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Off‐ Versus On‐Pump Coronary Surgery and the Effect of

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Offer Details: Off‐pump versus on‐pump coronary‐artery bypass grafting in elderly patients. N Engl J Med. 2013; 368:1189–1198. Crossref Medline Google Scholar; 21 Yu L, Gu T, Shi E, Wang C, Fang Q, Yu Y, Zhao X, Qian C. Off‐pump versus on‐pump coronary artery bypass surgery in patients with triple‐vessel disease and enlarged ventricles. Ann See more ...

Off‐ Versus On‐Pump Coronary Surgery and the Effect of

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Offer Details: “off pump or off-pump or OPCAB,”“beating heart.” The full search strategy can be found in Data S1. All citations were screened for study inclusion independently by 2 investigators (AA and JL). Any disagreements were discussed and resolved by consensus with a third investigator (MG). In addition, the bibliography of all studies and meta-analyses were searched to identify further See more ...

Direct Oral Anticoagulant Use: A Practical Guide to Common

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Offer Details: Off‐label indications: Prevention and treatment of cancer associated deep vein thrombosis: Prevention of thromboembolism after total knee replacement and after total hip replacement: Prevention of thromboembolism after PCI with peripheral artery disease: Betrixaban: FDA‐approved indications: Prevention of deep vein thrombosis and pulmonary embolism in adults hospitalized for an acute See more ...

Hybrid Coronary Revascularization Versus Off‐Pump Coronary

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Offer Details: All double off‐pump CABG (n=216; bypass graft of LITA to LAD and a venous graft to one of the non‐LAD vessels) and HCR (n=147; robotic‐assisted minimally invasive CABG of the LITA to the LAD and PCI to one of the non‐LAD vessels) performed at our institution between March 2004 and November 2015 were included in the analysis. All the robotic‐assisted minimally invasive CABG procedures See more ...

Anomalous Right Coronary Artery and Sudden Cardiac Death

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Offer Details: Further imaging with cardiac computed tomography angiography confirmed an anomalous origin of the RCA, arising from the left cusp via a separate ostium off of the left coronary cusp. In addition, the RCA had an acute angulation with a slit-like opening at the ostium measuring 4×1 mm. The RCA demonstrated an interarterial proximal course between the pulmonary artery and aorta. Further workup See more ...

ACC/AHA Guidelines for Coronary Artery Bypass Graft

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Offer Details: Alternatively, a combined approach with off-bypass, in situ internal mammary grafting to the LAD and percutaneous coronary intervention to treat other vessel stenoses has conceptual merit. Atrial Fibrillation and Stroke. Chronic atrial fibrillation is a hazard for perioperative stroke. Intraoperative surgical manipulation or spontaneous resumption of sinus rhythm during the early postoperative See more ...

Periprocedural Bridging Management of Anticoagulation

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Offer Details: From the Division of Cardiovascular Medicine, Section of Hematology Research, Mayo Clinic, Rochester, MN. More than 2.5 million Americans are chronically anticoagulated for indications including venous thromboembolism (VTE), mechanical heart valve(s), or atrial fibrillation (AF). 1 Each year, ≈10% See more ...

Six-Month Results of Treatment-Blinded Medication

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Offer Details: Patients were to remain off antihypertensive medications throughout the initial 2 months of follow-up unless specified office or home BP criteria were exceeded (180/110 mm Hg or 170/105 mm Hg, respectively. 1,2 Of note, 5 patients in the RDN group and 13 in the sham group were started on antihypertensive medications prior to the 2-month visit by physicians blinded to the randomization. 2 From See more ...

Optimizing Cutoff Scores for the Barthel Index and the

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Offer Details: The items bathing and grooming are scored 0 or 5; the items feeding, dressing, controlling bladder, controlling bowel, getting onto and off the toilet, and ascending and descending stairs are scored 0, 5, or 10. Items regarding moving from wheelchair to bed and walking on level surface are scored 0, 5, 10, or 15. The total BI is a cumulative score of the 10 items, with a maximum score of 100 See more ...

