Results Generated From:
Embase <1980 to 2016 Week 11>
Embase (updates since 2016-03-03)
<1>
Accession Number
25041686
Author
Hedenqvist P.; Jensen-Waern M.; Fahlman A; Hagman R.; Edner A.
Institution
(Hedenqvist) Department of Clinical Sciences, Faculty of Veterinary
Medicine and Animal Science, Swedish University of Agricultural Sciences,
Uppsala, Sweden
(Jensen-Waern) Department of Clinical Sciences, Faculty of Veterinary
Medicine and Animal Science, Swedish University of Agricultural Sciences,
Uppsala, Sweden
(Fahlman) Department of Clinical Sciences, Faculty of Veterinary Medicine
and Animal Science, Swedish University of Agricultural Sciences, Uppsala,
Sweden
(Hagman) Department of Clinical Sciences, Faculty of Veterinary Medicine
and Animal Science, Swedish University of Agricultural Sciences, Uppsala,
Sweden
(Edner) Department of Clinical Sciences, Faculty of Veterinary Medicine
and Animal Science, Swedish University of Agricultural Sciences, Uppsala,
Sweden
Title
Intravenous sufentanil-midazolam versus sevoflurane anaesthesia in
medetomidine pre-medicated Himalayan rabbits undergoing
ovariohysterectomy.
Source
Veterinary anaesthesia and analgesia. 42 (4) (pp 377-385), 2015. Date of
Publication: 01 Jul 2015.
Abstract
OBJECTIVE: To compare physiological effects of sufentanil-midazolam with
sevoflurane for surgical anaesthesia in medetomidine premedicated rabbits.
STUDY DESIGN: Prospective, randomized controlled experimental study.
ANIMALS: Eighteen female Himalayan rabbits, weight 2.1 +/- 0.1 kg.
METHODS: Premedication with 0.1 mg kg(-1) medetomidine and 5 mg kg(-1)
carprofen subcutaneously, was followed by intravenous anaesthetic
induction with sufentanil (2.3 mug mL(-1)) and midazolam (0.45 mg mL(-1)).
After endotracheal intubation, anaesthesia was maintained with
sufentanil-midazolam (n = 9) or sevoflurane (n = 9). Ovariohysterectomy
was performed. Intermittent positive pressure ventilation was performed as
required. Physiological variables were studied perioperatively. Group
means of physiologic data were generated for different anaesthetic
periods. Data were compared for changes from sedation, and between groups
by anova. Post-operatively, 0.05 mg kg(-1) buprenorphine was administered
once and 5 mg kg(-1) carprofen once daily for 2-3 days. Rabbits were
examined and weighed daily until one week after surgery.
RESULTS: Smooth induction of anaesthesia was achieved within 5 minutes.
Sufentanil and midazolam doses were 0.5 mug kg(-1) and 0.1 mg kg(-1),
during induction and 3.9 mug kg(-1) hour(-1) and 0.8 mg kg(-1) hour(-1)
during surgery, respectively. End-tidal sevoflurane concentration was 2.1%
during surgery. Assisted ventilation was required in nine rabbits
receiving sufentanil-midazolam and four receiving sevoflurane. There were
no differences between groups in physiologic data other than arterial
carbon dioxide. In rabbits receiving sevoflurane, mean arterial pressure
decreased pre-surgical intervention, heart rate increased 25% during and
after surgery and body weight decreased 4% post-operatively.
Post-operative problems sometimes resulted from catheterization of the ear
artery.
CONCLUSION: Sevoflurane and sufentanil-midazolam provided surgical
anaesthesia of similar quality. Arterial blood pressure was sustained
during sufentanil-midazolam anaesthesia and rabbits receiving sevoflurane
lost body weight following ovariohysterectomy. Mechanical ventilation was
required with both anaesthetic regimens.
CLINICAL RELEVANCE: Anaesthesia with sufentanil-midazolam in medetomidine
premedicated healthy rabbits is useful in the clinical and the research
setting, as an alternative to sevoflurane.
<2>
Accession Number
20151065727
Author
Kandzari D.E.; Amjadi N.; Caputo C.; Rowe S.K.; Williams J.; Tamboli H.P.;
Christen T.; Allocco D.J.; Dawkins K.D.
Institution
(Kandzari) Interventional Cardiology, Piedmont Hospital, Atlanta, GA,
United States
(Amjadi) Cardiac Cath Lab, Texas Heart and Vascular, South Austin
Hospital, South Austin, TX, United States
(Caputo) Interventional Cardiology, North Florida Regional Medical Center,
Gainesville, FL, United States
(Rowe) Interventional Cardiology, Cox Medical Centers, Springfield, MI,
United States
(Williams) Interventional Cardiology, Novant Health Heart and Vascular
Institute, Presbyterian Medical Center, Charlotte, NC, United States
(Tamboli) Cardiology, Brandon Regional Hospital, Brandon, FL, United
States
(Christen, Allocco, Dawkins) Boston Scientific Corporation, Marlborough,
MA, United States
Title
One-Year Outcomes in "real-World" Patients Treated with a Thin-Strut,
Platinum-Chromium, Everolimus-Eluting Stent (from the PROMUS Element Plus
US Post-Approval Study [PE-Plus PAS]).
Source
American Journal of Cardiology. 117 (4) (pp 539-545), 2016. Date of
Publication: 15 Feb 2016.
Publisher
Elsevier Inc.
Abstract
The PROMUS Element Plus US Post-Approval Study (PE-Plus PAS) was a
prospective, open-label, multicenter, observational study designed to
examine outcomes in everyday clinical practice in patients treated with
everolimus-eluting, platinum-chromium PROMUS Element Plus stents at 52
centers in the United States. This is the first report of results from
this large study. The primary end point of the PE-Plus PAS was 12-month
cardiac death or myocardial infarction in the more restricted population
of "PLATINUM-like" patients pooled from the PE-Plus PAS, PE-PROVE (PROMUS
Element European post-approval study), and PLATINUM Workhorse/Small Vessel
trials. Additional clinical end points were tested in the overall PE-Plus
PAS patient population. Of the 2,683 patients enrolled in PE-Plus PAS, 70%
were men, mean age was 64 years, 33% had diabetes, and 29% were
"PLATINUM-like." Among the PLATINUM-like patients, 12-month cardiac death
or myocardial infarction was 1.8% (33 of 1,855) with an upper 1-sided 95%
confidence interval of 2.3%, which was significantly less than the
prespecified performance goal of 3.2% (p<inf>noninferiority</inf> <0.001).
In the overall PE-Plus population, 12-month target vessel failure (defined
as death, MI, or revascularization related to the target vessel) was 6.7%
(170 of 2,554), cardiac death was 1.4% (37 of 2,554), MI was 1.1% (28 of
2,554), and ARC-definite/probable stent thrombosis was 0.7% (19 of 2,554).
A prespecified secondary end point of 12-month target vessel failure in
diabetic patients demonstrated a rate of 4.2% (14 of 332) with an upper
1-sided 95% confidence interval of 6.03%, which was significantly less
than the performance goal of 12.6% (p<inf>noninferiority</inf> <0.001). In
conclusion, in this large registry of unselected patients, coronary artery
revascularization with the PROMUS Element Plus everolimus-eluting stent
demonstrates favorable results with low 1-year clinical event rates.
<3>
Accession Number
20151061751
Author
Alfonso F.; Perez-Vizcayno M.J.; Garcia Del Blanco B.; Garcia-Touchard A.;
Masotti M.; Lopez-Minguez J.R.; Iniguez A.; Zueco J.; Velazquez M.;
Cequier A.; Lazaro-Garcia R.; Marti V.; Moris C.; Urbano-Carrillo C.;
Bastante T.; Rivero F.; Cardenas A.; Gonzalo N.; Jimenez-Quevedo P.;
Fernandez C.
Institution
(Alfonso, Bastante, Rivero) Hospital Universitario de la Princesa, Madrid,
Spain
(Perez-Vizcayno) Fundacion Interhospitalaria Investigacion Cardiovascular,
Madrid, Spain
(Garcia Del Blanco) Hospital Universitario Vall d'Hebron, Barcelona, Spain
(Garcia-Touchard) Hospital Universitario Puerta de Hierro-Majadahonda,
Madrid, Spain
(Masotti) Hospital Universitario Clinic de Barcelona, Barcelona, Spain
(Lopez-Minguez) Hospital Universitario Infanta Cristina, Badajoz, Spain
(Iniguez) Hospital Universitario de Meixoeiro, Vigo, Spain
(Zueco) Hospital Universitario Marques de Valdecilla, Santander, Spain
(Velazquez) Hospital Universitario 12 de Octubre, Madrid, Spain
(Cequier) Hospital Universitario de Bellvitge, Barcelona, Spain
(Lazaro-Garcia) Hospital Universitario de Torrecardenas, Almeria, Spain
(Marti) Hospital Universitario Sant Pau, Barcelona, Spain
(Moris) Hospital Universitario Central Asturias, Oviedo, Spain
(Urbano-Carrillo) Hospital Universitario Carlos Haya, Malaga, Spain
(Cardenas, Gonzalo, Jimenez-Quevedo, Fernandez) Hospital Universitario
Clinico San Carlos, Madrid, Spain
Title
Comparison of the Efficacy of Everolimus-Eluting Stents Versus
Drug-Eluting Balloons in Patients with In-Stent Restenosis (from the RIBS
IV and v Randomized Clinical Trials).
