Reviews in cardiovascular medicine最新文献

{"title":"Study on the Predictive Value of a Pulmonary Edema Imaging Score for Delayed Extubation in Patients after Heart Valve Surgery on Cardiopulmonary Bypass.","authors":"Xuefeng Lin, Funan Wang, Yuting Wang","doi":"10.31083/j.rcm2510387","DOIUrl":"10.31083/j.rcm2510387","url":null,"abstract":"<p><strong>Background: </strong>Delayed extubation with mechanical ventilation after cardiac valve surgery is an important clinical challenge. Early extubation can improve the survival rate and prognosis of patients. The study aims to explore the predictive value of a chest X-ray pulmonary edema imaging score on the first day after surgery for delayed extubation in patients after cardiac valve surgery on cardiopulmonary bypass.</p><p><strong>Method: </strong>Retrospective analysis of the clinical data of patients undergoing cardiac valve surgery under extracorporeal circulation admitted to the intensive care unit of Zhongshan Hospital Affiliated with Fudan University (Xiamen) from January 2020 to October 2023. The patients were divided into an early extubation group according to the postoperative mechanical ventilation time (time: <24 h) and a delayed extubation group (time: ≥24 h). The radiographic assessment of lung edema (RALE) score was performed on the chest X-ray of the patient on the first day after surgery to analyze the correlation between delayed extubation of mechanical ventilation and the chest radiograph RALE score on the first day after surgery and to verify its predictive performance.</p><p><strong>Results: </strong>Significant differences in age, the incidence of hypertension, body mass index (BMI), left ventricular ejection fraction (LVEF), pump time, RALE score, ventilation time, oxygenation index, P_aCO₂, and brain natriuretic peptide (BNP) levels after the first 24 h were seen between patients who were extubated before and 24 h post operation (<i>p</i> = 0.013, 0.001, 0.034, <0.001, <0.001, <0.001, <0.001, <0.001, 0.014, and <0.001, respectively). No significant differences were observed in the proportion of males and the lactate level after the first 24 h between the two groups (<i>p</i> = 0.792 and 0.191, respectively). The time of mechanical ventilation was positively correlated with the RALE score in all patients, and the correlation coefficient was 0.419; the difference was statistically significant (<i>p</i> < 0.001). Multivariate binary logistic regression analysis with stepwise regression was performed on each research factor, and it was found that RALE score, pump time, oxygenation index, and postoperative BNP were independent risk factors for predicting delayed extubation in patients undergoing cardiac surgery on cardiopulmonary bypass. A 10-fold cross-validation revealed that the mean accuracy, sensitivity, specificity, and area under the curve (AUC) of the regression model were 0.737, 0.749, 0.741, and 0.825, respectively.</p><p><strong>Conclusions: </strong>The RALE score on the chest radiograph on the first day after surgery is an independent risk factor for predicting delayed extubation in patients after cardiac valve surgery on cardiopulmonary bypass and has good predictive value.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11522776/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142558677","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recent Advances in the Wearable Devices for Monitoring and Management of Heart Failure.","authors":"Victor Adeyi Odeh, Yifan Chen, Wenyan Wang, Xiaorong Ding","doi":"10.31083/j.rcm2510386","DOIUrl":"10.31083/j.rcm2510386","url":null,"abstract":"<p><p>Heart failure (HF) is an acute and degenerative condition with high morbidity and mortality rates. Early diagnosis and treatment of HF can significantly enhance patient outcomes through admission and readmission reduction and improve quality of life. Being a progressive condition, the continuous monitoring of vital signs and symptoms of HF patients to identify any deterioration and to customize treatment regimens can be beneficial to the management of this disease. Recent breakthroughs in wearable technology have revolutionized the landscape of HF management. Despite the potential benefits, the integration of wearable devices into HF management requires careful consideration of technical, clinical, and ethical challenges, such as performance, regulatory requirements and data privacy. This review summarizes the current evidence on the role of wearable devices in heart failure monitoring and management, and discusses the challenges and opportunities in the field.