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<1>
Accession Number
2013000143
Authors
Haroutiunian S. Nikolajsen L. Finnerup N.B. Jensen T.S.
Institution
(Haroutiunian, Nikolajsen, Finnerup, Jensen) Danish Pain Research Center,
Aarhus University Hospital, Building 1A, Norrebrogade 44, DK-8000 Aarhus,
Denmark
(Nikolajsen) Department of Anesthesiology, Aarhus University Hospital,
Aarhus, Denmark
(Jensen) Department of Neurology, Aarhus University Hospital, Aarhus,
Denmark
Title
The neuropathic component in persistent postsurgical pain: A systematic
literature review.
Source
Pain. 154 (1) (pp 95-102), 2013. Date of Publication: January 2013.
Publisher
Elsevier (P.O. Box 211, Amsterdam 1000 AE, Netherlands)
Abstract
Persistent postsurgical pain (PPSP) is a frequent and often disabling
complication of many surgical procedures. Nerve injury-induced neuropathic
pain (NeuP) has repeatedly been proposed as a major cause of PPSP.
However, there is a lack of uniformity in NeuP assessment across studies,
and the prevalence of NeuP may differ after various surgeries. We
performed a systematic search of the PubMed, CENTRAL, and Embase databases
and assessed 281 studies that investigated PPSP after 11 types of surgery.
The prevalence of PPSP in each surgical group was examined. The prevalence
of NeuP was determined by applying the recently published NeuP probability
grading system. The prevalence of probable or definite NeuP was high in
patients with persistent pain after thoracic and breast surgeries - 66%
and 68%, respectively. In patients with PPSP after groin hernia repair,
the prevalence of NeuP was 31%, and after total hip or knee arthroplasty
it was 6%. The results suggest that the prevalence of NeuP among PPSP
cases differs in various types of surgery, probably depending on the
likelihood of surgical iatrogenic nerve injury. Because of large
methodological variability across studies, a more uniform approach is
desirable in future studies for evaluating persistent postsurgical NeuP.
2012 International Association for the Study of Pain. All rights reserved.

<2>
Accession Number
2013000407
Authors
Zirak N. Soltani G. Abbasi M. Hamadanchi A. Moeinipour A.A. Javan H.
Bagheri R.K. Shamloo A.S.
Institution
(Zirak, Abbasi, Moeinipour, Bagheri) Department of Anesthesiology, Imam
Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran,
Islamic Republic of
(Soltani) Department of Cardiac Surgery, Imam Reza Hospital, Mashhad
University of Medical Sciences, Mashhad, Iran, Islamic Republic of
(Hamadanchi) Department of Cardiology, Clinic of Internal Medicine,
University Hospital of Jena, Erlanger Allee 101, Jena 07747, Germany
(Javan) Research Administrator, Imam Reza Hospital, Mashhad University of
Medical Sciences, Mashhad, Iran, Islamic Republic of
(Shamloo) Student of Medicine, Mashhad University of Medical Sciences,
Mashhad, Iran, Islamic Republic of
Title
Prophylactic effect of a single intravenous dose of a combination of
Digoxin, Hydrocortisone, and amiodarone on atrial fibrillation after
off-pump coronary artery bypasses graft surgery.
Source
Iranian Heart Journal. 13 (3) (pp 33-38), 2012. Date of Publication: 2012.
Publisher
Iranian Heart Association (P.O. Box 15745-1341, Tehran, Iran, Islamic
Republic of)
Abstract
Objective: Postoperative atrial fibrillation (POAF) is the most common
complication after coronary artery bypass graft surgery (CABG) and a major
cause of increased hospital costs. Dispersed atrial refractoriness is
thought to be the primary mechanism, whereas myocardial inflammation has
an important role in altering atrial conduction. We evaluated the
preventive effect of an intravenous combination of Digoxin,
Hydrocortisone, and Amiodarone as antiinflammatory and anti-arrhythmic
agents on AF after off-pump CABG. Material and Methods: One hundred fifty
patients who underwent off-pump CABG between March 2010 and April 2011 and
met our inclusion criteria were enrolled. The patients were randomized
into two groups: the study group received 300 mg Amiodarone, 0.5 mg
Digoxin, and 200 mg Hydrocortisone before the induction of anesthesia, but
the control group did not. Surgical and anesthetic techniques were
identical in both groups. Results: Patient characteristics and surgical
variables were similar in both groups (p value<0.05). POAF was observed in
6 (8%) patients in the case group and in 18 (24%) of the controls. There
was a significant difference between the two groups in the prevalence of
new-onset POAF (p value=0.03). Conclusion: A preoperative dose of a
combination of Digoxin, Hydrocortisone, and Amiodarone is a safe and
feasible method to reduce POAF prevalence, produce a better outcome, and
reduce the duration of hospital stay and hospital costs.

<3>
Accession Number
2012648007
Title
Meta-analysis: Lowering LDL-C levels using statins reduces major vascular
events regardless of baseline risk.
Source
Annals of Internal Medicine. 157 (8) (pp JC4-JC2), 2012. Date of
Publication: 16 Oct 2012.
Publisher
American College of Physicians (190 N. Indenpence Mall West, Philadelphia
PA 19106-1572, United States)

<4>
Accession Number
2012740911
Authors
Latib A. Colombo A. Castriota F. Micari A. Cremonesi A. De Felice F.
Marchese A. Tespili M. Presbitero P. Sgueglia G.A. Buffoli F. Tamburino C.
Varbella F. Menozzi A.
Institution
(Latib, Colombo) Interventional Cardiology Unit, EMO-GVM Centro Cuore
Columbus, San Raffaele Scientific Institute, Via Buonarroti 48, 20145
Milan, Italy
(Castriota) Interventional Cardiology Unit, Citta di Lecce Hospital, GVM
Care and Research, Lecce, Italy
(Micari) Interventional Cardiology Unit, Maria Eleonora Hospital, GVM Care
and Research, Palermo, Italy
(Cremonesi) Interventional Cardiology Unit, Maria Cecilia Hospital, GVM
Care and Research, Cotignola, Italy
(De Felice) Interventional Cardiology Unit, Ospedale San Camillo, Rome,
Italy
(Marchese) Interventional Cardiology Unit, Anthea Hospital, GVM Care and
Research, Bari, Italy
(Tespili) Interventional Cardiology Unit, Ospedale Bolognini, Seriate,
Bergamo, Italy
(Presbitero) Interventional Cardiology Unit, Istituto Clinico Humanitas,
Rozzano, Milan, Italy
(Sgueglia) Interventional Cardiology Unit, Ospedale Santa Maria Goretti,
Latina, Italy
(Buffoli) Interventional Cardiology Unit, Ospedale di Mantova, Mantova,
Italy
(Tamburino) Division of Cardiology, Ferrarotto Hospital, University of
Catania, Catania, Italy
(Varbella) Interventional Cardiology Unit, Ospedale di Rivoli, Torino,
Italy
(Menozzi) Interventional Cardiology Unit, Cardiology Department, Ospedale
di Parma, Parma, Italy
Title
A randomized multicenter study comparing a paclitaxel drug-eluting balloon
with a paclitaxel-eluting stent in small coronary vessels: The bello
(balloon elution and late loss optimization) study.
Source
Journal of the American College of Cardiology. 60 (24) (pp 2473-2480),
2012. Date of Publication: 18 Dec 2012.
Publisher
Elsevier USA (6277 Sea Harbor Drive, Orlando FL 32862 8239, United States)
Abstract
Objectives: The aim of this study was to evaluate the efficacy of
drug-eluting balloons (DEB) compared with paclitaxel-eluting stents (PES)
for the reduction of restenosis in small vessels. Background: DEB have
been shown to be effective in the treatment of coronary in-stent
restenosis, but data are limited regarding their efficacy in de novo
disease. Methods: BELLO (Balloon Elution and Late Loss Optimization) is a
prospective, multicenter trial that randomized 182 patients with lesions
located in small vessels (reference diameter <2.8 mm) to treatment with
paclitaxel DEB and provisional bare-metal stenting (n = 90) or PES
implantation (n = 92). The primary endpoint was noninferiority of
angiographic in-stent (in-balloon) late loss with a delta of 0.25 mm.
Secondary endpoints were angiographic restenosis, target lesion
revascularization, and major adverse cardiac events (MACE; death,
myocardial infarction, target vessel revascularization) at 6 months.
Results: Baseline characteristics were well matched, except for a smaller
vessel size in the DEB group (2.15 +/- 0.27 mm vs. 2.25 +/- 0.24 mm; p =
0.003). The majority (89%) of lesions involved vessels with a diameter
<2.5 mm. Bailout stenting was required in 20% of lesions in the DEB group.
The primary endpoint of in-stent (in-balloon) late loss was significantly
less with DEB compared with PES (0.08 +/- 0.38 mm vs. 0.29 +/- 0.44 mm;
difference -0.21; 95% CI: -0.34 to -0.09; p_{noninferiority} <
0.001; p_superiority = 0.001). At 6 months, DEB and PES were
associated with similar rates of angiographic restenosis (8.9% vs. 14.1%;
p = 0.25), target lesion revascularization (4.4% vs. 7.6%; p = 0.37), and
MACE (7.8% vs. 13.2%; p = 0.77). Conclusions: Treatment of small-vessel
disease with a paclitaxel DEB was associated with less angiographic late
loss and similar rates of restenosis and revascularization as a PES.
(Balloon Elution and Late Loss Optimization [BELLO]; Study NCT01086579)
2012 American College of Cardiology Foundation.

<5>
Accession Number
2012750960
Authors
de Betue C.T.I. Verbruggen S.C.A.T. Schierbeek H. Chacko S.K. Bogers
A.J.J.C. van Goudoever J.B. Joosten K.F.M.
Institution
(de Betue) Intensive Care and Department of Pediatric Surgery, Erasmus MC
- Sophia Children's Hospital, University Medical Center Rotterdam, Dr.
Molewaterplein 60, 3015 GJ, Rotterdam, Netherlands
(Verbruggen, Joosten) Department of Pediatrics, Erasmus MC - Sophia
Children's Hospital, University Medical Center Rotterdam, Dr.
Molewaterplein 60, 3015 GJ, Rotterdam, Netherlands
(Schierbeek, van Goudoever) Department of Pediatrics, Emma Children's
Hospital, Academic Medical Center, University of Amsterdam, Meibergdreef
9, 1105 AZ, Amsterdam, Netherlands
(Chacko) Department of Pediatrics, Baylor College of Medicine, USDA-ARS
Children's Nutrition Research Center, 1100 Bates Street, Houston, TX
77030, United States
(Bogers) Department of Cardiothoracic Surgery, Erasmus MC, University
Medical Center Rotterdam, Dr. Molewaterplein 50, 3015 GE, Rotterdam,
Netherlands
(van Goudoever) Department of Pediatrics, VU University Medical Center, De
Boelelaan 1117, 1081 HV, Amsterdam, Netherlands
Title
Does a reduced glucose intake prevent hyperglycemia in children early
after cardiac surgery? A randomized controlled crossover study.
Source
Critical Care. 16 (5) , 2012. Article Number: R176. Date of Publication:
02 Oct 2012.
Publisher
BioMed Central Ltd. (Floor 6, 236 Gray's Inn Road, London WC1X 8HB, United
Kingdom)
Abstract
Introduction: Hyperglycemia in children after cardiac surgery can be
treated with intensive insulin therapy, but hypoglycemia is a potential
serious side effect. The aim of this study was to investigate the effects
of reducing glucose intake below standard intakes to prevent
hyperglycemia, on blood glucose concentrations, glucose kinetics and
protein catabolism in children after cardiac surgery with cardiopulmonary
bypass (CPB).Methods: Subjects received a 4-hour low glucose (LG; 2.5
mg/kg per minute) and a 4-hour standard glucose (SG; 5.0 mg/kg per minute)
infusion in a randomized blinded crossover setting. Simultaneously, an
8-hour stable isotope tracer protocol was conducted to determine glucose
and leucine kinetics. Data are presented as mean +/- SD or median (IQR);
comparison was made by paired samples t test.Results: Eleven subjects (age
5.1 (20.2) months) were studied 9.5 +/- 1.9 hours post-cardiac surgery.
Blood glucose concentrations were lower during LG than SG (LG 7.3 +/- 0.7
vs. SG 9.3 +/- 1.8 mmol/L; P < 0.01), although the glycemic target
(4.0-6.0 mmol/L) was not achieved. No hypoglycemic events occurred.
Endogenous glucose production was higher during LG than SG (LG 2.9 +/- 0.8
vs. SG 1.5 +/- 1.1 mg/kg per minute; P = 0.02), due to increased
glycogenolysis (LG 1.0 +/- 0.6 vs. SG 0.0 +/- 1.0 mg/kg per minute; P <
0.05). Leucine balance, indicating protein balance, was negative but not
affected by glucose intake (LG -54.8 +/- 14.6 vs. SG -58.8 +/- 16.7
mumol/kg per hour; P = 0.57).Conclusions: Currently recommended glucose
intakes aggravated hyperglycemia in children early after cardiac surgery
with CPB. Reduced glucose intake decreased blood glucose concentrations
without causing hypoglycemia or affecting protein catabolism, but
increased glycogenolysis.Trial registration: Dutch trial register NTR2079.
2012 de Betue et al.; licensee BioMed Central Ltd.