Cardiogenic Shock | Journal of the American Heart Association

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Offer Details: On or Off dosing, can cause hyponatremia: Dobutamine: B agonist: Inotropy and mild vasodilation: Commonly used in cardiogenic shock: May contribute to hypotension: Levosimendan: Myofilament Ca 2+ sensitizer and K + channel modifier: Ionotropy and inodilator: Used in acutely decompensated chronic heart failure: Minimal effect on myocardial oxygen consumption : CS indicates cardiogenic shock See more ...

Off-Pump Coronary Artery Bypass Surgery Is Associated With

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Offer Details: Off-pump coronary artery bypass is associated with improved risk-adjusted outcomes. Ann Thorac Surg. 2001; 72:114–119. Crossref Medline Google Scholar; 8. Cleveland JC, Shroyer AL, Chen AY, Peterson E, Grover FL. Off-pump coronary artery bypass grafting decreases risk-adjusted mortality and morbidity. Ann Thorac Surg. 2001; 72:1282–1289. See more ...

Five-Year Outcome After Off-Pump or On-Pump Coronary

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Offer Details: Off-pump coronary artery bypass may increase late mortality: a meta-analysis of randomized trials. Ann Thorac Surg. 2010; 89:1881–1888. doi: 10.1016/j.athoracsur.2010.03.010 Crossref Medline Google Scholar; 10. Thourani VH, Guyton RA. Graft patency after off-pump coronary artery bypass surgery. Circulation. See more ...

Acute Kidney Injury After Coronary Artery Bypass Grafting

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Offer Details: Kidney function after off-pump or on-pump coronary artery bypass graft surgery: a randomized clinical trial. JAMA. 2014; 311:2191–2198. Crossref Medline Google Scholar; 15. Jernberg T, Attebring MF, Hambraeus K, Ivert T, James S, Jeppsson A, Lagerqvist B, Lindahl B, Stenestrand U, Wallentin L. The Swedish Web-System for Enhancement and Development of Evidence-Based Care in Heart Disease See more ...

Long-Term Survival and Freedom From Reintervention After

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Offer Details: For example, the ROOBY trial (Veterans Affairs Randomized On/Off Bypass) was noted to have a conversion rate 6 times the national average, with OPCAB surgeons defined as those who had performed only ≥20 off-pump cases. 6 The second-largest trial in the meta-analysis had experienced surgeons performing OPCAB, but excluded patients <75 years of age and only followed up patients for 12 months See more ...

Comparing On-Pump and Off-Pump Coronary Artery Bypass

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Offer Details: Conversion in off-pump coronary artery bypass grafting: an analysis of predictors and outcomes. Ann Thorac Surg. 2003; 76: 1138–1143. Crossref Medline Google Scholar; 29 Jin R, Hiratzka LF, Grunkemeier GL, Krause A, Page US. Aborted off-pump coronary artery bypass patients have much worse outcomes than on-pump or successful off-pump patients. See more ...

Coronary Bypass Surgery Performed off Pump Does Not Result

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Offer Details: Off-pump coronary revascularization: current state of the art. Semin Thorac Cardiovasc Surg. 2002; 14: 70–81. Crossref Medline Google Scholar; 21 Hoff SJ, Ball SK, Coltharp WH, et al. Coronary artery bypass in patients 80 years and over: is off-pump the operation of choice? Ann Thorac Surg. 2002; 74: S1340–S1343. Crossref Medline Google Scholar See more ...

On-Pump and Off-Pump Coronary Artery Bypass Grafting

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Offer Details: Off-pump CABG is a newer technique with the proposed benefit of lower complication rates. It is a highly specialized technique that has good results in the hands of surgeons who perform this surgery regularly. The choice of procedure should depend on the comfort level of the surgeon performing the procedure on a particular patient because the 2 procedures seem equally effective. The See more ...

Canagliflozin for Primary and Secondary Prevention of

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Offer Details: All analyses of the effects of canagliflozin compared with placebo on cardiovascular and renal outcomes were based on the intention-to-treat principle using all follow-up time (on or off study treatment) for all randomized participants. Safety outcomes were analyzed using an on-treatment approach (based on patient time and events accrued while on study drug or within 30 days of study drug See more ...

