Drug-coated balloons versus drug-eluting stents in patients with acute myocardial infarction undergoing percutaneous coronary intervention: an updated meta-analysis with trial sequential analysis.

BACKGROUND: Drug-coated balloons (DCBs) are an established strategy for coronary artery disease. However, the new generation drug-eluting stent (DES) is recommended for patients with Acute myocardial infarction (AMI) for coronary artery revascularization. Our aim is to provide a comprehensive appraisal of the efficacy of DCBs in patients with AMI undergoing PCI. METHODS: We searched the WOS, PubMed, Scopus, and Cochrane CENTRAL till March 2023, for studies that compared DCBs versus DES in patients with AMI undergoing PCI. We used a random-effects model to compare major adverse cardiac events (MACE), cardiac death, all-cause death, myocardial infarction, target lesion revascularization (TLR), stent thrombosis, Late lumen Loss (LLL), and minimum lumen diameter (MLD) between the two groups. RESULTS: Thirteen studies comprising 2644 patients were included. The pooled OR showed non-inferiority of DCB over DES in terms of MACE (OR = 0.89, 95% CI [0.57 to 1.40], p = 0.63). When we defined MACE as a composite of cardiac death, MI, and TLR; the pooled OR favored DCB over DES (OR = 0.50, 95% CI [0.28 to 0.9], p = 0.02). Moreover, DCB was not inferior to DES in terms of all-cause mortality (OR = 0.88, 95% CI: 0.43 to 1.8, p = 0.73), cardiac mortality, (OR = 0.59, 95% CI: 0.22 to 1.56, p = 0.29), MI (OR = 0.88, 95% CI: 0.34 to 2.29, p = 0.79), stent thrombosis (OR = 1.21, 95% CI: 0.35 to 4.23, p = 0.76), TLR (OR = 0.9, 95% CI: 0.43 to 1.93, p = 0.8), LLL (MD = -0.6, 95% CI: -0.3 to 0.19, p = 0.64), or MLD (MD = -0.4, 95% CI: -0.33 to 0.25, p = 0.76). CONCLUSION: Our meta-analysis indicated that DCB intervention was not inferior to DES in the PCI setting in patients with AMI, and can be recommended as a feasible strategy in AMI. PROSPERO REGISTRATION: CRD42023412757.

Efficacy and Safety of Bedside Removal of Tunnelled Hemodialysis Catheter by Noninterventional Nephrologists among Adult Patients in the King Abdulaziz University Hospital Hemodialysis Centre in Jeddah: A Retrospective Cohort Study.

This study aimed to assess the efficacy and safety of bedside removal of tunnelled hemodialysis catheter (TDC) by noninterventional nephrologists among adult patients. It is a retrospective study that involved 53 patients from March 2020 to February 2022 at the King Abdulaziz University Hospital (KAUH) Hemodialysis Centre in Jeddah, Saudi Arabia. Of the 53 participants, 60.4% were male and 40.6% female, and their mean age was 50.94 ± 18.89 years. The most common comorbidities were hypertension (HTN) in 47 (88.7%), diabetes mellitus (DM) in 24 (45.3%), and DM and HTN together in 23 (43.4%) patients. The most common site of TDC removal was the right internal jugular vein (77.4%). In 84.9% of the cases, the TDC was removed as an inpatient procedure, and in the majority of the cases (64.2%), the TDC was removed by a noninterventional nephrologist. The most common reasons for TDC removal were sepsis or clinical concerns for infection (64.2%) and TDC not needed (20.8%) due to recovery of the renal function or access maturation. Most patients (96.2%) suffered no complications; only one of 34 (%) patients with catheter removal by a noninterventional nephrologist had bleeding, which required more observation and monitoring before discharge on the same day. Our study revealed that the bedside TDC removal was well tolerated with a minimal complication rate.

A molecular explanation of cardiovascular protection through abnormal cannabidiol: Involving the dysfunctional ß-adrenergic and ATP-sensitive K+ channel activity in cardiovascular compromised preterm infants.

Growing cannabis efficacy, usage frequency, legal supply, and declining awareness of danger recently led to expanded United States cannabis exposure. In turn, cannabis use among elderly people over 50 has more than tripled in a decade and has contributed toward a positive association of cannabis use with pathological conditions, which include type II diabetes, metabolic syndrome, neurovascular and cardiovascular disease. Remarkably, all these outcome results are mediated by the involvement of the ATP-sensitive K+ channel. Cardiovascular compromise is a common syndrome in preterm infants that leads to incidence and death and has been distinguished by poor systemic flow or hypotension. Conditions of cardiovascular compromise include vasodysregulation and myocardial malfunction through dysfunctional ß-adrenergic activity. To avoid organ hypoperfusion progressing to tissue hypoxia-ischemia, inotropic drugs are used. Many premature children, however, respond insufficiently to inotropic activity with adrenergic agonists. The clinical disturbance including myocardial dysfunction through the activation of the ATP-sensitive K+ channel is often involved and the comparative efficacy of the nonpsychotropic cannabinoid, abnormal cannabidiol (Abn-CBD) is not yet known. Therefore, our primary aim was to investigate the molecular exploration of the cannabinoid system specifically Abn-CBD in cardiovascular protection involving dysregulated KATP.