Source
American Journal of Cardiology. 117 (4) (pp 546-554), 2016. Date of
Publication: 15 Feb 2016.
Publisher
Elsevier Inc.
Abstract
Treatment of patients with in-stent restenosis (ISR) remains a challenge.
This study sought to compare the efficacy of everolimus-eluting stents
(EESs) and drug-eluting balloons (DEBs) with paclitaxel in patients with
ISR. A pooled analysis of the Restenosis Intra-Stent of Drug-Eluting
Stents: Drug-Eluting Balloon vs Everolimus-Eluting Stent (RIBS IV) and
Restenosis Intra-Stent of Bare-Metal Stents: Drug-Eluting Balloon vs
Everolimus-Eluting Stent (RIBS V) randomized trials was performed using
patient-level data. In both trials, EESs were compared with DEBs in
patients with ISR (RIBS V included 189 patients with bare-metal ISR; RIBS
IV included 309 patients with drug-eluting ISR). Inclusion and exclusion
criteria were identical in both trials. A total of 249 patients were
allocated to EES and 249 to DEB. Clinical follow-up at 1 year was obtained
in all (100%) patients and late angiography (median 249 days) in 91% of
eligible patients. Compared with patients treated with DEBs, patients
treated with EESs obtained better short-term results (postprocedural
minimal lumen diameter 2.28 +/- 0.5 vs 2.12 +/- 0.4 mm, p <0.0001). At
follow-up, patients treated with EESs had larger in-segment minimal lumen
diameter (primary end point 2.16 +/- 0.7 vs 1.88 +/- 0.6 mm, p <0.0001;
absolute mean difference 0.28 mm; 95% confidence interval [CI] 0.16 to
0.40) and net lumen gain (1.33 +/- 0.6 vs 1.00 +/- 0.7 mm, p <0.0001) and
had lower %diameter stenosis (19 +/- 21% vs 28 +/- 22%, p <0.0001) and
binary restenosis rate (8.7% vs 15.7%, p = 0.02). Consistent results were
observed in the in-lesion analysis. No interactions were found between the
underlying stent type and treatment effects. At 1-year clinical follow-up,
the composite of cardiac death, myocardial infarction, and target vessel
revascularization was significantly reduced in the EES arm (8.8% vs 14.5%,
p = 0.03; hazard ratio 0.59, 95% CI 0.31 to 0.94) mainly driven by a lower
need for target vessel revascularization (6% vs 12.4%, p = 0.01, hazard
ratio 0.46, 95% CI 0.25 to 0.86). This pooled analysis of the RIBS IV and
RIBS V randomized trials demonstrates the superiority of EES over DEB in
the treatment of patients with ISR.
<4>
Accession Number
20160160144
Author
Lee J.Z.; Singh N.; Howe C.L.; Low S.-W.; Huang J.J.; Ortega G.; Lee K.S.;
Pandit A.
Institution
(Lee, Singh, Low, Huang) Department of Internal Medicine, University of
Arizona, Tucson, AZ, United States
(Howe) Arizona Health Sciences Library, University of Arizona, Tucson, AZ,
United States
(Ortega) College of Medicine, University of Arizona, Tucson, AZ, United
States
(Lee) Department of Cardiovascular Diseases, University of Arizona, 3950
S. Country Club Road, Tucson, AZ 85714, United States
(Pandit) DeBakey Heart Institute, Hays, KS, United States
Title
Colchicine for prevention of post-operative atrial fibrillation: A
meta-analysis.
Source
JACC: Clinical Electrophysiology. 2 (1) (pp 78-85), 2016. Date of
Publication: 01 Feb 2016.
Publisher
Elsevier Inc.
Abstract
Objectives This study sought to investigate the efficacy and safety of
colchicine for prevention of post-operative atrial fibrillation.
Background Proinflammatory processes induced during cardiac surgery may
contribute toward post-operative atrial fibrillation (AF). Colchicine is a
potent anti-inflammatory agent, which may have a role in post-operative AF
prevention. Methods We searched PubMed, EMBASE, Web of Science, CINAHL,
ClinicalTrials.gov, and the Cochrane Library databases for randomized
controlled trials (RCT) comparing colchicine versus placebo for prevention
of post-operative AF. The main outcome measure of interest was the
development of AF within 12 months after cardiac surgery. The overall risk
ratio (RR) for the development of post-operative AF was computed using a
random-effects model. Results Data analyzed from 3 randomized studies with
a total of 912 patients, where 457 patients received colchicine and 455
patients received placebo, showed that perioperative colchicine therapy
was associated with a reduced incidence of post-operative AF (RR: 0.65;
95% confidence interval [CI]: 0.46 to 0.91; p < 0.01). Although colchicine
therapy was associated with increased incidence of gastrointestinal
intolerance (RR: 2.20; 95% CI: 1.31 to 3.70; p = 0.003), it was not
associated with early treatment discontinuation (RR: 1.37; 95% CI: 0.95 to
1.96; p = 0.09). Conclusions In conclusion, current evidence suggests that
colchicine therapy is efficacious for the prevention of post-operative AF,
and may be considered as adjunctive prophylaxis. Further studies may be
required to determine the optimal treatment protocol to reduce the
incidence of gastrointestinal intolerance.
<5>
Accession Number
20160160482
Author
Balasi L.R.; Paryad E.; Booraki S.H.; Leili E.K.; Sadeghi Meibodi A.M.;
Sheikhani N.N.
Institution
(Balasi, Paryad, Booraki, Leili, Sadeghi Meibodi, Sheikhani) Guilan
University of Medical Sciences, Social Determinants of Health Research
Center (SDHRC), Iran, Islamic Republic of
Title
Medication adherence after CABG and its related to medication belief.
Source
Biomedical and Pharmacology Journal. 8 (2) (pp 603-610), 2015. Date of
Publication: 2015.
Publisher
Oriental Scientific Publishing Company
Abstract
Patients think their illness cured after coronary artery bypass grafting
(CABG) completely but it is noticeable this therapeutic method can
decrease the signs and symptoms of disease but can't cure it. By the way
non medication adherent patients are high risk group for health delivery
systems, and this situation may lead to increase admitting in hospitals
and even lead to death.it seems the belief toward medication can affect on
medication adherence. The samples of this of this cross sectional study
were 217 patients six months after CABG surgery who selected by systematic
randomized sampling. They participated in study by answering to a
questionnaire that consisted of three sections about sociodemographic
data, medication belief and adherence. Data gathering was done by phone
calling. Data analysis was done by SPSS software version 16, by the use of
descriptive and inferential statistics such as Chi square and Mann Whitney
tests as appropriate. Results showed the majority of samples had higher
beliefs toward medication in specific necessity (62.7%), specific concerns
(61.8%), general harm (56.2%) and general overuse (56.7%). In addition
medication belief in majority of samples (56.2%) was desire and medication
adherence was better than, and 81.1% of samples medication adherence was
desire but relationship between medication beliefs and adherence was not
significant. The drug belief was undesired in some of patients who had
desire medication adherence. This point may indicate on other influenced
factors on medication adherence and we offer to investigate in future
studies.
<6>
Accession Number
20160145610
Author
Guo J.; Pan L.-H.; Li Y.-X.; Yang X.-D.; Li L.-Q.; Zhang C.-Y.; Zhong
J.-H.
Institution
(Guo, Yang, Zhang) Experimental Department, Affiliated Tumor Hospital,
Guangxi Medical University, He Di Rd. #71, Nanning 530021, China
(Pan) Anesthesia Department, Affiliated Tumor Hospital, Guangxi Medical
University, Nanning, China
(Li) Cancer Registry Department, People's Hospital of Fusui County, Fusui,
China
(Li, Zhong) Hepatobiliary Surgery Department, Affiliated Tumor Hospital,
Guangxi Medical University, He Di Rd. #71, Nanning 530021, China
Title
Efficacy of triclosan-coated sutures for reducing risk of surgical site
infection in adults: A meta-analysis of randomized clinical trials.
Source
Journal of Surgical Research. 201 (1) (pp 105-117), 2016. Date of
Publication: 01 Mar 2016.
Publisher
Academic Press Inc.
Abstract
Background Surgical site infection (SSI) is the third most frequent type
of nosocomial infections. Triclosan-coated sutures are often used to
reduce the risk of SSI, but studies examining this have given conflicting
results. Therefore, this meta-analysis was performed to assess the
efficacy of triclosan-coated sutures for reducing risk of SSI in adults.
Methods PubMed, EMBASE, Google Scholar, and ClinicalTrials.gov were
searched to identify randomized clinical trials evaluating
triclosan-coated sutures for preventing SSI on patients 18 y or older.
