Journal of Cardiovascular Pharmacology最新文献

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Kirenol Alleviates Inflammation and Oxidative Stress to Improve Myocardial Ischemia/Reperfusion Injury in Rats. Kirenol 可缓解炎症和氧化应激,从而改善大鼠心肌缺血再灌注损伤。
IF 2.6 4区 医学
Journal of Cardiovascular Pharmacology Pub Date : 2024-11-01 DOI: 10.1097/FJC.0000000000001626
Jinlong Shi, Bingfeng Guan, Minghui Gong, Xinyi He
{"title":"Kirenol Alleviates Inflammation and Oxidative Stress to Improve Myocardial Ischemia/Reperfusion Injury in Rats.","authors":"Jinlong Shi, Bingfeng Guan, Minghui Gong, Xinyi He","doi":"10.1097/FJC.0000000000001626","DOIUrl":"10.1097/FJC.0000000000001626","url":null,"abstract":"<p><strong>Abstract: </strong>Ischemic heart disease gravely threatens human health and even results in death. Kirenol is predominantly derived from the Herba Siegesbeckiae plant species and possesses a wide range of biological effects (such as antibacterial, anti-inflammatory, anticancer, and cardioprotective). However, the regulatory effects and associated mechanisms of kirenol in myocardial ischemia/reperfusion injury (MI/RI) remain unclear. In this study, first, the MI/RI rat model was established. It was demonstrated that kirenol protected against the aggravation of cardiac function in MI/RI rats. In addition, the inflammation was induced by ischemia reperfusion (IR), which was likewise affected by kirenol (5 or 10 mg/kg). Moreover, IR enhanced oxidative stress, a process that was counteracted by kirenol. Next, cell apoptosis was discovered to be heightened after IR, but this effect was neutralized by kirenol. Finally, it was revealed that kirenol has the ability to block the activation of the NF-κB pathway. In conclusion, it was disclosed that kirenol alleviated inflammation and oxidative stress through modulating the NF-κB pathway to improve MI/RI in rats. This work may offer novel insights for searching useful drugs for treating MI/RI.</p>","PeriodicalId":15212,"journal":{"name":"Journal of Cardiovascular Pharmacology","volume":" ","pages":"539-544"},"PeriodicalIF":2.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142072935","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Editorial on: Canagliflozin Mediates Mitophagy Through the AMPK/PINK1/PARKIN Pathway to Alleviate Isoprenaline-Induced Cardiac Remodeling. 社论:卡格列净通过 AMPK/PINK1/PARKIN 通路介导有丝分裂,减轻异丙肾上腺素诱导的心脏重构。
IF 2.6 4区 医学
Journal of Cardiovascular Pharmacology Pub Date : 2024-11-01 DOI: 10.1097/FJC.0000000000001629
Alfredo Caturano, Davide Nilo, Roberto Nilo, Vincenzo Russo, Marcellino Monda, Luca Rinaldi, Raffaele Marfella, Ferdinando Carlo Sasso
{"title":"Editorial on: Canagliflozin Mediates Mitophagy Through the AMPK/PINK1/PARKIN Pathway to Alleviate Isoprenaline-Induced Cardiac Remodeling.","authors":"Alfredo Caturano, Davide Nilo, Roberto Nilo, Vincenzo Russo, Marcellino Monda, Luca Rinaldi, Raffaele Marfella, Ferdinando Carlo Sasso","doi":"10.1097/FJC.0000000000001629","DOIUrl":"10.1097/FJC.0000000000001629","url":null,"abstract":"","PeriodicalId":15212,"journal":{"name":"Journal of Cardiovascular Pharmacology","volume":" ","pages":"490-492"},"PeriodicalIF":2.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142288005","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Erectile Dysfunction Risk Among Patients With Diabetes Mellitus Using Sodium-Glucose Cotransporter 2 Inhibitors. 使用钠-葡萄糖共转运体 2 抑制剂的糖尿病患者出现勃起功能障碍的风险。
IF 2.6 4区 医学
Journal of Cardiovascular Pharmacology Pub Date : 2024-11-01 DOI: 10.1097/FJC.0000000000001624
Wei-Syun Hu, Cheng-Li Lin
{"title":"Erectile Dysfunction Risk Among Patients With Diabetes Mellitus Using Sodium-Glucose Cotransporter 2 Inhibitors.","authors":"Wei-Syun Hu, Cheng-Li Lin","doi":"10.1097/FJC.0000000000001624","DOIUrl":"10.1097/FJC.0000000000001624","url":null,"abstract":"<p><strong>Abstract: </strong>The aim of this study was to explore the incidence of new-onset erectile dysfunction (ED) in diabetes mellitus (DM) patients with sodium-glucose cotransporter 2 inhibitors (SGLT2I) use compared with a control group of non-SGLT2I use by propensity score matching approach. Cox proportional hazards regression models were used to examine the effect of SGLT2I and risk factors on the risk of developing ED, presented as a hazard ratio with a 95% confidence interval. One lakhs fifty nine thousand seven hundred seventy three patients with DM using SGLT2I and 159,773 propensity score matching patients with DM who had never used SGLT2I were included. SGLT2I users had a higher risk of ED than the non-SGLT2I users (adjusted hazard ratio = 1.55, 95% confidence interval = 1.40-1.72). The likelihood of developing ED was higher in patients with SGLT2I use was found.