Current Cardiology Reports最新文献

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Impact of Fixed-Dose Combination Therapies on Cardiovascular Mortality and Major Cardiovascular Events. 固定剂量联合治疗对心血管死亡率和主要心血管事件的影响。
IF 4 3区 医学
Current Cardiology Reports Pub Date : 2026-10-20 DOI: 10.1007/s11886-026-02430-z
Jia Ee Chia, Eunseuk Lee, Jose Iglesias, Song Peng Ang
{"title":"Impact of Fixed-Dose Combination Therapies on Cardiovascular Mortality and Major Cardiovascular Events.","authors":"Jia Ee Chia, Eunseuk Lee, Jose Iglesias, Song Peng Ang","doi":"10.1007/s11886-026-02430-z","DOIUrl":"https://doi.org/10.1007/s11886-026-02430-z","url":null,"abstract":"<p><strong>Purpose of review: </strong>Fixed-dose combination therapy (the polypill) was developed to reduce treatment complexity and improve adherence to evidence-based cardiovascular therapies. This review evaluates contemporary evidence for its effects on major cardiovascular events and cardiovascular mortality across primary prevention, secondary prevention, and emerging heart failure applications, while addressing implementation barriers and remaining evidence gaps.</p><p><strong>Recent findings: </strong>Early pharmacodynamic and adherence trials established that co-formulation preserves the effects of individual components and improves medication adherence. Event-powered trials subsequently demonstrated clinical benefit: PolyIran and TIPS-3 reduced major cardiovascular events in predominantly primary prevention population, whereas SECURE reduced recurrent events after myocardial infarction. Individual-participant and aggregate-data meta-analyses showed relative reductions of approximately 20% to 40% in composite cardiovascular outcomes and a reduction in cardiovascular mortality, with larger benefits among patients with greater adherence and in aspirin-containing strategies. POLY-HF extended the approach to heart failure with reduced ejection fraction, improving left ventricular ejection fraction and uptake of guideline-directed therapy; reductions in heart failure events were secondary findings that require confirmation in larger outcome trials. These findings supports fixed-dose combination therapy as an effective strategy for improving adherence and reducing cardiovascular events, with a cardiovascular mortality benefit supported by pooled analyses. Its greatest potential may be in high-risk populations and resource-limited settings, where treatment complexity impedes implementation. Broader adoption will require formulation standardization, sufficient dosing flexibility, longer-term safety data, and effective integration into clinical guidelines and health systems.</p>","PeriodicalId":10829,"journal":{"name":"Current Cardiology Reports","volume":"28 1","pages":""},"PeriodicalIF":4.0,"publicationDate":"2026-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149227469","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Periodontal Disease and Heart Failure: Current Evidence and Perspectives. 牙周病和心力衰竭:目前的证据和观点。
IF 4 3区 医学
Current Cardiology Reports Pub Date : 2026-10-17 DOI: 10.1007/s11886-026-02438-5
Alícia Eliege da Silva, Valéria Duarte de Almeida, Gilson Aquino Cavalcante, Roque Ribeiro da Silva Júnior, Daria Raquel Queiroz de Almeida, José Veríssimo Fernandes, Ellany Gurgel Cosme do Nascimento, Cléber de Mesquita Andrade, Thales Allyrio Araújo de Medeiros Fernandes
{"title":"Periodontal Disease and Heart Failure: Current Evidence and Perspectives.","authors":"Alícia Eliege da Silva, Valéria Duarte de Almeida, Gilson Aquino Cavalcante, Roque Ribeiro da Silva Júnior, Daria Raquel Queiroz de Almeida, José Veríssimo Fernandes, Ellany Gurgel Cosme do Nascimento, Cléber de Mesquita Andrade, Thales Allyrio Araújo de Medeiros Fernandes","doi":"10.1007/s11886-026-02438-5","DOIUrl":"10.1007/s11886-026-02438-5","url":null,"abstract":"<p><strong>Purpose of review: </strong>Periodontal disease has been increasingly recognized as a chronic inflammatory condition with potential systemic implications, particularly in the cardiovascular system. Heart failure (HF), a pro-inflammatory syndrome with multisystem involvement, remains a major public health burden. This state-of-the-art narrative review aims to analyze the current scientific evidence on the association between periodontal disease and heart failure, emphasizing epidemiological data, cardiac biomarkers, inflammatory mediators, and future perspectives.