European Heart Journal - Cardiovascular Pharmacotherapy最新文献

{"title":"When randomization is not enough: divergent β-blocker trials and the illusion of universal causality.","authors":"Elmir Omerovic, Truls Råmunddal, Sandeep Jha, Petur Petursson, Kristofer Skoglund, Araz Rawshani, Björn Redfors","doi":"10.1093/ehjcvp/pvag037","DOIUrl":"10.1093/ehjcvp/pvag037","url":null,"abstract":"","PeriodicalId":11982,"journal":{"name":"European Heart Journal - Cardiovascular Pharmacotherapy","volume":" ","pages":"437-443"},"PeriodicalIF":8.2,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13593205/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148137004","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"May the universal truth rest in peace and us with her? On how to understand inconsistency in and among pharmacological trials.","authors":"Maura Marcucci, Holger J Schünemann, Federico Germini","doi":"10.1093/ehjcvp/pvag060","DOIUrl":"10.1093/ehjcvp/pvag060","url":null,"abstract":"","PeriodicalId":11982,"journal":{"name":"European Heart Journal - Cardiovascular Pharmacotherapy","volume":" ","pages":"433-436"},"PeriodicalIF":8.2,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13593218/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148673092","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From 'bridging specialties' to 'owning the patient': rethinking accountability in Cardiovascular-Kidney-Metabolic syndrome care.","authors":"Lu Li, Qing Ni, Lan Lin","doi":"10.1093/ehjcvp/pvag057","DOIUrl":"10.1093/ehjcvp/pvag057","url":null,"abstract":"","PeriodicalId":11982,"journal":{"name":"European Heart Journal - Cardiovascular Pharmacotherapy","volume":" ","pages":"496-497"},"PeriodicalIF":8.2,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13593201/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148591187","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bleeding risk assessment in coronary artery bypass grafting-related postoperative atrial fibrillation: clinical interpretation and future directions.","authors":"Xubo Zhao, Lingfan Sun","doi":"10.1093/ehjcvp/pvag050","DOIUrl":"10.1093/ehjcvp/pvag050","url":null,"abstract":"","PeriodicalId":11982,"journal":{"name":"European Heart Journal - Cardiovascular Pharmacotherapy","volume":" ","pages":"492-493"},"PeriodicalIF":8.2,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13593197/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148390259","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Statin adherence among patients with hypertension in Swedish primary health care: a QregPV cohort study using explainable machine learning.","authors":"Johan Sandslätt, Kristina Bengtsson Boström, Maria Åberg, Johan-Emil Bager, Koen Simons, Georgios Mourtzinis, Per Hjerpe, Tobias Andersson","doi":"10.1093/ehjcvp/pvag048","DOIUrl":"10.1093/ehjcvp/pvag048","url":null,"abstract":"<p><strong>Aims: </strong>Evidence regarding statin adherence among patients with hypertension in primary care is limited. We assessed statin adherence in Swedish primary care and examined associations between patient characteristics and adherence.</p><p><strong>Methods and results: </strong>In this retrospective register-based cohort study from a large Swedish region, data from all primary health care centres were linked to data on comorbidities, dispensed drugs, and socioeconomic factors. Patients with hypertension who initiated statin therapy in 2012-2015 were included. Adherence during 2 years after initiation was measured using the proportion of days covered (PDC). Explainable machine learning with XGBoost and SHAP values identified baseline characteristics associated with adherence. Associations were estimated using adjusted multilevel regression and presented as odds ratios (ORs) and median odds ratios (MORs). Among 30 497 patients (mean age 66 years; 48% women), the mean 2-year PDC was 73.2%, while 60.2% achieved adequate adherence (PDC > 80%). Adequate adherence differed by indication (P < 0.001): 54.0% in primary prevention, 61.3% in diabetes without cardiovascular disease, and 65.5% in secondary prevention. The five most important characteristics associated with adequate adherence according to SHAP values were dispensed antithrombotic therapy (OR 1.38, 95% CI 1.26-1.50), primary health care centre (MOR 1.16, 95% CI 1.12-1.20), 10-year increase in age (OR 1.14, 95% CI 1.12-1.17), initiation with atorvastatin (OR 1.33, 95% CI 1.24-1.44), and countries of birth outside Sweden (OR range 0.73-0.78).</p><p><strong>Conclusion: </strong>Only 60% of patients achieved adequate statin adherence, which varied substantially by indication. Patient- and provider-level factors identified could guide targeted interventions to optimize preventive cardiovascular care.</p>","PeriodicalId":11982,"journal":{"name":"European Heart Journal - Cardiovascular Pharmacotherapy","volume":" ","pages":"458-467"},"PeriodicalIF":8.2,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13594359/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148344274","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pharmacokinetics in the Fontan circulation: a multi-organ puzzle.","authors":"Panayotis K Vlachakis, Maria Drakopoulou, Panagiotis Theofilis, Paschalis Karakasis, Ioannis Leontsinis, Konstantinos Tsioufis, Konstantinos Toutouzas","doi":"10.1093/ehjcvp/pvag058","DOIUrl":"10.1093/ehjcvp/pvag058","url":null,"abstract":"<p><p>Patients with Fontan circulation represent a pharmacologically distinct population in whom the haemodynamic consequences of single-ventricle physiology alter every phase of drug disposition in ways that current prescribing practice systematically fails to account for. Fontan-associated liver disease suppresses hepatic CYP enzyme activity and reduces first-pass metabolism, increasing bioavailability and systemic exposure of drugs. Hypoalbuminaemia from protein-losing enteropathy elevates the free fraction of highly protein-bound agents, rendering standard