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

Effects of mineralocorticoid receptor antagonists on cardiometabolic profile and liver health in individuals with increased cardiometabolic risk: a systematic review and meta-analysis of randomized controlled trials. 矿皮质激素受体拮抗剂对心脏代谢风险增加个体的心脏代谢特征和肝脏健康的影响：随机对照试验的系统回顾和荟萃分析

IF 2.5

Expert Review of Cardiovascular Therapy Pub Date : 2026-01-01 Epub Date: 2026-02-26 DOI: 10.1080/14779072.2026.2634029

João Dias, Ana Rita Leite, Tiago Godinho, Joana Correia-Chaves, Marta Borges-Canha, Adelino Leite-Moreira, João Sérgio Neves

{"title":"Effects of mineralocorticoid receptor antagonists on cardiometabolic profile and liver health in individuals with increased cardiometabolic risk: a systematic review and meta-analysis of randomized controlled trials.","authors":"João Dias, Ana Rita Leite, Tiago Godinho, Joana Correia-Chaves, Marta Borges-Canha, Adelino Leite-Moreira, João Sérgio Neves","doi":"10.1080/14779072.2026.2634029","DOIUrl":"10.1080/14779072.2026.2634029","url":null,"abstract":"Introduction: Recent studies link overactivation of mineralocorticoid receptors to insulin resistance, inflammation, and metabolic dysfunction-associated steatotic liver disease. We aimed to assess the effects of mineralocorticoid receptor antagonists (MRAs) on liver steatosis, fibrosis, inflammation, and cardiometabolic risk.Methods: We conducted a systematic review and meta-analysis including placebo-controlled randomized controlled trials (RCTs) assessing MRAs' effects. A random-effects meta-analysis assessed MRAs effects on anthropometry, lipid profile, inflammatory parameters, and glucose metabolism. Outcomes were presented as mean differences (MD) with 95% confidence intervals (95% CI). Twenty-six studies were included and seventeen were meta-analyzed. MRAs studied included spironolactone, eplerenone, canrenone, apararenone, and finerenone. Most studies included participants with diabetes, metabolic syndrome, obesity, heart failure, or hypertension.Results: In the meta-analysis, we found a mild but significant decrease in body weight (MD = -1.27, 95% CI [-2.54, -0.01]) and a trend for higher HbA1c (MD = 0.13, 95% CI [-0.01, 0.27]) with MRAs. There was a trend toward a decrease in C-reactive protein levels (MD = -0.99, 95% CI [-2.22, 0.24]) with MRAs. RCTs on liver function and structure showed no differences compared to placebo.Conclusions: MRAs appear to have a mild impact on metabolic and inflammatory parameters in patients with increased cardiometabolic risk. However, more RCTs on MRAs' cardiometabolic impact are needed.Registration: This study was registered with PROSPERO (CRD42025632202).","PeriodicalId":12098,"journal":{"name":"Expert Review of Cardiovascular Therapy","volume":" ","pages":"235-252"},"PeriodicalIF":2.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146212500","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

Clinical approaches for determining idiopathic and inflammatory dilated cardiomyopathy in women. 确定女性特发性和炎性扩张型心肌病的临床方法。

IF 2.1

Expert Review of Cardiovascular Therapy Pub Date : 2026-01-01 Epub Date: 2026-02-26 DOI: 10.1080/14779072.2026.2637752

Andrea Silvio Giordani, Caterina Menghi, Matteo Castegnaro, Anna Baritussio, Alida Linda Patrizia Caforio

引用次数: 0

Alternatives to right ventricular pacing in patients with atrioventricular block: can we prevent pacing-induced cardiomyopathy? 房室传导阻滞患者右心室起搏的替代方案：我们能预防起搏诱发的心肌病吗？

IF 2.5

Expert Review of Cardiovascular Therapy Pub Date : 2026-01-01 Epub Date: 2026-01-27 DOI: 10.1080/14779072.2026.2621679

