Abstract:
Background:Bivalirudin has been shown to be associated with less major bleeding than heparin in patients undergoing percutaneous coronary intervention (PCI); but the confounding effect of concomitant glycoprotein IIb/IIIa inhibitors (GPI) limits meaningful comparison. We performed a systematic review and meta-analysis to compare bivalirudin to heparin, with and without adjunctive GPI in PCI. Methods:We searched PubMed, Cochrane, EMBASE, CINAHL and WOS from January 2000 to December 2017 for clinical trials comparing bivalirudin to heparin, with and without adjunctive GPI during PCI. Cochrane's Q statistics were used to determine heterogeneity. Random effects model was used. Results:Twenty-six comparison groups (22 original studies and 4 subgroup analyses) with 53,364 patients were included. Mean follow-up was 192±303 days. There was no difference between the two groups in all-cause mortality [risk ratio (RR: 0.93; 95% CI: 0.82-1.05, P=0.260), target vessel revascularization (TVR) (RR: 1.17; 95% CI: 0.93-1.46, P=0.174) or stroke (RR: 0.91; 95% CI: 0.71-1.18, P=0.490). Major bleeding was lower in the bivalirudin group with concomitant GPI in one or both arms (RR: 0.64; 95% CI: 0.53-0.77, P<0.001) and without (RR: 0.71; 95% CI: 0.51-0.99, P=0.041) provisional or routine GPIs. Bivalirudin appeared to have a higher risk of stent thrombosis (RR: 1.32; 95% CI: 1.04-1.68, P=0.022) and a trend towards more myocardial infarction (RR: 1.12; 95% CI: 0.98-1.28, P=0.098) though without statistical significance. However, exclusion of studies with GPI showed no difference in stent thrombosis or myocardial infarction with bivalirudin. Conclusions:Bivalirudin is associated with less major bleeding compared to heparin, regardless of GPI use. The lower anticoagulant effect of bivalirudin is linked with higher stent thrombosis and a trend towards more MI, however a confounding effect of GPI use in the heparin arm cannot be excluded.
journal_name
J Thorac Disjournal_title
Journal of thoracic diseaseauthors
Anantha-Narayanan M,Anugula D,Gujjula NR,Reddy YNV,Baskaran J,Kaushik M,Alla VM,Raveendran Gdoi
10.21037/jtd.2018.05.76subject
Has Abstractpub_date
2018-06-01 00:00:00pages
3341-3360issue
6eissn
2072-1439issn
2077-6624pii
jtd-10-06-3341journal_volume
10pub_type
杂志文章abstract:BACKGROUND:Subxiphoid thoracoscopic surgery has been used in various thoracic surgical procedures. The aim of this study is to compare the physiological and inflammatory responses between subxiphoid thoracoscopic surgery and standard transthoracic thoracoscopic surgery for anatomic pulmonary lobectomy in a canine model...
journal_title:Journal of thoracic disease
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doi:10.3978/j.issn.2072-1439.2015.11.44
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abstract:BACKGROUND:The characteristics of patients with urinothorax (UT) are poorly defined. METHODS:A systematic review was performed searching for studies reporting clinical findings, pleural fluid (PF) characteristics, and the most effective treatment of UT. Case descriptions and retrospective studies were included. RESUL...
journal_title:Journal of thoracic disease
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doi:10.21037/jtd.2017.04.22
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abstract::Malignant pleural mesothelioma (MPM) is a rare neoplasm that typically arises from mesothelial surfaces of the pleural cavity. Despite treatment improvements, it carries a dismal prognosis. The majority of patients either have unresectable disease or are not candidates for surgery due to medical comorbidities or old a...
journal_title:Journal of thoracic disease
pub_type: 杂志文章,评审
doi:10.21037/jtd.2017.10.19
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abstract::Cases of tracheobronchial foreign body aspiration are frequently encountered emergency cases of childhood; and, delays in its recognition and treatment do result in serious morbidity and mortality. Diagnosis mainly relies on taking history which should indicate what the foreign body is, when it has been aspirated and ...
journal_title:Journal of thoracic disease
pub_type: 杂志文章,评审
doi:10.21037/jtd.2016.12.69
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abstract::Surgery is the gold standard treatment of lung cancer. The minimally invasive technique does not only concern access to the chest but also the limits of parenchymal resection. The study debates on the safety and oncological adequacy of sublobar resections in bronchogenic carcinoma patients. A systematic analysis of th...
