Current Cardiology Reviews最新文献

{"title":"Adherence to Congestive Heart Failure Guidelines and Outcome in the Middle East.","authors":"Raed Aqel, Tareq Alzughayyar, Jihad Zalloum, Qais Salah, Qutaiba Qafisheh, Mahmoud Izraiq","doi":"10.2174/011573403X256576231017110252","DOIUrl":"10.2174/011573403X256576231017110252","url":null,"abstract":"<p><strong>Background: </strong>Adherence to Congestive Heart Failure with reduced Ejection Fraction (CHFrEF) guidelines is not easily attainable everywhere, particularly in countries with a high prevalence of low socioeconomic status, which includes many Middle Eastern countries. However, it is well-established that adherence to the guidelines is associated with lower mortality and morbidity rates.</p><p><strong>Objective: </strong>Our objective is to investigate the adherence to the degree of treatment guideline in CHFrEF within a patient population in the Middle East and correlate the level of compliance both fully and partially with morbidity and mortality outcomes. Methods and Statistics: We conducted a retrospective study on patients with CHFrEF in the Middle East region who were maintained on Sacubitril/Valsartan for up to 4 years (190 patients). This study included follow-up assessments for morbidity and mortality rates and their correlation with the level of adherence to guidelines.</p><p><strong>Results: </strong>Statistical analysis was performed using IBM SPSS® 27th version. In both the partial adherence group and the full adherence group, there was a statistically significant improvement in NYHA (pretreatment and post-treatment) and Ejection fraction (pretreatment and posttreatment). This means that regardless of the level of adherence to the use of Sacubitril/Valsartan in CHFrEF, there was an overall improvement in the morbidity and mortality rates over the four years of follow-up.</p><p><strong>Conclusion: </strong>While we fully support the idea of achieving full CHFrEF guideline adherence, we recognize the difficulty of this task. Nevertheless, this study reinforces the notion that any degree of adherence to guideline is correlated with better morbidity and mortality rates over a long-term follow-up.</p>","PeriodicalId":10832,"journal":{"name":"Current Cardiology Reviews","volume":" ","pages":"30-34"},"PeriodicalIF":2.4,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11284696/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138451157","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pharmacological Treatment of Heart Failure: Recent Advances.","authors":"Jonathan C H Chan, Areeb Siddiqui","doi":"10.2174/011573403X270178231228061314","DOIUrl":"10.2174/011573403X270178231228061314","url":null,"abstract":"<p><strong>Background: </strong>Heart failure is a clinical condition with high mortality and morbidity that occurs when the heart is unable to pump enough blood to meet the metabolic demands of the body. The pharmacological management of heart failure has been revolutionized over the past decade with novel treatments.</p><p><strong>Objective: </strong>The aim of the review is to highlight the recent pharmacological advances in the management of heart failure.</p><p><strong>Results: </strong>Sodium-glucose cotransporter-2 inhibitor (SGLT2i), iron carboxymaltose, finerenone, omecamtiv mecarbil, and vericiguat have been shown to reduce hospitalization for heart failure. However, only SGLT2i, vericiguat, and omecamtiv mecarbil have been shown to reduce cardiovascular death. Finerenone has been shown to reduce cardiovascular events and renal adverse outcomes in patients with diabetes and kidney disease. Currently, only SGLT2i has been studied in patients beyond the heart failure with reduced ejection fraction population.</p><p><strong>Conclusion: </strong>The current quadruple therapy in the treatment of heart failure has demonstrated a reduction in the hospitalization of patients and a decrease in mortality associated with the condition. Individualized heart failure therapy research have shown some benefit in select heart failure patients. Further research on novel therapies will help improve heart failure patient outcomes.</p>","PeriodicalId":10832,"journal":{"name":"Current Cardiology Reviews","volume":" ","pages":"29-38"},"PeriodicalIF":2.4,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11107472/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139569981","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Role of Triglycerides in Atherosclerosis: Recent Pathophysiologic Insights and Therapeutic Implications.","authors":"Yonatan Akivis, Hussam Alkaissi, Samy I McFarlane, Inna Bukharovich","doi":"10.2174/011573403X272750240109052319","DOIUrl":"10.2174/011573403X272750240109052319","url":null,"abstract":"<p><p>Triglycerides have long been recognized as a cardiovascular disease risk factor. However, their precise role in atherosclerosis and potential utility as a therapeutic target remains debated topics. This review aims to shed light on these aspects by exploring the complex relationship between triglycerides and atherosclerosis from pathophysiological and pharmacological perspectives. Triglycerides, primarily carried by chylomicrons and very low-density lipoproteins, play an essential role in energy storage and utilization. Dysregulation of triglyceride homeostasis and triglyceride- rich lipoproteins metabolism often leads to hypertriglyceridemia and subsequently