European Heart Journal - Cardiovascular Pharmacotherapy最新文献

{"title":"The Untapped Potential of Guideline-Directed Heart Failure Pharmacotherapy: Consequences of Missed Opportunities.","authors":"Ester J Herrmann, Samuel Sossalla","doi":"10.1093/ehjcvp/pvae096","DOIUrl":"https://doi.org/10.1093/ehjcvp/pvae096","url":null,"abstract":"","PeriodicalId":11982,"journal":{"name":"European Heart Journal - Cardiovascular Pharmacotherapy","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2024-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142885445","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":"Risk of bleeding with the concurrent use of amiodarone and DOACs: A systematic review and meta-analysis.","authors":"Faith Michael, Travis Quevilllon, Sabrina Maisonneuve, Cynthia A Jackevicius, Eugene Crystal, Ratika Parkash, Jason G Andrade, Jeff S Healey, Dennis T Ko, Mohammed Shurrab","doi":"10.1093/ehjcvp/pvae097","DOIUrl":"https://doi.org/10.1093/ehjcvp/pvae097","url":null,"abstract":"<p><strong>Background and aims: </strong>Amiodarone is frequently prescribed alongside direct oral anticoagulants (DOACs) in atrial fibrillation (AF). There are concerns regarding drug-drug interactions (DDIs) between amiodarone and DOACs. The literature is conflicting on the clinical implications of this DDI, hence we conducted a meta-analysis to compare bleeding risk among patients receiving DOACs, with and without concurrent amiodarone.</p><p><strong>Methods: </strong>A systematic search was conducted for studies published between January 1, 2009 and June 26, 2024 in MEDLINE via PubMed, Embase and CENTRAL. Included studies compared major bleeding in patients on concurrent amiodarone and DOACs to those on DOACs without amiodarone. Event rates were used to calculate odds ratios (ORs), which were pooled with a random-effects model.</p><p><strong>Results: </strong>Nine studies were identified, which included 124 813 patients on amiodarone/DOACs, and 314 074 on DOACs. Average age was 77.2 years in the amiodarone/DOAC group, compared to 74.4 years in the DOAC group (p= 0.21). Among DOAC patients, there was a statistically significant increase in major bleeding with concurrent amiodarone (OR 1.22, 95% confidence interval (CI) 1.03-1.44, p=0.02, I2=88%). Intracranial bleeding rate was numerically higher in the amiodarone/DOAC group (1.0% vs. 0.4%), but the difference did not reach statistical significance (OR 2.20, 95% CI 0.53-9.06, p=0.27, I2=100%). There were no significant differences in gastrointestinal bleeding (OR 1.10, 95% CI 0.98-1.23, p=0.12, I2=62%) and all-cause mortality (OR 1.38, 95% CI 0.70-2.73, p=0.35, I2=99%).</p><p><strong>Conclusion: </strong>Concurrent use of amiodarone and DOACs was associated with an increase in major bleeding. This should be considered when co-prescribing these medications.</p>","PeriodicalId":11982,"journal":{"name":"European Heart Journal - Cardiovascular Pharmacotherapy","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2024-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142885432","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":"Management of dyslipidaemia in patients with comorbidities - facing the challenge Value and limitations of lipid lowering drugs in liver disease Effects/Interactions of lipid-lowering agents on/with the liver.","authors":"Lisa Frühwald, Peter Fasching, Dobromir Dobrev, Juan Carlos Kaski, Claudio Borghi, Sven Wassmann, Kurt Huber, Anne Grete Semb, Stefan Agewall, Heinz Drexel","doi":"10.1093/ehjcvp/pvae095","DOIUrl":"https://doi.org/10.1093/ehjcvp/pvae095","url":null,"abstract":"<p><strong>Objectives: </strong>This review aims to examine the evidence on the benefits and risks of lipid lowering drugs in patients with liver disease. Elevated liver enzyme levels often lead to cautious discontinuation of these drugs, potentially withholding from patients their benefit in reducing cardiovascular disease morbidity and mortality.