Heart : official journal of the British Cardiac Society
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Coronary artery stenting is increasingly used as a treatment for coronary artery disease. A period of antiplatelet therapy is mandatory following coronary stenting, in order to minimise the risk of stent thrombosis. About 5% of patients who undergo coronary stenting will require non-cardiac surgery within 12 months, and the management of antiplatelet therapy in this setting is complex, requiring a balance between the risks of both operative haemorrhage and stent thrombosis. The available evidence to guide decision-making in the management of antiplatelet therapy in this setting is reviewed.
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To evaluate the feasibility and safety of home monitoring of chronic heart failure (CHF) patients using acoustic wireless communication with an implant directly measuring pulmonary artery (PA) pressures. ⋯ Meeting the prespecified safety objective of this study warrants a randomised trial to fully evaluate the potential of home monitoring by this miniature PA implant in guiding long-term management in CHF.
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Review Meta Analysis
Meta-analysis of randomised trials comparing the effectiveness of miniaturised versus conventional cardiopulmonary bypass in adult cardiac surgery.
The aim of this meta-analysis is to summarise the results of prospective, randomised studies comparing miniaturised (Mini-CPB) versus conventional cardiopulmonary bypass (C-CPB). ⋯ This meta-analysis suggests that the use of Mini-CPB may be associated with lower risk of postoperative stroke and blood losses and with a somewhat decreased mortality. However, due to the large heterogeneity of methods and the small number of studies and patients evaluated so far, larger and homogeneous studies should be performed to obtain more conclusive results on the safety and efficacy of Mini-CPB.
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Randomized Controlled Trial Comparative Study
A randomised, controlled study of rate versus rhythm control in patients with chronic atrial fibrillation and heart failure: (CAFE-II Study).
Atrial fibrillation (AF) and heart failure (HF) often coexist. The aim was to investigate whether restoring sinus rhythm (SR) could improve cardiac function, symptoms, exercise capacity and quality of life (QoL) in patients with chronic heart failure. ⋯ Restoring SR in patients with AF and heart failure may improve QoL and LV function when compared with a strategy of rate control.