</p>","PeriodicalId":15212,"journal":{"name":"Journal of Cardiovascular Pharmacology","volume":" ","pages":"545-549"},"PeriodicalIF":2.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142072934","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Sodium-Glucose Cotransporter 2 Inhibitors, Malnutrition, Cachexia, and Survival in Patients With Heart Failure With a History of Anthracycline Treatment. 有蒽环类药物治疗史的心衰患者的 SGLT2 抑制剂、营养不良、恶病质和存活率。
IF 2.6 4区 医学
Journal of Cardiovascular Pharmacology Pub Date : 2024-11-01 DOI: 10.1097/FJC.0000000000001620
Benjamin D Henson, Claudia A Bale-Neary, Ryan Mecaskey, Ogechi Gbujie, Michelle Zhan, Krishnasree Rao, Salvatore Carbone
{"title":"Sodium-Glucose Cotransporter 2 Inhibitors, Malnutrition, Cachexia, and Survival in Patients With Heart Failure With a History of Anthracycline Treatment.","authors":"Benjamin D Henson, Claudia A Bale-Neary, Ryan Mecaskey, Ogechi Gbujie, Michelle Zhan, Krishnasree Rao, Salvatore Carbone","doi":"10.1097/FJC.0000000000001620","DOIUrl":"10.1097/FJC.0000000000001620","url":null,"abstract":"<p><strong>Abstract: </strong>Patients undergoing anthracycline-based cancer treatments have an increased risk of heart failure or worsening preexisting heart failure as well as adverse metabolic outcomes such as malnutrition and cachexia. This retrospective study explored the impact of sodium-glucose cotransporter 2 inhibitors (SGLT2i) on these outcomes in patients with heart failure previously treated with anthracyclines. Using the TriNetX research network, we identified 1545 patients with a history of SGLT2i use and 17,681 patients without a history of SGLT2i use. We then performed 1:1 propensity score matching resulting in 1323 patients within each cohort. Patients were analyzed over a 5-year period. SGLT2i use was associated with significantly reduced risks of cachexia {hazard ratio (HR) 0.453, 95% confidence interval (CI) [0.286-0.718]}, malnutrition (HR 0.702, 95% CI [0.547-0.900]), adult failure to thrive (HR 0.489, 95% CI [0.345-0.693]), and all-cause mortality (HR 0.490, 95% CI [0.423-0.568]). These findings call for additional research to determine whether SGLT2i may indeed improve nutritional status and survival in patients with heart failure receiving anthracycline therapy.</p>","PeriodicalId":15212,"journal":{"name":"Journal of Cardiovascular Pharmacology","volume":" ","pages":"486-489"},"PeriodicalIF":2.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141901866","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Role of autophagy in myocardial remodeling after myocardial infarction. 自噬在心肌梗塞后心肌重塑中的作用
IF 2.6 4区 医学
Journal of Cardiovascular Pharmacology Pub Date : 2024-10-25 DOI: 10.1097/FJC.0000000000001646
Run-Ze Tian, Dong-Lin Zhuang, Chi Teng Vong, Xuyu He, Qing Ouyang, Jing-Hua Liang, Yan-Ping Guo, Yu-Hong Wang, Shuang Zhao, Haiyun Yuan, Moussa Ide Nasser, Ge Li, Ping Zhu
{"title":"Role of autophagy in myocardial remodeling after myocardial infarction.","authors":"Run-Ze Tian, Dong-Lin Zhuang, Chi Teng Vong, Xuyu He, Qing Ouyang, Jing-Hua Liang, Yan-Ping Guo, Yu-Hong Wang, Shuang Zhao, Haiyun Yuan, Moussa Ide Nasser, Ge Li, Ping Zhu","doi":"10.1097/FJC.0000000000001646","DOIUrl":"https://doi.org/10.1097/FJC.0000000000001646","url":null,"abstract":"<p><p>Autophagy is the process of reusing the body's senescent and damaged cell components, which can be regarded as the cellular circulatory system. There are three distinct forms of autophagy: macro-autophagy, micro-autophagy, and chaperone-mediated autophagy. In the heart, autophagy is regulated mainly through mitophagy due to the metabolic changes of cardiomyocytes caused by ischemia and hypoxia. Myocardial remodeling is characterized by gradual heart enlargement, cardiac dysfunction, and extraordinary molecular changes. Cardiac remodeling after myocardial infarction is almost inevitable, which is the leading cause of heart failure. Autophagy has a protective effect on myocardial remodeling improvement. Autophagy can minimize cardiac remodeling by preventing misfolded protein accumulation and oxidative stress. This review summarizes the nestest molecular mechanisms of autophagy and myocardial remodeling, the protective effects, and the new target of autophagy medicine in cardiac remodeling. The future development and challenges of autophagy in heart disease are also summarized.