<6>
Accession Number
2012740901
Authors
Romagnoli E. Biondi-Zoccai G. Sciahbasi A. Politi L. Rigattieri S.
Pendenza G. Summaria F. Patrizi R. Borghi A. Di Russo C. Moretti C.
Agostoni P. Loschiavo P. Lioy E. Sheiban I. Sangiorgi G.
Institution
(Romagnoli, Sciahbasi, Pendenza, Summaria, Patrizi, Lioy) Policlinico
Casilino, via Ugo de Carolis 48, 00136 Rome, Italy
(Biondi-Zoccai) Sapienza University of Rome, Rome, Italy
(Politi, Borghi) Meta-Analysis and Evidence-based Medicine Training in
Cardiology, Ospedaletti, Italy
(Rigattieri, Di Russo, Loschiavo) Sandro Pertini Hospital, Rome, Italy
(Moretti, Sheiban) University of Turin, San Giovanni Battista Hospital,
Turin, Italy
(Agostoni) University Medical Center Utrecht, Utrecht, Netherlands
(Sangiorgi) Universita Degli Studi di Roma Tor Vergata, Rome, Italy
Title
Radial versus femoral randomized investigation in st-segment elevation
acute coronary syndrome: The rifle-steacs (radial versus femoral
randomized investigation in st-elevation acute coronary syndrome) study.
Source
Journal of the American College of Cardiology. 60 (24) (pp 2481-2489),
2012. Date of Publication: 18 Dec 2012.
Publisher
Elsevier USA (6277 Sea Harbor Drive, Orlando FL 32862 8239, United States)
Abstract
Objectives: The purpose of this study was to assess whether transradial
access for ST-segment elevation acute coronary syndrome undergoing early
invasive treatment is associated with better outcome compared with
conventional transfemoral access. Background: In patients with acute
coronary syndrome, bleeding is a significant predictor of worse outcome.
Access site complications represent a significant source of bleeding for
those patients undergoing revascularization, especially when femoral
access is used. Methods: The RIFLE-STEACS (Radial Versus Femoral
Randomized Investigation in ST-Elevation Acute Coronary Syndrome) was a
multicenter, randomized, parallel-group study. Between January 2009 and
July 2011, 1,001 acute ST-segment elevation acute coronary syndrome
patients undergoing primary/rescue percutaneous coronary intervention were
randomized to the radial (500) or femoral (501) approach at 4 high-volume
centers. The primary endpoint was the 30-day rate of net adverse clinical
events (NACEs), defined as a composite of cardiac death, stroke,
myocardial infarction, target lesion revascularization, and bleeding).
Individual components of NACEs and length of hospital stay were secondary
endpoints. Results: The primary endpoint of 30-day NACEs occurred in 68
patients (13.6%) in the radial arm and 105 patients (21.0%) in the femoral
arm (p = 0.003). In particular, compared with femoral, radial access was
associated with significantly lower rates of cardiac mortality (5.2% vs.
9.2%, p = 0.020), bleeding (7.8% vs. 12.2%, p = 0.026), and shorter
hospital stay (5 days first to third quartile range, 4 to 7 days] vs. 6
[range, 5 to 8 days]; p = 0.03). Conclusions: Radial access in patients
with ST-segment elevation acute coronary syndrome is associated with
significant clinical benefits, in terms of both lower morbidity and
cardiac mortality. Thus, it should become the recommended approach in
these patients, provided adequate operator and center expertise is
present. (Radial Versus Femoral Investigation in ST Elevation Acute
Coronary Syndrome [RIFLE-STEACS]; NCT01420614) 2012 American College of
Cardiology Foundation.

<7>
Accession Number
2012755513
Authors
Honold J. Fischer-Rasokat U. Lehmann R. Leistner D.M. Seeger F.H.
Schachinger V. Martin H. Dimmeler S. Zeiher A.M. Assmus B.
Institution
(Honold, Fischer-Rasokat, Lehmann, Leistner, Seeger, Zeiher, Assmus)
Division of Cardiology, Department of Medicine III, Goethe University
Frankfurt, Frankfurt, Germany
(Schachinger) Department of Medicine I, Klinikum Fulda, Germany
(Martin) Division of Hematology and Oncology, Department of Medicine II,
Goethe University Frankfurt, Frankfurt, Germany
(Dimmeler) Institute for Cardiovascular Regeneration, Center of Molecular
Medicine, Goethe University Frankfurt, Frankfurt, Germany
Title
G-CSF stimulation and coronary reinfusion of mobilized circulating
mononuclear proangiogenic cells in patients with chronic ischemic heart
disease: Five-year results of the TOPCARE-G-CSF trial.
Source
Cell Transplantation. 21 (11) (pp 2325-2337), 2012. Date of Publication:
2012.
Publisher
Cognizant Communication Corporation (3 Hartsdale Road, Elmsford NY
10523-3701, United States)
Abstract
Prognosis of patients with heart failure remains poor despite improved
conventional and interventional treatment regimens. The improvement of
neovascularization and repair processes by administration of bone
marrow-derived cells modestly improved the recovery after acute myocardial
infarction. However, circulating patient-derived cells are reduced in
number and function particularly in chronic heart failure. Therefore, we
tested the hypothesis whether the mobilization of circulating mononuclear
proangiogenic cells (CPCs) by G-CSF may overcome some of these
limitations. In the present pilot study, 32 patients with at least
3-month-old myocardial infarction were randomized to G-CSF alone (G-CSF
group) or intracoronary infusion of G-CSFmobilized and cultured CPCs into
the infarct-related artery (G-CSF/CPC group). Primary endpoint of the
study was safety. Efficacy parameters included serial assessment of LV
function, NT-proBNP levels, and cardiopulmonary exercise testing. G-CSF
effectively mobilized circulating CD34⁺CD45⁺ cells
after 5 days in all patients (408 +/- 64%) without serious adverse events.
At 3 months, NYHA class and global LV function did not show significant
improvements in both treatment groups (G-CSF: LVEF 1.6 +/- 2.4%; p = 0.10;
G-CSF/CPC: LVEF 1.4 +/- 4.1%; p = 0.16). In contrast, target area
contractility improved significantly in the G-CSF/CPC group. During 5-year
follow-up, one patient died after rehospitalization for worsening heart
failure. Eleven patients underwent further revascularization procedures.
NT-proBNP levels, cardiopulmonary exercise capacity, and NYHA class
remained stable in both treatment groups. The results from our pilot trial
indicate that administration of G-CSF alone or G-CSF-mobilized and
cultured CPCs can be performed safely in patients with chronic ischemic
heart disease. However, only minor effects on LV function, NT-proBNP
levels, and NYHA classification were observed during follow-up, suggesting
that the enhancement of CPCs by G-CSF alone does not substantially improve
intracoronary cell therapy effects in patients with chronic ischemic heart
failure. 2012 Cognizant Comm. Corp.

<8>
Accession Number
2012685186
Authors
de Bruyne B.
Institution
(de Bruyne) OLV-Clinic, Aalst, Belgium
Title
Fractional flow reserve-guided PCI reduced urgent revascularization at 7
months in coronary artery disease.
Source
Annals of Internal Medicine. 157 (10) (pp JC5-9), 2012. Date of
Publication: 20 Nov 2012.
Publisher
American College of Physicians (190 N. Indenpence Mall West, Philadelphia
PA 19106-1572, United States)

<9>
Accession Number
2012744604
Authors
Clark S.C. Dunning J. Alfieri O.R. Elia S. Hamilton L.R. Kappetein P.A.
Lockowandt U. Sarris G.E. Kolh P.H.
Institution
(Clark, Hamilton) Department of Cardiothoracic Surgery, Freeman Hospital,
Newcastle upon Tyne, United Kingdom
(Dunning) Department of Cardiothoracic Surgery, James Cook University
Hospital, Middlesbrough, United Kingdom
(Alfieri) Division of Cardiac Surgery, Ospedale San Raffaele, Milan, Italy
(Elia) Department of Thoracic Surgery, University Tor Vergata, Rome, Italy
(Kappetein) Thoraxcenter, Erasmus MC, Rotterdam, Netherlands
(Lockowandt) Department of Cardiothoracic Surgery, Karolinska University
Hospital, Stockholm, Sweden
(Sarris) Department of Pediatric and Congenital Heart Surgery, Mitera
Children's and Hygeia Hospitals, Athens, Greece
(Kolh) Department of Cardiovascular Surgery, University Hospital of Liege,
Liege, Belgium
Title
EACTS guidelines for the use of patient safety checklists.
Source
European Journal of Cardio-thoracic Surgery. 41 (5) (pp 993-1004), 2012.
Date of Publication: 2012.
Publisher
Oxford University Press (Great Clarendon Street, Oxford OX2 6DP, United
Kingdom)
Abstract
The Safety Checklist concept has been an integral part of many industries
that face high-complexity tasks for many decades and in industries such as
aviation and engineering checklists have evolved from their very
inception. Investigations of the causes of surgical deaths around the
world have repeatedly pointed to medical errors that could be prevented as
an important cause of death and disability. As a result, the World Health
Organisation developed and evaluated a three-stage surgical checklist in
2007 demonstrating that complications were significantly reduced,
including surgical infection rates and even mortality. Together with the
results from other large cohort studies into the utility of the surgical
checklist, many countries have fully implemented the use of surgical
checklists into routine practice. A key factor in the successful
implementation of a surgical checklist is engagement of the staff
implementing the checklist. In surgical specialties such as our own it was
quickly seen that there were many important omissions in the generic
checklist that did not cover issues particular to our specialty, and thus
the European Association for Cardio-Thoracic Surgery embarked on a process
to create a version of the checklist that might be more appropriate and
specific to cardiothoracic surgery, including checks on preparations for
excessive bleeding, perfusion arrangements and ICU preparations, for
example. The guideline presented here summarizes the evidence for the
surgical checklist and also goes through in detail the changes recommended
for our specialty. The Author 2012. Published by Oxford University Press
on behalf of the European Association for Cardio-Thoracic Surgery. All
rights reserved.