Long-QT Syndrome | Circulation: Arrhythmia and

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Offer Details: There is an overall consensus for immediately implanting an ICD in cases in which there has been a documented cardiac arrest, either on or off therapy. Some exceptions exist, such as in a clear case of a drug-induced event in an otherwise asymptomatic patient with modest QT prolongation. In contrast, opinions differ strongly regarding the use of ICDs in patients without cardiac arrest. See more ...

Is There a Role for Preoperative Platelet Function Testing

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Offer Details: On-pump or off-pump CABG: Clopidogrel (n=149) Clopidogrel-naive (n=127) Retrospective, observational: VerifyNowP2Y 12 PRU: Low PRU had incrementally greater incidence of high chest tube drainage (OR, 1.72; P=0.002) and coagulation factor transfusion (OR, 2.08; P<0.001) than high PRU/clopidogrel-naive patients: Reed et al, 2015 67: CABG, aspirin and clopidogrel (n=39) Prospective, observational See more ...

Low-Dose Rivaroxaban and Risks of Adverse Events in

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Offer Details: Compared with off-label low-dose group, on-label dosing rivaroxaban was associated with a positive net clinical benefit in different weighted models. The results were consistent among the propensity-matched cohort. Conclusions— Off-label low-dosing rivaroxaban should be avoided for Asian patients with AF giving the higher risk of ischemic stroke without risk reduction in intracranial See more ...

Beyond Indications | Circulation: Cardiovascular Interventions

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Offer Details: The limitations in our knowledge are not specific to off-label and one-off circumstances, but often pertain equally to the approved, labeled indication(s) for the device. Thus the enthusiasm for and recent emphasis by the FDA on improved and expanded mechanisms of postmarket surveillance to bolster the US system for regulation of medical devices. The conundrums that can arise from a lack of See more ...

Optimal Cutoff Value of Fractional Flow Reserve Derived

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Offer Details: CLINICAL PERSPECTIVE. Fractional flow reserve (FFR) derived from coronary computed tomography angiography (FFR CT) is a novel noninvasive diagnostic tool for detecting hemodynamically significant coronary artery disease.However, the optimal cutoff value of FFR CT has not yet been adequately defined, although FFR CT ≤0.80 is empirically used as the cutoff for proceeding to invasive coronary See more ...

Randomized Comparison Between Stenting and Off-Pump Bypass

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Offer Details: Off-pump surgery, however, was associated with fewer repeat revascularizations, and these patients were more likely to be free of angina and medication. Yet, there was no difference in quality of life, and stenting was associated with lower costs. With respect to the in-hospital events as a measure of safety, there was a trend toward fewer events in favor of stenting. Considering the See more ...

Effects of Magnesium Supplementation on Blood Pressure

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Offer Details: ‡ Medication history represented for taking antihypertensive or antidiabetic drugs during the period of study or off medication <1 mo before entering the current study. § Trial quality was evaluated by Jadad score. Low: ≤3 and high: >3. Eleven trials used a crossover study design, and others were parallel designed; 55% (908) of the study population were women, and 45% (751) were men. The See more ...

Treatment of Blood Clots | Circulation

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Offer Details: The filter prevents large blood clots from reaching the lungs after breaking off from the pelvic or deep leg veins. However, the filter does not halt the blood clotting process. 5. LMWH. LMWHs have transformed acute uncomplicated DVT from a disease requiring at least a 5-day hospitalization to an illness that can usually be managed either on an outpatient basis or with an overnight hospital See more ...

Future of Hypertension | Hypertension

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Offer Details: However, further research will be needed to prevent off-target effects, unwanted immune effects, and validate the efficacy of the technology in clinical trials. In the future, genome editing (using CRISPR-Cas9) holds promise for curing genetic hypertension, and in targeting angiotensinogen and other targets, resulting in possible long-term control of essential hypertension. Regenerative See more ...

Optimal Cutoff Levels of More Sensitive Cardiac Troponin

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Offer Details: 2042 Circulation June 9, 2015 evaluation of alternative diagnoses and contribute to medical errors and costs associated with crowding in the emergency department (ED).7–9 For several reasons, patients with renal dysfunction merit See more ...