</p><p><strong>Methods and results: </strong>Using a literature search of PubMed, we examine the efficacy and safety profiles of various lipid lowering agents, including statins, ezetimibe, bempedoic acid, PCSK9 inhibitors, fibrates, and icosapent ethyl, focusing particularly on their potential side effects related to liver health. A major challenge in the assessment of drug-induced hepatotoxicity is the fact that it relies heavily on case reports rather than real world evidence. There is currently a lack of robust evidence on lipid-lowering therapy in people with pre-existing liver disease. Nevertheless, we have attempted to summarize the available data for all the drugs mentioned in order to provide guidance for the treatment of patients with liver dysfunction.</p><p><strong>Conclusion: </strong>This review highlights the need for further research to optimize treatment strategies for patients with coexisting liver and cardiovascular disease.</p>","PeriodicalId":11982,"journal":{"name":"European Heart Journal - Cardiovascular Pharmacotherapy","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2024-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142885429","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":"Lipid lowering therapies for aortic stenosis: a drug-target Mendelian randomisation study.","authors":"Jonathan L Ciofani, Daniel Han, Karan Rao, Dipender Gill, Benjamin Woolf, Kazem Rahimi, Usaid K Allahwala, Ravinay Bhindi","doi":"10.1093/ehjcvp/pvae092","DOIUrl":"https://doi.org/10.1093/ehjcvp/pvae092","url":null,"abstract":"","PeriodicalId":11982,"journal":{"name":"European Heart Journal - Cardiovascular Pharmacotherapy","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142750339","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":"STOPDAPT-3 subanalysis on prasugrel monotherapy after elective or emergent coronary intervention in patients with or without diabetes: are we ready for this?","authors":"Jeehoon Kang, Giuseppe Gargiulo","doi":"10.1093/ehjcvp/pvae079","DOIUrl":"10.1093/ehjcvp/pvae079","url":null,"abstract":"","PeriodicalId":11982,"journal":{"name":"European Heart Journal - Cardiovascular Pharmacotherapy","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142667681","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":"Pharmacogenetic testing to broaden patient eligibility for mavacamten.","authors":"Lorenz Van der Linden, Lucas Van Aelst, Iacopo Olivotto","doi":"10.1093/ehjcvp/pvae086","DOIUrl":"10.1093/ehjcvp/pvae086","url":null,"abstract":"","PeriodicalId":11982,"journal":{"name":"European Heart Journal - Cardiovascular Pharmacotherapy","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142617259","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":"Cost-effectiveness of Implementing a Genotype-Guided De-Escalation Strategy in Patients with Acute Coronary Syndrome.","authors":"W W A van den Broek, Jaouad Azzahhafi, Dean R P P Chan Pin Yin, Niels M R van der Sangen, Shabiga Sivanesan, Lea M Dijksman, Ronald J Walhout, Melvyn Tjon Joe Gin, Nicoline J Breet, Jorina Langerveld, Georgios J Vlachojannis, Rutger J van Bommel, Yolande Appelman, Ron H N van Schaik, José P S Henriques, Wouter J Kikkert, Jurriën M Ten Berg","doi":"10.1093/ehjcvp/pvae087","DOIUrl":"https://doi.org/10.1093/ehjcvp/pvae087","url":null,"abstract":"<p><strong>Aims: </strong>A genotype-guided P2Y12-inhibitor de-escalation strategy, switching acute coronary syndrome (ACS) patients without a CYP2C19 loss-of-function allele from ticagrelor or prasugrel to clopidogrel, has shown to reduce bleeding risk without affecting effectivity of therapy by increasing ischemic risk. We estimated the cost-effectiveness of this personalized approach compared to standard dual antiplatelet therapy (DAPT; aspirin plus ticagrelor/prasugrel) in the Netherlands.</p><p><strong>Methods and results: </strong>We developed a one-year decision tree based on results of the FORCE-ACS registry, comparing a cohort of ACS patients who underwent genotyping with a cohort of ACS patients treated with standard DAPT. This was followed by a lifelong Markov model to compare lifetime costs, and quality-adjusted life years (QALYs) for a fictional cohort of 1000 patients. The cost-effectiveness analysis was performed from the perspective of the Dutch healthcare system. A genotype-guided de-escalation strategy led to anincrease of 55.30 QALYs and saved €698,286 compared to standard DAPT based on a lifetime horizon. Probabilistic sensitivity analysis showed that the genotype-guided strategy was cost-saving in 93% and increased QALYs in 86% of simulations. The intervention remained cost-effective in the scenario where prices for all P2Y12-inhibitors were equalized. The genotype-guided strategy remained dominant in various other scenario and sensitivity analyses.