<10>
Accession Number
2012741485
Authors
Parenica J. Nemec P. Tomandl J. Ondrasek J. Pavkova-Goldbergova M. Tretina
M. Jarkovsky J. Littnerova S. Poloczek M. Pokorny P. Spinar J. Cermakova
Z. Miklik R. Malik P. Pes O. Lipkova J. Tomandlova M. Kala P.
Institution
(Parenica, Poloczek, Spinar, Miklik, Kala) University Hospital Brno, Brno,
Czech Republic
(Parenica, Poloczek, Spinar, Kala) Medical Faculty, Masaryk University,
Brno, Czech Republic
(Parenica, Nemec, Spinar) International Clinical Research
Center-Department of Cardiovascular Disease, University Hospital St.
Anne's, Brno, Czech Republic
(Nemec, Ondrasek, Tretina, Pokorny, Malik) Center of Cardiovascular
Surgery and Transplantations, Brno, Czech Republic
(Tomandl, Pes, Tomandlova) Institute of Biochemistry, Medical Faculty,
Masaryk University, Brno, Czech Republic
(Pavkova-Goldbergova, Lipkova) Institute of Pathological Physiology,
Faculty of Medicine, Masaryk University, Brno, Czech Republic
(Jarkovsky, Littnerova) Institute of Biostatistics and Analyses, Faculty
of Medicine, Masaryk University, Brno, Czech Republic
(Cermakova) Biochemistry Department, Faculty Hospital Brno, Brno, Czech
Republic
(Cermakova) Institute of Laboratory Methods, Masaryk University, Brno,
Czech Republic
Title
Prognostic Utility of Biomarkers in Predicting of One-Year Outcomes in
Patients with Aortic Stenosis Treated with Transcatheter or Surgical
Aortic Valve Implantation.
Source
PLoS ONE. 7 (12) , 2012. Article Number: e48851. Date of Publication: 14
Dec 2012.
Publisher
Public Library of Science (185 Berry Street, Suite 1300, San Francisco CA
94107, United States)
Abstract
Objectives: The aim of the work was to find biomarkers identifying
patients at high risk of adverse clinical outcomes after TAVI and SAVR in
addition to currently used predictive model (EuroSCORE). Background: There
is limited data about the role of biomarkers in predicting prognosis,
especially when TAVI is available. Methods: The multi-biomarker sub-study
included 42 consecutive high-risk patients (average age 82.0 years;
logistic EuroSCORE 21.0%) allocated to TAVI transfemoral and transapical
using the Edwards-Sapien valve (n = 29), or SAVR with the Edwards
Perimount bioprosthesis (n = 13). Standardized endpoints were
prospectively followed during the 12-month follow-up. Results: The
clinical outcomes after both TAVI and SAVR were comparable.
Malondialdehyde served as the best predictor of a combined endpoint at 1
year with AUC (ROC analysis) = 0.872 for TAVI group, resp. 0.765 (p<0.05)
for both TAVI and SAVR groups. Increased levels of MDA, matrix
metalloproteinase 2, tissue inhibitor of metalloproteinase (TIMP1),
ferritin-reducing ability of plasma, homocysteine, cysteine and
8-hydroxy-2-deoxyguanosine were all predictors of the occurrence of
combined safety endpoints at 30 days (AUC 0.750-0.948; p<0.05 for all).
The addition of MDA to a currently used clinical model (EuroSCORE)
significantly improved prediction of a combined safety endpoint at 30 days
and a combined endpoint (0-365 days) by the net reclassification
improvement (NRI) and the integrated discrimination improvement (IDI)
(p<0.05). Cystatin C, glutathione, cysteinylglycine, asymmetric
dimethylarginine, nitrite/nitrate and MMP9 did not prove to be
significant. Total of 14.3% died during 1-year follow-up. Conclusion: We
identified malondialdehyde, a marker of oxidative stress, as the most
promising predictor of adverse outcomes during the 30-day and 1-year
follow-up in high-risk patients with symptomatic, severe aortic stenosis
treated with TAVI. The development of a clinical "TAVIscore" would be
highly appreciated. Such dedicated scoring system would enable further
testing of adjunctive value of various biomarkers. 2012 Parenica et al.

<11>
Accession Number
2012745067
Authors
D'Ascenzo F. Agostoni P. Abbate A. Castagno D. Lipinski M.J. Vetrovec G.W.
Frati G. Presutti D.G. Quadri G. Moretti C. Gaita F. Zoccai G.B.
Institution
(D'Ascenzo, Castagno, Presutti, Quadri, Moretti, Gaita) Division of
Cardiology, University of Turin, Italy
(Frati, Zoccai) Department of Medico-Surgical Sciences and
Biotechnologies, Sapienza University of Rome, Italy
(Agostoni) Department of Cardiology, University Medical Center Utrecht,
Netherlands
(Abbate, Lipinski, Vetrovec) Virginia Commonwealth University, Richmond,
VA, United States
(Abbate, Lipinski, Vetrovec) University of Virginia, Charlottesville, VA,
United States
Title
Atherosclerotic coronary plaque regression and the risk of adverse
cardiovascular events: A meta-regression of randomized clinical trials.
Source
Atherosclerosis. 226 (1) (pp 178-185), 2013. Date of Publication: January
2013.
Publisher
Elsevier Ireland Ltd (P.O. Box 85, Limerick, Ireland)
Abstract
Introduction: Atherosclerotic coronary plaques represent the main
substrate for coronary artery disease (CAD), and changes in plaque volume,
investigated with intravascular ultrasound (IVUS), have been used as
surrogate end-points in several clinical trials. However, no conclusive
data are available to support the exploitation of IVUS-based plaque
changes as a measure of clinically meaningful treatment's effect. Methods:
Biomed Central, CENTRAL, and Medline/PubMed were searched for randomized
clinical trials investigating IVUS variations of plaque and reporting
clinical events. End-points of interest were major adverse cardiovascular
events (MACE, a composite of death, myocardial infarction [MI] or
revascularization), and the rates of MI or revascularization combined.
Meta-regression analysis was performed to appraise the association between
plaque changes and clinical events during follow-up. Results: Eleven
studies (2 focusing on patients with ACS) with 7864 patients were
included. After a median follow-up of 18 months, percentage of atheroma
volume (PAV) was 0.50 (95% confidence interval -0.25; 1.00), with a 15.0%
(95% CI 9.6%; 22.5%) rate of MACE and a 14.1% (95% CI 10.2%; 19.5%) rate
of MI or revascularization. Rates of plaque volume regression were
significantly associated with the incidence of MI or revascularization
(Beta = 6.3; p = 0.006) but not with MACE (Beta = 0.42; p = 0.208).
Conclusion: Regression of atherosclerotic coronary plaque volume may
represent a surrogate for myocardial infarction and repeat
revascularization but not for MACE. These results derive largely from
stable patients, and should consequently be applied only to this
population. 2012 Elsevier Ireland Ltd.

<12>
Accession Number
2012738258
Authors
Farkouh M.E. Domanski M. Sleeper L.A. Siami F.S. Dangas G. Mack M. Yang M.
Cohen D.J. Rosenberg Y. Solomon S.D. Desai A.S. Gersh B.J. Magnuson E.A.
Lansky A. Boineau R. Weinberger J. Ramanathan K. Sousa J.E. Rankin J.
Bhargava B. Buse J. Hueb W. Smith C.R. Muratov V. Bansilal S. King III S.
Bertrand M. Fuster V.
Institution
(Farkouh, Domanski, Dangas, Weinberger, Bansilal, Fuster) Michael A.
Wiener Cardiovascular Institute, Marie-Josee and Henry R. Kravis Center
for Cardiovascular Health, Mount Sinai School of Medicine, 1 Gustave L.
Levy Pl., Box 1030, New York, NY 10029, United States
(Dangas) Cardiovascular Research Foundation, New York, NY, United States
(Smith) New York Presbyterian Medical Center, New York, NY, United States
(Farkouh) Peter Munk Cardiac Centre, Li Ka Shing Knowledge Institute,
University of Toronto, Toronto, Canada
(Ramanathan) University of British Columbia, Vancouver, BC, Canada
(Sleeper, Siami, Yang, Muratov) New England Research Institutes,
Watertown, MA, United States
(Solomon, Desai) Cardiovascular Division, Brigham and Women's Hospital,
Boston, MA, United States
(Mack) Baylor University Medical Center, Dallas, TX, United States
(Cohen, Magnuson) St. Luke's Mid-America Heart Institute, University of
Missouri-Kansas City, Kansas City, MO, United States
(Rosenberg, Boineau) National Heart, Lung, and Blood Institute, Bethesda,
MD, United States
(Gersh) Mayo Clinic, Rochester, MN, United States
(Lansky) Yale University, New Haven, CT, United States
(Sousa) Dante Pazzanese Hospital, Sao Paulo, Brazil
(Hueb) Heart Institute InCor, University of Sao Paulo Medical School, Sao
Paulo, Brazil
(Rankin) Royal Perth Hospital, Perth, WA, Australia
(Bhargava) All India Institute of Medical Sciences, New Delhi, India
(Buse) University of North Carolina, Chapel Hill, NC, United States
(King III) St. Joseph's Hospital, Atlanta, United States
(Bertrand) University of Lille, Lille, France
(Fuster) Centro Nacional de Investigaciones Cardiovasculares, Madrid,
Spain
Title
Strategies for multivessel revascularization in patients with diabetes.
Source
New England Journal of Medicine. 367 (25) (pp 2375-2384), 2012. Date of
Publication: 20 Dec 2012.
Publisher
Massachussetts Medical Society (860 Winter Street, Waltham MA 02451-1413,
United States)
Abstract
BACKGROUND: In some randomized trials comparing revascularization
strategies for patients with diabetes, coronary-artery bypass grafting
(CABG) has had a better outcome than percutaneous coronary intervention
(PCI). We sought to discover whether aggressive medical therapy and the
use of drug-eluting stents could alter the revascularization approach for
patients with diabetes and multivessel coronary artery disease. METHODS:
In this randomized trial, we assigned patients with diabetes and
multivessel coronary artery disease to undergo either PCI with
drug-eluting stents or CABG. The patients were followed for a minimum of 2
years (median among survivors, 3.8 years). All patients were prescribed
currently recommended medical therapies for the control of low-density
lipoprotein cholesterol, systolic blood pressure, and glycated hemoglobin.
The primary outcome measure was a composite of death from any cause,
nonfatal myocardial infarction, or nonfatal stroke. RESULTS: From 2005
through 2010, we enrolled 1900 patients at 140 international centers. The
patients' mean age was 63.1+/-9.1 years, 29% were women, and 83% had
three-vessel disease. The primary outcome occurred more frequently in the
PCI group (P = 0.005), with 5-year rates of 26.6% in the PCI group and
18.7% in the CABG group. The benefit of CABG was driven by differences in
rates of both myocardial infarction (P<0.001) and death from any cause (P
= 0.049). Stroke was more frequent in the CABG group, with 5-year rates of
2.4% in the PCI group and 5.2% in the CABG group (P = 0.03). CONCLUSIONS:
For patients with diabetes and advanced coronary artery disease, CABG was
superior to PCI in that it significantly reduced rates of death and
myocardial infarction, with a higher rate of stroke. (Funded by the
National Heart, Lung, and Blood Institute and others; FREEDOM
ClinicalTrials.gov number, NCT00086450.) Copyright 2012 Massachusetts
Medical Society.

<13>
Accession Number
2012747719
Authors
Prasad S.R. Simha P.P. Jagadeesh A.M.
Institution
(Prasad, Simha, Jagadeesh) Department of Cardiac Anaesthesia, Sri Jayadeva
Institute of Cardiovascular Sciences and Research, Bannerghatta Road,
Bangalore, Karnataka, India
Title
Comparative study between dexmedetomidine and fentanyl for sedation during
mechanical ventilation in post-operative paediatric cardiac surgical
patients.
Source
Indian Journal of Anaesthesia. 56 (6) (pp 547-552), 2012. Date of
Publication: 2012.
Publisher
Indian Society of Anaesthetists (Flat No 12/1A K Point, 68-BAPC Roy Road,
Kolkata 700009, India)
Abstract
Aims and Objectives: To compare the effcacy of sedation and time taken for
extubation using dexmedetomidine and fentanyl sedation in post-operative
paediatric cardiac surgical patients. Methods: A prospective randomized
double-blind study involving 60 children undergoing open heart surgery was
conducted. The patients were divided into two groups, each involving 30
patients. One group received fentanyl at 1 mug/kg/h (Group A) and the
other received dexmedetomidine at 0.5 mug/kg/h (Group B) for
post-operative sedation with intermittent rescue fentanyl 0.5 mug/kg bolus
in either group as per requirement during suctioning. The effcacy of
sedation was assessed using the Ramsay sedation score, paediatric
intensive care unit sedation score and the tracheal suction score. The
time taken for extubation from the stoppage of infusion was noted.
Results: Haemodynamic parameters between the two groups were comparable.
All sedation scores were comparable in the fentanyl and dexmedetomidine
groups. Average time (in minutes) required for extubation was 131.0
(+/-51.06 SD) in the dexmedetomidine group compared with 373.0 (+/-121.4
SD) in the fentanyl group. The difference in mean time for extubation was
statistically significant. Conclusions: Dexmedetomidine facilitates
adequate sedation for mechanical ventilation and also early extubation as
compared with fentanyl.

