bluuebunny/crossref_metadata_2025_split huggingface dataset:
Efficacy of Intravascular Lithotripsy (IVL) in peripheral lesions with severe calcification and its use in TAVI procedure: A systematic review and meta-analysis
Authors: Sagris M , Dimitriadis K , Soulaidopoulos S , Beneki E , Ktenopoulos N , Papanikolaou A , Tzoumas A , Lichtenberg M , Korosoglou G , Iliakis P , Tsioufis P , Aznaouridis K , Toutouzas K , Tousoulis D , Tsioufis K 
Published: November 2023

Abstract

Background
Heavily calcified peripheral artery lesions increase the risk of vascular complications, constituting a severe challenge for the operator. Intravascular Lithotripsy (IVL) technology disrupts subendothelial calcification by using localized pulsative sonic pressure waves and is a promising technique for patients with severe calcification in peripheral arteries.

Purpose
Our aim was to systematically review and summarize available data regarding the safety and efficacy of IVL in preparing severely calcified plaques in peripheral arteries and its use in Transcatheter Aortic Valve Implantation (TAVI).

Methods
This study was conducted according to the PRISMA guidelines. We systematically searched PubMed, SCOPUS, and Cochrane databases from their inception to February 23, 2023, for studies assessing the characteristics and outcomes of patients undergoing IVL in peripheral vasculature. The diameter of the vessel lumen before and after IVL was estimated. The occurrence peri-procedural complications were assessed using a random-effects model.

Results
20 studies with a total of 1,223 patients with heavily calcified peripheral lesions were analyzed. The mean age of the cohort was 73.8 ± 8.9 years. Successful IVL delivery achieved in 100% (95% CI: 100%-100%, I2=0%), with an increase in the luminal diameter (SMD: 4.66, 95% CI: 3.41-5.92, I2=90.8%) and reduction in diameter stenosis (SMD: -4.15, 95% CI: -4.75 to -3.55, I2=92.8%), and a described low rate of complications. There was not observed any dissection in 97% (95% CI: 91%-100%, I2=81.4%), while dissections of any type (A, B, C, or D) were observed in 6% (95% CI: 2%-10%, I2=85.3%) of the patients. Several rare cases of abrupt closure, no-reflow phenomenon, perforation, thrombus formation, and distal embolization were recorded. Finally, the subgroup analysis of patients who underwent a TAVI with IVL assistance presented successful implantation in 100% (95% CI: 100%-100%, I2=0%) of the cases, with only 4% (95% CI: 0%-12%, I2=68.96%) presented dissections of any sort.

Conclusions
IVL seems to be an effective and safe technique for preparing severely calcified lesions in peripheral vessels during TAVI interventions. These results support the use of IVL for amelioration of overall outcome in high vascular risk TAVI settings.
Prognostic value of Wound, Ischemia and foot Infection (WIfI) score after lower extremities bypass surgery for peripheral artery disease in chronic hemodialysis patients
Authors: Kumada Y , Kawai N , Ishida N , Mori A , Takahashi H , Ishii H 
Published: November 2023

Abstract

Background
Although lower extremities bypass surgery has been commonly performed to treat peripheral artery disease (PAD) even in patients on hemodialysis (HD) as well as general population, poorer prognosis in such subjects still remains major problems compared to non-HD population. Recently, Wound, Ischemia and foot Infection (WIfI) scoring system has been developed for classification of lower extremity threatened limb to impact amputation risk. However, the utility of predictability still remain unclear in HD patients. The aim of this study is to clarify the characteristics of the WIfI score and its prognostic value after bypass surgery in such patients with PAD.

Methods
Pre-procedural threatened limb grade in consecutive 361 patients (224 HD patients and 137 non-HD patients) undergoing successfully bypass surgery were assessed using the WIfI scoring system.
Primary outcome was amputation-free survival (AFS) defined as freedom from major amputation and/or all-cause mortality. They were followed-up for 5 years.

