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<1>
Accession Number
2039307051
Title
Management and outcome of whole-spine epidural abscesses - institutional
case series and systematic review.
Source
Brain and Spine. 5 (no pagination), 2025. Article Number: 104297. Date of
Publication: 01 Jan 2025.
Author
Schulz E.; Battig L.; Stengel F.C.; Bertulli L.; Hejrati N.; Wegener M.;
Strahm C.; Martens B.; Stienen M.N.; Motov S.
Institution
(Schulz, Battig, Stengel, Bertulli, Hejrati, Martens, Stienen, Motov)
Spine Centre of Eastern Switzerland, Cantonal Hospital of St. Gallen &
Medical School of St. Gallen, St. Gallen, Switzerland
(Schulz, Battig, Stengel, Bertulli, Hejrati, Stienen, Motov) Department of
Neurosurgery, Cantonal Hospital of St. Gallen & Medical School of St.
Gallen, St. Gallen, Switzerland
(Wegener) Department of Radiology, Cantonal Hospital of St. Gallen &
Medical School of St. Gallen, St. Gallen, Switzerland
(Strahm) Division of Infectious Diseases, Infection Prevention and Travel
Medicine, Cantonal Hospital of St. Gallen & Medical School of St. Gallen,
St. Gallen, Switzerland
(Martens) Department of Orthopaedic Surgery, Cantonal Hospital of St.
Gallen & Medical School of St. Gallen, St. Gallen, Switzerland
Publisher
Elsevier B.V.
Abstract
Background: Whole-spine epidural abscesses (WSEAs) are rare infections
with potentially devastating neurological sequelae. As common treatment
guidelines remain absent, this study aims to describe the management and
resulting outcomes of WSEAs through an institutional case series and
systematic literature review. Research question: What are the optimal
management strategies for WSEAs based on current evidence? Methods: We
retrospectively analyzed a series of WSEAs treated at our tertiary spine
center (2009-2024) and conducted a systematic review using PubMed, Ovid,
and Web of Science (1990-2024). Data on patient demographics, clinical
presentation, bacteriology, diagnostics, treatment strategies, and
outcomes were extracted. Statistical analyses included multivariate and
risk-factor analysis. Result(s): We identified 48 patients (mean age
54 years, 69 % male), including four from our institutional series.
Staphylococcus aureus was the most common pathogen (67 %). Five patients
(10.4 %) received only conservative antibiotic treatment, primarily those
with mild neurological deficits or severe comorbidities. Surgical
intervention was performed in 43 patients (89.6 %), mainly utilizing
skip-laminectomies (68.8 %) with catheter-based epidural irrigation.
Favourable outcomes were comparable between surgical (86.1 %) and
conservative (80.0 %) treatment (p = 0.567). Initial neurological status
strongly correlated with neurological outcome (Spearman's rho = 0.563, p =
0.0001). Discussion and conclusion: Both surgical and conservative
approaches can achieve favourable outcomes in selected WSEA cases. The
strong correlation between initial and final neurological status
emphasizes the importance of early diagnosis and targeted intervention.
Skip-laminectomies with catheter-based irrigation appear effective while
minimizing surgical morbidity. Conservative treatment may be considered in
neurologically intact patients under close surveillance. Larger
multicenter studies are needed to establish reliable treatment
algorithms. Copyright © 2025 The Authors

<2>
Accession Number
2034975293
Title
Development and validation of a novel prediction model for new-onset
atrial fibrillation after lung resection.
Source
Annals of Medicine. 57(1) (no pagination), 2025. Article Number: 2519673.
Date of Publication: 2025.
Author
Chen Y.; Hu Y.; Wang J.; Sun J.; Hu B.; Huang K.; He Z.; Liang C.; Lin Y.
Institution
(Chen, Hu, Wang, Hu, Huang, He, Liang) Department of Cardiology, Shanghai
Changzheng Hospital, Navy Medical University, Shanghai, China
(Chen, Wang, Hu, Huang, He, Liang) Shanghai Cardiovascular Institute of
Integrative Medicine, Shanghai, China
(Chen, Sun, Lin) Department of Cardiology, Fujian Medical University Union
Hospital, Fujian Heart Medical Center, Fujian Clinical Medical Research
Center for Heart and Macrovascular Diseases, Fujian Institute of Coronary
Artery Disease, Fuzhou, China
(Hu) Department of Pharmacy, Shanghai Changzheng Hospital, Navy Medical
University, China
Publisher
Taylor and Francis Ltd.
Abstract
Background: Postoperative atrial fibrillation (POAF) is the most prevalent
and potentially life-threatening arrhythmia following thoracic surgery.
This study aimed to construct and validate a predictive model for
assessing POAF risk. Method(s): A meta-analysis was conducted to rank
risk factors associated with POAF based on their respective risk ratios
(RRs). Significant risk factors identified from the meta-analyses were
incorporated into the model and assigned weights. External validation was
performed using a retrospective cohort from China. Receiver operating
characteristic (ROC) curves, calibration plots and decision curve analysis
(DCA) were employed to assess the model's predictive performance,
calibration and clinical utility. Result(s): We screened 40 cohort
studies involving 58,899 patients. We developed a risk model that
incorporated age >= 70 years (RR 2.10, 95% CI 1.34-3.30; p < 0.05), male
sex (RR 1.46, 95% CI 1.34-1.60; p < 0.05), COPD (RR 2.28, 95% CI
1.81-2.89; p < 0.05), CAD (RR 1.72, 95% CI 1.49-1.99; p < 0.05), heart
failure (RR 1.62, 95% CI 1.12-2.35; p < 0.05), pneumonectomy (RR 2.32, 95%
CI 2.01-2.67; p < 0.05) and lobectomy (RR 1.86, 95% CI 1.38-2.51; p <
0.05) and thoracotomy (RR 1.46, 95% CI 1.30-1.64; p < 0.05). Validation
was performed in an external cohort of 1546 participants, demonstrating
strong discrimination with an area under the receiver operating
characteristic curve (95% CI) of 0.89 (95% CI 0.81-0.83). The calibration
curve and DCA curve results demonstrated good concordance and
applicability. Conclusion(s): This model, built with easily
accessible clinical variables, could accurately predict the risk of POAF.
This holds promise for improving clinical decision making and guiding
early interventions. Copyright © 2025 The Author(s). Published by
Informa UK Limited, trading as Taylor & Francis Group.

<3>
Accession Number
2029239676
Title
Which should you choose for post operative atrial fibrillation, carvedilol
or metoprolol? A systemic review and meta-analysis.
Source
Current Problems in Cardiology. 49(2) (no pagination), 2024. Article
Number: 102220. Date of Publication: 01 Feb 2024.
Author
Abouzid M.R.; Vyas A.; Eldahtoury S.; Anwar J.; Naccour S.; Elshafei S.;
Memon A.; Subramaniam V.; Bennett W.; Morin D.P.; Lavie C.J.; Nwaukwa C.
Institution
(Abouzid, Eldahtoury, Anwar, Naccour, Elshafei, Memon, Nwaukwa) Department
of Internal Medicine, Baptist Hospitals of Southeast Texas, Beaumont, TX,
United States
(Vyas, Subramaniam, Bennett, Morin, Lavie) Department of Cardiology,
Ochsner Medical Center, New Orleans, LA, United States
Publisher
Elsevier Inc.
Abstract
Background: Postoperative atrial fibrillation (POAF) is the most common
arrhythmic complication following cardiac surgery. Current guidelines
suggest beta-blockers for the prevention of POAF. In comparing metoprolol
succinate with carvedilol, the later has sparked interest in its usage as
an important medication for POAF prevention. Method(s): We considered
randomized controlled studies (RCTs) and retrospective studies that
evaluated the efficacy of carvedilol versus metoprolol for the prevention
of POAF. After literature search, data extraction, and quality evaluation,
pooled data were analyzed using either the fixed-effect or random-effect
model using Review Manager 5.3. The Cochrane risk of bias tool was used to
assess the bias of included studies. The incidence of POAF was the primary
endpoint, while mortality rate and bradycardia were secondary outcomes.
 Result(s): In meta-analysis 5 RCTs and 2 retrospective studies with a
total of 1000 patients were included. The overall effect did not favor the
carvedilol over metoprolol groups in terms of mortality rate [risk ratio
0.45, 95 % CI (0.1-1.97), P=0.29] or incidence of bradycardia [risk ratio
0.63, 95 % CI (0.32-1.23), P=0.17]. However, the incidence of POAF was
lower in patients who received carvedilol compared to metoprolol [risk
ratio 0.54, 95 % CI (0.42-0.71), P < 0.00001]. Conclusion(s): In
patients undergoing cardiac surgery, carvedilol may minimize the
occurrence of POAF more effectively than metoprolol. To definitively
establish the efficacy of carvedilol compared to metoprolol and other
beta-blockers in the prevention of POAF, a large-scale, well-designed
randomized controlled trials are required. Copyright © 2023

<4>
Accession Number
2032319093
Title
Cardiovascular outcomes of sodium-glucose Co-transporter 2 inhibitors use
after myocardial infarction: A systematic review and meta-analysis of
randomized controlled trials.
Source
Current Problems in Cardiology. 49(8) (no pagination), 2024. Article
Number: 102648. Date of Publication: 01 Aug 2024.
Author
Idowu A.; Adebolu O.; Wattanachayakul P.; Obomanu E.; Shah S.; Lo K.B.;
Pressman G.
Institution
(Idowu, Adebolu, Wattanachayakul, Obomanu) Department of Medicine,
Jefferson-Einstein Medical Center, Philadelphia, PA, United States
(Shah, Pressman) Department of Cardiology, Jefferson-Einstein Medical
Center, Philadelphia, PA, United States
(Lo) Department of Cardiology, Brigham and Women's Hospital, Boston, MA,
United States
Publisher
Elsevier Inc.
Abstract
Background: Patients who had acute myocardial infarction are at high risk
of negative cardiac outcomes and previous SGLT2i landmark trials excluded
these patients. It therefore remains unclear if SGLT2i is safe and confers
beneficial cardiovascular outcomes after acute myocardial infarction.
 Method(s): We systematically reviewed randomized controlled trials
that evaluated the outcomes of adding SGLT2i to conventional
post-myocardial infarction care. Random-effects model meta-analysis via
RevMan 5.4 was done on data extracted from pooled 11,204 patients.
 Result(s): SGLT2i use after acute myocardial infarction was
significantly associated with reduced heart failure hospitalization (OR:
0.77, 95%CI: 0.62-0.96, p=0.02), but was not associated with a reduction
in all-cause mortality (OR: 1.05, 95%CI: 0.77-1.43, p=0.75),
cardiac-related death (OR: 1.04, 95%CI: 0.83-1.30, p=0.76), or major
adverse cardiac events (OR: 0.90, 95%CI: 0.77-1.05, p=0.18).
 Conclusion(s): SGLT2 inhibitor therapy after acute myocardial
infarction is safe and is associated with a reduced risk of heart failure
hospitalization, but not with all-cause mortality. Copyright ©
2024 Elsevier Inc.

<5>
Accession Number
2034841681
Title
Antegrade approach versus retrograde approach percutaneous coronary
intervention for chronic total occlusion: An updated meta-analysis.
Source
Current Problems in Cardiology. 49(12) (no pagination), 2024. Article
Number: 102832. Date of Publication: 01 Dec 2024.
Author
Abdelaziz A.; Hafez A.; Atta K.; Elsayed H.; Elaraby A.; Ibrahim A.A.;
Gadelmawla A.F.; Helmi A.; Abdelazeem B.; Lavie C.J.; Tafur-Soto J.
Institution
(Abdelaziz, Hafez, Atta, Elsayed, Elaraby, Ibrahim, Gadelmawla, Helmi,
Abdelazeem) Medical Research Group of Egypt (MRGE), Negida Academy,
Arlington, MA, United States
(Abdelaziz, Hafez, Elaraby) Faculty of Medicine, Al-Azhar University,
Cairo, Egypt
(Atta) Institute of Medicine, National Research Mordovia State University,
Saransk, Russian Federation
(Elsayed) Faculty of Medicine, Zagazig University, Zagazig, Egypt
(Ibrahim, Gadelmawla) Faculty of Medicine, Menoufia University, Menoufia,
Egypt
(Helmi) Faculty of Medicine, Alexandria University, Alexandria, Egypt
(Abdelazeem) Department of Cardiology, West Virginia University,
Morgantown, WV, United States
(Lavie, Tafur-Soto) John Ochsner Heart and Vascular Institute, Department
of Cardiovascular Diseases, Ochsner Clinical School, The University of
Queensland School of Medicine, New Orleans, LA, United States
Publisher
Elsevier Inc.
Abstract
Background: Retrograde approach has notably improved success rates of
chronic total occlusion (CTO) percutaneous coronary intervention (PCI).
However, longer procedural time, increase use of fluoroscopy and contrast
dye have been reported in retrograde techniques in CTO PCI. We aimed to
study in-hospital and long-term outcomes of retrograde approach versus
antegrade approach in CTO PCI. Method(s): We searched PubMed, Scopus,
WOS, and Cochrane Central until June 2023 to include all relevant studies
that compared retrograde approach versus antegrade approach in patients
with CTO PCI. We synthesized the outcome data using a random-effects
model, expressing the effect estimates as odds ratios (OR) or mean
difference (MD) with corresponding 95 % confidence intervals (CI).
 Result(s): A total of 18 studies comprising 21,276 patients were
included in the analysis. Regarding in-hospital outcomes, antegrade
approach was associated with lower odds of MACE (OR= 0.34, 95 % CI: 0.23
to 0.51), all-cause mortality (OR= 0.35, 95 % CI: 0.19 to 0.64), MI (OR=
0.36, 95 % CI: 0.25 to 0.53), urgent pericardiocentesis (OR= 0.27, 95 %
CI: 0.16 to 0.46), CIN (OR= 0.46, 95 % CI: 0.33 to 0.65), procedural
complications (OR= 0.52, 95 % CI: 0.33 to 0.83), target vessel perforation
(OR= 0.45, 95 % CI: 0.32 to 0.64). while antegrade was associated with
higher success rates (OR= 1.16, 95 % CI: 1.1 to 1.22). Conclusion(s):
Compared to antegrade technique, retrograde was associated with higher
risk for in-hospital and long-term adverse events, and preferably should
be performed in more complex CTO lesions. Copyright © 2024

<6>
Accession Number
2030747073
Title
Transcarotid versus trans-axillary/subclavian transcatheter aortic valve
replacement (TAVR): A systematic review and meta-analysis.
Source
Current Problems in Cardiology. 49(5) (no pagination), 2024. Article
Number: 102488. Date of Publication: 01 May 2024.
Author
Dawadi S.; Oli P.R.; Shrestha D.B.; Shtembari J.; Pant K.; Shrestha B.;
Mattumpuram J.; Katz D.H.
Institution
(Dawadi) Department of Internal Medicine, Nepalese Army Institute of
Health Sciences, Kathmandu, Nepal
(Oli) Department of Internal Medicine, Province Hospital, Birendranagar,
Karnali Province, Surkhet, Nepal
(Shrestha, Shtembari) Department of Internal Medicine, Mount Sinai
Hospital, Chicago, IL, United States
(Pant) Department of Internal Medicine, Division of Cardiovascular
Medicine, University of Illinois College of Medicine, OSF Healthcare,
Peoria, IL, United States
(Shrestha, Katz) Division of Cardiology, Department of Internal Medicine,
Bassett Medical Center, 1 Atwell Rd, Cooperstown, NY, United States
(Mattumpuram) Division of Cardiology, Department of Internal Medicine,
University of Louisville School of Medicine, 550 S Jackson St, Louisville,
KY, United States
Publisher
Elsevier Inc.
Abstract
Background: Transcatheter Aortic Valve Replacement (TAVR) is the treatment
of choice in patients with severe aortic stenosis. Transcarotid (TCa) or
Trans-axillary/subclavian (TAx/Sc) are safer and less invasive non-femoral
approaches, where transfemoral access is difficult or impossible to
obtain. Method(s): This meta-analysis was performed based on PRISMA
guidelines after registering in PROSPERO (CRD42023482842). This
meta-analysis was performed to compare the safety of the transcarotid and
trans-axillary/subclavian approach for TAVR including studies from
inception to October 2023. Result(s): Seven studies with a total of
6227 patients were included in the analysis (TCa: 2566; TAx/Sc: 3661).
Transcarotid TAVR approach had a favorable trend for composite of stroke
and all-cause mortality (OR 0.79, CI 0.60-1.04), all-cause mortality,
stroke, major vascular complication, and new requirement of permanent
pacemaker though those were statistically insignificant. On sub-analysis
of the results of the studies based on the territory (USA vs French),
composite outcome of all cause mortality, stroke and major bleeding (OR
0.54, CI 0.54-0.81), composite of stroke and all cause mortality (OR 0.64,
CI 0.50-0.81), and stroke/TIA (OR 0.53, CI 0.39-0.73) showed lower odds of
occurrence among patient managed with TCa approach in the American cohort.
 Conclusion(s): Overall, transcarotid approach had favorable though
statistically insignificant odds for composite (stroke and all-cause
mortality) and individual outcomes (stroke, all-cause mortality, etc.).
There are significant variations in observed outcomes based on study's
geographic location. Large prospective randomized clinical trials
comparing the two approaches with representative samples are necessary to
guide the clinicians in choosing among these approaches. Copyright
© 2024 Elsevier Inc.

<7>
Accession Number
2028558027
Title
Efficacy and Complication Profiles of Left Ventricular Assist Devices in
Adult Heart Failure Management: A Systematic Review and Meta-Analysis.
Source
Current Problems in Cardiology. 49(1) (no pagination), 2024. Article
Number: 102118. Date of Publication: 01 Jan 2024.
Author
Llerena-Velastegui J.; Santafe-Abril G.; Villacis-Lopez C.; Hurtado-Alzate
C.; Placencia-Silva M.; Santander-Aldean M.; Trujillo-Delgado M.;
Freire-Ona X.; Santander-Fuentes C.; Velasquez-Campos J.
Institution
(Llerena-Velastegui, Santander-Aldean) Pontifical Catholic University of
Ecuador, Medical School, Quito, Ecuador
(Santafe-Abril) Juan N. Corpas University Foundation, Medical School,
Bogota, Colombia
(Villacis-Lopez) Central University of Ecuador, Medical School, Quito,
Ecuador
(Hurtado-Alzate) La Sabana University, Medical School, Bogota, Colombia
(Placencia-Silva, Velasquez-Campos) Equinoctial Technological University,
Medical School, Quito, Ecuador
(Trujillo-Delgado) Catholic University of Santiago de Guayaquil, Medical
School, Guayaquil, Ecuador
(Freire-Ona) Regional Autonomous University of Los Andes, Medical School,
Ambato, Ecuador
(Santander-Fuentes) San Francisco University of Quito, Medical School,
Quito, Ecuador
Publisher
Elsevier Inc.
Abstract
Left ventricular assist devices (LVADs) have marked a milestone in the
evolution of treatment for patients with end-stage heart failure. Their
popularity and use are steadily rising. This systematic review and
meta-analysis aimed to evaluate the effectiveness of LVADs in improving
the survival rate of patients with end-stage heart failure and to identify
the complications or adverse events associated with LVAD use. Articles for
this systematic review and meta-analysis were sourced from PubMed, Google
Scholar, and the Cochrane Library databases. Only studies that met the
predefined PICOS eligibility criteria were analyzed. LVADs significantly
improved the 6, 12, 18, and 24-month survival rates in patients with
end-stage heart failure compared to no LVAD or other therapies: OR 1.87
(95%CI [1.27-2.76]), OR 2.29 (95%CI [1.61-3.26]), OR 2.07 (95%CI
[0.61-6.61]), and OR 1.73 (95%CI [0.88-3.41]) for 6, 12, 18, and 24
months, respectively. The incidence of adverse events was significantly
higher in the LVAD group than in the non-LVAD treatments: bleeding OR
12.53 (95%CI [2.60-60.41]), infections OR 4.15 (95%CI [1.19-14.45]),
stroke OR 2.58 (95%CI [1.38-4.82]), and arrhythmia OR 2.81 (95%CI
[1.64-4.80]). Overall, complications were higher in the LVAD group
compared to those without LVAD treatment. Hospital readmissions due to
adverse events were significantly more frequent in the LVAD group, OR 2.98
(95%CI [1.38-6.43]). Despite the elevated risk of adverse events
associated with LVADs, these devices have demonstrated a notable
enhancement in the survival outcomes for patients with end-stage heart
failure. Copyright © 2023 Elsevier Inc.

<8>
Accession Number
2032151775
Title
Mechanical prosthetic valve thrombosis: A literature review of treatment
strategies.
Source
Current Problems in Cardiology. 49(7) (no pagination), 2024. Article
Number: 102628. Date of Publication: 01 Jul 2024.
Author
Ebrahimi P.; Sattartabar B.; Taheri H.; Soltani P.; Bahiraie P.;
Mousavinezhad S.M.; Gooshvar M.; Kampaktsis P.; Arsanjani R.; Sahebjam M.;
Hosseini K.; Siegel R.J.
Institution
(Ebrahimi, Sattartabar, Soltani, Sahebjam, Hosseini) Tehran Heart Center,
Cardiovascular Diseases Research Institute, Tehran University of Medical
Sciences, Tehran, Iran, Islamic Republic of
(Taheri, Siegel) Cedars-Sinai Smidt Heart Institute, Los Angeles, CA,
United States
(Bahiraie) School of Medicine, Shahid Beheshti University of Medical
Sciences, Tehran, Iran, Islamic Republic of
(Mousavinezhad, Gooshvar) School of Medicine, Ahvaz Jundishapur University
of Medical Sciences, Ahvaz, Iran, Islamic Republic of
(Kampaktsis) Division of Cardiology, Columbia University Irving Medical
Center, NYC, NY, United States
(Arsanjani) Department of Cardiovascular Medicine, Mayo Clinic, Phoenix,
AZ, United States
Publisher
Elsevier Inc.
Abstract
Mechanical prosthetic valve thrombosis (MPVT) is a common complication of
valvular implantations. This study compared the efficacy and safety of
different treatments for MPVT. A systematic search of electronic databases
identified studies evaluating surgical, anticoagulant, and thrombolytic
therapies. Although several studies of different types have been conducted
to evaluate the efficacy of these treatment strategies the lack of
randomized controlled trials has resulted in the inability to make a
definitive conclusion about the pros and cons of these treatments. Recent
treatments, such as slow and ultraslow infusion of thrombolytics, showed
comparable efficacy and lower complication rates than traditional methods.
Inadequate anticoagulant use is a major risk factor for MPVT, highlighting
the importance of prevention. Treatment selection should be individualized
based on patient factors and available expertise. Overall, slow and
ultraslow infusion of thrombolytics may be a promising treatment option
for MPVT. Copyright © 2024 Elsevier Inc.

<9>
Accession Number
2032283454
Title
Long-term outcomes comparison of mitral valve repair or replacement for
secondary mitral valve regurgitation. An updated systematic review and
reconstructed time-to-event study-level meta-analysis.
Source
Current Problems in Cardiology. 49(7) (no pagination), 2024. Article
Number: 102636. Date of Publication: 01 Jul 2024.
Author
Formica F.; Gallingani A.; Tuttolomondo D.; Hernandez-Vaquero D.;
D'Alessandro S.; Singh G.; Benassi F.; Grassa G.; Pattuzzi C.; Maestri F.;
Nicolini F.
Institution
(Formica, Grassa, Pattuzzi, Nicolini) University of Parma, Department of
Medicine and Surgery, Parma, Italy
(Formica, Gallingani, Benassi, Grassa, Pattuzzi, Maestri, Nicolini)
Cardiac Surgery Unit, University Hospital of Parma, Parma, Italy
(Tuttolomondo) Cardiology Unit, University Hospital of Parma, Parma, Italy
(Hernandez-Vaquero) Cardiac Surgery Department, Hospital Universitario
Central de Asturias, Oviedo, Spain
(D'Alessandro) Cardiac Surgery Unit, San Giovanni Bosco Hospital, Turin,
Italy
(Singh) Department of Critical Care Medicine and Division of Cardiac
Surgery, Mazankowski Alberta Heart Institute, University of Alberta,
Edmonton, Canada
Publisher
Elsevier Inc.
Abstract
Background and aim. The ideal surgical intervention for secondary mitral
regurgitation (SMR), a disease of the left ventricle not the mitral valve
itself, is still debated. We performed an updated systematic review and
study-level meta-analysis investigating mitral valve repair (MVr) versus
mitral valve replacement (MVR) for adult patients with SMR, with or
without coronary artery disease (CAD). Methods. PubMed, CENTRAL and EMBASE
were searched for studies comparing MVr versus MVR. Randomized trial or
observational studies were considered eligible. Primary endpoint was
long-term mortality for any cause. Kaplan-Meier survival curves were
reconstructed and compared with Cox linear regression. Landmark analysis
and time-varying hazard ratio (HR) were analyzed. Sensitivity analyses
included meta-regression and separate sub-analysis. A random effects model
was used. Results. Twenty-three studies (MVr=3,727 and MVR=2,839) were
included. One study was a randomized trial, and 19 studies were adjusted.
The mean weighted follow-up was 3.7+/-2.8 years. MVR was associated with
significative greater late mortality (HR=1.26; 95 % CI, 1.14-1.39;
P<0.0001) at 10-year follow-up. There was a time-varying trend showing an
increased risk of mortality in the first 2 years after MVR (HR=1.38; 95 %
CI, 1.21-1.56; P<0.0001), after which this difference dissipated (HR=0.94;
95 % CI, 0.81-1.09; P=0.41). Separate sub-analyses showed comparable
long-term mortality in patients with concomitant coronary surgery >=90 %,
left ventricle ejection fraction <=40 %, and sub-valvular apparatus
preservation rate of 100 %. Conclusions. Compared to repair, MVR is
associated with higher probability of mortality in the first 2 years
following surgery, after which the two procedures showed comparable late
mortality rate. Copyright © 2024 The Author(s)

<10>
Accession Number
2030126978
Title
Cardiac rehabilitation and acute aortic dissection: understanding and
addressing the evidence GAP a systematic review.
Source
Current Problems in Cardiology. 49(3) (no pagination), 2024. Article
Number: 102348. Date of Publication: 01 Mar 2024.
Author
Carbone A.; Lamberti N.; Manfredini R.; Trimarchi S.; Palladino R.; Savrie
C.; Marra A.M.; Ranieri B.; Crisci G.; Izzo R.; Esposito G.; Cittadini A.;
Manfredini F.; Rubenfire M.; Bossone E.
Institution
(Carbone) Unit of Cardiology, University of Campania Luigi Vanvitelli,
Naples, Italy
(Carbone, Palladino, Bossone) Department of Public Health, University of
Naples Federico II, Naples, Italy
(Lamberti, Savrie, Manfredini) Department of Neuroscience and
Rehabilitation, University of Ferrara, Ferrara, Italy
(Manfredini) Department of Medical Sciences, University of Ferrara,
Ferrara, Italy
(Trimarchi) Section of Vascular Surgery, Cardio Thoracic Vascular
Department, Fondazione IRCCS Ca Granda Ospedale Maggiore Policlinico,
Milan, Italy
(Trimarchi) Department of Clinical Sciences and Community Health,
Universita degli Studi di Milano, Milan, Italy
(Ranieri) IRCCS SYNLAB SDN, Naples, Italy
(Marra, Crisci, Cittadini) Department of Translational Medical Sciences,
University of Naples Federico II, Naples, Italy
(Izzo, Esposito) Division of Cardiology, Department of Advanced Biomedical
Sciences, University of Naples, Federico II, Naples, Italy
(Rubenfire) Division of Cardiovascular Medicine, Department of Internal
Medicine, University of Michigan Medical School, Ann Arbor, MI, United
States
Publisher
Elsevier Inc.
Abstract
Despite guideline recommendations, strategies for implementing cardiac
rehabilitation (CR) in patients with acute aortic dissection (AAD) are not
well established with little evidence to risk stratify prudent and
effective guidelines for the many required variables. We conducted a
systematic review of studies (2004-2023) reporting CR following type A
(TA) and type B (TB) AAD. Our review is limited to open surgical repair
for TA and medical treatment for TB. A total of 5 studies were included (4
TA-AAD and 1 TB-AAD) in the qualitative analysis. In general,
observational data included 311 patients who had an overall favorable
effect of CR in AAD consisting of a modestly improved exercise capacity
and work load during cycle cardiopulmonary exercise test (TB-AAD), and
improved quality of life (QoL). No adverse events were reported during
symptom limited pre-CR treadmill or cycle exercise VO<inf>2</inf> max or
CR. Given the overall potential in this high risk population without
adequate evidence for important variables such as safe time from post-op
to CR, intensity of training, duration and frequency of sessions and
followup it is time for a moderate sized well designed safe trial for
patients' post-op surgery for TA-AAD and medically treated TB-AAD who are
treated with standardized evidence based medical therapy and physical
therapy from discharge randomized to CR versus usual care. PROSPERO
registry ID: CRD42023392896. Copyright © 2024 The Author(s)

<11>
Accession Number
2028795404
Title
A Meta-Analysis of Atrial Septal Defect Closure in Patients With Severe
Pulmonary Hypertension: Is There a Room for Poking Holes Amid Debate?.
Source
Current Problems in Cardiology. 49(1) (no pagination), 2024. Article
Number: 102121. Date of Publication: 01 Jan 2024.
Author
Cool C.J.; Kamarullah W.; Pranata R.; Putra I.C.S.; Khalid A.F.; Akbar
M.R.; Setiabudiawan B.; Rahayuningsih S.E.
Institution
(Cool, Pranata, Putra, Khalid, Akbar) Department of Cardiology and
Vascular Medicine, Faculty of Medicine, University of Padjadjaran,
Bandung, Indonesia
(Kamarullah) Melinda Cardio Vascular Center, Bandung, Indonesia
(Setiabudiawan, Rahayuningsih) Department of Child Health, Faculty of
Medicine, University of Padjadjaran, Bandung, Indonesia
Publisher
Elsevier Inc.
Abstract
Severe pulmonary arterial hypertension (PAH) associated with atrial septal
defect (ASD) poses a challenge to a closure of ASD, particularly severe
PAH that persists even after pharmacological therapeutic strategy. Our
study was aimed to evaluate this matter. A systematic literature search
from several databases was conducted up until August 1st, 2023. A
meta-analysis was undertaken on studies that reported hemodynamic
measurements in ASD patients with severe PAH before and after closure. The
primary objectives were the extent of improvement in all hemodynamic
parameters following closure, and the secondary outcomes were major
adverse cardiac events (MACEs) during follow-up. Our study comprised 10
studies with a total of 207 participants. Patients were divided into
treat-and-repair and straight-to-repair groups based on the therapeutic
strategy. Meta-analysis of all studies demonstrated significant
improvement in mean pulmonary arterial pressure (mPAP), pulmonary vascular
resistance (PVR), pulmonary vascular resistance index (PVRI), 6-minutes
walking distance (6MWD), and lower prevalence of World Health Organization
functional classes (WHO fc), particularly in the treat-and-repair strategy
subgroup. Additionally, merely 4 of the 156 individuals died from cardiac
causes, and only 1 required rehospitalization, indicating a low likelihood
of MACEs arising. Our new findings support the notion that effective shunt
closure can improve various hemodynamic parameters in carefully chosen
patients with noncorrectable ASD-PAH. Further large and prospective
observational studies are still warranted to validate these
findings. Copyright © 2023 The Authors

<12>
Accession Number
2031580507
Title
Comparative efficacy and safety of mitral valve repair versus mitral valve
replacement in Rheumatic heart disease: A high-value care systematic
review and meta-analysis.
Source
Current Problems in Cardiology. 49(6) (no pagination), 2024. Article
Number: 102530. Date of Publication: 01 Jun 2024.
Author
Yasmin F.; Jawed S.; Najeeb H.; Moeed A.; Atif A.R.; Umar M.; Asghar M.S.;
Alraies M.C.
Institution
(Yasmin) Yale University School of Medicine, New Haven, CT, United States
(Jawed, Najeeb, Moeed, Atif) Dow Medical College, Karachi, Pakistan
(Umar) IU Health Ball Memorial Hospital, Muncie, IN, United States
(Asghar) Division of Nephrology and Hypertension, Mayo Clinic, Rochester,
United States
(Alraies) Cardiovascular Institute, Detroit Medical Center, DMC Heart
Hospital, Detroit, MI, United States
Publisher
Elsevier Inc.
Abstract
Rheumatic Heart Disease (RHD) remains a leading cause of cardiovascular
death (CVD) globally. Mitral Valve repair (MVP) and mitral valve
replacement (MVR) are the two most commonly and successfully used
techniques to treat the disease. MVP is associated with reduced
post-operative complications compared to MVR; however, it carries the risk
of valvular fibrosis and scarring. Given the lack of recommendations,
inconsistent findings, and paucity of pathophysiological evidence at
present, we aimed to conduct a meta-analysis and systematically review the
available literature to determine the efficacy and safety of MVP compared
to MVR in improving clinical outcomes among patients with RHD. A
comprehensive literature search was conducted on MEDLINE (PubMed),
Cochrane Central and Scopus from inception till September 2023. The
primary objective was early mortality defined as any cause-related death
occurring 30 days following surgery. Secondary outcomes included long-term
survival defined as the time duration between hospital discharge and
all-cause death. Infectious endocarditis, thromboembolic events (including
stroke, brain infarction, peripheral embolism, valve thrombosis, and
transient ischemic attack), and haemorrhagic events (any serious bleeding
event that required hospitalisation, resulted in death, resulted in
permanent injury, or required blood transfusion) were all considered as
post- operative complications. Additionally aggregated Kaplan-Meier curves
were reconstructed for long term survival, freedom from reoperation, and
freedom from valve-related adverse events by merging the reconstructed
individual patient data (IPD) from each individual study. A significant
decrease in early mortality with MV repair strategy versus MV replacement
[RR 0.63; P = 0.003) irrespective of mechanical or bioprosthetic valves
was noted. The results reported significantly higher long-term survival in
patients undergoing MVP versus MVR (HR 0.53; P = 0.0009). Reconstructed
Kaplan-Meier curves showed that the long term survival rates at 4, 8, and
12 years were 88.6, 82.0, 74.6 %, in the MVR group and 91.7, 86.8, 81.0 %,
in the MVP group, respectively. MVP showed statistically significant
reduction in early mortality, adverse vascular events, and better
long-term survival outcomes compared to the MVR strategy in this
analysis. Copyright © 2024 Elsevier Inc.

<13>
Accession Number
2028846499
Title
Assessing the Efficacy of Omega-3 Fatty Acids + Statins vs. Statins Only
on Cardiovascular Outcomes: A Systematic Review and Meta-Analysis of
40,991 Patients.
Source
Current Problems in Cardiology. 49(2) (no pagination), 2024. Article
Number: 102245. Date of Publication: 01 Feb 2024.
Author
Irfan A.; Haider S.H.; Nasir A.; Larik M.O.; Naz T.
Institution
(Irfan, Haider, Nasir, Larik, Naz) Department of Internal Medicine, Dow
Medical College, Dow University of Health Sciences, Karachi, Pakistan
Publisher
Elsevier Inc.
Abstract
Background: Clinical guidelines recommend statin use in patients with a
vast array of cardiovascular disturbances. However, there is insufficient
evidence regarding the concomitant use of omega-3 fatty acids in addition
to statins. This meta-analysis aims to uncover the complete effects of
this combination therapy on cardiovascular outcomes, lipid biomarkers,
inflammatory markers, and plaque markers. Method(s): A detailed
literature search was conducted using PubMed, Cochrane, and MEDLINE
databases, and all the relevant studies found up to September 2023 were
included. The primary outcomes assessed in this meta-analysis was 1)
Composite of fatal and non-fatal myocardial infarction, 2) Composite of
fatal and non-fatal stroke, 3) Coronary revascularization, 4) Death due to
cardiovascular causes, 5) MACE (Major Adverse Cardiovascular Events), 6)
Unstable angina, 7) Hospitalization due to unstable angina, 8) and lipid
volume index. Secondary outcomes included lipid markers, hsCRP, EPA
levels, and EPA/AA ratio. Result(s): 14 RCTs were included, featuring
a total of 40,991 patients. Patients receiving the omega-3 + statin
regimen were associated with a statistically significant decrease in the
incidence of MI, MACE, unstable angina, hospitalization due to unstable
angina, Total cholesterol levels, triglycerides, hsCRP, and lipid volume
index in comparison to their counterparts receiving placebo + statin (P <
0.05). In contrast, our analysis found no statistically significant
difference in the incidence of fatal and non-fatal stroke, coronary
revascularization, and cardiovascular mortality. Conclusion(s): Our
research reinforces that all patients, regardless of their cardiovascular
health, may benefit from adding omega-3 fatty acids to their statin
therapy. Copyright © 2023 Elsevier Inc.

<14>
Accession Number
2029708566
Title
Ischemia testing and revascularization in patients with monomorphic
ventricular tachycardia: A relic of the past?.
Source
Current Problems in Cardiology. 49(3) (no pagination), 2024. Article
Number: 102358. Date of Publication: 01 Mar 2024.
Author
Milaras N.; Kordalis A.; Tsiachris D.; Sakalidis A.; Ntalakouras I.;
Pamporis K.; Dourvas P.; Apostolos A.; Sotiriou Z.; Arsenos P.;
Archontakis S.; Tsioufis K.; Gatzoulis K.; Sideris S.
Institution
(Milaras, Ntalakouras, Pamporis, Dourvas, Archontakis, Sideris) State
Department of Cardiology, "Hippokration" General Hospital of Athens,
Greece
(Milaras, Kordalis, Tsiachris, Sakalidis, Apostolos, Sotiriou, Arsenos,
Tsioufis, Gatzoulis) School of Medicine, National and Kapodistrian
University of Athens, Hippokration General Hospital, Vasilissis Sofias
114, Athens, Greece
Publisher
Elsevier Inc.
Abstract
Testing for myocardial ischemia in patients presenting with sustained
monomorphic Ventricular Tachycardia(VT) even without evidence of acute
myocardial infarction is a tempting strategy that is frequently utilized
in clinical practice. Monomorphic VT is mainly caused by re-entry around
chronic myocardial scar and active ischemia has no role in its
pathogenesis, thus making testing for ischemia futile, at least in theory.
This systematic literature review sought to address the usefulness of
ischemia testing (mainly coronary angiography) in patients presenting with
monomorphic VT through 8 selected studies after evaluating a total of 130
published manuscripts. Particularly, we sought to unveil whether coronary
angiography and possibly concomitant revascularization leads to lesser
tachycardia recurrence. Our conclusion can be summarized as follows: this
approach whether combined with revascularization or not, does not seem to
reduce VT recurrence nor does it affect mortality in such patients. Even
though most of the published literature points at this direction,
validation from randomized controlled trials is imperative. Copyright
© 2023 Elsevier Inc.

<15>
Accession Number
2027717051
Title
Optimizing Safety and Success: The Advantages of Bloodless Cardiac
Surgery. A Systematic Review and Meta-Analysis of Outcomes in Jehovah's
Witnesses.
Source
Current Problems in Cardiology. 49(1) (no pagination), 2024. Article
Number: 102078. Date of Publication: 01 Jan 2024.
Author
Gemelli M.; Italiano E.G.; Geatti V.; Addonizio M.; Cao I.; Dimagli A.;
Dokollari A.; Tarzia V.; Gallo M.; Ferrari E.; Slaughter M.S.; Gerosa G.
Institution
(Gemelli, Italiano, Geatti, Addonizio, Cao, Tarzia, Gerosa) Cardiac
Surgery Unit, Department of Cardiac, Thoracic, Vascular Sciences and
Public Health, University of Padua, Padua, Italy
(Dimagli) Department of Cardiothoracic Surgery, Weill Cornell Medicine,
New York, NY, United States
(Dokollari) Department of Cardiac Surgery Research, Lankenau Institute for
Medical Research, Main Line Health, Wynnewood, PA, United States
(Gallo, Slaughter) Department of Cardiothoracic Surgery, University of
Louisville, Louisville, KY, United States
(Ferrari) Cardiac Surgery, Cardiocentro Ticino Institute, Ente Ospedaliero
Cantonale, Lugano, Switzerland
Publisher
Elsevier Inc.
Abstract
Transfusions are extremely frequent after cardiac surgery, and they have a
considerable economic burden and impact on outcomes. Optimal patient blood
management could play a fundamental role in reducing the rate of
transfusion and Jehovah's Witnesses (JW) represent the ideal surrogate
study population. This meta-analysis compares outcomes of JWs and non-JWs'
patients undergoing cardiac surgery, assessing the safety of a bloodless
cardiac surgery. A scoping review was conducted using a search strategy
for studies assessing outcomes of JW undergoing cardiac surgery. The
primary outcome was perioperative mortality, and a random-effects
meta-analysis was performed. Ten studies were included in our
meta-analysis, involving 780 JW patients refusing any type of transfusion
("JW") and 1182 patients accepting transfusion if needed ("non-JW"). 86%
of non-JW patients received at least 1 transfusion. There was no
significant difference in terms of perioperative mortality (OR 0.91; 95%
CI 0.55-1.52; p = 0.72). The volume blood loss was significantly less in
the JW (p = 0.001), while the rate of reoperation for bleeding was also
lower, but not statistically significative, in the JW (p = 0.16). Both
preoperative and postoperative hemoglobin and hematocrit were
significantly higher in the JW. Therefore, we concluded that bloodless
cardiac surgery is safe and early outcomes are similar between JW and
non-JW patients: optimal patient blood management is fundamental in
guarantying these results. Further studies are needed to assess if a
limitation of transfusion could have a positive long-term impact on
outcomes. Copyright © 2023 Elsevier Inc.

<16>
Accession Number
2032962557
Title
A review regarding the article 'impact of simulation-based training on
transesophageal echocardiography learning: A systemic review and
meta-analysis of randomized controlled trials'.
Source
Current Problems in Cardiology. 49(9) (no pagination), 2024. Article
Number: 102717. Date of Publication: 01 Sep 2024.
Author
Su Y.; Yuan D.
Institution
(Su) Department of Anesthesiology, West China Hospital, Sichuan
University/West China School of Nursing, Sichuan, Chengdu, China
(Yuan) Department of Cardiovascular Surgery, Chengdu Shang Jin Nan Fu
Hospital, West China Hospital of Sichuan University, Sichuan Province,
Chengdu, China
Publisher
Elsevier Inc.
Abstract
Transesophageal echocardiography (TEE) has emerged as a critical imaging
technique for anesthesiologists, enabling them to monitor and detect
significant cardiothoracic conditions in both cardiac and noncardiac
surgical patients throughout the perioperative period. Given the expanding
applications of TEE, its integration into the anesthesiology residency
curriculum at an early stage is crucial. This ensures that residents have
ample time to develop their TEE skills, thereby facilitating meaningful
clinical application post-residency. While studies have demonstrated the
successful use of simulators and web-based modules in TEE education, there
is currently a lack of educational materials that provide a structured
curriculum specifically designed to teach the fundamentals of TEE to
residents. Furthermore, simulation training in TEE prior to patient
exposure may contribute to enhanced patient safety and comfort. By
providing residents with the opportunity to practice their TEE skills in a
controlled, risk-free environment, simulation training can help to
mitigate the potential risks associated with real-world patient care. TEE
has become an indispensable tool for anesthesiologists, and its
integration into the residency curriculum is essential. The use of
simulation-based training, particularly in a virtual reality setting,
offers a promising avenue for enhancing TEE education and fostering the
development of competent practitioners. Copyright © 2024

<17>
Accession Number
2029542979
Title
Local versus General Anaesthesia for Transcatheter Aortic Valve
Implantation (TAVI): A Systematic Review, Meta-Analysis, and Trial
Sequential Analysis of Randomised and Propensity-Score Matched Studies.
Source
Current Problems in Cardiology. 49(3) (no pagination), 2024. Article
Number: 102360. Date of Publication: 01 Mar 2024.
Author
Jaffar-Karballai M.; Al-Tawil M.; Roy S.; Kayali F.; Vankad M.; Shazly A.;
Zeinah M.; Harky A.
Institution
(Jaffar-Karballai) Department of Medicine, St George's University of
London, London, United Kingdom
(Al-Tawil) Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
(Roy) School of Medicine, Queen's University Belfast, Ireland, Northern,
United Kingdom
(Kayali) University Hospitals Sussex, Sussex, United Kingdom
(Vankad) University Hospitals Birmingham, Birmingham, United Kingdom
(Shazly) Essex Cardiothoracic Centre, Basildon University Hospital,
Basildon, United Kingdom
(Zeinah, Harky) Department of Cardiothoracic Surgery, Liverpool Heart and
Chest Hospital, Liverpool, United Kingdom
(Zeinah) Faculty of Medicine, Ain Shams University, Cairo, Egypt
(Harky) Liverpool Centre for Cardiovascular Science, University of
Liverpool and Liverpool Heart and Chest Hospital, Liverpool, United
Kingdom
Publisher
Elsevier Inc.
Abstract
Transcatheter aortic valve implantation (TAVI) is a common practice for
severe aortic stenosis, but the choice between general (GA) and local
anesthesia (LA) remains uncertain. We conducted a comprehensive literature
review until April 2023, comparing the safety and efficacy of LA versus GA
in TAVI procedures. Our findings indicate significant advantages of LA,
including lower 30-day mortality rates (RR: 0.69; 95% CI [0.58, 0.82]; p <
0.001), shorter in-hospital stays (mean difference: -0.91 days; 95% CI
[-1.63, -0.20]; p = 0.01), reduced bleeding/transfusion incidents (RR:
0.64; 95% CI [0.48, 0.85]; p < 0.01), and fewer respiratory complications
(RR: 0.56; 95% CI [0.42, 0.76], p<0.01). Other operative outcomes were
comparable. Our findings reinforce prior evidence, presenting a compelling
case for LA's safety and efficacy. While patient preferences and clinical
nuances must be considered, our study propels the discourse towards a more
informed anaesthesia approach for TAVI procedures. Copyright ©
2023

<18>
Accession Number
2032741863
Title
A review regarding the article 'Traditional Chinese medicine compound
(Tongxinluo) and clinical outcomes of patients with acute myocardial
infarction the CTS-AMI randomized clinical trial'.
Source
Current Problems in Cardiology. 49(9) (no pagination), 2024. Article
Number: 102692. Date of Publication: 01 Sep 2024.
Author
Zhu H.; Jia G.
Institution
(Zhu, Jia) Department of Oncology, The 2nd Affiliated Hospital of Chengdu
Medical College & Nuclear Industry 416 Hospital, Chengdu, China
Publisher
Elsevier Inc.
Abstract
Tongxinluo, a traditional Chinese medicine compound, has shown promise in
improving outcomes for patients with ST-segment elevation myocardial
infarction (STEMI). This randomized, double-blind, placebo-controlled
trial investigated the efficacy of Tongxinluo in reducing major adverse
cardiac and cerebrovascular events (MACCEs) in STEMI patients. The study
enrolled 3777 patients from 124 hospitals in China, all of whom received
standard STEMI treatments in addition to either Tongxinluo or placebo for
12 months. The primary endpoint was the occurrence of MACCEs at 30 days,
with secondary endpoints including individual components of MACCEs, severe
STEMI complications, major bleeding, and all-cause mortality at 1 yr.
Results showed that Tongxinluo significantly reduced the 30-day MACCE rate
compared to placebo (3.4 % vs 5.2 %), and this benefit persisted at 1 year
(5.3 % vs 8.3 %). Cardiac death and myocardial reinfarction rates were
also significantly lower in the Tongxinluo group. These findings
underscore the importance of integrating traditional Chinese medicine with
conventional Western medical treatments, providing significant evidence to
support the development of evidence-based practices in traditional Chinese
medicine. This study represents a pivotal advancement in the field of TCM,
demonstrating its potential to contribute meaningfully to modern clinical
practice and highlighting the necessity for further high-quality research
in this area. Copyright © 2024 The Author(s)

<19>
Accession Number
2029877060
Title
Low-Flow, Low-Gradient Severe Aortic Stenosis in patients with preserved
or reduced ejection fraction: a systematic literature review.
Source
Current Problems in Cardiology. 49(3) (no pagination), 2024. Article
Number: 102392. Date of Publication: 01 Mar 2024.
Author
Aguilar-Molina O.; Barbosa-Balaguera S.; Campo-Rivera N.; Cabrales-Salcedo
Y.; Camacho-Garcia R.; Herrera-Escandon A.
Institution
(Aguilar-Molina, Barbosa-Balaguera, Campo-Rivera, Herrera-Escandon)
Cardiology Unit, Universidad del Valle, Cali, Colombia
(Aguilar-Molina, Barbosa-Balaguera, Campo-Rivera, Cabrales-Salcedo,
Herrera-Escandon) Hospital Universitario del Valle, Cali, Colombia
(Camacho-Garcia) Universidad de Cartagena, Cartagena, Colombia
Publisher
Elsevier Inc.
Abstract
OBJECTIVES: A systematic review of the literature was conducted to analyze
the current evidence on low-flow, low-gradient severe aortic stenosis.
This analysis aimed to differentiate between subgroups of patients with
reduced and preserved left ventricular ejection fraction (LVEF).
 Method(s): After conducting a systematic literature review, 35
observational studies were included. Out of these, 28 were prospective and
7 retrospective. The studies that included a mortality risk stratification
of low-flow, low-gradient aortic stenosis (LF- LG AS) with both preserved
and reduced LVEF were reviewed. Result(s): The importance of
considering multiple clinical and echocardiographic variables in
diagnostic evaluation and therapeutic decision-making was highlighted.
 Conclusion(s): LF- LG AS, in any of its subgroups, is a common and
challenging valve lesion. A careful assessment of severity and, in
specific scenarios, a thorough reclassification is important. More
high-quality studies are required to more precisely define the
classification and prognosis of this entity. Copyright © 2024
Elsevier Inc.

<20>
Accession Number
2032610485
Title
Impact of simulation-based training on transesophageal echocardiography
learning: A systemic review and meta-analysis of randomized controlled
trials.
Source
Current Problems in Cardiology. 49(8) (no pagination), 2024. Article
Number: 102679. Date of Publication: 01 Aug 2024.
Author
Salim N.; Shoaib A.; Amir M.A.; Shiraz M.I.; Ayaz A.; Shahid A.R.
Institution
(Salim, Shoaib, Ayaz) Department of Medicine, Karachi Medical and Dental
College, Block M, North Nazimabad Town, Sindh, Karachi, Pakistan
(Amir, Shiraz, Shahid) Department of Medicine, Dow International Medical
College, Dow University of Health Sciences, Sindh, Karachi, Pakistan
Publisher
Elsevier Inc.

<21>
Accession Number
2031147092
Title
Effectiveness of virtual reality on pain and anxiety in patients
undergoing cardiac procedures: A systematic review and meta-analysis of
randomized controlled trials.
Source
Current Problems in Cardiology. 49(5) (no pagination), 2024. Article
Number: 102532. Date of Publication: 01 May 2024.
Author
Micheluzzi V.; Burrai F.; Casula M.; Serra G.; Al Omary S.; Merella P.;
Casu G.
Institution
(Micheluzzi, Casula, Serra, Al Omary, Merella, Casu) Clinical and
interventional cardiology, University Hospital, Sassari, Italy
(Burrai, Casula, Serra, Al Omary, Casu) Department of Medicine, Surgery
and Pharmacy, University of Sassari, Sassari, Italy
Publisher
Elsevier Inc.
Abstract
Background: Cardiac procedures often induce pain and anxiety in patients,
adversely impacting recovery. Pharmachological approaches have
limitations, prompting exploration of innovative digital solutions like
virtual reality (VR). Although early evidence suggests a potential
favourable benefit with VR, it remains unclear whether the implementation
of this technology can improve pain and anxiety. We aimed to assess by a
systematic review and meta-analysis the effectiveness of VR in alleviating
anxiety and pain on patients undergoing cardiac procedures.
 Method(s): Our study adhered to the PRISMA method and was registered
in PROSPERO under the code CRD42024504563. The search was carried out in
the PubMed, Web of Science, Scopus, and the Cochrane Library databases in
January 2024. Four randomized controlled trials were included (a total of
382 patients). Risk of bias was employed to assess the quality of
individual studies, and a random-effects model was utilized to examine the
overall effect. Result(s): The results showed that VR, when compared
to the standard of care, had a statistically significant impact on anxiety
(SMD = -0.51, 95 % CI: -0.86 to -0.16, p = 0.004), with a heterogeneity I2
= 57 %. VR did not show a significant difference in terms of pain when
compared to standard care (SMD= -0.34, 95 % CI: -0.75 to -0.07, p = 0.10).
The included trials exhibited small sample sizes, substantial
heterogeneity, and variations in VR technology types, lengths, and
frequencies. Conclusion(s): VR effectively lowers anxiety levels in
patients undergoing cardiac procedures, however, did not show a
statistically significant difference on pain. Copyright © 2024
The Authors

<22>
Accession Number
2034766188
Title
Outcomes of definite vs probable/presumed cardiac sarcoidosis: a
systematic review and meta-analysis.
Source
Current Problems in Cardiology. 49(12) (no pagination), 2024. Article
Number: 102820. Date of Publication: 01 Dec 2024.
Author
Ahmed R.; Ahsan A.; Ahmed M.; Dragon M.; Caballero R.R.H.; Tabassum S.;
Jain H.; Ullah M.Z.S.; Dey D.; Ramphul K.; Collins P.; Chahal A.; Kouranos
V.; Paray N.B.; Sharma R.
Institution
(Ahmed, Collins, Kouranos, Sharma) Royal Brompton Hospital, part of Guy's
and St Thomas' NHS Foundation Trust, London, United Kingdom
(Ahmed, Collins, Kouranos, Sharma) National Heart and Lung Institute,
Imperial College London, United Kingdom
(Ahsan) Foundation University School of Health Sciences, Islamabad,
Pakistan
(Ahmed) Rawalpindi Medical University, Rawalpindi, Pakistan
(Dragon) Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
(Caballero) Department of Cardiology, Hospital Universitario Marques de
Valdecilla, Santander, Spain
(Tabassum) King Edward Medical University, Lahore, Pakistan
(Jain) All India Institute of Medical Sciences, Jodhpur, India
(Ullah) University Hospitals Birmingham NHS Foundation Trust, Birmingham,
United Kingdom
(Dey) Department of Internal Medicine, Medical College, Kolkata, India
(Ramphul) Independent Researcher, Triolet, Mauritius
(Chahal) Department of Cardiology, Barts Heart Centre, London, United
Kingdom
(Chahal) Department of Cardiovascular Medicine, Mayo Clinic, Rochester,
MN, United States
(Chahal) Center for Inherited Cardiovascular Diseases, Department of
Cardiology, Wellspan Health, York, PA, United States
(Paray) Royal Devon University Healthcare NHS Foundation Trust, Exeter,
United Kingdom
(Sharma) King's College London, London, United Kingdom
Publisher
Elsevier Inc.
Abstract
Background: Diagnosing cardiac sarcoidosis (CS), which can be associated
with arrhythmias and heart failure, remains challenging despite multiple
advances over time. The 2014 Heart Rhythm Society (HRS) consensus
statement recommends an endomyocardial biopsy (EMB) to establish a
definite diagnosis of CS. In the absence of a positive EMB, a diagnosis of
probable or presumed CS is made on the basis of clinical and imaging
criteria. Objective(s): To investigate whether there is any
difference in outcomes between definite vs probable/presumed CS.
 Method(s): PubMed/MEDLINE, Embase, and the Cochrane Library databases
were searched for relevant studies published after 2014. Risk ratios (RR)
with 95% confidence intervals (CI) were calculated using the random
effects model and presented in forest plots. Result(s): 6 studies
involving 2,204 patients were identified. The cohort had a mean age of
56.8 years (SD: +/-13.6 years). The median duration of follow-up was 40.5
months. No statistically significant difference was observed between
definite and probable/presumed CS for reduced risk of the composite
endpoint (RR: 1.80, 95% CI: 0.93 to 3.49), and all-cause death (RR: 1.01,
95% CI: 0.48 to 2.10). Conclusion(s): This meta-analysis demonstrated
the equivalence of clinical course and prognosis between definite and
probable/presumed CS. This highlights the importance of a
multi-disciplinary approach to CS care and emphasizes that histological
confirmation should not be a prerequisite to diagnose or manage this
condition. Copyright © 2024 Elsevier Inc.