</p><p><strong>Recent findings: </strong>Current evidence indicates a high prevalence of periodontal disease among patients with HF and suggests associations between periodontal disease and elevated cardiac biomarkers, including NT-proBNP and troponin T, as well as systemic inflammatory mediators such as C-reactive protein, IL-6, and TNF-α. Interventional studies have reported reductions in some of these biomarkers following periodontal treatment, suggesting a potential biological link between periodontal inflammation and HF. However, findings remain heterogeneous, and some studies have failed to demonstrate significant associations. Current evidence supports an association between periodontal disease and heart failure, with systemic inflammation representing a potential biological link. Nevertheless, the heterogeneity of study designs, small sample sizes, and predominance of observational and cross-sectional evidence limit causal inference. Longitudinal studies and randomized clinical trials are needed to clarify causal mechanisms and determine whether periodontal prevention and treatment can contribute to integrated strategies for patients with HF.</p>","PeriodicalId":10829,"journal":{"name":"Current Cardiology Reports","volume":"28 1","pages":""},"PeriodicalIF":4.0,"publicationDate":"2026-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13676481/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149215214","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Infection Prevention and Device Pocket Management in Cardiac Implantable Electronic Devices: Emerging Strategies. 心脏植入式电子设备的感染预防和设备口袋管理:新兴策略。
IF 4 3区 医学
Current Cardiology Reports Pub Date : 2026-10-15 DOI: 10.1007/s11886-026-02436-7
Benito Jonas Baldauf, Kerstin Bode, Ojan Assadian, Marzia Giaccardi, Pasquale Notarstefano, Ahmet Adiyaman, Martin Hemels, Ernest W Lau, Hendrik Bonnemeier
{"title":"Infection Prevention and Device Pocket Management in Cardiac Implantable Electronic Devices: Emerging Strategies.","authors":"Benito Jonas Baldauf, Kerstin Bode, Ojan Assadian, Marzia Giaccardi, Pasquale Notarstefano, Ahmet Adiyaman, Martin Hemels, Ernest W Lau, Hendrik Bonnemeier","doi":"10.1007/s11886-026-02436-7","DOIUrl":"10.1007/s11886-026-02436-7","url":null,"abstract":"<p><strong>Purpose of review: </strong>Cardiac implantable electronic device (CIED) infection remains one of the most serious complications of device therapy, causing significant morbidity, mortality, healthcare utilization, and costs. Despite advances in device technology and preventive strategies, infection rates have not declined and may be increasing. This review summarizes current evidence on CIED infection prevention and device pocket management, with a focus on risk-based prevention, procedural strategies, and emerging technologies.</p><p><strong>Recent findings: </strong>Increasing evidence supports individualized infection-prevention strategies based on patient-, procedure-, and device-related risk factors. Contemporary approaches extend beyond peri-procedural antibiotic prophylaxis and include structured risk stratification, optimization of modifiable risk factors, meticulous pocket management, prevention of pocket hematoma formation, taurolidine containing adjuncts and selective use of antibacterial technologies such as absorbable antibiotic envelopes. Novel device platforms including leadless pacemakers, subcutaneous and extravascular implantable cardioverter-defibrillators, and conduction system pacing may further reduce infectious burden in selected patients. Emerging technologies including antimicrobial biomaterials, artificial intelligence-assisted risk prediction, and digital wound surveillance may facilitate precision-based infection prevention. CIED infection prevention increasingly requires a comprehensive and individualized approach that addresses the entire contamination - biofilm - infection pathway. Contemporary prevention strategies integrate patient optimization, procedural excellence, pocket management, and selective use of adjunctive technologies. Future advances are likely to shift infection prevention toward precision-based interventions tailored to individual patient risk profiles and device requirements.</p>","PeriodicalId":10829,"journal":{"name":"Current Cardiology Reports","volume":"28 1","pages":""},"PeriodicalIF":4.0,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13672401/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149191810","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Ramadan Fasting in Chronic Heart Failure: A Systematic Review. 斋月禁食治疗慢性心力衰竭:系统综述。
