European Heart Journal - Cardiovascular Pharmacotherapy最新文献

{"title":"Continued Discussion Regarding the Duration of DAPT after DES implantation.","authors":"Sho Torii, Shinichi Goto, Shinya Goto","doi":"10.1093/ehjcvp/pvag095","DOIUrl":"https://doi.org/10.1093/ehjcvp/pvag095","url":null,"abstract":"","PeriodicalId":11982,"journal":{"name":"European Heart Journal - Cardiovascular Pharmacotherapy","volume":" ","pages":""},"PeriodicalIF":8.2,"publicationDate":"2026-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149285891","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ESC Congress 2026 Antithrombotic Highlights: Balancing Ischemic and Bleeding Risk After Percutaneous Intervention.","authors":"Neel Koyawala, Deepak L Bhatt","doi":"10.1093/ehjcvp/pvag093","DOIUrl":"https://doi.org/10.1093/ehjcvp/pvag093","url":null,"abstract":"","PeriodicalId":11982,"journal":{"name":"European Heart Journal - Cardiovascular Pharmacotherapy","volume":" ","pages":""},"PeriodicalIF":8.2,"publicationDate":"2026-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149264660","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early Initiation of SGLT2 inhibitor and Mortality in Heart Failure With Reduced Ejection Fraction: A Target Trial Emulation Study.","authors":"George Frederick Mkoma, Anders Hviid, Björn Pasternak, Henrik Svanström","doi":"10.1093/ehjcvp/pvag094","DOIUrl":"https://doi.org/10.1093/ehjcvp/pvag094","url":null,"abstract":"<p><strong>Background and aims: </strong>Sodium-glucose cotransporter 2 inhibitors (SGLT2i) improve outcomes in patients with heart failure with reduced ejection fraction (HFrEF), yet the optimal timing of initiation in routine clinical practice remains uncertain. We investigated the impact of early initiation of SGLT2i within 30 days of HFrEF diagnosis on mortality and HF hospitalization.</p><p><strong>Methods: </strong>Using Danish nationwide register data from July 2020 to August 2024, adults with incident HFrEF eligible for SGLT2i therapy were identified. A target trial comparing initiation of SGLT2i within 30 days of HFrEF diagnosis versus no SGLT2i initiation during this 30-day period was emulated. The analysis used a clone-censor-weight design with follow-up starting at HFrEF diagnosis. The primary outcome was one-year all-cause mortality, and HF hospitalization was assessed as a secondary outcome.</p><p><strong>Results: </strong>Among 10,346 patients with incident HFrEF, 3268 (31.6%) initiated an SGLT2i within 30 days of HFrEF diagnosis and 7078 (68.4%) did not initiate the treatment during this 30-day window. About 226 deaths occurred among SGLT2i initiators and 637 deaths among non-initiators. Compared with non-initiation, initiation of SGLT2i within 30 days was associated with lower one-year risks of both death (RD -1.1 percentage points; 95% CI (-2.0 to -0.2)) and HF hospitalization (RD -3.4 percentage points; 95% CI (-3.9 to -2.9)).</p><p><strong>Conclusions: </strong>Initiation of an SGLT2i within 30 days of HFrEF diagnosis was associated with lower one-year mortality and HF hospitalization compared with no initiation. These findings support prioritizing early SGLT2i initiation as part of foundational therapy for HFrEF in routine clinical practice.</p>","PeriodicalId":11982,"journal":{"name":"European Heart Journal - Cardiovascular Pharmacotherapy","volume":" ","pages":""},"PeriodicalIF":8.2,"publicationDate":"2026-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149264675","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dapagliflozin in phenotypically stratified HFpEF without myocardial fibrosis: the STADIA-HFpEF randomized crossover trial.","authors":"Mariëlle Scheffer, Willemijn van Maarschalkerwaart, Chaohui Dong, Jochem W D Landzaat, Fanni Nedenyi, Simin Delalat, Innas Sultana, Oliver Jarkas, Gergely Röst, Annet Driessen-Waaijer, Nazha Hamdani, Loek van Heerebeek","doi":"10.1093/ehjcvp/pvag091","DOIUrl":"https://doi.org/10.1093/ehjcvp/pvag091","url":null,"abstract":"<p><strong>Aims: </strong>Heart failure with preserved ejection fraction(HFpEF) is characterized by increased diastolic left ventricular(LV) stiffness resulting from variable contributions of myocardial extracellular matrix(ECM) remodeling and titin-based cardiomyocyte stiffness. Sodium-glucose cotransporter-2 inhibitors(SGLT2i) improved cardiomyocyte distensibility, inflammation, and oxidative stress in experimental and human HFpEF myocardium. We investigated whether dapagliflozin improves LV distensibility in phenotypically stratified HFpEF patients without significant myocardial fibrosis.