Current Cardiology Reviews最新文献

{"title":"Alirocumab versus Evolocumab on Cardiovascular Outcomes: A Systematic Review and Meta-analysis.","authors":"André Saad Cleto, João Matheus Schirlo, Janete Machozeki, Camila Marinelli Martins","doi":"10.2174/011573403X357542250526072430","DOIUrl":"https://doi.org/10.2174/011573403X357542250526072430","url":null,"abstract":"<p><strong>Introduction: </strong>The PCSK9 enzyme is present mainly in the liver and is responsible for the degradation of LDL-C receptors. Currently, there are some drugs that inhibit this enzyme, such as alirocumab and evolocumab. Consequently, these drugs reduce serum LDL-C levels. Therefore, a systematic review and a meta-analysis were carried out in order to compare alirocumab against evolocumab in reducing cardiovascular outcomes.</p><p><strong>Methods: </strong>This systematic review was carried out in accordance with PRISMA and was registered in PROSPERO (CRD42024573217). The following databases were searched on July, 9, 2024: Pubmed, Web of Science and Scopus. Randomized clinical trials with a control group were included and meta-analyses were performed to assess relative risk (RR). The random effects model was used in heterogeneous samples. The articles were distributed into 2 subgroups: use of alirocumab and evolocumab.</p><p><strong>Results: </strong>Initially, 2,213 articles were found, of which 6 were included. In total, 62,119 patients participated. The RR values were significant for alirocumab in the following outcomes: myocardial infarction (MI) 0.85 (95% CI 0.77-0.93), stroke 0.75 (95% CI 0.60-0.94) and hospitalization for unstable angina 0.58 (95% CI 0.39-0.86), while for evolocumab they were significant for MI 0.75 (95% CI 0.68-0.83) and coronary revascularization 0.81 (95 CI % 0.75-0.88). There was a statistically significant difference between the drugs for hospitalization for unstable angina (p=0.02).</p><p><strong>Discussion: </strong>This study highlights the benefits of PCSK9 inhibitors, especially alirocumab, in reducing major cardiovascular events. Alirocumab significantly lowered hospitalizations for unstable angina, with a 42% reduction, and showed favorable outcomes in reducing myocardial infarction, coronary revascularization, and stroke. These reductions are clinically meaningful, as they lower morbidity, improve patient quality of life, and reduce healthcare costs. Both alirocumab and evolocumab are effective and safe, offering important therapeutic options for high-risk cardiovascular patients.</p><p><strong>Conclusion: </strong>The use of alirocumab is preferable if the focus is to avoid hospitalizations for unstable angina or stroke, while evolocumab may be an option if one wants to avoid coronary revascularization. Both drugs are effective in reducing cardiovascular outcomes, but alirocumab was superior to evolocumab.</p>","PeriodicalId":10832,"journal":{"name":"Current Cardiology Reviews","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144282799","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improvement of Hemodynamics and Quality of Life Before and After Interatrial Shunt Devices Implantation for Chronic Heart Failure: A Systematic Review and Meta-analysis.","authors":"Yugen Guan, Lei Yang, Yuwen Lu, Xiaogan Liang, Ruiqi Wang, Rongrong Shen, Liang Yang, Jingwen Song, Shaofei Liu, Yuan Bai, Zhifu Guo, Ni Zhu","doi":"10.2174/011573403X376422250522094942","DOIUrl":"https://doi.org/10.2174/011573403X376422250522094942","url":null,"abstract":"<p><strong>Objective: </strong>The objective of this study was to compare the quality of life and hemodynamic changes before and after transcatheter atrial septal shunt implantation.</p><p><strong>Methods: </strong>A systematic search was conducted in the Cochrane Library, PubMed, and Embase from inception to September 2023 for studies reporting on hemodynamics or quality of life in patients with chronic heart failure after atrial septal shunt implantation. A meta-analysis was performed, in which a total of 1026 participants from 13 articles were included.