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

Sociodemographic determinants of gender disparity in primary percutaneous coronary intervention in Pakistan. 巴基斯坦初次经皮冠状动脉介入治疗中性别差异的社会人口学决定因素。

IF 2

Expert Review of Cardiovascular Therapy Pub Date : 2023-07-01 Epub Date: 2023-12-10 DOI: 10.1080/14779072.2023.2277356

Hasan Sohail, Muhammad Rizwan Umer, Muhammad Waqas Afzal, Asif Ullah, Syed Ahmad Salahuddin, Jahanzeb Malik, Waheed Ashraf

{"title":"Sociodemographic determinants of gender disparity in primary percutaneous coronary intervention in Pakistan.","authors":"Hasan Sohail, Muhammad Rizwan Umer, Muhammad Waqas Afzal, Asif Ullah, Syed Ahmad Salahuddin, Jahanzeb Malik, Waheed Ashraf","doi":"10.1080/14779072.2023.2277356","DOIUrl":"10.1080/14779072.2023.2277356","url":null,"abstract":"Objectives: This study aims to contribute to the body of literature on gender disparities after acute myocardial infarction (AMI) undergoing primary percutaneous coronary intervention (PPCI).Methods: We identified all adult patients who had AMI between January 2017, and December 2022 and were in follow-up at our institute. We collected data on PPCI, revascularization strategy, sociodemographic characteristics, and in-hospital complications in the years following the procedure.Results: A total of 5,872 patients who underwent PCI for AMI were included in the study, out of which 2,058 (35%) were women and 3,814 (65%) were men. Regarding the timing of PCI, female patients had a significantly longer median door-to-balloon time compared to male patients (136 minutes vs 108 minutes, P-value = 0.006). Female patients had a significantly higher rate of in-hospital mortality compared to male patients (5.5% vs 1.2%, P-value = 0.011). Multivariate logistic regression analysis showed that female gender, older age, and lower household income were independent predictors of longer door-to-balloon time.Conclusion: This study highlights gender disparities in PPCI in Pakistan, with female patients facing longer door-to-balloon times and higher in-hospital mortality rates. The findings suggest the need for targeted interventions to improve the access and quality of care for female patients with AMI.","PeriodicalId":12098,"journal":{"name":"Expert Review of Cardiovascular Therapy","volume":" ","pages":"895-899"},"PeriodicalIF":2.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71422004","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

Should atrial fibrillation be considered a vascular disease? The need for a comprehensive vascular approach. 心房颤动应该被认为是一种血管疾病吗？需要一个全面的血管途径。

IF 2

Expert Review of Cardiovascular Therapy Pub Date : 2023-07-01 Epub Date: 2023-12-10 DOI: 10.1080/14779072.2023.2272652

Carlos Escobar-Cervantes, Antonio Pose Reino, Pablo Díez-Villanueva, Lorenzo Facila, Román Freixa-Pamias, Alfonso Valle, Manuel Almendro-Delia, Clara Bonanad, David Vivas, Carmen Suarez

{"title":"Should atrial fibrillation be considered a vascular disease? The need for a comprehensive vascular approach.","authors":"Carlos Escobar-Cervantes, Antonio Pose Reino, Pablo Díez-Villanueva, Lorenzo Facila, Román Freixa-Pamias, Alfonso Valle, Manuel Almendro-Delia, Clara Bonanad, David Vivas, Carmen Suarez","doi":"10.1080/14779072.2023.2272652","DOIUrl":"10.1080/14779072.2023.2272652","url":null,"abstract":"Introduction: Atrial fibrillation (AF) cannot be considered an isolated disease. Patients with AF should be managed using a comprehensive approach that is not limited to stroke prevention.Areas covered: In this manuscript, the potential role of AF as a vascular disease that is managed as part of a holistic approach was reviewed.Expert opinion: The residual risk of stroke in patients with AF reaches 1-2% annually, despite appropriate anticoagulation therapy. Additionally, patients with AF may develop cognitive impairment through stroke-independent pathways. Furthermore, patients with AF may have a higher risk of developing atherosclerotic vascular disease in various vascular beds and chronic kidney disease; conversely, patients with atherosclerotic disease may have an increased risk of developing AF. AF should be considered a truly systemic vascular disease, since it brings together several hemodynamic and systemic changes, including inflammation, oxidative stress, activation of the renin-angiotensin-aldosterone and sympathetic systems, as well as a prothrombotic state and endothelial dysfunction. In this regard, patients with AF should be treated based on a holistic approach that is not limited to oral anticoagulation but includes complete vascular protection.","PeriodicalId":12098,"journal":{"name":"Expert Review of Cardiovascular Therapy","volume":" ","pages":"779-790"},"PeriodicalIF":2.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49689455","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