Optimal Cutoff Levels of More Sensitive Cardiac Troponin

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Offer Details: Introduction. Acute myocardial infarction (AMI) is a major cause of death and disability in Europe and the United States. 1 Its rapid and accurate diagnosis is critical for effective evidence-based medical management and treatment 2 – 4 but is still an unmet clinical need. Delays in diagnosing disease (“rule in”) hold back prompt use of evidence-based therapies. 5,6 Delays in excluding See more ...

On-Pump Versus Off-Pump Coronary Artery Bypass Surgery in

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Offer Details: If the procedure is performed off-pump, this code is recorded as zero. If, however, a procedure was started off-pump and then converted, it would be recorded as “on-pump.” There was a wide range in the number and percentage of off-pump procedures performed at the different sites. The average hospital performed 266 isolated CABG procedures See more ...

Use of Montreal Cognitive Assessment in Patients With Stroke

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Offer Details: The choice of the normality cut-off score for MoCA in patients with stroke is a crucial issue. Godefroy et al, 11 using published norms, found that 82% of their patients with acute stroke had a score below the normality. When the cut-off was adjusted for education and age, the proportion of patients decreased to 48%.11 Similarly, Lees et al,33 using the original cut-off of 26, diagnosed See more ...

Renal Considerations in Angiotensin Converting Enzyme

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Offer Details: Renal and Systemic Effects of Ang II During Volume Depletion and CHF. Under normal physiological conditions, renal autoregulation adjusts renal vascular resistance, so that RBF and GFR remain constant over a wide range of MAPs. 1 The intrinsic renal autoregulation mechanism is adjusted by Ang II and the sympathetic nervous system. When renal perfusion pressure falls (as in hypovolemia or CHF See more ...

Off-Label Use of Direct Oral Anticoagulants in

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Offer Details: Off-label use of direct oral anticoagulants in intracerebral hemorrhage patients with prosthetic valves. Yes, Off-Label Use of Direct Oral Anticoagulants Should Be Considered in Intracerebral Hemorrhage Patients With Prosthetic Valves Seemant Chaturvedi In this patient, the conventional treatment approach would be to place him back on a vitamin K antagonist (VKA) once the hemorrhage has See more ...

Ultrasound for Lower Extremity Deep Venous Thrombosis

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Offer Details: There are circumstances (eg, emergency departments, rural areas, off hours) when a complete study cannot be performed in a clinically relevant time frame. In this situation, if point-of-care ultrasound can be performed by a competent practitioner, it should be performed. 46,47. Extended compression ultrasound is a point-of-care protocol that has compression ultrasound from the inguinal See more ...

Cardiac Arrest in Pregnancy | Circulation

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Offer Details: Rees and Willis 52 found that at >30° left lateral tilt, the manikin slid off the incline plane and that chest compression force was reduced as the angle of inclination was increased. It has also been found that at >30° lateral tilt, inferior vena cava compression can still occur. 53 In addition, the heart has been shown to shift laterally during tilt 54 compared with the supine position See more ...

Redefining the Blanking Period After Catheter Ablation for

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Offer Details: One-year freedom from symptomatic AT off antiarrhythmic drugs after a single ablation procedure was 70.4% in patients without ER compared with 58.7%, 36.4%, and 6.1% in patients with ER 1, 2, and 3 months post ablation (P<0.0001). All 2-by-2 comparisons were statistically significant. Similar results were obtained when the end point of recurrence of any AT (symptomatic or asymptomatic) was See more ...

Low-Dose Aspirin Discontinuation and Risk of

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Offer Details: Absolute risks Off aspirin: from the end of the grace period. Although the hypothesis is answered with the use of groups 1 and 4, the other 2 groups are included for transparency. Persistence patterns were described for both aspirin-naïve patients and long-term aspirin users. Timing of Events After Aspirin Discontinuation For this set of analyses, we sought to determine the risk of See more ...

Classification of Blood Pressure Levels by Ambulatory

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Offer Details: of 0.46 and 0.61 for systolic and diastolic blood pressure, respectively (P 0.0001 for both; Figures 1A and 1B). The blood pressure. Blood Pressure See more ...