</p><p><strong>Results: </strong>Following the implantation, pulmonary capillary wedge pressure (PCWP) decreased by 2.60 mmHg. Right atrial pressure (RAP) increased by 1.30 mmHg and left ventricular ejection fraction (LVEF) increased by 2.13%. However, there were no significant differences in cardiac output and mean pulmonary artery pressure (mPAP) after operation. Minnesota Living with Heart Failure (MLWHF) Score decreased by -19.28, while the Kansas City Cardiomyopathy Questionnaire (KCCQ) score increased by 25.41. Moreover, 6-minute walking distance (6MWD) increased by 32.22 m. The results of subgroup analysis showed that for patients with heart failure with preserved ejection fraction (HFpEF) and heart failure with mildly reduced ejection fraction (HFmrEF), LVEF increased by 3.09% while CO increased by 1.01 L/min after operation. Meanwhile, PCWP significantly decreased by 2.67 mmHg and MLWHF scores decreased by 19.28. Additionally, 6MWD significantly increased by 27.5 m. However, there were no significant changes in RAP and mPAP after operation. For patients with heart failure with reduced ejection fraction (HFrEF), interatrial shunt device implantation did not achieve a significant increase in LVEF.</p><p><strong>Conclusion: </strong>These findings suggest that while atrial septal shunt implantation might not yield LVEF elevation among patients with HFrEF, it improves hemodynamic parameters, exercise endurance, and QoL among individuals with HFpEF/HFmrEF.</p>","PeriodicalId":10832,"journal":{"name":"Current Cardiology Reviews","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144282800","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of eRNAs in Cardiovascular Diseases.","authors":"Yuqing Li, Chao Song, Jian Cui, XiangYu Fei, XiaoYong Lei, Huifang Tang","doi":"10.2174/011573403X375542250529182602","DOIUrl":"https://doi.org/10.2174/011573403X375542250529182602","url":null,"abstract":"<p><p>Enhancer RNAs (eRNAs), a class of non-coding RNAs transcribed from enhancer regions, have emerged as critical regulators of gene expression in cardiovascular diseases (CVDs), which are among the leading causes of morbidity and mortality in China. The pathogenesis of CVD is complex, involving precise regulation of diverse biological processes. Recent advances in epigenetics have highlighted the pivotal role of eRNAs in gene regulation. This review summarizes the fundamental characteristics of eRNAs and their mechanisms of action in CVD, focusing on how they regulate gene expression through enhancer-promoter looping, chromatin remodeling, and transcriptional control. Key eRNAs, including IRENES, CARMEN, LINC00607, HERNA1, PSMB8-AS1, and WISPER, are discussed in detail, emphasizing their roles in pathological processes, such as cardiac development, vascular remodeling, atherosclerosis, and fibrosis. These eRNAs interact with transcription factors and others to influence cardiovascular gene regulatory networks. Advances in high-throughput sequencing have identified eRNAs as potential biomarkers and therapeutic targets in CVDs, offering implications for diagnosis, treatment, and precision medicine. For instance, targeting CARMEN may attenuate atherosclerosis, while LEENE could address endothelial dysfunction. Despite their therapeutic potential, further studies are needed to elucidate the mechanisms underlying eRNAs function and their roles in CVD pathogenesis. A deeper understanding of eRNAs may pave the way for novel therapeutic strategies in cardiovascular medicine.</p>","PeriodicalId":10832,"journal":{"name":"Current Cardiology Reviews","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144257519","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of Renal Impairment Severity with Surgical Outcomes in Patients with Infective Endocarditis.","authors":"Jing Yong Ng, Eu Fon Tan, Soubhagyashree Roy, Sungha Cho, Takakazu Ryan Yatoji Tan, Marsioleda Kemberi, Wael I Awad","doi":"10.2174/011573403X353597250515051547","DOIUrl":"https://doi.org/10.2174/011573403X353597250515051547","url":null,"abstract":"<p><strong>Introduction: </strong>This study aimed to assess the association of renal impairment (RI) severity on short and mid-term outcomes in patients undergoing cardiac surgery for infective endocarditis (IE).