Mert Dogan, Ugur Canpolat

{"title":"Alternatives to right ventricular pacing in patients with atrioventricular block: can we prevent pacing-induced cardiomyopathy?","authors":"Mert Dogan, Ugur Canpolat","doi":"10.1080/14779072.2026.2621679","DOIUrl":"10.1080/14779072.2026.2621679","url":null,"abstract":"Introduction: Right ventricular apical pacing (RVAP) has been a standard treatment for patients experiencing symptomatic advanced atrioventricular (AV) block. However, due to electrical and subsequent mechanical dyssynchrony, RVAP might lead to pacing-induced cardiomyopathy (PICM). Various predisposing risk factors for PICM have been identified.Areas covered: This review, based on a literature search of PubMed and Scopus databases (up to April 2025), focuses on alternative pacing strategies, including conduction system pacing (CSP) and biventricular pacing (BiVP), to reduce PICM.Expert opinion: Implementing pacing strategies that encourage physiological ventricular activation, like CSP and BiVP, can greatly diminish the risk of PICM in patients with AV block. Implementing alternative pacing strategies necessitates careful patient selection and consideration of individual anatomical and clinical factors. A team-based approach should be utilized to identify the most suitable pacing method for each patient, with the goal of optimizing cardiac function and reducing the risk of PICM.","PeriodicalId":12098,"journal":{"name":"Expert Review of Cardiovascular Therapy","volume":" ","pages":"107-113"},"PeriodicalIF":2.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146017771","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 implantable cardiac device trials for sudden cardiac death and future guidelines: how can we shape the future? 当代植入式心脏装置试验治疗心源性猝死及未来指南：我们如何塑造未来？

IF 2.5

Expert Review of Cardiovascular Therapy Pub Date : 2026-01-01 Epub Date: 2026-01-28 DOI: 10.1080/14779072.2026.2621666

Fabian Fastenrath, Katherine Sattler, Daniel Duerschmied, Michal Lewandowski, Ibrahim Akin, Juergen Kuschyk

{"title":"Contemporary implantable cardiac device trials for sudden cardiac death and future guidelines: how can we shape the future?","authors":"Fabian Fastenrath, Katherine Sattler, Daniel Duerschmied, Michal Lewandowski, Ibrahim Akin, Juergen Kuschyk","doi":"10.1080/14779072.2026.2621666","DOIUrl":"10.1080/14779072.2026.2621666","url":null,"abstract":"Introduction: Sudden cardiac death (SCD) remains a major cause of mortality despite substantial progress in heart failure management and arrhythmia prevention. Current implantable cardioverter-defibrillator (ICD) guideline recommendations, mainly based on left ventricular ejection fraction (LVEF), are largely derived from historical trials and may no longer reflect contemporary patient populations or therapies.Areas covered: This review critically appraises the historical and contemporary ICD evidence base with particular attention to evolving background therapy, competing risks of non-arrhythmic death, device technology, and modern risk stratification strategies. ICD trials cited in major international guidelines were reviewed and supplemented by a targeted PubMed literature search using ICD-related keywords, including relevant publications through September 2025. We emphasize emerging tools such as cardiac magnetic-resonance-imaging, genomics, artificial intelligence, remote monitoring data, and modular cardiac rhythm management systems.Expert opinion: We propose a future ICD trial framework grounded in multimodal risk assessment, competing-risk-adjusted endpoints, pragmatic and adaptive trial designs, and device-specific evaluation pathways. We further outline how future guidelines may evolve to incorporate enriched patient phenotyping, precision risk prediction, and personalized device selection. Together, these developments signal a paradigm shift toward an individualized, digitally supported, and modular approach to SCD prevention in the next decade.","PeriodicalId":12098,"journal":{"name":"Expert Review of Cardiovascular Therapy","volume":" ","pages":"71-80"},"PeriodicalIF":2.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146017709","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

Ensuring long-term arrhythmia freedom: what are the options for long-standing persistent atrial fibrillation? 确保长期心律失常自由：长期持续性心房颤动的选择是什么？

IF 2.5

Expert Review of Cardiovascular Therapy Pub Date : 2026-01-01 Epub Date: 2026-01-28 DOI: 10.1080/14779072.2026.2621670

