Therapeutic Advances in Cardiovascular Disease最新文献

{"title":"Empagliflozin and other SGLT2 inhibitors in patients with heart failure and preserved ejection fraction: a systematic review and meta-analysis.","authors":"Abdulrahman Khaldoon Hamid, AbdulJaber A'Ed Tayem, Sandra Thair Al-Aish, Ahmed Sermed Al Sakini, Dalia Dhia Hadi, Rami Thair Al-Aish","doi":"10.1177/17539447241289067","DOIUrl":"10.1177/17539447241289067","url":null,"abstract":"<p><strong>Background: </strong>Heart failure (HF) is a highly prevalent disease, among the primary factors contributing to morbidity and death. One of its types is heart failure with preserved ejection fraction (HFpEF) comprising 40%-50% of newly diagnosed HF cases. Despite the high prevalence of HFpEF, there is still a lack of knowledge regarding the best drugs and treatment approaches to be used. However, the sodium-glucose co-transporter 2 (SGLT2) inhibitors could be a promising treatment.</p><p><strong>Objectives: </strong>To examine SGLT2 inhibitors' effect on hospitalization, cardiovascular death, and estimated glomerular filtration rate (eGFR) in HFpEF patients.</p><p><strong>Search methods: </strong>We conducted searches for randomized controlled trials (RCTs) in PubMed, Embase, Scopus, and Web of Science up to July 2024.</p><p><strong>Selection criteria: </strong>We chose RCTs that examined the effects of SGLT2 inhibitors and placebo in individuals with higher than 40% ejection fraction (HFpEF).</p><p><strong>Data collection and analysis: </strong>The methodology for the systematic review and meta-analysis was in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis.</p><p><strong>Main results: </strong>We included 8 studies with 16,509 participants. Drugs examined in our paper included empagliflozin, dapagliflozin, sotogliflozin, and ertugliflozin. Various outcomes were analyzed in different papers. However, different SGLT2 inhibitors lead to a decreased risk of cardiovascular hospitalization and kidney injury. Our meta-analysis showed a decreased risk of cardiovascular hospitalization but not death due to cardiovascular causes or other causes. These results were regardless of baseline status of eGFR, systolic blood pressure, atrial fibrillation or flutter, diabetes mellitus, sex, body mass index, and nt-proBNP. The included studies were of moderate to high quality.</p><p><strong>Conclusion: </strong>For individuals with HFpEF, SGLT2 inhibitors have been proven to be a safe and effective medication. However, more studies are needed for longer durations, reporting adverse events, effects on exercise tolerance, and other secondary outcomes.</p>","PeriodicalId":23035,"journal":{"name":"Therapeutic Advances in Cardiovascular Disease","volume":"18 ","pages":"17539447241289067"},"PeriodicalIF":2.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11483696/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142475427","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}

{"title":"Gene polymorphism as a cause of hemorrhagic complications in patients with non-valvular atrial fibrillation treated with oral vitamin K-independent anticoagulants.","authors":"Ayan Abdrakhmanov, Aizhana Shaimerdinova, Zhanasyl Suleimen, Svetlana Abildinova, Rustam Albayev, Gulnar Tuyakova, Elena Rib, Akmaral Beysenbayeva, Gulden Kabduyeva, Makhabbat Bekbossynova","doi":"10.1177/17539447241249886","DOIUrl":"10.1177/17539447241249886","url":null,"abstract":"<p><p>Atrial fibrillation (AF) accounts for 40% of all cardiac arrhythmias and is associated with a high risk of stroke and systemic thromboembolic complications. Dabigatran, rivaroxaban, apixaban, and edoxaban are direct oral anticoagulants (DOACs) that have been proven to prevent stroke in patients with non-valvular AF. This review summarizes the pharmacokinetics, pharmacodynamics, and drug interactions of DOACs, as well as new data from pharmacogenetic studies of these drugs. This review is aimed at analyzing the scientific literature on the gene polymorphisms involved in the metabolism of DOACs. We searched PubMed, Cochrane, Google Scholar, and CyberLeninka (Russian version) databases with keywords: 'dabigatran', 'apixaban', 'rivaroxaban', 'edoxaban', 'gene polymorphism', 'pharmacogenetics', '<i>ABCB1</i>', '<i>CES1</i>', '<i>SULT1A</i>', '<i>ABCG2</i>', and '<i>CYP3A4</i>'. The articles referred for this review include (1) full-text articles; (2) study design with meta-analysis, an observational study in patients taking DOAC; and (3) data on the single-nucleotide polymorphisms and kinetic parameters of