Expert Review of Cardiovascular Therapy最新文献_第10页

Coronary artery bypass grafting versus percutaneous coronary intervention outcomes among patients with acute coronary syndrome and unprotected left main coronary artery disease: a meta-analysis with a reconstructed time-to-event analysis. 急性冠状动脉综合征和无保护的左主干冠状动脉疾病患者的冠状动脉旁路移植术与经皮冠状动脉介入治疗的结果：一项具有重建时间到事件分析的荟萃分析

IF 2.1

Expert Review of Cardiovascular Therapy Pub Date : 2026-01-01 Epub Date: 2025-12-18 DOI: 10.1080/14779072.2025.2603968

Mohammed A Elbahloul, Ahmed Farid Gadelmawla, Ahmed Hamdy G Ali, Ahmed K Awad, Ahmed Elazab, Ahmed Mansour, Ahmed N Mohamed, Hatem Sarhan, Islam Y Elgendy

{"title":"Coronary artery bypass grafting versus percutaneous coronary intervention outcomes among patients with acute coronary syndrome and unprotected left main coronary artery disease: a meta-analysis with a reconstructed time-to-event analysis.","authors":"Mohammed A Elbahloul, Ahmed Farid Gadelmawla, Ahmed Hamdy G Ali, Ahmed K Awad, Ahmed Elazab, Ahmed Mansour, Ahmed N Mohamed, Hatem Sarhan, Islam Y Elgendy","doi":"10.1080/14779072.2025.2603968","DOIUrl":"10.1080/14779072.2025.2603968","url":null,"abstract":"Introduction: Patients with an unprotected left main coronary artery (ULMCA) presenting with acute coronary syndrome (ACS) were underrepresented in randomized trials. We aimed to compare the outcomes of coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI) in these patients.Methods: Electronic databases were searched for studies comparing CABG vs PCI for patients with ULMCA presenting with ACS. The primary outcome was all-cause mortality. The outcomes were reported using a risk ratio (RR) and 95% confidence interval (CI) using random-effect model.Results: A total of 7 studies with 4033 patients were included. There was no difference in the incidence of all-cause mortality between CABG and PCI. CABG was associated with a trend toward a higher incidence of stroke in short-term, but with lower rates of lower target vessel revascularization, and target lesion revascularization during long-term follow-up.Conclusions: CABG and PCI were associated with comparable long-term mortality among patients with ULMCA who presented with ACS. However, CABG was associated with a lower incidence of MI and revascularization but a trend toward a higher incidence of stroke. These findings could help with informed decision-making among patients with ULMCA presenting with ACS.Registration: The protocol was registered on PROSPERO (CRD420251034578).","PeriodicalId":12098,"journal":{"name":"Expert Review of Cardiovascular Therapy","volume":" ","pages":"57-69"},"PeriodicalIF":2.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145741745","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

Use of sodium-glucose cotransporter 2 inhibitor in heart failure: a real-world study. 钠-葡萄糖共转运蛋白2抑制剂在心力衰竭中的应用：一项真实世界的研究。

IF 2.1

Expert Review of Cardiovascular Therapy Pub Date : 2025-12-01 Epub Date: 2025-12-12 DOI: 10.1080/14779072.2025.2598405

Luis Fernando Valladales-Restrepo, Daniela Torrente-López, Carlos Manuel Bedoya-Toro, María Fernanda Lerma-Barco, Ana Sofia Franco-Carvajal, Jorge Enrique Machado-Alba

