinic from January 1, 2022 to December 31, 2023.
Patients were randomly selected, retrospectively assessed, and divided
into two groups - Del Nido group (Group 1) and blood cardioplegia group
(Group 2). Comparisons were made between these groups in terms of
intensive care duration, drainage, and renal functions. <br/>Result(s):
The study included 120 patients. The Del Nido cardioplegia group included
60 patients, with 60 patients in the blood cardioplegia group. Comparisons
between the groups found that the aortic cross-clamping duration was
significantly high in Group 1 (P = 0.014). The noradrenaline dose given to
Group 1 was high (P = 0.004). In terms of renal injury, significant degree
of elevation was present in Group 1 (P = 0.027). The longer aortic
cross-clamping duration in Group 1 may be assessed as a determinant factor
for noradrenaline dose and acute kidney injury. <br/>Conclusion(s): This
study concluded that it will be appropriate to choose the cardioplegia
method by performing broader meta-analysis studies and minimizing limiting
factors.<br/>Copyright &#xa9; 2025, Sociedade Brasileira de Cirurgia
Cardiovascular. All rights reserved.

<25>
Accession Number
2038162948
Title
Impact of pre-procedural red cell distribution width on one-year all-cause
mortality following transcatheter aortic valve replacement: A systematic
review and meta-analysis.
Source
Cardiovascular Revascularization Medicine. 75 (pp 129-136), 2025. Date of
Publication: 01 Jun 2025.
Author
Pingili A.; Kodali L.S.M.; Vadiyala M.R.; Koskina L.; Patel B.A.; Sanku
K.; Desai R.; Kondapaneni M.
Institution
(Pingili) Department of Internal Medicine, MedStar Health, Baltimore, MD,
United States
(Kodali) Department of Public Health & Health Sciences, University of
Michigan - Flint, Flint, MI, United States
(Vadiyala) Department of Internal Medicine, Maimonides Medical Center,
Brooklyn, NY, United States
(Koskina) Department of Internal Medicine, MedStar Health Union Memorial
Hospital, Baltimore, MD, United States
(Patel) Department of Internal Medicine, Trinity Health Oakland Hospital,
Pontiac, MI, United States
(Sanku) Department of Cardiology, Mount Sinai Medical Center, Miami Beach,
FL, United States
(Desai) Independent Outcomes Researcher, Atlanta, GA, United States
(Kondapaneni) Department of Heart & Vascular Center, MetroHealth,
Cleveland, OH, United States
Publisher
Elsevier Inc.
Abstract
Background: Red cell distribution width (RDW) has emerged as a novel
biomarker associated with adverse outcomes in patients with cardiovascular
disease (CVD). We aimed to determine the prognostic significance of
pre-procedural RDW levels on one-year all-cause mortality (ACM) following
transcatheter aortic valve replacement (TAVR) by conducting a systematic
review and meta-analysis due to limited evidence on the impact of RDW
levels in TAVR patients. <br/>Method(s): We systematically reviewed
articles on pre-procedural RDW and one-year ACM post-TAVR until February
2024 using PubMed and Google Scholar. Binary random effects model was used
for pooled adjusted odds ratio (aOR), with 95 % confidence intervals (CI)
and I2 statistics for heterogeneity. <br/>Result(s): A total of 7 studies
with 3273 patients aged between 70-90 years and 45 % males were analyzed.
High pre-procedural RDW was an independent predictor of one-year ACM (aOR
1.60, 95%CI 1.13-2.27, p < 0.01). This association is even more prominent
when aged > 80 years vs. <80 years (aOR 1.64, 95 % CI 1.17-2.31, p < 0.01
vs. aOR 1.46, 95 % CI 0.49-4.32, p < 0.01). Leave-one-out sensitivity
analysis validated the robustness of our meta-analysis.
<br/>Conclusion(s): Our study indicated that elevated baseline RDW is an
independent predictor of one-year ACM post-TAVR. Further studies are
needed to validate the importance of RDW as a marker of post-TAVR
outcomes.<br/>Copyright &#xa9; 2025 Elsevier Inc.

<26>
Accession Number
2038916279
Title
Aortic Valve Calcium: A Narrative Review of its Role in the Assessment of
Aortic Stenosis and as a Predictor of Post-transcatheter Aortic Valve
Implantation Outcomes.
Source
Interventional Cardiology: Reviews, Research, Resources. 20 (no
pagination), 2025. Article Number: e16. Date of Publication: 2025.
Author
Krzowski J.; Weir-McCall J.; D'Errico L.; Costopoulos C.; Costanzo P.
Institution
(Krzowski, Weir-McCall, D'Errico, Costopoulos, Costanzo) Royal Papworth
Hospital, Royal Papworth Hospital, NHS Foundation Trust, Cambridge, United
Kingdom
Publisher
Radcliffe Medical Media
Abstract
Degenerative aortic valve disease is the third most common cause of heart
disease in the developed world. Calcific deposits accrue in the valve
endothelium causing progressive stenosis of the orifice. Increasingly,
transcatheter aortic valve implantation is being used in place of surgery
as treatment for aortic stenosis, particularly for patients who are
considered high surgical risk. Although echocardiography remains the gold
standard for the diagnosis and grading of aortic valve stenosis, there is
an increasing interest in the role that aortic valve calcification scoring
may play in these areas. In this review, the authors evaluate the current
evidence for aortic valve calcium scoring as an adjunct to
echocardiography in grading, and as a prognostic marker in challenging
cases. They also explore the ability of calcium scoring to predict
outcomes following transcatheter aortic valve implantation.<br/>Copyright
&#xa9; The Author(s) 2025.

<27>
Accession Number
2039097520
Title
Myocardial Ischemia Presenting with Hiccups.
Source
Journal of the College of Physicians and Surgeons Pakistan. 29(5) (pp
469-473), 2019. Date of Publication: 01 May 2019.
Author
Yuan S.-M.
Institution
(Yuan) Department of Cardiothoracic Surgery, Division of Cardiac Surgery,
The First Hospital of Putian, Teaching Hospital, Fujian Medical
University, Fujian Province, Putian, China
Publisher
College of Physicians and Surgeons Pakistan
Abstract
Myocardial infarction/ischemia can be an underlying etiology and a major
causative risk factor of cardiovascular hiccups. The objective of this
systematic review was to review the literature regarding clinical features
and treatments of hiccups of cardiac ischemia origin. PRISMA guidelines
were followed. In elderly patients with hiccups of uncertain causes,
electrocardiography is necessary to ensure the cardiogenic etiology. Both
symptomatic and etiologic treatments can be effective in terminating
hiccups. Of the therapeutic regimens, gabapentin is a second-line agent
alternative to baclofen in treating hiccups. It is especially helpful in
patients undergoing stroke rehabilitation or palliative care when
chlorpromazine is prohibited due to its adverse effects. Inferior
myocardial infarction is the most common cause of hiccups in this patient
setting. In addition to anti-myocardial ischemia agents and percutaneous
coronary intervention, coronary artery bypass grafting could be an
alternative to hiccups in such patients.<br/>Copyright &#xa9; 2019 College
of Physicians and Surgeons Pakistan. All rights reserved.

<28>
Accession Number
2034264824
Title
Adverse outcomes with left atrial appendage occlusion device implantation
in chronic and end stage kidney disease: A systematic review and
meta-analysis.
Source
Cardiovascular Revascularization Medicine. 75 (pp 56-63), 2025. Date of
Publication: 01 Jun 2025.
Author
Gill G.S.; Shailly S.; Chakrala T.; Palicherla A.; Ponna P.K.; Alla V.M.;
Kanmanthareddy A.
Institution
(Gill) Minneapolis Heart Institute, Abbott Northwestern Hospital,
Minneapolis, MN, United States
(Shailly) Division of Nephrology, University of Michigan, Ann Arbor, MI,
United States
(Chakrala) Department of Medicine, University of Florida, Gainesville, FL,
United States
(Palicherla) Department of Medicine, Creighton University School of
Medicine, Omaha, NE, United States
(Ponna) Department of Medicine, Louisiana State University, Shreveport,
LA, United States
(Alla, Kanmanthareddy) Division of Cardiovascular Disease, Creighton
University School of Medicine, Omaha, NE, United States
Publisher
Elsevier Inc.
Abstract
Background: Chronic kidney disease (CKD) and end stage renal disease
(ESRD) are associated with increased risk of bleeding events, including
hemorrhagic stroke, and periprocedural and gastrointestinal bleeding among
patients with atrial fibrillation who are on anticoagulation. Safety of
percutaneous left atrial appendage occlusion (LAAO) among this patient
population has been uncertain with studies showing contradictory results.
<br/>Method(s): PubMed and Google Scholar databases were queried for
studies comparing outcomes among patients with and without significant
CKD, and with and without ESRD who underwent LAAO device implantation.
Data on outcomes from the selected studies were extracted and analyzed
using random effects model. Heterogeneity was assessed using I²
test. <br/>Result(s): Data from eleven studies with 61,724 patients with
and without kidney disease were included in the final analyses. There was
an increased risk of in-hospital mortality (OR 2.76, 95 % CI [1.15-6.64];
p = 0.02) and peri-procedural bleeding (1.51 [1.33-1.71]; p < 0.01)
associated with kidney disease. There was no significant difference in
risk of stroke (1.19 [0.70-2.03]; p = 0.53), pericardial effusion (1.22
[0.77-1.92]; p = 0.40), vascular complications (1.18 [0.92-1.52]; p =
0.20), or device related thrombus (1.13 [0.53-2.40]; p = 0.75).
<br/>Conclusion(s): This study shows an increased risk of complications
among patients with kidney disease, who undergo LAAO device implantation.
These findings suggest the need for studies with randomized control design
specifically designed to compare outcomes with LAAO versus anticoagulation
in the CKD and ESRD populations.<br/>Copyright &#xa9; 2024 Elsevier Inc.

<29>
Accession Number
2038704379
Title
Impact of Baseline Anteroposterior Mitral Annular Dimensions on Clinical
Outcomes after MitraClip for Secondary Mitral Regurgitation.
Source
Structural Heart. 9(6) (no pagination), 2025. Article Number: 100460. Date
of Publication: 01 Jun 2025.
Author
Rogers J.H.; Smith T.W.; Bax J.J.; Asch F.M.; Lim D.S.; Wong N.; Aiyer J.;
Abraham W.T.; Lindenfeld J.; Mack M.J.; Stone G.W.; Bolling S.F.
Institution
(Rogers, Smith) Division of Cardiovascular Medicine, University of
California, Davis Medical Center Sacramento, CA, United States
(Bax) Department of Cardiology, Leiden University Medical Center, Leiden,
Netherlands
(Asch) Cardiovascular Core Laboratories and Cardiac Imaging Research,
MedStar Health Research Institute, Washington, DC, United States
(Lim) Division of Cardiovascular Medicine, University of Virginia,
Charlottesville, VA, United States
(Wong) Advanced Cardiac Valve Center, University of Virginia,
Charlottesville, VA, United States
(Aiyer) Abbott Structural Heart, Santa Clara, CA, United States
(Abraham) Division of Cardiovascular Medicine, Ohio State University
Medical Center, Columbus, OH, United States
(Lindenfeld) Division of Cardiology, Vanderbilt University Medical Center,
Nashville, TN, United States
(Mack) Division of Cardiothoracic Surgery, Baylor Scott & White Research
Institute, Plano, TX, United States
(Stone) Zena and Michael A. Wiener Cardiovascular Institute, Icahn School
of Medicine at Mount Sinai, New York, NY, United States
(Bolling) Department of Cardiac Surgery, University of Michigan, Ann
Arbor, MI, United States
Publisher
Cardiovascular Research Foundation
Abstract
Background: In the randomized Cardiovascular Outcomes Assessment of the
MitraClip Percutaneous Therapy for Heart Failure Patients with Functional
Mitral Regurgitation (COAPT; NCT01626079) trial, mitral transcatheter
edge-to-edge repair (M-TEER) improved clinical outcomes in patients with
severe secondary mitral regurgitation (MR). A prior post hoc analysis from
the COAPT trial showed that increasing anteroposterior mitral annular
diameter (APMAD) was the sole independent echocardiographic predictor of
the composite endpoint of death or heart failure hospitalizations (HFH) at
2 years. Given the relationship between the mitral annulus and leaflets,
we examined the association of baseline APMAD with long-term clinical
outcomes. <br/>Method(s): COAPT patients (n = 575) were stratified into
tertiles by baseline APMAD as follows: small APMAD, medium APMAD, and
large APMAD. APMAD was measured in the anteroposterior direction from the
parasternal long-axis view at end-diastole and in the intercommissural
direction from the apical two-chamber view. <br/>Result(s): Patients with
larger baseline APMAD were more often male and had fewer comorbidities,
larger ventricles, and larger mitral orifice areas. At 2 years, there were
no significant differences in MR severity and the composite endpoint of
death or HFH in patients treated with M-TEER by baseline APMAD. In
patients treated with guideline-directed medical therapy (GDMT) alone,
there were no significant differences in MR severity, but the composite
endpoint of death or HFH was higher in patients with the largest baseline
APMADs. The treatment effect of M-TEER was consistent among APMAD tertiles
(p<inf>interaction</inf> = 0.87). <br/>Conclusion(s): APMAD was a
predictor of adverse outcomes in patients treated with GDMT alone. M-TEER
reduced MR severity and the risk of death or HFH regardless of baseline
APMAD compared with GDMT alone.<br/>Copyright &#xa9; 2025 The Authors

<30>
Accession Number
2038737231
Title
Early Aortic Valve Replacement Versus Conservative Management: A
Meta-Analysis of Randomized Controlled Trials.
Source
Structural Heart. 9(6) (no pagination), 2025. Article Number: 100461. Date
of Publication: 01 Jun 2025.
Author
Shah T.; Shah Y.; Lansky A.J.; Giri J.; Fanaroff A.; Nathan A.
Institution
(Shah, Giri, Fanaroff, Nathan) Division of Cardiovascular Medicine,
Hospital of the University of Pennsylvania, Philadelphia, PA, United
States
(Shah) Department of Internal Medicine, Strong Memorial Hospital,
Rochester, NY, United States
(Lansky) Division of Cardiology, Yale School of Medicine, New Haven, CT,
United States
(Lansky) Barts Heart Centre, London and Queen Mary University of London,
London, United Kingdom
Publisher
Cardiovascular Research Foundation

<31>
Accession Number
2034640079
Title
Effect of Adding Integrated Core and Graduated Upper Limb Exercises to
Inpatient Cardiac Rehabilitation on Sternal Instability After Coronary
Artery Bypass Grafting: A Randomized Controlled Trial.
Source
Archives of Physical Medicine and Rehabilitation. 105(12) (pp 2245-2252),
2024. Date of Publication: 01 Dec 2024.
Author
Mehani S.H.M.; Helmy Z.M.; Ali H.M.; Mohamed Mahmoud M.I.
Institution
(Mehani, Ali, Mohamed Mahmoud) Physical Therapy Department for
Cardiovascular / Respiratory Disorders and Geriatrics, Faculty of Physical
Therapy, Beni-Suef University
(Helmy) Physical Therapy Department for Cardiovascular / Respiratory
Disorders and Geriatrics, Faculty of Physical Therapy, Cairo University,
Cairo, Egypt
Publisher
W.B. Saunders
Abstract
Objective: To evaluate the effect of adding integrated core and graduated
resistance upper limb exercises to an inpatient cardiac rehabilitation
program in patients with acute sternal instability after coronary artery
bypass grafting (CABG). <br/>Design(s): This was a single-center,
randomized, controlled, parallel-group intervention study.
<br/>Setting(s): This study was conducted at the National Heart Institute.
<br/>Participant(s): Forty patients with post-CABG with sternal
instability aged 50-60 years completed this study and were randomized into
2 groups: an intervention group (n=20) and an active control group (n=20).
<br/>Intervention(s): The intervention group (A) received a routine
inpatient rehabilitation program from the first postoperative day plus
integrated core and graduated resistance upper limb exercises, which
started from the seventh postoperative day for approximately 4 weeks,
whereas the control group (B) received only the routine inpatient
rehabilitation program. <br/>Main Outcome Measure(s): Sternal separation
measured by ultrasonography, visual analog scale for measuring pain, and
activities of daily living (ADL) index were main outcome measures.
<br/>Result(s): Patients in the intervention group (A) showed a
significant reduction in sternal separation from the supine and long
sitting positions, whereas those in the control group (B) showed a
significant increase in sternal separation (P=.0001). Both groups showed a
reduction in pain, and an increase in the ADL score was observed in group
A. There was a significant interaction between the time and group effects
(P=.0001). <br/>Conclusion(s): Adding integrated core and graduated upper
limb exercises to inpatient cardiac rehabilitation for patients with
sternal instability after coronary artery bypass grafting significantly
improved sternal healing, pain, and ADL.<br/>Copyright &#xa9; 2024
American Congress of Rehabilitation Medicine

<32>
Accession Number
615956392
Title
Evolocumab and clinical outcomes in patients with cardiovascular disease.
Source
New England Journal of Medicine. 376(18) (pp 1713-1722), 2017. Date of
Publication: 04 May 2017.
Author
Sabatine M.S.; Giugliano R.P.; Keech A.C.; Honarpour N.; Wiviott S.D.;
Murphy S.A.; Kuder J.F.; Wang H.; Liu T.; Wasserman S.M.; Sever P.S.;
Pedersen T.R.
Institution
(Sabatine, Giugliano, Wiviott, Murphy, Kuder) Division of Cardiovascular
Medicine, Brigham and Women's Hospital, 60 Fenwood Rd, Boston, MA, United
States
(Keech) Sydney Medical School, National Health and Medical Research
Council Clinical Trials Centre, University of Sydney, Sydney, Australia
(Honarpour, Wang, Liu, Wasserman) Amgen, Thousand OaksCAUnited States
(Sever) International Centre for Circulatory Health, National Heart and
Lung Institute, Imperial College London, London, United Kingdom
(Pedersen) Oslo University Hospital, Ulleval and Medical Faculty,
University of Oslo, Oslo, Norway
Publisher
Massachussetts Medical Society
Abstract
BACKGROUND Evolocumab is a monoclonal antibody that inhibits proprotein
convertase subtilisin-kexin type 9 (PCSK9) and lowers low-density
lipoprotein (LDL) cholesterol levels by approximately 60%. Whether it
prevents cardiovascular events is uncertain. METHODS We conducted a
randomized, double-blind, placebo-controlled trial involving 27,564
patients with atherosclerotic cardiovascular disease and LDL cholesterol
levels of 70 mg per deciliter (1.8 mmol per liter) or higher who were
receiving statin therapy. Patients were randomly assigned to receive
evolocumab (either 140 mg every 2 weeks or 420 mg monthly) or matching
placebo as subcutaneous injections. The primary efficacy end point was the
composite of cardiovascular death, myocardial infarction, stroke,
hospitalization for unstable angina, or coronary revascularization. The
key secondary efficacy end point was the composite of cardiovascular
death, myocardial infarction, or stroke. The median duration of follow-up
was 2.2 years. RESULTS At 48 weeks, the least-squares mean percentage
reduction in LDL cholesterol levels with evolocumab, as compared with
placebo, was 59%, from a median baseline value of 92 mg per deciliter (2.4
mmol per liter) to 30 mg per deciliter (0.78 mmol per liter) (P<0.001).
Relative to placebo, evolocumab treatment significantly reduced the risk
of the primary end point (1344 patients [9.8%] vs. 1563 patients [11.3%];
hazard ratio, 0.85; 95% confidence interval [CI], 0.79 to 0.92; P<0.001)
and the key secondary end point (816 [5.9%] vs. 1013 [7.4%]; hazard ratio,
0.80; 95% CI, 0.73 to 0.88; P<0.001). The results were consistent across
key subgroups, including the subgroup of patients in the lowest quartile
for baseline LDL cholesterol levels (median, 74 mg per deciliter [1.9 mmol
per liter]). There was no significant difference between the study groups
with regard to adverse events (including new-onset diabetes and
neurocognitive events), with the exception of injection-site reactions,
which were more common with evolocumab (2.1% vs. 1.6%). CONCLUSIONS In our
trial, inhibition of PCSK9 with evolocumab on a background of statin
therapy lowered LDL cholesterol levels to a median of 30 mg per deciliter
(0.78 mmol per liter) and reduced the risk of cardiovascular events. These
findings show that patients with atherosclerotic cardiovascular disease
benefit from lowering of LDL cholesterol levels below current
targets.<br/>Copyright &#xa9; 2017 Massachusetts Medical Society.

<33>
Accession Number
604918312
Title
Ezetimibe added to statin therapy after acute coronary syndromes.
Source
New England Journal of Medicine. 372(25) (pp 2387-2397), 2015. Date of
Publication: 18 Jun 2015.
Author
Cannon C.P.; Blazing M.A.; Giugliano R.P.; McCagg A.; White J.A.; Theroux
P.; Darius H.; Lewis B.S.; Ophuis T.O.; Jukema J.W.; De Ferrari G.M.;
Ruzyllo W.; De Lucca P.; Im K.; Bohula E.A.; Reist C.; Wiviott S.D.;
Tershakovec A.M.; Musliner T.A.; Braunwald E.; Califf R.M.
Institution
(Cannon, Giugliano, McCagg, Im, Bohula, Wiviott, Braunwald) Thrombolysis
in Myocardial Infarction (TIMI) Study Group, Brigham and Women's Hospital,
Harvard Medical School, Boston, United States
(Blazing, White, Reist, Califf) Duke Clinical Research Institute (DCRI),
Durham, NC, United States
(Theroux) Montreal Heart Institute, Montreal, Canada
(Darius) Vivantes Neukolln Medical Center, Berlin, Germany
(Lewis) Lady Davis Carmel Medical Center, Haifa, Israel
(Ophuis) Canisius-Wilhelmina Ziekenhuis, Nijmegen, Netherlands
(Jukema) Netherlands Leiden University Medical Center, Leiden, Netherlands
(De Ferrari) Fondazione IRCCS Policlinico San Matteo, University of Pavia,
Pavia, Italy
(Ruzyllo) National Institute of Cardiology, Warsaw, Poland
(De Lucca, Tershakovec, Musliner) Merck, Kenilworth, NJ, United States
Publisher
Massachussetts Medical Society
Abstract
BACKGROUND: Statin therapy reduces low-density lipoprotein (LDL)
cholesterol levels and the risk of cardiovascular events, but whether the
addition of ezetimibe, a nonstatin drug that reduces intestinal
cholesterol absorption, can reduce the rate of cardiovascular events
further is not known. <br/>METHOD(S): We conducted a double-blind,
randomized trial involving 18,144 patients who had been hospitalized for
an acute coronary syndrome within the preceding 10 days and had LDL
cholesterol levels of 50 to 100 mg per deciliter (1.3 to 2.6 mmol per
liter) if they were receiving lipid-lowering therapy or 50 to 125 mg per
deciliter (1.3 to 3.2 mmol per liter) if they were not receiving
lipid-lowering therapy. The combination of simvastatin (40 mg) and
ezetimibe (10 mg) (simvastatin-ezetimibe) was compared with simvastatin
(40 mg) and placebo (simvastatin monotherapy). The primary end point was a
composite of cardiovascular death, nonfatal myocardial infarction,
unstable angina requiring rehospitalization, coronary revascularization
(>=30 days after randomization), or nonfatal stroke. The median follow-up
was 6 years. <br/>RESULT(S): The median time-weighted average LDL
cholesterol level during the study was 53.7 mg per deciliter (1.4 mmol per
liter) in the simvastatin-ezetimibe group, as compared with 69.5 mg per
deciliter (1.8 mmol per liter) in the simvastatin-monotherapy group
(P<0.001). The Kaplan-Meier event rate for the primary end point at 7
years was 32.7% in the simvastatin-ezetimibe group, as compared with 34.7%
in the simvastatin-monotherapy group (absolute risk difference, 2.0
percentage points; hazard ratio, 0.936; 95% confidence interval, 0.89 to
0.99; P = 0.016). Rates of pre-specified muscle, gallbladder, and hepatic
adverse effects and cancer were similar in the two groups.
<br/>CONCLUSION(S): When added to statin therapy, ezetimibe resulted in
incremental lowering of LDL cholesterol levels and improved cardiovascular
outcomes. Moreover, lowering LDL cholesterol to levels below previous
targets provided additional benefit.<br/>Copyright &#xa9; 2015
Massachusetts Medical Society.

<34>
Accession Number
372153520
Title
Varespladib and cardiovascular events in patients with an acute coronary
syndrome: The VISTA-16 randomized clinical trial.
Source
JAMA. 311(3) (pp 252-262), 2014. Date of Publication: 15 Jan 2014.
Author
Nicholls S.J.; Kastelein J.J.P.; Schwartz G.G.; Bash D.; Rosenson R.S.;
Cavender M.A.; Brennan D.M.; Koenig W.; Jukema J.W.; Nambi V.; Wright
R.S.; Menon V.; Lincoff A.M.; Nissen S.E.
Institution
(Nicholls) South Australian Health and Medical Research Institute,
University of Adelaide, Adelaide, SA, Australia
(Kastelein) Academic Medical Center, Amsterdam, Netherlands
(Schwartz) Veterans Affairs Medical Center, University of Colorado,
Denver, CO, United States
(Bash, Brennan, Menon, Lincoff, Nissen) Cleveland Clinic Coordinating
Center for Clinical Research, Cleveland, OH, United States
(Rosenson) Icahn School of Medicine at Mount Sinai, New York, NY, United
States
(Cavender) Brigham and Women's Hospital, Boston, MA, United States
(Koenig) University of Ulm Medical Center, Ulm, Germany
(Jukema) Leiden University Medical Center, Leiden, Netherlands
(Jukema) Interuniversity Cardiology Institute of the Netherlands, Utrecht,
Netherlands
(Nambi) Michael E. DeBakey Veterans Affairs Hospital, Baylor College of
Medicine, Houston, TX, United States
(Wright) Mayo Clinic, Rochester, MN, United States
Publisher
American Medical Association (E-mail: smcleod@itsa.ucsf.edu)
Abstract
IMPORTANCE: Secretory phospholipase A<inf>2</inf> (sPLA<inf>2</inf>)
generates bioactive phospholipid products implicated in atherosclerosis.
The sPLA<inf>2</inf> inhibitor varespladib has favorable effects on lipid
and inflammatory markers; however, its effect on cardiovascular outcomes
is unknown. <br/>OBJECTIVE(S): To determine the effects of
sPLA<inf>2</inf> inhibition with varespladib on cardiovascular outcomes.
DESIGN, SETTING, AND PARTICIPANTS: A double-blind, randomized, multicenter
trial at 362 academic and community hospitals in Europe, Australia, New
Zealand, India, and North America of 5145 patients randomized within 96
hours of presentation of an acute coronary syndrome (ACS) to either
varespladib (n = 2572) or placebo (n = 2573) with enrollment between June
1, 2010, and March 7, 2012 (study termination on March 9, 2012).
INTERVENTIONS: Participants were randomized to receive varespladib (500
mg) or placebo daily for 16 weeks, in addition to atorvastatin and other
established therapies. MAIN OUTCOMES AND MEASURES: The primary efficacy
measurewas a composite of cardiovascular mortality, nonfatal myocardial
infarction (MI), nonfatal stroke, or unstable angina with evidence of
ischemia requiring hospitalization at 16 weeks. Six-month survival status
was also evaluated. <br/>RESULT(S): At a prespecified interim analysis,
including 212 primary end point events, the independent data and safety
monitoring board recommended termination of the trial for futility and
possible harm. The primary end point occurred in 136 patients (6.1%)
treated with varespladib compared with 109 patients (5.1%) treated with
placebo (hazard ratio [HR], 1.25; 95%CI, 0.97-1.61; log-rank P = .08).
Varespladib was associated with a greater risk of MI (78 [3.4%] vs 47
[2.2%]; HR, 1.66; 95%CI, 1.16-2.39; log-rank P = .005). The composite
secondary end point of cardiovascular mortality, MI, and stroke was
observed in 107 patients (4.6%) in the varespladib group and 79 patients
(3.8%) in the placebo group (HR, 1.36; 95% CI, 1.02-1.82; P = .04).
CONCLUSIONS AND RELEVANCE: In patients with recent ACS, varespladib did
not reduce the risk of recurrent cardiovascular events and significantly
increased the risk of MI. The sPLA<inf>2</inf> inhibition with varespladib
may be harmful and is not a useful strategy to reduce adverse
cardiovascular outcomes after ACS. TRIAL REGISTRATION: clinicaltrials.gov
Identifier: NCT01130246. Copyright 2014 American Medical Association. All
rights reserved.

<35>
Accession Number
2039086733
Title
Remimazolam for anesthesia in cardiac and noncardiac surgery. A narrative
literature review and synthesis.
Source
Anaesthesia Critical Care and Pain Medicine. 44(4) (no pagination), 2025.
Article Number: 101555. Date of Publication: 01 Aug 2025.
Author
D'Andria Ursoleo J.; Bottussi A.; Erdoes G.; Huang J.; Monaco F.
Institution
(D'Andria Ursoleo, Bottussi, Monaco) Department of Anesthesia and
Intensive Care, IRCCS San Raffaele Scientific Institute, Via Olgettina 60,
Milan, Italy
(Erdoes) Department of Anesthesiology and Pain Medicine, Inselspital, Bern
University Hospital, University of Bern, Bern, Switzerland
(Huang) Department of Anesthesiology and Perioperative Medicine,
University of Louisville, Louisville, KY, United States
Publisher
Elsevier Masson s.r.l.
Abstract
Despite decades of advancements in anesthetic techniques, a novel hypnotic
agent combining rapid onset and offset, hemodynamic stability, and
predictable effects has remained elusive. The recent approval of
remimazolam, a short-acting benzodiazepine, represents a potential
breakthrough in fulfilling these criteria. Since its first approval,
growing evidence highlights its benefits, including superior hemodynamic
stability, rapid emergence from anesthesia, and minimal respiratory
depression compared to widely used agents such as propofol. These
attributes have been demonstrated across various surgical contexts and
patient populations. However, existing studies have limitations that
challenge the generalizability of such findings. This review evaluates the
literature on remimazolam in both the cardiac and noncardiac perioperative
surgical contexts. A systematic search of PubMed/MEDLINE, EMBASE, and
Google Scholar databases identified studies published from 2020 to 2024,
with an emphasis on randomized controlled trials and observational
studies. By analyzing the limitations inherent in the retrieved studies,
we aimed to provide practicing anesthesiologists with an overview of
remimazolam's potential benefits and inherent challenges, while
identifying current knowledge gaps that warrant future
research.<br/>Copyright &#xa9; 2025 Societe Francaise d'Anesthesie et de
Reanimation (SFAR)

<36>
Accession Number
2029066699
Title
Randomized clinical trial of continuous transversus thoracis muscle plane
block for patients undergoing open heart valve replacement surgery.
Source
Journal of Cellular and Molecular Medicine. 28(7) (no pagination), 2024.
Article Number: e18184. Date of Publication: 01 Apr 2024.
Author
Zhan Y.; Li L.; Chen S.; Peng Y.; Zhang Y.
Institution
(Zhan, Li, Chen, Zhang) Department of Anaesthesiology, First Affiliated
Hospital of Nanchang University, Nanchang, China
(Peng) Department of Anaesthesiology, Jiangxi Maternal and Child Health
Hospital, Nanchang, China
Publisher
John Wiley and Sons Inc
Abstract
The optimal analgesia regimen after open cardiac surgery is unclear. The
aim of this study was to investigate the beneficial effects of continuous
transversus thoracis muscle plane (TTMP) blocks initiated before surgery
on open cardiac surgery outcomes. A group of 110 patients were randomly
allocated to either receive bilateral continuous TTMP blocks (TTP group)
or no nerve block (SAL group). The primary endpoint was post-operative
pain at 4, 8, 16, 24, 48 and 72 h after extubation at rest and exercise.
The secondary outcome measures included analgesia requirements (sufentanil
and flurbiprofen axetil administration), time to extubation, incidence of
reintubation, length of stay in the ICU, incidence of post-operative
nausea and vomiting (PONV), time until return of bowel function, time to
mobilization, urinary catheter removal and length of hospital stay. The
length of stay in the ICU and length of hospital stay were significantly
longer in the SAL group than in the TTP group. NRS scores at rest and
exercise were significantly lower in the TTP group than in the SAL group
at all time points. The TTP group required significantly less
intraoperative and post-operative sufentanil and post-operative dynastat
consumption than the SAL group. Time to extubation, time to first flatus,
time until mobilization and time until urinary catheter removal were
significantly earlier in the TTP group than in the SAL group. The
incidence of PONV was significantly lower in the TTP group. Bilateral
continuous TTMP blocks provide effective analgesia and accelerate recovery
in patients undergoing open heart valve replacement surgery.<br/>Copyright
&#xa9; 2024 The Authors. Journal of Cellular and Molecular Medicine
published by Foundation for Cellular and Molecular Medicine and John Wiley
& Sons Ltd.

<37>
Accession Number
2024958257
Title
Sternal wound infections following internal mammary artery grafts for a
coronary bypass: A meta-analysis.
Source
International Wound Journal. 21(1) (no pagination), 2024. Article Number:
e14349. Date of Publication: 01 Jan 2024.
Author
Li M.; Yu Z.; Chen Q.; Zhao Q.; Chen X.; Lei C.; Wang X.; Yang R.
Institution
(Li) Department of Nephrology, Erqiao Street Community Health Service
Cente affiliated of the Fifth Hospital of Wuhan, Wuhan, China
(Yu) Department of Respiratory and Critical Care Medicine, Wuhan Jinyintan
Hospital, Wuhan, China
(Chen) Department of Infectious Immunolog, Wuhan Jinyintan Hospital,
Wuhan, China
(Zhao, Yang) Department of Thoracic and Cardiovascular Surgery, The Fifth
Hospital of Wuhan, Wuhan, China
(Chen) Department of Health Management Center, Affiliated Hospital of
Guangdong Medical University, Zhanjiang, China
(Lei) Department of Oncology, The Fifth Hospital of Wuhan, Wuhan, China
(Wang) Department of Nephrology, The Fifth Hospital of Wuhan, Wuhan, China
Publisher
John Wiley and Sons Inc
Abstract
The meta-analysis aims to evaluate and compare the sternal wound
infections following internal mammary artery grafts for a coronary bypass.
Examinations comparing bilateral internal mammary artery to single
internal mammary artery for coronary artery bypass grafting were among the
meta-analyses from various languages that met the inclusion criteria.
Using dichotomous random- or fixed-effect models, the results of these
investigations were examined, and the Odd Ratio (OR) with 95% confidence
intervals (CIs) was computed. A total of 31 examinations from 2001 to 2023
were recruited for the current analysis including 181 503 personals with
coronary artery bypass grafting. Bilateral internal mammary artery had
significantly higher sternal wound infection (OR, 1.51; 95% CI, 1.37-1.68,
p < 0.001), superficial sternal wound infection (OR, 1.72; 95% CI,
1.16-2.56, p = 0.007), deep sternal wound infection (OR, 1.62; 95% CI,
1.41-1.86, p < 0.001), sternal wound infection in diabetics (OR, 1.48; 95%
CI, 1.16-1.90, p = 0.002), sternal wound infection in elderly (OR, 1.38;
95% CI, 1.22-1.57, p < 0.001), sternal wound infection in pedicled
preparation (OR, 1.70; 95% CI, 1.30-2.23, p < 0.001) and sternal wound
infection in skeletonized preparation (OR, 1.40; 95% CI, 1.09-1.81, p =
0.009) compared to single internal mammary artery in personals with
coronary artery bypass grafting. Bilateral internal mammary artery
grafting is linked to a higher risk of impaired wound healing,
particularly in diabetic individuals, elderly, pedicled preparation, and
skeletonized preparation. Nevertheless, caution should be exercised while
interacting with its values since examinations were performed by different
surgeons with different skills on different types of
personals.<br/>Copyright &#xa9; 2023 The Authors. International Wound
Journal published by Medicalhelplines.com Inc and John Wiley & Sons Ltd.

<38>
Accession Number
2038162929
Title
Fractional Flow Reserve Versus Angiography-Guided Revascularisation in
Patients With Severe Aortic Stenosis: A Systematic Review.
Source
Heart Lung and Circulation. 34(6) (pp 556-565), 2025. Date of Publication:
01 Jun 2025.
Author
Mridha N.; Zaka A.; Raffel C.; Murdoch D.; Walters D.
Institution
(Mridha, Raffel, Murdoch, Walters) The Prince Charles Hospital, Brisbane,
QLD, Australia
(Mridha, Raffel, Murdoch, Walters) The University of Queensland, School of
Medicine, Brisbane, QLD, Australia
(Mridha, Zaka) Griffith University, School of Medicine, Gold Coast, QLD,
Australia
(Zaka) Bond University, School of Medicine, Gold Coast, QLD, Australia
(Raffel) Queensland University of Technology, Brisbane, QLD, Australia
Publisher
Elsevier Ltd
Abstract
Background: Aortic stenosis (AS) and coronary artery disease usually
coexist in older adults. Although fractional flow reserve (FFR) is the
gold standard for demonstrating functionally significant coronary artery
stenoses, its efficacy in patients with severe AS awaiting transcatheter
aortic valve implantation is unclear. This systematic review assesses the
clinical outcomes between FFR- and angiography-guided coronary
revascularisation in patients with severe AS. <br/>Method(s): This review
conformed to the Preferred Reporting Items for Systematic Reviews and
Meta-Analyses (PRISMA) guidelines. PubMed, Ovid MEDLINE, Web of Science,
and Cochrane databases were searched until 12 March 2024. Eligible studies
included randomised controlled trials or observational studies including
patients with severe AS with concurrent coronary disease comparing FFR-
with angiography-guided percutaneous coronary intervention. Primary
outcomes were all-cause mortality and myocardial infarction. Secondary
outcomes were composite major adverse cardiovascular events.
<br/>Result(s): Five retrospective cohort studies were identified,
including 1,927 patients. The average follow-up was 34.7 months.
FFR-guided cohorts exhibited higher incidence rates for all-cause
mortality (17.4% vs 15.6%), myocardial infarction (4.4% vs 3.3%), and
major adverse cardiovascular events (21.8% vs 18.5%) than the
angiography-guided cohorts. A total of 32.8% the angiography-guided cohort
and 33.1% from the FFR-guided cohort underwent percutaneous coronary
intervention. Due to insufficient power and inconsistency of the available
data (including heterogenous patient selection criteria, differences in
procedural protocols, anatomical distribution of stented lesions,
non-uniform reporting of measured outcomes), a meta-analysis for the
primary and secondary outcomes was not conducted. The methodological
quality of the included studies was found to be of fair quality according
to the Newcastle-Ottawa checklist. <br/>Conclusion(s): Despite the
recognised usefulness of FFR in the assessment of coronary artery disease,
its clinical efficacy in patients with severe AS undergoing transcatheter
aortic valve implantation remains uncertain amidst inconclusive
observational data. Large-scale randomised controlled trials are
required.<br/>Copyright &#xa9; 2024 Australian and New Zealand Society of
Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of
Australia and New Zealand (CSANZ)

<39>
Accession Number
2038114003
Title
Perioperative Bleeding Is Not an Independent Risk Factor for Acute Kidney
Injury in On-pump Cardiac Surgery-A Post-hoc Analysis of a Randomized
Clinical Trial.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 39(7) (pp 1696-1705),
2025. Date of Publication: 01 Jul 2025.
Author
Vlasov H.E.; Petaja L.M.; Wilkman E.M.; Talvasto A.T.; Ilmakunnas M.K.;
Raivio P.M.; Hiippala S.T.; Suojaranta R.T.; Juvonen T.S.; Pesonen E.J.
Institution
(Vlasov, Petaja, Wilkman, Talvasto, Ilmakunnas, Hiippala, Suojaranta,
Pesonen) Department of Anesthesiology and Intensive Care Medicine,
University of Helsinki and Helsinki University Hospital, Helsinki, Finland
(Ilmakunnas) Finnish Red Cross Blood Service, Finland
(Raivio, Juvonen) Department of Cardiac Surgery, Heart and Lung Center,
University of Helsinki and Helsinki University Hospital, Helsinki, Finland
Publisher
W.B. Saunders
Abstract
Objectives: To study the association between bleeding and acute kidney
injury (AKI). <br/>Design(s): Post-hoc study of a randomized trial of 4%
albumin versus Ringer's acetate for cardiopulmonary bypass priming and
perioperative volume replacement. <br/>Setting(s): Single-center study.
<br/>Patient(s): 1,386 on-pump cardiac surgical patients. Measurements and
Results: AKI was defined by the Kidney Disease: Improving Global Outcomes
creatinine criteria, and bleeding by the Universal Definition of
Perioperative Bleeding (UDPB) classification. With univariably independent
factors, two logistic regression analyses (Model 1: AKI Risk Score,
EuroSCORE II, and UDPB class; Model 2: risk scores, components of the UDPB
classification, and factor VIII/von Willebrand factor concentrate) and a
mediation analysis (Model 3: risk scores, UDPB class, and perioperative
factors) were performed. A total of 139 (10%) patients developed AKI. In
Model 1, UDPB class "severe" (odds ratio: 2.16, 95% confidence interval:
1.19-3.89), "massive" bleeding (6.78, 1.8-25.33), and AKI Risk Score
(1.51, 1.29-1.78) were associated with AKI. In Model 2, AKI Risk Score
(1.55, 1.33-1.82) and fresh frozen plasma transfusion (1.29, 1.06-1.58)
were associated with AKI. In Model 3, the combined UDPB classes "severe"
and "massive" bleeding did not have a direct effect (regression
coefficient: 0.32, 95% confidence interval: -0.26 to 0.91), while mean
arterial pressure (0.08, 0.003-0.21) and fluid balance (0.12, 0.17-0.27)
had indirect effects on AKI. <br/>Conclusion(s): In on-pump cardiac
surgery, perioperative bleeding was not an independent risk factor for AKI
but manifested as AKI via hypotension and higher fluid balance. Prevention
of bleeding may reduce AKI in cardiac surgery.<br/>Copyright &#xa9; 2025
The Author(s)

<40>
Accession Number
2038950956
Title
Comparative Prognostic Value of Risk Factors for Predicting Pacemaker
Implantation After Transcatheter Aortic Valve Replacement: A Systematic
Review and Network Meta-Analysis.
Source
American Journal of Cardiology. 250 (pp 79-89), 2025. Date of Publication:
01 Sep 2025.
Author
Hosseini Mohammadi N.S.; Tavakoli K.; Taebi M.; Zafari A.; Riahi M.;
Molaei M.M.; Farooqi M.A.; Khanipour R.; Karvane H.B.; Shahrzad S.;
Vaseghi M.; Lakkirrddy G.R.; Mattumpuram J.; Tzeis S.; Jenab Y.; Hosseini
K.
Institution
(Hosseini Mohammadi, Tavakoli, Taebi, Karvane, Jenab, Hosseini) Tehran
Heart Center, Cardiovascular Disease Research Institute, Tehran University
of Medical Sciences, Tehran, Iran, Islamic Republic of
(Hosseini Mohammadi, Tavakoli, Taebi, Jenab, Hosseini) Cardiac Primary
Prevention Research Center, Cardiovascular Diseases Research Institute,
Tehran University of Medical Sciences, Tehran, Iran, Islamic Republic of
(Zafari) School of Medicine, Shahid Beheshti University of Medical
Sciences, Tehran, Iran, Islamic Republic of
(Riahi, Molaei) School of Medicine, Tehran University of Medical Sciences,
Tehran, Iran, Islamic Republic of
(Farooqi) Central Michigan University, Internal Medicine
(Khanipour) Department of Internal Medicine, HCA Florida Bayonet Point
Hospital - University of South Florida, United States
(Shahrzad) Shariati Hospital, Tehran University of Medical Sciences,
Tehran, Iran, Islamic Republic of
(Vaseghi) Division of Cardiology, Department of Medicine, UCLA Cardiac
Arrhythmia Center, University of California, Los Angeles, CA, United
States
(Lakkirrddy) Kansas City Heart Rhythm Institute and Research Foundation,
Overland Park, KA, United States
(Mattumpuram) Division of Cardiology, University of Louisville School of
Medicine, Louisville, KY, United States
(Tzeis) Department of Cardiology, Mitera Hospital, Hygeia Group, Athens,
Greece
Publisher
Elsevier Inc.
Abstract
This study compares the prognostic value of risk factors for Permanent
pacemaker implantation (PPI) following transcatheter aortic valve
replacement (TAVR). PubMed, Embase, Scopus, and Cochrane Library databases
were searched until November 2024 for studies reporting PPI incidence
within 30 days post-TAVR. A random-effect model was used to pool risk
ratios (RR) and standardized mean differences (SDM) for binary and
continuous risk factors. Network meta-analysis estimated pooled risk
differences (DELTARR) for binary predictors with male sex as the
reference. Significant predictors were ranked based on their surface under
the cumulative ranking curve (SUCRA) values. A total of 108 studies
comprising 77,538 patients (14,560 requiring PPI) were included. Male sex
(RR: 1.13), baseline atrial fibrillation (AF) (RR: 1.12), 2nd degree
Mobitz I (RR: 5.16) and Mobitz II (RR: 2.30) atrioventricular blocks
(AVB), 3rd degree AVB (RR: 13.46), left anterior (LAHB) (RR: 1.79) and
posterior hemiblocks (LPHB) (RR: 2.57), bifascicular block (RR: 2.34),
right bundle branch block (RBBB) (RR: 3.20) and intraprocedural AVB (RR:
4.15) were identified as predictors for PPI post-TAVR. The risk of PPI was
higher with self-expandable valves (RR: 1.79), subclavian access (RR:
1.75), and 29 mm prostheses (RR: 1.33) compared to balloon-expandable
valves, transfemoral access, and 23 mm prostheses. Network meta-analysis
ranked 3rd degree AVB (SUCRA <0.01), Mobitz I AVB (SUCRA: 0.14), Mobitz II
AVB (SUCRA: 0.33), intraprocedural AVB (SUCRA: 0.42), bifascicular block
(SUCRA: 0.48), RBBB (SUCRA: 0.49) and LPHB (SUCRA: 0.54) as major
predictors of PPI in descending order of significance. In conclusion,
clinicians should closely monitor conduction abnormalities as key
predictors of PPI following TAVR. Additionally, other risk factors such as
subclavian access, self-expanding implantation, AF, large prosthesis
diameter, and male sex should not be overlooked.<br/>Copyright &#xa9; 2025
Elsevier Inc.

