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Giovanni Landoni, Vladimir V Lomivorotov, Caetano Nigro Neto, Fabrizio Monaco, Vadim V Pasyuga, Nikola Bradic, Rosalba Lembo, Gordana Gazivoda, Valery V Likhvantsev, Chong Lei, Andrey Lozovskiy, Nora Di Tomasso, Nazar A R Bukamal, Fernanda S Silva, Andrey E Bautin, Jun Ma, Martina Crivellari, Ahmed M G A Farag, Nikolay S Uvaliev, Cristiana Carollo, Marina Pieri, Jan Kunstýř, Chew Yin Wang, Alessandro Belletti, Ludhmila A Hajjar, Evgeny V Grigoryev, Felice E Agrò, Hynek Riha, Mohamed R El-Tahan, A Mara Scandroglio, Abeer M Elnakera, Massimo Baiocchi, Paolo Navalesi, Vladimir A Shmyrev, Luca Severi, Mohammed A Hegazy, Giuseppe Crescenzi, Dmitry N Ponomarev, Luca Brazzi, Renato Arnoni, Dmitry G Tarasov, Miomir Jovic, Maria G Calabrò, Tiziana Bove, Rinaldo Bellomo, Alberto Zangrillo
BACKGROUND: Volatile (inhaled) anesthetic agents have cardioprotective effects, which might improve clinical outcomes in patients undergoing coronary-artery bypass grafting (CABG). METHODS: We conducted a pragmatic, multicenter, single-blind, controlled trial at 36 centers in 13 countries. Patients scheduled to undergo elective CABG were randomly assigned to an intraoperative anesthetic regimen that included a volatile anesthetic (desflurane, isoflurane, or sevoflurane) or to total intravenous anesthesia...
March 19, 2019: New England Journal of Medicine
#2
Jorrit S Lemkes, Gladys N Janssens, Nina W van der Hoeven, Lucia S D Jewbali, Eric A Dubois, Martijn Meuwissen, Tom A Rijpstra, Hans A Bosker, Michiel J Blans, Gabe B Bleeker, Rémon Baak, Georgios J Vlachojannis, Bob J W Eikemans, Pim van der Harst, Iwan C C van der Horst, Michiel Voskuil, Joris J van der Heijden, Albertus Beishuizen, Martin Stoel, Cyril Camaro, Hans van der Hoeven, José P Henriques, Alexander P J Vlaar, Maarten A Vink, Bas van den Bogaard, Ton A C M Heestermans, Wouter de Ruijter, Thijs S R Delnoij, Harry J G M Crijns, Gillian A J Jessurun, Pranobe V Oemrawsingh, Marcel T M Gosselink, Koos Plomp, Michael Magro, Paul W G Elbers, Peter M van de Ven, Heleen M Oudemans-van Straaten, Niels van Royen
BACKGROUND: Ischemic heart disease is a major cause of out-of-hospital cardiac arrest. The role of immediate coronary angiography and percutaneous coronary intervention (PCI) in the treatment of patients who have been successfully resuscitated after cardiac arrest in the absence of ST-segment elevation myocardial infarction (STEMI) remains uncertain. METHODS: In this multicenter trial, we randomly assigned 552 patients who had cardiac arrest without signs of STEMI to undergo immediate coronary angiography or coronary angiography that was delayed until after neurologic recovery...
March 18, 2019: New England Journal of Medicine
#3
Nikki A H A Pluymaekers, Elton A M P Dudink, Justin G L M Luermans, Joan G Meeder, Timo Lenderink, Jos Widdershoven, Jeroen J J Bucx, Michiel Rienstra, Otto Kamp, Jurren M Van Opstal, Marco Alings, Anton Oomen, Charles J Kirchhof, Vincent F Van Dijk, Hemanth Ramanna, Anho Liem, Lukas R Dekker, Brigitte A B Essers, Jan G P Tijssen, Isabelle C Van Gelder, Harry J G M Crijns
BACKGROUND: Patients with recent-onset atrial fibrillation commonly undergo immediate restoration of sinus rhythm by pharmacologic or electrical cardioversion. However, whether immediate restoration of sinus rhythm is necessary is not known, since atrial fibrillation often terminates spontaneously. METHODS: In a multicenter, randomized, open-label, noninferiority trial, we randomly assigned patients with hemodynamically stable, recent-onset (<36 hours), symptomatic atrial fibrillation in the emergency department to be treated with a wait-and-see approach (delayed-cardioversion group) or early cardioversion...
March 18, 2019: New England Journal of Medicine
#4
Dike B Ojji, Bongani Mayosi, Veronica Francis, Motasim Badri, Victoria Cornelius, Wynand Smythe, Nicky Kramer, Felix Barasa, Albertino Damasceno, Anastase Dzudie, Erika Jones, Charles Mondo, Okechukwu Ogah, Elijah Ogola, Mahmoud U Sani, Gabriel L Shedul, Grace Shedul, Brian Rayner, Ikechi G Okpechi, Karen Sliwa, Neil Poulter
BACKGROUND: The prevalence of hypertension among black African patients is high, and these patients usually need two or more medications for blood-pressure control. However, the most effective two-drug combination that is currently available for blood-pressure control in these patients has not been established. METHODS: In this randomized, single-blind, three-group trial conducted in six countries in sub-Saharan Africa, we randomly assigned 728 black patients with uncontrolled hypertension (≥140/90 mm Hg while the patient was not being treated or taking only one antihypertensive drug) to receive a daily regimen of 5 mg of amlodipine plus 12...