{"title":"Use of sodium-glucose cotransporter 2 inhibitor in heart failure: a real-world study.","authors":"Luis Fernando Valladales-Restrepo, Daniela Torrente-López, Carlos Manuel Bedoya-Toro, María Fernanda Lerma-Barco, Ana Sofia Franco-Carvajal, Jorge Enrique Machado-Alba","doi":"10.1080/14779072.2025.2598405","DOIUrl":"10.1080/14779072.2025.2598405","url":null,"abstract":"Background: The aim was to determine the use of Sodium - Glucose Cotransporter-2 Inhibitors (SGLT2i) in patients with heart failure with and without diabetes mellitus in Colombia.Research design and methods: The use of SGLT2i in patients with heart failure, followed for one year was evaluated. The patterns of use, indications, adherence and persistence of SGLT2i were analyzed. Descriptive and multivariate analyses were performed.Results: A total of 500 patients were selected, with a mean age of 70.8 ± 12.8 years and 53.0% men; 57.2% started management with dapagliflozin. SGLT2i were most frequently used for heart failure with a reduced ejection fraction (HFrEF) and New York Heart Association classification of II or III (41.0%). The drug adherence rate was 80.9 ± 16.4%, and 71.8% of the patients reported persistent SGLT2i use for one year. Hospitalizations were less common during SGLT2i treatment than in the previous year (12.2% vs. 24.4%; p < 0.001). Having a Charlson Comorbidity Index ≥3 increased the probability of persistence of SGLT2i use at one year (Odds Ratio:4.56; 95%-Confidence Interval:1.46-14.27).Conclusions: SGLT2i use predominates in patients with HFrEF and in those with a high comorbidity burden. Adherence and persistence were similar to or even better than those reported in other real-world evidence studies.","PeriodicalId":12098,"journal":{"name":"Expert Review of Cardiovascular Therapy","volume":" ","pages":"935-942"},"PeriodicalIF":2.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145631275","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

Personalized management and decision-making for non-ST-segment elevation acute coronary syndrome in vulnerable populations. 弱势人群非st段抬高急性冠状动脉综合征的个性化管理和决策。

IF 2.1

Expert Review of Cardiovascular Therapy Pub Date : 2025-12-01 Epub Date: 2025-11-04 DOI: 10.1080/14779072.2025.2583939

Pablo Díez-Villanueva, César Jiménez-Méndez, Pedro Cepas-Guillén, Lidia Vilches, Fernando Rivero, Héctor García-Pardo, Juan Sanchís, Albert Ariza, Fernando Alfonso

{"title":"Personalized management and decision-making for non-ST-segment elevation acute coronary syndrome in vulnerable populations.","authors":"Pablo Díez-Villanueva, César Jiménez-Méndez, Pedro Cepas-Guillén, Lidia Vilches, Fernando Rivero, Héctor García-Pardo, Juan Sanchís, Albert Ariza, Fernando Alfonso","doi":"10.1080/14779072.2025.2583939","DOIUrl":"10.1080/14779072.2025.2583939","url":null,"abstract":"Introduction: Acute coronary syndromes (ACS) remain the leading cause of mortality in developed countries, particularly affecting older adults. Managing vulnerable patients - particularly those who are frail or have significant comorbidities such as anemia or chronic kidney disease (CKD) - is challenging due to the lack of evidence-based guidelines tailored to this group.Areas covered: This review explores the management of non-ST-elevation acute coronary syndrome (NST-ACS) with a focus on antithrombotic therapy, invasive strategies, and cardiac rehabilitation (CR). Special attention is given to patients with frailty, atrial fibrillation (AF), and CKD, recognizing their complexity. For this purpose, studies specifically addressing the management of elderly patients with NST-ACS were reviewed.Expert opinion: Optimal management of elderly patients with NSTE-ACS requires a personalized approach. Antithrombotic therapy should be individualized, avoiding rigid guidelines. Less potent antiplatelet agents (e.g. clopidogrel) combined with direct oral anticoagulants (DOACs) offer improved safety in patients with AF. Early invasive strategies can reduce adverse events but may carry procedural risks in frail individuals. Systematic comprehensive geriatric assessment (CGA) should guide decision-making; and multidisciplinary care is essential to improving outcomes. Home-based or hybrid CR programs still need to be widely implemented and the integration of caregivers into them can enhance outcomes.","PeriodicalId":12098,"journal":{"name":"Expert Review of Cardiovascular Therapy","volume":" ","pages":"809-820"},"PeriodicalIF":2.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145437684","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