</p>","PeriodicalId":15212,"journal":{"name":"Journal of Cardiovascular Pharmacology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142501094","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Modulating Sympathetic Nervous System with the use of SGLT2 Inhibitors: Where There is Smoke, There is Fire? 使用 SGLT2 抑制剂调节交感神经系统:哪里有烟,哪里就有火?
IF 2.6 4区 医学
Journal of Cardiovascular Pharmacology Pub Date : 2024-10-22 DOI: 10.1097/FJC.0000000000001644
Kyriakos Dimitriadis, Daphne Pitsiori, Polyxeni Alexiou, Nikolaos Pyrpyris, Athanasios Sakalidis, Eirini Beneki, Panagiotis Iliakis, Fotis Tatakis, Panagiotis Theofilis, Panagiotis Tsioufis, Dimitrios Konstantinidis, Konstantina Aggeli, Konstantinos Tsioufis
{"title":"Modulating Sympathetic Nervous System with the use of SGLT2 Inhibitors: Where There is Smoke, There is Fire?","authors":"Kyriakos Dimitriadis, Daphne Pitsiori, Polyxeni Alexiou, Nikolaos Pyrpyris, Athanasios Sakalidis, Eirini Beneki, Panagiotis Iliakis, Fotis Tatakis, Panagiotis Theofilis, Panagiotis Tsioufis, Dimitrios Konstantinidis, Konstantina Aggeli, Konstantinos Tsioufis","doi":"10.1097/FJC.0000000000001644","DOIUrl":"10.1097/FJC.0000000000001644","url":null,"abstract":"<p><p>Heart failure (HF) has become even more prevalent in recent years, as a result of improved diagnostics and an increase in the risk factors predisposing to its pathology. Sodium-glucose co-transporter 2 inhibitors (SGLT2i) emerged as one of the key pharmacotherapy options for both reduced and preserved ejection fraction, providing cardio- and renoprotection and improving mortality and cardiovascular (CV) outcomes. The pleiotropism of SGLT2i has led to multiple efforts to understand their distinct pathophysiological interactions with various pathways, including microcirculation, endothelial dysfunction, and inflammation. More recently, the role of SGLT2i on the sympathetic nervous system (SNS) is starting to be recognized, especially as observations of retained or reduced heart rate (HR) despite volume contraction have been noted by investigators in the large clinical trials testing the safety and efficacy of these agents. Both preclinical and clinical studies have been performed, with conflicting results. Interestingly, in both settings, whilst there are indications of SNS modulation by SGLT2i, other studies contradict such findings, without showing, however, worsening of the autonomic homeostasis. Given the importance of neuromodulation in HF, in both pharmacological and interventional therapies, in this review, we aim to describe the role of SNS in CV disease, focusing on HF, analyse preclinical and clinical data regarding the efficacy of SGLT2i in modulating autonomic dysfunction by examining various markers of SNS activation, as well as provide the most plausible theoretical backgrounds on the mechanism of benefit of SNS from the inhibition of SGLT2 receptors.</p>","PeriodicalId":15212,"journal":{"name":"Journal of Cardiovascular Pharmacology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142466354","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Deubiquitinase USP47 ameliorates cardiac hypertrophy through reducing protein O-GlcNAcylation. 去泛素化酶 USP47 通过减少蛋白质 O-GlcNAcylation 改善心肌肥大。
IF 2.6 4区 医学
Journal of Cardiovascular Pharmacology Pub Date : 2024-10-22 DOI: 10.1097/FJC.0000000000001640
Yu Jiang, Wenyao Cai, Guangtao Lei, Guorong Cai, Qinghua Wu, Peng Lu
