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Coronary Artery Disease: HELP
Articles from Singapore Republic
Based on 368 articles published since 2009
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These are the 368 published articles about Coronary Artery Disease that originated from Singapore Republic during 2009-2019.
 
+ Citations + Abstracts
Pages: 1 · 2 · 3 · 4 · 5 · 6 · 7 · 8 · 9 · 10 · 11 · 12 · 13 · 14 · 15
1 Guideline Novel targets and future strategies for acute cardioprotection: Position Paper of the European Society of Cardiology Working Group on Cellular Biology of the Heart. 2017

Hausenloy, Derek J / Garcia-Dorado, David / Bøtker, Hans Erik / Davidson, Sean M / Downey, James / Engel, Felix B / Jennings, Robert / Lecour, Sandrine / Leor, Jonathan / Madonna, Rosalinda / Ovize, Michel / Perrino, Cinzia / Prunier, Fabrice / Schulz, Rainer / Sluijter, Joost P G / Van Laake, Linda W / Vinten-Johansen, Jakob / Yellon, Derek M / Ytrehus, Kirsti / Heusch, Gerd / Ferdinandy, Péter. ·The Hatter Cardiovascular Institute, University College London, 67 Chenies Mews, London WC1E 6HX, UK; The National Institute of Health Research University College London Hospitals Biomedical Research Centre, 149 Tottenham Court Road London, W1T 7DN, UK; Cardiovascular and Metabolic Disorders Program, Duke-National University of Singapore, 8 College Road, Singapore 169857; National Heart Research Institute Singapore, National Heart Centre Singapore, 5 Hospital Dr, Singapore 169609, Singapore; Yong Loo Lin School of Medicine, National University Singapore, Singapore; Barts Heart Centre, St Bartholomew's Hospital, London, UK. · Department of Cardiology, Vall d Hebron University Hospital and Research Institute. Universitat Autònoma, Passeig de la Vall d'Hebron, 119-129, 08035 Barcelona, Spain. · Department of Cardiology, Aarhus University Hospital Skejby, Palle Juul-Jensens Boulevard 99, 8200 Aarhus N, Denmark. · The Hatter Cardiovascular Institute, University College London, 67 Chenies Mews, London WC1E 6HX, UK. · Department of Physiology and Cell Biology, College of Medicine, University of South Alabama, 5851 USA Dr. N., MSB 3074, Mobile, AL 36688, USA. · Experimental Renal and Cardiovascular Research, Department of Nephropathology, Institute of Pathology, Friedrich-Alexander-Universität Erlangen-Nßrnberg, Schloßplatz 4, 91054 Erlangen, Germany. · Department of Cardiology, Duke University, Durham, NC 27708, USA. · Department of Medicine,  Hatter  Institute for Cardiovascular Research in Africa and South African Medical Research Council Inter-University Cape Heart Group, Faculty of Health Sciences, University of Cape Town, Chris Barnard Building, Anzio Road, Observatory, 7925, Cape Town, Western Cape, South Africa. · Tamman Cardiovascular Research Institute, Sheba Medical Center, Tel Hashomer, Israel; Neufeld Cardiac Research Institute, Tel-Aviv University, Sheba Medical Center, Tel Hashomer, 5265601, Israel; Sheba Center for Regenerative Medicine, Stem Cell, and Tissue Engineering, Tel Hashomer, 5265601, Israel. · Center of Aging Sciences and Translational Medicine - CESI-MeT, "G. d'Annunzio" University, Chieti, Italy; Institute of Cardiology, Department of Neurosciences, Imaging, and Clinical Sciences, "G. d'Annunzio University, Chieti, Italy; Texas Heart Institute and University of Texas Medical School in Houston, Department of Internal Medicine, 6770 Bertner Avenue, Houston, Texas 77030 USA. · Explorations Fonctionnelles Cardiovasculaires, Hôpital Louis Pradel, 28 Avenue du Doyen Jean Lépine, 69500 Bron, France; UMR 1060 (CarMeN), Université Claude Bernard Lyon, 43 Boulevard du 11 Novembre 1918, 69100 Villeurbanne, France. · Department of Advanced Biomedical Sciences, Division of Cardiology, Federico II University Corso Umberto I, 40, 80138 Napoli, Italy. · Department of Cardiology, University of Angers, University Hospital of Angers, 4 Rue Larrey, 49100 Angers, France. · Institute of Physiology, Justus-Liebig, University of Giessen, Ludwigstraße 23, 35390 Gießen, Germany. · Cardiology and UMC Utrecht Regenerative Medicine Center, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, Netherlands. · Division Heart and Lungs, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, Netherlands. · Division of Cardiothoracic Surgery, Department of Surgery, Emory University, 201 Dowman Dr, Atlanta, GA 30322, USA. · The Hatter Cardiovascular Institute, University College London, 67 Chenies Mews, London WC1E 6HX, UK; The National Institute of Health Research University College London Hospitals Biomedical Research Centre, 149 Tottenham Court Road London, W1T 7DN, UK. · Cardiovascular Research Group, Department of Medical Biology, UiT The Arctic University of Norway, Hansine Hansens veg 18, 9019 Tromsø, Norway. · Institute for Pathophysiology, West-German Heart and Vascular Center, University Hospital Essen, Hufelandstrasse 55, 45147 Essen, Germany. · Department of Pharmacology and Pharmacotherapy, Semmelweis University, Budapest, Nagyvárad tér 4, 1089 Hungary; Pharmahungary Group, Graphisoft Park, 7 Záhony street, Budapest, H-1031, Hungary. ·Cardiovasc Res · Pubmed #28453734.

ABSTRACT: Ischaemic heart disease and the heart failure that often results, remain the leading causes of death and disability in Europe and worldwide. As such, in order to prevent heart failure and improve clinical outcomes in patients presenting with an acute ST-segment elevation myocardial infarction and patients undergoing coronary artery bypass graft surgery, novel therapies are required to protect the heart against the detrimental effects of acute ischaemia/reperfusion injury (IRI). During the last three decades, a wide variety of ischaemic conditioning strategies and pharmacological treatments have been tested in the clinic-however, their translation from experimental to clinical studies for improving patient outcomes has been both challenging and disappointing. Therefore, in this Position Paper of the European Society of Cardiology Working Group on Cellular Biology of the Heart, we critically analyse the current state of ischaemic conditioning in both the experimental and clinical settings, provide recommendations for improving its translation into the clinical setting, and highlight novel therapeutic targets and new treatment strategies for reducing acute myocardial IRI.

