Therapeutic Advances in Cardiovascular Disease最新文献

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De-risking primary prevention: role of imaging. 降低初级预防风险:影像学的作用。
IF 2.3
Therapeutic Advances in Cardiovascular Disease Pub Date : 2021-01-01 DOI: 10.1177/17539447211051248
Ahmed M Shafter, Kashif Shaikh, Amit Johanis, Matthew J Budoff
{"title":"De-risking primary prevention: role of imaging.","authors":"Ahmed M Shafter,&nbsp;Kashif Shaikh,&nbsp;Amit Johanis,&nbsp;Matthew J Budoff","doi":"10.1177/17539447211051248","DOIUrl":"https://doi.org/10.1177/17539447211051248","url":null,"abstract":"<p><p>Atherosclerotic cardiovascular disease (ASCVD) is a common disease among the general population, and includes four major areas: (1) coronary heart disease (CHD), manifested by stable angina, unstable angina, myocardial infarction (MI), heart failure, and coronary death; (2) cerebrovascular disease, manifested by transient ischemia attack and stroke; (3) peripheral vascular disease, manifested by claudication and critical limb ischemia; and (4) aortic atherosclerosis and aortic aneurysm (thoracic and abdominal). CHD remains the leading cause of death for both men and women in the United States. So, it is imperative to identify people at risk of CHD and provide appropriate medical treatment or intervention to prevent serious complications and outcomes including sudden cardiac death. Coronary artery calcification (CAC) is a marker of subclinical coronary artery disease. Therefore, coronary artery calcium score is an important screening method for Coronary artery disease (CAD). In this article, we performed a comprehensive review of current literatures and studies assessing the prognostic value of CAC for future cardiovascular disease (CVD) events. We searched PubMed, MEDLINE, Google Scholar, and Cochrane library. We also reviewed the 2018 American College of Cardiology (ACC)/American Heart Association (AHA) guideline on the assessment of CVD risk. A CAC score of zero corresponds to very low CVD event rates (∼1% per year) and hence a potent negative risk marker. This has been referred to as the 'power of zero' and affords the lowest risk of any method of risk calculation. It is now indicated in the 2018 ACC/AHA Cholesterol guidelines to be used to avoid statins for 5-10 years after a score of zero, and then re-assess the patient.</p>","PeriodicalId":23035,"journal":{"name":"Therapeutic Advances in Cardiovascular Disease","volume":"15 ","pages":"17539447211051248"},"PeriodicalIF":2.3,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/6f/3f/10.1177_17539447211051248.PMC8640319.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39910396","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: 2
Vasopressin antagonism in heart failure: a review of the hemodynamic studies and major clinical trials. 抗利尿激素在心力衰竭中的拮抗作用:血流动力学研究和主要临床试验的综述。
IF 2.3
Therapeutic Advances in Cardiovascular Disease Pub Date : 2021-01-01 DOI: 10.1177/1753944720977741
Jonathan Urbach, Steven R Goldsmith
{"title":"Vasopressin antagonism in heart failure: a review of the hemodynamic studies and major clinical trials.","authors":"Jonathan Urbach,&nbsp;Steven R Goldsmith","doi":"10.1177/1753944720977741","DOIUrl":"https://doi.org/10.1177/1753944720977741","url":null,"abstract":"For decades, plasma arginine vasopressin (AVP) levels have been known to be elevated in patients with congestive heart failure (HF). Excessive AVP signaling at either or both the V1a and V2 receptors could contribute to the pathophysiology of HF by several mechanisms. V1a activation could cause vasoconstriction and/or direct myocardial hypertrophy as intracellular signaling pathways are closely related to those for angiotensin II. V2 activation could cause fluid retention and hyponatremia. A hemodynamic study with the pure V2 antagonist tolvaptan (TV) showed minimal hemodynamic effects. Compared with furosemide in another study, the renal and neurohormonal effects of TV were favorable. Several clinical trials with TV as adjunctive therapy in acute HF have shown beneficial effects on fluid balance and dyspnea, with no worsening of renal function or neurohormonal stimulation. Two smaller studies, one in acute and one in chronic HF, have shown