Circulation
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Randomized Controlled Trial Multicenter Study Clinical Trial
Effect of ramipril in reducing sudden deaths and nonfatal cardiac arrests in high-risk individuals without heart failure or left ventricular dysfunction.
ACE inhibitor therapy reduces the risk of cardiovascular death, myocardial infarction, stroke, hospitalization for heart failure, and need for revascularization in high-risk patients with clinical heart failure, overt left ventricular systolic dysfunction, or vascular disease. In patients with clinical heart failure or overt left ventricular systolic dysfunction, ACE inhibitor therapy also reduces the risk of sudden or arrhythmia-related cardiac death. The objective of this study was to assess the effect of the ACE inhibitor ramipril on sudden unexpected death or resuscitated cardiac arrest among the 9297 individuals without clinical heart failure or overt left ventricular dysfunction enrolled in the Heart Outcomes Prevention Evaluation (HOPE) trial. ⋯ Ramipril reduces the risk of fatal and nonfatal serious arrhythmic events in high-risk patients without clinical heart failure or overt left ventricular systolic dysfunction.
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Randomized Controlled Trial Multicenter Study Clinical Trial
Soluble human complement receptor 1 limits ischemic damage in cardiac surgery patients at high risk requiring cardiopulmonary bypass.
This study was undertaken to determine whether soluble human complement receptor type 1 (TP10), a potent inhibitor of complement activation, would reduce morbidity and mortality in high-risk patients undergoing cardiac surgery on cardiopulmonary bypass (CPB). ⋯ TP10 effectively inhibits complement activation during CPB; however, this was not associated with an improvement in the primary endpoint of the study. Nevertheless, TP10 did significantly decrease the incidence of mortality and MI in male patients.
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Neo-aortic root dilation (ARD) and neo-aortic regurgitation (AR) may be progressive after arterial switch operation (ASO) for d-loop transposition of the great arteries (dTGA). We sought to identify predictors of ARD and AR after ASO. ⋯ Significant ARD and AR continue to develop over time after ASO, but ARD does not tend to be progressive during late follow-up. Previous PAB was a significant risk factor for ARD. Older age at time of ASO, presence of VSD, and previous PAB were risk factors for AR.
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Review Comparative Study
Improvement of quality of life after surgery on the thoracic aorta: effect of antegrade cerebral perfusion and short duration of deep hypothermic circulatory arrest.
We have recently demonstrated that the use of deep hypothermic circulatory arrest (DHCA) during surgery for acute type A aortic dissections or thoracic aortic aneurysms adversely affect mid-term quality of life (QoL). The aim of this study is to assess the impact of DHCA duration and the potential effects of antegrade cerebral perfusion (ACP) on mid-term QoL. ⋯ DHCA duration >20 minutes, and especially >35 minutes, adversely affects mid-term QoL in patients undergoing surgery of the thoracic aorta. The use of ACP, however, improved averaged QoL score at each time period and allows DHCA to be extended up to 30 minutes, without impairment in mid-term QoL.
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Comparative Study
Statins are associated with a reduced incidence of perioperative mortality after coronary artery bypass graft surgery.
Statin therapy in nonsurgical patient populations is associated with a significant reduction in adverse cardiovascular events, including death, myocardial infarction (MI), and stroke. Recently, statin therapy was shown to be associated with a reduced incidence of postoperative mortality in patients undergoing major noncardiac vascular surgery. We investigated the influence of preoperative statin therapy on adverse outcomes after primary coronary artery bypass graft (CABG) surgery. ⋯ Preoperative statin therapy may reduce the risk of early mortality after primary CABG surgery with CPB.