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4. Coronary artery bypass grafting versus medical therapy in patients with stable coronary artery disease: An individual patient data pooled meta-analysis of randomized trials

Author

Gaudino, Mario, Audisio, Katia, Hueb, Whady A., Stone, Gregg W., Farkouh, Michael E., Di Franco, Antonino, Rahouma, Mohamed, Serruys, Patrick W., Bhatt, Deepak L., Biondi Zoccai, Giuseppe, Yusuf, Salim, Girardi, Leonard N., Fremes, Stephen E., Ruel, Marc, and Redfors, Bjorn

Published
2024
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6. Long-term results of surgical ventricular reconstruction and comparison with the Surgical Treatment for Ischemic Heart Failure trial

Author

Gaudino, Mario, Castelvecchio, Serenella, Rahouma, Mohamed, Robinson, N. Bryce, Audisio, Katia, Soletti, Giovanni J., Cancelli, Gianmarco, Tam, Derrick Y., Garatti, Andrea, Benedetto, Umberto, Doenst, Torsten, Girardi, Leonard N., Michler, Robert E., Fremes, Stephen E., Velazquez, Eric J., and Menicanti, Lorenzo

Published
2024
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13. Association between sternal wound complications and 10-year mortality following coronary artery bypass grafting

Author

Taggart, D., Ratnatunga, Westaby, S., Cook, J., Wallis, C., Wos, S., Jasinski, M., Deja, M., Widenka, K., Blach, A., Gocol, R., Hudziak, D., Zurek, P., Bachowski, R., Mrozek, R., Kargul, T., Domarardzki, W., Frackiewicz, J., Zamvar, V., Ezakadan, D., Buxton, B., Seevanayagam, S., Matalanis, G., Rosalion, A., Negri, J., Moten, S., Atkinson, V., Newcomb, A., Polidano, P., Pana, R., Gerbo, S., O'Keefe, P., von Oppell, U., Mehta, D., Azzu, A., Szafranek, A., Kulatilake, E., Evans, J., Martin, N., Banner, D., Trivedi, U., Forsyth, A., Hyde, J., Cohen, A., Lewis, M., Gardner, E., MacKenzie, A., Cooter, N., Joyce, E., Parker, J., Champney, F., Clark, S., Dark, J., Tocewicz, K., Pillay, T., Rowling, S., Adams-Hall, J., Bochenek, A., Cisowski, M., Bolkowski, M., Morawski, W., Guc, M., Krejca, M., Wilczynski, M., Duralek, A., Gerber, W., Skarysz, J., Shrestha, R., Swiech, W., Szmagala, X., Krzych, L., Pawlak, A., Kepa, K., Hasan, R., Keenan, D., Prendergast, B., Odom, N., McLaughlin, K., Cummings-Fosong, G., Mathew, C., Iles-Smith, H., Oomen, A., Desai, J., El-Gamel, A., John, L., Wendler, O., Andrews, M., Rance, K., Williams, R., Hogervorst, V., Gregory, J., Jessup, J., Knighton, A., Hoare, A., Ritchie, A., Choong, C., Nair, S., Sudarshan, C., Jenkins, D., Large, S., Barman, M., Dhital, K., Routledge, T., Rosengard, B., Munday, H., Rintoul, K., Jarrett, E., Lao-Sirieix, S., Wilkinson, A., Garner, L., Osmond, J., Holcombe, H., Cale, A., Griffin, S., Dickson, J., Spyt, T., Gershlick, A., Hickey, M., Sosnowski, A., Peek, G., Szostek, J., Hadjinikalaou, L., Logtens, E., Oakley, M., Leji, S., Gaer, J., Amrani, M., Dreyfus, G., Bahrami, T., de Robertis, F., Baig, K., Asimakopoulos, G., Vohra, H., Pai, V., Tadjkarimi, S., Soleimani, G., Stavri, G., Bull, H., Collappen, H., Sadowksi, J., Kapelak, B., Gaweda, B., Rudzinski, P., Stolinski, J., Konstanty-Kalandyk, J., Moraes, F., Moraes, C., Wanderley, J., Pepper, J., De Souza, A., Petrou, M., Trimlett, R., Morgan, T., Gavino, J., Wang, S.F., Chandrasekaran, V., Kanagasaby, R., Sarsam, M., Ryan, H., Billings, L., Ruddick, L., Achampong, A., Forster, E., Mohama, E., McDonnell, P., Pawlaczyk, R., Siondalski, P., Rogowski, J., Roszak, K., Jarmoszewicz, K., Jagielak, D., Gafka, S., Mannam, G., Naguboyin, Sajja, L. Rao, Dandu, B., Peddireddy, J., Adepu, A., Briffa, N., Braidley, P., Cooper, G., Allen, K., Sangha, G., Bridge, C., McMellon, H., Shaw, P., Casabona, R., Dato, G. Actis, Bardi, G., Del Ponte, S., Forsennati, F., Parisi, F., Punta, G., Flocco, R., Sansone, F., Zingarelli, E., Demartino, A., Dihmis, W., Kuduvali, M., Prince, C., Rogers, H., McQuade, L., Duran-Rosas, A., Anisimowicz, L., Bokszanski, M., Pawliszak, W., Kolakowski, J., Lau, G., Ogorzeja, W., Gumanska, I., Kulinski, P., Podesser, B., Trescher, K., Bernecker, O., Holzinger, C., Binder, K., Schor, I., Bergmann, P., Kassal, H., Dunkel, E., Motovova, B., Trehan, N., Meharwal, Z., Malhotra, R., Goel, M., Kumer, B., Bazaz, S., Bake, N., Singh, A., Mishka, Y., Gupta, R., Basumatary, S., Zembala, M., Szafron, B., Pacholewicz, J., Krason, M., Farmas, Wojarski, Zych, Szymanik, I., Kolwca, M., Mazur, W., Kurowicki, A., Zurek, S., Stacel, T., Jaworska, I., Gaudino, Mario, Audisio, Katia, Rahouma, Mohamed, Robinson, N. Bryce, Soletti, Giovanni J., Cancelli, Gianmarco, Masterson Creber, Ruth M., Gray, Alastair, Lees, Belinda, Gerry, Stephen, Benedetto, Umberto, Flather, Marcus, and Taggart, David P.