2 Editorial The Challenge of Percutaneous Coronary Intervention in Small Vessels. 2017

Loh, Joshua P / Ananthakrishna, Rajiv. ·Department of Cardiology, National University Heart Centre, Singapore. Electronic address: Joshua_py_loh@nuhs.edu.sg. · Department of Cardiology, National University Heart Centre, Singapore. ·Cardiovasc Revasc Med · Pubmed #28131331.

ABSTRACT: -- No abstract --

3 Editorial Bioresorbable Vascular Scaffolds in Routine Clinical Practice: Should We Wait Longer? 2016

Tan, Huay Cheem / Ananthakrishna, Rajiv. ·Department of Cardiology, National University Heart Centre, Singapore. Electronic address: tanhuaycheem@gmail.com. · Department of Cardiology, National University Heart Centre, Singapore. ·JACC Cardiovasc Interv · Pubmed #27476091.

ABSTRACT: -- No abstract --

4 Editorial Biodegradable vascular scaffold: is optimal expansion the key to minimising flow disturbances and risk of adverse events? 2015

Foin, Nicolas / Torii, Ryo / Mattesini, Alessio / Wong, Philip / Di Mario, Carlo. ·National Heart Centre Singapore, Singapore. ·EuroIntervention · Pubmed #25420789.

ABSTRACT: -- No abstract --

5 Review Machine learning-based coronary artery disease diagnosis: A comprehensive review. 2019

Alizadehsani, Roohallah / Abdar, Moloud / Roshanzamir, Mohamad / Khosravi, Abbas / Kebria, Parham M / Khozeimeh, Fahime / Nahavandi, Saeid / Sarrafzadegan, Nizal / Acharya, U Rajendra. ·Institute for Intelligent Systems Research and Innovation (IISRI), Deakin University, Australia. Electronic address: ralizadehsani@deakin.edu.au. · Département d'informatique, Université du Québec à Montréal, Montréal, Québec, Canada. · Department of Electrical and Computer Engineering, Isfahan University of Technology, Isfahan, Iran. · Institute for Intelligent Systems Research and Innovation (IISRI), Deakin University, Australia. · Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran. · Faculty of Medicine, SPPH, University of British Columbia, Vancouver, BC, Canada; Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Khorram Ave, Isfahan, Iran. · Department of Electronics and Computer Engineering, Ngee Ann Polytechnic, Singapore; Department of Biomedical Engineering, School of Science and Technology, Singapore University of Social Sciences, Singapore; Department of Biomedical Engineering, Faculty of Engineering, University of Malaya, Malaysia. ·Comput Biol Med · Pubmed #31288140.

ABSTRACT: Coronary artery disease (CAD) is the most common cardiovascular disease (CVD) and often leads to a heart attack. It annually causes millions of deaths and billions of dollars in financial losses worldwide. Angiography, which is invasive and risky, is the standard procedure for diagnosing CAD. Alternatively, machine learning (ML) techniques have been widely used in the literature as fast, affordable, and noninvasive approaches for CAD detection. The results that have been published on ML-based CAD diagnosis differ substantially in terms of the analyzed datasets, sample sizes, features, location of data collection, performance metrics, and applied ML techniques. Due to these fundamental differences, achievements in the literature cannot be generalized. This paper conducts a comprehensive and multifaceted review of all relevant studies that were published between 1992 and 2019 for ML-based CAD diagnosis. The impacts of various factors, such as dataset characteristics (geographical location, sample size, features, and the stenosis of each coronary artery) and applied ML techniques (feature selection, performance metrics, and method) are investigated in detail. Finally, the important challenges and shortcomings of ML-based CAD diagnosis are discussed.

6 Review Computer-aided diagnosis of congestive heart failure using ECG signals - A review. 2019

Jahmunah, V / Oh, Shu Lih / Wei, Joel Koh En / Ciaccio, Edward J / Chua, Kuang / San, Tan Ru / Acharya, U Rajendra. ·Department of Electronics and Computer Engineering, Ngee Ann Polytechnic, Singapore. Electronic address: e0145834@u.nus.edu. · Department of Electronics and Computer Engineering, Ngee Ann Polytechnic, Singapore. · Department of Medicine - Cardiology, Columbia University, USA. · National Heart Centre, Singapore. · Department of Electronics and Computer Engineering, Ngee Ann Polytechnic, Singapore; Department of Biomedical Engineering, School of Science and Technology, Singapore University of Social Sciences, Singapore; School of Medicine, Faculty of Health and Medical Sciences, Taylor's University, 47500 Subang Jaya, Malaysia. Electronic address: aru@np.edu.sg. ·Phys Med · Pubmed #31153403.

ABSTRACT: The heart muscle pumps blood to vital organs, which is indispensable for human life. Congestive heart failure (CHF) is characterized by the inability of the heart to pump blood adequately throughout the body without an increase in intracardiac pressure. The symptoms include lung and peripheral congestion, leading to breathing difficulty and swollen limbs, dizziness from reduced delivery of blood to the brain, as well as arrhythmia. Coronary artery disease, myocardial infarction, and medical co-morbidities such as kidney disease, diabetes, and high blood pressure all take a toll on the heart and can impair myocardial function. CHF prevalence is growing worldwide. It afflicts millions of people globally, and is a leading cause of death. Hence, proper diagnosis, monitoring and management are imperative. The importance of an objective CHF diagnostic tool cannot be overemphasized. Standard diagnostic tests for CHF include chest X-ray, magnetic resonance imaging (MRI), nuclear imaging, echocardiography, and invasive angiography. However, these methods are costly, time-consuming, and they can be operator-dependent. Electrocardiography (ECG) is inexpensive and widely accessible, but ECG changes are typically not specific for CHF diagnosis. A properly designed computer-aided detection (CAD) system for CHF, based on the ECG, would potentially reduce subjectivity and provide quantitative assessment for informed decision-making. Herein, we review existing CAD for automatic CHF diagnosis, and highlight the development of an ECG-based CAD diagnostic system that employs deep learning algorithms to automatically detect CHF.