comparable clinical and more favorable renal and neurohormonal effects of TV compared with loop diuretics. However, long-term treatment with TV did not alter outcomes in acute HF. No data are available other than single-dose studies of an intravenous pure V1a antagonist, which showed a vasodilating effect if plasma AVP levels were elevated. One hemodynamic study and one short-duration clinical trial with the balanced intravenous V1a/V2 antagonist conivaptan (CV) showed hemodynamic and clinical effects largely similar to those with TV in similar studies. A new orally effective balanced V1/V2 antagonist (pecavaptan) is currently undergoing phase II study as both adjunctive and alternative therapy during and after hospitalization for acute HF. The purpose of this review is to summarize what we have learned from the clinical experience with TV and CV, and to suggest implications of these findings for future work with newer agents.","PeriodicalId":23035,"journal":{"name":"Therapeutic Advances in Cardiovascular Disease","volume":"15 ","pages":"1753944720977741"},"PeriodicalIF":2.3,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1753944720977741","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38813158","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: 14
Modulating inflammation to reduce atherosclerotic cardiovascular events: should colchicine be part of the therapeutic regimen? 调节炎症以减少动脉粥样硬化性心血管事件:秋水仙碱应该成为治疗方案的一部分吗?
IF 2.3
Therapeutic Advances in Cardiovascular Disease Pub Date : 2021-01-01 DOI: 10.1177/17539447211042714
Ishwarlal Jialal, Naval Vikram
{"title":"Modulating inflammation to reduce atherosclerotic cardiovascular events: should colchicine be part of the therapeutic regimen?","authors":"Ishwarlal Jialal,&nbsp;Naval Vikram","doi":"10.1177/17539447211042714","DOIUrl":"https://doi.org/10.1177/17539447211042714","url":null,"abstract":"","PeriodicalId":23035,"journal":{"name":"Therapeutic Advances in Cardiovascular Disease","volume":"15 ","pages":"17539447211042714"},"PeriodicalIF":2.3,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/d1/16/10.1177_17539447211042714.PMC8450546.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39445477","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 role of directional atherectomy in critical-limb ischemia. 定向动脉粥样硬化切除术在危急肢体缺血中的作用。
IF 2.3
Therapeutic Advances in Cardiovascular Disease Pub Date : 2021-01-01 DOI: 10.1177/17539447211046953
Prakash Krishnan, Arthur Tarricone, Simon Chen, Samin Sharma
{"title":"The role of directional atherectomy in critical-limb ischemia.","authors":"Prakash Krishnan,&nbsp;Arthur Tarricone,&nbsp;Simon Chen,&nbsp;Samin Sharma","doi":"10.1177/17539447211046953","DOIUrl":"https://doi.org/10.1177/17539447211046953","url":null,"abstract":"<p><strong>Background: </strong>Our aim was to review the current literature of the use of directional atherectomy (DA) in the treatment of lower extremity critical-limb ischemia.</p><p><strong>Methods: </strong>A search for relevant literature was performed in PubMed and PubMed Central on 16 April 2020, sorted by best match. Three searches across two databases were performed. Articles were included that contained clinical and procedural data of DA interventions in lower extremity critical-limb ischemia patients. All studies that were systematic reviews were excluded.</p><p><strong>Results: </strong>Eleven papers were included in this review. Papers were examined under several parameters: primary patency and secondary patency, limb salvage/amputation, technical/procedural success, complications/periprocedural events, and mean lesion length. Primary and secondary patency rates ranged from 56.3% to 95.0% and 76.4% to 100%, respectively. Limb salvage rates ranged from 69% to 100%. Lesion lengths were highly varied, representing a broad population, ranging from 30 ± 33 mm to 142.4 ± 107.9 mm.</p><p><strong>Conclusions: </strong>DA may be a useful tool in the treatment of lower extremity critical-limb ischemia.</p>","PeriodicalId":23035,"journal":{"name":"Therapeutic Advances in Cardiovascular Disease","volume":"135 ","pages":"17539447211046953"},"PeriodicalIF":2.3,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/dc/96/10.1177_17539447211046953.PMC8606915.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39638435","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