<14>
Accession Number
2012647656
Title
Glargine did not reduce CV events more than standard care in patients with
dysglycemia.
Source
Annals of Internal Medicine. 157 (6) (pp JC3-10), 2012. Date of
Publication: 18 Sep 2012.
Publisher
American College of Physicians (190 N. Indenpence Mall West, Philadelphia
PA 19106-1572, United States)

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<1>
Accession Number
2012736191
Authors
Howell N. Senanayake E. Freemantle N. Pagano D.
Institution
(Howell, Senanayake, Pagano) Department of Cardiac Surgery, University
Hospital Birmingham, Birmingham, United Kingdom
(Howell, Senanayake, Pagano) School of Clinical and Experimental Medicine,
University Hospital Birmingham, Birmingham, United Kingdom
(Freemantle) Department of Primary Care and Population Health, University
College London, London, United Kingdom
Title
Putting the record straight on aprotinin as safe and effective: Results
from a mixed treatment meta-analysis of trials of aprotinin.
Source
Journal of Thoracic and Cardiovascular Surgery. 145 (1) (pp 234-240),
2013. Date of Publication: January 2013.
Publisher
Mosby Inc. (11830 Westline Industrial Drive, St. Louis MO 63146, United
States)
Abstract
Objective: Meta-analysis of small, randomized, placebo-controlled trials
demonstrated efficacy and safety of aprotinin. After highly publicized
retrospective studies and the early stopping of the Blood Conservation
Using Antifibrinolytics in a Randomized Trial (BART), aprotinin was
withdrawn. We conducted a new meta-analysis (including BART) on safety and
efficacy of aprotinin in cardiac surgery. Methods: We conducted a mixed
treatment comparisons network meta-analysis estimating the effects of
aprotinin and alternative agents in reducing blood loss during surgery. We
implemented a combination of direct and indirect evidence in mixed
treatment comparisons and estimated relative effects for different agents
on all-cause mortality and return to the operating room for bleeding and
conducted a supportive analysis of the effects of different agents with
only directly randomized trials. Results: Mixed treatment analysis of 88
trials randomizing 15,528 patients to 1 of 3 antifibrinolytic agents
demonstrated no difference in mortality between placebo and
antifibrinolytic agents. Analysis of aprotinin versus tranexamic acid and
-aminocaproic acid in 17 and 6 trials, respectively and tranexamic acid
versus -aminocaproic acid in 5 trials demonstrated no difference in
mortality between treatment allocations. All agents were superior to
placebo in reducing reexploration for bleeding, with aprotinin numerically
superior: aprotinin odds ratio, 2.6 (95% confidence interval, 1.9-3.7);
tranexamic acid odds ratio, 1.79 (1.2-2.9), and -aminocaproic acid odds
ratio, 2.4 (1.3-6.6). Conclusions: This mixed treatment comparisons
meta-analysis demonstrates no increased mortality risk with aprotinin
versus other antifibrinolytic agents. All agents were superior to placebo
in reducing reexploration for bleeding after adult cardiac surgery.
Copyright 2013 by The American Association for Thoracic Surgery.

<2>
Accession Number
2012745188
Authors
Rortgen D. Bergrath S. Rossaint R. Beckers S.K. Fischermann H. Na I.-S.
Peters D. Fitzner C. Skorning M.
Institution
(Rortgen, Bergrath, Rossaint, Beckers, Fischermann, Na, Peters, Skorning)
Section Emergency Medical Care, Department of Anaesthesiology, University
Hospital Aachen, RWTH Aachen University, Germany
(Beckers) Department of Intensive Care Medicine and Intermediate Care,
University Hospital Aachen, RWTH Aachen University, Germany
(Fitzner) Department of Medical Statistics, RWTH Aachen University,
Germany
Title
Comparison of physician staffed emergency teams with paramedic teams
assisted by telemedicine - a randomized, controlled simulation study.
Source
Resuscitation. 84 (1) (pp 85-92), 2013. Date of Publication: January 2013.
Publisher
Elsevier Ireland Ltd (P.O. Box 85, Limerick, Ireland)
Abstract
Purpose and background: Emergency medical services (EMSs) vary
considerably. While some are physician staffed, most systems are run by
paramedics. The objective of this randomized, controlled simulation study
was to compare the emergency care between physician staffed EMS teams
(control group) and paramedic teams that were supported telemedically by
an EMS physician (telemedicine group). Methods: Overall 16 teams (1 EMS
physician, 2 paramedics) were randomized to the control group or the
telemedicine group. Telemedical functionalities included two-way audio
communication, transmission of vital data (numerical values and curves)
and video streaming from the scenario room to the remotely located EMS
physician. After a run-in scenario all teams completed four standardized
scenarios, in which no highly invasive procedures (e.g. thoracic drain)
were required, two using high-fidelity simulation (burn trauma,
intoxication) and two using standardized patients (renal colic,
barotrauma). All scenarios were videotaped and analyzed by two
investigators using predefined scoring items. Results: Non case-specific
items (31 vs. 31 scenarios): obtaining of 'symptoms', 'past medical
history' and 'events' were carried out comparably, but in the telemedicine
group 'allergies' (17 vs. 28, OR 7.69, CI 2.1-27.9, p=0.002) and
'medications' (17 vs. 27, OR 5.55, CI 1.7-18.0, p=0.004) were inquired
more frequently. No significant differences were found regarding the
case-specific items and in both groups no potentially dangerous
mistreatments were observed. Conclusion: Telemedically assisted paramedic
care was feasible and at least not inferior compared to standard EMS teams
with a physician on-scene in these scenarios. 2012 Elsevier Ireland Ltd.

<3>
Accession Number
2012742468
Authors
Cardillo G. Carleo F. Carbone L. De Massimi A.R. Lococo A. Santini P.F.
Janni A. Gonfiotti A.
Institution
(Cardillo, Carleo, Carbone, De Massimi) Unit of Thoracic Surgery, Carlo
Forlanini Hospital, Azienda Ospedaliera S. Camillo Forlanini, Rome, Italy
(Lococo) Unit of Thoracic Surgery, Pescara General Hospital, Pescara,
Italy
(Santini, Janni, Gonfiotti) Unit of Thoracic Surgery, Careggi Hospital,
Florence, Italy
Title
Adverse effects of fibrin sealants in thoracic surgery: The safety of a
new fibrin sealant: Multicentre, randomized, controlled, clinical trial.
Source
European Journal of Cardio-thoracic Surgery. 41 (3) (pp 657-662), 2012.
Date of Publication: 2012.
Publisher
Oxford University Press (Great Clarendon Street, Oxford OX2 6DP, United
Kingdom)
Abstract
Objectives: The safety of fibrin sealants (FS) has been questioned in the
light of recent reports of adverse effects. We evaluated the safety of a
new FS in a randomized controlled trial (RCT). Methods: Multicentre,
open-label Phase II/III RCT to evaluate the safety of the new FS. The
trial was approved by the Ethic Committee of each three
participatingCentre. FS includes two components (component 1: fibrinogen;
component 2: thrombin), each of them subjected to two viralinactivation
procedures. Out of 200 screened patients, 185 eligible patients (49
females, 136 males), aged between 18 and 75 years, undergoing major
thoracic surgery were randomized to receive FS (#91 patients) as an
adjuvant for air leak control or no treatment (#94 patients, control
group). Safety variables were: percentage of subjects with adverse
eventsassociated with the therapy; formation of antibodies against bovine
aprotinin; vital signs (blood pressure, body temperature, heart and
respiratory rate); laboratory parameters. Results: Overall operative
mortality was 3.2% (6/185), 1.1% in the FS group and 5.3% in the control
group, respectively. Twenty patients (22%) had adverse events in the FS
group and 22 (23.4%) in the control group. Atrial fibrillation (five
patients in the FS group and four in the control group) and hyperpyrexia
(five and seven patients, respectively, in the two groups) were the most
common adverse events. No patient reported thromboembolic events
(pulmonary embolism or deep vein thrombosis) during the in hospital stay
or within 1 month from discharge. None of the adverse events was
considered as treatment related. The formation of bovine aprotinin
antibodies was reported in a total of 34 patients (37.4%) in the FS group
and was not related to any adverse effect. Conclusions: The present RCT
did not show any increased risk of adverse events, and of surgical
complications, related to the use of the new FS. The Author 2011.
Published by Oxford University Press on behalf of the European Association
for Cardio-Thoracic Surgery. All rights reserved.

<4>
Accession Number
2012742452
Authors
Aydemir N. Harmanda B. Karac A.R. Erdem A. Yurtseven N. Sasmaze A. Yekeler
I.
Institution
(Aydemir, Harmanda, Karac, Sasmaze, Yekeler) Department of Pediatric
Cardiac Surgery, Dr. Siyami Ersek Thoracic and Cardiovascular Training and
Research Hospital, Istanbul, Turkey
(Erdem) Department of Pediatric Cardiology, Dr. Siyami Ersek Thoracic and
Cardiovascular Training and Research Hospital, Istanbul, Turkey
(Yurtseven) Department of Anesthesiology and Reanimation, Dr. Siyami Ersek
Thoracic and Cardiovascular Training and Research Hospital, Istanbul,
Turkey
Title
Randomized comparison between mild and moderate hypothermic
cardiopulmonary bypass for neonatal arterial switch operation.
Source
European Journal of Cardio-thoracic Surgery. 41 (3) (pp 581-586), 2012.
Date of Publication: 2012.
Publisher
Oxford University Press (Great Clarendon Street, Oxford OX2 6DP, United
Kingdom)
Abstract
Objectives: To compare neonates receiving arterial switch operation (ASO)
either with mild or moderate hypothermic cardiopulmonary bypass. Methods:
Forty neonates undergoing ASO were randomized to receive either mild
(Mi>32degreeC, n=20) or moderate (Mo>26degreeC, n=20) hypothermic
cardiopulmonary bypass (CPB) between April 2007 and June 2010. All
patients were diagnosed with simple transposition of the great arteries.
Mean age (Mi: 8.32 +/-4.5 days, Mo: 7.54 +/-5.0 days, P=0.21) and body
weight were similar in both groups (Mi: 3.64 +/- 0.91 kg, Mo: 3.73 +/-
0.84 kg, P=0.14). Follow-up was 3.1 +/- 2.5 years for all patients.
Results: Lowest perioperative rectal temperature was 33.5+/- 1.4degreeC
(Mi) versus 28.2+/-2.1degreeC (Mo) (P<0.001). All patients safely weaned
from CPB required lower doses of dopamine (Mi: 5.1 +/-2.4 mug/kg min, Mo:
6.5 +/-2.1 mu/kg min, P=0.04), dobutamine (Mi: 7.2 +/- 2.5 mug/kg min, Mo:
8.6+/-2.4mu/kg min, P=0.04) and adrenalin (Mi: 0.02 +/- 0.02 mug/kg min,
Mo: 0.05 +/-0.03 mu/kg min, P=0.03) in mild hypothermia group.
Intraoperative blood transfusion (Mi: 190 +/-58 ml, Mo: 230 +/-24 ml,
P=0.03) and postoperative lactate levels (Mi: 2.7 +/-0.9 mmol/l, Mo: 3.1
+/-2.2 mmol/l, P=0.02) were lower under mild hypothermia. Secondary chest
closure was performed in 30% (Mi) versus 35% (Mo) (P=0.65). Duration of
inotropic support (Mi: 7 (4-11) days, Mo: 11 (7-15) days, P=0.03), time to
extubation (Mi: 108 (88-128) h, Mo: 128 (102-210) h, P=0.04), lengths of
intensive care unit (ICU) stay (Mi: 9 (5-14) days, Mo: 12 (10-18) days,
P=0.04) and hospital stay (Mi: 19 (10-29) days, Mo: 23 (15-37) days,
P=0.04) were significantly shorter under mild hypothermia. Two-year
freedom from reoperation was 100% for both the groups. Conclusions: The
ASO under mild hypothermia seemed to be beneficial for pulmonary recovery,
need for inotropic support and length of ICU and hospital stay. No worse
early-or intermediate-term effects of mild hypothermia were found. The
Author 2011. Published by Oxford University Press on behalf of the
European Association for Cardio-Thoracic Surgery. All rights reserved.