{"title":"Deubiquitinase USP47 ameliorates cardiac hypertrophy through reducing protein O-GlcNAcylation.","authors":"Yu Jiang, Wenyao Cai, Guangtao Lei, Guorong Cai, Qinghua Wu, Peng Lu","doi":"10.1097/FJC.0000000000001640","DOIUrl":"10.1097/FJC.0000000000001640","url":null,"abstract":"<p><p>Cardiac hypertrophy is a crucial risk factor for heart failure when the heart is confronted with physiological or pathological stimuli. The ubiquitin-proteasome system (UPS) plays a critical role in the pathogenesis of cardiac hypertrophy. However, as a key component of the UPS, the role of deubiquitinating enzymes (DUBs) in cardiac hypertrophy is not well understood. Here, we observed that the expression level of deubiquitinase USP47 was increased in hypertrophic hearts and angiotensin II (Ang II)-stimulated neonatal rat cardiomyocytes (NRCMs). Adenovirus-mediated gain- and loss-of-function approaches indicated that USP47 overexpression significantly attenuated Ang II-induced cardiac hypertrophy in vitro and in vivo, whereas endogenous USP47 deficiency promoted the pro-hypertrophic effect of Ang II. Further investigation demonstrated that USP47 inhibited O-GlcNAcylation in cardiomyocytes by controlling the expression of O-GlcNAcase (OGA). Mechanistically, USP47 bound, deubiquitinated, and stabilized protein arginine methyltransferase 5 (PRMT5), thus upregulating OGA expression. We found that the restoration of PRMT5 abolished the pro-hypertrophic effects of USP47 silence in vitro. Therefore, our results provide the first evidence of the involvement of USP47 in cardiac hypertrophy and identify USP47 as a potential target for hypertrophic therapy.</p>","PeriodicalId":15212,"journal":{"name":"Journal of Cardiovascular Pharmacology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142466352","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Investigating the Transfer of Lisinopril into Human Milk: A Quantitative Analysis. 利辛普利向母乳转移的研究:定量分析
IF 2.6 4区 医学
Journal of Cardiovascular Pharmacology Pub Date : 2024-10-15 DOI: 10.1097/FJC.0000000000001642
Julie Chugh, Jean Dai, Palika Datta, Kaytlin Krutsch
{"title":"Investigating the Transfer of Lisinopril into Human Milk: A Quantitative Analysis.","authors":"Julie Chugh, Jean Dai, Palika Datta, Kaytlin Krutsch","doi":"10.1097/FJC.0000000000001642","DOIUrl":"https://doi.org/10.1097/FJC.0000000000001642","url":null,"abstract":"<p><p>Lisinopril is commonly prescribed to manage conditions such as hypertension and heart failure. While concerns about fetal toxicity have traditionally limited the use of lisinopril in women of reproductive age, recent ACOG guidelines promote aggressive treatment of hypertension, which may require the use of pharmacologic agents not previously considered in the postpartum period. We aimed to estimate infant exposure to maternal lisinopril via breastmilk and report the tolerance of the breastfed infant. Five volunteers taking lisinopril provided samples of their human milk and their associated health information for research through the InfantRisk Center Human Milk Biorepository. The milk pharmacokinetics of lisinopril were measured using liquid chromatography-mass spectrometry. The mean milk concentration of lisinopril was 0.49 ng/mL per 10 mg daily dose. The Relative Infant Dose (RID) was 0.06% for lisinopril, more than 100 times lower than the standard 10% safety threshold. The minimal transfer of lisinopril into human milk in this study suggests the drug is unlikely to pose a clinically significant risk to healthy breastfed infants.</p>","PeriodicalId":15212,"journal":{"name":"Journal of Cardiovascular Pharmacology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142466353","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Canonical Transient Receptor Potential (TRPC) Channels in Cardiovascular Pathology and their Modulators. 心血管病理中的典型瞬时受体电位(TRPC)通道及其调节剂。
IF 2.6 4区 医学
Journal of Cardiovascular Pharmacology Pub Date : 2024-10-15 DOI: 10.1097/FJC.0000000000001643
Hussein N Rubaiy