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11522764/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142558674","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improvement of the Immunity System Through Sports: Novel Regulatory Mechanisms for Hypertension.","authors":"Jin Yang, Rui Sun, Zuowei Pei","doi":"10.31083/j.rcm2510385","DOIUrl":"10.31083/j.rcm2510385","url":null,"abstract":"<p><p>Hypertension and its resulting target organ damage is a complex process associated with a range of physiological and molecular factors, including immune regulation. The profound effects of exercise on normal immune system function and the development and progression of hypertension are well known. This review aims to create new avenues for preventing and treating hypertension and its associated target organ damage. This narrative review emphasizes the role of exercise training in the prevention/treatment of hypertension development through immune response modulation and presents current perspectives on the available scientific evidence. Several studies have shown that exercise regulates hypertension by altering immune cells, which is partly attributable to the anti-inflammatory effects of exercise training. Regular exercise modifies immune modulation and could represent a new mechanism for regulating hypertension. Although the utilization of exercise training and the immune system in conjunction for treating and preventing hypertension is still in its early stages, current scientific literature indicates numerous potential physiological links between exercise training, the immune system, and hypertension.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11522756/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142558659","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic Effects of Operation Age for Pediatric Patients with Supravalvar Aortic Stenosis.","authors":"Lizhi Lv, Yuekun Sun, Simeng Zhang, Aihua Zhi, Cheng Wang, Qiang Wang","doi":"10.31083/j.rcm2510384","DOIUrl":"10.31083/j.rcm2510384","url":null,"abstract":"<p><strong>Background: </strong>The appropriate age for surgical repair of asymptomatic congenital supravalvular aortic stenosis (SVAS) is still unknown. The purpose of this research was to assess the safety and effectiveness of various operation ages when managing SVAS.</p><p><strong>Methods: </strong>Consecutive asymptomatic SVAS pediatric patients in the Beijing Fuwai and Yunnan Fuwai hospitals over a period of 18 years were retrospectively analyzed. Patients were classified as follows: age <2.0 years (y) (n = 84), 2.0-5.0 y (n = 72), and >5.0 y (n = 92). The primary safety endpoint was in-hospital death or extracorporeal membrane oxygenation (ECMO) needed. The primary effectiveness outcome was re-operation or restenosis during follow-up. To calculate the hazard ratios (HR), Cox regression with inverse probability of treatment weighted was utilized.</p><p><strong>Results: </strong>At the time of surgery, the median age of the 248 patients that were included was 4 y (interquartile range (IQR): 1.8-6.5). For the primary safety outcome, 7 (8.3%) patients in the age <2.0 y group had in-hospital death or ECMO needed, while no patients in the age 2.0-5.0 y and age>5.0 y groups (<i>p</i> = 0.001). The median follow-up was 25.5 months (IQR: 7.0-59.0). Compared with the age 2.0-5.0 y group, the age <2.0 y group and age >5.0 y group had a higher risk of re-operation or restenosis (age <2.0 y, HR = 3.27, 95% CI 1.25-8.60; age >5.0 y, HR = 2.87, 95% CI 1.19-6.91).</p><p><strong>Conclusions: </strong>Asymptomatic children with SVAS without other cardiovascular abnormalities should be considered for delayed surgical intervention until 2 years of age, and then surgery should be conducted as soon as possible. Children with severe symptoms should undergo surgery immediately, regardless of age.</p><p><strong>Clinical trial registration: </strong>ChiCTR2300067851, https://www.chictr.org.cn/showproj.html?proj=177491.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11522753/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142558663","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between Systemic Immune-Inflammation Index (SII) and New-Onset In-Hospital Heart Failure in Patients with STEMI after Primary PCI.","authors":"Huibo Wang, Ying Yang, Ping Zeng, Rihong Huang, Xinyong Cai, Liang Shao, Fuyuan Liu, Yuhua Lei, Dongsheng Li, Zhixing Fan, Jun Yang, Jing Zhang, Jian Yang","doi":"10.31083/j.rcm2510382","DOIUrl":"10.31083/j.rcm2510382","url":null,"abstract":"<p><strong>Background: </strong>The systemic immune-inflammation index (SII) is a proven, reliable inflammatory marker of the atherosclerotic process. Additionally, inflammation is one of the most important mechanisms of heart failure (HF) after myocardial infarction (MI). However, it is not clear whether SII is related to the risk of in-hospital HF in patients with MI. Thus, we aimed to explore the relationship between SII and the risk of new-onset in-hospital HF in ST-segment elevation myocardial infarction (STEMI) patients treated with primary percutaneous coronary intervention (pPCI).