{"title":"RASopathies and Cardiac Complications: Insights into Mechanisms, Diagnosis, and Innovative Treatments.","authors":"Keshav Garg, Shubam Trehan, Fremita Fredrick, Ankur Singla, Kanishk Aggarwal, Aachal Gupta, Rohit Jain","doi":"10.2174/011573403X341624250324164700","DOIUrl":"https://doi.org/10.2174/011573403X341624250324164700","url":null,"abstract":"<p><p>RAS proteins are critical in cellular signal transduction, influencing cell proliferation, differentiation, and survival. While extensively studied for their role in cancer, RAS gene mutations also contribute significantly to cardiovascular diseases, such as hypertrophic cardiomyopathy, pulmonary valve stenosis, and atrial septal defects. Despite their similar primary structures, RAS proteins exhibit distinct functions in cardiac biology: H-RAS regulates cardiomyocyte size, K-RAS governs proliferation, and N-RAS, less associated with cardiac defects, is understudied in cardiac cells. Congenital RAS mutations, collectively known as RASopathies, include syndromes, like Noonan syndrome and cardio-facio-cutaneous syndrome, which often lead to severe cardiac complications, including heart failure. Genetic testing and imaging advances have improved the diagnosis and management of these conditions. Recent research has shown promise with MEK inhibitors and other targeted therapies, offering potential improvements in managing RAS-related cardiac conditions. This review explores the role of the RAS subfamily in heart disease, highlighting key concepts and potential therapeutic targets. PubMed database was searched using keywords, such as RASopathies, RAS gene mutations, cardiac hypertrophy, cardiovascular disease, RAS/MAPK pathway, congenital heart disease, and more. Relevant literature up to June 2024 was examined and summarized, consisting of data from various clinical trials, meta-analyses, retrospective/prospective cohort studies, and current guidelines.</p>","PeriodicalId":10832,"journal":{"name":"Current Cardiology Reviews","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143771693","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}
Kirtivardhan Vashistha, Akshat Banga, Michael Nestasie, Sarumathi Thangavel, Mian Tanveer Ud Din, George Shaw
{"title":"Unveiling the Hidden Culprit: A Case Report on Tachy-Bradyarrhythmias Presenting as Seizure Disorders.","authors":"Kirtivardhan Vashistha, Akshat Banga, Michael Nestasie, Sarumathi Thangavel, Mian Tanveer Ud Din, George Shaw","doi":"10.2174/011573403X344795250304084151","DOIUrl":"https://doi.org/10.2174/011573403X344795250304084151","url":null,"abstract":"<p><strong>Background: </strong>The misdiagnosis of seizure disorders in patients with cardiogenic syncope and tachy-bradyarrhythmias is a significant diagnostic challenge as the differentials for altered mental status and syncope are broad and can mimic other clinical conditions. This case report presents a unique case of an elderly male with life-threatening ventricular arrhythmia, initially misdiagnosed as a seizure disorder associated with syncope and treated with anti-epileptics for a neurogenic cause, before an ambulatory cardiac monitor revealed a sinister cardiogenic etiology.</p><p><strong>Case presentation: </strong>An 87-year-old man with ischemic cardiomyopathy (LVEF 20%) and persistent atrial fibrillation presented for implantable cardioverter-defibrillator (ICD) evaluation following a ventricular fibrillation (VF) arrest. He had a history of recurrent syncope accompanied by muscle jerking and was initially treated with anti-epileptic drugs. However, further evaluation with mobile telemetry revealed ventricular arrhythmias, including nonsustained VT, VF, and asystole. Anti-epileptic medications were discontinued, and the patient was started on amiodarone. A cardiac resynchronization therapy defibrillator (CRT-D) was implanted, which successfully resolved his symptoms. Post-treatment, he remained asymptomatic, with no new VT/VF episodes detected at one week and three months during follow-up device checks.