<41>
Accession Number
2039019955
Title
Balancing the benefits and risks of colchicine use among patients with
atherosclerotic cardiovascular disease: an umbrella review of
meta-analyses of randomised controlled trials.
Source
eClinicalMedicine. 84 (no pagination), 2025. Article Number: 103277. Date
of Publication: 01 Jun 2025.
Author
Bao R.-H.; Zhao N.; Jiang X.-F.; Cong Z.-H.; Liu J.; Kang L.-D.; Chen
Y.-H.; Sun J.-N.; Xing W.-Y.; Liu J.-X.; Bai X.-L.; Lv H.-C.; Zhao J.-Y.;
Ma Q.-P.; Gong T.-T.; Wu Q.-J.
Institution
(Bao, Xing, Liu, Wu) Department of Clinical Epidemiology, Shengjing
Hospital of China Medical University, Shenyang, China
(Bao, Chen, Sun, Ma, Gong, Wu) Department of Obstetrics and Gynecology,
Shengjing Hospital of China Medical University, Shenyang, China
(Bao) The First Clinical Department, China Medical University, Shenyang,
China
(Zhao, Cong) Department of Laboratory Medicine, The Fourth Affiliated
Hospital of China Medical University, Shenyang, China
(Jiang, Bai) Department of Obstetrics and Gynecology, The Fourth
Affiliated Hospital of China Medical University, Shenyang, China
(Liu) Department of Cardiology, The Fourth Affiliated Hospital of China
Medical University, Shenyang, China
(Kang) Department of Ophthalmology, The First Affiliated Hospital of China
Medical University, Shenyang, China
(Chen, Wu) Department of Epidemiology, School of Public Health, China
Medical University, Shenyang, China
(Lv) Department of Cardiology, The First Affiliated Hospital of Dalian
Medical University, Dalian, China
(Zhao) Department of Pediatrics, Shengjing Hospital of China Medical
University, Shenyang, China
(Wu) NHC Key Laboratory of Advanced Reproductive Medicine and Fertility
(China Medical University), National Health Commission, Shenyang, China
Publisher
Elsevier Ltd
Abstract
Background: The risks and benefits of colchicine use among patients with
atherosclerotic cardiovascular disease (ASCVD) have been widely reported.
Our umbrella review aimed to systematically analyse and synthesise the
available causal evidence on the therapeutic effects and safety profile of
colchicine in patients with ASCVD. <br/>Method(s): We searched PubMed,
Embase, Web of Science, and Cochrane Library from database inception to
December 4, 2024, to identify systematic reviews and meta-analyses of
randomised controlled trials (RCTs) investigating colchicine use among
patients with ASCVD. The primary endpoints were physical adverse events,
MACEs, and CV disorder. The quality of systematic reviews was evaluated
using A Measurement Tool to Assess Systematic Reviews (AMSTAR), and the
certainty of evidence was assessed using the Grading of Recommendations,
Assessment, Development, and Evaluations (GRADE) system. Risk of bias was
evaluated using Cochrane Systematic Review criteria. Inconsistency was
flagged if heterogeneity (I²) exceeded 50%, or 75% without
explanation. Publication bias was detected via funnel plot asymmetry or
Egger's test. Subgroup analyses were done according to colchicine dose,
treatment duration, geographical region, participant age and disease of
patients. This study is registered with PROSPERO (CRD 42025631311).
<br/>Finding(s): This review analysed 47 unique outcomes from 48
systematic reviews and meta-analyses of RCTs. Among 271 associations, 95
were supported by high-certainty evidence. For primary outcomes, compared
with placebo treatment, colchicine exhibited therapeutic efficacy in
coronary heart disease [relative risk (RR): 0.73, 95% confidence interval
(CI): 0.64-0.83, I²: 0%] and acute coronary syndromes (OR:
0.72, 95% CI: 0.58-0.89, I²: 0%), demonstrating secondary
prevention benefits in major adverse cardiovascular events (RR: 0.56, 95%
CI: 0.47-0.67, I²: 0%). Common adverse effects included
gastrointestinal reactions and hepatic toxicity, with dose-dependent
associations of drug discontinuation (RR: 4.63, 95% CI: 2.06-10.38,
I²: 36%). Evidence of publication bias was identified in 18 of
271 tested associations. Subgroup analyses indicated that optimal clinical
application required consideration of patient age, geographic variance in
pharmacogenomics, and protocol adjustments (recommended dose <=0.5 mg/day
for more than a month) to balance efficacy-risk profiles.
<br/>Interpretation(s): High-certainty evidence supported the therapeutic
and secondary preventive benefits of colchicine in patients with ASCVD
when dose and duration were appropriately controlled. Future studies could
focus on identifying ASCVD subgroups with pharmacogenomic and ethnographic
predictors of colchicine response heterogeneity to guide precision
therapy. <br/>Funding(s): This work was supported by the Liaoning
Revitalization Talents Program, Outstanding Youth Scientific Talent
Project of Dalian, and Outstanding Scientific Fund of Shengjing
Hospital.<br/>Copyright &#xa9; 2025 The Authors

<42>
Accession Number
2034706703
Title
Meta-Analytic Review of Coronary Angiography in Peri-Procedural Myocardial
Injury and Infarction After Cardiac Surgery.
Source
Journal of Clinical Medicine. 14(10) (no pagination), 2025. Article
Number: 3407. Date of Publication: 01 May 2025.
Author
Cereda A.F.; Toselli M.; Cimaglia P.; Franchina A.G.; Tua L.; Carla M.;
Tumminello G.; Aseni P.; Sangiorgi G.M.; Biolcati M.; Spangaro A.;
Rocchetti M.; Pezzoli E.; Vanelli P.; Lucreziotti S.
Institution
(Cereda, Franchina, Tua, Carla, Biolcati, Spangaro, Rocchetti, Pezzoli,
Lucreziotti) Cardiology Unit, ASST Santi Paolo e Carlo, Milan, Italy
(Toselli) Maria Cecilia Hospital, GVM Care & Research, Cotignola, Italy
(Cimaglia) Cardiovascular Institute, Azienda Ospedaliero Universitaria di
Ferrara, Ferrara, Italy
(Tumminello) Department of Cardio-Thoracic-Vascular Diseases, Foundation
IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
(Aseni) Department of Emergency Medicine, ASST Grande Ospedale
Metropolitano Niguarda, Milan, Italy
(Sangiorgi) Cardiac Cath Lab, Department of Biomedicine and Prevention,
University of Rome Tor Vergata, Rome, Italy
(Vanelli) Cardiac Surgery Unit, Fondazione IRCCS Ca' Granda Ospedale
Maggiore Policlinico, Milan, Italy
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Introduction: Peri-procedural myocardial infarction (PMI) after cardiac
surgery is a significant yet often under-recognised complication,
sometimes necessitating urgent coronary angiography (PMI-rCA). This
meta-analysis evaluates its prevalence, angiographic findings, management
strategies, and associated mortality. <br/>Method(s): A systematic review
and meta-analysis were conducted according to PRISMA guidelines. Data from
nine studies comprising 104,445 post-cardiac surgery patients were
analysed. Among them, those undergoing PMI-rCA were categorised by
treatment strategy: conservative management, percutaneous coronary
intervention (PCI), or reperform surgery. A network meta-analysis compared
mortality risks across these groups, with findings visualised using forest
plots, network diagrams, and SUCRA rankings. <br/>Result(s): PMI-rCA was
performed in 1205 patients (2%). Of these, 34.3% had no significant
angiographic abnormalities, 53.7% exhibited graft failure, and 10.4% had
native vessel ischemia. Management strategies included conservative
treatment (55.5%), PCI (23.5%), and reperforming surgery (21%). Network
meta-analysis indicated that conservative management was associated with
the lowest mortality risk, followed by PCI, while reperforming surgery had
the highest risk. <br/>Discussion(s): These findings highlight the
complexity of PMI diagnosis and treatment. The high proportion of patients
without significant angiographic abnormalities raises concerns about
potential overuse of invasive procedures. Meanwhile, PCI appears to be a
more favourable interventional strategy than reperforming surgery in terms
of mortality outcomes. <br/>Conclusion(s): PMI requiring coronary
angiography is uncommon but clinically significant, with a 16% mortality
rate. A tailored, risk-based approach is essential to optimise management,
balancing conservative therapy, PCI, and reperforming surgery based on
individual patient profiles.<br/>Copyright &#xa9; 2025 by the authors.

<43>
Accession Number
2033391792
Title
Predicting Surgical and Non-surgical Curvature Correction by Radiographic
Spinal Flexibility Assessments for Patients With Adolescent Idiopathic
Scoliosis: A Systematic Review and Meta-Analysis.
Source
Global Spine Journal. 15(5) (pp 2822-2838), 2025. Date of Publication: 01
Jun 2025.
Author
Luo Y.-Y.; Hung T.-M.; Zheng Q.; Wu H.-D.; Wong M.-S.; Bai Z.-Q.; Ma
C.Z.-H.
Institution
(Luo, Hung, Wong, Ma) Department of Biomedical Engineering, The Hong Kong
Polytechnic University, Hong Kong
(Zheng) Department of Rehabilitation Medicine, Tongji Hospital, Tongji
Medical College, Huazhong University of Science and Technology, Wuhan,
China
(Wu) Department of Prosthetic and Orthotic Engineering, School of
Rehabilitation, Kunming Medical University, Kunming, China
(Bai) School of Systems Design and Intelligent Manufacturing, Southern
University of Science and Technology, Shenzhen, China
(Ma) Research Institute for Smart Ageing, The Hong Kong Polytechnic
University, Hong Kong
Publisher
SAGE Publications Ltd
Abstract
Study Design: Systematic Review and Meta-analysis. <br/>Objective(s): This
systematic review and meta-analysis aimed to: (1) synthesize the prevalent
application ratios of 2 radiographic spinal flexibility assessment methods
in AIS patients treated with PSF or bracing; and (2) quantitatively
evaluate the accuracy of these methods in predicting post-intervention
correction outcomes. <br/>Method(s): A systematic search was conducted
across 5 electronic databases: CINAHL, Embase, Ovid, PubMed, and Web of
Science. Meta-analyses were performed to investigate the accuracy of the
spinal flexibility rate in predicting the post-intervention correction
rate in AIS patients treated with PSF surgery or bracing, using RevMan
5.4.1 software. <br/>Result(s): The results of 31 studies, involving 1868
AIS patients, showed that the side-bending method was utilized more
frequently than the fulcrum-bending method in both treatments. Meanwhile,
the spinal flexibility evaluated by the fulcrum-bending method may provide
a more accurate prediction of post-surgical correction compared to the
side-bending approach, particularly for main curves. For the bracing
treatment, only a few studies have preliminarily reported good capability
of the side-bending method in predicting the initial in-brace correction.
<br/>Conclusion(s): This review quantitatively assessed the clinical
application ratio and effectiveness of side-bending and fulcrum-bending
radiographs in predicting post-intervention curve corrections in AIS
patients undergoing surgical or bracing treatments. The results of the
current review supported to adopt the fulcrum-bending approach for AIS
patients undergoing PSF surgery with main thoracic curves, and the
side-bending approach for those with thoracolumbar/lumbar curves. For
patients receiving bracing treatment, further research is still needed to
confirm the clinical value of the side-bending method.<br/>Copyright
&#xa9; The Author(s) 2025.

<44>
Accession Number
2034706751
Title
Peri-Procedural Continuation Versus Interruption of Anticoagulation for
Transcatheter Aortic Valve Implantation: A Systematic Review and
Meta-Analysis.
Source
Journal of Clinical Medicine. 14(10) (no pagination), 2025. Article
Number: 3563. Date of Publication: 01 May 2025.
Author
Khater J.; Frazzetto M.; Gurgoglione F.L.; Hasan J.; Donelli D.; Attizzani
G.; Cortese B.
Institution
(Khater, Frazzetto, Gurgoglione, Hasan, Cortese) DCB Academy, Milan, Italy
(Khater) Faculty of Medical Sciences, Lebanese University, Rafic Hariri
University Campus, Hadath, Lebanon
(Frazzetto, Attizzani, Cortese) Department of Cardiology, University
Hospitals Cleveland Medical Center, Cleveland, OH, United States
(Gurgoglione, Donelli) Division of Cardiology, Parma University Hospital,
University of Parma, Parma, Italy
(Hasan) CHU Amiens-Picardie, Amiens, France
(Hasan) Mohammed Bin Khalifa Bin Salman Al Khalifa Specialist Cardiac
Centre (MKCC), P.O. Box 101, Awali, Bahrain
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Background/Objectives: Oral anticoagulation therapy (OAC) is crucial for
reducing the risk of ischemic complications in patients with atrial
fibrillation (AF). However, OAC also increases the risk of major bleeding
events. The optimal management of OAC in patients with AF undergoing
transaortic valve implantation (TAVI) is unclear. This study aimed to
compare the efficacy and safety of OAC interruption vs. continuation in
patients with AF scheduled for TAVI. <br/>Method(s): PubMed, EMBASE, and
Cochrane were searched to include all pertinent randomized and
observational studies. The primary endpoint was the occurrence of net
adverse clinical events (NACE), a composite of all-cause death, major
vascular complications, and major bleeding at 30-day follow-up. Secondary
endpoints included all-cause death, cardiovascular death, major vascular
complications, major bleeding, any bleeding, stroke, non-fatal myocardial
infarction, and the need for red-packed blood transfusion. <br/>Result(s):
A total of three studies and 2773 patients were included in the analysis
(1314 were allocated to continuation of OAC therapy and 1459 to
interruption of OAC therapy during TAVI). The two study groups experienced
a similar rate of NACE (OR = 0.89 [95% CI 0.61 to 1.31], I² =
77%, p = 0.56) compared to the OAC-interruption group. No significant
differences were observed in the rate of all-cause death (p = 0.21),
cardiovascular death (p = 0.35), major vascular complications (p = 0.84),
major bleeding events (p = 0.47), total bleeding events (p = 0.62), or
non-fatal MI (p = 0.55). Interestingly, the OAC-continuation group
experienced a lower occurrence of stroke (OR = 0.62 [95% CI 0.39 to 0.97],
I² = 0%, p = 0.04) and the need for red packed blood cells (OR
= 0.66 [95% CI 0.50 to 0.86], I² = 20%, p < 0.01) compared to
the OAC-interruption group. <br/>Conclusion(s): In patients with AF
undergoing TAVI, there was no significant difference between interruption
and continuation of OAC in terms of NACE, composite of all-cause death,
major vascular complications, or major bleeding at 30-day follow-up. Of
interest, the OAC-continuation group patients experienced lower rates of
stroke and the need for blood transfusion.<br/>Copyright &#xa9; 2025 by
the authors.

<45>
Accession Number
2034795991
Title
Single arm meta-analysis of the J-Valve system for aortic regurgitation in
Chinese populations.
Source
Frontiers in Cardiovascular Medicine. 12 (no pagination), 2025. Article
Number: 1436789. Date of Publication: 2025.
Author
Gao L.; Mao R.; Zeng J.; Wen L.
Institution
(Gao, Mao) Department of Medical Equipment, Sichuan Provincial People's
Hospital, School of Medicine, University of Electronic Science and
Technology of China, Chengdu, China
(Zeng) Department of Cardiology, Structure Heart Disease Center, Sichuan
Provincial People's Hospital, School of Medicine, University of Electronic
Science and Technology of China, Chengdu, China
(Wen) Department of Longquan Campus, Sichuan Provincial People's Hospital,
School of Medicine, University of Electronic Science and Technology of
China, Chengdu, China
Publisher
Frontiers Media SA
Abstract
Objective: This meta-analysis aimed to evaluate the efficacy and safety of
J-valve in patients with Aortic regurgitation (AR). <br/>Method(s):
PubMed, Embase, the Cochrane Library, and Web of Science databases were
searched from inception to November 2024. Primary outcome included
Procedural Success, and secondary outcome included In-Hospital Mortality,
30-Day Mortality, One-Year All-Cause Mortality, Stroke Incidence and
Complications. The risk of bias was assessed by subgroup analysis,
sensitivity analysis, and publication bias, including funnel plot, Egger's
test, and Begg's test. <br/>Result(s): A total of 9 studies involving 552
patients were included in this meta-analysis. The results indicated a
surgical success rate of 96% (95% CI: 0.94-0.99). The in-hospital
mortality rate was 3% (95% CI: 0.01-0.04), the 30-day mortality rate was
3% (95% CI: 0.01-0.05), and the 1-year all-cause mortality rate was 6%
(95% CI: 0.04-0.08). Additionally, the incidence of stroke was 2% (95% CI:
0.01-0.03), and the incidence of other complications was 22% (95% CI:
0.16-0.28). <br/>Conclusion(s): This meta-analysis indicates that the
J-Valve prosthesis exhibits favorable short-term efficacy in patients with
severe aortic regurgitation (AR); however, a significant incidence of
complications persists. A thorough risk assessment is crucial when
determining the appropriate treatment strategy. Furthermore, postoperative
follow-up duration should be extended to monitor patient outcomes
effectively. Systematic Review Registration:
https://www.crd.york.ac.uk/PROSPERO/view/CRD42024552406, identifier
CRD42024552406.<br/>Copyright 2025 Gao, Mao, Zeng and Wen.

<46>
Accession Number
2038843067
Title
ACURATE neo2 valve versus commercially available transcatheter heart
valves in patients with severe aortic stenosis (ACURATE IDE): a
multicentre, randomised, controlled, non-inferiority trial.
Source
The Lancet. 405(10494) (pp 2061-2074), 2025. Date of Publication: 07 Jun
2025.
Author
Makkar R.R.; Ramana R.K.; Gnall E.; Ramlawi B.; Cheng W.; Diamantouros P.;
Potluri S.; Kleinman N.; Gupta A.; Chakravarty T.; Samy S.; Rassi A.;
Rajagopal V.; Yakubov S.; Sorajja P.; Patel D.; Garcia S.; Yadav P.;
Thourani V.; Wang J.; Rinaldi M.; Kapadia S.; Waksman R.; Webb J.; Ren
C.B.; Gregson J.; Modolo R.; Sathananthan J.; Reardon M.J.
Institution
(Makkar, Cheng, Gupta, Chakravarty, Patel) Cedars-Sinai Medical Center,
Los Angeles, CA, United States
(Ramana, Ramlawi) Lankenau Hospital, Wynnewood, PA, United States
(Gnall) Advocate Christ Medical Center, Mokena, IL, United States
(Diamantouros) London Health Sciences Centre, London, ON, Canada
(Potluri) Baylor Scott & White The Heart Hospital, Plano, TX, United
States
(Kleinman, Reardon) Houston Methodist Hospital, Houston, TX, United States
(Samy) Albany Medical Center, Albany, NY, United States
(Rassi) Kaiser Permanente, San Francisco, CA, United States
(Rajagopal, Yadav, Thourani) Piedmont Hospital, Atlanta, GA, United States
(Yakubov) OhioHealth Research and Innovation Institute-Riverside Methodist
Hospital, Columbus, OH, United States
(Sorajja) Abbott Northwestern Hospital, Minneapolis, MN, United States
(Garcia) Lindner Center for Research and Education at Christ Hospital,
Cincinnati, OH, United States
(Wang) Union Memorial Hospital, Baltimore, MD, United States
(Rinaldi) Carolinas Medical Center, Charlotte, NC, United States
(Kapadia) Cleveland Clinic Foundation, Cleveland, OH, United States
(Waksman) Washington Hospital Center, Washington, DC, United States
(Webb) Providence Health-St Paul's Hospital, Vancouver, BC, Canada
(Ren) Cardialysis, Rotterdam, Netherlands
(Gregson) London School of Public Hygiene, London, United Kingdom
(Modolo, Sathananthan) Boston Scientific, Minneapolis, MN, United States
Publisher
Elsevier B.V.
Abstract
Background: ACURATE neo2 is an open-cell, supra-annular, self-expanding
transcatheter heart valve that is commercially available in over 50
countries but has not previously been evaluated in a randomised trial.
ACURATE-IDE aimed to prospectively evaluate the safety and efficacy of
transcatheter aortic valve replacement (TAVR) with the ACURATE neo2 valve
compared with commercially available valves for the treatment of severe
symptomatic aortic stenosis. <br/>Method(s): In this multicentre,
randomised, controlled, non-inferiority trial, patients with symptomatic
severe aortic stenosis and any level of surgical risk were recruited from
71 medical centres in the USA and Canada. Eligible patients were randomly
assigned (1:1) to TAVR with ACURATE neo2 or one of the control valves,
SAPIEN 3 (SAPIEN 3 or SAPIEN 3 Ultra) or Evolut, using permuted block
randomisation with a pseudo-random number generator, and stratified by the
clinical investigation site and type of control valve. All devices were
implanted according to the manufacturer's instructions. The primary
endpoint was a composite of all-cause mortality, all stroke, and
rehospitalisation at 1 year, tested for non-inferiority using a Bayesian
approach. The primary analysis was performed in the intention-to-treat
population and sensitivity analyses were done in the implanted population.
The non-inferiority margin was 8.0%. This study is registered with
ClinicalTrials.gov, NCT03735667, and is ongoing. <br/>Finding(s): Between
June 10, 2019, and April 19, 2023, 1500 patients were recruited, of whom
752 were randomly assigned to the ACURATE neo2 group and 748 to the
control group. The median age of participants was 79 years (IQR 74-83).
778 (51.9%) of 1500 patients were female and 721 (48.1%) were male. At 1
year, the posterior median probability of the primary composite endpoint
was higher in the ACURATE neo2 group (16.2% [95% Bayesian credible
interval 13.4-19.1) than in the control group (9.5% [7.5-11.9];
between-group difference 6.6% [3.0-10.2]). The upper bound of treatment
difference exceeded the prespecified non-inferiority margin of 8%, with a
posterior probability of treatment difference of >0.999. At 1 year, the
ACURATE neo2 group, had significantly higher Kaplan-Meier rates of the
composite endpoint of all-cause mortality, all stroke, and
rehospitalisation (14.8% [95% CI 12.5-17.6] vs 9.1% [7.2-11.4]; hazard
ratio [HR] 1.71 [95% CI 1.26-2.33]; p=0.0005). At 1 year, all-cause
mortality occurred in 36 of 752 patients in the ACURATE neo2 group versus
28 of 748 patients in the control group (HR 1.30 [95% CI 0.80-2.14]),
stroke in 41 patients versus 25 patients (1.68 [1.02-2.75]), and
rehospitalisation in 38 patients versus 25 patients (1.57 [0.95-2.61]).
Cardiovascular mortality (3.7% vs 1.8%, p=0.024) and spontaneous
myocardial infarction at 1 year (2.4% vs 0.7%, p=0.0092) were more
frequent in the ACURATE neo2 group than in the control group. Prosthetic
valve aortic regurgitation (central plus paravalvular) at 1 year was
significantly more frequent in the ACURATE neo2 group than in the control
group (mild aortic regurgitation 42.5% vs 24.8%, p<0.0001; moderate 4.4%
vs 1.8%, p=0.0070; severe 0.5% vs 0%; p=0.12). <br/>Interpretation(s): In
patients with symptomatic severe aortic stenosis, TAVR with ACURATE neo2
did not meet non-inferiority and resulted in significantly worse outcomes
with respect to the primary endpoint of composite of all-cause mortality,
all stroke, and rehospitalisation at 1 year when compared with commercial
valves. <br/>Funding(s): Boston Scientific.<br/>Copyright &#xa9; 2025
Elsevier Ltd

<47>
Accession Number
2038239325
Title
Advances in Cardiovascular Pharmacotherapy. II. Ivabradine, an Inhibitor
of the Hyperpolarization-Activated Cyclic Nucleotide-Gated Channel.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 39(7) (pp 1795-1814),
2025. Date of Publication: 01 Jul 2025.
Author
Pagel P.S.; Hang D.; Freed J.K.; Crystal G.J.
Institution
(Pagel, Hang, Freed) Department of Anesthesiology, the Medical College of
Wisconsin, Milwaukee, WI, United States
(Crystal) Department of Anesthesiology, University of Illinois College of
Medicine, Chicago, IL, United States
Publisher
W.B. Saunders
Abstract
Ivabradine selectively reduces heart rate by inhibiting the
hyperpolarization-activated cyclic nucleotide-gated (HCN) channel in the
sinoatrial node. Unlike other medications that produce negative
chronotropic effects [beta-blockers, calcium channel blockers], ivabradine
does not affect systemic, pulmonary, and coronary hemodynamics. Despite
several proof-of-concept clinical studies suggesting that ivabradine may
exert anti-ischemic effects, two large randomized trials did not support
its use in patients with chronic stable angina. Preliminary data also did
not support the use of ivabradine in patients with acute ST-segment
elevation myocardial infarction or acutely decompensated heart failure.
However, ivabradine improved outcome in patients with heart failure with
reduced ejection fraction (HFrEF), leading to its approval by the Food and
Drug Administration, but the drug failed to do so in those with heart
failure with preserved ejection fraction (HFpEF). Ivabradine may also be
useful in cardiac electrophysiology disorders characterized by tachycardia
(e.g., inappropriate sinus tachycardia, postural orthostatic tachycardia
syndrome), but it has not yet gained wide acceptance for these
indications. In this article, the authors briefly review the structure and
function of the cardiac HCN channel; discuss the development and actions
of drugs, including ivabradine, that modulate the channel's activity;
describe in detail the potential clinical applications of ivabradine in
patients with coronary artery disease, HFrEF and HFpEF, and cardiac
electrophysiology; comment on the adverse effects of ivabradine therapy;
and finally, consider the potential anesthetic implications of ivabradine
in patients undergoing noncardiac and cardiac surgery.<br/>Copyright
&#xa9; 2025 Elsevier Inc.

<48>
Accession Number
2034706678
Title
Minimally Invasive Percutaneous Techniques for the Treatment of Cervical
Disc Herniation: A Systematic Review and Meta-Analysis.
Source
Journal of Clinical Medicine. 14(10) (no pagination), 2025. Article
Number: 3280. Date of Publication: 01 May 2025.
Author
Rybaczek M.; Mariak Z.; Grabala P.; Lyson T.
Institution
(Rybaczek, Mariak, Grabala, Lyson) Department of Neurosurgery, Medical
University of Bialystok, M. Sklodowskiej-Curie 24A, Bialystok, Poland
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Background: In recent decades, the adoption of minimally invasive
(non-endoscopic) cervical techniques has grown significantly. Advancements
in surgical instrumentation have broadened the spectrum of available
percutaneous interventions, thus providing viable alternative treatment
options for patients with prolonged, conservative treatment-resistant
ailments due to contained cervical disc herniation. The aim of this study
was to perform a systematic review and meta-analysis in order to evaluate
the effectiveness and safety of minimally invasive percutaneous
(non-endoscopic) cervical techniques. <br/>Method(s): A comprehensive
literature search was conducted using the PubMed, Cochrane Library, and
SCOPUS databases up to July 2024, in accordance with the PRISMA
guidelines. Outcomes measured included Visual Analogue Scale (VAS) scores,
the Neck Disability Index (NDI), and MacNab scores, assessing pain relief
and functional recovery. The risk of bias was evaluated using the Cochrane
risk of bias tool (RoB 2) and the risk of bias in nonrandomized studies of
interventions (ROBINS-I) tool, with statistical analyses conducted in R
software (version 4.3.1). <br/>Result(s): Out of 847 records, 21 studies
(covering 1580 patients) were included in the final analysis. Five
different percutaneous minimally invasive cervical procedures were
incorporated into this review: nucleoplasty (n = 973), discectomy (n =
311), a combination of nucleoplasty and discectomy (n = 98), annuloplasty
(n = 33), and pulsed radiofrequency (n = 17). The mean patient age was
49.5, with a gender distribution of 47.7% male and 52.3% female. A
meta-analysis of six studies on cervical nucleoplasty (400 patients)
demonstrated a significant reduction in pain scores, with a standardized
mean difference (SMD) of -4.68 (95% CI: -8.77; -0.59, p = 0.032). However,
a high heterogeneity (I² = 98.8%, Q = 407.31, p < 0.001) was
observed, indicating significant variability across studies. The
reoperation rate among patients was 3.4%, with discitis and device-related
complications being the most frequently reported adverse events.
<br/>Conclusion(s): Minimally invasive percutaneous cervical interventions
provide effective pain relief and functional improvement for patients with
cervical disc herniation, as evidenced by reductions in VAS scores and
positive MacNab outcomes. The choice of the most appropriate technique
should be based on individual clinical scenarios, surgeon expertise, and
patient preferences, as no single method demonstrates clear superiority
according to clinical outcomes or complication rates.<br/>Copyright &#xa9;
2025 by the authors.

<49>
Accession Number
2035415921
Title
Anesthetic Management of Intracardiac Migration of Medical Devices.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 39(7) (pp 1866-1877),
2025. Date of Publication: 01 Jul 2025.
Author
Holloway J.; Lee M.; Stephens B.; Byun W.Y.; Saklayen S.; Anam K.; Awad H.
Institution
(Holloway, Saklayen, Anam, Awad) Department of Anesthesiology, The Ohio
State University, Columbus, OH, United States
(Lee) College of Nursing, Nurse Anesthesia Program, Otterbein University,
Columbus, OH, United States
(Stephens) Department of Anesthesiology & Perioperative Medicine,
University of Pittsburgh Medical Center, Pittsburgh, PA, United States
(Byun) College of Medicine, The Ohio State University, Columbus, OH,
United States
Publisher
W.B. Saunders
Abstract
The use of endovascular, percutaneous interventions to treat cardiac,
arterial, and venous pathologies is becoming increasingly common in
medical practice. While endovascular device placement typically carries a
low risk, device migration remains a persistent problem with these
procedures for which anesthesia providers must have a high index of
suspicion. Anesthesia providers should be aware of the wide range of
indications for such devices, potential migration locations, and
hemodynamic consequences of both the inciting pathology and device
migration so they can safely care for patients in these settings. This
article aims to discuss a case series of five different device migration
events, review the literature surrounding the migration of each device,
and propose unique anesthetic considerations as well as a systematic
approach by which to approach these complications.<br/>Copyright &#xa9;
2024 Elsevier Inc.

<50>
Accession Number
2038271425
Title
Low versus High Fraction of Inspired Oxygen During Lung Separation in
Thoracic Surgery: A Randomized Controlled Trial.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 39(7) (pp 1746-1754),
2025. Date of Publication: 01 Jul 2025.
Author
Spraider P.; Abram J.; Wally D.; Bernardi D.; Augustin F.; Hell T.;
Tscholl P.; Dejaco H.
Institution
(Spraider, Abram, Wally, Bernardi, Dejaco) Department of Anesthesia and
Intensive Care Medicine, Medical University of Innsbruck, Innsbruck,
Austria
(Augustin) Department of Visceral, Transplant and Thoracic Surgery,
Medical University of Innsbruck, Innsbruck, Austria
(Hell, Tscholl) Data Lab Hell, non-University Research Institution, Zirl,
Austria
Publisher
W.B. Saunders
Abstract
Objectives: To investigate whether a lower fraction of inspired oxygen
(FiO<inf>2</inf>) during the early phase of lung separation is able to
improve overall oxygenation of the blood assessed by the arterial partial
pressure of oxygen (PaO<inf>2</inf>)/FiO<inf>2</inf> ratio, and to
investigate its effect on lung collapse and postoperative pulmonary
complications (PPC). <br/>Design(s): Prospective, nonblinded, randomized
controlled trial. <br/>Setting(s): Single-center trial at a university
hospital. <br/>Participant(s): Patients scheduled for thoracic surgery
requiring one-lung ventilation (OLV). <br/>Intervention(s): Study
participants received either a low and then increasing oxygen
concentration after lung separation or pure oxygen and then a decreasing
oxygen concentration. <br/>Measurements and Main Results: The primary
endpoint was the PaO<inf>2</inf>/FiO<inf>2</inf> ratio 30 minutes after
the start of OLV. Secondary endpoint included lung collapse defined as
none, partial, or complete during the early phase of OLV and incidence of
PPC. A total of 55 patients were enrolled, 53 of whom were included in the
analysis. The primary endpoint, PaO<inf>2</inf>/FiO<inf>2</inf> ratio, was
comparable in the 2 groups, and the secondary endpoint, lung collapse, was
similar. However, the incidence of PPC was significantly reduced with a
low oxygen content strategy (19% vs 48%; p = 0.042). <br/>Conclusion(s): A
strategy of low FiO<inf>2</inf> before and after lung separation did not
improve the oxygenation capacity of the lungs, and lung collapse was
comparable in the 2 study groups. However, the occurrence of PPC was
significantly reduced in the group treated with low
FiO<inf>2</inf>.<br/>Copyright &#xa9; 2025 The Author(s)

<51>
Accession Number
2038114832
Title
Postoperative Pain Intensity After Single-port, Double-port, and
Triple-port Video-assisted Lung Lobectomy: A Three-arm Parallel Randomized
Clinical Trial.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 39(7) (pp 1755-1762),
2025. Date of Publication: 01 Jul 2025.
Author
Kosinski S.; Putowski Z.; Stachowicz J.; Czajkowski W.; Wilkojc M.;
Zietkiewicz M.; Zielinski M.
Institution
(Kosinski, Stachowicz, Czajkowski, Wilkojc, Zielinski) Klara Jelska's
Pulmonary Hospital, Zakopane, Poland
(Kosinski) Jagiellonian University Medical College,
Orthopaedic-Rehabilitation University Hospital, Zakopane, Poland
(Putowski) Jagiellonian University Medical College, Centre for Intensive
and Perioperative Care, Cracow, Poland
(Zietkiewicz) Jagiellonian University Medical College, John Paul II
Hospital, Cracow, Poland
Publisher
W.B. Saunders
Abstract
Objective: Video-assisted thoracic surgery (VATS) has evolved from a
multiport approach to a one-port approach to reduce the degree of surgical
trauma. However, there is no consensus on the number of incisions leading
to less postoperative pain. Early postoperative pain was compared after
three technical variants of VATS lobectomy under multimodal analgesia,
including thoracic epidural analgesia. <br/>Design(s): This study was
designed as a prospective, randomized, controlled clinical trial with
three parallel arms. <br/>Setting(s): Single-center study.
<br/>Participant(s): A total of 112 adult patients with ASA statuses I to
III who were scheduled to undergo elective VATS lobectomy for early-stage
non-small cell lung cancer were enrolled. <br/>Intervention(s): Patients
were randomly assigned to one of three groups: single-port, double-port,
and triple-port VATS lobectomy. The same postoperative analgesia protocol
was used in each group. <br/>Measurements and Main Results: The primary
outcome was postoperative pain intensity at rest and when coughing within
the first 72 hours after surgery. The secondary outcomes were cumulative
opioid consumption and the composite rate of postoperative complications.
A total of 112 patients were enrolled in the study, 91 of whom completed
the study protocol. There were no significant differences between the
study groups in terms of pain intensity either at rest (p = 0.319) or when
coughing (p = 0.202). There was no difference in the incidence of
postoperative complications. <br/>Conclusion(s): This study revealed no
differences in pain intensity in the early postoperative period between
three different technical variants of VATS lobectomy when an analgesia
protocol based on thoracic epidural anesthesia was used.<br/>Copyright
&#xa9; 2025 Elsevier Inc.

<52>
Accession Number
2034461951
Title
Maintaining ventilation with very low tidal volume and positive-end
expiratory pressure versus no ventilation during cardiopulmonary bypass
for cardiac surgery in adults: a randomized clinical trial.
Source
Intensive Care Medicine. 51(5) (pp 849-860), 2025. Date of Publication: 01
May 2025.
Author
Tadie J.-M.; Ouattara A.; Laviolle B.; Lesouhaitier M.; Esvan M.; Rousseau
C.; Gregoire M.; Gaudriot B.; Nesseler N.; Labaste F.; Sanchez P.;
Marcheix B.; Beurton A.; Dureau P.; Demondion P.; Fouquet O.; Rineau E.;
Amour J.; Verhoye J.-P.; Mercat A.; Terzi N.; Tarte K.; Bougle A.; Flecher
E.
Institution
(Tadie, Lesouhaitier, Terzi) Department of Infectious Diseases and
Intensive Care Unit, Centre Hospitalier Universitaire Rennes, Universite
de Rennes 1, Rennes, France
(Tadie, Lesouhaitier, Gregoire, Tarte) SITI Laboratory, UMR U1236, INSERM,
University of Rennes, EFS, Rennes University Hospital, Rennes, France
(Tadie, Lesouhaitier, Esvan, Rousseau, Terzi) Centre d'investigation
Clinique de Rennes (CIC1414), Inserm, Centre Hospitalier Universitaire
Rennes, Universite de Rennes 1, Rennes, France
(Ouattara, Beurton) Department of Cardiovascular Anaesthesia and Critical
Care, CHU Bordeaux, Magellan Medico-Surgical Centre, Bordeaux, France
(Laviolle) CHU Rennes, Univ Rennes, Inserm, UMR_S 1085 (IRSET), CIC 1414,
Rennes, France
(Gaudriot, Nesseler) Department of Anesthesia and Critical Care,
Pontchaillou, Rennes University Hospital, Rennes, France
(Labaste, Sanchez) Anesthesiology and Intensive Care Department, Centre
Hospitalier Universitaire de Toulouse, Toulouse, France
(Marcheix) Department of Cardiovascular Surgery, Centre Hospitalier
Universitaire de Toulouse, Toulouse, France
(Dureau, Bougle) Department of Anesthesiology and Critical Care Medicine,
Sorbonne University, Cardiology Institute, GRC 29, Assistance Publique -
Hopitaux de Paris, Pitie-Salpetriere Hospital, Paris, France
(Demondion) Thoracic and Cardiovascular Surgery Department, Groupe
Hospitalier Pitie-Salpetriere, Institute of Cardiology, Sorbonne
Universite, APHP, Paris, France
(Fouquet) Department of Cardiac Surgery, University Hospital of Angers,
Angers, France
(Rineau) Department of Anesthesiology and Critical Care, Angers
University, Angers, France
(Amour) Institute of Perfusion, Critical Care Medicine and Anesthesiology
in Cardiac Surgery Paris Sud (IPRA), Hopital Prive Jacques Cartier, Ramsay
Health Care, Massy, France
(Verhoye, Flecher) Department of Vascular and Cardio-Thoracic Surgery,
Rennes University Hospital, Rennes, France
(Mercat) Medical Intensive Care Unit, Vent'Lab, Angers University
Hospital, University of Angers, 4 Rue Larrey, Angers, France
(Ouattara, Beurton) UMR 1034, Biology of Cardiovascular Diseases, Univ.
Bordeaux, INSERM, Pessac, France
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Purpose: Cardiopulmonary bypass (CPB) during cardiac surgery mechanically
circulates and oxygenates the blood, bypassing the heart and lungs.
Despite limited evidence, maintaining mechanical ventilation (MV) during
CPB is recommended, as ventilator strategies during surgery may reduce the
occurrence of postoperative infections. We aimed to determine whether
maintaining MV for cardiac surgery would decrease postoperative infections
compared with stopping MV during CPB. <br/>Method(s): We conducted a
multicenter, single-blind, randomized trial among adult patients
undergoing scheduled cardiac surgery with CPB in six hospitals in France.
During CPB, the tracheal tube was disconnected from the ventilator in the
control group (MV- group). In the MV + group, ventilation was maintained
during CPB with very low tidal volume ventilation, using a tidal volume of
2.5 mL/kg of predicted body weight, with 5-7 cmH<inf>2</inf>O positive end
expiratory pressure. The primary outcome was the occurrence of all types
of postoperative infections within the first 28 days after surgery. There
were six secondary evaluation criteria including the number of days of
exposure to antibiotics. <br/>Result(s): A total of 1362 patients were
enrolled in the study. Postoperative infection occurred in 74 out of 680
patients (10.9%) in the MV- group, compared to 68 out of 682 patients
(10.0%) in the MV + group (relative risk, 0.92; 95% confidence interval
[CI] 0.67-1.25; p = 0.58). Antibiotic use was higher in the MV + group
than in the MV- group (incidence risk ratio, 1.08; 95% CI 1.02-1.15; p =
0.02). There were no significant differences between the groups for all
other secondary outcomes or for the incidence of adverse events.
<br/>Conclusion(s): Maintaining very low tidal volume ventilation with
positive end-expiratory pressure during CPB did not reduce postoperative
infections at 28 days compared to when mechanical ventilation was stopped
during CPB. An unexpectedly higher use of antibiotics was observed when
ventilation was maintained. Trial registration: ClinicalTrials.gov
(NCT03372174).<br/>Copyright &#xa9; The Author(s) 2025.