</p><p><strong>Methods: </strong>STADIA-HFpEF was a 34-week, randomized, double-blind, placebo-controlled crossover trial. HFpEF patients underwent multi-level phenotypic stratification including cardiac magnetic resonance imaging to exclude structural cardiomyopathies and significant myocardial ECM remodeling. Participants were randomized to dapagliflozin 10 mg or placebo for two 13-week treatment periods separated by an 8-week washout.The co-primary endpoints were changes in E/e'/LV end-diastolic volume index(LVEDVi) and mean LV e', reflecting LV distensibility and relaxation. Secondary endpoints included echocardiographic variables, quality of life, 6-minute walk distance, and inflammatory biomarkers.</p><p><strong>Results: </strong>Between February 2020 and October 2022, 32 patients were randomized and 29 completed the study protocol. Median age was 73(68-76) years including 28 women(88%). Dapagliflozin did not significantly modify E/e'/LVEDVi compared with placebo 0.24 (0.20-0.32) to 0.26 (0.22-0.34) vs. 0.23 (0.22-0.29) to 0.25 (0.21-0.31); p=0.370 nor did it change mean LV e' 6.2 (5.6-7.5) to 6.2 (5.7-7.1) vs. 6.6 (5.6-7.4) to 6.7 (5.4-7.5); p=0.448. Most secondary outcomes were neutral. However, an isolated improvement in LA conduit strain and numerical reductions in inflammatory biomarkers were observed during dapagliflozin treatment.</p><p><strong>Conclusions: </strong>In phenotypically stratified HFpEF patients without significant myocardial fibrosis, dapagliflozin did not improve LV distensibility or relaxation. An isolated improvement in LA conduit strain and numerical reductions in inflammatory biomarkers were observed; however, these exploratory findings require confirmation in larger studies.</p>","PeriodicalId":11982,"journal":{"name":"European Heart Journal - Cardiovascular Pharmacotherapy","volume":" ","pages":""},"PeriodicalIF":8.2,"publicationDate":"2026-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149206696","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Repositioning Vericiguat after VICTOR: Towards a Risk- and Timing-Based Framework in Contemporary HFrEF.","authors":"Teruhiko Imamura","doi":"10.1093/ehjcvp/pvag092","DOIUrl":"https://doi.org/10.1093/ehjcvp/pvag092","url":null,"abstract":"<p><p>Vericiguat, an oral soluble guanylate cyclase stimulator, provides a mechanistically distinct approach to reducing residual risk in heart failure with reduced ejection fraction (HFrEF). The VICTORIA trial demonstrated a reduction in cardiovascular death or heart failure hospitalisation among patients with recent worsening heart failure, whereas vericiguat did not significantly reduce the primary endpoint in the subsequent VICTOR trial in a more stable HFrEF population. Nevertheless, the prespecified pooled analysis of VICTORIA and VICTOR showed a significant reduction in cardiovascular death or first heart failure hospitalisation across the combined HFrEF population, without significant heterogeneity between the trials. Together, these findings shift the focus from efficacy alone to clinical prioritisation according to baseline risk and timing, while recognising that validated treatment-selection criteria and an optimal timing strategy remain undefined. Contemporary observational studies have identified associations between blood pressure, disease severity, prior heart failure hospitalisation, and clinical or biomarker outcomes during vericiguat treatment; however, these characteristics have not been validated as predictors of vericiguat-specific treatment benefit. This review integrates evidence from VICTORIA, VICTOR, pooled analyses, and contemporary real-world studies and proposes a hypothesis-generating, risk- and timing-based framework for vericiguat use. Clinically meaningful worsening heart failure may represent a period of increased absolute risk in which consideration of vericiguat may be particularly relevant after clinical stabilisation, but neither an optimal therapeutic window nor a validated responder phenotype has been established. Prospective studies specifically evaluating treatment-by-risk and treatment-by-timing interactions are required to validate this framework.