Expert Review of Cardiovascular Therapy最新文献

What is the impact of dynamic score reassessment for stroke and bleeding risk outcome prediction in atrial fibrillation patients? 动态评分重估对房颤患者卒中和出血风险结局预测有何影响？

IF 1.8

Expert Review of Cardiovascular Therapy Pub Date : 2025-04-09 DOI: 10.1080/14779072.2025.2489725

Eva Soler-Espejo, Francisco Marín, Vanessa Roldán, José Miguel Rivera-Caravaca

{"title":"What is the impact of dynamic score reassessment for stroke and bleeding risk outcome prediction in atrial fibrillation patients?","authors":"Eva Soler-Espejo, Francisco Marín, Vanessa Roldán, José Miguel Rivera-Caravaca","doi":"10.1080/14779072.2025.2489725","DOIUrl":"https://doi.org/10.1080/14779072.2025.2489725","url":null,"abstract":"Introduction: Dynamic reassessment of stroke and bleeding risks is a cornerstone of patient-centered care in atrial fibrillation (AF) management. Unlike traditional approaches that evaluate these risks only at diagnosis or at initiation of oral anticoagulation, current evidence emphasizes periodic reassessment due to the evolving nature of risks.Areas covered: Stroke and bleeding risks in AF patients are influenced by aging, new comorbidities, and worsening health conditions, requiring updates to management plans to optimize outcomes. Dynamic increases in CHA2DS2-VASc (or the sex-less CHA2DS2-VA) and HAS-BLED scores are associated with heightened risks of stroke and bleeding, underscoring the need for regular reassessment. Addressing modifiable risk factors such as hypertension, renal dysfunction, and concurrent medications is key to improving outcomes. Although several guidelines now recommend risk reassessment at least annually, optimal timing remains unclear. Evidence supports more frequent reassessments for low-risk stroke patients (every 4 months) and high-risk bleeding patients (within 4-6 weeks) to promptly identify changes requiring intervention.Expert opinion: Despite its benefits, challenges remain regarding risk reassessment, including the lack of universally applicable intervals and the complexity of multidisciplinary evaluations. Future advancements in artificial intelligence tools are expected to enhance risk reassessment by enabling more precise, personalized, and dynamic patient management.","PeriodicalId":12098,"journal":{"name":"Expert Review of Cardiovascular Therapy","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143810855","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}

引用次数: 0

Patient-centric no-option refractory angina management: establishing comprehensive angina relief (CARE) clinics. 以患者为中心的无选择难治性心绞痛管理：建立综合心绞痛缓解（CARE）诊所。

IF 1.8

Expert Review of Cardiovascular Therapy Pub Date : 2025-04-07 DOI: 10.1080/14779072.2025.2488859

Balaj Rai, Mehmet Yildiz, Jarrod Frizzell, Odayme Quesada, Timothy D Henry

{"title":"Patient-centric no-option refractory angina management: establishing comprehensive angina relief (CARE) clinics.","authors":"Balaj Rai, Mehmet Yildiz, Jarrod Frizzell, Odayme Quesada, Timothy D Henry","doi":"10.1080/14779072.2025.2488859","DOIUrl":"https://doi.org/10.1080/14779072.2025.2488859","url":null,"abstract":"Introduction: Refractory angina (RA) is a debilitating condition characterized by persistent angina despite optimized medical therapy and limited options for further revascularization, leading to diminished quality of life and increased healthcare utilization. The RA patient population is rapidly expanding with significant unmet needs. Specialty clinics should be developed to focus on the long-term efficacy and safety of clinically available and novel treatment strategies, emphasizing quality of life.Areas covered: Patient-focused Comprehensive Angina Relief (CARE) clinics can enhance care and outcomes by providing individualized management for complex RA. This review summarizes peer-reviewed articles from PubMed and trial data from ClinicalTrials.gov. We discuss the epidemiology and pathophysiology of RA, introduce standardized tools for evaluating angina and psychosocial factors, and address symptom management. We also review treatment options such as risk factor modification, medication, and complex revascularization. Additionally, we explore emerging therapies, including coronary sinus occlusion, regenerative therapy, and neuromodulation for 'no-option' RA.Expert opinion: In the next five years, patients with refractory chest pain with or without coronary artery disease will increasingly be referred to specialty clinics for follow-up. Conducting more randomized control clinical trials with larger population subsets will bring novel therapies to the forefront.","PeriodicalId":12098,"journal":{"name":"Expert Review of Cardiovascular Therapy","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143802862","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}