7 Review Nonsteroidal anti-inflammatory drug hypersensitivity in the Asia-Pacific. 2018

Thong, Bernard Yu-Hor. ·Department of Rheumatology, Allergy and Immunology, Tan Tock Seng Hospital, Singapore 308433. ·Asia Pac Allergy · Pubmed #30402405.

ABSTRACT: Nonsteroidal anti-inflammatory drug (NSAID) hypersensitivity reactions (HSRs) are often nonimmunologically mediated reactions which present with immediate HSR type manifestations. These are mediated by cyclooxygenase inhibition resulting in shunting towards the excessive production of leukotrienes. Important disease associations include asthma, nasal polyposis, and chronic spontaneous urticaria, especially among adults. The European Network on Drug Allergy/Global Allergy and Asthma European Network 2013 classification of NSAID HSR comprises nonselective HSR i.e., NSAID exacerbated respiratory disease (NERD), NSAIDs exacerbated cutaneous disease (NECD), NSAIDs induced urticarial-angioedema (NIUA); and selective (allergic) HSR i.e., single NSAID induced urticaria/angioedema or anaphylaxis, NSAIDs-induced delayed HSR. Much of the literature on genetic associations with NSAID HSR originate from Korea and Japan; where genetic polymorphisms have been described in genes involved in arachidonic acid metabolism, basophil/mast cell/eosinophil activation, various inflammatory mediators/cytokines, and different HLA genotypes. The Asian phenotype for NSAID HSR appears to be predominantly NIUA with overlapping features in some adults and children. NECD also appears to be more common than NERD, although both are not common in the Asian paediatric population. Between adults and children, children seem to be more atopic, although over time when these children grow up, it is likely that the prevalence of atopic adults with NSAID HSR will increase. Low-dose aspirin desensitization has been shown to be effective in the treatment of coronary artery disease, especially following percutaneous coronary intervention.

8 Review Treatment of obstructive sleep apnoea as primary or secondary prevention of cardiovascular disease: where do we stand now? 2018

Drager, Luciano F / Lee, Chi-Hang. ·Hypertension Unit, Heart Institute (InCor). · Hypertension Unit, Renal Division, University of Sao Paulo Medical School, Sao Paulo, Brazil. · Department of Cardiology, National University Heart Centre, Singapore, Singapore. ·Curr Opin Pulm Med · Pubmed #30124525.

ABSTRACT: PURPOSE OF REVIEW: The aim of this study was to provide an update of the primary and secondary prevention of obstructive sleep apnoea (OSA) treatment on cardiovascular disease. RECENT FINDINGS: Consistent evidence suggest that OSA can contribute to cardiovascular diseases, including hypertension, atrial fibrillation, coronary artery disease and stroke. In patients with no previous history of cardiovascular events (primary prevention scenario), observational studies suggest that continuous positive airway pressure (CPAP), the main treatment for OSA, is able to prevent hypertension incidence and to decrease nonfatal cardiovascular events in men and fatal cardiovascular events in men, women and elderly. In patients with a previous history of cardiovascular events (secondary prevention scenario), recent randomized trials showed that CPAP was not able to prevent a new cardiovascular event. These findings may suggest that in patients with high cardiovascular risk and multiple comorbidities, OSA may not have an incremental role on cardiovascular disease. However, a subanalysis from the same trials showed that good CPAP compliance was able to prevent cerebrovascular events. SUMMARY: OSA may predispose to cardiovascular disease, but additional efforts for improving CPAP use or development of new treatments may help to understand the magnitude of OSA on cardiovascular disease.

9 Review Coronary manifestations of Kawasaki Disease in computed tomography coronary angiography. 2018

Goh, Yong Geng / Ong, Ching Ching / Tan, Grace / Liang, Chong Ri / Soomar, Sanah Merchant / Terence Lim, Chee Wen / Quek, Swee Chye / Teo, Li San Lynette. ·Department of Diagnostic Imaging, National University Hospital (NUH), 5 Lower Kent Ridge Road, Singapore 119074. · Division of Paediatric Cardiology, Khoo Teck Puat-National University Children's Medical Institution National University Hospital (NUH), 5 Lower Kent Ridge Road, Singapore 119074. · Department of Diagnostic Imaging, National University Hospital (NUH), 5 Lower Kent Ridge Road, Singapore 119074. Electronic address: lynette_ls_teo@nuhs.edu.sg. ·J Cardiovasc Comput Tomogr · Pubmed #29426687.

ABSTRACT: Coronary arteritis in Kawasaki disease can lead to serious complications such myocardial infarction and sudden death. The identification of coronary manifestations with a method that is minimally invasive and of low radiation exposure is therefore important in paediatric patients with Kawasaki disease. Coronary CT angiography can be an attractive alternative to invasive coronary angiography. This paper describes imaging techniques for coronary CT angiography in pediatric patients and demonstrates the spectrum of cardiovascular manifestations in patients with Kawasaki disease.

10 Review Drug-Coated Balloons: Technologies and Clinical Applications. 2018

Ang, Huiying / Lin, Jinjie / Huang, Ying Ying / Chong, Tze Tec / Cassese, Salvatore / Joner, Michael / Foin, Nicolas. ·National Heart Centre Singapore, 5 Hospital Drive, Singapore 169609, Singapore. · School of Materials Science and Engineering, Nanyang Technological University, Nanyang Avenue, Singapore 639798, Singapore. · Department of Vascular Surgery, Singapore General Hospital, 169608 Singapore, Singapore. · Deutsches Herzzentrum Munchen, Technische Universitat Munchen, Munich 80636, Germany. · Duke-NUS Medical School, 8 College Road, Singapore 169857, Singapore. ·Curr Pharm Des · Pubmed #29283056.

ABSTRACT: The progress and development of drug-coated balloons (DCBs) represents an emerging alternative treatment in peripheral and coronary artery diseases, particularly when a non-stent approach is necessary. Several studies and meta-analyses have evaluated the clinical outcomes of DCBs in different lesions and this review aims to compile the progress and updated clinical data of DCB strategy in both peripheral artery diseases (PAD) and coronary artery diseases (CAD). The review highlights that clinical data has encouraged the use of DCB for applications in PAD and in the treatment of coronary in-stent restenosis (ISR). The employment of DCB in side branch treatment of bifurcation lesions has been reported to be feasible and safe, with good angiographic and clinical outcome. The use of DCB for arteriovenous fistula and grafts stenoses is a promising strategy, but more clinical data is required to draw reliable conclusions. The limitations and impact of the current generation of DCBs will be discussed and the clinical development of newer generation of the device is also covered in this review.