Results Thirteen randomized clinical trials involving 5256 participants
were included. Triclosan-coated sutures were associated with lower risk of
SSI than uncoated sutures across all surgeries (risk ratio [RR] 0.76, 95%
confidence interval [CI] 0.65-0.88, P < 0.001). Similar proportions of
patients experienced wound dehiscence with either type of suture (RR 0.97,
95% CI 0.49-1.89, P = 0.92). Subgroup analysis showed lower risk of SSI
with triclosan-coated sutures in abdominal surgeries (RR 0.70, 95% CI
0.50-0.99, P = 0.04) and group with prophylactic antibiotic (RR 0.79, 95%
CI 0.63-0.99, P = 0.04). However, such risk reduction was not observed in
cardiac surgeries, breast surgeries, or group without prophylactic
antibiotic. Conclusions Triclosan-coated sutures can decrease the
incidence of SSI in abdominal surgeries and might not interfere with wound
healing process. Nevertheless, further studies are needed to examine
whether triclosan-coated sutures are effective at preventing SSI in
non-abdominal surgeries and to further study the interaction of antibiotic
prophylaxis with triclosan-coated sutures.
<7>
Accession Number
20160154232
Author
Gargiulo G.; Costa F.; Ariotti S.; Biscaglia S.; Campo G.; Esposito G.;
Leonardi S.; Vranckx P.; Windecker S.; Valgimigli M.
Institution
(Gargiulo, Ariotti, Windecker, Valgimigli) Department of Cardiology, Bern
University Hospital, Bern, Switzerland
(Gargiulo, Esposito) Department of Advanced Biomedical Sciences, Federico
II University of Naples, Naples, Italy
(Costa, Valgimigli) Thoraxcenter, Erasmus Medical Center, Rotterdam,
Netherlands
(Costa) Department of Clinical and Experimental Medicine, Policlinico G.
Martino, University of Messina, Messina, Italy
(Biscaglia, Campo) Cardiovascular Institute, Azienda
Ospedaliero-Universitaria sant'Anna, Ferrara, Italy
(Leonardi) Fondazione I.R.C.C.S. Policlinico San Matteo, Pavia, Italy
(Vranckx) Department of Cardiology and Critical Care Medicine, Hartcentrum
Hasselt, Hasselt, Belgium
Title
Impact of proton pump inhibitors on clinical outcomes in patients treated
with a 6- or 24-month dual-antiplatelet therapy duration: Insights from
the PROlonging Dual-antiplatelet treatment after Grading stent-induced
Intimal hyperplasia studY trial.
Source
American Heart Journal. 174 (pp 95-102), 2016. Date of Publication: 2016.
Publisher
Mosby Inc.
Abstract
Background Proton pump inhibitors (PPIs) are frequently prescribed in
combination with clopidogrel, but conflicting data exist as to whether
PPIs diminish the efficacy of clopidogrel. We assessed the association
between PPI use and clinical outcomes for patients treated with
percutaneous coronary intervention (PCI) and dual-antiplatelet therapy
(DAPT) with clopidogrel plus aspirin. Methods and results In the PRODIGY
trial, 1,970 patients were randomized to 6- or 24-month DAPT at 30 days
from index procedure. Among them, 738 patients (37.5%) received PPI
(mainly lansoprazole; 90.1%) at the time of randomization. Proton pump
inhibitor users were older, were most likely to be woman, had a lower
creatinine clearance, presented more frequently with acute coronary
syndrome, and had a higher CRUSADE bleeding score. After adjustment, the
primary efficacy end point (composite of all-cause death, myocardial
infarction, and cerebrovascular accident) was similar between no PPI and
PPI users (9.2% vs 11.5%, adjusted hazard ratio [HR] 1.051, 95% CI
0.788-1.400, P =.736). Bleeding rates did not differ between the 2 groups
(Bleeding Academic Research Consortium type 2, 3, or 5: adjusted HR 0.996,
95% CI 0.672-1.474, P =.980). Net clinical adverse events were also
similar in no PPI and PPI patients (12.9% vs 14.9%, adjusted HR 0.99, 95%
CI 0.772-1.268, P =.93). Results remained consistent at sensitivity
analysis when focusing on the 548 patients who remained on PPI for the
whole study duration. Conclusions The current findings suggest that the
concomitant use of PPIs, when clinically indicated, in patients receiving
clopidogrel is not associated with adverse clinical outcome.
<8>
Accession Number
20160150336
Author
Ali-Hassan-Sayegh S.; Mirhosseini S.J.; Shahidzadeh A.; Rahimizadeh E.;
Sarrafan-Chaharsoughi Z.; Ghodratipour Z.; Lotfaliani M.; Rezaeisadrabadi
M.; Dehghan H.R.; Bireta C.; Weymann A.; Sabashnikov A.; Popov A.-F.
Institution
(Ali-Hassan-Sayegh, Mirhosseini, Shahidzadeh, Rahimizadeh,
Sarrafan-Chaharsoughi, Ghodratipour, Lotfaliani, Rezaeisadrabadi)
Cardiovascular Research Centre, Shahid Sadoughi University of Medical
Sciences, Yazd, Iran, Islamic Republic of
(Mirhosseini) Department of Cardiovascular Surgery, Shahid Sadoughi
University of Medical Sciences, Yazd, Iran, Islamic Republic of
(Dehghan) Dept. of Hlth. Technol. Assess. and Bio-statistics, Shahid
Sadoughi Univ. of Medical Sciences, Yazd, Iran, Islamic Republic of
(Bireta) Department of Thoracic and Cardiovascular Surgery, University
Hospital Goettingen, Goettingen, Germany
(Weymann, Sabashnikov, Popov) Department of Cardiothoracic Transplantation
and Mechanical Circulatory Support, Royal Brompton and Harefield NHS
Foundation Trust, London, United Kingdom
Title
Appropriate bolus administration of glycoprotein IIb/IIIa inhibitors for
patients with acute coronary syndromes undergoing percutaneous coronary
intervention: Intracoronary or intravenous? A comprehensive and updated
meta-analysis and systematic review.
Source
Kardiologia Polska. 74 (2) (pp 104-118), 2016. Date of Publication: 2016.
Publisher
Via Medica (Ul. Swietokrzyska 73, Gdansk 80-180, Poland)
Abstract
This systematic review with meta-analysis sought to compare the efficacy
and safety of intracoronary (IC) vs. intravenous (IV) administration of
glycoprotein (GP) IIb/IIIa receptor inhibitors on clinical outcomes
following percutaneous coronary intervention in patients with acute
coronary syndromes (ST-segment elevation myocardial infarction or
non-ST-segment-elevation acute coronary syndrome). Methods: Medline,
Embase, Elsevier, and Sciences online databases as well as Google Scholar
literature were used to select appropriate studies with randomised
controlled design. The primary end-points were mortality and target vessel
revascularisation (TVR), whereas the secondary end points were incidence
of thrombolysis in myocardial infarction score 3 flow (TIMI 3 flow means
complete perfusion in distal coronary artery bed), re-myocardial
infarction (re-MI), major bleeding, stent thrombosis left ventricular
ejection fraction (LVEF), and heart failure (HF). The literature search of
all major databases retrieved 1006 studies. After screening, a total of 18
trials (5812 patients) were identified with reported outcomes. Results:
Pooled analysis showed IC administration of GP IIb/IIIa receptor
inhibitors can significantly increase LVEF (WMD 4.97; 95% CI 3.34-6.60; p
= 0.000) and the incidence of TIMI 3 flow (OR of 0.77; 95% CI 0.64-0.92; p
= 0.005), and significantly decrease in incidence of HF (OR of 1.927; 95%
CI 1.189-3.124; p = 0.008). Incidences of TVR, re-MI, major bleeding,
stent thrombosis, and mortality showed no significant differences between
the IC and IV groups. Conclusions: Overall, the most appropriate route of
administration of GP IIb/IIIa inhibitors for patients with acute coronary
syndromes appeared to be an IC injection that could increase LVEF and TIMI
3 flow and decrease the incidence of HF. Furthermore, the IC
administration was not associated with increased adverse event rates when
compared to IV injection.
<9>
Accession Number
2015533281
Author
Chernyavskiy A.; Kareva Y.; Pak I.; Rakhmonov S.; Pokushalov E.; Romanov
A.
Institution
(Chernyavskiy, Kareva, Pak, Rakhmonov) Department of Surgery, Aorta,
Coronary and Peripheral Arteries, Novosibirsk Research Institute of
Circulation Pathology, Novosibirsk, Russian Federation
(Pokushalov, Romanov) Department of Rhythm Disorders of the Heart,
Novosibirsk Research Institute of Circulation Pathology, Novosibirsk,
Russian Federation
Title
Quality of Life after Surgical Ablation of Persistent Atrial Fibrillation:
A Prospective Evaluation.
Source
Heart Lung and Circulation. 25 (4) (pp 378-383), 2016. Date of
Publication: 01 Apr 2016.