Sotirios C Kotoulas, Ioannis Doundoulakis, Dimitrios Tsiachris, Luigi Pannone, Michail Botis, Leonidas S Poulimenos, Sotirios Chiotis, Athanasios Kordalis, Gian-Battista Chierchia, Carlo de Asmundis, Costas Tsioufis

{"title":"Ensuring long-term arrhythmia freedom: what are the options for long-standing persistent atrial fibrillation?","authors":"Sotirios C Kotoulas, Ioannis Doundoulakis, Dimitrios Tsiachris, Luigi Pannone, Michail Botis, Leonidas S Poulimenos, Sotirios Chiotis, Athanasios Kordalis, Gian-Battista Chierchia, Carlo de Asmundis, Costas Tsioufis","doi":"10.1080/14779072.2026.2621670","DOIUrl":"10.1080/14779072.2026.2621670","url":null,"abstract":"Introduction: Long-standing persistent atrial fibrillation (LSPAF) is among the most challenging arrhythmia phenotypes to manage, due to extensive atrial remodeling, fibrosis, and the presence of complex non-pulmonary vein substrates and triggers. Conventional antiarrhythmic drug (AAD) therapy provides limited efficacy and is constrained by short- and long-term toxicity. Catheter ablation (CA) remains the cornerstone of rhythm control but offers modest single-procedure success.Areas covered: This review examines current treatment strategies for LSPAF, including pharmacologic rhythm control, CA, and hybrid surgical - endocardial approaches. Evidence from major clinical trials and meta-analyses is summarized, highlighting the limitations of pulmonary vein isolation (PVI) as a stand-alone therapy and the role of adjunctive strategies. The article also discusses novel approaches, including pulsed field ablation (PFA), fibrosis-guided mapping, and insights from recent international guidelines.Expert opinion: CA remains the most effective rhythm-control strategy for LSPAF, but durable arrhythmia-free survival often requires repeat or hybrid procedures. Hybrid ablation should be considered, particularly in patients with advanced atrial remodeling. Emerging technologies, including PFA, offer the potential for improved outcomes. Future progress will depend on dedicated LSPAF trials with standardized endpoints, long-term follow-up, and broader patient representation to refine selection, optimize lesion sets, and establish the role of next-generation technologies.","PeriodicalId":12098,"journal":{"name":"Expert Review of Cardiovascular Therapy","volume":" ","pages":"93-106"},"PeriodicalIF":2.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146060963","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 forecasting of mortality associated with obstructive sleep apnea and hypertension among older adults in the United States (1999-2035). 美国老年人与阻塞性睡眠呼吸暂停和高血压相关的死亡率趋势和预测（1999-2035）

IF 2.5

Expert Review of Cardiovascular Therapy Pub Date : 2026-01-01 Epub Date: 2026-02-16 DOI: 10.1080/14779072.2026.2621677

Muhammad Umar, Syeda Simrah Shah, Sabahat Hafeez, Mirza Mohammad Ali Baig, Areej Amin, Amna Zafar, Ayesha Hidayat, Iqra Naz, Krish Patel, Yasar Sattar