11 Review Alopecia and the metabolic syndrome. 2018

Lie, Cheryl / Liew, Choon Fong / Oon, Hazel H. ·National Skin Centre, Singapore. · Raffles Hospital, Diabetes and Endocrine Center, Singapore. · National Skin Centre, Singapore. Electronic address: hazeloon@nsc.com.sg. ·Clin Dermatol · Pubmed #29241753.

ABSTRACT: Hair loss is a common condition that affects most people at some point in their lives. It can exist as an isolated problem or with other diseases and conditions. Androgenetic alopecia (AGA) and its association with the metabolic syndrome (MetS) have received increasing interest since 1972, when the first link between cardiovascular risk factors and hair loss was raised. We have reviewed studies concerning the relationship between alopecia and MetS. Many studies have investigated the relationship among AGA and MetS and its individual components, particularly in men, where a disproportionately large number of these studies supports this association. AGA has also been associated with other metabolic-related conditions, including coronary artery disease, polycystic ovary syndrome, and Cushing syndrome, as well as several nutritional deficiencies, all of which have led to many clinicians advocating for the screening of MetS and cardiovascular risk factors in patients who present with AGA.

12 Review Local Hemodynamic Forces After Stenting: Implications on Restenosis and Thrombosis. 2017

Ng, Jaryl / Bourantas, Christos V / Torii, Ryo / Ang, Hui Ying / Tenekecioglu, Erhan / Serruys, Patrick W / Foin, Nicolas. ·From the National Heart Centre Singapore (J.N., H.Y.A., N.F.) · Department of Biomedical Engineering, National University of Singapore, Singapore (J.N.) · Departments of Cardiovascular Sciences (C.V.B.) and Mechanical Engineering (R.T.), University College London, United Kingdom · Department of Cardiology, Barts Health NHS Trust, London, United Kingdom (C.V.B.) · Thoraxcenter, Erasmus MC, Rotterdam Erasmus University, The Netherlands (E.T., P.W.S.) · National Heart & Lung Institute, Imperial College London, United Kingdom (P.W.S.) · and Duke-NUS Medical School, National University of Singapore (N.F.). ·Arterioscler Thromb Vasc Biol · Pubmed #29122816.

ABSTRACT: Local hemodynamic forces are well-known to modulate atherosclerotic evolution, which remains one of the largest cause of death worldwide. Percutaneous coronary interventions with stent implantation restores blood flow to the downstream myocardium and is only limited by stent failure caused by restenosis, stent thrombosis, or neoatherosclerosis. Cumulative evidence has shown that local hemodynamic forces affect restenosis and the platelet activation process, modulating the pathophysiological mechanisms that lead to stent failure. This article first covers the pathophysiological mechanisms through which wall shear stress regulates arterial disease formation/neointima proliferation and the role of shear rate on stent thrombosis. Subsequently, the article reviews the current evidence on (1) the implications of stent design on the local hemodynamic forces, and (2) how stent/scaffold expansion can influence local flow, thereby affecting the risk of adverse events.

13 Review 2017 Multimodality Appropriate Use Criteria for Noninvasive Cardiac Imaging: Expert Consensus of the Asian Society of Cardiovascular Imaging. 2017

Anonymous3890925 / Beck, Kyongmin Sarah / Kim, Jeong A / Choe, Yeon Hyeon / Hian, Sim Kui / Hoe, John / Hong, Yoo Jin / Kim, Sung Mok / Kim, Tae Hoon / Kim, Young Jin / Kim, Yun Hyeon / Kuribayashi, Sachio / Lee, Jongmin / Leong, Lilian / Lim, Tae-Hwan / Lu, Bin / Park, Jae Hyung / Sakuma, Hajime / Yang, Dong Hyun / Yaw, Tan Swee / Wan, Yung-Liang / Zhang, Zhaoqi / Zhao, Shihua / Yong, Hwan Seok. ·Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea. · Department of Radiology, Ilsan Paik Hospital, Inje University College of Medicine, Goyang 10380, Korea. · Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Korea. · Department of Cardiology, Sarawak General Hospital Heart Centre, Sarawak 93586, Malaysia. · Department of Radiology, Mount Elizabeth Hospital, Singapore 228510, Singapore. · Department of Radiology, Severance Hospital, Yonsei University College of Medicine, Seoul 03722, Korea. · Department of Radiology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul 06273, Korea. · Department of Radiology, Chonnam National University Hospital, Gwangju 61469, Korea. · Department of Diagnostic Radiology, Keio University, Tokyo 9608582, Japan. · Department of Radiology, Kyungpook National University Hospital, Daegu 41944, Korea. · Department of Radiology, Hong Kong College of Radiologists, Hong Kong 251114, China. · Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea. · Department of Radiology, Fuwai Hospital, Chinese Academy of Medical Science & Peking Union Medical College, National Center for Cardiovascular Diseases, Beijing 100037, China. · Department of Radiology, Myongji Hospital, Goyang 10475, Korea. · Department of Radiology, Mie University Hospital, Mie 5148507, Japan. · Department of Cardiology, National Heart Centre Singapore, Singapore 169609, Singapore. · Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital at Linkou, Institute for Radiological Research, College of Medicine, Chang Gung University, Taoyuan 33305, Taiwan. · Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China. · Department of Radiology, Korea University Guro Hospital, Korea University College of Medicine, Seoul 08308, Korea. ·Korean J Radiol · Pubmed #29089819.

