Therapeutic Advances in Cardiovascular Disease最新文献

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Use of coronary artery calcium score and coronary CT angiography to guide cardiovascular prevention and treatment. 利用冠状动脉钙化评分和冠状动脉 CT 血管造影术指导心血管疾病的预防和治疗。
IF 2.3
Therapeutic Advances in Cardiovascular Disease Pub Date : 2024-01-01 DOI: 10.1177/17539447241249650
Maria Rita Lima, Pedro M Lopes, António M Ferreira
{"title":"Use of coronary artery calcium score and coronary CT angiography to guide cardiovascular prevention and treatment.","authors":"Maria Rita Lima, Pedro M Lopes, António M Ferreira","doi":"10.1177/17539447241249650","DOIUrl":"10.1177/17539447241249650","url":null,"abstract":"<p><p>Currently, cardiovascular risk stratification to guide preventive therapy relies on clinical scores based on cardiovascular risk factors. However, the discriminative power of these scores is relatively modest. The use of coronary artery calcium score (CACS) and coronary CT angiography (CCTA) has surfaced as methods for enhancing the estimation of risk and potentially providing insights for personalized treatment in individual patients. CACS improves overall cardiovascular risk prediction and may be used to improve the yield of statin therapy in primary prevention, and possibly identify patients with a favorable risk/benefit relationship for antiplatelet therapies. CCTA holds promise to guide anti-atherosclerotic therapies and to monitor individual response to these treatments by assessing individual plaque features, quantifying total plaque volume and composition, and assessing peri-coronary adipose tissue. In this review, we aim to summarize current evidence regarding the use of CACS and CCTA for guiding lipid-lowering and antiplatelet therapy and discuss the possibility of using plaque burden and plaque phenotyping to monitor response to anti-atherosclerotic therapies.</p>","PeriodicalId":23035,"journal":{"name":"Therapeutic Advances in Cardiovascular Disease","volume":"18 ","pages":"17539447241249650"},"PeriodicalIF":2.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11075618/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140865758","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
Quantifying the ‘distance to LDL-C goal’ in patients at very high cardiovascular risk with hyperlipidaemia in Germany: a retrospective claims database analysis. 量化德国心血管风险极高的高脂血症患者 "距离低密度脂蛋白血症目标的距离":一项回顾性索赔数据库分析。
IF 2.6
Therapeutic Advances in Cardiovascular Disease Pub Date : 2024-01-01 DOI: 10.1177/17539447241277402
Ksenija Stach, Hartmut Richter, Uwe Fraass, Alexandra Stein
{"title":"Quantifying the ‘distance to LDL-C goal’ in patients at very high cardiovascular risk with hyperlipidaemia in Germany: a retrospective claims database analysis.","authors":"Ksenija Stach, Hartmut Richter, Uwe Fraass, Alexandra Stein","doi":"10.1177/17539447241277402","DOIUrl":"10.1177/17539447241277402","url":null,"abstract":"<p><strong>Background and objectives: </strong>This study quantified the 'distance to LDL-C goal' in patients at very high cardiovascular risk with uncontrolled hyperlipidaemia. 'Distance to LDL-C goal' was defined as the percentage by which low-density lipoprotein cholesterol (LDL-C) levels needed to be reduced to achieve the LDL-C goals specified in the 2016 or 2019 European Society of Cardiology/European Atherosclerosis Society guidelines.</p><p><strong>Design and methods: </strong>This retrospective analysis using data from the IQVIA Disease Analyzer database included patients who were predominantly treated by a primary care physician, diabetologist or cardiologist between 2014 and 2018, with a diagnosis of hyperlipidaemia and an initial LDL-C measurement (index event) and one or more cardiovascular risk factors. The primary outcome was to assess the proportion of patients with uncontrolled hyperlipidaemia and to classify the 'distance to LDL-C goal' in these patients.</p><p><strong>Results: </strong>Data from 32,963 patients were analysed (<i>n</i> = 27,159, <i>n</i> = 3873 and <i>n</i> = 1931 patients in the primary care physician, diabetology and cardiology cohorts, respectively). Most patients had uncontrolled LDL-C levels (⩾70 mg/dL; ⩾1.8 mmol/L) at index (91.0%, 86.4% and 94.0% of patients in the primary care physician, diabetology and cardiology cohorts, respectively). Analysis of the 'distance to LDL-C goal' indicated that approximately one-third of patients in each cohort required an LDL-C level reduction of up to 50% relative to index to achieve their LDL-C goal (35.8%, 43.7% and 28.4% of patients in the primary care physician, diabetology and cardiology cohorts, respectively). LDL-C control was not achieved at 36 months post-index in most patients with uncontrolled LDL-C levels (86.8%, 81.7% and 90.2% of patients in the primary care physician, diabetology and cardiology cohorts, respectively).</p><p><strong>Conclusion: </strong>LDL-C levels were uncontrolled in most patients with hyperlipidaemia. Analysis of the 'distance to LDL-C goal' showed that most patients required a substantial LDL-C level reduction to achieve their LDL-C goal.</p>","PeriodicalId":23035,"journal":{"name":"Therapeutic Advances in Cardiovascular Disease","volume":"18 ","pages":"17539447241277402"},"PeriodicalIF":2.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11440620/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142354310","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
