Expert Review of Cardiovascular Therapy最新文献_第8页

Original algorithms for the detection of cardiovascular involvement of neglected tropical diseases. 用于检测被忽视热带疾病心血管受累情况的原创算法。

IF 2

Expert Review of Cardiovascular Therapy Pub Date : 2024-01-01 Epub Date: 2024-02-26 DOI: 10.1080/14779072.2024.2315090

Kiera Liblik, Ioana Tereza Florica, Adrian Baranchuk

{"title":"Original algorithms for the detection of cardiovascular involvement of neglected tropical diseases.","authors":"Kiera Liblik, Ioana Tereza Florica, Adrian Baranchuk","doi":"10.1080/14779072.2024.2315090","DOIUrl":"10.1080/14779072.2024.2315090","url":null,"abstract":"Introduction: Neglected tropical diseases (NTDs) introduce considerable morbidity and mortality on a global scale, directly impacting over 1 billion individuals as well as their families and communities. Afflicted individuals may have limited access to resources and care in these regions, contributing to a high proportion of chronic, progressive, and systemic disease. The cardiovascular system is at particular risk of demise for several NTDs, yet remains largely unstudied due in part to the lack of robust data collection mechanisms in the most impacted regions.Areas covered: The present review is a part of the Neglected Tropical Diseases and other Infectious Diseases affecting the Heart (NET-Heart) Project, aiming at summarizing the current knowledge on cardiovascular implications of NTDs and providing diagnostic as well as management recommendations which can be tailored to low-resource settings. The diagnostic and management algorithms of 13 unique NTDs are presented and summarized.Expert opinion: Recognizing cardiac manifestations of NTDs can significantly alter disease trajectory and all physicians benefit from improved knowledge about NTDs. Great potential exists to advance patient care by improving data collection, communication, and international collaboration.","PeriodicalId":12098,"journal":{"name":"Expert Review of Cardiovascular Therapy","volume":" ","pages":"59-74"},"PeriodicalIF":2.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139680867","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

Navigating the prime editing strategy to treat cardiovascular genetic disorders in transforming heart health. 在改变心脏健康的过程中，探索治疗心血管遗传疾病的主要编辑策略。

IF 2

Expert Review of Cardiovascular Therapy Pub Date : 2024-01-01 Epub Date: 2024-03-17 DOI: 10.1080/14779072.2024.2328642

Seyed Younes Hosseini, Rahul Mallick, Petri Mäkinen, Seppo Ylä-Herttuala

{"title":"Navigating the prime editing strategy to treat cardiovascular genetic disorders in transforming heart health.","authors":"Seyed Younes Hosseini, Rahul Mallick, Petri Mäkinen, Seppo Ylä-Herttuala","doi":"10.1080/14779072.2024.2328642","DOIUrl":"10.1080/14779072.2024.2328642","url":null,"abstract":"Introduction: After understanding the genetic basis of cardiovascular disorders, the discovery of prime editing (PE), has opened new horizons for finding their cures. PE strategy is the most versatile editing tool to change cardiac genetic background for therapeutic interventions. The optimization of elements, prediction of efficiency, and discovery of the involved genes regulating the process have not been completed. The large size of the cargo and multi-elementary structure makes the in vivo heart delivery challenging.Areas covered: Updated from recent published studies, the fundamentals of the PEs, their application in cardiology, potentials, shortcomings, and the future perspectives for the treatment of cardiac-related genetic disorders will be discussed.Expert opinion: The ideal PE for the heart should be tissue-specific, regulatable, less immunogenic, high transducing, and safe. However, low efficiency, sup-optimal PE architecture, the large size of required elements, the unclear role of transcriptomics on the process, unpredictable off-target effects, and its context-dependency are subjects that need to be considered. It is also of great importance to see how beneficial or detrimental cell cycle or epigenomic modifier is to bring changes into cardiac cells. The PE delivery is challenging due to the size, multi-component properties of the editors and liver sink.","PeriodicalId":12098,"journal":{"name":"Expert Review of Cardiovascular Therapy","volume":" ","pages":"75-89"},"PeriodicalIF":2.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140142986","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