<53>
Accession Number
2038902578
Title
A Randomized Controlled Trial on Nebulized Dexmedetomidine vs. Normal
Saline for Attenuating Hemodynamic Response to Intubation.
Source
Journal of Cardiovascular Disease Research. 15(12) (pp 5823-5834), 2024.
Date of Publication: 2024.
Author
Datar M.S.; Zanwar Y.N.; Dash A.B.; Tiwari S.B.
Institution
(Datar) Department of Anaesthesiology, Shri Vasantrao Naik Government
Medical College, Maharashtra, Yavatmal, India
(Zanwar) Department of Anaesthesiology, Government Medical College,
Maharashtra, Nagpur, India
(Dash) Department of Anaesthesiology Government Medical College,
Maharashtra, Nagpur, India
(Tiwari) Apollo Hospital, Maharashtra, Navi Mumbai, India
Publisher
EManuscript Technologies
Abstract
Background Direct laryngoscopy and intubation act as unpleasant stimuli
which are known to cause transient, but unpredictable hemodynamic changes.
Our hypothesis was that nebulized dexmedetomidine, given as premedication
blunts pressor response during laryngoscopy and intubation. Methods This
was an open label, prospective, randomized controlled study which was
carried out in 90 patients, male and female, aged 18 to 60 years, American
Society of Anaesthesiologists (ASA) I and II, undergoing planned
non-cardiac, non-neurosurgical surgery under general anesthesia with
endotracheal intubation. Study was aimed at evaluating the effects of
nebulized dexmedetomidine towards bringing down pressor response during
laryngoscopy and intubation when compared with normal saline. The study
population was split using pre-designed, computer-generated random
allocation plan into two groups. Control group (n = 50), where patients
were given nebulisation in sitting position, with 5 mL of 0.9% normal
saline and study group (n = 50), where patients were administered
nebulisation in the dose of 1 microg/kg dexmedetomidine (With 0.9% normal
saline added to make a full volume of 5 mL) in sitting position, ten
minutes before induction with anesthesia. Results The two groups were
demographically similar. Following laryngoscopy and intubation in the
control group, there were noticeable increase in heart rate (HR), systolic
blood pressure (SBP), diastolic systolic blood pressure (DBP) and mean
arterial pressure (MAP), but a drop in HR (at 1 min-72.11 +/- 5.57; P=
0.001, 3 min - 68.62 +/- 5.67; P< 0.001, 5 min-64.867 +/- 5.34; P< 0.001,
10 min-60.867 +/- 5.20; P< 0.001), SBP (at 1 min-116.53 +/- 8.88; P<
0.001, 3 min-110.778 +/- 9.2; P< 0.001, 5 min-105.289 +/- 8.79; P< 0.001,
10 min-99.133 +/- 7.87; P< 0.001), DBP (at 1 min-72.978 +/- 6.10; P=
0.001, 3 min-68.73 +/- 6.47; P< 0.001, 5 min-64.311 +/- 6.07; P< 0.001, 10
min- 60.422 +/- 5.79; P< 0.001) and MAP (at 1 min-87.5 +/- 6.8; P= 0.001,
3 min-82.76 +/- 6.76; P< 0.001, 5 min- 78.04 +/- 6.26; P< 0.001, 10 min-
73.29 +/- 5.57; P< 0.001) was recorded in the study group. Conclusion
Nebulized dexmedetomidine when given as a premedication effectually blunts
the pressor response during laryngoscopy and intubation.<br/>Copyright
&#xa9; 2024 EManuscript Technologies. All rights reserved.

<54>
Accession Number
2039003203
Title
The relationship of baseline high-sensitivity C-reactive protein with
incident cardiovascular events and all-cause mortality over 20 years.
Source
eBioMedicine. 117 (no pagination), 2025. Article Number: 105786. Date of
Publication: 01 Jul 2025.
Author
Hartley A.; Rostamian S.; Kaura A.; Chrysostomou P.; Welsh P.; Ariti C.;
Sattar N.; Sever P.; Khamis R.
Institution
(Hartley, Rostamian, Kaura, Chrysostomou, Ariti, Sever, Khamis) National
Heart and Lung Institute, Imperial College London, United Kingdom
(Welsh, Sattar) Institute of Cardiovascular and Medical Sciences,
University of Glasgow, Glasgow, United Kingdom
Publisher
Elsevier B.V.
Abstract
Background: The prediction of future cardiovascular events in those with
risk factors is important for the appropriate optimisation of preventative
therapies for those at greatest risk. The value of high sensitivity
C-reactive Protein (hsCRP) has been questioned in this regard. The
objectives of this post-hoc analysis of a randomised controlled trial were
to investigate the usefulness of baseline serum hsCRP for predicting very
long-term cardiovascular events in patients with hypertension in the
Anglo-Scandinavian Cardiac Outcomes Trial (ASCOT) Legacy Study.
<br/>Method(s): The ASCOT Legacy Study reports events up to 20 years of
follow-up of the UK participants in the Lipid Lowering Arm of the original
ASCOT trial. We examined outcomes related to serum hsCRP levels measured
using a commercial ELISA, in tertiles or continuously, adjusting for
classical cardiovascular risk factors as well as treatment allocation
within ASCOT. The primary outcome was non-fatal myocardial infarction (MI)
and fatal coronary heart disease (CHD); whilst secondary outcomes were
all-cause mortality, total coronary events and procedures, total
cardiovascular events and stroke. <br/>Finding(s): After excluding 3286
participants without hsCRP data, 5294 participants were included in the
final cohort. The highest tertile of hsCRP was associated with the
following outcomes compared to the lowest tertile: non-fatal myocardial
infarction (MI) and fatal CHD (HR 1.32 [1.05-1.67]); total coronary events
and procedures (HR 1.27 [1.09-1.47]); total cardiovascular events (HR 1.22
[1.08-1.37]); and all-cause mortality (HR 1.25 [1.10-1.42]). However,
there was insufficient evidence regarding the association between hsCRP
levels and stroke events. Addition of hsCRP in tertiles resulted in an
improved net reclassification index for the prediction of non-fatal MI and
fatal CHD at 20 years (9.68%, p < 0.0001). <br/>Interpretation(s): Higher
baseline serum hsCRP levels can independently predict cardiovascular
events and all-cause mortality at long-term follow-up in stable patients
with hypertension. <br/>Funding(s): British Heart Foundation Clinical
Research Fellowship (FS/17/16/32560), Wellcome Trust Clinical Research
Fellowship (220572/Z/20/Z), and Sansour Fund at Imperial Healthcare
Charity. The substudy of ASCOT Biomarker Programme was supported by
Pfizer, New York, NY, USA. Infrastructure support was provided by the NIHR
Imperial Biomedical Research Centre as well as the Imperial British Heart
Foundation Research Excellence Award (4) (RE/24/130023).<br/>Copyright
&#xa9; 2025 The Author(s)

<55>
Accession Number
2038858354
Title
Epicardial ablation in high-risk Brugada syndrome to prevent ventricular
fibrillation: Results from a randomized clinical trial.
Source
Europace. 27(5) (no pagination), 2025. Article Number: euaf097. Date of
Publication: 01 May 2025.
Author
Pappone C.; Ciconte G.; Vicedomini G.; Micaglio E.; Boccellino A.; Negro
G.; Giannelli L.; Rondine R.; Creo P.; Tarantino A.; Ballarotto M.; Maiolo
V.; Ciaccio C.; Manuello R.; Locati E.T.; Mazza B.C.; Vecchi M.; Calovic
Z.; Anastasia L.
Institution
(Pappone, Ciconte, Vicedomini, Micaglio, Boccellino, Negro, Giannelli,
Rondine, Ballarotto, Maiolo, Ciaccio, Manuello, Locati, Mazza, Vecchi,
Calovic) Arrhythmia and Electrophysiology Department, IRCCS Policlinico
San Donato, Piazza E. Malan 1, San Donato Milanese, Milano, Italy
(Pappone, Ciconte, Boccellino, Anastasia) School of Medicine, University
Vita-Salute San Raffaele, Via Olgettina, 58, Milan, Italy
(Pappone, Ciconte, Vicedomini, Micaglio, Creo, Tarantino, Locati,
Anastasia) Institute of Molecular and Translational Cardiology (IMTC),
Piazza Malan 2, San Donato Milanese, Milan, Italy
Publisher
Oxford University Press
Abstract
Aims: Epicardial ablation for Brugada syndrome (BrS) has shown promise in
reducing ventricular fibrillation (VF), but its role remains controversial
due to the lack of randomized trials. This study evaluates the efficacy of
catheter ablation in high-risk BrS patients. <br/>Methods and Results:
This prospective, single-centre, randomized (2:1) study enrolled BrS
patients with cardiac arrest (CA) or appropriate ICD therapies. All
patients had an ICD and were randomized to undergo epicardial ablation
(ablation group) or no ablation (control group). Enrolment began in
September 2017 and prematurely terminated in February 2024. The primary
endpoint was freedom from VF recurrences. Secondary endpoints included
procedure safety, ICD-related complications, and quality-of-life
assessment. Forty patients (83% male, mean age 43.7 +/- 12.1) were
randomized: 26 in the ablation group and 14 in the control group.
Thirty-six patients received appropriate ICD therapies before enrolment:
24 (92%) in the ablation group and 12 (86%) in the control group. One
patient in the ablation group experienced a post-procedural pericardial
effusion requiring pericardiocentesis. Thirteen patients (33%) had major
ICD-related complications. After a mean follow-up of 4.0 +/- 1.7 years,
freedom from VF recurrence was 96% (25/26) in the ablation group and 50%
(7/14) in the control group (P < 0.001). No unexplained or arrhythmic
deaths occurred during follow-up. <br/>Conclusion(s): Epicardial catheter
ablation was associated with a reduction in VF recurrence compared with
ICD therapy alone. These findings support the use of epicardial ablation
in high-risk BrS patients.<br/>Copyright &#xa9; 2025 The Author(s).

<56>
Accession Number
2034677606
Title
Determinants of stroke following percutaneous coronary intervention in
patients with acute coronary syndrome: a systematic review and
meta-analysis.
Source
Annals of Medicine. 57(1) (no pagination), 2025. Article Number: 2506481.
Date of Publication: 2025.
Author
Qanitha A.; Alkatiri A.H.; Qalby N.; Soraya G.V.; Alatsari M.A.;
Larassaphira N.P.; Hanifah R.; Kabo P.; Amir M.
Institution
(Qanitha, Alkatiri, Kabo, Amir) Department of Cardiology and Vascular
Medicine, Faculty of Medicine, Universitas Hasanuddin, Makassar, Indonesia
(Qanitha, Alkatiri, Soraya, Kabo, Amir) Makassar Cardiac Center (Pusat
Jantung Terpadu), Dr. Wahidin Sudirohusodo General Teaching Hospital,
Makassar, Indonesia
(Qanitha) Department of Physiology, Faculty of Medicine, Universitas
Hasanuddin, Makassar, Indonesia
(Qalby) Department of Public Health and Community Medicine, Faculty of
Medicine, Universitas Hasanuddin, Makassar, Indonesia
(Qalby) Departement of Cardiology, Heart and Lung Division, University
Medical Center Utrecht, Utrecht, Netherlands
(Soraya) Department of Neurology, Faculty of Medicine, Universitas
Hasanuddin, Makassar, Indonesia
(Alatsari, Larassaphira, Hanifah) Faculty of Medicine, Universitas
Hasanuddin, Makassar, Indonesia
Publisher
Taylor and Francis Ltd.
Abstract
Background: Despite advances in the field, no systematic review has
thoroughly documented the occurrence of stroke following Percutaneous
Coronary Intervention (PCI) in patients with Acute Coronary Syndrome
(ACS). This study aimed to investigate the factors contributing to stroke
occurrence post-PCI in ACS patients. <br/>Method(s): A systematic search
of PubMed and EMBASE identified 2,369 articles. After full-text screening,
109 articles were included in the systematic review, with 55 articles
selected for meta-analysis. <br/>Result(s): Data from 18,466,823 patients
across 109 studies were analyzed. Among these, 202,999 patients (1.1%)
experienced post-PCI stroke. The participants' ages ranged from 49.0 to
87.6 years (mean 64.3 +/- 6.2 years). The incidence of early post-PCI
stroke within 30 days was 1.1%, while the incidence of stroke occurring
>30 days post-PCI was 1.8%, predominantly ischemic strokes. Predictors of
stroke following PCI in ACS patients included traditional risk factors
(i.e. female sex, older age, diabetes mellitus, hypertension, prior stroke
or transient ischemic attack); comorbidities (i.e. chronic kidney disease,
atrial fibrillation, anemia, high bleeding risk); and procedural factors
(i.e. thrombus aspiration and Clopidogrel use). <br/>Conclusion(s): This
study highlights the relatively low prevalence of stroke following PCI,
estimated at approximately 1% of the studied population. These findings
emphasize the critical need for continued vigilance in identifying and
managing risk factors associated with post-PCI stroke in ACS patients.
Future research should prioritize refining risk prediction models,
developing innovative preventive strategies, and optimizing post-PCI care
pathways to effectively reduce the incidence of stroke in this
population.<br/>Copyright &#xa9; 2025 The Author(s). Published by Informa
UK Limited, trading as Taylor & Francis Group.

<57>
Accession Number
2034713832
Title
Temporary Mechanical Support in Cardiogenic Shock Secondary to Heart
Failure: An Evolving Paradigm.
Source
Journal of Personalized Medicine. 15(5) (no pagination), 2025. Article
Number: 184. Date of Publication: 01 May 2025.
Author
Nair N.; Du D.; Mahesh B.
Institution
(Nair) Division of Cardiology, Department of Medicine, PSU College of
Medicine, Hershey, PA, United States
(Du) Industrial, Manufacturing, Systems Engineering, Texas Tech
University, Lubbock, TX, United States
(Mahesh) Division of Cardiothoracic Surgery, Department of Surgery, PSU
College of Medicine, Hershey, PA, United States
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Cardiogenic shock can be defined as a state of circulatory collapse
resulting in hypoperfusion and end-organ dysfunction. It carries a large
burden of mortality, but management strategies are driven by expert
consensus rather than adequately powered randomized clinical trials. The
goal of this review is to highlight the differences in presentation and
outcomes in cardiogenic shock depending on the etiology, such as acute
myocardial infarction (AMI) versus acute-on-chronic heart failure (HF),
gender-based differences in treatment strategies and outcomes and the need
for more precise risk stratification and modeling to improve the
efficiency of treatment delivery in a personalized fashion. PubMed and
Google Scholar were used to search the literature for this qualitative
review. The differences in gender and etiology of cardiogenic shock are
not consistent in all studies in the exiting literature. There is a need
for identification of novel risk factors that define the different
phenotypes that present with similar hemodynamic and biomarker profiles.
There is an urgent need to devise a methodology to understand and
differentiate the different cardiogenic shock phenotypes and their
trajectories. Better risk prediction models should be generated to help
deliver well-tailored treatment, paving the way to the efficient delivery
of personalized medicine.<br/>Copyright &#xa9; 2025 by the authors.

<58>
Accession Number
2039049276
Title
Incidence, reasons, and mortality risk of ICU readmission in surgical
patients: A systematic review and meta-analysis.
Source
American Journal of Surgery. 247 (no pagination), 2025. Article Number:
116460. Date of Publication: 01 Sep 2025.
Author
Lu R.; kacha S.; phothikun N.; supphapipat A.; Chanchalotorn S.;
Siripakkaphant C.; Siriniran N.; Chienprasert M.; Chittawatanarat K.
Institution
(Lu, kacha, phothikun, supphapipat, Chittawatanarat) Department of
Surgery, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
(Lu) Department of Emergency Medicine, The Affiliated Hospital, Southwest
Medical University, Sichuan, Luzhou, China
(supphapipat, Chittawatanarat) Clinical Surgical Research Center,
Department of Surgery, Faculty of Medicine, Chiang Mai University, Chiang
Mai, Thailand
(kacha, phothikun) Department of Anesthesiology, Faculty of Medicine,
Chiang Mai University, Chiang Mai, Thailand
(Chanchalotorn, Siripakkaphant, Siriniran, Chienprasert) Faculty of
Medicine, Chiang Mai University, Chiang Mai, Thailand
Publisher
Elsevier Inc.
Abstract
Background: This study investigates the incidence, reasons, and mortality
risk of ICU readmission in surgical patients. <br/>Method(s): Systematic
searches of PubMed, Embase, Cochrane, and Scopus were conducted for
studies from January 2000 to August 2024. Included studies reported ICU
readmission or in-hospital mortality in adult surgical ICU patients.
Mortality risks were compared between readmitted and non-readmitted
patients. Pooled incidence and causes of ICU readmission across diseases
were analyzed. <br/>Result(s): Among 23 studies, ICU readmission
significantly increased mortality risk (OR: 8.44, 95 % CI: 6.35-11.21).
The overall readmission incidence was 6 % (95 % CI: 0.05-0.06), with
higher rates in gastrointestinal (9 %) and thoracic (8 %) surgeries.
Respiratory issues were the most frequent cause (40 %).
<br/>Conclusion(s): ICU readmission in surgical patients is associated
with higher mortality and longer stays. Gastrointestinal and thoracic
surgeries pose higher risks, with respiratory and cardiovascular factors
being key contributors.<br/>Copyright &#xa9; 2025 Elsevier Inc.

<59>
Accession Number
2034713824
Title
One-Stop Mitral Valve Transcatheter Edge-to-Edge Repair and Left Atrial
Appendage Occlusion in Patients with Atrial Fibrillation and Mitral
Regurgitation: A Systematic Review and Meta-Analysis.
Source
Journal of Personalized Medicine. 15(5) (no pagination), 2025. Article
Number: 197. Date of Publication: 01 May 2025.
Author
Pamporis K.; Tsiachris D.; Grigoriou K.; Karakasis P.; Doundoulakis I.;
Theofilis P.; Kouvatsos P.; Saplaouras A.; Kordalis A.; Karanikola A.-E.;
Goutis P.A.; Tsioufis K.
Institution
(Pamporis, Tsiachris, Doundoulakis, Theofilis, Kouvatsos, Kordalis,
Karanikola, Tsioufis) First Cardiology Department, "Hippokration" General
Hospital, School of Medicine, National and Kapodistrian University of
Athens, Athens, Greece
(Pamporis, Grigoriou, Goutis) Department of Pharmacology, University of
Athens, 75 Mikras Asias Avenue, Goudi, Greece
(Karakasis) Second Department of Cardiology, General Hospital
"Hippokration", Aristotle University of Thessaloniki, Thessaloniki, Greece
(Doundoulakis) Heart Rhythm Management Centre, Postgraduate Program in
Cardiac Electrophysiology and Pacing, Universitair Ziekenhuis Brussel,
Vrije Universiteit Brussel, European Reference Networks Guard-Heart,
Brussels, Belgium
(Saplaouras) Arrhythmia Unit, Onassis Cardiac Surgery Center, Athens,
Greece
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Background/Objectives: Patients with atrial fibrillation and mitral
regurgitation (MR) undergoing transcatheter edge-to-edge mitral valve
repair (M-TEER) often have concomitant indications for left atrial
appendage occlusion (LAAO), mandating a more personalized treatment
approach. This study aimed to examine the effectiveness and safety of
combining M-TEER/LAAO in one procedure. <br/>Method(s): MEDLINE (PubMed),
Scopus, and Cochrane were searched through 21 March 2025 for studies
examining M-TEER/LAAO with or without control (M-TEER only).
Double-independent study selection, extraction, and quality assessments
were performed. Frequentist random-effects models were used to calculate
mean differences (MDs) and risk ratios (RRs) with 95% confidence intervals
(CIs). <br/>Result(s): Seven studies (223 participants) were included. For
M-TEER/LAAO, the mean procedural time was 101.6 min (95% CI = [85.06,
118.13]), the mean radiation time was 29.97 min (95% CI = [23.85, 36.09]),
the mean length of stay was 5.21 days (95% CI = [3.31, 7.12]), procedural
success was achieved in 89.5% of cases (95% CI = [73.4, 96.3], and
post-procedure MR > 2+ occurred in 14.8% of cases (95% CI = [3.6, 44.5]).
Compared to M-TEER only, patients with M-TEER/LAAO had similar procedural
(RR = 0.91, 95% CI = [0.71, 1.17]) and technical success (RR = 1, 95% CI =
[0.94, 1.06]) with a similar risk of acute kidney injury (RR = 1, 95% CI =
[0.07, 15.12]), bleeding (RR = 0.40, 95% CI = [0.01, 18.06]), and
all-cause death (RR = 0.59, 95% CI = [0.22, 1.54]). M-TEER/LAAO was
non-significantly associated with in-hospital death (RR = 3, 95% CI =
[0.13, 70.23]), stroke (RR = 3, 95% CI = [0.13, 70.23]), and vascular
complications (RR = 1.55, 95% CI = [0.43, 5.59]) compared to M-TEER only.
Most patients (34.2%, 95% CI = [2.8, 90.4]) received dual antiplatelet
therapy at discharge, followed by anticoagulation only (20.2%, 95% CI =
[7.5, 44.3]). <br/>Conclusion(s): M-TEER/LAAO can be combined into a
single procedure with good peri-procedural outcomes. Safety was also
satisfactory; however, some concerns may arise regarding in-hospital
death, stroke, and vascular complications. Further research is needed to
explore the effectiveness and safety of this combined strategy and
elucidate the risk-benefit profile of this personalized treatment
approach.<br/>Copyright &#xa9; 2025 by the authors.

<60>
Accession Number
2038848516
Title
Multimodal analgesia in cardiac surgery: Impact on postoperative
medication consumption and cognitive function.
Source
World Journal of Cardiology. 17(5) (no pagination), 2025. Article Number:
103168. Date of Publication: 26 May 2025.
Author
Wang Q.; Yan X.-Q.; Ma X.-M.; Yan R.; Wang Z.-H.; Ma Y.-J.; Wang H.-B.
Institution
(Wang, Yan, Ma, Yan, Wang, Ma, Wang) Department of Anesthesiology and
Perioperative Medicine, General Hospital of Ningxia Medical University,
Ningxia Hui Autonomous Region, Yinchuan, China
Publisher
Baishideng Publishing Group Inc
Abstract
BACKGROUND Patients who undergo cardiac surgery often face postoperative
pain and potential cognitive issues. Multimodal analgesia may address
these problems. We hypothesized that multimodal analgesia can reduce
opioid use and improve cognitive recovery. AIM To investigate the effects
of multimodal analgesia on postoperative opioid consumption and cognitive
recovery in patients who underwent cardiac surgery. METHODS A prospective,
randomized controlled trial at General Hospital from January 2020 to April
2023 recruited a total of 150 adult patients who underwent elective
cardiac surgery. The patients were randomly divided into two groups. Group
A had patient-controlled intravenous analgesia with sufentanil and
flurbiprofen axil. Group B had flurbiprofen axil and paravertebral nerve
block. Data were analyzed with appropriate statistical methods. RESULTS
Group B had lower postoperative patient-controlled intravenous analgesia
drug consumption (2.21 mL/hour vs 4.26 mL/hour, P < 0.001), shorter
extubation time (2.32 hours vs 3.81 hours, P < 0.001), and intensive care
unit stay (15.32 h vs 28.63 h, P < 0.001). Visual Analogue Scale pain
scores were lower in group B (P < 0.001). Group B had fewer postoperative
complications (no respiratory depression vs 37.9% in group A, P < 0.05), a
lower postoperative cognitive dysfunction incidence (16.0% vs 28.0%, P <
0.05), and higher Barthel Index scores (P < 0.05). CONCLUSION Multimodal
analgesia with paravertebral nerve block and flurbiprofen axil reduces
opioid use and improves cognitive outcomes in patients who underwent
cardiac surgery.<br/>Copyright &#xa9;The Author(s) 2025. Published by
Baishideng Publishing Group Inc. All rights reserved.

<61>
Accession Number
2038852765
Title
Late Outcomes After Transcatheter Aortic Valve Implantation with
Balloon-Versus Self-Expandable Valves: Meta-Analysis of Reconstructed
Time-To-Event Data.
Source
Interventional Cardiology Clinics. 14(3) (pp 351-366), 2025. Date of
Publication: 01 Jul 2025.
Author
Jacquemyn X.; Van den Eynde J.; Caldonazo T.; Brown J.A.; Dokollari A.;
Serna-Gallegos D.; Clavel M.-A.; Pibarot P.; Sultan I.; Sa M.P.
Institution
(Jacquemyn, Van den Eynde) Department of Cardiovascular Sciences, KU
Leuven, Leuven, Belgium
(Caldonazo) Department of Cardiothoracic Surgery, Friedrich Schiller
University, Jena, Germany
(Brown, Serna-Gallegos, Sultan, Sa) Department of Cardiothoracic Surgery,
University of Pittsburgh, Pittsburgh, PA, United States
(Brown, Serna-Gallegos, Sultan, Sa) UPMC Heart and Vascular Institute,
University of Pittsburgh Medical Center, Pittsburgh, PA, United States
(Dokollari) Department of Cardiac Surgery, St. Boniface Hospital,
University of Manitoba, Winnepeg, Canada
(Clavel, Pibarot) Centre de Recherche de l'Institut Universitaire de
Cardiologie et de Pneumologie de Quebec, Quebec City, Quebec, Canada
(Clavel, Pibarot) Department of Medicine, Universite Laval, Quebec City,
Quebec, Canada
Publisher
Elsevier Inc.

<62>
Accession Number
2038985082
Title
Cardiac Biomarkers in Patients With Asymptomatic Severe Aortic Stenosis:
Analysis From the EARLY TAVR Trial.
Source
Circulation. 151(22) (pp 1550-1564), 2025. Date of Publication: 03 Jun
2025.
Author
Lindman B.R.; Pibarot P.; Schwartz A.; Oldemeyer J.B.; Su Y.R.; Goel K.;
Cohen D.J.; Fearon W.F.; Babaliaros V.; Daniels D.; Chhatriwalla A.;
Suradi H.S.; Shah P.; Szerlip M.; Mack M.J.; Dahle T.; O'neill W.W.;
Davidson C.J.; Makkar R.; Sheth T.; Depta J.; Devries J.T.; Southard J.;
Pop A.; Sorajja P.; Hahn R.T.; Zhao Y.; Leon M.B.; Genereux P.
Institution
(Lindman) Structural Heart and Valve Center, Vanderbilt University Medical
Center, Nashville, TN, United States
(Lindman, Su, Goel) Division of Cardiovascular Medicine, Vanderbilt
University Medical Center, Nashville, TN, United States
(Su) Cardiology Core Laboratory for Translational and Clinical Research,
Vanderbilt University Medical Center, Nashville, TN, United States
(Pibarot) Department of Cardiology, Quebec Heart and Lung Institute, Laval
University, Canada
(Schwartz, Cohen, Hahn, Leon) Columbia University Medical Center,
NewYork-Presbyterian Hospital, New York, United States
(Oldemeyer) University of Colorado Health, Loveland, United States
(Cohen, Leon) Cardiovascular Research Foundation, New York, NY, United
States
(Cohen) St Francis Hospital and Heart Center, Roslyn, NY, United States
(Fearon) Interventional Cardiology Section, Division of Cardiovascular
Medicine, Department of Medicine, Stanford University School of Medicine,
CA, United States
(Fearon) VA Palo Alto Health Care System, CA, United States
(Babaliaros) Emory School of Medicine, Atlanta, GA, United States
(Daniels) Division of Cardiology, California Pacific Medical Center, San
Francisco, United States
(Chhatriwalla) St Luke's Mid America Heart Institute, Kansas City, MO,
United States
(Suradi) Division of Cardiology, Rush University Medical Center, Chicago,
IL, United States
(Shah) Division of Cardiovascular Medicine, Brigham and Women's Hospital,
Boston, MA, United States
(Szerlip, Mack) Baylor Scott & White Heart Hospital, Plano, Richardson,
TX, United States
(Dahle) CentraCare Heart & Vascular Center, Saint Cloud, MN, United States
(O'neill) Center for Structural Heart Disease, Henry Ford Health System,
Detroit, MI, United States
(Davidson) Northwestern University Feinberg School of Medicine, Chicago,
IL, United States
(Makkar) Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles,
CA, United States
(Sheth) Population Health Research Institute, McMaster University and
Hamilton Health Sciences, Hamilton, ON, Canada
(Depta) Sands-Constellation Heart Institute, Rochester Regional Health,
NY, United States
(Devries) Heart and Vascular Center, Section of Cardiovascular Medicine,
Dartmouth-Hitchcock Medical Center, Lebanon, NH, United States
(Southard) Division of Cardiovascular Medicine, UC Davis Health System,
University of California-Davis, Sacramento, United States
(Pop) Department of Cardiology, AMITA Alexian Brothers Medical Center, Elk
Grove Village, IL, United States
(Sorajja) Minneapolis Heart Institute Foundation, Abbott Northwestern
Hospital, MN, United States
(Zhao) Edwards Lifesciences, Irvine, CA, United States
(Genereux) Gagnon Cardiovascular Institute, Morristown Medical Center, NJ,
United States
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND: The EARLY TAVR trial (Evaluation of TAVR Compared to
Surveillance for Patients With Asymptomatic Severe Aortic Stenosis)
demonstrated that early transcatheter aortic valve replacement (TAVR)
intervention was superior to clinical surveillance with delayed TAVR in
patients with asymptomatic severe aortic stenosis. Cardiac biomarkers are
associated with maladaptive remodeling, symptom onset, and worse outcomes
after TAVR. Whether elevated biomarkers identify asymptomatic patients
more likely to benefit from early intervention is unknown. <br/>METHOD(S):
A core laboratory measured NT-proBNP (N-terminal pro-B-type natriuretic
peptide) and high-sensitivity cardiac troponin T (hs-cTnT) levels.
Associations between biomarker levels and risk of the trial primary end
point (death, stroke, or unplanned cardiovascular hospitalization) and
other secondary end points were examined with Kaplan-Meier curves and Cox
proportional hazard models. Interaction tests were performed to assess
whether the treatment effect of early TAVR, compared with clinical
surveillance, differed according to biomarker levels. <br/>RESULT(S):
Among 901 patients randomized in EARLY TAVR, 798 (89%) had biospecimens
measured (median NT-proBNP level, 287 [145, 601]; median hs-cTnT level,
14.6 [10.5, 21.0]). Higher levels of NT-proBNP and hs-cTnT were broadly
associated with higher event rates for multiple end points. In general,
there was no significant interaction between baseline biomarkers and
treatment group with respect to any composite or individual end point
examined, although trends broadly demonstrated a greater relative benefit
of early TAVR at lower biomarker levels. There was a significant
interaction between hs-cTnT level and treatment group with respect to
death or heart failure hospitalization (P <inf>interaction</inf>=0.04) and
heart failure hospitalization alone (P <inf>interaction</inf>=0.03) such
that the relative benefit of early TAVR was greater for patients with
normal, rather than elevated, levels of hs-cTnT at baseline. For some end
points, higher baseline NT-proBNP level was associated with numerically
greater absolute risk reduction with early TAVR than were lower NT-proBNP
levels. <br/>CONCLUSION(S): In patients with asymptomatic severe
high-gradient aortic stenosis, higher NT-proBNP and hs-cTnT levels were
broadly associated with higher event rates, as expected. However, the
relative benefit of an early TAVR strategy was consistent regardless of
baseline biomarker levels and, contrary to our hypothesis, tended to be
more pronounced in patients with the lowest biomarker levels. These
findings suggest limited value for single measurements of these biomarkers
to guide the timing of TAVR in asymptomatic patients. REGISTRATION: URL:
https://www.clinicaltrials.gov; Unique identifier:
NCT03042104.<br/>Copyright &#xa9; 2025 The Authors.

<63>
Accession Number
2039056775
Title
Effect of a mHealth intervention on health literacy in patients completing
cardiac rehabilitation: A randomized controlled trial with one- and
five-year follow-up.
Source
International Journal of Cardiology: Cardiovascular Risk and Prevention.
26 (no pagination), 2025. Article Number: 200445. Date of Publication: 01
Sep 2025.
Author
Lunde P.; Finbraten H.S.; Pripp A.H.; Nilsson B.B.; Grimsmo J.; Bye A.
Institution
(Lunde, Pripp, Nilsson) Department of Rehabilitation Science and Health
Technology, Oslo Metropolitan University, PB 4, St.Olavs plass, Oslo,
Norway
(Finbraten) Department of Health and Nursing Sciences, University of
Inland Norway, PB 400, Elverum, Norway
(Pripp) Oslo Centre of Biostatistics and Epidemiology, Oslo University
Hospital, PB 4950 Nydalen, Oslo, Norway
(Nilsson) Division of Medicine, Department of Clinical Services, Oslo
University Hospital, PB 4950 Nydalen, Oslo, Norway
(Grimsmo) Department of Cardiac and pulmonary Rehabilitation, Lovisenberg
Rehabilitation, Cathinka Guldberg's Hospital, Ragnar Stroms Veg 10,
Jessheim, Norway
(Bye) Department of Nursing and Health Promotion, Oslo Metropolitan
University, PB 4 St.Olavs plass, Oslo, Norway
(Bye) European Palliative Care Research Centre (PRC), Department of
Oncology, Oslo University Hospital and University of Oslo, PB 4950,
Nydalen, Oslo, Norway
Publisher
Elsevier B.V.
Abstract
Background and aims: Adherence to treatment is a significant challenge for
patients with cardiac disease. Optimizing health literacy (HL) is
essential in this context. Mobile health (mHealth) interventions have been
suggested to improve both treatment adherence and HL. This study aimed to
examine the effect of a one-year mHealth intervention on HL and to compare
HL changes between the intervention- and the control group.
<br/>Method(s): This randomized controlled trial included patients
completing cardiac rehabilitation, who were randomly allocated to either
an intervention group receiving individualized follow-up via an app for
one year or a control group receiving usual care. From one-year follow-up
to the five-year follow-up, both groups received usual care. HL was
measured using the HLS-Q12. Mixed model for repeated measurements and
Wilcoxon signed rank test were used to analyse differences between groups,
while paired sample t-test and Kendall's Tau b correlation analysed
within-group changes. <br/>Result(s): A total of 113 patients were
included in the study. No statistically significant differences between
the groups were found in total HLS-Q12 score or at item level at any
follow-up. However, a statistically significant within-group improvement
was observed in the intervention group for the total score (mean change of
2.5 +/- 4.6, p < 0.01) and several HLS-Q12 items from baseline to one-year
follow-up. <br/>Conclusion(s): The one-year mHealth intervention did not
show an effect on HL levels at one- or five-year follow-ups. However,
significant within-group HL improvement from baseline to one-year
follow-up suggests that mHealth interventions may have the potential to
enhance HL.<br/>Copyright &#xa9; 2025 The Authors

<64>
Accession Number
2038447356
Title
Preferred Treatment and Expected Risk in Coronary Intervention Patients
With Peripheral Arterial Disease: Cardiologists' Views Versus Trials Data.
Source
CJC Open. 7(6) (pp 799-806), 2025. Date of Publication: 01 Jun 2025.
Author
Pinxterhuis T.H.; von Birgelen C.; Ploumen E.H.; van Vliet D.; Kok M.M.;
Buiten R.A.; van der Heijden L.C.; Zocca P.; Doggen C.J.M.
Institution
(Pinxterhuis, von Birgelen, Ploumen, van Vliet, Kok, Buiten, van der
Heijden, Zocca) Department of Cardiology, Thoraxcentrum Twente, Medisch
Spectrum Twente, Enschede, Netherlands
(Pinxterhuis, von Birgelen, Ploumen, van Vliet, Doggen) Health Technology
and Services Research, Faculty BMS, Technical Medical Centre, University
of Twente, Enschede, Netherlands
(Doggen) Clinical Research Centre, Rijnstate Hospital, Arnhem, Netherlands
Publisher
Elsevier Inc.
Abstract
Background: In aging Western populations, there is an increase in the
prevalence of both coronary artery disease and peripheral arterial disease
(PADs). Treatment of patients who undergo percutaneous coronary
intervention (PCI) and have concomitant PADs may pose a challenge, but
preferences of cardiologists regarding treatment and their views on
complication risks are unknown. <br/>Method(s): This work was a
survey-based study comparing cardiologists' views with patient-level data
of PCI trials (BIO-RESORT and BIONYX). <br/>Result(s): The survey was
completed by 47 of 208 (23%) invited cardiologists. A growing prevalence
of PADs was observed in the trials and by 50% of the respondents.
Cardiologists estimated that 22% of current PCI patients had PADs, whereas
this rate was 7.3% among 6002 all-comer patients. In PADs patients, PCI
procedural complication rates were estimated to be higher, which was not
observed in either trial. The estimated higher 3-year rates of bleeding,
myocardial infarction, and cardiac death in PCI patients with PADs were
corroborated by corresponding trial data (P = 0.014, P = 0.005, and P <
0.001, respectively). Nevertheless, PADs affected the preferred treatment
in many cardiologists, and cardiologists held disparate views on preferred
coronary treatment. <br/>Conclusion(s): Cardiologists correctly estimated
the increase in PADs over time among PCI patients, but they overestimated
the current prevalence. An increased risk of adverse clinical events after
PCI was correctly recognized, and concomitant PADs often affected the
preferred treatment. Notably, cardiologists held disparate views on
optimal preferred coronary treatment, which may be attributed to the lack
of reported data about this patient group. Thus, more clinical attention
and research is warranted.<br/>Copyright &#xa9; 2025 The Authors

<65>
Accession Number
2038598514
Title
Intussusception of the Left Atrial Appendage: A Systematic Review.
Source
CJC Open. 7(6) (pp 768-776), 2025. Date of Publication: 01 Jun 2025.
Author
Scagliola R.; Passerone G.; Balbi M.
Institution
(Scagliola) Cardiology Division, Cardinal G. Massaia Hospital, Asti, Italy
(Passerone) Cardiothoracic Surgery Unit, University of Genoa, Genoa, Italy
(Balbi) Cardiovascular Disease Unit, University of Genoa, Genoa, Italy
Publisher
Elsevier Inc.
Abstract
Background: Intussusception of the left atrial appendage (LAA) is an
uncommon and often underrecognized finding; poor knowledge of this
condition is still widespread in clinical practice. A systematic review
was carried out to provide a comprehensive and updated overview on this
condition. <br/>Method(s): A bibliographic search using major databases
resulted in 25 case reports meeting the criteria. Included records
reported data from patients aged > 18 years with a diagnosis of LAA
intussusception, determined either intraoperatively or incidentally by
imaging tools, and findings on baseline demographics, clinical findings,
imaging diagnostic workup, and management. <br/>Result(s): For the 25
patients included, the median age was 54 years, with a predominance of
female sex (53%). Most of intussuscepted LAA cases were disclosed
intraoperatively (60%) or incidentally by imaging tools (20%) in the
absence of associated clinical findings. All reported cases underwent
transoesophageal echocardiography, and in most, LAA intussusception was
confirmed by intraoperative inspection (44%) or further imaging (23%). In
most cases, LAA intussusception was resolved interventionally (60%). In
fewer subjects, LAA eversion occurred spontaneously (32%), and in the
remaining cases, a conservative approach was adopted (8%).
<br/>Conclusion(s): This study presents the largest systematic review to
date of an adult patient population with a diagnosis of intussuscepted
LAA. Regardless of the various etiologies and clinical manifestations
associated with LAA intussusception, physicians should be aware of the
possibility of this rare entity, to provide timely recognition and thereby
avoid misleading diagnoses and enable appropriate
decision-making.<br/>Copyright &#xa9; 2025 The Authors

<66>
Accession Number
2038988750
Title
Intravenous methadone for perioperative acute and chronic pain management
in Chinese adult cardiac surgical patients: A protocol for pilot
randomized controlled trial.
Source
PLOS ONE. 20(6 June) (no pagination), 2025. Article Number: e0323820. Date
of Publication: 01 Jun 2025.
Author
Wong H.M.K.; Wong W.T.; Liu X.; Au S.S.W.; Wong R.H.L.
Institution
(Wong, Wong, Liu, Au) Department of Anesthesia and Intensive Care, The
Chinese University of Hong Kong, Hong Kong
(Wong) Division of Cardiothoracic Surgery, Department of Surgery, Prince
of Wales Hospital, Hong Kong
Publisher
Public Library of Science
Abstract
Background Postoperative pain is significant in cardiac surgical patients.
Perioperative analgesia with intermittent administration of opioids can
result in significant fluctuations in serum opioid concentrations.
Methadone should provide a rapid onset and long-term pain relief upon a
single intravenous dose at induction of anesthesia, and may reduce chronic
postsurgical pain (CPSP) in cardiac surgical patients. The feasibility of
using intravenous methadone in Chinese cardiac surgical patients, and its
effect on acute and chronic pain management after cardiac surgery will be
evaluated. Methods A single-center, prospective, randomized-controlled
pilot trial. Adult cardiac surgical patients will be randomized to receive
0.2 mg/kg methadone or morphine at induction of anesthesia.
Patient-controlled analgesia morphine protocol, oral paracetamol and
dihydrocodeine will be given for postoperative analgesia. Venous blood
sampling for plasma methadone concentration will be obtained at regular
intervals from study drug infusion to 96 hours after administration. The
primary outcome will be a description of study feasibility, encompassing
recruitment and retention, protocol adherence and stakeholder
acceptability. Secondary outcomes include the time of ventilator weaning
to spontaneous breathing, time of extubation, morphine requirements within
24 hours and 72 hours after surgery, time to first morphine rescue,
postoperative pain scores, patient satisfaction, and length of stay in ICU
and hospital. Opioid-related side effects including sedation, nausea and
vomiting, and time to first bowel opening will be recorded. CPSP will be
assessed with Neuropathic Pain Scale and Pain Catastrophizing Scale at 3
and 6 months after surgery. Discussion Randomized controlled trials on
intravenous methadone in cardiac surgical patients are scarce, with none
in Chinese populations. This study, supported by plasma methadone
concentration analysis, will establish a basis for future large-scale
research aimed at improving recovery through optimized pain
management.<br/>Copyright &#xa9; 2025 Wong et al.