Trace elements in patients with aortic valve sclerosis. 主动脉瓣硬化患者的微量元素。
IF 2.3
Therapeutic Advances in Cardiovascular Disease Pub Date : 2021-01-01 DOI: 10.1177/1753944720985985
Hataw Al-Taesh, Abuzer Çelekli, Murat Sucu, Seyithan Taysi
{"title":"Trace elements in patients with aortic valve sclerosis.","authors":"Hataw Al-Taesh,&nbsp;Abuzer Çelekli,&nbsp;Murat Sucu,&nbsp;Seyithan Taysi","doi":"10.1177/1753944720985985","DOIUrl":"https://doi.org/10.1177/1753944720985985","url":null,"abstract":"<p><strong>Background: </strong>Aortic valve sclerosis (AVSc) is defined as the thickening and calcification of aortic valve cusps, in the absence of obstruction of ventricular outflow. AVSc is linked with a clear imbalance in some trace elements.</p><p><strong>Aims: </strong>The objective of this study was to investigate the relationship between AVSc and serum levels of iron (Fe), zinc (Zn), selenium (Se), and copper (Cu). Additionally, this research aimed to explore the clinical significance of human serum zinc, selenium, copper, and iron concentrations as a potential new biomarker for AVSc patients and to clarify the pathophysiological role in individuals at risk of developing AVSc.</p><p><strong>Patients and methods: </strong>The study included 40 subjects with AVSc (25% male and 75% female) who were compared with a healthy control group with the same gender ratio. AVSc was based on comprehensive echocardiographic assessments. Blood samples were taken and Zn and Cu concentrations were determined through the use of atomic absorption spectroscopy. Se was measured using an inductively coupled plasma mass spectrometry device and Fe was measured using a Beckman Coulter instrument.</p><p><strong>Results: </strong>There was a significant difference in the prevalence of diabetes, blood pressure levels, and body mass index between the patients and the healthy subjects (<i>p</i> < 0.05). The differences between the serum Fe, Se, and Cu levels of the AVSc patients and the healthy subjects (<i>p</i> > 0.05) were recorded. The serum Zn of AVSc patients when compared was significantly lower compared with that of the control group (<i>p</i> < 0.01).</p><p><strong>Conclusion: </strong>Patients with AVSc had an imbalance in some of the trace elements in their blood. The patient group's valves had higher serum Cu levels and lower serum Se, Zn, and Fe concentrations compared with the healthy group's valves. In the valve patients as compared, AVSc had a high prevalence of obesity, hypertension, and diabetes.</p>","PeriodicalId":23035,"journal":{"name":"Therapeutic Advances in Cardiovascular Disease","volume":"15 ","pages":"1753944720985985"},"PeriodicalIF":2.3,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1753944720985985","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25401839","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: 4
The dawn of the four-drug era? SGLT2 inhibition in heart failure with reduced ejection fraction. 四药时代的来临?SGLT2抑制剂治疗射血分数降低型心力衰竭。
IF 2.6
Therapeutic Advances in Cardiovascular Disease Pub Date : 2021-01-01 DOI: 10.1177/17539447211002678
Michael V Genuardi, Paul J Mather
{"title":"The dawn of the four-drug era? SGLT2 inhibition in heart failure with reduced ejection fraction.","authors":"Michael V Genuardi, Paul J Mather","doi":"10.1177/17539447211002678","DOIUrl":"10.1177/17539447211002678","url":null,"abstract":"<p><p>Sodium-glucose cotransporter type 2 (SGLT2) inhibitors are a relatively new class of antihyperglycemic drug with salutary effects on glucose control, body weight, and blood pressure. Emerging evidence now indicates that these drugs may have a beneficial effect on outcomes in heart failure with reduced ejection fraction (HFrEF). Post-approval cardiovascular outcomes data for three of these agents (canagliflozin, empagliflozin, and dapagliflozin) showed an unexpected improvement in cardiovascular endpoints, including heart failure hospitalization and mortality, among patients with type 2 diabetes mellitus (T2DM) and established cardiovascular disease or risk factors. These studies were followed by a placebo controlled trial of