Contemporary applications of multimodality imaging in infective endocarditis. 多模态成像在感染性心内膜炎中的当代应用。

IF 2

Expert Review of Cardiovascular Therapy Pub Date : 2024-01-01 Epub Date: 2023-11-29 DOI: 10.1080/14779072.2023.2288152

Mohamed Khayata, Alejandro Sanchez Nadales, Bo Xu

{"title":"Contemporary applications of multimodality imaging in infective endocarditis.","authors":"Mohamed Khayata, Alejandro Sanchez Nadales, Bo Xu","doi":"10.1080/14779072.2023.2288152","DOIUrl":"10.1080/14779072.2023.2288152","url":null,"abstract":"Introduction: Infective endocarditis (IE) is an increasingly important condition with significant morbidity and mortality. With advancements in cardiovascular interventions including prosthetic valve implantation and utilization of intracardiac devices, the prevalence of IE is rising in the modern era. Early detection and management of this condition are critical.Areas covered: This review presents a contemporary review of the applications of multi-modality imaging in IE, taking a comparative approach of the various imaging modalities.Expert opinion: Transthoracic and transesophageal echocardiography are essential imaging modalities in establishing the diagnosis of IE, as well as evaluating for complications of IE. Other imaging modalities such as cardiac computed tomography and nuclear imaging play an important role as adjuvant imaging modalities for the evaluation of IE, particularly in prosthetic valve IE and cardiovascular implantable device associated IE. It is crucial to understand the strengths, weaknesses, and clinical application of each imaging modality, to improve the diagnosis, management, and outcomes of patients with IE.","PeriodicalId":12098,"journal":{"name":"Expert Review of Cardiovascular Therapy","volume":" ","pages":"27-39"},"PeriodicalIF":2.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138298812","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

Sex differences in trends and outcomes of acute myocardial infarction with mechanical complications in the United States. 美国急性心肌梗死并发机械性并发症的趋势和结果的性别差异。

IF 2

Expert Review of Cardiovascular Therapy Pub Date : 2024-01-01 Epub Date: 2024-01-31 DOI: 10.1080/14779072.2024.2311707

Frederick Berro Rivera, Faye Salva, Jacques Simon Gonzales, Sung Whoy Cha, Samantha Tang, Grace Nooriza Opay Lumbang, Gurleen Kaur, Isabel Planek, Kyla Lara-Breitinger, Mark Dela Cruz, Tisha Marie B Suboc, Fareed Moses S Collado, Jonathan R Enriquez, Nishant Shah, Annabelle Santos Volgman

{"title":"Sex differences in trends and outcomes of acute myocardial infarction with mechanical complications in the United States.","authors":"Frederick Berro Rivera, Faye Salva, Jacques Simon Gonzales, Sung Whoy Cha, Samantha Tang, Grace Nooriza Opay Lumbang, Gurleen Kaur, Isabel Planek, Kyla Lara-Breitinger, Mark Dela Cruz, Tisha Marie B Suboc, Fareed Moses S Collado, Jonathan R Enriquez, Nishant Shah, Annabelle Santos Volgman","doi":"10.1080/14779072.2024.2311707","DOIUrl":"10.1080/14779072.2024.2311707","url":null,"abstract":"Background: Mechanical complications (MC) are rare but significant sequelae of acute myocardial infarction (AMI). Current data on sex differences in AMI with MC is limited.Methods: We queried the National Inpatient Sample database to identify adult patients with the primary diagnosis of AMI and MC. The main outcome of interest was sex difference in-hospital mortality. Secondary outcomes were sex differences in the incidence of acute kidney injury (AKI), major bleeding, use of inotropes, permanent pacemaker implantation (PPMI), performance of percutaneous coronary intervention (PCI), coronary artery bypass grafting (CABG), surgery (VSD repair and MV surgery), pericardiocentesis, use of mechanical circulatory support (MCS), ischemic stroke, and mechanical ventilation.Results: Among AMI-MC cohort, in-hospital mortality was higher among females compared to males (41.24% vs 28.13%: aOR 1.39. 95% CI 1.079-1.798; p = 0.01). Among those who had VSD, females also had higher in-hospital mortality compared to males (56.7% vs 43.1%: aOR 1.74, 95% CI 1.12-2.69; p = 0.01). Females were less likely to receive CABG compared to males (12.03% vs 20%: aOR 0.49 95% CI 0.345-0.690; p < 0.001).Conclusion: Despite the decreasing trend in AMI admission, females had higher risk of MC and associated mortality. Significant sex disparities still exist in AMI treatment.","PeriodicalId":12098,"journal":{"name":"Expert Review of Cardiovascular Therapy","volume":" ","pages":"111-120"},"PeriodicalIF":2.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139569301","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