ABSTRACT: In 2010, the Asian Society of Cardiovascular Imaging (ASCI) provided recommendations for cardiac CT and MRI, and this document reflects an update of the 2010 ASCI appropriate use criteria (AUC). In 2016, the ASCI formed a new working group for revision of AUC for noninvasive cardiac imaging. A major change that we made in this document is the rating of various noninvasive tests (exercise electrocardiogram, echocardiography, positron emission tomography, single-photon emission computed tomography, radionuclide imaging, cardiac magnetic resonance, and cardiac computed tomography/angiography), compared side by side for their applications in various clinical scenarios. Ninety-five clinical scenarios were developed from eight selected pre-existing guidelines and classified into four sections as follows: 1) detection of coronary artery disease, symptomatic or asymptomatic; 2) cardiac evaluation in various clinical scenarios; 3) use of imaging modality according to prior testing; and 4) evaluation of cardiac structure and function. The clinical scenarios were scored by a separate rating committee on a scale of 1-9 to designate appropriate use, uncertain use, or inappropriate use according to a modified Delphi method. Overall, the AUC ratings for CT were higher than those of previous guidelines. These new AUC provide guidance for clinicians choosing among available testing modalities for various cardiac diseases and are also unique, given that most previous AUC for noninvasive imaging include only one imaging technique. As cardiac imaging is multimodal in nature, we believe that these AUC will be more useful for clinical decision making.

14 Review Nordic walking for individuals with cardiovascular disease: A systematic review and meta-analysis of randomized controlled trials. 2017

Cugusi, Lucia / Manca, Andrea / Yeo, Tee Joo / Bassareo, Pier P / Mercuro, Giuseppe / Kaski, Juan C. ·1 Department of Medical Sciences and Public Health, University of Cagliari, Italy. · 2 Department of Biomedical Sciences, University of Sassari, Italy. · 3 Department of Cardiology, National University Heart Centre Singapore, Singapore. · 4 Cardiovascular and Cell Sciences Research Institute, St George's University of London, UK. ·Eur J Prev Cardiol · Pubmed #29067853.

ABSTRACT: Background Exercise is the cornerstone of rehabilitation programmes for individuals with cardiovascular disease (IwCVD). Although conventional cardiovascular rehabilitation (CCVR) programmes have significant advantages, non-conventional activities such as Nordic walking (NW) may offer additional health benefits. Our aim was to appraise research evidence on the effects of Nordic walking for individuals with cardiovascular disease. Design Systematic review and meta-analysis. Methods A literature search of clinical databases (PubMed, MEDLINE, Scopus, Web of Science, Cochrane) was conducted to identify any randomized controlled trials, including: (i) individuals with cardiovascular disease, (ii) analyses of the main outcomes arising from Nordic walking (NW) programmes. Data from the common outcomes were extracted and pooled in the meta-analysis. Standardized mean differences (SMDs) were calculated and pooled by random effects models. Results Fifteen randomized controlled trials were included and eight trials entered this meta-analysis. Studies focused on coronary artery disease, peripheral arterial disease, heart failure and stroke. In coronary artery disease, significant differences between NW+CCVR and CCVR were found in exercise capacity (SMD: 0.49; p = 0.03) and dynamic balance (SMD: 0.55; p = 0.01) favouring NW+CCVR. In peripheral artery disease, larger changes in exercise duration (SMD: 0.93; p < 0.0001) and oxygen uptake (SMD: 0.64; p = 0.002) were observed following NW compared with controls. In heart failure, no significant differences were found between NW and CCVR or usual care for peak VO

15 Review Mechanical behavior of polymer-based 2017

Ang, Hui Ying / Huang, Ying Ying / Lim, Soo Teik / Wong, Philip / Joner, Michael / Foin, Nicolas. ·National Heart Centre Singapore, Singapore, Singapore. · School of Materials Science and Engineering, Nanyang Technological University, Singapore, Singapore. · Duke-NUS Medical School, Singapore, Singapore. · Deutsches Herzzentrum München, Technische Universität München, Munich, Germany. ·J Thorac Dis · Pubmed #28894598.

ABSTRACT: Bioresorbable scaffolds (BRS) were developed to overcome the drawbacks of current metallic drug-eluting stents (DES), such as late in-stent restenosis and caging of the vessel permanently. The concept of the BRS is to provide transient support to the vessel during healing before being degraded and resorbed by the body, freeing the vessel and restoring vasomotion. The mechanical properties of the BRS are influenced by the choice of the material and processing methods. Due to insufficient radial strength of the bioresorbable material, BRS often required large strut profile as compared to conventional metallic DES. Having thick struts will in turn affect the deliverability of the device and may cause flow disturbance, thereby increasing the incidence of acute thrombotic events. Currently, the bioresorbable poly-l-lactic acid (PLLA) polymer and magnesium (Mg) alloys are being investigated as materials in BRS technologies. The bioresorption process, mechanical properties,

16 Review Is there a role for ischaemic conditioning in cardiac surgery? 2017

Candilio, Luciano / Hausenloy, Derek. ·The Hatter Cardiovascular Institute, Institute of Cardiovascular Science, University College London, London, UK. · The National Institute of Health Research-University College London Hospitals Biomedical Research Centre, London, UK. · Barts Heart Centre, St Bartholomew's Hospital, London, UK. · Cardiovascular and Metabolic Disorders Program, Duke-National University of Singapore Medical School, Singapore, Singapore. · National Heart Research Institute Singapore, National Heart Centre, Singapore, Singapore. · Yong Loo Lin School of Medicine, National University Singapore, Singapore, Singapore. ·F1000Res · Pubmed #28503301.

ABSTRACT: Coronary artery disease (CAD) is a major cause of morbidity and mortality worldwide. Coronary artery bypass graft (CABG) surgery is the revascularisation strategy of choice in patients with diabetes mellitus and complex CAD. Owing to a number of factors, including the ageing population, the increased complexity of CAD being treated, concomitant valve and aortic surgery, and multiple comorbidities, higher-risk patients are being operated on, the result of which is an increased risk of sustaining perioperative myocardial injury (PMI) and poorer clinical outcomes. As such, new treatment strategies are required to protect the heart against PMI and improve clinical outcomes following cardiac surgery. In this regard, the heart can be endogenously protected from PMI by subjecting the myocardium to one or more brief cycles of ischaemia and reperfusion, a strategy called "ischaemic conditioning". However, this requires an intervention applied directly to the heart, which may be challenging to apply in the clinical setting. In this regard, the strategy of remote ischaemic conditioning (RIC) may be more attractive, as it allows the endogenous cardioprotective strategy to be applied away from the heart to the arm or leg by simply inflating and deflating a cuff on the upper arm or thigh to induce one or more brief cycles of ischaemia and reperfusion (termed "limb RIC"). Although a number of small clinical studies have demonstrated less PMI with limb RIC following cardiac surgery, three recently published large multicentre randomised clinical trials found no beneficial effects on short-term or long-term clinical outcomes, questioning the role of limb RIC in the setting of cardiac surgery. In this article, we review ischaemic conditioning as a therapeutic strategy for endogenous cardioprotection in patients undergoing cardiac surgery and discuss the potential reasons for the failure of limb RIC to improve clinical outcomes in this setting. Crucially, limb RIC still has the therapeutic potential to protect the heart in other clinical settings, such as acute myocardial infarction, and it may also protect other organs against acute ischaemia/reperfusion injury (such as the brain, kidney, and liver).