<67>
Accession Number
2038841073
Title
Left atrial substrate modification in addition to pulmonary vein isolation
using a novel circular variable loop pulsed field ablation catheter.
Source
European Heart Journal - Case Reports. 9(5) (no pagination), 2025. Article
Number: ytaf209. Date of Publication: 01 May 2025.
Author
Parlato A.; Khalaph M.; Sommer P.; Sohns C.
Institution
(Parlato, Khalaph, Sommer, Sohns) Clinic for Electrophysiology, Herz- und
Diabeteszentrum NRW, Universitatsklinikum, Ruhr-Universitat Bochum,
Georgstr. 11, Bad Oeynhausen, Germany
(Parlato) Cardiovascular Division, Pisa University Hospital, University of
Pisa, Via Paradisa 2, Pisa, Italy
Publisher
Oxford University Press
Abstract
Background Pulsed field ablation (PFA) is a recently developed technology
that causes tissue necrosis through electroporation and has been employed
and validated for pulmonary vein isolation (PVI) in atrial fibrillation
(AF) ablation. Only few devices have received a CE mark for this use and
the Varipulse^TM catheter (Varipulse^TM, Biosense
Webster, Irvine, USA), a variable loop PFA catheter, has been recently
approved. Despite the growing experience with PVI, evidence is lacking
about the use of PFA catheters and linear ablation lesions, which could
potentially be performed with PFA catheters, reducing procedure related
costs and time.
..........................................................................
..........................................................................
......................................... ^{Case summary} A
73-year-old Caucasian woman with multiple cardiovascular risk factors
presented with highly symptomatic paroxysmal AF and was scheduled to
undergo PFA AF ablation using the new Varipulse catheter. The procedure
was performed under deep sedation and the catheters were advanced through
trans-septal puncture. 3D electroanatomic mapping of the left atrium
showed significant anterior wall fibrosis. After PVI, substrate
modification through an anterior mitral line (AML) approach was pursued.
The AML was performed with additional PFA applications and successful
bidirectional block was confirmed by pacing maneuvers without any
procedural complications. The patient was discharged the following day,
asymptomatic and in a state of well-being.
..........................................................................
..........................................................................
......................................... ^Conclusion Individual
LA substrate modification, including linear lesion sets, can be delivered
in addition to PVI using the novel Varipulse PFA catheter in patients with
AF.<br/>Copyright &#xa9; The Author(s) 2025. Published by Oxford
University Press on behalf of the European Society of Cardiology.

<68>
Accession Number
2038904804
Title
Does cardiopulmonary resuscitation before donor death affect solid organ
transplant function? A systematic review and meta-analysis.
Source
Resuscitation. 213 (no pagination), 2025. Article Number: 110654. Date of
Publication: 01 Aug 2025.
Author
Sandroni C.; Scquizzato T.; Cacciola S.; Bonizzoni M.A.; West S.; D'Arrigo
S.; Soar J.
Institution
(Sandroni, Cacciola, D'Arrigo) Department of Intensive Care, Emergency
Medicine and Anaesthesiology, Fondazione Policlinico Universitario A.
Gemelli-IRCCS, Rome, Italy
(Sandroni) Institute of Anaesthesiology and Intensive Care Medicine,
Universita Cattolica del Sacro Cuore, Rome, Italy
(Scquizzato, Bonizzoni) Department of Anesthesia and Intensive Care, IRCCS
San Raffaele Scientific Institute, Milan, Italy
(West, Soar) Intensive Care Unit, Southmead Hospital, North Bristol NHS
Trust, Bristol, United Kingdom
Publisher
Elsevier Ireland Ltd
Abstract
Introduction: Patients who die after cardiopulmonary resuscitation (CPR)
are an important source of solid organs, but ischaemia-reperfusion injury
may lead to worse recipient outcomes. This systematic review and
meta-analysis assessed if solid organs transplanted from donors who
underwent CPR had worse outcomes compared to organs from donors who did
not receive CPR. <br/>Method(s): PubMed, Embase, and the Cochrane Central
Register of Controlled Trials were searched until January 1, 2025. The
primary outcome (graft survival at the longest follow-up) and secondary
outcomes (30-day and 1-year graft survival) were calculated separately for
each organ and pathway (brain/circulatory death). <br/>Result(s): We
included 33 studies (26 in adults; 72,994 donors), of which three compared
multiple organs and pathways. In 24 studies comparing brain-dead donors
with vs without CPR in all organs, outcomes did not differ between groups.
In nine studies, donation after uncontrolled circulatory death compared to
donation after brain death showed a lower long-term survival for livers
(OR 0.51 [0.32-0.83]) and lower short-term but not long-term survival (OR
0.64[0.36-1.15]) for kidneys. Two studies in kidneys compared donation in
controlled vs uncontrolled circulatory death showing no different
long-term survival (OR 0.73[0.27-1.99]). <br/>Conclusion(s): Organs
transplanted from donors who received CPR demonstrated comparable outcomes
at the longest follow-up compared to organs from donors who did not
receive CPR. Kidneys and livers after uncontrolled donation after
circulatory death showed worse outcomes compared to donation after brain
death.<br/>Copyright &#xa9; 2025 Elsevier B.V.

<69>
Accession Number
2034637219
Title
Metrics to assess the quality of anesthesia, perioperative care, and acute
pain management in Canada: a scoping review.
Source
Canadian Journal of Anesthesia. 72(5) (pp 822-854), 2025. Article Number:
e010006. Date of Publication: 01 May 2025.
Author
Ke J.X.C.; Sparrow K.; Smith M.A.; Yoo K.M.; Yee M.-S.; Sun L.Y.; Beattie
W.S.; Lim E.; Gorges M.
Institution
(Ke, Gorges) Department of Anesthesiology, Pharmacology & Therapeutics,
The University of British Columbia, Vancouver, BC, Canada
(Ke) Department of Anesthesia, St. Paul's Hospital, Providence Health
Care, Vancouver, BC, Canada
(Ke) Department of Anesthesia, Pain Management & Perioperative Medicine,
Dalhousie University, Halifax, NS, Canada
(Sparrow) Discipline of Anesthesia, Memorial University of Newfoundland,
St. John's, NL, Canada
(Smith) Department of Family Medicine, Michigan State University, East
Lansing, MI, United States
(Yoo) MD Undergraduate Program, Faculty of Medicine, The University of
British Columbia, Vancouver, BC, Canada
(Yee) Department of Anesthesiology, Southlake Regional Health Centre,
Newmarket, ON, Canada
(Sun) Division of Cardiothoracic Anesthesiology, Department of
Anesthesiology, Perioperative and Pain Medicine, Stanford University
School of Medicine, Stanford, CA, United States
(Beattie) Department of Anesthesiology & Pain Medicine, University of
Toronto, Toronto, ON, Canada
(Lim) Woodward Library, The University of British Columbia, Vancouver, BC,
Canada
(Gorges) BC Children's Hospital Research Institute, Vancouver, BC, Canada
(Ke) Department of Anesthesia, St. Paul's Hospital, Third Floor,
Providence Building, 1081 Burrard Street, Vancouver, BC, Canada
Publisher
Springer
Abstract
Purpose: The aim of this scoping review was to consolidate a list of
metrics that can be used to measure quality in anesthesiology,
perioperative medicine, and acute pain management in Canada.
<br/>Method(s): We included English-language full-text articles involving
metrics (including patient-reported outcome and patient-reported
experience measures, quality and safety indicators, and practice
standards) for adults aged 18 yr and older undergoing inpatient
non-cardiac surgery requiring an anesthesiologist. We searched MEDLINE,
Embase, CINAHL, Web of ScienceTM, the Cochrane Database of Systematic
Reviews, and grey literature to find articles on the topic from January
2015 to March 2022. In addition, we contacted 64 Canadian hospitals for
existing anesthesia quality assurance and improvement metrics; they
responded from June to October 2022. Two independent reviewers performed
screening and data extraction. We grouped and condensed similar candidate
metrics using thematic analysis. <br/>Result(s): We assessed 4,493
publications, of which 63 met the inclusion criteria. We extracted 662
candidate metrics and consolidated them into 94 distinct metrics. Metrics
reflected themes of perioperative management (n = 47), safety and
standards (n = 23), patient-centredness (n = 11), intraoperative
anesthetic care (n = 5), perioperative team leadership (n = 4), and
efficiency (n = 4). Metrics spanned all quality-of-care categories
(process, outcome, and structure) and perioperative phases but were
limited by poor supporting evidence. <br/>Conclusion(s): We consolidated a
list of 94 metrics that can be used to evaluate the quality of anesthesia
care. Further work will require verification of feasibility and validity
prior to adoption, with operationalization of these metrics into practical
indicators that are measurable and comparable.<br/>Copyright &#xa9;
Canadian Anesthesiologists' Society 2025.

<70>
Accession Number
2038983378
Title
Platelet Transfusion: 2025 AABB and ICTMG International Clinical Practice
Guidelines.
Source
JAMA. (no pagination), 2025. Date of Publication: 2025.
Author
Metcalf R.A.; Nahirniak S.; Guyatt G.; Bathla A.; White S.K.; Al-Riyami
A.Z.; Jug R.C.; La Rocca U.; Callum J.L.; Cohn C.S.; Deanda A.; Desimone
R.A.; Dubon A.; Estcourt L.J.; Filipescu D.C.; Fung M.K.; Goel R.; Hess
A.S.; Hume H.A.; Kaufman R.M.; Kranke P.; Louw V.J.; Moller M.H.; Murphy
M.F.; Muszynski J.A.; O'kelly C.J.; Pagano M.B.; Patidar G.K.; Pavenski
K.; Poston J.N.; Saifee N.H.; Stolla M.; Szczepiorkowski Z.M.; Tobian
A.A.R.; Uberoi R.; Waters J.; Williams B.; Wood E.M.; Zantek N.D.; Zeller
M.P.; Grossman B.J.; Stanworth S.J.
Institution
(Metcalf, White) Department of Pathology, University of Utah, Salt Lake
City, United States
(Metcalf) ARUP Laboratories, Salt Lake City, UT, United States
(Nahirniak) Department of Laboratory Medicine and Pathology, University of
Alberta, Edmonton, AB, Canada
(Guyatt) Departments of Clinical Epidemiology and Biostatistics and
Medicine, McMaster University, Hamilton, ON, Canada
(Bathla) Canadian Blood Services, Toronto, ON, Canada
(Al-Riyami) Department of Hematology, Sultan Qaboos University Hospital,
University Medical City, Muscat, Oman
(Al-Riyami) College of Medicine and Health Sciences, Sultan Qaboos
University, Muscat, Oman
(Jug) Department of Pathology, University of Cincinnati, Cincinnati, OH,
United States
(La Rocca) National Blood Centre, Italian National Institute of Health,
Rome, Italy
(La Rocca) Sapienza University of Rome, Rome, Italy
(Callum) Department of Pathology and Molecular Medicine, Queen's
University and Kingston Health Sciences Centre, Kingston, ON, Canada
(Callum) Sunnybrook Research Institute, Toronto, ON, Canada
(Cohn, Zantek) Department of Laboratory Medicine and Pathology, University
of Minnesota, Minneapolis, United States
(Deanda) Cardiovascular Surgery Division, University of Texas Medical
Branch, Galveston, United States
(Desimone) Department of Pathology and Laboratory Medicine, Weill Cornell
Medicine, New York, NY, United States
(Dubon) Patient Partner, Salt Lake City, UT, United States
(Estcourt, Murphy, Stanworth) NHS Blood and Transplant, Oxford University
Hospitals NHS Trust, Radcliffe Department of Medicine, University of
Oxford, United Kingdom
(Filipescu) Department of Anesthesiology, University of Carol Davila,
Bucharest, Romania
(Fung, Poston) Department of Pathology and Laboratory Medicine, University
of Vermont, Burlington, United States
(Goel, Tobian) Department of Pathology, Johns Hopkins University,
Baltimore, MD, United States
(Goel) Department of Internal Medicine, Southern Illinois University,
Springfield, United States
(Hess) New Zealand Blood Service, Christchurch, New Zealand
(Hume) Centre Hospitalier Universitaire Ste-Justine, University of
Montreal, Montreal, QC, Canada
(Kaufman, Szczepiorkowski) Department of Pathology and Laboratory
Medicine, Dartmouth Geisel School of Medicine, Hanover, NH, United States
(Kranke) University of Wurzburg, Wurzburg, Germany
(Louw) Division of Clinical Haematology, Department of Medicine,
University of Cape Town, Groote Schuur Hospital, Cape Town, South Africa
(Louw) Department of Medicine, University of Stellenbosch and Tygerberg
Hospital, Cape Town, South Africa
(Moller) Department of Intensive Care University of Copenhagen -
Rigshospitalet and Department of Clinical Medicine, Copenhagen, Denmark
(Muszynski) Division of Critical Care Medicine, Nationwide Children's
Hospital, Columbus, OH, United States
(O'kelly) Department of Neurosurgery, University of Alberta, Edmonton, AB,
Canada
(Pagano) Department of Laboratory Medicine and Pathology, University of
Washington, Seattle, United States
(Patidar) Department of Transfusion Medicine, All India Institute of
Medical Sciences, New Delhi, India
(Pavenski) Department of Laboratory Medicine and Pathobiology, University
of Toronto, Toronto, ON, Canada
(Saifee) Department of Laboratory Medicine and Pathology, Seattle
Children's Hospital and University of Washington, Seattle, United States
(Stolla) Bloodworks Northwest Research Institute, Seattle, WA, United
States
(Uberoi) Interventional Radiology, Oxford University Hospitals, University
of Oxford, Oxford, United Kingdom
(Waters) Department of Anesthesiology, University of Pittsburgh,
Pittsburgh, PA, United States
(Waters) Department of Anesthesiology, University of Maryland, Baltimore,
United States
(Williams) Department of Haematology, Monash University, Melbourne, VIC,
Australia
(Wood) Division of Hematology and Thromboembolism and Michael G. DeGroote
Center for Transfusion Research, McMaster University, Hamilton, ON, Canada
(Zeller) Canadian Blood Services, Hamilton, ON, Canada
(Grossman) Department of Pathology and Immunology, Washington University,
St Louis, MO, United States
Publisher
American Medical Association
Abstract
Importance: Platelet transfusion is a frequent procedure with benefits and
risks. <br/>Objective(s): To provide recommendations in adult and
pediatric populations in whom platelet transfusions are commonly
performed. Evidence Review: Grading of Recommendations Assessment
Development and Evaluation (GRADE) methodology was applied to findings
from 21 randomized trials and 13 observational studies in contexts of
limited randomized clinical trial data. Transfusion strategies using fewer
(restrictive) vs greater (liberal) amounts of platelets were compared.
<br/>Finding(s): Evidence demonstrated that restrictive transfusion
strategies probably did not cause increases in mortality or bleeding
relative to liberal strategies across predefined clinical populations.
Exceedingly low incidence of spinal hematoma was identified in patients
with thrombocytopenia undergoing lumbar puncture. Because definitions of
restrictive strategies varied across trials, recommendations reflect
practical guidance. The following recommendations are strong
recommendations with high/moderate-certainty evidence. For
hypoproliferative thrombocytopenia in nonbleeding patients receiving
chemotherapy or undergoing allogeneic stem cell transplant, platelet
transfusion is recommended when platelet count is less than 10 x
10³/muL. For consumptive thrombocytopenia in neonates without
major bleeding, platelet transfusion is recommended when platelet count is
less than 25 x 10³/muL. In patients undergoing lumbar puncture,
platelet transfusion is recommended when platelet count is less than 20 x
10³/muL. In patients with consumptive thrombocytopenia due to
Dengue without major bleeding, platelet transfusion is not recommended.
The following recommendations are conditional recommendations with
low/very low-certainty evidence. For hypoproliferative thrombocytopenia in
nonbleeding adults undergoing autologous stem cell transplant or with
aplastic anemia, prophylactic platelet transfusion is not recommended. In
adults with consumptive thrombocytopenia without major bleeding, platelet
transfusion is recommended when platelet count is less than 10 x
10³/muL. In adults undergoing central venous catheter placement
in compressible anatomic sites, platelet transfusion is recommended when
platelet count is less than 10 x 10³/muL. In adults undergoing
interventional radiology, platelet transfusion is recommended when
platelet count is less than 20 x 10³/muL for low-risk
procedures and less than 50 x 10³/muL for high-risk procedures.
For adults undergoing major nonneuraxial surgery, platelet transfusion is
recommended when platelet count is less than 50 x 10³/muL. For
patients without thrombocytopenia undergoing cardiovascular surgery in the
absence of major hemorrhage, including those receiving cardiopulmonary
bypass, platelet transfusion is not recommended. For nonoperative
intracranial hemorrhage in adults with platelet count greater than 100 x
10³/muL, including those receiving antiplatelet agents,
platelet transfusion is not recommended. Conclusions And Relevance: A
consistent pattern of evidence supports the implementation of restrictive
platelet transfusion strategies. Restrictive strategies reduce risk of
adverse reactions, mitigate platelet shortages, and reduce costs. It is
good practice to consider overall clinical context and alternative
therapies in the decision to perform platelet transfusion.<br/>Copyright
&#xa9; 2025 American Medical Association. All rights reserved, including
those for text and data mining, AI training, and similar technologies.

<71>
Accession Number
2036506368
Title
Cardiovascular Benefit of Colchicine in Relation to Baseline Risk: A
Secondary Analysis of the LoDoCo2 Trial.
Source
Journal of the American Heart Association. 14(10) (no pagination), 2025.
Article Number: e038687. Date of Publication: 20 May 2025.
Author
Mohammadnia N.; Wesselink B.E.; Bax W.A.; Nidorf S.M.; Mosterd A.; Fiolet
A.T.L.; Cetinyurek-Yavuz A.; Thompson P.L.; Bangdiwala S.I.; Eikelboom
J.W.; Cornel J.H.; El Messaoudi S.
Institution
(Mohammadnia, Wesselink, Cornel, El Messaoudi) Department of Cardiology,
Radboud University Medical Center, Nijmegen, Netherlands
(Bax) Department of Internal Medicine, Northwest Clinics, Alkmaar,
Netherlands
(Nidorf, Thompson) Heart and Vascular Research Institute of Western
Australia, Perth, WA, Australia
(Mosterd, Fiolet, Cornel) Dutch Network for Cardiovascular Research (WCN),
Utrecht, Netherlands
(Mosterd) Department of Cardiology, Meander Medical Center, Amersfoort,
Netherlands
(Fiolet) Department of Cardiology, University Medical Center Utrecht,
Utrecht, Netherlands
(Cetinyurek-Yavuz) IQ Health Science, Radboud University Medical Center,
Nijmegen, Netherlands
(Thompson) School of Medicine, University of Western Australia, Perth, WA,
Australia
(Thompson) Sir Charles Gairdner Hospital, Perth, WA, Australia
(Bangdiwala) Department of Health Research Methods, Evidence and Impact,
McMaster University, Hamilton, ON, Canada
(Bangdiwala) Statistics Department, Population Health Research Institute,
McMaster University, Hamilton, ON, Canada
(Eikelboom) Department of Medicine, McMaster University, Hamilton, ON,
Canada
(Cornel) Department of Cardiology, Northwest Clinics, Alkmaar, Netherlands
Publisher
American Heart Association Inc.
Abstract
BACKGROUND: The LoDoCo2 (Low-Dose Colchicine 2) trial showed that
colchicine reduced the risk for cardiovascular events in patients with
chronic coronary syndrome. Current guidelines recommend colchicine use in
selected high-risk patients. The aim of this secondary analysis was to
explore the relative and absolute benefits of colchicine according to
baseline risk. <br/>METHOD(S): The LoDoCo2 trial randomized 5522 patients
to colchicine 0.5 mg or placebo. The primary end point was a composite of
cardiovascular death, spontaneous myocardial infarction, ischemic stroke,
or ischemia-driven coronary revascularization. First, a LoDoCo2 risk score
was developed by Cox regression to identify high-risk features for the
primary end point. Second, the Thrombolysis in Myocardial Infarction Risk
Score for Secondary Prevention was applied to explore robustness of
findings. <br/>RESULT(S): In the LoDoCo2 risk score, high-risk features
were age >=75, diabetes, and current smoker. In high-risk (>=1 high-risk
feature), compared with low-risk (0 high-risk features) patients,
colchicine was associated with consistent relative (high risk: hazard
ratio [HR], 0.72 [95% CI, 0.56-0.94] versus low risk: HR, 0.67 [95% CI,
0.52-0.88]; P for interaction=0.73) and absolute benefits (high risk: HR,
-1.33 [95% CI, -2.38 to -0.27] versus low risk: HR, -0.93 [95% CI -1.57 to
-0.30] events per 100 person-years). Using the Thrombolysis in Myocardial
Infarction Risk Score for Secondary Prevention, consistent relative and
absolute benefits were found in high-, intermediate-, and low-risk
patients. <br/>CONCLUSION(S): In patients with chronic coronary syndrome,
the relative and absolute benefits of colchicine were consistent in those
at high, intermediate, and low risk for cardiovascular events. These
findings support the use of colchicine across the spectrum of baseline
risk. REGISTRATION: URL: https://www.anzctr.org.au; Unique identifier:
12614000093684.<br/>Copyright &#xa9; 2025 The Author(s). Published on
behalf of the American Heart Association, Inc., by Wiley.

<72>
Accession Number
2037753435
Title
Intrapleural Fibrinolytics Versus Thoracic Surgery for Complicated Pleural
Infections: A Systematic Review and Meta-Analysis.
Source
Heart Lung and Circulation. 34(6) (pp 627-638), 2025. Date of Publication:
01 Jun 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. <br/>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. <br/>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%). <br/>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.<br/>Copyright &#xa9; 2024 Australian and New Zealand
Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society
of Australia and New Zealand (CSANZ)

<73>
Accession Number
2034672009
Title
Effectiveness of amino acid supplementation in preventing acute kidney
injury following cardiac surgery: A systematic review and meta-analysis of
randomized controlled trials.
Source
Acta Anaesthesiologica Scandinavica. 69(6) (no pagination), 2025. Article
Number: e70037. Date of Publication: 01 Jul 2025.
Author
Majeed M.W.; Finnegan E.; Gallo Ruelas M.; Lopes L.M.; Righetto B.B.;
Salha I.; Delgado D.; Quiros M.C.; Tomo A.T.J.; Ahmad R.; Andrabi S.;
Abujaber S.
Institution
(Majeed) Government Medical College Srinagar, VMMC and Safdarjung
Hospital, New Delhi, India
(Finnegan) School of Medicine, Trinity College Dublin, Dublin, Ireland
(Gallo Ruelas) Department of Nutrition, Instituto de Investigacion
Nutricional (IIN), Lima, Peru
(Lopes) Department of Epidemiology, Johns Hopkins Bloomberg School of
Public Health, Baltimore, MD, United States
(Righetto) Department of Medicine, Universidade Positivo, Curitiba, Brazil
(Salha) Department of Global Health, Trinity Centre for Global Health,
Trinity College Dublin, Dublin, Ireland
(Delgado) Universidad Peruana de Ciencias Aplicadas, Lima District, Peru
(Quiros) Facultad de Medicina, Universidad de Costa Rica, San Jose, Costa
Rica
(Tomo) Department of Medicine, Universidade Eduardo Mondlane, Maputo,
Mozambique
(Ahmad) Department of Cardiology, Royal Brompton Hospital, London, United
Kingdom
(Andrabi) Department of Nephrology, Columbia University Vagelos College of
Physicians and Surgeons, NYC Health + Hospitals/Harlem, New York, NY,
United States
(Abujaber) Department of Pulmonary and Critical Care, SUNY Downstate
Medical Center, New York, NY, United States
Publisher
John Wiley and Sons Inc
Abstract
Introduction: Acute kidney injury (AKI) is a frequent complication of
cardiac surgery, contributing to increased morbidity, longer hospital
stays, and higher mortality. Evidence suggests amino acid (AA)
supplementation may enhance renal blood flow and glomerular filtration
rate (GFR), potentially reducing AKI risk; however, findings remain
inconclusive. This study evaluated the efficacy of perioperative AA
supplementation in preventing AKI and related complications post-cardiac
surgery. <br/>Method(s): PubMed, Embase, and Cochrane databases were
searched for randomized controlled trials (RCTs) comparing AA
supplementation versus standard care in preventing cardiac
surgery-associated AKI. Main outcomes included AKI incidence (defined by
the Kidney Disease Improving Global Outcomes (KDIGO) criteria), 30-day
mortality, and renal replacement therapy (RRT) requirement. Pooled risk
ratios (RRs) with 95% confidence intervals (CIs) were calculated using
random-effects models. Statistical significance was set at p < 0.05. The
certainty of the evidence (CoE) was assessed using the GRADE approach.
<br/>Result(s): Six RCTs involving 4501 cardiac surgery patients were
included. AA mixture interventions significantly reduced the risk of AKI
stage 1 (RR: 0.56; 95% CI: 0.77-0.96; p =.009; CoE: Moderate) and Stage 3
(RR: 0.53; 95% CI: 0.34-0.83; p =.005; CoE: Moderate), but not stage 2
(RR: 1.24; 95% CI: 0.60-2.55; p =.568; CoE: Low). Preliminary findings
from glutamic acid and glutamine (single AA interventions) showed
potential benefits in reducing AKI incidence (CoE: Very low) and improving
surrogate biomarkers, respectively. No significant effects were observed
on mortality or RRT incidence for any intervention. <br/>Conclusion(s): AA
mixtures likely reduce AKI incidence following cardiac surgery but show
limited effects on mortality and RRT. Further trials are needed to confirm
the benefits of glutamic acid and glutamine supplementation. Editorial
Comment: Use of amino acid supplementation for the prevention of acute
kidney injury after cardiac surgery may be effective, but more trial data
and confidence in a beneficial effect is needed for this to be implemented
in everyday clinical practice.<br/>Copyright &#xa9; 2025 Acta
Anaesthesiologica Scandinavica Foundation.

<74>
Accession Number
2036506392
Title
Rationale and Design of the REPEAT Trial: A Multicenter Randomized Trial
Comparing Redo Surgical Aortic Valve Replacement to Valve-in-Valve
Transcatheter Aortic Valve Replacement.
Source
Journal of the American Heart Association. 14(10) (no pagination), 2025.
Article Number: e040954. Date of Publication: 20 May 2025.
Author
Raschpichler M.; de Waha S.; Blankenberg S.; Diniz M.A.; Bagiella E.;
Gelijns A.C.; Calsavara V.F.; Gupta A.; Schofer N.; Kaneko T.; Abdel-Wahab
M.; Thiele H.; Makkar R.; Borger M.A.
Institution
(Raschpichler, de Waha, Borger) Department of Cardiac Surgery, Heart
Center Leipzig at Leipzig University, Leipzig, Germany
(de Waha) Department of Rhythmology, University Hospital
Schleswig-Holstein, Campus Lubeck, Lubeck, Germany
(Blankenberg, Schofer) Department of Cardiology, University Heart &
Vascular Center Hamburg, Hamburg, Germany
(Diniz, Bagiella, Gelijns) Department of Population Health Science and
Policy, Icahn School of Medicine at Mount Sinai, New York, NY, United
States
(Calsavara) Department of Computational Biomedicine, Cedars-Sinai Medical
Center, Los Angeles, CA, United States
(Gupta, Makkar) Smidt Heart Institute, Department of Interventional
Cardiology, Cedars-Sinai Medical Center, Los Angeles, CA, United States
(Kaneko) Division of Cardiothoracic Surgery, Washington University in St.
Louis, St. Louis, MO, United States
(Abdel-Wahab, Thiele) Department of Cardiology, Heart Center Leipzig at
Leipzig University, Leipzig, Germany
Publisher
American Heart Association Inc.
Abstract
BACKGROUND: Redo surgical aortic valve replacement (rSAVR) has for long
been the therapeutic reference standard for degenerated surgical aortic
bioprostheses. Valve-in-valve transcatheter aortic valve replacement
(ViV-TAVR) has emerged as an alternative for patients at high surgical
risk due to its lower invasiveness. The long-term clinical efficacy of
ViV-TAVR in patients at low to intermediate surgical risk remains unknown.
METHODS AND RESULTS: To compare clinical outcomes of redo surgical aortic
valve replacement versus ViV-TAVR in lowto intermediate-risk patients with
degenerated surgical aortic bioprostheses. REPEAT (Repeat Intervention for
Deteriorated Surgical Bioprosthetic Aortic Valves) is an
investigator-initiated, international, multicenter, randomized, parallel,
open-label trial. A total of 890 patients aged <75 years with a failed
surgical aortic bioprosthesis due to structural valve degeneration and low
to intermediate surgical risk (ie, Society of Thoracic Surgeons predicted
risk of death of <8%) will be randomly assigned in a 1:1 ratio to either
redo surgical aortic valve replacement or ViV-TAVR. The primary end point
of REPEAT is a composite of all-cause death, stroke (including both
disabling and nondisabling), myocardial infarction, and rehospitalization
for heart failure or aortic valve reintervention at 5 years, based on
Valve Academic Research Consortium-3 definitions. Secondary end points
include each of the individual components of the primary composite end
point, Valve Academic Research Consortium-3-based conduction disturbances
and arrhythmia, Valve Academic Research Consortium-3-based wound and
bleeding complications, functional status (ie, 6-minute walk test, Kansas
City Cardiomyopathy questionnaire), and treatment costs.
<br/>CONCLUSION(S): The REPEAT trial has been designed to test the
hypothesis that redo surgical aortic valve replacement is superior to
ViV-TAVR regarding clinical outcomes at 5 years in patients with
degenerated surgical aortic bioprostheses and low to intermediate surgical
risk.<br/>Copyright &#xa9; 2025 The Author(s). Published on behalf of the
American Heart Association, Inc., by Wiley.

<75>
Accession Number
2039155744
Title
Machine learning approaches for cardiovascular disease prediction: A
review.
Source
Archives of Cardiovascular Diseases. (no pagination), 2025. Date of
Publication: 2025.
Author
Wan S.; Wan F.; Dai X.-J.
Institution
(Wan, Dai) Department of Radiology, The Second Affiliated Hospital,
Jiangxi Medical College, Nanchang University, Nanchang, China
(Wan, Dai) Jiangxi Provincial Key Laboratory of Intelligent Medical
Imaging, Nanchang, China
(Wan, Wan) Department of Electrical and Computer Engineering, Faculty of
Science and Technology, University of Macau, Taipa, Macau, China
Publisher
Elsevier Masson s.r.l.
Abstract
Cardiovascular disease is a leading cause of death worldwide and is
associated with significant morbidity and mortality. The use of artificial
intelligence techniques, particularly machine learning algorithms, has
emerged as a transformative approach for enhancing early diagnostic
accuracy of disease compared with conventional diagnostic methods. This
systematic review examines three core aspects: (1) comparative analysis of
current machine learning algorithms in early diagnosis of cardiovascular
disease, (2) operational frameworks for clinical implementation, and (3)
critical evaluation of regulatory compliance and ethical implications. It
summarizes recent advancements in machine learning-based heart disease
prediction, outlines a typical workflow for applying machine learning in
clinical settings, and discusses the regulatory and ethical challenges
associated with its implementation. Finally, this review explores
potential directions for future research in this rapidly evolving
field.<br/>Copyright &#xa9; 2025 Elsevier Masson SAS

<76>
Accession Number
2039049645
Title
The impact of recurrent mitral regurgitation after surgical or
transcatheter mitral valve repair: a comprehensive review and a
meta-analysis.
Source
Interdisciplinary Cardiovascular and Thoracic Surgery. 40(6) (no
pagination), 2025. Article Number: ivaf109. Date of Publication: 01 Jun
2025.
Author
Yu C.; Rad A.A.; He H.; Yang Y.; Maessen J.G.; Nia P.S.
Institution
(Yu, Rad, He, Yang, Maessen, Nia) Department of Cardiothoracic Surgery,
Maastricht University Medical Centre, Maastricht, Netherlands
(Rad) Medical Sciences Division, University of Oxford, Oxford, United
Kingdom
Publisher
Oxford University Press
Abstract
BACKGROUND: Recurrent mitral regurgitation (MR) is typically defined as MR
that is moderate or severe on follow-up echocardiography after the
intervention. This meta-analysis summarizes the results of all available
studies on the impact of recurrent MR on clinical outcomes after the
intervention. <br/>METHOD(S): Medline, EMBASE, PubMed and Web of Science
were searched from January 2000 to August 2024 for original studies
reporting outcomes about the clinical impact of recurrent MR. Five
clinical outcomes were analysed: reoperation, cardiovascular deaths,
readmission, heart failure and New York Heart Association (NYHA)
functional classification. The summary odds ratio (OR) with the 95%
confidence interval (CI) was used to assess the risk of clinical outcomes.
<br/>RESULT(S): A total of 22 studies were included in the final analysis,
involving 5,804 patients, of which 960 had recurrent MR. The overall
pooled incidence of recurrent MR is 16.54%. Secondary or primary patients
with MR with recurrent MR after an intervention had higher rates of
reoperation [(OR = 6.25, 95% CI, 2.95-14.41; P < 0.001) or (OR = 22.54,
95% CI, 14.96-33.98; P < 0.001)]or of cardiovascular death [(OR = 5.26,
95% CI, 2.35-11.77; P < 0.001) or (OR = 1.68, 95% CI, 1.32-2.14; P <
0.001)]. The rates were also high for readmission (OR = 3.95, 95% CI,
2.56-6.10; P < 0.001), heart failure incidence (OR = 2.87, 95% CI,
1.75-5.11; P < 0.001) and the number of NYHA functional class III/IV (OR =
5.40, 95% CI, 3.01-9.70; P < 0.001) for recurrent MR of secondary MR.
However, no significant association was found between recurrent MR of
primary MR and the incidence of NYHA functional class III/IV (OR = 1.02,
95% CI, 0.47-2.22; P = 0.96). <br/>CONCLUSION(S): Recurrent MR is
associated with higher rates of reoperations, readmissions, cardiovascular
deaths, incidences of heart failure and NYHA functional class III/IV
numbers. However, recurrent MR of primary MR is not correlated with NYHA
functional class III/IV.<br/>Copyright &#xa9; The Author(s) 2025.
Published by Oxford University Press on behalf of the European Association
for Cardio-Thoracic Surgery.

<77>
Accession Number
2034675102
Title
No benefit of adding mannitol to cardiopulmonary bypass priming solution
assessing cystatin C. A randomized clinical trial.
Source
Perfusion (United Kingdom). (no pagination), 2025. Article Number:
02676591251344857. Date of Publication: 2025.
Author
Skold A.; Dardashti A.; Lindstedt S.; Hyllen S.
Institution
(Skold, Dardashti, Lindstedt, Hyllen) Department of Cardiothoracic
Surgery, Anesthesia and Intensive Care, Skane University Hospital, Lund,
Sweden
(Skold, Dardashti, Lindstedt, Hyllen) Department of Clinical Sciences,
Cardiothoracic Surgery, Lund University, Lund, Lund, Sweden
Publisher
SAGE Publications Ltd
Abstract
Introduction: There is no recommendation regarding the optimal prime
solution for the cardiopulmonary bypass circuit in adult cardiac surgery.
Despite the lack of scientific evidence, mannitol has frequently been
added to the prime solution with intention to prevent acute kidney injury.
The aim of this study was to investigate the impact of mannitol in
cardiopulmonary bypass circuit prime in patients with preoperative renal
dysfunction. <br/>Method(s): This prospective, randomized, double-blind
study included 70 patients, who underwent coronary artery bypass grafting.
One group received 1200 mL of a prime based on Ringer's acetate (n = 35),
and the other a prime consisting of 1000 mL Ringer's acetate and 200 mL
mannitol (n = 35). Primary endpoint were levels of Cystatin C, a renal
function biomarker. Changes in renal-related parameters, electrolytes,
osmolality and acid-base status were monitored. <br/>Result(s): The median
cystatin C on day four in the mannitol group were 1.6 mg/L (IQR 1.4-2.0
mg/L) and 1,8 mg/L (IQR 1.5-2.1 mg/L) in the Ringer's acetate group at the
same time. Using mixed model analysis, no differences in cystatin C (p =
0.442), creatinine (p = 0.203), estimated glomerular filtration rate (p =
0.264) and urea (p = 0.141) could be detected between the groups. The
mannitol group showed a more pronounced reduction in sodium levels after
cardiopulmonary bypass circuit commencement compared to the Ringer's
acetate group p < 0.001. <br/>Conclusion(s): In patients with preoperative
renal dysfunction, the addition of mannitol in the prime solution did not
show any renoprotective effect measured by cystatin C compared to a
cardiopulmonary bypass circuit prime based on Ringer's acetate. This study
was reported to ClinicalTrials.org, id: NCT03302286. Effects of Extra
Corporeal Circuit Prime on Electrolytes Balance and Clinical Outcome
Following Cardiac Surgery
https://clinicaltrials.gov/study/NCT03302286?id=NCT03302286&rank=1<br/>Cop
yright &#xa9; The Author(s) 2025.

<78>
Accession Number
2039135803
Title
0GD4Q894GD Is Bariatric Surgery More Effective than Medical Therapy in
Metabolic Syndrome Remission Induction? A Systematic Review and
Comparative Meta-Analysis of 58 Studies with Insights Into Factors
Influencing the Effectiveness of Surgery.
Source
Surgery for Obesity and Related Diseases. Conference: American Society for
Metabolic and Bariatric Surgery (ASMBS) Annual Meeting 2025. Chicago
United States. 21(6 Supplement) (pp S131-S132), 2025. Date of Publication:
01 Jun 2025.
Author
Anonymous
Publisher
Elsevier Inc.
Abstract
Mohamed I. Mohamed Alexandria University, Faculty of Medicine, Alexandria,
Egypt; Yomna E. Dean Alexandria University, Faculty of Medicine,
Alexandria, Egypt; Abdulrahman Shokri Alexandria University, Faculty of
Medicine, Alexandria, Egypt; Moussa Nassar Lebanese American University;
Abu Omayer Tbilisi State Medical University, Faculty of Medicine, Tbilisi,
Georgia; Maryam Shahid Tbilisi State Medical University, Faculty of
Medicine, Tbilisi, Georgia; Arsalan Sharif Tbilisi State Medical
University, Faculty of Medicine, Tbilisi, Georgia; Soliman Zakaria
Alexandria University, Faculty of Medicine, Alexandria, Egypt; Almadani
Abdelrahman Department of Cardiovascular Surgery, Mayo Clinic Health
System, Eau Claire, WI; Yakout Guvem Mayo Clinic Jacksonville, FL; Asim
Eren Yasser Canakkale Onsekiz Mart University, Faculty of Medicine,
Canakkale, Turkiye; Urvij Jaiswal Government Medical College, Aurangabad,
India; Adham Hamza Alexandria University, Faculty of Medicine, Alexandria,
Egypt; Mohamed Zein Alexandria University, Faculty of Medicine,
Alexandria, Egypt; M. Elnemr Mohamed Alexandria University, Faculty of
Medicine, Alexandria, Egypt; Shahab Shahabi Department of Surgery,
Division of Minimally Invasive and Bariatric Surgery, Rasool-e Akram
Hospita Introduction: The rising prevalence of metabolic syndrome (MS) has
prompted the exploration of effective interventions beyond conventional
medical management. This systematic review and meta-analysis purports to
evaluate the impact of bariatric surgery (BS) on the resolution of MS
across diverse populations and follow-up durations while comparing its
effectiveness against medical treatments. <br/>Method(s): A comprehensive
literature search was conducted across databases including PubMed, Scopus,
MEDLINE, and Cochrane, using keywords like "bariatric surgery" and
"metabolic syndrome". Studies assessing the prevalence of MS post-BS were
included. We used the RevMan software for data analysis. <br/>Result(s):
The findings indicated that MS patients who underwent BS demonstrated
markedly lower odds of retaining MS within the first year post-surgery
(OR: 0.07, 95% CI 0.04-0.13, p < 0.00001). Similarly, significantly lower
MS odds persisted at 2 years post-surgery (CI 0.03-0.12). Sleeve
gastrectomy (SG) resulted in almost double the odds of retaining MS
compared to Roux-en-Y Gastric Bypass (RYGB) (CI 1.24-2.37). Notably,
patients with a preoperative BMI<50 experienced a more significant
reduction in MS prevalence compared to those categorized as super obese
(OR: 0.05 vs. OR: 0.10). Additionally, older individuals exhibited lower
odds of remaining with MS post-surgery (OR: 0.07 vs. OR: 0.10).
Geographically, South Americans showed the greatest reduction in MS
prevalence (OR: 0.03). Compared to BS, those receiving medical treatment
had an OR of 6.37 for retaining MS (95% CI 3.29-12.36). Moreover, a
significant decrease in the need for antihypertensive, anti-dyslipidemic,
and anti-diabetic medications was observed post-surgery.
<br/>Conclusion(s): BS is superior to medical treatment in remission of
MS.<br/>Copyright &#xa9; 2025

<79>
Accession Number
2039094575
Title
Two-Year Outcomes of Transcatheter Edge-to-Edge Repair for Severe
Tricuspid Regurgitation: The TRILUMINATE Pivotal Randomized Controlled
Trial.
Source
Circulation. 151(23) (pp 1630-1638), 2025. Date of Publication: 10 Jun
2025.
Author
Kar S.; Makkar R.R.; Whisenant B.K.; Hamid N.; Naik H.; Tadros P.; Price
M.J.; Singh G.; Schwartz J.G.; Kapadia S.; Alli O.; Horr S.; Seshiah P.;
Batchelor W.; Jones B.M.; Ahmed M.I.; Benza R.; Jorde U.; Thourani V.H.;
Ghobrial A.A.; Tang G.H.L.; Trusty P.M.; Huang D.; Hahn R.T.; Adams D.H.;
Sorajja P.
Institution
(Kar, Ghobrial) Los Robles Regional Medical Center, Thousand Oaks, CA,
United States
(Makkar) Cedars-Sinai Medical Center, Los Angeles, CA, United States
(Whisenant) Intermountain Health, Murray, UT, United States
(Hamid, Seshiah) Allina Health Abbott Northwestern Hospital, Minneapolis,
MN, United States
(Naik) Integrated Medical Services, Phoenix, AZ, United States
(Tadros) University of Kansas Medical Center, Kansas City, United States
(Price) Scripps Clinic, La Jolla, CA, United States
(Singh) University of California, Davis Medical Center, Sacramento, United
States
(Schwartz) Atrium Health, Charlotte, NC, United States
(Kapadia) Cleveland Clinic, OH, United States
(Alli) Novant Health Presbyterian Medical Center, Charlotte, NC, United
States
(Horr) Centennial Medical Center, Nashville, TN, United States
(Sorajja) The Christ Hospital, Cincinnati, OH, United States
(Batchelor) Inova, Fairfax, VA, United States
(Jones) Providence St. Vincent Medical Center, Portland, OR, United States
(Ahmed) University of Alabama-Birmingham Medicine, United States
(Benza, Tang, Adams) Mount Sinai, New York, NY, United States
(Jorde) Montefiore Medical Center, New York, NY, United States
(Thourani) Piedmont Healthcare, Atlanta, GA, United States
(Trusty, Huang) Abbott, Santa Clara, CA, United States
(Hahn) New York-Presbyterian Hospital, Columbia, NY, United States
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND: One-year outcomes of TRILUMINATE Pivotal (Trial to Evaluate
Cardiovascular Outcomes in Patients Treated With the Tricuspid Valve
Repair System Pivotal) found that transcatheter edge-to-edge repair (TEER)
for the treatment of severe, symptomatic tricuspid regurgitation improved
quality of life compared with medical therapy alone with similar rates of
mortality and heart failure hospitalization. However, additional follow-up
is necessary to determine the prolonged benefits of tricuspid TEER.
<br/>METHOD(S): A total of 572 patients with severe, symptomatic tricuspid
regurgitation were randomized to either tricuspid TEER+medical therapy
(device group) or medical therapy alone (control). Two-year prespecified
end points were recurrent heart failure hospitalization and freedom from
all-cause mortality, tricuspid valve surgery, and tricuspid valve
intervention after treatment visit, assessed in the intention-to-treat
population. <br/>RESULT(S): The annualized rate of recurrent heart failure
hospitalizations through 2 years was significantly lower with tricuspid
TEER compared with control (0.19 event per patient-year versus 0.26 event
per patient-year; P=0.02; joint frailty model hazard ratio, 0.72;
one-sided upper confidence limit, 0.93; P=0.02). Freedom from all-cause
mortality, tricuspid valve surgery, and tricuspid valve intervention
through 2 years was significantly higher with tricuspid TEER compared with
control (77.6% versus 29.3%; P<0.0001), driven by more tricuspid valve
intervention in control patients who crossed over to device treatment
(3.8% versus 61.5%). Rates of all-cause mortality (17.9% versus 17.1%) and
tricuspid valve surgery (2.3% versus 4.3%) were similar between groups.
Moderate or less tricuspid regurgitation was present in 84% at 2 years in
the device group. <br/>CONCLUSION(S): At the 2-year follow-up, tricuspid
TEER appeared safe, significantly reduced tricuspid regurgitation
severity, and decreased rates of heart failure hospitalization compared
with medical therapy alone.<br/>Copyright &#xa9; 2025 American Heart
Association, Inc.