</p><p><strong>Conclusion: </strong>This case underscores the importance of considering cardiogenic causes in patients with syncope and seizure-like symptoms. Therefore, a multidisciplinary approach is essential for accurate diagnosis and management.</p>","PeriodicalId":10832,"journal":{"name":"Current Cardiology Reviews","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669350","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":"An Updated Review on the Complex Association of Cardiovascular Disease (CVD) and Depression.","authors":"Namra Aziz, Tanya Tripathi, Anurag Rawat, Uttam Prasad Panigrahy, Darshan Jc, Mukesh Chandra Sharma, Pranay Wal","doi":"10.2174/011573403X337113250212093810","DOIUrl":"https://doi.org/10.2174/011573403X337113250212093810","url":null,"abstract":"<p><strong>Introduction: </strong>The presence of both cardiovascular disease (CVD) and depression is common, and their complex connection poses difficulties in therapy and affects patient outcomes. Thus, this study aims to examine the complex correlation between depression and cardiovascular disease (CVD), with a specific focus on potential biomarkers and innovative therapeutic approaches.</p><p><strong>Methods: </strong>Publications were considered between 2015-2024 from standard databases like Google Scholar, PUBMED-MEDLINE, and Scopus using standard keywords, \"Depression\", \"cardiovascular disease\", \"Biomarkers\", and \"Therapeutic Approaches\". Recent studies have discovered several potential biomarkers linked to depression and cardiovascular disease (CVD), including neuroendocrine factors, inflammatory markers, and signs of oxidative stress. Therapeutic approaches for depression and cardiovascular disease have emerged, with a focus on tackling their connections from multiple dimensions.</p><p><strong>Results: </strong>Emerging research suggests that depression has an impact on both the prognosis and risk of CVD. Conversely, depression can be caused by CVD, which triggers a series of events that lead to higher rates of illness and death.</p><p><strong>Conclusion: </strong>A comprehensive understanding of the fundamental pathophysiological pathways is essential for the identification of biomarkers that can serve as diagnostic tools or therapy targets. Among these interventions, exercise and dietary adjustments have shown promising impacts on cardiovascular health and results, as well as mental health. Ultimately, the selection of diagnostic techniques and treatments hinges on comprehending the complex interplay between depression and CVD. Researchers are developing novel therapeutic techniques to enhance the cardiovascular and mental health outcomes of individuals with both depression and CVD.</p>","PeriodicalId":10832,"journal":{"name":"Current Cardiology Reviews","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669346","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}
Tariel A Atabekov, Mikhail S Khlynin, Sergey N Krivolapov, Roman E Batalov, Sergey V Popov
{"title":"Impact of Combined Treatment with ARNi and SGLT2i on Clinical and Echocardiographic Outcomes in Patients with CRT During Mid-Term Period.","authors":"Tariel A Atabekov, Mikhail S Khlynin, Sergey N Krivolapov, Roman E Batalov, Sergey V Popov","doi":"10.2174/011573403X350660250203111206","DOIUrl":"https://doi.org/10.2174/011573403X350660250203111206","url":null,"abstract":"<p><strong>Background: </strong>Sodium-glucose co-transporter 2 inhibitors (SGLT2i) and angiotensin receptor neprilysin inhibitors (ARNi) are new classes of medications with an evolving role in heart failure (HF) patients. However, the effect of combining these drugs with cardiac resynchronization therapy (CRT) remains less certain.</p><p><strong>Objective: </strong>This study aimed to investigate the impact of combined treatment with ARNi and SGLT2i on clinical and echocardiographic outcomes in CRT patients during 12-month followup.</p><p><strong>Methods: </strong>HF patients with CRT implantation indications were enrolled in the non-randomized and retrospective study and were grouped in no ARNi and SGLT2i (1st group) and combined treatment with ARNi and SGLT2i (2nd group) cohorts. The CRT response criteria were as follows: improvement of NYHA class ≥1 and left ventricular end-systolic volume reduction ≥15% or left ventricular ejection fraction improvement ≥5% from the baseline during the 12-month follow- up.