Empagliflozin and other SGLT2 inhibitors in patients with heart failure and preserved ejection fraction: a systematic review and meta-analysis. Empagliflozin和其他SGLT2抑制剂在射血分数保留的心力衰竭患者中的应用:系统综述和荟萃分析。
IF 2.6
Therapeutic Advances in Cardiovascular Disease Pub Date : 2024-01-01 DOI: 10.1177/17539447241289067
Abdulrahman Khaldoon Hamid, AbdulJaber A'Ed Tayem, Sandra Thair Al-Aish, Ahmed Sermed Al Sakini, Dalia Dhia Hadi, Rami Thair Al-Aish
{"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}
引用次数: 0
Unlocking the potential of deferoxamine: a systematic review on its efficacy and safety in alleviating myocardial ischemia-reperfusion injury in adult patients following cardiopulmonary bypass compared to standard care. 释放去铁胺的潜能:与标准疗法相比,系统回顾去铁胺在减轻心肺搭桥术后成年患者心肌缺血再灌注损伤方面的疗效和安全性。
IF 2.6
Therapeutic Advances in Cardiovascular Disease Pub Date : 2024-01-01 DOI: 10.1177/17539447241277382
Aashish Lamichhane, Sadish Sharma, Bishwas Bastola, Bikesh Chhusyabaga, Nabin Shrestha, Prajwal Poudel
{"title":"Unlocking the potential of deferoxamine: a systematic review on its efficacy and safety in alleviating myocardial ischemia-reperfusion injury in adult patients following cardiopulmonary bypass compared to standard care.","authors":"Aashish Lamichhane, Sadish Sharma, Bishwas Bastola, Bikesh Chhusyabaga, Nabin Shrestha, Prajwal Poudel","doi":"10.1177/17539447241277382","DOIUrl":"10.1177/17539447241277382","url":null,"abstract":"<p><strong>Background: </strong>Reperfusion injury, characterized by oxidative stress and inflammation, poses a significant challenge in cardiac surgery with cardiopulmonary bypass (CPB). Deferoxamine, an iron-chelating compound, has shown promise in mitigating reperfusion injury by inhibiting iron-dependent lipid peroxidation and reactive oxygen species (ROS) production.</p><p><strong>Objectives: </strong>The objective of our study was to analyze and evaluate both the efficacy and safety of a new and promising intervention, that is, deferoxamine for ischemia-reperfusion injury (I/R).</p><p><strong>Design: </strong>Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines are used to perform the study.</p><p><strong>Data sources and methods: </strong>We conducted a systematic review following PRISMA guidelines to assess the efficacy and safety of deferoxamine in reducing I/R injury following CPB. A comprehensive search of electronic databases, namely, PubMed, Scopus, and Embase, yielded relevant studies published until August 18, 2023. Included studies evaluated ROS production, lipid peroxidation, cardiac performance, and morbidity outcomes.</p><p><strong>Results: </strong>(a) <i>ROS production</i>: Multiple studies demonstrated a statistically significant decrease in ROS production in patients treated with deferoxamine, highlighting its potential to reduce oxidative stress. (b) <i>Lipid peroxidation</i>: Deferoxamine was associated with decreased lipid peroxidation levels, indicating its ability to protect cardiac tissue from oxidative damage during CPB. (c) <i>Cardiac performance</i>: Some studies reported improvements in left ventricular ejection fraction and wall motion score index with deferoxamine.</p><p><strong>Conclusion: </strong>Our review shows that deferoxamine is an efficacious and safe drug that can be used to prevent myocardial I/R injury following CPB. It also highlights the need for trials on a larger scale to develop potential strategies and guidelines on the use of deferoxamine for I/R injury.</p>","PeriodicalId":23035,"journal":{"name":"Therapeutic Advances in Cardiovascular Disease","volume":"18 ","pages":"17539447241277382"},"PeriodicalIF":2.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11418332/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142296118","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
Role of multilayer flow modulator stents in the treatment of arterial aneurysms. 多层血流调节器支架在动脉动脉瘤治疗中的作用。
IF 2.6
Therapeutic Advances in Cardiovascular Disease Pub Date : 2024-01-01 DOI: 10.1177/17539447241283736
Rasit Dinc, Evren Ekingen
{"title":"Role of multilayer flow modulator stents in the treatment of arterial aneurysms.","authors":"Rasit Dinc, Evren Ekingen","doi":"10.1177/17539447241283736","DOIUrl":"https://doi.org/10.1177/17539447241283736","url":null,"abstract":"<p><p>Arterial aneurysms remain a significant public health problem because they often result in death when ruptured; therefore, they require immediate medical treatment. Endovascular aneurysm repair (EVAR) has recently become the primary treatment option, owing to the fewer side effects compared to those with open surgery. However, stents used for conventional EVAR often cause side-branch occlusion, which alters the perfusion of vital organs. Recently, multilayer flow modulator (MFM) stents have been used as a new treatment for arterial aneurysms. These stents appear to be feasible owing to their unique design consisting of an uncoated three-dimensionally braided multilayered structure. MFM stents generally remodulate laminar flow and reduce the flow velocity in the aneurysmal sac, leading to thrombosis, which causes the aneurysm to shrink over time. Thus, they reduce the risk of mortality. Moreover, they reduce morbidity by preserving the side-branch blood flow. They can be easily applied to complex aneurysms and are ready to use without customization, which shortens the waiting time for interventions. This study aimed to evaluate the role of MFM stents in the treatment of arterial aneurysms based on available data.