</p><p><strong>Methods: </strong>A total of 5586 patients with STEMI underwent pPCI at seven clinical sites in China from January 2015 to August 2021. The patients were divided into two groups based on the SII values. The association between SII and new-onset in-hospital HF in STEMI patients was assessed using logistic regression analysis.</p><p><strong>Results: </strong>Ultimately, 3808 STEMI patients with Killip class I who were treated with pPCI were included. All included patients were divided into two groups based on the calculated SII (Q1 SII: <1707.31 (×10⁹/L), Q2 SII: ≥1707.31 (×10⁹/L)). After unadjusted and multivariate adjustment for age, gender, vital signs, smoking, hypertension, diabetes mellitus, <i>etc</i>., the odds ratio (OR) of the in-hospital HF risk in Q2 was 1.378-1.427 times the Q1 in the calibration Models 1 to 5. Subgroup analysis showed that the OR of Q2 was 1.505-fold higher of Q1 in males and 1.525-fold in older people (≥60 years). Sensitivity analysis showed that after excluding patients who had previously experienced HF, MI, or underwent PCI, elevated SII was still associated with a significant increase in the risk of in-hospital HF.</p><p><strong>Conclusions: </strong>Elevated SII is associated with an increased risk of in-hospital HF in STEMI patients treated with pPCI, particularly in male and older patients.</p><p><strong>Clinical trial registration: </strong>The Chinese STEMI pPCI Registry was registered with ClinicalTrials.gov (NCT04996901, https://www.clinicaltrials.gov/study/NCT04996901?cond=NCT04996901&rank=1).</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11522793/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142558624","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and Safety of Chlortalidone and Hydrochlorothiazide in Prevention of Cardiovascular Diseases.","authors":"Xiang-Ning Song, Liang Wang, Zhu-Jun Shen","doi":"10.31083/j.rcm2510380","DOIUrl":"10.31083/j.rcm2510380","url":null,"abstract":"<p><strong>Background: </strong>The variance between guideline recommendations and real-world usage might stem from the perception that chlorthalidone poses a higher risk of adverse effects, although there is no clear evidence of disparities in cardiovascular outcomes. It is crucial to assess both the clinical cardiovascular effects and adverse reactions of both drugs for clinical guidance. In this study, we present a comprehensive and updated analysis comparing the efficacy and safety of chlorthalidone (CHLOR) versus hydrochlorothiazide (HCTZ) for the prevention of cardiovascular diseases through lower the blood pressure.</p><p><strong>Methods: </strong>We conducted a systematic literature search using reputable databases including PubMed, Embase, Cochrane, and Web of Science up to April 2023, to identify studies that compared the efficacy and safety of CHLOR versus HCTZ for the long term prognosis of cardiovascular disease. This analysis represents the most up-to-date and systematic evidence on the comparative efficacy and safety of CHLOR and HCTZ for cardiovascular diseases.</p><p><strong>Results: </strong>Our review included a total of 6 eligible articles with a cohort of 368,066 patients, of which 36,999 were treated with CHLOR and 331,067 were treated with HCTZ. The primary diagnosis studied in six articles was hypertension. Initial features between the two different groups were comparable across every possible outcome. These papers followed patients using the two drugs over a long period of time to compare the differences in the occurrence of cardiovascular disease, and the results were as follows, the confidence interval is described in square brackets, followed by the <i>p</i>-value: We measured the outcomes of myocardial infarction with an odds ratio (OR) of 0.80 [0.56, 1.14], <i>p</i> = 0.41, heart failure with an OR of 0.86 [0.64, 1.14], <i>p</i> = 0.05, cardiovascular events with an OR of 1.85 [0.53, 6.44], <i>p</i> = 0.34, non-cancer-related death with an OR of 1.02 [0.56, 1.85], <i>p</i> = 0.45, death from any cause with an OR of 1.95 [0.52, 7.28], <i>p</i> = 0.32, complication rate, stroke with an OR of 0.94 [0.80, 1.10], <i>p</i> = 0.45, hospitalization for acute kidney injury with an OR of 1.38 [0.40, 4.78], <i>p</i> = 0.61 and hypokalemia with an OR of 2.10 [1.15, 3.84], <i>p</i> = 0.01. Pooled analyses of the data revealed that CHLOR was associated with a higher incidence of hypokalemia compared to HCTZ and the results were statistically significant.