DOACs (plasma concentration), or a particular clinical outcome, published in English and Russian languages during the last 10 years. The ages of the patients ranged from 18 to 75 years. Out of 114 reviewed works, 24 were found eligible. As per the available pharmacogenomic data, polymorphisms affecting DOACs are different. This may aid in developing individual approaches to optimize DOAC pharmacotherapy to reduce the risk of hemorrhagic complications. However, large-scale population studies are required to determine the dosage of the new oral anticoagulants based on genotyping. Information on the genetic effects is limited owing to the lack of large-scale studies. Uncovering the mechanisms of the genetic basis of sensitivity to DOACs helps in developing personalized therapy based on patient-specific genetic variants and improves the efficacy and safety of DOACs in the general population.</p>","PeriodicalId":23035,"journal":{"name":"Therapeutic Advances in Cardiovascular Disease","volume":"18 ","pages":"17539447241249886"},"PeriodicalIF":2.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11131409/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141155482","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}

{"title":"Inhibitory effect of microRNA-21 on pathways and mechanisms involved in cardiac fibrosis development.","authors":"Amirreza Khalaji, Saba Mehrtabar, Armin Jabraeilipour, Nadia Doustar, Hamed Rahmani Youshanlouei, Amir Tahavvori, Payam Fattahi, Seyed Mohammad Amin Alavi, Seyed Reza Taha, Andarz Fazlollahpour-Naghibi, Mahdieh Shariat Zadeh","doi":"10.1177/17539447241253134","DOIUrl":"10.1177/17539447241253134","url":null,"abstract":"<p><p>Cardiac fibrosis is a pivotal cardiovascular disease (CVD) process and represents a notable health concern worldwide. While the complex mechanisms underlying CVD have been widely investigated, recent research has highlighted microRNA-21's (miR-21) role in cardiac fibrosis pathogenesis. In this narrative review, we explore the molecular interactions, focusing on the role of miR-21 in contributing to cardiac fibrosis. Various signaling pathways, such as the RAAS, TGF-β, IL-6, IL-1, ERK, PI3K-Akt, and PTEN pathways, besides dysregulation in fibroblast activity, matrix metalloproteinases (MMPs), and tissue inhibitors of MMPs cause cardiac fibrosis. Besides, miR-21 in growth factor secretion, apoptosis, and endothelial-to-mesenchymal transition play crucial roles. miR-21 capacity regulatory function presents promising insights for cardiac fibrosis. Moreover, this review discusses numerous approaches to control miR-21 expression, including antisense oligonucleotides, anti-miR-21 compounds, and Notch signaling modulation, all novel methods of cardiac fibrosis inhibition. In summary, this narrative review aims to assess the molecular mechanisms of cardiac fibrosis and its essential miR-21 function.</p>","PeriodicalId":23035,"journal":{"name":"Therapeutic Advances in Cardiovascular Disease","volume":"18 ","pages":"17539447241253134"},"PeriodicalIF":2.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11143841/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141180745","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}

{"title":"The impact of health maintenance organizations on improving cardiac surgery outcomes.","authors":"Kimberly L Skidmore, Farrah E Flattmann, Hayden Cagle, Sahar Shekoohi, Alan D Kaye","doi":"10.1177/17539447241299193","DOIUrl":"10.1177/17539447241299193","url":null,"abstract":"<p><strong>Background and objectives: </strong>California is one of a few states with mandatory reporting of mortality after coronary artery bypass graft (CABG) surgery. The Affordable Care Act restructured Medicaid, preferentially penalizing patients experiencing poverty because payments to hospitals for isolated surgical events overshadow payments to primary care clinicians. We propose outcomes are superior when hospital networks organize surgical episodes within the context of primary care inside that same network.</p><p><strong>Design and methods: </strong>We listed factors impacting outcomes after CABG. CABG surgery outcome depends upon the integration of issues beginning years preoperatively and extending for decades. Therefore, we studied one health maintenance organization (HMO) from 2009 to 2020 compared to surrounding individual hospitals. We divided 58 hospitals in Northern California in 2009 according to income and population. To focus on changes introduced because of COVID-19, we compared a public database for the subset in 2009 for any relationship between poverty in a zip code and low volumes of CABG in that area to overall mortality in 2020. First, we defined low-income zip codes as those with a higher rate of poverty than the state average or with a lower per capita average income, per Census Bureau. Second, low volume was defined as a population under 165,000 because a hospital adjacent to a larger community can easily transfer care, sharing surgeons and processes. Third, we defined low volume as fewer than 180 CABG per year.