increases atherosclerosis risk. Triglyceride-rich lipoproteins remnants interact with arterial wall endothelial cells, get retained in the subendothelial space, and elicit inflammatory responses, thereby accelerating atherogenesis. Despite the clear association between high triglyceride levels and increased cardiovascular disease risk, intervention trials targeting triglyceride reduction have produced mixed results. We discuss a range of triglyceride-lowering agents, from fibrates to omega-3 fatty acids, with a focus on their mechanism of action, efficacy, and major clinical trial outcomes. Notably, the role of newer agents, such as angiopoietin-like protein 3 and apolipoprotein C3 inhibitors, is also explored. We highlight the challenges and controversies, including the ongoing debate on the causal role of triglyceride in atherosclerosis and the discordant outcomes of recent clinical trials. The potential confounding effects of associated risk factors, such as elevated apolipoprotein B, insulin resistance, and metabolic syndrome, are considered. In conclusion, this review underscores the importance of a nuanced approach to understanding the role of triglycerides in atherosclerosis and their potential as a therapeutic target. Further research is needed to unravel the complex interplay between triglycerides, triglyceride-rich lipoproteins, and associated factors in atherosclerosis pathogenesis and refine triglyceride-targeted therapeutic strategies.</p>","PeriodicalId":10832,"journal":{"name":"Current Cardiology Reviews","volume":" ","pages":"39-49"},"PeriodicalIF":2.4,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11107470/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139575469","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Systematic Review of Economic Evidence of Cardiovascular Interventions in India.","authors":"Saba Abidi, Anandita Nair, Rakhi Ahuja, Shridhar Dwivedi, Sushama Talegaonkar","doi":"10.2174/011573403X309363240730095253","DOIUrl":"10.2174/011573403X309363240730095253","url":null,"abstract":"<p><strong>Background: </strong>Cardiovascular diseases (CVDs) continue to be the primary cause of mortality globally and invariably in India as well. The rapid upsurge in the prevalence of CVDs in India has created a pressing need to promote contemporary, sustainable, and cost-effective interventions to tackle the CVD burden. This systematic review integrates the research-based evidence of the cost-effectiveness of various interventions that can be adapted to control CVDs in India.</p><p><strong>Methods: </strong>Databases, namely, PubMed, Cochrane Library, Embase, and Google Scholar, were searched for data on the economic evaluation of interventions targeting CVD based on the Indian population for a period of 30 years (1991-2021). Two reviewers assessed the articles for eligibility, and data were extracted from the shortlisted articles as per a predefined template, including the quantification of methodological aspects.</p><p><strong>Results: </strong>In total, 1249 studies were examined, out of which 23 completely met the inclusion criteria for full-text review. A total of 16 studies were based solely on the Indian population, while the rest (7) included South Asia/Asia for the intervention, of which India was a participant nation. Most of the economic evaluations targeted treatment-based or pharmacological interventions (14) for CVDs. The evaluations were based on Decision-based models (10), Randomized controlled Trials (RCTs) (9), and Observational studies (4). The cost-effectiveness ratio for the included studies exhibited a diverse range due to variations in methodological approaches, such as differences in study settings, populations, and inconsistencies in study design. The mean ICER (Incremental Cost-effectiveness ratio) for primordial and primary preventions was found to be 3073.8 (US $2022) and 17489.9 (US $2022), respectively. Moreover, the combined mean value for secondary and tertiary prevention was 2029.6 (US$2022).</p><p><strong>Conclusion: </strong>The economic evidence of public health interventions are expanding, but their focus is restricted towards pharmacological interventions. There is an urgency to emphasize primordial and primary prevention for better outcomes in health economics decision-making. Technology- based avenues for intervention need more exploration in order to cater to a large population like India.</p>","PeriodicalId":10832,"journal":{"name":"Current Cardiology Reviews","volume":" ","pages":"e300724232473"},"PeriodicalIF":2.4,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11440333/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141855064","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Systematic Review of the Association of the Hospital Frailty Risk Score with Mortality in Patients with Cerebrovascular and Cardiovascular Disease.","authors":"Balamrit Singh Sokhal, Sowmya Prasanna Kumar Menon, Charles Willes, Nadia Corp, Andrija Matetić, Christian Mallen, Mamas Mamas","doi":"10.2174/011573403X276647240217112151","DOIUrl":"10.2174/011573403X276647240217112151","url":null,"abstract":"<p><strong>Background: </strong>There is limited systematic data on the association between the Hospital Frailty Risk Score (HFRS) and characteristics and mortality in patients with cerebrovascular and cardiovascular disease (CVD). This systematic review aimed to summarise the use of the HFRS in describing the prevalence of frailty in patients with CVD, the clinical characteristics of patients with CVD, and the association between frailty on the likelihood of mortality in patients with CVD.