<80>
Accession Number
2039168820
Title
Effectiveness and safety of different wire types for preoperative
localization of pulmonary nodules: A systematic review and meta-analysis.
Source
Lung Cancer. 205 (no pagination), 2025. Article Number: 108620. Date of
Publication: 01 Jul 2025.
Author
Zhang X.; Nie Z.; van Tuinen M.; van de Wauwer C.; Stams T.R.G.; Prokop
M.; de Bock G.H.; Dorrius M.
Institution
(Zhang, Nie, de Bock, Dorrius) Department of Epidemiology, University
Medical Center Groningen, University of Groningen, Groningen, Netherlands
(van Tuinen, Stams, Dorrius) Department of Radiology, University Medical
Center Groningen, University of Groningen, Groningen, Netherlands
(van de Wauwer) Department of Thoracic Surgery, University of Medical
Center Groningen, University of Groningen, Groningen, Netherlands
(Prokop) Department of Radiology, Radboud University Nijmegen Medical
Center, Nijmegen, Netherlands
Publisher
Elsevier Ireland Ltd
Abstract
Objectives: Wire localization systems are widely used for perioperative
lung nodule localization. This systematic review and meta-analysis aimed
to evaluate the efficacy and safety of five wire types (barb-thorn,
double-thorn, four-hook, spiral, and Q-type) for preoperative
localization. <br/>Material(s) and Method(s): PubMed, Embase, Web of
Science, and Cochrane databases were searched to December 2024 to retrieve
data and assess risk of bias. Meta-analysis used a random effects model to
obtain pooled estimates and prediction intervals (PI) for success rates,
complication rates, and pain scores. Heterogeneity was explored in
stratified analyses. <br/>Result(s): 80 studies involving 9,996 procedures
across 9,049 patients were included. The pooled technical success rate for
localization was 98% (95% CI: 0.98-0.99; PI: 96%-100%), while VATS success
reached 100% (95% CI: 1.00-1.00; PI: 99%-100%). Major and minor
complications were 0% (95% CI: 0.00-0.00; PI: 0%-1%) and 43% (95% CI:
0.36-0.50; PI: 0%-100%) (75 studies). However, Q-type wire demonstrated
lower success rates and a higher risk of major complications compared to
other wire types. Studies with low/some concerns showed lower minor
complication rates (21%; 95% CI: 0.08-0.34) compared to moderate (44%; 95%
CI: 0.35-0.52) and high-quality studies (46%; 95% CI: 0.31-0.61). Pain
scores (7 studies) averaged 3.41 (95% CI: 2.60-4.22; PI: 0.32-6.50) on a
0-10 scale. <br/>Conclusion(s): Different wire types demonstrated high
localization and VATS success rates with comparable safety profiles.
However, Q-type wire demonstrated lower success rates and higher
complication risks, though based on limited data. Further studies are
required to confirm its efficacy and safety.<br/>Copyright &#xa9; 2025 The
Author(s)

<81>
Accession Number
2039127903
Title
Cost-Effectiveness Analysis of Surgical Strategies Versus Medical
Management for Rheumatic Heart Disease in Rwanda.
Source
Journal of the American Heart Association. 14(11) (no pagination), 2025.
Article Number: e038365. Date of Publication: 2025.
Author
Mlambo V.; Wang S.; Musoni M.; Rando H.; Ingabire L.; Patton-Bolman C.;
Mukeshimana G.; Ntaganda E.; Bolman R.; Bendavid E.; Lin Y.
Institution
(Mlambo, Wang) School of Medicine, Stanford University, Stanford, CA,
United States
(Musoni) Department of Cardiothoracic Surgery, King Faisal Hospital,
Kigali, Rwanda
(Rando) Department of General Surgery, University of Vermont Medical
Center, Burlington, MD, United States
(Ingabire) King Faisal Hospital, Kigali, Rwanda
(Patton-Bolman) Team Heart, Kigali, Rwanda
(Mukeshimana) Department of Cardiology, King Faisal Hospital, Kigali,
Rwanda
(Ntaganda) Rwanda Biomedical Center, Kigali, Rwanda
(Bolman) Division of Cardiothoracic Surgery, University of Minnesota,
Minneapolis, MN, United States
(Bendavid) Department of Primary Care and Population Health, United States
(Lin) Department of Cardiothoracic Surgery, Stanford University, Stanford,
CA, United States
Publisher
American Heart Association Inc.
Abstract
BACKGROUND: One-third of the global rheumatic heart disease burden lies in
sub-Saharan Africa, where 17% of patients with severe rheumatic heart
disease die within 3 years without valve surgery. Surgery is often
considered uneconomical, although this assumption is not grounded in
cost-effectiveness analyses. <br/>METHOD(S): We evaluated the
cost-effectiveness of mechanical valve replacement, bioprosthetic valve
replacement, and valve repair compared with medical management for
patients with severe rheumatic heart disease in Rwanda. Using a Markov
model, we simulated disease progression, incorporating transition
probabilities from a meta-analysis of regional observational studies.
Costs were calculated using microcosting, and health effects were measured
in disability-adjusted life-years (DALYs). Cost-effectiveness was defined
by a willingness-to-pay threshold of United States dollars (USD) $2307 per
DALY, which is 3 times Rwanda's gross domestic product per capita. A 3%
discount rate for costs and DALYs was applied. <br/>RESULT(S): Surgical
strategies extended life expectancy from 7 to 11 to 13 years. Mechanical
and bioprosthetic valve replacements were cost-effective compared with
medical management. Mechanical valve replacement was most efficient,
averting 5.64 discounted DALYs for a lifetime discounted cost of USD $10
539.34, with an incremental cost-effectiveness ratio of USD $1704 per
DALY. Bioprosthetic valve replacement averted 5.27 discounted DALYs but
incurred higher costs (USD $10 873.06). Valve repair only averted 3.30
DALYs despite being least expensive (USD $8790.19). Repair became the most
efficient surgical strategy if valve degeneration rates dropped <3.7%
annually. <br/>CONCLUSION(S): Mechanical valve replacement is the most
efficient surgical strategy for severe rheumatic heart disease in
sub-Saharan Africa, challenging assumptions that surgery is uneconomical.
Reducing surgery costs and optimizing anticoagulation could further
enhance cost-effectiveness.<br/>Copyright &#xa9; 2025 The Author(s).
Published on behalf of the American Heart Association, Inc., by Wiley.
This is an open access article under the terms of the Creative Commons
Attribution-NonCommercial-NoDerivs License, which permits use and
distribution in any medium, provided the original work is properly cited,
the use is non-commercial and no modifications or adaptations are made.

<82>
Accession Number
2034662763
Title
Does the venous cannulation method affect gaseous embolic load to the
patient during extracorporeal circulation?.
Source
Perfusion (United Kingdom). (no pagination), 2025. Article Number:
02676591251344859. Date of Publication: 2025.
Author
Torild P.; Corderfeldt Keiller A.; Damen T.
Institution
(Torild, Corderfeldt Keiller) Department of Perfusion, Sahlgrenska
University Hospital, Gothenburg, Sweden
(Corderfeldt Keiller, Damen) Department of Anesthesiology and Intensive
Care Medicine, Institute of Clinical Sciences, Sahlgrenska Academy,
University of Gothenburg, Gothenburg, Sweden
(Damen) Department of Cardiothoracic Anaesthesia and Intensive Care,
Sahlgrenska University Hospital, Gothenburg, Sweden
Publisher
SAGE Publications Ltd
Abstract
Introduction: Cardiopulmonary bypass (CPB) is essential for cardiac
surgery but poses risks, including gaseous micro emboli (GME). While the
incidence of stroke-a common clinical consequence of embolism-ranges from
1-5% in cardiac surgery, prevalence of GME during CPB remain poorly
understood. <br/>Objective(s): To quantitatively compare GME incidence in
the arterial line between cavoatrial and bicaval cannulation during
open-heart surgery. Secondary exploratory objectives include evaluating
the impact of venous reservoir volume on GME, and the correlation between
GME in the venous and arterial lines. <br/>Method(s): This single center
randomized controlled trial was conducted at Sahlgrenska University
Hospital, Sweden. Patients >=18 years undergoing planned aortic valve
repair/replacement with cavoatrial cannulation, or mitral valve
repair/replacement with bicaval cannulation, with or without coronary
artery revascularization, were screened for eligibility. Patients were
further randomized to either venous reservoir volume of >=300 mL (control)
or 200-300mL (intervention). GME detection was performed using GAMPT
BCC300 with probes positioned at multiple locations within the CPB
circuit. <br/>Result(s): 39 patients were included. No significant
differences in GME quantity in the arterial line were observed between the
cannulation methods (count p=.444; volume p=967). Similarly, no
significant differences were found based on venous reservoir volume (count
p=.074; volume p=.166). Furthermore, no significant correlation was
observed between GME in venous line entering the arterial line (count
p-value=492; volume p-value=.750). The CPB circuit effectively removed
99.14% of GME, with no adverse events reported. <br/>Conclusion(s): No
significant differences were found in arterial GME count or volume between
cavoatrial and bicaval cannulation during CPB. These findings underscore
the importance of the bypass circuit's air-handling capacity, as well as
the role of modern oxygenators and arterial line filters in effectively
minimizing the passage of GME. Trial Registration:ClinicalTrials.gov
Identifier: NCT05820828URL:
https://clinicaltrials.gov/ct2/show/NCT05820828<br/>Copyright &#xa9; The
Author(s) 2025.

<83>
Accession Number
2039162524
Title
Perioperative Normoxia vs Hyperoxia in Neonates With Cyanotic Heart
Disease Undergoing Cardiac Surgery: A Randomized Controlled Trial.
Source
Annals of Thoracic Surgery. (no pagination), 2025. Date of Publication:
2025.
Author
Sznycer-Taub N.; Peng Y.-W.; Yu S.; Batazzi A.; Les A.; Lowery R.;
Griffith K.; Sturmer D.; Ohye R.G.; Russell M.W.; Pasquali S.K.; Charpie
J.
Institution
(Sznycer-Taub, Peng, Yu, Batazzi, Lowery, Russell, Pasquali, Charpie)
Division of Pediatric Cardiology, Department of Pediatrics, University of
Michigan, Ann Arbor, MI, United States
(Les, Griffith, Sturmer) Department of Perfusion, Department of Cardiac
Surgery, University of Michigan, Ann Arbor, MI, United States
(Ohye) Section of Pediatric Cardiovascular Surgery, Department of Cardiac
Surgery, University of Michigan, Ann Arbor, MI, United States
Publisher
Elsevier Inc.
Abstract
Background: Exposure to supraphysiologic levels of oxygen has been
associated with end-organ damage and worse outcomes across multiple
populations related to oxidative stress and inflammation. There is limited
evidence to guide practice in children undergoing surgery with
cardiopulmonary bypass, including neonates with cyanotic congenital heart
disease, who are particularly vulnerable to oxidative stress due to
immature and depleted antioxidant defenses. <br/>Method(s): We conducted a
randomized trial of perioperative normoxia (goal PaO<inf>2</inf> 60-100 mm
Hg during cardiopulmonary bypass and for the first 24 hours) vs hyperoxia
(goal PaO<inf>2</inf> 200-300 mm Hg during cardiopulmonary bypass)
exclusively in cyanotic neonates to examine feasibility, systemic
oxidative stress response, and safety. The primary outcome was a serum
measure of oxidative stress: thiobarbituric acid reactive substances.
Additional biomarkers and clinical outcomes were collected.
<br/>Result(s): Twenty-nine neonates (median age, 5 days) were enrolled.
Mean PaO<inf>2</inf> in the normoxia arm (n = 15) during cardiopulmonary
bypass was 106 +/- 27 mm Hg (vs hyperoxia 256 +/- 29 mm Hg, P < .0001).
Mean postoperative thiobarbituric acid reactive substances expressed as
fold-change from baseline was lower in the normoxia arm at 2 hours (1.21
+/- 0.26 vs 1.93 +/- 0.63), 6 hours (1.09 +/- 0.25 vs 1.77 +/- 0.7), and
24 hours (0.96 +/- 0.16 vs 1.41 +/- 0.29); all P < .01. Other biomarkers
of oxidative stress were significantly lower in the normoxia arm (all time
points P < .01). Safety outcomes including in-hospital mortality and
morbidities were similar between arms. <br/>Conclusion(s): Controlled
normoxia during cardiopulmonary bypass in cyanotic neonates is feasible,
safe, and associated with significant improvement in measures of oxidative
stress. These data are critical in informing larger-scale studies of
end-organ injury and clinical outcomes.<br/>Copyright &#xa9; 2025 The
Society of Thoracic Surgeons

<84>
Accession Number
2039110979
Title
When absence of evidence equates to evidence of absence: The case of
routine use of cerebral embolic protection devices in transcatheter aortic
valve implantation.
Source
Heart. (no pagination), 2025. Article Number: heartjnl-2025-326208. Date
of Publication: 2025.
Author
Heuts S.; Kawczynski M.J.; Maesen B.; Vriesendorp P.A.
Institution
(Heuts, Kawczynski, Maesen) Department of Cardiothoracic Surgery,
Maastricht University Medical Center, Maastricht, Netherlands
(Heuts, Kawczynski, Maesen, Vriesendorp) Cardiovascular Research Institute
Maastricht, Maastricht University, Maastricht, Netherlands
(Vriesendorp) Department of Cardiology, Maastricht University Medical
Center, Maastricht, Netherlands
Publisher
BMJ Publishing Group
Abstract
Objectives: This updated hierarchical Bayesian meta-analysis aims to
integrate the latest randomised controlled trials (RCTs) on the use of
cerebral embolic protection (CEP) in transcatheter aortic valve
implantation (TAVI) into previously available data, providing a definite
answer to the clinical effectiveness of CEP in TAVI patients.
<br/>Method(s): A systematic search was updated on 31 March 2025. RCTs
were included when comparing transfemoral TAVI with use of CEP versus
transfemoral TAVI without CEP. The primary outcome was all stroke, while
the secondary outcome was disabling stroke. A hierarchical Bayesian
meta-analysis was performed on the (log) relative risk (RR) scale and
transformed to absolute risk differences (ARDs) and numbers needed to
treat (NNTs). The threshold for clinical relevance was based on published
expert consensus and established on 1.1% ARD (NNT 91). <br/>Result(s): The
study was updated with one new RCT, totalling a number of eight RCTs (n=11
590, CEP n=5921 patients, control n=5669 patients). The prevalence of all
stroke and disabling stroke was 2.9% and 1.4% in the control group. The
median RR for all stroke was 0.94 (95% credible interval (CrI) 0.72-1.25),
translating to a mean of -0.17% ARD (NNT 588), and a posterior probability
of a clinically relevant CEP effect of <1%. The median RR for disabling
stroke was 0.76 (95% CrI 0.44-1.23), translating to a mean of -0.36% ARD
(NNT 278), and a posterior probability of a clinically relevant CEP effect
of <1%. <br/>Conclusion(s): Current-generation CEP devices are ineffective
in reducing periprocedural TAVI-stroke risk to a clinically relevant
degree, rendering future trials with these devices futile. PROSPERO
registration number: CRD42023407006.<br/>Copyright &#xa9; Author(s) (or
their employer(s)) 2025. No commercial re-use. See rights and permissions.
Published by BMJ Group.

<85>
Accession Number
2034819376
Title
Role of HTK solution in protecting cardiomyocytes against oxidative stress
by upregulating Nrf2 during cardiac arrest and resuscitation: a rat model
with a right thoracotomy.
Source
Perfusion (United Kingdom). (no pagination), 2025. Article Number:
02676591241307365. Date of Publication: 2025.
Author
Qiu B.; Wang L.; Ding P.; Wang A.; Zhang X.; Li Q.; Wang C.; Feng S.
Institution
(Qiu, Wang, Wang) Department of Cardiothoracic Surgery, Affiliated Jinling
Hospital, Nanjing Medical University, Nanjing, China
(Wang) Department of Thoracic and Cardiovascular Surgery, Nanjing First
Hospital, Nanjing Medical University, Nanjing, China
(Ding, Zhang) Department of Cardiothoracic Surgery, Children's Hospital of
Nanjing Medical University, Nanjing, China
(Li, Feng) Department of Anesthesiology, Women's Hospital of Nanjing
Medical University, Nanjing Women and Children's Healthcare Hospital,
Nanjing Medical University, Jiangsu, China
Publisher
SAGE Publications Ltd
Abstract
Introduction: The objective of this study was to establish a rat model for
cardiopulmonary bypass (CPB) with cardiac arrest and resuscitation and to
investigate the regulatory role of HTK solution in protecting
cardiomyocytes against oxidative stress by upregulating Nrf2.
<br/>Method(s): 40 rats were randomly assigned to four groups: the control
(Ctrl), the histidine-tryptophan-ketoglutarate (HTK), 4:1 blood
cardioplegia (BC) and del Nido cardioplegia (DN) groups. The
cardiopulmonary bypass (CPB) procedure was implemented and sustained for a
duration of 1 hour. Subsequent to the cessation of CPB, the rats were
subjected to monitoring and observation for an additional 2 hours.
Following this observation period, the heart and blood samples were
procured for subsequent analysis. <br/>Result(s): The MDA was
significantly higher in the HTK group, BC group, and DN group compared to
the Ctrl group. The HTK group had lower MDA levels than the BC group.
Regarding MPO activity, it increased in the HTK group, BC group, and DN
group relative to the Ctrl group. Both the BC and DN groups exhibited
elevated MPO levels compared to the HTK group. SOD levels were
significantly lower in the HTK, BC, and DN groups compared to the Ctrl
group. The HTK group had higher SOD levels than the BC group. With respect
to miRNA-210-3P and Nrf2, the expression were more efficient in the HTK,
BC, and DN groups compared to the Ctrl group. The BC and DN groups showed
reduced expression efficiency over the HTK group. Western blot analysis
indicated that the ratio of Nrf2 target was higher in the HTK group, BC
group, and DN group in comparison to the Ctrl group. Both the BC and DN
groups had lower protein content compared to the HTK group.
Immunohistochemistry scoring of HIF1-alpha and nuclear Nrf2 revealed
higher scores in the HTK, BC, and DN groups compared to the Ctrl group.
The HTK group achieved higher scores than both the BC and DN groups.
<br/>Conclusion(s): Varied degrees of oxidative stress damage were
exhibited by three distinct cardioplegia solutions. The HTK group
demonstrated a superior antioxidant effect. The protective response of the
HTK solution against oxidative stress may be linked to the up-regulation
of Nrf2.<br/>Copyright &#xa9; The Author(s) 2025.

<86>
Accession Number
2039155751
Title
Safety and Feasibility of Novel Single-Port Robotic-Assisted
Lobectomy/Segmentectomy for Lung Cancer.
Source
Annals of Thoracic Surgery. (no pagination), 2025. Date of Publication:
2025.
Author
Liang H.; Wang W.; Zhang M.; Wang R.; Jiang S.; Xu F.; Yang C.; Huang J.;
Li S.; Zhang Z.; Wu W.; Gonzalez-Rivas D.; He J.
Institution
(Liang, Wang, Zhang, Wang, Jiang, Xu, Yang, Huang, Li, He) Department of
Thoracic Surgery, National Clinical Research Center for Respiratory
Disease, the First Affiliated Hospital of Guangzhou Medical University,
Guangzhou, China
(Zhang) Department of Operating Room, the First Affiliated Hospital of
Guangzhou Medical University, Guangzhou, China
(Wu) Mingyi SuperMed View Technology Company, Guangzhou, China
(Gonzalez-Rivas) Department of Thoracic Surgery, Coruna University
Hospital, A Coruna, Spain
Publisher
Elsevier Inc.
Abstract
Background: Robotic-assisted thoracic surgery (RATS) has advanced lung
cancer treatment with precise robotic arm maneuvers and 3-dimensional
visualization. Whereas conventional RATS systems require multiple
incisions, a uniportal approach is increasingly favored. However, current
systems face challenges with maneuverability and incision size. The SHURUI
single-portal (SP) robotic system (Beijing Shurui Technology Co, Ltd),
with its total-flex single-arm design, addresses these limitations,
especially for patients with narrow intercostal spaces or limited
intrathoracic space. <br/>Method(s): This phase 1/2 single-arm registry
trial assessed the safety and feasibility of lobectomy/segmentectomy using
the SHURUI SP robotic system. The study enrolled patients aged 18 to 75
with lung cancer from November 2023 to April 2024. The SHURUI SP system's
"deformable dual continuum mechanism" technology enabled precise surgical
maneuvers, evaluating primary end points such as conversion rates, blood
loss, lymph node retrieval, transfusion needs, and intraoperative
complications. <br/>Result(s): Thirty-five patients, median age 58 years,
underwent lobectomy/segmentectomy, with successful procedures in all
cases. No conversions to video-assisted thoracic surgery or open surgery
were needed, and no additional trocars were used. Median operative time
was 155 minutes, docking time was 3 minutes, and console time was 81
minutes. Median blood loss was 10 mL, with no transfusions required. The
30-day morbidity rate was 11.43%, with no major complications or
rehospitalizations. All patients were discharged after a mean hospital
stay of 4 days. <br/>Conclusion(s): The SHURUI SP robotic system
demonstrates safety and feasibility for RATS in lung cancer. A
large-scale, multicenter randomized controlled trial is needed to further
validate this technology's efficacy and safety across a broader patient
population.<br/>Copyright &#xa9; 2025 The Society of Thoracic Surgeons

<87>
Accession Number
2038498486
Title
Late-Breaking Clinical Trials and Science: Clinical Trials Updates and
Registries I.
Source
Heart Rhythm. Conference: Heart Rhythm 2025. San Diego United States.
22(7) (pp e262-e264), 2025. Date of Publication: 01 Jul 2025.
Author
Anonymous
Publisher
Elsevier B.V.
Abstract
Late-Breaking Clinical Trials LB-495067 Friday, April 25, 2025 11:45 AM -
12:45 PM Chairs Dhanunjaya R. Lakkireddy Andrea M. Russo Commentators
Moussa Mansour T. Jared Bunch Rajesh Kabra Larry A. Chinitz LB-495067-01 A
MULTIELECTRODE SPHERICAL ARRAY PULSED FIELD ABLATION SYSTEM TO TREAT
PAROXYSMAL ATRIAL FIBRILLATION: 1-YEAR OUTCOMES OF THE PULSAR IDE TRIAL
Vivek Y. Reddy, Hans Kottkamp, Hugh Calkins, Devi G. Nair, Philipp Sommer,
Ayman A. Hussein, Burghard M. Schumacher, Srinivas R. Dukkipati, Petr
Neuzil, Saumil R. Oza, Christopher Woods, Marc W. Deyell, Jose Osorio and
Atul Verma Introduction: In a first-in-human study, PULSE-EU, a
multielectrode spherical array PFA system that can map, pace, sense
contact and ablate, exhibited high rates of durable PVI (94% durable PVI).
Here, we present first outcomes of PULSAR IDE (NCT05462145), a
prospective, multicenter, single-arm FDA IDE trial of the spherical PFA
array to treat paroxysmal AF (PAF). <br/>Method(s): PULSAR evaluated the
safety and effectiveness of the spherical array system (Globe PF System;
Kardium Inc) in treating symptomatic drug-resistant/intolerant PAF. Using
a 16Fr deflectable sheath, the spherical array was used to render LA
anatomy and voltage, and was then positioned at each PV ostia for PFA
(ungated directional biphasic/bipolar 1.7kV pulses; ~40 sec/application).
The primary effectiveness endpoint was freedom from treatment failure at
12-months, and the primary safety endpoint included safety events to 6
months post-PFA. Follow up was TTM weekly + symptoms, and 24hr Holters at
6M and 12M. <br/>Result(s): The study cohort of 183 pts included 19
roll-in and 164 pivotal pts (age 65+/-9.1; female 40%;
CHA<inf>2</inf>DS<inf>2</inf>-VASc 2.1+/-1.4; LA 3.8+/-0.6 cm; LVEF
60+/-6%) treated at 12 sites (in the US, EU, Canada) by 19 operators.
Mapping time (9.1+/-6.1 min), transpired ablation time (25.5+/-9.9 min),
LA catheter dwell time (59.9+/-11.6 min), procedure time (95.8+/-20.7
min), and 94% single-application ablation (605 of 646 PVs) revealed an
efficient procedure (times include a mandatory 20-min wait). There were no
device-related primary safety events. The primary safety event rate was
0.6% (1 of 164: a hemorrhagic stroke in a patient with severe
hypertension). The PV stenosis sub-study (n=33) revealed a 0% rate of the
secondary endpoint of moderate or severe PV narrowing. In the
pre-specified interim cohort (n=78), 12M primary effectiveness was 80.8%
(95% CI 70.3-88.8%). During redo ablation in 2 pts, all PVs were durably
isolated. Application: The unprecedented high clinical success observed in
this multicenter FDA trial of PAF appears to reflect the success
achievable with durable PVI. Next Steps/Future: The final 12M data on the
full 164-pt cohort will be available for presentation at HRS-2025.
[Formula presented] LB-495067-02 SAFETY, EFFICACY AND PVI DURABILITY OF A
CONTACT FORCE-SENSING LARGE-TIP FOCAL PULSED FIELD ABLATION CATHETER
INTEGRATED WITH 3D MAPPING TO TREAT PAROXYSMAL ATRIAL FIBRILLATION:
FIRST-IN-HUMAN OMNY-IRE 3-MONTH RESULTS Mattias F. Duytschaever, Massimo
Grimaldi, Tom De Potter, Atul Verma, Laurent Macle, Josef Kautzner,
Dominik K. Linz, Ante Anic, Hugo Van Herendael, Gediminas Rackauskas, Petr
Neuzil, Julian Chun, Boris Schmidt, Sebastien Knecht, Alexandre Almorad,
Benjamin Berte, Vivek Y. Reddy and Johan M. Vijgen Introduction: Omny-IRE
(NCT05971693) assesses safety and effectiveness of a novel large-tip
focal, multielectrode, contact force-sensing pulsed field ablation (PFA)
catheter (Omnypulse, Fig A) with electroanatomical mapping (EAM)
integration (Carto) for treating symptomatic paroxysmal atrial
fibrillation (PAF). We present 3-months (M) follow-up results.
<br/>Method(s): Pulmonary vein isolation (PVI) was performed as
recommended (Fig B). Primary effectiveness was adenosine-proof entrance
block. Primary safety was occurrence of primary adverse events (PAEs). A
prespecified patient (pts) subset underwent systematic brain imaging,
esophageal endoscopy, cardiac CT/MRA, and mandatory 3M remapping for PVI
durability assessment. <br/>Result(s): Of 188 pts enrolled (Sep 2023 - Aug
2024; 13 centers, 21 operators), the 136 main phase pts (59.8+/-9.6 y,
69.1% male) were included in the per protocol analysis. After touch-up for
adenosine-induced reconnection in 3% (16 of 528) veins, primary
effectiveness was 100% (136 of 136). Median (Q1/Q3) procedure, LA dwell,
PVI ablation, and total fluoroscopy times were 105.5 (91.0/124.0), 70.0
(56.0/81.5), 48.5 (37.5/59.0), and 5.0 (3.1/9.8) mins, respectively. The
PAE rate was 3.0% (4 of 135, 3 major vascular access complications, 1
pericarditis). In subset analyses, 3.3% (1 of 30) presented with an
asymptomatic silent cerebral event at discharge which resolved at 1M
without neurological change. No esophageal injury was observed in the
endoscopy subset (n=30). Additionally, CT/MRA imaging showed no PV
narrowing >70% (0%; 0 of 24). During remapping procedures (at 81.7+/-9.1
days post-PFA), PVI was durable in 84.5% (98 of 116) of veins and 62.1%
(18 of 29) of pts. Restricting to optimized workflow, PVI durability
improved to 89.3% (75 of 84) and 71.4% (15 of 21) per vein and pts,
respectively. Application: The large focal PFA catheter with 3D EAM
integration shows 100% acute success with a promising safety profile in
the treatment of PAF. Prespecified 3M remapping showed high PVI
durability. Next Steps/Future: Patient follow-up is ongoing and 12M data
will be reported in the future. [Formula presented] LB-495067-03 LEFT
BUNDLE BRANCH AREA PACING COMPARED TO BIVENTRICULAR PACING IN CANDIDATES
FOR CARDIAC RESYNCHRONIZATION THERAPY (LVEF <50%): RESULTS FROM
INTERNATIONAL COLLABORATIVE LBBAP STUDY (I-CLAS) Pugazhendhi Vijayaraman,
Ramez Morcos, Oscar Cano, Francesco Zanon, Shunmuga Sundaram Ponnusamy,
Bengt Herweg, Parikshit S. Sharma, Marek Jastrzebski, Manuel Molina-Lerma,
Zachary I. Whinnett, Kevin Vernooy, Jiangang Zou, Girish M. Nair, Rajeev
K. Pathak, Roderick Tung, Gaurav A. Upadhyay, Karol Curila, Mihail G.
Chelu and Kenneth A. Ellenbogen Introduction: Cardiac resynchronization
therapy (CRT) with biventricular pacing (BVP) is a guideline-recommended
therapy in pts with mild (LVEF 36-50%) and severely reduced LVEF (<=35%),
heart failure and wide QRS or indication for ventricular pacing. Left
bundle branch area pacing (LBBAP) has been shown to be a physiologic
alternative to BVP. The aim of this study was to compare the clinical
outcomes between BVP and LBBAP among all pts with LVEF<50% undergoing CRT.
<br/>Method(s): This registry included consecutive pts who underwent BVP
or LBBAP in patients with LVEF<50% between Jan 2018 to June 2023 at 18
international centers. Patient demographics, echocardiographic outcomes,
heart failure hospitalization (HFH), and mortality were assessed. The
primary outcome was the composite endpoint of time to death or HFH.
Secondary endpoints included individual endpoints of death and HFH.
<br/>Result(s): A total of 2579 pts met inclusion criteria: BVP 1118,
LBBAP 1461. Mean age was 70+/-13 yrs, female 32%, HTN 66%, DM 38%, AF 41%,
LBBB 52%, QRSd 156+/-29 and LVEF 32+/-9%. Paced QRSd in LBBAP was
significantly narrower compared to BVP (129+/-20 vs 143+/-22,p<0.001).
LVEF improved during f/u in both groups. During a mean follow-up of 4.8
yrs, LBBAP was associated with significant reduction in the primary
endpoint of time to death or HFH compared to BVP (20.5% vs 29.5%; HR 0.79
(95% C<br/> 0.66-0.93): p = 0.007) (Figure). Time to HFH was significantly
reduced with LBBAP compared to BVP (12% vs 20.8%; HR 0.65; 95%CI
0.52-0.81; p<0.001) along with a signifiant reduction in all-cause
mortality (11.7% vs 17.4%;HR 0.76;95%CI 0.60-0.95;p=0.012). Application:
LBBAP was associated with better clinical outcomes compared to BVP in all
pts with EF<50% requiring CRT. Our findings support the hypothesis that
targeting the conduction system may result in superior electrical
resynchronization leading to better clinical outcomes. Propensity-score
match analysis will be performed. Next Steps/Future: Ongoing large
randomized controlled trials such as Left vs Left trial comparing LBBAP to
BVP may provide the final answer. [Formula presented] LB-495067-04 ATRIAL
FIBRILLATION RECURRENCE AFTER LEFT ATRIAL APPENDAGE OCCLUSION IN PATIENTS
UNDERGOING ATRIAL FIBRILLATION ABLATION: LESSONS FROM THE OPTION TRIAL
Arwa Younis, Luigi Di Biase, Roland R. Tilz, Walid I. Saliba, Mohamed
Kanj, Chadi Tabaja, Christopher Woods, Nicolas Lellouche, Pascal Defaye,
Stephan Willems, Thomas Christen, Kristine Roy, Brad Sutton and Oussama M.
Wazni Introduction: The OPTION trial has demonstrated the safety and
efficacy of left atrial appendage closure (LAAC) in patients undergoing
atrial fibrillation (AF) ablation. However, it remains unclear whether
concomitant or subsequent LAAC may compromise AF ablation outcomes or
influence AF recurrence. Furthermore, the impact of AF recurrence on
stroke/systemic embolism (SE) in these patients remains scarce.
<br/>Method(s): A prespecified sub-analysis was conducted on the 1600
patients enrolled in the OPTION trial. Patients were stratified into three
groups: Anticoagulation group (no device), Concomitant LAAC, and
Sequential LAAC. The primary endpoint was defined as AF recurrence,
defined in patients needing the following interventions: newly prescribed
or increased doses of antiarrhythmic drugs, cardioversion, or repeat
ablation. The secondary endpoint involved the occurrence of subsequent
stroke/SE occurring after 12 months of follow-up. Patients were
categorized based on AF recurrence (Yes/No) at the 12-month mark
(time-dependent analysis). <br/>Result(s): Of the total cohort, 328
patients (41%) received concomitant LAAC, 475 patients (59%) underwent
sequential LAAC, and 797 patients were included in the control group.
Baseline characteristics were balanced across all groups. At the 36-month
follow-up, the rate of AF recurrence was comparable among the three groups
(Anticoagulation group [No Device]: 43.3%, Concomitant LAAC: 43.7%,
Sequential LAAC: 43.9%; p=0.93 for the overall comparison). The rates of
stroke/SE after 12 months were low across all groups, with a trend toward
a higher incidence in patients with AF recurrence compared to those
without, though this difference did not reach statistical significance (No
AF: 1.00% vs. AF recurrence: 1.30%; p=0.57). Application: Among patients
undergoing AF ablation, concomitant or sequential LAAC does not appear to
affect AF ablation outcomes. The trial highlights that stroke and SE
remain significant risks, even in patients without AF recurrence, and
should not be overlooked. Next Steps/Future: The interaction between
pulsed field ablation and concomitant LAAC implantation has to be studied.
In addition, the role of LAAC or anticoagulation in patients who are free
from AF post AF ablation has to be studied as well. [Formula
presented]<br/>Copyright &#xa9; 2025

<88>
Accession Number
2034905616
Title
Comparison of the Ivor-Lewis vs McKeown Procedure in Esophageal Cancers:
An Updated Meta-Analysis and Systematic Review.
Source
American Surgeon. (no pagination), 2025. Article Number:
00031348251346537. Date of Publication: 2025.
Author
Tejada B.; Giannaris E.S.; Hashemi S.; Fountos D.M.; Ali M.M.; Mathew
J.A.; German D.E.
Institution
(Tejada, Giannaris, Hashemi, Fountos, Ali, Mathew, German) CUNY School of
Medicine, New York, NY, United States
Publisher
SAGE Publications Inc.
Abstract
Background: The Ivor Lewis and McKeown techniques are two established
approaches for esophagectomy in the treatment of esophageal cancer.
Despite their widespread use, limited direct comparisons exist to assess
the efficacy of these techniques across key intraoperative and
postoperative outcomes. We performed an updated pooled pairwise
meta-analysis to discern the relative benefits and risks associated with
each approach. <br/>Method(s): A systematic search of PubMed, Embase,
MEDLINE, and the Cochrane Library through September 2024 was conducted.
Eligible studies compared Ivor Lewis and McKeown techniques for
esophagectomy. Primary outcomes were 12-month mortality and anastomotic
complications; secondary outcomes were number of lymph nodes resected,
recurrent laryngeal nerve palsy, pulmonary complications, and chyle-leaked
complications. <br/>Result(s): A total of 9 studies comprising 15 341
patients were included. There were no significant differences in terms of
12-month mortality (OR.89, 95% CI.65 to 1.22, P =.48), the number of lymph
nodes resected (MD -1.18, 95% CI -4.51 to 2.16, P =.49), and pulmonary
complications (OR.87, 95% CI.61 to 1.24, P =.27). However, Ivor Lewis
significantly reduced the incidence of anastomotic leakage (OR.42, 95%
CI.18 to.98, P =.050), recurrent laryngeal nerve palsy (OR.13, 95% CI.06
to.27, P <.00001), and chyle-related complications (OR.63, 95% CI.39 to
1.04, P =.05) compared to the McKeown technique. <br/>Conclusion(s): This
meta-analysis reveals certain significant advantages in Ivor Lewis, while
both maintain similarities in other areas.<br/>Copyright &#xa9; The
Author(s) 2025.

<89>
Accession Number
647570298
Title
CardioAlex 2018 Conference.
Source
European Heart Journal, Supplement. Conference: CardioAlex Conference
2018. Alexandria Egypt. 20(Supplement H) (no pagination), 2018. Date of
Publication: 01 Oct 2018.
Author
Anonymous
Publisher
Oxford University Press
Abstract
The proceedings contain 18 papers. The topics discussed include: clinical
heterogeneity in a family with pathogenic variant in theKCNQ1 gene:
dilated cardiomyopathy and long QT syndrome; leadless ultrasound-based
cardiac resynchronization system in heart failure results from the
SOLVE-CRT randomized sub-study; accessory fascicolo-ventricular pathway in
hypertrophic phenotype cardiomyopathy suspected for Prkag2 mutation:
diagnostic role of myocardial biopsy; oral semaglutide: an innovative
paradigm in the management of cardiovascular risk in patients with type 2
diabetes; over 10 years of non-vitamin k antagonist oral anticoagulants:
highlights, challenges, and future developments; left atrial appendage
occlusion: behind the bleeding risk; and the era of interventional imaging
has arrived: what role for computed tomography and magnetic resonance?.

<90>
Accession Number
2039149196
Title
A Comparative Study of Intravenous Propofol with Intravenous thiopentone
induction During insertion of Laryngeal mask Airway in Adults for
Laparoscopic Tubectomy.
Source
International Journal of Life Sciences Biotechnology and Pharma Research.
14(5) (pp 1409-1414), 2025. Date of Publication: 01 May 2025.
Author
Narayana C.B.; Nagesh V.; Kumar M.P.
Institution
(Narayana) Department of Anaesthesiology, Government Medical College and
Hospital, Telangana, Nalgonda, India
(Nagesh) Department of Anaesthesiology, Government Medical College and
Hospital, Telangana, Nalgonda, India
(Kumar) Department of Anaesthesiology, Government Medical College and
Hospital, Telangana, Nalgonda, India
Publisher
International Journal of Life Sciences Biotechnology and Pharma Research
Abstract
Background: Induction of anesthesia focuses on the comfort and safety of
the patient during the surgery. In the case of laparoscopic tubectomy, it
is essential to pay special attention to airway management. Among the
range of intravenous induction agents, thiopentone and propofol are
gaining favor due to their ideal pharmacological profile. Propofol is
characterized by short onset time, smooth induction and recovery but at
the expense of hypotension and pain on injection. Comparison to
thiopentone is that it provides quick induction with less hypotension but
with the price of inducing respiratory depression and prolonged sedation.
This study compared intravenous propofol and thiopentone regarding the
safety, efficacy, and patient outcome during LMA insertion in the propofol
group and laparoscopic tubectomy in adults. Aim and Objective: The present
study was a try to find out the efficacy of intravenous thiopentone and
propofol induction during laryngeal mask airway insertion in adults
undergoing laparoscopic tubectomy. The precise objectives were: * To
compare the response to insertion of the laryngeal mask airway following
induction with equipotent doses of propofol (2.5 mg/kg) or thiopentone (5
mg/kg). * To evaluate which induction agent provided better conditions for
LMA insertion. <br/>Method(s): This prospective, double-blinded,
randomized comparative study was conducted at the Department of
Anesthesiology, Kakatiya Medical College, Warangal, over a 24-month period
from August 2022 to August 2024. A total of 60 adult female patients
scheduled for elective laparoscopic tubectomy were enrolled and randomized
into two groups: Group P (n=30) receiving propofol 2.5 mg/kg, and Group T
(n=30) receiving thiopentone 5 mg/kg. Both groups were assessed for LMA
insertion parameters, number of insertion attempts, time taken for
successful insertion, hemodynamic stability, patient responses to
insertion, grading of insertion responses, and the incidence of
postoperative complications. Standard statistical methods including
Chi-square test, Fisher's exact test, paired t-test, and ANOVA were
applied, with a p-value <0.05 considered statistically significant.
<br/>Result(s): Both groups were comparable in terms of demographic
profiles, anthropometric parameters, duration of surgery, baseline heart
rate, blood pressure, and SpO2 levels. Significant differences were
observed in LMA size requirement (p=0.05), number of insertion attempts
(p=0.05), cuff volume (p=0.04), cuff pressure (p=0.03), and mean time
required for successful LMA insertion (54.1 +/- 6.58 seconds in Group P
vs. 85.5 +/- 5.34 seconds in Group T; p=0.001). Propofol demonstrated
superior insertion conditions with significantly fewer adverse responses
including head movement (p=0.03), gag reflex (p=0.002), laryngospasm
(p=0.03), inadequate relaxation (p=0.001), cough (p=0.05), and limb
movement (p=0.002). Grading of responses also showed better tolerance in
the propofol group (p=0.002). Postoperative complications such as sore
throat, dysphagia, nausea, and vomiting were significantly lower in the
propofol group (p-values ranging from 0.01 to 0.03). <br/>Conclusion(s):
The study demonstrated that propofol provides superior conditions for LMA
insertion during laparoscopic tubectomy, offering smoother insertion,
reduced airway responses, minimal hemodynamic variations, and lower
incidence of postoperative complications compared to thiopentone.
Therefore, propofol may be considered the preferred induction agent for
such procedures.<br/>Copyright &#xa9;2025Int. J. Life Sci. Biotechnol.
Pharma. Res.