</p>","PeriodicalId":23035,"journal":{"name":"Therapeutic Advances in Cardiovascular Disease","volume":"18 ","pages":"17539447241283736"},"PeriodicalIF":2.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11489923/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142475428","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
Challenging anticoagulation decisions in atrial fibrillation: a narrative review. 质疑心房颤动患者的抗凝决定:叙述性综述。
IF 2.6
Therapeutic Advances in Cardiovascular Disease Pub Date : 2024-01-01 DOI: 10.1177/17539447241290429
Michael Griffin, Riccardo Proietti, Gregory Y H Lip, Azmil H Abdul-Rahim
{"title":"Challenging anticoagulation decisions in atrial fibrillation: a narrative review.","authors":"Michael Griffin, Riccardo Proietti, Gregory Y H Lip, Azmil H Abdul-Rahim","doi":"10.1177/17539447241290429","DOIUrl":"https://doi.org/10.1177/17539447241290429","url":null,"abstract":"<p><p>Atrial fibrillation (AF) is common and warrants consideration of oral anticoagulant (OAC) medication. Usually, the decision is straightforward, following the pathway outlined in the European Society of Cardiology's guideline; however, certain situations fall outside of this evidence base - such as a diagnosis of subclinical AF made via implanted devices or wearable electrocardiogram monitors, or alternatively diagnosis of 'secondary AF' following a major stressor. Subclinical AF is associated with stroke, though not to the extent of clinical AF, and the benefits of anticoagulation appear to be lower. Longer episodes are more clinically meaningful, and recent randomised controlled trials have demonstrated that some patients derive benefit from OAC. Similarly, when AF is triggered by sepsis or non-cardiac surgery, specific evidence supporting OAC initiation is lacking and clinician behaviour is variable. Observational data demonstrate poorer outcomes in these patients, implying that the perception of a transient, reversible phenomenon may not be correct. Contrastingly, cardiac surgery very frequently induces AF, and the benefits of anticoagulation rarely outweigh the risks of bleeding. Following ischaemic stroke, recent evidence suggests that early (re-)initiation of OAC should be considered as this does not increase the risk of haemorrhagic transformation as previously hypothesised. This narrative review summarises the available literature and outlines, where possible, practical advice for clinicians facing these common clinical dilemmas.</p>","PeriodicalId":23035,"journal":{"name":"Therapeutic Advances in Cardiovascular Disease","volume":"18 ","pages":"17539447241290429"},"PeriodicalIF":2.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11483789/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142475426","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
Gene polymorphism as a cause of hemorrhagic complications in patients with non-valvular atrial fibrillation treated with oral vitamin K-independent anticoagulants. 基因多态性是接受维生素 K 依赖性抗凝剂口服治疗的非瓣膜性心房颤动患者出现出血性并发症的原因之一。
IF 2.3
Therapeutic Advances in Cardiovascular Disease Pub Date : 2024-01-01 DOI: 10.1177/17539447241249886
Ayan Abdrakhmanov, Aizhana Shaimerdinova, Zhanasyl Suleimen, Svetlana Abildinova, Rustam Albayev, Gulnar Tuyakova, Elena Rib, Akmaral Beysenbayeva, Gulden Kabduyeva, Makhabbat Bekbossynova
{"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}
引用次数: 0
Inhibitory effect of microRNA-21 on pathways and mechanisms involved in cardiac fibrosis development. microRNA-21 对心脏纤维化发展途径和机制的抑制作用。
IF 2.3
Therapeutic Advances in Cardiovascular Disease Pub Date : 2024-01-01 DOI: 10.1177/17539447241253134
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
{"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}
引用次数: 0
The impact of health maintenance organizations on improving cardiac surgery outcomes. 健康维护组织对改善心脏手术效果的影响。
IF 2.6
Therapeutic Advances in Cardiovascular Disease Pub Date : 2024-01-01 DOI: 10.1177/17539447241299193
Kimberly L Skidmore, Farrah E Flattmann, Hayden Cagle, Sahar Shekoohi, Alan D Kaye
{"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}
引用次数: 0
Assessing the completeness of patient-reported outcomes reporting in congestive heart failure clinical trials. 评估充血性心力衰竭临床试验中患者报告结果的完整性。
IF 2.6
Therapeutic Advances in Cardiovascular Disease Pub Date : 2024-01-01 DOI: 10.1177/17539447241303724
Drayton Rorah, Jonathan Pollard, Corbin Walters, Will Roberts, Micah Hartwell, Christian Hemmerich, Matt Vassar
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