</p><p><strong>Results: </strong>Our qualitative evidence synthesis reveals that informal communication and hospital HMO policies improve CABG outcomes. In our small pilot data, Chi-square analysis showed higher crude mortality rates in 1507 CABG in 17 low-income low-volume hospitals versus 8163 CABG in the other 41 Northern California hospitals (2.72% vs 1.69%, <i>p</i> = 0.0064). Low-income low-volume hospitals had a relative mortality risk of 1.61 (95% CI: 1.14-2.27). These hospitals had a mean mortality rate of 3.79%, readmission 11.12%, and stroke 1.84%. A patient undergoing CABG in a low-income low-volume hospital has a 61% higher chance of dying. The number needed to treat analysis shows that one life can potentially be saved for every 97 patients referred to another institution.</p><p><strong>Conclusion: </strong>We describe features of an HMO that contribute to up to fourfold lower mortality rates.</p>","PeriodicalId":23035,"journal":{"name":"Therapeutic Advances in Cardiovascular Disease","volume":"18 ","pages":"17539447241299193"},"PeriodicalIF":2.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11558733/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142626976","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}

{"title":"Assessing the completeness of patient-reported outcomes reporting in congestive heart failure clinical trials.","authors":"Drayton Rorah, Jonathan Pollard, Corbin Walters, Will Roberts, Micah Hartwell, Christian Hemmerich, Matt Vassar","doi":"10.1177/17539447241303724","DOIUrl":"10.1177/17539447241303724","url":null,"abstract":"<p><strong>Objective: </strong>We aim to evaluate the quality of patient-reported outcomes included in randomized control trials for the treatment of congestive heart failure using the International Society for Quality of Life Research (ISOQOL) checklist, a validated tool for critically appraising the quality of patient-reported outcomes.</p><p><strong>Design: </strong>We performed a cross-sectional analysis of 65 randomized control trials with patient-reported outcomes for drug intervention trials for treating congestive heart failure.</p><p><strong>Setting: </strong>N/A.</p><p><strong>Participants: </strong>N/A.</p><p><strong>Main outcome measures: </strong>The primary outcome of this study was to evaluate the reporting completeness of patient-reported outcomes in congestive heart failure clinical trials with drug interventions according to the ISOQOL checklist.</p><p><strong>Results: </strong>Our search returned 1114 studies, of which, 65 are included in the analysis. The average completion of the ISOQOL reporting standards was 44.51%. Higher completion of the ISOQOL patient-reported outcome standards was observed in the clinical trials with patient-reported outcomes as primary endpoints compared to the clinical trials with patient-reported outcomes as a secondary endpoint. The multivariable regression model showed that clinical trials with patient-reported outcomes as a primary endpoint had a 21.46% better completion percentage (<i>t</i> = 4.45, <i>p</i> ⩽ 0.001) when controlling for PRO recording duration and trial registration. Eight (8/65, 12.31%) of the clinical trials met the satisfaction criteria of completing two-thirds of the ISOQOL patient-reported outcomes reporting standards. All of these RCTs had a patient-reported outcome as a primary endpoint.</p><p><strong>Conclusion: </strong>Our analysis of the reporting of patient-reported outcomes in congestive heart failure clinical trials with drug interventions suggests that the quality of reporting is suboptimal. This evidence of substandard reporting of patient-reported outcomes is disconcerting as it reduces the transparency of randomized control trials, which are considered the foundation of evidenced-based medicine. Inadequate reporting may result in clinicians implementing misrepresented or incomplete evidence into clinical practice. Validated reporting tools, such as the ISOQOL, can be used by trialists and clinicians alike to improve and critically appraise the reporting of patient-reported outcomes in randomized control trials.</p><p><strong>Trial registration: </strong>N/A.</p>","PeriodicalId":23035,"journal":{"name":"Therapeutic Advances in Cardiovascular Disease","volume":"18 ","pages":"17539447241303724"},"PeriodicalIF":2.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11622310/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142787196","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}