</p><p><strong>Conclusions: </strong>CHLOR and HCTZ are comparable in efficacy for prevention cardiovascular diseases, with the only difference being a higher incidence of hypokalemia in patients using CHLOR compared to those using HCTZ. Considering the potential heterogeneity and bias in the analytical studies, these results should be interpreted with caution.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11522762/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142558642","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating the Impact and Financial Implications of Immediate versus Delayed Stenting Strategies in High Thrombus Burden Acute Myocardial Infarction: A Propensity Score-Matched Analysis.","authors":"Bin Xie, Jilin Li, Weiwen Li, Ying Lin, Huaiwen Wang","doi":"10.31083/j.rcm2510381","DOIUrl":"10.31083/j.rcm2510381","url":null,"abstract":"<p><strong>Background: </strong>The efficacy of delayed stenting strategies in the management of high thrombus burden acute myocardial infarction remains uncertain. We aimed to compare the therapeutic effects and financial implications of immediate and delayed stenting strategies in patients with acute myocardial infarction and high thrombus burden treated at our institution.</p><p><strong>Methods: </strong>This was a retrospective analysis of 158 patients who underwent intracoronary thrombus aspiration for acute ST-elevation myocardial infarction (STEMI) at the Second Affiliated Hospital of Shantou University Medical College between 2013 and 2023. Patients were divided into two groups: immediate stenting (immediate group; n = 101) and delayed stenting (delayed group; n = 57), based on the timing of the stenting procedure. Propensity score matching was performed to minimize confounding bias. Therapeutic effects and cost of treatment were compared between the two groups.</p><p><strong>Results: </strong>After propensity score matching (n = 52 for each group), there were no significant differences in terms of baseline clinical characteristics, characteristics of vascular lesions (number of diseased vessels, culprit vessels, thrombolysis in myocardial infarction (TIMI) thrombus grade, proximal coronary artery lesion), the incidence of no-reflow/slow flow during the first surgery, or the use of antiplatelet drugs, intraprocedural anticoagulants, intracoronary drugs, and tirofiban. There were no significant between-group differences in terms of in-hospital all-cause mortality, in-hospital major adverse cardiovascular events, or hospitalization costs. However, peak creatine kinase-myocardial band (CK-MB) levels were significantly lower in the delayed group.</p><p><strong>Conclusions: </strong>For patients with STEMI undergoing emergency thrombus aspiration, a delayed stenting strategy appears to be non-inferior to immediate stenting strategy in terms of clinical efficacy and hospitalization costs, and may reduce the extent of myocardial injury. Delayed stenting strategy may allow for a more individualized surgical approach based on assessment of thrombus burden and lesion complexity.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11522752/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142558654","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Erratum: Leiter <i>et al</i>. Review of Evolocumab for the Reduction of LDL Cholesterol and Secondary Prevention of Atherosclerotic Cardiovascular Disease. Reviews in Cardiovascular Medicine. 2024; 25: 190.","authors":"Lawrence A Leiter, Robert A Hegele, Vivien Brown, Jean Bergeron, Erin S Mackinnon, G B John Mancini","doi":"10.31083/j.rcm2510383","DOIUrl":"10.31083/j.rcm2510383","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.31083/j.rcm2505190.].</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11522857/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142560334","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic Value of Magnetocardiography to Detect Abnormal Myocardial Perfusion: A Pilot Study.","authors":"Huan Zhang, Zhao Ma, Hongzhi Mi, Jian Jiao, Wei Dong, Shuwen Yang, Linqi Liu, Shu Zhou, Lanxin Feng, Xin Zhao, Xueyao Yang, Chenchen Tu, Xiantao Song, Hongjia Zhang","doi":"10.31083/j.rcm2510379","DOIUrl":"10.31083/j.rcm2510379","url":null,"abstract":"<p><strong>Background: </strong>Magnetocardiography (MCG) is a novel non-invasive technique that detects subtle magnetic fields generated by cardiomyocyte electrical activity, offering sensitive detection of myocardial ischemia. This study aimed to assess the ability of MCG to predict impaired myocardial perfusion using single-photon emission computed tomography (SPECT).