Publisher
Elsevier Ltd
Abstract
Aim: To compare the quality of life (QoL) of patients with persistent
atrial fibrillation (AF) and ischaemic heart disease after modified
mini-maze (MM) procedure or pulmonary vein isolation (PVI) using
radiofrequency ablation (RFA) with patients in the control group (coronary
artery bypass graft [CABG]) alone. Methods: In this prospective randomised
study, we included 95 patients with persistent AF and coronary heart
disease who underwent open-heart surgery combined with intraoperative
irrigated RFA (irrRFA). Patients were randomly assigned to three groups:
CABG and PVI using irrRA (CABG+PVI, n=31), CABG and MM procedure using
irrRA (CABG+MM, n=30), and isolated CABG (CABG alone, n=34). All patients
received implantable loop recorders (ILRs). Patient QoL was assessed using
the Short Form 36 (SF-36) preoperatively, and one and two years
post-operatively. The study primary end point was freedom from AF one year
after operation, measured by implantable loop recorders (ILRs); secondary
endpoint included long-term clinical outcomes. Results: No reoperations or
hospital mortalities were recorded. Mean follow-up was 14.4+/-9.7 months.
The percentages of patients free from AF determined by ILR were 80%,
86.2%, and 44.1% in the CABG+PVI, CABG+MM, and in the CABG alone groups,
respectively. The QoL significantly improved in CABG+PVI and CABG+MM
groups compared with CABG alone group in most domains. Conclusion:
Effective elimination of AF during CABG surgery improves QoL in all
physical health domains of the SF-36 and the role-emotional functioning
domain. Thus, patients with concomitant AF and coronary heart disease may
benefit from intraoperative radiofrequency ablation to prevent relapse of
the arrhythmia.
<10>
Accession Number
20160159436
Author
Keh Y.S.; Yap J.; Yeo K.K.; Koh T.H.; Eeckhout E.
Institution
(Keh, Yap, Yeo, Koh) Department of Cardiology, National Heart Centre
Singapore, Singapore, Singapore
(Yeo) Duke-NUS Graduate Medical School, Singapore, Singapore
(Eeckhout) Division of Cardiology, Centre Hospitalier Universitaire
Vaudois, Lausanne, Switzerland
Title
Clinical Outcomes of Bioresorbable Scaffold in Coronary Artery Disease: A
Systematic Literature Review.
Source
Journal of Interventional Cardiology. 29 (1) (pp 57-69), 2016. Date of
Publication: 01 Feb 2016.
Publisher
Blackwell Publishing Inc.
Abstract
Objectives: We aim to perform a systematic literature review on all
studies reporting the clinical outcomes of the use of bioresorbable
scaffolds (BRS) in different settings of coronary artery disease (CAD).
Background: BRS are designed to provide early support of the vessel wall
postangioplasty, deliver antiproliferative agents to prevent excessive
hyperplastic healing responses and finally "disappear" when no longer
required. Emerging data have provided evidence of their use in specific
clinical scenarios. Methods: A comprehensive literature search was
performed by 2 independent reviewers utilizing MEDLINE, EMBASE, and
Cochrane Library databases. The only 2 CE marked BRS: everolimus-eluting
Bioresorbable vascular scaffold ABSORB BVS and the myolimus-eluting
DESolve Bioresorbable Coronary Scaffold (BCS) System were included.
Results: The studies were categorized into: ST elevation myocardial
infarction (STEMI), stable CAD, and "all-comers" group. Thirty-one studies
were included; 8 in STEMI patients (all ABSORB), 15 in stable CAD
patients. In the STEMI group (n = 606), acute procedural success ranged
from 96% to 100%, cardiac mortality 0-9.1%, recurrent MI and stent
thrombosis rates were 0-4.3%. In the stable CAD group, the 13 ABSORB
studies (n = 3259) demonstrated cardiac mortality rate of 0-0.6%,
recurrent MI rate 0-4.5%, and stent thrombosis rate 0-4.3% Conclusions:
Current clinical data suggest the BRS, especially the ABSORB BVS, may
represent a reasonable alternative to DES in uncomplicated coronary
anatomy.
<11>
Accession Number
20160159434
Author
Lesiak M.; Araszkiewicz A.; Grajek S.; Colombo A.; Lalmand J.; Carstensen
S.; Namiki A.; Tobaru T.; Merkely B.; Moreno R.; Barbato E.; Wijns W.;
Saito S.
Institution
(Lesiak, Araszkiewicz, Grajek) 1st Department of Cardiology, University of
Medical Sciences, Dluga 1/2, Poznan 61-848, Poland
(Colombo) Cardiac Cath Lab., Interventional Cardiology Unit, EMO GVM
Centro Cuore, Columbus, San Raffaele Hospital, Milan, Italy
(Lalmand) Department of Cardiology, CHU de Charleroi, Charleroi, Belgium
(Carstensen) Department of Cardiology, Roskilde University Hospital,
Roskilde, Denmark
(Namiki) Department of Cardiology, Kanto Rosai Hospital, Kawasaki, Japan
(Tobaru) Department of Cardiology, Sakakibara Heart Institute, Tokyo,
Japan
(Merkely) Heart and Vascular Center, Semmelweis University, Budapest,
Hungary
(Moreno) Department of Interventional Cardiology, University Hospital la
Paz, Madrid, Spain
(Barbato, Wijns) Cardiovascular Center Aalst, OLV Hospital, Aalst, Belgium
(Barbato) Departement of Advanced Biomedical Sciences, Federico II
University of Naples, Naples, Italy
(Saito) Department of Cardiology, Catheterization Laboratory, Shonan
Kamakura General Hospital, Kamakura, Japan
Title
Long Coronary Lesions Treated with Thin Strut Bioresorbable Polymer Drug
Eluting Stent: Experience from Multicentre Randomized CENTURY II Study.
Source
Journal of Interventional Cardiology. 29 (1) (pp 47-56), 2016. Date of
Publication: 01 Feb 2016.
Publisher
Blackwell Publishing Inc.
Abstract
Objectives: to assess performance of new, bioresorbable polymer
sirolimus-eluting stent (BP-SES), in patients with long coronary lesions
(LL) and to compare it to permanent polymer everolimus-eluting stent
(PP-EES). Background: LL have been associated with worse clinical outcomes
in percutaneous coronary interventions (PCI). The impact of lesion length
on the outcomes of drug eluting stent (DES) implantations is not as clear.
Methods: In the frame of a randomized, multicentre CENTURY II study, out
of 1119 patients enrolled, 182 patients had LL (defined as >25 mm), and
were assigned randomly to treatment with BP-SES (101) or PP-EES (81).
Primary endpoint was target lesion failure (TLF, composite of cardiac
death, target vessel related myocardial infarction [MI], and target lesion
revascularization [TLR]) at 9 months. All data were 100% monitored and
adverse events were adjudicated by an independent clinical event
committee. Results: The baseline patient and lesion characteristics were
similar in the 2 study arms. At 9-months, the rates of cardiac death (2.0%
vs 1.2%; P = 0.70), MI (3.0% vs 4.9%; P = 0.49) and clinically driven TLR
(2.0% vs 3.7%; P = 0.48) and TLF (6.9% vs 8.6%; P = 0.67) were similar for
BP-SES and PP-EES, respectively. There was no stent thrombosis (ST) in
BP-SES group up to 9 months, while 1 case (1.2%) of ST was recorded in
PP-EES group (P = 0.44). Conclusions: Patients with LL showed similar
clinical outcomes when treated with Ultimaster BP-SES and Xience PP-EES.
<12>
Accession Number
20160154239
Author
Akca B.; Kanbak M.; Kilicaslan B.; Celebiotlu B.; Aypar U.
Institution
(Akca, Kanbak, Kilicaslan, Celebiotlu, Aypar) Hacettepe University Faculty
of Medicine, Department of Anesthesiology and Reanimatlon, Ankara, Turkey
Title
The effects of hydroxyethyl starch (130/0.4) versus lactated ringer
solution on coagulation parameters in cyanotic children undergoing
cardiopulmonary bypass: A randomized trial.
Source
Anestezi Dergisi. 23 (4) (pp 219-225), 2015. Date of Publication: 2015.
Publisher
Anestezi Dergisi
Abstract
Objective: In this prospective, randomized study, we compared the effects
on standard coagulation parameters of the standard Lactated Ringer (LR)
priming solution with the latest generation of hydroxyethyl starch
solutions, HES (130/0.4). Method: Twenty patients with cyanotic heart
disease aged between 6 months and 10 years were included. A LR solution
was used as a priming solution in group I, and in group II, a HES
(130/0.4) solution was used. Demographic and clinical data (age, sex,
weight, duration of operation, cardiopulmonary bypass (CPB), and aortic
cross-clamping time), duration of ICU stay, and hospitalization time were
also recorded. Laboratory parameters of blood samples were collected after
anesthesia induction (T1),five minutes after heparinization (T2), ten
minutes after the initiation of CPB (T3), after weaning from CPB and
protamine administration (T4), at 24 hours postoperatively (T5), and at 48
hours postoperatively (T6) in all patients. Hematocrit, hemoglobin, and
platelet counts were recorded at T1-6. Coagulation parameters
(international normalized ratio, activated partial thromboplastin time)
and liver function tests were analyzed at T1 and T4-6. Total fluid
administration, urine output, fresh frozen plasma and erythrocyte
suspension amount, inotropic and diuretic requirements, and chest tube
drainage amount were recorded at the end of the operation and 24 and 48
hours postoperatively in all patients. Results: Hemoglobin (gldL) and
hematocrit levels, platelet count and activated partial thromboplastin
time values did not differ significantly between groups. There was also no
statistically significant difference in usage of inotropic and diuretic
agents, postoperative drainage from chest tube, total urine output, fluid
administration, or amount of red blood cells or fresh frozen plasma used.