</p><p><strong>Results: </strong>A total of 52 patients were included. At the 12-month follow-up, 18 of 35 (51.4%) patients in the 1st group and 16 of 17 patients (94.1%) in the 2nd cohort met CRT responder criteria (p=0.002). In multivariable logistic regression, combined treatment with ARNi and SGLT2i [odds ratio (OR): 20.09; 95% confidence interval (CI): 2.10-192.15; p=0.009] and non-ischemic HF (OR 5.51; 95% CI 1.21-24.91; p=0.026) were associated with CRT response.</p><p><strong>Conclusion: </strong>The combined treatment with SGLT2i and ARNi in patients with CRT improved the echocardiographic and clinical outcomes during the 12-month follow-up. In our study cohort, the CRT response was associated with non-ischemic HF and combined treatment with ARNi and SGLT2i.</p>","PeriodicalId":10832,"journal":{"name":"Current Cardiology Reviews","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143662984","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}
Brian Mendel, Kelvin Kohar, Richie Jonathan Djiu, Defin Allevia Yumnanisha, Justin Winarta, Gusti Ngurah Prana Jagannatha, Theresia Feline Husen, Sisca Natalia Siagian, Radityo Prakoso
{"title":"Percutaneous Zero-Fluoroscopy Atrial Septal Defect Closure Versus Fluoroscopy-Guided Method: A Systematic Review and Meta-analysis.","authors":"Brian Mendel, Kelvin Kohar, Richie Jonathan Djiu, Defin Allevia Yumnanisha, Justin Winarta, Gusti Ngurah Prana Jagannatha, Theresia Feline Husen, Sisca Natalia Siagian, Radityo Prakoso","doi":"10.2174/011573403X337854250227052833","DOIUrl":"https://doi.org/10.2174/011573403X337854250227052833","url":null,"abstract":"<p><strong>Introduction: </strong>Percutaneous atrial septal defects (ASD) closure with fluoroscopy guidance is the standard procedure. However, fluoroscopy poses stochastic and deterministic risks for small infants and children. Zero fluoroscopy ASD closure is an alternative, yet its feasibility and safety compared to fluoroscopy remain unclear. Therefore, this study compares outcomes using standardized fluoroscopy and zero fluoroscopy methods for transcatheter ASD closure.</p><p><strong>Methods: </strong>Four databases (PubMed, ProQuest, Google Scholar, Wiley) were used to search literature published before July 2023. The main results were the success rate and the complications. Outcomes were processed using the DerSimonian-Laird random-effects model of proportional meta-analysis to determine the overall proportion.</p><p><strong>Results: </strong>A total of 68 cohort studies (8,989 patients) were included in this meta-analysis. Overall, percutaneous ASD closure was successfully performed in 97% of patients (95%CI: 96-98%) based on 59 studies (8,989 patients), of which fluoroscopy accounted for 97% (95%CI: 96- 98%) based on 51 studies (7,760 patients) and non-fluoroscopy for 98% (95%CI: 96-100%)] based on 8 studies (1,229 patients). Device embolization, AV block, and other arrhythmias did not differ significantly between the two groups. However, the percentage difference in residual leaks between the two groups was quite vast, with 5% in the non-fluoroscopy group and 12% in the fluoroscopy group.</p><p><strong>Conclusion: </strong>Percutaneous ASD closure with zero fluoroscopy is safe and effective, as evidenced by the high success rate, and is non-inferior to the standardized fluoroscopy method.</p>","PeriodicalId":10832,"journal":{"name":"Current Cardiology Reviews","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143572420","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}
Aakash R Sheth, Harsh P Patel, Krutharth Pandya, Samarthkumar Thakkar, Kesar Prajapati, Ambica Niar, Mohammad Rafa Labedi, Christopher V DeSimone, Abhishek Deshmukh