Results
Although ischemia grade ≥ 2 was comparable between HD and non-HD patients (97.8% vs. 99.2%, p=0.74), wound grade and infection grade ≥ 2 were significantly higher prevalent in HD patients than in non-HD patients (56.7% vs. 32.8%, p&lt;0.0001 and 53.1% vs. 30.7%, p&lt;0.0001, respectively). The AFS rate for 5-year was 72.6%, 46.5%, 44.4% and 32.7% in wound grade 0, 1, 2 and 3 [adjusted hazard ratio (aHR) 3.67, 95% confidence interval (CI) 1.67-8.31, p=0.0009 for grade 3 vs. grade 0], and was 57.0%, 57.8%, 45.7% and 19.4% in infection grade 0, 1, 2 and 3 (aHR 2.71, 95% CI 1.35-5.32, p=0.0052 for grade 3 vs. grade 0) in HD patients, respectively. However, even in subgroup without any wound, HD patients had markedly poorer AFS (vs. 100% in non-HD, p&lt;0.0001) compared to non-HD patients. Also in patients without any infection, similar results were obtained (vs. 95.3% in non-HD, aHR 13.7, 95% CI 3.12-60.5, p=0.0005). HD was also consistently identified as a strong risk factor for poor AFS (aHR 2.83, 95% CI 1.67-5.09, p&lt;0.0001).

Conclusion
Wound and foot infection grade as components of the WIfI score could stratify the risk of amputation and/or mortality after bypass surgery even in HD patients. Severity of wound or infection status was higher in HD patients compared to non-HD patients, however, high risk of poor AFS even without any wound or infection should be paid attention in this high-risk population.
Early life cardiovascular risk factor trajectories and vascular aging in midlife: a 30-year prospective cohort study
Authors: Wang Y , Wang J , Du M F , Zhang X , Chu C , Wang D , Liao Y Y , Ma Q , Jia H , Hu G L , Yan Y , Sun Y , Lu Y , Mu J J 
Published: November 2023

Abstract

Background
Vascular aging, as assessed by structural and functional arterial properties, is an independent predictor of cardiovascular outcomes. We aimed to explore the associations of individual cardiovascular risk factors from childhood to midlife and their accumulation over a 30-year span with vascular aging in midlife.

Methods
Using data from the ongoing cohort of Hanzhong Adolescent Hypertension study, 2180 participants aged 6 to 18 years at baseline were followed for over 30 years. Distinct trajectories of systolic blood pressure (SBP), body mass index (BMI), and heart rate (HR) from childhood to midlife were identified by group-based trajectory modeling. Vascular aging was assessed by carotid intima–media thickness (cIMT) or brachial-ankle pulse wave velocity (baPWV).

Results
We identified 4 distinct SBP trajectories, 3 distinct BMI trajectories and 2 distinct HR trajectories from childhood to midlife. Persistently-increasing SBP, high-increasing BMI, and high-stable HR were all shown to have a positive association with baPWV in midlife. For cIMT, similar associations were observed for persistently-increasing SBP and high-increasing BMI. After further adjustment for SBP, BMI and HR at the time of vascular assessment in 2017, associations were also observed for cardiovascular risk factor trajectories accumulation with baPWV (β=0.656 (95%CI, 0.265-1.047)] and with cIMT [β=0.045 (95%CI, 0.011-0.079)] in adulthood.

Conclusions
Longitudinal exposure to individual cardiovascular risk factors from childhood to midlife and cardiovascular risk factor accumulation were associated with an increased risk of vascular aging in midlife. Our study lends support for early targeting of risk factors in order to prevent cardiovascular disease later in life.Long-term SBP, BMI, HR trajectories
Clinical effectiveness and safety of aspirin versus anticoagulation for venous thromboembolism prevention following orthopedic trauma and surgery: a meta-analysis of randomized controlled trials
Authors: Dakay D , Gallardo E 
Published: November 2023

Abstract

Background
The risk for venous thromboembolism (VTE) following orthopedic trauma and surgery is high. When preventive measures are not used, the odds of DVT can reach 60% within 90 days from surgery and 1.5% for fatal pulmonary embolism. Until now, consensus is not yet reached for the best pharmacologic prevention given the clinical situation. Guidelines on VTE prophylaxis vary across expert societies.

