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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

Coronary atherosclerotic burden assessed by SYNTAX scores and outcomes in surgical, percutaneous or medical strategies: a retrospective cohort study
Conclusions Coronary atherosclerotic burden alone was not associated with significantly increased risk of all-cause mortality. The SSII better discriminates the risk of death. Trial registration number ISRCTN66068876.
Source: BMJ Open - September 22, 2022 Category: General Medicine Authors: Scudeler, T. L., Farkouh, M. E., Hueb, W., Rezende, P. C., Campolina, A. G., Martins, E. B., Godoy, L. C., Soares, P. R., Ramires, J. A. F., Kalil Filho, R. Tags: Open access, Cardiovascular medicine Source Type: research

Comparative efficacy of eight therapeutic methods in the treatment of left main coronary artery disease: a Bayesian network meta-analysis protocol
Introduction As for coronary artery bypass grafting, although there are many direct comparative studies on different minimally invasive methods and traditional thoracotomy (off-pump/on-pump), there is still a lack of further ranking and summary of the efficacy of all surgical methods for left main coronary artery (LMCA) lesions. Combined with the current controversial views, this study aims to introduce a planned network meta-analysis (NMA) in detail, with a view to comparing the long-term efficacy and safety of multiple therapeutic methods in the treatment of patients with LMCA disease, and finally providing some referenc...
Source: BMJ Open - September 6, 2022 Category: General Medicine Authors: Hou, B., Chen, M., Li, Q., Huang, W., Wang, L. Tags: Open access, Cardiovascular medicine Source Type: research

Cost-effectiveness of follow-up invasive coronary angiography after percutaneous coronary stenting: a real-world observational cohort study in Japan
Conclusions FUICA increased the costs but did not improve clinical benefits. Thus, FUICA is not economically more attractive than CF alone. Trial registration number UMIN000039768.
Source: BMJ Open - August 30, 2022 Category: General Medicine Authors: Shiina, T., Goto-Hirano, K., Takura, T., Daida, H. Tags: Open access, Health economics 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

Efficacy of a glucagon-like peptide-1 agonist and restrictive versus liberal oxygen supply in patients undergoing coronary artery bypass grafting or aortic valve replacement: study protocol for a 2-by-2 factorial designed, randomised clinical trial
The objective of this study is to determine the efficacy of the GLP-1-analogue exenatide versus placebo and restrictive oxygenation (50% fractional inspired oxygen, FiO2) versus liberal oxygenation (100% FiO2) in patients undergoing open heart surgery. Methods and analysis A randomised, placebo-controlled, double blind (for the exenatide intervention)/single blind (for the oxygenation strategy), 2x2 factorial designed single-centre trial on adult patients undergoing elective or subacute CABG and/or surgical AVR. Patients will be randomised in a 1:1 and 1:1 ratio to a 6-hour and 15 min infusion of 17.4 µg of exenatid...
Source: BMJ Open - November 5, 2021 Category: General Medicine Authors: Wiberg, S., Kjaergaard, J., Mogelvang, R., Moller, C. H., Kandler, K., Ravn, H., Hassager, C., Kober, L., Nilsson, J. C. Tags: Open access, Surgery Source Type: research

Surgical aortic valve replacement in the era of transcatheter aortic valve implantation: a review of the UK national database
Conclusions Surgical SAVR±CABG has low mortality risk and a low level of complications in the UK in people of all ages and risk factors. These results should inform consideration of treatment options in people with aortic valve disease.
Source: BMJ Open - October 28, 2021 Category: General Medicine Authors: Jahangiri, M., Bilkhu, R., Embleton-Thirsk, A., Dehbi, H.-M., Mani, K., Anderson, J., Avlonitis, V., Baghai, M., Birdi, I., Booth, K., Bose, A., Briffa, N., Buchan, K., Bhudia, S., Cale, A., Deglurkar, I., Farid, S., Hadjinikolaou, L., Jarvis, M., Javadpo Tags: Open access, Cardiovascular medicine 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

Estimating the economic burden of cardiovascular events in patients receiving lipid-modifying therapy in the UK
Conclusions Revascularisation and myocardial infarction were associated with the highest incremental costs following a CV event. On the basis of real-world data, the economic burden of CV events in the UK is substantial, particularly among those with greater comorbidity burden.
Source: BMJ Open - August 4, 2016 Category: Journals (General) Authors: Danese, M. D., Gleeson, M., Kutikova, L., Griffiths, R. I., Azough, A., Khunti, K., Seshasai, S. R. K., Ray, K. K. Tags: Open access, Cardiovascular medicine, Health economics, Health services research Source Type: research

Has the difference in mortality between percutaneous coronary intervention and coronary artery bypass grafting in people with heart disease and diabetes changed over the years? A systematic review and meta-regression
Conclusions The difference in outcome between PCI and CABG in diabetics has not narrowed from the beginning—with balloon angioplasty to current PCI—with the second generation of drug eluting stents. In contrast to the non-diabetics, there is a persistent 30% benefit in all cause mortality favouring CABG in diabetics, and this should be a major factor in treatment recommendation.
Source: BMJ Open - December 30, 2015 Category: Journals (General) Authors: Herbison, P., Wong, C.-K. Tags: Open access, Cardiovascular medicine, Diabetes and Endocrinology Research Source Type: research

Clinical characteristics, management and 1-year outcomes of patients with acute coronary syndrome in Iran: the Iranian Project for Assessment of Coronary Events 2 (IPACE2)
Conclusions Our study showed that the composition of Iranian patients with ACS regarding the type of ACS is similar to that in developed European countries and is unlike that in developing countries of the Middle East and Africa. We found that our patients with ACS are treated with high levels of adherence to guideline-recommended in-hospital medications.
Source: BMJ Open - December 15, 2015 Category: Journals (General) Authors: Kassaian, S. E., Masoudkabir, F., Sezavar, H., Mohammadi, M., Pourmoghaddas, A., Kojouri, J., Ghaffari, S., Sanaati, H., Alaeddini, F., Pourmirza, B., Mir, E., on-behalf of the IPACE2 registry investigators Tags: Open access, Cardiovascular medicine, Evidence based practice, Medical management Research Source Type: research

Long-term follow-up results in patients undergoing percutaneous coronary intervention (PCI) with drug-eluting stents: results from a single high-volume PCI centre
Conclusions PCI patients with STEMI had the worst hospital and long-term prognosis. The mortality rate after hospital increased markedly in patients with NSTE-ACS. SESs seem to be more effective than PESs.
Source: BMJ Open - August 11, 2014 Category: Journals (General) Authors: Yao, H.-M., Wan, Y.-D., Zhang, X.-J., Shen, D.-L., Zhang, J.-Y., Li, L., Zhao, L.-S., Sun, T.-W. Tags: Open access, Cardiovascular medicine, Surgery Research Source Type: research