</p><p><strong>Methods: </strong>Patients undergoing cardiac surgery for IE between January 2010 and October 2022 were included. They were stratified based on preoperative renal function into four groups: Normal (N: Creatinine clearance (CrCl) >85mL/min), moderate RI (M: CrCl 51-85mL/min), severe RI (S: CrCl ≤50mL/min), and haemodialysis-dependent (H). Each group was compared with group N. Survival analysis was performed using Kaplan-Meier curves.</p><p><strong>Results: </strong>A total of 487 patients (N: 198; M: 154; S: 96; H: 39) were included. Mean age 55.92 ± 14.60 years, 375 (77%) males. Groups M, S, and H vs N demonstrated more atrial fibrillation [17 (11.0%), 20 (20.8%), 6 (15.4%) vs 8 (4.0%); p<0.05]. Groups S and H vs. N had increased incidence of left ventricular ejection fraction <50% [43 (44.8%), 22 (56.4%) vs 43 (21.7%); p<0.001] and preoperative cardiogenic shock [16 (16.7%), 13 (33.3%) vs 9 (4.5%); p<0.001]. The need for postoperative haemodialysis was 21 (13.6%) in M and 23 (23.0%) in S vs. 13 (6.6%) in N (p<0.05). In-hospital mortality was 13 (8.4%), 21 (21.9%), and 11 (28.2%) vs. 12 (6.1%) (p=0.388, <0.001, <0.001), and mortality at a mean of 69.1months was 49 (31.8%), 46 (46.9%), 30 (76.9%) vs. 49 (24.7%) (p=0.142, <0.001, <0.001) in groups M, S, H vs. N, respectively.</p><p><strong>Conclusions: </strong>The incidence of renal impairment in patients with IE undergoing surgery remains high. Early and mid-term outcomes of those with severe RI and haemodialysis dependence are significantly worse.</p>","PeriodicalId":10832,"journal":{"name":"Current Cardiology Reviews","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144215193","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Dilemma in the Management of Patients with Heart Failure with Reduced Ejection Fraction, Sinus Rhythm and Left Ventricular Spontaneous Echo Contrast: A Narrative Review.","authors":"Hedieh Alimi, Ali Tajik","doi":"10.2174/011573403X363285250519064030","DOIUrl":"https://doi.org/10.2174/011573403X363285250519064030","url":null,"abstract":"<p><p>Heart failure (HF) is a complex clinical syndrome that arises from structural or functional impairment of ventricular filling or ejection of blood, resulting in previous characteristic symptoms of fatigue, dyspnea, and fluid retention. Among the complications of heart failure is the development of spontaneous echo contrast (SEC), characterized by a smoke-resembling appearance on echocardiograms, which indicates blood stasis in heart chambers. Despite being identified as an echocardiographic marker in the left atrium that correlates with thrombus formation and causes thromboembolic events, the clinical importance of left ventricular spontaneous echo contrast (LV-SEC) and the appropriate management for patients with this condition remain uncertain due to insufficient data. Anticoagulant therapy is generally recommended for patients with established left ventricular thrombus (LVT). However, for patients with heart failure with reduced ejection fraction (HFrEF) and sinus rhythm (SR), as a result of a decrease in thromboembolic events over time, it is typically not recommended. The main challenge lies in assessing the thromboembolic risk and determining appropriate management in patients with HFrEF, sinus rhythm (SR), and left ventricular spontaneous echo contrast (LV-SEC), compared to those with left ventricular thrombus (LVT) and those with HFrEF and SR without LV-SEC. The aim of this paper is to review the guidelines and trials on clinical characteristics, outcomes, and management of patients with LV-SEC and compare the suggested management with the established management for LVT and HF patients with sinus rhythm without LV-SEC.</p>","PeriodicalId":10832,"journal":{"name":"Current Cardiology Reviews","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144186751","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predicting Coronary Artery Lesion Severity Using Pulse Wave Harmonics: A SYNTAX Score-Based Study.","authors":"Haitian Li, Buxing Chen, GinChung Wang, Yunxiao Wang, Yang Yang","doi":"10.2174/011573403X400522250519073551","DOIUrl":"https://doi.org/10.2174/011573403X400522250519073551","url":null,"abstract":"&lt;p&gt;&lt;p&gt;Introduction This study aimed to investigate the correlation between the differences in pulse wave harmonic indices between the left and right hands and the SYNTAX score and to explore