International journal of cardiology
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Editorial Comment
Reply to the Hong-Lin Chen article on CONSORT (2010) recommendations.
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The post-pericardiotomy syndrome (PPS) is not uncommon following cardiac surgery and may be a cause of severe complications (cardiac tamponade, large pleural effusion), hospital stay prolongation, and readmissions. The estimated incidence of the syndrome has a relatively wide range affecting from 10 to 40% of patients, depending on the adopted diagnostic criteria, institution, and type of cardiac surgery. On this basis, there is a need for standardized criteria for epidemiological and clinical purposes. ⋯ In any case, pharmacologic preventive strategies are worthy of further investigation. At present, data from 2 RCTs enrolling a total of 471 patients, have shown that colchicine was associated with a reduced risk of PPS (OR=0.38 95% CI 0.22 to 0.65). Available evidence suggests that colchicine 0.5-1.0mg/day is effective for reducing recurrences of pericarditis and at the same doses is efficacious to prevent the PPS.
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The Evaluation of Xience Prime or Xience V versus Coronary Artery Bypass Surgery for Effectiveness of Left Main Revascularization (EXCEL) trial is a multicenter, ongoing trial conducted in patients with left main disease and SYNTAX score ≤ 32 to establish the presumptive advantage of percutaneous coronary intervention (PCI) versus bypass surgery in patients with less complex coronary artery disease than those enrolled in the Synergy between PCI with Taxus and Cardiac Surgery (SYNTAX) trial. In this article, we aimed at critically discussing key features and issues relevant to design and clinical interpretation of this new contemporary trial of left main PCI.