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  • 1
    Online Resource
    Online Resource
    Datasheet1.docx
    Frontiers Media SA ; 2023
    In:  Frontiers in Cardiovascular Medicine Vol. 10 ( 2023-9-27)
    Details
    In: Frontiers in Cardiovascular Medicine, Frontiers Media SA, Vol. 10 ( 2023-9-27)
    Abstract: Two recent randomized controlled trials (RCTs), the PROTECT-AF and the PREVAIL, showed that in atrial fibrillation (AF) patients, left atrial appendage closure (LAAC) is comparable to oral anticoagulants (OAC) in the prevention of stroke and could also possibly reduce mortality. Nevertheless, this net clinical benefit was not confirmed in the most recent RCT comparing LAAC vs. OAC, the PRAGUE-17 trial. Aim aim of the present study was to evaluate the efficacy and safety of LAAC compared with OAC among available high-quality studies. Methods A systematic search of electronic databases (Medline, Scopus, Embase and the Cochrane Library) was performed to identify eligible RCTs and observational studies with propensity score matching (PSM) analysis. PRISMA guidelines were used for abstracting data and assessing data quality and validity. Outcomes of interest were the occurrence of cardiovascular death (CVD), all-cause death, all-type stroke, and major bleedings. Results A total of 3 RCTs and 7 PMS studies involving 25,700 patients were identified. 12,961 patients received LAAC while 12,739 received OAC therapy. After a median follow-up of 2.6 years (IQR 2–4.4), patients who received LAAC had lower risk of CVD (RR = 0.62; 95%CI, 0.51–0.74, I 2  = 0%), all-cause death (RR = 0.67; 95% CI, 0.57–0.78, I 2 68%) and major bleedings (RR = 0.68; 95%CI, 0.48–0.95 I 2  = 87%) compared with patients on OAC. No difference was found between the two groups regarding strokes incidence (RR = 0.94; 95% CI, 0.77–1.15, I 2  = 0%). Conclusions According to this meta-analysis, LAAC has comparable efficacy in the prevention of stroke compared with OAC and a reduced risk of major bleedings, all-cause death and CVD that may be even larger with longer follow-up. Systematic Review Registration https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=269768 , identifier CRD42021269768.
    Type of Medium: Online Resource
    ISSN: 2297-055X
    URL: Article
    URL: Article
    DOI: 10.3389/fcvm.2023.1212161
    DOI: 10.3389/fcvm.2023.1212161.s001
    Language: Unknown
    Publisher: Frontiers Media SA
    Publication Date: 2023
    detail.hit.zdb_id: 2781496-8
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  • 2
    Online Resource
    Online Resource
    Datasheet1.pdf
    Frontiers Media SA ; 2023
    In:  Frontiers in Cardiovascular Medicine Vol. 10 ( 2023-8-31)
    Details
    In: Frontiers in Cardiovascular Medicine, Frontiers Media SA, Vol. 10 ( 2023-8-31)
    Abstract: Computational fluid dynamics (CFD) is emerging as an effective technology able to improve procedural outcomes and enhance clinical decision-making in patients with coronary artery disease (CAD). The present study aims to assess the state of knowledge, use and clinical acceptability of CFD in the diagnosis and treatment of CAD. Methods We realized a 20-questions international, anonymous, cross-sectional survey to cardiologists to test their knowledge and confidence on CFD as a technology applied to patients suffering from CAD. Responses were recorded between May 18, 2022, and June 12, 2022. Results A total of 466 interventional cardiologists (mean age 48.4 ± 8.3 years, males 362), from 42 different countries completed the survey, for a response rate of 45.9%. Of these, 66.6% declared to be familiar with the term CFD, especially for optimization of existing interventional techniques (16.1%) and assessment of hemodynamic quantities related with CAD (13.7%). About 30% of respondents correctly answered to the questions exploring their knowledge on the pathophysiological role of some CFD-derived quantities such as wall shear stress and helical flow in coronary arteries. Among respondents, 85.9% would consider patient-specific CFD-based analysis in daily interventional practice while 94.2% declared to be interested in receiving a brief foundation course on the basic CFD principles. Finally, 87.7% of respondents declared to be interested in a cath-lab software able to conduct affordable CFD-based analyses at the point-of-care. Conclusions Interventional cardiologists reported to be profoundly interested in adopting CFD simulations as a technology supporting decision making in the treatment of CAD in daily practice.