引用次数: 0

Optimizing the management of tricuspid regurgitation: an update on current treatment strategies and perspectives. 优化三尖瓣反流的管理：当前治疗策略和观点的更新。

IF 1.8

Expert Review of Cardiovascular Therapy Pub Date : 2025-04-06 DOI: 10.1080/14779072.2025.2488869

Domenico Angellotti, Anna Franzone, Nicolas Brugger, David Reineke, Giovanni Esposito, Fabien Praz

{"title":"Optimizing the management of tricuspid regurgitation: an update on current treatment strategies and perspectives.","authors":"Domenico Angellotti, Anna Franzone, Nicolas Brugger, David Reineke, Giovanni Esposito, Fabien Praz","doi":"10.1080/14779072.2025.2488869","DOIUrl":"10.1080/14779072.2025.2488869","url":null,"abstract":"Introduction: Tricuspid regurgitation (TR) is a prevalent condition and is independently associated with high morbidity and mortality rates. Despite its prognostic impact, TR remains undertreated, with patients often referred at late stages when medical therapy is ineffective and surgical intervention high risk. Emerging transcatheter therapies offer a promising alternative for safer and effective management of this elderly patient population with numerous comorbidities.Areas covered: This review highlights recent advances in treatment strategies and future directions for addressing significant TR. The literature search was conducted across the PubMed, Embase, Scopus, and Google Scholar databases. A structured search strategy was developed using 'tricuspid regurgitation' and 'management' or 'treatment' or 'therapy' and 'surgery' or 'tricuspid valve repair' or 'tricuspid valve replacement' or 'transcatheter tricuspid intervention' as MeSH terms and keywords. Selected articles from 2017 to present were critically analyzed for strengths, limitations, and gaps in evidence.Expert opinion: Enhancing disease awareness, the involvement of multidisciplinary Heart Team and intervening earlier are critical priorities for TR therapies to prevent treatment futility. Improved device designs, more performant imaging techniques, and dedicated research endpoints will help optimizing the management of TR.","PeriodicalId":12098,"journal":{"name":"Expert Review of Cardiovascular Therapy","volume":" ","pages":"1-9"},"PeriodicalIF":1.8,"publicationDate":"2025-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143771878","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}

引用次数: 0

Antithrombotic therapy after left atrial appendage occlusion. 左心耳闭塞后的抗血栓治疗。

IF 1.8

Expert Review of Cardiovascular Therapy Pub Date : 2025-04-03 DOI: 10.1080/14779072.2025.2486154

Carmelo Raffo, Antonio Greco, Davide Capodanno

{"title":"Antithrombotic therapy after left atrial appendage occlusion.","authors":"Carmelo Raffo, Antonio Greco, Davide Capodanno","doi":"10.1080/14779072.2025.2486154","DOIUrl":"10.1080/14779072.2025.2486154","url":null,"abstract":"Introduction: Left atrial appendage occlusion (LAAO) represents a strategy to minimize thromboembolic risk in atrial fibrillation (AF) patients. However, LAAO carries some risks of periprocedural bleeding, device embolization, peri-device leaks or device-related thrombosis; the latter is due to direct blood contact with the device, justifying and represents the rationale behind antithrombotic therapy following LAAO.Areas covered: A comprehensive literature search (PubMed, Web of Science, Cochrane) has been performed up to November 2024. Antithrombotic drugs after LAAO include vitamin K antagonists (VKA), direct oral anticoagulants (DOAC), antiplatelet drugs, and their combinations. Initially, high-intensity regimens were implemented, while current strategies prioritize simplified approaches to promote device healing without increasing the bleeding risk. The aims of our review were to define the rationale and implications for post-LAAO antithrombotic therapy and provide an overview of current evidence on various antithrombotic regimens.Expert opinion: The optimal post-LAAO antithrombotic regimen remains controversial, highlighting the need for randomized trials on this topic. Current data suggest that DOACs have the lowest probability of thromboembolic events and major bleeding, while DAPT may be preferred in patients who do not tolerate OAC; finally, single antiplatelet therapy or no antithrombotic therapy are alternative options for patients at high bleeding risk.","PeriodicalId":12098,"journal":{"name":"Expert Review of Cardiovascular Therapy","volume":" ","pages":"1-12"},"PeriodicalIF":1.8,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143728767","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}