dapagliflozin in patients with HFrEF both with and without T2DM, showing a reduction in all-cause mortality comparable to current guideline-directed HFrEF medical therapies such as angiotensin-converting enzyme inhibitors and beta-blockers. In this review, we discuss the current landscape of evidence, safety and adverse effects, and proposed mechanisms of action for use of these agents for patients with HFrEF. The United States (US) and European guidelines are reviewed, as are the current US federally approved indications for each SGLT2 inhibitor. Use of these agents in clinical practice may be limited by an uncertain insurance environment, especially in patients without T2DM. Finally, we discuss practical considerations for the cardiovascular clinician, including within-class differences of the SGLT2 inhibitors currently available on the US market (217/300).</p>","PeriodicalId":23035,"journal":{"name":"Therapeutic Advances in Cardiovascular Disease","volume":"15 ","pages":"17539447211002678"},"PeriodicalIF":2.6,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/8c/5c/10.1177_17539447211002678.PMC8010852.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25527067","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
Mechanisms and management of prothrombotic state in COVID-19 disease. COVID-19疾病血栓形成前状态的机制和处理。
IF 2.3
Therapeutic Advances in Cardiovascular Disease Pub Date : 2021-01-01 DOI: 10.1177/17539447211053470
Trishna Acherjee, Aparna Behara, Muhammad Saad, Timothy J Vittorio
{"title":"Mechanisms and management of prothrombotic state in COVID-19 disease.","authors":"Trishna Acherjee,&nbsp;Aparna Behara,&nbsp;Muhammad Saad,&nbsp;Timothy J Vittorio","doi":"10.1177/17539447211053470","DOIUrl":"https://doi.org/10.1177/17539447211053470","url":null,"abstract":"<p><p>The novel severe acute respiratory syndrome viral disease outbreak due to SARS-CoV-2 is a rapidly evolving disease and represents one of the greatest medical challenges in recent times. It is believed that SARS-CoV-2 has migrated from bats to an intermediate host and then to humans. This article aims at the mechanism and management of prothrombotic state in COVID-19 positive patients. We tried to present how the SARS-CoV-2 virus can induce thromboembolic events and the incidence of these thromboembolic events. We also tried to depict anticoagulation management in these patients as well as postdischarge plan and follow-up. Invasion of type 2 pneumocytes by the SARS-CoV-2 virus is critical in the course of illness because it results in activation of immune cells leading to elevation of cytokines. The subsequent activation of T cells and macrophages infiltrates the infected myocardial cells causing direct myocardiocyte toxicity and development of arrhythmia. Hypoxia or hypotension during the clinical course causes a mismatch between myocyte oxygen supply and workload demand resulting in cardiac distress. SARS-CoV-2 affects endothelial cells and pericytes that lead to severe micro and macrovascular dysfunction, and together with oxygen supply-demand mismatch, immune hyperresponsivity can potentially cause destabilization and plaque rupture causing acute coronary syndromes. Other mechanisms of injury include myocarditis, pericarditis, stress cardiomyopathy, vasculitis, and DIC (Disseminated intravascular coagulation)/microthrombi. SARS-CoV-2 enters the cells by the Spike protein S whose surface unit, S1, binds to the ACE2 receptor on the host cell. The type II transmembrane serine proteases TMPRSS2 and histone acetyltransferases (HAT) are host cell proteases that are recruited by the virus to cleave ACE2 surface protein S which facilitates the viral entry. Therefore, TMPRSS2 and HAT could be targeted for potential drugs against SARS-CoV-2. SARS-CoV-2 uses an RNA-dependent RNA polymerase for proliferation, which is targeted by remdesivir that is currently approved for emergency use by Food and Drug Administration (FDA). We need to adopt a multifaceted approach when combating SARS-CoV-2 because it presents several challenges including medical, psychological, socioeconomic, and ethical. COVID-19 is the biggest calamity during the 21st century, we need to have a keen understanding of its pathophysiology and clinical implications for the development of preventive measures and therapeutic modalities.</p>","PeriodicalId":23035,"journal":{"name":"Therapeutic Advances in Cardiovascular Disease","volume":"15 ","pages":"17539447211053470"},"PeriodicalIF":2.3,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/04/af/10.1177_17539447211053470.PMC8785300.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39554782","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: 14