    Type of Medium: Online Resource
    ISSN: 2297-055X
    URL: Article
    URL: Article
    DOI: 10.3389/fcvm.2023.1216796
    DOI: 10.3389/fcvm.2023.1216796.s001
    Language: Unknown
    Publisher: Frontiers Media SA
    Publication Date: 2023
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  • 3
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    Online Resource
    Table_1.docx
    Frontiers Media SA ; 2020
    In:  Frontiers in Endocrinology Vol. 11 ( 2020-11-30)
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    In: Frontiers in Endocrinology, Frontiers Media SA, Vol. 11 ( 2020-11-30)
    Abstract: Dysnatremia is associated with increased mortality in patients with community-acquired pneumonia. SARS-COV2 (Severe-acute-respiratory syndrome caused by Coronavirus-type 2) pneumonia can be fatal. The aim of this study was to ascertain whether admittance dysnatremia is associated with mortality, sepsis, or intensive therapy (IT) in patients hospitalized with SARS-COV2 pneumonia. This is a retrospective study of the HOPE-COVID-19 registry, with data collected from January 1 th through April 31 th , 2020. We selected all hospitalized adult patients with RT-PCR-confirmed SARS-COV2 pneumonia and a registered admission serum sodium level (SNa). Patients were classified as hyponatremic (SNa & lt;135 mmol/L), eunatremic (SNa 135–145 mmol/L), or hypernatremic (SNa & gt;145 mmol/L). Multivariable analyses were performed to elucidate independent relationships of admission hyponatremia and hypernatremia, with mortality, sepsis, or IT during hospitalization. Four thousand six hundred sixty-four patients were analyzed, median age 66 (52–77), 58% males. Death occurred in 988 (21.2%) patients, sepsis was diagnosed in 551 (12%) and IT in 838 (18.4%). Hyponatremia was present in 957/4,664 (20.5%) patients, and hypernatremia in 174/4,664 (3.7%). Both hyponatremia and hypernatremia were associated with mortality and sepsis. Only hyponatremia was associated with IT. In conclusion, hyponatremia and hypernatremia at admission are factors independently associated with mortality and sepsis in patients hospitalized with SARS-COV2 pneumonia. Clinical Trial Registration https://clinicaltrials.gov/ct2/show/NCT04334291 , NCT04334291.
    Type of Medium: Online Resource
    ISSN: 1664-2392
    URL: Article
    URL: Article
    DOI: 10.3389/fendo.2020.599255
    DOI: 10.3389/fendo.2020.599255.s001
    Language: Unknown
    Publisher: Frontiers Media SA
    Publication Date: 2020
    detail.hit.zdb_id: 2592084-4
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  • 4
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    Online Resource
    Data_Sheet_1.docx
    Frontiers Media SA ; 2021
    In:  Frontiers in Medicine Vol. 8 ( 2021-10-14)
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    In: Frontiers in Medicine, Frontiers Media SA, Vol. 8 ( 2021-10-14)
    Abstract: Background: Patients with sepsis with a concomitant coronavirus (COVID-19) infection are related to a high morbidity and mortality rate. We investigated a large cohort of patients with sepsis with a concomitant COVID-19, and we developed a risk score for the estimation of sepsis risk in COVID-19. Methods: We conducted a sub-analysis from the international Health Outcome Predictive Evaluation Registry for COVID-19 (HOPE-COVID-19-Registry, NCT04334291). Out of 5,837 patients with COVID-19, 624 patients were diagnosed with sepsis according to the Sepsis-3 International Consensus. Results: In multivariable analysis, the following risk factors were identified as independent predictors for developing sepsis: current smoking, tachypnoea ( & gt;22 breath per minute), hemoptysis, peripheral oxygen saturation (SpO 2 ) & lt;92%, blood pressure (BP) (systolic BP & lt;90 mmHg and diastolic BP & lt;60 mmHg), Glasgow Coma Scale (GCS) & lt;15, elevated procalcitonin (PCT), elevated troponin I (TnI), and elevated creatinine & gt;1.5 mg/dl. By assigning odds ratio (OR) weighted points to these variables, the following three risk categories were defined to develop sepsis during admission: low-risk group (probability of sepsis 3.1–11.8%); intermediate-risk group (24.8–53.8%); and high-risk-group (58.3–100%). A score of 1 was assigned to current smoking, tachypnoea, decreased SpO 2 , decreased BP, decreased GCS, elevated PCT, TnI, and creatinine, whereas a score of 2 was assigned to hemoptysis. Conclusions: The HOPE Sepsis Score including nine parameters is useful in identifying high-risk COVID-19 patients to develop sepsis. Sepsis in COVID-19 is associated with a high mortality rate.