Although international normalized ratio values increased in both groups at
different times compared to the baseline levels (Tl) (p < 0.05), there was
no significant difference between two groups. Conclusion: We concluded
that HES (13010.4) solution does not affect the standard coagulation
parameters of children with cyanotic heart diseases undergoing CPB.
<13>
Accession Number
20160156556
Author
Tomasello S.D.; Boukhris M.; Giubilato S.; Marza F.; Garbo R.;
Contegiacomo G.; Marzocchi A.; Niccoli G.; Gagnor A.; Varbella F.;
Desideri A.; Rubartelli P.; Cioppa A.; Baralis G.; Galassi A.R.
Institution
(Tomasello, Boukhris, Giubilato, Marza, Galassi) Ospedale Cannizz Aro,
Universita di Catania, Via Antonello da Messina 75, Acicastello, Catania
95021, Italy
(Garbo) Ospedale G. Bosco, Torino, Italy
(Contegiacomo) Casa di Cura S. Maria, Bari, Italy
(Marzocchi) Policlinico S. Orsola Malpigli, Bologna, Italy
(Niccoli) Ospedale Policlinico Gemelli, Roma, Italy
(Gagnor, Varbella) Ospedale Degli Infermi, Rivoli, Italy
(Desideri) Ospedale S. Giacomo, Castelfranco, Veneto Genova, Italy
(Rubartelli) Ospedale Villa Scassi, Genova, Italy
(Cioppa) Casa di Cura Montevergine, Mercogliano, Italy
(Baralis) Ospedale S. Croce e Carle, Cuneo, Italy
(Boukhris) Faculty of Medicine of Tunis, University Tunis El Manar,
Tunisia
Title
Management strategies in patients affected by chronic total occlusions:
Results from the Italian Registry of Chronic Total Occlusions.
Source
European Heart Journal. 36 (45) (pp 3189-3198a), 2015. Date of
Publication: 2015.
Publisher
Oxford University Press
Abstract
Background Through contemporary literature, the optimal strategy to manage
coronary chronic total occlusions (CTOs) remains under debate. Objectives
The aim of the Italian Registry of Chronic Total Occlusions (IRCTO) was to
provide data on prevalence, characteristics, and outcome of CTO patients
according to the management strategy. Methods The IRCTO is a prospective
real world multicentre registry enrolling patients showing at least one
CTO. Clinical and angiographic data were collected independently from the
therapeutic strategy [optimal medical therapy (MT), percutaneous coronary
intervention (PCI), or coronary artery bypass grafting (CABG)]; a
comparative 1-year clinical followup was performed. Results A total of
1777 patients were enrolled for an overall CTO prevalence of 13.3%. The
adopted therapeutic strategies were as follows: MT in 826 patients
(46.5%), PCI in 776 patients (43.7%), and CABG in the remaining 175
patients (9.8%). At 1-year follow-up, patients undergoing PCI showed lower
rate of major adverse cardiac and cerebrovascular events (MACCE) (2.6% vs.
8.2% and vs. 6.9%; P < 0.001 and P < 0.01) and cardiac death (1.4% vs.
4.7% and vs. 6.3%; P < 0.001 and P < 0.001) in comparison with those
treated with MT and CABG, respectively. After propensity scorematching
analysis, patients treated with PCI showed lower incidence of cardiac
death (1.5 vs. 4.4%; P < 0.001), acute myocardial infarction (1.1 vs.
2.9%; P = 0.03), and re-hospitalization (2.3 vs. 4.4% P = 0.04) in
comparison with those managed by MT. Conclusions Our data showed how CTO
PCI might significantly improve the survival and decrease MACCE occurrence
at 1 year follow-up in comparison with MT and/or CABG.
<14>
Accession Number
20160156555
Author
Leitman M.; Shmueli R.; Rubchevsky V.; Hendler A.; Vered Z.
Institution
(Leitman, Shmueli, Hendler, Vered) Department of Cardiology, Assaf Harofeh
Medical Center, Zerifin 70300, Israel
(Leitman, Shmueli, Rubchevsky, Hendler, Vered) Sackler School of Medicine
Tel Aviv University, Tel Aviv, Israel
(Rubchevsky) Department of Cardiac Surgery, Rabin Medical Center, Petah
Tikva, Israel
Title
A 45-year-old woman with chest pain after coronary stenting.
Source
European Heart Journal. 36 (45) (pp 3188), 2015. Date of Publication:
2015.
Publisher
Oxford University Press
<15>
Accession Number
20160156554
Author
Zimmermann F.M.; Ferrara A.; Johnson N.P.; Van Nunen L.X.; Escaned J.;
Albertsson P.; Erbel R.; Legrand V.; Gwon H.-C.; Remkes W.S.; Stella P.R.;
Van Schaardenburgh P.; Jan Willem Bech G.; De Bruyne B.; Pijls N.H.J.
Institution
(Zimmermann, Van Nunen, Pijls) Department of Cardiology, Catharina
Hospital Eindhoven, Michelangelolaan 2, Eindhoven 5623 EJ, Netherlands
(Ferrara, De Bruyne) Cardiovascular Center, Aalst, Belgium
(Johnson) Weatherhead PET Center for Preventing and Reversing
Atherosclerosis, Division of Cardiology, Department of Medicine,
University of Texas Medical, School and Memorial Hermann Hospital,
Houston, TX, United States
(Van Nunen, Pijls) Department of Biomedical Engineering, Eindhoven
University of Technology, Eindhoven, Netherlands
(Escaned) Hospital Clinico San Carlos, Faculty of Medicine, Complutense
University of Madrid, Centro Nacional de Investigaciones Cardiovasculares
Carlos III (CNIC), Madrid, Spain
(Albertsson) Department of Cardiology, Sahlgrenska University Hospital
Gothenburg, Sweden
(Erbel) Department of Cardiology, West-German Heart and Vascular Centre,
University Hospital of Essen, Essen, Germany
(Legrand) Department of Cardiology, University Hospital of Liege, Liege,
Belgium
(Gwon) Division of Cardiology, Cardiac and Vascular Center, Samsung
Medical Center, Sungkyunkwan University School of Medicine, Seoul, South
Korea
(Remkes) Department of Cardiology, Isala Klinieken, Zwolle, Netherlands
(Stella) Department of Interventional Cardiology, University Medical
Center Utrecht, Utrecht, Netherlands
(Van Schaardenburgh) Department of Cardiology, VieCuri, Venlo, Netherlands
(Jan Willem Bech) Department of Cardiology, HagaZiekenhuis, The Hague,
Netherlands
(Jan Willem Bech) Reinier de Graaf Groep, Delft, Netherlands
Title
Deferral vs. performance of percutaneous coronary intervention of
functionally non-significant coronary stenosis: 15-year follow-up of the
DEFER trial.
Source
European Heart Journal. 36 (45) (pp 3182-3188), 2015. Date of Publication:
2015.
Publisher
Oxford University Press
Abstract
Aims Stenting an angiographically intermediate but functionally
non-significant stenosis is controversial. Nevertheless, it has been
questioned if deferral of a functionally non-significant lesion on the
basis of fractional flow reserve (FFR) measurement, is safe, especially on
the long term. Five-year follow-up of the DEFER trial showed that outcome
after deferral of percutaneous coronary intervention (PCI) of an
intermediate coronary stenosis based on FFR = 0.75 is excellent and was
not improved by stenting. The aim of this study was to investigate the
validity of this position on the very long term. Met hods and resul ts In
325 patients scheduled for PCI of an intermediate stenosis, FFR was
measured just before the planned intervention. If FFR was = 0.75, patients
were randomly assigned to deferral (Defer group; n = 91) or performance
(Perform group; n = 90) of PCI. If FFR was, 0.75, PCI was performed as
planned (Reference group; n = 144). Clinical follow-up was 15 years. There
were no differences in baseline clinical characteristics between the
randomized groups. Complete 15-year follow-up was obtained in 92% of
patients. After 15 years of follow-up, the rate of death was not different
between the three groups: 33.0% in the Defer group, 31.1% in the Perform
group, and 36.1% in the Reference group (Defer vs. Perform, RR 1.06, 95%
CI: 0.69 1.62, P = 0.79). The rate of myocardial infarction was
significantly lower in the Defer group (2.2%) compared with the Perform
group (10.0%), RR 0.22, 95% CI: 0.05 0.99, P = 0.03. Conclusion Deferral
of PCI of a functionally non-significant stenosis is associated with a
favourable very long-term follow-up without signs of late 'catch-up'
phenomenon.
<16>
Accession Number
20160156552
Author
De Maria G.L.; Cuculi F.; Patel N.; Dawkins S.; Fahrni G.; Kassimis G.;
Choudhury R.P.; Forfar J.C.; Prendergast B.D.; Channon K.M.; Kharbanda
R.K.; Banning A.P.