Safety of day-case endovascular interventions for peripheral arterial disease in a rural, underserved area. 在农村,服务不足地区外周动脉疾病的一天病例血管内介入治疗的安全性。
IF 2.3
Therapeutic Advances in Cardiovascular Disease Pub Date : 2020-01-01 DOI: 10.1177/1753944720948651
Athar Ansari, Moiz Ali Shah, Manaim Amir Shah, Zahra Ansari
{"title":"Safety of day-case endovascular interventions for peripheral arterial disease in a rural, underserved area.","authors":"Athar Ansari,&nbsp;Moiz Ali Shah,&nbsp;Manaim Amir Shah,&nbsp;Zahra Ansari","doi":"10.1177/1753944720948651","DOIUrl":"https://doi.org/10.1177/1753944720948651","url":null,"abstract":"<p><strong>Background: </strong>We aimed to investigate the safety of endovascular procedures undertaken in a single outpatient center located in a rural, underserved area. Endovascular procedures for Peripheral Arterial Disease (PAD) have become increasingly common in outpatient settings; their safety is yet to be determined in a rural, underserved area with no stand-by vascular surgeon on site.</p><p><strong>Methods: </strong>We undertook a retrospective case review of endovascular procedures for the investigation and management of lower extremity PAD between December 2012 and August 2015. Patients were classified by Rutherford score, degree of stenosis and length of lesions. Complications were major (requiring hospitalization) or minor, including perforation, distal embolization, hematoma, and allergic reactions, which could be treated immediately in the catheterization laboratory with no sequelae. Patients were monitored in the facility and followed up using clinical, biochemical and radiological parameters at 24 h and 1 month.</p><p><strong>Results: </strong>A total of 692 patients underwent endovascular procedures for the investigation and/or treatment of PAD, of which 608 were interventional. Of these patients, 10.20% experienced procedural complications, of which 0.66% were classified as major, including wire retention and retroperitoneal hemorrhage. In total, 99.34% were discharged safely on the same day as the procedure. No adverse events were reported at follow up.</p><p><strong>Conclusion: </strong>Endovascular procedures for PAD can be performed safely in a rural outpatient setting with low complication rates. Most complications are minor and do not require hospitalization. Outpatient procedures for PAD are safe and may widen access to specialist procedures in areas of socio-economic deprivation.</p>","PeriodicalId":23035,"journal":{"name":"Therapeutic Advances in Cardiovascular Disease","volume":"14 ","pages":"1753944720948651"},"PeriodicalIF":2.3,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1753944720948651","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38344181","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: 4
Differences in RAAS/vitamin D linked to genetics and socioeconomic factors could explain the higher mortality rate in African Americans with COVID-19. 与遗传和社会经济因素有关的 RAAS/维生素 D 的差异可能是 COVID-19 非裔美国人死亡率较高的原因。
IF 2.6
Therapeutic Advances in Cardiovascular Disease Pub Date : 2020-01-01 DOI: 10.1177/1753944720977715
Virna Margarita Martín Giménez, León Ferder, Felipe Inserra, Joxel García, Walter Manucha