Insight into tricuspid transcatheter edge-to-edge repair: no longer the forgotten valve. 洞察三尖瓣经导管边缘到边缘修复:不再被遗忘的瓣膜。

IF 2

Expert Review of Cardiovascular Therapy Pub Date : 2023-07-01 Epub Date: 2023-12-10 DOI: 10.1080/14779072.2023.2286010

Rongfeng Xu, Zhenyu Cai, Jiandong Ding, Genshan Ma

{"title":"Insight into tricuspid transcatheter edge-to-edge repair: no longer the forgotten valve.","authors":"Rongfeng Xu, Zhenyu Cai, Jiandong Ding, Genshan Ma","doi":"10.1080/14779072.2023.2286010","DOIUrl":"10.1080/14779072.2023.2286010","url":null,"abstract":"Introduction: Tricuspid regurgitation (TR) is one of the most prevalent types of valvular heart disease linked to poor prognosis in patients with heart failure and is usually ignored. TR has received considerable attention due to the progressive advancements in transcatheter therapies in recent years.Areas covered: With relatively solid data and rapid technological advancements, tricuspid transcatheter edge-to-edge repair (T-TEER) is the most frequently employed in a series of tricuspid transcatheter interventional treatments for TR. However, the efficacy and technical benefits of T-TEER are limited because of the unique anatomical characteristics and pathological mechanisms of the tricuspid valve. The aim of this review is to summarize reported data on current status of T-TEER and to provide an expert opinion regarding the challenges it is now experiencing and future development direction and approach.Expert opinion: T-TEER is a significant treatment for TR, but its effectiveness and technical promotion are limited due to the tricuspid valve unique anatomical characteristics and pathological mechanisms. The selection criteria for suitable patients, the choice of when to intervene, device innovation, the advancement of ultrasound technology, and the volume of evidence in evidence-based medicine all indicate that the disorder of TR will eventually be better treated and understood.","PeriodicalId":12098,"journal":{"name":"Expert Review of Cardiovascular Therapy","volume":" ","pages":"877-885"},"PeriodicalIF":2.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138046629","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

Managing older people with atrial fibrillation and preventing stroke: a review of anticoagulation approaches. 管理患有心房颤动的老年人并预防中风：抗凝方法综述。

IF 2

Expert Review of Cardiovascular Therapy Pub Date : 2023-07-01 Epub Date: 2023-12-13 DOI: 10.1080/14779072.2023.2276892

Leona A Verma, Peter E Penson, Asangaedem Akpan, Gregory Y H Lip, Deirdre A Lane

{"title":"Managing older people with atrial fibrillation and preventing stroke: a review of anticoagulation approaches.","authors":"Leona A Verma, Peter E Penson, Asangaedem Akpan, Gregory Y H Lip, Deirdre A Lane","doi":"10.1080/14779072.2023.2276892","DOIUrl":"https://doi.org/10.1080/14779072.2023.2276892","url":null,"abstract":"Introduction: Oral anticoagulants (OACs) are the cornerstone of stroke prevention in atrial fibrillation (AF), but prescribing decisions in older people are complicated. Clinicians must assess the net clinical benefit of OAC in the context of multiple chronic conditions, polypharmacy, frailty and life expectancy. The under-representation of high-risk, older adult sub-populations in clinical trials presents the challenge of choosing the right OAC, where a 'one-size-fits-all' approach cannot be taken.Areas covered: This review discusses OAC approaches for stroke prevention in older people with AF and presents a prescribing aid to support clinicians' decision-making. High-risk older adults with multiple chronic conditions, specifically chronic kidney disease, dementia/cognitive impairment, previous stroke/transient ischemic attack or intracranial hemorrhage, polypharmacy, frailty, low body weight, high falls risk, and those aged ≥75 years are considered.Expert opinion: Non-vitamin K antagonist OACs are the preferred first-line OAC in older adults with AF, including high-risk subpopulations, after individual assessment of stroke and bleeding risk, except those with mechanical heart valves and moderate-to-severe mitral stenosis. Head-to-head comparisons of NOACs are not available, therefore the choice of drug (and dose) should be based on an individual's risk (stroke and bleeding) and incorporate their treatment preferences. Treatment decisions must be person-centered and principles of shared decision-making applied.","PeriodicalId":12098,"journal":{"name":"Expert Review of Cardiovascular Therapy","volume":"21 12","pages":"963-983"},"PeriodicalIF":2.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138801031","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