</p><p><strong>Conclusion: </strong>A genotype-guided de-escalation strategy in patients with ACS was both cost-saving and yielded higher QALYs compared to standard DAPT, highlighting its potential for implementation in clinical practice. Trial registration: ClinicalTrials.gov identifier: NCT03823547.</p>","PeriodicalId":11982,"journal":{"name":"European Heart Journal - Cardiovascular Pharmacotherapy","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142617258","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":"Subcutaneous furosemide in heart failure: a systematic review.","authors":"Joanna Osmanska, Mark C Petrie, Kieran F Docherty, Matthew M Y Lee, John J V McMurray, Ross T Campbell","doi":"10.1093/ehjcvp/pvae083","DOIUrl":"https://doi.org/10.1093/ehjcvp/pvae083","url":null,"abstract":"<p><strong>Background and aim: </strong>Intravenous loop diuretics are the primary treatment for congestion in patients with decompensated heart failure (HF). Furosemide is the most commonly used loop diuretic and is licensed for administration either orally, intramuscularly or intravenously but not subcutaneously. Recently developed, pH-neutral, concentrated, 'skin-friendly' preparations of furosemide have been developed which allow subcutaneous administration. In this systematic review, we summarize and critically appraise the current evidence for subcutaneous furosemide in patients with HF.</p><p><strong>Methods and results: </strong>The electronic databases MEDLINE, EMBASE, the Cochrane Library, and ClinicalTrials.gov registry were searched up to 31 December 2023. Of the 17 studies identified, 5 were randomised controlled trials (RCTs), 2 were non-randomised controlled studies, 3 were prospective observational cohort studies, and 7 were retrospective observational studies.All RCTs utilised novel pH-neutral, subcutaneous preparations of furosemide. Bioavailability of novel subcutaneous preparations were similar to intravenous furosemide 10 mg/ml: 99.7% for an 8 mg/ml preparation and 112% for a 30 mg/ml preparation. Natriuresis and diuresis were also similar with novel subcutaneous and conventional intravenous furosemide. Adverse events of novel preparations included infusion site pain or discomfort, localised skin erythema and minimal swelling. All studies of conventional subcutaneous furosemide were non-randomised with very limited data re bioavailability or diuretic and natriuretic effect. Conventional subcutaneous furosemide was associated with substantial skin irritation (affecting 3-23% of patients), and skin infections requiring treatment with antibiotics (3-17%).</p><p><strong>Conclusions: </strong>Novel, pH-neutral preparations of subcutaneous furosemide achieved similar diuresis, natriuresis, and bioavailability to intravenous furosemide, and were well tolerated. Novel preparations may be a treatment option for patients with HF.</p>","PeriodicalId":11982,"journal":{"name":"European Heart Journal - Cardiovascular Pharmacotherapy","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142617261","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":"Extensive LDL-cholesterol lowering by PCSK9 inhibitor on the risk of venous thrombosis.","authors":"Shinya Goto, Shinichi Goto","doi":"10.1093/ehjcvp/pvae077","DOIUrl":"https://doi.org/10.1093/ehjcvp/pvae077","url":null,"abstract":"","PeriodicalId":11982,"journal":{"name":"European Heart Journal - Cardiovascular Pharmacotherapy","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142603303","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 ESC Working Group on cardiovascular pharmacotherapy: continuity through transformation.","authors":"Dobromir Dobrev, Bianca Rocca, Juan-Carlos Kaski","doi":"10.1093/ehjcvp/pvae070","DOIUrl":"10.1093/ehjcvp/pvae070","url":null,"abstract":"","PeriodicalId":11982,"journal":{"name":"European Heart Journal - Cardiovascular Pharmacotherapy","volume":" ","pages":"571"},"PeriodicalIF":5.3,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142344127","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}