{"title":"Differences in RAAS/vitamin D linked to genetics and socioeconomic factors could explain the higher mortality rate in African Americans with COVID-19.","authors":"Virna Margarita Martín Giménez, León Ferder, Felipe Inserra, Joxel García, Walter Manucha","doi":"10.1177/1753944720977715","DOIUrl":"10.1177/1753944720977715","url":null,"abstract":"<p><p>COVID-19 is said to be a pandemic that does not distinguish between skin color or ethnic origin. However, data in many parts of the world, especially in the United States, begin to show that there is a sector of society suffering a more significant impact from this pandemic. The Black population is more vulnerable than the White population to infection and death by COVID-19, with hypertension and diabetes mellitus as probable predisposing factors. Over time, multiple disparities have been observed between the health of Black and White populations, associated mainly with socioeconomic inequalities. However, some mechanisms and pathophysiological susceptibilities begin to be elucidated that are related directly to the higher prevalence of multiple diseases in the Black population, including infection and death by COVID-19. Plasma vitamin D levels and evolutionary adaptations of the renin-angiotensin-aldosterone system (RAAS) in Black people differ considerably from those of other races. The role of these factors in the development and progression of hypertension and multiple lung diseases, among them SARS-CoV-2 infection, is well established. In this sense, the present review attempts to elucidate the link between vitamin D and RAAS ethnic disparities and susceptibility to infection and death by COVID-19 in Black people, and suggests possible mechanisms for this susceptibility.</p>","PeriodicalId":23035,"journal":{"name":"Therapeutic Advances in Cardiovascular Disease","volume":"14 ","pages":"1753944720977715"},"PeriodicalIF":2.6,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/dc/68/10.1177_1753944720977715.PMC7724257.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38680500","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
Endpoint selection for noninferiority percutaneous coronary intervention trials: a methodological description. 非劣效性经皮冠状动脉介入试验的终点选择:方法学描述。
IF 2.3
Therapeutic Advances in Cardiovascular Disease Pub Date : 2020-01-01 DOI: 10.1177/1753944720911329
Matthias Waliszewski, Mark Rosenberg, Harald Rittger, Viktor Breul, Florian Krackhardt
{"title":"Endpoint selection for noninferiority percutaneous coronary intervention trials: a methodological description.","authors":"Matthias Waliszewski,&nbsp;Mark Rosenberg,&nbsp;Harald Rittger,&nbsp;Viktor Breul,&nbsp;Florian Krackhardt","doi":"10.1177/1753944720911329","DOIUrl":"https://doi.org/10.1177/1753944720911329","url":null,"abstract":"<p><strong>Background: </strong>The objective of this review is to provide a practical update on endpoint selection for noninferiority (NI) studies in percutaneous coronary intervention studies.</p><p><strong>Methods: </strong>A PubMed search was conducted for predefined terms to explore the use of NI designs and intrapatient comparisons to determine their current importance. Sample size calculations for the most frequently used endpoints with NI hypotheses were done to increase statistical awareness.</p><p><strong>Results: </strong>Reported NI trials, with the most frequently chosen clinical endpoint of major adverse cardiac events (MACE), had NI margins ranging from 1.66% to 5.00%, resulting in patient populations of 400-1500 per treatment group. Clinical study endpoints comprising of MACE complemented with rates of bleeding complications and stent thrombosis (ST) are suggested to conduct a statistically and clinically meaningful NI trial. Study designs with surrogate endpoints amenable to intrapatient randomizations, are a very attractive option to reduce the number of necessary patients by about half. Comparative clinical endpoint studies with MACE and ST/bleeding rates to study a shortened dual antiplatelet therapy (DAPT) in coronary stent trials are feasible, whereas ST as the sole primary endpoint is not useful.</p><p><strong>Conclusions: </strong>Expanded composite clinical endpoints (MACE complemented by ST and bleeding rates and intrapatient randomization for selected surrogate endpoints) may be suitable tools to meet future needs in device approval, recertification and reimbursement.</p>","PeriodicalId":23035,"journal":{"name":"Therapeutic Advances in Cardiovascular Disease","volume":"14 ","pages":"1753944720911329"},"PeriodicalIF":2.3,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1753944720911329","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37735249","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: 2
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