    Type of Medium: Online Resource
    ISSN: 2296-858X
    URL: Article
    URL: Article
    DOI: 10.3389/fmed.2021.728102
    DOI: 10.3389/fmed.2021.728102.s001
    Language: Unknown
    Publisher: Frontiers Media SA
    Publication Date: 2021
    detail.hit.zdb_id: 2775999-4
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  • 5
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    Online Resource
    Table_1.DOCX
    Frontiers Media SA ; 2022
    In:  Frontiers in Cardiovascular Medicine Vol. 9 ( 2022-4-29)
    Details
    In: Frontiers in Cardiovascular Medicine, Frontiers Media SA, Vol. 9 ( 2022-4-29)
    Abstract: Data regarding management of patients with unprotected left main coronary artery in-stent restenosis (LM-ISR) are scarce. Objectives This study investigated the safety and effectiveness of percutaneous coronary intervention (PCI) vs. coronary artery bypass grafting (CABG) for the treatment of unprotected LM-ISR. Methods Consecutive patients who underwent PCI or CABG for unprotected LM-ISR were enrolled. The primary endpoint was a composite of major adverse cardiac and cerebrovascular events (MACCE), defined as cardiac death, myocardial infarction (MI), target vessel revascularization (TVR), and stroke. Results A total of 305 patients were enrolled, of which 203(66.6%) underwent PCI and 102(33.4%) underwent CABG. At 30-day follow-up, a lower risk of cardiac death was observed in the PCI group, compared with the CABG-treated group (2.1% vs. 7.1%, HR 3.48, 95% CI 1.01–11.8, p = 0.04). At a median of 3.5 years [interquartile range ( IQR ) 1.3–5.5] follow-up, MACCE occurred in 27.7% vs. 29.6% ( HR 0.82, 95% CI 0.52–1.32, p = 0.43) in PCI- and CABG-treated patients, respectively. There were no significant differences between PCI and CABG in cardiac death (9.9% vs. 18.4%; HR 1.56, 95% CI 0.81–3.00, p = 0.18), MI (7.9% vs. 5.1%, HR 0.44, 95% CI 0.15–1.27, p = 0.13), or stroke (2.1% vs. 4.1%, HR 1.79, 95% CI 0.45–7.16, p = 0.41). TVR was more frequently needed in the PCI group (15.2% vs. 6.1%, HR 0.35, 95% CI 0.15–0.85, p = 0.02). Conclusions This analysis of patients with LM-ISR revealed a lower incidence of cardiac death in PCI compared with CABG in short-term follow-up. During the long-term follow-up, no differences in MACCE were observed, but patients treated with CABG less often required TVR. Visual overview A visual overview is available for this article. Registration https://www.clinicaltrials.gov ; Unique identifier: NCT04968977.
    Type of Medium: Online Resource
    ISSN: 2297-055X
    URL: Article
    URL: Article
    URL: Article
    DOI: 10.3389/fcvm.2022.849971
    DOI: 10.3389/fcvm.2022.849971.s001
    DOI: 10.3389/fcvm.2022.849971.s002
    Language: Unknown
    Publisher: Frontiers Media SA
    Publication Date: 2022
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  • 6
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    Table2.docx
    Frontiers Media SA ; 2023
    In:  Frontiers in Cardiovascular Medicine Vol. 10 ( 2023-3-23)
    Details
    In: Frontiers in Cardiovascular Medicine, Frontiers Media SA, Vol. 10 ( 2023-3-23)
    Abstract: Older patients who treated by percutaneous coronary intervention (PCI) are at a higher risk of adverse cardiac outcomes. We sought to investigate the clinical impact of bifurcation PCI in older patients from Korea and Italy. Methods We selected 5,537 patients who underwent bifurcation PCI from the BIFURCAT (comBined Insights from the Unified RAIN and COBIS bifurcAtion regisTries) database. The primary outcome was a composite of target vessel myocardial infarction, clinically driven target lesion revascularization, and stent thrombosis at two years. Results In patients aged ≥75 years, the mean age was 80.1 ± 4.0 years, 65.2% were men, and 33.7% had diabetes. Older patients more frequently presented with chronic kidney disease (CKD), severe coronary calcification, and left main coronary artery disease (LMCA). During a median follow-up of 2.1 years, older patients showed similar adverse clinical outcomes compared to younger patients (the primary outcome, 5.7% vs. 4.5%; p  = 0.21). Advanced age was not an independent predictor of the primary outcome ( p  = 0.93) in overall patients. Both CKD and LMCA were independent predictors regardless of age group. Conclusions Older patients (≥75 years) showed similar clinical outcomes to those of younger patients after bifurcation PCI. Advanced age alone should not deter physicians from performing complex PCIs for bifurcation disease.
    Type of Medium: Online Resource
    ISSN: 2297-055X
    URL: Article
    URL: Article
    DOI: 10.3389/fcvm.2023.1106594
    DOI: 10.3389/fcvm.2023.1106594.s001
    Language: Unknown
    Publisher: Frontiers Media SA
    Publication Date: 2023
    detail.hit.zdb_id: 2781496-8
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