Published
2023
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18. Impact of tricyclic antidepressants, selective serotonin reuptake inhibitors, and other antidepressants on overall survival of patients with advanced lung cancer from 2004 to 2014: University of Cincinnati experience

Author

Karim, Nagla Fawzy Abdel, Hassan, Rammey, Siddiqi, Nabeela Iffat, Eldessouki, Ihab, Gaber, Ola, Rahouma, Mohamed, Kamel, Mohamed, Yellu, Mhender, Gulati, Shuchi, Xie, Changchun, Magdy, Mohamed, and Pruemer, Jane

Subjects
Biomedical and Clinical Sciences, Oncology and Carcinogenesis, Cancer, Mental Health, Lung Cancer, Lung, Depression, Aged, Antidepressive Agents, Tricyclic, Case-Control Studies, Drug Prescriptions, Female, Humans, Kaplan-Meier Estimate, Lung Neoplasms, Male, Middle Aged, Neoplasm Staging, Proportional Hazards Models, Selective Serotonin Reuptake Inhibitors, Universities, Lung cancer, tricyclic antidepressants, SSRIs, drug repositioning, apoptosis, overall survival, Medical and Health Sciences, General & Internal Medicine, Biomedical and clinical sciences, Health sciences
Abstract

OBJECTIVES: To evaluate and categorize the survival benefit of tricyclic antidepressants (TCAs) in lung cancer patients based on systematic computational drug repositioning data. METHODS: Data were retrospectively extracted from the medical records of non-small cell lung cancer (NSCLC) patients from the University of Cincinnati Cancer Medical Center database. Patients receiving antidepressants during their course of anti-cancer treatment were compared with those without antidepressants. Data were analyzed using Kaplan–Meier survival curves with the log-rank test, and overall survival (OS) was calculated from the date of diagnosis until last follow-up or death. RESULTS: The median OS at 2 and 5 years for patients on antidepressants was 20.3 months (54.7% and 42%) vs 44.3 months (47.6% and 43.2%), which was not significant. The median OS for patients receiving TCAs, selective serotonin reuptake inhibitors, and other antidepressants was 3.17 months, 31.33 months, and 18.50 months, respectively. CONCLUSION: We found no significant survival benefit for TCA use in combination with anti-cancer agents in NSCLC patients.

Published
2019

32. Risk Factors for Early Postoperative Morbidity and Mortality following Extremity Metastatic Pathologic or Impending Fracture Fixation.