{"title":"Trends and forecasting of mortality associated with obstructive sleep apnea and hypertension among older adults in the United States (1999-2035).","authors":"Muhammad Umar, Syeda Simrah Shah, Sabahat Hafeez, Mirza Mohammad Ali Baig, Areej Amin, Amna Zafar, Ayesha Hidayat, Iqra Naz, Krish Patel, Yasar Sattar","doi":"10.1080/14779072.2026.2621677","DOIUrl":"10.1080/14779072.2026.2621677","url":null,"abstract":"Background: Obstructive sleep apnea (OSA) and hypertension (HTN) frequently coexist and are associated with increased cardiovascular morbidity and mortality in the United States.Research design and methods: Mortality data from 1999-2023 were obtained from the CDC WONDER Multiple Causes of Death database. Deaths were identified when ICD-10 codes for OSA (G47.3) and HTN (I10-I15) were listed as underlying or contributing causes of death. Age-adjusted mortality rates (AAMRs) were calculated and stratified by demographic and geographic factors. Temporal trends were evaluated using Joinpoint regression, and mortality was forecasted using Poisson regression model.Results: A total of 107,514 deaths were associated with OSA and HTN between 1999 and 2023. AAMRs increased from 0.4 in 1999 to 12.4 in 2023, with higher rates observed among males, adults aged ≥75 years, NH-White individuals, rural populations, and residents of the Midwest. Among states, West Virginia had the highest AAMR. Forecasting models project continued increases in overall mortality, with AAMRs reaching 55.38 by 2035.Conclusions: Mortality associated with OSA and HTN has increased substantially over the past two decades, disproportionately affecting older adults, males, and rural populations. Forecasted trends highlight the need for targeted prevention, early diagnosis, and improved access to effective therapies.","PeriodicalId":12098,"journal":{"name":"Expert Review of Cardiovascular Therapy","volume":" ","pages":"273-284"},"PeriodicalIF":2.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146084988","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

Technological advancements for improving preoperative assessment and precision in cardiovascular surgery. 提高心血管手术术前评估和准确性的技术进步。

IF 2.5

Expert Review of Cardiovascular Therapy Pub Date : 2026-01-01 Epub Date: 2026-02-21 DOI: 10.1080/14779072.2026.2634022

George Galyfos, Alexandros Chamzin, Alexios Theodorou, Frangiska Sigala, Konstantinos Filis, Dimitrios Theodorou

{"title":"Technological advancements for improving preoperative assessment and precision in cardiovascular surgery.","authors":"George Galyfos, Alexandros Chamzin, Alexios Theodorou, Frangiska Sigala, Konstantinos Filis, Dimitrios Theodorou","doi":"10.1080/14779072.2026.2634022","DOIUrl":"10.1080/14779072.2026.2634022","url":null,"abstract":"Introduction: Cardiovascular surgery, including cardiac surgery and complex endovascular procedure, needs careful preoperative planning as well as intraoperative precision to improve outcomes and ameliorate complications. During the last decades, several technological advancements have been made that could improve preoperative assessment, design of the surgical procedure, risk prediction as well as surgical precision.Areas covered: Several areas of technological advancements referring to cardiovascular surgery are discussed in this review. Data have been collected using the Pubmed, Scopus, and Google Scholar databases. We report advancements regarding the utilization of artificial intelligence in preoperative assessment and risk prediction. We also report on advancements made in intraoperative imaging including holographic and fusion imaging techniques. Furthermore, operating techniques such as the use of novel endovascular tools or robotic surgery are also discussed. Finally, other novel technologies, such as three-dimentional (3D) printing, is also presented.Expert opinion: In the next 5 years, technological advancements in cardiovascular surgery will be definitely improved and more broadly used. Although these advancements are associated with a very high cost and a longer learning curve, the associated healthcare cost benefit is evident. Due to bioethical reasons, this progress will need to be contained and controlled by humans.","PeriodicalId":12098,"journal":{"name":"Expert Review of Cardiovascular Therapy","volume":" ","pages":"149-157"},"PeriodicalIF":2.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146212472","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

Cardiovascular and periprocedural outcomes of endovascular intervention for acute limb ischemia at experienced urban versus rural centers in the US: national inpatient sample analysis 2016-2021. 美国经验丰富的城市和农村中心血管内介入治疗急性肢体缺血的心血管和围手术期结果：2016-2021年全国住院患者样本分析

IF 2.1

Expert Review of Cardiovascular Therapy Pub Date : 2026-01-01 Epub Date: 2025-08-11 DOI: 10.1080/14779072.2025.2527707

Yasar Sattar, Adishwar Rao, Sivaram Neppala, Himaja Dutt Chigurupati, Waleed Alruwaili, Hafeez Ul Hassan Virk, Fadi Saab, Jihad Mustapha, Abdullah Naveed Muhammad, Ramesh Daggubati, Akram Kawsara

