Circulation journal : official journal of the Japanese Circulation Society
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Randomized Controlled Trial
Effects of remote ischemic preconditioning with postconditioning in patients undergoing off-pump coronary artery bypass surgery--randomized controlled trial.
Myocardial injury is associated with an adverse outcome after off-pump coronary artery bypass graft surgery (OPCAB). The authors conducted a randomized controlled trial to evaluate whether remote ischemic preconditioning (RIPC) with remote ischemic postconditioning (RIPostC) reduces myocardial injury in patients undergoing OPCAB. ⋯ RIPC+RIPostC by lower limb ischemia decreased postoperative myocardial enzyme elevation by almost half postoperatively in patients undergoing OPCAB.
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Randomized Controlled Trial Multicenter Study Comparative Study
Landiolol, an ultra-short-acting β₁-blocker, more effectively terminates atrial fibrillation than diltiazem after open heart surgery: prospective, multicenter, randomized, open-label study (JL-KNIGHT study).
Recent studies have suggested that esmolol is the first choice for rate control in patients with postoperative atrial fibrillation (AF) after coronary artery bypass surgery, but side-effects of esmolol such as hypotension are problematic. To overcome this problem, landiolol, an ultra-short-acting β(1)-blocker with a less negative inotropic effect than esmolol, has been developed. The aim of the present study was to investigate whether landiolol was effective for both rate control and conversion to normal sinus rhythm (NSR). ⋯ Landiolol is more effective and safer than diltiazem for patients with postoperative AF after open heart surgery.
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Randomized Controlled Trial
Effect of tranexamic acid on transfusion requirement in dual antiplatelet-treated anemic patients undergoing off-pump coronary artery bypass graft surgery.
Anemia is not rare in patients presenting for coronary artery bypass graft surgery (CABG) and as these patients are frequently on dual antiplatelet therapy (DAPT), the coexisting conditions could potentially increase the risk of bleeding and transfusion. The aim of this study was to evaluate the effect of tranexamic acid (TA) on blood loss and transfusion in preoperatively anemic patients who continued DAPT until within 5 days of off-pump CABG (OPCAB). ⋯ TA infusion could reduce the amount of transfusion during the perioperative period in patients with preoperative anemia who continue DAPT until within 5 days of OPCAB.
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Randomized Controlled Trial
Randomized study on the efficacy and safety of landiolol, an ultra-short-acting β1-adrenergic blocker, in patients with acute myocardial infarction undergoing primary percutaneous coronary intervention.
It is still controversial whether intravenous administration of β-blocker in the very acute phase of acute myocardial infarction (AMI) is beneficial. Landiolol is an ultra-short-acting β-blocker that has less effect on blood pressure, but little is known about its efficacy and safety for patients with AMI undergoing primary percutaneous coronary intervention (PCI). ⋯ Early intravenous administration of landiolol in patients with AMI undergoing PCI is safe and has the potential to improve cardiac function and inhibit cardiac remodeling in the chronic phase.
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Randomized Controlled Trial
Effect of limb ischemic preconditioning on myocardial injury in patients undergoing mitral valve replacement surgery. -A randomized controlled trial-.
Whether limb ischemic preconditioning (LIPC) is beneficial for patients undergoing mitral valve replacement (MVR) surgery is unknown. ⋯ Myocardial injury is obvious after MVR surgery. LIPC can protect the myocardium from ischemia-reperfusion injury and decrease the inotropic requirement after surgery. The data also confirmed the requirement for the preconditioning stimulus to cross a threshold.