Author

Wang, Patrick Qi, Charron, Brynn P., Hali, Kalter, Raleigh, Matthew, Del Balso, Christopher, Macleod, Mark D., Sanders, David W., Lawendy, Abdel-Rahman, and Rahouma, Mohamed

Abstract

Background. As cancer survivorship continues to improve, the perioperative morbidity and mortality following surgical treatment of metastatic bone disease become an increasingly important consideration. The objective of this study is to identify risk factors for early postoperative complications and mortality following extremity prophylactic fixation and pathologic fracture stabilization. Methods. A single‐centre retrospective review of 185 patients (226 total surgeries) who underwent prophylactic fixation or pathologic fracture stabilization for extremity metastatic bone disease between 2005 and 2020 was performed. Skull, spine, pelvic, and revision surgeries along with diagnosis of primary bone neoplasm were excluded. Univariate, multivariate, and subgroup analyses were performed to identify predictors and independent risk factors for 30‐day postoperative morbidity and mortality. Results. Primary cancers included lung (n = 41), breast (n = 36), multiple myeloma (n = 35), prostate (n = 16), lymphoma (n = 11), renal cell carcinoma (n = 10), and other (n = 36). The 30‐day postoperative complication and mortality rates were 32.30% (n = 73) and 17.26% (n = 39), respectively. The most common complications were pulmonary‐related, cardiac events, surgical site infection, sepsis, and thromboembolism. Pathologic fracture, presence of extra‐skeletal metastases, longer surgical duration, and blood transfusion requirements were associated with 30‐day postoperative complications overall. A past medical history for cardiac disease was also associated with systemic but not local surgical complications. Pathologic fracture, presence of extra‐skeletal metastases, lung cancer, blood transfusion requirements, and increasing pack‐year smoking history were predictors for 30‐day mortality. In the multivariate analysis, pathologic fracture (p = 0.016) and presence of extra‐skeletal metastases (p = 0.029) were independent predictors of complications. For mortality, pathologic fracture (p = 0.014), presence of extra‐skeletal metastases (p = 0.0085), and increased blood transfusion requirements (p = 0.048) were independent risk factors. Conclusions. The findings of this study provide additional guidance for perioperative risk assessment and patient counselling. Additionally, improving clinical assessment tools to identify and quantify patients at risk of pathologic fractures becomes increasingly important given the significant morbidity and mortality associated with pathologic fracture treatment. [ABSTRACT FROM AUTHOR]

Published
2024
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33. Differentiated Thyroid Carcinoma Long‐Term Prognostic Factors.

Author

Luis, Pacheco-Ojeda, Lucía, Martínez-Jaramillo Ana, Hugo, Romo-Castillo, Ramiro, Recalde-Maldonado, Stalin, Cañizares-Quisiguiña, and Rahouma, Mohamed

Abstract

Introduction. Thyroid cancer is the most common cancer in women in Ecuador. Objective. The aim of this study was to determine the demographics and clinical and treatment variables of patients with papillary or follicular thyroid cancer, referred to as differentiated thyroid cancer (DTC), treated at a third‐level hospital in Quito, Ecuador. Methods. We reviewed retrospectively the medical records of patients with DTC, who underwent surgical treatment, from 1990 to 2019. Data included demographics, pathological information, clinical stage, type of surgery, and radioactive iodine (RAI) adjuvant therapy. Patients were monitored for up to 29 years (median follow‐up time 6.9 years). Results. The corrected overall 5‐, 10‐, 20‐, and 30‐year survival rates (Kaplan–Meier) were 93%, 85%, 70%, and 63%, respectively. On univariate analysis, age, histological type, tumor grade, histological variants, capsular invasion, vascular invasion, tumor size, clinical stage, distant metastases at diagnosis, surgical margins, extrathyroidal invasion, radioactive iodine adjuvant treatment, and locoregional recurrence were found to be significant prognostic factors. In a multivariate analysis, the following independent variables: age over 55 years, extrathyroidal spread, metastasis at diagnosis, and stage II to IV raised the risk of death (hazard risk) (HR). Conclusions. Age over 55 years, extrathyroidal spread, metastasis at diagnosis, and advanced clinical stage were found to have a harmful prognosis and an increased risk of death in a series of Ecuadorian patients surgically treated for a DTC. [ABSTRACT FROM AUTHOR]

Published
2024
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34. Predictors of premature termination of cardiac surgery trials: insights from the Clinicaltrial.gov database.

