JRSM Cardiovascular Disease最新文献

{"title":"Associations between anthropometric measures and cardiovascular risk biomarkers in women with short stature.","authors":"Revilane Parente De Alencar Britto, Luiz Gonzaga Ribeiro Silva-Neto, Telma Maria De Menezes Toledo Florêncio, Nassib Bezerra Bueno, Ana Paula Grotti Clemente, Lucas Almeida Das Chagas, Gustavo Yano Callado, Edward Araujo Júnior, Ana Lydia Sawaya","doi":"10.1177/20480040261461825","DOIUrl":"10.1177/20480040261461825","url":null,"abstract":"<p><strong>Objective: </strong>The study aimed to investigate which anthropometric indicator are most associated with cardiovascular risk (CVR) in low-income women with short stature and to determine the cut-off point that best determined CVR.</p><p><strong>Methods: </strong>This cross-sectional study was conducted with meticulous attention to detail. We evaluated a comprehensive range of sociodemographic and anthropometric data, including body mass index (BMI), waist circumference, waist-to-hip ratio, waist-to-height ratio, and body adiposity index. Additionally, dietary and biochemical data such as glucose and lipid profile, ultrasensitive C-reactive protein (CRP), and blood pressure were assessed in 83 women. Body composition was measured using dual-energy X-ray absorptiometry.</p><p><strong>Results: </strong>Approximately 85% had excess total body fat, 70% had low levels of high-density lipoprotein and increased levels of ultrasensitive CRP, 29.3% were hypercholesterolemic, and 13.4% were hypertensive. Multivariate logistic regression analyses indicated that BMI was the most associated factor of CVR (ultrasensitive CRP) (OR: 1.31, 95% CI: 1.10-1.56). The area under the receiver operating characteristic curve was 0.64 for cholesterol (95% CI 0.517-0.766; p = 0.04) and 0.72 for ultrasensitive CRP (95% CI 0.601-0.840; p = 0.002). BMI cut-off points with the best balance of sensitivity and specificity were 24.0 kg/m² for identifying hypercholesterolemia and 23.8 kg/m² for identifying elevated high-sensitivity CRP levels.</p><p><strong>Conclusion: </strong>BMI was the most associated factor of CVR in low-income women with short stature. The results indicate that more sensitive BMI cut-off points should be considered to detect CVR in this population group.</p>","PeriodicalId":30457,"journal":{"name":"JRSM Cardiovascular Disease","volume":"15 ","pages":"20480040261461825"},"PeriodicalIF":0.6,"publicationDate":"2026-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13276236/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148296538","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":"Virtual population-based analysis of anatomical and electrophysiological risk markers for atrial fibrillation.","authors":"Giada S Romitti, María Termenón-Rivas, Alejandro Liberos, Miguel Rodrigo","doi":"10.1177/20480040261455938","DOIUrl":"10.1177/20480040261455938","url":null,"abstract":"<p><p>Atrial fibrillation (AF) prevalence has increased markedly over the past two decades, underscoring the need for personalized approaches to diagnosis, risk stratification, and therapy. Computational modeling provides a framework to integrate patient-specific anatomy and electrophysiology, offering mechanistic insights into arrhythmia susceptibility. We analyzed a virtual population of 160 bi-atrial models to investigate how structural and electrophysiological markers contribute to AF vulnerability and patterns. Each virtual patient incorporated geometries with varying enlargement, structural (conduction velocity, CV), and electrical (action potential duration, APD) remodeling. Virtual patients were characterized through anatomical markers, defined as inter-landmark distances, and electrophysiological markers, such as total activation time. AF vulnerability was tested by programmed stimulation from multiple atrial sites in 800 simulations. Lower CV and APD increased arrhythmic incidence, consistent with prior work. Larger atrial lateral extent and longer Bachmann's bundle length raised AF initiation likelihood by ∼20% (<i>p</i> < 0.05), while total activation time did not distinguish inducible from non-inducible anatomies (<i>p</i> > 0.05). Anatomical features, including superior-to-inferior vena cava distance, distinguished organized from disorganized patterns, while electrophysiological biomarkers alone did not. Combined high anatomical and electrophysiological marker values were linked to greater inducibility during AF progression (+20%). These findings provide mechanistic evidence for the role of atrial biomarkers in AF initiation and maintenance, highlighting the value of virtual populations in capturing inter-patient variability. By linking structural and electrophysiological characteristics to arrhythmic risk, this approach supports improved patient stratification and the design of individualized therapeutic strategies for AF.