PCSK9 inhibitors: current status and emerging frontiers in lipid control. PCSK9抑制剂:血脂控制的现状和新兴领域。

IF 2

Expert Review of Cardiovascular Therapy Pub Date : 2024-01-01 Epub Date: 2023-11-28 DOI: 10.1080/14779072.2023.2288169

Federica Agnello, Maria Sara Mauro, Carla Rochira, Davide Landolina, Simone Finocchiaro, Antonio Greco, Nicola Ammirabile, Carmelo Raffo, Placido Maria Mazzone, Marco Spagnolo, Giovanni Occhipinti, Antonino Imbesi, Daniele Giacoppo, Davide Capodanno

{"title":"PCSK9 inhibitors: current status and emerging frontiers in lipid control.","authors":"Federica Agnello, Maria Sara Mauro, Carla Rochira, Davide Landolina, Simone Finocchiaro, Antonio Greco, Nicola Ammirabile, Carmelo Raffo, Placido Maria Mazzone, Marco Spagnolo, Giovanni Occhipinti, Antonino Imbesi, Daniele Giacoppo, Davide Capodanno","doi":"10.1080/14779072.2023.2288169","DOIUrl":"10.1080/14779072.2023.2288169","url":null,"abstract":"Introduction: Atherosclerotic cardiovascular disease (ASCVD) is a leading cause of global mortality, imposing substantial healthcare economic burdens. Among the modifiable risk factors, hypercholesterolemia, especially elevated low-density lipoprotein cholesterol (LDL-C), plays a pivotal role in ASCVD development. Novel therapies such as PCSK9 (Proprotein Convertase Subtilisin/Kexin type 9) inhibitors are emerging to address this concern. These inhibitors offer the potential to reduce ASCVD risk by directly targeting LDL-C levels.Areas covered: The article reviews the structural and functional aspects of PCSK9, highlighting its role in LDL receptor regulation. The pharmacological strategies for PCSK9 inhibition, including monoclonal antibodies, binding peptides, gene silencing, and active immunization, are explored. Clinical evidence from various trials underscores the safety and efficacy of PCSK9 inhibitors in reducing LDL-C levels and potentially improving cardiovascular outcomes. Despite these promising results, challenges such as cost-effectiveness and long-term safety considerations are addressed.Expert opinion: Among PCSK9 inhibitors, monoclonal antibodies represent a cornerstone. Many trials have showed their efficacy in reducing LDL-C and the risk for major adverse clinical events, revealing long-lasting effects, with special benefits particularly for statin-intolerant and familial hypercholesterolemia patients. However, long-term impacts, high costs, and patient selection necessitate further research.","PeriodicalId":12098,"journal":{"name":"Expert Review of Cardiovascular Therapy","volume":" ","pages":"41-58"},"PeriodicalIF":2.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138298813","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

A cost-effectiveness analysis of empagliflozin for heart failure patients across the full spectrum of ejection fraction in Spain: combined results of the EMPEROR-Preserved and EMPEROR-Reduced trials. 西班牙射血分数全谱心衰患者服用安格列净的成本效益分析：EMPEROR-Preserved 和 EMPEROR-Reduced 试验的综合结果。