Objective
To compare the clinical effectiveness and safety between aspirin and anticoagulation in preventing venous thromboembolism (VTE) following an orthopedic trauma or surgery

Study Selection
Only randomized controlled trials (RCT) comparing aspirin and any anticoagulants as VTE prophylaxis following an orthopedic trauma or surgery were selected for review.

Methods
Pubmed, Embase, and Cochrane databases were searched for randomized controlled trials (RCTs) reporting clinical outcomes of aspirin versus any anticoagulants for VTE prevention. Primary endpoint was composite of venous thromboembolism (VTE) events. Secondary endpoints were mortality, bleeding events, and wound complications.

Results
Eleven RCTs with 17,963 patients were included in the analysis. Patients receiving aspirin as VTE prophylaxis have no significant difference in terms of reducing venous thromboembolism (VTE) events (RR 1.03; 95% CI, 0.71-1.48; p = 0.88), mortality (RR 1.01; 95% CI, 0.68-1.49; p = 0.97), bleeding events (RR 0.97; 95% CI, 0.80-1.05; p = 0.38), and wound complications (RR 0.76; 95% CI, 0.50-1.16; p = 0.21), as compared to anticoagulation after orthopedic trauma or surgery.

Conclusion
There are no significant differences between aspirin and anticoagulation in terms of reducing venous thromboembolism events, mortality, bleeding events, and wound complications following orthopedic trauma or surgery.
Sexual dimorphism in peripheral blood cell characteristics relate to success of endovascular thrombectomy in acute ischemic stroke
Authors: Overmars M , Van Solinge W W , Den Ruijter H M , Van Der Worp H B , Van Es B , Hulsbergen-Veelken C A R , Biessels G J , Exalto L G , Haitjema S 
Published: November 2023

Abstract

Introduction
The success of endovascular thrombectomy (EVT) in acute ischemic stroke is related to stroke etiology and clot composition. The latter two may differ between women and men. An improved understanding of sex differences in EVT success may contribute to more personalized treatment. We therefore tested the hypothesis that blood cell characteristics (BCCs) related to EVT success in acute ischemic stroke differ by sex.

Methods
We analyzed electronic health record (EHR) data of AIS patients undergoing EVT at a single intervention center. Of 311 patients, 71 pretreatment erythrocyte-, leukocyte-, and thrombocyte-related BCCs from the Sapphire hematology analyzer were extracted. BCCs were sex-stratified, clustered, and analyzed based on the first principal component of the clusters. To identify BCC clusters related to successful EVT (TICI 3), Partial Least Squares Discriminant Analysis (sPLS-DA) was performed, including cross-validation and stability selection to identify stable BCCs relative to EVT success in women and men. We also related the identified BCCs to stroke etiology (cardioembolism (CE), large-artery atherosclerosis (LAA), undetermined), and controlled for known cardiovascular risk factors.

Results
Successful EVT was achieved in 69 women (51%) and 87 men (49%). Women and men differed on 21 out of 71 BCCs (pFDR-corrected &lt; 0.05). Analyzing sex-stratified data led to lower error rates for the female model for EVT success compared to the pooled (t(192.4) = 5.9, p &lt; 0.001), and male model (t(182.6) = -15.6, p &lt; 0.001). In women, a higher number of reticulocytes was associated with successful EVT and CE, whereas a higher mean corpuscular hemoglobin concentration was associated with unsuccessful EVT and LAA. In men, a higher coefficient of variance of lymphocyte complexity of the intracellular structure was associated unsuccessful EVT and LAA.