<23>
Accession Number
2028562787
Title
Epigenetic MicroRNAs as Prognostic Markers of Postoperative Atrial
Fibrillation: A Systematic Review.
Source
Current Problems in Cardiology. 49(1) (no pagination), 2024. Article
Number: 102106. Date of Publication: 01 Jan 2024.
Author
Lee J.; Lee H.; Sherbini A.E.; Baghaie L.; Leroy F.; Abdel-Qadir H.;
Szewczuk M.R.; El-Diasty M.
Institution
(Lee, Lee, Sherbini) Faculty of Health Sciences, Queen's University,
Kingston, ON, Canada
(Baghaie, Leroy, Szewczuk) Department of Biomedical & Molecular Sciences,
Queen's University, Kingston, ON, Canada
(Leroy) Faculte de Medecine, Maieutique et Sciences de la Sante,
Universite de Strasbourg, Strasbourg, France
(Abdel-Qadir) Women's College Hospital, Peter Munk Cardiac Center,
Toronto, ON, Canada
(El-Diasty) Department of Cardiac Surgery, Harrington Heart and Vascular
Institute, University Hospitals Cleveland Medical Center, Cleveland, OH,
United States
Publisher
Elsevier Inc.
Abstract
Postoperative atrial fibrillation (POAF) is a common complication after
cardiac surgery, increasing the risk for adverse outcomes such as
perioperative and long-term mortality, stroke, myocardial infarction, and
other thromboembolic events. Epigenetic biomarkers show promise as
prognostic tools for POAF. Epigenetic changes, such as DNA methylation,
histone modification, and microRNAs (miRNA), can result in altered gene
expression and the development of various pathological conditions. This
systematic review aims to present the current literature on the
association between various epigenetic markers and the development of POAF
following cardiac surgery. Here, an electronic literature search was
performed using MEDLINE, EMBASE, Cochrane Central Register of Controlled
Trials, ClinicalTrials.gov, and Google Scholar to identify studies that
reported the role of epigenetic markers in the development of POAF. Five
of the 6 studies focused on miRNAs and their association with POAF. In
POAF patients, the expression of miR-1 and miR-483-5p were upregulated in
the right atrial appendage (RAA), while the levels of miR-133A, miR-208a,
miR-23a, miR-26a, miR-29a, miR-29b, and miR-29c were decreased in the RAA
and venous blood. One study examined cytosines followed by guanines (CpGs)
as DNA methylation markers. Across all studies, 488 human subjects who had
undergone cardiac surgery were investigated, and 195 subjects (39.9%)
developed new-onset POAF. The current literature suggests that miRNAs may
play a role in predicting the development of atrial fibrillation after
cardiac surgery. However, more robust clinical data are required to
justify their role in routine clinical practice. Copyright © 2023
Elsevier Inc.

<24>
Accession Number
2028994548
Title
The prognostic impact of diastolic dysfunction after transcatheter aortic
valve replacement: A systematic review and meta-analysis.
Source
Current Problems in Cardiology. 49(2) (no pagination), 2024. Article
Number: 102228. Date of Publication: 01 Feb 2024.
Author
Stalikas N.; Anastasiou V.; Botis I.; Daios S.; Karagiannidis E.; Zegkos
T.; Karamitsos T.; Vassilikos V.; Ziakas A.; Kamperidis V.; Giannakoulas
G.; Giannopoulos G.
Institution
(Stalikas, Anastasiou, Botis, Daios, Zegkos, Karamitsos, Ziakas,
Kamperidis, Giannakoulas) AHEPA Hospital, Medical School, Aristotle
University, St. Kiriakidi 1, Thessaloniki, Greece
(Karagiannidis, Vassilikos, Giannopoulos) Ippokratio General Hospital,
Medical School, Aristotle University, Thessaloniki, Greece
Publisher
Elsevier Inc.
Abstract
Background: Diastolic dysfunction (DD) is a long-established marker of
disease progression in patients with aortic valve stenosis (AS),
indicating valvular myocardial damage. Recently, substantial observational
data have emerged demonstrating that worse pre-operative DD assessed using
echocardiography is associated with adverse long-term clinical outcomes
after transcatheter aortic valve replacement (TAVR). Aim(s): To
systematically appraise and quantitatively synthesize current evidence on
the prognostic impact of echocardiographic severe DD derived by
echocardiography before TAVR. Method(s): A systemic literature review
was undertaken in electronic databases to identify studies reporting the
predictive value of severe DD in AS subjects undergoing TAVR. A
random-effects meta-analysis was conducted to quantify the adjusted and
unadjusted hazard ratios (HRs) for all-cause mortality and major adverse
cardiovascular events (MACEs) for the presence of severe DD.
 Result(s): Ten studies were deemed eligible for inclusion. Of those,
9 provided appropriate quantitative data for the meta-analysis,
encompassing a total of 4,619 patients. The presence of severe DD was
associated with increased risk for all-cause mortality (pooled unadjusted
HR=2.56 [1.46-4.48]; p<0.01; I2=76 %) and MACEs (pooled
unadjusted HR=1.82 [1.29-2.58]; p<0.01; I2=86 %). When adjusted
for clinically-relevant parameters, the presence of severe DD retained
independent association with all-cause mortality (pooled adjusted HR=2.35
[1.26-4.37]; p<0.01; I2=79 %) and MACEs (pooled adjusted HR=
2.52 [1.72-3.65]; p<0.01; I2=0 %). In subgroup analysis there
was no difference on post-TAVR risk between the use of different diastolic
function grading scores. Conclusion(s): Presence of severe DD
assessed by echocardiography pre-TAVR is a major determinant of long-term
adverse outcomes after the procedure. Copyright © 2023 Elsevier
Inc.

<25>
Accession Number
2032283530
Title
The left atrial appendage: An enigmatic friend or foe and implications of
closure.
Source
Current Problems in Cardiology. 49(8) (no pagination), 2024. Article
Number: 102620. Date of Publication: 01 Aug 2024.
Author
Benson J.-M.; Keesee J.; Smith L.; Navarro J.; Khouzam R.N.
Institution
(Benson, Keesee, Smith, Khouzam) Grand Strand Medical Center, Department
of Internal Medicine, Myrtle Beach, SC, United States
(Navarro, Khouzam) Edward Via College of Osteopathic Medicine,
Spartanburg, SC, United States
(Khouzam) University of South Carolina (USC) School of Medicine, SC,
United States
(Khouzam) Mercer School of Medicine, GA, United States
(Khouzam) University of Tennessee Health Science Center, TN, United States
Publisher
Elsevier Inc.
Abstract
The left atrial appendage (LAA) is often thought of as a vestigial organ
serving as a nidus for clot formation in those with atrial fibrillation
(A-fib). The LAA, however, has unique anatomy which allows it to serve
special functions in the human body. Closing the LAA has been shown to
decrease the risk of thromboembolic events in patients who cannot tolerate
anticoagulation. Several methods of closure exist including percutaneous
endocardial closure, epicardial closure, and surgical clipping. In
addition to decreasing stroke risk, there appears to be physiologic
changes that occur after LAA closure. This comprehensive review aims to
describe the functions of the LAA, compare the different methods of
closure, and propose a new method for identifying which patients may
benefit from LAA closure versus anticoagulation based on each patients'
individual comorbidities rather than their
contraindications. Copyright © 2024

<26>
Accession Number
2032143725
Title
The effect of individualized nutrition training of children with
congenital heart disease (CHD) on their growth and development a
randomized controlled trial.
Source
Current Problems in Cardiology. 49(7) (no pagination), 2024. Article
Number: 102567. Date of Publication: 01 Jul 2024.
Author
Yuruk E.; Cetinkaya S.
Institution
(Yuruk, Cetinkaya) Department of Nursing, Child Health and Diseases
Nursing, Cukurova University, Faculty of Health Sciences, Adana, Turkey
Publisher
Elsevier Inc.
Abstract
Objective: This study investigated the effectiveness of individualized
nutrition training for mothers of children who underwent congenital heart
disease (CHD) surgery on their children's growth and development.
 Method(s): The researchers conducted a randomized controlled trial at
Cukurova University Medical Faculty Balcali Hospital in Adana, Turkey,
between January 20th, 2021, and June 30th, 2021. They recruited 42
children with CHD and their families. Researchers used a personal
information form, growth parameter measurements, and the Ankara
Developmental Screening Inventory to assess the children. Participants
were randomly divided into three groups. Control group, received standard
care. Experimental group 1 (orally fed), received family-centered care and
individualized nutrition training focused on age-appropriate food content,
preparation methods, and meeting children's caloric needs. Experimental
group 2 (orally and nutritionally fed), received the same interventions as
group 1. The training programs for the experimental groups included
information on strengthening breast milk and additional nutritional
nutrition support. The training programs for the experimental groups
likely addressed feeding challenges specific to children with CHD.
 Result(s): The study found a statistically significant difference in
weight gain between the first and third follow-ups within the training
group (children who received individualized nutrition education). This
suggests that the training may have positively impacted weight gain.
Additionally, the children in the training groups who were breastfed for
longer than 12 months had better growth parameters and developmental
scores compared to those with shorter breastfeeding durations.
 Conclusion(s): This study suggests that individualized nutrition
training for mothers of children with CHD surgery may support their
children's growth and development, particularly when combined with
prolonged breastfeeding. Copyright © 2024

<27>
Accession Number
2030056603
Title
Safety and efficacy of glucagon-like peptide-1 receptor agonists on
cardiovascular events in overweight or obese non-diabetic patients.
Source
Current Problems in Cardiology. 49(3) (no pagination), 2024. Article
Number: 102403. Date of Publication: 01 Mar 2024.
Author
Singh S.; Garg A.; Tantry U.S.; Bliden K.; Gurbel P.A.; Gulati M.
Institution
(Singh) Department of Medicine, Sinai Hospital of Baltimore, Baltimore,
MD, United States
(Garg) Division of Cardiology, Ellis Hospital, NY, United States
(Tantry, Bliden) Sinai Center for Thrombosis Research, Sinai Hospital of
Baltimore, Baltimore, MD, United States
(Gurbel) Division of Cardiology, Sinai Hospital of Baltimore, Baltimore,
MD, United States
(Gulati) Division of Cardiology, Smidt Heart Institute, Los Angeles, CA,
United States
Publisher
Elsevier Inc.
Abstract
Background: Randomized controlled trials (RCTs) have shown variable
cardiovascular (CV) outcomes in overweight or obese patients without
diabetes mellitus (DM) who are treated with glucagon-like peptide-1
receptor agonists (GLP-1 RAs) vs. placebo. We conducted a meta-analysis of
the available studies. Method(s): Online databases were searched for
RCTs comparing GLP-1 RA to placebo in overweight or obese non-diabetic
patients. The clinical endpoints of interest were major adverse CV events
(MACE), CV death, all cause death, myocardial infarction (MI), stroke,
revascularization, total adverse events and their subtypes. Pooled odds
ratios (OR) and 95 % confidence intervals (CI) were calculated using a
random-effects model. Result(s): A total of 10 RCTs with 29,325
patients (n = 16,900 GLP-1 RA, n = 12,425 placebo) were included. The mean
age was 48 years and 34 % of patients were men. As compared with placebo,
the GLP-1 RA group was associated with significant reduction of MACE (OR
0.79, 95 % CI 0.71-0.89, p < 0.0001), all cause death (OR 0.80, 95 % CI
0.70-0.92, p = 0.002), MI (OR 0.72, 95 % CI 0.61-0.85, p = 0.0001) and
revascularization (OR 0.76, 95 % CI 0.67-0.86, p < 0.0001), without any
differences in CV death or stroke. Total adverse events, gastrointestinal
and gallbladder-related disorders were higher in the GLP-1 RA group, with
a similar rate of renal adverse events, malignant neoplasms and acute
pancreatitis to placebo. Conclusion(s): In overweight or obese
patients without DM, patients treated with GLP-1 RAs had significantly
reduced MACE, all cause death, MI and revascularization when compared with
placebo. Copyright © 2024 Elsevier Inc.

<28>
Accession Number
2027744694
Title
Frequency of Stroke in Intermediate-Risk Patients in the Long-Term
Undergoing TAVR vs SAVR: A Systematic Review and Meta-Analysis.
Source
Current Problems in Cardiology. 49(1) (no pagination), 2024. Article
Number: 102099. Date of Publication: 01 Jan 2024.
Author
Llerena-Velastegui J.; Navarrete-Cadena C.; Delgado-Quijano F.;
Trujillo-Delgado M.; Aguayo-Zambrano J.; Villacis-Lopez C.; Marcalla-Rocha
M.; Benitez-Acosta K.; Vega-Zapata J.
Institution
(Llerena-Velastegui, Navarrete-Cadena) Pontifical Catholic University of
Ecuador, Medical School, Quito, Ecuador
(Delgado-Quijano) Vantage Healthcare, Rehabilitation Center, MA, United
States
(Trujillo-Delgado, Aguayo-Zambrano) Catholic University of Santiago de
Guayaquil, Medical School, Guayaquil, Ecuador
(Villacis-Lopez) Central University of Ecuador, Medical School, Quito,
Ecuador
(Marcalla-Rocha) National University of Chimborazo, Medical School,
Riobamba, Ecuador
(Benitez-Acosta) La Sabana University, Medical School, Bogota, Colombia
(Vega-Zapata) Regional Autonomous University of Los Andes, Medical School,
Ambato, Ecuador
Publisher
Elsevier Inc.
Abstract
The aim of this research is to compare the long-term incidence of stroke
in intermediate-risk patients who have undergone either transcatheter
aortic valve replacement (TAVR) or surgical aortic valve replacement
(SAVR) procedures. The objective is to identify which method exhibits a
higher propensity for stroke occurrence, potentially contributing to
disability or stroke-related mortality. We conducted a systematic review
and meta-analysis to evaluate the frequency of stroke post-TAVR and SAVR
procedures. Data were compiled from a diverse array of research articles,
retrieved from the Embase, Cochrane Library, and PubMed databases.
Conclusions were derived from the comprehensive analysis of forest plots.
The analysis indicates no significant reduction in stroke incidence among
patients undergoing TAVR compared to those receiving SAVR. This
conclusion, underscored by a P-value of 0.76 and a 95% confidence interval
(CI) ranging from 0.80 to 1.17, arises from a careful review of multiple
pertinent studies. The meta-analysis of pooled data does not reveal a
significant decrease in stroke frequency associated with TAVR. For
intermediate-risk patients, both TAVR and SAVR present similar stroke
risks, indicating no procedure is inherently safer. Healthcare providers
must take this into account when counseling patients, considering each
procedure's benefits and drawbacks. This study focuses specifically on
intermediate-risk individuals, so results may not apply universally.
Further research across different risk categories is needed. This study
emphasizes the need for individualized patient care and informed
decision-making in aortic stenosis management. Copyright © 2023
Elsevier Inc.

<29>
Accession Number
2027175820
Title
Transcatheter Edge-to-Edge Repair for Tricuspid Regurgitation-A Systematic
Review and Meta-Analysis.
Source
Current Problems in Cardiology. 49(1) (no pagination), 2024. Article
Number: 102055. Date of Publication: 01 Jan 2024.
Author
Rehan S.T.; Eqbal F.; ul Hussain H.; Ali E.; Ali A.; Ullah I.; Ullah W.;
Ahmed J.; Brailovsky Y.; Rajapreyar I.N.; Asghar M.S.
Institution
(Rehan, Eqbal, ul Hussain, Ali, Ali, Ahmed) Dow University of Health
Sciences, Karachi, Pakistan
(Ullah) Kabir Medical College, Gandhara University, Peshawar, Pakistan
(Ullah, Brailovsky, Rajapreyar) Thomas Jefferson University Hospitals,
Philadelphia, PA, United States
(Asghar) Mayo Clinic, Rochester, MN, United States
Publisher
Elsevier Inc.
Abstract
Transcatheter edge-to-edge repair (TEER) has emerged as a widely accepted
procedure for tricuspid regurgitation (TR) as gauged by echocardiographic
parameters and clinical outcomes. Our study aims to assess TR severity and
other echocardiographic outcomes in patients undergoing TEER with TriClip,
MitraClip, and PASCAL devices. A literature search of 5 databases was
performed until 1st June 2023. Randomized controlled trials (RCTs) or
observational studies with moderate to severe (grade III-V) TR patients
undergoing isolated TEER were considered eligible. Echocardiographic, and
quality of life determining outcomes such as improvement in TR severity
grade >=3, New York Heart Association (NYHA) class >=3, procedural
success, 6-minute walking distance (6MWD), and adverse outcomes were
analyzed. Grade assessment was performed and studies were assessed for
risk of bias and publication bias. We included 15 studies (14
observational and 1 RCT) in our paper. Analysis revealed a substantial
reduction in TR volume (P < 0.00001), TR grading (P < 0.00001), tricuspid
annular diameter (P < 0.00001), proximal isovelocity surface area radius
(P < 0.00001), effective regurgitant orifice area (P < 0.00001), and
improvement in NYHA class (P < 0.00001) at 30 days from baseline,
postprocedurally. A significant increase in 6MWD at 1 year (P = 0.001) was
also recorded. No significant differences in left ventricular ejection
fraction (P = 0.87), fractional area change (P = 0.37), or tricuspid
annular plane systolic excursion (P = 0.76) were observed. TEER procedural
success was 97%. TEER produced a significant reduction in TR grade and
volume, NYHA class, 6MWD, and showed prominent procedural success. Large
scale RCTs comparing the TEER devices are needed to strengthen the present
findings. Copyright © 2023 Elsevier Inc.

<30>
Accession Number
2032196197
Title
A review regarding the article 'Comparative efficacy and safety of mitral
valve repair versus mitral valve replacement in Rheumatic heart disease: A
high-value care systematic review and meta-analysis'.
Source
Current Problems in Cardiology. 49(7) (no pagination), 2024. Article
Number: 102622. Date of Publication: 01 Jul 2024.
Author
Luo M.; Yuan D.
Institution
(Luo) Department of Cardiology, West China Hospital of Sichuan University,
West China School of Nursing, Sichuan University, Sichuan, Chengdu, China
(Yuan) Department of Cardiovascular Surgery, Chengdu Shang Jin Nan Fu
Hospital, West China Hospital of Sichuan University, Sichuan Province,
Chengdu, China
Publisher
Elsevier Inc.
Abstract
Rheumatic heart disease remains a major cause of cardiovascular death
worldwide. Limited real-world nationwide data are available to compare the
long-term outcomes between mitral valve repair and replacement in
rheumatic heart disease. For patients with RHD, MVP is the superior choice
of surgical intervention owing to better long-term survival, reduced
incidence of early mortality and thromboembolic events. However, it
entails higher chances of re-operation at follow-up at four, eight and
twelve years. Although feasible, surgeons may opt for MVR in patients with
a worse prognosis. Whereas degenerative mitral repair for severe MR has
been proven superior to replacement, the optimal operative strategy for
mitral RHD remains unclear. In developing countries, mitral RHD commonly
develops in young patients, predominantly consists of MR rather than MS,
and occurs more frequently than in the United States. In addition, the
predominant MR etiology (rather than MS), relatively early intervention in
the RHD timeline, and variation in Carpentier MR types among developing
world populations further make these rheumatic MVs more amenable to repair
than replacement. Patients should be carefully selected for mitral valve
repair because of its higher reoperation rate, particularly those with
previous percutaneous transvenous mitral commissurotomy. Careful
assessment of anterior leaflet mobility/calcification to determine mitral
repair or replacement was associated with improved outcomes. This
decision-making strategy may alter the threshold for rheumatic mitral
replacement in the current valve-in-valve era. Copyright © 2024

<31>
Accession Number
2028563686
Title
Prognosis of Elevated Mitral Valve Pressure Gradient After Transcatheter
Edge-to-Edge Repair: Systematic Review and Meta-Analysis.
Source
Current Problems in Cardiology. 49(2) (no pagination), 2024. Article
Number: 102095. Date of Publication: 01 Feb 2024.
Author
Du Y.; Han H.; Zhang T.; Shen H.; Han W.; Jia S.; Yu Y.; Guo Y.; Wang Z.;
Liu Y.; Shi D.; Zhou Y.
Institution
(Du, Han, Zhang, Shen, Han, Jia, Yu, Guo, Wang, Liu, Shi, Zhou) Department
of Cardiology, Beijing Anzhen Hospital, Capital Medical University,
Beijing Institute of Heart Lung and Blood Vessel Disease, Beijing Key
Laboratory of Precision Medicine of Coronary Atherosclerotic Disease,
Clinical Center for Coronary Heart Disease, Capital Medical University,
Beijing, China
Publisher
Elsevier Inc.
Abstract
Elevation in mitral valve pressure gradient (MVPG) after mitral valve
transcatheter edge-to-edge repair (M-TEER) is common, however, evidence on
its prognosis is scarce and debatable. Thus, this study aims to
investigate the impact of increased MVPG after M-TEER on outcomes. Studies
reporting the associations between the elevated MVPG after M-TEER and
outcomes were identified in a systematic search of published literatures.
Associations were pooled by meta-analysis using a random-effects model.
The primary outcome was the composite of all-cause mortality and heart
failure (HF) hospitalization. Seven observational studies with 2,730
patients (mean age, 77.7 +/- 9.3 years; male, 64.4%; functional mitral
regurgitation [MR], 65.2%) were eligible for the present analysis. M-TEER
was performed entirely using the MitraClip system (Abbott), followed by
29.7% of patients having increased MVPG. Elevated postprocedural MVPG was
not associated with a higher risk of the primary outcome, compared to low
MVPG [hazard ratio (HR) = 1.22; 95% confidence interval (CI) 0.95-1.58; p
= 0.12; I2 = 53.5%). However, the prognosis of elevated MVPG
was observed in degenerative MR patients (HR = 1.37; 95% CI 1.03-1.84; p =
0.03; I2 = 0%), whereas not in functional MR patients. Patients
with low MVPG + high residual MR had a higher risk of the primary outcome
than those with high MVPG + low residual MR after M-TEER (HR = 1.50; 95%
CI 1.10-2.03; p = 0.01; I2 = 13%). In conclusion, elevated MVPG
seems to predict adverse outcomes mainly in patients with degenerative MR.
Future studies are needed to prove these findings. Copyright ©
2023 Elsevier Inc.

<32>
Accession Number
2031938021
Title
Effectiveness of mechanical circulatory support devices in reversing
pulmonary hypertension among heart transplant candidates: A systematic
review.
Source
Current Problems in Cardiology. 49(7) (no pagination), 2024. Article
Number: 102579. Date of Publication: 01 Jul 2024.
Author
Albulushi A.; Al-Riyami M.B.; Al-Rawahi N.; Al-Mukhaini M.
Institution
(Albulushi, Al-Riyami, Al-Rawahi, Al-Mukhaini) Division of Adult
Cardiology, National Heart Center, The Royal Hospital, Muscat, Oman
Publisher
Elsevier Inc.
Abstract
Background: Pulmonary hypertension (PH) poses a significant challenge in
the selection of candidates for heart transplantation, impacting their
eligibility and post-transplant outcomes. Mechanical circulatory support
(MCS) devices, particularly left ventricular assist devices (LVADs), have
emerged as a therapeutic option to manage PH in this patient population.
This systematic review aims to evaluate the effectiveness of MCS devices
in reversing fixed pulmonary hypertension in heart transplant candidates.
 Method(s): A comprehensive literature search was conducted across
multiple databases, including PubMed, Scopus, and Web of Science, to
identify studies that evaluated the effectiveness of MCS devices in
reversing fixed pulmonary hypertension in heart transplant candidates.
Data on pulmonary vascular resistance, PH reversal, heart transplant
eligibility, and post-transplant outcomes were extracted and synthesized.
 Result(s): The review included studies that demonstrated the
potential of MCS devices, especially LVADs, to significantly reduce
pulmonary vascular resistance and reverse fixed pulmonary hypertension in
heart transplant candidates. These findings suggest that MCS devices can
improve transplant eligibility and may positively impact post-transplant
survival rates. However, the literature also indicates a need for further
comparative studies to optimize MCS device selection and treatment
protocols. Conclusion(s): MCS devices, particularly LVADs, play a
crucial role in the management of fixed pulmonary hypertension in heart
transplant candidates, improving their eligibility for transplantation and
potentially enhancing post-transplant outcomes. Future research should
focus on comparative effectiveness studies to guide clinical
decision-making and optimize patient care in this challenging clinical
scenario. Copyright © 2024 Elsevier Inc.

<33>
Accession Number
2033926222
Title
Drug-Coated Balloon Angioplasty vs Plain Balloon Angioplasty in patients
with coronary In-Stent Restenosis: A systematic review and meta-analysis
of randomized controlled trials.
Source
Current Problems in Cardiology. 49(10) (no pagination), 2024. Article
Number: 102761. Date of Publication: 01 Oct 2024.
Author
Sabina M.; Rivera-Martinez J.C.; Khanani A.; Rigdon A.; Owen P.; Massaro
J.
Institution
(Sabina, Rivera-Martinez, Khanani, Rigdon, Owen, Massaro) Lakeland
Regional Health Medical Center, 1664 Red Loop, Lakeland, FL, United States
Publisher
Elsevier Inc.
Abstract
Background: In-stent restenosis (ISR) remains a significant challenge in
interventional cardiology despite advancements in stent technology.
Drug-coated balloons (DCBs), which deliver antiproliferative agents
directly to the vessel wall, have emerged as a promising alternative to
plain balloon angioplasty for ISR treatment. This meta-analysis evaluates
the efficacy of DCBs compared to plain balloon angioplasty in patients
with coronary ISR. Method(s): A comprehensive search of PubMed and
Embase was conducted on June 27, 2024. The search identified randomized
controlled trials comparing DCBs and plain balloon angioplasty for ISR
treatment. Six trials involving 1,322 patients met the inclusion criteria.
Quality was assessed with the Cochrane Risk of Bias tool. Data extraction
and statistical analysis were performed using RevMan software, assessing
heterogeneity with the I2 statistic and publication bias using
funnel plots. Result(s): The analysis showed that DCBs significantly
reduced late in-stent and in-segment luminal loss (P < 0.001) and target
lesion revascularization (P = 0.02) compared to plain balloon angioplasty.
Major adverse cardiovascular events and the combined endpoint of target
lesion revascularization, myocardial infarction, and death also showed
highly significant improvements with DCB treatment (P < 0.00001 and P =
0.0002, respectively). However, no significant effect was observed on
myocardial infarction and mortality rates. Conclusion(s): DCBs
significantly reduce in-stent late luminal loss, target lesion
revascularization, and major adverse cardiovascular events compared to
plain balloon angioplasty. Copyright © 2024

<34>
Accession Number
2034169303
Title
Empowering treatment decisions: ChatGPT in severe coronary artery disease.
Source
Current Problems in Cardiology. 49(11) (no pagination), 2024. Article
Number: 102789. Date of Publication: 01 Nov 2024.
Author
Savithri Nandeesha D.S.
Institution
(Savithri Nandeesha) Internal Medicine, Karnataka Institute of Medical
Sciences, Hubli, India
Publisher
Elsevier Inc.

<35>
Accession Number
2028619955
Title
Outcomes of Patients With Left Ventricular Assist Devices Requiring
Intermittent Hemodialysis: Single-Center Cohort, Systematic Review, and
Individual-Participant Data Meta-Analysis.
Source
Current Problems in Cardiology. 49(1) (no pagination), 2024. Article
Number: 102090. Date of Publication: 01 Jan 2024.
Author
daSilva-deAbreu A.; Faaborg-Andersen C.; Joury A.; Tutor A.; Desai S.;
Eiswirth C.; Krim S.R.; Wever-Pinzon J.; Lavie C.J.; Ventura H.O.
Institution
(daSilva-deAbreu) Department of Cardiovascular Medicine, Mayo Clinic,
Rochester, MN, United States
(Faaborg-Andersen) Department of Internal Medicine, Massachusetts General
Hospital/Harvard Medical School, Boston, MA, United States
(Joury) Division of Cardiology, McGill University Health Centre, McGill
University, Montreal, QC, Canada
(Joury) King Salman Heart Center, King Fahad Medical City, Riyadh, Saudi
Arabia
(Tutor, Desai, Eiswirth, Krim, Wever-Pinzon, Lavie, Ventura) John Ochsner
Heart and Vascular Institute, Ochsner Clinic Foundation, New Orleans, LA,
United States
(Desai, Eiswirth, Krim, Wever-Pinzon, Lavie, Ventura) The University of
Queensland Ochsner Clinical School, Faculty of Medicine, The University of
Queensland, New Orleans, LA, United States
Publisher
Elsevier Inc.
Abstract
Patients with left ventricular assist devices (LVADs) who require
intermittent hemodialysis (iHD) are considered to have a poor prognosis
despite a paucity of supportive evidence, mostly from small single-center
cohorts and extrapolations from studies of patients who received
continuous renal replacement therapy but no iHD. We conducted a systematic
review and individual-participant-data meta-analysis of the literature
including our single-center cohort to examine the outcomes of patients
initiated on iHD following LVAD implantation. Sixty-four patients from 5
cohorts met selection criteria (age 57.5 [46-64.5] years, 87% HeartMate
II, mostly bridge to transplantation). Follow-up after iHD initiation was
87.5 (38.5-269.5) days, although it was considerably longer in our center
than in other cohorts (601.5 [93-1559] days vs 65 [26-180] days, P =
0.0007). The estimated median survival was 308 (76-912.5) days and varied
significantly among cohorts, ranging from 60 (57-65) to 838 (103-1872)
days (P = 0.0096). Twelve (18.8%) patients achieved either heart
transplantation (HT) or remission during follow-up. Patients who received
HT had an 8-fold longer estimated median survival (1972 [799-1972] days vs
244 [64-838] days, P = 0.0112). Being from a more recent cohort was
associated with better 1-year survival. Renal recovery occurred in eight
patients (13.1%) at 30 days and its cumulative incidence increased to 73%
(27/37 patients with available data) at 1 year. Most patients initiated on
iHD after LVAD experienced renal recovery within the first year after
implantation. Improved survival was observed for patients who received HT
and in those from more recent cohorts. Some patients were able to survive
on LVAD and iHD support for several years. Copyright © 2023
Elsevier Inc.

<36>
Accession Number
2029192955
Title
Efficacy and outcomes of Bempedoic acid versus placebo in patients with
statin-intolerance: A pilot systematic review and meta-analysis of
randomized controlled trials.
Source
Current Problems in Cardiology. 49(2) (no pagination), 2024. Article
Number: 102236. Date of Publication: 01 Feb 2024.
Author
Goyal A.; Changez M.I.K.; Tariq M.D.; Mushtaq F.; Shamim U.; Sohail A.H.;
Mahalwar G.
Institution
(Goyal) Department of Internal Medicine, Seth GS Medical College and KEM
Hospital, Mumbai, India
(Changez) Department of Surgery, Quetta Institute of Medical Sciences,
Quetta, Pakistan
(Tariq) Department of Internal Medicine, Foundation University Medical
College, Islamabad, Pakistan
(Mushtaq) Department of Internal Medicine, Allama Iqbal Medical College,
Lahore, Pakistan
(Shamim) Department of Internal Medicine Aga Khan University Hospital,
Karachi, Pakistan
(Sohail) Department of Surgery, University of New Mexico Health Sciences,
Albuquerque, NM, United States
(Mahalwar) Department of Internal Medicine, Cleveland Clinic Foundation,
Cleveland, OH, United States
Publisher
Elsevier Inc.
Abstract
Introduction: Bempedoic acid (BA) has shown significant progress in
reducing cholesterol levels and is relatively free from the many side
effects encountered with the use of other hyperlipidemic drugs such as
statins. However, its efficacy in patients with statin intolerance is
controversial with inconsistent results among studies. Material(s)
and Method(s): An electronic literature search was performed using various
databases such as Medline, Google Scholar, and the International Registry
of Clinical Trials. The primary endpoint was the change in LDL-C levels.
The secondary endpoints included changes in HDL-C, non-HDL-C,
triglycerides (TG), clinical outcomes such as MACE, all-cause mortality
(ACM), cardiovascular mortality, myocardial infarction (MI), and
additional safety outcomes. The least-square mean (LSM) percent change for
assessing changes in lipid parameter levels from the baseline and the risk
ratio (RR) were used for the evaluation of binary endpoints, with
statistical significance set at p<0.05. Random-effects meta-analyses were
performed for all the outcomes. Result(s): Our analysis included 5
randomized controlled trials (RCTs) with a total of 18,848 participants.
BA showed a significant reduction in LDL-C [LSM difference in %: -25.24;
95 % CI: -30.79 to -19.69; p < 0.00001], total cholesterol [LSM difference
in %:-21.28; 95 % CI:-30.58 to-11.98; p < 0.00001], non-HDL-C [LSM
difference in %: -23.27; 95 % Cl: -29.80 to -16.73 p < 0.00001], and HDL-C
[LSM difference in %:-3.37, 95 % CI:-3.73 to-3.01, p < 0.00001] compared
to placebo. In terms of clinical efficacy, BA was associated with a lower
risk of coronary revascularization [RR:0.81; 95 % CI:0.66 to 0.99; p =
0.04], hospitalization for unstable angina [RR:0.67; 95 % CI:0.50 to 0.88;
p = 0.005], and myocardial infarction [RR:0.76; 95 % CI:0.66 to 0.88;p =
0.0004]. No significant difference was observed in MACE [RR:0.81; p =
0.15], ACM [RR:0.86; p = 0.46], cardiovascular-related mortality [RR:0.79;
p = 0.44], and stroke [RR:0.83; p = 0.08] between the two groups. In terms
of safety efficacy, the risk for myalgia was significantly lower in
BA-treated patients than in placebo [RR:0.80; p = 0.0002], while the risk
for gout [RR:1.46; p < 0.0001] and hyperuricemia [RR:1.93; p < 0.00001]
was higher for BA than for placebo. The risks for other adverse effects,
such as neurocognitive disorder, nasopharyngitis urinary tract infection,
upper respiratory infection, muscular disorder, and worsening
hyperglycemia/DM were comparable between the two groups.
 Conclusion(s): Our analysis demonstrated that BA significantly
reduced the levels of LDL-C, total cholesterol, non-HDL-C, HDL-C, ApoB,
and hs-CRP compared with the placebo group. Additionally, patients who
received BA had a lower likelihood of coronary revascularization and
hospitalization due to unstable angina, MI, and myalgia. Further
large-scale RCTs are required to generate more robust
evidence. Copyright © 2023

<37>
Accession Number
2033590893
Title
Prognostic relevance of pre-procedural plasma volume status estimation in
patients undergoing transcatheter aortic valve implantation: A
meta-analysis.
Source
Current Problems in Cardiology. 49(10) (no pagination), 2024. Article
Number: 102749. Date of Publication: 01 Oct 2024.
Author
Papazoglou A.S.; Moysidis D.V.; Anastasiou V.; Daios S.; Kamperidis V.;
Ziakas A.; Giannakoulas G.
Institution
(Papazoglou) Athens Naval Hospital, Athens, Greece
(Moysidis) 424 Military General Hospital of Thessaloniki, Thessaloniki,
Greece
(Anastasiou, Daios, Kamperidis, Ziakas, Giannakoulas) First Department of
Cardiology, AHEPA University Hospital of Thessaloniki, Thessaloniki,
Greece
Publisher
Elsevier Inc.
Abstract
Background: To systematically evaluate the prognostic utility of estimated
plasma volume status (ePVS) on the outcomes of patients undergoing
transcatheter aortic valve implantation (TAVI). Method(s): The
exposure variable of interest was the ePVS, enumerating the percentage
change of the actual plasma volume from the ideal plasma volume, and being
calculated on the basis of weight and hematocrit using sex-specific
constants. A random-effects meta-analysis was performed after a systematic
literature search in PubMed, Scopus and Web Of Science. Result(s):
The systematic literature search yielded 5 eligible observational cohort
studies encompassing a total of 7,121 patients undergoing TAVI. The
meta-analysis suggested that "high ePVS" status was independently
associated with increased risk for 1-year all-cause mortality (pooled
adjusted hazard ratio: 1.63, 95 % confidence intervals: 1.36-1.95)
compared to "low ePVS". Also, the pooled unadjusted odds for 1-year
mortality, 30-day mortality, peri-procedural stroke, major bleeding, and
acute kidney injury were significantly increased in the "high ePVS" group
of patients. Conversely, the unadjusted risk of pacemaker implantation and
major vascular complications did not differ significantly between the 2
groups. Conclusion(s): Plasma volume expansion appears to be linked
with a worse peri-procedural and long-term prognostic course in TAVI. Its
use in clinical practice could refine risk stratification and candidate
selection practices. Copyright © 2024

<38>
Accession Number
2032130254
Title
A review regarding the article 'Local versus General Anaesthesia for
Transcatheter Aortic Valve Implantation (TAVI): A systematic review,
meta-analysis, and trial sequential analysis of randomised and
propensity-score matched studies'.
Source
Current Problems in Cardiology. 49(7) (no pagination), 2024. Article
Number: 102629. Date of Publication: 01 Jul 2024.
Author
Li H.; Li J.; Huang J.
Institution
(Li, Huang) Department of Anesthesiology, Sichuan Provincial People's
Hospital, School of Medicine, University of Electronic Science and
Technology of China, Sichuan, Chengdu, China
(Li) Department of Anesthesiology, Chengdu Seventh People's Hospital,
Sichuan, Chengdu, China
Publisher
Elsevier Inc.
Abstract
Transcatheter aortic valve implantation (TAVI) is a promising treatment
strategy for high-risk surgical patients, and trials investigating its
effectiveness in intermediate- and lower-risk patients are underway. Data
are inconsistent regarding the superiority of using local anesthesia with
conscious sedation alone versus general anesthesia (GA) as the anesthesia
management of choice for elderly frail patients. Historically, TAVI
procedure is performed under GA with transesophageal echocardiography.
This approach gives operators stable hemodynamic control of the patient
and helps decrease the risk of many of the operation's documented
complications, including paravalvular leak and valve malpositioning.
However, some studies have criticized the dependence of GA on mechanical
ventilation and an increased need for catecholamine and/or vasopressor
agents. Alternatively, to further capitalize on the minimally invasive
nature of TAVI, some authors have advocated for the use of local
anesthesia (LA) and/or conscious sedation approach, which would decrease
procedure time, length of hospital stay, and minimize the need for
postoperative inotropes. Ultimately and at present, the choice of
anesthesia is based on the personal experience and preference of the Heart
Team involved in the TAVI procedure, which will dictate the best possible
management plan for each patient. Many patients currently undergoing TAVI
are elderly and have multiple comorbidities, making their care complex.
Anesthetic care is shifting from GA to sedation and regional block, but
life-threatening complications are still relatively common and safety
during planning and conduct of these procedures by the heart team, with
the anesthesiologist at the center, is paramount. Copyright ©
2024

<39>
Accession Number
2028560797
Title
Skeletonized versus Pedicled harvesting of internal mammary artery: A
systematic review and Meta-analysis.
Source
Current Problems in Cardiology. 49(1) (no pagination), 2024. Article
Number: 102160. Date of Publication: 01 Jan 2024.
Author
Shafiq A.; Maniya M.T.; Duhan S.; Jamil A.; Hirji S.A.
Institution
(Shafiq, Jamil) Department of Medicine, Dow University of Health Sciences,
Karachi, Pakistan
(Maniya) Department of Medicine, Ziauddin Medical University, Karachi,
Pakistan
(Duhan) Department of Medicine, Sinai Hospital of Baltimore, MD, United
States
(Hirji) Division of Thoracic and Cardiac Surgery, Department of Surgery,
Brigham and Women's Hospital, Harvard Medical School, Boston, Mass, United
States
Publisher
Elsevier Inc.
Abstract
There are two recognized internal mammary artery (IMA) harvesting
techniques during coronary artery bypass grafting (CABG): pedicled and
skeletonized. This systematic review and meta-analysis sought to compare
the clinical outcomes of the two harvesting techniques. A comprehensive
electronic literature search of PubMed, Scopus, and Embase was conducted
from inception till June 2023. Thirty-one studies with a total of 13005
patients met our inclusion criteria. The results from the included studies
were presented as weighted mean difference (WMD) with its relevant
standard deviation (SD) for continuous variables, while Odds Ratio (OR)
was used for dichotomous variables. A 95% confidence interval (CI) was
used, and the results were pooled using a random effects model. The
skeletonized IMA demonstrated a significantly reduced risk of sternal
wound infection (SWI) compared to the pedicled IMA (OR = 0.45 [95% CI,
0.32-0.66]; p = 0.0001). The conduit length used was significantly longer
in the skeletonized IMA (WMD -2.48, 95% CI, [-3.75, -1.20], P = 0.0001)
and a significantly higher postoperative flow rate was observed while
using skeletonization compared to the pedicled harvesting (WMD -13.11, 95%
CI, [-22.52, -3.70], P = 0.006). However, no significant difference was
seen in mortality between the two techniques (OR = 1.19 [95% CI,
1.00-1.41]; p = 0.05). Pedicled harvesting demonstrated significantly
reduced incidents of MI (OR = 1.38 [95% CI, 1.13-1.69]; p = 0.002), while
significant results in graft patency were observed favoring pedicled
harvesting over skeletonization (OR = 0.63 [95% CI, 0.40-0.98]; p =
0.04). Copyright © 2023

<40>
Accession Number
2028557351
Title
Very Long-term Outcome of Bilateral Internal Thoracic Artery in Diabetic
Patients: A Systematic Review and Reconstructed Time-To-Event
Meta-analysis.
Source
Current Problems in Cardiology. 49(1) (no pagination), 2024. Article
Number: 102135. Date of Publication: 01 Jan 2024.
Author
Formica F.; Gallingani A.; Tuttolomondo D.; Hernandez-Vaquero D.;
D'Alessandro S.; Singh G.; Grassa G.; Pattuzzi C.; Nicolini F.
Institution
(Formica, Grassa, Pattuzzi, Nicolini) Department of Medicine and Surgery,
University of Parma, Parma, Italy
(Gallingani, Grassa, Pattuzzi, Nicolini) Cardiac Surgery Unit, University
Hospital of Parma, Parma, Italy
(Tuttolomondo) Cardiology Unit, University Hospital of Parma, Parma, Italy
(Hernandez-Vaquero) Cardiac Surgery Department, Hospital Universitario
Central de Asturias, Oviedo, Spain
(D'Alessandro) Cardiac Surgery Unit, San Giovanni Bosco Hospital, Turin,
Italy
(Singh) Department of Critical Care Medicine and Division of Cardiac
Surgery, Mazankowski Alberta Heart Institute, University of Alberta,
Edmonton, Canada
Publisher
Elsevier Inc.
Abstract
The benefits of single (SITA) and bilateral internal thoracic arteries
(BITA) in diabetics undergoing coronary bypass grafting (CABG) are
conflicting. We undertook a study-level meta-analysis to compare early and
long-term outcomes of both CABG configurations. PubMed, CENTRAL, and
EMBASE were searched for studies comparing BITA versus SITA for isolated
CABG surgery in diabetics. Randomized trials or observational studies were
considered eligible for the analysis. Kaplan-Meier curves of long-term
survival were reconstructed and compared with Cox linear regression;
incidence rate ratios (IRR) with 95% confidence intervals (CI) for
long-term survival were calculated. Landmark analysis and time-varying
hazard ratio (HR) were analyzed. Odds ratios (OR) were extracted for early
mortality, postoperative stroke, deep sternal wound infection (DSWI), and
myocardial infarction (MI). A random effects meta-analysis was performed.
Sensitivity analyses included leave-one-out-analyses and meta-regression.
Thirteen studies (7332 patients) were included. Overall, at 20-year
follow-up, BITA was associated with higher survival (HR = 0.77; 95% CI,
0.71-0.84; P < 0.0001). Time-varying HR and landmark analysis reported
BITA was associated with a higher rate of 10-year survival (HR = 0.75, 95%
CI 0.68-0.82, P < 0.0001), while from 10 to 20-year follow-up no
difference was revealed (HR = 0.99, 95% CI 0.82-1.19, P = 0.93). There was
no increase in early mortality, postoperative MI, stroke, or DSWI between
the groups. At meta-regression, the higher the age, the higher the
long-term overall survival in patients with BITA. In diabetics, the BITA
approach is associated with improved 10-year survival with no increase in
early mortality, MI, stroke, or DSWI. In the 10-20-year timeframe, BITA
and SITA showed comparable survival. Copyright © 2023 Elsevier
Inc.

<41>
Accession Number
2025615595
Title
Delayed Ventricular Septal Rupture Repair After Myocardial Infarction: An
Updated Review.
Source
Current Problems in Cardiology. 48(10) (no pagination), 2023. Article
Number: 101887. Date of Publication: 01 Oct 2023.
Author
Arsh H.; Pahwani R.; Arif Rasool Chaudhry W.; Khan R.; Khenhrani R.R.;
Devi S.; Malik J.
Institution
(Arsh) Department of Medicine, THQ Hospital, Pasrur, Pakistan
(Pahwani) Department of Medicine, Jinnah Sindh Medical University,
Karachi, Pakistan
(Arif Rasool Chaudhry) Department of Surgery, Cavan General Hospital,
Cavan, Ireland
(Khan) Department of Neurosurgery, Sherwan Rural Health Center, Sherwan,
Pakistan
(Khenhrani, Devi) Department of Medicine, Liaquat University of Medical
and Health Sciences, Jamshoro, Pakistan
(Malik) Department of Cardiovascular Research, Cardiovascular Analytics
Group, Islamabad, Pakistan
Publisher
Elsevier Inc.
Abstract
Ventricular septal rupture (VSR) is a rare but serious complication that
can occur after myocardial infarction (MI) and is associated with
significant morbidity and mortality. The optimal management approach for
VSR remains a topic of debate, with considerations including early versus
delayed surgery, risk stratification, pharmacological interventions,
minimally invasive techniques, and tissue engineering. The pathophysiology
of VSR involves myocardial necrosis, inflammatory response, and enzymatic
degradation of the extracellular matrix (ECM), particularly mediated by
matrix metalloproteinases (MMPs). These processes lead to structural
weakening and subsequent rupture of the ventricular septum.
Hemodynamically, VSR results in left-to-right shunting, increased
pulmonary blood flow, and potentially hemodynamic instability. The early
surgical repair offers the advantages of immediate closure of the defect,
prevention of complications, and potentially improved outcomes. However,
it is associated with higher surgical risk and limited myocardial recovery
potential during the waiting period. In contrast, delayed surgery allows
for a period of myocardial recovery, risk stratification, and optimization
of surgical outcomes. However, it carries the risk of ongoing
complications and progression of ventricular remodeling. Risk
stratification plays a crucial role in determining the optimal timing for
surgery and tailoring treatment plans. Various clinical factors, imaging
assessments, scoring systems, biomarkers, and hemodynamic parameters aid
in risk assessment and guide decision-making. Pharmacological
interventions, including vasopressors, diuretics, angiotensin-converting
enzyme inhibitors, beta-blockers, antiplatelet agents, and antiarrhythmic
drugs, are employed to stabilize hemodynamics, prevent complications,
promote myocardial healing, and improve outcomes in VSR patients.
Advancements in minimally invasive techniques, such as percutaneous device
closure, and tissue engineering hold promise for less invasive
interventions and better outcomes. These approaches aim to minimize
surgical morbidity, optimize healing, and enhance patient recovery. In
conclusion, the management of VSR after MI requires a multidimensional
approach that considers various aspects, including risk stratification,
surgical timing, pharmacological interventions, minimally invasive
techniques, and tissue engineering. Copyright © 2023 Elsevier
Inc.

<42>
Accession Number
2017846998
Title
Transcatheter Versus Surgical Aortic Valve Replacement in Hypertrophic
Cardiomyopathy Patients with Aortic Stenosis.
Source
Current Problems in Cardiology. 48(8) (no pagination), 2023. Article
Number: 101180. Date of Publication: 01 Aug 2023.
Author
Mhanna M.; Minhas A.M.K.; Ariss R.W.; Ahuja K.R.; Mostafa A.; Nazir S.;
Sheikh M.
Institution
(Mhanna) Department of Internal Medicine, The University of Toledo,
Toledo, OH, United States
(Minhas) Division of Medicine, Forrest General Hospital, Hattiesburg, MS,
United States
(Ariss, Mostafa, Nazir) Department of Cardiovascular Medicine, University
of Toledo, Toledo, OH, United States
(Ahuja) Division of Cardiology, Reading Hospital-Tower Health System, West
Reading, PA, United States
(Sheikh) Division of Cardiovascular Medicine, ProMedica Toledo Hospital,
Toledo, OH, United States
Publisher
Elsevier Inc.
Abstract
Surgical aortic valve replacement (SAVR) and transcatheter aortic valve
replacement (TAVR) are well established treatment options for severe
aortic stenosis (AS). However, patients with hypertrophic cardiomyopathy
(HCM) were excluded from pivotal randomized controlled trials of TAVR vs
SAVR. We queried the 2016 to 2019 National Inpatient Sample to identify
adult hospitalizations with HCM who underwent SAVR or TAVR for severe AS.
The primary outcome was in-hospital mortality. Secondary outcomes included
cardiac arrest, new permanent pacemaker (PPM), cardiac tamponade, bleeding
requiring transfusion, stroke/transient ischemic attack, acute kidney
injury (AKI), and resource utilization (length of stay [LOS], hospital
costs, and discharge to facility). Of 1245 HCM hospitalizations with
severe AS, 595(47.8%) underwent TAVR and 650 (52.2%) underwent SAVR.
In-hospital mortality rate was lower in the TAVR group. Cardiac arrest,
cardiogenic shock, pressor use, new PPM, and cardiac tamponade were not
significantly different between the 2 groups. When compared to SAVR, TAVR
was associated with lower rates of bleeding requiring transfusion,
vascular complications, AKI, and invasive mechanical ventilation.
Furthermore, TAVR was associated with a shorter hospital stay, fewer
facility discharges, but comparable hospital costs. Our findings indicate
that TAVR is associated with lower risk of in-hospital mortality, certain
peri-procedural complications, shorter hospital stay, and fewer facility
discharges in HCM patients with isolated AS compared to SAVR. Further
studies are needed to assess the mid- and long-term outcomes of TAVR vs
SAVR in HCM patients with AS. Copyright © 2022 Elsevier Inc.

<43>
Accession Number
2021126744
Title
Causes and Determinants of Heart Failure Readmissions Post Transcutaneous
Aortic Valve Replacement: A Systematic Review and Meta-Analysis.
Source
Current Problems in Cardiology. 48(1) (no pagination), 2023. Article
Number: 101428. Date of Publication: 01 Jan 2023.
Author
Yasmin F.; Aamir M.; Moeed A.; Iqbal K.; Iqbal A.; Asghar M.S.; Ullah W.;
Rajapreyar I.; Brailovsky Y.
Institution
(Yasmin, Moeed, Iqbal, Iqbal) Department of Medicine, Dow Medical College,
Dow University of Health Sciences, Karachi, Pakistan
(Aamir) Division of Cardiology, Lehigh Valley Heart and Vascular
Institute, Allentown, PA, United States
(Asghar) Division of Nephrology and Hypertension, Mayo Clinic, Rochester,
MN
(Ullah, Rajapreyar, Brailovsky) Division of Cardiology, Thomas Jefferson
University Hospitals, Philadelphia, PA
(Brailovsky) Department of Advanced Heart Failure, Mechanical Circulatory
Support, Heart Transplant, Jefferson Heart Institute, Sidney Kimmel School
of Medicine at Thomas Jefferson University, 833 Chestnut Street, Suite
640, Philadelphia, PA
Publisher
Elsevier Inc.
Abstract
Transcutaneous aortic valve implantation (TAVI) has transformed the
management of aortic stenosis (AS) and is increasingly being used for
patients with symptomatic, severe aortic stenosis who are ineligible or at
high risk for conventional cardiac surgery. PUBMED, Google Scholar, and
SCOPUS databases were searched to identify studies reporting heart failure
hospitalization after TAVI. Major factors evaluated for HF hospitalization
were age, comorbidities such as hypertension, atrial fibrillation (AF),
chronic pulmonary disease including COPD, chronic kidney disease, baseline
LVEF before the procedure, NYHA symptom class, and society of thoracic
surgeons (STS) score. Hazard ratio (HR) with a 95% confidence interval
were computed using random-effects models. A total of eight studies were
included comprising 77,745 patients who underwent TAVI for severe aortic
stenosis. The presence of diabetes mellitus (HR: 1.39, 95% CI [1.17,
1.66], chronic kidney disease (CKD) (HR: 1.39, 95% CI [1.31, 1.48], atrial
fibrillation (HR: 1.69, 95% CI [1.42, 2.01], chronic pulmonary disease
(HR: 1.33, 95% CI [1.12, 1.58], and a high STS score (HR: 1.07, 95% CI
[1.03, 1.11] were positive predictors of 1-year HF hospitalization after
TAVI. Patients with diabetes mellitus, AF, CKD, chronic pulmonary disease,
and a high STS score are at an increased risk of heart failure
hospitalization at 1-year of TAVI, whereas increasing age, hypertension,
LVEF <50%, and NYHA class III/IV symptoms did not predict HF
hospitalization. Careful follow-up after TAVI in high-risk patients, with
closer surveillance for HF particularly, is key to preventing HF
hospitalizations and death. Copyright © 2022

<44>
Accession Number
2021340106
Title
Cardiovascular Outcomes of Older versus Newer Generation Transcatheter
Aortic Valve Replacement Recipients: A Systematic Review & Meta-analysis.
Source
Current Problems in Cardiology. 48(2) (no pagination), 2023. Article
Number: 101467. Date of Publication: 01 Feb 2023.
Author
Sattar Y.; Prakash P.; Almas T.; Mir T.; Titus A.; Ahmad S.; Khan M.S.;
Aggarwal A.; Ullah W.; Alhharbi A.; Kakouros N.; Alraies M.C.; Qureshi
W.T.
Institution
(Sattar, Alhharbi) Department of Cardiology, West Virginia University,
Morgantown, WV, United States
(Prakash, Mir) Department of Internal Medicine, Detroit Medical center,
Wayne State University, Detroit, MI, United States
(Almas) Royal College of Surgeons in Ireland, Dublin, Ireland
(Titus) Department of Internal Medicine, Saint Vincent Hospital,
Worcester, MA
(Ahmad) Department of Internal Medicine, Icahn School of Medicine at Mount
Sinai - Elmhurst Hospital, Queens, NY, United States
(Khan) Department of Internal Medicine, Mercy St Vincent Medical Centre,
Toledo Ohio
(Aggarwal) Department of Internal Medicine, Ascension providence Rochester
(Ullah) Department of Internal Medicine, Abington Jefferson Health,
Abington, PA
(Kakouros, Qureshi) Division of Cardiology, University of Massachusetts
School of Medicine, Worcester, MA
(Alraies) Department of Interventional Cardiology, Detroit Medical Center,
DMC Heart Hospital, Detroit, MI, United States
Publisher
Elsevier Inc.
Abstract
Newer generation transcatheter heart valves (THV) are presumed to yield
better clinical efficacy and postprocedural complication profile as
compared to transcatheter aortic valve replacement (TAVR) using older
generation THVs. The real impact of newer generation valves on TAVR
outcomes is not well known. Studies comparing older and newer generation
THVs were identified from online databases including PubMed, EMBASE,
Cochrane, and ClinicalTrials.gov from inception until August 2020. The
primary outcome of the study was to compare mortality. Secondary outcomes
included cerebrovascular events, myocardial infarction, major vascular
complications, major bleeding, acute kidney injury, paravalvular leak, and
post-procedural pacemaker implantation. Statistical analysis was performed
using the Mantel-Haenszel random effect model with an odds ratio (OR), 95%
confidence interval (CI), and p-value significance <=0.05. A total of 14
studies were included with a combined patient population of 5697 patients
(older generation n=1996; newer generation n=3701). Newer generation
valves showed statistically significant results favoring lower major
vascular complications (OR=2.05; 95% CI, 1.33-3.18; P = 0.00), major
bleeding (OR=1.99; 95% CI, 1.35-2.93; P = 0.00), acute kidney injury
(OR=1.71; 95% CI, 1.13-2.59; P = 0.01), paravalvular leak (OR=2.41; 95%
CI, 1.11-5.28; P = 0.03) and mortality (OR=1.50; 95% CI, 1.10-2.06; P =
0.01) as compared to older generation valves. Cerebrovascular events,
myocardial infarction, and pacemaker placement rates were found to be
similar between older and newer generation valves. TAVR outcomes using
newer generation valves are superior to those of older generation valves
in terms of major vascular complications, acute kidney injury,
paravalvular leak, and mortality. Copyright © 2022 Elsevier Inc.