Montreal Cognitive Assessment

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Offer Details: off scores were described as consistent when the classifications of the single and norm-derived cutoff scores agreed with each other; a miss was defined when a patient classified as impaired by the norm was classified as unimpaired by the single cutoffs; a false positive was determined when a patient classified as unimpaired by the norm was classified as impaired by the single cutoff scores See more ...

Implantable Cardioverter-Defibrillator Shocks in Dying

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Offer Details: In the Sudden Cardiac Death in Heart Failure trial, 63% of ICD recipients died in the hospital. 19 Also, as noted by the authors, 20% of the devices had detection turned off at the time of death, and so the terminal rhythm could not be determined, although this was unlikely to create a systematic bias. See more ...

Management of Left Main Coronary Artery Disease

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Offer Details: the LM branches, the calculated LM-MLA cutoff by linear law was 5.8 mm.23 Although IVUS is good at describing the anatomical extent of disease, the LM-MLA cutoff for determining a functionally See more ...

On-Pump Versus Off-Pump Coronary Artery Bypass Surgery in

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Offer Details: Off-pump coronary artery bypass grafting (OPCAB) has been suggested to reduce the number of perioperative complications, especially in elderly patients. In a multicenter, randomized trial, we assigned 900 patients >70 years of age to conventional coronary artery bypass grafting or OPCAB surgery. The primary end point was to test the noninferiority of a composite end point of death, stroke, and See more ...

Low-Dose Aspirin Discontinuation and Risk of

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Offer Details: Off aspirin is from the end of the grace period. Subgroup analyses further revealed that patients with higher age and prior cardiovascular disease were at higher risk increase for cardiovascular events when off aspirin, whereas treatment with oral anticoagulant or other antiplatelet drugs was associated with lower risk increase for cardiovascular events when off aspirin . The majority (54%) of See more ...

Open-Label Dose-Titration Safety and Efficacy Study of

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Offer Details: weeks 4, 8, 16, and 18 (after 1 week off tizanidine). The safety profile of tizanidine was assessed through recording of adverse events, laboratory values, and vital signs. The primary outcome measure was the change in spasticity from baseline to week 16, evaluated by adding individual MAS scores to give a total MAS score for the upper extremity. Additional outcome measures included change See more ...

Neurocardiogenic Syncope and Related Disorders of

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Offer Details: Hypotension, sliding off bed, leg cramps: Elastic support hose: Requires at least 30–40 mm Hg ankle counterpressure, works best if waist high: Uncomfortable, hot, difficult to get on: Diet * Fluid intake of 2–2.5 L/d Na + intake of 150–250 mEq/d: Supine hypertension; peripheral edema: Exercise : Aerobic exercise (mild) may aid venous return; water exercise particularly helpful: May lower See more ...

Guidelines for the Management of Aneurysmal Subarachnoid

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Offer Details: that the trend either is continuing or has leveled off.27 Racial differences in mortality have emerged, with white Americans having a lower mortality rate than black Americans, Hispanic Americans, American Indians/Alaskan Natives, and Asian/ Pacific Islanders in the United States.35 Risk Factors for Aneurysmal SAH Risk factors for SAH have been studied in a number of settings. Multivariate See more ...

On-Pump Versus Off-Pump Coronary Artery Bypass Surgery in

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Offer Details: On/Off Bypass (ROOBY) trial comprising 2203 mainly younger patients showed better long-term outcome of CCABG than of OPCAB.6 Studies comparing self-assessed symp-toms and quality of life (QoL) in younger patients have failed to show a significant benefit of 1 method over another. 11–14 Age is an independent predictor of major complications after cardiac surgery. Several authors have claimed See more ...

Use of Dual Antiplatelet Therapy Following Ischemic Stroke

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Offer Details: Figure. Diffusion restriction (A) with apparent diffusion coefficient (B) correlate in right pons.The role of single antiplatelet agents after stroke is well established, and several large studies support its use. See more ...

Comparing On-Pump and Off-Pump Coronary Artery Bypass

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Offer Details: Off-pump coronary artery bypass grafting provides complete revascularization with reduced myocardial injury, transfusion requirements, and length of stay: a prospective randomized comparison of two hundred unselected patients undergoing off-pump versus conventional coronary artery bypass grafting. J Thorac Cardiovasc Surg. 2003; 125: 797–808. See more ...

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