Conclusions
BCCs associated with EVT success differed by sex and were related to stroke subtype. This improved understanding may contribute to more personalized treatment of acute ischemic stroke.Model performance after sex-stratifyingSex-specific BCCs relate to EVT success
Prevalence of atrial septal defects and patent foramen ovale in a large cohort of sudden cardiac death patients undergoing autopsy
Authors: Fahy L , Spanos C , Rowe S , Nehme Z , Stub D , Zentner D , James P , Pflaumer A , Connell V , Semsarian C , Ingles J , La Gerche A , Paratz E 
Published: November 2023

Abstract

Background
The prevalence of patent foramen ovale and atrial septal defects has previously been described in early autopsy series and transoesophageal echocardiograms as ranging from 25 to 30%. Updated pathologic data is lacking.

Methods
A state-wide prospective out-of-hospital cardiac arrest registry identified all patients aged 1 to 50 years who experienced a sudden cardiac arrest in Victoria, Australia from April 2019 to April 2022 and subsequently underwent autopsy with a cardiac cause of death identified. A comprehensive autopsy assessment was performed including visual description of any atrial septal defect and identification of probe patency of the foramen ovale.

Results
517 patients underwent autopsy in the setting of sudden cardiac death with documentation of their atrial septal status. 36 patients (6.9%) had a probe-patent foramen ovale, 2 patients (0.4%) had secundum atrial septal defects, and 2 patients (0.4%) had a simultaneous atrial septal defect and patent foramen ovale (1 of whom had undergone percutaneous repair of both lesions). 12 patients (2.3%) had a prior history of cerebrovascular accident either recorded on medical history or detected on neuropathological examination; however none of these patients had atrial septal defects or patent foramen ovale.

Conclusions
The combined rate of atrial septal defects and patent foramen ovale in a cohort of approximately 500 patients undergoing autopsy was 7.7%. None of these patients had experienced a cerebrovascular accident. This appears lower than earlier reports, and warrants further investigation in expanded cohorts of patients.
Clinical profile, treatment strategy and prognostic value of intraventricular thrombus detection
Authors: Ortiz Lozada R Y , Pozo Osinalde E , Ferrera Duran C , Fernandez Vega A , Provencio Regidor A , Zulet Fraile P , Noriega Sanz F J , Marcos Alberca P , Fernandez Jimenez R , Mahia Casado P , Gomez De Diego J J , Fernandez Ortiz A , Perez Villacastin J , Viana Tejedor A , De Agustin Loeches A 
Published: November 2023

Abstract

Background
The clinical course of patients with intraventricular thrombus (IVT) is highly variable. Controversy still exists about the length of anticoagulant treatment and its prognostic relevance.

Purpose
Our objective is to describe the epidemiology and clinical course of patients with IVT.

Methods
All patients with an echocardiographic finding of IVT in our tertiary hospital between 2005 and 2021 were retrospectively analyzed. Demographic, clinical, echocardiographic, and treatment variables were collected. Patients were followed-up to 24 months.

Results
A total of 195 patients with IVT were finally included. The 84.4% were male and the mean age was 65.4 ± 14.1 years. Baseline characteristics are shown in the Table. The diagnosis of IVT was mostly made in the context of an acute myocardial infarction (AMI) (55.9%), of which 60.5% had new-onset ST-segment elevation AMI and 23.5% evolved infarction. The thrombus finding was incidental in 38.0% of the cases while 5.6% debuted as stroke. Regarding the morphological characteristics, 40.5% of the thrombi were sessile, 31.2% mural shape, and 28.3% pedicled. At diagnosis, the LVEF was 38.6 ± 11.7% with an end-diastolic volume of 132.3 ± 64.2ml. Once diagnosed 86.7% of patients were on anticoagulation, 55.4% on 2PY12 inhibitor and 78.5% on acetylsalicylic acid. At 12 and 24 months, the proportion of anticoagulated patients was significantly reduced (62% and 59.4%, respectively). 24.9% continued with a P2Y12 inhibitor at 12 months and only 9% at 2 years. During follow-up, 24.4% of the patients had events at 6 months (2.4% AMI, 7.2% stroke, 2.4% systemic embolism and mortality was 14.7%). In this period there were 8.9% of hemorrhages. The proportion of ischemic events and mortality decreased at one year (5.6%) and at two years (12.1%). Complete IVT clearance was documented in 87% and the median time to resolution was 119 days [49.5-347.5]. IVT recurrence was observed in 10.7% of the cases, up to 50% detected before 2 years from diagnosis.