IF 2

Expert Review of Cardiovascular Therapy Pub Date : 2024-01-01 Epub Date: 2024-02-29 DOI: 10.1080/14779072.2024.2324027

Xavier García-Moll, Francesco Croci, Alexandra Solé, Elisabeth S Hartgers-Gubbels, Miguel A Calleja-Hernández

{"title":"A cost-effectiveness analysis of empagliflozin for heart failure patients across the full spectrum of ejection fraction in Spain: combined results of the EMPEROR-Preserved and EMPEROR-Reduced trials.","authors":"Xavier García-Moll, Francesco Croci, Alexandra Solé, Elisabeth S Hartgers-Gubbels, Miguel A Calleja-Hernández","doi":"10.1080/14779072.2024.2324027","DOIUrl":"10.1080/14779072.2024.2324027","url":null,"abstract":"Background: Heart failure (HF) is a chronic condition with considerable clinical burden for patients and economic burden for healthcare systems. Treatment for HF is typically based on ejection fraction (EF) phenotype. The cost-effectiveness of empagliflozin + standard of care (SoC) compared to SoC has been examined for HF phenotypes below or above 40% EF separately, but not across the full spectrum of EF in Spain.Methods: The results of two preexisting, validated, and published phenotype-specific Markov cohort models were combined using a population-weighted approach, reflecting the incidence of each phenotype in the total HF population in Spain. A probabilistic sensitivity analysis was performed by sampling each model's probabilistic results.Results: Empagliflozin + SoC compared to SoC resulted in increased life-years (LYs) (6.48 vs. 6.35), quality-adjusted LYs (QALYs) (4.80 vs. 4.63), and healthcare costs (€19,090 vs. €18,246), over a lifetime time horizon for the combined HF population in Spain. The incremental cost-effectiveness ratio (ICER) was €5,089/QALY. All subgroup, scenario, and probabilistic ICERs were consistently below €10,000/QALY.Conclusions: Empagliflozin is the first treatment with established efficacy and cost-effectiveness for HF patients across EF from the perspective of healthcare payers in Spain. Empagliflozin also proved to be cost-effective for all subgroups of patients included in the analysis.","PeriodicalId":12098,"journal":{"name":"Expert Review of Cardiovascular Therapy","volume":" ","pages":"131-139"},"PeriodicalIF":2.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139982758","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

Trends and cardiovascular outcomes of Takotsubo syndrome with cardiogenic shock vs. mixed cardiogenic and septic shock: a nationwide propensity matched analysis. 塔克次氏综合征合并心源性休克与混合型心源性休克和脓毒性休克的趋势和心血管预后：全国范围内的倾向匹配分析。

IF 2

Expert Review of Cardiovascular Therapy Pub Date : 2024-01-01 Epub Date: 2023-12-18 DOI: 10.1080/14779072.2023.2295378

Sadaf Fakhra, Mohammed Faisaluddin, Yasar Sattar, Danielle DeCicco, Asmaa Ahmed, Neel Patel, Senthil Balasubramanian, Dipesh Ludhwani, Hassan Masood, Sameer Raina, Karthik Gonuguntla, Scott C Feitell, Tushar Tarun, Sudarshan Balla