Optimal use of intravenous landiolol in acute cardiac care. 静脉滴注兰地洛尔在急性心脏护理中的最佳应用。

IF 2

Expert Review of Cardiovascular Therapy Pub Date : 2023-07-01 Epub Date: 2023-12-10 DOI: 10.1080/14779072.2023.2277354

Sofia Bezati, Antonios Boultadakis, Ioannis Ventoulis, Eftihia Polyzogopoulou, John T Parissis

{"title":"Optimal use of intravenous landiolol in acute cardiac care.","authors":"Sofia Bezati, Antonios Boultadakis, Ioannis Ventoulis, Eftihia Polyzogopoulou, John T Parissis","doi":"10.1080/14779072.2023.2277354","DOIUrl":"10.1080/14779072.2023.2277354","url":null,"abstract":"Introduction: B-blockers are regarded as beneficial pharmacologic agents in cardiac care, but their role in the acute setting remains ambiguous. Increasing evidence supports the important role of landiolol in critical care, a highly cardioselective intravenous b-blocker with rapid onset of action and short elimination time. Among its most valuable properties, which may aid to overcome special reservations related to b-blocker therapy in the acute setting, landiolol has a potent negative chronotropic effect while at the same time it exhibits a mild negative inotropic effect.Areas covered: This expert opinion review aims to present basic pharmacologic aspects of landiolol and provide current clinical research focused on its efficacy and safety.Expert opinion: Landiolol is a valuable and safe pharmacologic agent in acute cardiac care. Japanese and European guidelines have incorporated its use for the management of atrial tachyarrhythmia in patients with cardiac dysfunction. Although emerging clinical trials have experimented its use in patients with sustained ventricular tachycardia/fibrillation, acute myocardial infarction undergoing primary percutaneous intervention and in patients with septic cardiomyopathy, more studies are needed in order to establish its value in such cardiac conditions.","PeriodicalId":12098,"journal":{"name":"Expert Review of Cardiovascular Therapy","volume":" ","pages":"855-866"},"PeriodicalIF":2.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71411246","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 management of infective endocarditis in pregnancy. 妊娠期感染性心内膜炎的现代治疗。

IF 2

Expert Review of Cardiovascular Therapy Pub Date : 2023-07-01 Epub Date: 2023-12-10 DOI: 10.1080/14779072.2023.2276891

Ailís Pollock, Thomas J Kiernan

{"title":"Contemporary management of infective endocarditis in pregnancy.","authors":"Ailís Pollock, Thomas J Kiernan","doi":"10.1080/14779072.2023.2276891","DOIUrl":"10.1080/14779072.2023.2276891","url":null,"abstract":"Introduction: Infective endocarditis (IE) during pregnancy is a rare condition that is associated with a high level of morbidity and mortality. The epidemiology, diagnosis, treatment, and prognosis have changed significantly in the last two decades. The declining incidence of rheumatic heart disease, improved life expectancy with congenital heart disease, advances in cardiac surgery and cardiac devices, rise in resistant microorganisms, complications of the opioid epidemic, and increasing maternal age are some of the many factors contributing to these changes.Areas covered: This article explores existing literature on the topic including case reports, case series, registry data, and clinical guidelines. The focus of this article is the evolving epidemiology, predisposing factors and preventative measures, clinical presentation, investigation, management, and potential complications of IE in pregnancy.Expert opinion: Robust prospective data on the management of IE in pregnancy is lacking, and obtaining these data will be very challenging. It is imperative that international registries are used to provide data on best clinical practices and inform future clinical guidelines. Multimodal imaging should be incorporated in the investigation of complicated cases. A multidisciplinary approach to the management of this rare and life-threatening condition is essential to ensure the best outcomes for both the mother and the fetus.","PeriodicalId":12098,"journal":{"name":"Expert Review of Cardiovascular Therapy","volume":" ","pages":"839-854"},"PeriodicalIF":2.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71421993","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

Adverse events and drug-drug interactions of sodium glucose co-transporter 2 inhibitors in patients treated for heart failure. 心力衰竭患者中钠-葡萄糖共转运蛋白2抑制剂的不良事件和药物相互作用。

IF 2

Expert Review of Cardiovascular Therapy Pub Date : 2023-07-01 Epub Date: 2023-12-10 DOI: 10.1080/14779072.2023.2273900