Conclusions
Most patients with IVT were diagnosed after an AMI. Despite current recommendations, more than 50% of patients continued anticoagulation at 2 years. A quarter developed events 6 months after diagnosis, and this proportion decreased significantly after this period. A recurrence rate of 10.7% was observed in our population.
Fractional-flow reserve use in coronary artery revascularization: a 78.897 patients systematic review and meta-analysis
Authors: Martinez Sole J , Sorolla-Romero J A , Farjat-Pasos J , Hussain B , Garg M , Chiarito M , Diez-Gil J L , Waksman R , Garcia-Garcia H , Sanz-Sanchez J 
Published: November 2023

Abstract

Background
Fractional flow reserve (FFR)-guided percutaneous coronary intervention (PCI) is recommended in the guidelines of revascularization for patients presenting with coronary artery disease (CAD) with intermediate lesion severity. However, recently published studies comparing FFR-guided PCI with non-physiology guided revascularization strategies have reported conflicting result.

Methods
The PubMed and Embase databases were searched for randomized clinical trials and observational studies comparing FFR-guided PCI with non-physiology-guided revascularization strategies (angiography-guided, intracoronary imaging-guided, coronary artery bypass grafting) in patients with CAD. Data were pooled by meta-analysis using a random-effects model.

Results
26 studies enrolling 78,897 patients were included. Patients undergoing FFR-guided PCI as compared to those undergoing non-physiology guided coronary revascularization had a lower risk of all-cause mortality (OR 0.79 95% CI 0.64-0.99, I2=53%) and myocardial infarction (OR 0.74 95% CI 0.59-0.93, I2=44.7%). However, no differences between groups were found in terms of MACE (OR 0.86 95% CI 0.72-1.03, I2=72.3%) and repeat revascularization (OR 1 95% CI 0.82-1.20, I2=43.2%).

Conclusions
Among patients with CAD, FFR-guided PCI as compared to non-physiology-guided revascularization was associated with a lower risk of all-cause mortality and MI.Clinical outcomes in patients undergoingFFR-guided PCI as compared to non-physio
Validation of pressure - derived microvascular resistance reserve (MRR) by Doppler wire measurement - the impact of correction for the error of hydrostatic pressure
Authors: Koszegi Z , Dorj A , Agoston A , Uveges A , Tar B , Kest M , Szabo G T , Czuriga D 
Published: November 2023

Abstract

Background
The pressure-bounded coronary flow reserve (CFRpb) defines the possible CFR interval (between CFRpbmin and CFRpbmax) using intracoronary pressure data. However, its correlation to the Doppler wire measurement was reported to be poor, partly due to the non-inclusion of the hydrostatic pressure error in the calculations. Microvascular resistance reserve (MRR), a specific index of coronary microcirculation, can be calculated from CFR and intracoronary pressure data (Pa: aortic pressure, Pd: distal pressure) by the following equation: MRR= CFR; × (Pa, rest)/(pd, hyper).

Purpose
We aimed to design a prediction model of MRR using intracoronary pressure data and to validate the results against the gold-standard Doppler wire measurement.

Methods
In our study, hydrostatic pressure between the tip of the catheter and the sensor of the pressure wire was calculated by height difference measurement from a lateral angiographic view. After hydrostatic pressure error correction, the pressure-bounded MRR interval (between MRRpbmin and MRRpbmax) was determined by the aforementioned equation. In the training population, 23 actual MRRp-3D were defined within the pressure-bounded interval by hemodynamic calculations using the measured intracoronary pressure data and the angiography-based 3D anatomical features. These results were analyzed by regression analyses to find relations between the MRRpb and the actual MRRp-3D.