{"title":"Cardiovascular and periprocedural outcomes of endovascular intervention for acute limb ischemia at experienced urban versus rural centers in the US: national inpatient sample analysis 2016-2021.","authors":"Yasar Sattar, Adishwar Rao, Sivaram Neppala, Himaja Dutt Chigurupati, Waleed Alruwaili, Hafeez Ul Hassan Virk, Fadi Saab, Jihad Mustapha, Abdullah Naveed Muhammad, Ramesh Daggubati, Akram Kawsara","doi":"10.1080/14779072.2025.2527707","DOIUrl":"10.1080/14779072.2025.2527707","url":null,"abstract":"Background: Acute limb ischemia (ALI) is a critical vascular emergency marked by a sudden reduction in blood flow to the limb, significantly increasing amputation risk. Revascularization outcomes in urban versus rural areas have not been examined.Research design and methods: The National Inpatient Sample from 2016 to 2021 identified patients with ALI who underwent revascularization. Propensity score matching compared outcomes, analyzed using STATA version 18.Results: Of 85,760 hospitalizations for ALI receiving percutaneous revascularization 81,880 (95.5%) were in urban centers and 3,880 (4.5%) in rural facilities. Patients in urban hospitals showed higher mortality (4% vs. 2.7%), myocardial infarction (MI) (3.4% vs. 2.7%), cardiogenic shock (1.6% vs. 0.6%), cardiac arrest (6.5% vs. 5.9%), major adverse cardiovascular and cerebrovascular events (MACCE) (7.5% vs. 5.3%), mechanical circulatory support (1.1% vs. 0.5%), and acute kidney injury (18.5% vs. 15.4%). However, urban patients had lower intravascular ultrasound (IVUS) (3.4% vs. 6.5%), major amputation (6.3% vs. 7.8%), fasciotomy (1.8% vs. 2.2%), and major adverse limb events (MALE) (46.4% vs. 49.1%), with a significant difference of p < 0.01 compared to rural hospitals.Conclusions: Urban hospitals in the United States report elevated mortality rates and significant cardiovascular events in comparison to their rural counterparts.","PeriodicalId":12098,"journal":{"name":"Expert Review of Cardiovascular Therapy","volume":" ","pages":"137-143"},"PeriodicalIF":2.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144527074","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

Endocrine hypertension in 2025: how AI and multiomics are revolutionizing detection. 2025年的内分泌高血压：人工智能和多组学如何彻底改变检测。

IF 2.5

Expert Review of Cardiovascular Therapy Pub Date : 2026-01-01 Epub Date: 2026-02-21 DOI: 10.1080/14779072.2026.2634025

Jenyfer M Fuentes-Mendoza, Marcio J Concepción-Zavaleta, Jeny J Mendoza-Godoy, Juan Eduardo Quiroz-Aldave, Juan Carlos Morón-Siguas, José L Paz-Ibarra

{"title":"Endocrine hypertension in 2025: how AI and multiomics are revolutionizing detection.","authors":"Jenyfer M Fuentes-Mendoza, Marcio J Concepción-Zavaleta, Jeny J Mendoza-Godoy, Juan Eduardo Quiroz-Aldave, Juan Carlos Morón-Siguas, José L Paz-Ibarra","doi":"10.1080/14779072.2026.2634025","DOIUrl":"10.1080/14779072.2026.2634025","url":null,"abstract":"Introduction: Endocrine hypertension (EH) represents a small yet clinically significant subset of secondary hypertension with curative potential. Recent advances in multiomics and artificial intelligence (AI) are transforming the diagnostic and therapeutic paradigms of EH, enabling earlier detection, precise subtyping, and personalized treatment strategies.Areas covered: This review integrates evidence from PubMed, Scopus, and Web of Science (2000-July 2025) addressing the role of genomics, transcriptomics, proteomics, and metabolomics combined with AI in the diagnosis and management of EH, including primary aldosteronism, Cushing's syndrome, pheochromocytoma/paraganglioma, and thyroid-related hypertension. It highlights the shift toward molecularly informed clinical pathways, noninvasive biomarkers, and predictive algorithms for subtype differentiation and therapeutic optimization.Expert opinion: The convergence of multiomics and AI heralds a transformative era in EH care. While proof-of-concept studies demonstrate diagnostic accuracy comparable to invasive tests, translation into routine practice is limited by infrastructural inequities, lack of data harmonization, and gaps in clinician digital literacy. Future efforts should prioritize federated data systems, longitudinal multiomic integration, and hybrid models of human - machine collaboration. Within a decade, endocrine hypertension management will likely evolve from static, phenotype-based diagnosis to dynamic, data-driven systems medicine, integrating continuous biosensing and AI-guided decision support for truly individualized care.","PeriodicalId":12098,"journal":{"name":"Expert Review of Cardiovascular Therapy","volume":" ","pages":"159-184"},"PeriodicalIF":2.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146219154","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 efficacy and safety of cerebral embolic protection devices in patients undergoing transcatheter aortic valve replacement: a systematic review and meta-analysis with trial sequential analysis of randomized controlled trials. 经导管主动脉瓣置换术患者使用脑栓塞保护装置的有效性和安全性：随机对照试验的系统回顾和荟萃分析。