<5>
Accession Number
2012742387
Authors
Aarsaether E. Straumbotn E. Rosner A. Busund R.
Institution
(Aarsaether, Rosner, Busund) Department of Cardiothoracic and Vascular
Surgery, University Hospital of North Norway, Tromso, Norway
(Straumbotn, Rosner, Busund) Department of Clinical Medicine, Faculty of
Health Sciences, University of Tromso, Tromso, Norway
Title
Oral beta-glucan reduces infarction size and improves regional contractile
function in a porcine ischaemia/reperfusion model.
Source
European Journal of Cardio-thoracic Surgery. 41 (4) (pp 919-925), 2012.
Date of Publication: 2012.
Publisher
Oxford University Press (Great Clarendon Street, Oxford OX2 6DP, United
Kingdom)
Abstract
Objectives: We previously reported a cardioprotective effect of oral
beta-glucan in patients who underwent coronary artery bypass grafting. The
present study was conducted to determine whether oral beta-glucan could
reduce myocardial infarction size and whether these changes would be
reflected by better preservation of contractile indices measured by
speckle tracking echocardiography (STE). Methods: Fourteen pigs were
randomized to receive oral beta-glucan 50 mg/kg (n = 7) or placebo
(control, n = 7) 10 days before they were anaesthetized and subjected to 1
h clamping of the left anterior descending coronary artery followed by
reperfusion for 3 h. Longitudinal strain, circumferential strain and
radial strain were assessed by STE after 3 h of reperfusion. Infarction
size and area at risk were determined by Evans blue and
2,3,5-triphenyltetrazolium chloride staining. Results: Pretreatment with
beta-glucan reduced the infarct area/area at risk ratio by 36% (P < 0.05)
and the total necrotic area of the left ventricle by 37% (P < 0.05)
compared with controls. Viable myocardium at risk was 30% higher in the
beta-glucan vs. control group (P < 0.05). Anterior apical strain values
for beta-glucan vs. control were -4.7 +/- 9.4 vs. 5.9 +/- 6.1% (P < 0.05)
for longitudinal strain, -14.7 +/- 6.6 vs. -7.7 +/- 4.3 (P < 0.05) for
circumferential strain, 15.1 +/- 7.7 vs. 7.1 +/- 11.8 (ns) for radial
strain. Conclusions: Oral beta-glucan pretreatment reduces infarction size
and improves regional contractile function in a porcine
ischaemia/reperfusion model. The Author 2012. Published by Oxford
University Press on behalf of the European Association for Cardio-Thoracic
Surgery. All rights reserved.

<6>
Accession Number
2012742354
Authors
Siregar S. Groenwold R.H.H. de Heer F. Bots M.L. van der Graaf Y. van
Herwerden L.A.
Institution
(Siregar, de Heer, van Herwerden) Department of Cardio-Thoracic Surgery,
Heart and Lungs Division, University Medical Center Utrecht, Utrecht,
Netherlands
(Siregar, Groenwold, Bots, van der Graaf) Julius Center for Health
Sciences and Primary Care, University Medical Center Utrecht, Utrecht,
Netherlands
Title
Performance of the original EuroSCORE.
Source
European Journal of Cardio-thoracic Surgery. 41 (4) (pp 746-754), 2012.
Date of Publication: 2012.
Publisher
Oxford University Press (Great Clarendon Street, Oxford OX2 6DP, United
Kingdom)
Abstract
The European system for cardiac operative risk evaluation (EuroSCORE) is a
commonly used risk score for operative mortality following cardiac
surgery. We aimed to conduct a systematic review of the performance of the
additive and logistic EuroSCORE. A literature search resulted in 67
articles. Studies applying the EuroSCORE on patients undergoing cardiac
surgery and which reported early mortality were included. Weighted
meta-regression showed that the EuroSCORE overestimated mortality.
However, this performance depended on the risk profile of patients: in
high-risk patients, the additive model actually underestimated mortality.
Discriminative performance was good. Given the poor predictive
performance, the EuroSCORE may not be suitable as a tool for patient
selection nor for benchmarking. The Author 2012. Published by Oxford
University Press on behalf of the European Association for Cardio-Thoracic
Surgery. All rights reserved.

<7>
Accession Number
2012740074
Authors
Yu J. Mehran R. Dangas G.D. Claessen B.E. Baber U. Xu K. Parise H. Fahy M.
Lansky A.J. Witzenbichler B. Grines C.L. Guagliumi G. Kornowski R. Wohrle
J. Dudek D. Weisz G. Stone G.W.
Institution
(Yu, Mehran, Dangas, Baber, Weisz, Stone) Zena and Michael A. Weiner
Cardiovascular Institute, Mount Sinai Medical Center, Mount Sinai School
of Medicine, One Gustave L. Levy Place, New York, NY 10029, United States
(Yu) Prince of Wales Clinical School, Randwick, NSW, Australia
(Mehran, Dangas, Claessen, Xu, Parise, Fahy) Clinical Trials Center,
Cardiovascular Research Foundation, New York, NY, United States
(Lansky) Yale Cardiovascular Research Group, Yale University School of
Medicine, New Haven, CT, United States
(Witzenbichler) Detroit Medical Center Heart and Vascular Institute,
Detroit, MI, United States
(Grines) Charite Campus Benjamin Franklin, Berlin, Germany
(Guagliumi) Clinic of Internal Medicine II, University of Ulm, Ulm,
Germany
(Kornowski) Cardiovascular Department, Ospedali Riuniti di Bergamo,
Bergamo, Italy
(Wohrle) Interventional Cardiology, Rabin Medical Center, Petah Tikva,
Israel
(Dudek) Jagiellonian University, Krakow, Poland
(Weisz, Stone) Division of Cardiology, Columbia University Medical Center,
New York, NY, United States
Title
Safety and efficacy of high- versus low-dose aspirin after primary
percutaneous coronary intervention in ST-segment elevation myocardial
infarction: The HORIZONS-AMI (Harmonizing Outcomes with Revascularization
and Stents in Acute Myocardial Infarction) trial.
Source
JACC: Cardiovascular Interventions. 5 (12) (pp 1231-1238), 2012. Date of
Publication: December 2012.
Publisher
Elsevier Inc. (360 Park Avenue South, New York NY 10010, United States)
Abstract
Objectives: This study sought to examine the relationship between the
aspirin dose prescribed at hospital discharge and long-term outcomes after
ST-segment elevation myocardial infarction in patients treated with
primary percutaneous coronary intervention (PCI). Background: Patients
with ST-segment elevation myocardial infarction who undergo primary PCI
are prescribed maintenance aspirin doses that vary between 75 and 325 mg
daily. Whether the dose of aspirin affects long-term patient outcomes is
unknown. Methods: We compared 3-year outcomes in patients who were
prescribed high-dose (>200 mg daily) versus low-dose (<=200 mg daily)
aspirin from the large-scale HORIZONS-AMI (Harmonizing Outcomes With
Revascularization and Stents in Acute Myocardial Infarction) trial.
Results: Among 2,851 patients, 2,289 patients (80.3%) were discharged on
low-dose aspirin and 562 patients (19.7%) were discharged on high-dose
aspirin. Patients discharged on high-dose rather than low-dose aspirin
were more likely to have a history of hypertension, hyperlipidemia, family
history of premature coronary disease, prior treatment with PCI or
coronary artery bypass surgery, and to be enrolled in the United States.
Patients discharged on high-dose aspirin had higher 3-year rates of major
adverse cardiovascular events, reinfarction, ischemic target vessel
revascularization, major bleeding, and stent thrombosis. After
multivariable analysis, discharge on high-dose aspirin was an independent
predictor of major bleeding (hazard ratio: 2.80; 95% confidence interval:
1.31 to 5.99; p = 0.008), but not of adverse ischemic events. Conclusions:
In patients with ST-segment elevation myocardial infarction undergoing
primary PCI, discharge on high-dose rather than low-dose aspirin may
increase the rate of major bleeding without providing additional ischemic
benefit. 2012 American College of Cardiology Foundation.

<8>
Accession Number
2012740073
Authors
Van Geuns R.-J. Tamburino C. Fajadet J. Vrolix M. Witzenbichler B.
Eeckhout E. Spaulding C. Reczuch K. La Manna A. Spaargaren R.
Garcia-Garcia H.M. Regar E. Capodanno D. Van Langenhove G. Verheye S.
Institution
(Van Geuns, Regar) Thoraxcenter, Erasmus Medical Center, Rotterdam,
Netherlands
(Tamburino, La Manna, Capodanno) Division of Cardiology, Ferrarotto
Hospital, University of Catania, Catania, Italy
(Fajadet) Department of Interventional Cardiology, Clinique Pasteur,
Toulouse, France
(Vrolix) Department of Cardiology, Ziekenhuis Oost-Limburg, Genk, Belgium
(Witzenbichler) Department of Cardiology, Charite Campus Benjamin
Franklin, Berlin, Germany
(Eeckhout) Cardiology Service, Centre Hospitalier Universitaire Vaudois,
Lausanne, Switzerland
(Spaulding) Hopital Europeen Georges Pompidou, Assistance Publique
Hopitaux de Paris, Paris Descartes University, Paris, France
(Spaulding) Institut National de la Sante et de la Recherche Medicale
Unite 970, Paris, France
(Reczuch) Military Hospital, Wroclaw, Poland
(Reczuch) Medical University, Wroclaw, Poland
(Spaargaren) STENTYS SA, Paris, France
(Garcia-Garcia) Cardialysis, Rotterdam, Netherlands
(Van Langenhove, Verheye) Department of Cardiology, Antwerp Cardiovascular
Center, ZNA Middelheim, Antwerp, Belgium
Title
Self-expanding versus balloon-expandable stents in acute myocardial
infarction: Results from the APPOSITION II Study: Self-expanding stents in
ST-segment elevation myocardial infarction.
Source
JACC: Cardiovascular Interventions. 5 (12) (pp 1209-1219), 2012. Date of
Publication: December 2012.
Publisher
Elsevier Inc. (360 Park Avenue South, New York NY 10010, United States)
Abstract
Objectives: This study sought to investigate whether self-expanding stents
are more effective than balloon-expandable stents for reducing stent
malapposition at 3 days after implantation in patients with ST-segment
elevation myocardial infarction undergoing primary percutaneous coronary
intervention. Background: Acute myocardial infarction is associated with
vasoconstriction and large thrombus burden. Resolution of vasoconstriction
and thrombus load during the first hours to days after primary
percutaneous coronary intervention may lead to stent undersizing and
malapposition, which may subsequently lead to stent thrombosis or
restenosis. In addition, aggressive stent deployment may cause distal
embolization. Methods: Eighty patients with ST-segment elevation
myocardial infarction undergoing primary percutaneous coronary
intervention were randomized to receive a self-expanding stent (STENTYS,
STENTYS SA, Paris, France) (n = 43) or a balloon-expandable stent (VISION,
Abbott Vascular, Santa Clara, California; or Driver, Medtronic,
Minneapolis, Minnesota) (n = 37) at 9 European centers. The primary
endpoint was the proportion of stent strut malapposition at 3 days after
implantation measured by optical coherence tomography. Secondary endpoints
included major adverse cardiac events (cardiac death, recurrent myocardial
infarction, emergent bypass surgery, or clinically driven target lesion
revascularization). Results: At 3 days after implantation, on a per-strut
basis, a lower rate of malapposed stent struts was observed by optical
coherence tomography in the self-expanding stent group than in the
balloon-expandable group (0.58% vs. 5.46%, p < 0.001). On a per-patient
basis, none of the patients in the self-expanding stent group versus 28%
in the balloon-expandable group presented >=5% malapposed struts (p <
0.001). At 6 months, major adverse cardiac events were 2.3% versus 0% in
the self-expanding and balloon-expandable groups, respectively (p = NS).
Conclusions: Strut malapposition at 3 days is significantly lower in
ST-segment elevation myocardial infarction patients allocated to
self-expanding stents when than in those allocated to balloon-expandable
stents. The impact of this difference on clinical outcome and the risk of
late stent thrombosis need to be evaluated further. (Randomized Comparison
Between the STENTYS Self-expanding Coronary Stent and a Balloon-expandable
Stent in Acute Myocardial Infarction [APPOSITION II]; NCT01008085) 2012
American College of Cardiology Foundation.