</p><p><strong>Methods: </strong>A systematic literature search for observational studies using terms related to CVD, cerebrovascular disease, and the HFRS was conducted using 6 databases in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Studies were appraised using the Newcastle-Ottawa Scale (NOS).</p><p><strong>Results: </strong>Seventeen observational studies were included, all rated 'good' quality according to the NOS. One study investigated 5 different CVD cohorts (atrial fibrillation (AF), heart failure (HF), hypotension, hypertension, and chronic ischemic heart disease), 1 study investigated 2 different CVD cohorts (AF and acute myocardial infarction (AMI)), 6 studies investigated HF, 3 studies investigated AMI, 4 studies investigated stroke, 1 study investigated AF, and 1 study investigated cardiac arrest. Increasing frailty risk category was associated with increased age, female sex, and non-white racial group across all CVD. Increasing frailty risk category is also associated with increased length of hospital stay, total costs, and increased odds of 30-day all-cause mortality across all CVD.</p><p><strong>Conclusions: </strong>The HFRS is an efficient and effective tool for stratifying frailty in patients with CVD and predicting adverse health outcomes.</p>","PeriodicalId":10832,"journal":{"name":"Current Cardiology Reviews","volume":" ","pages":"45-62"},"PeriodicalIF":2.4,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11284698/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139995829","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Interplay of Comorbidities in Chronic Heart Failure: Challenges and Solutions.","authors":"Shashipriya Agress, Jannat S Sheikh, Aida A Perez Ramos, Durlav Kashyap, Soha Razmjouei, Joy Kumar, Mankaranvir Singh, Muhammad Ali Lak, Ali Osman, Muhammad Zia Ul Haq","doi":"10.2174/011573403X289572240206112303","DOIUrl":"10.2174/011573403X289572240206112303","url":null,"abstract":"<p><strong>Background: </strong>Chronic heart failure (HF) is frequently associated with various comorbidities. These comorbid conditions, such as anemia, diabetes mellitus, renal insufficiency, and sleep apnea, can significantly impact the prognosis of patients with HF.</p><p><strong>Objective: </strong>This review aims to synthesize current evidence on the prevalence, impact, and management of comorbidities in patients with chronic HF.</p><p><strong>Methods: </strong>A comprehensive review was conducted, with a rigorous selection process. Out of an initial pool of 59,030 articles identified across various research modalities, 134 articles were chosen for inclusion. The selection spanned various research methods, from randomized controlled trials to observational studies.</p><p><strong>Results: </strong>Comorbidities are highly prevalent in patients with HF and contribute to increased hospitalization rates and mortality. Despite advances in therapies for HF with reduced ejection fraction, options for treating HF with preserved ejection fraction remain sparse. Existing treatment protocols often lack standardization, reflecting a limited understanding of the intricate relationships between HF and associated comorbidities.</p><p><strong>Conclusion: </strong>There is a pressing need for a multidisciplinary, tailored approach to manage HF and its intricate comorbidities. This review underscores the importance of ongoing research efforts to devise targeted treatment strategies for HF patients with various comorbid conditions.</p>","PeriodicalId":10832,"journal":{"name":"Current Cardiology Reviews","volume":" ","pages":"13-29"},"PeriodicalIF":2.4,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11284697/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139721994","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiovascular Manifestations in Inflammatory Bowel Disease.","authors":"Anish Meda, Fremita Fredrick, Urvashi Rathod, Priyanshi Shah, Rohit Jain","doi":"10.2174/011573403X256094231031074753","DOIUrl":"10.2174/011573403X256094231031074753","url":null,"abstract":"<p><p>Inflammatory bowel disease is a group of long-term systemic inflammatory disorders affecting the gastrointestinal tract, including Crohn's disease and ulcerative colitis, which may be associated with an increased risk of developing extraintestinal manifestations, including cardiovascular disease, thereby decreasing the quality of life. Pathophysiological changes associated with inflammatory bowel disease include alterations of the microbiome, endotoxemia, and changes to glucose and lipid metabolism. Inflammatory bowel disease patients have higher carotid intima-media thickness, lower flow-mediated dilatation, and increased carotid-femoral pulse wave velocity, which are markers of elevated cardiovascular risk. In addition, inflammatory bowel disease patients are at an increased risk for developing venous and arterial thrombotic events due to a hypercoagulable state caused by thrombocytosis and coagulation system activation. To reduce the risk of developing cardiovascular disease, lifestyle modifications, such as smoking cessation, dietary changes, and increased physical activity alongside management with appropriate medication, should be