Author

Cancelli, Gianmarco, Rossi, Camilla S, Dell'Aquila, Michele, Mantaj, Polina, Hirofuji, Aina, Soletti, Giovanni, Harik, Lamia, Cangut, Busra, Zaghari, Talal Al, Leith, Jordan, Falco, Giorgia, Ibrahim, Mudathir, Dimagli, Arnaldo, Rahouma, Mohamed, and Gaudino, Mario F L

Subjects
LOGISTIC regression analysis, HEART valves, CARDIAC surgery, ODDS ratio, DATABASES, TERMINATION of treatment, HEART assist devices
Abstract

Open in new tab Download slide OBJECTIVES Clinical trials that are terminated prematurely may generate incomplete and potentially biased data and the reasons for premature trials termination are poorly understood. Our objective was to describe the incidence of premature trial termination and identify factors associated with it. METHODS We performed a systematic search on ClinicalTrials.gov to identify all cardiac surgery trials from 1991 to 2023. Trials that were terminated prematurely were identified. Factors independently associated with premature termination were identified using multivariable logistic regression analysis. RESULTS A total of 746 clinical trials were included; of them 577 were completed and 169 (22.6%) were terminated prematurely. Most of the trials originated from North America [294 (39.4%)], Europe [264 (35.4%)] or Asia [141 (18.9%)]. Fourteen of the trials terminated prematurely (8.3%) were phase 1, 75 (44.4%) phase 2, 49 (29.0%) phase 3 and 31 (18.3%) phase 4. Fifty (29.6%) trials were terminated because of slow recruitment, 20 (11.8%) because of sponsor decision and 12 (7.1%) because of lack of funding. Left ventricular assist device trials [odds ratio (OR) 3.65, 95% confidence interval (CI) (1.65–8.00) P  = 0.001], valve surgery trials [OR 4.30, 95% CI (2.33–8.00) P  < 0.001], aortic surgery trials [OR 2.86 95% CI (1.22–6.43) P  = 0.012], phase 2 [OR 3.02, 95% CI (1.31–7.93) P  = 0.015] and phase 4 trials [OR 3.62, 95% CI (1.43–10.23) P  = 0.010] were at higher risk of premature termination while trials performed in Asia [OR 0.18, 95% CI (0.07–0.39) P  ≤ 0.001] and Europe [OR 0.49, 95% CI (0.30–0.80) P  = 0.004] were less likely to be terminated prematurely. CONCLUSIONS Slow recruitment is the most common reason for premature termination of cardiac surgery trials. Trials on left ventricular assist device, valve surgery, aortic surgery, phase 2 trials and phase 4 trials are more likely to be terminated, while trials conducted in Asia and Europe are less likely to be terminated prematurely. [ABSTRACT FROM AUTHOR]

Published
2024
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37. Posterior left pericardiotomy for the prevention of atrial fibrillation after cardiac surgery: an adaptive, single-centre, single-blind, randomised, controlled trial

Author

Gaudino, Mario, Sanna, Tommaso, Ballman, Karla V, Robinson, N Bryce, Hameed, Irbaz, Audisio, Katia, Rahouma, Mohamed, Di Franco, Antonino, Soletti, Giovanni J, Lau, Christopher, Rong, Lisa Q, Massetti, Massimo, Gillinov, Marc, Ad, Niv, Voisine, Pierre, DiMaio, J Michael, Chikwe, Joanna, Fremes, Stephen E, Crea, Filippo, Puskas, John D, and Girardi, Leonard

Published
2021
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40. Thorax support vest to prevent sternal wound infections in cardiac surgery patients—a systematic review and meta-analysis

Author

Caldonazo, Tulio, primary, Dell’Aquila, Michele, additional, Cancelli, Gianmarco, additional, Harik, Lamia, additional, Soletti, Giovanni, additional, Fischer, Johannes, additional, Kirov, Hristo, additional, Rahouma, Mohamed, additional, Ibrahim, Mudathir, additional, Demetres, Michelle, additional, An, Kevin R, additional, Girardi, Leonard, additional, Doenst, Torsten, additional, and Gaudino, Mario, additional

Published
2024
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41. Impact of Center Volume on Cardiopulmonary and Mortality Outcomes after Immune-Checkpoint Inhibitors for Cancer: A Systematic Review and Meta-Analysis

Author

Rahouma, Mohamed, primary, Mynard, Nathan, additional, Baudo, Massimo, additional, Khairallah, Sherif, additional, Al-Thani, Shaikha, additional, Dabsha, Anas, additional, Shmushkevich, Shon, additional, Shoeib, Osama, additional, Hossny, Mohamed, additional, Eldeeb, Elsayed, additional, Aziz, Hala, additional, Abdelkarim, Naglaa, additional, Gaudino, Mario, additional, Mohamed, Abdelrahman, additional, Girardi, Leonard, additional, Zhang, Jun, additional, and Mutti, Luciano, additional

Published
2024
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45. The Outcomes of Surgical Pulmonary Embolectomy for Pulmonary Embolism: A Meta-Analysis.