{"title":"Trends in Readmissions Rates and Mortality after Cardiac Resynchronization Therapy in Patients with Nonischemic Cardiomyopathy.","authors":"Aakash R Sheth, Harsh P Patel, Krutharth Pandya, Samarthkumar Thakkar, Kesar Prajapati, Ambica Niar, Mohammad Rafa Labedi, Christopher V DeSimone, Abhishek Deshmukh","doi":"10.2174/011573403X345244250217052010","DOIUrl":"https://doi.org/10.2174/011573403X345244250217052010","url":null,"abstract":"<p><strong>Introduction: </strong>Advances in cardiac implanted electronic devices (CIED) have significantly improved outcomes for patients with heart failure. However, there is a bereft of recent real- world data on the relative effectiveness of cardiac resynchronization therapy with pacing and defibrillator (CRT-D) and continuous resynchronization therapy with pacing (CRT-P) in patients with nonischemic cardiomyopathy (NICM). We hypothesized that the addition of defibrillation therapy in patients with NICM would offer no significant benefit.</p><p><strong>Methods: </strong>We searched the National Readmissions Database (NRD) from 2016-2020 to identify hospitalizations with NICM using appropriate ICD-10 diagnosis and procedure codes. The cohort was further divided into groups with NICM and CRT-D implantation and NICM with CRTP implantation.</p><p><strong>Results: </strong>Our final cohort included 8,801 hospitalizations with NICM and CRT-D implantation and 3,399 hospitalizations with NICM and CRT-P implantation. Propensity matching was performed using comorbidities through multivariate logistic regression. Two thousand nine hundred seventeen hospitalizations were included in each of the two groups, CRT-D and CRT-P. Analysis of the propensity-matched cohorts at 180 days revealed a trend toward lower heart failure readmission, all-cause readmission, and all-cause mortality rates in the group with CRTP implantation. However, there was no difference noted in the 180-day hazard ratios of HF readmission [1.08 (0.98-1.19); p = 0.1], all-cause readmission [1.04 (0.87-1.12); p = 0.23], and all-cause mortality [0.83 (0.58-1.19); p = 0.32].</p><p><strong>Conclusion: </strong>It was found that NICM patients with CRT-D have a trend towards higher HF readmissions, all-cause readmission, and all-cause mortality compared to those with CRT-P, but no significant difference was noted in hazard ratios. The findings of our study raise further questions about the need for defibrillator therapy in patients with NICM and merit further studies to better select candidates for each of these therapies.</p>","PeriodicalId":10832,"journal":{"name":"Current Cardiology Reviews","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143540429","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}
Ewa Kwiecień, Marta Kot, Łukasz Czyż, Leszek Drabik, Adam Mazurek, Martyna Sikorska, Maciej Skubera, Łukasz Tekieli, Marcin Majka, Piotr Musiałek
{"title":"Umbilical Cord Matrix (Wharton Jelly) Mesenchymal Stem Cells in Next-Generation Myocardial Repair and Regeneration: Mechanisms and Pre-Clinical Evidence.","authors":"Ewa Kwiecień, Marta Kot, Łukasz Czyż, Leszek Drabik, Adam Mazurek, Martyna Sikorska, Maciej Skubera, Łukasz Tekieli, Marcin Majka, Piotr Musiałek","doi":"10.2174/011573403X372908250117092252","DOIUrl":"https://doi.org/10.2174/011573403X372908250117092252","url":null,"abstract":"<p><p>Chronic ischemic heart failure (CIHF), caused by myocardial injury and cell loss, is a growing public health concern. Despite substantial investments in pharmaco- and device therapies for acute myocardial infarction and CIHF over the past decades, long-term prognosis has shown little improvement. There is a clear need to develop novel therapeutic strategies capable of attenuating progression from acute to chronic myocardial damage, reducing adverse myocardial remodeling, and enhancing myocardial contractility. Cell-based approaches are an important direction in basic and clinical research. Nevertheless, candidate cell types tested to-date in experimental and human studies show several fundamental limitations, including insufficient quantities and potency, poor myocardial uptake, immunogenicity and/or risk of tumorigenicity. Human umbilical cord matrix is a rich source of mesenchymal stem cells (Wharton's jelly mesenchymal stem cells, WJMSCs). WJMSCs are naturally low-immunogenic, demonstrate high plasticity and proliferation capacity, and exhibit an absence of tumorigenic