Cardiac magnetic resonance imaging in myocardial infarction with non-obstructive coronary arteries (MINOCA): current and evolving perspectives. 非阻塞性冠状动脉心肌梗死（MINOCA）的心脏磁共振成像：当前和未来的观点。

IF 2.1

Expert Review of Cardiovascular Therapy Pub Date : 2025-12-01 Epub Date: 2025-10-21 DOI: 10.1080/14779072.2025.2577397

Michele Di Leo, Nicolò Vasumini, Angelo Maida, Tommaso Manaresi, Marco Basile, Francesco Angeli, Matteo Armillotta, Marcello Casuso Alvarez, Leonardo Luca Bavuso, Rebecca Belà, Jessica Salerno, Damiano Fedele, Lisa Canton, Sara Amicone, Roberto Carletti, Elisa Gardini, Luca Bergamaschi, Carmine Pizzi

{"title":"Cardiac magnetic resonance imaging in myocardial infarction with non-obstructive coronary arteries (MINOCA): current and evolving perspectives.","authors":"Michele Di Leo, Nicolò Vasumini, Angelo Maida, Tommaso Manaresi, Marco Basile, Francesco Angeli, Matteo Armillotta, Marcello Casuso Alvarez, Leonardo Luca Bavuso, Rebecca Belà, Jessica Salerno, Damiano Fedele, Lisa Canton, Sara Amicone, Roberto Carletti, Elisa Gardini, Luca Bergamaschi, Carmine Pizzi","doi":"10.1080/14779072.2025.2577397","DOIUrl":"10.1080/14779072.2025.2577397","url":null,"abstract":"Introduction: Myocardial Infarction with Non-Obstructive Coronary Arteries (MINOCA) represents a diagnostic challenge, requiring the exclusion of non-ischemic causes such as myocarditis, Takotsubo syndrome, and cardiomyopathies. Cardiac magnetic resonance (CMR) plays a pivotal role in differentiating MINOCA from these conditions by providing detailed tissue characterization to identify inflammation, edema, and fibrosis. This review explores the expanding role of CMR in diagnosing, reclassifying, and managing MINOCA, emphasizing its ability to guide treatment, improve prognosis, and aid risk stratification by identifying underlying causes.Areas covered: This narrative review discusses recent advancements in CMR protocols for suspected MINOCA, its role in distinguishing ischemic from non-ischemic causes of acute myocardial injury, and its emerging utility in risk stratification and personalized therapy. Relevant articles were searched in PubMed, Scopus, and Cochrane databases up to February 2025.Expert opinion: CMR is the noninvasive gold standard for diagnosing MINOCA. Its emerging role in evaluating coronary microcirculation, along with integrated approaches using coronary computed tomography, will further enhance the noninvasive assessment of MINOCA, in particular determining potential coronary and non-coronary etiologies.","PeriodicalId":12098,"journal":{"name":"Expert Review of Cardiovascular Therapy","volume":" ","pages":"765-775"},"PeriodicalIF":2.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145307388","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

Myocardial injury biomarkers and their assays: advances, insights, and future directions. 心肌损伤生物标志物及其测定：进展、见解和未来方向。

IF 2.1

Expert Review of Cardiovascular Therapy Pub Date : 2025-12-01 Epub Date: 2025-11-14 DOI: 10.1080/14779072.2025.2586669