</p>","PeriodicalId":30457,"journal":{"name":"JRSM Cardiovascular Disease","volume":"15 ","pages":"20480040261455938"},"PeriodicalIF":0.6,"publicationDate":"2026-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13276220/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148296559","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":"Analysis of cardiac dynamic global function.","authors":"Leon Axel, Mikael Kanski, Amit Jhaveri, Meng Ye, Bangwei Guo, Xiaoxiao He, Dimitris Metaxas","doi":"10.1177/20480040261439970","DOIUrl":"10.1177/20480040261439970","url":null,"abstract":"<p><strong>Objectives: </strong>Although cardiac function is truly vital, and can be adversely affected by many diseases, conventional quantitative global function analysis from images is largely limited to assessing the cardiac volumes at end-diastole and end-systole, and the associated ejection fraction, due to the time-consuming associated image segmentation. Advances in AI-assisted cardiac image segmentation can potentially enable more detailed analysis of the dynamic changes in cardiac volumes over the cardiac cycle, in clinically practical times, but there are now no standardized ways to analyze such data. In this work, we propose a systematic approach to the analysis of dynamic global cardiac function from imaging data.</p><p><strong>Design: </strong>We use some cardiac magnetic resonance imaging (CMR) data here to illustrate this approach, but the methods are not limited to MRI. The focus here is on the technical approach, rather than on potential clinical applications. Representative short-axis cine CMRs from 19 normal subjects and 22 patients with clinical diagnosis of \"heart failure with preserved ejection fraction\" were analyzed for ventricular volumes over the cardiac cycle. The resulting data were used to calculate a set of dynamic global function variables.</p><p><strong>Results: </strong>A set of representative measures of the timing and rates of ventricular emptying and filling is promising as compact means to characterize dynamic global function.</p><p><strong>Conclusions: </strong>More efficient cardiac segmentation offers the potential to characterize dynamic global cardiac function, through a set of representative measures of the timing and rates of ventricular emptying and filling.</p>","PeriodicalId":30457,"journal":{"name":"JRSM Cardiovascular Disease","volume":"15 ","pages":"20480040261439970"},"PeriodicalIF":0.6,"publicationDate":"2026-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13272871/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148279052","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":"Shape and flow characterization of the pulmonary arteries after the LeCompte maneuver.","authors":"Jose Enzo Bunag, Thomas Casto, Tin The Phan, Bryan Gonzalez, Ryan O'Hara, Yves d'Udekem, Elias Balaras, Francesco Capuano, Yue-Hin Loke","doi":"10.1177/20480040261447953","DOIUrl":"10.1177/20480040261447953","url":null,"abstract":"<p><strong>Objectives: </strong>Integrate statistical shape modeling (SSM) and 4D flow analysis to evaluate the impact of pulmonary artery (PA) geometry in patients with transposition of the great arteries (TGA) after the arterial switch operation (ASO).</p><p><strong>Design: </strong>Retrospective single-center cohort study.</p><p><strong>Setting: </strong>Congenital cardiac center performing clinically indicated cardiac magnetic resonance imaging, including 4D flow.</p><p><strong>Participants: </strong>Seventy TGA patients post-ASO and 49 age/size-matched controls with structurally normal hearts. Exclusion criteria included PA stents, significant right ventricular (RV) outflow obstruction, reintervention, or inadequate image quality.</p><p><strong>Main outcome measures: </strong>Primary measures were PA shape modes (derived via SSM) and 4D flow-based kinetic energy (KE), viscous energy loss (VEL), and vorticity. Secondary measures included RV pressure and RV-to-systemic pressure ratio.</p><p><strong>Results: </strong>Compared with controls, TGA patients demonstrated higher peak systolic VEL rate (0.106 ± 0.109 mW/mL vs. 0.0125 ± 0.0599 mW/mL), systolic VEL (20.2 ± 18.2 mJ/mL vs. 1.91 ± 8.63 mJ/mL), peak KE (0.300 ± 0.126 mJ/mL vs. 0.0316 ± 0.0897 mJ/mL), and vorticity (194 ± 46.6 1/s vs. 105 ± 30.5 1/s; all <i>p</i> < 0.0001). Statistical shape modeling identified major geometric deviations, including shorter, flatter main PA segments, and increased branch curvature. Shape modes p4, p5, and p8 were significantly associated with increased curvature, reduced vessel caliber, elevated vorticity, and higher RV pressures. Right ventricular-to-systemic ratio also correlated with these shape modes, in addition to PA size, RPA curvature, and peak vorticity.