<45>
Accession Number
2023850070
Title
Transseptal vs Transapical Transcatheter Mitral Valve-in-Valve and
Valve-in-Ring Implantation: A Systematic Review and Meta-Analysis.
Source
Current Problems in Cardiology. 48(7) (no pagination), 2023. Article
Number: 101684. Date of Publication: 01 Jul 2023.
Author
Al-Tawil M.; Butt S.; Reap S.; Duric B.; Harahwa T.; Chandiramani A.;
Zeinah M.; Harky A.
Institution
(Al-Tawil) Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
(Butt) Department of Thoracic Surgery, Nottingham City Hospital,
Nottingham, United Kingdom
(Reap) Department of Vascular Surgery, Manchester Royal Infirmary,
Manchester, United Kingdom
(Duric) King's College London, GKT School of Medical Education, London,
United Kingdom
(Harahwa) Department of Obstetrics and Gynecology, University Hospital
Lewisham, London, United Kingdom
(Chandiramani) Department of General Surgery, Aberdeen Royal Infirmary,
Scotland, United Kingdom
(Zeinah) Faculty of Medicine, Ain Sham University, Cairo, Egypt
(Zeinah, Harky) Department of Cardiothoracic Surgery, Liverpool Heart and
Chest Hospital, Liverpool, United Kingdom
Publisher
Elsevier Inc.
Abstract
Transcatheter mitral valve replacement has become a useful alternative for
patients with failed mitral prosthesis or annuloplasty rings who are
deemed high risk for redo surgery. We aimed to compare the clinical
outcomes following transseptal (TS) and transapical (TA) approaches in
transcatheter mitral valve-in-valve and valve-in-ring implantation
(TMViV/R). Electronic databases PubMed, MEDLINE, and Embase were searched
through November 2022. Both clinical trials and observational studies
comparing patients undergoing TS and TA TMViV/R were eligible for
inclusion. Primary outcomes were 30-day and 1-year mortality.
Postoperative stroke, left ventricle outlet tract (LVOT) obstruction,
mitral valve pressure gradient (MVPG), bleeding, and length of hospital
stay were also evaluated. Seven observational studies were included
comparing patients undergoing TS (n = 1875) and TA (n = 1120) TMViV/R. The
TS group had significantly lower 30-day mortality (OR: 0.66; 95%
confidence interval [CI] [0.47, 0.94]; P = 0.02, I2 = 0%) and lower
one-year mortality risk group (HR: 0.79; 95% CI [0.63, 0.99]; P = 0.04, I2
= 0%) compared to the TA group. The TS group had consistent shorter
in-hospital stay (MD = -3.79; 95% CI [-5.23, -2.34] days; P < 0.0001, I2 =
75%). Postoperative stroke, bleeding and LVOT obstruction tended to be
lower in the TS but the results did not reach statistical significance.
Postoperative MVPG was similar between both groups. The TS approach has
lower early mortality, lower 1-year death hazard, shorter in-hospital
stay, and a trend toward lower complication rates when compared to TA
TMViV/R. Further controlled trials may support the evidence and provide
long-term outcomes. Copyright © 2023 Elsevier Inc.

<46>
Accession Number
2021850541
Title
Cardiac Rehabilitation After TAVI -A Systematic Review and Meta-Analysis.
Source
Current Problems in Cardiology. 48(3) (no pagination), 2023. Article
Number: 101531. Date of Publication: 01 Mar 2023.
Author
Oz A.; Tsoumas I.; Lampropoulos K.; Xanthos T.; Karpettas N.; Papadopoulos
D.
Institution
(Oz, Tsoumas, Lampropoulos, Xanthos, Karpettas, Papadopoulos) European
University Cyprus, School of medicine, Nicosia, Cyprus
Publisher
Elsevier Inc.
Abstract
Despite the increasing popularity of Transcatheter aortic valve
implantation (TAVI) in patients with high surgical risk, there is no
current guideline for the management of patients following the
intervention. This systematic review and meta-analysis aims to summarize
and analyse all clinical data and evidence regarding the effectiveness and
outcomes of CR following TAVI. The first meta-analysis measured the walked
distance in the Six-Minute Walk Test (6MWT) and the second meta-analysis
included studies that showed the Barthel Index (BI) before and after CR.
The mean distance walked prior to CR was 235.88 +/- 69.36 m increased to
292.12 +/- 54.92 m after rehabilitation, signifying a moderate clinically
relevant effect size (0.593 (0.42, 0.76); P=0.00). The mean BI score
before CR was 76.6 +/- 11.5 which increased to 89.8 +/- 5.5 after the
programme and similarly demonstrated a significant standardized mean
improvement (0.75 (0.57, 0.93); I= 0.00). Exercise-based CR in patients
with aortic stenosis treated with TAVI demonstrated a significant
improvement in exercise tolerance and functional independence shown by the
6MWT and BI. Copyright © 2022 Elsevier Inc.

<47>
Accession Number
2017201609
Title
Cerebral Embolic Protection during Transcatheter Aortic Valve
Implantation: Updated Systematic Review and Meta-Analysis.
Source
Current Problems in Cardiology. 48(6) (no pagination), 2023. Article
Number: 101127. Date of Publication: 01 Jun 2023.
Author
Zahid S.; Ullah W.; Zia Khan M.; Faisal Uddin M.; Rai D.; Abbas S.; Usman
Khan M.; Hussein A.; Salama A.; Bandyopadhyay D.; Baibhav B.; Rao M.; Alam
M.; Alraies M.C.; Balla S.; Alkhouli M.; Depta J.P.
Institution
(Zahid, Faisal Uddin, Rai, Hussein, Salama, Baibhav, Rao, Depta)
Sands-Constellation Heart Institute, Rochester General Hospital,
Rochester, NY, United States
(Ullah, Usman Khan) Department of Cardiovascular Medicine, Thomas
Jefferson University Hospitals, Philadelphia, PA, United States
(Zia Khan, Balla) Division of Cardiovascular Medicine, West Virginia
University Heart & Vascular Institute, Morgantown, WV, United States
(Abbas) Department of Medicine, Dow Medical College, Karachi, Pakistan
(Bandyopadhyay) Division of Cardiovascular Medicine, Westchester Medical
Center at New York Medical College, Valhalla, New York, NY, United States
(Alam) Division of Cardiology, Baylor College of Medicine, Houston, TX,
United States
(Alraies) Division of Cardiology, Detroit Medical Center, Detroit, MI,
United States
(Alkhouli) Division of Interventional Cardiology, Mayo Clinic, Rochester,
MN, United States
Publisher
Elsevier Inc.
Abstract
In patient undergoing transcatheter aortic valve implantation (TAVI),
stroke remains a potentially devastating complication associated with
significant morbidity, and mortality. To reduce the risk of stroke,
cerebral protection devices (CPD) were developed to prevent debris from
embolizing to the brain during TAVI. We performed a systematic review and
meta-analysis to determine the safety and efficacy of CPD in TAVI. The
MEDLINE (PubMed, Ovid) and Cochrane databases were queried with various
combinations of medical subject headings to identify relevant articles.
Statistical analysis was performed using a random-effects model to
calculate unadjusted odds ratio (OR), including subgroup analyses based on
follow-up duration, study design, and type of CPD. Using a pooled
analysis, CPD was associated with a significant reduction in major adverse
cardiovascular events MACE (OR 0.75, 95% CI 0.70-0.81, P < 0.01),
mortality (OR 0.65, 95% CI 0.58-0.74, P < 0.01) and stroke (OR 0.84, 95%
CI 0.76-0.93, P < 0.01) in patients undergoing TAVI. Similarly, on MRI
volume per lesion were lower for patients with CPD use. No significant
difference was observed in acute kidney injury (OR 0.75, 95% CI 0.42-1.37,
P = 0.68), bleeding (OR 0.92, 95% CI 0.71-1.20, P = 0.55) or vascular
complications (OR 0.90, 95% CI 0.62-1.31, P = 0.6) for patients undergoing
TAVI with CPD. In conclusion, CPD device use in TAVI is associated with a
reduction of MACE, mortality, and stroke compared with patients undergoing
TAVI without CPD. However, the significant reduction in mortality is
driven mainly by observational studies. Copyright © 2022 Elsevier
Inc.

<48>
Accession Number
2017918513
Title
Clopidogrel Vs Aspirin Monotherapy Following Dual Antiplatelet Therapy
After Percutaneous Coronary Intervention: A Systematic Review and
Meta-analysis.
Source
Current Problems in Cardiology. 48(8) (no pagination), 2023. Article
Number: 101174. Date of Publication: 01 Aug 2023.
Author
Tan B.E.-X.; Wong P.Y.; Baibhav B.; Thakkar S.; Azhar A.Z.; Rao M.; Cheung
J.W.
Institution
(Tan, Thakkar, Azhar) Department of Internal Medicine, Rochester General
Hospital, Rochester, NY, United States
(Wong) Department of Internal Medicine, Sungai Buloh Hospital, Selangor,
Malaysia
(Baibhav, Rao) Sands-Constellation Heart Institute, Rochester Regional
Health, Rochester, NY, United States
(Cheung) Division of Cardiology, Department of Medicine, Weill Cornell
Medicine, New York, NY, United States
Publisher
Elsevier Inc.
Abstract
Current guidelines recommend 6-12 months of dual antiplatelet therapy
(DAPT) after percutaneous coronary intervention (PCI) followed by aspirin
monotherapy indefinitely. We aimed to assess the efficacy and safety of
clopidogrel vs aspirin in the post-PCI population after completing DAPT.
We systematically searched 5 electronic databases to identify studies
comparing clopidogrel with aspirin following completion of DAPT after PCI.
We pooled outcomes for major adverse cardiac events (MACE), cardiac death,
all-cause death, major bleeding, myocardial infarction (MI), and stroke.
We included 5 studies with 13,850 patients, of whom 5601 (40.4%) received
clopidogrel. Mean follow-up was 12-36 months. All patients received
drug-eluting stents. Duration of DAPT before antiplatelet monotherapy was
1-18 months. Clopidogrel was associated with reductions in MACE (Risk
ratio [RR] 0.77, 95% confidence interval [CI] 0.65-0.91), any stroke (RR
0.51; 95% confidence interval [CI] 0.35-0.76), ischemic stroke (RR 0.55;
95% CI 0.32-0.94), and hemorrhagic stroke (RR 0.24; 95% CI 0.09-0.68) when
compared with aspirin. Cardiac death (RR 0.87; 95% CI 0.53-1.41),
all-cause death (RR 1.06; 95% CI 0.81-1.39), major bleeding (RR 0.74; 95%
CI 0.43-1.29), MI (RR 1.01; 95% CI 0.64-1.60), repeat revascularization
(RR 0.88; 95% CI 0.71-1.09), target vessel revascularization (RR 0.76; 95%
CI 0.52-1.13), and stent thrombosis (RR 0.96; 95% CI 0.35-2.59) were not
significantly different among groups. Compared with aspirin, clopidogrel
was associated with reductions in MACE and stroke (ischemic and
hemorrhagic) following DAPT completion after PCI. There were no
significant differences in mortality, major bleeding, MI, and repeat
revascularization between groups. Copyright © 2022 Elsevier Inc.

<49>
Accession Number
2022142529
Title
Racial Disparity Among the Clinical Outcomes Post-Myocardial Infarction
Patients: A Systematic Review and Meta-analysis.
Source
Current Problems in Cardiology. 48(4) (no pagination), 2023. Article
Number: 101528. Date of Publication: 01 Apr 2023.
Author
Jaiswal V.; Hanif M.; Ang S.P.; Mehta A.; Ishak A.; Song D.; Daneshvar F.;
Butey S.; Gera A.; Aujla S.; Raj N.; Iqbal A.; Kumar V.; Huang H.;
Mukherjee D.; Jaiswal A.; Wajid Z.
Institution
(Jaiswal, Ishak, Gera, Raj, Mukherjee, Jaiswal) JCCR Cardiology Research,
Varanasi, India
(Hanif) Department of Internal Medicine, SUNY Upstate Medical University,
NY, United States
(Ang) Department of Internal medicine, Rutgers Health/Community Medical
Center, NJ
(Mehta) University of Debrecen, Faculty of Medicine, Debrecen, Hungary
(Song) Department of Internal Medicine, Icahn School of Medicine at Mount
Sinai, NY, United States
(Daneshvar) Department of Cardiology, AdventHealth, FL
(Butey) Department of Medicine, Indira Gandhi Government Medical College,
Nagpur, India
(Aujla) Department of Medicine, Government Medical College, Punjab,
Amritsar, India
(Iqbal) Saidu Group of Teaching Hospital Swat, Dublin, Ireland
(Kumar) Department of Medicine, The Brooklyn Hospital Center, NY, United
States
(Huang) Royal College of Surgeons in Ireland, Dublin, Ireland
(Wajid) Department of Internal Medicine, Wayne State University School of
Medicine, MI
Publisher
Elsevier Inc.
Abstract
The clinical outcomes post-Myocardial Infarction (MI) between Black and
White patients have not been well studied, with limited literature
available. We conducted a meta-analysis to estimate the clinical outcomes
between Black and White patients post-MI.We systematically searched the
PubMed, Embase, and Scopus databases from inception until September 26,
2022. A total of 6 studies with 220,984 patients have been included in the
analysis. The mean age of patients with White and Black race was 68.46 and
65.14 years, respectively. The most common comorbidity among White and
Black patients was hypertension (53% vs 87.73%). Our analysis showed that
the likelihood of all-cause mortality (OR, 0.71[95%CI: 0.56-0.91]),
P=0.01] and stroke (OR, 0.74[95%CI: 0.67-0.81]), P<0.001] were
significantly lower in white patients compared with black patients.
However, Black patients had fewer utilization of CABG (OR, 1.38[95%CI:
1.19-1.62], P<0.001]) and PCI (OR, 1.31[95%CI: 1.101-1.68]), P=0.04]
compared with White patients, while 30-day mortality was comparable
between both the groups. To our knowledge, this is the first meta-analysis
with the largest sample size thus far, highlighting that Black patients
are at increased risk for all-cause mortality and stroke but have lower
utilization of revascularization among MI patients than White
patients. Copyright © 2022 Elsevier Inc.

<50>
Accession Number
2026212129
Title
Clinical Outcomes of Transcatheter Aortic Valve Replacement With and
Without Percutaneous Coronary Intervention-An Updated Meta-Analysis and
Systematic Review.
Source
Current Problems in Cardiology. 48(11) (no pagination), 2023. Article
Number: 101980. Date of Publication: 01 Nov 2023.
Author
Yassen M.; Moustafa A.; Venkataramany B.; Schodowski E.; Royfman R.;
Eltahawy E.
Institution
(Yassen) Department of Internal Medicine, University of Toledo Medical
Center, Toledo, OH, United States
(Moustafa, Eltahawy) Department of Internal Medicine, Division of
Cardiovascular Medicine, University of Toledo Medical Center, Toledo, OH,
United States
(Venkataramany, Schodowski, Royfman) University of Toledo, College of
Medicine and Life Sciences, Toledo, OH, United States
Publisher
Elsevier Inc.
Abstract
Transcatheter aortic valve replacement (TAVR) is indicated for high-risk
patients with severe degenerative aortic stenosis (AS). Given the shared
risk factors and coexistence of obstructive coronary artery disease (CAD)
and AS, there is inconsistent clinical data regarding potential survival
benefits of paired percutaneous coronary intervention (PCI) with TAVR
procedures. We performed a literature search using PubMed, Embase, and
Cochrane Library from inception through June 2023 assessing the impact of
concomitant PCI in patients with obstructive CAD undergoing TAVR. The
primary outcomes were 30-day all-cause mortality, 30-day cardiovascular
mortality, and 6 months-1 year all-cause mortality. Secondary outcomes
included 30-day myocardial infarction, stroke, major bleeding
complications, and acute kidney injury (AKI). A total of 11 studies
involving 2804 patients were included in the final analysis. Compared to
patients undergoing TAVR alone, the TAVR+PCI group showed no significant
difference in 30-day all-cause mortality (RR 0.90, CI 0.66, 1.22, P =
0.49), 30-day cardiovascular mortality (RR 0.71 CI 0.44, 1.14, P = 0.16),
or 6 months-1 year all-cause mortality (RR 0.94, CI 0.75, 1.18, P = 0.57).
Regarding secondary outcomes, 30-day myocardial infarction was higher in
the TAVR+PCI group (RR 3.09, CI 1.26, 7.57, P = 0.01), with no significant
differences noted in rates of 30-day stroke (RR 1.14, CI 0.56, 2.33, P =
0.72), major bleeding/vascular complications (RR 1.11, CI 0.79, 1.56, P =
0.55), and AKI (RR 1.07, CI 0.75, 1.54, P = 0.71). Concomitant PCI does
not confer any mortality benefit in patients with obstructive CAD and
high-grade AS undergoing TAVR. Further trials are needed to confirm our
findings. Copyright © 2023 Elsevier Inc.

<51>
Accession Number
2023609298
Title
Utility of Cerebral Embolic Protection Devices in Transcatheter
Procedures: A Systematic Review and Meta-Analysis.
Source
Current Problems in Cardiology. 48(7) (no pagination), 2023. Article
Number: 101675. Date of Publication: 01 Jul 2023.
Author
Baloch Z.Q.; Haider S.J.; Siddiqui H.F.; Shaikh F.N.; Shah B.U.D.; Ansari
M.M.; Qintar M.
Institution
(Baloch, Qintar) Michigan State University/Sparrow Hospital Lansing,
Lansing, MI, United States
(Haider) University of Alabama, Birmingham, AL, United States
(Siddiqui, Shaikh) Department of Medicine, Dow University of Health
Sciences
(Shah) Pakistan Institute of Medical Sciences - Islamabad, Islamabad,
Pakistan
(Ansari) Texas Tech University Health Sciences Center
Publisher
Elsevier Inc.
Abstract
With the emergence of the largest randomized control trial to date-the
Stroke Protection With Sentinel During Transcatheter Aortic Valve
Replacement (PROTECTED TAVR) study-we sought to conduct an updated
meta-analyses to evaluate the utility of CEP devices on both clinical
outcomes and neuroimaging parameters. Electronic databases were queried
through November 2022 for clinical trials comparing the utility of
Cerebral Embolic Protection (CEP) devices in Transcatheter Aortic Valve
Replacement (TAVR) with non-CEP TAVR procedures. Meta-analyses were
performed using the generic inverse variance technique, and a
random-effects model, and results are presented as weighted mean
differences (WMD) for continuous outcomes, and hazard ratios (HR) for
dichotomous outcomes. Outcomes of interest included stroke, disabling
stroke, nondisabling stroke, bleeding, mortality, vascular complications,
new ischemic lesions, acute kidney injury (AKI), and total lesion volume.
Thirteen studies (8 RCTs, 5 observational studies) consisting of 128,471
patients were included in the analysis. Results from our meta-analyses
showed a significant reduction in stroke (OR: 0.84 [0.74-0.95]; P < 0.01;
I2 = 0%), disabling stroke (OR: 0.37 [0.21-0.67]; P < 0.01;
I2 = 0%) and bleeding events (OR: 0.91 [0.83-0.99]; P = 0.04;
I2 = 0%) through CEP device use in TAVR. The use of CEP devices
had no significant impact on nondisabling stroke (OR: 0.94 [0.65-1.37]; P
< 0.01; I2 = 0%), mortality (OR: 0.78 [0.53-1.14]; P < 0.01;
I2 = 17%), vascular complications (OR: 0.99 [0.63-1.57]; P <
0.01; I2 = 28%), AKI (OR: 0.78 [0.46-1.32]; P < 0.01;
I2 = 0%), new ischemic lesions (MD: -1.72 [-4.01, 0.57]; P <
0.001; I2 = 95%) and total lesion volume (MD: -46.11 [-97.38,
5.16]; P < 0.001; I2 = 81%). The results suggest that CEP
device use was associated with a lower risk of disabling stroke and
bleeding events in patients undergoing TAVR. Copyright © 2023
Elsevier Inc.

<52>
Accession Number
2021731093
Title
Delayed Ventricular Septal Rupture Repair on Patient Outcomes After
Myocardial Infarction: A Systematic Review.
Source
Current Problems in Cardiology. 48(3) (no pagination), 2023. Article
Number: 101521. Date of Publication: 01 Mar 2023.
Author
Rashid H.; Kumar K.; Ullah A.; Kamin M.; Shafique H.M.; Elahi A.; Najam
A.; Zaidi S.M.J.; Asad M.; Mahmoodi A.; Malik J.
Institution
(Rashid) Department of Medicine, North Manchester General Hospital,
Manchester, United Kingdom
(Kumar) Department of Medicine, Dr. Ruth K.M. Pfau Civil Hospital,
Karachi, Pakistan
(Ullah) Department of Cardiology, Khyber Medical University Institute of
Medical Sciences, Kohat, Pakistan
(Kamin) Department of Endocrinology, Bolan Medical University and Health
Sciences, Quetta, Pakistan
(Shafique) Department of Interventional Cardiology, Armed Forces Institute
of Cardiology, Rawalpindi, Pakistan
(Elahi, Najam) Department of Medicine, Shifa International Hospital,
Islamabad, Pakistan
(Zaidi, Malik) Cardiovascular Analytics Group, Hong Kong, Hong Kong
(Asad) Department of Cardiology, Benazir Bhutto Hospital, Rawalpindi,
Pakistan
(Mahmoodi) Department of Medicine, Ibn e Seena Hospital, Kabul,
Afghanistan
Publisher
Elsevier Inc.
Abstract
Even though the prevalence of VSR after MI is only 1%-3%, the mortality
associated with the condition is more than 80%. Very few studies in the
literature have described in detail the treatment options for delayed VSR
repair. This systematic review was conducted to evaluate the outcomes of
delayed ventricular septal rupture (VSR) repair following acute myocardial
infarction (AMI). Digital databases were searched systematically to
identify studies reporting the outcomes of delayed VSR repair. Detailed
study and patient-level baseline characteristics including the type of
study, sample size, follow-up, number of delayed repairs, time to repair,
outcomes (in terms of major adverse cardiovascular events), and predictors
of outcome were abstracted. A total of 12 studies, recruiting 8,579
patients were included in the final analysis. Male gender, young age (<60
years), and delayed VSR repair were reported as predictors of survival
along with left ventricular assist devices (LVADs) and extracorporeal
membrane oxygenation (ECMO), and the use of inotropes before surgery.
Postoperative renal failure, higher New York Heart Association (NYHA)
score, early repair, and history of heart failure (HF) were demonstrated
as predictors of mortality. This study demonstrated that delayed VSR
repair can reduce mortality in patients who develop VSR after AMI.
Furthermore, the use of LVADs can prolong the time of surgery, and the use
of inotropes can predict survival benefits in this patient
cohort. Copyright © 2022 Elsevier Inc.

<53>
Accession Number
2026448325
Title
Clinical Efficacy and Safety of Bempedoic Acid in High Cardiovascular Risk
Patients: A Systematic Review and Meta-analysis of Randomized Controlled
Trials.
Source
Current Problems in Cardiology. 48(12) (no pagination), 2023. Article
Number: 102003. Date of Publication: 01 Dec 2023.
Author
Uddin N.; Syed A.A.; Ismail S.M.; Ashraf M.T.; Khan M.K.; Sohail A.
Institution
(Uddin, Syed, Ismail, Ashraf, Khan, Sohail) Department of Internal
Medicine, Dow University of Health Sciences, Karachi, Pakistan
Publisher
Elsevier Inc.
Abstract
Bempedoic acid (BA) is the new addition to lipid-lowering medications.
This systematic review and meta-analysis of randomized controlled trials
(RCTs) assess the clinical efficacy and safety of BA in high
cardiovascular (CV) risk patients along with its effects on low-density
lipoprotein cholesterol (LDL-C) and total cholesterol. PubMed, Google
Scholar, Cochrane Central Register of Controlled Trials, Embase, and
ClinicalTrials.gov were searched for RCTs comparing BA with placebo,
reporting CV outcomes. Seven RCTs with a total of 17,816 patients were
selected for the analysis. Results showed that BA significantly reduced
the risk of MACE (RR 0.87, 95% CI 0.80-0.94; P = 0.007), nonfatal
myocardial infarction (RR 0.73; 95% CI 0.62-0.85; P < 0.0001),
hospitalization for unstable angina (RR 0.69; 95%CI 0.54-0.88; P = 0.003),
coronary and noncoronary revascularization (RR 0.82; 95%CI 0.73-0.92; P =
0.0007) and (RR 0.41; 95%CI 0.18-0.96; P = 0.04), respectively. However,
BA increased the risk of gout (RR 1.55; 95% CI 1.26-1.90; P < 0.0001),
hyperuricemia (RR 1.94; 95% CI 1.73-2.18; P < 0.00001) and worsening renal
function (RR 1.34; 95%CI 1.21-1.48; P < 0.00001). BA also reduced LDL-C
(MD -22.38%; 95% CI -25.94 to - 18.82; P < 0.00001) and total cholesterol
(MD -13.86%; 95% CI -15.82 to -11.91; P < 0.0000) compared with placebo.
Bempedoic acid is an addition to the arsenal of lipid-lowering drugs used
in patients that are statin intolerant or need additional lipid-lowering
therapy. Copyright © 2023 Elsevier Inc.

<54>
Accession Number
2024974284
Title
Cardiac Surgery in Jehovah's Witnesses Patients and Association With
Peri-Operative Outcomes: A Systematic Review and Meta-Analysis.
Source
Current Problems in Cardiology. 48(9) (no pagination), 2023. Article
Number: 101789. Date of Publication: 01 Sep 2023.
Author
Vitolo M.; Mei D.A.; Cimato P.; Bonini N.; Imberti J.F.; Cataldo P.;
Menozzi M.; Filippini T.; Vinceti M.; Boriani G.
Institution
(Vitolo, Mei, Bonini, Imberti, Cataldo, Menozzi, Boriani) Cardiology
Division, Department of Biomedical, Metabolic and Neural Sciences,
University of Modena and Reggio Emilia, Policlinico di Modena, Modena,
Italy
(Vitolo, Bonini, Imberti) Clinical and Experimental Medicine PhD Program,
University of Modena and Reggio Emilia, Modena, Italy
(Cimato) Department of Cardiac Surgery, Villa Torri Hospital, GVM Care &
Research, Bologna, Italy
(Filippini, Vinceti) Environmental, Genetic and Nutritional Epidemiology
Research Center, Department of Biomedical, Metabolic and Neural Sciences,
University of Modena and Reggio Emilia Modena Italy
(Filippini) School of Public Health, University of California Berkeley,
Berkeley, CA, United States
(Vinceti) Department of Epidemiology, Boston University School of Public
Health, Boston, MA, United States
Publisher
Elsevier Inc.
Abstract
Background: Strategies for blood conservation, coupled with a careful
preoperative assessment, may be applied to Jehovah's Witnesses (JW)
patients who are candidates for cardiac surgery interventions. There is a
need to assess clinical outcomes and safety of bloodless surgery in JW
patients undergoing cardiac surgery. Method(s): We performed a
systematic review and meta-analysis of studies comparing JW patients with
controls undergoing cardiac surgery. The primary endpoint was short-term
mortality (in-hospital or 30-day mortality). Peri-procedural myocardial
infarction, re-exploration for bleeding, pre-and postoperative Hb levels
and cardiopulmonary bypass (CPB) time were also analyzed. Result(s):
A total of 10 studies including 2,302 patients were included. The pooled
analysis showed no substantial differences in terms of short-term
mortality among the two groups (OR 1.13, 95% CI 0.74-1.73,
I2=0%). There were no differences in peri-operative outcomes
among JW patients and controls (OR 0.97, 95% CI 0.39-2.41,
I2=18% for myocardial infarction; OR 0.80, 95% CI 0.51-1.25,
I2=0% for re-exploration for bleeding). JW patients had a
higher level of preoperative Hb (Standardized Mean Difference [SMD] 0.32,
95% CI 0.06-0.57) and a trend toward a higher level of postoperative Hb
(SMD 0.44, 95% CI -0.01-0.90). A slightly lower CPB time emerged in JWs
compared with controls (SMD -0.11, 95% CI -0.30-0.07). Conclusion(s):
JW patients undergoing cardiac surgery, with avoidance of blood
transfusions, did not have substantially different peri-operative outcomes
compared with controls, with specific reference to mortality, myocardial
infarction, and re-exploration for bleeding. Our results support the
safety and feasibility of bloodless cardiac surgery, applying patient
blood management strategies. Copyright © 2023 Elsevier Inc.

<55>
Accession Number
2023896074
Title
Venous External Support in Coronary Artery Bypass Surgery: A Systematic
Review and Meta-Analysis.
Source
Current Problems in Cardiology. 48(7) (no pagination), 2023. Article
Number: 101687. Date of Publication: 01 Jul 2023.
Author
Gemelli M.; Gallo M.; Addonizio M.; Pahwa S.; Van den Eynde J.; Trivedi
J.; Slaughter M.S.; Gerosa G.
Institution
(Gemelli, Addonizio, Gerosa) Cardiac Surgery Unit, Department of Cardiac,
Thoracic, Vascular Sciences and Public Health, University of Padua, Italy
(Gallo, Pahwa, Trivedi, Slaughter) Department of Cardiothoracic Surgery,
University of Louisville, Louisville, KY
(Van den Eynde) Department of Cardiovascular Sciences, KU Leuven, Leuven,
Belgium
Publisher
Elsevier Inc.
Abstract
Neointimal hyperplasia and lumen irregularities are major contributors to
vein graft failure and the use of VEST(R) should prevent this.
In this review, we aim to evaluate the angiographic outcomes of externally
supported vein grafts. Medline, Embase and Cochrane Library were
systematically reviewed for randomized clinical trials published by August
2022. The primary outcome was graft failure. Secondary outcomes included
graft ectasia, intimal hyperplasia area and thickness, and graft
nonuniformity. Odds ratios (OR) for dichotomous variables and mean
difference (MD) for continuous variables with 95% confidence intervals
(CI) were pooled using a fixed-effects model. Three randomized controlled
trials with a total of 437 patients were included with follow-up ranging
from 1 to 2 years. The odds of graft failure were similar in the 2 groups
(OR 1.22; 95%CI 0.88-1.71; I2 = 0%). Intimal hyperplasia area [MD -0.77
mm2; 95%CI -1.10 to -0.45; I2 = 0%] and thickness
[MD -0.06 mm; 95% CI -0.08 to -0.04; I2=0%] were significantly
lower in the VEST group. Fitzgibbon Patency Scale of II or III
(representing angiographic conduit nonuniformity; OR 0.67; 95%CI
0.48-0.94; I2 = 0%) and graft ectasia (OR 0.53; 95%CI
0.32-0.88; I2 = 33%) were also significantly lower in the VEST
group. At short-term follow-up, VEST does not seem to reduce the incidence
of graft failure, although it is associated with attenuation of intimal
hyperplasia and nonuniformity. Longer angiographic follow-up is warranted
to determine whether these positive effects might translate into a
positive effect in graft failure and in long-term clinical
outcomes. Copyright © 2023 Elsevier Inc.

<56>
Accession Number
2023103891
Title
Severe Aortic Stenosis in Patients With Chronic Liver Disease: A
Comprehensive Review.
Source
Current Problems in Cardiology. 48(6) (no pagination), 2023. Article
Number: 101639. Date of Publication: 01 Jun 2023.
Author
Craig D.; Bond A.J.; Ahmad L.; Stanley M.; Asfaw A.; Latham S.B.; Ibebuogu
U.N.
Institution
(Craig, Bond, Ahmad, Stanley, Asfaw, Latham, Ibebuogu) Department of
Medicine, University of Tennessee Health Science Center, Memphis, TN,
United States
Publisher
Elsevier Inc.

<57>
Accession Number
2025687089
Title
Percutaneous Mitral-Valve Intervention for Secondary Mitral Regurgitation:
Data From Real-Life.
Source
Current Problems in Cardiology. 48(10) (no pagination), 2023. Article
Number: 101889. Date of Publication: 01 Oct 2023.
Author
Kaddoura R.; Al-Badriyeh D.; Abushanab D.; Al-Hijji M.
Institution
(Kaddoura, Al-Hijji) Heart Hospital, Hamad Medical Corporation, Doha,
Qatar
(Al-Badriyeh) College of Pharmacy, QU Health, Qatar University, Doha,
Qatar
(Abushanab) Drug Information Center, Hamad Medical Corporation, Doha,
Qatar
Publisher
Elsevier Inc.
Abstract
Many questions were raised due to the divergent results between
cardiovascular outcomes assessment of the MitraClip percutaneous therapy
for heart failure patients with functional mitral regurgitation (COAPT)
and multicenter study of percutaneous mitral valve Repair MitraClip device
in patients with severe secondary mitral regurgitation (MITRA-FR) trials
on the use of percutaneous mitral valve repair for secondary mitral
regurgitation. This paper examined pooled patients' characteristics and
outcomes from real-life experience compared with those in the 2 landmark
trials. A comprehensive search identified eligible studies published in
2020 and 2021. Mean difference and odds ratio (OR) were used to compare
continuous and categorical data. Thirty-three studies included more than
9200 patients. Patients in landmark trials were younger than in real-life,
less likely to present with severe heart failure symptoms ([COAPT: OR
0.25; 95% CI: 0.21, 0.31]; [MITRA-FR: OR 0.32; 95% CI: 0.23, 0.45]) or
severe mitral regurgitation grade (COAPT only: OR 0.57; 95% CI: 0.45,
0.71) with larger left ventricular end diastolic volume. Procedure success
(OR 1.94; 95% CI: 1.10, 3.40) was more frequent with lower all-cause
mortality (OR 0.73; 95% CI: 0.54, 0.99) in COAPT. Real-life patients
experienced more favorable procedural and clinical outcomes compared with
MITRA-FR patients. Real-life data on percutaneous mitral valve repair in
secondary mitral regurgitation showed important variations in patient
selection and procedural outcomes. Rates of death and heart failure
hospitalization in observational studies were lower than MITRA-FR but
higher than COAPT trial. Copyright © 2023 The Author(s)

<58>
Accession Number
2021978721
Title
Early Transcatheter or Surgical Aortic Valve Replacement Versus
Conservative Management in Asymptomatic Patients With Severe Aortic
Stenosis: A Systematic Review and Meta-analysis.
Source
Current Problems in Cardiology. 48(3) (no pagination), 2023. Article
Number: 101477. Date of Publication: 01 Mar 2023.
Author
Yasmin F.; Shaikh A.; Asghar M.S.; Moeed A.; Najeeb H.; Waqar E.; Ram
M.D.; Nankani A.; Ochani R.K.; Aamir M.; Ullah W.; Waqar F.; Johnson D.M.
Institution
(Yasmin, Moeed, Najeeb, Waqar, Ram, Nankani, Ochani) Department of
Internal Medicine, Dow University of Health Sciences, Karachi, Pakistan
(Shaikh) Department of Medicine, Aga Khan University Hospital, Karachi,
Pakistan
(Asghar) Division of Nephrology and Hypertension, Mayo Clinic, Rochester,
MN
(Aamir) Lehigh Valley Heart Specialists, Lehigh Valley Health Network,
Allentown, PA, United States
(Ullah, Johnson) Division of Cardiology, Sidney Kimmel Medical College,
Thomas Jefferson University Hospitals, Philadelphia, PA
(Waqar) Division of Cardiovascular Health and Disease, University of
Cincinnati College of Medicine, Cincinnati, OH
Publisher
Elsevier Inc.
Abstract
The merits of conservative management vs early intervention in patients
with asymptomatic severe aortic stenosis remains unknown. Digital
databases (MEDLINE, Google Scholar, and Embase) were searched for all
relevant studies from inception through September 2022. Studies comparing
conservative management with early intervention were compared using a
random-effects model to calculate risk ratios (RRs) with 95% confidence
interval (CI). A total of 12 studies comprising 3624 asymptomatic aortic
stenosis patients (1747 receiving surgery, and 1877 receiving conservative
treatment) were included in the analysis. The average follow-up time was
4.45 (IQR 3.5-5) years. Early intervention was associated with a
significantly reduced risk of cardiac (RR 0.42, 95% CI 0.25-0.72; P =
0.001; I2 = 54%), non-cardiac (RR 0.46, 95% CI 0.32-0.68; P <
0.0001; I2 = 0%), all-cause mortality (RR 0.40, 95% CI
0.32-0.51; P < 0.00001; I2 = 58%), heart failure
hospitalization (RR 0.21, 95% CI 0.13-0.36; P < 0.00001; I2 =
0%), sudden cardiac death (RR 0.29, 95% CI 0.12-0.66; P = 0.004,
I2 = 24%), and MACE (RR 0.46, 95% CI; 0.28-0.75; P = 0.002;
I2 = 68%), compared with conservative management. There was no
significant difference in the 30-day mortality (RR 0.63, 95% CI 0.19-2.04;
P = 0.44; I2 = 28%), myocardial infarction (RR 0.44, 95% CI
0.19-1.06; P = 0.07, I2=0%), and 90-day mortality (RR 0.68, 95%
CI 0.20-2.37; P = 0.55; I2 = 61%) between the 2 groups. This
meta-analysis shows statistically significant reductions in the risk for
all-cause mortality, cardiac specific mortality, non-cardiac mortality,
heart failure hospitalization, MACE, and sudden cardiac death among
asymptomatic aortic stenosis patients who underwent early intervention as
opposed to conservative management. Copyright © 2022 Elsevier
Inc.

<59>
Accession Number
2021076931
Title
Left Ventricular Assist Devices and Pregnancy: Systematic Review of
Existing Literature and Case Report.
Source
Current Problems in Cardiology. 48(2) (no pagination), 2023. Article
Number: 101469. Date of Publication: 01 Feb 2023.
Author
Yadalam A.K.; Yoo B.W.; Horton J.P.; Krishna I.; Vega J.D.; Bhatt K.N.;
Gupta D.; Abdou M.H.
Institution
(Yadalam) Department of Medicine, Emory University School of Medicine,
Atlanta, GA, United States
(Yoo, Bhatt, Gupta, Abdou) Department of Medicine, Division of Cardiology,
Emory University School of Medicine, Atlanta, GA, United States
(Horton) Department of Obstetrics and Gynecology, Emory University School
of Medicine, Atlanta, GA, United States
(Krishna) Department of Obstetrics and Gynecology, Division of Maternal
Fetal Medicine, Emory University School of Medicine, Atlanta, GA, United
States
(Vega) Department of Surgery, Division of Cardiothoracic Surgery, Emory
University School of Medicine, Atlanta, GA, United States
Publisher
Elsevier Inc.
Abstract
Although pregnancy is generally contraindicated in advanced heart failure
(AHF), successful pregnancies have been observed in patients with left
ventricular assist devices (LVADs). The number of pregnancies in patients
with LVADs is increasing, yet optimal management strategies remain
undefined. Additionally, no successful pregnancies have been reported with
the HeartMate 3 (HM3) (Abbott) LVAD. A systematic review of pregnancy in
patients with LVADs was prepared utilizing 3 major scientific databases.
We also present the first reported case of successful pregnancy and
delivery in a patient supported by an HM3 LVAD. The systematic search
yielded 95 results. After filtering to include only relevant citations,
eight unique cases were identified. Cases were compared on the basis of
several clinical factors. Although pregnancies supported by LVADs are
medically complex, several cases of successful deliveries have been
observed. Clinical management between cases, however, did vary
significantly. Several areas requiring further study were
identified. Copyright © 2022 Elsevier Inc.

<60>
Accession Number
2024781617
Title
Utility of Intracardiac Echocardiography for Infective Endocarditis and
Cardiovascular Device-Related Endocarditis: A Contemporary Systematic
Review.
Source
Current Problems in Cardiology. 48(9) (no pagination), 2023. Article
Number: 101791. Date of Publication: 01 Sep 2023.
Author
Sanchez-Nadales A.; Cedeno J.; Sonnino A.; Sarkar A.; Igbinomwanhia E.;
Asher C.R.; Xu B.
Institution
(Sanchez-Nadales, Sarkar, Asher) Department of Cardiovascular Medicine,
Cleveland Clinic Florida, Weston, FL
(Cedeno, Sonnino) Department of Internal Medicine, Cleveland Clinic
Florida, Weston, FL
(Igbinomwanhia) Department of Cardiovascular Disease, MetroHealth System,
Cleveland, OH
(Xu) Section of Cardiovascular Imaging, Robert and Suzanne Tomsich
Department of Cardiovascular Medicine, Sydell and Arnold Miller Family
Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, OH
Publisher
Elsevier Inc.
Abstract
The diagnosis of infective endocarditis (IE) can pose a significant
challenge, particularly in cases of prosthetic valve endocarditis (PVE) or
cardiac device-related endocarditis (CDIE) (1). While echocardiography
remains a crucial diagnostic tool for identifying IE, including PVE and
CDIE, there are certain circumstances where transesophageal
echocardiography (TEE) may not be conclusive or practically feasible (2).
Recently, intracardiac echocardiography (ICE) has emerged as a promising
alternative for diagnosing IE and evaluating intracardiac infections,
especially in cases where transthoracic echocardiography (TTE) has not
been revealing, and TEE has been contraindicated. Furthermore, ICE has
been found to be useful in guiding transvenous lead extractions in
infected implantable cardiac devices (3). This systematic review aims to
comprehensively explore the various applications of ICE in the diagnosis
of IE and assess its efficacy in comparison to traditional diagnostic
methods. Copyright © 2023 Elsevier Inc.

<61>
Accession Number
2023145140
Title
Optimal Anticoagulation on TAVI Patients Based on Thrombotic and Bleeding
Risk and the Challenge Beyond: A Systematic Review and Meta-Analysis.
Source
Current Problems in Cardiology. 48(6) (no pagination), 2023. Article
Number: 101632. Date of Publication: 01 Jun 2023.
Author
Tsoumas I.; Oz A.; Lampropoulos K.
Institution
(Tsoumas, Oz, Lampropoulos) European University Cyprus, Nicosia, Cyprus
Publisher
Elsevier Inc.
Abstract
Transcatheter Aortic Valve Replacement (TAVR) has been established as the
treatment of choice for symptomatic aortic stenosis, while it is expanding
in all risk-related group categories of patients, gaining gradually ground
over the surgical approach. However, complications and adverse events are
yet to be effectively limited and diminished with thrombotic and
hemorrhagic events being rooted as a crucial topic of discussion.
Favorable anticoagulation pharmacotherapy options are constantly being
revised and tested, whilst guidelines are being modified to meet current
clinical evidence. This review aims to systematically assess already
existing guidelines on anticoagulation in post-TAVI patients and examine
novel regimens for the specific use, like apixaban, rivaroxaban, and other
anticoagulants, essentially constructing a holistic point of view on
future progress on this matter. The added complexity brought by
coagulation-affecting comorbidities such as atrial fibrillation, coronary
artery disease, and more contributes to the direct association of the
topic to the quality of healthcare as a public service. The literature was
systematically searched to examine the effectiveness and safety of various
anticoagulation treatments and cross-evaluate them based on the according
category of patients that were assigned to. Clinical trials, observational
studies and systematic reviews were included and, eventually, conclusive
remarks and future considerations were developed and presented. In the
category of patients without prior indication to anticoagulation, SAPT was
proven safer and still effective, when antiplatelet therapies were
compared, while a comparison of antiplatelet versus anticoagulation
strategies noted the first one, with limited data, as the optimal one.
Lastly, direct oral anticoagulants were shown to be safe substitutes for
vitamin K antagonists for patients with prior indication to
anticoagulation Copyright © 2023 Elsevier Inc.

<62>
Accession Number
2022039238
Title
Mitral Annular Calcification Related Infective Endocarditis: A
Contemporary Systematic Review.
Source
Current Problems in Cardiology. 48(3) (no pagination), 2023. Article
Number: 101558. Date of Publication: 01 Mar 2023.
Author
Kumar A.; Samra G.; Kaur S.; Ogunnowo G.; Kocyigit D.; Xu B.
Institution
(Kumar, Kocyigit, Xu) Section of Cardiovascular Imaging, Robert and
Suzanne Tomsich Department of Cardiovascular Medicine, Sydell and Arnold
Miller Family Heart, Vascular and Thoracic Institute, Cleveland Clinic,
Cleveland, OH, United States
(Kumar) Department of Internal Medicine, MedStar Georgetown University
Hospital, Washington, DC, United States
(Samra) Department of Internal Medicine, Cleveland Clinic, Cleveland, OH,
United States
(Kaur, Ogunnowo) Robert and Suzanne Tomsich Department of Cardiovascular
Medicine, Sydell and Arnold Miller Family Heart, Vascular and Thoracic
Institute, Cleveland Clinic, Cleveland, OH, United States
Publisher
Elsevier Inc.
Abstract
Mitral annular calcification (MAC) is a chronic degenerative process often
found incidentally on imaging. MAC is associated with elevated risk of
atherosclerosis and stroke. The association between MAC and the risk of
infective endocarditis (IE) is less well known. Therefore, we conducted
this systematic review in order to understand the diagnosis, clinical
outcomes, and management of IE associated with MAC. We conducted a
systematic review of published data regarding MAC related IE in various
databases until November 20, 2019. Case series and cohort studies were
included. A total of 8 studies with a cohort of 113 patients were
included. Mean age was 69 years with equal gender distribution (50%
female). Hypertension (55.8%) was the most common comorbidity seen in this
patient population. IE was diagnosed by either antemortem trans esophageal
echocardiographic examination (76%) or post-mortem autopsy (24%).
Staphylococcus aureus (47%) was the most common pathogen identified. MAC
was adjudicated to be moderate-to-severe in 100% of identified cases, with
77.9% of cases presenting with distinct vegetation's. Twenty-six percent
of patients (n = 29) underwent surgery. MAC may be associated with
development of IE. Echocardiography is the most common non-invasive
technique for diagnosis. Due to the difficulties associated with
antemortem diagnosis, diagnosis is occasionally made on post-mortem
examination. Neurologic complications are frequently encountered, and
reported mortality is high in MAC associated IE. Copyright © 2022
Elsevier Inc.

<63>
Accession Number
2015979833
Title
Clinical and Cardiovascular Characteristics of Patients Suffering
ST-Segment Elevation Myocardial Infarction After Covid-19: A Systematic
Review and Meta-Analysis.
Source
Current Problems in Cardiology. 48(1) (no pagination), 2023. Article
Number: 101045. Date of Publication: 01 Jan 2023.
Author
Gharibzadeh A.; Shahsanaei F.; Rahimi Petrudi N.
Institution
(Gharibzadeh) Assistant Professor of Cardiology, Cardiovascular Research
Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran,
Islamic Republic of
(Shahsanaei) Interventional Cardiologist, Hypertension Research center,
Cardiovascular Research Institute, Isfahan University Of Medical Sciences,
Isfahan, Iran, Islamic Republic of
(Rahimi Petrudi) Resident Of Cardiology, Cardiovascular Research Center,
Hormozgan University of Medical Sciences, Bandar Abbas, Iran, Islamic
Republic of
Publisher
Elsevier Inc.
Abstract
ST-segment elevation myocardial infarction (STEMI) is one of the fatal
complications following Covid-19. We aimed to systematically assess the
clinical sequels as well as cardiovascular findings in patients suffering
STEMI following Covid-19.The manuscripts databases including PubMed, Web
of knowledge (ISI), SCOPUS, Embase, and Google Scholar were deeply
searched by the two reviewers using the relevant keywords related to the
issue considered in the current review. Of 88 studies initially reviewed,
9 articles were included in final assessment. Nine articles including 447
patients with Covid-19 were included in the study. In terms of
electrocardiographic findings, anterior lead involvement was reported in
12% - 61.6% of cases, inferior lead in 28.2% - 75% and lateral involvement
in 7.7% - 100% of cases. The prevalence of LBBB was in the range of 10.7%
- 61.6% of cases. In terms of echocardiographic findings, a decrease in
left ventricular ejection fraction was reported in 60% - 88% of patients.
Wall motion abnormality was also observed in 60% - 82.1% of patients. In
terms of angiographic findings, the multi-vessel disease was reported in
17.9% - 69% of cases. Also, 24% - 83% of cases needed to revascularization
procedures. Cardiac arrest was also reported in 3.1% - 28.2% of cases.
Based on the meta-analysis performed on the mortality of patients with
STEMI in the field of Covid-19, the pooled prevalence of mortality was
estimated at 25.2% (95%CI:17.5%-34.8%). Mortality and adverse consequences
of STEMI in patients with Covid-19 are far higher than in the general
population. Therefore, in-hospital cardiovascular tracking and monitoring
of Covid-19 patients with potential cardiovascular disorders is necessary
to achieve a more favorable outcome. Copyright © 2021 Elsevier
Inc.

<64>
Accession Number
2020898401
Title
Impella Versus Extracorporeal Membranous Oxygenation (ECMO) for
Cardiogenic Shock: A Systematic Review and Meta-analysis.
Source
Current Problems in Cardiology. 48(1) (no pagination), 2023. Article
Number: 101427. Date of Publication: 01 Jan 2023.
Author
Ahmad S.; Ahsan M.J.; Ikram S.; Lateef N.; Khan B.A.; Tabassum S.; Naeem
A.; Qavi A.H.; Ardhanari S.; Goldsweig A.M.
Institution
(Ahmad) Department of Internal Medicine, East Carolina University,
Greenville, NC
(Ahsan) Division of Cardiovascular Medicine, Iowa Heart Center, Des
Moines, IA, United States
(Ikram) Department of Internal Medicine, SEGi University, MY, Petaling
Jaya, Malaysia
(Lateef, Goldsweig) Division of Cardiovascular Medicine, University of
Nebraska Medical Center, Omaha, NE, United States
(Khan) Department of Internal Medicine, The Jewish Hospital - Mercy
Health, Cincinnati, OH, United States
(Tabassum, Naeem) Department of Internal Medicine, King Edward Medical
University, Lahore, PK
(Qavi, Ardhanari) Division of Cardiovascular Medicine, East Carolina
University, Greenville, NC
Publisher
Elsevier Inc.
Abstract
The use of mechanical circulatory support (MCS) in cardiogenic shock (CS)
is increasing. We conducted a systematic review and meta-analysis to
compare the outcomes of Impella use with extracorporeal membranous
oxygenation (ECMO) support in patients with CS. We searched the Medline,
EMBASE, Cochrane, and Clinicaltrials.gov databases for observational
studies comparing Impella to ECMO in patients with CS. Risk ratios (RRs)
for categorical variables and standardized mean differences (SMDs) for
continuous variables were calculated with 95% confidence intervals (CIs)
using a random-effects model. Twelve retrospective studies and one
prospective study (Impella n=6652, ECMO n=1232) were identified. Impella
use was associated with lower incidence of in-hospital mortality (RR 0.88
[95% CI 0.80-0.94], P=0.0004), stroke (RR 0.30 [0.21-0.42], P<0.00001),
access-site bleeding (RR 0.50 [0.37-0.69], P<0.0001), major bleeding (RR
0.56 [0.39-0.80], P=0.002), and limb ischemia (RR 0.42 [0.27-0.65],
P=0.0001). Baseline lactate levels were significantly lower in the Impella
group (SMD -0.52 [-0.73- -0.31], P<0.00001). There was no significant
difference in mortality at 6-12 months, MCS duration, need for MCS
escalation, bridge-to-LVAD or heart transplant, and renal replacement
therapy use between Impella and ECMO groups. In patients with CS, Impella
device use was associated with lower in-hospital mortality, stroke, and
device-related complications than ECMO. However, patients in the ECMO
group had higher baseline lactate levels. Copyright © 2022
Elsevier Inc.