Institution
(De Maria, Cuculi, Patel, Dawkins, Fahrni, Kassimis, Forfar, Prendergast,
Channon, Kharbanda, Banning) Oxford Heart Centre, NIHR Biomedical Research
Centre, Oxford University Hospitals, Headley Way, Oxford OX39DU, United
Kingdom
(Cuculi) Department of Cardiology, LuzernerKantonsspital, Luzern,
Switzerland
(Choudhury) Acute Vascular Imaging Centre, Radcliffe Department of
Medicine, University of Oxford, Oxford, United Kingdom
(Choudhury) Division of Cardiovascular Medicine, BHF Centre of Research
Excellence, University of Oxford, Oxford, United Kingdom
Title
How does coronary stent implantation impact on the status of the
microcirculation during primary percutaneous coronary intervention in
patients with ST-elevation myocardial infarction?.
Source
European Heart Journal. 36 (45) (pp 3165-3177), 2015. Date of Publication:
2015.
Publisher
Oxford University Press
Abstract
Aims Primary percutaneous coronary intervention (PPCI) is the optimal
treatment for patients presenting with ST-elevation myocardial infarction
(STEMI). An elevated index of microcirculatory resistance (IMR) reflects
microvascular function and when measured after PPCI, it can predict an
adverse clinical outcome. We measured coronary microvascular function in
STEMI patients and compared sequential changes before and after stent
implantation. Methods and results In 85 STEMI patients, fractional flow
reserve, coronary flow reserve, and IMR were measured using a pressure
wire (Certus, St Jude Medical, St Paul, MN, USA) immediately before and
after stent implantation. Stenting significantly improved all of the
measured parameters of coronary physiology including IMR from 67.7
[interquartile range (IQR): 56.2 95.8] to 36.7 (IQR: 22.7 59.5), P, 0.001.
However, after stenting, IMR remained elevated (. 40) in 28 (32.9%)
patients. In 15 of these patients (17.6% of the cohort), only a partial
reduction in IMR occurred and these patients were more likely to be late
presenters (pain to wire time. 6 h). The extent of jeopardized myocardium
[standardized beta: 2 0.26 (IMR unit/Bypass Angioplasty Revascularization
Investigation score unit), P: 0.009] and pre-stenting IMR [standardized
beta: 2 0.34 (IMR unit), P: 0.001] predicted a reduction in IMR after
stenting (DIMR 14 post-stenting IMR 2 pre-stenting IMR), whereas
thrombotic burden [standardized beta: 0.24 (IMR unit/thrombus score unit),
P: 0.01] and deployed stent volume [standardized beta: 0.26 (IMR unit/mm3
of stent), P: 0.01] were associated with a potentially deleterious
increase in IMR. Conclusion Improved perfusion of the myocardium by stent
deployment during PPCI is not universal. The causes of impaired
microvascular function at the completion of PPCI treatment are
heterogeneous, but can reflect a later clinical presentation and/or the
location and extent of the thrombotic burden.
<17>
[Use Link to view the full text]
Accession Number
20160148276
Author
Owens A.T.; Brozena S.C.; Jessup M.
Institution
(Owens, Brozena, Jessup) Department of Medicine, Cardiovascular Division,
University of Pennsylvania Perelman School of Medicine, Penn Heart and
Vas., 2 E P. P., 3400 Civic Cenr. Blvd, Philadelphia, PA 19104, United
States
Title
New Management Strategies in Heart Failure.
Source
Circulation Research. 118 (3) (pp 480-495), 2016. Date of Publication:
2016.
Publisher
Lippincott Williams and Wilkins
Abstract
Despite >100 clinical trials, only 2 new drugs had been approved by the US
Food and Drug Administration for the treatment of chronic heart failure in
more than a decade: the aldosterone antagonist eplerenone in 2003 and a
fixed dose combination of hydralazine-isosorbide dinitrate in 2005. In
contrast, 2015 has witnessed the Food and Drug Administration approval of
2 new drugs, both for the treatment of chronic heart failure with reduced
ejection fraction: ivabradine and another combination drug,
sacubitril/valsartan or LCZ696. Seemingly overnight, a range of
therapeutic possibilities, evoking new physiological mechanisms, promise
great hope for a disease that often carries a prognosis worse than many
forms of cancer. Importantly, the newly available therapies represent a
culmination of basic and translational research that actually spans many
decades. This review will summarize newer drugs currently being used in
the treatment of heart failure, as well as newer strategies increasingly
explored for their utility during the stages of the heart failure
syndrome.
<18>
Accession Number
20151043864
Author
Virk S.A.; Bowman S.R.A.; Chan L.; Bannon P.G.; Aty W.; French B.G.;
Saxena A.
Institution
(Virk) South Western Sydney Clinical School, University of New South
Wales, Elizabeth St and Goulburn St, Sydney, Australia
(Bowman) Melbourne Medical School, University of Melbourne, Melbourne,
Australia
(Chan, Aty, French) Department of Cardiothoracic Surgery, Liverpool
Hospital, Sydney, Australia
(Bannon, Saxena) Department of Cardiothoracic Surgery, Royal Prince Alfred
Hospital, Sydney, Australia
(Bannon, Saxena) Discipline of Surgery, Sydney Medical School, University
of Sydney, Sydney, Australia
Title
Equivalent outcomes after coronary artery bypass graft surgery performed
by consultant versus trainee surgeons: A systematic review and
meta-analysis.
Source
Journal of Thoracic and Cardiovascular Surgery. 151 (3) (pp 647-654e1),
2016. Date of Publication: 01 Mar 2016.
Publisher
Mosby Inc.
Abstract
Objective In recent years, concerns have been raised about the learning
opportunities available to cardiac surgical trainees. This meta-analysis
was conducted to assess the impact of trainee operator status on clinical
outcomes after coronary artery bypass graft (CABG) surgery. Methods
Medline, EMBASE, and the Cochrane Library were systematically searched for
studies that reported CABG outcomes according to the training status of
the primary operator (consultant vs trainee). Data were independently
extracted by 2 investigators; a meta-analysis was conducted according to
predefined clinical endpoints. Results Sixteen observational studies (n =
52,966) met criteria for inclusion, with 8 studies (n = 36,479) reporting
propensity-adjusted analyses. Trainee cases were associated with increased
aortic crossclamp duration (mean difference: 4.80; 95% confidence interval
[CI], 0.76-8.83) and cardiopulmonary bypass duration (mean difference:
4.24; 95% CI, 0.00-8.47). Perioperative mortality was similar for CABG
performed primarily by trainees versus consultants (odds ratio 0.98; 95%
CI, 0.81-1.18). No significant difference was found in the incidence of
perioperative stroke, myocardial infarction, acute renal failure,
reoperation for bleeding, or wound infection. Trainee operator status was
not associated with increased midterm mortality (hazard ratio 1.00; 95%
CI, 0.90-1.11). In subgroup analysis that included 5 studies and 8025
patients, off-pump CABG trainee cases were not associated with increased
perioperative mortality or morbidity. Conclusions With appropriate
supervision, conventional CABG can be performed by trainee surgeons
without an adverse impact on perioperative outcomes or midterm survival.
Data regarding off-pump CABG are limited, and further research is
warranted to ascertain the impact of trainee operator status on long-term
outcomes after off-pump CABG.
<19>
Accession Number
20160156019
Author
Bertolet M.; Brooks M.M.; Bittner V.
Institution
(Bertolet) Department of Epidemiology, Clinical and Translational
Sciences, University of Pittsburgh, Pittsburgh, PA, United States
(Brooks) Department of Epidemiology and Biostatistics, Clinical and
Translational Sciences, University of Pittsburgh, Pittsburgh, PA, United
States
(Bittner) Preventive Cardiology, University of Alabama at Birmingham,
Birmingham, AL, United States
Title
Tree-based identification of subgroups for time-varying covariate survival
data.
Source
Statistical Methods in Medical Research. 25 (1) (pp 488-501), 2016. Date
of Publication: 01 Feb 2016.
Publisher
SAGE Publications Ltd
Abstract
Classification and regression tree analyses identify subsets of a sample
that differ on an outcome. Discrimination of subsets is performed using
recursive binary splitting on a set of covariates, allowing for
interactions of variable subgroups not easily captured in standard model
building techniques. Using classification and regression tree with
epidemiological data can be problematic as there is often a need to adjust
for potential confounders and to account for time-varying covariates in
the context of right-censored survival data. While classification and
regression tree variations exist individually for survival analysis,
time-varying covariates and incorporating possible confounders, examples
of classification and regression tree using all three together are
lacking. We propose a method to identify subsets of time-varying covariate
risk factors that affect survival while adjusting for possible
confounders. The technique is demonstrated on data from the Bypass
Angioplasty Revascularization Investigation 2 Diabetes clinical trial to
find combinations of modifiable time-varying cardiac risk factors (e.g.
smoking status, blood pressure, lipid levels and HbA1c level) that are
associated with time-to-event clinical outcomes.