{"title":"Effects of sacubitril/valsartan on renal function and outcome in patients with heart failure and reduced ejection fraction: an Italian cohort study.","authors":"Alberto Palazzuoli, Filippo Pirrotta, Alessandra Cartocci, Elvira Delcuratolo, Frank Loyd Dini, Michele Correale, Giuseppe Dattilo, Daniele Masarone, Laura Scelsi, Stefano Ghio, Carlo Gabriele Tocchetti, Valentina Mercurio, Natale Daniele Brunetti, Savina Nodari, Francesco Barillà, Giuseppe Ambrosio, Erberto Carluccio","doi":"10.1177/17539447241285136","DOIUrl":"10.1177/17539447241285136","url":null,"abstract":"<p><strong>Background: </strong>Sacubitril/valsartan (S/V) is a cornerstone treatment for heart failure (HF). Beneficial effects on hospitalization rates, mortality, and left ventricular remodeling have been observed in patients with heart failure and reduced ejection fraction (HFrEF). Despite the positive results, the influence of S/V on renal function during long-term follow-up has received little attention.</p><p><strong>Aims: </strong>We investigated the long-term effects of S/V therapy on renal function in a large cohort of patients with HFrEF. Additionally, we examined the effects of the drug in patients with chronic kidney disease (CKD) compared to those with preserved renal function and identified primary risk characteristics.</p><p><strong>Methods: </strong>We studied 776 outpatients with HFrEF and left ventricular ejection fraction (LVEF) <40% from an observational registry of the Italian Society of Cardiology, all receiving optimized standard-of-care therapy with S/V. The patients were included in a multicentric open-label registry from 11 Italian academic hospitals. Kidney function was evaluated at baseline, after 6 months of S/V, and at 4 years. Patients were followed-up through periodic clinical visits.</p><p><strong>Results: </strong>During a 48-month follow-up period, 591 patients remained stable and 185 patients (24%) experienced adverse events (85 deaths and 126 hospitalizations). S/V therapy marginally affects renal function during the follow-up period (estimated glomerular filtration rate (eGFR) at baseline 72.01 vs eGFR at follow-up 70.38 ml/min/m², <i>p</i> = 0.01; and creatinine was 1.06 at baseline vs 1.10 at follow-up, <i>p</i> < 0.04). Among patients who maintained preserved renal function, 35% were in Dose 3 and 10% dropped out of S/V therapy (<i>p</i> < 0.006). Univariate analysis showed that Drop-out of S/V (HR 2.73 [2.01, 3.71], <i>p</i> < 0.001), history of previous HF hospitalization (HR 1.75 [1.30, 2.36], <i>p</i> < 0.001), advanced NYHA class (HR 2.14 [1.60, 2.86], <i>p</i> < 0.001), NT-proBNP values >1000 pg/ml (HR 1.95[1.38, 2.77], <i>p</i> < 0.001), furosemide dose >50 mg (HR 2.04 [1.48, 2.82], <i>p</i> < 0.001), and creatinine values >1.5 mg/dl occurred during follow-up (HR 1.74 [1.24, 2.43], <i>p</i> < 0.001) were linked to increased risk. At multivariable analysis, increased doses of loop diuretics, advanced NYHA class, creatinine >1.5 mg/dl, and atrial fibrillation were independent predictors of adverse events.</p><p><strong>Conclusion: </strong>Long-term S/V therapy is associated with improved outcomes and renal protection in patients with HFrEF. This effect is more pronounced in patients who tolerate escalating doses. The positive effects of the drug are maintained in both CKD and preserved renal function. Future research may study the safety and underlying causes of current protection.</p>","PeriodicalId":23035,"journal":{"name":"Therapeutic Advances in Cardiovascular Disease","volume":"18 ","pages":"17539447241285136"},"PeriodicalIF":2.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11607766/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142751656","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}

