Journal and News Scan

The DECAF randomized clinical trial investigated whether caffeinated coffee influences the recurrence of atrial fibrillation (AF) after cardioversion. Two hundred patients with persistent AF were randomized to either continue consuming caffeinated coffee (≥1 cup daily) or abstain entirely for six months. AF or atrial flutter recurred in 47 percent of coffee drinkers compared to 64 percent of abstainers, corresponding to a 39 percent lower recurrence risk (HR 0.61; 95 percent CI 0.42–0.89; P = .01). Secondary analyses showed similar trends for AF alone. No differences were seen in adverse events. Contrary to longstanding assumptions, moderate caffeinated coffee intake was associated with a reduced risk of AF recurrence. Proposed mechanisms for this effect include adenosine receptor antagonism, anti-inflammatory effects, and enhanced physical activity. 

In this international randomized trial involving 2,124 thoracic surgery patients requiring one-lung ventilation, the authors compared high positive end-expiratory pressure (PEEP) with recruitment maneuvers (10 cm H2O) to standard low PEEP without recruitment (5 cm H2O). Despite improved oxygenation and lower driving pressures with the high-PEEP strategy, there was no significant reduction in postoperative pulmonary complications (53.6 percent vs 56.4 percent). High PEEP caused substantially more intraoperative hypotension and arrhythmias, whereas hypoxemia occurred more often with low PEEP. Postoperative outcomes, including mortality and extrapulmonary complications, were similar between the groups. These findings indicate that routine intraoperative lung-expansion strategies do not improve pulmonary outcomes in this setting, and PEEP selection should instead be individualized based on real-time gas-exchange and hemodynamic status. 

This cross-sectional study compared the personality traits of 224 Dutch vascular surgeons, cardiothoracic surgeons, and interventional radiologists using the validated Big Five Inventory-2. While all specialists showed higher levels of open-mindedness, conscientiousness, extraversion, and agreeableness, along with lower levels of negative emotionality compared to the general population, notable differences emerged between the specialties. Cardiothoracic surgeons were found to be more agreeable than interventional radiologists, while vascular surgeons showed lower levels of negative emotionality. Facet-level analyses revealed distinctions in compassion, creative imagination, and assertiveness. These differences suggest that unique personality patterns exist even among professionals working within similar cardiovascular care pathways. Importantly, personality differences have been linked with surgical outcomes, clinical decision-making, and teamwork, and should be investigated further. 

This multicenter study from the TITAN trial examined the quality of life in 157 patients with moderate ascending thoracic aortic aneurysms (ATAA) undergoing surgery (n=52) or surveillance (n=105) between 2019 and 2022. After propensity matching and a 13-month follow-up using short form survey (SF)-36 questionnaires, surgical patients who underwent surgery showed significantly greater improvements compared to those receiving surveillance in mental component summary scores, general health, and mental health. The study concluded that surgical treatment of moderate ATAAs improves the mental aspects of quality of life at one year compared to surveillance.