<20>
Accession Number
20160149290
Author
Nelson R.E.; Nelson S.D.; Khader K.; Perencevich E.L.; Schweizer M.L.;
Rubin M.A.; Graves N.; Harbarth S.; Stevens V.W.; Samore M.H.
Institution
(Nelson, Nelson, Khader, Rubin, Stevens, Samore) Veterans Affairs Salt
Lake City Health Care System, Salt Lake City, UT, United States
(Nelson, Khader, Rubin, Samore) Department of Internal Medicine,
University of Utah School of Medicine, Salt Lake City, UT, United States
(Nelson, Stevens) Department of Pharmacotherapy, University of Utah
College of Pharmacy, Salt Lake City, UT, United States
(Perencevich, Schweizer) Iowa City Veterans Affairs Health Care System,
Iowa City, IA, United States
(Perencevich, Schweizer) Department of Internal Medicine, University of
Iowa Carver College of Medicine, Iowa City, IA, United States
(Graves) School of Public Health and Social Work, Queensland University of
Technology, Brisbane, Australia
(Harbarth) GenevaSwitzerland
Title
The magnitude of time-dependent bias in the estimation of excess length of
stay attributable to healthcare-associated infections.
Source
Infection Control and Hospital Epidemiology. 36 (9) (pp 1089-1094), 2015.
Date of Publication: 2015.
Publisher
Cambridge University Press
Abstract
background. Estimates of the excess length of stay (LOS) attributable to
healthcare-associated infections (HAIs) in which total LOS of patients
with and without HAIs are biased because of failure to account for the
timing of infection. Alternate methods that appropriately treat HAI as a
time-varying exposure are multistate models and cohort studies, which
match regarding the time of infection. We examined the magnitude of this
time-dependent bias in published studies that compared different
methodological approaches. methods. We conducted a systematic review of
the published literature to identify studies that report attributable LOS
estimates using both total LOS (time-fixed) methods and either multistate
models or matching patients with and without HAIs using the timing of
infection. results. Of the 7 studies that compared time-fixed methods to
multistate models, conventional methods resulted in estimates of the LOS
to HAIs that were, on average, 9.4 days longer or 238% greater than those
generated using multistate models. Of the 5 studies that compared
timefixed methods to matching on timing of infection, conventional methods
resulted in estimates of the LOS to HAIs that were, on average, 12.6 days
longer or 139% greater than those generated by matching on timing of
infection. conclusion. Our results suggest that estimates of the
attributable LOS due to HAIs depend heavily on the methods used to
generate those estimates. Overestimation of this effect can lead to
incorrect assumptions of the likely cost savings from HAI prevention
measures.
<21>
Accession Number
20160142660
Author
Lijkendijk M.; Licht P.B.; Neckelmann K.
Institution
(Lijkendijk, Licht, Neckelmann) Department of Cardiothoracic Surgery,
Odense University Hospital, Odense, Denmark
Title
Electronic versus traditional chest tube drainage following lobectomy: A
randomized trial.
Source
European Journal of Cardio-thoracic Surgery. 48 (6) (pp 893-898), 2015.
Date of Publication: 2015.
Publisher
European Association for Cardio-Thoracic Surgery
Abstract
OBJECTIVES: Electronic drainage systems have shown superiority compared
with traditional (water seal) drainage systems following lung resections,
but the number of studies is limited. As part of a medico-technical
evaluation, before change of practice to electronic drainage systems for
routine thoracic surgery, we conducted a randomized controlled trial (RCT)
investigating chest tube duration and length of hospitalization. METHODS:
Patients undergoing lobectomy were included in a prospective open label
RCT. A strict algorithm was designed for early chest tube removal, and
this decision was delegated to staff nurses. Data were analysed by Cox
proportional hazard regression model adjusting for lung function, gender,
age, BMI, video-assisted thoracic surgery (VATS) or open surgery and
presence of incomplete fissure or pleural adhesions. Time was
distinguished as possible (optimal) and actual time for chest tube
removal, as well as length of hospitalization. RESULTS: A total of 105
patients were randomized. We found no significant difference between the
electronic group and traditional group in optimal chest tube duration (HR
= 0.83; 95% CI: 0.55-1.25; P = 0.367), actual chest tube duration (HR =
0.84; 95% CI: 0.55-1.26; P = 0.397) or length of hospital stay (HR = 0.91;
95% CI: 0.59-1.39; P = 0.651). No chest tubes had to be reinserted.
Presence of pleural adhesions or an incomplete fissure was a significant
predictor of chest tube duration (HR = 1.72; 95% CI: 1.15-2.77; P =
0.014). CONCLUSIONS: Electronic drainage systems did not reduce chest tube
duration or length of hospitalization significantly compared with
traditional water seal drainage when a strict algorithm for chest tube
removal was used. This algorithm allowed delegation of chest tube removal
to staff nurses, and in some patients chest tubes could be removed safely
on the day of surgery.
<22>
Accession Number
20160142649
Author
Phan K.; Ha H.S.; Phan S.; Medi C.; Thomas S.P.; Yan T.D.
Institution
(Phan, Phan, Yan) The Collaborative Research (CORE) Group, Macquarie
University, Sydney, Australia
(Phan, Medi, Thomas) Department of Cardiology, Westmead Hospital, Sydney,
Australia
(Phan, Ha) St Vincent's Clinical School, The University of New South
Wales, Sydney, Australia
(Yan) Department of Cardiothoracic Surgery and Cardiology, Royal Prince
Alfred Hospital, University of Sydney, Sydney, Australia
Title
New-onset atrial fibrillation following coronary bypass surgery predicts
long-term mortality: A systematic review and meta-analysis.
Source
European Journal of Cardio-thoracic Surgery. 48 (6) (pp 817-824), 2015.
Date of Publication: 2015.
Publisher
European Association for Cardio-Thoracic Surgery
Abstract
Atrial fibrillation (AF) is one of the most common postoperative
complications following cardiac surgery. Recent evidence suggests that
postoperative atrial fibrillation (POAF) may be more 'malignant' than
previously thought, associated with follow-up mortality and morbidity. To
evaluate the long-term survival of POAF versus No-POAF cohorts following
coronary bypass surgery, the current meta-analysis with reconstructed
individual patient data was performed. Electronic searches were performed
using six databases from their inception to August 2014. Relevant studies
with long-term survival data presented for POAF versus No-POAF were
identified. Data were extracted by two independent reviewers and analysed
according to predefined clinical endpoints. The pooled hazard ratio (HR)
significantly favoured higher survival in No-POAF over POAF (HR 1.28; 95%
CI, 1.19-1.37; I<sup>2</sup> = 96%; P < 0.00001). Individual patient data
of 69 518 patients were available for inverted Kaplan-Meier survival curve
analysis. Analysis of aggregate data using Kaplan-Meier curve methods for
POAF versus No-POAF groups determined survival rates at the 1-year (95.7
vs 98%), 2-year (92.3 vs 95.4%), 3-year (88.7 vs 93.9%), 5-year (82.6 vs
89.4%) and 10-year (65.5 vs 75.3%) follow-up. Other complications
including 30-day mortality, strokes, respiratory failure, pneumonia and
hospitalization were significantly higher in the POAF group. New-onset AF
following coronary bypass surgery is associated with significantly higher
risk of mortality in short- and long-term follow-up. Current evidence
suggests the need for stricter surveillance and monitoring of POAF
following coronary bypass surgery.
<23>
Accession Number
20160151287
Author
Hasanzadeh F.; Kashouk N.M.; Amini S.; Asili J.; Emami S.A.; Vashani H.B.;
Sahebkar A.
Institution
(Hasanzadeh, Kashouk, Vashani) Department of Medical-surgical Nursing,
School of Nursing and Midwifery, Mashhad University of Medical Sciences,
Mashhad, Iran, Islamic Republic of
(Amini) Department of Anesthesiology, Imam Reza Hospital, Mashhad
University of Medical Sciences, Mashhad, Iran, Islamic Republic of
(Asili, Emami) Department of Pharmacognosy, School of Pharmacy, Mashhad
University of Medical Sciences, Mashhad, Iran, Islamic Republic of
(Sahebkar) Biotechnology Research Center, Mashhad University of Medical
Sciences, Mashhad, Iran, Islamic Republic of
(Sahebkar) Metabolic Research Centre, Royal Perth Hospital, School of
Medicine and Pharmacology, University of Western Australia, Perth,
Australia
Title
The effect of cold application and lavender oil inhalation in cardiac
surgery patients undergoing chest tube removal.
Source
EXCLI Journal. 15 (pp 64-74), 2016. Date of Publication: 22 Jan 2016.