<65>
Accession Number
2026251086
Title
Therapeutic Outcomes Following Isolated Transcatheter Tricuspid Valve
Repair: A Systematic Review and Meta-analysis.
Source
Current Problems in Cardiology. 48(12) (no pagination), 2023. Article
Number: 101985. Date of Publication: 01 Dec 2023.
Author
Siddiqui H.F.; Khan A.B.; Nasir M.M.; Latif F.; Siddiqui A.F.; Akhtar P.;
Hamza M.; Barmanwalla A.
Institution
(Siddiqui, Khan, Nasir, Latif) Department of Internal Medicine, Dow
University of Health Sciences, Sindh, Karachi, Pakistan
(Siddiqui) Department of Internal Medicine, Aga Khan University Hospital,
Sindh, Karachi, Pakistan
(Akhtar) Department of Cardiology, National Institute of Cardiovascular
Diseases, Sindh, Karachi, Pakistan
(Hamza) Department of Internal Medicine, Albany Medical Center, Albany,
NY, United States
(Barmanwalla) MD Brigham and Women's Hospital and Cape Cod Hospital,
Boston, MA, United States
Publisher
Elsevier Inc.
Abstract
Tricuspid regurgitation (TR) is traditionally treated surgically, but
isolated transcatheter tricuspid valve repair (ITTVR) offers a less
invasive option. This study conducts a meta-analysis and systematic review
to evaluate ITTVR outcomes in patients with TR. Database searches until
March 2023 identified studies assessing ITTVR safety and efficacy in
moderate/severe TR patients. Primary outcomes analyzed were severe TR,
NYHA functional class improvement, and 6-minute walking distance.
Meta-analyses used Risk ratio (RR) or mean difference with a random
effects model. The review included 25 studies with 2421 patients. ITTVR
improved NYHA functional class (RR: 3.262), reduced TR severity (RR:
0.303), and enhanced 6-minute walking distance (MD: +47.077 m).
Echocardiographic parameters improved, including reductions in TR vena
contracta, TR EROA, septolateral tricuspid annular diameter, RVEDD, RV
FAC, and TAPSE. LVEF and PASP showed no significant changes. ITTVR
improves functional outcomes and echocardiographic parameters in TR
patients. Copyright © 2023 Elsevier Inc.

<66>
Accession Number
2024078542
Title
Transcatheter vs Surgical Aortic Valve Replacement Outcomes Among Solid
Organ Transplant Patients: A Systematic Review and Meta-Analysis.
Source
Current Problems in Cardiology. 48(8) (no pagination), 2023. Article
Number: 101685. Date of Publication: 01 Aug 2023.
Author
Jaiswal V.; Ang S.P.; Ishak A.; Joshi A.; Chia J.E.; Kalra K.; Attia A.M.;
Sharma P.; Biswas M.; Grubb K.J.
Institution
(Jaiswal, Joshi) Department of Cardiovascular Research, Larkin Community
Hospital, South Miami, FL, United States
(Ang) Department of Internal Medicine, Rutgers Health/Community Medical
Center, NJ, United States
(Ishak) Department of Research and Academic affairs, Larkin Community
Hospital, South Miami, FL, United States
(Chia) Department of Medicine, International Medical University, Malaysia
(Kalra) Department of Cardiology, Medstar Washington Hospital Center, WD
(Attia) Department of Medicine, Cairo University, Egypt
(Sharma) Department of Cardiology, King George's Medical University, Uttar
Pradesh, Lucknow, India
(Biswas) General Cardiology & Advanced Heart Failure, Wellspan Cardiology,
Lancaster, Pennsylvania, USA & University of Maryland Medical Center,
Baltimore, MD, United States
(Grubb) Division of Cardiothoracic Surgery, Department of Surgery, Emory
University School of Medicine, Atlanta, GA, United States
Publisher
Elsevier Inc.
Abstract
The safety and clinical outcomes of transcatheter aortic valve replacement
(TAVR) compared to surgical aortic valve replacement (SAVR) among patients
with solid organ transplants is not well understood. This study aimed to
evaluate the clinical outcomes of TAVR and SAVR among patients with a
history of solid organ transplantation. We performed a systematic
literature search of databases for relevant articles from inception until
May 1st, 2022. Unadjusted odds ratios (OR) were pooled using a
random-effect model, and a P-value of <0.05 was considered statistically
significant. A total of 3240 studies were identified of which 3 studies
with a total of 2960 patients were included in the final analysis. For
solid organ transplants patients, the odds of in-hospital mortality (OR
0.37, 95% CI 0.20-0.71, P < 0.001), 30-day mortality (OR 0.51, 95% CI
0.35-0.74, P < 0.001), acute kidney injury (OR 0.45, 95% CI 0.35-0.59, P <
0.001), and bleeding (OR 0.35, 95% CI 0.27-0.46, P < 0.001) were
significantly lower in patients undergoing TAVR compared to SAVR. In
contrast, the odds of pacemaker implantation (OR 2.60, 95% CI 0.36-18.90,
P = 0.34), postprocedural stroke (OR 0.36, 95% CI 0.13-1.03, P = 0.06)
were similar between both groups of patients. Length of hospital stay was
significantly lower in TAVR compared to SAVR patients (SMD -0.82, 95% CI
-0.95 to -0.70, P < 0.001). In solid organ transplant patients, TAVR
appeared to be a safe procedure with fewer postprocedure complications,
shorter length of hospital stay, and lower in hospital mortality compared
with SAVR. Copyright © 2023 Elsevier Inc.

<67>
Accession Number
2023847701
Title
Long-Term Outcomes Comparison Between Surgical and Percutaneous Coronary
Revascularization in Patients With Multivessel Coronary Disease or Left
Main Disease: A Systematic Review and Study Level Meta-Analysis of
Randomized Trials.
Source
Current Problems in Cardiology. 48(7) (no pagination), 2023. Article
Number: 101699. Date of Publication: 01 Jul 2023.
Author
Formica F.; Gallingani A.; Tuttolomondo D.; Hernandez-Vaquero D.; Singh
G.; Pattuzzi C.; Maestri F.; Niccoli G.; Ceccato E.; Lorusso R.; Nicolini
F.
Institution
(Formica, Pattuzzi, Niccoli, Nicolini) Department of Medicine and Surgery,
University of Parma, Parma, Italy
(Gallingani, Pattuzzi, Maestri, Nicolini) Cardio-Thoracic-Vascular
Department, Cardiac Surgery Unit, University Hospital of Parma, Parma,
Italy
(Tuttolomondo, Niccoli) Cardio-Thoracic-Vascular Department, Cardiology
Unit, University Hospital of Parma, Parma, Italy
(Hernandez-Vaquero) Cardiac Surgery Department, Hospital Universitario
Central de Asturias, Oviedo, Spain
(Singh) Department of Critical Care Medicine and Division of Cardiac
Surgery, Mazankowski Alberta Heart Institute, University of Alberta,
Edmonton, Canada
(Ceccato) Division of Medical and Law Library, Medical Library, University
of Parma, Parma, Italy
(Lorusso) Department of Cardio-Thoracic Surgery, Cardiovascular Research
Institute Maastricht (CARIM), Maastricht, Netherlands
Publisher
Elsevier Inc.
Abstract
Recent randomized trials comparing coronary artery bypass graft (CABG)
with percutaneous coronary intervention (PCI) utilizing drug-eluting
stents in patients with left main disease (LMD) and/or multivessel disease
(MVD), reported conflicting results. We performed a study level
meta-analysis comparing the 2 interventions for the treatment of LMD or
MVD. Using electronic databases, we retrieved 6 trials, between January,
2010 and December, 2022. Five-years Kaplan-Meier curves of endpoints where
reconstructed. Comparisons were made by cox-linear regression frailty
model and by landmark analysis. A random-effect method was applied. A
total of 8269 patients were included and randomly assigned to CABG (n =
4135) or PCI (n = 4134). During 5-years follow-up, PCI showed a higher
incidence of all-cause mortality (hazard ratio [HR] 1.28; 95% confidence
interval [CI], 1.11-1.47; P < 0.0001]), myocardial infarction (HR 1.84;
95% CI, 1.54-2.19; P < 0.0001) and repeat coronary revascularization (HR
1.96; 95% CI, 1.72-2.24; P < 0.0001). There was no long-term difference
between the 2 interventions for cardiovascular death (P = 0.14) and stroke
(P = 0.20), although the incidence of stroke was higher with CABG within
30-days from intervention (P < 0.0001). PCI was associated with an
increased risk for composite endpoints (P < 0.0001) and major cerebral and
cardiovascular events. (P < 0.0001). In conclusion, at 5-year follow-up,
in patients with LMD and/or MVD there was a significant higher incidence
of all-cause mortality, myocardial infarction and repeat revascularization
with PCI compared to CABG. The incidence of stroke was higher with CABG
during the postprocedural period, but no difference was found during
5-years follow-up. Longer follow-up is mandatory to better define outcome
difference between the 2 interventions. Copyright © 2023 Elsevier
Inc.

<68>
Accession Number
2017527373
Title
Gender Differences and Outcomes of Hypoattenuated Leaflet Thickening
(HALT) Following Transcatheter Aortic Valve Replacement: A Meta-analysis
of Randomized and Cohort Studies.
Source
Current Problems in Cardiology. 48(7) (no pagination), 2023. Article
Number: 101155. Date of Publication: 01 Jul 2023.
Author
Salah H.M.; Almaddah N.; Xu J.; Al-Hawwas M.; Agarwal S.K.; Uretsky B.F.;
Dhar G.; Al'Aref S.J.
Institution
(Salah, Xu, Al-Hawwas, Dhar, Al'Aref) Department of Medicine, Division of
Cardiology. University of Arkansas for Medical Sciences, Little Rock, AR,
United States
(Almaddah) Arkansas Heart Hospital, Little Rock, AR, United States
(Agarwal, Uretsky) Central Arkansas Veterans Health System, Little Rock,
AR, United States
Publisher
Elsevier Inc.
Abstract
Subclinical leaflet thrombosis is characterized by hypoattenuated leaflet
thickening (HALT) after transcatheter aortic valve replacement (TAVR) on
computed tomography. However, given the low incidence of HALT after TAVR,
the clinical significance of HALT is still being investigated. We sought
to generate a more reliable estimate of the risk factors and adverse
outcomes associated with HALT after TAVR by pooling data from randomized
trials and cohort studies. PubMed/Medline database was systematically
searched from inception until November 24, 2021, using the following
terms: ("hypoattenuated leaflet thickening" and "transcatheter aortic
valve replacement") and ("Subclinical leaflet thrombosis" and
"transcatheter aortic valve replacement"). A random effects model
meta-analysis was conducted using Mantel-Haenszel odds ratios (ORs) and
the associated 95% confidence intervals (CIs), mean difference and the
associated 95%. Ten studies with a total of 1462 patients were included,
with follow-up ranging between 4 months and 3 years. HALT occurred in
14.4% of the patients undergoing TAVR. HALT was not associated with
increased risk of stroke/TIA (OR 1.38; 95% CI [0.61-3.11]; I2=0%) or
increased risk of all-cause mortality (OR 0.67; 95% CI [0.25-1.80]; I2=0).
HALT was associated with a greater post-procedural mean aortic valve
gradient (mean difference 2.31 mmHg; 95% CI [0.27, 4.35]; I2=71%).
Interestingly, there was a trend of higher risk of HALT in men (OR 1.37;
95% CI [0.82-2.30]; I2=44%) while there was a trend towards lower risk of
HALT in the presence of CKD (OR 0.76; 95% CI [0.49-1.19]; I2=0%); these
trends did not reach statistical significance. This meta-analysis shows
that the occurrence of HALT following TAVR is associated with a greater
post-procedural mean aortic valve gradient but no excess risk of death or
cerebrovascular events. The clinical significance of this higher
post-procedural mean aortic valve gradient is uncertain and requires
further investigations. Copyright © 2022 Elsevier Inc.

<69>
Accession Number
2014435538
Title
Coronary artery revascularizations and cognitive decline - A systematic
review.
Source
Current Problems in Cardiology. 47(10) (no pagination), 2022. Article
Number: 100960. Date of Publication: 01 Oct 2022.
Author
Lappalainen L.; Rajamaki B.; Tolppanen A.-M.; Hartikainen S.
Institution
(Lappalainen, Rajamaki, Tolppanen, Hartikainen) School of Pharmacy,
University of Eastern Finland, FI, Kuopio, Finland
(Rajamaki, Tolppanen, Hartikainen) Kuopio Research Center of Geriatric
Care, University of Eastern Finland, FI, Kuopio, Finland
Publisher
Elsevier Inc.
Abstract
Coronary artery disease (CAD) is a risk factor for cognitive decline. The
aim of this study was to systematically review recent literature on
whether coronary artery revascularizations are associated to cognitive
decline and dementia. Pubmed, Scopus, and CINAHL (EBSCO) were searched
systematically from January 2009 to September 2020. Studies were conducted
on persons with CAD undergoing coronary artery bypass grafting (CABG) or
percutaneous coronary intervention (PCI) procedure compared to other
coronary artery disease treatments, and the outcome was cognitive decline
or dementia. Altogether four of the 680 reviewed articles met inclusion
criteria. Results were inconsistent, and the outcome measurements
heterogeneous between studies. Our findings indicate an evidence gap in
the current understanding of long-term outcomes following coronary artery
revascularization. However, evidence of long-term effects on cognition
would complement our understanding of their benefits. There is a need for
more studies on long-term cognitive outcomes after coronary artery
revascularizations. Copyright © 2021 The Authors

<70>
Accession Number
2020270091
Title
Mitral Valve Repair for Anterior/Bi-leaflet Versus Posterior Leaflet
Degenerative Mitral Valve Disease: A Systematic Review and Meta-analysis.
Source
Current Problems in Cardiology. 47(12) (no pagination), 2022. Article
Number: 101355. Date of Publication: 01 Dec 2022.
Author
Iqbal K.; Haque I.U.; Shaikh V.F.; Rathore S.S.; Yasmin F.; Iqbal A.;
Shariff M.; Kumar A.; Stulak J.M.
Institution
(Iqbal, Haque, Shaikh, Yasmin, Iqbal) Department of Internal Medicine, Dow
Medical College, Dow University of Health Sciences, Karachi, Pakistan
(Rathore) Department of Internal Medicine, Dr. Sampurnanand Medical
College, Rajasthan, Jodhpur, India
(Shariff, Stulak) Department of General Surgery, Mayo Clinic, Rochester,
MN
(Kumar) Department of Internal Medicine, Cleveland Clinic Akron General,
Akron, OH
(Kumar) Section of Cardiovascular Research, Heart, Vascular and Thoracic
Department, Cleveland Clinic Akron General, Akron, OH
(Stulak) Department of Cardiovascular Surgery, Mayo Clinic, Rochester, MN
Publisher
Elsevier Inc.
Abstract
Mitral valve repair (MVr) secondary to degenerative anterior/bi-leaflet
mitral valve disease is more challenging than posterior leaflet repair.
However, conclusive evidence is needed to make decisions based on the
outcomes rather than technical difficulties. This meta-analysis compares
anterior/bi-leaflet MVr with isolated posterior leaflet repair in patients
with mitral regurgitation (MR) due to degenerative mitral valve disease.
The outcomes of interest were long-term (>= 5 years) survival and freedom
from re-operation and moderate-to-severe MR. Meta-analysis of 10 studies
showed that there was no significant difference in long-term survival
(risk ratio, RR: 1.00; 95% confidence interval, 95% CI 0.96-1.04), freedom
from moderate-to-severe MR (RR: 0.95; 95% CI 0.87-1.03), and freedom from
re-operation (RR: 0.96; 95% CI 0.90-1.02) between anterior/bi-leaflet MVr
and posterior leaflet repair. As outcomes of anterior/bilateral repair
were comparable with those of isolated posterior leaflet repair, our
findings do not support the inclination towards replacement over repair
for MR caused by anterior/bilateral degenerative mitral
disease. Copyright © 2022 Elsevier Inc.

<71>
Accession Number
2016604060
Title
Role of Platelets in Acute Lung Injury After Extracorporeal Circulation in
Cardiac Surgery Patients: A Systemic Review.
Source
Current Problems in Cardiology. 47(11) (no pagination), 2022. Article
Number: 101088. Date of Publication: 01 Nov 2022.
Author
Sandeep B.; Xiao Z.; Zhao F.; Feng Q.; Gao K.
Institution
(Sandeep, Xiao, Gao) Department of Cardiothoracic Surgery, Chengdu Second
People's Hospital, Sichuan, Chengdu, China
(Zhao, Feng) Department of Intensive Care Unit, Chengdu Second People's
Hospital, Sichuan, Chengdu, China
Publisher
Elsevier Inc.
Abstract
In vitro circulation (cardiopulmonary bypass, CPB) has been widely used in
heart surgery. In the past, it was believed that the reduction of platelet
count and impaired platelet function during cardiac surgery were the main
causes of acute lung injury (ALI). ALI is a life-threatening clinical
syndrome in critically ill patients due to an uncontrolled systemic
inflammatory response resulting from direct injury to the lung or indirect
injury in the setting of a systemic process. Platelets have an emerging
and incompletely understood role in a myriad of ALI after extracorporeal
circulation in cardiac surgery patients. An electronic literature search
was performed using Pubmed, Scopus and Cinahl investigating ALI,
pathogenesis, and role of platelets, treatment and management for ALI
patients. Many studies have shown that in vitro circulation is a
nonphysiological process that can lead to a decrease in the number of
platelets and impaired platelet function, as well as varying degrees of
lung damage. The relationship between the effects of in vitro circulation
on platelets and acute lung injury is still controversial. This review
article discusses the role of platelets in lung injury after
cardiopulmonary bypass and resent development in the management of
ALI. Copyright © 2021 Elsevier Inc.

<72>
Accession Number
2016907949
Title
Non-invasive Imaging in the Evaluation of Cardiac Allograft Vasculopathy
in Heart Transplantation: A Systematic Review.
Source
Current Problems in Cardiology. 47(8) (no pagination), 2022. Article
Number: 101103. Date of Publication: 01 Aug 2022.
Author
Ajluni S.C.; Mously H.; Chami T.; Hajjari J.; Stout A.; Zacharias M.;
ElAmm C.; Wilson D.; Janus S.E.; Al-Kindi S.G.
Institution
(Ajluni, Hajjari) Department of Medicine, University Hospitals, Cleveland,
OH
(Mously, Zacharias, ElAmm, Wilson, Janus, Al-Kindi) Harrington Heart and
Vascular Institute, University Hospitals and School of Medicine, Case
Western Reserve University, Cleveland, OH
(Chami) Minneapolis Heart Institute, Minneapolis, MN, United States
(Stout) Core Library, University Hospitals Cleveland Medical Center,
Cleveland, OH
Publisher
Elsevier Inc.
Abstract
Cardiac allograft vasculopathy (CAV) is the leading cause of long-term
graft dysfunction in patients with heart transplantation and is linked
with significant morbidity and mortality. Currently, the gold standard for
diagnosing CAV is coronary imaging with intravascular ultrasound during
traditional invasive coronary angiography. Invasive imaging, however,
carries increased procedural risk and expense to patients in addition to
requiring an experienced interventionalist. With the improvements in
non-invasive cardiac imaging modalities such as transthoracic
echocardiography, computed tomography, magnetic resonance imaging and
positron emission tomography, an alternative non-invasive imaging approach
for the early detection of CAV may be feasible. In this systematic review,
we explored the literature to investigate the utility of non-invasive
imaging in diagnosis of CAV in >3000 patients across 49 studies. We also
discuss the strengths and weaknesses for each imaging modality. Overall,
all 4 imaging modalities show good to excellent accuracy for identifying
CAV with significant variations across studies. Majority of the studies
compared non-invasive imaging with invasive coronary angiography without
intravascular imaging. In summary, non-invasive imaging modalities offer
an alternative approach to invasive coronary imaging for CAV. Future
studies should investigate longitudinal non-invasive protocols in low-risk
patients after heart transplantation. Copyright © 2022 Elsevier
Inc.

<73>
Accession Number
2020019309
Title
Direct Oral Anticoagulant Versus Warfarin After Left Atrial Appendage
Closure With WATCHMAN: Updated Systematic Review and Meta-analysis.
Source
Current Problems in Cardiology. 47(11) (no pagination), 2022. Article
Number: 101335. Date of Publication: 01 Nov 2022.
Author
Tan B.E.-X.; Wong P.Y.; Lee J.Z.; Tan N.Y.; Rao M.; Cheung J.W.
Institution
(Tan, Wong) Department of Internal Medicine, Rochester General Hospital,
Rochester, NY
(Lee) Department of Cardiology, Mayo Clinic Arizona, Phoenix, AZ
(Tan) Department of Cardiovascular Medicine, Mayo Clinic Rochester,
Rochester, MN
(Rao) Sands-Constellation Heart Institute, Rochester Regional Health,
Rochester, NY
(Cheung) Division of Cardiology, Department of Medicine, Weill Cornell
Medicine, New York, NY
Publisher
Elsevier Inc.
Abstract
In the pivotal WATCHMAN trials, warfarin was used for post-procedural
anticoagulation in the first 45 days after left atrial appendage closure.
We aimed to investigate the efficacy and safety of direct oral
anticoagulant (DOAC) versus warfarin after WATCHMAN. We performed a
literature search of 5 electronic databases to identify studies comparing
DOAC with warfarin after WATCHMAN. We pooled outcomes for the efficacy
(thromboembolism, device-related thrombus [DRT], peridevice leak [PDL] >5
mm) and safety endpoints (bleeding, mortality). Thromboembolism was
defined as ischemic stroke, transient ischemic attack, or systemic
embolism. We included 10 cohort studies with 2,440 patients, of whom 1,397
(57.3%) received DOAC. Concerning periprocedural outcomes (within 7 days
following implantation), DOAC was associated with a reduction in major
bleeding (Risk ratio [RR] 0.32; 95% confidence interval [CI] 0.11-0.92)
compared with warfarin, without significant differences in all bleeding
(RR 0.46; 95% CI 0.15-1.42) and thromboembolism (RR 0.93; 95% CI
0.21-4.16). On first follow-up transesophageal echocardiography, DRT (RR
0.79; 95% CI 0.39-1.60) and PDL>5 mm (RR 0.44; 95% CI 0.16-1.20) were
comparable among groups. With a mean follow-up of 1.5-12 months, DOAC was
associated with reductions in major bleeding (RR 0.52; 95% CI 0.30-0.89)
and all bleeding (RR 0.38; 95% CI 0.25-0.58) compared with warfarin. The
outcomes of thromboembolism (RR 0.79; 95% CI 0.36-1.73) and all-cause
mortality (RR 0.49; 95% CI 0.19-1.28) were not significantly different
between the 2 groups. Following WATCHMAN implantation, DOAC was associated
with reductions in major bleeding and all bleeding compared with warfarin
at mid-term follow-up. The outcomes of thromboembolism, all-cause
mortality, DRT, and PDL >5 mm were comparable among groups. Copyright
© 2022 Elsevier Inc.

<74>
Accession Number
2015266862
Title
Next-Day Discharge vs Early Discharge After Transcatheter Aortic Valve
Replacement: Systematic Review and Meta-Analysis.
Source
Current Problems in Cardiology. 47(10) (no pagination), 2022. Article
Number: 100998. Date of Publication: 01 Oct 2022.
Author
Gupta R.; Mahajan S.; Mehta A.; Nyaeme M.; Mehta N.A.; Cheema A.; Khanal
L.; Malik A.H.; Aronow W.S.; Vyas A.V.; Mehta S.S.; Patel N.C.
Institution
(Gupta, Vyas, Patel) Lehigh Valley Heart Institute, Lehigh Valley Health
Network, Allentown, PA, United States
(Mahajan, Mehta, Nyaeme, Cheema, Khanal) Department of Internal Medicine,
Carle Foundation Hospital, Urbana, IL
(Mehta) Department of Cardiology, University of Missouri Kansas City,
Kansas City, MO
(Malik, Aronow) Department of Cardiology, Westchester Medical Center and
New York Medical College, Valhalla, NY
(Mehta) Heart and Vascular Institute, Carle Foundation Hospital, Urbana,
IL
Publisher
Elsevier Inc.
Abstract
With the growing utilization of transcatheter aortic valve replacement
(TAVR) as an alternative option to surgical valve replacement (SAVR) in
patients considered to be suboptimal for surgery, there is a need to
explore the possibility of next day discharge (NDD) and its potential
outcomes. The aim of our study is to compare outcomes and complications
following NDD vs the standard early discharge (ED) (less than 3 days). A
comprehensive literature search was performed in PubMed, Embase, and
Cochrane to identify relevant trials. Summary effects were calculated
using a DerSimonian and Laird random effects model as odds ratio with 95%
confidence intervals for all the clinical endpoints. Studies comparing
same-day or next-day discharge vs discharge within the next three days
were included in our analysis. 6 studies with 2,672 patients were
identified. The risk of bleeding and vascular complications was
significantly lower in patients with NDD compared to ED (OR 0.10, P <
0.00001 and OR 0.22, P = 0.002 respectively). The incidence of permanent
pacemaker (PPM) implants was significantly lower in patients who had NDD
compared to ED (OR 0.21, P = 0.0005). The incidence of 30 day mortality,
stroke, AKI and readmission rates was not different between the two
groups. NDD after TAVR allows for reduction in hospital stay and can
mitigate hospital costs without an increased risk of complications. Our
analysis shows that complication rate is comparable to ED, NDD is a
reasonable option for certain patients with severe aortic stenosis who
undergo TAVR. Further studies are needed to elucidate whether higher risk
patients who would benefit from an extended inpatient monitoring post
TAVR. Copyright © 2021 Elsevier Inc.

<75>
Accession Number
2020272846
Title
A Review of Cardiac Amyloidosis: Presentation, Diagnosis, and Treatment.
Source
Current Problems in Cardiology. 47(12) (no pagination), 2022. Article
Number: 101366. Date of Publication: 01 Dec 2022.
Author
Pour-Ghaz I.; Bath A.; Kayali S.; Alkhatib D.; Yedlapati N.; Rhea I.;
Khouzam R.N.; Jefferies J.L.; Nayyar M.
Institution
(Pour-Ghaz, Bath, Kayali, Alkhatib, Rhea, Khouzam, Jefferies) Department
of Internal Medicine, Division of Cardiovascular Diseases, University of
Tennessee Health Science Center, Memphis, TN, United States
(Yedlapati) Stern Cardiovascular Foundation, Memphis, TN, United States
(Nayyar) Department of Cardiology, Regional One Health, Memphis, TN,
United States
Publisher
Elsevier Inc.
Abstract
Amyloidosis is a group of disorders that can affect almost any organ due
to the misfolding of proteins with their subsequent deposition in various
tissues, leading to various disease manifestations based on the location.
When the heart is involved, amyloidosis can manifest with a multitude of
presentations such as heart failure, arrhythmias, orthostatic hypotension,
syncope, and pre-syncope. Diagnosis of cardiac amyloidosis can be
difficult due to the non-specific nature of symptoms and the relative
rarity of the disease. Amyloidosis can remain undiagnosed for years,
leading to its high morbidity and mortality due to this delay in
diagnosis. Newer imaging modalities, such as cardiac magnetic resonance
imaging, advanced echocardiography, and biomarkers, make a timely cardiac
amyloidosis diagnosis more feasible. Many treatment options are available,
which have provided new hope for this patient population. This manuscript
will review the pathology, diagnosis, and treatment options available for
cardiac amyloidosis and provide a comprehensive overview of this
complicated disease process. Copyright © 2022 Elsevier Inc.

<76>
Accession Number
2020527440
Title
Advanced Cardiovascular Imaging for the Diagnosis of Mycobacterium
chimaera Prosthetic Valve Infective Endocarditis After Open-heart Surgery:
A Contemporary Systematic Review.
Source
Current Problems in Cardiology. 47(12) (no pagination), 2022. Article
Number: 101392. Date of Publication: 01 Dec 2022.
Author
Sanchez-Nadales A.; Diaz-Sierra A.; Mocadie M.; Asher C.; Gordon S.; Xu B.
Institution
(Sanchez-Nadales, Asher) Department of Cardiovascular Disease, Cleveland
Clinic Florida, Weston, FL
(Diaz-Sierra) Department of Medicine, Advocate Illinois Masonic Medical
Center, Chicago, IL
(Mocadie) Department of Infectious Diseases, University Hospitals,
Cleveland, OH
(Gordon) Department of Infectious Diseases, Cleveland Clinic, Cleveland,
OH
(Xu) Section of Cardiovascular Imaging, Robert and Suzanne Tomsich
Department of Cardiovascular Medicine, Sydell and Arnold Miller Family
Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, OH
Publisher
Elsevier Inc.
Abstract
Mycobacterium chimaera is an opportunistic and emerging pathogen, which
has been recognized to cause prosthetic valve infective endocarditis and
disseminated infection following open-chest cardiac surgery with certain
contaminated heater-cooler systems. Diagnostic evaluation of suspected
prosthetic valve infective endocarditis due to M chimaera is challenging
and requires a very high index of suspicion. This systematic review aims
to evaluate prosthetic valve infective endocarditis due to M chimaera.
Based on the current literature review, transesophageal echocardiography
and 18F-fluorodeoxyglucose positron emission tomography/computed
tomography are the most common imaging modalities used to establish the
diagnosis. Based on 22 published cases, the reported cases of M chimaera
endocarditis have occurred almost entirely in males. Within this cohort,
the patients developed endocarditis on average 2.7 years after exposure to
contaminated heater-cooler systems during cardiac surgery. M chimaera
infection is associated with significant morbidity and
mortality. Copyright © 2022 Elsevier Inc.

<77>
Accession Number
2019615518
Title
Meta-analysis Comparing Percutaneous Coronary Intervention With Coronary
Artery Bypass Grafting for Non-ST Elevation Acute Coronary Syndrome in
Patients With Multivessel or Left Main Disease.
Source
Current Problems in Cardiology. 47(10) (no pagination), 2022. Article
Number: 101306. Date of Publication: 01 Oct 2022.
Author
Barssoum K.; Kumar A.; Rai D.; Kharsa A.; Chowdhury M.; Thakkar S.; Patel
H.P.; Amin A.; Tan B.E.-X.; Ibrahim F.; Bandyopadhyay D.; Elkaryoni A.;
Elbadawi A.; Abtahian F.; Nanda N.C.; Depta J.
Institution
(Barssoum) Department of Internal Medicine, Unity Hospital, Rochester
Regional Health System, Rochester, NY, United States
(Kumar) Department of Internal Medicine, Cleveland Clinic Akron General,
Akron, OH, United States
(Barssoum, Rai, Kharsa, Chowdhury, Thakkar, Amin, Tan) Department of
Internal Medicine, Rochester General Hospital, Rochester, NY, United
States
(Patel) Department of Internal Medicine, Louis A Weiss Memorial Hospital,
Chicago, IL, United States
(Ibrahim) Department of Internal Medicine, American University of Antigua,
Antigua and Barbuda, Antigua and Barbuda
(Bandyopadhyay) Department of Cardiovascular Medicine, Loyola University
Medical Center, Maywood, IL, United States
(Elkaryoni, Abtahian) Department of Cardiology, Sands Constellation Heart
Institute, Rochester Regional Health, Rochester, NY, United States
(Elbadawi) Division of Cardiovascular Medicine, University of Texas
Medical Branch, Galveston, TX, United States
(Nanda) Division of Cardiovascular Disease, University of Alabama at
Birmingham, Birmingham, AL, United States
(Depta) Department of Cardiology, Sands Constellation Heart Institute,
Rochester Regional Health, Rochester, NY, United States
Publisher
Elsevier Inc.
Abstract
Outcomes of patients presenting with non-ST-elevation acute coronary
syndrome (NSTE-ACS) with multivessel coronary disease (MVD) and/or
unprotected left main coronary artery disease (CAD) revascularized with
percutaneous coronary intervention (PCI) or coronary artery bypass
grafting (CABG) is not well defined. MEDLINE/PubMed and EMBASE/Ovid were
queried for studies that investigated PCI vs CABG in this disease subset.
The primary outcome was major cardiac adverse events (MACE) at 30 days and
long-term follow-up (3-5 years). The final analysis included 9 studies
with a total of 9299 patients. No significant difference was observed
between PCI and CABG in 30 days MACE (risk ratio [RR] 0.96; 95% confidence
interval [CI] 0.38-2.39, all-cause mortality, myocardial infarction, and
stroke. A meta-regression analysis revealed patients with a history of PCI
had higher risk of MACE with PCI as compared with CABG. At long-term
follow-up, PCI compared with CABG was associated with higher risk of MACE
(RR 1.52; 95% CI 1.28-1.81), myocardial infarction, and repeat
revascularization, while no difference was observed in the risk of stroke
and all-cause mortality. In patients with NSTE-ACS and MVD or unprotected
left main CAD, no differences were observed in the clinical outcomes
between PCI and CABG at 30 days follow-up. With long-term follow-up, PCI
was associated with a higher risk of MACE. Copyright © 2022
Elsevier Inc.

<78>
Accession Number
2020053863
Title
Clinical Outcomes of Revascularization with Percutaneous Coronary
Intervention Prior to Transcatheter Aortic Valve Replacement: A
Comprehensive Meta-Analysis.
Source
Current Problems in Cardiology. 47(11) (no pagination), 2022. Article
Number: 101339. Date of Publication: 01 Nov 2022.
Author
Altibi A.M.; Ghanem F.; Hammad F.; Patel J.; Song H.K.; Golwala H.; Zahr
F.E.; Rahmouni H.
Institution
(Altibi, Song, Golwala, Zahr, Rahmouni) Knight Cardiovascular Institute,
Oregon Health and Science University, Portland, OR, United States
(Ghanem, Patel) Internal Medicine Department, East Tennessee State
University, Johnson City, TN, United States
(Hammad) Internal Medicine Department, St. Vincent Charity Medical Center,
Cleveland, OH, United States
Publisher
Elsevier Inc.
Abstract
Background: Prior studies on revascularization prior to transcatheter
aortic valve replacement (TAVR), in patients with significant coronary
artery disease (CAD), have reported mixed results. Aim(s): We sought
to perform a meta-analysis combining current evidence by investigating
outcomes of revascularization in patients who undergo TAVR with coexisting
CAD. Method(s): We searched literature for studies reporting on
outcomes following TAVR performed with versus without pre-TAVR PCI, for
coexisting CAD. Random-effect model was used to pool estimates of odds
ratios (ORs). Result(s): Twenty-four reports with 12,182 TAVR
patients were included: 22 observational and 2 clinical trials. 4,110
(33.7%) were in the pre-TAVR PCI group, 51.4% were females, and mean age
was 81.9 years. The 30-day mortality was 5.2% versus 5.0% in patients with
versus without pre-TAVR PCI, respectively [OR= 1.19 (95% CI: 0.91-1.55, P=
0.20)]. Pooled 1-year mortality was 18.1% versus 19.1% in patients with
versus without pre-TAVR PCI (OR= 1.12, 95% CI: 0.95-1.31, P= 0.61). There
was no significant difference between the groups for myocardial
infarction, stroke, acute kidney injury, pacemaker implantation, or
re-hospitalization. Pre-TAVR PCI was associated with an increased risk of
life-threatening bleeding at 30 days. Conclusion(s): Pre-TAVR
revascularization with PCI was not associated with improved 30-day or
1-year mortality; however, it was associated with an increased risk of
life-threatening bleeding at 30-day post-TAVR. Our results do not support
routine revascularization with PCI prior to TAVR with coexisting CAD.
Future trials addressing anatomical complexity and symptom burden may help
better risk stratify patients who may benefit from pre-TAVR
revascularization. Copyright © 2022 Elsevier Inc.

<79>
Accession Number
2020223816
Title
Efficacy and Safety of Concomitant Tricuspid Repair in Patients Undergoing
Mitral Valve Surgery: a Systematic Review and Meta-Analysis.
Source
Current Problems in Cardiology. 47(12) (no pagination), 2022. Article
Number: 101360. Date of Publication: 01 Dec 2022.
Author
Yasmin F.; Najeeb H.; Naeem U.; Moeed A.; Zaidi F.; Asghar M.S.; Aamir M.
Institution
(Yasmin, Najeeb, Naeem, Moeed, Zaidi) Department of Internal Medicine, Dow
Medical College, Dow University of Health Sciences, Karachi, Pakistan
(Asghar) Division of Nephrology and Hypertension, Mayo Clinic, MN,
Rochester, Pakistan
(Aamir) Leyhigh Valley Heart Institute, Leyhigh Valley Health Network,
Allentown, PA, United States
Publisher
Elsevier Inc.
Abstract
Tricuspid valve repair (TVR) is recommended for patients with moderate
primary tricuspid regurgitation (TR), those with moderate TR, and a
history of heart failure without annular dilation, while being essential
for patients with severe secondary TR undergoing MVS. The meta-analysis
aimed to evaluate the efficacy and safety of tricuspid valve repair in
patients undergoing MVS. We systematically searched PubMed, Embase, and
Google Scholar through January 2022, and studies comparing patients with
TVR and those without TVR were selected. The primary outcomes were 30-day,
and all-cause mortality. In this meta-analysis, 20 studies were included
with a patient population of 72,422. No significant differences were
observed between patients undergoing TVR with MVS, in comparison to MVS
group only for the primary outcomes i.e., 30-day mortality (RR: 1.14, 95%
CI [0.69, 1.87], and all-cause mortality (RR: 1.16, 95% CI [0.86, 1.57].
From the secondary outcomes, pacemaker insertion (RR: 2.62, 95% CI [2.24,
3.06]), new-onset TR or progression (RR: 0.32, 95% CI [0.16, 0.66]),
stroke (RR: 1.22, 95% CI [1.05, 1.42]), cross-clamp time (WMD: 17.67, 95%
CI [13.96, 21.37]), surgery time (WMD: 43.59, 95% CI [37.07, 50.10]), ICU
time (WMD: 19.50, 95% CI [9.31, 29.67]), and ventilation time (WMD: 6.62,
95% CI [0.69, 12.55]) were significant. However, major bleeding events,
atrial fibrillation, renal failure, heart failure hospitalization,
postoperative MI, wound infection, early or prolonged morbidity,
cardiopulmonary bypass time, and duration of hospital stay were
non-significant. Our meta-analysis has furthered the discussion for
weighing the risks and benefits of pursuing TVR during MVS. Copyright
© 2022 Elsevier Inc.

<80>
Accession Number
2012120610
Title
Prevalence of Return to Work in Cardiovascular Patients After Cardiac
Rehabilitation: A Systematic Review and Meta-analysis.
Source
Current Problems in Cardiology. 47(7) (no pagination), 2022. Article
Number: 100876. Date of Publication: 01 Jul 2022.
Author
Sadeghi M.; Rahiminam H.; Amerizadeh A.; Masoumi G.; Heidari R.; Shahabi
J.; Mansouri M.; Roohafza H.
Institution
(Sadeghi) Cardiac Rehabilitation Research Center, Isfahan Cardiovascular
Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran,
Islamic Republic of
(Rahiminam, Amerizadeh) Heart Failure Research Center, Cardiovascular
Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran,
Islamic Republic of
(Masoumi) Anesthesiology Department, Chamran Cardiovascular Medical and
Research Hospital, Isfahan University of Medical Sciences, Isfahan, Iran,
Islamic Republic of
(Heidari, Mansouri, Roohafza) Isfahan Cardiovascular Research Center,
Cardiovascular Research Institute, Isfahan University of Medical Sciences,
Isfahan, Iran, Islamic Republic of
(Shahabi) Interventional Cardiology Research Center, Cardiovascular
Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran,
Islamic Republic of
Publisher
Elsevier Inc.
Abstract
The present systematic review and meta-analysis aimed to clarify the
effects of cardiac rehabilitation (CR) on the prevalence of return to work
(RTW) in cardiovascular diseases (CVDs) patients. CR plays a very
important role in the management of CVDs and improves the patients'
physical activity, quality of life, and a decrease in the cost of
healthcare. RTW is the most important goal in the rehabilitation of CVD
patients. PubMed, Web of Science, Scopus, and Google scholar were searched
systematically from inception up to January 2021 for English published
clinical trials and observational studies. In total, 16 studies were
analyzed, of them, 8 were controlled studies. Pooled results showed that
the mean age of patients was 52.30 (50.04, 54.57). The prevalence of RTW
in the CR attending group was 66% (60%, 71%) and in the control group was
58% (47%, 68%). Subgroup analysis showed that the proportion of RTW was
higher in white-collars 76% (73%-79%) compared to. blue-collars 63%
(56%-70%). Out-patient CR with 72% (61%-81%) RTW was more effective
compared to in-patient CR with 62% (44%- 78%) and usual care (control). It
can be concluded that CR especially out-patient CR increases the
prevalence of RTW but not much. Improved and appropriate CR programs
related to each individual's disease and patient condition which follow
the valid guidelines might help to increase the effectiveness of CR in
terms of RTW. Copyright © 2021 Elsevier Inc.

<81>
Accession Number
2020416707
Title
Antithrombotic Strategy After Transcatheter Aortic Valve Replacement: A
Network Meta-Analysis.
Source
Current Problems in Cardiology. 47(12) (no pagination), 2022. Article
Number: 101348. Date of Publication: 01 Dec 2022.
Author
Mahalwar G.; Kumar A.; Majmundar M.; Adebolu O.; Yendamuri R.; Lao N.;
Barve N.; Kreutz R.P.; Reed G.W.; Puri R.; Dani S.S.; Kalra A.
Institution
(Mahalwar, Kumar, Adebolu, Yendamuri, Lao, Barve) Department of Medicine,
Cleveland Clinic Akron General, Akron, OH, United States
(Majmundar) Department of Cardiovascular Medicine, Maimonides Medical
Center, New York, NY, United States
(Kreutz) Division of Cardiovascular Medicine, Krannert Cardiovascular
Research Center, Indiana University School of Medicine, Indianapolis, IN,
United States
(Reed, Puri) Department of Cardiovascular Medicine, Heart, Vascular,
Thoracic Institute, Cleveland Clinic, Cleveland, OH
(Dani) Department of Cardiovascular Medicine, Lahey Hospital & Medical
Center, Burlington, MA
(Kalra) Division of Cardiology, Department of Medicine, Cardiovascular
Institute, Kalra Hospitals, New Delhi, India
Publisher
Elsevier Inc.
Abstract
The ideal antithrombotic therapy post transcatheter aortic valve
replacement (TAVR) remains uncertain. We performed a network meta-analysis
of RCTs to report the outcomes with various antithrombotic strategies to
determine the optimal therapy. A systematic search of the PubMed/Medline
and Cochrane databases was performed through January 6, 2022. The primary
outcome was stroke and the secondary outcomes were major/life-threatening
bleeding, myocardial infarction, all-cause mortality, and cardiac
mortality. A network meta-analysis was conducted with a random-effects
model. All analysis was carried out using R version 4.0.3. Six RCTs were
included in the final analysis. SAPT when compared with DAPT was
associated with a reduced risk of major or life-threatening bleeding [OR:
0.42; 95% CI: 0.25-0.70]. Other antithrombotic strategies were associated
with similar odds of major and life-threatening bleeding post TAVR
compared with DAPT. There was no difference in the incidence of stroke,
myocardial infarction, all-cause and cardiac mortality between the various
antithrombotic strategies post TAVR. The present analysis reported SAPT as
the preferred antithrombotic regimen post TAVR compared with other
regimens in patients who do not have other indications for
anticoagulation. Additional studies such as ADAPT-TAVR, CLOE and ATLANTIS
trials will further add to our understanding of the adequate
antithrombotic regimen post TAVR in patients with otherwise no indication
for anticoagulation. Copyright © 2022 Elsevier Inc.

<82>
Accession Number
2014353569
Title
Paravalvular Leak After Transcatheter Aortic Valve Implantation Its
Incidence, Diagnosis, Clinical Implications, Prevention, Management, and
Future Perspectives: A Review Article.
Source
Current Problems in Cardiology. 47(10) (no pagination), 2022. Article
Number: 100957. Date of Publication: 01 Oct 2022.
Author
Bhushan S.; Huang X.; Li Y.; He S.; Mao L.; Hong W.; Xiao Z.
Institution
(Bhushan, Li, He, Mao, Hong, Xiao) Department of Cardiothoracic Surgery,
Chengdu Second People's Hospital, Sichuan, Chengdu, China
(Huang) Department of Anesthesiology, West China Hospital of Medicine,
Sichuan University, Sichuan, China
Publisher
Elsevier Inc.
Abstract
Paravalvular leak (PVL) is very common after TAVI and has been reported to
have a negative impact on both short- and long-term survival. The current
study identified incidence, diagnosis, clinical implications, and
prevention, management and future perspectives for post-TAVI paravalvular
leak. A systematic literature search was conducted using PubMed and
EMBASE, using the MeSH terms and key words "paravalvular leak,"
"diagnostic criteria," "implication," "influencing factors," and
"prevention strategies." Studies were retained for review after meeting
strict inclusion criteria that included only prospective studies
evaluating Paravalvular leak in patients who had TAVI. Thirty articles
were selected for inclusion, incidence of PVL across the studies ranged
from 7% to 40%. Many factors have been associated with incidence and
increased risk of PVL, including AVC volume, larger annulus dimensions,
pre-TAVI transvalvular peak velocity, under sizing of the prosthesis,
surgical, and other factors. PVL after TAVI is common and can be predicted
by aortic root calcification volume, larger annulus dimensions, and
pre-TAVI transvalvular peak velocity, with calcification volume being an
independent predictor for PVL. The strength and nature of the association
of various degrees of post-TAVI PVL and mortality are still to be further
evaluated. Copyright © 2021 The Author(s)

<83>
Accession Number
2019983200
Title
Percutaneous Repair of Mitral Regurgitation: A Comprehensive Review of
Literature.
Source
Current Problems in Cardiology. 47(11) (no pagination), 2022. Article
Number: 101338. Date of Publication: 01 Nov 2022.
Author
Salehin S.; Hasan S.M.; Mai S.; Rasmussen P.; Shahzad A.; Abdelmaseih R.;
Jazar D.A.; Shalaby M.; Motiwala A.; Gilani S.; Khalife W.I.
Institution
(Salehin, Mai, Rasmussen, Jazar) Internal Medicine, University of Texas
Medical Branch, Galveston, TX
(Hasan, Shahzad, Abdelmaseih, Shalaby, Motiwala, Gilani, Khalife)
Cardiology, University of Texas Medical Branch, Galveston, TX
Publisher
Elsevier Inc.
Abstract
Mitral regurgitation is the most common valvular disease in the US and the
second most common worldwide. Left untreated, it can lead to the
development of heart failure, giving rise to increased mortality rates.
Mitral valve intervention is usually indicated in severe mitral
regurgitation at the onset of symptoms, even if the function of the left
ventricle is preserved. A surgical approach is generally favored according
to current guidelines, with excellent clinical outcomes. However, the
emergence of novel data from contemporary trials indicates that
percutaneous, catheter-based approach may have similar improvements in
mortality outcomes while maintaining a superior safety profile when
compared to the surgical approach. Here, we discuss transcatheter mitral
valve repair as a treatment option for mitral regurgitation and summarize
the major clinical trials which were recently conducted on transcatheter
repair. Copyright © 2022 Elsevier Inc.

<84>
Accession Number
2010556044
Title
Endomyocardiofibrosis: A Systematic Review.
Source
Current Problems in Cardiology. 46(4) (no pagination), 2021. Article
Number: 100784. Date of Publication: 01 Apr 2021.
Author
Scatularo C.E.; Posada Martinez E.L.; Saldarriaga C.; Ballesteros O.A.;
Baranchuk A.; Sosa Liprandi A.; Wyss F.; Sosa Liprandi M.I.
Institution
(Scatularo, Ballesteros) Division of Cardiology, Sanatorio de la Trinidad
Palermo, Buenos Aires, Argentina
(Posada Martinez) Echocardiography department, Instituto Nacional de
Cardiologia Ignacio Chavez, Ciudad de Mexico, Mexico
(Saldarriaga) Department of Cardiology and Heart Failure Clinic,
Cardiovascular Clinic Santa Maria, University of Antioquia, Medellin,
Colombia
(Baranchuk) Division of Cardiology, Kingston Health Science Center,
Queen's University, Kingston, ON, Canada
(Sosa Liprandi) Division of Cardiology, Sanatorio Guemes, Buenos Aires,
Argentina
(Wyss) Cardiovascular Services and Technology of Guatemala -
Cardiosolutions, Guatemala City, Guatemala
(Sosa Liprandi) Department of Cardiology and Heart Failure Unit, Sanatorio
Guemes, Buenos Aires, Argentina
Publisher
Mosby Inc.
Abstract
Endomyocardiofibrosis was described first time in Uganda as an infrequent
restrictive cardiomyopathy with a poor prognosis, characterized by
fibrosis of the ventricular subendocardium and severe restrictive
physiology leading to difficult therapeutic management and frequently
associated with hypereosinophilic syndrome. Its higher prevalence in the
tropics and its relationship in some cases with hypereosinophilic
endocarditis has led to the search for genetic, infectious, autoimmune and
nutritional causes, but its etiology remains unclear. It is a rare
cardiomyopathy, difficult to diagnose and with a nonexistent effective
treatment. Imaging methods such as echocardiography and cardiac magnetic
resonance are essential for the initial diagnosis, although endomyocardial
biopsy establishes the definitive diagnosis. Immunosuppressive treatment
is only useful in the early stages of the disease and usually ineffective
if installed late when signs of heart failure are present. Surgical
treatment is generally palliative. Copyright © 2021 Elsevier Inc.

<85>
Accession Number
2006988023
Title
Meta-Analysis and Trial Sequential Analysis of Randomized Controlled
Trials for Multivessel PCI Versus Culprit Artery Only PCI in STEMI Without
Cardiogenic Shock.
Source
Current Problems in Cardiology. 46(3) (no pagination), 2021. Article
Number: 100646. Date of Publication: 01 Mar 2021.
Author
Rai D.; Tahir M.W.; Bandyopadhyay D.; Chowdhury M.; Kharsa A.; Pendala
V.S.; Ali H.; Naidu S.S.; Baibhav B.
Publisher
Mosby Inc.
Abstract
Background: Traditionally ST-elevation myocardial infarction (STEMI) with
multivessel coronary artery disease is treated with percutaneous coronary
intervention (PCI) to culprit lesion only. The benefit of multivessel (MV)
PCI among STEMI patients without cardiogenic shock is unclear.
 Method(s): PubMed, EMBASE, and Cochrane Database were searched from
1996 to 2019, for studies of patients with STEMI without cardiogenic
shock, who underwent PCI. Only randomized controlled trials comparing
culprit PCI to MV PCI vs culprit vessel PCI were included for pairwise
meta-analysis. All-cause mortality, cardiac mortality, reinfarction,
revascularization and major adverse cardiovascular events (MACE) were
compared. Trial sequential analysis (TSA) was performed for outcome
variables. Result(s): Nine randomized controlled trials contributed
6930 patients meeting inclusion criteria. Three thousand three hundred
seventy-six underwent MV PCI, and 3554 underwent culprit PCI. Our analysis
demonstrated no significant difference in all-cause mortality. MV PCI had
a lower risk of cardiac mortality, reinfarction, MACE and repeat
revascularization compared to culprit PCI (P values <0.05). TSA showed
futility for further trials to detect all-cause mortality benefit and lack
of firm evidence of benefit in cardiac mortality and re-infarction, but
firm evidence of benefit in revascularization and MACE.
 Conclusion(s): In conclusion, MV PCI strategy was beneficial in
reducing cardiac mortality, reinfarction, repeat revascularization, and
MACE but there was no all-cause mortality benefit when compared to culprit
only PCI strategy. Evidence for benefit in cardiac mortality and
re-infarction is not robust per TSA. Copyright © 2020 Elsevier
Inc.

<86>
Accession Number
2001913320
Title
A Comparative Analysis of Mitraclip Versus Mitral Valve-In-Valve
Replacement for High-Risk Patients With Severe Mitral Regurgitation After
Transcatheter Aortic Valve Replacement.
Source
Current Problems in Cardiology. 46(2) (no pagination), 2021. Article
Number: 100423. Date of Publication: 01 Feb 2021.
Author
Nanda A.; Bob-Manuel T.; Jefferies J.; Ibebuogu U.; Khouzam R.N.
Publisher
Mosby Inc.

<87>
Accession Number
2006161023
Title
Left Atrial or Transeptal Approach for Mitral Valve Surgery: A Systematic
Review and Meta-analysis.
Source
Current Problems in Cardiology. 46(3) (no pagination), 2021. Article
Number: 100602. Date of Publication: 01 Mar 2021.
Author
Harky A.; Kusu-Orkar T.-E.; Chan J.S.K.; Noshirwani A.; Savarimuthu S.;
Pousios D.; Muir A.D.
Institution
(Harky, Kusu-Orkar, Noshirwani, Pousios, Muir) Department of
cardiothoracic surgery, Liverpool Heart and Chest Hospital, Liverpool,
United Kingdom
(Harky) School of Medicine, University of Liverpool, Liverpool, United
Kingdom
(Chan) Division of Cardiology, Department of Medicine and Therapeutics,
Prince of Wales Hospital, Hong Kong
(Chan) Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
(Savarimuthu) Department of cardiothoracic surgery, Barts Heart Centre,
St. Bartholomew's Hospital, London, United Kingdom
Publisher
Mosby Inc.
Abstract
To compare outcomes of mitral valve surgery through conventional left
atriotomy and transeptal approach (TS). Preferred Reporting Items for
Systematic Reviews and Meta-Analyses guidelines were followed. Primary
outcomes were operative mortality and permanent pacemaker (PPM)
implantation; secondary outcomes were new onset of atrial fibrillation
(AF), stroke and operative times. Sixteen articles met the inclusion
criteria with 4537 patients. Cardiopulmonary bypass was longer with TS
(weighted mean differences - 16.44 minutes [-29.53, -3.36], P = 0.01).
Rates of PPM implantation (risk ratio 0.65 [0.47, 0.89], P = 0.007) and
new onset AF (risk ratio 0.87 [0.78, 0.97], P = 0.02) were higher with TS.
Subgroup analysis of isolated mitral valve surgery cohort showed no
difference in operative times, mortality, new onset of AF, stroke, and PPM
implantation. There is equal outcomes between both approaches during
isolated mitral valve surgery; however, TS was associated with longer
operative times and higher postoperative AF and PPM rates when pooling
combined procedures. A large randomized controlled trial is required to
confirm those findings. Copyright © 2020 Elsevier Inc.

<88>
Accession Number
2012856107
Title
The Better Option of Revascularization in Complex Coronary Artery Disease
Patients Complicate With Chronic Kidney Disease: A Review and
Meta-Analysis.
Source
Current Problems in Cardiology. 46(9) (no pagination), 2021. Article
Number: 100886. Date of Publication: 01 Sep 2021.
Author
Chen X.; Zhang X.; Yan Y.; Wang G.
Institution
(Chen, Wang) Department of Emergency, Beijing Friendship Hospital, Capital
Medical University, Beijing, China
(Zhang, Yan) Department of Cardiology, Beijing Anzhen Hospital, Capital
Medical University, Beijing, China
Publisher
Mosby Inc.
Abstract
The treatment of complex coronary artery disease (CAD) combined with
chronic kidney disease (CKD) faces great challenges. We thus did a
systematic review and meta-analysis to assess the effect of percutaneous
coronary intervention (PCI) and coronary artery bypass graft (CABG). We
systematically searched PubMed, Embase, Cochrane Library and other
relevant articles refer to reference. Our main endpoints were main adverse
cardiovascular and cerebrovascular events (MACCE), all cause death,
myocardial infarction (MI), repeat revascularization and stoke. 24 studies
were included in our analysis. Compared with PCI, CABG improved outcomes
such as MACCE (Odds Ratio [OR] 1.75; 95%CI 1.26-2.42), all cause death (OR
1.13; 95%CI 1.00-1.28), repeat revascularization (OR 4.24; 95%CI
3.29-5.47) and MI (OR 2.16; 95%CI 1.59-2.91), but stoke (OR 0.84, 95%CI
0.61-1.17). CABG shows absolute advantage in complex CAD complicated with
CKD and ESRD patients than stent implantation in the long-term
following-up. Copyright © 2021 Elsevier Inc.