March 18, 2019: New England Journal of Medicine
#5
EDITORIAL
Jeff S Healey, William F McIntyre
No abstract text is available yet for this article.
March 18, 2019: New England Journal of Medicine
#6
EDITORIAL
Benjamin S Abella, David F Gaieski
No abstract text is available yet for this article.
March 18, 2019: New England Journal of Medicine
#7
LETTER
Henning Bundgaard, Nikolaj Ihlemann, Sabine U Gill, Niels E Bruun, Hanne Elming, Trine Madsen, Kaare T Jensen, Kurt Fursted, Jens J Christensen, Martin Schultz, Lauge Østergaard, Flemming Rosenvinge, Henrik C Schønheyder, Jannik Helweg-Larsen, Emil L Fosbøll, Lars Køber, Christian Torp-Pedersen, Niels Tønder, Claus Moser, Kasper Iversen
No abstract text is available yet for this article.
March 17, 2019: New England Journal of Medicine
#8
Michael J Mack, Martin B Leon, Vinod H Thourani, Raj Makkar, Susheel K Kodali, Mark Russo, Samir R Kapadia, S Chris Malaisrie, David J Cohen, Philippe Pibarot, Jonathon Leipsic, Rebecca T Hahn, Philipp Blanke, Mathew R Williams, James M McCabe, David L Brown, Vasilis Babaliaros, Scott Goldman, Wilson Y Szeto, Philippe Genereux, Ashish Pershad, Stuart J Pocock, Maria C Alu, John G Webb, Craig R Smith
BACKGROUND: Among patients with aortic stenosis who are at intermediate or high risk for death with surgery, major outcomes are similar with transcatheter aortic-valve replacement (TAVR) and surgical aortic-valve replacement. There is insufficient evidence regarding the comparison of the two procedures in patients who are at low risk. METHODS: We randomly assigned patients with severe aortic stenosis and low surgical risk to undergo either TAVR with transfemoral placement of a balloon-expandable valve or surgery...
March 17, 2019: New England Journal of Medicine
#9
Khaldoun G Tarakji, Suneet Mittal, Charles Kennergren, Ralph Corey, Jeanne E Poole, Edward Schloss, Jose Gallastegui, Robert A Pickett, Rudolph Evonich, François Philippon, Janet M McComb, Steven F Roark, Denise Sorrentino, Darius Sholevar, Edmond Cronin, Brett Berman, David Riggio, Mauro Biffi, Hafiza Khan, Marc T Silver, Jack Collier, Zayd Eldadah, David J Wright, Jeff D Lande, Daniel R Lexcen, Alan Cheng, Bruce L Wilkoff
BACKGROUND: Infections after placement of cardiac implantable electronic devices (CIEDs) are associated with substantial morbidity and mortality. There is limited evidence on prophylactic strategies, other than the use of preoperative antibiotics, to prevent such infections. METHODS: We conducted a randomized, controlled clinical trial to assess the safety and efficacy of an absorbable, antibiotic-eluting envelope in reducing the incidence of infection associated with CIED implantations...
March 17, 2019: New England Journal of Medicine
#10
Renato D Lopes, Gretchen Heizer, Ronald Aronson, Amit N Vora, Tyler Massaro, Roxana Mehran, Shaun G Goodman, Stephan Windecker, Harald Darius, Jia Li, Oleg Averkov, M Cecilia Bahit, Otavio Berwanger, Andrzej Budaj, Ziad Hijazi, Alexander Parkhomenko, Peter Sinnaeve, Robert F Storey, Holger Thiele, Dragos Vinereanu, Christopher B Granger, John H Alexander
BACKGROUND: Appropriate antithrombotic regimens for patients with atrial fibrillation who have an acute coronary syndrome or have undergone percutaneous coronary intervention (PCI) are unclear. METHODS: In an international trial with a two-by-two factorial design, we randomly assigned patients with atrial fibrillation who had an acute coronary syndrome or had undergone PCI and were planning to take a P2Y12 inhibitor to receive apixaban or a vitamin K antagonist and to receive aspirin or matching placebo for 6 months...