Author

Rahouma, Mohamed, Al-Thani, Shaikha, Salem, Haitham, Mahmoud, Alzahraa, Khairallah, Sherif, Shenouda, David, Sultan, Batool, Khalil, Laila, Alomari, Mohammad, Ali, Mostafa, Makey, Ian A., Haney, John C., Mick, Stephanie, and El-Sayed Ahmed, Magdy M.

Subjects
*LITERATURE reviews, *HOSPITAL mortality, *GASTROINTESTINAL hemorrhage, *DEATH rate, *CARDIAC arrest
Abstract

Objectives: The purpose of this study is to assess the efficacy, short- and long-term cardiovascular and non-cardiovascular mortalities and postoperative morbidities of surgical pulmonary embolectomy (SPE) for patients with massive or submassive pulmonary embolism. Methods: A comprehensive literature review was performed to identify articles reporting SPE for pulmonary embolism. The outcomes included in-hospital and long-term mortality in addition to postoperative morbidities. The random effect inverse variance method was used. Cumulative meta-analysis, leave-one-out sensitivity analysis, subgroup analysis and meta-regression were performed. Results: Among the 1949 searched studies in our systematic literature search, 78 studies met our inclusion criteria, including 6859 cases. The mean age ranged from 42 to 65 years. The percentage of males ranged from 25.6% to 86.7%. The median rate of preoperative cardiac arrest was 27.6%. The percentage of contraindications to preoperative systemic thrombolysis was 30.4%. The preoperative systemic thrombolysis use was 11.5%. The in-hospital mortality was estimated to be 21.96% (95% CI: 19.21–24.98); in-hospital mortality from direct cardiovascular causes was estimated to be 16.05% (95% CI: 12.95–19.73). With a weighted median follow-up of 3.05 years, the late cardiovascular and non-cardiovascular mortality incidence rates were 0.39 and 0.90 per person-year, respectively. The incidence of pulmonary bleeding, gastrointestinal bleeding, surgical site bleeding, non-surgical site bleeding and wound complications was 0.62%, 4.70%, 4.84%, 5.80% and 7.2%, respectively. Cumulative meta-analysis showed a decline in hospital mortality for SPE from 42.86% in 1965 to 20.56% in 2024. Meta-regression revealed that the publication year and male sex were associated with lower in-hospital mortality, while preoperative cardiac arrest, the need for inotropes or vasopressors and preoperative mechanical ventilation were associated with higher in-hospital mortality. Conclusions: This study demonstrates acceptable perioperative mortality rates and late cardiovascular and non-cardiovascular mortality in patients who undergo SPE for massive or submassive pulmonary embolism. [ABSTRACT FROM AUTHOR]

Published
2024
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46. Succinate dehydrogenase mutations in head and neck paragangliomas: A systematic review and meta‐analysis of individual patients' data.

Author

Koh, Elizabeth S., Dabsha, Anas, Rahouma, Mohamed, Zappi, Kyle, Srinivasan, Yashes, Hickner, Andy, and Kutler, David I.

Subjects
PARAGANGLIOMA, SUCCINATE dehydrogenase, GENETIC mutation, NECK, PUBLICATION bias, CAROTID body, DEGLUTITION
Abstract

Background: Head and neck paragangliomas (HNPs) have been associated with gene mutations in the succinate dehydrogenase (SDH) complex, but the clinical significance remains unclear. We sought to explore the demographics, clinical characteristics, treatment methods, and outcomes of SDH‐mutated HNPs. Methods: Databases were systematically searched. Pooled event ratio and relative 95% confidence intervals were calculated for dichotomous outcomes. Meta‐regression was performed. Cochran's Q test and I2 test assessed heterogeneity. Funnel plot and Egger's regression test assessed publication bias. Results: Forty‐two studies with 8849 patients were included. Meta‐regression revealed a significant correlation between multifocality and SDHD mutations (0.03 ± 0.006, p < 0.0001) and between distant metastases and SDHB mutations (0.06 ± 0.023, p = 0.008). There was no correlation between sex, age, tumor size, or familial occurrences and SDH‐related mutations. Conclusion: Multifocality of HNPs correlates with the SDHD mutational subtype, and metastases correlate with the SDHB subtype. Knowledge of HNP phenotypes associated with SDH‐related mutations has the potential to influence the management approach to such HNPs. [ABSTRACT FROM AUTHOR]

Published
2024
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