Evidence map›Paper›PMID 31400333›Full record

Trial reportThe Annals of thoracic surgery2020

Impact of Aortic Atherosclerosis Burden on Outcomes of Surgical Aortic Valve Replacement.

Alexander Iribarne, Stephanie Pan, Jock N McCullough, Joseph P Mathew, Judy Hung, Xin Zeng, Pierre Voisine, Patrick T O'Gara, Nancy M Sledz, Annetine C Gelijns and 10 more

Open access · bronzeAbstract readRandomized Controlled Trial
In one paragraph

Trial report in The Annals of thoracic surgery, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
1.1field-weighted citation impact, top 20% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 12 citations in OpenAlex.

  1. Review
  2. Intimal aortic atherosclerosis in cardiac surgery: surgical strategies to prevent embolic stroke.European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery · 2021
    Review
  3. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

20 authors at 12 institutions in 2 countries.

Alexander IribarneSection of Cardiac Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire.
Stephanie PanDepartment of Population Health Science & Policy, Icahn School of Medicine at Mount Sinai, New York, New York.
Jock N McCulloughSection of Cardiac Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire.
Joseph P MathewDivision of Cardiothoracic Anesthesiology, Duke University Medical Center, Durham, North Carolina.
Judy HungDivision of Cardiology, Massachusetts General Hospital, Boston, Massachusetts.
Xin ZengDivision of Cardiology, Massachusetts General Hospital, Boston, Massachusetts.
Pierre VoisineInstitut Universitaire de Cardiologie et Pneumologie de Québec, Québec, Québec, Canada.
Patrick T O'GaraCardiovascular Medicine, Brigham and Women's Hospital, Boston, Massachusetts.
Nancy M SledzDepartment of Population Health Science & Policy, Icahn School of Medicine at Mount Sinai, New York, New York.
Annetine C GelijnsDepartment of Population Health Science & Policy, Icahn School of Medicine at Mount Sinai, New York, New York. Electronic address: annetine.gelijns@mssm.edu.
Wendy C Taddei-PetersDivision of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, Bethesda, Maryland.
Steven R MesséDepartment of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
Alan J MoskowitzDepartment of Population Health Science & Policy, Icahn School of Medicine at Mount Sinai, New York, New York.
Vinod H ThouraniDepartment of Cardiac Surgery, MedStar Heart and Vascular Institute, Washington, DC.
Michael ArgenzianoDivision of Cardiothoracic Surgery, Department of Surgery, New York-Presbyterian Hospital/Columbia University Medical Center, New York, New York.
Mark A GrohCardiovascular and Thoracic Surgery, Mission Health and Hospitals, Asheville, North Carolina.
Gennaro GiustinoDepartment of Population Health Science & Policy, Icahn School of Medicine at Mount Sinai, New York, New York.
Jessica R OverbeyDepartment of Population Health Science & Policy, Icahn School of Medicine at Mount Sinai, New York, New York.
J Michael DiMaioDepartment of Cardiothoracic Surgery, The Heart Hospital Baylor Plano, Baylor Scott & White Health, Plano, Texas.
Peter K SmithDivision of Cardiovascular and Thoracic Surgery, Department of Surgery, Duke University Medical Center, Durham, North Carolina.
Icahn School of Medicine at Mount Sinai · USDartmouth–Hitchcock Medical Center · USDuke Medical Center · USMassachusetts General Hospital · USBaylor Scott & White Health · USBrigham and Women's Hospital · USInstitut Universitaire de Cardiologie et de Pneumologie de Québec · CAMedStar Heart & Vascular Institute · USMission Hospital · USNational Heart Lung and Blood Institute · USNew York Hospital Queens · USUniversity of Pennsylvania · US

Funding

REVISED CAROL ACT IIU01HL088942 · NHLBI · ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI · PI GELIJNS, ANNE CHRISTINE, MOSKOWITZ, ALAN J · 2007 to 2025
$122.6M
CIHRNHLBI NIH HHS U01 HL088942
6 · The paper itself

Abstract

backgroundEpiaortic ultrasound detects and localizes ascending aortic atherosclerosis. In this analysis we investigated the association between epiaortic ultrasound-based atheroma grade during surgical aortic valve replacement (SAVR) and perioperative adverse outcomes.

methodsSAVR patients in a randomized trial of 2 embolic protection devices underwent a protocol-defined 5-view epiaortic ultrasound read at a core laboratory. Aortic atherosclerosis was quantified with the Katz atheroma grade, and patients were categorized as mild (grade I-II) or moderate/severe (grade III-V). Multivariable logistic regression was used to estimate associations between atheroma grade and adverse outcomes, including death, clinically apparent stroke, cerebral infarction on diffusion-weighted magnetic resonance imaging, delirium, and acute kidney injury (AKI) by 7 and 30 days.

resultsPrecannulation epiaortic ultrasound data were available for 326 of 383 randomized patients (85.1%). Of these, 106 (32.5%) had moderate/severe Katz atheroma grade at any segment of the ascending aorta. Although differences in the composite of death, stroke, or cerebral infarction on diffusion-weighted magnetic resonance imaging by 7 days were not statistically significant, moderate/severe atheroma grade was associated with a greater risk of AKI by 7 days (adjusted odds ratio, 2.63; 95% confidence interval, 1.24-5.58; P = .01). At 30 days, patients with moderate/severe atheroma grade had a greater risk of death, stroke, or AKI (adjusted odds ratio, 1.97; 95% confidence interval, 1.04-3.71; P = .04).

conclusionsModerate/severe aortic atherosclerosis was associated with an increased risk of adverse events after SAVR. Epiaortic ultrasound may serve as a useful adjunct for identifying patients who may benefit from strategies to reduce atheroembolic complications during SAVR.

Indexed as

Heart Valve Prosthesis ImplantationAgedAged, 80 and overAortaAortic DiseasesAortic ValveAtherosclerosisFemaleHeart Valve DiseasesHumansMalePostoperative ComplicationsSeverity of Illness IndexTreatment Outcome

Identifiers

PMID31400333
PMCPMC6939455
OpenAlexW2966213742

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.