March 17, 2019: New England Journal of Medicine
#11
Jeffrey J Popma, G Michael Deeb, Steven J Yakubov, Mubashir Mumtaz, Hemal Gada, Daniel O'Hair, Tanvir Bajwa, John C Heiser, William Merhi, Neal S Kleiman, Judah Askew, Paul Sorajja, Joshua Rovin, Stanley J Chetcuti, David H Adams, Paul S Teirstein, George L Zorn, John K Forrest, Didier Tchétché, Jon Resar, Antony Walton, Nicolo Piazza, Basel Ramlawi, Newell Robinson, George Petrossian, Thomas G Gleason, Jae K Oh, Michael J Boulware, Hongyan Qiao, Andrew S Mugglin, Michael J Reardon
BACKGROUND: Transcatheter aortic-valve replacement (TAVR) is an alternative to surgery in patients with severe aortic stenosis who are at increased risk for death from surgery; less is known about TAVR in low-risk patients. METHODS: We performed a randomized noninferiority trial in which TAVR with a self-expanding supraannular bioprosthesis was compared with surgical aortic-valve replacement in patients who had severe aortic stenosis and were at low surgical risk...
March 17, 2019: New England Journal of Medicine
#12
Mandeep R Mehra, Nir Uriel, Yoshifumi Naka, Joseph C Cleveland, Melana Yuzefpolskaya, Christopher T Salerno, Mary N Walsh, Carmelo A Milano, Chetan B Patel, Steven W Hutchins, John Ransom, Gregory A Ewald, Akinobu Itoh, Nirav Y Raval, Scott C Silvestry, Rebecca Cogswell, Ranjit John, Arvind Bhimaraj, Brian A Bruckner, Brian D Lowes, John Y Um, Valluvan Jeevanandam, Gabriel Sayer, Abeel A Mangi, Ezequiel J Molina, Farooq Sheikh, Keith Aaronson, Francis D Pagani, William G Cotts, Antone J Tatooles, Ashok Babu, Don Chomsky, Jason N Katz, Paul B Tessmann, David Dean, Arun Krishnamoorthy, Joyce Chuang, Ia Topuria, Poornima Sood, Daniel J Goldstein
BACKGROUND: In two interim analyses of this trial, patients with advanced heart failure who were treated with a fully magnetically levitated centrifugal-flow left ventricular assist device were less likely to have pump thrombosis or nondisabling stroke than were patients treated with a mechanical-bearing axial-flow left ventricular assist device. METHODS: We randomly assigned patients with advanced heart failure to receive either the centrifugal-flow pump or the axial-flow pump irrespective of the intended goal of use (bridge to transplantation or destination therapy)...
March 17, 2019: New England Journal of Medicine
#13
EDITORIAL
Shamir R Mehta
No abstract text is available yet for this article.
March 17, 2019: New England Journal of Medicine
#14
Deepak L Bhatt, Charles V Pollack, Jeffrey I Weitz, Lisa K Jennings, Sherry Xu, Susan E Arnold, Bret R Umstead, Michael C Mays, John S Lee
BACKGROUND: Ticagrelor is an oral P2Y12 inhibitor that is used with aspirin to reduce the risk of ischemic events among patients with acute coronary syndromes or previous myocardial infarction. Spontaneous major bleeding and bleeding associated with urgent invasive procedures are concerns with ticagrelor, as with other antiplatelet drugs. The antiplatelet effects of ticagrelor cannot be reversed with platelet transfusion. A rapid-acting reversal agent would be useful. METHODS: In this randomized, double-blind, placebo-controlled, phase 1 trial, we evaluated intravenous PB2452, a monoclonal antibody fragment that binds ticagrelor with high affinity, as a ticagrelor reversal agent...
March 17, 2019: New England Journal of Medicine
#15
J Brian Byrd, Glenn M Chertow, Vivek Bhalla
No abstract text is available yet for this article.
March 13, 2019: New England Journal of Medicine
#16
Andrew J Nunn, Patrick P J Phillips, Sarah K Meredith, Chen-Yuan Chiang, Francesca Conradie, Doljinsuren Dalai, Armand van Deun, Phan-Thuong Dat, Ngoc Lan, Iqbal Master, Tesfamarium Mebrahtu, Daniel Meressa, Ronelle Moodliar, Nosipho Ngubane, Karen Sanders, Stephen Bertel Squire, Gabriela Torrea, Bazarragchaa Tsogt, I D Rusen
BACKGROUND: Cohort studies in Bangladesh showed promising cure rates among patients with multidrug-resistant tuberculosis who received existing drugs in regimens shorter than that recommended by the World Health Organization (WHO) in 2011. METHODS: We conducted a phase 3 noninferiority trial in participants with rifampin-resistant tuberculosis that was susceptible to fluoroquinolones and aminoglycosides. Participants were randomly assigned, in a 2:1 ratio, to receive a short regimen (9 to 11 months) that included high-dose moxifloxacin or a long regimen (20 months) that followed the 2011 WHO guidelines...
March 13, 2019: New England Journal of Medicine
#17
EDITORIAL
Gavin J Churchyard
No abstract text is available yet for this article.
March 13, 2019: New England Journal of Medicine
#18
Vinh-Kim Nguyen
No abstract text is available yet for this article.
March 6, 2019: New England Journal of Medicine
#19
(no author information available yet)
New England Journal of Medicine, Volume 380, Issue 11, Page 1090-1090, March 2019.
February 28, 2019: New England Journal of Medicine
#20
Ingrid A Binswanger
No abstract text is available yet for this article.
February 27, 2019: New England Journal of Medicine
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