{"title":"Trends and cardiovascular outcomes of Takotsubo syndrome with cardiogenic shock vs. mixed cardiogenic and septic shock: a nationwide propensity matched analysis.","authors":"Sadaf Fakhra, Mohammed Faisaluddin, Yasar Sattar, Danielle DeCicco, Asmaa Ahmed, Neel Patel, Senthil Balasubramanian, Dipesh Ludhwani, Hassan Masood, Sameer Raina, Karthik Gonuguntla, Scott C Feitell, Tushar Tarun, Sudarshan Balla","doi":"10.1080/14779072.2023.2295378","DOIUrl":"10.1080/14779072.2023.2295378","url":null,"abstract":"Introduction: Takotsubo syndrome (TTS), also known as stress-induced cardiomyopathy, can be complicated by shock. The outcomes of patients with TTS complicated with cardiogenic shock (CS) versus mixed cardiogenic and septic shock (MS) is not known.Methods: We queried Nationwide Inpatient Sample (NIS) from 2009-2020 to compare TTS patients with CS and MS using International Classification of Disease, Ninth & Tenth Edition, Clinical Modification (ICD- 9 & 10-CM) coding. In-hospital outcomes were compared using one: one propensity score matched (PSM) analysis. The primary outcome was in-hospital mortality.Results: Of 23,126 patients with TTS 17,132 (74%) had CS, and 6,269 (26%) had MS. The mean age was 67 years in CS and 66 years in MS, and majority of patients were female (n = 17,775, 77%). On adjusted multivariate analysis, MS patients had higher odds of in-hospital mortality (aOR 1.44, 95% CI 1.36-1.52), AKI (aOR 1.53, 95% CI 1.48-1.58), pressor requirement (aOR 1.37, 95% CI 1.25-1.50). However, had lower odds of MCS use (aOR 0.44, 95% CI 0.40-0.48) and cardiac arrest (aOR: 0.81, 95% CI 0.73-0.90) (p-value <0.0001). Mean LOS and inflation-adjusted hospital charges were higher in MS.Conclusion: MS in the setting of TTS have higher rates of in-hospital mortality, AKI, and pressor requirements.","PeriodicalId":12098,"journal":{"name":"Expert Review of Cardiovascular Therapy","volume":" ","pages":"103-109"},"PeriodicalIF":2.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138801030","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 clinical characteristics, managements, and outcomes of acute myocardial infarction in osteoarthritis patients; a cross-sectional analysis of 6.5 million patients. 骨关节炎患者急性心肌梗死的临床特征、处理方法和预后；对 650 万患者的横断面分析。

IF 2

Expert Review of Cardiovascular Therapy Pub Date : 2024-01-01 Epub Date: 2024-01-31 DOI: 10.1080/14779072.2024.2311696

Simran Singh Parmar, Mohamed O Mohamed, Mamas A Mamas, Ross Wilkie

{"title":"The clinical characteristics, managements, and outcomes of acute myocardial infarction in osteoarthritis patients; a cross-sectional analysis of 6.5 million patients.","authors":"Simran Singh Parmar, Mohamed O Mohamed, Mamas A Mamas, Ross Wilkie","doi":"10.1080/14779072.2024.2311696","DOIUrl":"10.1080/14779072.2024.2311696","url":null,"abstract":"Objectives: The prevalence of osteoarthritis (OA) and cardiovascular disease are increasing and both conditions share similar risk factors. We investigated the association between OA and receipt of invasive managements and clinical outcomes in patients with acute myocardial infarction (AMI).Methods: Using the National Inpatient Sample, adjusted binary logistic regression determined the association between OA and each outcome variable.Results: Of 6,561,940 AMI hospitalizations, 6.3% had OA. OA patients were older and more likely to be female. OA was associated with a decreased odds of coronary angiography (adjusted odds ratio 0.91; 95% confidence interval 0.90, 0.92), PCI (0.87; 0.87, 0.88), and coronary artery bypass grafting (0.98; 0.97, 1.00). OA was associated with a decreased odds of adverse outcomes (in-hospital mortality: 0.68; 0.67, 0.69; major acute cardiovascular and cerebrovascular events: 0.71; 0.70, 0.72; all-cause bleeding: 0.76; 0.74, 0.77; and stroke/TIA: 0.84; 0.82, 0.87).Conclusions: This study of a representative sample of the US population highlights that OA patients are less likely to be offered invasive interventions following AMI. OA was also associated with better outcomes post-AMI, possibly attributed to a misclassification bias where unwell patients with OA were less likely to receive an OA code because codes for serious illness took precedence.","PeriodicalId":12098,"journal":{"name":"Expert Review of Cardiovascular Therapy","volume":" ","pages":"121-129"},"PeriodicalIF":2.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139569364","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