<9>
Accession Number
2012742546
Authors
Khan R. Jang I.-K.
Institution
(Khan) Department of Medicine, Division of Cardiology, University of
Western Ontario, London, ON, Canada
(Jang) Department of Medicine, Division of Cardiology, Massachusetts
General Hospital and Harvard Medical School, Boston, MA, United States
Title
Evaluation of coronary allograft vasculopathy using multi-detector row
computed tomography: A systematic review.
Source
European Journal of Cardio-thoracic Surgery. 41 (2) (pp 415-422), 2012.
Date of Publication: 2012.
Publisher
Oxford University Press (Great Clarendon Street, Oxford OX2 6DP, United
Kingdom)
Abstract
Coronary allograft vasculopathy (CAV) is a significant cause of morbidity
and mortality aftercardiac transplantation and requires frequent
surveillance with catheter-based coronary angiography (CCA).
Multi-detector row computed tomography (MDCT) has been shown to be
effective in assessingatherosclerosis in native coronary arteries. This
article systematically reviews the literature todetermine the accuracy of
MDCT in CAV assessment. An English-language literature search was
performed using EMBASE, OVID, PubMed, and Cochrane Library databases.
Studies that directly compared MDCT with CCA and/or IVUS for the detection
of coronary artery stenosis or significant intimal thickening in cardiac
transplant patients were analyzed. Data were pooled to obtain weighted
sensitivities, specificities, and diagnostic accuracies. Negative and
positive predictive values (NPV/PPV)were calculated. A total of seven
studies with a sum of 272 patients were included in this review. There
were three studies examining 16-slice MDCTand four studies looking at
64-slice MDCT in CAV.Using per-segment analysis, MDCTassessed between 91%
and 96% of all coronary segments when evaluatingfor stenosis. Pooled
estimates for sensitivity and specificity for MDCT ranged from 82% to 89%
an 89% to 99%, respectively, while NPV was 99%. Per-patient analysis
revealed a sensitivity of 87-100% and NPV of 96-100%. PPV was less than
50% for 64-slice MDCT in both per-segment and per-patient analysis. When
compared with IVUS, MDCT had a sensitivity of 74-96% and specificity of
88-92%in assessment of intimal thickening. NPV and PPV were 80-81% and
84-98%, respectively. The high sensitivity and NPV of MDCTsuggest that it
may be a useful, noninvasive screening tool to rule out CAV. The Author
2011. Published by Oxford University Press on behalf of the European
Association for Cardio-Thoracic Surgery. All rights reserved.

<10>
Accession Number
2012742591
Authors
Biancari F. Mikkola R. Heikkinen J. Lahtinen J. Airaksinen K.E.J. Juvonen
T.
Institution
(Biancari, Mikkola, Heikkinen, Lahtinen, Juvonen) Department of Surgery,
Oulu University Hospital, Oulu, Finland
(Airaksinen) Division of Cardiology, Department of Internal Medicine,
Turku University Hospital, Turku, Finland
Title
Estimating the risk of complications related to re- exploration for
bleeding after adult cardiac surgery: A systematic review and
meta-analysis.
Source
European Journal of Cardio-thoracic Surgery. 41 (1) (pp 50-55), 2012. Date
of Publication: 2012.
Publisher
Oxford University Press (Great Clarendon Street, Oxford OX2 6DP, United
Kingdom)
Abstract
Objective: The aim of this study was to evaluate the impact of
re-exploration for bleeding after cardiac surgery on the immediate
postoperative outcome. Methods: Systematic review of the literature and
meta-analysis of data on re-exploration for bleeding after adult cardiac
surgery were performed. Results: The literature search yielded eight
observational studies reporting on 557 923 patients and were included in
the present analysis. Patients requiring re-exploration were significantly
older, more frequently males, had a higher prevalence of peripheral
vascular disease and preoperative exposure to aspirin, and more frequently
underwent urgent/emergency surgery. Re-exploration was associated with
significantly increased risk ratio (RR) of immediate postoperative
mortality (RR 3.27, 95% confidence interval (CI) 2.44-4.37), stroke, need
of intra-aortic balloon pump, acute renal failure, sternal wound
infection, and prolonged mechanical ventilation. The pooled analysis of
four studies (two being propensity score-matched pairs analysis) reporting
adjusted risk for mortality led to an RR of 2.56 (95%CI 1.46-4.50).
Studies published during the last decade tended to report a higher risk of
re-exploration-related mortality (RR 4.30, 95%CI 3.09-5.97) than those
published in the 1990s (RR 2.75, 95%CI 2.06-3.66). Conclusions: This study
suggests that re-exploration for bleeding after cardiac surgery carries a
significantly increased risk of postoperative mortality and morbidity.
The Author 2011. Published by Oxford University Press on behalf of the
European Association for Cardio-Thoracic Surgery. All rights reserved.

<11>
Accession Number
2012742582
Authors
Esmea H. Apiliogullari B. Duran F.M. Yoldas B. Bekci T.T
Institution
(Esmea, Apiliogullari, Duran, Yoldas) Departments of Thoracic Surgery,
Konya Education and Research Hospital, Konya, Turkey
(Bekci) Departments of Pulmonary Diseases, Konya Education and Research
Hospital, Konya, Turkey
Title
Comparison between intermittent intravenous analgesia and intermittent
paravertebral subpleural analgesia for pain relief after thoracotomy.
Source
European Journal of Cardio-thoracic Surgery. 41 (1) (pp 10-13), 2012. Date
of Publication: 2012.
Publisher
Oxford University Press (Great Clarendon Street, Oxford OX2 6DP, United
Kingdom)
Abstract
Objective: In the present prospective double-blind randomized trial, the
effects of intermittent paravertebral subpleural bupivacaine and morphine
on pain management in patients undergoing thoracotomy were evaluated and
compared with intermittent systemic analgesia. Methods: Forty-five
patients undergoing elective lobectomy were included in the present study.
Three randomized groups consisting of 15 patients each were compared.
Those in the control group were administered intravenously with tramadol
100 mg plus metamizol 1000 mg every 4 h for 3 days. We placed the catheter
just below the parietal pleura along the paravertebral sulcus at the level
of T5-T7. At the end of the operation and every 4 h thereafter, the
patients received either 1.5 mg kg^-1 bupivacaine (bupivacaine
group) or 0.2 mg kg^-1 morphine sulfate (morphine group) with
paravertebral subpleural catheter for 3 days. Data regarding demographics,
visual analog pain scores, need for supplementary intravenous analgesia,
pulmonary function tests, and postoperative pulmonary complications were
recorded for each patient. Results: Visual analog pain scores (visual
analog scale (VAS)) were lower in the morphine and bupivacaine groups
compared with control group at all postoperative time points. The mean
postoperative VAS was significantly different between the control and
bupivacaine groups at postoperative hour 12, the control and morphine
groups at postoperative hours 6, 12, 48, and 72, and the bupivacaine and
morphine groups at postoperative hours 6 and 24 (p < 0.05). In the control
group, additional analgesic requirement was significantly higher than in
the bupivacaine and morphine groups (p < 0.05). Postoperative pulmonary
complications occurred in three patients (20%) in the control group, in
two patients (13%) in the bupivacaine group, and in one (6%) in the
morphine group. Conclusions: The patients undergoing lung resection
through a thoracotomy were observed with reduced postoperative pain and
better surgical outcomes with respect to the length of hospital stay,
postoperative forced expiratory volume in the first second, pulmonary
complications, and need for bronchoscopic management, when paravertebral
subpleural analgesia was induced by morphine. The Author 2011. Published
by Oxford University Press on behalf of the European Association for
Cardio-Thoracic Surgery. All rights reserved.

<12>
Accession Number
2012731384
Authors
Al-Lawati J.A. Al-Zakwani I. Sulaiman K. Al-Habib K. Al Suwaidi J.
Panduranga P. Alsheikh-Ali A.A. Almahmeed W. Al Faleh H. Al Saif S. Hersi
A. Asaad N. Al-Motarreb A. Mikhailidis D.P. Amin H.
Institution
(Al-Lawati) Department of Non-Communicable Diseases Surveillance and
Control, Ministry of Health, Muscat, Oman
(Al-Zakwani) Department of Pharmacology and Clinical Pharmacy, College of
Medicine and Health Sciences, Sultan Qaboos University, P.O. Box 35,
Al-Khodh, PC-123, Muscat, Oman
(Al-Zakwani) Gulf Health Research, Muscat, Oman
(Sulaiman, Panduranga) Department of Cardiology, Royal Hospital, Muscat,
Oman
(Al-Habib, Al Faleh, Hersi) King Fahad Cardiac Centre, King Khalid
University Hospital, College of Medicine, Riyadh, Saudi Arabia
(Al Suwaidi, Asaad) Department of Cardiology, Hamad Medical Corporation
(HMC), Doha, Qatar
(Alsheikh-Ali, Almahmeed) Department of Cardiology, Sheikh Khalifa Medical
City, Abu Dhabi, United Arab Emirates
(Alsheikh-Ali) Tufts Clinical and Translational Science Institute, Tufts
University School of Medicine, Boston, MA, United States
(Al Saif) Saud Al Babtain Cardiac Center, Dammam, Saudi Arabia
(Asaad) Weill Cornell Medical School, Doha, Qatar
(Al-Motarreb) Faculty of Medicine, Sana'a University, Sana'a, Yemen
(Mikhailidis) Department of Clinical Biochemistry, Royal Free Hospital,
University College London Medical School, University College London,
London, United Kingdom
(Amin) Mohammed Bin Khalifa Cardiac Centre, Bahrain
Title
Weekend versus weekday, morning versus evening admission in relationship
to mortality in acute coronary syndrome patients in 6 middle Eastern
Countries: Results from Gulf Race 2 registry.
Source
Open Cardiovascular Medicine Journal. 6 (1) (pp 106-112), 2012. Date of
Publication: 2012.
Publisher
Bentham Science Publishers B.V. (P.O. Box 294, Bussum 1400 AG,
Netherlands)
Abstract
We used prospective cohort data of patients with acute coronary syndrome
(ACS) to compare their manage-ment on weekdays/mornings with
weekends/nights, and the possible impact of this on 1-month and 1-year
mortality. Analyses were evaluated using univariate and multivariate
statistics. Of the 4,616 patients admitted to hospitals with ACS, 76% were
on weekdays. There were no significant differences in 1-month (odds ratio
(OR), 0.88; 95% CI: 0.68-1.14) and 1-year mortality (OR, 0.88; 95% CI:
0.70-1.10), respectively, between weekday and weekend admissions.
Similarly, there were no significant differences in 1-month (OR, 0.92; 95%
CI: 0.73-1.15) and 1-year mortality (OR, 0.98; 95% CI: 0.80-1.20),
respectively, between nights and day admissions. In conclusion, apart from
lower utilization of angiography (P <.001) at weekends, there were largely
no significant discrepancies in the management and care of patients
admitted with ACS on weekdays and during morning hours compared with
patients admitted on weekends and night hours, and the overall 30-day and
1-year mortality was similar between both the cohorts. Al-Lawati et al.

