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Invasive versus conservative strategy in patients aged 80 years or older with non-ST-elevation myocardial infarction or unstable angina pectoris (After Eighty study): an open-label randomised controlled trial
This study is registered with ClinicalTrials.gov, number NCT01255540. Findings During a median follow-up of 1·53 years of participants recruited between Dec 10, 2010, and Feb 21, 2014, the primary outcome occurred in 93 (40·6%) of 229 patients assigned to the invasive group and 140 (61·4%) of 228 patients assigned to the conservative group (hazard ratio [HR] 0·53 [95% CI 0·41–0·69], p=0·0001). Five patients dropped out of the invasive group and one from the conservative group. HRs for the four components of the primary composite endpoint were 0·52 (0·35–0·76; p=0·0010) for myocardial infarction, 0·19 (0·0...
Source: The Lancet - January 13, 2016 Category: Journals (General) Source Type: research

Percutaneous coronary angioplasty versus coronary artery bypass grafting in treatment of unprotected left main stenosis (NOBLE): a prospective, randomised, open-label, non-inferiority trial
Publication date: Available online 31 October 2016 Source:The Lancet Author(s): Timo Mäkikallio, Niels R Holm, Mitchell Lindsay, Mark S Spence, Andrejs Erglis, Ian B A Menown, Thor Trovik, Markku Eskola, Hannu Romppanen, Thomas Kellerth, Jan Ravkilde, Lisette O Jensen, Gintaras Kalinauskas, Rikard B A Linder, Markku Pentikainen, Anders Hervold, Adrian Banning, Azfar Zaman, Jamen Cotton, Erlend Eriksen, Sulev Margus, Henrik T Sørensen, Per H Nielsen, Matti Niemelä, Kari Kervinen, Jens F Lassen, Michael Maeng, Keith Oldroyd, Geoff Berg, Simon J Walsh, Colm G Hanratty, Indulis Kumsars, Peteris Stradins, Terje K Steigen, O...
Source: The Lancet - October 31, 2016 Category: Journals (General) Source Type: research

Deriving literature-based benchmarks for surgical complications in high-income countries: a protocol for a systematic review and meta-analysis
This study of secondary data does not require ethics approval. It will be presented internationally and published in the peer-reviewed literature. Results will inform a future quality improvement tool and provide benchmarks of surgical complication rates within HICs. Trial registration International Prospective Register of Systematic Reviews (PROSPERO). Registration number CRD42016037519.
Source: BMJ Open - May 9, 2017 Category: General Medicine Authors: Brindle, M. E., Roberts, D. J., Daodu, O., Haynes, A. B., Cauley, C., Dixon, E., La Flamme, C., Bain, P., Berry, W. Tags: Open access, Health policy Protocol Source Type: research

Rivaroxaban with or without aspirin in patients with stable coronary artery disease: an international, randomised, double-blind, placebo-controlled trial
Publication date: Available online 10 November 2017 Source:The Lancet Author(s): Stuart J Connolly, John W Eikelboom, Jackie Bosch, Gilles Dagenais, Leanne Dyal, Fernando Lanas, Kaj Metsarinne, Martin O'Donnell, Anthony L Dans, Jong-Won Ha, Alexandr N Parkhomenko, Alvaro A Avezum, Eva Lonn, Liu Lisheng, Christian Torp-Pedersen, Petr Widimsky, Aldo P Maggioni, Camilo Felix, Katalin Keltai, Masatsugu Hori, Khalid Yusoff, Tomasz J Guzik, Deepak L Bhatt, Kelley R H Branch, Nancy Cook Bruns, Scott D Berkowitz, Sonia S Anand, John D Varigos, Keith A A Fox, Salim Yusuf Background Coronary artery disease is a major cause of morbi...
Source: The Lancet - November 11, 2017 Category: General Medicine Source Type: research

Radial versus femoral access and bivalirudin versus unfractionated heparin in invasively managed patients with acute coronary syndrome (MATRIX): final 1-year results of a multicentre, randomised controlled trial
Publication date: Available online 25 August 2018Source: The LancetAuthor(s): Marco Valgimigli, Enrico Frigoli, Sergio Leonardi, Pascal Vranckx, Martina Rothenbühler, Matteo Tebaldi, Ferdinando Varbella, Paolo Calabrò, Stefano Garducci, Paolo Rubartelli, Carlo Briguori, Giuseppe Andó, Maurizio Ferrario, Ugo Limbruno, Roberto Garbo, Paolo Sganzerla, Filippo Russo, Marco Nazzaro, Alessandro Lupi, Bernardo CorteseSummaryBackgroundThe Minimizing Adverse Haemorrhagic Events by Transradial Access Site and Systemic Implementation of Angiox (MATRIX) programme was designed to assess the comparative safety and effectiveness of ra...
Source: The Lancet - August 25, 2018 Category: General Medicine Source Type: research