IF 2.5

Expert Review of Cardiovascular Therapy Pub Date : 2026-01-01 Epub Date: 2026-03-04 DOI: 10.1080/14779072.2026.2636590

Ahmed Elazab, Ahmed W Hageen, Ahmed Elbataa, Ahmed Mansour, Eman E Labeeb, Qasi Najah, Mohammed A Elbahloul, Mohamed Ismail Elnady, Sohaila Mansour Abdelsatar, Anas Mansour, Mohamed Hamouda Elkasaby, Ramez M Odat, Laith Rhabneh, Mahmoud Nassar, Mustafa Turkmani, Diaa Hakim

{"title":"The efficacy and safety of cerebral embolic protection devices in patients undergoing transcatheter aortic valve replacement: a systematic review and meta-analysis with trial sequential analysis of randomized controlled trials.","authors":"Ahmed Elazab, Ahmed W Hageen, Ahmed Elbataa, Ahmed Mansour, Eman E Labeeb, Qasi Najah, Mohammed A Elbahloul, Mohamed Ismail Elnady, Sohaila Mansour Abdelsatar, Anas Mansour, Mohamed Hamouda Elkasaby, Ramez M Odat, Laith Rhabneh, Mahmoud Nassar, Mustafa Turkmani, Diaa Hakim","doi":"10.1080/14779072.2026.2636590","DOIUrl":"10.1080/14779072.2026.2636590","url":null,"abstract":"Introduction: Transcatheter aortic valve replacement (TAVR) is an established treatment for severe aortic stenosis but carries a risk of stroke and cerebral embolism. Cerebral embolic protection devices (CEPD), including filter-based and deflection-based systems (Sentinel and TriGUARD), aim to reduce embolic complications; however, their clinical benefit remains uncertain. This study evaluated the efficacy and safety of CEPD during TAVR using trial sequential analysis (TSA) and the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) framework.Methods: Randomized controlled trials (RCTs) comparing TAVR with and without CEPD were identified through four electronic databases from inception to April 2025. Primary outcomes were all-cause mortality, major adverse cardiovascular and cerebrovascular events (MACCE), stroke, and disabling stroke. Pooled risk ratios (RR) with 95% confidence intervals (CI) were calculated. TSA was conducted with a 5% type I error and 80% power.Results: Nine RCTs including 11,876 patients were analyzed. CEPD use showed no significant reduction in mortality, MACCE, stroke, or disabling stroke. Secondary and subgroup analyses yielded consistent findings. TSA demonstrated that the accrued evidence was insufficient to confirm a clinical benefit.Conclusions: Current evidence does not support the routine use of CEPD during TAVR, given the lack of significant benefit in key clinical outcomes.Registration: The protocol of this study was registered at Prospero CRD420251036308.","PeriodicalId":12098,"journal":{"name":"Expert Review of Cardiovascular Therapy","volume":" ","pages":"253-271"},"PeriodicalIF":2.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147270220","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