<89>
Accession Number
2012058387
Title
Surgical Risk Scoring in TAVR: Still Needed? A Metaregression Analysis.
Source
Current Problems in Cardiology. 46(12) (no pagination), 2021. Article
Number: 100875. Date of Publication: 01 Dec 2021.
Author
Baro R.; Cura F.; Belardi J.; Brugaletta S.; Lamelas P.
Institution
(Baro, Cura, Belardi, Lamelas) Instituto Cardiovascular de Buenos Aires,
Buenos Aires, Argentina
(Brugaletta) Clinic Cardiovascular Institute, Hospital Clinic, IDIBAPS,
Barcelona, Spain
(Lamelas) Health Research Methods, Evidence, and Impact, McMaster
University, Hamilton, ON, Canada
Publisher
Elsevier Inc.
Abstract
Several randomized controlled trials evaluating the effectiveness of
transcatheter aortic valve replacement (TAVR) against surgical aortic
valve replacement have been published to date. The fact that higher risk
populations were implemented first does not necessarily mean that they
benefit more from a TAVR procedure. We performed meta-analysis of the 8
randomized clinical trials performing TAVR for both mortality and stroke
outcomes. Meta-regression was used to evaluate the association between
mean surgical risk using the Society of Thoracic Surgeons (STS) score and
hazard ratio observed in each of the trials. Overall, TAVR was associated
with a significant reduction of both mortality and stroke across the whole
spectrum of patients enrolled, with no evidence of significant
heterogeneity. Metaregression analysis does not suggest a statistically
significant association between STS score and hazard ratio for both
mortality and stroke. This observation suggests reconsidering the use of
risk scores to prioritize TAVR utilization in higher risk patients, while
more focus should be done on patient's life expectancy related to TAVR
durability. Copyright © 2021 Elsevier Inc.

<90>
Accession Number
606082394
Title
Aortic Stenosis and Noncardiac Surgery: Managing the Risk.
Source
Current Problems in Cardiology. 40(11) (pp 483-503), 2015. Date of
Publication: 01 Nov 2015.
Author
Pislaru S.V.; Abel M.D.; Schaff H.V.; Pellikka P.A.
Publisher
Mosby Inc.
Abstract
Managing the risk of noncardiac surgery in patients with aortic stenosis
is a problem that is frequently confronted in clinical practice.
Traditionally, patients with severe aortic stenosis were considered to be
at substantial risk during noncardiac surgery, and as such, elective
procedures were avoided before intervention on the aortic valve in most
patients other than those who were ineligible or refused aortic valve
replacement. Recent data suggest that with contemporary anesthesia and
surgical techniques, the risk of noncardiac surgery is substantially lower
than previously believed. We review the existent literature in the field,
and propose a practical approach to complex patients. Copyright ©
2015 Elsevier Inc.

<91>
Accession Number
2039139894
Title
Navigating troubled waters: a systematic review of prosthetic valve
endocarditis reported cases treated with suppressive antimicrobial
treatment.
Source
International Journal of Infectious Diseases. 158 (no pagination), 2025.
Article Number: 107934. Date of Publication: 01 Sep 2025.
Author
Valsecchi P.; Calia M.; Giordani P.; Giuliani C.; Arcuri A.; Scotti V.;
Seminari E.; Bruno R.
Institution
(Valsecchi, Calia, Giordani, Giuliani, Arcuri, Seminari, Bruno) Infectious
Diseases I Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
(Calia, Giordani, Giuliani, Arcuri, Bruno) Department of Clinical,
Surgical, Diagnostic, and Pediatric Sciences, University of Pavia, Pavia,
Italy
(Scotti) UOSD Grant Office, TTO and Scientific Documentation, Fondazione
IRCCS Policlinico San Matteo, Pavia, Italy
Publisher
Elsevier B.V.
Abstract
Objectives: We aimed to characterize suppressive antimicrobial treatment
(SAT) for non-surgical candidate patients with prosthetic valve
endocarditis (PVE). Method(s): We systematically reviewed PubMed and
Embase databases for studies reporting individual data on patients with
PVE medically treated for longer than 8 weeks published until the
31st of June 2024. The review protocol was registered on
PROSPERO database [CRD42024529650]. Result(s): One hundred seventy
patients were retrieved from 91 studies. PVE-related death during
follow-up occurred in 26 (15.57%) patients, being associated with
coagulase-negative staphylococci PVE in multivariate Cox regression model
(HR 3.40, 95% CI 1.06-10.97, P-value = 0.04). Relapse occurred in 15
(8.92%) patients and was similar according to SAT discontinuation
(long-rank test P-value = 0.8). This was confirmed after performing
landmark analysis to adjust for survival bias (HR 0.97; 95% CI 0.21-4.4,
P-value = 0.98). SAT-related adverse events were reported in 15% of the
patients. Conclusion(s): Supporting evidence for SAT is low and
derived from case reports and case series. SAT seems well tolerated, but
clinical effectiveness should be further evaluated due to the relevant
mortality rate. In selected cases when SAT discontinuation is considered,
close and long-term follow-up is crucial to prevent relapse. Copyright
© 2025

<92>
Accession Number
2039203698
Title
Link Between Cardiac Allograft Vasculopathy and Metabolic Syndrome: A
Systematic Review and Meta-Analysis.
Source
Metabolic Syndrome and Related Disorders. (no pagination), 2025. Date of
Publication: 2025.
Author
Pajareya P.; Chuanchai W.; Siranart N.; Phutinart S.; Jansem P.; Basch N.;
Techasatian W.; Tokavanich N.; Prasitlumkum N.; Chokesuwattanaskul R.
Institution
(Pajareya, Chuanchai, Siranart, Phutinart, Chokesuwattanaskul) Division of
Cardiovascular Medicine, Center of Excellence in Arrhythmia Research,
Cardiac Center, Faculty of Medicine, King Chulalongkorn Memorial Hospital,
Chulalongkorn University, Bangkok, Thailand
(Jansem) Department of Psychiatry, Faculty of Medicine, Prince of Songkla
University, Songkhla, Thailand
(Basch) Faculty of Medicine, King Chulalongkorn Memorial Hospital,
Chulalongkorn University, Bangkok, Thailand
(Techasatian) Division of Cardiovascular Medicine, Louisiana State
University, Shreveport, LA, United States
(Tokavanich) Division of Cardiovascular Medicine, University of Michigan
Health, Ann Arbor, MI, United States
(Prasitlumkum) Department of Cardiovascular Medicine, Mayo Clinic,
Rochester, MN, United States
Publisher
Mary Ann Liebert Inc.
Abstract
Background: Metabolic syndrome (MetS) is increasingly prevalent globally
and is linked to inflammation in cardiac tissues. Cardiac allograft
vasculopathy (CAV) is a significant inflammatory condition and a leading
cause of graft failure after orthotopic heart transplantation (OHT). The
relationship between MetS and CAV remains poorly understood.
 Method(s): A literature search was conducted from inception to
September 2024, including studies that reported associations between MetS
or its components (obesity, hypertension, dyslipidemia, and diabetes
mellitus) and CAV. The primary endpoint was the development of CAV after
OHT. Results were presented as odds ratios (OR) or hazard ratios (HR) with
95% confidence intervals (CI), employing both random and fixed-effect
models based on heterogeneity. Result(s): A total of 16 studies
involving 3,366 patients were included. The prevalence of MetS was high
before OHT (32%, 95% CI: 24-41%, I2 = 75%) and increased after
OHT (37%, 95% CI: 18-61%, I2 = 83%). MetS was significantly
associated with CAV (OR = 1.99, 95% CI: 1.28-3.09, I2 = 36%).
Key components of MetS linked to CAV included obesity (OR = 1.54, 95% CI:
1.11-2.13, I2 = 0%) and dyslipidemia (OR = 1.87, 95% CI:
1.49-2.36, I2 = 0%). New-onset diabetes mellitus after
transplantation increases the risk of CAV with an HR of 1.71 (95% CI:
1.56-1.88, I2 = 0%). Conclusion(s): The high prevalence of
MetS both before and after OHT is associated with an increased risk of
CAV, highlighting the need for targeted interventions to manage MetS in
heart transplant recipients. Copyright 2025, Mary Ann Liebert, Inc.,
publishers.

<93>
Accession Number
2034683313
Title
Coronary Vasculitis in Takayasu's: A Case Report and Review of the
Literature on Optimal Surgical Intervention.
Source
Journal of Investigative Medicine High Impact Case Reports. 13 (no
pagination), 2025. Article Number: 23247096251342427. Date of Publication:
01 Jan 2025.
Author
Konon E.; Shahzad A.; Quintana Quezada R.; Kolfenbach J.
Institution
(Konon, Shahzad, Quintana Quezada, Kolfenbach) University of Colorado
Anschutz Medical Campus, Aurora, United States
Publisher
SAGE Publications Ltd
Abstract
Takayasu's arteritis (TAK) is a rare, large-vessel vasculitis that
typically involves the aorta and its major branches. Patients may
experience coronary involvement, most commonly the left main coronary
ostia. Patients with coronary artery occlusion often require emergent
revascularization; however, there is debate regarding the optimal timing
and type of surgical intervention in the setting of TAK. Herein we
describe a 32-year-old female presenting with non-ST elevation myocardial
infarction (NSTEMI) who underwent percutaneous intervention (PCI) with
drug-eluting stent (DES) placement and was subsequently diagnosed with
TAK. A 32-year-old female presented to the emergency department with chest
pressure and dyspnea. Her electrocardiogram findings and troponin
elevation were consistent with NSTEMI and she underwent coronary
angiography with DES placement. During angiography, aortic insufficiency
was noted. Transesophageal echocardiogram confirmed intimal thickening of
the aortic root with aortic regurgitation. She was diagnosed with TAK,
started on high-dose steroids, and transferred to a tertiary care center
for rheumatology consultation. This patient's clinical course raised
several questions regarding surgical intervention in TAK. The optimal
timing of surgery and preferred approach (endovascular intervention vs
coronary artery bypass grafting [CABG]) were specifically critiqued. While
endovascular intervention (PCI with angioplasty or stent) is typically
less invasive than CABG, it may be associated with a higher risk of
postsurgical re-stenosis and studies are conflicting regarding the optimal
approach. Further research is necessary to determine the long-term
efficacy and safety of these interventions, as well as their timing in the
overall management plan. Copyright © 2025 American Federation for
Medical Research.

<94>
[Use Link to view the full text]
Accession Number
2039285475
Title
Efficacy and Safety of Prothrombin Complex Concentrate Compared to Fresh
Frozen Plasma in Cardiac Surgery: A Systematic Review and Meta-Analysis of
Randomized Controlled Trials.
Source
Cardiology in Review. (no pagination), 2025. Article Number: 0973. Date
of Publication: 2025.
Author
Ali M.A.; Afridi A.; Sethi F.A.; Raja H.A.A.; Bacha Z.; Shahid S.; Alam
U.; Iqbal A.; Aslam B.; Sabir A.; Khalil A.; Shah A.; Ahmed R.
Institution
(Ali, Afridi, Sethi, Bacha, Alam) Department of Medicine, Khyber Medical
College, Peshawar, Pakistan
(Raja) Department of Medicine, Rawalpindi Medical University, Rawalpindi,
Pakistan
(Shahid) Department of Medicine, Khawaja Muhammad Safdar Medical College,
Sialkot, Pakistan
(Iqbal) Department of Medicine, Bacha Khan Medical College, Mardan,
Pakistan
(Aslam) Department of Medicine, University of Lahore, Lahore, Pakistan
(Sabir) Department of Cardiac Surgery, Rawalpindi Institute of Cardiology,
Rawalpindi, Pakistan
(Khalil) Department of Cardiology, Royal Brompton Hospital, London, United
Kingdom
(Shah) Department of Cardiology, Freeman Hospital, Newcastle Upon Tyne,
United Kingdom
(Ahmed) Department of Cardiac Function, National Heart and Lung Institute,
Imperial College London, London, United Kingdom
Publisher
Lippincott Williams and Wilkins
Abstract
Coagulopathy and bleeding are common complications following cardiac
surgery, often requiring the use of hemostatic agents such as prothrombin
complex concentrate (PCC) or fresh frozen plasma (FFP). This systematic
review and meta-analysis compared the efficacy and safety of PCC versus
FFP in adult patients undergoing cardiac surgery complicated by bleeding
or coagulopathy. A comprehensive search of PubMed, Embase, and Web of
Science was conducted from inception to March 30, 2025, identifying
randomized controlled trials comparing these interventions. Primary
outcomes included chest tube drainage within 24 hours, the number of red
blood cell (RBC) units transfused, and the proportion of patients
requiring RBC transfusion. Secondary outcomes were hospital and intensive
care unit length of stay, the incidence of stroke or transient ischemic
attack, thromboembolic events, acute kidney injury, and all-cause
mortality within 30 days. Four randomized controlled trials, including 671
patients (PCC: 343; FFP: 328), were analyzed. PCC significantly reduced
chest tube output [mean difference = -162.12 mL, 95% confidence interval
(CI): -264.46 to -59.78, P = 0.002], number of RBC units transfused (mean
difference = -0.93, 95% CI: -1.34 to -0.51, P < 0.0001), and proportion of
patients requiring RBC transfusion (risk ratio = 0.81, 95% CI: 0.71-0.91,
P = 0.0007). No significant differences were found in intensive care
unit/hospital stay, thromboembolic events, stroke/transient ischemic
attack, or mortality. Sensitivity analysis suggested a potential reduction
in acute kidney injury with PCC. These findings support the selective use
of PCC for bleeding management in cardiac surgery. Copyright ©
2025 The Author(s). Published by Wolters Kluwer Health, Inc.

<95>
Accession Number
644447371
Title
Efficacy of N-acetylcysteine in reducing the risk of postoperative atrial
fibrillation in cardiothoracic surgery: a systematic review and
meta-analysis of randomized controlled trials.
Source
Minerva cardiology and angiology. 73(3) (pp 387-396), 2025. Date of
Publication: 01 Jun 2025.
Author
Hassan A.A.; Ismail N.R.; Rezk A.E.; Elfeky H.M.; Mady A.M.; Allam A.G.;
Abbas K.S.
Institution
(Hassan) Medical Research Group of Egypt (MRGE), Arlington, MA, United
States
(Hassan) Faculty of Medicine, Al-Azhar University, Cairo, Egypt
(Ismail, Rezk, Elfeky, Mady, Allam, Abbas) Medical Research Group of Egypt
(MRGE), Arlington, MA, United States
(Ismail) Faculty of Medicine, University of Zagazig, Zagazig, Egypt
(Rezk) Faculty of Medicine
(Elfeky) th of October University, Cairo, Egypt
(Mady, Allam) Faculty of Medicine, Al-Azhar University, Cairo, Egypt
Abstract
INTRODUCTION: New-onset postoperative atrial fibrillation (POAF) is a
common complication following cardiac surgeries. N-acetylcysteine (NAC)
showed a significant reduction in the incidence of POAF. This review aimed
to systematically summarize and Meta-analyze data from previously
published Randomized Controlled Trials (RCTs). EVIDENCE ACQUISITION:
Electronic databases: PubMed, Cochrane, Embase, Scopus, and Web of Science
were searched. Data was extracted and the quality of the included studies
was assessed. A random-effects DerSimonian Laird model was employed for
meta-analysis. EVIDENCE SYNTHESIS: Fifteen RCTs were included in this
study (NAC, N.=940; control, N.=935). In the NAC group, 16.38% developed
POAF compared with 23.53% in the control group. NAC supplementation was
associated with a decreased incidence of POAF in patients undergoing
cardiothoracic surgery (RR 0.69; 95% CI 0.52, 0.91; P=0.008).
Meta-regression of randomized trial data showed that the incidence of POAF
was not related to the NAC dose (P=0.439). A subgroup analysis in terms of
the time of NAC administration revealed that preoperative and
postoperative NAC administration was the only subgroup that demonstrated a
statistically significant difference (RR 0.48, 95% CI 0.32, 0.71;
P=0.0003) compared with placebo and showed no heterogeneity.
 CONCLUSION(S): Atrial fibrillation is a significant postoperative
complication, particularly in cardiothoracic surgery. This study
highlights the need for further research on optimal NAC dosing and timing,
with evidence suggesting that preoperative and postoperative NAC
administration may significantly decrease postoperative atrial
fibrillation in cardiothoracic surgery patients, although limitations and
variability in study designs need to be considered.

<96>
Accession Number
2039207887
Title
Meta-analysis of transcatheter edge-to-edge repair vs surgery for
secondary mitral regurgitation.
Source
Cardiovascular Revascularization Medicine. (no pagination), 2025. Date of
Publication: 2025.
Author
Singh S.; Shabbir M.A.; Tiwari N.; Bliden K.; Tantry U.S.; Gurbel P.A.;
Kanjwal M.Y.; Lundgren S.W.
Institution
(Singh) Department of Medicine, Sinai Hospital of Baltimore, Baltimore,
MD, United States
(Shabbir, Tiwari, Lundgren) Division of Cardiology, University of Nebraska
Medical Center, Omaha, NE, United States
(Bliden, Tantry) Sinai Center for Thrombosis Research, Sinai Hospital of
Baltimore, Baltimore, MD, United States
(Gurbel, Kanjwal) Division of Cardiology, Sinai Hospital of Baltimore,
Baltimore, MD, United States
Publisher
Elsevier Inc.
Abstract
Background: Transcatheter edge-to-edge repair (TEER) in patients with
secondary mitral regurgitation (MR) has shown variable outcomes in
clinical studies when compared with mitral valve surgery. We conducted a
meta-analysis to reconcile the data. Method(s): Online databases were
searched for studies assessing TEER vs surgery for secondary MR. The
outcomes of interest were length of hospital stay, all deaths, heart
failure (HF) rehospitalization, mitral valve reintervention, implantation
of left ventricular assist device (LVAD), stroke and recurrence of grade 3
or 4 MR. Pooled odds ratios (OR) and standardized mean difference (SMD),
with 95 % confidence intervals (CI) were calculated. Result(s): Eight
studies (1 randomized and 7 observational) with a total of 1436 patients
(TEER n = 826, surgery n = 610) were included. Length of hospital stay was
shorter in the TEER group (SMD -2.50, 95 % CI -4.65 to -0.35, p = 0.02).
No significant differences were found between the two groups with respect
to all deaths (p = 0.80), HF rehospitalization, mitral valve
reintervention, implantation of LVAD and stroke. Recurrence of grade 3 or
4 MR was higher in the TEER group (OR 5.33, 95 % CI 2.57 to 11.03, p <
0.00001). Conclusion(s): In patients with secondary MR, TEER and
surgery have comparable outcomes such as mortality, except for the lower
recurrence of grade 3 or 4 MR in the surgical group. Thus, TEER may be the
first approach in such patients, except in low surgical risk cases who
need other concomitant cardiac surgeries. Copyright © 2025
Elsevier Inc.

<97>
Accession Number
2036647995
Title
Exploratory Non-Causal Associations of Variables with New-Onset Atrial
Fibrillation Incidence and Mortality in Critically Ill Patients [Response
To Letter].
Source
Clinical Epidemiology. 17 (pp 547-550), 2025. Date of Publication: 2025.
Author
Zhang H.-D.; Ding L.; Shen Y.-J.; Tang M.
Institution
(Zhang, Ding, Shen, Tang) State Key Laboratory of Cardiovascular Disease,
Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese
Academy of Medical Sciences & Peking Union Medical College, Beijing, China
Publisher
Dove Medical Press Ltd

<98>
Accession Number
2038208829
Title
Investigating the effects of applying low acoustic frequencies on the pain
from venous and arterial blood sampling: A clinical trial study.
Source
Advances in Integrative Medicine. 12(4) (no pagination), 2025. Article
Number: 100480. Date of Publication: 01 Dec 2025.
Author
Mohammadi S.; Ezzati E.; Mahooti R.; Kavyannejad F.; Paran M.S.;
Kavyannejad R.
Institution
(Mohammadi) Department of Anesthesiology, School of Medicine, Kermanshah
University of Medical Sciences, Kermanshah, Iran, Islamic Republic of
(Ezzati) Department of Anesthesiology, School of Paramedical, Kermanshah
University of Medical Sciences, Kermanshah, Iran, Islamic Republic of
(Mahooti) Emam Khomaini Hospital, Kermanshah University of Medical
Sciences, Kermanshah, Iran, Islamic Republic of
(Kavyannejad, Paran) Al-Zahra Hospital, Kermanshah University of Medical
Sciences, Kermanshah, Iran, Islamic Republic of
(Kavyannejad) Department of Physiology, School of Medicine, Kermanshah
University of Medical Sciences, Kermanshah, Iran, Islamic Republic of
Publisher
Elsevier Australia
Abstract
Background: The pain of the blood sampling process is an unpleasant and
common experience in the treatment process. Stimulation the thalamus
structure and corticothalamic pathways with at specific frequencies could
play a role in modulating pain perception. The aim of this study was to
investigate the use low acoustic frequencies in reducing pain during
arterial and venous blood sampling. Material(s) and Method(s): In a
triple-blinded clinical trial study, 300 patients in each process were
randomly divided into control and intervention groups. Patients in the
intervention groups received sound frequencies of 10-200 Hz with an
intensity of 50 dB during the procedures. Pain intensity, heart rate
changes, number of attempts for successful sampling, and time required for
each procedure were measured. Data were analyzed using Prism 10 software.
 Result(s): Pain levels were significantly lower in the intervention
groups with increasing sound frequencies in both procedures (P < 0.05).
The duration of blood sampling procedures was significantly shorter with
increasing sound frequency (P < 0.05), but no difference was observed in
the frequency of sampling attempts (P > 0.05). By increasing the sound
frequency, the intensity of tachycardia significantly decreased following
the blood sampling process (P < 0.05), especially at higher frequencies.
 Conclusion(s): Applying low sound frequencies effectively could
reduce acute pain and its consequences resulting from an invasive process.
Sound frequencies appear to play a role in modulating pain pathways in the
central nervous system. Implications for Clinical Practice: The study
findings suggest that sound frequency ranges as a non-pharmacological
analgesia intervention can be used to reduce pain and discomfort following
a variety of blood sampling procedures, which performed by
nurses. Copyright © 2025 Elsevier Ltd

<99>
Accession Number
2039207308
Title
The Protective Effect of Remote Ischemic Preconditioning on Acute Kidney
Injury Following Pediatric Cardiac Surgery: A Systematic Review and
Meta-Analysis.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2025.
Date of Publication: 2025.
Author
Cheng P.; Wang G.; An Y.
Institution
(Cheng, Wang, An) Department of Thoracic Surgery, Children's Hospital of
Chongqing Medical University, National Clinical Research Center for Child
Health and Disorders, Ministry of Education, Key Laboratory of Child
Development and Disorders, Chongqing Key Laboratory of Structural Birth
Defect and Reconstruction, Chongqing, China
Publisher
W.B. Saunders
Abstract
Cardiac surgery in children is a major risk factor for acute kidney injury
(AKI) because of the high risk of AKI due to the combination of
hemodynamic instability, ischemia-reperfusion injury, and inflammation.
However, the protective role of remote ischemic preconditioning (RIPC) in
this setting is unclear. This systematic review and meta-analysis was
conducted to assess whether RIPC reduces the incidence of AKI in pediatric
cardiac surgery patients. PubMed, EMBASE, and the Cochrane Library were
systematically searched for randomized controlled trials (RCTs) of RIPC in
pediatric cardiac surgery. The primary outcome indicator was the incidence
of postoperative AKI, and secondary outcome indicators included serum
creatinine (sCr) level, tumor necrosis factor (TNF)-alpha level, and
intensive care unit (ICU) length of stay (LOS). Six RCTs with a total of
1,098 patients were included in the analysis. RIPC significantly reduced
the incidence of AKI (odds ratio, 0.38; 95% confidence interval,
0.25-0.60; p < 0.00001; I2 = 38%). There was no significant effect on
postoperative sCr, TNF-alpha levels and ICU LOS (p > 0.05 for all; I2
>80%). Sensitivity analyses showed a large impact of some studies on the
results. The data indicate that RIPC significantly reduced the incidence
of AKI after pediatric cardiac surgery, showing its potential
renoprotective effect. Although the effect on other postoperative
indicators was not significant, high heterogeneity limits the certainty of
the conclusions. Future studies should focus on multicenter, large-scale
trials with detailed subgroup analyses to explore the mechanism of action
and effects of RIPC in different patient populations. Copyright ©
2025 Elsevier Inc.

<100>
[Use Link to view the full text]
Accession Number
2039231020
Title
Colchicine for prevention of major adverse cardiovascular events: A
meta-analysis of randomized clinical trials.
Source
Journal of Cardiovascular Medicine. (no pagination), 2025. Date of
Publication: 2025.
Author
Ballacci F.; Giordano F.; Conte C.; Telesca A.; Collini V.; Imazio M.
Institution
(Ballacci, Giordano, Conte, Telesca, Collini, Imazio) Cardiothoracic
Department, University Hospital Santa Maria della Misericordia, Udine,
Italy
(Imazio) Department of Medicine, University of Udine, Udine, Italy
Publisher
Lippincott Williams and Wilkins
Abstract
Aims Inflammation is a main pathophysiological driver in atherosclerotic
cardiovascular diseases (ASCVD). Low-dose long-term colchicine for
secondary prevention in patients with established ASCVD has been studied
in multiple randomized trials in the last decade. This meta-analysis aimed
to evaluate the efficacy and safety of long-term low-dose colchicine for
secondary prevention in patients with established ASCVD. Methods We
conducted a systematic review and meta-analysis following PRISMA
guidelines to evaluate studies reporting long-term outcomes in patients
with ASCVD. We systematically searched PubMed, EMBASE and Scopus databases
for relevant studies up to 1 December 2024. The primary outcome was the
occurrence of major adverse cardiovascular events (MACE), a composite of
cardiovascular death (CVD), myocardial infarction (MI) and stroke.
Random-effects models were used to calculate pooled risk ratios (RRs).
Results Ten randomized clinical trials enrolling 22 532 patients were
identified. Addition of colchicine to standard medical treatment in
patients with established ASCVD reduced the risk for MACE by 27% [RR 0.73,
95% confidence interval (CI) 0.57-0.95], with a number needed to treat of
52. Colchicine was found to significantly reduce the risk of MI (RR 0.83,
95% CI 0.72-0.96) and coronary revascularization (RR 0.79, 95% CI
0.65-0.94). There were no significant differences between the two groups
concerning cardiovascular and noncardiovascular mortality, risk of serious
gastrointestinal events, infections requiring hospitalization and cancer.
Conclusions These findings support the use of long-term low-dose
colchicine for secondary prevention of MACE in clinical
practice. Copyright © 2025 Italian Federation of
Cardiology-I.F.C. All rights reserved.

<101>
Accession Number
2039124818
Title
Use of the Ostial Flash Balloon in Aorto-Ostial Chronic Total Occlusion
Percutaneous Coronary Intervention.
Source
Journal of Invasive Cardiology. 37(5) (no pagination), 2025. Date of
Publication: 05 Jan 2025.
Author
Mutlu D.; Strepkos D.; Carvalho P.E.; Alexandrou M.; Al-Ogaili A.; Jalli
S.; Alaswad K.; Jaffer F.A.; Davies R.; Poommipanit P.; Frizzel J.;
Elbarouni B.; Khatri J.J.; Gorgulu S.; Goktekin O.; Ozdemir R.; Uluganyan
M.; ElGuindy A.; Sadek Y.; Ahmad Y.; Basir M.B.; Raj L.; Ybarra L.; Murad
B.; Rangan B.V.; Mastrodemos O.C.; Azzalini L.; Sandoval Y.; Burke M.N.;
Brilakis E.S.
Institution
(Mutlu, Strepkos, Carvalho, Alexandrou, Al-Ogaili, Jalli, Murad, Rangan,
Mastrodemos, Sandoval, Burke, Brilakis) Minneapolis Heart Institute,
Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital,
Minneapolis, MN, United States
(Alaswad, Basir) Henry Ford Cardiovascular Division, Detroit, MI, United
States
(Jaffer) Massachusetts General Hospital, Boston, MA, United States
(Davies) WellSpan York Hospital, York, PA, United States
(Poommipanit) University Hospitals, Case Western Reserve University,
Cleveland, OH, United States
(Frizzel) The Christ Hospital, Cincinnati, OH, United States
(Elbarouni) St. Boniface General Hospital, Winnipeg, MB, Canada
(Khatri) Cleveland Clinic, Cleveland, OH, United States
(Gorgulu) Biruni University Medical School, Istanbul, Turkey
(Goktekin) Memorial Bahcelievler Hospital, Istanbul, Turkey
(Ozdemir, Uluganyan) Bezmialem Vakif University, Istanbul, Turkey
(ElGuindy) Aswan Heart Center, Magdi Yacoub Foundation, Egypt
(Sadek) National Heart Center, Cairo, Egypt
(Ahmad) Yale University, New Haven Hospital, New Haven, CT, United States
(Raj) Vanderbilt University, Nashville, TN, United States
(Ybarra) Western University, London, ON, Canada
(Azzalini) University of Washington, Seattle, WA, United States
Publisher
Cliggott Publishing Co.
Abstract
Background. The use of the Ostial Flash balloon (Ostial Corporation) has
received limited study in aorto-ostial chronic total occlusion (CTO)
percutaneous coronary artery intervention (PCI). Methods. The authors
evaluated the outcomes of Ostial Flash balloon use in a large CTO-PCI
registry (PROGRESS-CTO, NCT02061436). Results. The Ostial Flash balloon
was used in 54 of 907 aorto-ostial CTO PCIs in 905 patients (6.0%). The
mean patient age was 65.1 +/- 10.7 and 80.6% were men, with a high
prevalence of diabetes mellitus, hypertension, prior PCI, and prior
myocardial infarction. The mean occlusion length was 40.5 +/- 25.1 mm,
52.2% had moderate to severe calcification, and the mean Japanese-CTO
score was 2.8 +/- 1.1. Lesions treated with the Ostial Flash balloon were
more frequently located in the right aorto-ostium (79.6% vs 66.0%, P
=.002). In the Ostial Flash group, the most common successful CTO crossing
technique was antegrade wiring (46.3%), followed by the retrograde
approach (40.7%); intravascular imaging was used in 61.1% of cases.
Technical success (92.6% vs 87.9%, P =.300) and the incidence of major
adverse cardiac events (MACE) (5.6% vs 3.6%, P =.450) was similar in the
Ostial Flash vs non-Ostial Flash patients, respectively. In multivariable
analysis, PCI of proximal right coronary artery CTOs was independently
associated with use of the Ostial Flash balloon (odds ratio 2.2; 95% CI,
1.1-4.8; P =.036). Conclusions. The Ostial Flash balloon is infrequently
used in aorto-ostial CTO PCI. Although there were no differences in MACE
with use of the balloon, randomized controlled trials are needed to
determine its effectiveness. Copyright © 2025 HMP Global. All
Rights Reserved

<102>
Accession Number
2028868551
Title
The impact of cardiopulmonary rehabilitation in phase II cardiac
rehabilitation program on the health-related quality of life of patients
undergoing coronary artery bypass graft surgery.
Source
Current Problems in Cardiology. 49(2) (no pagination), 2024. Article
Number: 102221. Date of Publication: 01 Feb 2024.
Author
Akar M.; Miri K.; Mazloum S.R.; Hajiabadi F.; Hamedi Z.; Vakilian F.;
Dehghan H.
Institution
(Akar) Department of Medical - Surgical Nursing, School of Nursing and
Midwifery (MSC Student), Mashhad University of Medical Sciences, Mashhad,
Iran, Islamic Republic of
(Akar, Mazloum, Hajiabadi) Nursing and Midwifery Care Research Center,
Mashhad University of Medical Sciences, Mashhad, Iran, Islamic Republic of
(Miri) Department of Nursing, School of Nursing and Midwifery, Torbat
Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran,
Islamic Republic of
(Mazloum, Hajiabadi) Department of Medical Surgical Nursing, School of
Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad,
Iran, Islamic Republic of
(Hamedi, Dehghan) Department of Cardiac Rehabilitation, Mashhad University
of Medical Sciences, Imam Reza Hospital, Mashhad, Iran, Islamic Republic
of
(Vakilian) Vascular Surgery Research Center, Mashhad University of Medical
Sciences, Mashhad, Iran, Islamic Republic of
Publisher
Elsevier Inc.
Abstract
Background: Coronary artery bypass surgery is the leading cause of change
in the quality of life and pulmonary function of patients. One strategy to
enhance lung muscle strength and improve overall quality of life is
pulmonary rehabilitation. This study aimed to investigate the impact of
incorporating a pulmonary rehabilitation program into phase II cardiac
rehabilitation program on the quality of life of patients undergoing
coronary artery bypass graft surgery. Method(s): This randomized
clinical trial study included 53 patients who underwent coronary artery
bypass graft surgery at Imam Reza Hospital in Mashhad between September
2019 and March 2020. The research participants were selected based on
specific inclusion criteria and divided into two groups. The control group
followed the routine rehabilitation program, whereas the intervention
group underwent a pulmonary rehabilitation program for 20-30 min after
each session of the cardiac rehabilitation program. Data collection tools
included a demographic information questionnaire and the Ferrans and
Powers' quality of life index. The data were analyzed using the
independent t-test, Mann-Whitney test, paired t-test, Spearman
correlation, Wilcoxon test, and SPSS25. Result(s): The mean quality
of life score in the intervention group(20.7+/-1.8) was significantly
higher than that of the control group (18.8+/-2.3)(P < 0.05). Furthermore,
the intervention group exhibited significantly higher mean scores in the
physical, psychological-spiritual, and family dimensions than the control
group(P < 0.05). Conclusion(s): The study results demonstrate the
positive impact of incorporating a pulmonary rehabilitation program into
cardiac rehabilitation on the health-related quality of life of patients
undergoing coronary artery bypass graft surgery. Trial registration:
IRCT20190707044132N1 Copyright © 2023 Elsevier Inc.

<103>
Accession Number
2020586665
Title
Prevalence of Post-Heart Transplant Malignancies: A Systematic Review and
Meta-Analysis.
Source
Current Problems in Cardiology. 47(12) (no pagination), 2022. Article
Number: 101363. Date of Publication: 01 Dec 2022.
Author
Lateef N.; Farooq M.Z.; Latif A.; Ahmad S.; Ahsan M.J.; Tran A.; Nickol
J.; Wasim M.F.; Yasmin F.; Kumar P.; Arif A.W.; Shaikh A.; Mirza M.
Institution
(Lateef, Nickol) Department of Cardiovascular Medicine, University of
Nebraska Medical Center, Omaha, NB, United States
(Farooq) Department of Hematology/Oncology, Moffitt Cancer Center,
Florida, FL
(Latif) Department of Cardiovascular Medicine, Baylor University, Houston,
TX
(Ahmad) Department of Internal Medicine, East Carolina University, NC
(Ahsan) Division of Cardiovascular Medicine, Iowa Heart Center, Iowa
(Tran, Mirza) Department of Internal Medicine, Creighton University, NB
(Wasim) Department of Medicine, Baqai Medical University, Karachi,
Pakistan
(Yasmin, Kumar) Department of Medicine, Dow University of Health Sciences,
Karachi, Pakistan
(Arif) Department of Cardiovascular Medicine, Cook County Health Sciences,
Chicago, IL
(Shaikh) Department of Internal Medicine, Rochester General Hospital,
Rochester, NY
Publisher
Elsevier Inc.
Abstract
The prevalence of different cancers after heart transplant (HT) is unclear
due to small and conflicting prior studies. Herein, we report a systematic
review and meta-analysis to highlight the prevalence and pattern of
malignancies post-HT. We conducted an extensive literature search on
PubMed, Scopus, Cochrane databases for prospective or retrospective
studies reporting malignancies after HT. The proportions from each study
were subjected to random effects model that yielded the pooled estimate
with 95% confidence intervals (CI). Fifty-five studies comprising 60,684
HT recipients reported 7759 total cancers during a mean follow-up of 9.8
+/- 5.9 years, with an overall incidence of 15.3% (95% CI = 12.7%-18.1%).
Mean time from HT to cancer diagnosis was 5.1 +/- 4 years. The most
frequent cancers were gastrointestinal (7.6%), skin (5.7%), and
hematologic/blood (2.5%). Meta-regression showed no association between
incidence of cancer and mean age at HT (coeff: -0.008; P = 0.25),
percentage of male recipients (coeff: -0.001; P = 0.81), donor age (coeff:
-0.011; P = 0.44), 5-year (coeff: 0.003; P = 0.12) and 10-year (coeff:
0.02; P = 0.68) post-transplant survival. There is a substantial risk of
malignancies in HT recipients, most marked for gastrointestinal, skin, and
hematologic. Despite their occurrence, survival is not significantly
impacted. Copyright © 2022 Elsevier Inc.

<104>
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. 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.
 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.
 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). Copyright © The Author(s) 2025.

<105>
Accession Number
2034902144
Title
Tacrolimus Intrapatient Variability as a Biomarker in Solid Organ
Transplantation.
Source
Clinical Transplantation. 39(6) (no pagination), 2025. Article Number:
e70197. Date of Publication: 01 Jun 2025.
Author
Nogueiras-Alvarez R.; Garcia-Saiz M.D.M.
Institution
(Nogueiras-Alvarez) Clinical Pharmacology, Osakidetza Basque Health
Service, Galdakao-Usansolo University Hospital, Galdakao, Bizkaia, Spain
(Garcia-Saiz) Clinical Pharmacology Service, Marques de Valdecilla
University Hospital, Cantabria, Santander, Spain
Publisher
John Wiley and Sons Inc
Abstract
Tacrolimus is the primary calcineurin inhibitor agent prescribed in
different solid organ transplantation modalities. Among its
characteristics, tacrolimus has a high inter- and intrapatient
variability. Recently, tacrolimus intrapatient variability (Tac-IPV) has
been proposed as a useful biomarker to predict outcomes in different types
of solid organ transplantation. This work includes a systematic review of
the literature that evaluates Tac-IPV influence on solid organ
transplantation outcomes from inception to September 18, 2024. Although
there are several publications assessing the influence of Tac-IPV in
transplantation, we found that there is a lack of consensus regarding
which is the best measure to evaluate Tac-IPV. Moreover, the ideal
post-transplantation period for evaluating this biomarker has not been
established so far. Different cut-off points have been proposed,
especially in adult kidney transplantation, where most of the studies have
been carried out, but these cut-off values may not be applicable to other
transplantation modalities. This work includes a description of the main
findings of different studies in an attempt to state what the current
knowledge on the topic is in different solid organ transplantation
modalities. Copyright © 2025 John Wiley & Sons A/S. Published by
John Wiley & Sons Ltd.

<106>
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.
 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.
 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. Copyright © 2025 The Author(s). Transfusion published by
Wiley Periodicals LLC on behalf of AABB.

<107>
Accession Number
2034983492
Title
The effects of extracorporeal blood purification (oXiris) in patients with
cardiogenic shock who require VA-ECMO (CLEAN ECMO): a prospective,
open-label, randomized controlled pilot study.
Source
Critical Care. 29(1) (no pagination), 2025. Article Number: 255. Date of
Publication: 01 Dec 2025.
Author
Ko R.-E.; Choi K.H.; Lee K.; Jeon J.; Jang H.R.; Chung C.R.; Cho Y.H.;
Park T.K.; Lee J.M.; Song Y.B.; Hahn J.-Y.; Choi S.-H.; Gwon H.-C.; Yang
J.H.
Institution
(Ko, Chung, Yang) Department of Critical Care Medicine, Samsung Medical
Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
(Choi, Park, Lee, Song, Hahn, Choi, Gwon, Yang) Division of Cardiology,
Department of Medicine, Heart Vascular Stroke Institute, Samsung Medical
Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
(Lee, Jeon, Jang) Division of Nephrology, Department of Medicine, Samsung
Medical Center, Sungkyunkwan University School of Medicine, Seoul, South
Korea
(Cho) Department of Thoracic and Cardiovascular Surgery, Samsung Medical
Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
Publisher
BioMed Central Ltd
Abstract
Background: A systemic inflammatory response can contribute to poor
outcomes in an advanced stage of cardiogenic shock (CS). We investigated
the efficacy of extracorporeal endotoxin and cytokine adsorption using
oXiris in patients with CS undergoing venoarterial extracorporeal membrane
oxygenation (VA-ECMO). Method(s): In this prospective, single-center,
randomized, open-label pilot trial, 40 patients with CS who were
undergoing VA-ECMO were randomly assigned to receive either oXiris for 24
h (n = 20) or usual care (n = 20). The primary endpoint was endotoxin
levels at 48 h. Secondary endpoints included changes in inflammatory
cytokines, vasoactive-inotropic score (VIS), ECMO weaning success, and
in-hospital and 30-day mortality. Result(s): The median endotoxin
levels at 48 h were 0.5 (IQR 0.4-1.0) in the oXiris group and 0.4 (IQR
0.2-0.5) in the control group, with no significant difference between them
(P = 0.097). The oXiris group showed significant temporal reductions in
GDF-15 and IL-6 levels, with IL-6 revealing significant reductions from
baseline to 24 h (P = 0.020) and from baseline to 7 days (P = 0.003). VIS
decreased significantly from baseline to 48 h (-13.63, 95% CI: -20.90 -
-6.34, P < 0.001) and 7 days (-12.19, 95% CI: -21.0 - -3.31, P = 0.007) in
the oXiris group, but intergroup differences were insignificant. ECMO
weaning success, duration of ECMO support, and mortality rates were
similar between the groups. Conclusion(s): In this pilot study
conducted on CS patients requiring VA-ECMO, oXiris treatment did not
significantly reduce endotoxin levels or improve patient centered clinical
outcomes. Trial registration: NCT05642273, registered 8 December
2022. Copyright © The Author(s) 2025.

<108>
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. Copyright © The Author(s) under
exclusive licence to Japanese Association of Cardiovascular Intervention
and Therapeutics 2025.

<109>
Accession Number
2034994433
Title
Efficacy and Safety of Transcatheter Tricuspid Valve Replacement in
Patients With Moderate to Severe Tricuspid Regurgitation: A Systematic
Review and Meta-Analysis on Clinical Outcomes and Echocardiographic
Indices.
Source
Health Science Reports. 8(6) (no pagination), 2025. Article Number:
e70950. Date of Publication: 01 Jun 2025.
Author
Azami P.; Hosseinpour A.; Kamalpour J.; Rajabi F.; Razeghian-Jahromi I.;
Farhangdoost S.; Vafa R.G.; Bagheri G.
Institution
(Azami, Hosseinpour, Kamalpour) Department of Cardiovascular Medicine,
School of Medicine, Shiraz University of Medical Sciences, Iran, Islamic
Republic of
(Azami, Hosseinpour, Kamalpour, Rajabi, Farhangdoost, Vafa) School of
Medicine, Shiraz University of Medical Sciences, Shiraz, Iran, Islamic
Republic of
(Azami, Razeghian-Jahromi) Cardiovascular Research Center, School of
Medicine, Shiraz University of Medical Sciences, Shiraz, Iran, Islamic
Republic of
(Bagheri) Clinical Biochemistry Department, School of Medicine, Lorestan
University of Medical Sciences, Iran, Islamic Republic of
Publisher
John Wiley and Sons Inc
Abstract
Background and Aims: Tricuspid regurgitation (TR) is a prevalent, often
overlooked condition linked to significant morbidity and mortality in
older adults. Due to the high risks associated with conventional surgery,
transcatheter tricuspid valve replacement (TTVR) has emerged as a less
invasive alternative. This systematic review and meta-analysis evaluated
the clinical outcomes and echocardiographic indices of TTVR.
 Method(s): Five databases were searched systematically, and eligible
studies included patients with moderate or severe TR who underwent TTVR.
Risk of bias was assessed using the ROBINS-I tool for observational
studies and the JBI checklist for case series. A random-effects
meta-analysis was performed to evaluate the impact of TTVR on major
adverse cardiovascular events (MACE) and echocardiographic parameters.
 Result(s): Twenty-one studies with 643 patients (mean age 75.8 years,
70.76% female) reported a 94% technical success rate for TTVR (95% CI:
91-96%). 30-day mortality was 4% (95% CI: 2-6%) and 1-year mortality was
9% (95% CI: 6%-13%). Significant improvements were noted in TR severity
(OR = 0.0013, 95% CI: 0.0006-0.0027, p < 0.001) and PASP (MD = -8.69 mmHg,
95% CI: -11.54 to -5.84, p < 0.001), along with reductions in right
ventricular base diameter (MD = -6.33 mm, 95% CI: -8.92 to -3.75, p <
0.001) and RV end-diastolic mid diameter (MD = -6.33 mm; 95% CI [-8.18,
-5.52]; p < 0.001; I2 = 5%). Conclusion(s): TTVR presents a promising
treatment alternative for high-risk patients with severe TR, demonstrating
high technical success, favorable clinical outcomes, and significant
echocardiographic improvements. While the procedure is associated with low
in-hospital and 1-year mortality, further studies are needed to evaluate
long-term outcomes and optimize patient selection for this emerging
therapy. Copyright © 2025 The Author(s). Health Science Reports
published by Wiley Periodicals LLC.

<110>
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. 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.
 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). 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. Copyright ©2025Int. J. Life Sci. Biotechnol.
Pharma. Res.

<111>
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. 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. 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. 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. Copyright © The Author(s) under exclusive
licence to Japanese Association of Cardiovascular Intervention and
Therapeutics 2025.

<112>
Accession Number
2035010619
Title
A Meta-Analysis of Randomized Controlled Trials (RCTs) Investigating the
Efficacy and Safety of Acupuncture in Treating Myocardial
Ischemia/Reperfusion (I/R) Injury.
Source
Cardiology Research and Practice. 2025(1) (no pagination), 2025. Article
Number: 9970541. Date of Publication: 2025.
Author
Xiong J.; Wei Y.; Huang X.; Hu J.; Ling F.; Shang Z.; Qi W.; Zheng Q.; Li
D.; Liang F.
Institution
(Xiong, Wei, Hu, Ling, Qi, Zheng, Liang) College of Acupuncture and Tuina,
Chengdu University of Traditional Chinese Medicine, Sichuan, Chengdu,
China
(Huang) The First College of Clinical Medicine, Guangxi University of
Traditional Chinese Medicine, Guangxi, Nanning, China
(Shang) The First College of Clinical Medicine, Nanjing University of
Traditional Chinese Medicine, Jiangsu, Nanjing, China
(Li) Acupuncture Department, The Affiliated Hospital of Chengdu University
of Traditional Chinese Medicine, Sichuan, Chengdu, China
Publisher
John Wiley and Sons Ltd
Abstract
Objectives: This study systematically reviewed and meta-analyzed
randomized controlled trials (RCTs) evaluating the efficacy and safety of
acupuncture in myocardial ischemia/reperfusion (I/R) injury.
 Method(s): A comprehensive literature search was conducted in PubMed,
Cochrane Library, Web of Science, Chinese National Knowledge
Infrastructure, China Science and Technology Journal Database, and Wanfang
from database inception to November 3, 2024. Eligible RCTs assessing
acupuncture for myocardial I/R injury were included. Statistical analyses
were performed using Review Manager 5.3 and Stata 16. Result(s): A
total of 26 RCTs of moderate methodological quality were included.
Acupuncture significantly reduced myocardial enzyme levels compared to
controls. Inflammatory markers (hs-CRP, TNF-alpha, IL-6, IL-8, and IL-1)
were suppressed, while anti-inflammatory and immunoregulatory factors
(IL-10 and IL-2) increased. Oxidative stress parameters showed
improvements, with reductions in MDA and SOD levels. Echocardiographic
findings demonstrated enhanced cardiac function, reflected by increased
LVEF and LVESV, along with reductions in LVFS, LVEDD, LVEDV, and LVESD.
Additionally, acupuncture alleviated TCM chest pain symptoms, shortened
ICU stays, lowered MACE incidence, and improved 6MWT and SAQ indicators.
No adverse reactions were reported. Conclusion(s): Acupuncture
attenuates myocardial injury, inflammation, and oxidative stress while
activating anti-inflammatory and immune responses, enhancing cardiac
function, and mitigating ventricular remodeling. Furthermore, it
alleviates chest pain, shortens ICU stays, reduces adverse cardiovascular
events, and improves 6MWT and SAQ indicators. Copyright © 2025
Jian Xiong et al. Cardiology Research and Practice published by John Wiley
& Sons Ltd.

<113>
Accession Number
2034097496
Title
Home-Based Rehabilitation After Transcatheter Aortic Valve Replacement
(REHAB-TAVR): A Pilot Randomized Controlled Trial.
Source
Journal of the American Geriatrics Society. 73(6) (pp 1836-1846), 2025.
Date of Publication: 01 Jun 2025.
Author
Shi S.M.; Rapley F.-A.; Margulis H.; Laham R.J.; Guibone K.; Percy E.;
Kaneko T.; Wang K.-Y.; Kim D.H.
Institution
(Shi, Wang, Kim) Frailty Research Center, Hinda and Arthur Marcus
Institute for Aging Research, Hebrew SeniorLife, Boston, MA, United States
(Shi, Wang, Kim) Division of Gerontology, Department of Medicine, Beth
Israel Deaconess Medical Center, Boston, MA, United States
(Shi, Laham, Wang, Kim) Harvard Medical School, Boston, MA, United States
(Rapley) Clinical Research Center, Beth Israel Deaconess Medical Center,
Boston, MA, United States
(Margulis) Rehabilitation Services, Hebrew SeniorLife, Boston, MA, United
States
(Laham, Guibone) Division of Cardiology, Department of Medicine, Beth
Israel Deaconess Medical Center, Boston, MA, United States
(Percy) Division of Cardiac Surgery, Department of Surgery, University of
British Columbia, Vancouver, Canada
(Kaneko) Department of Surgery, Washington University School of Medicine,
St. Louis, MO, United States
Publisher
John Wiley and Sons Inc
Abstract
Background: The benefit of early cardiac rehabilitation after
transcatheter aortic valve replacement (TAVR) is not well established.
This pilot study evaluated the feasibility and short-term effects of a
home-based exercise program, with or without cognitive-behavioral
intervention (CBI). Method(s): We randomized 51 patients (mean age,
83.9 years; 19 women) to a home-based exercise program with CBI (Group A;
n = 18) or without CBI (Group B; n = 15), or telephone-based education
control (Group C; n = 18). The exercise program focusing on balance,
flexibility, strength, and endurance began within 7 days post-discharge
and was delivered once weekly by a physical therapist for 8 weeks. CBI
included discussions on exercise benefits and barriers, goal setting,
detailed exercise planning, and a weekly cash adherence incentive. The
primary outcome was a disability score (range: 0-22; higher scores
indicate greater disability) at 8 weeks. Secondary outcomes included the
Short Physical Performance Battery (SPPB) (range: 0-12; higher scores
indicate better function), self-efficacy, and outcome expectation scores.
Feasibility outcomes included adherence and drop-out rates.
 Result(s): Fifteen participants (83.3%) in Group A, 10 (58.8%) in
Group B, and 10 (52.6%) in Group C completed >= 5 of the eight assigned
weekly sessions (p = 0.196). Two participants in each group were lost to
follow-up. At 8 weeks, the home-based exercise groups (Group A and B
combined) demonstrated lower disability scores (mean [SE]: 2.6 [0.3] vs.
4.5 [0.5]; p = 0.042) and higher SPPB scores (9.5 [0.6] vs. 6.5 [0.8]; p =
0.003) compared with the education group (Group C). Group A had lower
disability scores than Group B (2.1 [0.4] vs. 3.4 [0.5]; p = 0.047), with
no differences in self-efficacy and outcome expectation scores.
 Conclusion(s): An early, home-based, multi-domain exercise program
appears feasible and may prevent disability and improve physical function
in older adults after TAVR. Adding CBI, including a modest cash incentive,
showed trends toward improved adherence and reduced disability. Trial
Registration: NCT02805309. Copyright © 2025 The American
Geriatrics Society.

<114>
Accession Number
2038817632
Title
Effects of various hydrotherapeutic procedures on heart rate variability
and blood pressure: A systematic review.
Source
Advances in Integrative Medicine. 12(3) (no pagination), 2025. Article
Number: 100500. Date of Publication: 01 Sep 2025.
Author
Abinaya S.; Vijay A.; Nivethitha L.; Mooventhan A.; Manavalan N.
Institution
(Abinaya, Vijay, Nivethitha, Manavalan) Department of Naturopathy,
Government Yoga and Naturopathy Medical College, Tamilnadu, Chennai, India
(Mooventhan) Department of Research, Government Yoga and Naturopathy
Medical College, Tamilnadu, Chennai, India
Publisher
Elsevier Australia
Abstract
Background: The autonomic nervous system (ANS) regulates involuntary
physiological processes including blood pressure. Hydrotherapy uses water
to treat various conditions and research on effect of different
hydrotherapy modalities at varying temperatures on the heart rate
variability (HRV) is increasing for the past few years. However, there is
no systematic review of on it. Hence, this systematic review was performed
to provide evidence-based effects of hydrotherapy on HRV. Material(s)
and Method(s): We have searched PubMed/Medline and google scholar
electronic databases to find relevant articles using following keywords:
hydrotherapy, balneotherapy, cryotherapy, sauna bath, immersion bath, foot
bath, spinal bath, hip bath, arm and foot bath, ice massage and heart rate
variability. Out of 121 articles found, 24 potentially eligible articles
were reported in this review. Result(s): In this systematic review 24
articles (including 6 RCTs) with 961 participants with various condition,
underwent various hydrotherapy modalities with different temperatures were
reported. The finding showed that majority of the hydrotherapy modalities
produces improvements in parasympathetic activity and regulation of
autonomic nervous system. However, only one study showed increased
sympathetic activity during the session and transitioned into
parasympathetic activity after 15-120 min of session. Conclusion(s):
Literature suggests that hydrotherapy is effective in reducing blood
pressure and improving HRV as an adjuvant in healthy volunteers,
sportspeople, and in patients with hypertension, heart failure, migraines,
allergic rhinitis, and chronic fatigue syndrome. However, the quality of
the studies included in this review low. Hence, we recommend high quality
long-term RCTs to determine the efficacy and safety of
hydrotherapy. Copyright © 2025 Elsevier Ltd

<115>
[Use Link to view the full text]
Accession Number
641749186
Title
Reviewing the Impact of Topical and Intravenous Tranexamic Acid Use in
Breast Plastic Surgery.
Source
Annals of plastic surgery. 91(5) (pp 622-628), 2023. Date of Publication:
01 Nov 2023.
Author
Parmeshwar N.; Mehta S.R.; Piper M.
Institution
(Parmeshwar) From the Division of Plastic and Reconstructive Surgery,
University of California San Francisco, San Francisco, CA, United States
(Mehta) Wright State University, School of Medicine, Fairborn, OH, United
States
(Piper) University of California San Francisco, San Francisco, CA, United
States
Abstract
BACKGROUND: Topical and intravenous uses of tranexamic acid (TXA) have
been shown to reduce bleeding and ecchymosis in various surgical fields.
However, there is a lack of data evaluating the efficacy of TXA in breast
surgery. This systematic review evaluates the impact of TXA on hematoma
and seroma incidence in breast plastic surgery. METHOD(S): A
systematic review of the literature was performed for all studies that
evaluated the use of TXA in breast surgery including reduction
mammoplasty, gynecomastia surgery, masculinizing chest surgery, or
mastectomy. Outcomes of interest included rate of hematoma, seroma, and
drain output. RESULT(S): Thirteen studies met the inclusion criteria
with a total of 3297 breasts, of which 1656 were treated with any TXA, 745
with topical TXA, and 1641 were controls. There was a statistically
significant decrease in hematoma formation seen in patients who received
any form of TXA compared with control (odds ratio [OR], 0.37; P < 0.001),
and a similar tendency toward decreased hematoma with topically treated
TXA (OR, 0.42; P = 0.06). There was no significant difference in seroma
formation with any TXA (OR, 0.84; P = 0.33) or topical TXA (OR, 0.91; P =
0.70). When stratified by surgery, there was a 75% decrease in the odds of
hematoma formation with any TXA compared with the control for oncologic
mastectomy (OR, 0.25; P = 0.003) and a 56% decrease in nononcologic breast
surgery (OR, 0.44; P = 0.003). CONCLUSION(S): This review suggests
that TXA may significantly reduce hematoma formation in breast surgery and
may also decrease seroma and drain output. Future high-quality prospective
studies are required to evaluate the utility of topical and intravenous
TXA in decreasing hematoma, seroma, and drain output in breast surgery
patients. Copyright © 2023 Wolters Kluwer Health, Inc. All rights
reserved.