journal_title:Journal of thoracic disease
pub_type: 杂志文章,评审
doi:10.21037/jtd.2020.02.54
更新日期:2020-06-01 00:00:00
abstract::Central venous catheters (CVCs) have an important role in the management of critically ill patients. In contrast to the immediate complications after CVC insertion, the late complications were difficult to be noticed without high suspicion despite their life-threatening outcome. We report a rare but fatal delayed vasc...
journal_title:Journal of thoracic disease
pub_type:
doi:10.21037/jtd.2017.08.50
更新日期:2017-09-01 00:00:00
abstract:Background:To investigate the capability of radiomic analysis using T2-weighted (T2W) and spectral attenuated inversion-recovery T2-weighted (SPAIR T2W) magnetic resonance imaging (MRI) for predicting the therapeutic response of esophageal squamous cell carcinoma (ESCC) to chemoradiotherapy (CRT). Methods:Pretreatment...
journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.21037/jtd.2018.03.123
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abstract:BACKGROUND:The feasibility and practicality of preoperative rehabilitation (PR) programs remains quite controversial in the treatment of lung cancer (LC). This study explored whether a short-term high-intensity rehabilitation program could improve postoperative outcomes compared to those achieved with conventional insp...
journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.21037/jtd.2017.06.15
更新日期:2017-07-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:Chronic obstructive pulmonary disease (COPD) represents an increasing healthcare concern as a leading cause of morbidity and mortality worldwide. Our objective was to predict the outcome of COPD patients associated with multiple organ dysfunction syndrome (MODS) by scoring models. METHODS:A re...
journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.3978/j.issn.2072-1439.2014.11.27
更新日期:2015-03-01 00:00:00
abstract:Background:We previously reported the techniques for total endoscopic atrial septal defect (ASD) repair on hearts arrested with cardioplegia through three small incisions in the chest wall without aid of a surgical robotic system. The optimal results motivated us to use total thoracoscopic technology for ASD on perfuse...
journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.21037/jtd.2018.10.89
更新日期:2018-12-01 00:00:00
abstract:Background:Persistent cardiac hypertrophy threatens health worldwide. Long non-coding RNAs (lncRNAs) attracted lots of attention in cardiac diseases such as cardiac hypertrophy. In this study, we aimed to study the function of KCNQ1OT1 in cardiac hypertrophy. Methods:We first used qRT-PCR to detect the expression of K...
journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.21037/jtd-20-203
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abstract::Concomitant occurrence of atrial myxoma and esophageal carcinoma is an extremely rare entity. Here we present two cases of synchronously suffered left atrial myxoma and esophageal carcinoma. Both patients underwent simultaneous resection of two tumors via the right thoraco-abdominal approach and recovered well. ...
journal_title:Journal of thoracic disease
pub_type:
doi:10.21037/jtd.2016.05.89
更新日期:2016-07-01 00:00:00
abstract:BACKGROUND:To explore the incidences of chronic obstructive pulmonary disease (COPD), obstructive ventilatory dysfunction, and obstructive small airway disease and their risk factors in a health check-up population, with an attempt to inform the early diagnosis and treatment of COPD. METHODS:Subjects who aged 20 years...
journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.3978/j.issn.2072-1439.2015.09.35
更新日期:2015-09-01 00:00:00
abstract:Background:This meta-analysis aims to investigate the effects of postoperative acute kidney injury (AKI) on 30-day postoperative outcomes and the independent risk factors for postoperative AKI in patients with type A acute aortic dissection (TAAD). Methods:Relevant reports published between January 1, 2011 and May 31,...
journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.21037/jtd.2018.05.47
更新日期:2018-05-01 00:00:00
abstract::Cone beam computed tomography (CBCT) is a well-established imaging modality with numerous proven applications across multiple clinical disciplines. More recently, CBCT has emerged as an important imaging tool for bronchoscopists, primarily used during transbronchial biopsy of peripheral pulmonary lesions (PPLS). For t...
journal_title:Journal of thoracic disease
pub_type: 杂志文章,评审
doi:10.21037/jtd-20-2382
更新日期:2020-12-01 00:00:00
abstract:BACKGROUND:In the patients with longer-segment aortic arch hypoplasia or interruption with ventricular septal defect, surgery with homograft vessel or autologous pericardial patch to augment descending aortic arch will not result in adverse reactions caused by end-to-end anastomosis. In this study, we retrospectively a...
journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.21037/jtd.2016.11.43
更新日期:2016-11-01 00:00:00
abstract:Background:Angiolymphatic invasion (ALI) plays an important role in lymph node metastasis. The presence of an ALI predicts a high risk for lymph node metastasis and a poor prognosis in patients with lymph node negative esophageal carcinoma. The independent prognostic value of ALI in node-negative patients remains contr...
journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.21037/jtd.2019.08.50
更新日期:2019-08-01 00:00:00
abstract:BACKGROUND:Esophagectomy is accompanied by a high postoperative complication rate. Minimally invasive esophageal surgery appears to be a promising technique that might be associated with a lower pulmonary morbidity rate. The objective of this study was to describe the implementation of minimally invasive esophageal sur...
journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.3978/j.issn.2072-1439.2012.09.05
更新日期:2012-10-01 00:00:00
abstract:BACKGROUND:Hand sewn cervical esophagogastric anastomosis (CEGA) is regarded as preferred technique by surgeons after esophagectomy. However, considering the anastomotic leakage and stricture, the optimal technique for performing this anastomosis is still under debate. METHODS:Between November 2010 and September 2012,...
journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.3978/j.issn.2072-1439.2015.11.09
更新日期:2015-11-01 00:00:00
abstract::Chronic obstructive pulmonary disease (COPD) primarily affects the lungs but due to the accompanying chronic systematic inflammation and the symptoms associated with the disease there are many extrapulmonary effects which include complex physical and metabolic adaptations. These changes have been associated with reduc...
journal_title:Journal of thoracic disease
pub_type: 杂志文章,评审
doi:10.21037/jtd.2019.10.41
更新日期:2019-10-01 00:00:00
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journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.21037/jtd.2018.04.08
更新日期:2018-04-01 00:00:00
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journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.3978/j.issn.2072-1439.2015.04.30
更新日期:2015-04-01 00:00:00
abstract::The bidirectional interaction between sleep-disordered breathing (SDB) and stroke has been the subject of many studies. On the one hand, different forms of SDB, and especially obstructive sleep apnea, increase the risk of stroke either directly or indirectly by influencing other known cardiovascular risk factors such ...
journal_title:Journal of thoracic disease
pub_type: 杂志文章,评审
doi:10.21037/jtd.2018.12.66
更新日期:2018-12-01 00:00:00
abstract:Background:Eosinophilic chronic obstructive pulmonary disease (COPD) patients have eosinophilic airway inflammation. No prospective study has reported blood eosinophil counts in an endemic area for parasitic infection. The primary objective was to compare exacerbation rates. The secondary objectives were patient-report...
journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.21037/jtd-19-4101
更新日期:2020-09-01 00:00:00
abstract::Video-assisted thoracoscopic surgery (VATS) segmentectomy is a promising treatment option for rigorously selected patients with earlystage non-small cell lung cancer. In the presented video, a 66-year-old male with a 1.6 cm suspicious nodule located at the posterior segment of the right upper lobe was treated with ana...
journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.3978/j.issn.2072-1439.2014.11.43
更新日期:2014-12-01 00:00:00
abstract::Increased recognition of advantages, over the last decade, of minimizing surgical trauma by operating through smaller incisions and its direct impact on reduced postoperative pain, quicker recovery, improved cosmesis and earlier return to work has spurred the minimally invasive cardiac surgical revolution. This transi...
journal_title:Journal of thoracic disease
pub_type: 杂志文章,评审
doi:10.3978/j.issn.2072-1439.2013.11.01
更新日期:2013-11-01 00:00:00
abstract:Background:Various approaches and markers for marking the lungs prior to lung tumor resection have been reported. In clinical practice, the hook wire localization method is often used owing to the simplicity of the technique. However, although rare, this method is associated with air embolism, which can be lethal. Beca...
journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.21037/jtd.2020.01.06
更新日期:2020-03-01 00:00:00
abstract::Congenital pericardial defects are a rare anomaly, found during autopsy and cardiothoracic surgery. We describe a case of a 69-year-old female, with a right-sided congenital pericardial defect associated with a giant bronchogenic cyst (BC) found during surgery. The cyst was resected and the patient developed arrhythmi...
journal_title:Journal of thoracic disease
pub_type:
doi:10.21037/jtd.2016.06.65
更新日期:2016-08-01 00:00:00
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journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.3978/j.issn.2072-1439.2014.09.10
更新日期:2014-10-01 00:00:00
abstract::Emphysema causes significant morbidity and mortality, incurring both financial and psychosocial costs. Alternatives to medical therapy and surgical lung volume reduction surgery (LVRS) have increased interest in bronchoscopic techniques. Bronchoscopic lung volume reduction (BLVR) is still in its infancy and additional...
journal_title:Journal of thoracic disease
pub_type: 杂志文章,评审
doi:10.21037/jtd.2018.02.72
更新日期:2018-04-01 00:00:00