IF 4 3区 医学
Current Cardiology Reports Pub Date : 2026-10-14 DOI: 10.1007/s11886-026-02434-9
Ahad Nourmohammad, Negar Sheibani, Nima Ghasemzadeh, Amirreza Naseri, Elnaz Javanshir, Erfan Banisefid
{"title":"Ramadan Fasting in Chronic Heart Failure: A Systematic Review.","authors":"Ahad Nourmohammad, Negar Sheibani, Nima Ghasemzadeh, Amirreza Naseri, Elnaz Javanshir, Erfan Banisefid","doi":"10.1007/s11886-026-02434-9","DOIUrl":"10.1007/s11886-026-02434-9","url":null,"abstract":"<p><strong>Background: </strong>Chronic heart failure (CHF) is a significant global health concern, affecting over 64 million individuals worldwide. During Ramadan, the ninth month of the Islamic calendar, Muslims abstain from food, drink, smoking, and sexual activity between dawn and sunset. This systematic review investigates the potential impact of Ramadan observance in patients with CHF.</p><p><strong>Methods: </strong>In accordance with JBI and PRISMA guidelines, a comprehensive literature search was performed across PubMed, Scopus, and Web of Science to identify clinical studies examining the effects of Ramadan fasting in patients with CHF. Review articles, case reports, animal studies, editorials, conference abstracts, and commentaries were excluded. Risk of bias was evaluated using the JBI critical appraisal tools.</p><p><strong>Results: </strong>The search identified 137 articles, of which seven met the inclusion criteria. The included studies were mostly conducted in MENA region. Overall, Ramadan fasting was not associated with increased hospitalization rates, deterioration in clinical status, or higher mortality among patients with heart failure.</p><p><strong>Conclusion: </strong>This study suggest that fasting may be relatively safe when undertaken with appropriate medical supervision and adherence to prescribed treatment. Nonetheless, larger prospective studies are warranted to further validate these observations.</p>","PeriodicalId":10829,"journal":{"name":"Current Cardiology Reports","volume":"28 1","pages":""},"PeriodicalIF":4.0,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149180018","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Pharmacologic Stress Myocardial Perfusion Imaging with SPECT and PET in Liver Transplant Candidates: Physiologic Limitations, Current Evidence, and Future Directions. 药物应激心肌灌注显像与SPECT和PET肝移植候选人:生理限制,目前的证据和未来的方向。
IF 4 3区 医学
Current Cardiology Reports Pub Date : 2026-10-09 DOI: 10.1007/s11886-026-02429-6
Menachem M Jacobs, Attila Feher
{"title":"Pharmacologic Stress Myocardial Perfusion Imaging with SPECT and PET in Liver Transplant Candidates: Physiologic Limitations, Current Evidence, and Future Directions.","authors":"Menachem M Jacobs, Attila Feher","doi":"10.1007/s11886-026-02429-6","DOIUrl":"10.1007/s11886-026-02429-6","url":null,"abstract":"<p><strong>Purpose of review: </strong>Myocardial perfusion imaging with SPECT and PET is commonly used to assess coronary artery disease, but its role in liver transplant candidates remains incompletely defined. This review examines how cirrhotic physiology affects pharmacologic stress imaging and summarizes current evidence for the use of SPECT, PET, and quantitative perfusion measures in this population.</p><p><strong>Recent findings: </strong>Hyperdynamic circulation, elevated resting myocardial blood flow, impaired chronotropic response, and attenuated vasodilator reserve may reduce the diagnostic performance of relative perfusion imaging. Reported SPECT sensitivity for coronary artery disease in liver transplant candidates is substantially lower than the general population. Quantitative PET, particularly myocardial flow reserve, has shown possible prognostic value, although evidence is limited to small observational cohorts. SPECT should be interpreted cautiously in higher-risk candidates. PET may offer additional physiologic and prognostic information, but transplant-specific thresholds and clinical pathways remain unvalidated. Whether improved perfusion-based risk stratification changes management and improves outcomes remains to be determined.</p>","PeriodicalId":10829,"journal":{"name":"Current Cardiology Reports","volume":"28 1","pages":""},"PeriodicalIF":4.0,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149147578","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Disparities in GLP-1RA and SGLT2i Uptake: a Systematic Review and an Equity-First Framework for Cardiovascular-Kidney-Metabolic Care. GLP-1RA和SGLT2i摄取的差异:心血管-肾脏-代谢护理的系统评价和公平优先框架