引用次数: 0

Coronary atherosclerotic plaque modification: the present and the future. 冠状动脉粥样硬化斑块修饰：现在和未来。

IF 1.8

Expert Review of Cardiovascular Therapy Pub Date : 2025-01-01 Epub Date: 2025-03-05 DOI: 10.1080/14779072.2025.2476132

Panagiotis Theofilis, Aggelos Papanikolaou, Paschalis Karakasis, Kyriakos Dimitriadis, Panayotis K Vlachakis, Evangelos Oikonomou, Konstantinos Tsioufis, Dimitris Tousoulis

{"title":"Coronary atherosclerotic plaque modification: the present and the future.","authors":"Panagiotis Theofilis, Aggelos Papanikolaou, Paschalis Karakasis, Kyriakos Dimitriadis, Panayotis K Vlachakis, Evangelos Oikonomou, Konstantinos Tsioufis, Dimitris Tousoulis","doi":"10.1080/14779072.2025.2476132","DOIUrl":"10.1080/14779072.2025.2476132","url":null,"abstract":"Introduction: Coronary atherosclerosis, marked by lipid deposition and inflammation, drives cardiovascular morbidity. Traditional treatments focus on lipid reduction, yet newer therapies target plaque composition, aiming to enhance stability and prevent coronary events.Areas covered: A comprehensive literature search was conducted across PubMed, Embase, and Scopus till January 2025 to identify studies on coronary plaque modification. This review highlights current and emerging therapies for coronary plaque modification. Key pharmacologic agents include Proprotein convertase subtilisin/kexin type 9 inhibitors for lipid management, colchicine for inflammation control, and Glucagon-like peptide-1 receptor agonists, and Sodium-glucose cotransporter-2 inhibitors for metabolic benefits. Clinical trials indicate these agents' roles in reducing plaque volume and vulnerability. Advances in imaging and biomarkers, such as lipoprotein(a) and inflammatory markers, enable refined monitoring of plaque changes over time.Expert opinion: Future management of atherosclerosis may involve personalized strategies, integrating AI-driven predictive tools and biomarkers to assess individual plaque characteristics and optimize therapy. Continued exploration of targeted anti-inflammatory therapies and novel biomarkers like Lp(a) could enhance outcomes, offering a more precise approach to reducing cardiovascular risk and stabilizing high-risk plaques.","PeriodicalId":12098,"journal":{"name":"Expert Review of Cardiovascular Therapy","volume":" ","pages":"65-71"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143556396","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}

引用次数: 0

Impella effects on reverse myocardial remodeling in anterior ST-elevation myocardial infarction: insights from a comprehensive analysis of acute and chronic MRI findings. 前段st段抬高型心肌梗死中Impella对逆转心肌重构的影响：来自急性和慢性MRI结果综合分析的见解。

IF 1.8

Expert Review of Cardiovascular Therapy Pub Date : 2025-01-01 Epub Date: 2025-03-11 DOI: 10.1080/14779072.2025.2476129

Daisuke Fukamachi, Akimasa Yamada, Kurara Takahashi, Ran Sumida, Yudai Tanaka, Shohei Migita, Saki Mizobuchi, Masatsugu Miyagawa, Hidesato Fujito, Yutaka Koyama, Akihito Oogaku, Katsunori Fukumoto, Riku Arai, Yasunari Ebuchi, Masaki Monden, Tomoyuki Morikawa, Takashi Mineki, Keisuke Kojima, Nobuhiro Murata, Mitsumasa Sudo, Daisuke Kitano, Naoya Matsumoto, Yasuo Okumura