The emerging potential of SIRT-3 in oxidative stress-inflammatory axis associated increased neuroinflammatory component for metabolically impaired neural cell.

People suffering from conditions like epilepsy, where there is an excess of neuron excitement, stroke, and cardiac arrest, where there are oxygen and glucose deprivation, Alzheimer, Parkinson, and Huntington's disease that causes metabolic and also oxidative stress-inflammatory axis; are known to be more vulnerable to disturbances in the metabolism, and there is a lot of inadequacy in defining the inflammation's mechanistic connections, as well as neurodegeneration and the bioenergetic deficiencies in the CNS. We retrieved relevant studies from PubMed/ScienceDirect/Medline/Public library of science/Mendeley/Springer link as well as Google Scholar. We used various keywords both individually and in combination with the literature search. 'Epidemiology of neurodegenerative disorders', 'neurodegenerative diseases associated hyper inflammation', 'Mechanism of inflammation in neuronal cell', 'Involvement of SIRTin inflammation', 'Pathogenesis of mitochondrial associated metabolic impairment in neurons', 'Reactive oxygen species-mediated mitochondrial dysfunction' were a few of the keywords used for the search. PINCH, which is a chronic neuro-inflammatory component that cannot be detected in matured neurons which are healthy, though expressed in oxidative stress inflammatory axis related tauopathy and diseases that cause neurodegeneration. We attempted to study the regulatory mechanisms that cause changes in the bioenergetics and its neuronal defects and mitochondrial subcellular localization that are PINCH protein-mediated on the other handSIRT1, the most intensively studied sirtuin, in oxidative stress-mediated inflammatory consequence for many diseases but very few research data explore the role of SIRT-3 for correction of the chronic neuroinflammatory component. Thus, in this review, we investigate the very recently identified molecules involving in the pathogenesis during stimulated oxidative stress-inflammatory axis in the excitatory neuronal cell which changes brain metabolism. Simultaneously, in CNS neurons of diseases with a component of chronic neuroinflammation which exhibit neuroprotective response, the consequences (mechanistic and biological) of SIRT-3, could be emerging future targets for neurodegenerative disorder treatment with impaired metabolisms.

Left ventricular function outcome after coronary artery bypass grafting, King Abdullah Medical City (KAMC)- single-center experience.

BACKGROUND: Coronary artery bypass grafting is known to be associated with better outcome in ischemic heart disease patients with low ejection fraction. We aim to demonstrate the effect of coronary artery bypass grafting (CABG) on left ventricle (LV) systolic function and to identify the predictors that adversely lead to postoperative poor outcome. RESULT: This is a cross-sectional prospective study; we included 110 patients with left ventricular ejection fraction (LVEF) < 50% who underwent CABG with a mean age of 56.1 ± 12.2 years old. Those patients were classified into two groups: group I, 76 (69%) patients with LVEF > 35%, and group II, 34 (31%) patients with LVEF < 35%. Our results as regards demographic and clinical data revealed that group II patients had a significantly higher prevalence of diabetes mellitus (DM) and Euro SCORE II compared to group I patients (p = 0.05 and < 0.001 respectively); otherwise, all other clinical predictors did not differ between the two studied groups. There was a significant improvement in LVEF post-surgery (p = 0.05) in both groups with observed no significant difference recorded for in-hospital mortality rate among patients with different groups. DM, significant diastolic dysfunction, and insertion of IABP are predictors of in-hospital mortality of the patients (p = 0.001, 0.03 and < 0.001, respectively) CONCLUSION: We concluded that there is a significant improvement of LV systolic function after CABG and hence better survival rate. DM, significant diastolic dysfunction, and perioperative insertion of IABP are predictors of mortality after cardiac surgery. Special care should be provided to such patients to improve their outcome.

Three-dimensional transesophageal echocardiographic delineation of ventricular septal aneurysm producing right ventricular outflow obstruction in an adult.

We report three-dimensional echocardiographic delineation of a congenital aneurysm of the membranous interventricular septum causing right ventricular outflow tract obstruction in an adult patient. To our knowledge, these findings have not been described before.