the potential of pulse wave harmonics in predicting the degree of coronary artery lesions. Methods The arterial pressure wave signals from both hands of the patients scheduled for coronary angiography were recorded using photoplethysmography. According to the \"visceral resonance theory,\" taking integer multiples of the heartbeat from 0 to 11 as the resonance frequencies, the collected arterial pressure waves were decomposed into the 0th to 11th harmonics via the Fourier transform method. The harmonic characteristics were quantified by amplitude (Cn), phase (Pn), and energy (Dn) (n is the harmonic serial number), and the coefficient of variation of the indices was calculated and suffixed as CV. The difference between the measured values of the left- and right-hand parameters of the same patient was calculated (ΔCn,ΔPn,ΔDn,ΔCnCV,ΔPnCV), and the absolute value of the difference was obtained (|ΔCn|, |ΔPn|, |ΔDn|, |ΔCnCV|, |ΔPnCV|). Based on the coronary angiography imaging data, SYNTAX scores were computed for all participants, who were stratified by gender into male and female cohorts. For each group, logistic regression models were established with SYNTAX score≥22 as the dependent variable, and harmonic index differences as the independent variables. To determine the best prediction model, the Akaike Information Criterion (AIC) was used and model with the lowest score was selected. Finally, the discriminant ability of the prediction model was evaluated using the ROC curve analysis and the Bootstrap internal validation method. Results: A total of 348 patients were included, with 249 males and 99 females. In the male group, the discriminant model was based on |ΔC10|,ΔD6, |ΔD9|, |ΔD10|, |ΔP8|, |ΔP10|, ΔP1CV, and ΔC9CV, with the minimum AIC value of 105.47, the area under the ROC curve (AUC) of 0.89, and the average AUC of 0.85 in the Bootstrap internal validation. In the female group, the discriminant model was based on |ΔD2|, |ΔD3|, |ΔD5|, |ΔD6|, |ΔD9|, |ΔC2CV|, |ΔC4CV|, |ΔC5CV|, | ΔC6CV|, and |ΔC9CV|, with the minimum AIC value of 59.34. The AUC of the ROC curve of this prediction model was 0.92, and the average AUC in the Bootstrap internal validation was 0.84. Discussion In this study, the degree of coronary artery occlusion was evaluated through a noninvasive method combined with the SYNTAX score, providing a valuable noninvasive tool for clinical evaluation of CAD. This detection method is easy to operate, has high repeatability, and the equipment is small in size, making it suitable for various environments, it can be operated independently by the patients. Yet, the current study, being cross-sectional, only found an association rather than a causal relationship, calling for future prospective studies to clarify the causal link. Conclusion: The different ch","PeriodicalId":10832,"journal":{"name":"Current Cardiology Reviews","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144109853","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Association of Neuropeptide Y with the Presence and Frequency of Ventricular Premature Beats.","authors":"Necip Fazıl Dedeoglu, Mustafa Begenc Tascanov, Kenan Toprak, Halil Fedai, Asuman Bicer, İbrahim Halil Altiparmak, Zulkif Tanriverdi, Recep Demirbag, Ismail Koyuncu","doi":"10.2174/011573403X361970250507035931","DOIUrl":"https://doi.org/10.2174/011573403X361970250507035931","url":null,"abstract":"<p><strong>Background: </strong>The estimated prevalence of ventricular extra systole (VES) in the general population is about 1-4% on ECG, but 24-hour Holter monitoring has shown a prevalence of 40-75%. While it may be asymptomatic in many patients, frequent VES persisting for a long time can negatively affect left ventricular (LV) systolic function in patients without structural heart disease. The etiology of VES is not completely known. In this study, we investigated the role of neuropeptide Y (NPY) in the occurrence of VES.</p><p><strong>Material and methods: </strong>In this study, we included 150 patients with VES and 86 cases without VES as the control group. 24-hour Holter monitoring was performed on all subjects. Patients with VES were divided into two subgroups according to the frequency of VES as those >15,000 (Group 1, n= 48) and <15,000 (Group 2, n= 102). Venous blood was collected from all cases for biochemistry parameters and NPY level measurement.