</p><p><strong>Conclusions: </strong>Abnormal PA geometry after ASO is strongly linked to adverse flow energetics and increased RV afterload. These findings suggest that curvature-driven flow inefficiency, beyond stenosis alone, contributes to long-term hemodynamic burden in TGA, highlighting potential targets for surveillance and intervention.</p>","PeriodicalId":30457,"journal":{"name":"JRSM Cardiovascular Disease","volume":"15 ","pages":"20480040261447953"},"PeriodicalIF":0.6,"publicationDate":"2026-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13272852/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148279049","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":"Isolated and combined effects of papillary muscle approximation and mitral annuloplasty in dilated left ventricles.","authors":"Gediminas Gaidulis, Kanika Kalra, Muralidhar Padala","doi":"10.1177/20480040261451936","DOIUrl":"10.1177/20480040261451936","url":null,"abstract":"<p><strong>Objectives: </strong>Functional mitral regurgitation (FMR) remains challenging to repair surgically, as highlighted by the Cardiothoracic Surgical Trials Network (CTSN) trial, which showed limited durability of mitral annuloplasty. We previously demonstrated in vivo and experimentally that papillary muscle approximation (PMA) can improve mitral valve (MV) function, with or without annuloplasty. In this study, we assessed valve biomechanics after PMA, mitral annuloplasty, and their combination in imaging-derived computational models.</p><p><strong>Methods: </strong>3D echo images were obtained in three pigs with heart failure, dilated ventricles, and FMR. Each echo dataset was segmented, and a subject-specific computational model of the MV was created. Virtual FMR repair was performed on each valve using PMA, annuloplasty with true-sized (40 mm) and downsized (38 mm and 36 mm) rings, and a combination of both techniques. For each repair strategy, leaflet closure was simulated, and MV geometry and biomechanics at peak systole were evaluated.</p><p><strong>Results: </strong>Isolated PMA improved valve coaptation, reduced leaflet stresses and chordal tension forces, but failed to completely eliminate FMR. Isolated mitral annuloplasty also improved coaptation, but overall provided only limited geometric and biomechanical benefits. Combining annuloplasty and PMA resulted in the most favorable outcomes, eliminating FMR, increasing coaptation length (up to 97.7%), and reducing leaflet stresses (up to 43.7%) and chordal forces (up to 43.0%).</p><p><strong>Conclusions: </strong>While both PMA and annuloplasty independently improved MV function, neither technique fully resolved FMR on its own. Their combination yielded the most favorable repair outcomes, eliminating FMR and significantly improving valve geometry and biomechanics without the need for excessive annular downsizing.</p>","PeriodicalId":30457,"journal":{"name":"JRSM Cardiovascular Disease","volume":"15 ","pages":"20480040261451936"},"PeriodicalIF":0.6,"publicationDate":"2026-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13272872/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148279042","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 inverse problem of electrocardiography: From a clinical point of view.","authors":"José Nunes de Alencar, Gabriel Scarpioni Barbosa","doi":"10.1177/20480040261457700","DOIUrl":"10.1177/20480040261457700","url":null,"abstract":"<p><strong>Background: </strong>The 12-lead electrocardiogram (ECG) records body-surface potentials that represent cardiac electrical activity filtered through the torso. Recovering the original cardiac sources from these surface signals-the inverse problem of electrocardiography-is mathematically ill-posed: multiple distinct source configurations produce identical tracings. This constraint is seldom discussed in clinical practice, yet it underlies many recognized ECG diagnostic limitations.</p><p><strong>Methods: </strong>This narrative review provides a clinician-oriented summary of the forward and inverse formulations, and then organizes ECG interpretive pitfalls into five mechanistic categories: volume-conductor filtering, source-model ambiguity, cardiac motion during repolarization, patient-specific anatomy and lead-placement variability, and signal noise and filtering. Each category is linked to quantitative clinical data and to practical reporting recommendations.</p><p><strong>Results: </strong>Volume-conductor attenuation limits VA localization accuracy to 38.9% at the AHA-segment level. Source ambiguity allows 59% of combined anterior-inferior ST elevation to originate from RCA rather than LAD occlusion, and permits unrelated diseases (pulmonary embolism, arrhythmogenic cardiomyopathy) to produce identical repolarization patterns. Cardiac motion during repolarization introduces time-variant geometric distortion independent of pathology. The Mason-Likar lead system erases established inferior infarctions and shifts QRS axes by up to 60°. Fragmented QRS detects scar (sensitivity 68%, specificity 80%) but fails territorial localization (sensitivity 1.7%). Electrocardiographic imaging reduces localization error but cannot recover spatial detail lost to the torso filter.