{"title":"Canonical Transient Receptor Potential (TRPC) Channels in Cardiovascular Pathology and their Modulators.","authors":"Hussein N Rubaiy","doi":"10.1097/FJC.0000000000001643","DOIUrl":"10.1097/FJC.0000000000001643","url":null,"abstract":"<p><p>Ion channels play a crucial role in various aspects of cardiac function, such as regulating rhythm and contractility. As a result, they serve as key targets for therapeutic interventions in cardiovascular diseases. Cell function is substantially influenced by the concentration of free cytosolic calcium (Ca 2+ ) and the voltage across the plasma membrane. These characteristics are known to be regulated by Ca 2+ -permeable non-selective cationic channels, although our knowledge of these channels is still inadequate. The transient receptor potential (TRP) superfamily comprises of many non-selective cation channels with diverse Ca 2+ permeability. Canonical or classical TRP (TRPC) channels are a subgroup of the TRP superfamily that are expressed ubiquitously in mammalian cells. TRPC channels are multidimensional signalling protein complexes that play essential roles in a variety of physiological and pathological processes in humans, including cancer, neurological disorders, cardiovascular diseases, and others. The objective of this article is to focus on the role that TRPC channels play in the cardiovascular system. The role of TRPC channels will be deeply discussed in cardiovascular pathology. Together, a critical element in developing novel treatments that target TRPC channels is comprehending the molecular mechanisms and regulatory pathways of TRPC channels in related cardiovascular diseases and conditions.</p>","PeriodicalId":15212,"journal":{"name":"Journal of Cardiovascular Pharmacology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142466351","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Comparative Analysis of Anticoagulation Versus Combination Anticoagulation and Antiplatelet Therapy in Atrial Fibrillation Patients Presenting With Gastrointestinal Bleeding. 对出现消化道出血的心房颤动患者进行抗凝与抗凝及抗血小板联合疗法的比较分析
IF 2.6 4区 医学
Journal of Cardiovascular Pharmacology Pub Date : 2024-10-10 DOI: 10.1097/FJC.0000000000001641
Ali Dakroub, Hadi Beaini, Ramzi Kibbi, Mohamad B Moumneh, Saleem M Halablab, Razan Dankar, Nour Adra, Chantal Rizk, Kassem Barada, Marwan Refaat
{"title":"Comparative Analysis of Anticoagulation Versus Combination Anticoagulation and Antiplatelet Therapy in Atrial Fibrillation Patients Presenting With Gastrointestinal Bleeding.","authors":"Ali Dakroub, Hadi Beaini, Ramzi Kibbi, Mohamad B Moumneh, Saleem M Halablab, Razan Dankar, Nour Adra, Chantal Rizk, Kassem Barada, Marwan Refaat","doi":"10.1097/FJC.0000000000001641","DOIUrl":"https://doi.org/10.1097/FJC.0000000000001641","url":null,"abstract":"<p><p>Patients with atrial fibrillation (AF) taking antithrombotic (AT) therapy are at increased risk of gastrointestinal bleeding (GIB). The comparative effect of a combination of anticoagulant (AC) and antiplatelet (AP) versus AC monotherapy on clinical outcomes in patients with AF presenting with GIB is not well characterized. This study compares outcomes in AF patients with GIB on AC alone to those on combination AP and AC therapy, as part of a larger prospective study from 2013 to 2023. 137 patients diagnosed with AF who presented with overt GIB were evaluated during their hospitalization, at one month and one year post-discharge, and then annually. The median follow-up of patients was 57 months. Patients in the combination AP +AC therapy group had a higher prevalence of CAD, myocardial infarction, and coronary/vascular stent placement compared to the AC monotherapy group. No statistically significant differences were noted between the two groups in terms of end-of-follow-up mortality, in-hospital mortality, major bleeding, rebleeding, and length of hospital stay. Cox regression analysis revealed chronic kidney disease (CKD) (hazard ratio (HR) 2.05, 95% confidence interval (CI) [1.04,4.05] (p= 0.038)] and warfarin use [(HR 4.94, 95% CI [1.11,22.09] (p= 0.037)] to be independent predictors of mortality at 12 months. Anti-thrombotic therapy in patients with AF who experience GIB should be mainly directed by their cardiovascular needs. Healthcare providers may explore non-vitamin K antagonist oral anticoagulants as alternatives to warfarin for AF patients at risk of GIB, and efforts must be maximized to prevent bleeding in patients with CKD.</p>","PeriodicalId":15212,"journal":{"name":"Journal of Cardiovascular Pharmacology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142400405","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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