<91>
Accession Number
647562656
Title
Evaluating Antithrombotic Therapy for Hospitalized and Emergency
Department Patients with Non-valvular Atrial Fibrillation (NVAF).
Source
American Journal of Health-System Pharmacy. Conference: 2024 ASHP Midyear
Clinical Meeting. New Orleans, LA United States. 82(Supplement 1) (pp
S643), 2025. Date of Publication: 01 Jan 2025.
Author
Herb E.; Butler K.; Troup H.
Institution
(Herb) Paoli Hospital, PA, United States
Publisher
Oxford University Press
Abstract
Purpose: Management of antithrombotic therapy is essential for patients
with NVAF as these patients are at a proportionally higher risk for
stroke. NVAF can be found incidentally during non-cardiac surgery or acute
hospitalization. Incidental rates of NVAF vary but can be as high as 46%.
Despite identifying new NVAF, many patients are not adequately being
treated with anticoagulation therapy. The purpose of this retrospective,
quality assessment study aims to evaluate anticoagulation patterns in
patients with NVAF and assess adherence to recommended AHA guidelines at a
community hospital. <br/>Method(s): This is a retrospective single-site,
observational study at a 261-bed community hospital. Data will be
collected from January 1st to December 31st of 2024. Data will include all
patients 18 years or older who were diagnosed with new onset NVAF.
Patients less than 18 years old or who have a previous history of NVAF
will be excluded. Through a systematic review of patient charts, baseline
demographics will be collected including age, gender, weight, height,
comorbidities, and AF patterns. The primary end point will be assessing if
the number of patients were assessed treated properly based on their
CHADS-VASc score. Secondary endpoints will include utilization of
appropriate antithrombotic therapy by analyzing medication, dose, INR, and
concomitant medications. CHADs-VASc scores are currently being calculated
by hand and will be evaluated for accuracy. Statistics will be collected
using Chi-square or Fisher's exact test for nominal data as appropriate.
Student's t-test or Wilcoxon signed-rank test will be used for continuous
data as appropriate.

<92>
Accession Number
647566362
Title
Anticoagulation Strategies after Left Ventricular Thrombus.
Source
American Journal of Health-System Pharmacy. Conference: 2024 ASHP Midyear
Clinical Meeting. New Orleans, LA United States. 82(Supplement 1) (pp
S357), 2025. Date of Publication: 01 Jan 2025.
Author
Uetrecht C.N.; Sposito J.; Foellinger K.; Gaul J.; Ferrell S.
Institution
(Uetrecht) RPh Parkview Health, IN, United States
Publisher
Oxford University Press
Abstract
Purpose: Left ventricular (LV) thrombus affects 12%-27% of patients after
a myocardial infarction (MI). Guidance regarding inpatient anticoagulation
management after diagnosis of a LV thrombus is lacking. Vitamin K
antagonists (VKA) have traditionally been used for anticoagulation upon
discharge, but their monitoring challenges and interactions have prompted
interest in direct oral anticoagulants (DOACs). A 2022 American Heart
Association (AHA) meta-analysis showed no significant difference in
therapeutic or safety outcomes between DOACs and VKA. This study aims to
assess the inpatient and discharge anticoagulation strategies for LV
thrombus following the recently published AHA statement within a large
community teaching health system. <br/>Method(s): This retrospective,
cross-sectional, analysis was conducted within a single health system from
October 2021 to April 2024 and determined to be IRB exempt. Adult patients
hospitalized with a newly diagnosed LV thrombus were included. Patients
who underwent coronary artery bypass graft were excluded. Data was
collected from electronic medical records via automated data extraction
and manual collection. Endpoints were related to inpatient admissions and
evaluated the most utilized anticoagulant choice, dosing, duration, and
activated partial thromboplastin time (aPTT) goal. Upon discharge from the
hospital, endpoints were related to oral anticoagulant (OAC) of choice and
its associated dosing strategy, use of more than one anticoagulant,
monitoring (if required), and LV thrombus resolution at 6 months.

<93>
Accession Number
647565075
Title
Analysis of a Systematic Program to Transition Patients on Warfarin to
Direct Oral Anticoagulants.
Source
American Journal of Health-System Pharmacy. Conference: 2024 ASHP Midyear
Clinical Meeting. New Orleans, LA United States. 82(Supplement 1) (pp
S1593), 2025. Date of Publication: 01 Jan 2025.
Author
Misiti K.; Trujillo T.; Wagner M.; Ingle J.
Institution
(Misiti) University of Colorado, Skaggs School of Pharmacy and
Pharmaceutical Sciences, CO, United States
Publisher
Oxford University Press
Abstract
Purpose: Direct Oral Anticoagulants (DOACs) are the standard of care for
stroke prevention in Atrial Fibrillation (AF) and treatment of Venous
thromboembolism (VTE). Despite being first line, many patients are still
managed with warfarin. The purpose of this study was to assess a
systematic program which will evaluate patients on warfarin for a variety
of thromboembolic conditions within UCHealth Anticoagulation Management
Services for transition to a DOAC. <br/>Method(s): 2453 patients were
identified from the UCHealth North and South Anticoagulation registries as
taking warfarin for anticoagulation during a 12-month period (October 1,
2023 to October 1, 2024). Patients were evaluated by clinical pharmacists
regarding whether they were good candidates for switching to a DOAC
according to the following criteria. Inclusion criteria: patients
currently treated with warfarin for anticoagulation for AF or VTE
prophylaxis. Exclusion: Drug-drug interactions, dialysis, moderate-severe
mitral stenosis, ablation, antithrombin III deficiency, DOAC failure,
antiphospholipid antibody syndrome, within 3 months of a bioprosthetic
heart valve, severe hepatic impairment and mechanical valves. Patients
meeting eligibility criteria were approached with physician approval
regarding a potential switch. For analysis, a retrospective review of
patient charts was performed to identify qualities to describe this
population including age, sex, BMI, indication, clinical and outreach
candidacy, CHA2DS2VASc and HAS-BLED scores. A comprehensive analysis was
conducted to determine patient eligibility for transition from warfarin to
Direct Oral Anticoagulants (DOACs) and with physician approval, each
patient was notified and offered the opportunity for transition. Endpoints
to be analyzed include the number of successful transitions, common
barriers, and whether patients remained on therapy.

<94>
Accession Number
2039133119
Title
Ultrasound-guided Emergency Pericardiocentesis Simulation on Human
Cadavers: A Scoping Review.
Source
Western Journal of Emergency Medicine. 26(3) (pp 685-691), 2025. Date of
Publication: 01 May 2025.
Author
Unlu L.; Margenfeld F.; Zendehdel A.; Griese J.A.; Poilliot A.;
Muller-Gerbl M.; Nickel C.H.; Dedic M.
Institution
(Unlu, Griese, Nickel, Dedic) University Hospital Basel, Department of
Emergency Medicine, Petersgraben 2, Basel, Switzerland
(Margenfeld, Zendehdel, Poilliot, Muller-Gerbl) University of Basel,
Department of Anatomy, Pestalozzistrasse 20, Basel, Switzerland
Publisher
eScholarship
Abstract
Objectives: Emergency pericardiocentesis is a critical but infrequently
performed procedure in emergency medicine, necessitating effective
training modalities for emergency physicians. In this scoping review we
aimed to identify existing literature on simulation of ultrasound-guided
pericardiocentesis in human cadavers. <br/>Method(s): We carried out a
scoping review based on a search on the use of sonography on human
cadavers. The following databases were searched: MEDLINE; EMBASE; CENTRAL;
BIOSIS Previews; and Web of Science Core Collection. Additionally, we
performed a gray literature search. Title and abstract screening were done
by a single reviewer, and full-text review was performed by two
independent reviewers. Studies included were limited to those published in
English or German, focusing specifically on ultrasound-guided
pericardiocentesis training models in human cadavers, with no restrictions
on publication year or outcomes. <br/>Result(s): Our search strategy
yielded 9,821 publications and 1,440 reports were assessed for
eligibility. Ultimately, four studies met the inclusion criteria. All were
conducted in the USA; two used soft-embalmed cadavers, one reported using
fresh frozen cadavers, and one did not specify the cadaver type used. All
studies accessed the pericardial sac using large-bore catheters or
peripheral lines, filling it with (colored) water for simulation.
<br/>Conclusion(s): Evidence on ultrasound-guided emergency
pericardiocentesis simulation on human cadavers remains limited, but based
on the four studies we reviewed human cadavers could be used for
(emergency) pericardiocentesis simulation.<br/>Copyright &#xa9; 2025 Unlu
et al.

<95>
Accession Number
2034907502
Title
Preexisting statin therapy is not associated with reduced acute kidney
injury following cardiac surgery: a retrospective analysis.
Source
Frontiers in Pharmacology. 16 (no pagination), 2025. Article Number:
1613681. Date of Publication: 2025.
Author
Wang J.; Huang C.; Chen Y.; Huang Y.; Wu Z.
Institution
(Wang, Huang, Chen, Huang, Wu) The First Affiliated Hospital of Shantou
University School of Medicine, Shantou, China
Publisher
Frontiers Media SA
Abstract
Background: Cardiac surgery-associated acute kidney injury (CSA-AKI) is
one of the most prevalent forms of acute kidney injury (AKI) encountered
in clinical practice, and its occurrence is significantly correlated with
increased mortality and poor prognosis in patients. Although existing
studies suggest that statins may influence the development of CSA-AKI
through pleiotropic mechanisms, the findings from available studies and
meta-analyses remain inconsistent. Therefore, the relationship between
preexisting statin use and the risk of CSA-AKI development requires
further investigation. <br/>Method(s): This study employed a retrospective
cohort analysis based on the MIMIC-IV database. Patients undergoing
ascending aortic surgery, coronary artery bypass grafting (CABG), or heart
valve surgery were included and categorized based on preexisting statin
use. Multifactorial logistic regression models were utilized to assess the
association between statin use and outcome metrics, adjusting for
confounding variables. To further validate the results, propensity score
matching (PSM), sensitivity analyses, and subgroup analyses were
conducted. <br/>Result(s): A total of 4,783 patients were included, and
the overall incidence of CSA-AKI was 30.02% (n = 1,436). Preliminary
analysis showed that the incidence of AKI was significantly higher in the
statin use group than in the non-use group (34.06% vs. 29.23%, P = 0.007).
In the uncorrected model, statin use was associated with an elevated risk
of AKI (OR = 1.25, 95% CI: 1.06-1.47); however, after multifactorial
correction, the association was not statistically significant (OR = 1.00,
95% CI: 0.00-Inf, P = 1.000). Similarly, in the uncorrected model, statin
use was associated with increased in-hospital mortality (OR = 1.28, 95%
CI: 1.01-1.62) and ICU mortality (OR = 1.36, 95% CI: 1.07-1.72); however,
after multifactorial correction, statin use was not significantly
associated with in-hospital mortality (HR, 1.19; 95% CI, 0.92-1.53; P =
0.184) and ICU mortality (HR, 1.21; 95% CI, 0.94-1.55; P = 0.147) in the
corrected model. PSM analysis (1:1 matching) further confirmed these
findings (AKI: OR = 1.05, P = 0.621; in-hospital mortality: HR = 1.13, P =
0.438; ICU mortality: HR = 1.18, P = 0.299). None of the subgroup analyses
(stratified by statin dose, AKI severity, and type of surgery) revealed
significant interactions. Before PSM, no statistically significant
differences were observed in 30-day (p = 0.126), 60-day (p = 0.372), or
90-day mortality (p = 0.652). After PSM, the mortality rates remained
comparable between groups at all time points (30-day p = 0.297; 60-day p =
0.837; 90-day p = 0.966). <br/>Conclusion(s): Preexisting statin use was
not significantly associated with the risk of developing CSA-AKI,
in-hospital mortality, or ICU mortality after appropriate correction for
confounding variables. Similarly, no significant associations were
observed for 30-day, 60-day, or 90-day mortality outcomes. Sensitivity
analyses and subgroup analyses consistently supported this conclusion,
suggesting that statin use may not significantly impact clinical outcomes
in patients undergoing cardiac surgery.<br/>Copyright &#xa9; 2025 Wang,
Huang, Chen, Huang and Wu.

<96>
Accession Number
647566891
Title
Dual Antiplatelet Therapy Compared to Therapeutic Anticoagulation
Status-Post Left Atrial Appendage Occlusion.
Source
American Journal of Health-System Pharmacy. Conference: 2024 ASHP Midyear
Clinical Meeting. New Orleans, LA United States. 82(Supplement 1) (pp
S1871), 2025. Date of Publication: 01 Jan 2025.
Author
Quiroz D.C.; Hutcheson B.; Thompson K.
Institution
(Quiroz) Butler University, Indianapolis Campus, College of Pharmacy and
Health Sciences, IN, United States
Publisher
Oxford University Press
Abstract
Purpose: In atrial fibrillation, left atrial appendage occlusion (LAAO)
with the WATCHMAN and WATCHMAN FLX devices is an alternative to oral
anticoagulation (OAC) in patients whom OAC necessary but is
contraindicated or not tolerated. Current guidelines recommend 45 days or
longer of anticoagulation post-LAAO, however, the FDA recently approved
dual antiplatelet therapy (DAPT) post-LAAO. Due to a lack of head-to- head
studies comparing OAC's to DAPT in patients that are post-LAAO, this
practice remains controversial. Thus, the purpose of this study is to
determine if DAPT is as effective as OAC's post-LAAO. <br/>Method(s): This
was a retrospective, single-center noninferiority study evaluating
clinical outcomes in patients post-LAAO with a WATCHMAN or WATCHMAN FLX
device implanted between September 2017 and August 2023. Patients 18 years
of age and older prescribed DAPT or OAC plus aspirin following a LAAO
procedure were included. Patients were excluded if they were discharged on
monotherapy or if their procedure was unsuccessful. Pertinent baseline
characteristics collected per chart review were age, sex, and components
of the CHA2DS2-VASc and HAS-BLED scores. The comparator groups were
patients discharged on DAPT versus patients discharged on OAC plus aspirin
post-LAAO. The primary outcome was device-related thrombus within 45 days
of the procedure. Key secondary outcomes included device-related thrombus
within 1 year as evidenced by echocardiogram, major bleeding within 45
days and 1 year according to criteria of the International Society on
Thrombosis and Haemostasis (ISTH), stroke within 1 year, and all-cause
death within 1 year. Based upon review of a previous meta-analysis, it was
determined that the expected rates of device related thrombus (DRT) are
about 3.8% with a standard deviation of 3%. The noninferiority margin was
therefore set at 2.5%. Based on an alpha level of 0.05 and a power of 90%,
the number of patients needed per treatment arm was 1003.

<97>
Accession Number
647567244
Title
Assessment of Pre-Operative and Post-Operative Antibiotic Appropriateness.
Source
American Journal of Health-System Pharmacy. Conference: 2024 ASHP Midyear
Clinical Meeting. New Orleans, LA United States. 82(Supplement 1) (pp
S436), 2025. Date of Publication: 01 Jan 2025.
Author
Chieffo N.; Amato M.; Carr D.; Trienski T.; Bremmer D.
Institution
(Chieffo) Allegheny General Hospital, PA, United States
Publisher
Oxford University Press
Abstract
Purpose: In 2016, the World Health Organization (WHO) released guidance on
the use of antimicrobials to prevent surgical site infections. Within this
guidance, the WHO made a strong recommendation to discontinue antibiotics
after completion of surgery based on multiple randomized controlled
trials. Post-operative antibiotics should not be continued for more than
24 hours post-procedure based on the lack of evidence supporting this
practice. Additionally, prolonged courses of antibiotics after procedures
have been associated with increased risk of adverse events, increased
antibiotic resistance, and increased costs. <br/>Method(s): This project
will be completed via retrospective chart review using an electronic
health record. Patients 18 years of age or older who underwent,
transplant, orthopedic, neurological, general, or thoracic surgical
procedures at Allegheny General Hospital between January 1, 2023 and
December 31, 2023 will be included. The primary objectives of this project
will be to assess the appropriateness of pre-operative and post-operative
antibiotic practices as defined by the Allegheny Health Network
Antimicrobial Stewardship Guide surgical prophylaxis guidelines. The
secondary objective of this project will be to assess the rate of surgical
site infections within 30 days of surgery for included patients. Data
collection and analysis will be conducted using a standardized data
collection tool in Microsoft Excel .

<98>
Accession Number
647565099
Title
Evaluation of Bromocriptine for the Treatment of Peripartum
Cardiomyopathy.
Source
American Journal of Health-System Pharmacy. Conference: 2024 ASHP Midyear
Clinical Meeting. New Orleans, LA United States. 82(Supplement 1) (pp
S2015), 2025. Date of Publication: 01 Jan 2025.
Author
Smith K.E.; Dey S.
Institution
(Smith) Roseman University of Health Sciences, College of Pharmacy, NV,
United States
Publisher
Oxford University Press
Abstract
Purpose: Peripartum Cardiomyopathy (PPCM) is an uncommon form of heart
failure that affects women during the last month of pregnancy or within
five months following delivery. The exact cause of PPCM is not fully
understood, but involves factors such as hormonal changes, including the
increase in prolactin production. Presently, the treatment regimen is
similar to heart failure with adjustments for pregnancy, including the use
of bromocriptine in addition to standard heart failure treatment. The
objective of this work is to review published clinical trials that have
compared standard heart failure treatment with the addition of
bromocriptine for the treatment of PPCM. <br/>Method(s): A single study
was conducted to determine the efficacy of the addition of bromocriptine
to standard heart failure treatment for the treatment of PPCM. Patients
were randomized at a 1:1 ratio to receive standard heart failure treatment
with or without the addition of bromocriptine. Patients were evaluated at
baseline and at 6 months to observe left ventricular ejection fraction
(LVEF) recovery. Inclusion criteria included patients newly diagnosed with
PPCM, had no other causes of heart failure, and a LVEF < 35% at baseline.
Exclusion criteria included patients with underlying causes of heart
failure and conditions that could increase inflammatory markers. A
following study was conducted to determine the length of treatment of
bromocriptine. Patients were randomly assigned to receive short-term or
long-term bromocriptine in addition to standard heart failure treatment.
Inclusion criteria included patients with a diagnosis of PPCM, LVEF < 35%,
and 18 years of age or older. Exclusion criteria included patients with
pre-existing cardiovascular conditions, history of drug or alcohol abuse,
and previous cardiac surgery or percutaneous coronary artery intervention.
The current work involved a) analyzing current treatment options for
patients diagnosed with PPCM, b) a systematic review of published clinical
trials and their success rates and c) analyzing the effect of
bromocriptine as a potential addition to standard heart failure treatment.
<br/>Result(s): The addition of bromocriptine to standard heart failure
treatment was associated with significant improvement in left ventricular
ejection fraction. At baseline, patients in both treatment groups
displayed a LVEF of 27%. Per Sliwa et al, patients receiving standard
heart failure treatment plus bromocriptine displayed greater recovery of
left ventricular ejection fraction (27% to 58%; P=0.012) compared with
standard heart failure treatment patients (27% to 36%) at 6 months.
Significantly fewer patients receiving the addition of bromocriptine
experienced poor outcome defined as death, New York Heart Association
functional class III/IV, or left ventricular ejection fraction < 35% at 6
months compared to standard heart failure treatment (P=0.006).
Bromocriptine is associated with a high rate of full left ventricular
ejection fraction recovery with low morbidity and mortality outcomes. Per
Kleiner et al, patients receiving a short-term vs. long-term bromocriptine
treatment in addition to heart failure therapy was not significant. Left
ejection fraction increased from 28% to 49% in the patients receiving
1-week bromocriptine, and from 37% to 51% in the patients receiving 8-week
bromocriptine (P=0.381). No significant difference was observed between
the two treatment groups however, the addition of bromocriptine for 8
weeks did have a better full recovery (LVEF > 50%). <br/>Conclusion(s):
Bromocriptine, a dopamine agonist, has been explored as a treatment option
for PPCM due to its potential effects on improving cardiac function and
promoting full recovery of left ventricular ejection fraction. Due to it
being well tolerated, with low morbidity and mortality outcomes,
bromocriptine is becoming a reliable additive. Even though it has yet to
be studied in the United States, studies overseas have shown its potential
benefit. Hopefully as time goes on, new studies will show that
bromocriptine should be considered as standard heart failure treatment for
women with new onset peripartum cardiomyopathy.

<99>
Accession Number
647563732
Title
Utilization of Methylene Blue and Hydroxocobalamin in Vasoplegic Shock
after Cardiac Surgery.
Source
American Journal of Health-System Pharmacy. Conference: 2024 ASHP Midyear
Clinical Meeting. New Orleans, LA United States. 82(Supplement 1) (pp
S2727), 2025. Date of Publication: 01 Jan 2025.
Author
Jubas S.; McKnight A.
Institution
(Jubas) University of North Carolina (UNC) at Chapel Hill, Eshelman School
of Pharmacy, NC, United States
Publisher
Oxford University Press
Abstract
Purpose: Vasoplegic shock is a life-threatening condition characterized by
a reduction in systemic vascular resistance with a mortality rate as high
as 25% following cardiovascular surgery. Vasopressors are first-line
treatment for vasoplegic shock, while methylene blue and hydroxocobalamin
target nitric oxide-mediated vasodilation and are used second-line. Both
agents function as catecholamine-sparing agents to increase systemic
vascular resistance. However, no prospective, randomized controlled trials
have compared the use of methylene blue and hydroxocobalamin. The purpose
of this study is to characterize the institutional prescribing practice
and outcomes of methylene blue and hydroxocobalamin use in vasoplegic
shock following cardiac surgery. <br/>Method(s): This single-center,
retrospective cohort study includes patients admitted to an Atrium
Health's Carolinas Medical Center Intensive Care Unit (ICU) from August 1,
2023 to August 31, 2024. Adult patients receiving methylene blue or
hydroxocobalamin for vasoplegic shock after cardiac surgery will be
eligible for inclusion. Patients will be excluded if they are pregnant,
incarcerated, or receiving methylene blue or hydroxocobalamin for a
non-vasoplegic shock indication. The primary outcome is to characterize
the prescribing practice of methylene blue and hydroxocobalamin based on
vasopressor requirements [norepinephrine equivalents (NEE)] at the time of
administration. Secondary outcomes include establishing the change in
vasopressor requirements after initial and subsequent doses of methylene
blue and hydroxocobalamin at times 0-, 1-, 6-, and 12-hours post
administration, medication cost, ICU and hospital length of stay,
in-hospital mortality, and incidence of adverse reactions
(methemoglobinemia, hemolytic anemia, and serotonin syndrome). Patient
baseline characteristics, SOFA score, hospital and ICU length of stay,
surgical characteristics, vasopressor use, incidence of adverse effects,
mortality, and methylene blue and hydroxocobalamin administration and
dosing will be extracted from the electronic medical record, EPIC.

<100>
Accession Number
647563242
Title
The impact of somatostatin use in post-CABG adults with chylothorax on
chest tube output or time to chest tube removal.
Source
American Journal of Health-System Pharmacy. Conference: 2024 ASHP Midyear
Clinical Meeting. New Orleans, LA United States. 82(Supplement 1) (pp
S2660-S2661), 2025. Date of Publication: 01 Jan 2025.
Author
Hobe K.D.; Escano A.K.; Brody E.R.; Gibson C.M.
Institution
(Hobe) Virginia Commonwealth University, School of Pharmacy, VA, United
States
Publisher
Oxford University Press
Abstract
Purpose: Chylothorax is a rare but serious condition that can arise after
damage to the thoracic duct during CABG and can result in respiratory
failure, infections, and nutritional deficiencies. Current treatment
guidance for chylothorax includes conservative management with nutrition
and medication, or surgical management. Somatostatin analogues may reduce
thoracic duct leakage by decreasing absorption of triglycerides and
reducing thoracic duct lymph flow, but data are limited. The purpose of
this review is to analyze case reports to determine if the use of
somatostatin analogues reduces chest tube (CT) output in post-CABG
chylothorax patients. <br/>Method(s): A systematic review of case reports
was performed. Searches were conducted in PubMed, Embase, and Web of
Science to identify articles addressing the concepts of coronary artery
bypass and chylothorax. Covidence was used to deduplicate citations and to
support independent review of titles and abstracts followed by review of
the full-text of articles by two authors who were blinded to each others
inclusion and exclusion judgements. If a conflict arose, a third reviewer
decided whether to include or exclude the article. Articles were included
if they were retrospective and prospective adult human studies in which
coronary artery bypass was performed and a somatostatin analogue was used
to treat chylothorax. Reports were excluded if they were not in English,
no patient information was included, if the patient was not an adult, no
CABG was performed, if no octreotide or somatostatin analogue was used, if
there was no data on chest tube output or duration, if there was an
inability to interpret the data, and if the full text was unavailable.
<br/>Result(s): After removal of duplicate results, 262 papers were
identified in the search. Title and abstract screening excluded 202
papers, and full text review excluded an additional 47 results.
Ultimately, 13 case reports/series representing 15 unique patients were
included in the systematic review. Thirteen of the 15 patients experienced
reductions in CT output after initiation of somatostatin/analogues; two
patients had worsening CT output. Six cases of CT output reduction were
directly attributed to pharmacotherapy and seven were attributed to
pharmacotherapy plus dietary modifications. Three patients with CT output
reductions after somatostatin analogue initiation still required surgical
intervention for chylothorax resolution. None of the papers reported any
side effects of octreotide or somatostatin. <br/>Conclusion(s):
Somatostatin and analogues were a safe and possibly effective conservative
intervention to reduce CT output after CABG. Future research on
somatostatin and analogues in patients with chylothorax post-CABG is
needed to determine its effectiveness.

<101>
Accession Number
647564367
Title
Evaluation of Post-Operative Albumin Usage in Cardiothoracic Surgery
Patients Following the Removal of Albumin from the Post-Operative Order
Set.
Source
American Journal of Health-System Pharmacy. Conference: 2024 ASHP Midyear
Clinical Meeting. New Orleans, LA United States. 82(Supplement 1) (pp
S2072), 2025. Date of Publication: 01 Jan 2025.
Author
Ruzicka A.M.; Rinehimer B.; Limouze K.
Institution
(Ruzicka) Wilkes University, Nesbitt School of Pharmacy, PA, United States
Publisher
Oxford University Press
Abstract
Purpose: Following cardiothoracic surgery patients may experience
hemodynamic instability, necessitating fluid resuscitation to maintain
stable hemodynamics and allow for adequate blood perfusion. Albumin
maintains oncotic pressure by retaining fluid within the intravascular
space, helping to prevent edema, improve cardiac output, and maintain
stable blood volume. Previously, albumin has been preferred within this
integrated health system's "Cardiac Surgery Proven Recovery Postop" order
set but has since been replaced by isolyte-S. The purpose of this study is
to determine if a change in post-operative albumin usage in cardiothoracic
surgery patients after the removal of albumin from the post-operative
order set was observed. <br/>Method(s): A retrospective chart review was
performed using the health system's electronic health record on patients
that had undergone cardiothoracic surgery before and after the order set
change. Patients must have had cardiothoracic surgery between March 1,
2023, and June 1, 2023, or March 1, 2024, and June 1, 2024. Patients under
the age of 18 years old or those who experienced an intraoperative death
were excluded. Data collection included the patient's age, gender, type of
cardiac surgery, albumin concentration, the amount of albumin administered
in the first 24 and 72 hours, if mechanical circulatory support was
required, the total amount of crystalloid boluses given, if crystalloids
were given before albumin, and the "Cardiac Surgery Proven Recovery
Postop" order-set usage. <br/>Result(s): There were 30 patients reviewed
in the pre-order set change group and 30 patients in the post-order set
change group. The order set was used in 27 and 30 patients in the pre-and
post-order set change groups, respectively. Observed baseline
characteristics were similar between the groups. The groups were
comparable in types of surgeries, coronary artery bypass graft (17 vs.
18), aortic valve replacement (12 vs 10), mitral valve replacement/repair
(7 vs 3), and aortic repair (3 vs 5). An intra-aortic balloon pump was
used in 2 patients (7.5%) and 1 patient (3.3%) in the pre-and post-order
change groups. More patients in the pre-order set change group received
albumin (80% vs. 70%). The median total albumin dose received decreased in
the post-order set change group (50 g vs. 25 g). There was no median
difference for albumin administered in the first 24 and 72 hours in both
groups. Of the 45 patients who received albumin, 5 (5/45, 11.1%) received
25% in addition to 5%, with the remainder receiving only 5% (40/45,
88.9%). There were 4 patients in the pre-order set change group and 18
patients in the post-order set change group who received isolyte-S before
albumin administration. <br/>Conclusion(s): The change in the "Cardiac
Surgery Proven Recovery Postop" order set resulted in a lower quantity of
albumin being administered. The absolute number of patients that received
albumin were similar between the groups. Crystalloids were used with a
higher frequency and given prior to albumin more often in the post-order
set change group.

<102>
Accession Number
2034853557
Title
The Effects of Dexmedetomidine on Postoperative Delirium in Adult Cardiac
Surgical Patients: A Bayesian Meta-Analysis and Trial Sequential Analysis.
Source
Acta Anaesthesiologica Scandinavica. 69(6) (no pagination), 2025. Article
Number: e70069. Date of Publication: 01 Jul 2025.
Author
Keith N.; Harrowell L.; Alexandrou E.; Aneman A.; Frost S.A.
Institution
(Keith, Alexandrou, Aneman, Frost) Intensive Care, Liverpool Hospital,
Liverpool, Australia
(Keith, Harrowell, Alexandrou, Frost) University of Wollongong,
Wollongong, Australia
(Harrowell) Liverpool Hospital, Liverpool, Australia
(Alexandrou, Frost) Critical Care in Collaboration and Evidence
Translation (CCRiCET), Sydney, Australia
(Alexandrou, Aneman) University of New South Wales, Kensington, Australia
Publisher
John Wiley and Sons Inc
Abstract
Background: An acute episode of delirium among adults following cardiac
surgery is associated with increased length of stay in intensive care,
prolonged mechanical ventilation, and increased risk of mortality. This
robust systematic review with Bayesian meta-analysis, including trial
sequential analysis, has been undertaken to explore the use of
dexmedetomidine to reduce the occurrence of delirium. <br/>Method(s): A
systematic search for relevant published clinical trial reports was
registered on PROSPERO (CRD42023460126) and guided by the PRISMA statement
guidelines. Databases included Cochrane, CINAHL, PubMed, Embase, Medline
and PsychInfo. Studies included were randomised controlled trials
reporting on the adult population (> 18 years) undergoing cardiac surgery,
comparing dexmedetomidine to another drug or placebo. Trials of paediatric
populations, protocols and reviews were excluded. The primary outcome
examined was the effect of dexmedetomidine on the incidence of delirium in
postoperative cardiac surgery in the Intensive Care Unit (ICU). Secondary
outcomes of interest were the occurrence of hypotension, bradycardia,
length of ICU stay and sedation utilised in the control and comparator
groups. Trial sequential analysis and meta-regression were used to explore
heterogeneity. Risk ratios (RRs) and Bayesian posterior probabilities are
presented. The prior for this was empirical, being based on distributions
for emergency and critical care systematic reviews from the Cochrane
Database. The Cochrane ROB-2 tool was utilised to assess risk of bias, and
the GRADE approach for certainty of evidence is presented. <br/>Result(s):
A total of 699 randomised control trials were identified. After the
removal of duplicates and screening for eligibility, 27 studies were
included in the meta-analysis. The Robust Bayesian Model Averaging summary
effect for delirium prevention was estimated to be 0.76 (95% credible
interval [CrI] 0.56-1.00) for using dexmedetomidine, with a posterior
probability of 97% of any treatment effect. Meta-regression suggested that
the baseline risk of delirium is a strong indicator of increased
effectiveness, and trial sequential analysis indicates potential
effectiveness. A low risk of bias was evident in 19 of the 27 studies, 6
studies had some risk of bias, and 2 studies were judged to be high risk.
The certainty of evidence used across the 27 studies was determined to be
low overall. <br/>Conclusion(s): Dexmedetomidine may reduce the risk of
delirium among adults following cardiac surgery; however, uncertainty
remains due to heterogeneity. Therefore, adequately powered and
well-designed multi-centre trials are needed to address this current
uncertainty. Editorial Comment: The effects of dexmedetomidine on
postoperative delirium in adult cardiac surgical patients: a Bayesian
meta-analysis and trial sequential analysis. This systematic review with
meta-analysis concerning evidence for possible effects of dexmedetomidine
on post-cardiac surgery delirium presents detailed analysis showing a
possible treatment drug effect on reducing post-operative delirium in this
type of cohort, though still with some uncertainty.<br/>Copyright &#xa9;
2025 The Author(s). Acta Anaesthesiologica Scandinavica published by John
Wiley & Sons Ltd on behalf of Acta Anaesthesiologica Scandinavica
Foundation.

<103>
Accession Number
2034824174
Title
Dexmedetomidine as a Ropivacaine Adjuvant in a Thoracic Paravertebral
Block Combined With an Erector Spinae Plane Block for Improving Early
Quality of Recovery After Transapical Transcatheter Aortic Valve
Implantation.
Source
Kaohsiung Journal of Medical Sciences. (no pagination), 2025. Date of
Publication: 2025.
Author
Dong G.-L.; Qiu R.-E.; Xu C.-Z.
Institution
(Dong, Qiu, Xu) Department of Anesthesiology, The Quzhou Affiliated
Hospital of Wenzhou Medical University, Quzhou People's Hospital, Quzhou,
China
Publisher
John Wiley and Sons Inc
Abstract
The study aimed to investigate the effectiveness of dexmedetomidine (Dex)
as an adjuvant for ropivacaine in a thoracic paravertebral block (TPVB)
combined with an erector spinae plane block (ESPB) for improving early
quality of recovery and postoperative pain after transapical transcatheter
aortic valve implantation (TAVI). A total of 89 patients who were
scheduled to undergo transapical TAVI under general anesthesia were
allocated into Group RS and Group RD by using a computer-generated
random-number list. Group RS (n = 45) received 35 mL of 0.5% ropivacaine
with 5 mL of a normal saline mixture in TPVB combined with ESPB and Group
RD (n = 44) received 35 mL of 0.5% ropivacaine with 1 mug/kg Dex in 5 mL
of normal saline. The RD group exhibited significantly higher global
QoR-15 scores with lower visual analog scale (VAS) scores at 12 and 24 h
postoperatively than the RS group. The RD group needed fewer press times
of PCIA than the RS group. The postoperative sufentanil consumption was
significantly less in the RD group than that in the RS group. A longer
time to first use of flurbiprofen with less remedial doses of flurbiprofen
consumption within 48 h postoperatively was required for the RD group than
that for the RS group. The two groups did not differ in the incidence of
side effects. The findings of the study suggest that adding Dex to
ropivacaine in TPVB combined with ESPB is effective in improving early
quality of recovery and alleviating postoperative pain for patients
undergoing transapical TAVI under general anesthesia.<br/>Copyright &#xa9;
2025 The Author(s). The Kaohsiung Journal of Medical Sciences published by
John Wiley & Sons Australia, Ltd on behalf of Kaohsiung Medical
University.

<104>
Accession Number
2034897835
Title
Comparative Analysis of Perceval and Conventional Bovine Bioprosthetic
Valves in Aortic Valve Replacement: Hemodynamics, Reverse Remodeling, and
Long-Term Outcomes.
Source
Journal of Clinical Medicine. 14(11) (no pagination), 2025. Article
Number: 3899. Date of Publication: 01 Jun 2025.
Author
Lin S.-C.; Chen J.-S.; Huang J.-H.; Chiu K.-M.; Chiang C.-Y.
Institution
(Lin, Chen, Huang, Chiu, Chiang) Department of Cardiovascular Surgery,
Cardiovascular Center, Far Eastern Memorial Hospital, New Taipei City,
Taiwan (Republic of China)
(Chiu) Department of Electrical Engineering, Yuan Ze University, Taoyuan,
Taiwan (Republic of China)
(Chiang) Division of Cardiovascular Surgery, Department of Surgery, School
of Medicine, National Defense Medical Center, Taipei, Taiwan (Republic of
China)
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Background/Objectives: Surgical aortic valve replacement effectively
relieves left ventricular afterload and promotes reverse remodeling in
patients with severe aortic stenosis. The Perceval prosthesis offers a
hybrid approach, combining complete annular decalcification with
sutureless deployment. This design allows for reduced operative times and
potentially larger effective orifice areas. However, comparative data with
conventional stented bioprosthetic valves remain limited, particularly
regarding reverse remodeling, hemodynamic performance, and long-term
clinical outcomes. <br/>Method(s): In this retrospective cohort study, 115
patients underwent aortic valve replacement with either the Perceval valve
(n = 44) or conventional stented bovine pericardial valves (n = 71).
<br/>Result(s): The Perceval group showed a 100% procedural success rate
with no in-hospital mortality, significantly shorter cardiopulmonary
bypass and cross-clamp times, larger effective orifice areas, and a lower
incidence of patient-prosthesis mismatch. Both groups demonstrated
favorable left ventricular mass regression and reverse remodeling. The
rates of paravalvular leakage, permanent pacemaker implantation, and redo
aortic valve replacement were comparable between groups. Multivariate Cox
regression identified the follow-up indexed left ventricular mass as an
independent predictor of major adverse cardiac and cerebral events.
<br/>Conclusion(s): In this study, the Perceval valve was associated with
promising hemodynamic characteristics and procedural efficiencies,
particularly in cases with small aortic annuli and during minimally
invasive procedures. The valve was associated with reverse ventricular
remodeling and clinical outcomes that appeared similar to those of
conventional stented bioprostheses. These observations suggest it may
represent a potential alternative option for surgical aortic valve
replacement in appropriate clinical scenarios. However, randomized control
trials are needed to confirm these associations.<br/>Copyright &#xa9; 2025
by the authors.

<105>
Accession Number
2036542629
Title
Empagliflozin in Patients With Type 2 Diabetes Undergoing On-Pump CABG:
The POST-CABGDM Randomized Clinical Trial.
Source
Diabetes Care. 48(6) (pp 987-995), 2025. Date of Publication: 01 Jun 2025.
Author
Pitta F.G.; Lima E.G.; Tavares C.A.M.; Martins E.B.; Rached F.H.; Moreira
E.M.; Mioto B.M.; Lottenberg S.A.; Bolta P.M.P.; Justino L.G.; Favarato
D.; Carvalho L.N.S.; Pinesi H.T.; Barbosa C.T.M.; Dallan L.A.O.; Dallan
L.R.P.; Barbosa M.H.M.; Filho R.K.; De Lemos J.A.; Serrano C.V.
Institution
(Pitta, Lima, Tavares, Martins, Rached, Moreira, Mioto, Bolta, Justino,
Favarato, Carvalho, Pinesi, Barbosa, Dallan, Dallan, Barbosa, Filho,
Serrano) Instituto do coracao, Hospital das Clinicas Hospital das Clinicas
da Faculdade de Medicina da Universidade de Sao Paulo (HCFMUSP,
Universidade de Sao Paulo, Sao Paulo, Brazil
(Pitta, Tavares, Martins, Rached, Mioto, Lottenberg, Pinesi, Barbosa,
Barbosa, Serrano) Hospital Israelita Albert Einstein, Sao Paulo, Brazil
(Lima) Hospital Nove de Julho, Sao Paulo, Brazil
(Lottenberg) Servico de endocrinologia e metabolismo, Hospital das
Clinicas HCFMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil
(De Lemos) Division of Cardiology, Department of Internal Medicine,
University of Texas Southwestern Medical Center, Dallas, TX, United States
Publisher
American Diabetes Association Inc.
Abstract
OBJECTIVE To evaluate the efficacy and safety of empagliflozin in patients
with type 2 diabetes mellitus (T2DM) undergoing elective on-pump coronary
artery bypass grafting (CABG). RESEARCH DESIGN AND METHODS
Investigator-initiated, pragmatic, single-center, randomized, open-label
trial with blinded outcome adjudication conducted in Brazil. A total of
145 patients with T2DM scheduled for elective on-pump CABG were randomized
to receive empa gliflozin 25 mg daily plus standard care (n = 71) for at
least 3 months, which was discontinued 72 h before surgery, or to received
standard care alone (n = 74).The primary outcome was postoperative acute
kidney injury (AKI) within 7 days of sur gery, defined by creatinine-based
criteria (namely, Acute Kidney Injury Network; Risk, Injury, Failure, Loss
of Kidney Function, and End-Stage Kidney Disease; or Kid ney Disease:
Improving Global Outcomes). Secondary outcomes included 30-day
postoperative atrial fibrillation and type 5 myocardial infarction (MI).
Safety out comes were ketoacidosis, urinary tract infection,
hospital-acquired pneumonia, and woundinfection within 30 days after CABG.
RESULTS AKI occurred in 22.5% of the empagliflozin group vs. 39.1% in the
control group (rela tive risk [RR] 0.57 [95% CI 0.34-0.96]; P = 0.03).
Rates of atrial fibrillation (15.4% vs. 13.5%; RR 1.15 [95% CI 0.52-2.53];
P = 0.73) and type 5 MI (1.4% vs. 4.1%; RR 0.35 [95% CI 0.04-3.26]; P =
0.62) were similar between groups. No statistically significant
differences between groups were observed for safety events.Three deaths
occurred, all in the control group. CONCLUSIONS Empagliflozin use before
on-pump CABG in patients with T2DM was associated with areduced incidence
of postoperative AKI withoutanincrease in safety events. These findings
warrant confirmation in largerclinical trials.<br/>Copyright &#xa9; 2025
by the American Diabetes Association.