Samuel McGrath, Bashir Alaour, Michael Marber

{"title":"Myocardial injury biomarkers and their assays: advances, insights, and future directions.","authors":"Samuel McGrath, Bashir Alaour, Michael Marber","doi":"10.1080/14779072.2025.2586669","DOIUrl":"10.1080/14779072.2025.2586669","url":null,"abstract":"Introduction: Cardiac Troponin (cTn) is fundamental to the diagnosis of myocardial injury. High sensitivity cTn assays have transformed acute cardiac care by shifting the focus toward rapid rule-out of myocardial infarction, allowing the early identification and safe discharge of low-risk patients. However, cTn proteins and their assays have limitations.Areas covered: The review summarizes cTn as a biomarker of myocardial injury, high-sensitivity cTn assay performance, and their combined impact on chest pain pathways. It explores Cardiac Myosin-Binding Protein C (cMyC) and discusses the evidence behind its use as an alternative biomarker. Studies available on Pubmed were analyzed using keywords cTn, cMyC, myocardial infarction, triage, chest pain and assay. The second half of this review explores the proteolysis of both these biomarkers, and how this information could be used in clinical practice.Expert opinion: Both hs-cTn and hs-cMyC assays have shown equivalent diagnostic performance in the rule-out of myocardial infarction. Unfortunately, both are also plagued by the similar liabilities: decreased specificity for Type 1 AMI, and an inability to distinguish between types of myocardial injury. Proteolysis of each biomarker differs according to underlying pathology. Novel assays that quantify distinct forms could enhance patient triage.","PeriodicalId":12098,"journal":{"name":"Expert Review of Cardiovascular Therapy","volume":" ","pages":"855-866"},"PeriodicalIF":2.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145476937","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

Undetected acute hypertension-mediated organ damage: a very important but insufficiently recognized problem. 未被发现的急性高血压介导的器官损害：一个非常重要但未被充分认识的问题。

IF 2.1

Expert Review of Cardiovascular Therapy Pub Date : 2025-12-01 Epub Date: 2025-11-22 DOI: 10.1080/14779072.2025.2591328

Goran Koraćević, Milovan Stojanović

{"title":"Undetected acute hypertension-mediated organ damage: a very important but insufficiently recognized problem.","authors":"Goran Koraćević, Milovan Stojanović","doi":"10.1080/14779072.2025.2591328","DOIUrl":"10.1080/14779072.2025.2591328","url":null,"abstract":"Introduction: The presence of acute hypertension-mediated organ damage (HMOD) makes the difference between hypertensive emergency (HTN-E) and hypertensive urgency (HTN-U). In the case of unrecognized ('false negative') acute HMOD, a misclassification ensues: the diagnosis is HTN-U instead of HTN-E, and the treatment of these patients is inadequate.Areas covered: This review aims to investigate the presence of undiagnosed acute HMODs in the hypertension (HTN) guidelines, to analyze the significance of the undiagnosed acute HMODs, and to evaluate the gaps in the knowledge on the topic. The following databases were searched: Scopus, PubMed, Cambridge, Oxford Journals, Springer, Science Direct, SAGE, Wiley, and Google Scholar.Expert opinion: There is insufficient awareness of the problem of unrecognized ('false negative') acute HMODs in clinical practice. HTN-Es have poor prognosis, with high risk of cardiovascular events and even death. Acute HMODs are prerequisite for the diagnosis of HTN-E, and it can be expected that undetected HMODs have even worse outcome. Therefore, undetected (false - negative) acute HMODs are worth of accepting and studying.","PeriodicalId":12098,"journal":{"name":"Expert Review of Cardiovascular Therapy","volume":" ","pages":"841-853"},"PeriodicalIF":2.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145548800","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

The role of enhanced stent visualization imaging in percutaneous coronary intervention: a systematic review of efficacy and clinical outcomes. 增强支架可视化成像在经皮冠状动脉介入治疗中的作用：疗效和临床结果的系统回顾。

IF 2.1

Expert Review of Cardiovascular Therapy Pub Date : 2025-12-01 Epub Date: 2025-10-14 DOI: 10.1080/14779072.2025.2574262