</p><p><strong>Conclusions: </strong>The inverse problem imposes identifiability limits on every 12-lead ECG. Territorial labels should be treated as probabilistic and corroborated with imaging or hemodynamics when localization carries therapeutic consequences.</p>","PeriodicalId":30457,"journal":{"name":"JRSM Cardiovascular Disease","volume":"15 ","pages":"20480040261457700"},"PeriodicalIF":0.6,"publicationDate":"2026-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13241609/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148200207","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":"Pharmacologic therapies for hypertrophic cardiomyopathy: The past, the present, and the future.","authors":"Vasile-Bogdan Halațiu, Dan Alexandru Cozac, Alina Scridon","doi":"10.1177/20480040261431384","DOIUrl":"10.1177/20480040261431384","url":null,"abstract":"<p><p>Hypertrophic cardiomyopathy (HCM) stands as the most common monogenic cardiac disease, with an estimated prevalence historically reported as 1:500, but likely closer to 1:200 based on contemporary population studies in the general population. The past decade has marked a fundamental shift in therapeutic strategy: from symptomatic relief toward interventions directly targeting pathological sarcomeric hypercontractility. Conventional therapy relies on <i>beta</i>-blockers and non-dihydropyridine calcium channel antagonists, which provide symptomatic benefits through negative inotropic effects. For refractory left ventricular outflow tract obstruction, disopyramide constitutes an effective third-line option, although its anticholinergic profile requires cautious administration. Cardiac myosin inhibitors, mavacamten and aficamten, have introduced a novel therapeutic paradigm through direct modulation of actin-myosin cross-bridge formation. Pivotal clinical trials have demonstrated significant improvements in exercise capacity, reduction in obstruction severity, and enhancement of functional status, validating for the first time a therapeutic strategy that directly targets the underlying sarcomeric mechanism of hypercontractility. The therapeutic horizon includes next-generation myosin modulators, metabolic pathway interventions, and gene-based strategies. Current challenges involve accessibility to these therapies, substantial costs, and the requirement for mandatory regular echocardiographic monitoring. Future perspectives are oriented toward precision personalized medicine, integrating molecular therapeutics with genetic profiling to enable increasingly individualized risk stratification and therapeutic decision making.</p>","PeriodicalId":30457,"journal":{"name":"JRSM Cardiovascular Disease","volume":"15 ","pages":"20480040261431384"},"PeriodicalIF":0.6,"publicationDate":"2026-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13213116/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148057171","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":"Lipid-lowering therapy: Evidence and future perspective.","authors":"Maki Komiyama, Hiromichi Wada, Gheorghe-Andrei Dan, Koji Hasegawa","doi":"10.1177/20480040261435032","DOIUrl":"10.1177/20480040261435032","url":null,"abstract":"<p><p>Lowering low-density lipoprotein cholesterol (LDL-C) is a cornerstone of atherosclerotic cardiovascular disease (ASCVD) prevention, with robust evidence supporting the principle that \"the lower, the better,\" particularly in secondary prevention. Contemporary guidelines recommend intensive LDL-C lowering to <70 mg/dL in high-risk patients and <55 mg/dL in very high-risk populations, including those with acute coronary syndrome and familial hypercholesterolemia. In addition to statins, proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors, including monoclonal antibodies and small interfering RNA, have emerged as highly effective therapies, demonstrating substantial LDL-C reduction and cardiovascular event risk reduction, as exemplified by the Further Cardiovascular Outcomes Research with PCSK9 Inhibition in Subjects with Elevated Risk (FOURIER) trial. Patients with peripheral arterial disease, including lower extremity arteriosclerosis obliterans, represent a particularly high-risk population in whom PCSK9 inhibition provides marked absolute risk reduction. Despite intensive LDL-C lowering, considerable residual cardiovascular risk persists. Accumulating evidence indicates that elevated triglyceride (TG) levels are