17 Review Association of Diabetic Macular Edema and Proliferative Diabetic Retinopathy With Cardiovascular Disease: A Systematic Review and Meta-analysis. 2017

Xie, Jing / Ikram, M Kamran / Cotch, Mary Frances / Klein, Barbara / Varma, Rohit / Shaw, Jonathan E / Klein, Ronald / Mitchell, Paul / Lamoureux, Ecosse L / Wong, Tien Yin. ·Centre for Eye Research Australia, University of Melbourne, East Melbourne, Victoria, Australia. · Singapore Eye Research Institute, Singapore National Eye Centre, National University of Singapore, Singapore3Duke-NUS Medical School, National University of Singapore, Singapore. · Division of Epidemiology and Clinical Applications, National Eye Institute, Intramural Research Program, National Institutes of Health, Bethesda, Maryland. · Department of Ophthalmology and Visual Sciences, University of Wisconsin School of Medicine and Public Health, Madison. · Department of Ophthalmology and Visual Sciences, University of Illinois College of Medicine at Chicago, Chicago. · Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia. · Centre for Vision Research, Westmead Insitute for Medical Research and University of Sydney, Sydney, New South Wales, Australia. ·JAMA Ophthalmol · Pubmed #28472362.

ABSTRACT: Importance: Previous studies on the relationship between diabetic retinopathy (DR) and cardiovascular disease (CVD) focused on the early stages of DR. Understanding whether patients with type 2 diabetes and severe stages of DR (diabetic macular edema [DME] and proliferative diabetic retinopathy [PDR]) have a higher risk of CVD will allow physicians to more effectively counsel patients. Objective: To examine the association of severe stages of DR (DME and PDR) with incident CVD in patients with type 2 diabetes. Data Sources: English-language publications were reviewed for articles evaluating the relationship of DR and CVD in MEDLINE, EMBASE, Current Contents, and the Cochrane Library from inception (January 1, 1950) to December 31, 2014, using the search terms diabetic retinopathy OR macular edema AND stroke OR cerebrovascular disease OR coronary artery disease OR heart failure OR myocardial infarction OR angina pectoris OR acute coronary syndrome OR coronary artery disease OR cardiomyopathy. Study Selection: Among 656 studies screened for eligibility, 7604 individuals were included from 8 prospective population-based studies with data on photographic-based DR grading, follow-up visits, and well-defined incident CVD end point. Data Extraction and Synthesis: Two independent reviewers conducted a systematic search of the 4 databases, and a single pooled database was developed. Incidence rate ratios (IRRs) were estimated for patients with DME, PDR, and vision-threatening DR, compared with persons without these conditions, by using individual participant data followed by a standard inverse-variance meta-analysis (2-step analysis). The review and analyses were performed from January 1, 2009, to January 1, 2017. Main Outcome and Measures: Incident CVD, including coronary heart disease, stroke, or death from cardiovascular causes. Results: Among 7604 patients with type 2 diabetes, the prevalence of DME was 4.6% and PDR, 7.4%. After a mean follow-up of 5.9 years (range, 3.2-10.1 years), 1203 incident CVD events, including 916 coronary heart disease cases, were reported. Persons with DME or PDR were more likely to have incident CVD (IRR, 1.39; 95% CI, 1.16-1.67) and fatal CVD (IRR, 2.33; 95% CI, 1.49-3.67) compared with those without DME or PDR. Conclusions and Relevance: Patients with type 2 diabetes and DME or PDR have an increased risk of incident CVD, which suggests that these persons should be followed up more closely to prevent CVD.

18 Review Invasive or non-invasive imaging for detecting high-risk coronary lesions? 2017

Patel, Kush / Tarkin, Jason / Serruys, Patrick W / Tenekecioglu, Erhan / Foin, Nicolas / Zhang, Yao-Jun / Crake, Tom / Moon, James / Mathur, Anthony / Bourantas, Christos V. ·a Barts Heart Centre, Barts Health NHS Trust , London , UK. · b Division of Cardiovascular Medicine , University of Cambridge , Cambridge , UK. · c Thoraxcenter , Erasmus Medical Centre , Rotterdam , The Netherlands. · d Faculty of Medicine , National Heart & Lung Institute, Imperial College , London , UK. · e National Heart Centre Singapore , Duke-NUS Medical School , Singapore. · f Nanjing First Hospital , Nanjing Medical University , Nanjing , China. · g Institute of Cardiovascular Sciences , University College London , London , UK. ·Expert Rev Cardiovasc Ther · Pubmed #28256179.

ABSTRACT: INTRODUCTION: Advances in our understanding about atherosclerotic evolution have enabled us to identify specific plaque characteristics that are associated with coronary plaque vulnerability and cardiovascular events. With constant improvements in signal and image processing an arsenal of invasive and non-invasive imaging modalities have been developed that are capable of identifying these features allowing in vivo assessment of plaque vulnerability. Areas covered: This review article presents the available and emerging imaging modalities introduced to assess plaque morphology and biology, describes the evidence from the first large scale studies that evaluated the efficacy of invasive and non-invasive imaging in detecting lesions that are likely to progress and cause cardiovascular events and discusses the potential implications of the in vivo assessment of coronary artery pathology in the clinical setting. Expert commentary: Invasive imaging, with its high resolution, and in particular hybrid intravascular imaging appears as the ideal approach to study the mechanisms regulating atherosclerotic disease progression; whereas non-invasive imaging is expected to enable complete assessment of coronary tree pathology, detection of high-risk lesions, more accurate risk stratification and thus to allow a personalized treatment of vulnerable patients.

19 Review Stress cardiovascular magnetic resonance imaging: current and future perspectives. 2017

Le, Thu-Thao / Huang, Weiting / Bryant, Jennifer Ann / Cook, Stuart Alexander / Chin, Calvin Woon-Loong. ·a Department of cardiovascular medicine , National Heart Centre Singapore , Singapore , Singapore. · b Duke-NUS Medical School , Singapore , Singapore. ·Expert Rev Cardiovasc Ther · Pubmed #28256176.