considered. This research paper examines how inflammatory bowel disease can influence the risk of cardiovascular complications and the involvement of drug therapy. Methods: PubMed was searched using keywords, such as inflammatory bowel disease, Crohn's disease, ulcerative colitis, cardiovascular disease, pericarditis, thromboembolism, and many more. Relevant literature up to March 2023 has been examined and summarized, which consisted 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":"2023-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11071669/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138451158","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acknowledgements to Reviewers","authors":"","doi":"10.2174/1573403x1906231002102918","DOIUrl":"https://doi.org/10.2174/1573403x1906231002102918","url":null,"abstract":"","PeriodicalId":10832,"journal":{"name":"Current Cardiology Reviews","volume":"152 9","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135011672","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":"Prevention of Contrast-induced Nephropathy in Patients Undergoing Percutaneous Coronary Intervention.","authors":"Raymond Pranata, Dendi Puji Wahyudi","doi":"10.2174/011573403X260319231016075216","DOIUrl":"10.2174/011573403X260319231016075216","url":null,"abstract":"<p><p>Contrast-induced nephropathy (CIN) or contrast-induced acute kidney injury has varying definitions, but in general, increased serum creatinine level by ≥ 0.3 mg/dL (26.5 µmol/L) or 1.5x of baseline value or urine output <0.5 mL/kg/h within 1-7 days after contrast media (CM) administration can be considered as CIN. CIN is one of the most common complications and is associated with increased mortality in patients undergoing percutaneous coronary intervention (PCI). Thus, risk stratification for CIN should be made and preventive strategies should be employed in which the intensity of the approach must be tailored to patient's risk profile. In all patients, adequate hydration is required, nephrotoxic medications should be discontinued, and pre-procedural high-intensity statin is recommended. In patients with an estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m2, IV hydration should be started 12 hours pre-procedure up until 12-24 hours after the procedure. Remote ischemic preconditioning may be performed pre-procedurally. Radial first approach for vascular access is recommended. During the procedure, low or iso-osmolar CM should be used and its volume should be limited to eGFR x 3.7. In patients at high risk for CIN, additional contrast-sparing strategies may be applied, such as using a contrast reduction system, 5 Fr catheter with no sideholes, CM dilution, limiting test injection, confirming placement using guidewire, use of stent enhancing imaging technology, using metallic/software roadmap to guide PCI, use of IVUS or dextran-based OCT, and coronary aspiration. A more advanced hydration technique based on central venous pressure, left ventricular end-diastolic pressure, or using furosemide-matched hydration, might be considered.</p>","PeriodicalId":10832,"journal":{"name":"Current Cardiology Reviews","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2023-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11071674/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50157263","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"When Pulmonary Arterial Hypertension may be Associated with Portal Hypertension: A Case Report of Two Different Hepatic Disorders in One Patient with Pulmonary Hypertension.","authors":"Ganna Radchenko, Yuriy Sirenko","doi":"10.2174/011573403X267162231011154808","DOIUrl":"10.2174/011573403X267162231011154808","url":null,"abstract":"<p><strong>Background: </strong>pulmonary arterial hypertension (PAH) is a rare complication of hepatic diseases with portal hypertension that, however, has a significant influence on prognosis. We present a mini-review of how to diagnose and treat it based on a clinical case.</p><p><strong>Case presentation: </strong>in early childhood, a patient had portal hypertension associated with cavernous transformation of the portal vein. It was successfully treated by reno-splenic surgery. At the age of 20 years, this patient experienced increased dyspnea at minimal physical activity after the hepatic biopsy due to a hepatocellular adenoma. The examination in the specialized unit showed PAH, which was evaluated as associated with portal hypertension (PAH-PoH). The specific two-drug combination therapy was started with prominent improvement in patient's state. Successful surgical tumor treatment was provided some months later. The practical and clinical approaches to the diagnosis and treatment of PAH-PoH are discussed. It was emphasized that not all patients with portal hypertension have pulmonary hypertension, which needs to be treated. A lot of evidence gaps exist in management of these patients.</p><p><strong>Conclusion: </strong>all patients, even with past history of portal hypertension, should be monitored closely and screened for PAH earlier, for better results of treatment.</p>","PeriodicalId":10832,"journal":{"name":"Current Cardiology Reviews","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2023-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11071676/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50161042","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}