Claudia Stöllberger, Josef Finsterer, Birke Schneider

{"title":"Adverse events and drug-drug interactions of sodium glucose co-transporter 2 inhibitors in patients treated for heart failure.","authors":"Claudia Stöllberger, Josef Finsterer, Birke Schneider","doi":"10.1080/14779072.2023.2273900","DOIUrl":"10.1080/14779072.2023.2273900","url":null,"abstract":"Introduction: Sodium glucose co-transporter 2-inhibitors (SGLT2-I), antihyperglycemic agents, are increasingly prescribed in chronic heart failure (CHF). Their risk for drug-drug interactions (DDI) seems low. Safety-data derive mainly from diabetes-patients. This review aims to summarize adverse-events (AE) and DDI of the SGLT2-I dapagliflozin, empagliflozin and sotagliflozin in patients with CHF.Areas covered: Literature-search-terms in PubMed were 'adverse event/drug-drug interaction' and 'heart failure AND 'dapagliflozin' OR 'empagliflozin' OR 'sotagliflozin.'AEreported in randomized controlled trials (RCT) comprisegenitaland urinary-tract infections, hypotension, ketoacidosis, renal impairment, hypoglycemia, limb-amputations, Fournier's gangrene, bone-fractures, hepatopathy, pancreatitis, diarrhea, malignancy and venous thromboembolism. Their incidence is largely unknown, since they were not consistently evaluated in RCT of CHF. Further AE from meta-analyses, pharmacovigilance reports, case-series and case-reports include erythrocytosis, hypertriglyceridemia, myopathy, sarcopenia, skin problems, ventricular tachycardia, and urinary retention. The maximal observation period of RCT in CHF was 26 months.DDI were mainly studied in healthy volunteers for 3-8 days. In CHF or diabetes-patients, DDI were reported with interleukin-17-inhibitors, linezolid, lithium, tacrolimus, valproate, angiotensin-receptor-neprilysin-inhibitors and intravenous iron.Expert opinion: Guidelines recommend treatment with SGLT2-I for CHF but no data on AE during long-term therapy and only little information on DDI are available, which stresses the need for further research. Evidence-based recommendations for ketoacidosis-prevention are desirable.","PeriodicalId":12098,"journal":{"name":"Expert Review of Cardiovascular Therapy","volume":" ","pages":"803-816"},"PeriodicalIF":2.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49675964","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 biomechanical insights in atrial fibrillation: opportunities & challenges. 房颤的个性化生物力学见解:机遇与挑战。

IF 1.8

Expert Review of Cardiovascular Therapy Pub Date : 2023-07-01 Epub Date: 2023-12-10 DOI: 10.1080/14779072.2023.2273896

Åshild Telle, Clarissa Bargellini, Yaacoub Chahine, Juan C Del Álamo, Nazem Akoum, Patrick M Boyle

{"title":"Personalized biomechanical insights in atrial fibrillation: opportunities & challenges.","authors":"Åshild Telle, Clarissa Bargellini, Yaacoub Chahine, Juan C Del Álamo, Nazem Akoum, Patrick M Boyle","doi":"10.1080/14779072.2023.2273896","DOIUrl":"10.1080/14779072.2023.2273896","url":null,"abstract":"Introduction: Atrial fibrillation (AF) is an increasingly prevalent and significant worldwide health problem. Manifested as an irregular atrial electrophysiological activation, it is associated with many serious health complications. AF affects the biomechanical function of the heart as contraction follows the electrical activation, subsequently leading to reduced blood flow. The underlying mechanisms behind AF are not fully understood, but it is known that AF is highly correlated with the presence of atrial fibrosis, and with a manifold increase in risk of stroke.Areas covered: In this review, we focus on biomechanical aspects in atrial fibrillation, current and emerging use of clinical images, and personalized computational models. We also discuss how these can be used to provide patient-specific care.Expert opinion: Understanding the connection betweenatrial fibrillation and atrial remodeling might lead to valuable understanding of stroke and heart failure pathophysiology. Established and emerging imaging modalities can bring us closer to this understanding, especially with continued advancements in processing accuracy, reproducibility, and clinical relevance of the associated technologies. Computational models of cardiac electromechanics can be used to glean additional insights on the roles of AF and remodeling in heart function.","PeriodicalId":12098,"journal":{"name":"Expert Review of Cardiovascular Therapy","volume":" ","pages":"817-837"},"PeriodicalIF":1.8,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10841537/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50157467","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

Diagnosis of cardiac sarcoidosis: histological evidence vs. imaging. 心脏结节病的诊断：组织学证据与影像学。