</p><p><strong>Results: </strong>There were statistically significant differences between the two groups in terms of gender, smoking, LVEF, NPY, total cholesterol, LVEDD, SDNN, SDNNINDEX, RMSD, PNN50, LF, HF, VLF, and LF/HF (p<0.05, for all). Correlation analysis showed a significant positive correlation between serum NPY level and number of VES (r=0.577, p=0.001), LF (r=0140, p=0.032), LVEDD (r=0.162, p=0.013), and LVESD (r=0.290, p=0.001). Conversely, a negative correlation was observed between NPY and RMSSD (r=-0.162, p=0.012), SDNNINDEX (r=-0.136, p=0.037). Multivariate logistic regression analysis showed that NPY (odds ratio [OR]: 1.204; 95% confidence interval [CI]: 1.103-1.315; p=0.001) was an independent predictor of VES development. ROC curve analysis showed that NPY ≥ 47.9 ng/L predicted the occurrence of VES with a sensitivity of 82.0% and specificity of 81.4%. In addition, NPY ≥ 79.8 predicted the frequency of VES with a sensitivity of 85.5% and specificity of 87.3 %.</p><p><strong>Conclusion: </strong>Our study showed that serum NPY levels may play an important role in the development of VES. Also, it was found that the frequency of VES increased as the NPY level increased.</p>","PeriodicalId":10832,"journal":{"name":"Current Cardiology Reviews","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144076567","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pharmacological Foundation and Novel Insights of Resveratrol in Cardiovascular System: A Review.","authors":"Ruchi Tiwari, Gaurav Tiwari, Anju Singh, Namdev Dhas","doi":"10.2174/011573403X343252250502045328","DOIUrl":"https://doi.org/10.2174/011573403X343252250502045328","url":null,"abstract":"<p><p>Research into drugs that can enhance cardiovascular health has been sparked by the rising prevalence of cardiovascular illnesses (CVDs). In addition to its anti-inflammatory and antioxidant qualities, Resveratrol (RES) is well known for its capacity to increase endothelial NO synthase (eNOS) activity. This page summarises RES's wide effects on energy metabolism, resilience to stress, exercise mimicking, circadian rhythm, lifespan control, and microbiome composition. This article addresses the poor and contradictory results shown in preclinical and clinical trials provides an update on the cardiovascular preventive properties of RES. The activation of AMP-activated protein kinase (AMPK), silent information regulator 1 (SIRT1), and natural antioxidant enzymes is associated with some of the positive effects of RES on the cardiovascular system. A microarray data summary indicates a strong correlation between the heart's reaction to calorie restriction and the transcriptional responses to RES. RES has been demonstrated to reduce contractile dysfunction, cardiac remodelling, and hypertrophy in several animal models of heart failure. Its preventive properties are believed to be due to several molecular pathways, including the suppression of prohypertrophic signalling molecules, enhancement of cardiac Ca2+ handling, control of autophagy, and decreases in inflammation. RES thus has the potential to be used in several novel therapeutic approaches for treating diseases such as atherosclerosis, ischemia/reperfusion damage, metabolic syndrome, heart failure, and inflammatory changes associated with ageing.</p>","PeriodicalId":10832,"journal":{"name":"Current Cardiology Reviews","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144076566","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antiplatelet-Proton Pump Inhibitor Interactions and Arterial Thrombotic Events: A Pharmacovigilance Assessment Using Disproportionality and Interaction Analysis.","authors":"Kannan Sridharan","doi":"10.2174/011573403X374906250417043907","DOIUrl":"https://doi.org/10.2174/011573403X374906250417043907","url":null,"abstract":"<p><strong>Aims: </strong>The aim of this study is to evaluate the safety profiles of antiplatelet-proton pump inhibitors (PPIs) combinations and assess the clinical implications of their concurrent use in real-world settings through pharmacovigilance data analysis.