ABSTRACT: INTRODUCTION: Vasodilator and dobutamine are the main pharmacological agents used in current stress cardiovascular magnetic resonance (CMR). Exercise stress has well-established advantages and it is commonly used in other stress imaging, but the technical considerations have limited its use in stress CMR. In this review, we will describe the diagnostic performance, prognostic value, strengths and challenges of current stress CMR techniques. We will also discuss future perspectives of exercise stress CMR. Areas covered: Despite notable mechanistic differences, vasodilator and dobutamine stress CMR offer similar diagnostic and prognostic value in coronary artery disease. Combined perfusion and wall motion assessment has been explored with dobutamine stress CMR: diagnostic sensitivity improved at the expense of reduced specificity. However, a combined assessment may provide additional prognostic value in selected patients. There is emerging interest and promising data in exercise stress CMR because of the availability of CMR-compatible stress equipment and development of novel real-time sequences that allow imaging during exercise with adequate spatiotemporal resolution. Expert commentary: Exercise stress CMR is able to assess wall motion abnormalities, perfusion defects, exercise capacity and viability in a single examination. This holds important clinical potential in a variety of cardiovascular conditions.

20 Review Biomechanical stress in coronary atherosclerosis: emerging insights from computational modelling. 2017

Thondapu, Vikas / Bourantas, Christos V / Foin, Nicolas / Jang, Ik-Kyung / Serruys, Patrick W / Barlis, Peter. ·Melbourne Medical School, Faculty of Medicine, Dentistry & Health Sciences, The University of Melbourne, Victoria, Australia · Department of Mechanical Engineering, Melbourne School of Engineering, The University of Melbourne, Victoria, Australia · University College London Hospitals, National Health Service Foundation Trust, London, UK. · National Heart Centre, Singapore, Singapore · Duke-National University Singapore Medical School, Singapore · Cardiology Division, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA. · National Heart & Lung Institute, Imperial College, London, UK. ·Eur Heart J · Pubmed #28158723.

ABSTRACT: Coronary plaque rupture is the most common cause of vessel thrombosis and acute coronary syndrome. The accurate early detection of plaques prone to rupture may allow prospective, preventative treatment; however, current diagnostic methods remain inadequate to detect these lesions. Established imaging features indicating vulnerability do not confer adequate specificity for symptomatic rupture. Similarly, even though experimental and computational studies have underscored the importance of endothelial shear stress in progressive atherosclerosis, the ability of shear stress to predict plaque progression remains incremental. This review examines recent advances in image-based computational modelling that have elucidated possible mechanisms of plaque progression and rupture, and potentially novel features of plaques most prone to symptomatic rupture. With further study and clinical validation, these markers and techniques may improve the specificity of future culprit plaque detection.

21 Review Computer aided diagnosis of Coronary Artery Disease, Myocardial Infarction and carotid atherosclerosis using ultrasound images: A review. 2017

Faust, Oliver / Acharya, U Rajendra / Sudarshan, Vidya K / Tan, Ru San / Yeong, Chai Hong / Molinari, Filippo / Ng, Kwan Hoong. ·Department of Engineering and Mathematics, Sheffield Hallam University, United Kingdom. · Department of Electronic & Computer Engineering, Ngee Ann Polytechnic, Singapore; Department of Biomedical Engineering, School of Science and Technology, SIM University, Singapore; Department of Biomedical Engineering, Faculty of Engineering, University of Malaya, Kuala Lumpur, Malaysia. · Department of Electronic & Computer Engineering, Ngee Ann Polytechnic, Singapore. · Department of Biomedical Imaging, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia. · Department of Electronics and Telecommunications, Politecnico di Torino, Turin, Italy. · Department of Biomedical Engineering, Faculty of Engineering, University of Malaya, Kuala Lumpur, Malaysia. Electronic address: ngkh@ummc.edu.my. ·Phys Med · Pubmed #28010920.

ABSTRACT: The diagnosis of Coronary Artery Disease (CAD), Myocardial Infarction (MI) and carotid atherosclerosis is of paramount importance, as these cardiovascular diseases may cause medical complications and large number of death. Ultrasound (US) is a widely used imaging modality, as it captures moving images and image features correlate well with results obtained from other imaging methods. Furthermore, US does not use ionizing radiation and it is economical when compared to other imaging modalities. However, reading US images takes time and the relationship between image and tissue composition is complex. Therefore, the diagnostic accuracy depends on both time taken to read the images and experience of the screening practitioner. Computer support tools can reduce the inter-operator variability with lower subject specific expertise, when appropriate processing methods are used. In the current review, we analysed automatic detection methods for the diagnosis of CAD, MI and carotid atherosclerosis based on thoracic and Intravascular Ultrasound (IVUS). We found that IVUS is more often used than thoracic US for CAD. But for MI and carotid atherosclerosis IVUS is still in the experimental stage. Furthermore, thoracic US is more often used than IVUS for computer aided diagnosis systems.

22 Review Bioresorbable stents: Current and upcoming bioresorbable technologies. 2017

Ang, Hui Ying / Bulluck, Heerajnarain / Wong, Philip / Venkatraman, Subbu S / Huang, Yingying / Foin, Nicolas. ·National Heart Centre Singapore, 5 Hospital Drive, 169609, Singapore. · School of Materials Science and Engineering, Nanyang Technological University, Nanyang Avenue, 639798, Singapore. · School of Materials Science and Engineering, Nanyang Technological University, Nanyang Avenue, 639798, Singapore. Electronic address: yingyinghuang@ntu.edu.sg. · National Heart Centre Singapore, 5 Hospital Drive, 169609, Singapore; DUKE-NUS Medical School, 8 College Road, 169857, Singapore. Electronic address: nicolas.foin@gmail.com. ·Int J Cardiol · Pubmed #27912202.