Physical activity, exercise and adverse cardiovascular outcomes in individuals with pre-existing cardiovascular disease: a narrative review. 原有心血管疾病患者的体育活动、锻炼和不良心血管后果：叙述性综述。

IF 2

Expert Review of Cardiovascular Therapy Pub Date : 2024-01-01 Epub Date: 2024-03-15 DOI: 10.1080/14779072.2024.2328644

Setor K Kunutsor, Jari A Laukkanen

{"title":"Physical activity, exercise and adverse cardiovascular outcomes in individuals with pre-existing cardiovascular disease: a narrative review.","authors":"Setor K Kunutsor, Jari A Laukkanen","doi":"10.1080/14779072.2024.2328644","DOIUrl":"10.1080/14779072.2024.2328644","url":null,"abstract":"Introduction: The evidence supporting the cardiovascular health benefits of physical activity and/or exercise training is well-established. While the role of physical activity in primary prevention is unequivocal, its significance in secondary prevention (among those with preexisting cardiovascular disease) is less definitive. Though guidelines universally recommend physical activity as part of the secondary preventive strategy, the empirical evidence underpinning these recommendations is not as robust as that for primary prevention.Areas covered: This review distills the body of available observational and interventional evidence on the relationship between physical activity, exercise, and adverse cardiovascular outcomes among those with preexisting cardiovascular disease. The postulated biologic mechanisms underlying the relationships, areas of prevailing uncertainty, and potential public health implications are also discussed.Expert opinion: A physical activity level of 500 MET-min/week (equivalent to 150 min of moderate-intensity physical activity or 75 min of vigorous-intensity physical activity or an equivalent combination) may be a minimum requirement for patients with preexisting CVD. However, to reap the maximum benefits of physical activity and also minimize adverse effects, physical activity and/or exercise regimens should be tailored to unique factors such as individual's baseline physical activity habits, cardiovascular health status and the specific nature of their cardiovascular disease.","PeriodicalId":12098,"journal":{"name":"Expert Review of Cardiovascular Therapy","volume":" ","pages":"91-101"},"PeriodicalIF":2.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11057847/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140131106","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Preventive cardiology for the aging population: how can we better design clinical trials of statins? 针对老龄人口的预防心脏病学：如何更好地设计他汀类药物的临床试验？

IF 2

Expert Review of Cardiovascular Therapy Pub Date : 2024-01-01 Epub Date: 2024-01-23 DOI: 10.1080/14779072.2024.2302122

Anthony S Wierzbicki

{"title":"Preventive cardiology for the aging population: how can we better design clinical trials of statins?","authors":"Anthony S Wierzbicki","doi":"10.1080/14779072.2024.2302122","DOIUrl":"10.1080/14779072.2024.2302122","url":null,"abstract":"Introduction: Older adults form a fast-increasing proportion of the world population. However, gains in increasing quantity of life have not been accompanied by similar gains in quality of life. Older people frequently experience frailty, memory problems, and chronic diseases including cardiovascular disease (CVD) and neurodegenerative diseases. Recent trials have demonstrated the efficacy of anti-hypertensive therapy in older populations but failed to show benefits for aspirin.Area covered: Statins clearly reduce CVD events in middle-aged populations. There seems to be evidence that the effect is similar in primary prevention older populations based on meta-analyses mainly from sub-groups in large trials, but this becomes less clear with increasing age. However, given differences in drug metabolism and possibly efficacy, competing co-morbidities, their effects on mortality, disability, and dementia in this age group remain to be determined.Expert opinion: Two large trials are now underway to clarify the role of statin therapy in people aged over 70 years using endpoints of mortality, disability, and neurocognitive endpoints as well as standard cardiovascular disease outcomes. They may provide also provide more evidence on how to approach the over 80 year age group.","PeriodicalId":12098,"journal":{"name":"Expert Review of Cardiovascular Therapy","volume":" ","pages":"13-18"},"PeriodicalIF":2.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139519467","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