<106>
Accession Number
2034897559
Title
The Application of Bioelectrical Impedance Analysis Phase Angle in Cardiac
Surgery.
Source
Nutrients. 17(11) (no pagination), 2025. Article Number: 1914. Date of
Publication: 01 Jun 2025.
Author
Popiolek-Kalisz J.; Kalisz G.; Zembala M.
Institution
(Popiolek-Kalisz) Department of Clinical Dietetics, Medical University of
Lublin, Lublin, Poland
(Popiolek-Kalisz) Department of Cardiology, Cardinal Wyszynski Hospital in
Lublin, Lublin, Poland
(Kalisz) Department of Bioanalytics, Medical University of Lublin, Lublin,
Poland
(Zembala) Department of Cardiac Surgery and Transplantology, John Paul II
Catholic University of Lublin, Lublin, Poland
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Introduction: Malnutrition is a recognized risk factor for unfavorable
clinical outcomes and complications in cardiovascular and surgical
patients. Nutritional status can be assessed with various methods, and the
phase angle (PA) derived from bioelectrical impedance analysis is one of
the most reliable parameters for that purpose. <br/>Method(s): The aim of
this narrative review was to present the available data regarding PA
application in cardiac surgery. After careful analysis of PubMed and
Scopus databases, 21 articles were included in the final analysis.
<br/>Result(s): PA is a parameter that can be used for nutritional status
assessment in a cardiac surgery environment. It is suggested that it is
more accurate than other criteria in malnutrition identification in this
group of patients. The available data shows its association with
mortality, length of intensive care unit stay, and hospital stay. It can
also predict adverse events such as blood transfusion or mechanical
ventilation. <br/>Conclusion(s): The available data underscores the
usefulness of PA in preoperative risk assessment and post-procedural
monitoring. PA could be introduced in everyday clinical assessment in
cardiac surgery.<br/>Copyright &#xa9; 2025 by the authors.

<107>
Accession Number
2034895892
Title
Optimizing Analgesia After Minimally Invasive Cardiac Surgery: A
Randomized Non-Inferiority Trial Comparing Interpectoral Plane Block Plus
Serratus Anterior Plane Block to Erector Spinae Plane Block.
Source
Journal of Clinical Medicine. 14(11) (no pagination), 2025. Article
Number: 3786. Date of Publication: 01 Jun 2025.
Author
Baran O.; Sahin A.; Gurkan S.; Gur O.; Arar C.
Institution
(Baran, Sahin, Arar) Department of Anesthesiology and Reanimation, Faculty
of Medicine, Tekirdag Namik Kemal University, Tekirdag, Turkey
(Gurkan, Gur) Department of Cardiovascular Surgery, Faculty of Medicine,
Tekirdag Namik Kemal University, Turkey
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Background: Regional anesthesia techniques are increasingly used for pain
management in minimally invasive cardiac surgery (MICS). We aimed to
evaluate whether the combination of interpectoral plane block (IPB) and
superficial serratus anterior plane block (SAPB) provides non-inferior
postoperative analgesia compared to erector spinae plane block (ESPB) in
adult patients undergoing MICS. <br/>Method(s): In this prospective,
single-center, double-blind, randomized, non-inferiority trial, 40 adult
patients scheduled for MICS were allocated to receive either ESPB (n = 20)
or a combination of IPB + SAPB (n = 20) prior to surgical incision. All
patients received standardized anesthesia. Pain was assessed using the
Critical-Care Pain Observation Tool (CPOT) during intubation and the
Numerical Rating Scale (NRS) at 6-48 h postoperatively, following
extubation. The primary outcome was the NRS score at 24 h. A
non-inferiority margin of 2 NRS points was pre-specified, and
non-inferiority was evaluated using between-group differences with 95%
confidence intervals. Opioid consumption was recorded via PCA fentanyl and
rescue analgesics, converted to morphine milligram equivalents (MMEs).
Secondary outcomes included extubation time and postoperative nausea and
vomiting (PONV). <br/>Result(s): Median 24 h NRS was 3.0 (0-5.0) in the
ESPB group and 2.5 (0-5.0) in the IPB + SAPB group. The between-group
difference remained within the predefined two-point margin (95% CI: -0.8
to 1.2). Opioid consumption (p = 0.394), extubation time, and PONV
incidence were comparable (all p > 0.05). No block-related complications
occurred. <br/>Conclusion(s): IPB + SAPB was non-inferior to ESPB for
postoperative analgesia in MICS. Despite requiring two injections, it
remains an effective alternative. Larger trials are needed to confirm
these findings.<br/>Copyright &#xa9; 2025 by the authors.

<108>
Accession Number
2039143487
Title
Reply to "Comment on: Mechanical outcomes of coronary stenting guided by
intravascular ultrasound versus optical coherence tomography: A systematic
review and meta-analysis with trial sequential analysis of randomized
trials".
Source
International Journal of Cardiology. 437 (no pagination), 2025. Article
Number: 133505. Date of Publication: 15 Oct 2025.
Author
Lingamsetty S.S.P.; Doma M.; Kritya M.; Megaly M.S.; Goldsweig A.M.
Institution
(Lingamsetty) Mamata Medical College, Khammam, India
(Doma) Alexandria Faculty of Medicine, Alexandria, Egypt
(Kritya) Houston Methodist Research Institute, TX, United States
(Megaly) Ascension St John Medical Center-Tulsa, OK, United States
(Goldsweig) Department of Cardiovascular Medicine, Baystate Medical Center
and Division of Cardiovascular Medicine, University of
Massachusetts-Baystate, Springfield, MA, United States
Publisher
Elsevier Ireland Ltd

<109>
Accession Number
2039137884
Title
Efficacy of Ondansetron in Reduction of Risk of Hypotension After Spinal
Anaesthesia in LSCS.
Source
International Journal of Life Sciences Biotechnology and Pharma Research.
14(6) (pp 426-431), 2025. Date of Publication: 01 Jun 2025.
Author
Yadav D.S.K.; Gupta A.; Jeenger L.; Sarkar D.
Institution
(Yadav) Department Of Anaesthesia, Santosh Medical College And Hospital,
UP, Ghaziabad, India
(Gupta) Department Of Anaesthesia, Santosh Medical College And Hospital,
UP, Ghaziabad, India
(Jeenger) Department Of Anaesthesia, Santosh Medical College And Hospital,
UP, Ghaziabad, India
(Sarkar) Department Of Anaesthesia, Santosh Medical College And Hospital,
UP, Ghaziabad, India
Publisher
International Journal of Life Sciences Biotechnology and Pharma Research
Abstract
Background: Spinal anaesthesia is commonly used for lower-segment cesarean
sections due to its safety and minimal neonatal risks. However, it often
causes hypotension in about 60% of obstetric cases. While fluids,
vasopressors, and anticholinergics are standard preventive measures,
recent studies suggest that ondansetron may reduce hypotension and
bradycardia. This study evaluates ondansetron's effectiveness versus
placebo in managing hemodynamic changes and perioperative symptoms like
nausea, vomiting, and shivering. <br/>Method(s): A comparative
interventional study at Santosh Medical College, Ghaziabad, involved
pregnant women undergoing LSCS. Group A received 6 mg of ondansetron in
saline, while Group B received 20 ml. Perioperative monitoring included
heart rate, respiratory rate, blood pressure, and SpO<inf>2.</inf>
Incidence of hypotension was observed and documented in both groups.
<br/>Result(s): The mean age was 27.06 +/- 5.20 years in the Ondansetron
group and 26.67 +/- 6.04 years in the Placebo group, with no significant
difference in age, weight, or height. Mean BMI was comparable: 30.86 +/-
5.17 kg/m² (Ondansetron) vs. 31.21 +/- 5.75 kg/m²
(Placebo). Most participants were ASA PS 1 or 2. Baseline heart rate and
blood pressures were similar, but from 5 minutes onward, the Ondansetron
group showed significantly higher systolic and diastolic blood pressures,
indicating better hemodynamic stability during the procedure. Heart rate
remained stable across both groups. <br/>Conclusion(s): The study found
intravenous ondansetron significantly reduced hypotension risk during LSCS
under spinal anaesthesia. From the 5-minute mark onward, the ondansetron
group maintained higher systolic and diastolic pressures, suggesting its
potential as a preventive measure for better hemodynamic
stability.<br/>Copyright &#xa9; 2025 International Journal of Life
Sciences Biotechnology and Pharma Research. All rights reserved.

<110>
Accession Number
2034534528
Title
Cardiovascular Disorders in Systemic Lupus Erythematosus.
Source
Current Vascular Pharmacology. (no pagination), 2025. Date of
Publication: 2025.
Author
Manolis A.A.; Manolis T.A.; Manolis A.S.
Institution
(Manolis) Department of Internal Medicine, Elpis General Hospital of
Athens, Athens, Greece
(Manolis) Department of Psychiatry, Aiginiteio University Hospital,
Athens, Greece
(Manolis) Athens University School of Medicine, Athens, Greece
Publisher
Bentham Science Publishers
Abstract
Systemic Lupus Erythematosus (SLE) is a chronic autoimmune disease with
multiorgan and system involvement, including the Cardiovascular (CV)
system. Cardiac involvement in these patients is frequent and most often
asymptomatic, at least in the early stages. It includes accelerated
atherosclerosis, premature Coronary Artery Disease (CAD), and a high risk
of CV complications. The risk of developing CV Disease (CVD) in SLE is
linked not only with classical CV risk factors but also with
disease-specific factors, like the degree of activity, autoantibodies,
organ damage, and type of therapy. Clinical presentation comprises several
clinical manifestations ranging from angina to acute Myocardial Infarction
(MI) and Sudden Cardiac Death (SCD). The leading cause of death in SLE
patients is from CVD due to accelerated atherosclerosis, which often has a
more rapid progression compared with the general population. The CV risk
in SLE is greater when antiphospholipid antibodies are present. Regarding
diagnosis, apart from relevant blood tests, the simplest and readily
available diagnostic test, echocardiography, with its contemporary
techniques that include global longitudinal strain, is needed to provide a
more thorough cardiac evaluation and allow for early management. These
aspects of the disease, together with issues regarding phenotypes,
biomarkers, neonatal lupus, heart block, SLE-related CV ailments such as
coronary artery disease (CAD), myocarditis, valvular heart disease, and
the antiphospholipid syndrome, as well as diagnostic modalities, drug and
interventional therapies, and current relevant guidelines are all
thoroughly reviewed and discussed in this article.<br/>Copyright &#xa9;
2025 Bentham Science Publishers.

<111>
Accession Number
2034838898
Title
Saline-based modified del Nido cardioplegia versus multidose St. Thomas
cardioplegia in canine mitral valve repair: A randomized controlled trial.
Source
Veterinary Surgery. (no pagination), 2025. Date of Publication: 2025.
Author
Kurogochi K.; Takahashi A.; Nii Y.; Chen A.; Nishiyama M.; Furusato S.;
Sugiya H.; Uechi M.
Institution
(Kurogochi, Takahashi, Nii, Chen, Nishiyama, Furusato, Sugiya, Uechi)
JASMINE Veterinary Cardiovascular Medical Center, Yokohama, Japan
(Kurogochi) Department of Clinical Sciences, North Carolina State
University, College of Veterinary Medicine, Raleigh, NC, United States
(Furusato) Department of Health Data Science, Yokohama City University,
Yokohama, Japan
Publisher
John Wiley and Sons Inc
Abstract
Objective: To compare the utility of a saline-based modified del Nido
(mDN) cardioplegia solution with a conventional institutional technique
(multidose St. Thomas blood cardioplegia) for mitral valve repair (MVR) in
dogs. Study design: Prospective, randomized, open-label trial. Animals:
Forty client-owned dogs with myxomatous mitral valve disease (stage B2 and
C) eligible for MVR were divided into control and modified mDN groups.
<br/>Method(s): Cardioplegia was induced in the control group using 50%
blood containing St. Thomas solution every 10 min. In the mDN group, a
cardioplegia solution containing 20% blood was administered once or when
required. As the primary outcome, serum cardiac troponin I levels were
compared 12 h postoperatively between the groups. The other clinical
findings were evaluated as secondary outcomes. <br/>Result(s): Troponin
levels 12 h after surgery were a median of 27.8 ng/mL (interquartile
range, 15.1-43.2) in the control group and 19.4 ng/mL (15.2-33.6) in the
mDN group (p =.478). The sinus rhythm recovery time following aortic
cross-clamp removal was 362 s (103-995) in the control group and 60 s
(44-605) in the mDN group (p =.027). The total amount of crystalloid
cardioplegia solution required was 12.6 mL/kg (11.3-15.0) in the control
group and 23.6 mL/kg (18.0-35.1) in the mDN group (p <.001).
<br/>Conclusion(s): Cardiac troponin I levels did not show differences
between the groups. The saline-based mDN cardioplegia facilitated earlier
sinus rhythm recovery. Clinical significance: Saline-based mDN
cardioplegia may be a viable alternative for canine MVR.<br/>Copyright
&#xa9; 2025 Japan Animal Specialty Medical Institute Inc. Veterinary
Surgery published by Wiley Periodicals LLC on behalf of American College
of Veterinary Surgeons.

<112>
Accession Number
2034897881
Title
Incidence and Early Mortality of Prosthetic Valve Endocarditis in Patients
Undergoing TAVI Compared to SAVR: A Systematic Review and Meta-Analysis.
Source
Journal of Clinical Medicine. 14(11) (no pagination), 2025. Article
Number: 3866. Date of Publication: 01 Jun 2025.
Author
Gastino E.; Scarpanti M.; Parolari A.; Barili F.
Institution
(Gastino, Scarpanti, Parolari) University Unit of Cardiac Surgery, IRCCS
Policlinico S. Donato, Universita Degli Studi Di Milano, San Donato
Milanese, Milan, Italy
(Parolari) Department of Biomedical and Clinical Sciences, Universita
Degli Studi Di Milano, Milan, Italy
(Barili) University Cardiac Surgery Unit, IRCCS Ospedale
Galeazzi-Sant'Ambrogio, Milan, Italy
(Barili) Department of Epidemiology, Harvard T.H. Chan School of Public
Health, Boston, MA, United States
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Background: Transcatheter aortic valve implantation (TAVI) is becoming the
most important treatment strategy for aortic valve disease. With its
dramatic increase, the rate of major complications and the impact of TAVI
on long term outcomes is becoming a pressing issue, especially in terms of
comparison with surgical aortic valve replacement (SAVR). PVE is a severe
complication that can arise post-procedure, leading to significant
morbidity and mortality. The aim of this meta-analysis is to compare the
incidence of PVE and 30-day mortality rates between TAVI and SAVR.
<br/>Method(s): A comprehensive literature review was conducted,
identifying studies that reported the incidence and outcomes of PVE in
patients undergoing TAVI and SAVR. The selected studies were assessed for
heterogeneity using the chi² test and I² statistic.
A random effect model was applied to account for variability among
studies. The Odds Ratios (ORs) for 30-day mortality and the incidence of
PVE were calculated. Funnel plots were utilized to assess the reliability
of the data and potential publication bias. <br/>Result(s): The analysis
showed no significant difference in 30-day mortality of PVE in TAVI and
SAVR, with an OR of 1.29 (CI 0.98-1.69). However, there was a significant
difference in the incidence of PVE (HR 0.76, CI 0.61-0.96), with TAVI
demonstrating a protective effect attributed to its lesser invasiveness
and shorter procedural times. The funnel plots indicated high reliability
of the data, with low standard errors and minimal publication bias.
<br/>Conclusion(s): TAVI and SAVR carry similar 30-day mortality rates for
patients with PVE; on the other hand, TAVI shows a lower incidence of PVE
due to its minimally invasive nature. These findings suggest that TAVI
might be a preferable option for certain patient populations, though
further randomized clinical trials are needed to confirm these results and
address the limitations of the current study.<br/>Copyright &#xa9; 2025 by
the authors.

<113>
Accession Number
2034883124
Title
Current Knowledge of the Impact of Vitamin D in Coronary Artery Disease.
Source
International Journal of Molecular Sciences. 26(11) (no pagination), 2025.
Article Number: 5002. Date of Publication: 01 Jun 2025.
Author
Jespersen F.E.; Grimm D.; Kruger M.; Wehland M.
Institution
(Jespersen, Grimm) Department of Biomedicine, Aarhus University, Aarhus,
Denmark
(Grimm, Kruger, Wehland) Department of Microgravity and Translational
Regenerative Medicine, Otto von Guericke University, Magdeburg, Germany
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Coronary artery disease and vitamin D deficiency are both widespread
conditions with a high incidence worldwide. Coronary artery disease is a
complex illness with variable manifestation and pathogenesis. It often
involves the development of atherosclerosis, and it frequently has serious
or even fatal consequences for the patient. Vitamin D receptor expression
is found in many tissues throughout the body, which results in a broad
effect of the vitamin. Studies have found correlations between vitamin D
deficiency and the development of coronary artery disease as well as other
cardiovascular diseases, such as hypertension. This review will discuss
randomized controlled trials conducted from 2020 forward, aiming to
elucidate whether vitamin D supplements have the potential to be used as
an add-on treatment for coronary artery disease. The randomized controlled
trials all used vitamin D as intervention and tested a population
suffering from coronary artery disease or the risk of developing it. Even
though animal studies found evidence that vitamin D can regulate
inflammation, lipid profile, foam cell formation, vessel reactivity, and
blood pressure, which are all mediators in the development of
atherosclerosis, the results from the randomized controlled trials were
ambiguous. The general older population did not seem to benefit from the
treatment, but different subgroups such as patients with type 2 diabetes
and patients with more developed coronary artery disease exhibited some
positive effects from the treatment. Furthermore, vitamin D showed
cardioprotective effects following coronary artery bypass surgery, which
make it a possible add-on treatment before invasive coronary intervention.
The question in focus still needs further research and a more focused
approach on subgroups that may benefit from treatment.<br/>Copyright
&#xa9; 2025 by the authors.

<114>
Accession Number
2039122272
Title
Use of coronary artery bypass graft surgery and percutaneous coronary
intervention and associated outcomes in the ISCHEMIA trial.
Source
American Heart Journal. 289 (pp 78-94), 2025. Date of Publication: 01 Nov
2025.
Author
White H.D.; O'Brien S.M.; Boden W.E.; Fremes S.E.; Bangalore S.; Reynolds
H.R.; Stone G.W.; Ali Z.A.; Parakh N.; Lopez-Sendon J.L.; Wang Y.; Chen
Y.Q.; Mark D.B.; Chaitman B.R.; Spertus J.A.; Maron D.J.; Hochman J.S.
Institution
(White) Health New Zealand - Te Whatu Ora, Te Toka Tumai, Green Lane
Cardiovascular Service, Auckland City Hospital, Auckland, New Zealand
(O'Brien, Mark) Duke Clinical Research Institute, Duke University Medical
Center, Durham, NC, United States
(Boden) VA New England Healthcare System, Boston University School of
Medicine, Boston, MA, United States
(Fremes) Schulich Heart Centre, Sunnybrook Health Sciences Centre,
University of Toronto, Toronto, ON, Canada
(Bangalore, Reynolds, Hochman) Department of Medicine, NYU Grossman School
of Medicine, NYU Langone Health, New York, NY, United States
(Stone) Department of Medicine, Icahn School of Medicine at Mount Sinai,
New York, NY, United States
(Ali) Cardiololgy Department, Cardiovascular Research Foundation, New
York, NY, United States
(Ali) Columbia University Medical Center/New York-Presbyterian Hospital,
New York, NY, United States
(Ali) Cardiology Department, St Francis Hospital, Roslyn, NY, United
States
(Parakh) Cardiology Department, All India Institute of Medical Sciences,
New Delhi, India
(Lopez-Sendon) Cardiology Department, IdiPaz Research Institute and
Hospital Universitario La Paz, Madria, Spain
(Wang, Chen, Maron) Department of Medicine, Stanford Prevention Research
Center, Stanford, CA, United States
(Mark) Department of Medicine, Duke University, Durham, NC, United States
(Chaitman) School of Medicine Center for Comprehensive Cardiovascular
Care, Saint Louis University, St. Louis, MO, United States
(Spertus) Luke's Mid America Heart Institute, University of Missouri -
Kansas City's Healthcare Institute for Innovations in Quality and Saint,
Kansas City, MO, United States
(Maron) Department of Medicine, Stanford University, Stanford, CA, United
States
Publisher
Elsevier Inc.
Abstract
Background: In the ISCHEMIA Trial, 5,179 patients with stable coronary
disease were randomized to initial invasive or conservative management.
<br/>Method(s): PCI was recommended with a SYNTAX score 0 to 22 (low) and
CABG with a SYNTAX score >=33 (high). Either could be recommended for
intermediate scores. The composite primary outcome was cardiovascular
death, MI, or hospitalization for unstable angina, heart failure, or
resuscitated cardiac arrest. There were 2 cohorts in this analysis. The
descriptive cohort included patients who underwent CABG or PCI within 180
days of randomization and had no primary outcome before revascularization.
The comparative cohort excluded patients with prior CABG, single vessel
disease, SYNTAX score >= 45, and without core laboratory assessment. We
focused on the intermediate (23-32) SYNTAX comparative group for which
either CABG or PCI could be recommended. <br/>Result(s): For 1,935
patients in the descriptive cohort (485 CABG, 1,450 PCI), the SYNTAX score
was 27.3 +/- 11.0 in the CABG group and 15.3 +/- 8.6 in the PCI group, P <
.0001. Most patients with low SYNTAX scores underwent PCI (87.1%), while
most with high SYNTAX scores underwent CABG (72.6%). For the 1,203
patients (385 CABG, 818 PCI) in the comparative cohort, the adjusted
4-year primary event rate was 14.5% for CABG and 13.2% for PCI (difference
1.3%, 95% CI, -4.9% to 7.7%). For the 346 patients (163 CABG, 183 PCI) in
the intermediate SYNTAX group, the adjusted 4-year primary event rate was
10.6% for CABG and 18.3% for PCI (difference -7.6%, 95% CI, -16.1% to
0.9%). <br/>Conclusion(s): Selection of revascularization method resulted
in more PCI in the low SYNTAX group and more CABG in the high SYNTAX
group. There was no statistical evidence of a difference between PCI and
CABG in the intermediate SYNTAX group but the CIs are broad, reflecting
uncertainty. Clinical Trials.gov Identifier: NCT01471522;
https://clinicaltrials.gov/ct2/show/NCT01471522.<br/>Copyright &#xa9; 2025
Elsevier Inc.

<115>
Accession Number
2034897926
Title
Effects of Stroke Volume Maximization Before One-Lung Ventilation on
Video-Assisted Thoracic Surgery: A Randomized Controlled Trial.
Source
Diagnostics. 15(11) (no pagination), 2025. Article Number: 1405. Date of
Publication: 01 Jun 2025.
Author
Wang M.-L.; Hsiao P.-N.; Hsu H.-H.; Chen J.-S.; Cheng Y.-J.
Institution
(Wang, Hsiao, Cheng) Department of Anesthesiology, National Taiwan
University Hospital, National Taiwan University College of Medicine,
Taipei, Taiwan (Republic of China)
(Hsu, Chen) Department of Surgery, National Taiwan University Hospital,
National Taiwan University College of Medicine, Taipei, Taiwan (Republic
of China)
(Hsu) Medical Services Department, National Taiwan University Cancer
Center, Taipei, Taiwan (Republic of China)
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Background/Objectives: The use of goal-directed fluid therapy (GDFT)
guided by stroke volume (SV) variation during thoracic surgery,
particularly with one-lung ventilation (OLV) and protective ventilation
strategies, is not well established. This study aimed to determine whether
maximizing stroke volume (SV) before initiating one-lung ventilation (OLV)
reduces the incidence of intraoperative hypotension requiring vasoactive
agents during video-assisted thoracoscopic surgery (VATS). <br/>Method(s):
Sixty patients undergoing VATS were randomly assigned to an SVM group (n =
30) or a control group (n = 30). The SVM group received 6% hydroxyethyl
starch before OLV to achieve and maintain an SV increase of less than 10%.
The control group received no active fluid therapy before OLV positioning.
Both groups received Ringer's lactate solution intraoperatively based on
baseline (control) or maximized (SVM) SV goals. The primary outcome was
the use of vasoactive agents for hypotension. <br/>Result(s): Patients in
the SVM group received significantly less Ringer's lactate solution than
controls (4.2 +/- 2.4 vs. 6.1 +/- 2.8 mL/kg/h, p = 0.005). While fewer
patients in the SVM group required vasoactive agents (20% vs. 40%), the
difference was not statistically significant (p = 0.091). IL-6 levels were
significantly lower during OLV in the SVM group. <br/>Conclusion(s):
Pre-OLV SVM was associated with reduced intraoperative crystalloid
administration and attenuation of inflammatory response, with a
non-significant trend toward lower vasopressor use. These findings suggest
a potential benefit of SVM in thoracic surgery, though larger multicenter
trials are needed to confirm clinical efficacy.<br/>Copyright &#xa9; 2025
by the authors.

<116>
Accession Number
647547395
Title
HTA ANALYSIS FOR THE INCLUSION OF ANDEXANET ALFA (AA) WITHIN THE HOSPITAL
THERAPEUTIC HANDBOOK (HTH) - THE EXPERIENCE OF AN ITALIAN CENTRE
SPECIALISING IN CARDIOVASCULAR DISEASES.
Source
European Journal of Hospital Pharmacy. Conference: 28th EAHP Congress.
Bordeaux France. 31(Supplement 1) (pp A9), 2024. Date of Publication: 01
Mar 2024.
Author
Zitelli S.; Iezzi A.; Teso V.; Ballardini G.; Tebaldini B.; Faioni E.M.;
Ballotta A.; Omodeo Sale E.
Institution
(Zitelli, Iezzi, Teso, Ballardini, Tebaldini) Monzino Cardiology Centre,
Hospital Pharmacy, Milan, Italy
(Faioni, Ballotta, Omodeo Sale) Monzino Cardiology Centre, Analysis
Laboratory, Milan, Italy
Publisher
BMJ Publishing Group
Abstract
Background and Importance The drug Andexanet Alfa (AA), an
anti-haemorrhagic antidote capable of rapidly reversing the effect of
factor Xa inhibitor DOACS (Apixaban, Rivaroxaban), was recently introduced
on the market. The 4-factor prothrombin complex (CPP4), already in use at
our centre, also has the same indication. Aim and Objectives In
collaboration with a haematologist and a cardiologist-anaesthetist, an HTA
analysis was conducted with the aim of evaluating the real need for the
inclusion of AA within the Hospital Therapeutic Handbook (HTH) and its use
in cardiac surgery emergency situations and cardiovascular emergency.
Material and Methods A brief review of the literature currently available
on various search engines (PubMed, clinicaltrials. gov) was conducted by
the hospital pharmacy, looking in particular for comparison studies
between AA and CPP4. In parallel, a search was conducted for poison
control centres (PCC) and hospital centres close to the facility that had
the drug available, an economic evaluation and an analysis of the Summary
of Product Characteristics (SmPC). Results From the retrospective studies
analysed (eight, of which only three meta-analyses), data were collected
and summarised in terms of efficacy/haemostasis rate (AA: 77.88% vs CPP4:
76.47%, average data) and safety/incidence of posttreatment thromboembolic
events (AA: 10.47% vs CPP4: 5.98% average figure). From the parallel
research, the following results emerged: availability of the antidote (one
PCC and two hospital centres); treatment costs (AA: Euro 52,666.52 vs
CPP4: Euro 3795.90); reimbursement (non-reimbursable drug); AA
preparation/ infusion times (approximately 2h 30). Conclusion and
Relevance The analysed studies, subject to bias due to the variability of
the analysed sample, were mainly focused on intracranial haemorrhage
events and not on cardiac surgical complications. From these, it also
emerged that AA promotes a refractoriness to the anticoagulant effect of
unfractionated heparin, making the use of AA incompatible in patient
candidates for a cardiac surgical procedure that requires
pre-heparinisation. Therefore, by virtue of the poor and unfavourable
quality of the trials and the unfavourable cost-effectiveness and
riskbenefit ratios, it was not considered necessary to introduce the drug
within the HTH.

<117>
Accession Number
2039095713
Title
Unilateral access versus bilateral access in transfemoral transcatheter
aortic valve replacement: A systematic review and meta-analysis.
Source
Indian Heart Journal. (no pagination), 2025. Date of Publication: 2025.
Author
Jain H.; Shahabi M.; Shafiq A.; Agrawal S.P.; Saad M.S.; Sharaf B.L.;
Gordon P.C.; Abbott J.D.; Vallabhajosyula S.
Institution
(Jain) Department of Cardiology, All India Institute of Medical Sciences,
Jodhpur, India
(Shahabi, Shafiq) Department of Internal Medicine, Dow University of
Health Sciences, Karachi, Pakistan
(Agrawal) Department of Internal Medicine, New York Medical
College/Landmark Medical Center, Woonsocket, RI, United States
(Saad, Sharaf, Gordon, Abbott, Vallabhajosyula) Division of Cardiology,
Department of Medicine, Warren Alpert Medical School of Brown University,
Providence, RI, United States
(Saad, Sharaf, Gordon, Abbott, Vallabhajosyula) Brown University Health
Cardiovascular Institute, Providence, RI, United States
Publisher
Elsevier B.V.
Abstract
Background: Transcatheter aortic valve replacement (TAVR) procedures
frequently require a second arterial access to perform aortic root
angiography. In recent times, there has been an increase in the use of
unilateral access, however, the outcomes data are conflicting.
<br/>Method(s): A systematic database search was conducted to retrieve
studies comparing unilateral to bilateral access in TAVR. Risk ratios (RR)
with 95 % confidence intervals (CI) were pooled using the Mantel-Haenszel
random-effects model. Outcomes of interest included minor vascular
complications, major vascular complications, 30-day stroke, and 30-day
all-cause mortality. <br/>Result(s): Three studies with a total of 2,181
patients undergoing TAVR (unilateral 368, bilateral 1813) were included in
this meta-analysis. Unilateral access was comparable to bilateral access
for minor vascular complications (RR: 0.88; 95 % CI: 0.48-1.62), major
vascular complications (RR: 0.61, 95 % CI: 0.14-2.75), stroke (RR: 0.95;
95 % CI: 0.42, 2.17) and all-cause mortality (RR: 0.52; 95 % CI: 0.04,
6.93). <br/>Conclusion(s): Unilateral access for TAVR was associated with
similar short-term outcomes and safety profiles compared to bilateral
access for TAVR.<br/>Copyright &#xa9; 2025 Cardiological Society of India

<118>
Accession Number
2034833832
Title
Correction to: Randomized clinical trial of continuous transversus
thoracis muscle plane block for patients undergoing open heart valve
replacement surgery (Journal of Cellular and Molecular Medicine, (2024),
28, 7, 10.1111/jcmm.18184).
Source
Journal of Cellular and Molecular Medicine. 29(11) (no pagination), 2025.
Article Number: e70648. Date of Publication: 01 Jun 2025.
Author
Anonymous
Publisher
John Wiley and Sons Inc
Abstract
Zhan Y, Li L, Chen S, Peng Y, Zhang Y. Randomized Clinical Trial of
Continuous Transversus Thoracis Muscle Plane Block for Patients Undergoing
Open Heart Valve Replacement Surgery. J Cell Mol Med. 2024; 28:e18184.
doi: 10.1111/jcmm.18184. In the article, references 12, 13, 14, 17, and 18
were incorrect and should be replaced. The incorrect references are: 12.
Ueshima H, Otake H. Continuous transversus thoracic muscle plane block is
effective for the median sternotomy. J Clin Anesth. 2017;37:174. 13.
Ueshima H, Otake H. Where is an appropriate injection point for an
ultrasound-guided transversus thoracic muscle plane block? J Clin Anesth.
2016;33:190-191. 14. Ueshima H, Takeda Y, Ishikawa S, Otake H.
Ultrasound-guided transversus thoracic muscle plane block: a cadaveric
study of the spread of injectate. J Clin Anesth. 2015;27:696. 17. Ueshima
H, Hara E, Marui T, Otake H. The ultrasound-guided transversus thoracic
muscle plane block is effective for the median sternotomy. J Clin Anesth.
2016;29:8. 18. Ueshima H, Otake H. Ultrasound-guided transversus thoracic
muscle plane block: complication in 299 consecutive cases. J Clin Anesth.
2017;41:60. The correct references are: 12. Avneet Singh, Indumati,
Dheeraj Kapoor, Suman Dhillon, Jasmine K Narula, Sidharth Garg. Continuous
Bilateral Transversus Thoracic Muscle Plane Block: An Analgesia Boon for
Scoliotic Patients Undergoing Cardiac Surgery. Ann Card Anaesth. 2024 Jan
1;27(1):61-64. 13. Samerchua Artid, Leurcharusmee Prangmalee, Supphapipat
Kittitorn, Unchiti Kantarakorn, Lapisatepun Panuwat, Maikong Naraporn,
Kantakam Perada, Navic Pagorn, Mahakkanukrauh Pasuk. Optimal techniques of
ultrasound-guided superficial and deep parasternal intercostal plane
blocks: a cadaveric study. Region Anesth Pain M. 2024-05-07;49(5):320-325.
14. Harbell Monica W, Langley Natalie R, Seamans David P, Kraus Molly B,
Carey Frederick J, Craner Ryan C.Deep parasternal intercostal plane nerve
block: an anatomical study. Region Anesth Pain M.
2024-03-04;49(3):179-183. 17. Mohamed Ahmed Hamed, Maged Labib Boules,
Mina Mahrou Sobhy, Mahdy Ahmed Abdelhady.The Analgesic Efficacy of
Ultrasound-Guided Bilateral Transversus Thoracic Muscle Plane Block After
Open-Heart Surgeries: A Randomized Controlled Study.J Pain Res.
2022-01-01;15:675-682. 18. Jian-Jun Xue, Yi-Yang Cui, Jason W Busse, Long
Ge, Ting Zhou, Wei-Hua Huang, Sheng-Shuang Ding, Jie Zhang, Ke-Hu Yang.
Transversus thoracic muscle plane block for pain during cardiac surgery: a
systematic review and meta-analysis. Int J Surg. 2023 Aug
1;109(8):2500-2508. The online version of the article was corrected. We
apologize for these errors.<br/>Copyright &#xa9; 2025 The Author(s).
Journal of Cellular and Molecular Medicine published by Foundation for
Cellular and Molecular Medicine and John Wiley & Sons Ltd.

<119>
Accession Number
647542723
Title
In-Silico Modelling in the Development of Novel Devices in Thoracic and
Abdominal Surgery: A Systematic Review.
Source
British Journal of Surgery. Conference: Annual Scientific Meeting of the
Surgical Research Society. Cambridge United Kingdom. 112(Supplement 6) (pp
vi9), 2025. Date of Publication: 01 Mar 2025.
Author
Pattani N.; Sanghera J.; Mills E.; Bolton W.; Harji D.; Burke J.
Institution
(Pattani) Epsom and St Helier NHS Trust, London, United Kingdom
(Sanghera) Walsall Healthcare NHS Trust, Birmingham, United Kingdom
(Mills) Mid and South Essex NHS Trust, Essex, United Kingdom
(Bolton) University of Leeds and Leeds Hospitals, Leeds, United Kingdom
(Harji) Manchester University NHS Foundation Trust, Manchester, United
Kingdom
(Burke) Leeds Institute Medical Research, Leeds, United Kingdom
Publisher
Oxford University Press
Abstract
Background: Surgical innovation has made significant leaps in recent
years, but the adoption of novel devices has lagged due to prolonged
efficacy and safety assessment through randomised controlled trials.
In-silico modelling may provide a solution, utilising computational
simulations to develop and improve surgical devices. This systematic
review aimed to evaluate the current use of in-silico modelling for
devices utilised in thoracic and abdominal surgery. <br/>Method(s):
Studies in the last five years were searched in PubMed databases (Jan 2019
- Aug 2024). Specified inclusion criteria included original studies using
mathematical/computational modelling to investigate thoracic/abdominal
surgical devices which are invasive in nature. <br/>Result(s): Of 2968
studies derived from the search strategy, 42 were included in the final
analysis and categorised by surgical specialty: general surgery (n=4);
hepato-pancreato-biliary (n=2); vascular (n=5); paediatric (n=9); and
cardiothoracic (n=22). Three core themes were identified: proof of concept
(n=19), device improvement (n=22), and in-silico clinical trials (ISCTs)
with simulated human patients (n=1). Most studies were at IDEAL stage 0
(pre-clinical) and 19 studies validated in-silico results with in-vitro/
in-vivo data. <br/>Discussion(s): In future, in-silico modelling could
replace components of pre-clinical in-vitro and in-vivo testing of
surgical devices. Applications include generating efficacy data for novel
devices in the pre-clinical stage, modelling minority patient demographics
or rare diseases, and developing/repurposing existing devices to reduce
complications. Standardised core outcomes and credibility frameworks will
minimise inter-study heterogeneity in methodologies and reporting of
results. Global collaboration will help bring in-silico modelling to the
forefront of surgical device research.

<120>
Accession Number
2039109938
Title
Impact factor, indexing in PubMed and new monographs in Cardiovascular
Surgery.
Source
Cirugia Cardiovascular. (no pagination), 2025. Date of Publication: 2025.
Author
Garcia Fuster R.
Institution
(Garcia Fuster) Editor Jefe de CIRUGIA CARDIOVASCULAR. Consorcio Hospital
General Universitario de Valencia, Facultad de Medicina, Universidad
Catolica de Valencia, Valencia, Spain
Publisher
Sociedad Espanola de Cirugia Cardiovascular y Endovascular (SECCE)

<121>
Accession Number
2039108286
Title
Comment on: "Mechanical outcomes of coronary stenting guided by
intravascular ultrasound versus optical coherence tomography: A systematic
review and meta-analysis with trial sequential analysis of randomized
trials".
Source
International Journal of Cardiology. 437 (no pagination), 2025. Article
Number: 133489. Date of Publication: 15 Oct 2025.
Author
Guo X.; Yu R.; Wu Q.
Institution
(Guo, Yu, Wu) Department of Cardiovascular Medicine, Lanzhou University
Second Hospital, Lanzhou, China
Publisher
Elsevier Ireland Ltd

<122>
Accession Number
2039084223
Title
Percutaneous Mitral Valve Repair Versus Surgery in Patients With Mitral
Regurgitation: A Meta-Analysis.
Source
Cardiology in Review. (no pagination), 2025. Date of Publication: 2025.
Author
Ali M.A.; Ali M.F.; Sabir A.; Alvi A.S.; Arif A.; Khawaja S.; Qayyum R.;
Vardag Z.B.; Ikram M.; Arshad H.; Naveed M.A.; Neppala S.; Ahmed M.; Ahmed
R.; Hussain A.; Paray N.B.
Institution
(Ali) Khyber Medical College Peshawar, Peshawar, Pakistan
(Ali) Jinnah Postgraduate Medical Center, Karachi, Pakistan
(Sabir) Department of Cardiac Surgery, Rawalpindi Institute of Cardiology,
Rawalpindi, Pakistan
(Alvi) Fatima Memorial College of Medicine and Dentistry, Lahore, Pakistan
(Arif) Sahara Medical College, Narowal, Pakistan
(Khawaja) Services Institute of Medical Sciences, Lahore, Pakistan
(Qayyum) Indus Hospital Gda, Gwadar, Pakistan
(Vardag) Continental Medical College, Lahore, Pakistan
(Ikram) Frontier Medical and Dental College Abbottabad, Abbottabad,
Pakistan
(Arshad) Shifa College of Medicine, Islamabad, Pakistan
(Naveed) Dow University of Health Sciences, Karachi, Pakistan
(Neppala) Division of Cardiology, Ut Health Science Center, San Antonio,
TX, United States
(Ahmed) Rawalpindi Medical University, Rawalpindi, Pakistan
(Ahmed) National Heart and Lung Institute, Imperial College London,
London, United Kingdom
(Ahmed) Department of Cardiology, Royal Brompton Hospital, London, United
Kingdom
(Hussain) Department of Cardiac Surgery, Vanderbilt University Medical
Center, Nashville, TN, United States
(Paray) Royal Devon University Healthcare Nhs Foundation Trust, Exeter,
United Kingdom
Publisher
Lippincott Williams and Wilkins
Abstract
While studies confirm the feasibility of percutaneous mitral valve repair,
its short- and long-term outcomes compared with mitral valve surgery
remain debated. This meta-analysis aims to evaluate the clinical outcomes
with a percutaneous approach and surgery. A comprehensive literature
search of major databases that included PubMed, Embase, and the Cochrane
Library was performed from inception to November 2024. Randomized
controlled trials (RCTs) and propensity-adjusted observational studies
that reported clinical outcomes following percutaneous mitral valve repair
versus mitral valve surgery in patients with mitral regurgitation were
included in the review. The pooled estimates were calculated using a
random effects model. A total of 6 studies (n = 5411 patients) were
included. The pooled analysis demonstrated no statistically significant
difference between the 2 approaches for all-cause death at 1 month [risk
ratio (RR) = 1.13, 95% confidence interval (CI): 0.54-2.37], and 1 year
(RR = 1.98, 95% CI: 0.91-4.32). The risk of stroke was significantly
reduced in the percutaneous group (RR = 0.42, 95% CI: 0.23-0.74); however,
the pooled estimates remained comparable for hospitalization for heart
failure (RR = 0.88, 95% CI: 0.38-2.04), all-cause rehospitalization (RR =
1.03, 95% CI: 0.55-1.95), sepsis (RR = 0.25, 95% CI: 0.06-1.13), atrial
fibrillation (RR = 0.44, 95% CI: 0.10-2.06), and Grade 3+ or 4+ mitral
regurgitation (RR = 3.02, 95% CI: 0.74-12.37). Compared with surgery, the
percutaneous approach demonstrates a similar safety profile and a reduced
risk of stroke. However, long-term mortality is comparable between the 2
techniques, indicating that a patient-tailored approach will lead to
optimal results.<br/>Copyright &#xa9; 2025 Wolters Kluwer Health, Inc.

