bluuebunny/crossref_metadata_2025_split huggingface dataset:
Incidence of gastrointestinal bleeding after transoesophageal echocardiography in patients with gastro-oesophageal varices: a systematic review and meta-analysis
Authors: Hui R W H , Leung C M 
Published: February 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.
Introduction
Transoesophageal echocardiography (TEE) is useful for cardiac assessment and intraoperative monitoring. However, the safety of TEE in cirrhotic patients with gastro-oesophageal varices has remained uncertain.

Purpose
This meta-analysis aims to determine the incidence of gastrointestinal bleeding after TEE in patients with varices. The secondary objectives are to compare the bleeding risks between patients with and without varices; and to determine the incidences of TEE-related oesophageal perforation and mortality.

Methods
Systematic literature search was conducted on MEDLINE, EMBASE and Cochrane Database using the terms "Transoesophageal echocardiography", "Varices", "Bleeding", and related terms. Articles describing the incidence of post-TEE bleeding in patients with varices were included. Non-English articles were excluded. Risk of bias was assessed through a validated scale for bias assessment in prevalence studies. The level of evidence was assessed using the Grades of Recommendation, Assessment, Development, and Evaluation approach. Pooled weighted incidence of gastrointestinal bleeding and risk difference in bleeding were calculated with a random effects model.

Results
569 articles were identified initially, and 10 articles (comprising of 908 patients) were included. The incidence of post-TEE bleeding in patients with varices was 0.84% (95% CI 0.34%-1.56%). When stratified by TEE indication, the pooled incidence of bleeding was 0.68% (95% CI 0.11%-1.63%) in intraoperative TEE; and 1.03% (95% CI 0.23%-2.29%) in diagnostic TEE. No cases of oesophageal perforation or mortality were reported. 6 studies included a comparator group of patients without varices, and the bleeding risk was comparable between patients with and without varices (risk difference 0.26%; 95% CI -0.80%-1.32%; I2 = 0%, p = 0.88). Eight studies had moderate or high risk of bias, and overall level of evidence was low.

Conclusion
TEE appears to be associated with low gastrointestinal bleeding incidence in patients with gastro-oesophageal varices. Nonetheless, results should be treated with caution due to bias and low level of evidence. Large-scale high-quality studies will be required to confirm the safety of TEE in patients with gastro-oesophageal varices. Abstract Figure. Study selection process Abstract Figure. Forest plot of pooled bleeding incidence
High sensitivity C-reactive protein is associated with vulnerable characteristics in non-culprit plaques in patients with ST-segment elevation myocardial infarction
Authors: Katamine M , Minami Y , Nagata T , Asakura K , Katsura A , Kinoshita D , Hashimoto T , Ako J 
Published: February 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
Higher level of high sensitivity C-reactive protein (hsCRP) is associated with an increased risk of recurrent cardiovascular events in patients with ST-segment elevation myocardial infarction (STEMI). However, the association between hsCRP and the characteristics of non-culprit plaques in patients with STEMI remains to be elucidated.

Purpose
To clarify the morphological characteristics of non-culprit plaque in patients with STEMI according to the hsCRP levels using optical coherence tomography (OCT).

Methods
A total of 79 non-culprit plaques in 76 consecutive patients with STEMI, who underwent OCT imaging of the non-culprit plaques in a culprit vessel were included. The characteristics of non-culprit plaques assessed by OCT were compared between the higher hsCRP group (hsCRP ≥ 0.16 mg/dL, 38 plaques in 38 patients) and the lower hsCRP group (hsCRP &lt; 0.16 mg/dL, 41 plaques in 38 patients).

Results
The prevalence of plaque with macrophage (63.2 vs. 31.7%, p = 0.006), plaque with large lipid (maximal lipid arc &gt; 180 °) (57.9 vs. 31.7%, p = 0.018), healed plaque (50.0 vs. 26.8%, p = 0.045) and cholesterol crystal (18.4 vs. 2.4%, p = 0.045) was significantly higher in the higher hsCRP group than in the lower hsCRP group (Figure). In a multivariate analysis, the higher hsCRP was independently associated with the presence of plaque with macrophage (Odds ratio [OR], 3.031; 95% confidence interval [CI]: 1.112-8.264, p = 0.030), plaque with large lipid (OR, 2.897; 95% CI: 1.122-7.478, p = 0.026) and healed plaque (OR, 2.666; 95% CI: 1.030-6.896, p = 0.040).