IF 4 3区 医学
Current Cardiology Reports Pub Date : 2026-10-07 DOI: 10.1007/s11886-026-02431-y
Andre H Chu, Boomer Olsen, Joshua Choi, Amara Sarwal, Farrant Sakaguchi, Farideh Akramimoghadam, Joshua A Jacobs, Deepika Reddy, Nikhil Bhatt, Oshozimhede Iyalomhe, Niharika Katkam, Matthew Wahl, Aarya Choudhary, Polina Kukhareva
{"title":"Disparities in GLP-1RA and SGLT2i Uptake: a Systematic Review and an Equity-First Framework for Cardiovascular-Kidney-Metabolic Care.","authors":"Andre H Chu, Boomer Olsen, Joshua Choi, Amara Sarwal, Farrant Sakaguchi, Farideh Akramimoghadam, Joshua A Jacobs, Deepika Reddy, Nikhil Bhatt, Oshozimhede Iyalomhe, Niharika Katkam, Matthew Wahl, Aarya Choudhary, Polina Kukhareva","doi":"10.1007/s11886-026-02431-y","DOIUrl":"10.1007/s11886-026-02431-y","url":null,"abstract":"<p><strong>Purpose of review: </strong>Glucagon-like peptide-1 receptor agonists (GLP-1RAs) and sodium-glucose cotransporter-2 inhibitors (SGLT2is) improve cardiovascular, kidney, and metabolic outcomes, but equitable access remains a major challenge. This review synthesizes U.S. evidence on disparities in their use and proposes an Equity-First Framework for cardiovascular-kidney-metabolic care to advance pharmacoequity.</p><p><strong>Recent findings: </strong>Across 100 U.S.o studies published from 2013 to 2026, the most consistent inequities involved race and ethnicity, socioeconomic status, insurance coverage, age, and access to specialty care, while geographic and sex-related patterns were more heterogeneous. Black and Hispanic patients, Medicaid beneficiaries, lower-income populations, and older adults frequently experienced lower prescribing or initiation. Although use increased following landmark trials and guideline updates, uptake remained well below the eligible population, and disparities persisted or widened for some newer agents. Barriers spanned societal and policy, health-system, provider, patient, and therapy-related domains. Achieving pharmacoequity will require coordinated, multilevel implementation. Our framework links equity-relevant factors and implementation determinants to actionable strategies, including equity monitoring, identification and engagement of eligible patients, equitable care pathways, reduction of structural access barriers, and support for clinicians and patients.</p>","PeriodicalId":10829,"journal":{"name":"Current Cardiology Reports","volume":"28 1","pages":""},"PeriodicalIF":4.0,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149126854","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Racial and Ethnic Disparities in the Utilization and Outcomes of Catheter Ablation for Atrial Fibrillation and Flutter: a State-of-the-Art Review. 导管消融治疗心房颤动和扑动的应用和结果的种族和民族差异:最新的综述。
IF 4 3区 医学
Current Cardiology Reports Pub Date : 2026-10-06 DOI: 10.1007/s11886-026-02425-w
Daniel Antwi-Amoabeng, T David Gbadebo
{"title":"Racial and Ethnic Disparities in the Utilization and Outcomes of Catheter Ablation for Atrial Fibrillation and Flutter: a State-of-the-Art Review.","authors":"Daniel Antwi-Amoabeng, T David Gbadebo","doi":"10.1007/s11886-026-02425-w","DOIUrl":"10.1007/s11886-026-02425-w","url":null,"abstract":"<p><strong>Purpose of review: </strong>Catheter ablation (CA) has become a first-line option for rhythm control strategy for atrial fibrillation (AF) and atrial flutter (AFL). We synthesize recent evidence regarding racial and ethnic disparities in CA utilization in the United States and examine the structural mechanism driving them.</p><p><strong>Recent findings: </strong>Black patients are 28 to 36% less likely to undergo CA for AF or AFL compared to White patients, with similarly reduced odds (22 - 35%) observed among Hispanic and Asian patients for AF. While subgroup analysis from clinical trials like CABANA demonstrate survival benefits of CA among minority cohorts, real-world data reveal that the very populations that stand to benefit the most are the least likely to receive CA. Public insurance models, upstream referral bottlenecks, geographic specialty deserts, and clinician-level implicit bias serve as primary structural drivers of these disparities. Racial and ethnic gaps persist in CA utilization and outcomes for both AF and AFL. AF/AFL prevalence is influenced by racial and ancestral biology while CA access disparity is driven by race as a social construct. These two phenomena require fundamentally different investigative frameworks and intervention targets.</p>","PeriodicalId":10829,"journal":{"name":"Current Cardiology Reports","volume":"28 1","pages":""},"PeriodicalIF":4.0,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13642398/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149105364","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The Left Atrial Appendage: Anatomy, Electrophysiology, and Clinical Implications for Atrial Fibrillation and Stroke. 左心房附件:解剖、电生理学和心房颤动和中风的临床意义。