<123>
Accession Number
2034874566
Title
Intraoperative Hemostatic Agents in Thoracic Aortic Surgery-A Scoping
Review.
Source
Journal of Clinical Medicine. 14(11) (no pagination), 2025. Article
Number: 4001. Date of Publication: 01 Jun 2025.
Author
van Haeren M.M.T.; Bozic C.; Breel J.S.; Eberl S.; Jamaludin F.S.; Veelo
D.P.; Muller M.C.A.; Vlaar A.P.J.; Hermanns H.
Institution
(van Haeren, Bozic, Breel, Eberl, Veelo, Hermanns) Department of
Anesthesiology, Amsterdam University Medical Centers, Amsterdam,
Netherlands
(van Haeren, Muller, Vlaar) Department of Intensive Care, Amsterdam
University Medical Centers, Amsterdam, Netherlands
(Jamaludin) Medical Library, Amsterdam University Medical Centers,
Location University of Amsterdam, Amsterdam, Netherlands
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Background/Objectives: Patients undergoing open thoracic aortic surgery
have the highest bleeding complication rates within cardiac-vascular
surgery, but research on coagulation management mostly targets general
cardiac surgery. This scoping review evaluates current evidence on
intraoperative hemostatic agents and their effect on bleeding and blood
transfusions in these patients. <br/>Method(s): We searched MEDLINE
(PubMed), Embase, and Cochrane Library on 2 July 2024. Eligible studies
included randomized controlled (RCT) and observational trials with a
comparison group and at least a sub-analysis regarding thoracic aortic
surgery (excluding thoracoabdominal and isolated descending aorta
surgery). <br/>Result(s): Our search yielded 4697 articles, with 33
included. These covered antifibrinolytics (3 RCTs, 10 observational
studies), fibrinogen supplementation (3 RCTs, 4 observational studies),
recombinant factor VIIa (rFVIIa, 8 observational studies), blood products
(3 observational studies), and factor eight inhibitor bypassing activity
(FEIBA, 1 RCT, 1 observational study). The impact of blood product
transfusion on bleeding control is unclear due to a lack of placebo or
no-transfusion comparisons, though it appears associated with more
complications. Both FEIBA studies suggest reduced blood product use in
aortic dissection surgery-one as rescue therapy, the other as standard
treatment. Evidence on fibrinogen supplementation is mixed: a multicenter
RCT showed increased transfusions, while smaller RCTs and observational
studies showed reductions, possibly due to differences in pretreatment
fibrinogen levels and patient selection. Observational studies on rFVIIa
show conflicting results, likely due to selection bias. Two small RCTs-one
on TXA, one on aprotinin-suggest reduced transfusions and blood loss.
Comparative studies of different types of antifibrinolytics yielded
conflicting results. <br/>Conclusion(s): Evidence on hemostatic agents in
thoracic aortic surgery is limited. Small studies suggest potential for
the routine use of antifibrinolytics, FEIBA, and fibrinogen
supplementation-but only in bleeding patients with hypofibrinogenemia.
High-quality RCTs focused on thoracic aortic procedures are needed to
determine optimal coagulation management.<br/>Copyright &#xa9; 2025 by the
authors.

<124>
Accession Number
2039096448
Title
Concomitant Atrial Fibrillation Ablation in Surgical Aortic Valve
Replacement: A Systematic Review and Meta-Analysis.
Source
CJC Open. (no pagination), 2025. Date of Publication: 2025.
Author
Polat E.; Kharbanda R.K.; Ghafar M.; Schoones J.W.; Klautz R.J.M.; de Riva
M.; Palmen M.; Girdauskas E.; Tomsic A.
Institution
(Polat, Girdauskas, Tomsic) Department of Cardiothoracic Surgery, Augsburg
University Medical Centre, Augsburg, Germany
(Kharbanda, Ghafar, Klautz, Palmen) Department of Cardiothoracic Surgery,
Leiden University Medical Centre, Leiden, Netherlands
(Schoones) Directorate of Research Policy, Leiden University Medical
Centre, Leiden, Netherlands
(de Riva) Department of Cardiology, Leiden University Medical Centre,
Leiden, Netherlands
Publisher
Elsevier Inc.
Abstract
Background: Atrial fibrillation (AF) is common in patients undergoing
surgical aortic valve replacement; however, surgical ablation remains
underused due to limited data on its efficacy. <br/>Method(s): We
conducted a systematic review of the literature by searching PubMed,
Embase, Web of Science, Emcare, and the Cochrane Library for studies
reporting outcomes of concomitant surgical AF ablation in patients
undergoing surgical aortic valve replacement. The primary outcomes
included freedom from AF recurrence, overall survival, and complications.
We analyzed outcomes using traditional meta-analysis at specific time
points, alongside pooled Kaplan-Meier curves. <br/>Result(s): Nine studies
were included, encompassing a total of 12,683 patients. Concomitant
ablation reduced the risk of postoperative AF but increased the risk of
permanent pacemaker implantation (risk ratio 1.36, 95% confidence interval
[CI] 1.16-1.60, P < 0.01) and postoperative renal failure (RR 1.38, 95% CI
1.11-1.71, P < 0.01). During follow-up, concomitant ablation effectively
restored and maintained sinus rhythm, with up to 80% of patients remaining
free from recurrent AF 2-4 years post-surgery. Moreover, improved late
survival was observed with concomitant ablation (unadjusted hazard ratio
0.84, 95% CI 0.73-0.96, P = 0.013). <br/>Conclusion(s): Surgical ablation
during surgical aortic valve replacement was effective in restoring and
maintaining sinus rhythm after surgery. Preoperative rhythm status may
play an important role in guiding treatment plans, potentially enhancing
the clinical outcomes for patients scheduled for aortic valve
intervention.<br/>Copyright &#xa9; 2025 The Authors

<125>
Accession Number
647535620
Title
The prognosis of moderate in stent restenosis detected at third month
control coronary angiography after stent implantation.
Source
Anatolian Journal of Cardiology. Conference: 31st Turkish Cardiology
Congress. Antalya Turkey. 15(Supplement 1) (pp 30), 2015. Date of
Publication: 01 Oct 2015.
Author
Haqmal H.; Yuksel U.C.; Ozturk C.; Demir M.; Yildirim A.O.; Iyisoy A.
Institution
(Haqmal, Yuksel, Ozturk, Demir, Yildirim, Iyisoy) Gulhane Military Medical
Academy (GMMA) Ankara, Ankara, Turkey
Publisher
Turkish Society of Cardiology
Abstract
Introduction: Stent restenosis is a yet unsolved problem, so there were
few reports of prospective randomized clinical studies about comparing the
efficacy of third month control angiographic results to detect the
prognosis of moderate ISR after BMS implantation. The aim of this study
was to evaluate the prognosis of moderate ISR and compare the sixth and
third month control coronary angiographic results after bare metal stent
(BMS) implantation. <br/>Material(s) and Method(s): This study is a
retrospectivet study included patients undergone bare metal stent
implantation in coronary angiography (CAG) laboratory in our centre. 248
patients who had procedural success of coronary stenting with BMS due to
of any indication of percutanous intervention (PCI) were enrolled and
moderate degree ISR in the 3th month angiographic follow-up from January
2012 to march 2013 were determined. The baseline characteristics,
angiographic and procedural parameters of these patients were determined.
Diagnosis of severity of in-stent restenosis was done by two blind
interventional cardiologists. <br/>Result(s): >70% ISR were accepted as
severe restenosis at third month control angiography. The patients who did
not come back were excluded from the study. Patients were grouped into two
groups. "No restenosis" (n=188) group consisted of patients having less
then 50% restenosis and "moderate restenosis group" consisted of patients
having restenosis 50-70% (n=60) based on the results of third month
control coronary angiogram. All patients had exercise treadmill test at
sixth months. 49 patients (%19.8) had positive test results. 47 of the 49
patients (95.9%) belonged to restenosis group. All of those 49 patients
had coronary angiograms and 45 (%91,8) of those patients required
revascularization due to severe restenosis at sixth months. Instent
restenosis rates were higher in hypertensive and diabetic patients (%54,
p<0.005 and %37 p<0.005 respectively). Correlation analysis revealed
lesion type, length, target vessel diameter, implanted number of stents
were all related with instent restenosis (p<0.005). Discussion and
<br/>Conclusion(s): We found that restenosis detected at third month
control coronary angiography frequently progressed to severe restenosis
which required reintervention at sixth months. Meticulous follow up is
required in such patients to prevent adverse cardiac events. Our study
showed the most powerful predictors of angiographic restenosis of
bare-metal stents were the post-procedure minimal luminal diameter,
presence of diabetes mellitus, hypertension, lesion type, length, target
vessel diameter and number of stents. Thus, all patients with these risk
factors may need more aggressive risk modification and aggressive
angiographic follow-up.

<126>
Accession Number
647535937
Title
The effects of NAC on renal functions evaluated by NGAL blood levels in
geriatric patients undergoing CABG.
Source
Anatolian Journal of Cardiology. Conference: 31st Turkish Cardiology
Congress. Antalya Turkey. 15(Supplement 1) (pp 75), 2015. Date of
Publication: 01 Oct 2015.
Author
Carsanba G.; Aldemir M.; Bugra Koca H.; Dogan Baki E.; Ozturk Kavrut N.;
Sait Kavakli A.; Adali F.; Emmiler M.; Darcin O.T.
Institution
(Carsanba, Aldemir, Bugra Koca, Dogan Baki, Adali, Darcin) Afyon Kocatepe
University, Faculty of Medicine, Afyon, Turkey
(Ozturk Kavrut, Sait Kavakli, Emmiler) Antalya Education and Research
Hospital, Antalya, Turkey
Publisher
Turkish Society of Cardiology
Abstract
Introduction: Recent conflicting studies on the renal effects of N-acetyl
cysteine (NAC) after cardiac surgery have been published. The aim of this
study was to evaluate the renal effects of NAC using neutrophil
gelatinase-associated lipocalin (NGAL) blood levels in elderly patients
undergoing coronary artery bypass surgery. <br/>Material(s) and Method(s):
This randomized, double-blinded, placebo-controlled study was conducted
among geriatric patients (>65 years) scheduled for CABG. A total of 60
consecutive patients were randomly assigned into two groups. The first
group received I.V. NAC (n=30) and the second group received placebo
(n=30) at induction of anaesthesia and then for 20 hrs. NGAL values were
determined and conventional renal function tests were performed.
<br/>Result(s): Plasma creatinine level at the P.O. 24th hr was
significantly higher in the placebo group than the NAC group (1.41+/-0.63
vs 1.13+/-0.35, p<0.05). The mean serum NGAL level in the third
postoperative hour was higher in the placebo group than in the NAC group
(104.94+/-30.51 vs 87.82+/-25.18, p<0.05). Its level was similar at all
other measurement times for the two groups. The number of patients (%)
with increased plasma creatinine >=1.5 mg/dL or >25% of the baseline value
at any time of the study period was 27% in the NAC group and 37% in the
placebo group, which was statistically significant (p<0.05). Discussion
and <br/>Conclusion(s): In the present study, we found that I.V.
N-acetylcysteine infusion in elderly patients undergoing coronary artery
by-pass surgery reduced the incidence of acute kidney injury as determined
by blood NGAL and creatinine levels.

<127>
Accession Number
647535887
Title
Nebivolol compared with metoprolol for erectile function in males
undergoing coronary artery bypass graft.
Source
Anatolian Journal of Cardiology. Conference: 31st Turkish Cardiology
Congress. Antalya Turkey. 15(Supplement 1) (pp 34), 2015. Date of
Publication: 01 Oct 2015.
Author
Tecer E.; Aldemir M.; Keles I.; Karalar M.; Adali F.; Pektas M.B.; Parlar
A.I.; Darcin O.T.
Institution
(Tecer, Aldemir, Keles, Karalar, Adali, Pektas, Darcin) Afyon Kocatepe
University, Faculty of Medicine, Afyon, Turkey
(Parlar) Private Acute Heart Hospital, Izmir, Turkey
Publisher
Turkish Society of Cardiology
Abstract
Introduction: The aim of this study was to evaluate the effects of two
widely used adrenoceptor betablockers, namely nebivolol and metoprolol on
erectile function in males undergoing coronary artery bypass grafting.
<br/>Material(s) and Method(s): Sixty patients scheduled for coronary
artery bypass grafting surgery were randomly assigned into two groups: the
N group, which received 5 mg of nebivolol orally for 2 weeks before
surgery plus 12 weeks after surgery or the M group, which received 50 mg
of metoprolol orally for the same period. All patients were evaluated by
the erectile function domain of the International Index of Erectile
Function (IIEF) at time of admission (before starting beta blocker) and
three months after surgery. <br/>Result(s): In the metoprolol group, the
mean IIEF-5 score decreased significantly from a baseline of 15.2+/-5.8 to
12.9+/-5.8 (p<0.001), but in the nebivolol group this difference was not
statistically significant (from baseline 12.9+/-5.5 to 12.4+/-5.5 and
p=0.053). For all patients the mean IIEF-5 score decreased significantly
from a baseline of 14.0+/-5.7 to 12.6+/-5.6 (p<0.001). Discussion and
<br/>Conclusion(s): While the selective beta1-blocker metoprolol
significantly affects erectile function, the vasodilating selective
beta1-blocker nebivolol exerts protective effects on erectile function
against the disruptive effects of CPB in patients undergoing CABG. (Table
Presented).

<128>
Accession Number
647536100
Title
Prospective observational comparison of TTR in patients followed by
specialized INR outpatient clinic and by the general cardiology outpatient
clinic.
Source
Anatolian Journal of Cardiology. Conference: 31st Turkish Cardiology
Congress. Antalya Turkey. 15(Supplement 1) (pp 41), 2015. Date of
Publication: 01 Oct 2015.
Author
Kilic S.; Yuce E.I.; Simsek E.; Yagmur B.; Kemal H.S.; Akgul N.M.; Cinar
C.S.; Zoghi M.; Gurgun C.
Institution
(Kilic, Yuce, Simsek, Yagmur, Kemal, Akgul, Cinar, Zoghi, Gurgun) Ege
University, Faculty of Medicine, Izmir, Turkey
Publisher
Turkish Society of Cardiology
Abstract
Introduction: The comparison of target therapeutic range (TTR) period of
INR in one-year warfarin users followed in the same centre by educated,
single health personnel and by general cardiology outpatient clinic
<br/>Material(s) and Method(s): One-year individual TTR percentage of INR
values in patients followed in our tertiary centre, by specialized INR
outpatient clinic (Group A, n=233) and by general cardiology outpatient
clinic (Group B, n=148) was calculated by Roosendaal formula. Target INR
values for atrial fibrillation (AF) and other reasons for warfarin use was
defined as 2-3 and for prosthetic valve as 2.5-3.5. <br/>Result(s): There
was no significant difference between groups in basal characteristics of
the patients such as, sex, age, heart failure, hypertension, diabetes
mellitus, smoke, renal failure and anti-inflammatory use. The mean age of
patients was 62+/-12.3 years and 43.8% (n=167) were male. All of the
patients were using warfarin for a long time and 64.8% for more than 3
years. In Group A warfarin was used for AF more often (59.1%) and Group B
the use for AF and prosthetic valve was equal. There was no significant
difference between groups in terms of factors effecting on reaching target
INR level, such as gender, educational degree, antiplatelet use, advanced
age (>75, n=67) and lifestyle. The average number of INR control in a-year
was 14.1+/-3.6 and was similar in both groups. There were no significant
difference between HAS-BLED score and CHADS2-VASc2 score of the groups.
Group B had high risk of embolism with an average CHADS2-VASc2 score of
3.5, while a relatively low risk of bleeding with an average HAS-BLED
score of 2.09+/-1.3. The average TTR of the whole study group was
62.1+/-20.7% and there was a significant difference between groups (Group
A, 68.8%+/-15.8% vs. Group 51.6%+/-23%, p<0.001). Bleeding complications
occurred in 93 patients and 26.8% of them (n = 25) had a major bleeding
(The Bleeding Academic Research Consortium [BARC 3 and above]) and no
significant difference between the groups. Discussion and
<br/>Conclusion(s): Despite tight controls of INR levels, most randomized
controlled trials' TTR percentages do not surpass 70%. In real life
experiences, these rates fall further. In our study, the real-life
experience shows that, while TTR percentage of general outpatient
follow-up is 51.6%, it is 68.8% in specialized outpatient follow-up,
revealing the importance of specialized clinics. In conclusion, our study
shows that with similar INR level controls in a year, specialized
outpatient clinics are more effective in reaching TTR rates than general
cardiology outpatient clinics.

<129>
Accession Number
2034828373
Title
Stroke prevention in atrial fibrillation: A narrative review of current
evidence and emerging strategies.
Source
European Journal of Clinical Investigation. (no pagination), 2025. Date
of Publication: 2025.
Author
Askarinejad A.; Lane D.A.; Sadeghipour P.; Haghjoo M.; Lip G.Y.H.
Institution
(Askarinejad, Lane, Lip) Liverpool Centre for Cardiovascular Sciences at
University of Liverpool, Liverpool John Moores University and Liverpool
Heart & Chest Hospital, Liverpool, United Kingdom
(Askarinejad, Lane, Lip) Department of Cardiovascular and Metabolic
Medicine, Institute of Life Course and Metabolic Medicine, University of
Liverpool, Liverpool, United Kingdom
(Lane, Lip) Department of Clinical Medicine, Aalborg University, Aalborg,
Denmark
(Sadeghipour, Haghjoo) Rajaie Cardiovascular, Medical, and Research
Center, Iran University of Medical Sciences, Tehran, Iran, Islamic
Republic of
(Lip) Medical University of Bialystok, Bialystok, Poland
Publisher
John Wiley and Sons Inc
Abstract
Background: Atrial fibrillation (AF), the most prevalent cardiac
arrhythmia, is associated with a significantly increased risk of mortality
and morbidity from stroke, thromboembolism and dementia. Recent advances
in stroke prevention strategies necessitate an updated approach to
management. <br/>Result(s): Published evidence shows that the Atrial
Fibrillation Better Care (ABC) pathway significantly improves stroke
prevention outcomes in AF patients, reducing mortality, stroke incidence
and bleeding events. Characterisation of AF using the 4S-AF framework
helped guide personalised treatment selection and was associated with
improved clinical outcomes. For patients unsuitable for anticoagulation,
left atrial appendage occlusion has been identified as a viable
alternative. Digital health technologies demonstrate increasing utility in
early AF detection to enable timely stroke prevention interventions. There
is evidence for the dynamic nature of stroke (and bleeding) risk, as well
as arrhythmia burden and AF progression over time, in addition to changes
in ABC pathway adherence. <br/>Conclusion(s): Effective stroke prevention
in AF requires a comprehensive holistic approach incorporating appropriate
risk stratification, guideline-adherent anticoagulation and management of
underlying cardiovascular conditions and other comorbidities. The ABC
pathway, supported by characterisation using the 4S-AF framework, provides
a structured approach to optimise outcomes. Regular reassessment of risk,
along with careful selection of anticoagulation strategies, remains
crucial. Integration of digital health technologies and structured care
pathways shows promise in improving patient outcomes.<br/>Copyright &#xa9;
2025 The Author(s). European Journal of Clinical Investigation published
by John Wiley & Sons Ltd on behalf of Stichting European Society for
Clinical Investigation Journal Foundation.

<130>
Accession Number
2039030077
Title
Left Atrial Appendage Closure after Ablation for Atrial Fibrillation.
Source
New England Journal of Medicine. 392(13) (pp 1277-1287), 2025. Date of
Publication: 03 Apr 2025.
Author
Wazni O.M.; Saliba W.I.; Nair D.G.; Marijon E.; Schmidt B.; Hounshell T.;
Ebelt H.; Skurk C.; Oza S.; Patel C.; Kanagasundram A.; Sadhu A.; Sundaram
S.; Osorio J.; Mark G.; Gupta M.; Delurgio D.B.; Olson J.; Nielsen-Kudsk
J.E.; Boersma L.V.A.; Healey J.S.; Phillips K.P.; Asch F.M.; Wolski K.;
Roy K.; Christen T.; Sutton B.S.; Stein K.M.; Reddy V.Y.
Institution
(Wazni, Saliba, Wolski) Cleveland Clinic, Cleveland, United States
(Nair) St. Bernards Medical Center, Arrhythmia Research Group, Jonesboro,
AR, United States
(Marijon) Cardiology Department, Georges Pompidou European Hospital,
Paris, France
(Schmidt) Cardioangiologisches Centrum Bethanien, Agaplesion Markus
Krankenhaus, Frankfurt am Main, Germany
(Hounshell) Iowa Heart Center, West Des Moines, United States
(Ebelt) Catholic Hospital, Sankt Johann Nepomuk, Erfurt, Germany
(Skurk) Deutsches Herzzentrum der Charite (DHZC), Campus Benjamin
Franklin, Berlin, Germany
(Oza) Ascension St. Vincent's Medical Center, Jacksonville, FL, United
States
(Patel) UPMC Pinnacle, Harrisburg, PA, United States
(Kanagasundram) Vanderbilt University, Nashville, United States
(Sadhu) Phoenix Cardiovascular Research Group, Phoenix, AZ, United States
(Sundaram) South Denver Cardiology, Littleton, CO, United States
(Osorio) Grandview Medical Center, Birmingham, AL, United States
(Mark) Heart House-Cooper University, Camden, NJ, United States
(Gupta) Lindner Center for Research and Education, Christ Hospital,
Cincinnati, United States
(Delurgio) Emory University, Atlanta, United States
(Olson) St. Vincent Heart Center of Indiana, Indianapolis, United States
(Nielsen-Kudsk) Department of Cardiology, Aarhus University Hospital,
Aarhus, Denmark
(Boersma) Amsterdam University Medical Center, Amsterdam, Netherlands
(Boersma) St. Antonius Hospital, Nieuwegein, Netherlands
(Healey) Population Health Research Institute, Hamilton, ON, Canada
(Phillips) Brisbane AF Clinic, Greenslopes Private Hospital, Brisbane,
QLD, Australia
(Asch) Medstar Health Research Institute, Medstar Washington Hospital
Center, Washington, DC, United States
(Roy, Christen, Sutton, Stein) Boston Scientific, Marlborough, MA, United
States
(Reddy) Mount Sinai Fuster Heart Hospital School of Medicine, New York,
United States
Publisher
Massachussetts Medical Society
Abstract
Background Oral anticoagulation is recommended after ablation for atrial
fibrillation among patients at high risk for stroke. Left atrial appendage
closure is a mechanical alternative to anticoagulation, but data regarding
its use after atrial fibrillation ablation are lacking. Methods We
conducted an international randomized trial involving 1600 patients with
atrial fibrillation who had an elevated score (>=2 in men and >=3 in
women) on the CHA2DS2-VASc scale (range, 0 to 9, with higher scores
indicating a greater risk of stroke) and who underwent catheter ablation.
Patients were randomly assigned in a 1:1 ratio to undergo left atrial
appendage closure or receive oral anticoagulation. The primary safety end
point, tested for superiority, was non-procedure-related major bleeding or
clinically relevant nonmajor bleeding. The primary efficacy end point,
tested for noninferiority, was a composite of death from any cause,
stroke, or systemic embolism at 36 months. The secondary end point, tested
for noninferiority, was major bleeding, including procedure-related
bleeding, through 36 months. Results A total of 803 patients were assigned
to undergo left atrial appendage closure, and 797 to receive anticoagulant
therapy. The mean (+/-SD) age of the patients was 69.6+/-7.7 years, 34.1%
of the patients were women, and the mean CHA2DS2-VASc score was 3.5+/-1.3.
At 36 months, a primary safety end-point event had occurred in 65 patients
(8.5%) in the left atrial appendage closure group (device group) and in
137 patients (18.1%) in the anticoagulation group (P<0.001 for
superiority); a primary efficacy end-point event had occurred in 41
patients (5.3%) and 44 patients (5.8%), respectively (P<0.001 for
noninferiority); and a secondary end-point event had occurred in 3.9% and
5.0% (P<0.001 for noninferiority). Complications related to the appendage
closure device or procedure occurred in 23 patients. Conclusions Among
patients who underwent catheter-based atrial fibrillation ablation, left
atrial appendage closure was associated with a lower risk of
non-procedure-related major or clinically relevant nonmajor bleeding than
oral anticoagulation and was noninferior to oral anticoagulation with
respect to a composite of death from any cause, stroke, or systemic
embolism at 36 months. (Funded by Boston Scientific; OPTION
ClinicalTrials.gov number, NCT03795298.)<br/>Copyright &#xa9; 2024
Massachusetts Medical Society.

<131>
Accession Number
2039032350
Title
Dapagliflozin in Patients Undergoing Transcatheter Aortic-Valve
Implantation.
Source
New England Journal of Medicine. 392(14) (pp 1396-1405), 2025. Date of
Publication: 10 Apr 2025.
Author
Raposeiras-Roubin S.; Amat-Santos I.J.; Rossello X.; Gonzalez Ferreiro R.;
Gonzalez Bermudez I.; Lopez Otero D.; Nombela-Franco L.; Gheorghe L.; Diez
J.L.; Baladron Zorita C.; Baz J.A.; Munoz Garcia A.J.; Vilalta V.;
Ojeda-Pineda S.; De La Torre Hernandez J.M.; Cordoba Soriano J.G.;
Regueiro A.; Bordes Siscar P.; Salgado Fernandez J.; Garcia Del Blanco B.;
Martin-Reyes R.; Romaguera R.; Moris C.; Garcia Blas S.; Franco-Pelaez
J.A.; Cruz-Gonzalez I.; Arzamendi D.; Romero Rodriguez N.; Diez-Del Hoyo
F.; Camacho Freire S.; Bosa Ojeda F.; Astorga Burgo J.C.; Molina Navarro
E.; Caballero Borrego J.; Ruiz Quevedo V.; Sanchez-Recalde A.; Peral
Disdier V.; Alegria-Barrero E.; Torres-Llergo J.; Feltes G.; Fernandez
Diaz J.A.; Cuellas C.; Jimenez Britez G.; Sanchez-Rubio Lezcano J.;
Barreiro-Pardal C.; Nunez-Gil I.; Abu-Assi E.; Iniguez-Romo A.; Fuster V.;
Ibanez B.
Institution
(Raposeiras-Roubin, Rossello, Fuster) Centro Nacional de Investigaciones
Cardiovasculares Carlos III, Madrid, Spain
(Gonzalez Ferreiro, Gonzalez Bermudez, Baz, Iniguez-Romo) Cardiology
Department, University Hospital Alvaro Cunqueiro, Instituto de
Investigacion Sanitaria Galiciasur, Vigo, Spain
(Raposeiras-Roubin) University of Santiago de Compostela, Santiago de
Compostela, Spain
(Amat-Santos, Rossello, Lopez Otero, Baladron Zorita, Baz, Ojeda-Pineda,
Garcia Del Blanco, Garcia Blas, Cruz-Gonzalez, Iniguez-Romo) Centro de
Investigacion Biomedica en Red en Enfermedades Cardiovasculares, Madrid,
Spain
(Amat-Santos, Baladron Zorita) Cardiology Department, University Clinical
Hospital of Valladolid, Valladolid, Spain
(Rossello, Peral Disdier) Cardiology Department, University Hospital Son
Espases, Instituto de Investigacion Sanitaria Islas Baleares, Palma de
Mallorca, Spain
(Rossello) Universitat de les Illes Balears, Palma, Spain
(Lopez Otero) Cardiology Department, University Hospital Montecelo,
Pontevedra, Spain
(Nombela-Franco, Nunez-Gil) Cardiology Department, University Clinical
Hospital, San Carlos, Madrid, Spain
(Gheorghe) Cardiology Department, University Hospital Puerta Del Mar,
Cadiz, Spain
(Diez) Cardiology Department, University Hospital la Fe, Valencia, Spain
(Munoz Garcia) Cardiology Department, University Hospital Virgen de la
Victoria, Malaga, Spain
(Vilalta) Cardiology Department, University Hospital German Trias i Pujol,
Badalona, Spain
(Ojeda-Pineda, Ibanez) Cardiology Department, University Hospital Reina
Sofia, Cordoba, Spain
(De La Torre Hernandez) Cardiology Department, University Hospital Marques
de Valdecilla, Instituto de Investigacion Sanitaria Valdecilla, Santander,
Spain
(Cordoba Soriano) Cardiology Department, University Hospital of Albacete,
Albacete, Spain
(Regueiro) Cardiology Department, University Clinical Hospital, Barcelona,
Spain
(Bordes Siscar) Cardiology Department, University General Hospital of
Alicante, Alicante, Spain
(Salgado Fernandez) Cardiology Department, University Hospital Juan
Canalejo, A Coruna, Spain
(Garcia Del Blanco) Cardiology Department, University Hospital Vall
d'Hebron, Barcelona, Spain
(Martin-Reyes) Cardiology Department, University Hospital la Luz, Madrid,
Spain
(Romaguera) Cardiology Department, University Hospital Bellvitge,
Barcelona, Spain
(Moris) Cardiology Department, University Hospital Central de Asturias,
Oviedo, Spain
(Garcia Blas) Cardiology Department, University Clinical Hospital of
Valencia, Valencia, Spain
(Franco-Pelaez, Ibanez) Cardiology Department, University Hospital
Fundacion Jimenez Diaz, Instituto de Investigacion Sanitaria-Fundacion
Jimenez Diaz, Universidad Autonoma de Madrid, Madrid, Spain
(Cruz-Gonzalez) Cardiology Department, University Clinical Hospital of
Salamanca, Salamanca, Spain
(Arzamendi) Cardiology Department, University Hospital Santa Creu i Sant
Pau, Biomedical Research Institute IIB-Sant Pau, Barcelona, Spain
(Romero Rodriguez) Cardiology Department, University Hospital Virgen Del
Rocio, Seville, Spain
(Diez-Del Hoyo) Cardiology Department, University Hospital 12 de Octubre,
Madrid, Spain
(Camacho Freire) Cardiology Department, University Hospital Juan Ramon
Jimenez, Huelva, Spain
(Bosa Ojeda) Cardiology Department, University Hospital of Canarias,
Tenerife, Spain
(Astorga Burgo) Cardiology Department, University Hospital of Cruces,
Baracaldo, Spain
(Molina Navarro) Cardiology Department, University Hospital Virgen de Las
Nieves, Granada, Spain
(Caballero Borrego) Cardiology Department, University Hospital San
Cecilio, Granada, Spain
(Ruiz Quevedo) Cardiology Department, University Hospital of Navarra,
Pamplona, Spain
(Sanchez-Recalde) Cardiology Department, University Hospital Ramon y
Cajal, Madrid, Spain
(Alegria-Barrero) Cardiology Department, University Hospital Torrejon,
University Francisco de Vitoria, Madrid, Spain
(Torres-Llergo) Cardiology Department, University Hospital of Jaen, Jaen,
Spain
(Feltes) Cardiology Department, University Hospital Vithas Arturo Soria,
Madrid, Spain
(Feltes, Nunez-Gil) University Europea of Madrid, Madrid, Spain
(Fernandez Diaz) Cardiology Department, University Hospital Puerta Del
Hierro, Madrid, Spain
(Cuellas) Cardiology Department, University Hospital of Leon, Leon, Spain
(Jimenez Britez) Cardiology Department, Clinica Teknon, Barcelona, Spain
(Sanchez-Rubio Lezcano) Cardiology Department, University Hospital Miguel
Servet, Zaragoza, Spain
(Barreiro-Pardal) Anesthesiology Department, University Hospital
Montecelo, Pontevedra, Spain
(Nunez-Gil) Cardiology Department, University Hospital of Torrejon, Ribera
Salud Group, Madrid, Spain
(Abu-Assi) Cardiology Department, University Hospital of Povisa, Ribera
Salud Group, Vigo, Spain
(Fuster) Cardiovascular Institute, Icahn School of Medicine at Mount
Sinai, New York, United States
Publisher
Massachussetts Medical Society
Abstract
Background Sodium-glucose cotransporter 2 (SGLT2) inhibitors reduce the
risk of heart-failure admission among high-risk patients. However, most
patients with valvular heart disease, including those undergoing
transcatheter aortic-valve implantation (TAVI), have been excluded from
randomized trials. Methods We conducted this randomized, controlled trial
in Spain to evaluate the efficacy of dapagliflozin (at a dose of 10 mg
once daily) as compared with standard care alone in patients with aortic
stenosis who were undergoing TAVI. All the patients had a history of heart
failure plus at least one of the following: renal insufficiency, diabetes,
or left ventricular systolic dysfunction. The primary outcome was a
composite of death from any cause or worsening of heart failure, defined
as hospitalization or an urgent visit, at 1 year of follow-up. Results A
total of 620 patients were randomly assigned to receive dapagliflozin and
637 to receive standard care alone after TAVI; after exclusions, a total
of 1222 patients were included in the primary analysis. A primary-outcome
event occurred in 91 patients (15.0%) in the dapagliflozin group and in
124 patients (20.1%) in the standard-care group (hazard ratio, 0.72; 95%
confidence interval [CI], 0.55 to 0.95; P=0.02). Death from any cause
occurred in 47 patients (7.8%) in the dapagliflozin group and in 55 (8.9%)
in the standard-care group (hazard ratio, 0.87; 95% CI, 0.59 to 1.28).
Worsening of heart failure occurred in 9.4% and 14.4% of the patients,
respectively (subhazard ratio, 0.63; 95% CI, 0.45 to 0.88). Genital
infection and hypotension were significantly more common in the
dapagliflozin group. Conclusions Among older adults with aortic stenosis
undergoing TAVI who were at high risk for heart-failure events,
dapagliflozin resulted in a significantly lower incidence of death from
any cause or worsening of heart failure than standard care
alone.<br/>Copyright &#xa9; 2025 Massachusetts Medical Society.

<132>
Accession Number
2039066258
Title
Right Ventricular Function and Echocardiographic Pressure-Volume Loops:
Overview and Perioperative Clinical Implications.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2025.
Date of Publication: 2025.
Author
Ahmed U.; Mahmood F.; Nicoara A.; Kiarad V.
Institution
(Ahmed, Mahmood, Kiarad) Department of Anesthesia, Beth Israel Deaconess
Medical Center, Harvard Medical School, Boston, MA, United States
(Nicoara) Department of Anesthesiology, Duke University Hospital, Durham,
NC, United States
Publisher
W.B. Saunders
Abstract
Right ventricular (RV) mechanics have critical roles in cardiovascular
physiology, yet their assessment remains challenging owing to the right
ventricle's complex geometry and unique interaction with the pulmonary
vascular system. This review explores RV structural, functional, and
physiologic considerations, emphasizing their interplay with pulmonary
hypertension (PH), heart failure, and perioperative outcomes. Traditional
pressure- and volume-centric methods of RV evaluation, including
echocardiography and right heart catheterization, often fail to provide
comprehensive, load-independent measures of RV function. The integration
of these measures for pressure-volume (PV) loop analysis has emerged as a
valuable tool, offering insights into RV contractility, compliance, and
ventriculoarterial coupling. This review highlights advances in
intraoperative and noninvasive PV loop methodologies, including
echocardiography-derived techniques and integration with catheter-based
pressure measurements. These approaches enable detailed assessment of RV
function, enhancing prognostic capabilities in such conditions as PH,
heart failure with preserved ejection fraction, and postsurgical
interventions like left ventricular assist device implantation and valve
replacement. Despite the potential of RV PV loop analysis, its clinical
adoption has been limited by technical complexities, cost, and the need
for specialized expertise. This underscores the importance of
standardizing PV loop acquisition techniques and validating surrogate
markers, such as tricuspid annular plane systolic excursion/pulmonary
artery systolic pressure ratio, to improve accessibility and utility. By
providing a comprehensive overview of current and emerging methods for RV
assessment, this review aims to foster a deeper understanding of RV
mechanics, driving innovation in diagnostic, therapeutic, and prognostic
strategies for cardiac surgeries.<br/>Copyright &#xa9; 2025 Elsevier Inc.

<133>
Accession Number
2039066230
Title
Colchicine in Acute Myocardial Infarction.
Source
New England Journal of Medicine. 392(7) (pp 633-642), 2025. Date of
Publication: 13 Feb 2025.
Author
Jolly S.S.; D'Entremont M.-A.; Lee S.F.; Mian R.; Tyrwhitt J.; Kedev S.;
Montalescot G.; Cornel J.H.; Stankovic G.; Moreno R.; Storey R.F.; Henry
T.D.; Mehta S.R.; Bossard M.; Kala P.; Layland J.; Zafirovska B.;
Devereaux P.J.; Eikelboom J.; Cairns J.A.; Shah B.; Sheth T.; Sharma S.K.;
Tarhuni W.; Conen D.; Tawadros S.; Lavi S.; Yusuf S.
Institution
(Jolly, D'Entremont, Lee, Mian, Tyrwhitt, Mehta, Devereaux, Eikelboom,
Sheth, Conen, Tawadros, Yusuf) Population Health Research Institute,
McMaster University, Hamilton, ON, Canada
(Jolly, D'Entremont, Lee, Mian, Mehta, Devereaux, Eikelboom, Sheth, Conen)
Hamilton Health Sciences, Hamilton, ON, Canada
(D'Entremont) Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke,
QC, Canada
(Kedev, Zafirovska) Medical Faculty, University Clinic of Cardiology,
University Ss. Cyril and Methodius, Skopje, North Macedonia
(Montalescot) Centre Hospitalier Universitaire Pitie-Salpetriere
Assistance Publique-Hopitaux de Paris, ACTION Study Group, Sorbonne
University, Paris, France
(Cornel) Dutch Network for Cardiovascular Research, Utrecht, Netherlands
(Cornel) Radboud University Medical Center, Nijmegen, Netherlands
(Cornel) Northwest Clinics, Alkmaar, Netherlands
(Stankovic) University Clinical Center of Serbia , Faculty of Medicine,
University of Belgrade, Belgrade, Serbia
(Moreno) Cardiology Department, University Hospital la Paz, Madrid, Spain
(Storey) NIHR Sheffield Biomedical Research Centre, Sheffield Teaching
Hospitals NHS Foundation Trust, Sheffield, United Kingdom
(Storey) Division of Clinical Medicine, University of Sheffield,
Sheffield, United Kingdom
(Henry) Caril and Edyth Lindner Center for Research and Education, Christ
Hospital Health Network, Cincinnati, United States
(Bossard) Cardiology Division, Faculty of Health Sciences and Medicine,
University of Lucerne, Heart Center, Luzerner Katonsspital, Lucerne,
Switzerland
(Kala) University Hospital Brno, Brno, Czechia
(Layland) Department of Cardiology, Peninsula Health, Frankston, VIC,
Australia
(Layland) Peninsula Clinical School, Monash University, Melbourne, VIC,
Australia
(Cairns) University of British Columbia , Centre for Cardiovascular
Innovation, Vancouver Coastal Health, Vancouver, Canada
(Shah) Department of Medicine, Division of Cardiology, NYU Grossman School
of Medicine, New York, United States
(Shah) Department of Medicine, Section of Cardiology, VA New York Harbor
Healthcare System, New York, United States
(Sharma) B.P. Koirala Institute of Health Sciences, Dharan, Nepal
(Tarhuni) Department of Medicine, University of Saskatchewan, Moose Jaw,
Canada
(Lavi) London Health Sciences Centre, University of Western Ontario,
London, Canada
Publisher
Massachussetts Medical Society
Abstract
Background Inflammation is associated with adverse cardiovascular events.
Data from recent trials suggest that colchicine reduces the risk of
cardiovascular events. Methods In this multicenter trial with a 2-by-2
factorial design, we randomly assigned patients who had myocardial
infarction to receive either colchicine or placebo and either
spironolactone or placebo. The results of the colchicine trial are
reported here. The primary efficacy outcome was a composite of death from
cardiovascular causes, recurrent myocardial infarction, stroke, or
unplanned ischemia-driven coronary revascularization, evaluated in a
time-to-event analysis. C-reactive protein was measured at 3 months in a
subgroup of patients, and safety was also assessed. Results A total of
7062 patients at 104 centers in 14 countries underwent randomization; at
the time of analysis, the vital status was unknown for 45 patients (0.6%),
and this information was most likely missing at random. A primary-outcome
event occurred in 322 of 3528 patients (9.1%) in the colchicine group and
327 of 3534 patients (9.3%) in the placebo group over a median follow-up
period of 3 years (hazard ratio, 0.99; 95% confidence interval [CI], 0.85
to 1.16; P=0.93). The incidence of individual components of the primary
outcome appeared to be similar in the two groups. The least-squares mean
difference in C-reactive protein levels between the colchicine group and
the placebo group at 3 months, adjusted according to the baseline values,
was -1.28 mg per liter (95% CI, -1.81 to -0.75). Diarrhea occurred in a
higher percentage of patients with colchicine than with placebo (10.2% vs.
6.6%; P<0.001), but the incidence of serious infections did not differ
between groups. Conclusions Among patients who had myocardial infarction,
treatment with colchicine, when started soon after myocardial infarction
and continued for a median of 3 years, did not reduce the incidence of the
composite primary outcome (death from cardiovascular causes, recurrent
myocardial infarction, stroke, or unplanned ischemia-driven coronary
revascularization).<br/>Copyright &#xa9; 2024 Massachusetts Medical
Society.

<134>
Accession Number
2036585882
Title
Erector spinae plane block for pain management after total hip
arthroplasty. A systematic review and meta-analysis.
Source
Chirurgia Narzadow Ruchu i Ortopedia Polska - Polish Orthopaedics. 89(4)
(pp 170-177), 2024. Date of Publication: 18 Nov 2024.
Author
Reysner T.; Kowalski G.; Resyner M.; Geisler-Wojciechowska A.; Grochowicka
M.; Wieczorowska-Tobis K.
Institution
(Reysner, Kowalski, Resyner, Geisler-Wojciechowska, Grochowicka,
Wieczorowska-Tobis) Department of Palliative Medicine, University of
Medical Sciences, Poznan, Poland
Publisher
Exemplum Scientific Publishing House
Abstract
Purpose. The Erector Spinae Plane Block (ESPB) is a widely used regional
anesthesia technique in breast, thoracic, and spine surgery. However, its
effectiveness and pain-relief capabilities in total hip arthroplasty have
not been definitively established. This meta-analysis seeks to establish
the analgesic effectiveness of ESPB in total hip arthroplasty. Methods. As
per PRISMA guidelines, we carried out a meta-analysis of prospective
randomized clinical trials that compared the effects of ESPB in the
control group and different peripheral nerve blocks in total hip
arthroplasty. The study was registered in the International Register of
Systematic Reviews (PROSPERO) and can be accessed online
(www.crd.york.uk/prospero, CRD42024498350). Results. Six studies involving
299 participants were critically evaluated and included for analysis. The
results showed that ultrasound-guided ESPB led to a decrease in
postoperative opioid consumption 24 hours after surgery compared to a
placebo (mean difference -4.29, 95% CI -5.33 to -3.25; p < 0.00001).
However, there were no significant differences in postoperative pain
scores at Department of Palliative Medicine, Poznan University of Medical
Sciences, Poznan, Poland 3-6 hours and 24 hours between the two groups.
Conclusion. ESPB improved the effectiveness of pain relief in total hip
arthroplasty, particularly without nerve block analgesia. More
high-quality, well-defined RCTs are urgently required to assess the pros
and cons of ESPB for total hip arthroplasty.<br/>Copyright &#xa9; 2024,
Exemplum Scientific Publishing House. All rights reserved.