Percutaneous coronary angioplasty versus coronary artery bypass grafting in the treatment of unprotected left main stenosis: updated 5-year outcomes from the randomised, non-inferiority NOBLE trial
Publication date: Available online 23 December 2019Source: The LancetAuthor(s): Niels R Holm, Timo Mäkikallio, M Mitchell Lindsay, Mark S Spence, Andrejs Erglis, Ian B A Menown, Thor Trovik, Thomas Kellerth, Gintaras Kalinauskas, Lone Juul Hune Mogensen, Per H Nielsen, Matti Niemelä, Jens F Lassen, Keith Oldroyd, Geoffrey Berg, Peteris Stradins, Simon J Walsh, Alastair N J Graham, Petter C Endresen, Ole FröbertSummaryBackgroundPercutaneous coronary intervention (PCI) is increasingly used in revascularisation of patients with left main coronary artery disease in place of the standard treatment, coronary artery bypass gra...
Source: The Lancet - December 24, 2019 Category: General Medicine Source Type: research

Disability-free survival after major cardiac surgery: a population-based retrospective cohort study
CMAJ Open. 2021 Apr 16;9(2):E384-E393. doi: 10.9778/cmajo.20200096. Print 2021 Apr-Jun.ABSTRACTBACKGROUND: Cardiovascular research has traditionally been dedicated to "tombstone" outcomes, with little attention dedicated to the patient's perspective. We evaluated disability-free survival as a patient-defined outcome after cardiac surgery.METHODS: We conducted a retrospective cohort study of patients aged 40 years and older who underwent coronary artery bypass grafting (CABG) or single or multiple valve (aortic, mitral, tricuspid) surgery in Ontario between Oct. 1, 2008, and Dec. 31, 2016. The primary outcome was disability...
Source: cmaj - April 17, 2021 Category: General Medicine Authors: Louise Y Sun Anan Bader Eddeen Thierry G Mesana Source Type: research

Utility of a smartphone application in assessing palmar circulation prior to radial artery harvesting for coronary artery bypass grafting: rationale and design of the randomised CAPITAL iRADIAL-CABG trial
Introduction There is emerging evidence supporting the use of the radial artery (RA) as a preferred secondary conduit for coronary artery bypass grafting (CABG) as it is associated with higher rates of graft patency at 5 years when compared with saphenous vein grafts (SVG). The modified Allen’s test (MAT) is traditionally regarded as the standard of care in the assessment of ulnar artery (UA) patency prior to RA harvesting. Unfortunately, due to high false-positive rates, a substantial number of pre-CABG patients are found to have an abnormal MAT despite normal UA patency, resulting in inappropriate exclusion from RA...
Source: BMJ Open - April 8, 2022 Category: General Medicine Authors: Goh, C. Y., Parlow, S., Di Santo, P., Simard, T., Jung, R., Ahmed, Z., Verreault-Julien, L., Kuhar, P., Chan, V., Al-Atassi, T., Toeg, H., Bernick, J., Wells, G. A., Ruel, M., Hibbert, B. Tags: Open access, Cardiovascular medicine Source Type: research

Atorvastatin and the influence on postoperative atrial fibrillation after surgical aortic valve replacement (STARC) in adults at Odense University Hospital, Denmark: study protocol for a randomised controlled trial
Introduction Atrial fibrillation (AF) is the most common postoperative complication after surgical aortic valve replacement (SAVR) and occurs in up to 50% of the patients. Development of postoperative AF (POAF) is associated with a 2–3 fold increased risk of adverse events, including stroke, myocardial infarction and death. Several studies have implied that prophylactic Atorvastatin therapy could prevent POAF in patients undergoing coronary artery bypass graft. These studies suggest that Atorvastatin has rapid and significant pleiotropic actions that reduce the risk of POAF. However, prophylactic treatment with stati...
Source: BMJ Open - May 10, 2023 Category: General Medicine Authors: Krasniqi, L., Brandes, A., Mortensen, P. E., Dahl, J. S., Gerke, O., Ali, M., Riber, L. P. S. Tags: Open access, Cardiovascular medicine Source Type: research