IF 4 3区 医学
Current Cardiology Reports Pub Date : 2026-10-06 DOI: 10.1007/s11886-026-02428-7
Adriana Daniela Sârb, Csilla-Andrea Eötvös, Teodora Avram, Iulia-Georgiana Zehan, Mădălina Patricia Moldovan, Roxana Daiana Lazar, Giorgia Coșeriu, Patricia Schiop-Tentea, Ioana-Diana Mihuș, Oliviu Florențiu Sârb, Mihnea Istrate, Doinita Crisan, Edwin Kevin Heist, Sorin Pop, Dan Blendea
{"title":"The Left Atrial Appendage: Anatomy, Electrophysiology, and Clinical Implications for Atrial Fibrillation and Stroke.","authors":"Adriana Daniela Sârb, Csilla-Andrea Eötvös, Teodora Avram, Iulia-Georgiana Zehan, Mădălina Patricia Moldovan, Roxana Daiana Lazar, Giorgia Coșeriu, Patricia Schiop-Tentea, Ioana-Diana Mihuș, Oliviu Florențiu Sârb, Mihnea Istrate, Doinita Crisan, Edwin Kevin Heist, Sorin Pop, Dan Blendea","doi":"10.1007/s11886-026-02428-7","DOIUrl":"10.1007/s11886-026-02428-7","url":null,"abstract":"<p><strong>Purpose of review: </strong>The left atrial appendage (LAA) is nowadays recognized as both an arrhythmogenic substrate and the dominant source of thromboembolism in atrial fibrillation (AF). In this review we tried to summarize recent data on the anatomy, physiology, and imaging of the LAA, and examine how these findings help guide rhythm-control and stroke-prevention strategies.</p><p><strong>Recent findings: </strong>High-resolution mapping confirms the LAA as a non-pulmonary-vein trigger source in persistent and post-ablation AF, supporting LAA electrical isolation in selected patients, though isolation may induce mechanical standstill and mandate continued thromboprophylaxis. The 2024 ESC guidelines reframed stroke-risk assessment around the sex-neutral CHA₂DS₂-VA score within the AF-CARE pathway. An important recent study was the OPTION trial, which showed that LAA closure after AF ablation was as effective as oral anticoagulation for preventing death, stroke, or systemic embolism and was associated with less non-procedure-related bleeding. These findings support the use of LAA closure in selected patients after ablation. New imaging and emerging computational tools may also improve patient selection and help guide device sizing. A comprehensive assessment of the anatomy, function, and electrical activity of the LAA can help adapt AF treatment to each patient.</p>","PeriodicalId":10829,"journal":{"name":"Current Cardiology Reports","volume":"28 1","pages":""},"PeriodicalIF":4.0,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13642397/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149105396","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Known Unknowns: Unpacking Controversies and Uncertainties in the 2025 Guidelines for Management of Acute Coronary Syndromes. 已知的未知:2025年急性冠脉综合征管理指南中的争议和不确定性。
IF 4 3区 医学
Current Cardiology Reports Pub Date : 2026-10-05 DOI: 10.1007/s11886-026-02427-8
Valentina Jaramillo Restrepo, Sunil V Rao
{"title":"Known Unknowns: Unpacking Controversies and Uncertainties in the 2025 Guidelines for Management of Acute Coronary Syndromes.","authors":"Valentina Jaramillo Restrepo, Sunil V Rao","doi":"10.1007/s11886-026-02427-8","DOIUrl":"10.1007/s11886-026-02427-8","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Purpose of review: &lt;/strong&gt;The 2025 ACC/AHA/ACEP/NAEMSP/SCAI Guideline for managing patients with acute coronary syndromes (ACS) is the first major update since the 2013-2015 ST-elevation myocardial infarction (STEMI) and non-ST elevated myocardial infarction (NSTEMI) guidelines. It brings both conditions together into a single framework. This review covers the most important new and revised recommendations and points out where evidence is still lacking.