{"title":"Impella effects on reverse myocardial remodeling in anterior ST-elevation myocardial infarction: insights from a comprehensive analysis of acute and chronic MRI findings.","authors":"Daisuke Fukamachi, Akimasa Yamada, Kurara Takahashi, Ran Sumida, Yudai Tanaka, Shohei Migita, Saki Mizobuchi, Masatsugu Miyagawa, Hidesato Fujito, Yutaka Koyama, Akihito Oogaku, Katsunori Fukumoto, Riku Arai, Yasunari Ebuchi, Masaki Monden, Tomoyuki Morikawa, Takashi Mineki, Keisuke Kojima, Nobuhiro Murata, Mitsumasa Sudo, Daisuke Kitano, Naoya Matsumoto, Yasuo Okumura","doi":"10.1080/14779072.2025.2476129","DOIUrl":"10.1080/14779072.2025.2476129","url":null,"abstract":"Background: Late adverse myocardial remodeling after ST elevation myocardial infarction (STEMI) is strongly associated with cardiac death. Global Longitudinal strain (GLS) and circumferential diastolic strain rate (CDSR) derived cardiovascular magnetic resonance imaging (CMRI) is a powerful predictor of late myocardial remodeling. However, the Impella's effects on CMRI after STEMI are not fully understood.Research design and methods: We retrospectively compared the CMRI in the acute (18 [14-22] vs. 14 [6-22] days, p = 0.43) and chronic phases (118 [102-242] vs. 117 [101-202] days, p = 1.0) after anterior STEMI.Results: Five patients received Impella before percutaneous coronary intervention (PCI), and seven underwent intra-aortic balloon pumping (IABP). There were no significant differences in the peak creatine kinase levels (2595 [2069 -12,932] vs. 4372 [2941-5601] IU/L, p = 0.76) and LVEF upon admission (51 ± 11 vs. 50 ± 9%, p = 1.0). The Impella group had significantly better acute CMRI-derived LVEF (49 ± 10 vs. 35 ± 7%, p = 0.02) and CDSR (0.9 ± 0.2 vs. 0.5 ± 0.3 s- 1, p = 0.018). In the chronic phase, the CMRI-derived LVEF and GLS were significantly higher in the Impella group (54 ± 9 vs. 39 ± 5%, p = 0.01; -9.9 ± 1.3 vs. -6.5 ± 2.2%, p = 0.01).Conclusions: The Impella implantation led to better LVEF and CDSR in the acute phase than IABP and better maintenance of both the LVEF and GLS through the chronic phase.","PeriodicalId":12098,"journal":{"name":"Expert Review of Cardiovascular Therapy","volume":" ","pages":"97-105"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143585274","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}

引用次数: 0

Cost-effectiveness of apixaban in non-valvular atrial fibrillation (NVAF) based on effectiveness data from a Spanish study in clinical practice (real-world evidence). 阿哌沙班治疗非瓣膜性心房颤动（NVAF）的成本-效果：基于西班牙临床实践研究的有效性数据（真实世界证据）。

IF 1.8

Expert Review of Cardiovascular Therapy Pub Date : 2025-01-01 Epub Date: 2025-02-17 DOI: 10.1080/14779072.2025.2464180

Manuel Anguita, Francisco Marín, Javier Soto, Susana Fernández de Cabo, Darío Rubio-Rodríguez, Carlos Rubio-Terrés