Conclusions
Higher level of hsCRP is associated with a higher prevalence of vulnerable characteristics in non-culprit plaques in patients with STEMI. The present results may partly explain the pathogenesis of an increased incidence of recurrent cardiovascular events in patients with STEMI. Abstract Figure.
The diagnostic value of different criteria in predicting the response of LBBB patients: a systematic review and meta-analysis
Authors: Peng X , Cheng C D , Zeng L J 
Published: February 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background

The left bundle branch has emerged as an essential part of the cardiac conduction system. However, many patients with conventional left bundle branch block (LBBB) QRS morphology appeared to have a poor response to cardiac resynchronization therapy (CRT) therapy; these might be due to they were non-LBBB patients who met the conventional diagnostic criteria but failed to meet the strict LBBB standard. There are different criteria to select appropriate CRT patients currently. Several studies have reported that patients with complete LBBB had worse ventricular synchronization and worse prognosis. Thus, it is of great clinical significance to distinguish between complete LBBB and non-LBBB.

Purpose

To compare the difference in mortality and CRT response between complete LBBB and non-LBBB patients.

Methods

This meta-analysis has been registered on the International Prospective Register of Systematic Reviews (ID: CRD42021242318). A systematic search on PubMed, Cochrane library, Embase databases was conducted before July 2021. All the included studies were screened and identified based on the specific inclusion and exclusion criteria. Relevant data, including time to event data for different outcomes (e.g., hazard ratio, HR), responders, electrocardiogram parameters, and echocardiographic changes, were extracted for meta-analysis.

Results

A total of 15 studies were ultimately involved in this meta-analysis. A random-effect model was conducted due to the substantial heterogeneity. The results showed that patients who received CRT treatment in the complete LBBB group had a 35% reduction in mortality than in the non-LBBB group (HR 0.65, 95% CI 0.56 to 0.77, P =0.000). The subgroup analysis showed that when stratified by the Strauss criteria, the survival was much higher in complete LBBB patients (HR 0.58, 95% CI 0.43 to 0.77, P =0.000), compared with other criteria, including ESC, AHA, Marriot, and conventional (HR 0.72, 95% CI 0.63 to 0.82, P =0.000). The pooled results suggested that the patient survival rate was significantly better under the Strauss criteria than other standards.

Conclusions

Present criteria differentiating complete LBBB and non-LBBB have good predictive value for survival. Among those, Strauss criteria may provide the most valuable information on the predictive effects of mortality and survival rate. This meta-analysis indicates that the use of Strauss criteria correlated independently with the response and prognosis of CRT patients with LBBB.
The influence of physical rehabilitation on bone mineral density in patients with chronic heart failure before and after heart transplantation
Authors: Sujayeva V , Rudenka E V , Koshlataya O V , Spirina V V , Dubovik T A 
Published: February 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

Objective
to estimate the influence of physical rehabilitation on bone metabolism density (BMD) in patients with heart failure (HF) before and after heart transplantation (HT).
Methods. We studied 95 patients with CHF before and after HT at the age of 53.8 ± 9.5 years. The period of the HT ranged from 0 to 26 months, on average 8.5 ± 8.9 months. We performed dual-energy X-ray absorptiometry (DXA) and morphometry (using GE Lunar Prodigy Advance (USA) tool) and spine X-ray to estimate both BMD end bones fractures. We also performed 6-minute walk test and spirobicycle ergometry test (spiroBET) for tolerance to physical loading (TPL) verification. SpiroBET was done with Schiller AG AT-104 ErgoSpiro equipment using Bruce protocol. Rehabilitation program (RP) included individualized according to TPL physical trainings (aerobic weight exercises, training with dosed walking and bicycle or treadmill trainings). RP has started before HT and continued for 1 year after HT. Individualization was also carried out depending on the presence of fractures.
Results. There were no complications when using the developed program of CRP, which required discontinuation. We revealed significant growth of TPL from 86.1 ± 10.2 Wt to 105.0 ± 6.2 Wt (p &lt; 0.05) according to spiroBET under the influence of the developed PR. We also revealed the tendency in reduction of bone mineral density loss according to DRA data: the incidence of osteopenia has decreased from 39% to 19%, osteoporosis – from 50% to 44% (p &gt; 0.05).
Conclusion. RP helps to improve not only the TPL but also BMD in patients with HF before and after HT. This phenomenon may be due to the presence of common mechanisms for the develop
Yield of surveillance endomyocardial biopsies after heart transplantation: a 10-year experience
Authors: Aekarach A , Sinphurmsukskul S , Siwamogsatham S , Puwanant S , Ongcharit P , Benjacholamas V 
Published: February 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
Endomyocardial biopsy (EMB) is recommended as a surveillance procedure for the detection of allograft rejection in all patients after heart transplant. However, the clinical yield of EMB is reported to be low and there are limited evidence in Asian population.