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Recent findings: &lt;/strong&gt;New findings show that several significant updates are based on recent large-scale trials. The use of bivalirudin with high-dose infusion after percutaneous coronary intervention (PCI) is now given a Class I recommendation for primary PCI in the case of STEMI, as a result of the BRIGHT-4 trial. Complete revascularization is also now recommended as Class I for stable STEMI patients who have multivessel disease, according to the COMPLETE trial. For a selected group of patients with refractory cardiogenic shock resulting from a myocardial infarction, the percutaneous microaxial flow pump has received a new Class IIa recommendation from the DanGer Shock trial, while the intra-aortic balloon pump and extracorporeal membrane oxygenation are classified as Class III for routine use. Intracoronary imaging (intravascular ultrasound and optical coherence tomography) is now given a Class I recommendation for complex PCI, based on the data of the RENOVATE-COMPLEX-PCI, OCTOBER, and OCTIVUS trials. The guidelines also suggest specific low-density lipoprotein cholesterol (LDL-C) targets, and non-statin drugs should be added if the LDL-C level remains above 70 mg/dL even when maximum statin therapy is used. Regarding antiplatelet therapy, ticagrelor or prasugrel is now preferred to clopidogrel in the case of ACS-PCI, and it is formally recommended to switch to P2Y12 monotherapy at one month in patients at high risk for bleeding as an alternative to standard DAPT. The updates indicate a shift towards more potent antiplatelet therapy at hospital presentation, use of radial access when feasible, more use of imaging-guided PCI, stricter lipid targets, and more refined antiplatelet approaches at the time of discharge. That said, significant gaps in the evidence still exist. It has not yet become clear whether physiology-guided revascularization of non-culprit arteries in patients with STEMI or NSTEMI is better than angiography-guided PCI-a question that is currently being investigated in the randomized COMPLETE-2 trial. The optimal time to provide mechanical circulatory supper in cases of cardiogenic shock remains uncertain. The recent neutral findings from intracoronary imaging studies such as OPTIMAL and IVUS-CHIP might alter the existing Class I recommendation. Lastly, new data from the HOST-EXAM, and SMART CHOICE 3, studies suggest that P2Y12 monotherapy may be better than aspirin for the long-term prevention of major adverse cardiovascular events, and this could","PeriodicalId":10829,"journal":{"name":"Current Cardiology Reports","volume":"28 1","pages":""},"PeriodicalIF":4.0,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149105400","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Health-Related Social Needs and Cardiovascular Disease. 与健康相关的社会需求和心血管疾病。
IF 4 3区 医学
Current Cardiology Reports Pub Date : 2026-10-03 DOI: 10.1007/s11886-026-02424-x
Charity Foxx, Seth A Berkowitz
{"title":"Health-Related Social Needs and Cardiovascular Disease.","authors":"Charity Foxx, Seth A Berkowitz","doi":"10.1007/s11886-026-02424-x","DOIUrl":"10.1007/s11886-026-02424-x","url":null,"abstract":"<p><strong>Purpose of review: </strong>To examine the relationship between health-related social needs, specifically food insecurity, housing instability, and transportation barriers, interventions to address those needs, and cardiovascular health outcomes.</p><p><strong>Recent findings: </strong>Food insecurity and housing instability are associated with many adverse cardiovascular disease outcomes, including greater prevalence and incidence, worse disease management, and greater risk of complications. Transportation barriers are plausibly linked to worse outcomes, but relatively understudied. Food is medicine interventions, which address food insecurity and help overcome barriers to healthy eating, have shown important benefits for blood pressure and heart failure in large-scale randomized clinical trials. Few interventions have evaluated the impacts on cardiovascular outcomes of addressing housing instability or transportation barriers. Health-related social needs clearly contribute to worse cardiovascular health. Several recent trials show promising benefits from addressing food insecurity. There is not yet enough evidence to draw conclusions about the cardiovascular health impacts of addressing housing instability and transportation barriers.</p>","PeriodicalId":10829,"journal":{"name":"Current Cardiology Reports","volume":"28 1","pages":""},"PeriodicalIF":4.0,"publicationDate":"2026-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149105398","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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