{"title":"Relevance of cardiac imaging in the evolving landscape of infective endocarditis management.","authors":"Alice Haouzi, Mohamed Khayata, Bo Xu","doi":"10.1177/17539447241305587","DOIUrl":"10.1177/17539447241305587","url":null,"abstract":"<p><p>Infective endocarditis (IE) is an increasingly recognized condition with high morbidity. Patients with atypical symptoms, culture-negative infections, and prosthetic cardiac devices and implants represent challenging populations to evaluate and manage. Recent major society guidelines have recommended the appropriate incorporation of multimodality imaging in the evaluation of these more complex IE cases. This article draws on the available literature regarding the different cardiac imaging modalities and discusses the role of multimodality imaging in IE.</p>","PeriodicalId":23035,"journal":{"name":"Therapeutic Advances in Cardiovascular Disease","volume":"18 ","pages":"17539447241305587"},"PeriodicalIF":2.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11632876/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142802227","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}

{"title":"Safety and potential usefulness of sequential intracoronary acetylcholine and ergonovine administration for spasm provocation testing.","authors":"Yasusuke Kinoshita, Yuichi Saito, Yuetsu Kikuta, Katsumasa Sato, Masahito Taniguchi, Kenji Goto, Hideo Takebayashi, Seiichi Haruta, Yoshio Kobayashi","doi":"10.1177/17539447241233168","DOIUrl":"10.1177/17539447241233168","url":null,"abstract":"<p><strong>Background: </strong>Although guidelines recommend intracoronary acetylcholine (ACh) and ergonovine (ER) provocation testing for diagnosis of vasospastic angina, the feasibility and safety of sequential (combined) use of both pharmacological agents during the same catheterization session remain unclear.</p><p><strong>Objectives: </strong>In this study, we investigated the feasibility and safety of sequential intracoronary ACh and ER administration for coronary spasm provocation testing.</p><p><strong>Methods: </strong>The study included 235 patients who showed positive results on ACh and ER provocation testing. Initial intracoronary ACh administration was followed by ER administration for left coronary artery (LCA) spasm provocation testing. Subsequently, the right coronary artery (RCA) was subjected to sequential ACh and ER administration for provocation testing. The primary outcome of the study was the safety of sequential intracoronary ACh and ER provocation testing, which was assessed based on a composite of all-cause death, sustained ventricular tachycardia and fibrillation, and cardiogenic shock.</p><p><strong>Results: </strong>Even in patients with negative results on sequential intracoronary ACh and ER provocation testing in the LCA and only ACh administration into the RCA, additional administration of ER into the RCA showed a positive provocation test result in 33 of 235 (14.0%) patients; three (1.3%) patients developed adverse effects (cardiogenic shock occurred in all cases) during LCA provocation testing. We observed no deaths attributable to spasm provocation testing.</p><p><strong>Conclusion: </strong>Sequential administration of intracoronary ACh and ER was associated with a relatively low major complication rate and may be safe and potentially useful for diagnosis of vasospastic angina.</p>","PeriodicalId":23035,"journal":{"name":"Therapeutic Advances in Cardiovascular Disease","volume":"18 ","pages":"17539447241233168"},"PeriodicalIF":2.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10894506/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139940847","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}

{"title":"The impact of platelet-to-lymphocyte ratio on clinical outcomes in heart failure: a systematic review and meta-analysis.","authors":"Mehrbod Vakhshoori, Niloofar Bondariyan, Sadeq Sabouhi, Keivan Kiani, Nazanin Alaei Faradonbeh, Sayed Ali Emami, Mehrnaz Shakarami, Farbod Khanizadeh, Shahin Sanaei, Niloofaralsadat Motamedi, Davood Shafie","doi":"10.1177/17539447241227287","DOIUrl":"10.1177/17539447241227287","url":null,"abstract":"<p><strong>Background: </strong>Inflammation has been suggested to play a role in heart failure (HF) pathogenesis. However, the role of platelet-to-lymphocyte ratio (PLR), as a novel biomarker, to assess HF prognosis needs to be investigated. We sought to evaluate the impact of PLR on HF clinical outcomes.</p><p><strong>Methods: </strong>English-published records in PubMed/Medline, Scopus, and Web-of-science databases were screened until December 2023. Relevant articles evaluated PLR with clinical outcomes (including mortality, rehospitalization, HF worsening, and HF detection) were recruited, with PLR difference analysis based on death/survival status in total and HF with reduced ejection fraction (HFrEF) patients.