{"title":"Cost-effectiveness of apixaban in non-valvular atrial fibrillation (NVAF) based on effectiveness data from a Spanish study in clinical practice (real-world evidence).","authors":"Manuel Anguita, Francisco Marín, Javier Soto, Susana Fernández de Cabo, Darío Rubio-Rodríguez, Carlos Rubio-Terrés","doi":"10.1080/14779072.2025.2464180","DOIUrl":"10.1080/14779072.2025.2464180","url":null,"abstract":"Objective: To analyze the cost-effectiveness of apixaban in the prevention of stroke in adult patients with non-valvular atrial fibrillation (NVAF), compared to other direct-acting oral anticoagulants (dabigatran, rivaroxaban, edoxaban) and the vitamin K antagonist acenocoumarol, based on data on effectiveness in clinical practice in Spain obtained in the FANTASIIA study.Research design and methods: A probabilistic Markov economic model (second-order Monte Carlo simulation) was performed to analyze the costs and utilities (quality-adjusted life years, QALYs) associated with the compared treatments, according to the different probabilities of stroke, major bleeding and death observed in FANTASIIA.Results: The cost per QALY gained in the patient treated with apixaban versus comparators ranged from €2,919 to €7,462. The probability of apixaban being cost-effective ranges from 91.1% (vs dabigatran 150 mg), 97.8% (vs dabigatran 110 mg), and 100% (vs. rivaroxaban, edoxaban, and acenocoumarol).Conclusions: Based on the results of the FANTASIIA study, apixaban is a cost-effective treatment (below a willingness to pay of €25,000 per QALY gained) compared to dabigatran, rivaroxaban, edoxaban, and acenocoumarol in treating patients with NVAF.","PeriodicalId":12098,"journal":{"name":"Expert Review of Cardiovascular Therapy","volume":" ","pages":"45-51"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143364139","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}

引用次数: 0

What role could clinical staging standardization play in Fabry disease? 临床分期标准化对法布里病有何作用？

IF 1.8

Expert Review of Cardiovascular Therapy Pub Date : 2025-01-01 Epub Date: 2025-03-05 DOI: 10.1080/14779072.2025.2476128

Elisabete Martins, Janete Santos, Inês Fortuna

引用次数: 0

The fitter the better? The relationship between high cardiorespiratory fitness and the risk of atrial fibrillation and stroke. 越健康越好？高心肺适能与房颤和中风风险的关系。

IF 1.8

Expert Review of Cardiovascular Therapy Pub Date : 2025-01-01 Epub Date: 2025-03-06 DOI: 10.1080/14779072.2025.2476123

Marius Myrstad, Adrian Elliott

引用次数: 0

Risk scoring systems for early prediction of short-term mortality in resuscitated out-of-hospital cardiac arrest patients. 院外心脏骤停复苏患者短期死亡率早期预测的风险评分系统。

IF 1.8

Expert Review of Cardiovascular Therapy Pub Date : 2025-01-01 Epub Date: 2025-01-04 DOI: 10.1080/14779072.2025.2449899

Tharusan Thevathasan, Ulf Landmesser, Anne Freund, Janine Pöss, Carsten Skurk, Holger Thiele, Steffen Desch

{"title":"Risk scoring systems for early prediction of short-term mortality in resuscitated out-of-hospital cardiac arrest patients.","authors":"Tharusan Thevathasan, Ulf Landmesser, Anne Freund, Janine Pöss, Carsten Skurk, Holger Thiele, Steffen Desch","doi":"10.1080/14779072.2025.2449899","DOIUrl":"10.1080/14779072.2025.2449899","url":null,"abstract":"Introduction: Out-of-hospital cardiac arrest (OHCA) is a critical condition associated with high mortality rates and neurological impairment among survivors. In comatose OHCA patients who achieve return of spontaneous circulation, early risk stratification is important to inform treatment pathways and potentially improve outcomes. A range of prognostic tools have been developed to predict survival and neurological recovery. Each tool incorporates a unique combination of clinical, biochemical and physiological markers.Areas covered: This review article evaluates the required clinical data, predictive performances and practical applicability of major risk scores. A literature review was conducted in PubMed and Embase for studies published between January 2000 and October 2024. The review emphasizes the variability in discriminative power among the selected scores, with some models offering high sensitivity and specificity in outcome prediction, while others prioritize simplicity and accessibility.Expert opinion: Despite the advancements of these tools, limitations persist in data dependency and the clinical adaptability, highlighting areas for future improvement. Integrating artificial intelligence and real-time analytics could enhance predictive accuracy, offering dynamic prognostic capabilities that adapt to individual patient trajectories. This evolution must be grounded in ethical considerations to ensure predictive technologies complement rather than replace clinical judgment, balancing technology's potential with the complexities of individualized patient care.","PeriodicalId":12098,"journal":{"name":"Expert Review of Cardiovascular Therapy","volume":" ","pages":"5-13"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142921120","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}

引用次数: 0