Objective
The purpose of this study was to investigate the incidence of allograft rejection in after heart transplantation (HT) and yield of surveillance EMB.

Method
We conducted a retrospective study of consecutive patients who underwent heart transplantation between 2008 and 2017. Of these patients, EMB were classified into surveillance and clinically indicated EMB and were included for analysis. The study assessed EMB results, allograft rejection episodes, and rejection treatments. All patients received induction immunosuppressant and maintaining immunosuppressant regimen including calcineurin inhibitor, mycophenolate, and 6- month tapering off steroid. T-test, Chi-square were used to analyze.

Results
A total of 622 EMBs of 67 patients were assess. There were 173, 114, 162, 87 and 86 procedures performed during 0-30 days, 31-90 days, 91-365 days, 1-2 year and more than 2 years after HT, respectively. Of these, 560 (90%) EMBs were performed for surveillance. The common reasons for clinically indicated EMB are post anti-rejection treatment (46.8%) and symptoms and signs of rejection (25.8%). Overall, the 2R and 3R episodes of acute cellular rejection were found in 5.5% of EMB results. The clinically indicated EMBs had higher episodes of abnormal EMB result and rejection requiring treatment (53.2% vs 28.1% and 20.1% vs 3.9%, p &lt;0.001 for both) (Table).

Conclusion
In this single center study, The EMBs in asymptomatic patients had lower likelihood of abnormal result when compared to clinically indicated EMBs. the clinical yield of EMB is comparable with previously reports in developed countries. This is the largest cohort reported from Southeast Asia. Abstract Figure.
In-hospital outcomes of acute heart failure according to left ventricular ejection fraction: a single-center retrospective cohort study
Authors: Han-Gla A , Viriyanukulvong K , Ariyachaipanich A 
Published: February 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
Acute heart failure (AHF) is a common cause of hospitalization and associated with high mortality rate. However, the study on outcomes of AHF patients classified by left ventricular ejection fraction (LVEF) in Thailand remains limited.

Purpose
To compared outcomes of AHF patients across LVEF categories.

Methods
We retrospectively analyzed all consecutive AHF patients who admitted during Jan 2018 to Dec 2019 and had been evaluated for LVEF during hospitalization or within the last 12 months prior to admission. Baseline characteristics, management and outcomes were compared between AHF with reduced LVEF (HFrEF; LVEF &lt; 40%), mid-ranged LVEF (HFmrEF; LVEF 40–49%), and preserved LVEF (HFpEF; LVEF≥50%). Primary outcome was in-hospital mortality. Secondary outcomes were length of stay (LOS), 1-year all-cause mortality and 1-year heart failure (HF) readmission rate. Statistical differences with a p-value &lt;0.05 were considered to be significant.

Results
A total of 614 patients were enrolled in the study (mean age 68.6 years, 52% male, 81% history of heart failure). Of those, there were 43%, 12%, and 45% of HFpEF, HFmrEF and HFrEF, respectively. The in-hospital mortality of HFpEF and HFmrEF were not significantly different from HFrEF (6.1% vs 4% vs 10.1%, respectively, p = 0.10). Similarly, there were no differences in LOS (the median LOS was 7 days, IQR 4-12, p= 0.34), 1-year all-cause mortality and 1-year heart failure (HF) readmission rate among these group (p &gt; 0.05).