Results
Using the established linear relation (MRRpredicted=1.04+0.51×MRRpbmax), our prediction was tested in the population of 21 patients undergoing the gold standard Doppler wire measurements, and a significant correlation was found (r=0.54, p=0.01). If the area stenosis was included in the prediction model, the correlation had even improved (r=0.63, p=0.004). In parallel, the Bland-Altman analysis showed reduced mean differences between the predicted MRR and the MRR values determined during the Doppler wire measurement from 0.04 (±1.96SD: 0.88, –0.8) to –0.01 (±1.96SD: 0.77, –0.79). The latter prediction utilized the quadratic relation between the area stenosis in % (AS) and the ratio of the (MRRmax−MRRp-3D)/(MRRmax−MRRmin) (ratio=0.0047+0.0067×AS+0.000039×AS2).

Conclusions
The MRR can be predicted reliably by our simple model to assess microvascular function. After the correction for hydrostatic pressure error, the pressure data during routine FFR measurement (especially with the inclusion of area stenosis) provides a simultaneous physiological assessment of the macro- and microvasculature.Flow chart of the calculations
Prognosis after non-infarct related artery PCI in patients with acute myocardial infarction and multivessel disease: substudy of FRAME-AMI trial
Authors: Hong D , Lee S H , Shin D , Kim H K , Hong Y J , Joh H S , Choi K H , Park T K , Yang J H , Song Y B , Choi S H , Jeong M H , Gwon H C , Hahn J Y , Lee J M 
Published: November 2023

Abstract

Background
Complete revascularization either angiography-guided or fractional flow reserve (FFR)-guided can improve the clinical outcomes in patients with acute myocardial infarction (AMI) and multivessel disease. However, there is concern that angiography-guided percutaneous coronary intervention (PCI) may result in unnecessary PCI of non-infarct related artery (IRA) and its long-term prognosis is still unclear.

Purpose
We sought to evaluate clinical outcomes after non-IRA PCI according to quantitative flow ratio (QFR).

Methods
We performed post-hoc QFR analysis of non-IRA lesions of AMI patients who enrolled in the FRAME-AMI trial which randomly allocated patients into either FFR-guided PCI (FFR≤0.80) or angiography-guided PCI (diameter stenosis of &gt;50%) for non-IRA lesions. Patients were classified by non-IRA QFR values into the QFR≤0.80 and QFR&gt;0.80 groups. The primary end point was a major adverse cardiac event (MACE), a composite of cardiac death, MI, and repeat revascularization.

Results
A total of 443 patients (552 lesions) were eligible for the QFR analysis. Of 209 patients in the angiography-guided PCI group, 30.0% (N=60) underwent non-IRA PCI despite having QFR&gt;0.80 in non-IRA. Conversely, only 2.7% (N=4) among 209 patients in the FFR-guided PCI group had QFR&gt;0.80 in non-IRA. At a median follow-up of 3.5 years (interquartile range 2.7 to 4.1 years), the rate of MACE was significantly higher among patients with non-IRA PCI despite QFR&gt;0.80 than patients with deferred PCI for non-IRA lesions (12.9% vs. 3.1%; HR=4.13, 95% CI 1.10-15.57, P=0.036). Non-IRA PCI despite QFR&gt;0.80 was associated with higher risk of non-IRA MACE than patients with deferred PCI for non-IRA lesions (12.9% vs. 2.1%; HR 5.44, 95% CI 1.13-26.19, P=0.035).

Conclusions
In AMI patients with multivessel disease, 30.0% of angiography-guided PCI resulted in unnecessary PCI for non-IRA with QFR&gt;0.80, which was significantly associated with the increased risk of MACE than those with deferred PCI for non-IRA lesions.