<13>
Accession Number
2012738396
Authors
Chevalier B. Moulichon R. Teiger E. Brunel P. Metzger J.-P. Pansieri M.
Carrie D. Stoll H.-P. Wittebols K. Spaulding C. Fajadet J.
Institution
(Chevalier) Institut Cardiovasculaire Paris-Sud, 6 Avenue Noyer Lambert,
91300 Massy, France
(Moulichon) Clinique Saint Pierre, Perpignan, France
(Teiger) Centre Hospitalier Henri Mondor, Assistance Publique Hopitaux de
Paris, Creteil, France
(Brunel) Nouvelles Cliniques Nantaises-Site Saint-Henri, Nantes, France
(Metzger) Centre Hospitalier Universitaire Pitie-Salpetriere, Assistance
Publique Hopitaux de Paris, Paris, France
(Pansieri) Centre Hospitalier Henri Duffaut, Avignon, France
(Carrie) Centre Hospitalier Universitaire Rangeuil, Toulouse, France
(Stoll, Wittebols) Cordis Corporation (Johnson and Johnson), Waterloo,
Belgium
(Spaulding) Hopital Europeen Georges Pompidou, Assistance Publique
Hopitaux de Paris, Paris Descartes University, Paris, France
(Fajadet) Unite de Cardiologie Interventionnelle, Clinique Pasteur,
Toulouse, France
Title
One-year results of the CRISTAL trial, a randomized comparison of cypher
sirolimus-eluting coronary stents versus balloon angioplasty for
restenosis of drug-eluting stents.
Source
Journal of Interventional Cardiology. 25 (6) (pp 586-595), 2012. Date of
Publication: December 2012.
Publisher
Blackwell Publishing Inc. (350 Main Street, Malden MA 02148, United
States)
Abstract
Objectives: We compared the efficacy of the Cypher Select (Cordis
Corporation, Bridgewater, NJ, USA) sirolimus-eluting stent (SES) versus
balloon angioplasty (BA) in in-stent restenosis (ISR) of Taxus or Taxus
Liberte paclitaxel-eluting stents (PES; Boston Scientific, Natick, MA,
USA) or Cypher/Cypher Select SES. Background: Optimal treatment strategies
have not been identified for drug-eluting stent (DES) ISR. Methods:
Patients with a native coronary artery SES or PES ISR were randomized to
SES or BA. In addition, a control group included BMS ISR treated with SES.
Angiographic control was performed at 12 months. Results: 281 patients
were enrolled. Significant differences favoring SES over BA were noted in
immediate and net gain (1.39 +/- 0.51 vs. 0.97 +/- 0.54 mm, P < 0.0001 and
1.07 +/- 0.69 vs. 0.49 +/- 0.67 mm, P < 0.0001), 12-month mean luminal
diameter (MLD; 2.14 +/- 0.62 vs. 1.71 +/- 0.55 mm, P < 0.0001) and percent
diameter stenosis (%DS; 21 +/- 19.24 vs. 29.82 +/- 18.47, P = 0.001).
There was no significant difference at 12 months between SES and BA in the
primary end-point late lumen loss (LLL; 0.37 +/- 0.57 vs.0.41 +/- 0.63, P
= 0.73) and in in-stent binary restenosis (11.1% vs. 14%, P = 0.59).
Target-lesion revascularization (TLR) was numerically lower in patients
treated with SES (5.9% vs. 13.1%, P = 0.097). There was no difference
according to the initial DES. In contrast, significantly higher immediate
and net gains and MLD were noted in the BMS control group treated by SES.
Conclusions: In this angiographic randomized trial comparing SES and BA in
SES or PES restenosis, 12 month MLD, immediate and net gain, and %DS
favored SES whereas no difference was noted in LLL. Condensed Abstract
Optimal treatment strategies have not been identified for sirolimus- (SES)
or paclitaxel-eluting stent (PES) in-stent restenosis (ISR). We randomized
patients with a native coronary artery SES or PES ISR to SES or BA. In
addition, a control group included BMS ISR treated with SES. There was no
difference in the primary end-point, late lumen loss (LLL) at 12 months
between the SES and BA groups. However, follow-up MLD and immediate and
net gain favored SES. 2012, Wiley Periodicals, Inc.

<14>
Accession Number
2012735591
Authors
Shim J.-K. Yang S.-Y. Yoo Y.-C. Yoo K.-J. Kwak Y.-L.
Institution
(Shim, Yoo, Kwak) Department of Anaesthesiology and Pain Medicine,
Anaesthesia and Pain Research Institute, Yonsei University Health System,
250 Seongsanno, Seodaemun-Gu, Seoul 120-752, South Korea
(Yoo) Department of Cardiothoracic Surgery, Yonsei University Health
System, 250 Seongsanno, Seodaemun-Gu, Seoul 120-752, South Korea
(Yang) Department of Anaesthesiology and Pain Medicine, Chung-Ang
University, College of Medicine, Seoul, South Korea
(Kwak) Severance Biomedical Science Institute, Yonsei University, College
of Medicine, Seoul, South Korea
Title
Myocardial protection by glucose-insulin-potassium in acute coronary
syndrome patients undergoing urgent multivessel off-pump coronary artery
bypass surgery.
Source
British Journal of Anaesthesia. 110 (1) (pp 47-53), 2013. Date of
Publication: January 2013.
Publisher
Oxford University Press (Great Clarendon Street, Oxford OX2 6DP, United
Kingdom)
Abstract
BackgroundThe aim of this randomized and controlled trial was to
investigate the effect of a glucose-insulin-potassium (GIK) solution on
myocardial protection in acute coronary syndrome (ACS) patients undergoing
urgent multivessel off-pump coronary artery bypass (OPCAB)
surgery.MethodsSixty- six patients were randomly allocated either to
receive 0.3 ml kg^-1 h^-2 GIK solution (potassium 80
mEq and regular insulin 325 IU in 500 ml of 50% glucose) or equivalent
volume of normal saline (control) upon anaesthetic induction until 6 h
after reperfusion. The primary endpoints were to compare the
concentrations of creatine kinase-MB (CK-MB) and troponin-T between the
groups after reperfusion. The secondary endpoints were to compare the
incidences of postoperative troponin-T >0.8 ng ml^-1 and
myocardial infarction (MI) between the groups.ResultsHighest CK-MB [8.7
(4.4) vs 13.1 (7.9) ng ml^-1, P=0.006] and troponin-T [0.20
(0.13-0.49) vs 0.48 (0.18-0.91) ng ml^-1, P<0.0001] values after
reperfusion were significantly lower in the GIK group compared with the
control group. The area under the curve of serially measured troponin-T
was also significantly smaller in the GIK group compared with the control
group [0.83 (0.43-1.81) vs 0.46 (0.31-1.00), P=0.036]. Significantly fewer
patients in the GIK group showed troponin-T >0.8 ng ml^-1 after
reperfusion compared with the control group (3 vs 11, P=0.033). The
incidence of postoperative MI was similar between the
groups.ConclusionsGIK administration in ACS patients undergoing urgent
multivessel OPCAB significantly attenuated the degree of ensuing
myocardial injury without complications related to glycaemic
control.Clinical Trial Registry. URL:
http://clinicaltrials.gov/ct2/show/NCT01384656?term= GIK+AND+OPCAB&rank=1.
Unique identification number NCT01384656. The Author [2012]. Published by
Oxford University Press on behalf of the British Journal of Anaesthesia.
All rights reserved.

<15>
Accession Number
2012723965
Authors
Stoppe C. Spillner J. Rossaint R. Coburn M. Schalte G. Wildenhues A. Marx
G. Rex S.
Institution
(Stoppe, Rossaint, Coburn, Schalte, Wildenhues, Rex) Department of
Anesthesiology, University Hospital, RWTH Aachen, Germany
(Stoppe) Institute of Biochemistry and Molecular Cell Biology, University
Hospital of the RWTH Aachen, Germany
(Spillner) Department of Thoracic, Cardiac and Vascular Surgery,
University Hospital, RWTH Aachen, Germany
(Marx) Department of Intensive Care, University Hospital, RWTH Aachen,
Germany
(Rex) Department of Anesthesiology, University Hospitals Gasthuisberg, KU
Leuven, Belgium
Title
Selenium blood concentrations in patients undergoing elective cardiac
surgery and receiving perioperative sodium selenite.
Source
Nutrition. 29 (1) (pp 158-165), 2013. Date of Publication: January 2013.
Publisher
Elsevier Inc. (360 Park Avenue South, New York NY 10010, United States)
Abstract
Objectives: We recently reported that cardiac surgical patients in our
institution exhibited low selenium blood levels preoperatively, which were
further aggravated during surgery and independently associated with the
development of postoperative multiorgan failure. Low circulating selenium
levels result in a decreased antioxidant capacity. Both can be treated
effectively by sodium-selenite administration. Little is known about the
kinetics of exogenously administered sodium-selenite during acute
perioperative oxidative stress. The aim of this study was to assess the
effects of perioperative high-dose sodium-selenite administration on
selenium blood concentrations in cardiac surgical patients. Methods: One
hundred four cardiac surgical patients were enrolled in this prospective
observational trial. Patients received an intravenous bolus of 2000 mug
selenium after an induction of anesthesia and 1000 mug selenium every day
further during their intensive care unit (ICU) stay. Selenium blood levels
were measured at regular intervals. Results: Preoperative sodium-selenite
administration increased selenium blood concentrations to normal values on
ICU admission, but failed to prevent a significant decrease of circulating
selenium on the first postoperative day. During the further ICU stay,
selenium blood levels were normalized by the administration strategy and
did not exceed the German reference range. No acute selenium-specific side
effects occurred. When matching the participating patients to a historical
control group without sodium-selenite administration, the chosen strategy
was associated with a decrease in SAPS II (23 +/- 7 versus 29 +/- 8, P =
0.005) and SOFA scores (4 +/- 3 versus 7 +/- 2, P = 0.007) on the first
postoperative day, but was unable to improve the postoperative outcome in
patients staying >1 d in ICU. Conclusions: Despite preemptive high-dose
sodium-selenite administration, cardiac surgical patients experienced a
significant decrease in circulating selenium levels on the first
postoperative day. 2013 Elsevier Inc.

<16>
Accession Number
2012728040
Authors
Gorantla R. Murthy J.S.N. Muralidharan T.R. Mandava R. Dev B. Chandaga H.
Rajeswaran R. Roy Santosham J.D. Joseph S.
Institution
(Gorantla, Dev, Rajeswaran, Roy Santosham, Joseph) Department of
Radiology, Sri Ramachandra Medical College, Chennai - 600116, India
(Murthy, Mandava) Sri Ramachandra Medical College, Chennai - 600116, India
(Muralidharan) Department of Cardiology, Sri Ramachandra Medical College,
Chennai - 600116, India
(Chandaga) Columbia Asia Hospital, Bengaluru, India
Title
Diagnostic accuracy of 64-slice multidetector computed tomography in
evaluation of post-coronary artery bypass grafts in correlation with
invasive coronary angiography.
Source
Indian Heart Journal. 64 (3) (pp 254-260), 2012. Date of Publication: May
2012.
Publisher
Elsevier (P.O. Box 211, Amsterdam 1000 AE, Netherlands)
Abstract
64-slice multidetector computed tomography (MDCT) allows more reliable and
non-invasive evaluation of the coronary artery bypass grafts for occlusion
or stenosis both in symptomatic and asymptomatic patients and also
progression of disease in native coronary vessels. 2012, Cardiological
Society of India. All rights reserved.

<17>
Accession Number
2012735648
Authors
Farooq V. Serruys P.W. Bourantas C. Vranckx P. Diletti R. Garcia Garcia
H.M. Holmes D.R. Kappetein A.-P. MacK M. Feldman T. Morice M.C. Colombo A.
Morel M.-A. De Vries T. Van Es G.A. Steyerberg E.W. Dawkins K.D. Mohr F.W.
James S. Stahle E.
Institution
(Farooq, Serruys, Bourantas, Vranckx, Diletti, Garcia Garcia) Department
of Interventional Cardiology, Erasmus University Medical Centre,
Thoraxcenter, s-Gravendijkwal 230, 3015 CE, Rotterdam, Netherlands
(Holmes) Mayo Clinic, Rochester, MN, United States
(Kappetein) Department of Cardiothoracic Surgery, Erasmus University
Medical Centre, Thoraxcenter, Rotterdam, Netherlands
(MacK) Medical City Dallas Hospital, Dallas, TX, United States
(Feldman) Evanston Hospital, Evanston, IL, United States
(Morice) Institut Jacques Cartier, Massy, France
(Colombo) San Raffaele Scientific Institute, Milano, Italy
(Morel, De Vries, Van Es) Cardialysis BV, Rotterdam, Netherlands
(Steyerberg) Department of Public Health, Erasmus University Medical
Center, Rotterdam, Netherlands
(Dawkins) Boston Scientific Corporation, Natick, MA, United States
(Mohr) Herzzentrum, Leipzig, Germany
(James, Stahle) University Hospital Uppsala, Uppsala, Sweden
Title
Incidence and multivariable correlates of long-term mortality in patients
treated with surgical or percutaneous revascularization in the Synergy
between Percutaneous Coronary Intervention with Taxus and Cardiac Surgery
(SYNTAX) trial.
Source
European Heart Journal. 33 (24) (pp 3105-3113), 2012. Date of Publication:
December 2012.
Publisher
Oxford University Press (Great Clarendon Street, Oxford OX2 6DP, United
Kingdom)
Abstract
Aims The aim of this investigation was to determine the incidence and
multivariable correlates of long-term (4-year) mortality in patients
treated with surgical or percutaneous revascularization in the synergy
between percutaneous coronary intervention (PCI) with TAXUS Express and
Cardiac Surgery (SYNTAX) trial.Methods and resultsA total of 1800 patients
were randomized to undergo coronary artery bypass graft (CABG) surgery (n
= 897) or PCI (n = 903). Prospectively collected baseline and peri-and
post-procedural data were used to determine independent correlates of
4-year all-cause death in the CABG and the PCI arms (Cox proportional
hazards model). Four-year mortality rates in the CABG and the PCI arms
were 9.0% [74 deaths (12 in-hospital)] and 11.8% [104 deaths (16
in-hospital)], respectively (log-rank P-value = 0.063). Censored data
comprised 78 patients (8.7%) in the CABG arm, and 24 patients (2.7%) in
the PCI arm (log-rank P-value < 0.001). Within the CABG arm, the strongest
independent correlates of 4-year mortality were lack of discharge aspirin
[hazard ratio (HR) 3.56; 95% CI: 2.04, 6.21; P < 0.001], peripheral
vascular disease (PVD) (HR: 2.65; 95% CI: 1.49, 4.72; P = 0.001), chronic
obstructive pulmonary disease, age, and serum creatinine. Within the PCI
arm, the strongest independent correlate of 4-year mortality was lack of
post-procedural anti-platelet therapy (HR: 152.16; 95% CI: 53.57, 432.22;
P < 0.001), with 10 reported early (within 45 days) in-hospital deaths
secondary to multifactorial causes precluding administration of
anti-platelet therapy. Other independent correlates of mortality in the
PCI arm included amiodarone therapy on discharge, pre-procedural poor left
ventricular ejection fraction, a 'history of gastrointestinal bleeding or
peptic ulcer disease', PVD (HR: 2.13; 95% CI: 1.26, 3.60; P = 0.005), age,
female gender (HR: 1.60; 95% CI: 1.01, 2.56; P = 0.048), and the SYNTAX
score (Per increase in 10 points: HR: 1.25; 95% CI: 1.06, 1.47; P =
0.007).ConclusionIndependent correlates of 4-year mortality in the SYNTAX
trial were multifactorial. Lack of discharge aspirin and lack of
post-procedural anti-platelet therapy were the strongest independent
correlates of mortality in the CABG and the PCI arms, respectively.
Peripheral vascular disease is a common independent correlate of 4-year
mortality and may be a marker of the severity of baseline coronary disease
and risk of future native coronary disease (and extra-cardiac disease)
progression. 2012 The Author.