</p><p><strong>Background: </strong>The concomitant use of PPIs with antiplatelet therapy remains controversial due to potential drug interactions affecting clinical outcomes. While PPIs are recommended for gastroprotection in patients receiving antiplatelet therapy, concerns persist regarding their impact on antiplatelet efficacy, particularly with dual antiplatelet therapy (DAPT).</p><p><strong>Objectives: </strong>The objective of this study is to analyze and compare the thrombo-embolic risk profiles of various antiplatelet-PPI combinations using the FDA Adverse Event Reporting System database.</p><p><strong>Methods: </strong>We conducted a comprehensive analysis of the FDA Adverse Event Reporting System (FAERS) database to evaluate the thrombo-embolic risk associated with antiplatelet-PPI combinations. The reporting odds ratio (ROR) and information component were calculated to detect safety signals. The interaction signal score (INTSS) was used to assess the protective or harmful effects of adding acetylsalicylic acid to clopidogrel-PPI combinations.</p><p><strong>Results: </strong>Analysis revealed significant safety signals for thrombo-embolic events with clopidogrel-rabeprazole (ROR: 62.67, 95% CI: 38.38-102.32) and clopidogrel-omeprazole (ROR: 6.87, 95% CI: 4.89-9.66) combinations. DAPT-PPI combinations showed comparable safety profiles to monotherapy-PPI combinations. The INTSS analysis suggested a potential protective effect of acetylsalicylic acid when added to clopidogrel-PPI combinations. Genderspecific analysis revealed female predominance in monotherapy complications and male predominance in combination therapy events. Clinical outcomes, including mortality and hospitalization rates, were comparable between groups.</p><p><strong>Conclusion: </strong>This pharmacovigilance analysis suggests that while DAPT-PPI combinations demonstrate acceptable safety profiles, careful consideration should be given to PPI selection, particularly given the unexpected safety signals with rabeprazole and confirmed risks with omeprazole. The addition of acetylsalicylic acid to clopidogrel-PPI combinations may offer protective effects against thrombo-embolic events. These findings support individualized riskbenefit assessment in selecting antiplatelet-PPI combinations while ensuring adequate gastroprotection for high-risk patients.</p>","PeriodicalId":10832,"journal":{"name":"Current Cardiology Reviews","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143981616","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evolving Strategies in the Detection and Management of Left Ventricular Thrombus: A Clinical Summary.","authors":"Mahmoud Abdelnabi, Ramzi Ibrahim, Hoang Nhat Pham, Yehia Saleh, Abdallah Almaghraby","doi":"10.2174/011573403X364065250429095440","DOIUrl":"https://doi.org/10.2174/011573403X364065250429095440","url":null,"abstract":"<p><p>Recent advancements have emerged in understanding the epidemiology and optimal therapeutic options for left ventricular thrombi (LVT). With early percutaneous interventions in acute myocardial infarction, the prevalence of LVT has decreased. However, the best strategies for prevention, risk stratification, and management remain unclear, especially among nonischemic cardiomyopathy disorders. This review outlines these advancements and provides an overview of the diagnostic and therapeutic implications of LVT in ischemic and non-ischemic cardiomyopathies. Significant gaps in the current evidence persist, particularly regarding the optimal timing for LVT screening and the need for prophylactic anticoagulation, highlighting opportunities for prospective cohort studies. Furthermore, a better understanding of the unique risk factors that contribute to increased LVT risk would lead to more comprehensive algorithms that may quantify the risk of LVT development, aiding in developing preventive strategies targeted at reducing rates of LVT. Until more definitive evidence is available, clinicians should custom LVT screening, preventive measures, and management strategies based on individual patient risk factors.</p>","PeriodicalId":10832,"journal":{"name":"Current Cardiology Reviews","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143976097","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}