Vibhootee Sant Bakshsingh, Shawmendra S Bundhoo, Majd B Protty

{"title":"The role of enhanced stent visualization imaging in percutaneous coronary intervention: a systematic review of efficacy and clinical outcomes.","authors":"Vibhootee Sant Bakshsingh, Shawmendra S Bundhoo, Majd B Protty","doi":"10.1080/14779072.2025.2574262","DOIUrl":"10.1080/14779072.2025.2574262","url":null,"abstract":"Introduction: Coronary artery disease (CAD) is a major global cause of morbidity and mortality. Percutaneous coronary intervention (PCI) is central to its management, and optimal stent deployment is critical. This systematic review evaluates the efficacy and clinical outcomes associated with enhanced stent visualization (ESV) systems - X-ray-based fluoroscopic tools such as StentBoost and CLEARstent - in PCI.Methods: A systematic literature search of PubMed, PubMed Central, and Cochrane Library was conducted according to PRISMA guidelines. Inclusion criteria comprised all study types evaluating ESV use in PCI, excluding case reports and non-English articles. Study quality was assessed using Newcastle-Ottawa tool.Results: Twelve studies involving ESV were included. ESV improved detection of stent expansion and deployment versus standard angiography and showed strong agreement with OCT and IVUS. ESV-guided PCI was associated with reduced rates of major adverse cardiac events (MACE), particularly in long-term follow-up. Radiation exposure was modestly increased but deemed acceptable.Conclusions: ESV systems enhance stent deployment accuracy and clinical outcomes in PCI, offering a cost-effective and accessible alternative to OCT and IVUS. Evidence supports routine integration of ESV in PCI workflows, although further large-scale trials are warranted.Registration: PROSPERO identifier is CRD420251020834.","PeriodicalId":12098,"journal":{"name":"Expert Review of Cardiovascular Therapy","volume":" ","pages":"915-921"},"PeriodicalIF":2.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145274172","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

Fixing the rhythm in transcatheter aortic valve implantation patients: can we reduce the need for permanent pacemaker implantation? 固定经导管主动脉瓣植入术患者的心律：我们能减少永久性心脏起搏器植入术的需要吗？

IF 2.1

Expert Review of Cardiovascular Therapy Pub Date : 2025-12-01 Epub Date: 2025-11-23 DOI: 10.1080/14779072.2025.2591793

Teodor Serban, Andrea Papa, Patrick Badertscher

{"title":"Fixing the rhythm in transcatheter aortic valve implantation patients: can we reduce the need for permanent pacemaker implantation?","authors":"Teodor Serban, Andrea Papa, Patrick Badertscher","doi":"10.1080/14779072.2025.2591793","DOIUrl":"10.1080/14779072.2025.2591793","url":null,"abstract":"Introduction: Transcatheter aortic valve implantation (TAVI) has revolutionized the treatment of severe aortic stenosis, yet conduction disturbances remain the most common complication. Permanent pacemaker implantation (PPI), while often necessary, may negatively impact long-term outcomes and increase healthcare burden. Identifying patients at risk of PPI and optimizing post-TAVI rhythm management is therefore of critical importance.Areas covered: This Special Report reviews key predictors of conduction disturbances after TAVI, including baseline electrocardiographic features (e.g. right bundle branch block), anatomical parameters (e.g. short membranous septum), and procedural factors (e.g. valve type and implantation depth) identified by literature review. Dynamic post-procedural changes in PR interval and QRS duration are discussed as triggers for further monitoring or electrophysiological testing. The report synthesizes findings from recent multicenter studies, guideline recommendations, and emerging tools such as ECG ambulatory monitoring using artificial intelligence and the MIDAS implantation technique.Expert opinion: Reducing unnecessary PPI requires an individualized, risk-adapted approach that integrates imaging, ECG, and procedural planning. Dynamic post-TAVI monitoring and selective use of electrophysiological studies may help avoid overtreatment. As TAVI expands to younger and lower-risk populations, refining conduction management will be essential to optimize patient outcomes and healthcare resource utilization.","PeriodicalId":12098,"journal":{"name":"Expert Review of Cardiovascular Therapy","volume":" ","pages":"785-791"},"PeriodicalIF":2.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145534304","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

An assessment of Fontan procedure outcomes and how we can reduce post-Fontan complications. 对Fontan手术结果的评估以及我们如何减少Fontan术后并发症。

IF 2.1

Expert Review of Cardiovascular Therapy Pub Date : 2025-12-01 Epub Date: 2025-11-21 DOI: 10.1080/14779072.2025.2591333

Massimo A Padalino, Giuseppe Imperatore, Domenico Crea, Biagio Castaldi, Jürgen Hörer, Bart Meyns, Claudia Montanaro, Eva Sames Dolzer, George Sarris, Tomaso Bottio, Andrew Constantine, Konstantinos Dimopoulos