potential. Moreover, by producing specific anti-inflammatory cytokines and chemokines, they reduce the inflammatory response (hence their use in graft-versus-host disease) and have pro-angiogenic, antiapoptotic, and anti-fibrotic properties, making them a natural player in myocardial repair and regeneration. Furthermore, WJMSCs can be expanded ex vivo with high genomic stability and full clonogenic potential and can be standardized as an \"off-the-shelf\" next-generation advanced therapy medicinal product (ATMP). This review aggregates essential, contemporary information on the properties and fundamental mechanisms of WJMSCs, addressing the process of infarct healing and chronic myocardial injury. It discusses outcomes from pre-clinical studies, such as improvements in myocardial function and reductions in fibrosis in animal models, paving the way for human ATMP trials.</p>","PeriodicalId":10832,"journal":{"name":"Current Cardiology Reviews","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143514996","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}
Habeeb Abdulkareem Habeeb, Fraser Todd, Rohith Valsalan, Emily Schembri, John K Noyhar, Gary Yip, Mahesan Anpalahan
{"title":"Prevalence and Adverse Outcomes of Iron Deficiency in Heart Failure.","authors":"Habeeb Abdulkareem Habeeb, Fraser Todd, Rohith Valsalan, Emily Schembri, John K Noyhar, Gary Yip, Mahesan Anpalahan","doi":"10.2174/011573403X351268250130070459","DOIUrl":"https://doi.org/10.2174/011573403X351268250130070459","url":null,"abstract":"<p><strong>Introduction/objective: </strong>Outcomes of iron deficiency (ID) in heart failure (HF) with preserved ejection fraction (HFpEF) or in samples with mixed heart failure subtypes are variably described. Hence, we investigated the prevalence and adverse outcomes of ID in a sample of mixed heart failure subtypes.</p><p><strong>Methods: </strong>Adult patients admitted with HF over a six-month period were retrospectively studied. ID was defined as serum ferritin<100mcg/L, or serum ferritin 100-300mcg/L with serum transferrin saturation<20%. For each case of ID, sex- and age-matched (within five years) controls were selected. The primary outcome was the composite of all-cause mortality or readmissions up to 12 months post-index admission.</p><p><strong>Results: </strong>Of the 245 patients admitted with HF [HFpEF: 83 (70.3%), HFrEF: 35 (29.6%)], 233 met the inclusion criteria. Iron studies were available for 131 patients and 59 (45%) had ID. ID had a significant univariate association with the primary outcome (OR: 3.80, 95% CI: 1.42- 10.18, P=0.008), and it remained significant after controlling for age, anaemia, comorbidities, and frailty (OR: 6.04, 95% CI: 1.18-30.85, P=0.031). ID also had a significant independent association with readmissions (OR: 4.61, 95% CI: 1.15-18.43, P=0.03), but not with mortality (OR: 1.17, 95% CI: 0.67-4.35, P=0.257). In post-hoc analysis, ID exhibited a significant association with primary outcome in patients with HFrEF (OR: 14.12, 95% CI: 1.7-0-117.33, P=0.014), but not in patients with HFpEF (OR: 1.8, 95% CI: 0.71-4.58, P=0.214).</p><p><strong>Conclusion: </strong>ID is common in patients hospitalised for heart failure and has been found to have a significant association with the composite primary outcome, largely due to its effect on readmissions. ID may have a differential effect on adverse outcomes with respect to heart failure subtypes.</p>","PeriodicalId":10832,"journal":{"name":"Current Cardiology Reviews","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143448497","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}
Wilbert Huang, Siti Shofia Syahruddin, Alexandra Aurelia Johansyah, Siti Saqinah Suriadiredja, Dhanny Primantara Johari Santoso, R M Sonny Sasotya, Muhammad Alamsyah Azis, Adhi Pribadi, Hawani Sasmaya Prameswari