<116>
[Use Link to view the full text]
Accession Number
2038237109
Title
2025 ACC/AHA/ACEP/NAEMSP/SCAI Guideline for the Management of Patients
With Acute Coronary Syndromes: A Report of the American College of
Cardiology/American Heart Association Joint Committee on Clinical Practice
Guidelines.
Source
Circulation. 151(13) (pp e771-e862), 2025. Date of Publication: 01 Apr
2025.
Author
Rao S.V.; O'Donoghue M.L.; Ruel M.; Rab T.; Alexander J.H.; Baber U.;
Baker H.; Cohen M.G.; Cruz-Ruiz M.; Davis L.L.; de Lemos J.A.; DeWald
T.A.; Elgendy I.Y.; Feldman D.N.; Goyal A.; Isiadinso I.; Menon V.; Morrow
D.A.; Mukherjee D.; Platz E.; Promes S.B.; Sandner S.; Sandoval Y.;
Schunder R.; Shah B.; Stopyra J.P.; Talbot A.W.; Taub P.R.; Williams M.S.;
Beavers C.J.; Beckie T.; Blankenship J.; Diercks D.; Lo B.; Louis C.;
Merchant F.M.; Nazir N.T.; So D.; Tomey M.; Welt F.; Otto C.M.; Beckman
J.A.; Armbruster A.; Blumer V.; de las Fuentes L.; Deswal A.; Ferrari
V.A.; Fremes S.E.; Gaudino M.; Hernandez A.F.; Jneid H.; Johnson H.M.;
Jones W.S.; Khan S.S.; Khazanie P.; Kittleson M.M.; Palaniappan L.; Sharma
G.; Shimbo D.; Tamis-Holland J.E.; Woo Y.J.; Ziaeian B.; Biga C.; Gates
C.C.; Kovacs R.J.; Turco J.V.; Saraco M.J.; Ronan G.D.; Patterson L.;
Getchius T.S.D.; Abdullah A.R.; Churchwell K.; Brown N.; Jessup M.; Sapio
N.A.; Singh R.R.; Nedungadi P.; St. Laurent P.; Hundley J.
Institution
(Sapio) Office of Science Strategies and Operations
(Singh, St. Laurent) Office of Science and Medicine
(Hundley) Office of Science Operations
Publisher
Lippincott Williams and Wilkins
Abstract
Aim: The "2025 ACC/AHA/ACEP/NAEMSP/SCAI Guideline for the Management of
Patients With Acute Coronary Syndromes" incorporates new evidence since
the "2013 ACCF/AHA Guideline for the Management of ST-Elevation Myocardial
Infarction" and the corresponding "2014 AHA/ACC Guideline for the
Management of Patients With Non-ST-Elevation Acute Coronary Syndromes" and
the "2015 ACC/AHA/SCAI Focused Update on Primary Percutaneous Coronary
Intervention for Patients With ST-Elevation Myocardial Infarction." The
"2025 ACC/AHA/ACEP/NAEMSP/SCAI Guideline for the Management of Patients
With Acute Coronary Syndromes" and the "2021 ACC/AHA/SCAI Guideline for
Coronary Artery Revascularization" retire and replace, respectively, the
"2016 ACC/AHA Guideline Focused Update on Duration of Dual Antiplatelet
Therapy in Patients With Coronary Artery Disease." Methods: A
comprehensive literature search was conducted from July 2023 to April
2024. Clinical studies, systematic reviews and meta-analyses, and other
evidence conducted on human participants were identified that were
published in English from MEDLINE (through PubMed), EMBASE, the Cochrane
Library, Agency for Healthcare Research and Quality, and other selected
databases relevant to this guideline. Structure: Many recommendations from
previously published guidelines have been updated with new evidence, and
new recommendations have been created when supported by published
data. Copyright © 2025 by the American College of Cardiology
Foundation and the American Heart Association, Inc.

<117>
Accession Number
2039169893
Title
The Association of Lipoprotein(a) with Major Adverse Cardiovascular Events
after Acute Myocardial Infarction: A Meta-Analysis of Cohort Studies.
Source
Reviews in Cardiovascular Medicine. 26(5) (no pagination), 2025. Article
Number: 27376. Date of Publication: 01 May 2025.
Author
Liu H.; Wang L.; Wang H.; Hao X.; Du Z.; Li C.; Hou X.
Institution
(Liu, Wang, Wang, Hao, Du, Li, Hou) Centre for Cardiac Intensive Care,
Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing Anzhen
Hospital, Capital Medical University, Beijing, China
Publisher
IMR Press Limited
Abstract
Background: Despite evidence suggesting a link between lipoprotein(a)
(Lp(a)) and the occurrence of acute myocardial infarction (AMI), the
relationship regarding prognoses related to AMI remains unclear. This
meta-analysis was conducted to summarize the association between Lp(a) and
the risks of major adverse cardiovascular events (MACEs) among populations
surviving AMI. Method(s): We searched PubMed, Embase, Web of Science,
MEDLINE, and Cochrane Library databases until February 14, 2024. Cohort
studies reporting multivariate-adjusted hazard ratios (HRs) for the
correlation of Lp(a) with MACEs in AMI populations were identified. The
Lp(a) level was analyzed using categorical and continuous variables.
Subgroup analyses were conducted based on gender, type of AMI, diabetic
and hypertensive status. Publication bias was assessed using funnel plots.
A random-effect model was utilized to pool the results. Result(s): In
total, 23 cohorts comprising 30,027 individuals were recruited. In
comparison to those categorized with the lowest serum Lp(a), individuals
in the highest category showed higher risks of MACEs after AMI (HR: 1.05,
95% confidence interval (CI): 1.01-1.09, p = 0.006). Similar findings were
exhibited when Lp(a) was analyzed as a continuous variable (HR: 1.14, 95%
CI: 1.02-1.26, p = 0.02). Subgroup analyses indicated that this
correlation persisted significantly among females (HR: 1.23, p = 0.005),
diabetes mellitus (DM) (HR: 1.39, p = 0.01), hypertension (HR: 1.36, p <
0.00001), ST-segment elevation myocardial infarction (STEMI) (HR: 1.03, p
= 0.04), non-STEMI (HR: 1.40, p = 0.03), and long-term (>1 year) MACE (HR:
1.41, p = 0.0006) subgroups. Conclusion(s): Higher Lp(a) levels might
be an independent indicator for MACE risks after AMI, especially among
female populations with DM and/or hypertension, and more suitable for
evaluating long-term MACEs. Copyright © 2025 The Author(s).

<118>
[Use Link to view the full text]
Accession Number
2039110897
Title
PCI in Patients Undergoing TAVI: To the Editor [2].
Source
New England Journal of Medicine. 392(10) (pp 1038), 2025. Date of
Publication: 06 Mar 2025.
Author
Besis G.; Manmathan G.; Narayan O.
Institution
(Besis, Manmathan) Victorian Heart Hospital, Melbourne, VIC, Australia
(Narayan) Northern Heart, Melbourne, VIC, Australia
Publisher
Massachussetts Medical Society

<119>
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). 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. 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. 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. Copyright © 2025
by the authors.

<120>
[Use Link to view the full text]
Accession Number
2036480661
Title
How Many Patients Are Needed to Detect a Difference in Pain With
Parasternal Blocks?.
Source
Anesthesia and Analgesia. 141(1) (pp 210-211), 2025. Date of Publication:
01 Jul 2025.
Author
Cameron M.J.; Long J.; Yang S.S.; Kardash K.
Institution
(Cameron, Long, Yang, Kardash) Department of Anesthesia, Faculty of
Medicine, McGill University, Montreal, QC, Canada
(Cameron, Yang, Kardash) Department of Anesthesia, Jewish General
Hospital, Montreal, QC, Canada
(Cameron, Yang) Lady Davis Research Institute, Montreal, QC, Canada
Publisher
Lippincott Williams and Wilkins

<121>
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. 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. 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.
 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. Copyright © 2025 Elsevier Inc.

<122>
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. 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.
 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. 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. Copyright © 2025 International Journal of Life
Sciences Biotechnology and Pharma Research. All rights reserved.

<123>
Accession Number
2039204346
Title
TAVI Through the Years: A Systematic Review of Progress.
Source
Journal of Pharmacy and Bioallied Sciences. 17 (pp S1115-S1123), 2025.
Date of Publication: 01 Jun 2025.
Author
Ahmad S.; Prabhu M.M.; Bhat R.; Hasan A.; Ahmad A.; Ahmad R.
Institution
(Ahmad, Prabhu, Bhat) Department of General Medicine, Kasturba Medical
College, Manipal Academy of Higher Education, Karnataka, Manipal, India
(Hasan) Department of Cardiology, Jawaharlal Nehru Medical College and
Hospital, Uttar Pradesh, Aligarh, India
(Ahmad) Department of Medicine, Emirates Health Services, Ras Al Khaimah,
United Arab Emirates
(Ahmad) Department of Medicine, RAK Medical and Health Sciences
University, Ras Al Khaimah, United Arab Emirates
Publisher
Wolters Kluwer Medknow Publications
Abstract
Introduction: Transcatheter Aortic Valve Implantation (TAVI) has evolved
over the years and now is being used in the management of patients with
symptomatic severe aortic stenosis (AS) in categories of high,
intermediate, and even low operative risk. Previously TAVI was used as an
option only in inoperable or high operative risk elderly patients. Our
systematic review gives an idea of how TAVI has evolved in use over the
last ten years. Material(s) and Method(s): A comprehensive literature
search was conducted across electronic databases, including MEDLINE,
Embase, Web of Science, Scopus, and the Cochrane Library. This research
used keywords such as 'TAVI,' 'AF,' 'PPI,' 'aortic regurgitation,' and
Surgical Aortic Valve Replacement (SAVR) and included only those studies
that were published in English between January 2014 and December 2024. The
intervention is TAVI. Extracted data included study design, sample size,
participant demographics, details of the intervention, control conditions,
and outcome metrics. Outcomes noted were stroke, cardiovascular outcomes,
procedural complications, cerebrovascular incidents, vascular outcomes,
bleeding, length of hospital stay, and mortality. Sensitivity analyses
were conducted, excluding studies with significant bias or small sample
sizes (fewer than 10 participants). Based on the study findings, TAVI
demonstrates significant advantages in terms of shorter hospital stays,
reduced bleeding, and non inferiority to SAVR in short-term mortality
outcomes. However, TAVI is associated with higher rates of paravalvular
leaks, conduction disturbances requiring Permanent Pacemaker Implantation,
and mild-to-moderate Aortic Regurgitation. SAVR patients had higher
incidences of New-Onset Atrial Fibrillation and procedural bleeding.
Long-term survival and freedom from reintervention were slightly better in
SAVR patients in certain studies, although not universally significant.
Both procedures showed comparable rates of stroke and Myocardial
Infarction in most studies, emphasizing the need to tailor treatment based
on individual patient profiles. In our systematic review of TAVI we have
covered the application of TAVI in different patients with varying
anatomical and clinical phenotypes. Result(s): TAVI has been
successful in the treatment of symptomatic severe AS and the recent
advances in radiological imaging have created a path to explore different
anatomical variations. Various trials have already established TAVI as a
viable treatment in elderly patients with high and intermediate operative
risk, while certain studies also advocated the use of TAVI in patients
with low risk. Conclusion(s): The expansion of TAVI to manage
patients in other horizons involving younger patients with asymptomatic
severe AS, and long-term outcomes of valve durability and moderate AS in
combination with cardiac failure bicuspid aortic valve stenosis and pure
native aortic regurgitation are however still under
research. Copyright © 2025 Journal of Pharmacy and Bioallied
Sciences.

<124>
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. Copyright © 2025
by the American Diabetes Association.

<125>
Accession Number
2039208573
Title
Incidence, Predictors, and Outcomes of Complete Angina Relief in
Symptomatic Patients in the ISCHEMIA Trial.
Source
Journal of the American Heart Association. 14(12) (pp 1-10), 2025. Article
Number: e040057. Date of Publication: 05 Jun 2025.
Author
Singh A.; Rodman J.C.S.; Brown D.L.
Institution
(Singh) Department of Medicine, University of Southern California+Los
Angeles General Medical Center, Keck Medicine of USC, Los Angeles, CA,
United States
(Rodman) Southern California Clinical and Translational Science Institute,
University of Southern California, Los Angeles, CA, United States
(Brown) Division of Cardiovascular Medicine, Keck Medicine of USC, Los
Angeles, CA, United States
Publisher
American Heart Association Inc.
Abstract
BACKGROUND: Patients with chronic coronary disease experience less angina
with revascularization plus optimal medical therapy compared with optimal
medical therapy alone. However, patients may prefer to better understand
their individual likelihood of complete angina relief associated with each
treatment approach before selecting a strategy. We therefore sought to
determine the incidence, predictors, and outcomes of complete angina
relief in symptomatic patients treated with invasive management using
revascularization plus optimal medical therapy or conservative therapy
with optimal medical therapy alone in the ISCHEMIA (International Study of
Comparative Health Effectiveness With Medical and Invasive Approaches)
trial. METHOD(S): Angina was assessed using the Seattle Angina
Questionnaire Angina Frequency (AF) score. We analyzed patients in the
invasive management treatment arm with angina at baseline (Seattle Angina
Questionnaire Angina Frequency <100) who underwent revascularization and
all patients in the conservative therapy arm with angina at baseline. The
primary outcome was angina status at 12 months defined as a Seattle Angina
Questionnaire Angina Frequency=100 (complete angina relief) or Seattle
Angina Questionnaire Angina Frequency <100 (persistent angina). The
association of angina status with the composite of cardiovascular
death/myocardial infarction was assessed at 5 years. RESULT(S): Among
1376 patients in the conservative therapy arm with angina at baseline, 50%
experienced complete angina relief at 12 months. Independent predictors
included older age, male sex, recent angina onset, and less baseline
angina. Among 1158 patients who underwent revascularization, 70% achieved
complete angina relief. Predictors included younger age, nonsmoking,
coronary artery bypass graft, and less baseline angina. Cardiovascular
death/myocardial infarction rates at 5 years did not differ between
patients with or without complete angina relief. CONCLUSION(S):
Complete angina relief at 12 months in symptomatic patients with chronic
coronary disease was achieved in 70% of patients undergoing
revascularization and 50% of patients treated ith conservative therapy and
did not influence cardiovascular death/myocardial infarction
outcomes. Copyright © 2025 The Author(s).

<126>
Accession Number
2039152921
Title
Training of the adult congenital cardiac interventionalist: A call to
action.
Source
European Heart Journal. 45(45) (pp 4822-4825), 2024. Date of Publication:
01 Dec 2024.
Author
Aboulhosn J.; Pedra C.; Horlick E.; Akagi T.; Chessa M.
Institution
(Aboulhosn) Division of Cardiology, Department of Medicine, David Geffen
School of Medicine, UCLA, Los Angeles, CA, United States
(Pedra) Dante Pazzanese Instituto de Cardiologia, Sao Paulo, Brazil
(Horlick) Toronto General Hospital, Toronto, ON, Canada
(Akagi) Department of Cardiovascular Medicine, Adult Congenital Heart
Disease Center, Okayama University Hospital, Okayama, Japan
(Chessa) ACHD Unit - IRCCS-Policlinico San Donato, San Donato M.se, Milan,
Italy
(Chessa) Vita Salute San Raffaele University, Milan, Italy
Publisher
Oxford University Press

<127>
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. 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. 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. 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. 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. Copyright ©
2024 Elsevier Inc.

<128>
[Use Link to view the full text]
Accession Number
2038353617
Title
Anesthesia for pediatric organ transplantation, current concepts.
Source
Current Opinion in Anaesthesiology. 38(3) (pp 230-235), 2025. Date of
Publication: 01 Jun 2025.
Author
Licata S.; Blasiole B.; Visoiu M.; Damian D.
Institution
(Licata, Blasiole, Visoiu) Department of Anesthesiology and Perioperative
Medicine, UPMC Children's Hospital of Pittsburgh, Pittsburgh, PA, United
States
(Damian) Department of Anesthesiology and Perioperative Medicine, UPMC
Children's Hospital of Pittsburgh, 4401 Penn Avenue, Pittsburgh, PA,
United States
Publisher
Lippincott Williams and Wilkins
Abstract
Purpose of review Although less common than in adults, pediatric organ
transplantation has seen significant recent innovations in surgical
techniques, perioperative management, and postoperative outcomes. These
advances, which we will delve into in this review, are at the forefront of
improving the survival and quality of life of pediatric transplant
recipients. Recent findings Advances in donor utilization (e.g. donation
after circulatory death and split-liver grafts) and surgical approaches
(partial heart transplants and novel multiorgan procedures) have expanded
the donor pool and enhanced graft viability. Improved perioperative care,
including refined anesthetic monitoring, fluid management, and immediate
extubation, reduces the incidence of complications. Research into
model-informed precision dosing for antibiotics addresses under- or
overdosing in critically ill children, whereas emerging immunosuppressants
offer potential benefits over conventional regimens. Nonetheless,
coagulopathy, hemodynamic instability, and developmental variations remain
major challenges. Summary Optimization of pediatric transplantation is a
complex task that requires multidisciplinary collaboration. This review
underscores the importance of standardizing perioperative protocols,
advancing precision medicine, and refining surgical and anesthetic
techniques. It also highlights the need for dedicated pediatric transplant
registries and multicenter trials to generate robust data, minimize
practice variability, and improve outcomes. Copyright © 2025
Lippincott Williams and Wilkins. All rights reserved.

<129>
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.
 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. 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).
 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. Copyright © 2024 Elsevier Inc.

<130>
Accession Number
2034855954
Title
Multivariable Modeling of Postoperative Risk in Infant Cardiac Surgery:
Integrating Clinical Variables and 20 Inflammatory Biomarkers.
Source
Acta Anaesthesiologica Scandinavica. 69(6) (no pagination), 2025. Article
Number: e70073. Date of Publication: 01 Jul 2025.
Author
Kvaran R.B.; Skagervik A.; Pernbro F.; Romlin B.; Molin M.; Wahlander H.;
Aass H.C.D.; Vistnes M.; Ojala T.; Thorlacius E.M.; Castellheim A.G.
Institution
(Kvaran, Skagervik, Thorlacius, Castellheim) Department of Anesthesiology
and Intensive Care Medicine, Sahlgrenska Academy, University of
Gothenburg, Gothenburg, Sweden
(Kvaran, Skagervik, Pernbro, Romlin, Thorlacius, Castellheim) Region
Vastra Gotaland, Sahlgrenska University Hospital, Queen Silvia Children's
Hospital, Gothenburg, Sweden
(Molin) Statistiska Konsultgruppen Sweden, Gothenburg, Sweden
(Wahlander) Region Vastra Gotaland, Sahlgrenska University Hospital,
Children's Heart Center, Gothenburg, Sweden
(Wahlander) Department of Pediatrics, Institute of Clinical Sciences,
Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
(Aass) Department of Medical Biochemistry, Oslo University Hospital, Oslo,
Norway
(Vistnes) Institute of Clinical Medicine, University of Oslo, Oslo, Norway
(Vistnes) Department of Cardiology, Oslo University Hospital Ulleval,
Oslo, Norway
(Ojala) Department of Pediatric Cardiology, Children's Hospital, Helsinki
University Hospital, Helsinki University, Helsinki, Finland
Publisher
John Wiley and Sons Inc
Abstract
Introduction: Cardiac surgery in infants often triggers a severe
inflammatory response. The role of biomarkers in predicting clinical
outcomes in this group of patients has been debated in the literature.
This study aimed to investigate the predictive value of 20 inflammatory
biomarkers, in combination with clinical data, for acute kidney injury,
ventilator support duration, and inotropic score following infant cardiac
surgery by developing and comparing three models: Clinical-Data-Only,
Biomarker-Only, and Combined. Method(s): This secondary analysis of
the MiLe-1 study included infants undergoing surgery with cardiopulmonary
bypass. Biomarkers were measured before and after CPB. Using BIC-guided
logistic regression, we developed and compared three multivariable
models-Clinical-Data-Only, Biomarker-Only, and Combined-for each outcome.
Model performance was assessed using c-statistics and p-contrast tests.
 Result(s): Regarding AKI risk prediction, the c-statistics for
Biomarker-Only, Clinical-Data-Only, and Combined Model were 0.79, 0.60,
and 0.78 respectively. The difference in performance between the Combined
and Clinical-Data-Only Models was statistically significant (p < 0.001).
Concerning ventilator support time prediction, the c-statistics were 0.80,
0.72, and 0.77 for the models respectively (p-contrast = 0.10). As for
inotropic score prediction, the c-statistics were 0.83, 0.77, and 0.85 for
the models (p-contrast = 0.007). Conclusion(s): Inflammatory
biomarkers may enhance risk stratification for postoperative outcomes in
infant cardiac surgery. However, given the exploratory nature of this
study, further validation in larger and more diverse cohorts is
needed. Copyright © 2025 The Author(s). Acta Anaesthesiologica
Scandinavica published by John Wiley & Sons Ltd on behalf of Acta
Anaesthesiologica Scandinavica Foundation.

<131>
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. 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). 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. 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. Copyright © 2025 by the authors.

<132>
Accession Number
2038647665
Title
Exploring the influence of extra-corporeal membrane oxygenation (ECMO)
support on neurodevelopmental outcomes in paediatric cardiac patients: a
systematic review.
Source
Cardiology in the Young. 35(5) (pp 888-899), 2025. Date of Publication: 01
May 2025.
Author
Francis J.; Chandiramani A.; George A.; George J.; Jones T.
Institution
(Francis) Department of Cardiothoracic Surgery, Aberdeen Royal Infirmary,
Aberdeen, United Kingdom
(Chandiramani) Department of Cardiothoracic Surgery, Royal Papworth
Hospital, Cambridge, United Kingdom
(George) Department of Anaesthesia, Aberdeen Royal Infirmary, Aberdeen,
United Kingdom
(George, Jones) Department of Paediatric Cardiac Surgery, Birmingham
Women's and Children's Hospital, Birmingham, United Kingdom
Publisher
Cambridge University Press
Abstract
Background: Mechanical circulatory support, and specifically
extra-corporeal membrane oxygenation, plays a critical role in managing
paediatric cardiac patients with severe heart failure. Whilst these
technologies are vital for bridging patients to recovery or heart
transplantation, it is imperative to study the influence of
extra-corporeal membrane oxygenation on neurodevelopmental outcomes.
 Objective(s): This systematic review aimed to evaluate the influence
of extra-corporeal membrane oxygenation on neurodevelopmental outcomes in
paediatric cardiac patients, both post-cardiotomy and non-cardiotomy
patients were included. Methodology: A comprehensive search was conducted
using PubMed, EMBASE, and PsychInfo to identify primary research articles
exploring the effects of extra-corporeal membrane oxygenation on
neurodevelopmental outcomes in paediatric heart patients from inception to
June 2024. Result(s): Our search yielded 5488 papers of which eight
papers were included featuring 302 patients. Conclusion(s): The
discussion highlights the considerable variability in neurodevelopmental
outcomes and how they are measured among extracorporeal membrane
oxygenation survivors. Outcomes vary by patient factors, with recovery
potential influenced by the duration and timing of follow-up. We
emphasised the importance of standardised assessment tools and extended
follow-ups to gain a clearer understanding of these
outcomes. Copyright © The Author(s), 2025.

<133>
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

<134>
Accession Number
2039233889
Title
Immediate versus staged complete revascularization in patients presenting
with multivessel disease and ST- or non-ST-segment elevation acute
coronary syndrome.
Source
International Journal of Cardiology. 437 (no pagination), 2025. Article
Number: 133496. Date of Publication: 15 Oct 2025.
Author
Elscot J.J.; Kakar H.; den Dekker W.K.; Bennett J.; Sabate M.; Esposito
G.; Boersma E.; McFadden E.; Garcia-Garcia H.M.; Van Mieghem N.M.; Diletti
R.
Institution
(Elscot, Kakar, den Dekker, Boersma, Van Mieghem, Diletti) Erasmus MC
Cardiovascular Institute, Thorax Center, Department of Cardiology,
Rotterdam, Netherlands
(Bennett) Department of Cardiovascular Medicine, University Hospital
Leuven, Leuven, Belgium
(Sabate) Interventional Cardiology Department, Cardiovascular Institute,
Hospital Clinic, Barcelona, Spain
(Esposito) Department of Advanced Biomedical Sciences, University of
Naples Federico II, Naples, Italy
(McFadden) Division of Cardiology, Cork University Hospital. Cork, Ireland
(Garcia-Garcia) MedStar Washington Hospital Center, Washington, DC, United
States
Publisher
Elsevier Ireland Ltd
Abstract
Background: Recent randomized trials have suggested that immediate
complete revascularization (ICR) is a viable alternative to staged
complete revascularization (SCR) in patients with acute coronary syndrome
(ACS) and multivessel disease. However, long-term outcomes comparing ICR
with SCR in ST-segment elevation (STE) and non-ST-segment elevation (NSTE)
ACS remain unclear. Method(s): This study analyzes 2-year follow-up
data from the BIOVASC trial, randomizing ACS patients to ICR or SCR. The
primary composite endpoint includes all-cause mortality, myocardial
infarction, unplanned ischemia-driven revascularization, and
cerebrovascular events. Secondary endpoints evaluate these outcomes
individually. Cox regression assessed if STE/NSTE-ACS diagnosis influences
treatment effect. Result(s): In 608 STE-ACS patients, the 2-year
cumulative incidence of the primary composite endpoint was 10.9 % (ICR)
and 11.7 % (SCR) (risk difference [RD] 0.8 %, 95 % confidence interval
[CI] -4.3 % to 5.9 %; P = 0.71). In NSTE-ACS, cumulative incidence was
13.5 % (ICR) and 12.8 % (SCR) (RD -0.7 %, 95 % CI -5.1 % to 3.7 %; P =
0.90). No differential effect was observed comparing ICR with SCR between
STE- and NSTE-ACS. Conclusion(s): ICR did not sustain a significant
benefit in terms of the primary and secondary outcomes at 2 years
follow-up. In addition, no differential effect of ICR versus SCR was
observed between STE-ACS and NSTE-ACS after 2 years follow-up. However,
there seems to be a late catch-up in the cumulative event rate in patients
randomized to ICR. Copyright © 2025

<135>
Accession Number
2039169872
Title
Platelet-To-Lymphocyte Ratio Efficiency in Predicting Major Adverse
Cardiovascular Events After Percutaneous Coronary Intervention in Acute
Coronary Syndromes: A Meta-Analysis.
Source
Reviews in Cardiovascular Medicine. 26(5) (no pagination), 2025. Article
Number: 27942. Date of Publication: 01 May 2025.
Author
Wang H.; Zulikaier T.; Yumaierjiang B.; Lyu S.; He P.
Institution
(Wang, Lyu) Clinical Medicine Department, Xinjiang Medical University,
Xinjiang, Urumqi, China
(Zulikaier, Yumaierjiang, He) Heart Center, The Fifth Affiliated Hospital
of Xinjiang Medical University, Xinjiang, Urumqi, China
Publisher
IMR Press Limited
Abstract
Background: The platelet-to-lymphocyte ratio (PLR) is applied as a
potential first-line prognostic predictor for many cardiovascular diseases
due to its simplicity and accessibility. This meta-analysis aimed to
quantify the predictive power of PLR for major adverse cardiovascular
events (MACEs) in patients with acute coronary syndrome (ACS) undergoing
percutaneous coronary intervention (PCI), explore its predictive efficacy
in different populations, and identify other potential influencing
factors. Method(s): PubMed, Embase, Cochrane Library, and Web of
Science databases were comprehensively searched for eligible studies until
February 7, 2025, based on the inclusion and exclusion criteria. The
Newcastle-Ottawa scale (NOS) was employed for quality assessment.
Sensitivity, specificity, summary receiving operating characteristic
(SROC) and area under the curve (AUC) were combined using Stata 15.1 and
Meta-DiSc software. Meta-regression analyses, subgroup analyses, threshold
effect analyses, sensitivity analyses, and publication bias tests were
performed. Result(s): Nine studies (7174 patients) were enrolled.
High PLR could predict MACEs in ACS patients undergoing PCI, with 0.68
sensitivity (95% CI, 0.60-0.76), 0.65 specificity (95% CI, 0.57-0.73), and
0.72 AUC (95% CI, 0.68-0.76). Subgroup analyses noted that PLR better
predicted MACEs after PCI in ACS patients in the subgroup with a higher
proportion of female patients and the subset aged >60 years.
Meta-regression analyses unveiled that study type (p < 0.01) and PLR
cutoff value (p < 0.01) might be sources of heterogeneity in the
sensitivity analyses, while the mean age (p < 0.001) and sex ratio (p =
0.05) might be sources of heterogeneity in the specificity analyses.
 Conclusion(s): High PLR levels have favorable values in predicting
in-hospital and long-term MACEs after PCI in ACS patients. The PLR had
greater sensitivity and an improved ability to identify risk in patients
aged >60 years and the subgroup with a higher proportion of women and was
also more sensitive to in-hospital MACEs. Copyright © 2025 The
Author(s).

<136>
[Use Link to view the full text]
Accession Number
2039093073
Title
Single vs. dual antithrombotic therapy in patients with oral
anticoagulation and stabilized coronary artery disease: A systematic
review and meta-analysis of randomized-controlled trials.
Source
Journal of Cardiovascular Medicine. 26(6) (pp 258-265), 2025. Date of
Publication: 01 Jun 2025.
Author
Gargiulo G.; Piccolo R.; Park D.-W.; Nam G.-B.; Okumura Y.; Esposito G.;
Valgimigli M.
Institution
(Gargiulo, Piccolo, Esposito) Department of Advanced Biomedical Sciences,
University of Naples Federico Ii, Naples, Italy
(Park, Nam) Department of Cardiology, Division of Interventional
Cardiology, Asan Medical Center, University of Ulsan College of Medicine,
Songpa-gu, Seoul, South Korea
(Okumura) Division of Cardiology, Department of Medicine, Nihon University
School of Medicine, Tokyo, Japan
(Valgimigli) Department of Cardiology, Cardiocentro Ticino Institute, Ente
Ospedaliero Cantonale (EOC), Lugano, Switzerland
(Valgimigli) The Faculty of Biomedical Sciences, University of Italian
Switzerland, Lugano, Switzerland
(Valgimigli) The University of Bern, Bern, Switzerland
Publisher
Lippincott Williams and Wilkins
Abstract
AimsDespite consistent recommendations from clinical guidelines, data from
randomized trials on a long-term antithrombotic treatment strategy for
patients with oral anticoagulation (OAC) and stabilized coronary artery
disease (CAD) are still limited and underpowered for ischaemic events.
Therefore, we investigated the safety and efficacy of single vs. dual
antithrombotic therapy (SAT vs. DAT) in patients with OAC and stabilized
CAD.MethodsA systematic review and meta-analysis was performed using
PubMed to search for randomized clinical trials comparing SAT vs. DAT in
patients with OAC and stabilized CAD.ResultsFive trials encompassing 5758
patients (SAT=2897 vs. DAT=2861) were included. The predominant indication
of OAC was atrial fibrillation (n=5495, 95.4%). Most of the patients had
prior percutaneous coronary intervention (PCI) (81.1%). The primary safety
outcome (trial-defined major bleeding) was lower with SAT compared with
DAT [hazard ratio 0.58, 95% confidence interval (95% CI) 0.40-0.83;
P<0.001; I2=65.9%] as was the composite of major bleeding or clinically
relevant nonmajor (CRNM) bleeding (hazard ratio 0.62, 95% CI 0.400.96;
P=0.03; I2=54.6%). There were no differences between the groups in terms
of all-cause death, myocardial infarction, stroke, and the trial-defined
composite of major adverse cardiovascular events. These findings were
consistent among sensitivity analyses.ConclusionIn OAC patients with
stabilized CAD, largely due to atrial fibrillation and prior (6-12months)
PCI, SAT is associated with lower major bleeding without increased risk of
ischaemic complications compared with DAT. Copyright © 2025
Italian Federation of Cardiology - I.F.C.

<137>
Accession Number
2039171261
Title
Transcarotid artery revascularization in symptomatic carotid stenosis: a
systematic review.
Source
International Angiology. 44(2) (pp 131-140), 2025. Date of Publication: 01
Apr 2025.
Author
Garcia F.; Jacome F.; Sousa J.; Mansilha A.
Institution
(Garcia, Jacome, Sousa, Mansilha) Faculty of Medicine of the University of
Porto, Porto, Portugal
(Jacome, Sousa, Mansilha) Department of Angiology and Vascular Surgery,
Hospital de S. Joao, Porto, Portugal
Publisher
Edizioni Minerva Medica
Abstract
Introduction: Carotid endarterectomy is currently the gold standard
treatment option for significant symptomatic carotid stenosis. Carotid
artery stenting can be an alternative in selected patients, although with
inferior results when compared with its open counterpart. Transcarotid
artery revascularization (TCAR) emerged as a new option, with promising
results. This study aims to systematically review current evidence of the
safety of TCAR in patients with symptomatic carotid artery stenosis.
 Evidence Acquisition: A systematic review of the literature was
performed, according to PRISMA guidelines. Literature search was performed
on the PubMed and Web of Science databases, which returned 178 studies.
Eleven studies were selected. Data were extracted using predefined forms.
 Evidence Synthesis: A total of 28326 symptomatic patients undergoing
TCAR were included for analysis. Reported TIA/stroke rates after TCAR
ranged between 2.3-3.3% in-hospital and 1.2-4.3% at 30-days. Similarly,
in-hospital post-operative mortality was reported in 0.5-0.7% of the
cases, and 1-4.9% at 30 days. After 1 year, TIA/Stroke and death rates
ranged between 3.5-3.7% and 2.5-13%, respectively. Postoperative
cardiovascular events were observed in up to 2.9% of the patients among
the included studies. Cranial nerve injuries were reported in up to 0.7%
of the cases, while surgical and vascular access complications ranged
between 1.2-6.1%. Conclusion(s): TCAR has shown promising results for
significant symptomatic carotid stenosis treatment, and may be a relevant
alternative to carotid endarterectomy, especially in high-risk patients.
Further studies are required to assess the effectiveness of TCAR and its
comparability with carotid endarterectomy. Copyright © 2024
EDIZIONI MINERVA MEDICA.

<138>
Accession Number
2032444100
Title
Definition of Palliative Surgery in Cancer Care: A Systematic Review.
Source
Journal of Surgical Oncology. 131(7) (pp 1439-1454), 2025. Date of
Publication: 01 Jun 2025.
Author
Wong J.S.M.; Low X.C.; Farber O.N.; Mack J.W.; Cooper Z.; Lilley E.J.
Institution
(Wong, Farber, Cooper, Lilley) Center for Surgery and Public Health,
Department of Surgery, Brigham and Woman's Hospital, Boston, MA, United
States
(Wong, Low) Department of Sarcoma, Peritoneal & Rare Tumors, Division of
Surgery and Surgical Oncology, National Cancer Center Singapore &
Singapore General Hospital, Singapore City, Singapore
(Low) Programme in Health Services and Systems Research, Duke-NUS Medical
School, Singapore City, Singapore
(Farber, Cooper, Lilley) Department of Surgery, Brigham and Woman's
Hospital, Boston, MA, United States
(Farber, Cooper, Lilley) Department of Surgery, Harvard Medical School,
Boston, MA, United States
(Mack) Department of Pediatric Oncology, Dana-Farber Cancer Institute,
Boston, MA, United States
(Lilley) Department of Psychosocial Oncology and Palliative Care,
Dana-Farber Cancer Institute, Boston, MA, United States
Publisher
John Wiley and Sons Inc
Abstract
Palliative surgery is commonly performed in cancer centers worldwide. Yet,
there is little agreement on the definition of palliative surgery or its
relevant outcomes. This systematic review sought to characterize the
definitions of palliative surgery and outcomes for patients with cancer
undergoing thoraco-abdominal procedures. Following PRISMA guidelines, we
conducted a search using PubMed, EMBASE and CINAHL databases to identify
English-language publications between August 1, 2005, and December 31,
2023 reporting palliative thoraco-abdominal procedures for patients with
cancer. Definitions of palliative surgery were coded and analyzed using an
inductive approach. Outcomes were classified according to an outcome
measures hierarchy. Among 92 articles met inclusion criteria and four
themes emerged in how palliative surgery was defined throughout the
literature: prognosis (incurable cancer diagnosis), purpose (intent to
treat symptoms or improve quality of life), procedure type (specific
operative interventions), or persistent disease following surgery
(incomplete cytoreduction). Survival (90%) and perioperative
complications/morbidity (72%) were the most commonly reported outcomes,
whereas symptom relief, quality of life, and sustainability of success
were infrequently reported. Definitions of palliative surgery vary across
studies of patients with cancer undergoing thoracic or abdominal
procedures and measured outcomes often do not align with the intent of
surgery. Copyright © 2024 Wiley Periodicals LLC.

<139>
Accession Number
2039274554
Title
Etiology-specific survival and reoperation trends following surgical
mitral valve repair and replacement: A meta-analysis of reconstructed
time-to-event data.
Source
Trends in Cardiovascular Medicine. (no pagination), 2025. Date of
Publication: 2025.
Author
Al-Tawil M.; Sicouri S.; Yamashita Y.; Ramlawi B.
Institution
(Al-Tawil, Sicouri, Yamashita, Ramlawi) Department of Cardiothoracic
Surgery Research, Lankenau Institute for Medical Research, Wynnewood, PA,
United States
(Yamashita, Ramlawi) Lankenau Heart Institute, Wynnewood, PA, United
States
Publisher
Elsevier Inc.
Abstract
Current American and European guidelines recommend mitral valve repair
(MVr) over replacement (MVR) whenever feasible. However, these
recommendations are primarily based on data from patients with
degenerative mitral regurgitation (DMR), whereas evidence supporting MVr
in other etiologies, such as infective endocarditis (IE) or ischemic
mitral regurgitation (IMR), remains less conclusive. We systematically
searched for and identified studies published after 2000 that compared MVr
and MVR in patients with specific mitral valve disease etiologies,
including DMR, IE, IMR, and rheumatic heart disease (RHD). A total of 61
records (10 DMR, 21 IE, 18 IMR, and 12 RHD) of 59 studies published
between 2005 and 2024, were included. MVr consistently demonstrated
superior survival compared to MVR in DMR and IE patients. Parametric
time-varying hazard ratios revealed a sustained survival benefit of MVr in
DMR and IE, whereas in IMR and RHD, the survival advantage was
transient-lasting only up to six months and 2.7 years postoperatively,
respectively-after which survival hazards between MVr and MVR became
comparable. This was further corroborated by the results of a two-year
landmark and the propensity-matched subgroup analyses. In DMR, MVr was
associated with lower reoperation rates compared to MVR; however, in IE,
IMR, and RHD, MVr was associated with significantly higher reoperation
rates compared to MVR. Our study supports current guidelines favoring MVr
over MVR, demonstrating sustained survival benefits in DMR. In IE-specific
MR, MVr also showed consistent benefits over MVR, demonstrating that MVr
should be prioritized when feasible. However, in IMR and RHD, there was no
notable survival advantage of MVr over MVR, with higher reoperation rates
observed with MVr. These findings highlight the need for etiology-specific
and individualized surgical planning. Copyright © 2025

<140>
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.
 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. 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.
 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. Copyright © 2025 by
the authors.

<141>
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. Copyright © 2025 Elsevier Masson SAS

<142>
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. 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. 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. 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.
 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. Copyright
© The Author(s) 2025.

<143>
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. 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. 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. 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. Copyright ©
2025 The Author(s). Acta Anaesthesiologica Scandinavica published by John
Wiley & Sons Ltd on behalf of Acta Anaesthesiologica Scandinavica
Foundation.

<144>
Accession Number
2038881775
Title
Noninvasive Ventilation for Cardiac Surgical Patients: Reducing
Postoperative Complications.
Source
Chest. 167(6) (pp 1528-1529), 2025. Date of Publication: 01 Jun 2025.
Author
Tetteh E.S.
Institution
(Tetteh) Department of Anesthesiology and Perioperative Medicine, Loyola
University Medical Center, Maywood, IL, United States
Publisher
Elsevier Inc.

<145>
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.
 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. 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. 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. Copyright ©
The Author(s) 2025.

<146>
Accession Number
2039111046
Title
Recruitment Feasibility of Patients with Peripheral Arterial Disease for a
Multidisciplinary Intervention: Findings from the TEAM-PAD Trial.
Source
Annals of Vascular Surgery. 121 (pp 14-24), 2025. Date of Publication: 01
Dec 2025.
Author
Chimoriya R.; James S.; Kritharides L.; Sen S.; Behdasht S.; Suryawanshi
A.; Davie H.; Thillainadesan J.; Elias N.; Aitken S.J.
Institution
(Chimoriya, Aitken) Vascular Department, Institute of Academic Surgery,
Concord Repatriation General Hospital, Sydney, NSW, Australia
(Chimoriya, James, Kritharides, Sen, Suryawanshi, Thillainadesan, Aitken)
Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW,
Australia
(James, Kritharides) Department of Cardiology, Concord Hospital, The
University of Sydney, Concord, NSW, Australia
(Sen) Department of Renal Medicine, Concord Repatriation General Hospital,
Concord, Australia
(Behdasht) Department of Pharmacy, Concord Repatriation General Hospital,
Concord, Australia
(Suryawanshi) Department of Endocrinology and Metabolism, Concord
Repatriation General Hospital, Concord, NSW, Australia
(Davie) Concord Drug Health Services, Concord Repatriation General
Hospital, Concord, NSW, Australia
(Thillainadesan) Centre for Education and Research on Ageing, Concord
Hospital, Sydney, NSW, Australia
(Thillainadesan, Elias) Department of Geriatric Medicine, Concord
Hospital, Sydney, NSW, Australia
Publisher
Elsevier Inc.
Abstract
Background: Peripheral arterial disease (PAD) is a chronic progressive
vascular condition with high morbidity and mortality, often necessitating
comprehensive management to mitigate cardiovascular risk. This study
assessed the feasibility of recruiting patients with PAD for a
multidisciplinary team (MDT)-based care intervention, comparing its
effectiveness to standard care within a clinical trial setting.
 Method(s): This study was conducted as a cross-sectional analysis
nested within the ongoing TEAM-PAD trial and targeted the recruitment of
30 patients within 12 weeks and evaluated recruitment, consent, and
retention rates to assess feasibility. Result(s): A total of 30
participants were consented within 11 weeks, with an overall recruitment
rate of 36.4% and retention rate of 90%. Baseline characteristics were
balanced between groups. Participants had a mean age of 68.9 years and a
high prevalence of comorbidities. The mean 10-year cardiovascular risk
(SMART-REACH) was 42.8%. In the intervention group, implementing MDT
recommendations is projected to reduce this risk by 12.1%.
 Conclusion(s): Recruitment of patients with PAD into an MDT
intervention was feasible and timely, with strong retention and
well-balanced baseline characteristics. Although modeled estimates suggest
a potential benefit from MDT recommendations, these findings are
preliminary and based on a small interim cohort. Evaluation of clinical
effectiveness within the larger ongoing randomized controlled trial is
needed to evaluate the medium- and long-term impacts of integrated
vascular care. Copyright © 2025 Elsevier Inc.

<147>
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. Copyright
© 2025 by the authors.

<148>
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). Design(s): Prospective, nonblinded, randomized
controlled trial. Setting(s): Single-center trial at a university
hospital. Participant(s): Patients scheduled for thoracic surgery
requiring one-lung ventilation (OLV). 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. 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). 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>. Copyright © 2025 The Author(s)

<149>
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). Design(s): Post-hoc study of a randomized trial of 4%
albumin versus Ringer's acetate for cardiopulmonary bypass priming and
perioperative volume replacement. Setting(s): Single-center study.
 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. 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. Copyright © 2025
The Author(s)

<150>
Accession Number
2037912913
Title
Patient Selection for Surgery vs Surveillance in Moderately Dilated
Ascending Aorta: Insights From Treatment in Thoracic Aortic Aneurysm:
Surgery versus Surveillance (TITAN:SvS), an International Prospective
Trial.
Source
Annals of Thoracic Surgery. 120(1) (pp 25-32), 2025. Date of Publication:
01 Jul 2025.
Author
Makarem A.; Appoo J.J.; Boodhwani M.; Guo M.H.; Brownlee S.; Demers P.;
Patel H.J.; Hughes G.C.; Dagenais F.; Chu M.W.A.; Ouzounian M.; Grau J.B.;
Bozinovski J.; Pozeg Z.; Tseng E.; Atoui R.; Jassar A.S.
Institution
(Makarem, Brownlee, Jassar) Division of Cardiac Surgery, Massachusetts
General Hospital and Harvard Medical School, Boston, MA, United States
(Appoo) Division of Cardiac Surgery, Libin Cardiovascular Institute,
Calgary, AB, Canada
(Boodhwani, Guo) Division of Cardiac Surgery, University of Ottawa Heart
Institute, Ottawa, ON, Canada
(Demers) Division of Cardiac Surgery, University of Montreal, Montreal,
QC, Canada
(Patel) Division of Cardiac Surgery, University of Michigan Health, Ann
Arbor, MI, United States
(Hughes) Division of Cardiac Surgery, Duke University, Durham, NC, United
States
(Dagenais) Division of Cardiac Surgery, Laval University, Quebec City, QC,
Canada
(Chu) Division of Cardiac Surgery, London Health Centre, London, ON,
Canada
(Ouzounian) Division of Cardiac Surgery, Toronto General Hospital,
Toronto, ON, Canada
(Grau) Division of Cardiac Surgery, Valley Health System, Ridgewood, NJ,
United States
(Bozinovski) Division of Cardiac Surgery, Ohio State University Wexner
Medical Center, Columbus, OH, United States
(Pozeg) Division of Cardiac Surgery, New Brunswick Heart Centre, Saint
John, NB, Canada
(Tseng) Division of Cardiac Surgery, University of California at San
Francisco Medical Center, San Francisco, CA, United States
(Atoui) Division of Cardiac Surgery, Health Sciences North, Sudbury, ON,
Canada
Publisher
Elsevier Inc.
Abstract
Background: Guidelines for treating ascending thoracic aortic aneurysms
(ATAA) are largely based on single-center studies. To understand factors
influencing patient selection for surgery vs surveillance, patient and
aneurysm characteristics were compared for patients in the randomized and
registry arms of a large prospective, multicenter, multinational trial.
 Method(s): TITAN:SvS (Treatment in Thoracic Aortic aNeurysm: Surgery
versus Surveillance) is a large prospective multicenter study of patients
with ATAA between 5.0 and 5.4 cm, randomizing patients 1:1 to initial
surgery vs surveillance. Nonrandomized patients are enrolled into a
registry where results of operative or surveillance strategy can be
monitored prospectively. Between 2018 and 2023, 615 patients were enrolled
at 22 sites in the United States and Canada. Demographic and aneurysm
characteristics were compared between randomized and registry arms.
 Result(s): Compared with randomized and operative registry groups,
patients in the surveillance registry were older with more comorbidities.
No significant differences were observed in maximal ascending aortic
diameter (5.1 cm [interquartile range, 5.0-5.2 cm] vs 5.1 cm
[interquartile range, 4.9-5.2 cm] P =.2) or other aneurysm
characteristics. Despite similar numbers of enrolling centers in the
United States (n = 11) and Canada (n = 12), Canadian patients were more
likely to be randomized (58% vs 7%, P <.01) and less likely to be enrolled
in the operative (9% vs 42%, P <.01) or surveillance registry (34% vs
51%). Conclusion(s): Enrollment data for TITAN:SvS suggest that
patient and geographic characteristics, rather than aortic size, influence
decision-making regarding the initial treatment strategy for ATAAs. These
findings highlight the need for caution when generalizing outcomes from
operative registries, because sicker patients may be
excluded. Copyright © 2025 The Authors

<151>
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. 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. 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.
 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). Copyright © The Author(s) 2025.

<152>
Accession Number
2039377138
Title
Cardiovascular Prehabilitation in Patients Awaiting Heart Transplantation-
Addressing Clinical Needs (the PREHAB HTx Study).
Source
CJC Open. (no pagination), 2025. Date of Publication: 2025.
Author
Reed J.L.; Tulloch H.E.; Ross H.; Terada T.; Mistura M.; Marcal I.R.; Oh
P.; Chih S.
Institution
(Reed, Tulloch, Terada, Mistura, Marcal, Chih) University of Ottawa Heart
Institute, Ottawa, ON, Canada
(Reed, Marcal) School of Human Kinetics, Faculty of Health Sciences,
University of Ottawa, Ottawa, ON, Canada
(Reed) School of Epidemiology and Public Health, Faculty of Medicine,
University of Ottawa, Ottawa, ON, Canada
(Tulloch) Department of Medicine, Faculty of Medicine, University of
Ottawa, Ottawa, ON, Canada
(Ross) Toronto General Hospital Research Institute, University of Toronto,
Toronto, ON, Canada
(Terada) School of Life Sciences, Division of Physiology, Pharmacology,
and Neuroscience, University of Nottingham, Nottingham, United Kingdom
(Oh) Toronto Rehabilitation Institute, Toronto, ON, Canada
Publisher
Elsevier Inc.
Abstract
Background: To compare the effects of a 12-week prehabilitation (PREHAB)
program vs usual care (UC) on functional capacity in adults listed for
heart transplantation. Secondary aims included comparing peak oxygen
uptake (VO<inf>2</inf>peak), frailty, physical activity, mental health,
cognitive function, quality of life (QoL), and dietary habits.
 Method(s): A multicentre randomized controlled trial was conducted.
Participants were randomized to PREHAB or UC. The 12-week PREHAB program
included twice weekly high-intensity interval training sessions on an
upright cycle ergometer, a stress management course, and a nutrition
workshop. The primary outcome was functional capacity (6-minute walk test
distance) from baseline to 12 weeks of follow-up. Secondary outcomes
included changes in VO<inf>2</inf>peak, frailty, physical activity,
severity of anxiety, depression, and stress, cognitive function, QoL, and
dietary habits. Result(s): Trial recruitment began in October 2018
and closed, due to the COVID-19 pandemic, in October 2020. Of 84 patients
screened, 17 were recruited (age: 44 +/- 9 years, 71% male), and 4 were
randomized (PREHAB = 2; UC = 2). Both patients completed PREHAB, and 1
patient completed UC. Reasons for dropout throughout the trial included
the following: receiving a transplant; medication and device
contraindications; commitment and travel constraints; and lack of
interest. PREHAB showed potential for improvements in the 6-minute walk
test distance (Baseline [B]: 343 +/- 120; follow-up [FU]: 465 m),
VO<inf>2</inf>peak (B: 14.9 +/- 0.1; FU: 15.8 +/- 0.4 mL/kg/min), and QoL
measured using the Minnesota Living with Heart Failure Questionnaire (B:
41 +/- 33; FU: 26 +/- 1 points). Conclusion(s): Recruitment for and
completion of PREHAB for patients listed for heart transplantation proved
challenging. Given wait-time limitations, future research should examine
alternative PREHAB programming, offered sooner following listing, that
addresses reported barriers to participation. Clinical Trial Registration:
NCT02957955. Copyright © 2025 The Authors

<153>
Accession Number
2039378011
Title
Intracardiac versus transesophageal echocardiographic guidance for left
atrial appendage occlusion: Design and rationale of the ICE-TEE trial.
Source
Cardiovascular Revascularization Medicine. (no pagination), 2025. Date of
Publication: 2025.
Author
Al-Azizi K.; Thomas S.; Hajar M.B.A.; Pickering T.; McCullough K.; Dorton
C.; Moubarak G.; Ma T.-W.; Banwait J.; Hale S.; Gupta S.; DiMaio J.M.;
Szerlip M.; Matar R.; Aqtash O.; Baig I.; Trehan S.; Potluri S.
Institution
(Al-Azizi, Thomas, Szerlip, Matar, Aqtash, Baig, Trehan, Potluri)
Department of Cardiology, Baylor Scott and White The Heart Hospital,
Plano, TX, United States
(Hajar, Pickering, McCullough, Dorton, Moubarak, Ma, Banwait, Hale, Gupta,
DiMaio) Baylor Scott & White Research Institute, Plano, TX, United States
(Moubarak) Department of Internal Medicine, Baylor University Medical
Center, TX, United States
Publisher
Elsevier Inc.
Abstract
Left atrial appendage occlusion (LAAO) has emerged as an alternative to
long-term anticoagulation for stroke prevention in patients with
non-valvular atrial fibrillation deemed high risk for bleeding. LAAO is
performed via a transseptal approach with the placement of an occlusion
device in the left atrial appendage (LAA) to seal it. Intraoperative
imaging with echocardiography is needed to guide and complete the
procedure. Historically, Transesophageal echocardiography (TEE) has been
the most frequently used modality for intraprocedural guidance. Recently,
there has been a growing interest in the use of intracardiac
echocardiography (ICE) as an adjunct to, or even an alternative to,
transesophageal echocardiography (TEE), with several unique advantages and
potential challenges. Several publications have highlighted the safety and
feasibility of ICE in LAAO (Hemam et al., 2019; Morcos et al., 2022; Zhang
et al., 2023 [2, 5, 7]). The most recent SCAI/HRS consensus statement
recommends using TEE or ICE in procedural guidance (Saw et al., 2023 [8]).
To date, no prospective randomized controlled trials have addressed the
safety and feasibility of ICE-guided LAAO, compared to TEE guidance. The
ICE TEE trial is a single-center, prospective, randomized,
parallel-controlled, open-label clinical trial that will assess the
efficacy and safety of ICE-guided LAAO compared to traditional TEE-guided
LAAO. Patients are randomized in a 1:1 fashion. The primary endpoint of
the study is the procedural success of LAAO device implantation, defined
as the appropriate device implantation as per the IFU, without
device-related complications, and no peri-device leaks >5 mm on color
Doppler, according to the Munich consensus. Secondary endpoints include
periprocedural complications, procedural characteristics, and cost of
hospitalization. Patients will be assessed at 45 days with a TEE to
evaluate for any peri-device leak (PDL). The trial aims to assess the
efficacy and potential complications of using ICE to guide the
implantation of percutaneous left atrial appendage occlusion (LAAO)
devices compared to the traditional transesophageal echocardiography
(TEE)- guided LAAO. Copyright © 2025 Elsevier Inc.