ABSTRACT: Bioresorbable scaffolds (BRS) represent a novel horizon in interventional cardiology for the treatment of coronary artery disease. The technology was introduced to overcome limitations of current metallic drug-eluting stents such as late in-stent restenosis and permanently caging the vessel. The concept of the BRS is to provide temporal support to the vessel during healing before being degraded and resorbed by the body, promoting restoration of the vessel vasomotion. Currently, there are several BRS that are under development or already commercially available. Although several reviews have elegantly covered progress of current clinical programs and newer scaffold technologies, little is available currently to describe the mechanistic differences between biomaterials used in current and newer bioresorbable technologies. This aim of this review is to discuss the status of the different BRS technologies and materials currently under investigation, explore the newer strategies being adopted to improve material mechanical properties and optimize BRS degradation and summarize the performance of BRS in the clinical setting so far.

23 Review A review of bioresorbable scaffolds: hype or hope? 2017

Tan, Huay Cheem / Ananthakrishna, Rajiv. ·Department of Cardiology, National University Heart Centre, Singapore. ·Singapore Med J · Pubmed #27868135.

ABSTRACT: In the field of percutaneous coronary intervention, the evolution of coronary metal stents has been well established for the past three decades, but research on bioresorbable scaffolds has only gained momentum in the recent past. Although second-generation drug-eluting metal stents are the gold standard for the treatment of obstructive coronary artery disease, a few drawbacks exist. The development of bioresorbable scaffolds is an attempt to overcome the limitations of metal stents. This review highlights the rationale for the bioresorbable scaffold, its properties and potential applications. It also focuses on the current evidence and concerns regarding the application of the bioresorbable scaffold in day-to-day practice.

24 Review A new novolimus-eluting bioresorbable coronary scaffold: Present status and future clinical perspectives. 2017

Nef, Holger M / Wiebe, Jens / Foin, Nicolas / Blachutzik, Florian / Dörr, Oliver / Toyloy, Sara / Hamm, Christian W. ·University of Giessen, Medizinische Klinik I, Department of Cardiology, Giessen, Germany. · Deutsches Herzzentrum München, Technische Universität München, Munich, Germany. · National Heart Centre Singapore, Singapore. · Friedrich-Alexander University Erlangen-Nürnberg, University Hospital Erlangen, Department of Cardiology, Erlangen, Germany. Electronic address: florian.blachutzik@uk-erlangen.de. · Elixir Medical, 870 Hermosa Drive, Sunnyvale, CA 94965, USA. ·Int J Cardiol · Pubmed #27863289.

ABSTRACT: The DESolve® scaffold (Elixir Medical Corporation, Sunnyvale, California, USA) is manufactured from a poly-l-lactide based polymer and elutes an anti-proliferative, anti-inflammatory drug, Novolimus from a poly-l-lactide based topcoat mixture. The strut thickness is 150μm and the scaffold has platinum-iridium radiopaque markers at both ends. Radial support is available during the early time period to prevent recoil. The scaffold biodegrades within 1year (>90% reduction in molecular weight) and then completely bioresorbs within 2years. The DESolve® scaffold permits a wide range of expansion with a consequently reduced risk for strut fracture. Lumen and scaffold enlargement is observed within 3-6months in both preclinical and clinical studies potentially allowing for the scaffolded region to respond to vasoactive stimuli. The device has a unique property of self-correction observed in bench top studies, which in clinical practice has the potential to eliminate minor malapposition following deployment.

25 Review Renoprotection by remote ischemic conditioning during elective coronary revascularization: A systematic review and meta-analysis of randomized controlled trials. 2016

Zhou, Chenghui / Jeon, Yunseok / Meybohm, Patrick / Zarbock, Alexander / Young, Paul Jeffrey / Li, Lihuan / Hausenloy, Derek J. ·Department of Anesthesiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China. · Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Daehakro 101, Seoul 110-744, South Korea. · Department of Anesthesiology, Intensive Care Medicine, and Pain Therapy, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt, Germany. · Department of Anesthesiology, Critical Care Medicine and Pain Therapy, University Hospital Münster, Albert- Schweitzer-Campus 1, Gebäude A1, 48149 Münster, Germany. · Wellington Hospital, Capital and Coast District Health Board, Private Bag 7902, Wellington 6242, New Zealand. · Department of Anesthesiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China. Electronic address: llhfw59@163.com. · The Hatter Cardiovascular Institute, University College London, 67 Chenies Mews, London WC1E 6HX, United Kingdom; The National Institute of Health Research University College London Hospitals Biomedical Research Centre, London, United Kingdom; National Heart Research Institute Singapore, National Heart Centre Singapore, Singapore; Cardiovascular and Metabolic Disorders Program, Duke-National University of Singapore, Singapore. ·Int J Cardiol · Pubmed #27498373.

ABSTRACT: BACKGROUND: Remote ischemic conditioning (RIC) has been recognized an emerging non-invasive approach for preventing acute kidney injury (AKI) in patients undergoing either elective coronary artery bypass graft (CABG) surgery or percutaneous coronary intervention (PCI). On the other hand, accumulating evidence has indicated the involving role of pre-CABG contrast usage for coronary angiography in post-surgery AKI risk. Along with the shortening time delay of CABG after coronary angiography, and the prevalent hybrid coronary revascularization (HCR), the AKI prevention by RIC has faced challenges following coronary revascuralization. METHODS: Randomized controlled trials (RCTs) were searched from Pubmed, EMBase, and Cochrane library (until May 2016). The primary outcome was postoperative AKI. The second outcomes were included the requirement for renal replacement therapy (RRT), and in-hospital or 30-day mortality. RESULTS: Twenty eligible RCTs (CABG, 3357 patients; PCI, 1501 patients) were selected. RIC significantly halved the incidence of AKI following PCI when compared with controls [n=1501; odds ratio (OR)=0.51; 95% CI, 0.32 to 0.82; P=0.006; I(2)=29.6%]. However, RIC did not affect the incidence of AKI following CABG (n=1850; OR=0.94; 95% CI, 0.73 to 1.19; P=0.586; I(2)=12.4%). The requirement for RRT and in-hospital mortality was not affected by RIC in CABG (n=2049, OR=1.04, P=0.87; n=1920, OR=0.89, P=0.7; respectively). CONCLUSIONS: Our meta-analysis suggests that RIC for preventing AKI following CABG has faced with challenges in terms of AKI, the requirement for RRT, and mortality. However, RIC shows a renoprotective benefit for PCI. Hence, our findings may infer the preserved renal effects of RIC in CABG with preconditioning before the coronary angiography, or in HCR.

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