IF 2

Expert Review of Cardiovascular Therapy Pub Date : 2023-07-01 Epub Date: 2023-10-26 DOI: 10.1080/14779072.2023.2266367

Shinichi Kurashima, Takeshi Kitai, Andrew Xanthopoulos, John Skoularigis, Filippos Triposkiadis, Chisato Izumi

{"title":"Diagnosis of cardiac sarcoidosis: histological evidence vs. imaging.","authors":"Shinichi Kurashima, Takeshi Kitai, Andrew Xanthopoulos, John Skoularigis, Filippos Triposkiadis, Chisato Izumi","doi":"10.1080/14779072.2023.2266367","DOIUrl":"10.1080/14779072.2023.2266367","url":null,"abstract":"Introduction: The prognosis for cardiac sarcoidosis (CS) remains unfavorable. Although early and accurate diagnosis is crucial, the low detection rate of endomyocardial biopsy makes accurate diagnosis challenging.Areas covered: The Heart Rhythm Society (HRS) consensus statement and the Japanese Circulation Society (JCS) guidelines are two major diagnostic criteria for the diagnosis of CS. While the requirement of positive histology for the diagnosis in the HRS criteria can result in overlooked cases, the JCS guidelines advocate for a group of 'clinical' diagnoses based on advanced imaging, including cardiovascular magnetic resonance and 18F-fluorodeoxyglucose positron emission tomography, which do not require histological evidence. Recent studies have supported the usefulness of clinical diagnosis of CS. However, other evidence suggests that clinical CS may sometimes be inaccurate. This article describes the advantages and disadvantages of the current diagnostic criteria for CS, and typical imaging and clinical courses.Expert opinion: The diagnosis of clinical CS has been made possible by recent developments in multimodality imaging. However, it is still crucial to look for histological signs of sarcoidosis in other organs in addition to the endomyocardium. Additionally, phenotyping based on clinical manifestations such as heart failure, conduction abnormality or ventricular arrhythmia, and extracardiac abnormalities is clinically significant.","PeriodicalId":12098,"journal":{"name":"Expert Review of Cardiovascular Therapy","volume":" ","pages":"693-702"},"PeriodicalIF":2.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41112649","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

Bivalirudin in acute coronary syndromes. 双缬氨酸治疗急性冠状动脉综合征。

IF 2

Expert Review of Cardiovascular Therapy Pub Date : 2023-07-01 Epub Date: 2023-12-13 DOI: 10.1080/14779072.2023.2273902

Mattia Galli, Marco Bernardi, Luis Ortega-Paz, Roberto Nerla, Domenico D'Amario, Francesco Franchi, Giuseppe Biondi-Zoccai, Dominick J Angiolillo

{"title":"Bivalirudin in acute coronary syndromes.","authors":"Mattia Galli, Marco Bernardi, Luis Ortega-Paz, Roberto Nerla, Domenico D'Amario, Francesco Franchi, Giuseppe Biondi-Zoccai, Dominick J Angiolillo","doi":"10.1080/14779072.2023.2273902","DOIUrl":"10.1080/14779072.2023.2273902","url":null,"abstract":"Introduction: Bivalirudin, a bivalent direct thrombin inhibitor, has been developed to reduce bleeding without any trade-off in thrombotic events in acute coronary syndrome (ACS) patients undergoing percutaneous coronary intervention (PCI).Areas covered: Despite showing a superior safety profile compared with unfractionated heparin (UFH), bivalirudin is not considered the anticoagulant of choice in ACS patients undergoing PCI, mainly because of an increased rate of acute stent thrombosis (ST) shown by several randomized controlled trials (RCTs), in addition to limited availability in certain countries and increased costs. However, RCTs on bivalirudin have been characterized by several confounding factors hindering the interpretation of its safety and efficacy compared with UFH among the spectrum of ACS patients. Furthermore, a significant body of evidence has demonstrated that the risk of acute ST can be mitigated by a full-dose infusion regimen following PCI, without compromising the favorable safety profile compared to UFH.Expert opinion: In light of the increased understanding of the prognostic relevance of bleeding events and the excellent safety profile of bivalirudin, recent trial evidence may allow for this anticoagulant agent to reemerge and have a more prominent role in the management of ACS patients undergoing PCI.","PeriodicalId":12098,"journal":{"name":"Expert Review of Cardiovascular Therapy","volume":" ","pages":"901-911"},"PeriodicalIF":2.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71421992","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: 1