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Utility of glycated hemoglobin screening in patients undergoing elective coronary artery surgery: Prospective, cohort study from the E-CABG registry
<p>Background: Patients with increased glycated hemoglobin (HbA1c) seem to be at increased risk of sternal wound infection (SWI) after coronary artery bypass grafting (CABG). However, it is unclear whether increased baseline ...
Occurrence and Classification of Cerebrovascular Events after Isolated Bioprosthetic Surgical Aortic Valve Replacement: A Competing Risk Analysis of the CAREAVR Study
<p><b>Background:</b> The long-term incidence of stroke and the proportion of cardioembolic events after bioprosthetic surgical aortic valve replacement (SAVR) remain largely unknown.</p><p><b>Methods:</b> The CAREAVR study ...
Subtype of atrial fibrillation and the outcome of transcatheter aortic valve replacement: The FinnValve Study
Whether the subtype of atrial fibrillation affects outcomes after transcatheter aortic valve replacement for aortic stenosis is unclear. The nationwide FinnValve registry included 2130 patients who underwent primary after ...
Postcardiotomy Venoarterial Extracorporeal Membrane Oxygenation in Patients Aged 70 Years or Older
Background. There is uncertainty whether venoarterial extracorporeal membrane oxygenation (VA-ECMO) should be used in older patients with cardiopulmonary failure after cardiac surgery.Methods. This was a retrospective ...
MANTA versus ProGlide vascular closure devices in transfemoral transcatheter aortic valve implantation
<p>Background: The MANTA system is a novel vascular closure device (VCD) and its safety and efficacy were compared to the ProGlide VCD in patients undergoing transfemoral transcatheter aortic valve implantation ...
Association of Heart Rate With Troponin Levels Among Patients With Symptomatic Atrial Fibrillation
This cohort study investigates heart rate and cardiac troponin levels in patients admitted to the emergency department with symptomatic atrial fibrillation.
Prognostic Significance of Arterial Lactate Levels at Weaning from Postcardiotomy Venoarterial Extracorporeal Membrane Oxygenation
Background: The outcome after weaning from postcardiotomy venoarterial extracorporeal membrane oxygenation (VA-ECMO) is poor. In this study, we investigated the prognostic impact of arterial lactate levels at the time of ...
Bleeding in Patients Treated With Ticagrelor or Clopidogrel Before Coronary Artery Bypass Grafting
<div><div><div><h3>Background</h3><p>We evaluated perioperative bleeding after <a href="https://www.sciencedirect.com/topics/medicine-and-dentistry/coronary-artery-bypass-graft" title="Learn more about Coronary Artery Bypass Graft from ScienceDirect's AI-generated Topic Pages">coronary artery bypass grafting</a> (CABG) in patients preoperatively treated with <a href="https://www.sciencedirect.com/topics/medicine-and-dentistry/ticagrelor" title="Learn more about Ticagrelor from ScienceDirect's AI-generated Topic Pages">ticagrelor</a> or <a href="https://www.sciencedirect.com/topics/medicine-and-dentistry/clopidogrel" title="Learn more about Clopidogrel from ScienceDirect's AI-generated Topic Pages">clopidogrel</a>, stratified by discontinuation of these P2Y<sub>12</sub> inhibitors.</p></div><div><h3>Methods</h3><p>All
patients from the prospective, European Multicenter Registry on
Coronary Artery Bypass Grafting (E-CABG) treated with ticagrelor or
clopidogrel undergoing isolated primary CABG were eligible. The primary
outcome measure was severe or massive bleeding defined according to the
Universal Definition of Perioperative Bleeding, stratified by P2Y<sub>12</sub> inhibitor discontinuation. Secondary outcome measures included four additional definitions of major bleeding. <a href="https://www.sciencedirect.com/topics/medicine-and-dentistry/propensity-score-matching" title="Learn more about Propensity Score Matching from ScienceDirect's AI-generated Topic Pages">Propensity score matching</a> was performed to adjust for differences in preoperative and perioperative covariates.</p></div><div><h3>Results</h3><p>Of
2,311 patients who were included, 1,293 (55.9%) received clopidogrel
and 1,018 (44.1%) ticagrelor preoperatively. Mean time between
discontinuation and the operation was 4.5 ± 3.2 days for clopidogrel and
4.9 ± 3.0 days for ticagrelor. In the propensity score–matched cohort,
ticagrelor-treated patients had a higher incidence of major bleeding
according to Universal Definition of Perioperative Bleeding when
ticagrelor was discontinued 0 to 2 days compared with 3 days before the
operation (16.0% vs 2.7%, p = 0.003). Clopidogrel-treated
patients had a higher incidence of major bleeding according to the
Universal Definition of Perioperative Bleeding when clopidogrel was
discontinued 0 to 3 days compared with 4 to 5 days before the operation
(15.6% vs 8.3%, p = 0.031).</p></div><div><h3>Conclusions</h3><p>In
patients receiving ticagrelor 2 days before CABG and in those receiving
clopidogrel 3 days before CABG, there was an increased rate of severe
bleeding. Postponing nonemergent CABG for at least 3 days after
discontinuation of ticagrelor and 4 days after clopidogrel should be
considered.</p></div></div></div>...
Adverse events and survival with postpericardiotomy syndrome after surgical aortic valve replacement
<div>Objectives</div><div>Postpericardiotomy syndrome (PPS) is a relatively common complication after cardiac surgery. However, long-term follow-up data on the adverse events and mortality of PPS patients requiring invasive ...