</p><p><strong>Methods: </strong>A total of 112 patients with chest pain underwent SPECT and MCG scans, from which 65 MCG output parameters were analyzed. Using least absolute shrinkage and selection operator (LASSO) regression to screen for significant MCG variables, three machine learning models were established to detect impaired myocardial perfusion: random forest (RF), decision tree (DT), and support vector machine (SVM). The diagnostic performance was evaluated based on the sensitivity, specificity, accuracy, positive predictive value (PPV), negative predictive value (NPV), and area under the receiver operating characteristic curve (AUC).</p><p><strong>Results: </strong>Five variables, the ratio of magnetic field amplitude at R-peak and positive T-peak (RoART+), R and T-peak magnetic field angle (RTA), maximum magnetic field angle (MAmax), maximum change in current angle (CCAmax), and change positive pole point area between the T-wave beginning and peak (CPPPATbp), were selected from 65 automatic output parameters. RTA emerged as the most critical variable in the RF, DT, and SVM models. All three models exhibited excellent diagnostic performance, with AUCs of 0.796, 0.780, and 0.804, respectively. While all models showed high sensitivity (RF = 0.870, DT = 0.826, SVM = 0.913), their specificity was comparatively lower (RF = 0.500, DT = 0.300, SVM = 0.100).</p><p><strong>Conclusions: </strong>Machine learning models utilizing five key MCG variables successfully predicted impaired myocardial perfusion, as confirmed by SPECT. These findings underscore the potential of MCG as a promising future screening tool for detecting impaired myocardial perfusion.</p><p><strong>Clinical trial registration: </strong>ChiCTR2200066942, https://www.chictr.org.cn/showproj.html?proj=187904.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11522775/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142558641","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Systematic Review and Meta-analysis of Efficacy and Safety of Mavacamten for the Treatment of Hypertrophic Cardiomyopathy.","authors":"Li Zheng, Xiaotong Gu, Yumiao Chen, Deping Liu","doi":"10.31083/j.rcm2510375","DOIUrl":"10.31083/j.rcm2510375","url":null,"abstract":"<p><strong>Background: </strong>Hypertrophic cardiomyopathy (HCM) is a common hereditary cardiomyopathy. Mavacamten, a first-in-class cardiac myosin inhibitor, is considered to be a specific drug for the treatment of HCM. This meta-analysis aimed to assess the efficacy and safety of mavacamten in patients with HCM.</p><p><strong>Methods: </strong>PubMed, Cochrane Library, Embase and Clinical Trials.gov databases were searched from inception to February 6, 2024 for randomized controlled trials (RCTs) which compared the efficacy and safety between mavacamten and placebo in treating HCM.</p><p><strong>Results: </strong>Six RCTs involving 732 patients were included in this meta-analysis. This meta-analysis showed that mavacamten improved the New York Heart Association (NYHA) function class [risk ratios (RR): 2.21, 95% confidence interval (CI): 1.48 to 3.30, <i>p</i> = 0.00001], Clinical Summary Score of the Kansas City Cardiomyopathy Questionnaire (KCCQ-CSS) scores [mean difference (MD): 9.33, 95% CI: 7.09 to 11.57, <i>p</i> < 0.00001] and composite functional end point (RR: 1.86, 95% CI: 1.25 to 2.78, <i>p</i> = 0.002). Meanwhile, mavacamten decreased N-terminal pro-B-type natriuretic peptide (NT-proBNP) (MD: -492.28, 95% CI: -611.55 to -373.02, <i>p</i> < 0.00001), cardiac troponin I (cTnI) (MD: -14.58, 95% CI: -26.98 to -2.17, <i>p</i> = 0.02) and Valsalva left ventricular outflow tract (LVOT) gradient (MD: -57.96, 95% CI: -82.15 to -33.78, <i>p</i> < 0.00001). The results for the incidence of ≥1 total emergent adverse event (TEAE) and ≥1 serious adverse event (SAE) showed that there was no significant difference between both groups (RR: 1.9, 95% CI: 0.97 to 1.24, <i>p</i> = 0.16) (RR: 1.06, 95% CI: 0.46 to 2.44, <i>p</i> = 0.90).</p><p><strong>Conclusions: </strong>Mavacamten has great efficacy for the treatment of HCM. Meanwhile, mavacamten did not increase the incidence of adverse events or serious adverse events.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11522755/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142558622","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}