Publisher
Leibniz Research Centre for Working Environment and Human Factors
(Ardeystr.67, Dortmund D-44139, Germany. E-mail: excli@ifado.de)
Abstract
Post-surgical chest tube removal (CTR) is associated with a significant
pain and discomfort for patients. Current treatment strategies for
reducing CTR-associated pain and anxiety are limited and partially
efficacious. To determine the effects of cold application, inhalation of
lavender essential oil, and their combination on pain and anxiety during
CTR was investigated. This randomized controlled open-label trial was
conducted with 80 patients in the cardiac surgery intensive care unit who
had a chest tube for duration of at least 24 hours after coronary artery
bypass grafting (CABG). Patients were randomized (n=20 in each group) to
receive cold application, aromatherapy with lavender oil, cold application
in combination with lavender oil inhalation, or none of the above
interventions (control group). The intensity and quality of pain and
anxiety were evaluated using the visual analogue scale, short form and
modified-McGill pain questionnaire (SFM-MPQ) and the Spielberger
situational anxiety level inventory (STAII) scale, respectively. Patients
in all treatment groups had significantly lower pain intensity and anxiety
compared with the control group immediately, 5, 10 and 15 min after CTR.
There was no statistically significant difference in the SFM-MPQ total
scores between the intervention groups. With respect to anxiety score,
there was a significantly reduced anxiety level immediately after CTR in
the aromatherapy and cold-aromatherapy combination groups versus the cold
application group. The present results suggested the efficacy of cold
application and aromatherapy with lavender oil in reducing pain and
anxiety associated with post- CABG CTR.
<24>
Accession Number
20160158721
Author
Zheng X.-W.; Zhao D.-H.; Peng H.-Y.; Fan Q.; Ma Q.; Xu Z.-Y.; Fan C.; Liu
L.-Y.; Liu J.-H.
Institution
(Zheng, Zhao, Peng, Fan, Ma, Xu, Fan, Liu) Department of Cardiology,
Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of
Heart Lung and Blood Vessel Diseases, Beijing 100029, China
(Liu) Key Laboratory of Soft Matter Physics, Institute of Physics, Chinese
Academy of Sciences, Beijing 100190, China
Title
Randomized comparison of the crush versus the culotte stenting for
coronary artery bifurcation lesions.
Source
Chinese Medical Journal. 129 (5) (pp 505-510), 2016. Date of Publication:
05 Mar 2016.
Publisher
Chinese Medical Association
Abstract
Background: The crush and the culotte stenting were both reported to be
effective for complex bifurcation lesion treatment. However, their
comparative performance remains elusive. Methods: A total of 300 patients
with coronary bifurcation lesions were randomly assigned to crush (n =
150) and culotte (n = 150) treatment. The primary endpoint was the
occurrence of major adverse cardiac events (MACEs) at 12 months including
cardiac death, myocardial infarction, stent thrombosis, and target vessel
revascularization. Index lesion restenosis at 12 months was a secondary
endpoint. The surface integrals of time-averaged wall shear stress at
bifurcation sites were also be quantified. Results: There were no
significant differences in MACE rates between the two groups at 12-month
follow-up: Crush 6.7%, culotte 5.3% (P = 0.48). The rates of index lesion
restenosis were 12.7% versus 6.0% (P = 0.047) in the crush and the culotte
groups, respectively. At 12-month follow-up, the surface integrals of
time-averaged wall shear stress at bifurcation sites in the crush group
were significantly lower than the culotte group ([5.01 +/- 0.95] x
10<sup>-4</sup> Newton and [6.08 +/- 1.16] x 10<sup>-4</sup> Newton,
respectively; P = 0.003). Conclusions: Both the crush and the culotte
bifurcation stenting techniques showed satisfying clinical and
angiographic results at 12-month follow-up. Bifurcation lesions treated
with the culotte technique tended to have lower restenosis rates and more
favorable flow patterns.
<25>
Accession Number
20160148460
Author
Kaya M.; Satilmisoglu M.H.; Bugra A.K.; Kyaruzi M.; Kafa U.; Utkusavas A.;
Bakira I.
Institution
(Kaya, Bugra, Kyaruzi, Kafa, Bakira) Department of Cardiovascular Surgery,
Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training
and Research Hospital, Halkaly, Kucukcekmece, Istanbul 34000, Turkey
(Satilmisoglu) Department of Cardiology, Istanbul Mehmet Akif Ersoy
Thoracic and Cardiovascular Surgery Training and Research Hospital,
Istanbul, Turkey
(Utkusavas) Department of Pulmonology, Istanbul Mehmet Akif Ersoy Thoracic
and Cardiovascular Surgery Training, Research Hospital, Istanbul, Turkey
Title
Impact of the total pericardial closure using bilateral trap door incision
and pericardial cavity intervention on outcomes following coronary artery
bypass grafting: A randomized, controlled, parallel-group prospective
study.
Source
Interactive Cardiovascular and Thoracic Surgery. 21 (6) (pp 727-733),
2015. Date of Publication: 2015.
Publisher
Oxford University Press
Abstract
Objectives: In this randomized, controlled and parallel-group prospective
study, the feasibility of total pericardial closure with an
intrapericardial drain and a pericardio-pleural window (pericardial cavity
intervention) was investigated by examining postoperative outcomes,
including atrial fibrillation and pericardial effusion, following coronary
artery surgery. Methods: Cases were classified into two groups using a
random procedure: the closure group and the open group. Insertion of an
intrapericardial drain along the right atrium, pericardio-pleural window
and total closure of the pericardium were performed in patients in the
closure group. Partial closure of the pericardium was performed in
patients in the open group. A straight semi-rigid drain was inserted into
the extrapericardial anterior mediastinum and a right angle drain was
inserted into the left chest in all patients. The primary endpoint was to
evaluate the impact of surgical technique on the rate of postoperative
in-hospital atrial fibrillation in the closure group. The secondary
endpoint was to evaluate the relationship between the surgical technique
and postoperative amount of pericardial effusion. Results: A total of 142
isolated, on-pump cases were examined: 72 in the open group and 70 in the
closure group. Postoperative atrial fibrillation occurred in 27.78% of the
cases in the open group and 8.57% of the patients in the closure group (P
= 0.003). Another statistically significant outcome was the lower
incidence of small pericardial effusion in the patient group with a closed
pericardium during the second day of postoperative care (P = 0.039). The
length of both critical care unit (P = 0.008) and hospital stay (P =
0.047) were also significantly shorter in the patient group with a closed
pericardium. Conclusions: Total pericardiorrhaphy with pericardial cavity
intervention can be acceptable and favourable in terms of its outcomes,
including reducing incidence of postoperative atrial fibrillation,
pericardial effusion and length of hospitalization.
<26>
Accession Number
20160144862
Author
Jacob K.A.; Leaf D.E.; Dieleman J.M.; Van Dijk D.; Nierich A.P.; Rosseel
P.M.; Van Der Maaten J.M.; Hofland J.; Diephuis J.C.; De Lange F.; Boer
C.; Kluin J.; Waikar S.S.
Institution
(Jacob, Dieleman, Van Dijk) Department of Anesthesiology and Intensive
Care Medicine, University Medical Center Utrecht, Intensive Care and
Emergency Medicine, Mail Stop F.06.149, PO Box 85500, Utrecht 3508 GA,
Netherlands
(Jacob, Kluin) Department of Cardiothoracic Surgery, University Medical
Center Utrecht, Utrecht, Netherlands
(Leaf, Waikar) Division of Renal Medicine, Harvard Medical School, Brigham
and Women's Hospital, Boston, MA, United States
(Nierich) Department of Anesthesiology, Isala Klinieken, Zwolle,
Netherlands
(Rosseel) Department of Anesthesiology, Amphia Ziekenhuis, Breda,
Netherlands
(Van Der Maaten) Department of Anesthesiology, University Medical Center,
Groningen, Netherlands
(Hofland) Department of Anesthesiology, Erasmus Medical Center, Rotterdam,
Netherlands
(Diephuis) Department of Anesthesiology, Medisch Spectrum Twente,
Enschede, Netherlands
(De Lange) Department of Cardiac Anesthesiology, Medical Center
Leeuwarden, Leeuwarden, Netherlands
(Boer) Department of Anesthesiology, Vrije Universiteit University Medical
Center, Amsterdam, Netherlands
Title
Intraoperative high-dose dexamethasone and severe AKI after cardiac
surgery.
Source
Journal of the American Society of Nephrology. 26 (12) (pp 2947-2951),
2015. Date of Publication: December 2015.
Publisher
American Society of Nephrology
Abstract
Administration of prophylactic glucocorticoids has been suggested as a
strategy to reduce postoperative AKI and other adverse events after
cardiac surgery requiring cardiopulmonary bypass. In this post hoc
analysis of a large placebo-controlled randomized trial of dexamethasone
in 4465 adult patients undergoing cardiac surgery, we examined severe AKI,
defined as use of RRT, as a primary outcome. Secondary outcomes were
doubling of serum creatinine level or AKI-RRT, as well as AKI-RRT or
in-hospital mortality (RRT/death). The primary outcome occurred in ten
patients (0.4%) in the dexamethasone group and in 23 patients (1.0%) in
the placebo group (relative risk, 0.44; 95% confidence interval, 0.19 to
0.96). In stratified analyses, the strongest signal for potential benefit
of dexamethasone was in patients with an eGFR,15 ml/min per 1.73 m2. In
conclusion, comparedwith placebo, intraoperative dexamethasone appeared to
reduce the incidence of severe AKI after cardiac surgery in those with
advanced CKD.