<154>
Accession Number
647718087
Title
Early postoperative atrial fibrillation is associated with late mortality
after cardiac surgery: a systematic review and reconstructed individual
patient data meta-analysis.
Source
Journal of cardiothoracic surgery. 20(1) (pp 265), 2025. Date of
Publication: 18 Jun 2025.
Author
Kawczynski M.J.; van der Heijden C.A.J.; Maessen J.G.; Schotten U.;
Kowalewski M.; Suwalski P.; Bidar E.; Maesen B.
Institution
(Kawczynski, Maessen, Bidar, Maesen) Department of Cardiothoracic Surgery,
Heart and Vascular Centre, Maastricht University Medical Centre, Postbus
5800, Maastricht, Netherlands
(Kawczynski, Schotten) Department of Physiology, Maastricht University,
Maastricht, Netherlands
(Kawczynski, Maessen, Schotten, Kowalewski, Bidar, Maesen) Cardiovascular
Research Institute Maastricht (CARIM), Maastricht, Netherlands
(van der Heijden) Department of Cardiology, Heart and Vascular Centre,
Maastricht University Medical Centre, Maastricht, Netherlands
(Kowalewski, Suwalski) Clinical Department of Cardiac Surgery and
Transplantology, National Medical Institute of the Ministry of Interior
and Administration, Centre of Postgraduate Medical Education, Warsaw,
Poland
Abstract
BACKGROUND: Early postoperative atrial fibrillation (early-POAF) is the
most common complication after cardiac surgery. Although prior studies
have demonstrated an association between early-POAF and late outcomes, it
is questionable whether these long-term adverse events result from
early-POAF or from comorbidities that underlie the development of
early-POAF. Therefore, the aim of this study was to investigate the
association of early-POAF with late mortality and stroke after adjustment
for age and cardiovascular comorbidities. METHOD(S): A systematic
search was conducted to identify studies reporting on late mortality after
cardiac surgery in patients with and without early-POAF. Articles
presenting Kaplan-Meier were included for a pooled analysis of late
mortality (primary outcome) and stroke (secondary outcome). Individual
time-to-event data were reconstructed from the Kaplan-Meier curves and
incorporated into a multivariable mixed-effects Cox model. RESULT(S):
In total, 33 studies were included in the analysis for late mortality (131
031 patients) and 10 studies in the analysis for late stroke (42 042
patients). Overall, 36 991 patients had early-POAF with a pooled incidence
of 31.5% (95% CI: 27.7 to 35.6%). Unadjusted analysis showed that
early-POAF was significantly associated with late mortality (Hazard Ratio
[HR] = 1.62, 95%CI: 1.58-1.67, P < 0.001) and late stroke (HR = 1.72,
95%CI: 1.61-1.85, P < 0.001). Early-POAF was significantly associated with
late mortality (adjusted HR = 1.19, 95% CI: 1.07-1.33, P = 0.002), but not
with late stroke (adjusted HR = 1.14, 95% CI: 0.96-1.35, P = 0.122) after
adjustment for age, comorbidities, surgery type, and the random effects
term. CONCLUSION(S): Early-POAF after cardiac surgery is
significantly associated with late mortality, but not with late stroke,
after adjustments for age, sex, cardiovascular comorbidities, and type of
surgery. Copyright © 2025. The Author(s).

<155>
Accession Number
2035075018
Title
Systematic Review of Pharmacogenetics of Immunosuppressants in Heart
Transplantation.
Source
Cardiogenetics. 15(2) (no pagination), 2025. Article Number: 18. Date of
Publication: 01 Jun 2025.
Author
Megias-Vericat J.E.; Palanques-Pastor T.; Fernandez-Sanchez M.;
Guerrero-Hurtado E.; Gil-Candel M.; Solana-Altabella A.; Ballesta-Lopez
O.; Centelles-Oria M.; Garcia-Pellicer J.; Poveda-Andres J.L.
Institution
(Megias-Vericat, Garcia-Pellicer) Pharmacy Department, Hospital
Universitari i Politecnic La Fe, Valencia, Spain
(Palanques-Pastor, Gil-Candel, Ballesta-Lopez, Centelles-Oria) Accredited
Research Group on Pharmacy, Instituto Investigacion Sanitaria La Fe,
Valencia, Spain
(Fernandez-Sanchez) Pharmacy Department, Consorcio Hospitalario Provincial
de Castellon, Castello de la Plana, Spain
(Guerrero-Hurtado) Pharmacy Department, Hospital Universitario Fundacion
Jimenez Diaz, Madrid, Spain
(Solana-Altabella) Accredited Research Group on Hematology, Instituto
Investigacion Sanitaria La Fe, Valencia, Spain
(Poveda-Andres) Management Department, Hospital Universitari i Politecnic
La Fe, Valencia, Spain
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
The standard immunosuppressive treatments in heart transplantation are
calcineurin inhibitors, corticosteroids, and antimetabolite agents or
inhibitors of the mammalian target of rapamycin. Pharmacogenetic studies
show the impact on clinical course of genetic variability in genes that
encode transporters, metabolizers, or molecular targets of
immunosuppressants. The aim of this systematic review is to elucidate the
role that pharmacogenetics of immunosuppressant drugs plays in clinical
outcomes upon heart transplantation. PubMed, EMBASE, the Cochrane Central
Register, and the Database of Abstracts of Reviews of Effects were
searched without restrictions. The 64 studies analyzed followed these
criteria: (1) were based on clinical data on heart transplantation
patients; (2) analyzed the associations between polymorphisms and clinical
response; (3) analyzed the impact of polymorphisms on immunosuppressant
safety. CYP3A4/5 variants were associated with higher doses of tacrolimus,
whereas POR*28 variants with lower doses-ABCB1, ABCC2, SLCO1B1, and
SLC13A1-contribute to interindividual variability in drug absorption,
distribution, and toxicity. An ABCC2 polymorphism (rs717620) was related
to higher risk of graft rejection in pediatrics. Variations in HLA-G,
TNF-alpha and TGF-beta genes influence transplant rejection risk and
immune response. Implementing pharmacogenetic screening of polymorphisms
could enhance therapeutic outcomes by improving drug efficacy, reducing
toxicity, and ultimately increasing heart graft survival rates. Strong
evidence supports genotyping for CYP3A5 and TPMT, but further research is
required for transporter genes and cytokine polymorphisms. Copyright
© 2025 by the authors.

<156>
Accession Number
2039349302
Title
Cardiac CT Versus Transesophageal Echocardiography Following Left Atrial
Appendage Closure: A Systemic Review and Meta-Analysis.
Source
Circulation: Cardiovascular Imaging. (no pagination), 2025. Article
Number: 018151. Date of Publication: 2025.
Author
Tan B.E.-X.; Baqai F.; Padilla F.; Nimri N.; Cheung J.W.; Kottam A.;
Medina H.M.
Institution
(Tan, Nimri, Kottam) Section of Cardiology, Department of Medicine, Baylor
College of Medicine, Houston, TX, United States
(Baqai, Padilla) Section of General Internal Medicine, Department of
Medicine, Baylor College of Medicine, Houston, TX, United States
(Cheung) Division of Cardiology, Department of Medicine, Weill Cornell
Medicine, New York, NY, United States
(Medina) Department of Cardiology, The Texas Heart Institute, Baylor
College of Medicine, Houston, United States
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND: In the landmark WATCHMAN trials, transesophageal
echocardiography (TEE) was used to evaluate peri-device leak (PDL) and
device-related thrombus (DRT) after percutaneous left atrial appendage
closure (LAAC). We aimed to investigate the diagnostic utility of cardiac
computed tomography angiography (CCTA) compared with TEE for post-LAAC
device surveillance. METHOD(S): We conducted a literature search of 5
electronic databases to identify studies that included patients who
underwent both CCTA and TEE after LAAC. We performed a meta-analysis by
pooling outcomes for residual leak (left atrial appendage patency), any
PDL, large PDL (>5 mm), and DRT. RESULT(S): We included 17 cohort
studies with 1313 patients who underwent both CCTA and TEE after LAAC.
CCTA was associated with higher odds of detecting residual leak (58.8%
versus 34.6%, odds ratio, 2.26 [95% CI, 1.48-3.44], P=0.0002;
I2=73%; 15 studies, 975 patients; moderate certainty) and any
PDL (51.6% versus 35.5%, odds ratio, 1.59 [95% CI, 1.01-2.51], P=0.04;
I2=73%; 12 studies, 870 patients; moderate certainty) when
compared with TEE. There were no significant differences in the detection
rates of large PDL (>5 mm) between CCTA and TEE (2.8% versus 0.8%, odds
ratio, 3.12 [95% CI, 0.73-13.36], P=0.13; I2=0%; 5 studies, 338
patients; moderate certainty). The incidence of DRT was low (1.7%), and
the detection rate did not differ between the 2 modalities (1.7% versus
1.7%, odds ratio, 1.0 [95% CI, 0.41-2.42], P=1.0; I2=0%; 6
studies, 584 patients; high-certainty). CONCLUSION(S): Following
LAAC, CCTA had higher odds of detecting residual leak and any PDL compared
with TEE, whereas there were no significant differences in the detection
of large PDL and DRT between the 2 modalities. The findings of this
meta-analysis should provide reassurance to patients and clinicians who
prefer CCTA over TEE after LAAC. While DRT and left atrial appendage
patency with visible PDL are known to be associated with thromboembolism,
the clinical significance of left atrial appendage patency without visible
PDL is uncertain and warrants further investigation. REGISTRATION: URL:
https://www.crd.york.ac.uk/PROSPERO/; Unique identifier:
CRD42024578802. Copyright © 2025 American Heart Association, Inc.

<157>
Accession Number
2035040178
Title
Exploring Use-Rates of and Scientific Evidence on Sutureless Devices in
Aortic Valve Replacement: A Bibliographic Meta-Analysis and Clinical
Considerations.
Source
Journal of Clinical Medicine. 14(12) (no pagination), 2025. Article
Number: 4049. Date of Publication: 01 Jun 2025.
Author
Spadaccio C.; Dimagli A.; Agler C.J.; Paneitz D.C.; Wolfe S.B.; Nenna A.;
Osho A.A.; Rose D.
Institution
(Spadaccio, Agler) Department of Cardiac Surgery, University of Cincinnati
College of Medicine, 231 Albert Sabin Way, MSB 2474, Cincinnati, OH,
United States
(Dimagli) Department of Surgery, Columbia University, New York, NY, United
States
(Paneitz) Department of Surgery, Johns Hopkins University School of
Medicine, Baltimore, MD, United States
(Wolfe) Department of Cardiothoracic Surgery, West Virginia University,
Morgantown, WV, United States
(Nenna) Department of Cardiac Surgery, Ospedale Maggiore Della Carita,
Novara, Italy
(Osho) Department of Cardiothoracic Surgery, Harvard Medical School,
Massachusetts General Hospital, Boston, MA, United States
(Rose) Department of Cardiothoracic Surgery, Blackpool Teaching Hospital,
Blackpool, United Kingdom
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Sutureless aortic valve replacement (SuAVR) has emerged as a potential
alternative to conventional surgical aortic valve replacement (SAVR),
particularly in minimally invasive settings. However, its global adoption
remains limited, with a notable concentration of use and scientific
production in select European countries. This bibliographic meta-analysis
systematically reviewed 538 studies to assess the evidence landscape
surrounding SuAVR, highlighting a predominance of observational data,
sparse randomized controlled trials (1.3%), and significant geographical
imbalances in research output. Europe accounted for 80% of publications,
while North America contributed less than 10%. Key structural
factors-including reimbursement policies, earlier regulatory approvals,
and population characteristics-appear to influence SuAVR adoption. Despite
procedural advantages such as reduced cross-clamp times, concerns over
cost, pacemaker implantation rates, and uncertain long-term durability
persist. Importantly, SuAVR may offer its greatest clinical value by
facilitating minimally invasive surgery, a niche still underutilized
worldwide. The limited randomized data and industrial focus on
transcatheter approaches have further hindered widespread acceptance. Our
findings underscore the need for high-quality comparative trials and
standardized guidelines to define the role of SuAVR in modern valve
therapy. Copyright © 2025 by the authors.

<158>
Accession Number
2039324982
Title
Rhomboid Intercostal Block for Postoperative Analgesia in Mastectomy: A
Prospective, Randomized Controlled Trial.
Source
Bali Journal of Anesthesiology. 9(2) (pp 113-118), 2025. Date of
Publication: 01 Apr 2025.
Author
Gunawan P.; Gusti Ngurah Mahaalit Aribawa I.; Adi M.S.P.
Institution
(Gunawan) Department of Anesthesiology and Intensive Care, Harapan
Hospital, Magelang, Indonesia
(Gusti Ngurah Mahaalit Aribawa, Adi) Udayana University, Jimbaran,
Indonesia
Publisher
Wolters Kluwer Medknow Publications
Abstract
Background: Postoperative pain following mastectomy remains a significant
concern, often requiring high-dose opioids that may lead to adverse
effects. The rhomboid intercostal block (RIB) is a novel ultrasound-guided
fascial plane block shown to reduce pain in thoracic and breast surgeries.
This study aimed to evaluate the effectiveness of RIB in reducing
postoperative opioid consumption and pain scores in patients undergoing
mastectomy. Material(s) and Method(s): In a randomized, double-blind
trial, 28 patients (American Society of Anesthesiologists [ASA] I-II, aged
19-60 years) were randomized 1:1 to receive either general anesthesia with
RIB (Group A) or general anesthesia alone (Group B). The sample size was
based on prior data demonstrating opioid reduction with RIB undergoing
mastectomy. The primary outcome was total morphine consumption within 24 h
postoperatively. Secondary outcomes included pain scores at multiple time
points and intraoperative fentanyl use. Data were analyzed using
appropriate statistical tests based on data distribution, with a
significance level of P < 0.05. Result(s): Group A demonstrated
significantly lower morphine consumption in the first 24 h postoperatively
(1.71 +/- 0.99 mg vs. 10 +/- 1.30 mg; P < 0.001). Pain scores were
significantly reduced in Group A across all time points (1st, 3rd, 6th,
12th, and 24th h; P < 0.001). Intraoperative fentanyl requirements were
also significantly lower in Group A (125 microg vs. 225 microg; P <
0.001). No significant differences in side effects were observed between
groups. Conclusion(s): RIB significantly reduces postoperative opioid
requirements and pain intensity in mastectomy patients and may serve as a
valuable adjunct in enhanced recovery pathways for breast
surgery. Copyright © 2025 Bali Journal of Anesthesiology 
Published by Wolters Kluwer - Medknow.

<159>
Accession Number
2039348140
Title
Strategies for Antithrombotic Management During Non-cardiac Arterial
Procedures: Results of the International ACTION Survey.
Source
EJVES Vascular Forum. 64 (pp 8-15), 2025. Date of Publication: 01 Jan
2025.
Author
Hoebink M.; Jongkind V.; Arendt C.; de Borst G.J.; Busch A.; Caradu C.;
Croo A.; Dabravolskaite V.; Darwish M.; D'Oria M.; Ebben H.P.; Enzmann F.;
Ghulam Q.M.; Gombert A.; Gratl A.; Johannesdottir B.K.; Karelis A.;
Kiernan A.; Kukulski L.; Lareyre F.; e Melo R.G.; Moller C.M.; Doukas P.;
Patelis N.; Spanos K.; Spath P.; Teraa M.; Tran B.L.; Zielasek C.;
Zlatanovic P.; Yeung K.K.; Roosendaal L.C.; Blankensteijn J.D.; Buscher
H.C.J.L.; Eefting D.; Fioole B.; Heyligers J.M.M.; Hissink R.J.; Hoencamp
R.; Koelemay M.J.W.; Kropman R.H.J.; van der Laan L.; Lemson S.; Pierie
M.E.N.; Reichmann B.L.; Reijnen M.M.P.J.; van Schaik J.; Schlejen P.M.;
Teijink J.A.W.; Willigendael E.M.; Zeebregts C.J.; Wiersema A.M.
Institution
(Hoebink, Jongkind) Amsterdam UMC location University of Amsterdam,
Vascular Surgery, Meibergdreef 9, Amsterdam, Netherlands
(Hoebink, Jongkind) Dijklander Ziekenhuis, Vascular Surgery, Maelsonstraat
3, Hoorn, Netherlands
(Hoebink, Jongkind) Amsterdam Cardiovascular Sciences, Atherosclerosis and
Aortic Syndromes, Amsterdam, Netherlands
Publisher
Elsevier Ltd
Abstract
Objective: Peri-procedural antithrombotics are used extensively to prevent
thromboembolic complications during non-cardiac arterial procedures (NCAP)
worldwide. However, there is a lack of evidence to support recommendations
on antithrombotic strategies, possibly leading to substantial variation in
local practices. A comprehensive overview of antithrombotic strategies is
needed to identify the most widely accepted protocols employed during
NCAP, highlight variations in local practices, and identify new research
targets to establish evidence based peri-procedural anticoagulation
management. Method(s): An international, web based survey study was
conducted from March to October 2023, targeting vascular clinical
specialists who applied antithrombotic strategies during NCAP in daily
practice. Result(s): The survey was completed by 436 vascular
clinical specialists from 45 countries (Europeans: 93%, vascular surgeons
or vascular surgery residents: 98%). Systemic unfractionated heparin was
used by nearly all vascular specialists during all procedures (varying
between 98-99%, depending on the procedure type), but could vary depending
on specific NCAP. A fixed starting dose (39-52%, most often 5 000 IU
[80-89%]) or an actual bodyweight dependent dose (42-52%, most commonly
100 IU/kg [40-67%] or 50 IU/kg [17-40%]) was mainly used. Except during
fenestrated or branched endovascular aneurysm repair procedures (51%),
activated clotting time (ACT) was employed by a minority (26-31%). A large
variety in measurement protocols was observed, yet a target ACT of 200
seconds was most often used for all NCAP types (44-54%). Most vascular
specialists considered a heparin follow up dose (61-81%) and heparin
reversal using protamine (54-63%), both for a variety of indications. Of
the participants, 68% expressed discontent with their current
antithrombotic protocol(s). Conclusion(s): This comprehensive,
international survey study revealed large variation among vascular
clinical specialists' heparinisation strategies during NCAP. Together with
the considerable discontent expressed regarding protocols, this emphasises
the urgent need for comparative, randomised studies on antithrombotic
management during NCAP. Copyright © 2025 The Authors

<160>
Accession Number
647691127
Title
Cost-Effectiveness of an Intraoperative Antibacterial Envelope in
Preventing Cardiac Implantable Device Associated Infections: A Systematic
Review.
Source
Europace : European pacing, arrhythmias, and cardiac electrophysiology :
journal of the working groups on cardiac pacing, arrhythmias, and cardiac
cellular electrophysiology of the European Society of Cardiology. (no
pagination), 2025. Date of Publication: 16 Jun 2025.
Author
Mudigonda S.; Hagarty E.; Lei L.; Rennert-May E.; Joza J.; Exner D.V.;
Andrade J.; Raj S.R.; Chew D.S.
Institution
(Mudigonda, Hagarty, Exner, Raj, Chew) Libin Cardiovascular Institute,
Department of Cardiac Sciences, University of Calgary, Calgary, AB, Canada
(Lei, Andrade, Chew) Department of Medicine, University of British
Columbia, Vancouver, BC, Canada
(Rennert-May, Chew) Department of Community Health Sciences, University of
Calgary, AB, Canada
(Rennert-May) Department of Medicine, University of Calgary, AB, Canada
(Rennert-May) O'Brien Institute for Public Health, University of Calgary,
Calgary, AB, Canada
(Rennert-May) Department of Microbiology, Immunology and Infectious
Diseases, University of Calgary, Calgary, AB, Canada
(Joza) Department of Medicine, McGill University, Montreal, QC, Canada
Abstract
BACKGROUND AND AIMS: Intraoperative use of an antibacterial envelope
during surgery for cardiac implantable electronic device surgery reduces
infection risk at increased procedural costs. The objective of this
systematic review was to synthesize the published economic literature on
the cost-effectiveness of the antibacterial envelope. METHOD(S): A
systematic review of the published literature was conducted to identify
economic evaluations (i.e. cost-utility, cost-effectiveness, cost-benefit
studies) comparing the antibacterial envelope compared with standard of
care in preventing post-operative CIED infection. Systematic review best
practices were followed, and study quality was assessed. RESULT(S):
Of 142 unique citations, 7 studies met the inclusion criteria for
qualitative synthesis. All cost-effectiveness studies were conducted from
the health care payer perspective of high-income countries. The base case
analysis of most economic studies (5/7) reported a cost per
quality-adjusted life year gained that exceeded country-specific societal
thresholds for good value in health care. Cost-effectiveness was highly
dependent on the baseline infection risk. That is, at current pricing, the
antibacterial envelope may be cost-effective at base infection rates of
greater than 3%, and cost-savings at infection rates than exceed 6%.
 CONCLUSION(S): Routine use of an antibacterial envelope in patients
undergoing CIED procedures (implantation or revision) is unlikely to be
cost-effective except among those at high risk. Individualized risk
assessment may help guide efficient and value-based use of this
technology. Copyright © The Author(s) 2025. Published by Oxford
University Press on behalf of the European Society of Cardiology.

<161>
Accession Number
2035109961
Title
Urine Output Response to a Furosemide Infusion in Infants After
Cardiopulmonary Bypass as a Predictor of Acute Kidney Injury.
Source
Pediatric Cardiology. (no pagination), 2025. Date of Publication: 2025.
Author
Pierick A.R.; Luckritz K.E.; Huebschman A.; Duimstra A.; Yu S.;
Sznycer-Taub N.
Institution
(Pierick, Duimstra, Yu, Sznycer-Taub) Divison of Pediatric Cardiology,
Department of Pediatrics, University of Michigan, Ann Arbor, MI, United
States
(Luckritz) Division of Pediatric Nephrology, Department of Pediatrics,
University of Michigan, Ann Arbor, MI, United States
(Huebschman) Department of Pediatric Pharmacy, University of Michigan, Ann
Arbor, MI, United States
Publisher
Springer
Abstract
Acute kidney injury (AKI) is a common complication in infants after
cardiac surgery. Prior studies have demonstrated that urine output
response to bolus dose furosemide correlates with AKI development but have
excluded infants receiving a furosemide infusion. We sought to determine
if urine output in response to a furosemide infusion in infants after
cardiac surgery predicts AKI development. Single center retrospective
cohort study of infants post cardiac surgery requiring cardiopulmonary
bypass and received a post-operative furosemide infusion. A furosemide
response score (FRS) (urine output [mL]/furosemide delivered [mg/kg]) was
calculated. The FRS was used to determine optimal cut-offs to predict
clinically significant AKI (CS-AKI), defined as stage 2 or 3 AKI. A
furosemide infusion was started at a median of 9.4 h (interquartile range
6.6-13.6 h) after intensive care unit (ICU) admission in 155 infants. The
post-operative incidence of AKI was 76.8%, with 44.5% having CS-AKI. The
optimal FRS cut-off to correlate with AKI was 11.3 mL/mg/kg at 4 h (area
under the curve [AUC] = 0.75), 25.5 mL/mg/kg at 10 h (AUC = 0.70), and
53.3 mL/mg/kg at 24 h (AUC = 0.70) post-infusion initiation, and
independently associated with the development of AKI. Lower FRS also
correlated with increased mechanical ventilation days and ICU/hospital
length of stay. Urine output in response to a furosemide infusion in
infants following cardiac surgery is associated with post-operative
CS-AKI. The FRS can be used to predict AKI and potentially improve
hemodynamics while minimizing risks. Copyright © The Author(s)
2025.

<162>
Accession Number
647697558
Title
Understanding gastrointestinal bleeding in patients with cardiac disease:
an interdisciplinary approach.
Source
Expert review of cardiovascular therapy. (no pagination), 2025. Date of
Publication: 16 Jun 2025.
Author
Gries J.J.; Virk H.U.H.; Birnbaum Y.; Jneid H.; Virani S.S.; Sharma S.;
Krittanawong C.
Institution
(Gries) Department of Internal Medicine, Geisinger Medical Center,
Danville, PA, United States
(Virk) Harrington Heart & Vascular Institute, Case Western Reserve
University, University Hospitals Cleveland Medical Center, Cleveland, OH,
United States
(Birnbaum, Jneid) Section of Cardiology, Baylor College of Medicine,
Houston, TX, United States
(Jneid) Division of Cardiology, University of Texas Medical Branch,
Houston, TX, United States
(Virani) Office of the Vice Provost (Research), Aga Khan University,
Karachi, Pakistan
(Virani) Section of Cardiology and Cardiovascular Research, Department of
Medicine, Baylor College of Medicine, Houston, TX, United States
(Sharma) Cardiac Catheterization Laboratory of the Cardiovascular
Institute, Mount Sinai Hospital, New York, NY, USA
(Krittanawong) Cardiology Division, NYU Langone Health and NYU School of
Medicine, New York, NY, USA
Abstract
INTRODUCTION: Cardiovascular disease remains the leading cause of global
mortality and a significant contributor to disability. The incidence of
gastrointestinal bleeding (GIB) varies across cardiac conditions, with
notable risks observed in patients undergoing complex antiplatelet or
anticoagulant therapy, acute coronary syndrome, hypertrophic
cardiomyopathy, percutaneous coronary interventions, mechanical cardiac
support, acute decompensated heart failure, and post-cardiac surgery.
AREAS COVERED: A comprehensive search of the PubMed/Medline database was
conducted to retrieve articles related to GIB and cardiovascular disease
from 2014 to 2024. The authors then synthesized a narrative review that
endorses an interdisciplinary approach to this challenging paradigm,
drawing from cardiology and gastroenterology perspectives to provide a
comprehensive overview of the current understanding of the risk of GIB in
cardiac patients. EXPERT OPINION: In acute coronary syndrome, upper GIB
significantly increases mortality risk, with early endoscopic intervention
proving beneficial. Post-coronary revascularization presents a low GIB
incidence but a high mortality rate when it occurs. Decompensated heart
failure patients frequently experience GIB due to concomitant conditions.
Cardiogenic shock and mechanical cardiac support also show notable GIB
risks, with mechanical support patients facing higher mortality. Following
transcatheter aortic valve implantation, GIB incidence is low, but
hospitalization rates are significant.

<163>
Accession Number
2039289223
Title
The Impact of Depth of Anaesthesia Monitoring on Postoperative Cognitive
Dysfunction.
Source
International Journal of Current Pharmaceutical Review and Research. 17(5)
(pp 1192-1195), 2025. Date of Publication: 2025.
Author
Dubey N.; Chandra K.N.; Dutta P.K.
Institution
(Dubey) Department of Anaesthesia, MGM Medical College & Hospital,
Jharkhand, Jamshedpur, India
(Chandra) Department of Anaesthesia, MGM Medical College & Hospital,
Jharkhand, Jamshedpur, India
(Dutta) Department of Anaesthesia, MGM Medical College & Hospital,
Jharkhand, Jamshedpur, India
Publisher
Dr. Yashwant Research Labs Pvt. Ltd.
Abstract
Background: Elderly surgical patients often develop postoperative
cognitive dysfunction (POCD), which is adjustable by anaesthetic depth.
Anaesthesia depth monitoring may reduce neurocognitive impairment.
 Objective(s): To evaluate the impact of intraoperative DOA monitoring
using the bispectral index (BIS) on the incidence of POCD in elderly
patients undergoing non-cardiac surgery. Material(s) and Method(s): A
prospective, randomised study at MGM Medical College examined 100 patients
aged >=50 years receiving elective surgery under general anaesthesia.
Group A was BIS-monitored while Group B was conventional anaesthesia
without BIS. Preoperative and postoperative MMSE and Trail Making Tests
investigated cognitive function on days 3 and 7. Result(s): Group A
showed significantly lower POCD incidence on day 3 (20%) and day 7 (12%)
compared to Group B (42% and 32%, respectively). BIS-monitored patients
had better MMSE scores and lower anaesthetic consumption.
 Conclusion(s): BIS-guided anaesthesia significantly reduces the
incidence of POCD and improves cognitive recovery in elderly
patients. Copyright © 2025 Dr. Yashwant Research Labs Pvt. Ltd..
All rights reserved.

<164>
[Use Link to view the full text]
Accession Number
2039305873
Title
Protective effect of sevoflurane on myocardial ischemia-reperfusion
injury: a systematic review and meta-analysis.
Source
International Journal of Surgery. 110(11) (pp 7311-7330), 2024. Date of
Publication: 01 Nov 2024.
Author
Nasiri-Valikboni A.; Rashid M.; Azimi A.; Zarei H.; Yousefifard M.
Institution
(Nasiri-Valikboni, Azimi, Zarei, Yousefifard) Physiology Research Center,
Iran University of Medical Sciences, Tehran, Iran, Islamic Republic of
(Rashid) Student Research Committee, Babol University of Medical Sciences,
Babol, Iran, Islamic Republic of
Publisher
Wolters Kluwer Health Inc
Abstract
Background: Myocardial ischemia-reperfusion (I/R) injury significantly
impacts recovery in both cardiac and noncardiac surgeries, potentially
leading to severe cardiac dysfunction. Sevoflurane, a volatile anesthetic,
is reputed for its protective effects against myocardial I/R injury,
although evidence remains inconclusive. This systematic review and
meta-analysis aim to clarify the cardioprotective efficacy of sevoflurane.
 Method(s): The systematic search of databases including Medline,
Embase, Scopus, and Web of Science, was supplemented with a manual search
to retrieve studies using rat or mouse models of myocardial I/R injury,
comparing sevoflurane pretreatment (>= 24 h before I/R), preconditioning
(within 24 h before I/R), or postconditioning (after I/R) against
nontreated controls. The outcomes were cardiac function, myocardial
infarct size, apoptosis, inflammation, oxidative stress, and cardiac
biomarkers. Using the random effects model, standardized mean differences
(SMD) were pooled to perform meta-analyses. Result(s): Fifty-one
studies, encompassing 8189 subjects, were included in the meta-analysis.
Pretreatment with Sevoflurane significantly reduced infarct size.
Sevoflurane preconditioning exhibited positive effects on left ventricular
parameters and ejection fraction, and reduced infarct size, apoptosis, and
oxidative stress. Postconditioning with Sevoflurane demonstrated
improvements in cardiac function, including enhanced left ventricular
parameters and reduced infarct size, apoptosis, inflammation, oxidative
stress, and cardiac biomarkers. Conclusion(s): Sevoflurane
demonstrates a significant protective effect against myocardial I/R injury
in animal models. These findings support the potential clinical utility of
sevoflurane as an anesthetic choice in preventing and managing myocardial
I/R injury during surgeries. Copyright © 2024 The Author(s).
Published by Wolters Kluwer Health, Inc.

<165>
Accession Number
2039344963
Title
Electrical impedance tomography-based evaluation of regional lung
ventilation according to ventilation strategy during cardiopulmonary
bypass in minimally invasive cardiac surgery: a prospective randomized
controlled trial.
Source
Journal of Thoracic Disease. 17(6) (pp 3912-3923), 2025. Date of
Publication: 30 Jun 2025.
Author
Yeo H.J.; Kim H.Y.; Je H.G.; Kim H.-J.; Park S.; Yoon J.-P.; Ju M.H.; Lim
M.H.; Lee C.-H.
Institution
(Yeo) Department of Internal Medicine, Pusan National University School of
Medicine, Yangsan, South Korea
(Yeo) Research Institute for Convergence of Biomedical Science and
Technology, Pusan National University Yangsan Hospital, Yangsan, South
Korea
(Kim, Kim, Park, Yoon) Department of Anesthesia and Pain Medicine, Pusan
National University Yangsan Hospital, Yangsan, South Korea
(Kim, Kim, Park, Yoon) Department of Anesthesia and Pain Medicine, School
of Medicine, Pusan National University, Yangsan, South Korea
(Je) Department of Cardiovascular and Thoracic Surgery, Seoul National
University College of Medicine, Seoul National University Bundang
Hospital, Seongnam-si, South Korea
(Ju, Lim, Lee) Department of Cardiovascular and Thoracic Surgery, Research
Institute for Convergence of Biomedical Science and Technology, Pusan
National University Yangsan Hospital, Pusan National University College of
Medicine, Pusan, South Korea
Publisher
AME Publishing Company
Abstract
Background: Despite the potential benefits of minimally invasive cardiac
surgery (MICS), cardiopulmonary bypass (CPB) during MICS can cause
pulmonary complications. However, the optimal ventilation strategy for the
left lung under CPB during MICS remains unclear. Thus, this study aimed to
evaluate differences in postoperative pulmonary ventilation and
complications according to ventilation strategy during MICS.
 Method(s): This prospective, randomized controlled trial included 60
patients who underwent MICS with one-lung ventilation. They were randomly
assigned to either the non-ventilation (NV) group, in which ventilation
was halted during CPB, or the ventilation (V) group, in which ventilation
at a tidal volume of 5 mL/kg was maintained during CPB. Electrical
impedance tomography (EIT) monitoring was performed immediately after
surgery to evaluate differences in regional ventilation and ventilation
heterogeneity. Result(s): The V group exhibited better ventilation
homogeneity across the entire lung (0.5+/-0.1 vs. 0.6+/-0.2, P=0.02) and
increased ventilation in the left posterior region (1.3+/-0.4 vs.
1.0+/-0.3, P=0.003). However, no differences were found in the clinical
outcomes, including arterial blood gas analysis and postoperative
respiratory complications. Conclusion(s): Ventilation of the left
lung during CPB in MICS showed better ventilation homogeneity and
ventilation of the left posterior lung area, but did not result in
differences in early complications, including respiratory issues.
Therefore, the necessity of left lung ventilation during CPB in short
surgeries with a CPB time of <90 min is unclear. Copyright © AME
Publishing Company.

<166>
Accession Number
2039334289
Title
Analgesic efficacy of pregabalin in dogs undergoing mastectomy with
ovariohysterectomy.
Source
Topics in Companion Animal Medicine. 67 (no pagination), 2025. Article
Number: 100993. Date of Publication: 01 Jul 2025.
Author
Cerazo L.M.L.; Peruchi L.G.; Bruno T.S.; Segatto C.Z.; Nicacio G.M.; Cassu
R.N.
Institution
(Cerazo, Peruchi, Bruno, Segatto, Nicacio) Department of Veterinary
Surgery and Anesthesiology, Faculty of Veterinary Medicine, University of
Western Sao Paulo (UNOESTE), Presidente Prudente, Sao Paulo, Brazil
(Cassu) Department of Veterinary Surgery and Animal Reproduction, School
of Veterinary Medicine and Animals Science, Sao Paulo State University
(UNESP), SP, Botucatu, Brazil
Publisher
W.B. Saunders
Abstract
The aim of this study was to evaluate the analgesic efficacy of pregabalin
in dogs diagnosed with mammary carcinoma undergoing mastectomy with
ovariohysterectomy. In a randomized, blinded, clinical, placebo-controlled
study, 24 dogs were assigned to receive either an oral pregabalin
suspension (4 mg/kg/0.1 mL/kg, Pregabalin group, n = 12) or a placebo
solution (0.1 mL/kg, Placebo group, n = 12), administered 60 minutes
before and every 8 hours after surgery. The dogs were premedicated with
intramuscular (IM) morphine (0.3 mg/kg). Anesthesia was induced with
intravenous (IV) propofol at a sufficient dose to allow intubation and was
maintained with isoflurane. Intraoperatively, a constant rate infusion of
morphine (0.1 mg/kg/h) was maintained until the end of surgery. Meloxicam
(0.2 mg/kg, IV) was administered immediately after intubation.
Intraoperatively, fentanyl (2.5 microg/kg, IV) was administered to control
cardiovascular responses to surgical stimulation. Pain was assessed using
the short-form Glasgow Composite Pain Scale 24 hours prior to surgery
(baseline) and at 0.5, 1, 2, 4, 6, 8, 12, and 24 hours after extubation.
Sedation scores were evaluated at the same time points using a descriptive
numerical scale. Morphine (0.5 mg/kg, IM) was administered as rescue
analgesia. Data were analyzed using t-tests, Fisher's exact test,
Kaplan-Meier curve, Mann-Whitney test, and Friedman test. Differences were
considered significant when P < 0.05. Pain scores, sedation scores, and
analgesic requirements did not differ significantly between groups.
Intraoperative fentanyl and postoperative rescue analgesia were required
in 100% and 75% of the dogs, respectively, in both treatment groups. In
conclusion, as part of a multimodal analgesic protocol, oral pregabalin at
4 mg/kg every 8 hours did not provide additional postoperative analgesic
benefits over placebo in dogs undergoing mastectomy with
ovariohysterectomy. Copyright © 2025 Elsevier Inc.

<167>
Accession Number
2039374769
Title
Serratus posterior superior intercostal plane block versus thoracic
paravertebral block for pain management after video-assisted thoracoscopic
surgery: a randomized prospective study.
Source
Brazilian Journal of Anesthesiology (English Edition). 75(5) (no
pagination), 2025. Article Number: 844647. Date of Publication: 01 Sep
2025.
Author
Dogan G.; Kucuk O.; Kayir S.; Dal G.C.; Ciftci B.; Zengin M.; Alagoz A.
Institution
(Dogan, Kayir) Hitit University Faculty of Medicine, Department of
Anesthesiology and Reanimation, Corum, Turkey
(Kucuk, Alagoz) University of Health Sciences, Ankara Ataturk Chest
Diseases and Thoracic Surgery Training and Research Hospital, Department
of Anesthesiology and Reanimation, Ankara, Turkey
(Dal) Siirt Training and Research Hospital, Department of Anesthesiology
and Reanimation, Siirt, Turkey
(Ciftci) Istanbul Medipol University, Department of Anesthesiology and
Reanimation, Istanbul, Turkey
(Zengin) Ankara Etlik City Hospital, Department of Anesthesiology and
Reanimation, Ankara, Turkey
Publisher
Elsevier Editora Ltda
Abstract
Background: Video-Assisted Thoracoscopic Surgery (VATS) is a minimally
invasive procedure associated with faster recovery and fewer complications
compared to open thoracotomy. Effective postoperative pain management is
important for optimizing recovery. This study compares the analgesic
efficacy of the Serratus Posterior Superior Intercostal Plane Block
(SPSIPB) and Thoracic Paravertebral Block (TPVB) for postoperative pain
following VATS. Method(s): In this randomized, prospective,
double-blind study, 70 patients aged 18-65 years (ASA I-III) undergoing
VATS were randomly assigned to Group TPVB (n = 35) or Group SPSIPB (n =
35). The primary outcome was the 24-hour postoperative Visual Analog Scale
(VAS) pain score at rest. Secondary outcomes included VAS pain scores
during coughing, time to first opioid request, total opioid consumption
within 24 hours, patient satisfaction, and Quality of Recovery-15 (QoR-15)
scores. Opioid consumption was assessed using intravenous tramadol through
Patient-Controlled Analgesia (PCA), with additional morphine, if required.
 Result(s): The mean age of the patients was 52 +/- 11 years, and
64.2% were male. VAS pain scores were evaluated at 24 hours and at seven
time points. There was no significant difference between groups (p > 0.05)
except at 1 hour postoperatively, where the TPVB group had a significantly
lower resting VAS score (19 [8-28] vs. 26 [18.5-33], p = 0.031). The total
24 hour tramadol consumption was 220 mg (135-260) in the TPVB group versus
150 mg (110-230) in the SPSIPB group (p = 0.129). The proportion of
patients requiring additional analgesia was 25.7% in the TPVB group versus
28.5% in the SPSIPB group (p = 0.788). Preoperative and postoperative
QoR-15 scores were similar between the groups (preoperative: 137 vs. 136,
p = 0.878; postoperative: 133 vs. 132, p = 0.814). Patient satisfaction
scores were also comparable (8 [7-10] vs. 9 [7-10], p = 0.789).
 Conclusion(s): SPSIPB provides analgesic efficacy similar to TPVB for
VATS, with comparable pain scores, opioid consumption, and recovery
outcomes. Given its ease of use and safety profile, SPSIPB represents a
promising alternative to TPVB in multimodal analgesia for minimally
invasive thoracic surgery. Copyright © 2025

<168>
Accession Number
2039318632
Title
Surgical revascularization of chronic coronary total occlusions - A
systematic review and meta-analysis.
Source
Revista Portuguesa de Cardiologia. (no pagination), 2025. Date of
Publication: 2025.
Author
Silva A.L.; Costa G.F.; Martins J.L.; Leite L.; Goncalves L.
Institution
(Silva, Costa, Martins, Leite, Goncalves) Cardiology Department, Unidade
Local de Saude de Coimbra, Coimbra, Portugal
(Costa, Leite, Goncalves) Faculty of Medicine of the University of
Coimbra, Coimbra, Portugal
(Costa, Leite, Goncalves) ICBR, Coimbra Institute for Clinical and
Biomedical Research, Coimbra, Portugal
Publisher
Sociedade Portuguesa de Cardiologia
Abstract
Introduction and objectives: Chronic coronary total occlusion (CTO)
optimal therapeutic management remains a topic of debate despite its
association with adverse clinical outcomes. This study aimed to compare
clinical outcomes of patients with CTOs treated with coronary artery
bypass graft (CABG) versus medical therapy (MT), assessing the effect of
CTO revascularization in patients with multivessel disease undergoing
CABG. Method(s): In July 2023, PubMed, Embase, Cochrane, and Web of
Science databases were systematically searched for studies comparing CTOs
treated with CABG versus MT. A sub-analysis of CABG patients, comparing
complete surgical revascularization, including CTO bypass, to CABG without
CTO bypass, was performed. A pooled odds ratio meta-analysis assessed four
main outcomes: mortality, myocardial infarction (MI), stroke, and major
adverse cardiovascular events (MACE). The primary outcome was all-cause
mortality. Result(s): Ten observational studies (6458 patients)
comparing CABG-CTO with MT-CTO showed lower all-cause mortality in the
CABG group (OR 0.31, 95% CI 0.24-0.40, p<0.001, I2=36%).
Despite heterogeneity, CABG exhibited reduced CV mortality and MACE (OR
0.37, 95% CI 0.24-0.57, p<0.001, I2=59%; OR 0.37, 95% CI
0.15-0.92, p=0.03, I2=80%, respectively). The MI rate was lower
in the CABG group (OR 0.41, 95% CI 0.30-0.56, p<0.001, I2=0%).
Comparing bypassed to non-bypassed CTO groups (5 studies, 1949 patients),
the bypassed-CTO group had considerably lower MACE (OR 0.49, 95% CI
0.30-0.81, p=0.005, I2=44%). Conclusion(s): This study
suggests a clinical benefit of bypassing a CTO in multivessel disease
patients during CABG, with significantly lower MACE. The improved outcomes
of CABG over MT further underscore these findings, warranting careful
consideration by the Heart Team during their decision-making
process. Copyright © 2025 Sociedade Portuguesa de Cardiologia

<169>
Accession Number
2039334175
Title
Impact of Cardiopulmonary Bypass Duration on the Renal Effects of Amino
Acids Infusion in Cardiac Surgery Patients.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2025.
Date of Publication: 2025.
Author
Pontillo D.; Rong L.Q.; Pruna A.; Pisano A.; Monaco F.; Bruni A.; Baiardo
Redaelli M.; Ti L.K.; Belletti A.; Bradic N.; Massaro C.; Barucco G.;
Viscido C.; Losiggio R.; Federici F.; Marmiere M.; Silvetti S.; Marchetti
C.; Carmosino M.; Manazza M.; Oliva F.M.; Cortegiani A.; Guarracino F.;
Ranucci M.; Paternoster G.; Landoni G.; Zangrillo A.; Gaudino M.F.L.;
Bellomo R.; Bonaccorso A.; D'Amico F.; D'Andria Ursoleo J.; Lombardi G.;
Marzaroli M.; Mongardini E.; Vietri S.; Ferrod F.; Porta S.; Prezzi L.;
Vignale R.; Gallicchio F.; Neri G.; Mellace F.; Venditto M.; Baryshnikova
E.; Re M.R.; Rocco M.; Baldassarri R.; Salsano A.; Angeletti P.M.
Institution
(Pontillo, Pruna, Monaco, Belletti, Barucco, Losiggio, Marmiere,
Marchetti, Manazza, Oliva, Landoni, Zangrillo) Department of Anesthesia
and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy
(Rong) Department of Anesthesiology, Weill Cornell Medicine, New York, NY,
United States
(Pisano) Cardiac Anesthesia and ICU, AORN "Dei Colli", Monaldi Hospital,
Naples, Italy
(Bruni) Anesthesia and Intensive Care Unit, Department of Medical and
Surgical Sciences, "Magna Graecia" University of Catanzaro, Catanzaro,
Italy
(Baiardo Redaelli) Anesthesia and Intensive Care, Department of
Biotechnologies and Life Sciences, University of Insubria, Varese, Italy
(Baiardo Redaelli) Intensive Care Unit, Circolo Hospital, Varese, Italy
(Ti) Department of Anaesthesia, National University Hospital, Singapore
(Bradic) Clinic of Anesthesiology, Resuscitation and Intensive Medicine,
University Hospital Dubrava, Zagreb, Croatia
(Bradic) Department of Nursing, University North, Varazdin, Croatia
(Massaro, Viscido) Department of Cardiovascular Anesthesia and Intensive
Care, A.O. Ordine Maurizio Umberto I di Torino, Turin, Italy
(Federici) Department of Anesthesia and Intensive Care, Azienda
Ospedaliero-Universitaria Sant' Andrea, Rome, Italy
(Silvetti) Department of Cardiac Anesthesia and Intensive Care, Ospedale
Policlinico San Martino IRCCS, IRCCS Cardiovascular Network, Genova, Italy
(Carmosino, Paternoster) Department of Health Science School of Medicine,
University of Basilicata, Potenza, Italy
(Cortegiani) Department of Precision Medicine in Medical, Surgical and
Critical Care Area, University of Palermo, Palermo, Italy
(Cortegiani) Department of Anesthesia Analgesia Intensive Care and
Emergency, University Hospital Policlinico "Paolo Giaccone", Palermo,
Italy
(Guarracino) Department of Cardiothoracic Anaesthesia and Intensive Care,
Azienda Ospedaliero Universitaria Pisana, Pisa, Italy
(Ranucci) Department of Cardiovascular Anesthesia and Intensive Care,
IRCCS Policlinico San Donato, Milan, Italy
(Paternoster) Anesthesia and ICU, San Carlo Hospital, Potenza, Italy
(Landoni, Zangrillo) School of Medicine, Vita-Salute San Raffaele
University, Milan, Italy
(Bellomo) Department of Critical Care, The University of Melbourne,
Melbourne, Australia
(Bellomo) Australian and New Zealand Intensive Care Research Centre,
Monash University, Melbourne, Australia
(Bellomo) Data Analytics Research and Evaluation Centre, Austin Hospital,
Melbourne, Australia
(Bellomo) Department of Intensive Care, Austin Hospital, Melbourne,
Australia
(Bellomo) Department of Intensive Care, Royal Melbourne Hospital,
Melbourne, Australia
(Gaudino) Department of Cardiothoracic Surgery, Weill Cornell Medicine,
New York, NY, United States
(Bonaccorso, D'Amico, D'Andria Ursoleo, Lombardi, Marzaroli, Mongardini,
Vietri) Departmentof Anesthesia and Intensive Care, IRCCS San Raffaele
Scientific Institute, Milan, Italy
(Venditto) CardiacAnesthesia and ICU, AORN "Dei Colli", Monaldi Hospital,
Naples, Italy
(Neri, Mellace) Anesthesiaand Intensive Care Unit, Department of Medical
and Surgical Sciences, "Magna Graecia" University of Catanzaro, Catanzaro,
Italy
(Ferrod, Porta, Prezzi) S.C.Anestesia, e Rianimazione Cardiovascolare,
A.O. Ordine Maurizio Umberto I di Torino, Turin, Italy
(Rocco) UOCAnestesia e Rianimazione, Azienda Ospedaliero-Universitaria
Sant'Andrea, Azienda Ospedaliero-Universitaria Sant'Andrea, Rome, Italy
(Re) Departmentof Anesthesia Analgesia Intensive Care and Emergency,
University Hospital Policlinico "Paolo Giaccone", Palermo, Italy
(Vignale, Gallicchio) Departmentof Cardiovascular Anesthesia and ICU, San
Carlo Hospital, Potenza, Italy
(Baryshnikova) Departmentof Cardiovascular Anesthesia and Intensive Care,
IRCCS Policlinico San Donato, Milan, Italy
(Baldassarri) Departmentof Cardiothoracic Anaesthesia and Intensive Care,
Azienda Ospedaliero Universitaria Pisana, Pisa, Italy
(Salsano) Divisionof Cardiac Surgery, Ospedale Policlinico San Martino,
Genoa, Italy
(Salsano) Departmentof Integrated Surgical and Diagnostic Sciences,
University of Genoa, Genoa, Italy
(Angeletti) CardiovascularDepartment, UO of Cardiac Anesthesia, IRCCS
Humanitas Research Hospital, Rozzano, Italy
Publisher
W.B. Saunders
Abstract
Objective: To test whether the duration of cardiopulmonary bypass (CPB)
affects the nephroprotective effect of amino acids (AA) infusion in
decreasing the occurrence of acute kidney injury (AKI) among cardiac
surgery patients. Design(s): A post hoc study of the PROTECTION
multicenter randomized double-blind placebo-controlled trial aiming to
assess the effect of CPB duration on the differential impact of AA
infusion on both the absolute and relative risk reduction in AKI incidence
by comparing medians of CPB duration and CPB duration as a continuous
variable. Setting(s): International, multicenter.
 Participant(s): The entire population of the PROTECTION trial,
comprising 3511 adult patients undergoing cardiac surgery with CPB.
 Intervention(s): Intravenous AA infusion at a dosage of 2 g/kg/day,
up to a maximum of 100 g/day. Measurements and Main Results: Compared
with patients with CPB duration above the median (prolonged [P]-CPB
group), patients with CPB duration below the median (brief [B]-CPB group)
had a significantly lower incidence of AKI (23% [n/N =391/1716] vs 36%
[n/N = 617/1723]; relative risk [RR], 0.64; 95% confidence interval [CI],
0.57-0.71; p <0.001). However, in the P-CPB group, AA infusion achieved an
8% absolute risk reduction (32% vs 40%) and a 0.79 RR reduction (95% CI,
0.70-0.90; p < 0.001; number needed to treat, 14). Moreover, AA also
decreased the occurrence of AKI stage 3 (2.2% [n = 19] vs 5.0% [n = 43];
RR, 0.45; 95% CI, 0.26-0.76; p < 0.001) with a >95% probability of this
effect being significantly greater in the P-CPB group compared to the
B-CPB group. Conclusion(s): Cardiac surgery patients with prolonged
CPB exposure had a significantly higher incidence of AKI. Notably, the
P-CPB group received a greater benefit from AA therapy with an absolute
risk and relative risk reduction of both any and severe AKI compared with
the B-CPB group. Patients with prolonged CPB may be the specific targets
of future studies. Copyright © 2025 Elsevier Inc.