<18>
Accession Number
2012735644
Authors
Min J.K. Berman D.S. Dunning A. Achenbach S. Al-Mallah M. Budoff M.J.
Cademartiri F. Callister T.Q. Chang H.-J. Cheng V. Chinnaiyan K. Chow
B.J.W. Cury R. Delago A. Feuchtner G. Hadamitzky M. Hausleiter J. Kaufmann
P. Karlsberg R.P. Kim Y.-J. Leipsic J. Lin F.Y. Maffei E. Plank F. Raff G.
Villines T. Labounty T.M. Shaw L.J.
Institution
(Min, Berman, Cheng, Labounty) Department of Medicine Imaging, and
Biomedical Sciences, Cedars-Sinai Heart Institute, Cedars-Sinai Medical
Center, 8700 Beverly Blvd., Los Angeles, CA 90048, United States
(Min, Berman, Cheng, Labounty) Department of Imaging, Cedars-Sinai Medical
Center, Los Angeles, CA, United States
(Dunning) Department of Public Health, Weill Cornell Medical College, New
York Presbyterian Hospital, New York, NY, United States
(Achenbach) Department of Medicine, University of Erlangen, Erlangen,
Germany
(Al-Mallah) Department of Medicine, Wayne State University, Henry Ford
Hospital, Detroit, MI, United States
(Budoff) Department of Medicine, Harbor UCLA Medical Center, Los Angeles,
CA, United States
(Cademartiri, Maffei) Department of Radiology, Giovanni XXIII Hospital,
Monastier, Treviso, Italy
(Cademartiri, Maffei) Department of Radiology, Erasmus Medical Center,
Rotterdam, Netherlands
(Callister) Tennessee Heart and Vascular Institute, Hendersonville, TN,
United States
(Chang) Division of Cardiology, Severance Cardiovascular Hospital, Seoul,
South Korea
(Chinnaiyan, Raff) William Beaumont Hospital, Royal Oaks, MI, United
States
(Chow) Department of Medicine and Radiology, University of Ottawa, ON,
Canada
(Cury) Baptist Cardiac and Vascular Institute, Miami, FL, United States
(Delago) Capitol Cardiology Associates, Albany, NY, United States
(Feuchtner, Plank) Department of Radiology, Medical University of
Innsbruck, Innsbruck, Austria
(Hadamitzky, Hausleiter) Division of Cardiology, Deutsches Herzzentrum
Munchen, Munich, Germany
(Kaufmann) University Hospital, Zurich, Switzerland
(Karlsberg) Cardiovascular Medical Group, Los Angeles, CA, United States
(Kim) Seoul National University Hospital, Seoul, South Korea
(Leipsic) Department of Radiology, University of British Columbia,
Vancouver, BC, Canada
(Lin) Department of Medicine, Weill Cornell Medical College, New York
Presbyterian Hospital, New York, NY, United States
(Villines) Department of Medicine, Walter Reed Medical Center, Washington,
DC, United States
(Shaw) Department of Medicine, Emory University School of Medicine,
Atlanta, GA, United States
Title
All-cause mortality benefit of coronary revascularization vs. medical
therapy in patients without known coronary artery disease undergoing
coronary computed tomographic angiography: Results from CONFIRM (COronary
CT Angiography EvaluatioN for Clinical Outcomes: An InteRnational
Multicenter Registry).
Source
European Heart Journal. 33 (24) (pp 3088-3097), 2012. Date of Publication:
December 2012.
Publisher
Oxford University Press (Great Clarendon Street, Oxford OX2 6DP, United
Kingdom)
Abstract
Aims To date, the therapeutic benefit of revascularization vs. medical
therapy for stable individuals undergoing invasive coronary angiography
(ICA) based upon coronary computed tomographic angiography (CCTA) findings
has not been examined.Methods and resultsWe examined 15 223 patients
without known coronary artery disease (CAD) undergoing CCTA from eight
sites and six countries who were followed for median 2.1 years
(interquartile range 1.4-3.3 years) for an endpoint of all-cause
mortality. Obstructive CAD by CCTA was defined as a >=50% luminal diameter
stenosis in a major coronary artery. Patients were categorized as having
high-risk CAD vs. non-high-risk CAD, with the former including patients
with at least obstructive two-vessel CAD with proximal left anterior
descending artery involvement, three-vessel CAD, and left main CAD. Death
occurred in 185 (1.2%) patients. Patients were categorized into two
treatment groups: revascularization (n = 1103; 2.2% mortality) and medical
therapy (n = 14 120, 1.1% mortality). To account for non-randomized
referral to revascularization, we created a propensity score developed by
logistic regression to identify variables that influenced the decision to
refer to revascularization. Within this model (C index 0.92, chi2 = 1248,
P < 0.0001), obstructive CAD was the most influential factor for referral,
followed by an interaction of obstructive CAD with pre-test likelihood of
CAD (P = 0.0344). Within CCTA CAD groups, rates of revascularization
increased from 3.8% for non-high-risk CAD to 51.2% high-risk CAD. In
multivariable models, when compared with medical therapy,
revascularization was associated with a survival advantage for patients
with high-risk CAD [hazards ratio (HR) 0.38, 95% confidence interval
0.18-0.83], with no difference in survival for patients with non-high-risk
CAD (HR 3.24, 95% CI 0.76-13.89) (P-value for interaction =
0.03).ConclusionIn an intermediate-term follow-up, coronary
revascularization is associated with a survival benefit in patients with
high-risk CAD by CCTA, with no apparent benefit of revascularization in
patients with lesser forms of CAD. 2012 The Author.

<19>
Accession Number
2012735636
Authors
Kang H.-J. Kim M.-K. Lee H.-Y. Park K.-W. Lee W. Cho Y.-S. Koo B.-K. Choi
D.-J. Park Y.-B. Kim H.-S.
Institution
(Kang, Lee, Park, Koo, Park, Kim) Division of Cardiology, Department of
Internal Medicine, Seoul National University Hospital, 101 DaeHak-ro,
JongRo-gu, Seoul 110-744, South Korea
(Kim) Healthcare System Gangnam Center, Seoul National University
Hospital, Seoul, South Korea
(Lee) Department of Radiology, Seoul National University, College of
Medicine, Seoul, South Korea
(Cho, Choi) Division of Cardiology, Department of Internal Medicine, Seoul
National University Bundang Hospital, Bundang, South Korea
Title
Five-year results of intracoronary infusion of the mobilized peripheral
blood stem cells by granulocyte colony-stimulating factor in patients with
myocardial infarction.
Source
European Heart Journal. 33 (24) (pp 3062-3069), 2012. Date of Publication:
December 2012.
Publisher
Oxford University Press (Great Clarendon Street, Oxford OX2 6DP, United
Kingdom)
Abstract
AimTo evaluate the long-term effects of peripheral blood stem cell therapy
in myocardial infarction (MI) patients.Methods and resultsA total of 163
patients with MI who were successfully revascularized with drug-eluting
stents were enrolled and randomly assigned to four groups: acute MI (AMI)
cell infusion, AMI control, old MI (OMI) cell infusion, and OMI control.
We compared 5 years' clinical outcomes between the cell infusion group (57
and 22 patients with AMI and OMI, respectively) and the control (60 and 24
patients with AMI and OMI, respectively). In the time-sequence comparison
from baseline to 6 and 24 months follow-up after AMI, left ventricular
ejection fraction (LVEF) by cardiac magnetic resonance imaging was
significantly improved in the cell infusion group (n = 57), but not in the
control group (n = 60). In the between-group comparison, the difference in
improvement of LVEF for 2 years after AMI did not reach statistical
significance between cell infusion and control groups. Intriguingly, the
major adverse cardiac events for 5 years were significantly reduced in the
cell infusion group (n = 79) compared with the control (n = 84; composite
of cardiac death, non-fatal MI, hospitalization for heart failure and
angina, and target vessel revascularization; 22.8 vs. 39.3%, P =
0.015).ConclusionsPeripheral blood stem cell therapy has potential to
improve long-term cardiovascular outcomes in MI patients. 2012 The
Author.

<20>
Accession Number
2012730285
Authors
Bjordahl P.M. Helmer S.D. Gosnell D.J. Wemmer G.E. O'Hara W.W. Milfeld
D.J.
Institution
(Bjordahl, Helmer, Milfeld) Department of Surgery, University of Kansas,
School of Medicine-Wichita, 929 N. Saint Francis St., Wichita, KS 67214,
United States
(Helmer) Department of Medical Education, Via Christi Hospital on Saint
Francis, Wichita, KS, United States
(Gosnell) Department of Nursing, Via Christi Hospital on Saint Francis,
Wichita, KS, United States
(Wemmer) Department of Nursing, Duke University Hospital, Durham, NC,
United States
(O'Hara) Department of Cardiovascular Surgery, Methodist Hospital, Weill
Cornell Medical School, Houston, TX, United States
Title
Perioperative supplementation with ascorbic acid does not prevent atrial
fibrillation in coronary artery bypass graft patients.
Source
American Journal of Surgery. 204 (6) (pp 862-867), 2012. Date of
Publication: December 2012.
Publisher
Elsevier Inc. (360 Park Avenue South, New York NY 10010, United States)
Abstract
Background: Atrial fibrillation occurs after approximately 25% to 45% of
coronary artery bypass graft (CABG) surgeries. Oxidative stress and
related electrophysiological remodeling has been proposed as a potential
cause of this atrial fibrillation. Perioperative supplementation of the
antioxidant ascorbic acid has been evaluated as a preventive agent. The
current investigation was conducted to evaluate the efficacy of ascorbic
acid in reducing atrial fibrillation in CABG patients. Methods: A
prospective, randomized, placebo-controlled, triple-blind,
single-institution study was conducted in nonemergency CABG patients.
Subjects were monitored for episodes of arrhythmia and other
complications. Results: Eighty-nine treatment and 96 control subjects
completed the study protocol. Demographics, comorbidities, and
preoperative drugs were similar between groups. Surgical characteristics
and postoperative medication use also were similar. The incidence of
atrial fibrillation was 30.3% in the treatment group and 30.2% in the
control group (P =.985). No difference was found in postoperative
complications or mortality. Conclusions: Our data indicate that
supplementation of ascorbic acid in addition to routine postoperative care
does not reduce atrial fibrillation after coronary artery bypass grafting.
2012 Elsevier Inc.