</p>","PeriodicalId":11982,"journal":{"name":"European Heart Journal - Cardiovascular Pharmacotherapy","volume":" ","pages":""},"PeriodicalIF":8.2,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149180118","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis and Interpretation of a Hierarchical Outcome in a Small Pilot Randomized Trial: An Example in the CORTAHF Trial.","authors":"Jan Biegus, Christopher Edwards, Gary Koch, Gad Cotter, Yonathan Freund, Adriaan A Voors, Koji Takagi, Piotr Ponikowski, Gerasimos Filippatos, Ovidiu Chioncel, Matteo Pagnesi, Marco Metra, Douglas L Mann, Beth Davison","doi":"10.1093/ehjcvp/pvag089","DOIUrl":"https://doi.org/10.1093/ehjcvp/pvag089","url":null,"abstract":"<p><strong>Aims: </strong>Hierarchical composite endpoints (HCE) analyzed using generalized pairwise comparisons (GPC) have been increasingly adopted in cardiovascular trials. Stratified, but not covariate-adjusted, win statistics have been frequently presented. We apply methods to a post hoc HCE for the randomized 100-patient CORTAHF pilot trial of short-term corticosteroid therapy in acute heart failure (AHF).</p><p><strong>Methods and results: </strong>The HCE comprised 90-day death, 90-day HF readmission, 30-day worsening HF, and 30-day change in EQ-5D visual analogue scale (EQ-VAS) score from baseline. Win statistics and patient ranks from worst to best outcome were derived from GPC. These ranks were used to produce site-stratified and baseline EQ-VAS-adjusted win odds.Analysis of individual components suggested beneficial prednisone effects on 90-day HF readmission and 30-day WHF adverse events, with little effect on 30-day change in EQ-VAS. The win ratio and win odds were 1.82 and 1.71, respectively (both p<0.05), with 10% ties remaining after most comparisons were resolved at the last tier. HF readmission contributed most to the overall win difference of 26.1%. Stratification and baseline covariate adjustment using patients' ranks were feasible, but in this example did not substantially alter the estimated win odds.</p><p><strong>Conclusions: </strong>Patients' ranks can be derived from GPC and used to estimate stratified and covariate-adjusted win statistics as well as to visualize the treatment effect. Use of a well-constructed HCE in a small pilot trial should be considered; a positive signal may support further examination of the treatment. A full analysis can aid in interpretation.</p>","PeriodicalId":11982,"journal":{"name":"European Heart Journal - Cardiovascular Pharmacotherapy","volume":" ","pages":""},"PeriodicalIF":8.2,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149105553","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Refining cardiovascular pharmacotherapy in cardio-oncology and cardiac amyloidosis: news from ESC Congress 2026.","authors":"Massimiliano Camilli, Marianna Fontana, Pietro Ameri","doi":"10.1093/ehjcvp/pvag088","DOIUrl":"https://doi.org/10.1093/ehjcvp/pvag088","url":null,"abstract":"","PeriodicalId":11982,"journal":{"name":"European Heart Journal - Cardiovascular Pharmacotherapy","volume":" ","pages":""},"PeriodicalIF":8.2,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149105910","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nebivolol for the Prevention of Left Ventricular Systolic Dysfunction in Patients With Duchenne Muscular Dystrophy: the NEBIDYS trial.","authors":"Luca Monzo, Henri-Marc Becane, Yves Dulac, Helge Amthor, Claude Cances, Aurélie Chalard, Jean-Baptiste Davion, Isabelle Desguerre, Isabelle Durand, Sylvie Falcon-Eicher, Sophie Guillaumont, Arnaud Isapof, Fabien Labombarda, Léa Jilet, Hendy Abdoul, Denis Duboc, Karim Wahbi","doi":"10.1093/ehjcvp/pvag090","DOIUrl":"https://doi.org/10.1093/ehjcvp/pvag090","url":null,"abstract":"","PeriodicalId":11982,"journal":{"name":"European Heart Journal - Cardiovascular Pharmacotherapy","volume":" ","pages":""},"PeriodicalIF":8.2,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149105748","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Same Target but Different Bleeding Outcomes: Insights from a Randomized Apixaban-Rivaroxaban Comparison in Patients with Acute Venous Thromboembolism.","authors":"Jean-Luc Reny, Youssef Daali, Jean Terrier","doi":"10.1093/ehjcvp/pvag087","DOIUrl":"https://doi.org/10.1093/ehjcvp/pvag087","url":null,"abstract":"","PeriodicalId":11982,"journal":{"name":"European Heart Journal - Cardiovascular Pharmacotherapy","volume":" ","pages":""},"PeriodicalIF":8.2,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149106003","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The LIBREXIA-ACS trial: new fuel for debate?","authors":"Renske H Olie, Jurrien Ten Berg, Hugo Ten Cate","doi":"10.1093/ehjcvp/pvag085","DOIUrl":"https://doi.org/10.1093/ehjcvp/pvag085","url":null,"abstract":"","PeriodicalId":11982,"journal":{"name":"European Heart Journal - Cardiovascular Pharmacotherapy","volume":" ","pages":""},"PeriodicalIF":8.2,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149105948","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}