<170>
Accession Number
2039345221
Title
The Safety and Feasibility of Same-Day Discharge for Patients Undergoing
Transcatheter Aortic Valve Replacement: A Systematic Review and
Meta-analysis.
Source
Canadian Journal of Cardiology. (no pagination), 2025. Date of
Publication: 2025.
Author
Litkouhi P.N.; Rao K.; Baer A.; Hansen P.S.; Bhindi R.
Institution
(Litkouhi, Rao, Baer, Hansen, Bhindi) Department of Cardiology, Royal
North Shore Hospital, St Leonards, Australia
(Litkouhi, Rao, Hansen, Bhindi) School of Medicine, University of Sydney,
Camperdown, Australia
Publisher
Elsevier Inc.
Abstract
Background: Next-day discharge (NDD) after transcatheter aortic valve
replacement (TAVR) has been shown to be safe in appropriately selected
patients and has been implemented into clinical practice. As the demand
for TAVR grows, improving its accessibility is crucial. Several studies
have trialled same-day discharge (SDD) after TAVR, but a review has not
been performed. Method(s): Five databases were searched. Baseline
demographics, study characteristics and the assessment criteria used to
determine eligibility for SDD were extracted and compared. Proportional
meta-analysis was used to compare post-TAVI outcomes between SDD and NDD
patients. Result(s): Six studies were included from 1734 screened
articles. Of 3519 patients, 318 (9.0%) underwent SDD (mean age 78.2 +/-
8.7 years, 59.3% male). Balloon-expandable valves were used in 91.6% of
cases, and self-expanding valves in the remaining 8.4%. Patients that
underwent SDD experienced lower rates of mortality (OR 0.104, 95% CI
0.015-0.998), all-cause readmission (OR 0.194, 95% CI 0.052-0.717),
cardiovascular readmissions (OR 0.155, 95% CI 0.026-0.971), and new
pacemaker requirement (OR 0.167, 95% CI 0.028-0.995) at 30 days after TAVR
compared with patients that underwent NDD. There was no difference in
rates of stroke (OR 0.407, 95% CI 0.015-16.694) or major vascular
complications (0.0% vs 0.0%). Conclusion(s): Current evidence
supports the safety and feasibility of SDD after elective transfemoral
TAVR in appropriately selected patients. Heterogeneity between eligibility
criteria used to select patients for SDD, especially related to conduction
disease, poses a barrier to implementation. Further research on
self-expanding valves is needed. Copyright © 2025 Canadian
Cardiovascular Society

<171>
Accession Number
2039162491
Title
Postoperative 20% Albumin Infusion and Acute Kidney Injury in High-Risk
Cardiac Surgery Patients The ALBICS AKI Randomized Clinical Trial.
Source
JAMA Surgery. (no pagination), 2025. Date of Publication: 2025.
Author
Shehabi Y.; Balachandran M.; Al-Bassam W.; Bailey M.; Bellomo R.; Bihari
S.; Brown A.; Collins D.; Darlison P.R.; Li M.A.; Mandarano R.; Sarode V.;
Pakavakis A.; Glassford N.; Grant P.; Harington C.; Raymond L.; Dougherty
L.; Maeda A.; Chaba A.; Phongphithakchai A.; Eastwood G.; Spano S.; Young
H.; Peck L.; Bleetman D.; Holmes J.; King M.; Ordering A.; Luk V.;
McIntyre J.; Bottar V.; Olivo G.; Galeotti I.; Albano F.; Paul E.
Institution
(Shehabi, Al-Bassam, Brown, Li, Pakavakis) Monash Health School of
Clinical Sciences, Clayton, VIC, Australia
(Shehabi, Balachandran, Al-Bassam, Brown, Li, Pakavakis) The Victorian
Heart Hospital, Clayton, VIC, Australia
(Shehabi) Clinical School of Medicine, University of New South Wales,
Prince of Wales Hospital Randwick, NSW, Australia
(Balachandran, Al-Bassam, Pakavakis) Department of Intensive Care, Monash
Health, Clayton, VIC, Australia
(Bailey, Brown) Australian and New Zealand Intensive Care Research Centre,
School of Public Health and Preventive Medicine, Monash University,
Melbourne, VIC, Australia
(Bellomo) Department of Critical Care, The University of Melbourne, New
Zealand Intensive Care Research Centre, Monash University, Melbourne, VIC,
Australia
(Bellomo) Department of Intensive Care, Austin Hospital, Melbourne, VIC,
Australia
(Bihari) Department of ICU, Flinders Medical Centre, Bedford Park, SA,
Australia
(Bihari) College of Medicine and Public Health, Flinders University,
Bedford Park, SA, Australia
(Brown, Darlison) Department of Critical Care, University of Melbourne,
Melbourne, VIC, Australia
(Collins, Grant, Harington, Raymond) Prince of Wales and Prince of Wales
Private Hospital, Randwick, NSW, Australia
(Mandarano) Department of Anesthesia and Critical Care, Azienda
Ospedaliero-Universitaria Careggi, Florence, Italy
(Sarode) Department of Intensive Care, Cabrini Health, Malvern, VIC,
Australia
(Sarode) School of Translational Medicine, Monash University, Melbourne,
VIC, Australia
(Glassford) Monash Medical Centre, Victorian Heart Hospital, Clayton, VIC,
Australia
(Dougherty) Cabrini Health, Victoria, Malvern, VIC, Australia
(Maeda, Chaba, Phongphithakchai, Eastwood, Spano, Young, Peck) Austin
Health, Melbourne, VIC, Australia
(Bleetman, Holmes, King, Ordering, Luk) St Vincent's Hospital, Fitzroy,
VIC, Australia
(McIntyre) Flinders Medical Centre, Bedford Park, SA, Australia
(Bottar, Olivo, Galeotti, Albano) Careggi University Hospital, Florence,
Italy
(Paul) Monash University, Melbourne, VIC, Australia
Publisher
American Medical Association
Abstract
Importance: Acute kidney injury (AKI) after cardiac surgery is a common
and serious complication. Protein loading appears nephroprotective; thus,
continuous hyperoncotic albumin infusion may impact AKI following
high-risk cardiac surgery. Objective(s): To evaluate the effect of
postoperative 20% albumin infusion compared with usual care on the
occurrence of AKI in high-risk cardiac surgery patients. Design,
Setting, and Participant(s): This was an investigator-initiated randomized
multicenter open-label pragmatic clinical trial. Participants were
stratified by site and estimated glomerular filtration rate (eGFR) above
and below 60 mL/min/1.73 m2. The study was conducted at 7
cardiac centers in Australia and Italy between July 2019 and August 2024.
Patients undergoing on-pump cardiac surgery with a preoperative eGFR of
greater than 15 mL/min/1.73 m2 and less than 60 mL/min/1.73
m2 or undergoing a combined cardiac surgical procedure or major
aortic surgery were included, excluding those who were in intensive care
for longer than 6 hours following the index surgery, had a serum albumin
level less than 20 g/L, were dialysis dependent, had a previous kidney
transplant, were receiving extracorporeal life support or ventricular
assist device, or had an objection to receiving albumin or blood products.
 Intervention(s): Participants were randomized 1:1 within 6 hours
after surgery to receive a 300-mL infusion of 20% albumin over 15 hours or
usual care, as per clinician discretion. All patients received volume
resuscitation and hemodynamic treatment according to participating
centers' protocols. Main Outcomes and Measures: The primary outcome
was stage 1-3 AKI according to the creatinine-based Kidney Disease
Improving Global Outcomes definition. The main secondary outcomes included
major adverse kidney events and mortality at hospital discharge or day 28
following randomization. Result(s): The primary analysis included 307
patients randomized to the 20% albumin group and 304 to usual care. The
mean (SD) age was 69 (10.8) years, and 281 patients (45.8%) had an eGFR
less than 60 mL/min/1.73 m2. The median (IQR) European System
for Cardiac Operative Risk Evaluation score-II was 3.23 (1.91-5.30). AKI
occurred in 150 of 307 patients in the albumin group (48.9%) vs 132 of 304
in usual care (43.4%) (unadjusted relative risk, 1.13; 95% CI, 0.95-1.34;
P =.18; strata-adjusted relative risk, 1.12; 95% CI, 1.04-1.21; P =.003).
This effect was more pronounced in patients with an eGFR of <60
mL/min/1.73 m2 (adjusted relative risk, 1.14; 95% CI;
1.07-1.22; P <.001). There were more blood transfusions given in the
albumin group (116 [37.8%] vs 91 [29.9%]; P =.04) but no other significant
differences in secondary outcomes. Conclusions and Relevance: In this
study of cardiac surgery patients at high risk of AKI, an infusion of 20%
albumin increased the risk of AKI. These findings do not support the
routine use of hyperoncotic albumin infusion in patients undergoing
high-risk cardiac surgery. Copyright © 2025 American Medical
Association. All rights reserved.

<172>
Accession Number
2035042222
Title
Left Ventricular Assist Device Implantation Under Argatroban
Anticoagulation in Heparin-Induced Thrombocytopenia: A Literature Review
and Clinical Case Presentation.
Source
Journal of Clinical Medicine. 14(12) (no pagination), 2025. Article
Number: 4083. Date of Publication: 01 Jun 2025.
Author
Ksela J.; Kafol J.; Kerin M.; Pirc D.; Novak R.; Goslar T.
Institution
(Ksela, Novak) Department of Cardiovascular Surgery, University Medical
Centre Ljubljana, Ljubljana, Slovenia
(Ksela, Kafol, Kerin, Goslar) Faculty of Medicine, University of
Ljubljana, Ljubljana, Slovenia
(Kafol) Department of Vascular Diseases, University Medical Centre
Ljubljana, Ljubljana, Slovenia
(Pirc) Department of Anesthesiology and Surgical Intensive Care,
University Medical Centre Ljubljana, Ljubljana, Slovenia
(Goslar) Department of Intensive Internal Medicine, University Medical
Centre Ljubljana, Ljubljana, Slovenia
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
This review provides an in-depth analysis of argatroban as an alternative
anticoagulant in cardiac surgery, with a focus on its use in patients with
heparin-induced thrombocytopenia (HIT). We examine argatroban's
pharmacokinetics and dosing regimens and the challenges associated with
cosnventional monitoring methods-such as activated clotting time (ACT) and
activated partial thromboplastin time (aPTT)-to evaluate its safety and
effectiveness in high-risk surgical settings. Drawing on data from
multiple case reports and series, our review highlights both the potential
benefits and limitations of argatroban, including complications such as
clot formation in extracorporeal circulation systems and prolonged
postoperative coagulopathy. In addition to the literature review, we
present a detailed clinical case of urgent HeartMate 3 left ventricular
assist device implantation in a patient with advanced heart failure and
active HIT. In this case, despite targeting an ACT above 400 s,
intraoperative complications such as clot formation in the heart-lung
machine and difficulty achieving hemostasis highlight the need for
improved monitoring and dosing protocols. Our findings call for refined
anticoagulation strategies and advanced monitoring techniques to optimize
argatroban use in cardiac surgery, offering valuable insights for
clinicians managing complex scenarios where conventional heparin therapy
is contraindicated. Copyright © 2025 by the authors.

<173>
Accession Number
2035039530
Title
Embolic Protection Devices in Transcatheter Aortic Valve Implantation: A
Narrative Review of Current Evidence.
Source
Journal of Clinical Medicine. 14(12) (no pagination), 2025. Article
Number: 4098. Date of Publication: 01 Jun 2025.
Author
Latsios G.; Ktenopoulos N.; Apostolos A.; Koliastasis L.; Kachrimanidis
I.; Vlachakis P.K.; Katsaros O.; Mantzouranis E.; Tsalamandris S.;
Drakopoulou M.; Synetos A.; Aggeli C.; Tsioufis K.; Toutouzas K.
Institution
(Latsios, Ktenopoulos, Apostolos, Koliastasis, Kachrimanidis, Vlachakis,
Katsaros, Mantzouranis, Tsalamandris, Drakopoulou, Synetos, Aggeli,
Tsioufis, Toutouzas) First Department of Cardiology, National and
Kapodistrian University of Athens, Hippokration General Hospital of
Athens, Athens, Greece
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Transcatheter aortic valve implantation (TAVI) has emerged as a
transformative therapy for patients with severe aortic stenosis (AS)
across all surgical risk groups. However, periprocedural cerebrovascular
events (CVEs), including overt stroke and silent cerebral embolism, remain
significant complications. As a result, the use of embolic protection
devices (EPDs) during TAVI has been proposed to mitigate this risk. Our
aim was to provide a comprehensive review of the current evidence on the
efficacy, safety, and clinical utility of embolic protection devices in
TAVI procedures. According to the existing literature, EPDs are effective
in capturing embolic debris during TAVI and are associated with a
reduction in silent cerebral lesions as detected by diffusion-weighted
MRI. While some RCTs and meta-analyses demonstrate a potential benefit in
reducing disabling stroke, evidence for a consistent reduction in overall
stroke or mortality remains inconclusive. Subgroup analyses suggest the
greatest benefit in patients at elevated stroke risk, while
current-generation EPDs demonstrate high technical success and an
acceptable safety profile. Subsequently, EPDs represent a promising
adjunct to TAVI, particularly in high-risk populations. However, routine
use in all patients is not yet supported by consistent clinical evidence.
Further large-scale trials and long-term outcome data are needed to
clarify their role in improving neurological outcomes and to guide
selective patient application. Copyright © 2025 by the authors.

<174>
Accession Number
2039269878
Title
Early Invasive or Conservative Strategies for Older Patients With Acute
Coronary Syndromes: A Meta-Analysis.
Source
JAMA Internal Medicine. (no pagination), 2025. Date of Publication: 2025.
Author
Reddy R.K.; Koeckerling D.; Eichhorn C.; Jamil Y.; Ardissino M.; Braun V.;
Abu Sharar H.; Frey N.; Howard J.P.; Ahmad Y.
Institution
(Reddy, Ardissino, Howard) National Heart and Lung Institute, Imperial
College London, London, United Kingdom
(Reddy) Nuffield Department of Population Health, University of Oxford,
Oxford, United Kingdom
(Koeckerling, Abu Sharar, Frey) Department of Cardiology Angiology and
Respiratory Medicine, Heidelberg University Hospital, Heidelberg, Germany
(Eichhorn) Division of Acute Medicine, University Hospital Basel, Basel,
Switzerland
(Jamil) Inova Heart and Vascular Institute, Inova Fairfax Medical Campus,
Falls Church, VA, United States
(Ardissino) British Heart Foundation Cardiovascular Epidemiology Unit,
Department of Public Health and Primary Care, University of Cambridge,
Cambridge, United Kingdom
(Ardissino) Medical Research Council Laboratory of Medical Sciences,
Imperial College London, London, United Kingdom
(Braun) Medical Faculty Mannheim, University of Heidelberg, Heidelberg,
Germany
(Ahmad) Division of Cardiology, University of California, San Francisco,
United States
Publisher
American Medical Association
Abstract
Importance: The optimal management strategy for older patients who present
with acute coronary syndrome (ACS) remains unclear due to a paucity of
randomized evidence. New large and longer-term randomized data are
available. Objective(s): To test the association of an early invasive
strategy vs a conservative strategy with clinical outcomes for patients 70
years or older who present with ACS. Data Sources: A literature
search strategy was designed in collaboration with a medical librarian.
MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials
were systematically searched,with no language restrictions from inception
through October 2024. Bibliographies of previous reviews and conference
abstracts from major cardiovascular scientific meetings were handsearched.
Study Selection: Studies were deemed eligible following review by 2
independent, masked investigators if they randomly allocated patients 70
years or older who presented with ACS to early invasive or conservative
management and reported clinical end points. Observational analyses were
excluded. No trials were excluded based on sample size or follow-up
duration. Data Extraction and Synthesis: Data were extracted independently
and in triplicate. Clinical end points were pooled in meta-analyses that
applied fixed-effects and random-effects modeling to calculate summary
estimates for relative risks (RRs) and hazard ratios, along with their
corresponding 95% CIs. Main Outcomes and Measures: The prespecified
primary end point was all-cause death. Secondary end points included
recurrent myocardial infarction (MI), repeated coronary revascularization,
major bleeding, cardiovascular death, death or MI, stroke, heart failure
hospitalization, major adverse cardiac events, major adverse
cardiovascular or cerebrovascular events, and length of hospital stay.
 Result(s): The sample size-weighted mean age of participants across
included trials was 82.6 years, and 46% were female. In the pooled
analysis, there was no significant difference in all-cause death between
the invasive and conservative strategies (RR, 1.05; 95% CI, 0.98-1.11; P
=.15; I2 = 0%). An early invasive strategy was associated with
a reduced risk of recurrent MI of 22% (RR, 0.78; 95% CI, 0.67-0.91; P
=.001; I2 = 0%) and repeated coronary revascularization during
follow-up of 57% (RR, 0.43; 95% CI, 0.30-0.60; P <.001; I2 =
33.3%). However, an invasive strategy was associated with an increased
risk of major bleeding (RR, 1.60; 95% CI, 1.01-2.53; P =.05; I2
= 16.7). No differences were observed in secondary end points. Results in
the non-ST-elevation ACS population were consistent with the overall
findings. Conclusions and Relevance: The results of this systematic
review and meta-analysis suggest that, in older patients with ACS, an
early invasive strategy was not associated with reduced all-cause death
compared with conservative management. An early invasive strategy was
associated with reduced recurrent MI and repeated coronary
revascularization during follow-up but increased risk of major bleeding.
Competing risks associated with an early invasive strategy should be
weighed in shared therapeutic decision-making for older patients with
ACS. Copyright © 2025 American Medical Association. All rights
reserved.

<175>
Accession Number
2035042189
Title
A Systematic Review of Heated Intrathoracic Chemotherapy for Thymic
Epithelial Tumors and the First Case Report of a Robotic Approach: Could a
Minimally Invasive Approach Offer a New Paradigm of Care?.
Source
Journal of Clinical Medicine. 14(12) (no pagination), 2025. Article
Number: 4094. Date of Publication: 01 Jun 2025.
Author
Martins R.S.; Christophel E.; Poulikidis K.; Razi S.S.; Latif M.J.; Luo
J.; Bhora F.Y.
Institution
(Martins, Poulikidis, Razi, Latif, Luo, Bhora) Division of Thoracic
Surgery, Department of Surgery, Hackensack Meridian Health Network,
Edison, NJ, United States
(Christophel) Hackensack Meridian School of Medicine, Hackensack Meridian
Health Network, Nutley, NJ, United States
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Background/Objectives: Thymic epithelial tumors with pleural metastasis
require a multimodal treatment approach with the use of novel modalities
such as hyperthermic intrathoracic chemotherapy (HITHOC). This systematic
review and case report aims to summarize the existing evidence regarding
HITHOC for these tumors and presents the first case of a robotic approach
to HITHOC. Method(s): A search in November 2023 yielded a total of 17
articles, including 281 patients who met the eligibility criteria (i.e.,
underwent HITHOC for treatment of a thymic epithelial tumor).
 Result(s): Variations existed among HITHOC regimens and surgical
approaches. The most common complications observed were air leaks. Overall
survival ranged 92-95% at 1 year, 83-91.7% at 3 years, 66.7-92% at 5
years, 40-83.3% at 10 years, and 27.8-58.2% at 15 years.
 Conclusion(s): While HITHOC for thymic epithelial tumors with pleural
dissemination has been shown to yield successful outcomes in the
literature, this procedure has historically been performed almost
exclusively via an open thoracotomy. The robotic approach to HITHOC is
feasible and affords several important benefits. Copyright © 2025
by the authors.

<176>
Accession Number
2035022521
Title
Commando procedure in cardiac surgery: a narrative review.
Source
General Thoracic and Cardiovascular Surgery. (no pagination), 2025. Date
of Publication: 2025.
Author
Yi H.; Li Y.; Zhao Q.; Wu X.
Institution
(Yi, Li, Zhao, Wu) Lanzhou University Second Hospital, No. 82, Cuiyingmen,
Linxia Road, Chengguan District, Gansu, Lanzhou, China
Publisher
Springer
Abstract
Objective: The Commando procedure is a technically demanding, high-risk
cardiac operation. This review synthesizes advancements in the Commando
procedure, with emphasis on technical modifications, broadening clinical
applications, and associated clinical outcomes. Method(s): The study
employed a systematic literature search in PubMed, utilizing the term
"Commando Procedure," covering all publication dates, yielding 178
identified articles. The inclusion criteria favored peer-reviewed studies
that offered detailed surgical accounts, case series with a minimum of
five patients, outcome evaluations, or technical innovations-e.g., novel
patching or suture techniques. The editorials and studies devoid of
procedural details or quantitative results were excluded. Editorials and
studies devoid of procedural details or quantitative results were
excluded. Result(s): The review details the expanded clinical
applications, technical improvements, and outcome trends of the Commando
procedure. Initially crafted to manage aortic annular dilation, the
technique now covers a broader spectrum of complex multivalvular diseases.
The correlation between recent procedural standardization and broader
clinical adoption is evident in improved survival rates. However,
unresolved challenges remain. However, unresolved challenges remain.
 Conclusion(s): In recent years, we have witnessed a proliferation of
procedural modifications and adaptations of the Commando technique,
tailored to address anatomically distinct pathologies across heterogeneous
clinical scenarios. Copyright © The Author(s), under exclusive
licence to The Japanese Association for Thoracic Surgery 2025.

<177>
[Use Link to view the full text]
Accession Number
2039288191
Title
Erector spinae plane block versus intercostal nerve blocks in uniportal
videoscopic assisted thoracic surgery: a multicenter, double-blind,
prospective randomized placebo controlled trial.
Source
Anesthesiology. (no pagination), 2025. Article Number:
10.1097/ALN.0000000000005625. Date of Publication: 2025.
Author
Coppens S.; Hoogma D.F.; Dewinter G.; Neyrinck A.; Van Loon P.; Stessel
B.; Hassanin J.; Vandenbrande J.; Du Pont B.; Jansen Y.; Fieuws S.; Rex S.
Institution
(Coppens, Hoogma, Dewinter, Neyrinck, Van Loon, Rex) Department of
Anesthesiology, University Hospitals of Leuven, Herestraat 49, Leuven,
Belgium
(Coppens, Hoogma, Dewinter, Neyrinck, Rex) Biomedical Sciences Group,
Department of Cardiovascular Sciences, University of Leuven, KU Leuven,
Leuven, Belgium
(Stessel, Hassanin, Vandenbrande) Department of Anesthesiology and Pain
Medicine, Jessa Hospital, Campus Virga Jesse, Hasselt, Belgium
(Stessel, Vandenbrande) Faculty of Medicine and Life Sciences, UHasselt,
Hasselt, Belgium
(Du Pont) Department of Cardiothoracic Surgery, Jessa Hospital, Campus
Virga Jesse, Hasselt, Belgium
(Jansen) Department of Cardiothoracic Surgery, University Hospitals of
Leuven, Herestraat 49, Leuven, Belgium
(Fieuws) Biomedical Sciences Group, Leuven Biostatistics and Statistical
Bioinformatics Centre (L-BioStat), University of Leuven, Leuven, Belgium
Publisher
Lippincott Williams and Wilkins
Abstract
Background: Although, intercostal nerve blocks are sometimes approached
with caution due to concerns about potentially high local anesthetic
uptake, they remain a valuable tool in specific clinical situations. On
the other hand, the erector spinae plane block is nowadays often favored
for its broader coverage and versatility. We hypothesized that the
intercostal nerve block, applied directly by surgeons under direct vision
in patients undergoing uniportal video-assisted thoracoscopic surgery,
might offer superior analgesia and fewer complications compared to the
erector spinae plane block. Method(s): In this multi-center,
double-blind placebo controlled, randomized trial, 100 patients undergoing
uniportal thoracoscopic surgery (wedge excision or lobectomy) within an
enhanced recovery program received either a surgical intercostal nerve
block under thoracoscopic guidance or an ultrasound-guided erector spinae
plane block, followed by 30 ml of ropivacaine 0.5% (n=50) or saline
(n=50). Primary outcome measured was 12-hour morphine consumption
post-extubation. Secondary outcomes included 24-hour morphine use, pain
severity, rescue analgesia need, postoperative complications, and length
of stay. Plasma levels of local anesthetics were also assessed.
 Result(s): The intercostal nerve block group had significantly lower
mean 12-hour morphine consumption compared to the erector spinae plane
block group (10.9 mg vs. 17.6 mg, p=0.0015), as well as lower mean 24-hour
consumption (18.7 mg vs. 26.7 mg, p=0.018). Intercostal blocks also led to
lower pain scores in the first two hours postoperatively and a reduced
need for rescue analgesia (16% vs. 40%, p=0.0033). No differences were
found in patient satisfaction, complications, or length of stay. Notably,
the erector spinae plane block group showed higher systemic absorption of
local anesthetics. Conclusion(s): For uniportal thoracoscopic
surgery, intercostal nerve block significantly reduces morphine
consumption and systemic anesthetic absorption compared to erector spinae
plane block. Copyright © 2025 American Society of
Anesthesiologists. All Rights Reserved.

<178>
[Use Link to view the full text]
Accession Number
2039265598
Title
Stellate ganglion block for visceral pain in elderly patients undergoing
video-assisted thoracoscopic lung cancer surgery: a randomized, controlled
trial.
Source
International Journal of Surgery. 110(11) (pp 6996-7002), 2024. Date of
Publication: 01 Nov 2024.
Author
Xiang X.-B.; Wu Y.-Y.; Fang Z.; Tang X.; Wu Y.-L.; Zhou J.; Cheng X.-Q.
Institution
(Xiang, Tang, Wu, Zhou) Department of Anesthesiology, Zhejiang Cancer
Hospital , Hangzhou Institute of Medicine (HIM), Chinese Academy of
Sciences, Zhejiang, Hangzhou, China
(Wu, Fang, Cheng) Department of Anesthesiology, First Affiliated Hospital
of Anhui Medical University , Key Laboratory of Anesthesiology ,
Perioperative Medicine of Anhui Higher Education Institutes, Anhui Medical
University, Hefei, China
Publisher
Wolters Kluwer Health Inc
Abstract
Background: Visceral pain occurs commonly following thoracic surgery, but
an effective method to relieve visceral pain in thoracic surgery remains
controversial. The authors test the effect of stellate ganglion blocks
(SGB) on perioperative visceral pain following video-assisted
thoracoscopic surgery (VATS). Method(s): A prospective, randomized,
controlled trial enrolled 77 elderly patients undergoing VATS. Patients
were randomized to SGB followed by modified intercostal nerve block (Group
S, n=37); or modified intercostal nerve block only (Group C, n=40).
Remifentanil 0.02-0.2 mug.kg -1 .min -1 was titrated to keep pain
threshold index values between 40 and 65 and maintain mean arterial
pressure or heart rate values around 20% of baseline values.
Patient-controlled intravenous analgesia with sufentanil was used in the
postoperative period. The co-primary outcomes were the perioperative
cumulative opioid consumption and pain scores on movement at 24 h after
surgery. Result(s): Compared with the control group, SGB greatly
reduced the intraoperative remifentanil consumption [300.00
(235.00-450.00)mug versus 710.00 (500.00-915.00)mug; P<0.01], with no
difference in cumulative sufentanil consumption to 48 h postsurgery. There
was a statistically significant difference in pain scores on movement at
24 h between groups [4.00 (3.00-4.00) versus 4.00 (3.25-5.00); P=0.01].
Further exploratory analyses showed a significant difference in intrachest
pain on movement at 24 h [3.00 (2.00-3.00) versus 3.00 (2.25-4.00);
P=0.01]. No significant difference was observed in nausea/vomiting, time
to pass flatus, and postoperative length of stay. Conclusion(s):
Preoperative SGB for elderly patients could effectively blunt
intraoperative visceral stress and reduce postoperative visceral pain
extending 24 h after VATS. This initial finding deserves further
investigation. Copyright © 2024 The Author(s). Published by
Wolters Kluwer Health, Inc.

<179>
Accession Number
647671690
Title
Long-term mortality and MACE outcomes of yoga-based cardiac rehabilitation
in patients with CABG: a 15-year legacy study of a randomized controlled
trial.
Source
Scientific reports. 15(1) (pp 20068), 2025. Date of Publication: 13 Jun
2025.
Author
Majumdar V.; Patil S.; Singh A.; Panigrahi S.; Nagarathna R.; Hr N.
Institution
(Majumdar, Patil, Singh, Panigrahi, Nagarathna, Hr) BengaluruIndia
Abstract
This study reports the 15th year follow-up of a previously reported
monocentric, randomized controlled trial comparing the effectiveness of
yoga vs. conventional exercise-based cardiac rehabilitation (CR) on
mortality and major adverse cardiovascular outcomes in middle-aged, male
patients who underwent coronary artery bypass graft surgery (CABG). Three
hundred male patients, aged 53.32 (SD, 6.72) years, were recruited for
CABG at Narayana Institute of Cardiac Sciences, India, in 2005, followed
by random assignment into a yoga-based cardiac rehabilitation program
(YCRP) or conventional exercise-based cardiac rehabilitation program
(CCRP). This legacy study reports the extended follow-up outcomes for
all-cause mortality and cardiovascular events for a median of 14.14 years
(IQR 13.82-14.47) since randomisation in 2005. The YCRP group received
lectures on yoga philosophy combined with sequential phase-wise
administration of yoga modules suited for their pre-and post-operative
health status with gradual phase-wise addition of physical postures to
initially administered relaxation-based techniques, under continued
home-based practice model monitored telephonically until 12 months
post-surgery related discharge from the hospital. The CCRP group received
conventional exercise-based cardiac rehabilitation with similar phase-wise
administration. Both study groups were under continued outpatient
department-based care with 6 monthly review sessions until 2020. The
exploratory follow-up outcomes [the all-cause mortality, and the major
adverse cardiac events (MACE)] were analyzed using an intention-to-treat
approach comparing the initially randomized study groups. MACE was a
composite of cardiovascular death, nonfatal myocardial infarction, or
stroke. The study staff determined the occurrence of death from the
medical records or telephonic calls and ascertained it by matching and
identifying information reported by participants/or their family members.
The Cox proportional hazard estimates and Kaplan-Meier Curve with Log-rank
test estimates were used to compare the mortality and MACE outcomes
between the study groups. Participants of the YCRP group exhibited
significantly reduced risk of all-cause mortality [HR = 0.41 (95% CI =
0.16-0.91, P = 0.02)] and trends of reduction in MACE outcomes [HR = 0.57
(95% CI = 0.30-1.04, P = 0.065)] compared to the CCRP. No significant
interaction effects were observed between the intervention and the
baseline covariates, such as age, ejection fraction values, or presence of
comorbidities. This first-ever long-term follow-up established the
survival advantage of the YCRP over CCRP for patients who underwent
coronary artery bypass graft surgery (CABG). The results support the
utility of yoga-based CR as an alternative to CCRP in low-resource
settings. Copyright © 2025. The Author(s).

<180>
Accession Number
2035002002
Title
Dexmedetomidine-enhanced chest wall fascial plane blocks in
ultra-fast-track minimally invasive heart valve surgery: a randomized
controlled trial.
Source
Perioperative Medicine. 14(1) (no pagination), 2025. Article Number: 62.
Date of Publication: 01 Dec 2025.
Author
Jiang S.-J.; Jiang T.; Wei H.-W.; Lou X.-K.; Wang Y.; Yan M.-J.
Institution
(Jiang) Department of Anesthesiology, Sir Run Run Shaw Hospital, School of
Medicine, Zhejiang University, Zhejiang, Hangzhou, China
(Jiang, Wei, Lou, Wang, Yan) Center for Rehabilitation Medicine,
Department of Anesthesiology, Zhejiang Provincial People's Hospital
(Affiliated People's Hospital, Hangzhou Medical College), Research
Institute of Anesthesiology and Perioperative Medicine, Hangzhou Medical
College, Zhejiang, Hangzhou, China
Publisher
BioMed Central Ltd
Abstract
Background: Injury to the sternocostal joint during minimally invasive
cardiac surgery frequently results in severe pain, yet there is no
established standard for perioperative analgesia. This randomized
controlled trial evaluated whether adding 1 mug/kg dexmedetomidine to
0.375% ropivacaine for chest wall fascial plane blocks enhances opioid
sparing in ultra-fast-track (UFT) minimally invasive heart valve surgery.
 Method(s): Seventy-six elective patients were randomized (1:1) in a
double-blind manner. The control group received 60 mL of 0.375%
ropivacaine, while the DEX group was administered 60 mL of 1 mug/kg
dexmedetomidine plus 0.375% ropivacaine. The primary outcomes were
intraoperative remifentanil use and 24-h postoperative sufentanil
consumption, which served as co-primary endpoints to evaluate
opioid-sparing effects. Secondary outcomes included 24-h postoperative
sufentanil consumption, 24-h oxycodone use, patient-controlled analgesia
(PCA) activations, episodes of Visual Analog Scale (VAS) scores >= 3
within 48 h, time to recovery of consciousness, time to extubation,
duration of intensive care unit (ICU), and hospital stays, and
complications. Result(s): The DEX group exhibited significantly
reduced intraoperative remifentanil consumption (2.45 +/- 0.47 vs. 2.98
+/- 0.53 mg, p < 0.001) and 24-h sufentanil use (median with interquartile
range (IQR) 57 [54-60] vs. 63 [63-66] mug, p < 0.001). It also
demonstrated lower 24-h oxycodone consumption (median [IQR] 5 [0-10] vs.
10 [10-20] mg, p < 0.001), fewer 24-h PCA activations (median [IQR] 3
[2-4] vs. 5 [5-6], p < 0.001), and less frequent VAS >= 3 episodes (median
[IQR] 3 [2.5-4] vs. 6 [5-6], p < 0.001), alongside shorter lengths of ICU
(21.34 +/- 3.59 vs. 24.29 +/- 4.07 h, p = 0.002) and hospital stays (6.51
+/- 1.04 vs. 8.65 +/- 1.80 days, p < 0.001). Postoperative complications
did not differ significantly between groups, though
dexmedetomidine-related hemodynamic effects were not systematically
monitored. Conclusion(s): The administration of 1 mug/kg
dexmedetomidine in combination with ropivacaine for chest wall fascial
plane blocks reduces opioid requirements and shortens ICU/hospital stays
in UFT cardiac surgery, supporting its safety and efficacy, but
limitations include the single-center design, fixed dexmedetomidine
dosage, and incomplete complication assessment, warranting multicenter
validation with standardized safety monitoring. Trial registration:
ChiCTR2100051182. Copyright © The Author(s) 2025.

<181>
[Use Link to view the full text]
Accession Number
2039222437
Title
Bridging surgical oncology and personalized medicine: The role of
artificial intelligence and machine learning in thoracic surgery.
Source
Annals of Medicine and Surgery. (no pagination), 2025. Date of
Publication: 2025.
Author
Ijlal A.; Mumtaz H.; Hassan S.M.; Mustafa Q.-U.-A.; Khalil A.B.B.; Ali U.;
Tanveer Z.K.; Sajjad L.
Institution
(Ijlal) Jinnah Sindh Medical University, Pakistan
(Mumtaz) Bpp University, London, United Kingdom
(Hassan, Ali) Karachi Medical and Dental College, Karachi, Pakistan
(Mustafa) South City Institute of Physical Therapy and Rehabilitation,
Karachi, Pakistan
(Khalil) Shaheed Mohtarma Benazir Bhutto Medical College Lyari, Karachi,
Pakistan
(Tanveer) University College of Medicine and Dentistry, Lahore, Pakistan
(Sajjad) Dow Medical College, Karachi, Pakistan
Publisher
Lippincott Williams and Wilkins
Abstract
Lung cancer remains the leading cause of cancer-related deaths globally,
often detected in advanced stages with poor prognosis. While surgical
resection is the mainstay of curative treatment, early detection remains a
significant challenge. Advances in personalized medicine, including
genomic profiling and low-dose CT scans, have led to more tailored
therapies, offering improved outcomes. Integrating artificial intelligence
(AI) and machine learning (ML) into oncology has the potential to
revolutionize lung cancer management by enhancing early detection,
improving treatment precision, and supporting surgical decision-making.
AI-driven technologies, such as deep learning algorithms and predictive
models, have demonstrated effectiveness in identifying lung nodules,
predicting immunotherapy response, and reducing diagnostic errors.
Additionally, AI-powered robotics have contributed to improved surgical
precision and better patient recovery. However, the widespread adoption of
AI in clinical practice faces challenges, including data standardization,
ethical concerns, and the need for robust validation. This study explores
the question: How can AI and ML optimize thoracic surgical oncology by
improving early detection, enhancing surgical precision, and enabling
personalized care? This review highlights the significance of AI and ML in
thoracic surgery and oncology, discussing their current applications,
limitations, and future potential to advance personalized cancer care and
improve patient outcomes. Copyright © 2025 Lippincott Williams
and Wilkins. All rights reserved.

<182>
Accession Number
2035002093
Title
Increase in calcidiol level is associated with improved sternal bone
healing after cardiac surgery with sternotomy-REINFORCE-D trial results.
Source
Trials. 26(1) (no pagination), 2025. Article Number: 224. Date of
Publication: 01 Dec 2025.
Author
Cerny D.; Cecrle M.; Sedlackova E.; Mikova B.; Drncova E.; Skalsky I.;
Mieresova M.; Halacova M.
Institution
(Cerny, Cecrle, Mieresova, Halacova) Department of Clinical Pharmacy, Na
Homolce Hospital, Prague, Czechia
(Cerny, Cecrle) Institute of Pharmacology, First Faculty of Medicine,
Charles University in Prague, Albertov 4, Prague, Czechia
(Sedlackova, Skalsky) Department of Cardiac Surgery, Na Homolce Hospital,
Prague, Czechia
(Mikova) Department of Radiology, Na Homolce Hospital, Prague, Czechia
(Drncova) Department of Clinical Biochemistry, Hematology and Immunology,
Na Homolce Hospital, Prague, Czechia
(Mieresova, Halacova) Department of Pharmacology, Second Faculty of
Medicine, Charles University in Prague, Prague, Czechia
(Cerny) Department of Clinical Pharmacy, Regional Hospital Liberec,
Liberec, Czechia
(Cerny) Institute of Biomedicine and Radiology, Faculty of Health Studies,
Technical University of Liberec, Liberec, Czechia
(Cecrle) Department of Occupational Medicine, General University Hospital
in Prague, Prague, Czechia
(Halacova) Department of Anaesthesia and Intensive Care Medicine, Third
Faculty of Medicine, Charles University in Prague and FNKV University
Hospital, Prague, Czechia
(Sedlackova) Department of Infectious Diseases, Masaryk Hospital, Usti and
Labem, Labem, Czechia
Publisher
BioMed Central Ltd
Abstract
Introduction : Heart surgery is associated with a sternotomy in most
patients. Low serum calcidiol level below 80 nmol/l carries the risk of
bone loss as a risk factor in sternotomy healing. Objective(s): The
primary objective was to compare postoperative complications of sternotomy
healing in two groups of patients treated with cholecalciferol or placebo.
Secondary objectives were focused on the degree of sternal healing, length
of hospitalization, number of days spent in ICU and mechanical
ventilation, and number of repeated hospitalizations for sternotomy
complications. Methodology: Monocentric, randomized, double-blind,
placebo-controlled, prospective study was conducted from September 2016 to
December 2020 at Na Homolce Hospital. Of the 216 originally recruited and
randomized subjects, 141 completed the study. Seventy-two subjects were
enrolled in the cholecalciferol arm, and sixty-nine subjects in the
placebo arm. The detailed methodology has been published previously. The
results are presented as a comparison between two groups: calcidiol above
80 nmol/l (saturated subjects) and the calcidiol lower or equal to 80
nmol/l (unsaturated subjects). Result(s): Statistics include 141
subjects. After a 6-month follow-up, CT imaging and calcidiol levels were
performed. Primary objective: postoperative complications in sternotomy
were not among the population under or above 80 nmol/l statistical
difference (p = 0.907). Secondary Objectives: monitored parameters
did not differ between individual arms. But the key was the state of
saturation with calcidiol (> 80 nmol/l), which was associated with a
significantly lower risk of complete non-healed sternotomy (p = 0.008).
 Conclusion(s): Optimal calcidiol level (> 80 nmol/l) indicates a
positive trend towards greater sternal healing. Cholecalciferol oral
administration can be considered as a safe method how to achieve the
required calcidiol concentration. Trial registration: EU Clinical Trials
Register, EUDRA CT No: 2016-002606-39. Copyright © The Author(s)
2025.

<183>
Accession Number
2035001545
Title
Adjustment of positive end-expiratory pressure based on body mass index
during general anaesthesia: a randomised controlled trial*.
Source
Anaesthesia. (no pagination), 2025. Date of Publication: 2025.
Author
Selpien H.; Penon J.; Thunecke D.; Schadler D.; Lautenschlager I.;
Ohnesorge H.; Eimer C.; Wolf C.; Sablewski A.; Becher T.
Institution
(Selpien, Penon, Thunecke, Schadler, Lautenschlager, Ohnesorge, Eimer,
Wolf, Sablewski, Becher) Department for Anaesthesiology and Intensive Care
Medicine, University Hospital Schleswig-Holstein, Campus Kiel, Germany
Publisher
John Wiley and Sons Inc
Abstract
Introduction: Lung-protective ventilation is essential for preventing
postoperative pulmonary complications. While maintaining a low driving
pressure and optimising PEEP is of importance, the ideal strategy remains
contentious. This study evaluated whether adjusting PEEP based on BMI,
compared with standard PEEP, could reduce driving pressure and
peri-operative loss of lung aeration. Method(s): We conducted a
randomised controlled, patient-blinded, single-centre superiority trial
with two parallel groups. Adult patients undergoing surgery with general
anaesthesia who required tracheal intubation were assigned randomly to
either standardised PEEP (PEEP = 5 cmH<inf>2</inf>O; group PEEP-5) or PEEP
set according to BMI (PEEP = BMI/3 cmH<inf>2</inf>O; group PEEP-BMI/3).
Patients' lungs were ventilated using a volume-controlled mode with tidal
volumes of 7 ml.kg-1 predicted body weight. Lung aeration
scores were assessed using ultrasound pre- and postoperatively.
 Result(s): Sixty patients were enrolled and allocated randomly.
Adjustment of PEEP according to BMI/3 was associated with a significantly
lower driving pressure, with a median (IQR [range]) of 8.9 (7.1-10.4
[5.2-14.9]) cmH<inf>2</inf>O in group PEEP-5 and 7.9 (7.2-8.5 [5.9-14.1])
cmH<inf>2</inf>O in group PEEP-BMI/3 (p = 0.027) and higher mean (SD)
respiratory system compliance (group PEEP-5, 0.83 (0.20) ml
cmH<inf>2</inf>O-1 kg-1 predicted body weight vs.
group PEEP-BMI/3, 0.95 (0.17) ml cmH<inf>2</inf>O-1
kg-1 predicted body weight; p = 0.020). Lung ultrasound
revealed a reduced postoperative loss of lung aeration in patients
allocated to the BMI/3 group. Patients allocated to the BMI-adjusted group
required less supplemental oxygen, had less newly developed atelectasis
and had higher oxygen saturations upon arrival in the post-anaesthesia
care unit. Discussion(s): In patients without major pulmonary disease
who were undergoing non-cardiothoracic surgeries with tracheal intubation,
adjusting PEEP based on a calculation of BMI/3 improved lung mechanics and
reduced postoperative loss of lung aeration. This approach provides a
straightforward and pragmatic method for individualising PEEP in patients
undergoing general anaesthesia. Copyright © 2025 The Author(s).
Anaesthesia published by John Wiley & Sons Ltd on behalf of Association of
Anaesthetists.

<184>
Accession Number
2039302189
Title
Modified Measurement of Tricuspid Annular Plane Systolic Excursion for
Assessing Right Ventricular Function During Cardiac Surgery.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2025.
Date of Publication: 2025.
Author
Ye K.; Zhao Y.; Hu X.; Zhou X.
Institution
(Ye, Zhao, Hu, Zhou) Department of Anesthesiology, Second Affiliated
Hospital, Zhejiang University School of Medicine, Hangzhou, China
Publisher
W.B. Saunders
Abstract
Precise and prompt identification of right ventricular (RV) dysfunction is
critical in cardiac surgery. Tricuspid annular plane systolic excursion
(TAPSE) has been widely used as a simple, rapid, and repeatable index for
assessing RV function. However, the current measurement of TAPSE is based
mainly on M-mode ultrasound and is used predominantly in transthoracic
echocardiography (TTE). Owing to differences in imaging views and the
angle dependence of M-mode ultrasound, directly applying TAPSE measurement
from TTE to transesophageal echocardiography (TEE) is not advisable.
Therefore, exploring a modified TAPSE measurement method suitable for TEE
is of great value for obtaining more accurate TAPSE values and informing
subsequent clinical decision making. This review summarizes and discusses
in detail the research progress on modified TAPSE in TEE as reported in
the literature. By systematically reviewing relevant studies, it aims to
provide new methods and insights for cardiac subspecialist
anesthesiologists. Modified measurement methods will enable them to more
accurately use TAPSE to assess RV function during perioperative TEE. This
not only will help optimize clinical decision making, but also will
provide an important basis for predicting patients' clinical
outcomes. Copyright © 2025 The Authors

<185>
Accession Number
2039276840
Title
Efficacy of Superficial versus Deep Parasternal Intercostal Plane Blocks
in Cardiac Surgery: A Systematic Review and Meta-Analysis.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2025.
Date of Publication: 2025.
Author
Dost B.; De Cassai A.; Karapinar Y.E.; Turunc E.; Beldagli M.; Yalin
M.S.O.; Navalesi P.
Institution
(Dost, Turunc) Department of Anesthesiology and Reanimation, Ondokuz Mayis
University Faculty of Medicine, Samsun, Turkey
(De Cassai, Navalesi) Department of Medicine, University of Padua, Padua,
Italy
(De Cassai, Navalesi) Institute of Anesthesia and Intensive Care Unit,
University Hospital of Padua, Padua, Italy
(Karapinar, Yalin) Department of Anesthesiology and Reanimation, Ataturk
University School of Medicine, Erzurum, Turkey
(Beldagli) Department of Anesthesiology and Reanimation, Samsun Training
and Research Hospital, Samsun, Turkey
Publisher
W.B. Saunders
Abstract
Objectives: To compare the analgesic efficacy of superficial parasternal
intercostal plane (S-PIP) block and deep parasternal intercostal plane
(D-PIP) to determine which technique provides superior pain relief in
cardiac surgery. Design(s): A systematic search of MEDLINE (via
PubMed), Scopus, Embase, Cochrane Library, Web of Science, Google Scholar,
and ClinicalTrials.gov from inception until January 18, 2025. Eligible
studies included randomized controlled trials (RCTs) and observational
studies that compared the S-PIP and D-PIP blocks in patients undergoing
cardiac surgery. The primary outcome of the study was postoperative opioid
consumption of morphine milligram equivalent (MME) at 24 hours. Secondary
outcomes included resting and movement pain scores at 0, 6, 12 and 24
hours, time to first analgesics, incidence of postoperative nausea and
vomiting (PONV), extubation time, length of stay (LOS) in the intensive
care unit (ICU), and the number of patients requiring rescue analgesics.
 Main Result(s): Seven RCTs and 1 observational study, including a
total of 510 patients, were identified. The findings demonstrated no
statistically significant difference in MME at 24 hours between the S-PIP
and D-PIP block groups (mean difference, -1.23; 95% confidence interval,
-2.51 to 0.05; p = 0.061). Additionally, there were no significant
differences in pain scores, PONV incidence, time to rescue analgesics,
extubation time, or ICU LOS of stay between the 2 techniques.
 Conclusion(s): S-PIP and D-PIP blocks provide comparable
postoperative analgesic efficacy in patients undergoing cardiac
surgery. Copyright © 2025 Elsevier Inc.

<186>
Accession Number
647657239
Title
Decellularized scaffolds and heart valve treatment: present techniques,
long-standing hurdles and the challenging future.
Source
Biomaterials advances. 177 (pp 214367), 2025. Date of Publication: 03 Jun
2025.
Author
Tzavellas N.P.; Simos Y.V.; Tsamis K.I.; Markopoulos G.S.; Lekkas P.;
Peschos D.; Lakkas L.
Institution
(Tzavellas, Simos, Tsamis, Markopoulos, Lekkas, Peschos, Lakkas)
Department of Physiology, Faculty of Medicine, School of Health Sciences,
University of Ioannina, Ioannina, Greece
Abstract
Decellularized scaffolds represent a promising frontier in heart valve
therapy, offering potential advantages over traditional mechanical and
bioprosthetic alternatives. However, significant challenges persist in
their clinical implementation. We try to review the critical factors
affecting decellularized valve performance, focusing on the interplay
between physical, chemical, and enzymatic decellularization methods and
their impact on extracellular matrix (ECM) integrity. Our comprehensive
analysis reveals that while these scaffolds can support cellular
repopulation and demonstrate growth potential- particularly beneficial for
pediatric applications- they face substantial limitations including
thrombogenicity, calcification, immunogenicity, and leaflet retraction.
The balance between effective cellular removal and ECM preservation
emerges as a central challenge, with evidence suggesting that optimization
of decellularization protocols may mitigate calcification risks. The
development of standardized processing parameters across various tissue
sources remains challenging, as source-dependent variations significantly
influence functional outcomes. Xenogeneic tissues, while more readily
available, demonstrate heightened immunogenicity and thrombogenic
potential compared to allogeneic alternatives. Recent advancements in
antigen removal techniques, particularly targeting the alpha-Gal epitope,
show promise in reducing xenogeneic scaffold immunogenicity. Novel
approaches incorporating surface modifications and crosslinking agents
demonstrate significant potential in enhancing scaffold durability and
cellular integration. Recellularization strategies, including
pre-implantation endothelialization and the use of mesenchymal stem cells,
may further improve scaffold functionality and reduce thrombogenic risk.
Here, we examine advanced methodological developments in the field of
heart valve decellularization, while identifying critical technical
barriers that currently limit broad clinical translation. The ongoing
refinement of decellularization technologies represents significant
progress toward a fundamental objective in cardiovascular medicine:
creating functional valve replacements with capacity for growth,
regeneration, and hemodynamic adaptation throughout the patient's
lifespan. Copyright © 2025 The Authors. Published by Elsevier
B.V. All rights reserved.

<187>
Accession Number
647659256
Title
Research of imaging in left Atrium: A Bibliometric Analysis.
Source
Current medical imaging. (no pagination), 2025. Date of Publication: 10
Jun 2025.
Author
Cui C.; Zhu J.-H.; Tao Y.-H.; Zhao Z.-Y.; Peng Y.; Zuo M.
Institution
(Cui, Zhu, Tao, Zhao, Peng, Zuo) Department of Radiology, Second
Affiliated Hospital, Jiangxi Medical College, Nanchang University,
Nanchang, China
(Cui, Tao, Zhao, Peng, Zuo) Intelligent Medical Imaging of Jiangxi Key
Laboratory, Nanchang, China
Abstract
BACKGROUND: The evaluation of the left atrial (LA) by imaging is becoming
increasingly essential due to its significant role in numerous diseases.
This study aimed to analyze and summarize research on LA imaging in the
past 20 years through bibliometric analysis and offer insights into future
research prospects. METHOD(S): The Web of Science (WOS) core
collection database was retrieved for literature in LA imaging research
from 2004 to 2023. Subsequently, the literature was processed and
visualized by the VOSviewer and CiteSpace. VOSviewer was used to create
cooperation networks for countries/regions and institutions. CiteSpace was
used to analyze burst keywords in citation analysis. RESULT(S): A
total of 3664 articles published in this field between January 2004 and
December 2023 were analyzed. The number of published articles is
increasing year by year. The USA contributed the most articles (1072).
Hugh Calkins (44) was the most productive author with the highest
publications. CONCLUSION(S): Over the past 20 years, research on LA
imaging has grown rapidly. The results of the present study provide
insights into the field's status and indicate the research hotspots. In
recent years, research on left atrial appendage occlusion (LAAO) and LA
strain has been notably focused, which is expected to remain a prominent
topic in future research. Copyright© Bentham Science Publishers;
For any queries, please email at epub@benthamscience.net.

<188>
Accession Number
647659822
Title
Alirocumab versus Evolocumab on Cardiovascular Outcomes: A Systematic
Review and Meta-analysis.
Source
Current cardiology reviews. (no pagination), 2025. Date of Publication:
10 Jun 2025.
Author
Saad Cleto A.; Schirlo J.M.; Machozeki J.; Martins C.M.
Institution
(Saad Cleto, Schirlo, Machozeki, Martins) Department of Medicine, State
University of Ponta Grossa, Ponta Grossa, Brazil
Abstract
INTRODUCTION: The PCSK9 enzyme is present mainly in the liver and is
responsible for the degradation of LDL-C receptors. Currently, there are
some drugs that inhibit this enzyme, such as alirocumab and evolocumab.
Consequently, these drugs reduce serum LDL-C levels. Therefore, a
systematic review and a meta-analysis were carried out in order to compare
alirocumab against evolocumab in reducing cardiovascular outcomes.
 METHOD(S): This systematic review was carried out in accordance with
PRISMA and was registered in PROSPERO (CRD42024573217). The following
databases were searched on July, 9, 2024: Pubmed, Web of Science and
Scopus. Randomized clinical trials with a control group were included and
meta-analyses were performed to assess relative risk (RR). The random
effects model was used in heterogeneous samples. The articles were
distributed into 2 subgroups: use of alirocumab and evolocumab.
 RESULT(S): Initially, 2,213 articles were found, of which 6 were
included. In total, 62,119 patients participated. The RR values were
significant for alirocumab in the following outcomes: myocardial
infarction (MI) 0.85 (95% CI 0.77-0.93), stroke 0.75 (95% CI 0.60-0.94)
and hospitalization for unstable angina 0.58 (95% CI 0.39-0.86), while for
evolocumab they were significant for MI 0.75 (95% CI 0.68-0.83) and
coronary revascularization 0.81 (95 CI % 0.75-0.88). There was a
statistically significant difference between the drugs for hospitalization
for unstable angina (p=0.02). DISCUSSION(S): This study highlights
the benefits of PCSK9 inhibitors, especially alirocumab, in reducing major
cardiovascular events. Alirocumab significantly lowered hospitalizations
for unstable angina, with a 42% reduction, and showed favorable outcomes
in reducing myocardial infarction, coronary revascularization, and stroke.
These reductions are clinically meaningful, as they lower morbidity,
improve patient quality of life, and reduce healthcare costs. Both
alirocumab and evolocumab are effective and safe, offering important
therapeutic options for high-risk cardiovascular patients.
 CONCLUSION(S): The use of alirocumab is preferable if the focus is to
avoid hospitalizations for unstable angina or stroke, while evolocumab may
be an option if one wants to avoid coronary revascularization. Both drugs
are effective in reducing cardiovascular outcomes, but alirocumab was
superior to evolocumab. Copyright© Bentham Science Publishers;
For any queries, please email at epub@benthamscience.net.

<189>
Accession Number
2035000001
Title
Comparison of left atrial appendage occlusion with medical treatment for
non-valvular atrial fibrillation: systematic review, network and
reconstructed individual patient data meta-analysis.
Source
Clinical Research in Cardiology. (no pagination), 2025. Date of
Publication: 2025.
Author
Lerman T.T.; Hershenson R.; Greenberg N.; Kheifets M.; Talmor-Barkan Y.;
Codner P.; Perl L.; Witberg G.; Rotholz A.; Vons S.; Orvin K.; Eisen A.;
Belkin D.; Fishman B.; Golovchiner G.; Kornowski R.; Levi A.
Institution
(Lerman, Hershenson, Kheifets, Talmor-Barkan, Codner, Perl, Witberg,
Rotholz, Vons, Orvin, Eisen, Golovchiner, Kornowski, Levi) Department of
Cardiology, Rabin Medical Center, 39 Jabotinski St., Petah Tikva, Israel
(Lerman, Hershenson, Greenberg, Kheifets, Talmor-Barkan, Codner, Perl,
Witberg, Rotholz, Vons, Orvin, Eisen, Belkin, Fishman, Golovchiner,
Kornowski, Levi) The Faculty of Medicine, Tel Aviv University, Tel Aviv,
Israel
(Greenberg) Department of Internal Medicine F-Recanati, Beilinson
Hospital, Rabin Medical Center, Petah Tikva, Israel
(Fishman) University of Pittsburgh Medical Center, Pittsburgh, PA, United
States
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Background: Percutaneous left atrial appendage occlusion (LAAO) is a
non-pharmacological strategy to prevent stroke and systemic emboli in
patients with non-valvular atrial fibrillation (AF). However, data
regarding its safety and efficacy profile compared to different oral
anti-coagulant regimens remain limited. Method(s): A network
meta-analysis compared LAAO, warfarin, and NOACs (standard dose [SD] and
low-dose [LD]). Outcomes included all-cause mortality, stroke or systemic
embolism, and bleeding risk. Bayesian models with surface under the
cumulative ranking curve (SUCRA) and reconstructed individual patient data
(IPD) were utilized. Result(s): Twelve studies, including eight
randomized controlled trials, were analyzed (13,049 patients with LD NOAC,
29,513 with SD NOAC, 29,611 with warfarin, and 2811 with LAAO). Warfarin
was inferior for all-cause mortality compared to LAAO (OR 1.44 [95% CrI;
1.07-1.89]), LD NOAC (OR 1.13 [95% CrI; 1.01-1.26]), and SD NOAC (OR 1.11
[95% CrI; 1.02-1.20]). SUCRA analysis ranked SD NOAC as the most effective
for stroke or systemic emboli prevention, LD NOAC as the most effective in
preventing major bleeding and LAAO in preventing hemorrhagic stroke.
 Conclusion(s): SD NOACs were the most effective for preventing stroke
or systemic embolism, while LD NOACs were the safest in terms of major
bleeding. LAAO was comparable to NOACs and superior to warfarin in both
safety and efficacy. Further studies are needed to clarify LAAO's role in
the management of atrial fibrillation. Copyright ©
Springer-Verlag GmbH Germany, part of Springer Nature 2025.

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