{"title":"Association of Hypertensive Disorders of Pregnancy and their Clinical Features with Peripartum Cardiomyopathy: A Systematic Review and Meta-analysis.","authors":"Wilbert Huang, Siti Shofia Syahruddin, Alexandra Aurelia Johansyah, Siti Saqinah Suriadiredja, Dhanny Primantara Johari Santoso, R M Sonny Sasotya, Muhammad Alamsyah Azis, Adhi Pribadi, Hawani Sasmaya Prameswari","doi":"10.2174/011573403X329136250116050817","DOIUrl":"https://doi.org/10.2174/011573403X329136250116050817","url":null,"abstract":"<p><strong>Background: </strong>Peripartum Cardiomyopathy (PPCM) is a rare yet fatal cardiac disease associated with pregnancy. PPCM has been shown to have similar etiopathogenesis with hypertensive disorders of pregnancy (HDP). Hence, this study aims to study the association between HDP and the development of PPCM.</p><p><strong>Methods: </strong>Three databases (PubMed, Scopus, Cochrane Library) were searched and screened based on prespecified inclusion and exclusion criteria. Predictors of PPCM evaluated were HDP (preeclampsia, superimposed preeclampsia, chronic hypertension, and gestational hypertension) and its clinical features (severe preeclampsia, age, parity, serum creatinine, etc.). Data were analyzed using the random effects model of pooled odds ratios (ORs) with the Mantel Haenszel method, and publication bias was assessed with a funnel plot.</p><p><strong>Results: </strong>A total of 13 observational studies with 11,951 PPCM cases from 7 countries were identified. All types of HDP were associated with significantly increased odds of developing PPCM, and severe preeclampsia was associated with the highest OR of 13.33 (CI: 5.95 - 29.83, p < 0.01). Additionally, superimposed preeclampsia, chronic hypertension, preeclampsia, and lastly gestational hypertension were associated with increased odds of PPCM with OR 5.77, 4.73, 4.70, and 3.13, respectively. Other clinical features being statistically significant for PPCM development included advanced age > 35 years and multiple pregnancies (p < 0.05). No significant difference in creatinine level was found between PPCM and no PPCM group. No publication bias was found based on funnel plot assessment.</p><p><strong>Conclusion: </strong>HDP, especially severe preeclampsia, is associated with increased odds of PPCM development; hence, a low threshold for PPCM screening in this high-risk group is required.</p>","PeriodicalId":10832,"journal":{"name":"Current Cardiology Reviews","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143412830","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}
Rubela Ray, Arhum Mahmood, Raheel Chaudhry, Mohd Diya Masmoum, Muhammad Talha, Fahad I Siddiqui, Imdad Ullah
{"title":"The Impact of Novel Lipid-Lowering Agents on Cardiovascular Risk Reduction: A Systematic Review and Meta-Analysis.","authors":"Rubela Ray, Arhum Mahmood, Raheel Chaudhry, Mohd Diya Masmoum, Muhammad Talha, Fahad I Siddiqui, Imdad Ullah","doi":"10.2174/011573403X345749250122092324","DOIUrl":"https://doi.org/10.2174/011573403X345749250122092324","url":null,"abstract":"<p><strong>Introduction: </strong>Reducing the risk of atherosclerotic cardiovascular disease is the aim of lipid-lowering therapy (ASCVD). It is commonly acknowledged that low-density lipoprotein (LDL) is a major cause of ASCVD. Several online databases and search engines, such as Pub- Med and the Cochrane Library, were used to conduct a thorough search.</p><p><strong>Method: </strong>This study included RCTs assessing the effect of PCSK9 inhibitors on cardiovascular events. The RevMan 5.4 software was used to conduct the meta-analysis. This analysis included nine RCTs in total.</p><p><strong>Results: </strong>Meta-analysis of the included studies showed that the levels of total cholesterol, LDL, and triglycerides were reduced after the use of PCSK9 inhibitors, and HDL levels were increased, which is good cholesterol. Most adverse cardiac events (MACE) were reduced after the use of PCSK9 inhibitors.</p><p><strong>Conclusion: </strong>In conclusion, ezetimibe, a PCSK9 inhibitor added to statin therapy, further reduces MACE risk without affecting all-cause mortality, even though statins already significantly reduce major adverse cardiovascular events (MACE) and mortality.</p>","PeriodicalId":10832,"journal":{"name":"Current Cardiology Reviews","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143413196","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}