Conclusion
The outcomes of HFpEF and HFmrEF were as poor as that of HFrEF. These findings highlight the need for effective therapeutic strategies to improve prognosis of HFpEF and HFmrEF patients. Abstract Figure.
Can paraoxonase activity serve as a comparable marker than high density lipoprotein in the follow-up of patients of coronary artery disease?
Authors: Chatterjee S , Majumder B , Biswas P , Sarkar S , Sinha P K , Mukhopadhyay L , Chakraborty I 
Published: February 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
Human serum paraoxonase (PON1) produced by the liver and residing almost exclusively on high density lipoproteins (HDL), has been demonstrated to prevent the oxidation of low density lipoprotein (LDL), which is the central initiating factor in the causation of atherosclerosis. (1,2) Thus, PON1 along with HDL, plays an important role in the pathophysiology of atherosclerosis and consequently coronary artery disease. Statins are commonly used in clinical practice for the management of dyslipidemia , a known risk factor for coronary artery disease (CAD).Keeping this in mind, it was deemed necessary to set up an observational study to explore whether the changes in PON1 activity after 3 months of statin therapy could help in the follow up of CAD patients.

Purpose
The purpose of the study was to evaluate the alterations in the PON1 activity along with the concentrations of HDL and LDL in patients of CAD before and after 3 months of statin therapy and to explore whether PON1 can be used as a comparable marker for assessment of the atherosclerotic risk in the follow up of these patients.

Materials and Methods
The study included 30 new patients who were put on statin therapy following the diagnosis of acute coronary syndrome in the Cardiology outpatients department. The activity of PON1 and the lipid profile parameters were estimated before starting statin therapy and again three months later. Patients with co-morbidities like diabetes, chronic kidney disease, chronic liver disease and other cardiac diseases of infectious etiology were excluded from the study. The data thus obtained was compiled and tabulated in Excel and statistically analyzed.

Results
The mean, median and standard deviation of the PON1, LDL and HDL, both before and after starting statin therapy, were calculated and the distribution of the individual parameters were determined. Analysis of the compiled data revealed that there was a statistically significant increase in both PON1 (p &lt; 0.05) and HDL (p &lt; 0.001) and a decrease (p &lt;0.05, also statistically significant) in LDL after 3 months of statin therapy. The results both before and after 3 months of statin therapy are summarised in the table attached.(Table 1)

Conclusion
It may be concluded from the above study that the activity of PON1 may be used to indicate the changes in the lipid profile in the follow up of patients of CAD being treated with statins. It is however necessary to conduct larger, well designed studies in future to explore whether it may be used as a comparable marker better than HDL in the follow up of these patients. Abstract Figure.
The use of bedside haemodynamic parameters to predict risk and in-hospital outcomes in non-ST elevation acute coronary syndromes: data from resource- limited settings in Iraq
Authors: Dakhil Z A 
Published: February 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
There is lack of data on the value of bedside hemodynamic parameters in predicting risk and outcomes in NSTE-ACS. This study aimed to assess if the following bedside haemodynamic tests : mean arterial pressure (MAP) [DBP + 1/3(SBP-DBP)], shock index (SI) [heart rate/SBP], pulse pressure (PP) [SBP-DBP] and proportional PP (PPP) [PP/SBP] can predict risk and adverse in-hospital outcomes in NSTE-ACS.

Purpose
To assess if bedside haemodynamic tests like mean arterial pressure (MAP), shock index (SI), pulse pressure (PP) and proportional PP (PPP) can predict risk and adverse in-hospital outcomes in NSTE-ACS

Methods
Patients with NSTE-ACS were prospectively included, we calculate GRACE score, SI, MAP, PP and PPP. Patients were stratified into low, intermediate and high GRACE risk class

Results
n.=179. When stratifying patients according to SI ≥0.7 vs &lt;0.7: 31% had SI≥0.7, those with SI ≥0.7 were at high GRACE risk class in 52.5% vs 24.3%, p &lt; 0.001. AF was recorded in those with SI≥0.7 in 19.7% vs 3.7%, p &lt; 0.001. Time to catheterization (days) was 3.26 ± 2.55 in SI ≥0.7 vs 3.23 ± 1.96, p = 0.9, hospitalization duration (days) 5.11 ± 2.8 in SI ≥0.7 vs 4.8 ± 2.7, p = 0.4. For those who developed cardiogenic shock; MAP was 86.1 ± 17.6 vs 100.04 ± 15.3, p = 0.03 and SI was 0.91 ± 0.3 vs 0.63 ± 0.2, p = 0.02 compared to those who did not develop cardiogenic shock. No significant differences observed in PP and PPP between two groups. There was significant correlation between SI and GRACE score, p &lt; 0.001 as well as with EF%, p &lt; 0.001. MAP correlated significantly with GRACE score, p = 0.001. On multiple regression analysis: high GRACE risk class [95% CI 0.002-0.056, p = 0.03] and SI≥0.7 [95%CI 0.007-0.12, p = 0.02] were significant predictors of in-hospital death, while high GRACE risk class predicted in-hospital AHF [95% CI 0.13-0.26, p &lt; 0.001]. SI≥0.7 predicted in-hospital stroke [95% CI 0.008-0.082, P = 0.01]. While MAP, PP and PPP did not predict in-hospital outcomes