total drug concentration targets unreliable. Reduced cardiac output contracts the volume of distribution of hydrophilic drugs and diminishes renal perfusion, while creatinine-based glomerular filtration rate equations systematically overestimate true renal function due to reduced skeletal muscle mass, leading to inadequate dose reduction for renally cleared agents. These disturbances are predicted to affect the pharmacokinetics of every major cardiovascular drug class prescribed in this population, including anticoagulants, antiarrhythmics, neurohormonal antagonists, and pulmonary vasodilators, although direct Fontan-specific pharmacokinetic data remain scarce and confirm these effects for only a minority of agents, with dosing largely extrapolated from non-congenital populations. This review examines the mechanistic basis of pharmacokinetic alterations across drug disposition, evaluate available drug-class evidence, and outlines a research agenda including physiologically based pharmacokinetic modelling, registry-embedded studies, and dedicated inclusion of Fontan patients in future trials.</p>","PeriodicalId":11982,"journal":{"name":"European Heart Journal - Cardiovascular Pharmacotherapy","volume":" ","pages":"480-489"},"PeriodicalIF":8.2,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13593209/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148701106","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond API-CAT: the remaining challenges of extended anticoagulation for cancer-associated thrombosis.","authors":"Marcello Di Nisio, Tzu-Fei Wang","doi":"10.1093/ehjcvp/pvag054","DOIUrl":"10.1093/ehjcvp/pvag054","url":null,"abstract":"","PeriodicalId":11982,"journal":{"name":"European Heart Journal - Cardiovascular Pharmacotherapy","volume":" ","pages":"444-446"},"PeriodicalIF":8.2,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13593206/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148548287","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical and experimental insights into hydroxychloroquine-associated electrical abnormalities and cardiomyopathy.","authors":"Mikio Shiba, Zhaoyang Liu, Shuichiro Higo, Junjun Li, Yoshihiko Ikeda, Lifu Sun, Yuting Liu, Yuki Hara, Shinji Higa, Tatsuya Nishikawa, Yuki Matsuoka, Yu Morishita, Shigeru Miyagawa, Yasushi Sakata, Li Liu, Yoshiharu Higuchi","doi":"10.1093/ehjcvp/pvag063","DOIUrl":"10.1093/ehjcvp/pvag063","url":null,"abstract":"<p><strong>Aims: </strong>Hydroxychloroquine (HCQ) is commonly prescribed for malaria and autoimmune diseases, yet its potential for cardiotoxicity remains under-recognized. The objective of this study was to investigate the clinical and experimental features of HCQ-associated cardiotoxicity.</p><p><strong>Methods and results: </strong>We retrospectively analysed 261 HCQ-treated patients, assessing cardiac adverse events and electrocardiographic intervals. Endomyocardial biopsy specimens were examined via transmission electron microscopy. To explore potential pathophysiological correlates, human-induced pluripotent stem cell-derived cardiomyocytes (hiPSC-CMs) were exposed to HCQ, and electrophysiological, ultrastructural, contractile and autophagy-related responses were evaluated. Hydroxychloroquine was discontinued in 14 patients, including 3 patients with clinically significant cardiotoxicity manifesting as heart failure or an isolated conduction abnormality (1.1% of the cohort). QTc intervals increased from a median of 413 ms [interquartile range (IQR), 399-426 ms] pre-treatment to 421 ms (IQR, 407-440 ms) on-treatment (P = 0.003), indicating a modest but statistically significant change. PR interval also increased modestly from 148 ms (IQR, 140-163 ms) to 150 ms (IQR, 142-168 ms) (P = 0.041). In vitro, HCQ exposure in hiPSC-CMs prolonged corrected field potential duration (P = 0.013) and induced arrhythmic activity. Motion analysis demonstrated a reduced peak relaxation velocity (P < 0.01), with concomitant attenuation of contractile function. Transmission electron microscopy showed lamellar inclusions consistent with myelin-like bodies. Hydroxychloroquine exposure significantly increased autophagy-related protein levels, suggesting impaired autophagic degradation. These cellular phenotypes were consistent with clinical manifestations of HCQ-associated electrical abnormalities and cardiomyopathy.</p><p><strong>Conclusion: </strong>Hydroxychloroquine therapy was associated with electrical abnormalities and cardiomyopathy. Experimental findings in hiPSC-CMs recapitulated key clinical features and provided biological support for the clinical observations.</p>","PeriodicalId":11982,"journal":{"name":"European Heart Journal - Cardiovascular Pharmacotherapy","volume":" ","pages":"468-479"},"PeriodicalIF":8.2,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13593202/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148812111","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From digital reminders to AI-enabled understanding: can personalized treatment predictions improve therapeutic adherence?","authors":"Valentin Goutaudier, Jean-Sébastien Hulot","doi":"10.1093/ehjcvp/pvag079","DOIUrl":"https://doi.org/10.1093/ehjcvp/pvag079","url":null,"abstract":"","PeriodicalId":11982,"journal":{"name":"European Heart Journal - Cardiovascular Pharmacotherapy","volume":" ","pages":""},"PeriodicalIF":8.2,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149016100","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":"Universal evidence and contextual pharmacotherapy.","authors":"Bianca Rocca","doi":"10.1093/ehjcvp/pvag065","DOIUrl":"10.1093/ehjcvp/pvag065","url":null,"abstract":"","PeriodicalId":11982,"journal":{"name":"European Heart Journal - Cardiovascular Pharmacotherapy","volume":"12 6","pages":"431-432"},"PeriodicalIF":8.2,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13593215/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149016126","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}