independently associated with cardiovascular events. However, clinical trials targeting TG reduction, including fibrate-based therapies such as pemafibrate, have not consistently demonstrated cardiovascular benefit, highlighting the complexity of lipid metabolism and the limitations of TG lowering alone. Lipoprotein(a) [Lp(a)] has recently gained recognition as a genetically determined, independent risk factor for ASCVD. Emerging antisense and RNA-targeted therapies have shown profound Lp(a)-lowering effects and are currently being evaluated in large-scale outcome trials. Future lipid management strategies will require a comprehensive approach that integrates LDL-C lowering, residual risk modification, and novel therapeutic targets such as Lp(a), with personalized risk stratification to optimize clinical benefit and cost-effectiveness.</p>","PeriodicalId":30457,"journal":{"name":"JRSM Cardiovascular Disease","volume":"15 ","pages":"20480040261435032"},"PeriodicalIF":0.6,"publicationDate":"2026-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13213117/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148057155","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":"Decongestion in chronic heart failure.","authors":"Antohi Laura, Mihaileanu Serban","doi":"10.1177/20480040261431376","DOIUrl":"10.1177/20480040261431376","url":null,"abstract":"<p><p>Congestion drives symptoms and adverse outcomes in heart failure (HF), and loop diuretics remain the cornerstone of decongestion. Yet randomized trials of diuretic strategies and other acute decongestive approaches have not shown mortality benefit, while mechanistic studies demonstrate rapid neurohormonal activation after acute loop diuretic administration. In chronic HF, observational data consistently associate higher loop diuretic requirements-particularly above ∼40 mg/day furosemide equivalent or with dose escalation-with worse prognosis across HF phenotypes, though confounding by disease severity is likely. Decongestion needs vary across the HF trajectory: early guideline-directed therapy provides intrinsic decongestive effects, whereas advanced HF is marked by diuretic resistance and renal vulnerability. Preload-dependent states (notably cardiac amyloidosis and selected HFpEF phenotypes) require especially careful titration to avoid hypovolemia and low output, and robust protocol-level trial evidence is lacking. Contemporary randomized data do not demonstrate superiority of torsemide over furosemide. Small trials and systematic reviews suggest that in carefully selected, stable, non-congested patients, diuretic withdrawal or reduction can be feasible, with ∼25-35% requiring re-initiation within 1-3 months and consistent lowering of renin activity; however, clinical outcome benefit remains unproven. Overall, evidence supports maintaining euvolemia with the lowest effective diuretic dose and considering monitored deprescribing in appropriate low-risk patients.</p>","PeriodicalId":30457,"journal":{"name":"JRSM Cardiovascular Disease","volume":"15 ","pages":"20480040261431376"},"PeriodicalIF":0.6,"publicationDate":"2026-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13201938/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148044081","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":"Anticoagulation in venous thromboembolism and in atrial fibrillation.","authors":"Oriol Martínez-Torrecilla, Josune Cabello Calleja, Antonio Martínez-Rubio","doi":"10.1177/20480040261431387","DOIUrl":"10.1177/20480040261431387","url":null,"abstract":"<p><p>Atrial fibrillation and venous thromboembolism cause significant morbidity and mortality worldwide. Therefore, anticoagulation therapy (even chronic) is mandatory for the broad majority of affected persons. Warfarin therapy has been, for decades, the best oral anticoagulant alternative for venous thromboembolism, as well as for stroke prevention in atrial fibrillation. However, modern oral direct oral anticoagulants (DOACs) are consolidated drugs for these purposes with well-designed pivotal randomized clinical trials, and with long data bases of clinical posterior experience which demonstrate better efficacy, safety, or both than warfarin. However, since DOACs also present some limitations, there are diverse emergent agents and strategies in anticoagulation. This manuscript reviews the available anticoagulation strategies for both clinical entities and presents new rational therapeutic targets in the hemostatic system.</p>","PeriodicalId":30457,"journal":{"name":"JRSM Cardiovascular Disease","volume":"15 ","pages":"20480040261431387"},"PeriodicalIF":0.6,"publicationDate":"2026-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13201943/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148044050","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}