{"title":"An assessment of Fontan procedure outcomes and how we can reduce post-Fontan complications.","authors":"Massimo A Padalino, Giuseppe Imperatore, Domenico Crea, Biagio Castaldi, Jürgen Hörer, Bart Meyns, Claudia Montanaro, Eva Sames Dolzer, George Sarris, Tomaso Bottio, Andrew Constantine, Konstantinos Dimopoulos","doi":"10.1080/14779072.2025.2591333","DOIUrl":"10.1080/14779072.2025.2591333","url":null,"abstract":"Introduction: The Fontan procedure and its modifications have dramatically transformed prognosis in individuals with single ventricle physiology, yet long-term outcomes remain challenging due to the high incidence of short and long-term complications. Common issues include arrhythmias, heart failure, Fontan-associated liver disease and an increasing need for reintervention or transplantation, all of which substantially impact on patients' quality of life and longevity. As this population ages, late cardiac and extracardiac complications are common, which underscores the need for ongoing monitoring and comprehensive multidisciplinary care aimed at early and effective management.Areas covered: This review summarizes current evidence on the long-term outcomes after Fontan-type surgery. It describes the unique pathophysiology of the Fontan circuit, and critically evaluates incidence, severity, and management strategies for common cardiac and extracardiac complications, focusing on established clinical practice and recent advances. The review also highlights the value of continued specialist multidisciplinary care.Expert opinion: Emerging research supports the potential of novel medical therapies and devices to further improve outcomes, yet optimal care remains grounded in multidisciplinary management rather than experimental approaches. Continued research is vital to support clinical guidelines and improve the quality of life and outcomes of individuals living with a Fontan-type circulation.","PeriodicalId":12098,"journal":{"name":"Expert Review of Cardiovascular Therapy","volume":" ","pages":"883-902"},"PeriodicalIF":2.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145539477","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

Diagnosis and treatment of coronary artery disease in patients with chronic kidney disease. 慢性肾病患者冠状动脉病变的诊断与治疗。

IF 2.1

Expert Review of Cardiovascular Therapy Pub Date : 2025-12-01 Epub Date: 2025-12-03 DOI: 10.1080/14779072.2025.2597772

Rohan Dod, Harika Yadav, Ion S Jovin

{"title":"Diagnosis and treatment of coronary artery disease in patients with chronic kidney disease.","authors":"Rohan Dod, Harika Yadav, Ion S Jovin","doi":"10.1080/14779072.2025.2597772","DOIUrl":"10.1080/14779072.2025.2597772","url":null,"abstract":"Introduction: Patients with chronic kidney disease (CKD) have a significantly elevated risk of coronary artery disease. The relationship between CAD and CKD is multifaceted involving complex physiological mechanisms that result in increased inflammation, oxidative stress, and lipid abnormalities. Medical therapy and interventions in these comorbid conditions are highly complex, as they must ideally address both cardiovascular risk reduction and renal protection.Areas covered: This literature review provides an overview of the epidemiology, unique pathophysiology, clinical presentation, and management of CAD in patients with CKD. We searched PubMed and Web of Science databases from inception to November 2025 to gather evidence-based recommendations regarding CAD in CKD. We also discuss the challenges of medical and revascularization therapy that arise in patients with concurrent CAD and CKD, including providing insight into outcome differences in percutaneous coronary intervention compared to coronary artery bypass grafting.Expert opinion: CAD in CKD remains sub-optimally treated due to provider hesitancy, poor risk stratification tools, and limited dedicated trials. New medical therapies show potential. Future advances may include CKD-specific CAD calculators, contrast-free imaging, artificial intelligence driven treatment models, and expanded guideline-based use, though real-world implementation will require overcoming cost and education barriers.","PeriodicalId":12098,"journal":{"name":"Expert Review of Cardiovascular Therapy","volume":" ","pages":"867-881"},"PeriodicalIF":2.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145647872","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