Conclusions
SI correlates with GRACE score and predicted in-hospital stroke and death in NSTE-ACS. MAP correlated with GRACE score, but MAP, PP and PPP did not predict in-hospital outcomes. SI is readily obtainable than GRACE score and can be used to guide management particularly in resources-limited settings where proper risk stratification is needed to choose those who will benefit the most from invasive strategy Abstract Figure.
Differential association between significant coronary stenosis and cardiac troponin T serial algorithms in renal dysfunction patients diagnosed with non-ST-segment elevation acute coronary syndromes
Authors: Kotruchin P , Tangpaisarn T , Srimakam N , Phungoen P , Senthong V 
Published: February 2022

Abstract

Funding Acknowledgements
Type of funding sources: Public Institution(s). Main funding source(s): Faculty of Medicine Khon Kaen University

Background
High-sensitivity cardiac troponin T (hs-cTnT) is recommended for diagnosing non-ST segment elevation acute coronary syndromes (NSTE-ACS). While the standard practice guidelines recommend using the 0,1-hour (hr) and 0,3-hr hs-cTnT algorithms, their efficacy has been not clearly established in chronic kidney disease (CKD) patients.

Purpose
We aimed to assess the differential associations between the two algorithms mentioned above with significant coronary stenosis in CKD patients.

Methods
This was a retrospective cohort study. Patients aged ≥18 years (yr) who were diagnosed with NSTE-ACS and had undergone coronary angiogram were recruited. The differential association between significant coronary stenosis and being ruled in based on the 0,1-hr and 0,3-hr hs-cTnT algorithm in both CKD patients and those normal renal function was analyzed and reported.

Results
There were 158 and 160 patients in the CKD group and the normal renal function group, respectively. The prevalence of significant coronary stenosis was higher in the CKD group (70.4% vs. 57.8%, P =0.028). Among CKD patients, factors associated with significant coronary stenosis were hypertension (OR =2.68; 95%CI 1.10-6.50) and being ruled in by the 0,3-hr algorithm (OR =3.65; 95%CI 1.27-10.52). In the normal renal function group, age (OR =1.04; 95%CI 1.01-1.06), male sex (OR =2.15; 95%CI 1.09-4.22), and being ruled in by the 0,1-hr algorithm (OR =3.12; 95%CI 1.20-8.10) were associated with significant coronary stenosis.

Conclusions
Being ruled in according to the 0,3-hr algorithm was significantly associated with coronary stenosis in CKD patients, making this a likely algorithm of choice in these patients. Abstract Figure. Adjusted OR of a coronary stenosis
Spontaneous coronary artery dissection - case series of a rare disease
Authors: Hashmani S H , Garrod R G , Shamsi F S , Hasan K Y , Jamal S J , Bafadel A B , Traina M T , Al Mahmeed W M 
Published: February 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
Spontaneous coronary artery dissection (SCAD) is an important cause of acute coronary syndrome (ACS) particularly in young women. Female sex, pregnancy, emotional stress and fibromuscular dysplasia are known triggering factors for SCAD.

Aim
To identify clinical profile, outcomes and recurrence of SCAD within United Arab Emirates (UAE)

Methods
Prospective, observational collection of data from all patients with diagnosis of SCAD based on angiographic findings. The time period is March, 2020 till February, 2021. Six months follow up data has been recorded (till date). All patients underwent genetic screening for TSR and PHACTR genes however data was available for two patients only at the time of write up.

Results
(Tables)

Conclusion
We report positive outcomes of patients presenting with SCAD. Female predominance, non-atherosclerotic risk factors, post-partum & SCAD Type B was seen, which is comparable to western cohorts. Our region may have high incidence of SCAD, given the five cases that we had in short period of recruitment. Abstract Figure. SCAD_E-poster