</p><p><strong>Results: </strong>In total, 21 articles (<i>n</i> = 13,924) were selected. The total mean age was 70.36 ± 12.88 years (males: 61.72%). Mean PLR was 165.54 [95% confidence interval (CI): 154.69-176.38]. In total, 18 articles (<i>n</i> = 10,084) reported mortality [either follow-up (PLR: 162.55, 95% CI: 149.35-175.75) or in-hospital (PLR: 192.83, 95% CI: 150.06-235.61) death rate] and the mean PLR was 166.68 (95% CI: 154.87-178.50). Further analysis revealed PLR was significantly lower in survived HF patients rather than deceased group (152.34, 95% CI: 134.01-170.68 <i>versus</i> 194.73, 95% CI: 175.60-213.85, standard mean difference: -0.592, 95% CI: -0.857 to -0.326, <i>p</i> < 0.001). A similar trend was observed for HFrEF patients. PLR failed to show any association with mortality risk (hazard ratio: 1.02, 95% CI: 0.99-1.05, <i>p</i> = 0.289). Analysis of other aforementioned outcomes was not possible due to the presence of few studies of interest.</p><p><strong>Conclusion: </strong>PLR should be used with caution for prognosis assessment in HF sufferers and other studies are necessary to explore the exact association.</p>","PeriodicalId":23035,"journal":{"name":"Therapeutic Advances in Cardiovascular Disease","volume":"18 ","pages":"17539447241227287"},"PeriodicalIF":2.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10838041/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139672754","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}

{"title":"Vascular-endothelial adaptations following low and high volumes of high-intensity interval training in patients after myocardial infarction.","authors":"Rodrigo Aispuru-Lanche, Jon Ander Jayo-Montoya, Sara Maldonado-Martín","doi":"10.1177/17539447241286036","DOIUrl":"10.1177/17539447241286036","url":null,"abstract":"<p><strong>Background: </strong>Determinants of coronary artery disease, such as endothelial dysfunction and oxidative stress, could be attenuated by high-intensity aerobic interval exercise training (HIIT). However, the volume of this type of training is not well established.</p><p><strong>Objective: </strong>To assess the impact of two volumes of HIIT, low (LV-HIIT, <10 min at high intensity) and high (HV-HIIT, >10 min at high intensity), on vascular-endothelial function in individuals after an acute myocardial infarction (AMI).</p><p><strong>Materials and methods: </strong>Clinical trial in 80 AMI patients (58.4 ± 8.3 years, 82.5% men) with three study groups: LV-HIIT (<i>n</i> = 28) and HV-HIIT (<i>n</i> = 28) with two sessions per week for 16 weeks and control group (CG, <i>n</i> = 24) with unsupervised physical activity recommendations. Endothelial function (brachial flow-mediated dilation, FMD), atherosclerosis (carotid intima-media thickness ultrasound, cIMT), and levels of oxidized low-density lipoprotein (ox-LDL) as a marker of oxidative stress were determined before and after the intervention period.</p><p><strong>Results: </strong>After the intervention, in the exercise groups, there was an increase in FMD (LV-HIIT, ↑58.8%; HV-HIIT, ↑94.1%; <i>p</i> < 0.001) concurrently with a decrease in cIMT (LV-HIIT, ↓3.0%; HV-HIIT, ↓3.2%; <i>p</i> = 0.019) and LDLox (LV-HIIT, ↓5.2%; HV-HIIT, ↓8.9%; <i>p</i> < 0.001), with no significant changes in the CG. Furthermore, a significant inverse correlation was observed between ox-LDL and endothelial function related to the volume of HIIT training performed (LV-HIIT: <i>r</i> = -0.376, <i>p</i> = 0.031; HV-HIIT: <i>r</i> = -0.490, <i>p</i> < 0.004), with no significance in the CG (<i>r</i> = 0.021, <i>p</i> = 0.924).</p><p><strong>Conclusion: </strong>In post-AMI patients, HIIT may lead to a volume-dependent enhancement in endothelial function, attributed to a decrease in oxidative stress, with added beneficial effects in reducing vascular wall thickness. An LV-HIIT program, with less than 10 min at high intensity per session, has proven enough efficiency to initiate favorable vascular-endothelial adaptations, potentially reducing cardiovascular risk among patients with coronary artery disease.</p><p><strong>Trial registration: </strong>INTERFARCT, ClinicalTrials.gov: NCT02876952.</p>","PeriodicalId":23035,"journal":{"name":"Therapeutic Advances in Cardiovascular Disease","volume":"18 ","pages":"17539447241286036"},"PeriodicalIF":2.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11483797/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142393594","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}